Nutrition Transition, Processed Foods, and Cardiometabolic Risk in Somalia: A Public Health Commentary

Somalia is undergoing a nutrition transition in which traditional camel milk, sorghum, and legume-centred diets are being progressively displaced by imported processed foods high in refined sugars, saturated fats, and dietary cholesterol. This shift is occurring in a population already burdened by undernutrition and a fragile health system.

This narrative commentary synthesises published evidence on the biochemical mechanisms linking excess sugar and cholesterol intake to dyslipidaemia, type 2 diabetes mellitus (T2DM), and cardiovascular disease, and considers how these mechanisms may apply to the Somali context.

Globalisation, conflict-driven displacement, urbanisation, and food-import dependency are identified as structural drivers of the transition, though their interaction with Somalia's cyclical droughts and fragmented governance is likely to produce a trajectory distinct from that of more institutionally stable settings. The biological mechanisms by which added sugars, refined carbohydrates, and dietary fats promote insulin resistance, dyslipidaemia, and systemic inflammation are well established in the global literature; direct epidemiological evidence from Somalia itself remains largely absent, and this commentary draws cautiously on data from Somaliland, Djibouti, Morocco, and other comparator settings to illustrate a plausible-rather than confirmed-trajectory for Somalia.

Multi-sectoral action encompassing nutrition policy, food-system investment, community education, and health-system capacity building, sequenced according to feasibility in a resource-constrained and politically fragmented setting, is needed to reduce the risk of an entrenched NCD epidemic. Integrating traditional Somali dietary practices with evidence-based nutrition guidance offers a culturally grounded starting point, although traditional diets are not uniformly protective and require region-specific characterisation.