Facing declining markets in Western countries, multinational food companies are targeting Africa, Asia, and Latin America as new consumers of packaged foods, in a move that may worsen the global epidemic of chronic illness related to diabetes. Governments are striking back at obesity risk factors, including unhealthy foods. Singapore, which might have as many as one million residents with diabetes by 2050, now requires soda producers to reduce sugar content. Obesity and other lifestyle-related diseases have now become a ‘silent’ long-term challenge that will cost governments in healthcare liabilities and lost productivity. But improving public health requires more than piecemeal legislation; governments must promote lifestyle changes through education and improve access to healthy foods. Not a ‘rich only’ disease: Across Asia, rural populations accustomed to active farming jobs are migrating in increasing numbers to urban areas, where they occupy more sedentary manufacturing or service sector jobs. Due to time constraints and easy availability of affordable high-calorie foods, these migrant populations are also changing their eating habits. A recently published study of 98,000 adults in China argues that linking obesity only to affluence is simplistic, and that geographic variations in China’s “nutritional transition” explain differences in public health. Alarmingly, two out of five adults in the Asia-Pacific region are either overweight or obese. The World Heath Organization (WHO) estimates that roughly half of the world’s share of adults with diabetes live in Asia. The cost of obesity in the Asia-Pacific region is estimated to be roughly $166 billion annually. Among Southeast Asian countries, healthcare and productivity losses from obesity are the highest in Indonesia ($2-$4 billion), Malaysia ($1-$2 billion), and Singapore ($400 million). In the world’s two most populous countries, China and India, malnutrition has long been a concern but obesity is on the rise. According to a 2015 New England Journal of Medicine study, the prevalence of obesity in males in India nearly quadrupled between 1980 and 2015. For China, home to 110 million adults with obesity and potentially 150 million by 2040, the prevalence of obesity increased 15 times between 1980 and 2015. Between 2005 and 2015, yearly national income loss due to heart disease, stroke, and diabetes increased more than sixfold in India and sevenfold in China. Statistics about child health point to a grim future. In India, one quarter of urban youth entering middle school are obese and 66 per cent of children have an elevated risk for diabetes, while China is home to the world’s largest population of obese children. Numerous factors could contribute to this trend, including lack of open space for physical activity, the preference among young people for sedentary pastimes such as computer gaming, and a growing emphasis on time spent preparing for university entrance exams. Published in Daily Times, October 9th 2017.