From door-to-door deliveries to influencing politics, companies like Nestlé, PepsiCo, and McDonald’s spend big bucks to enmesh themselves in third world markets, and their processed, packaged foods bring obesity and health problems with them.

In the first in a The New York Times series about global obesity, Andrew Jacobs and Matt Richtel report from Brazil, where low-income, isolated residents who once suffered from hunger now suffer from diabetes and heart disease. To impoverished people, the allure of packaged Western food is obvious: it’s inexpensive and more readily available. Although access means more people are getting fed, this sweet, fatty, salty food is not only destroying traditional foodways and changing local agriculture, it’s harming those who subsist on it. One nutrition professor describes the situation in Brazil as “a war between two food systems,” but it’s a war where “one food system has disproportionately more power than the other.” Just as religious missionaries replace indigenous culture with European culture, now we have Western corporations replacing local culture and regional identity with a homogeneous global identity of Coke and Kit-Kit and pudding. To me, the loss of regional identity is as tragic as the increase in obesity.

Dr. Gibney, the nutritionist and Nestlé consultant, said the company deserved credit for reformulating healthier products. But of the 800 products that Nestlé says are available through its vendors, Mrs. da Silva says her customers are mostly interested in only about two dozen of them, virtually all sugar-sweetened items like Kit-Kats; Nestlé Greek Red Berry, a 3.5-ounce cup of yogurt with 17 grams of sugar; and Chandelle Pacoca, a peanut-flavored pudding in a container the same size as the yogurt that has 20 grams of sugar — nearly the entire World Health Organization’s recommended daily limit. Until recently, Nestlé sponsored a river barge that delivered tens of thousands of cartons of milk powder, yogurt, chocolate pudding, cookies and candy to isolated communities in the Amazon basin. Since the barge was taken out of service in July, private boat owners have stepped in to meet the demand. “On one hand, Nestlé is a global leader in water and infant formula and a lot of dairy products,” said Barry Popkin, professor of nutrition at the University of North Carolina. “On the other hand, they are going into the backwoods of Brazil and selling their candy.” Dr. Popkin finds the door-to-door marketing emblematic of an insidious new era in which companies seek to reach every doorstep in an effort to grow and become central to communities in the developing world. “They’re not leaving an inch of country left aside,” he said.

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