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Comment: Obesity Patterns and the Nutrition Transition in China-Reply

Jeremiah Stamler, MD
Arch Intern Med. 1994;154(19):2249-2253. doi:10.1001/archinte.1994.00420190153019.
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Popkin calls attention to recent adverse trends of diet and physical activity in China and Japan. These should be of more than casual interest to American health practitioners,

Continued on page 2253 Continued from page 2249 researchers, and policy makers. In addition to our appropriate general concern for international health, we need to comprehend that these adverse trends have their origins in part in the United States. In the modern era of rapid and extensive communication on a global scale, American culture affects the populations of all countries, influencing them to adopt multiple components of the American lifestyle, some worthwhile and some, unfortunately, deleterious. This happens in many ways—often subtle, but also obtrusive, eg, the impact of our movies, TV programs, advertising, exported fast-food emporia, as well as direct governmental pressures to accept products (such efforts for the US cigarette industry are especially shameful). In these circumstances, all of us


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