This study examines how cultural dietary patterns shape global obesity trends using a mixed‑methods design that integrates (i) a PRISMA‑guided systematic review and meta‑analysis (48 studies, 2005-2023), (ii) a cross‑cultural comparative analysis of 68 countries using WHO STEPS, DHS, and Global Dietary Database data, and (iii) a longitudinal assessment (1990-2022) of nutrition transition dynamics in low‑ and middle‑income countries (LMICs) using a Traditional Dietary Pattern Index (TDPI). We also analyze migrant acculturation and evaluate culturally tailored interventions and food policies. Traditional diets-high in whole foods and low in ultra-processed foods (UPFs)-are associated with a 23% lower obesity risk (pooled OR ≈0.77), while a 10‑point decline in TDPI corresponds to an ≈0.9 percentage‑point rise in obesity prevalence in LMIC case studies. Indigenous/traditional diets are linked to lower BMI (≈22%-28%) relative to Westernized patterns, whereas acculturation toward UPF‑heavy diets among migrants raises obesity risk by ≈12%-14%. Culturally tailored interventions achieve ≈16% higher adherence and ≈0.6 kg/m2 greater BMI reduction than standardized programs, and UPF‑related fiscal/retail policies reduce UPF purchases by ≈13% with early signals of population‑level BMI benefit. Findings present a multidimensional framework linking nutritional anthropology, social ecology, and cultural adaptation to explain how cultural food systems shape obesity. Policy implications include preserving traditional diets, implementing gender- and age-sensitive programs, and curbing UPFs while improving access to culturally relevant foods. Limitations include reliance on secondary data and regional heterogeneity; future research should enhance causal inference and expand longitudinal coverage in understudied areas.
Anyibama et al. (2026) studied this question.