European Journal of Nutrition & Food Safety

Developing countries have become central actors in the global food system, serving as major agricultural exporters while simultaneously relying on food imports, which creates complex links between local production, trade dynamics, and evolving dietary patterns. This review article examines how agricultural production, international trade, and the nutrition transition are interconnected across Asia, Africa, and Latin America, with a particular focus on the double burden of malnutrition. A comprehensive methodology integrates FAO, ITC, WHO, and World Bank data with systematic literature analysis from 1961 to 2024. Key findings reveal significant growth in agricultural output, especially in cereals from India and China and soybean exports from Brazil. However, an export-oriented paradigm has led to structural imbalances, where countries export staples but import essential foods, presenting trade-nutrition trade-offs. Diets have shifted away from traditional staples toward refined cereals, edible oils, and ultra-processed foods, fuelling undernutrition and the rise of obesity and diet-related non-communicable diseases. Agricultural policies favouring staple crops have undermined the cultivation of nutrient-dense foods, while trade liberalization, though expanding access, also increases vulnerability to price shocks. The evidence highlights a fundamental paradox: agricultural transformation and trade integration have enhanced food availability and economic growth while simultaneously accelerating nutrition risks. Overcoming these cycles of undernutrition, obesity, and inequality requires nutrition-sensitive policy frameworks that integrate agricultural production goals, trade strategies, and health objectives to prevent the perpetuation of cycles of undernutrition, obesity, and inequality that undermine sustainable development progress.