The world has seen a remarkable shift from a period when diets, activity patterns and body composition were characterized by the period termed the receding famine pattern to one dominated by nutrition-related non-communicable diseases (NR-NCDs). This presentation first examines the speed of these changes, summarizes dietary changes, and provides some sense of the way the burden of obesity is shifting from the rich to the poor not only in urban but also rural areas throughout the world. The focus is on the lower- and middle- income countries of Asia, Africa, the Middle East, and Latin America but some examples will come from the United States, Australia, and the UK. After showing that changes are occurring at great speed and at earlier stages of countries' economic and social development, the presentation shifts to some of the critical policy opportunities and some example of options. Few policy lessons exist at a macro level outside of selected countries such as South Korea and Finland. Examples of ways price policy and other options might work, using Chinese longitudinal case studies, are presented. The challenge is for the agricultural economics profession to focus on this major global issue-one which challenges some of the earlier paradigms of food policy an agricultural development.