Urbanization and globalization may enhance access to non traditional foods as a result of changing prices and production practices, as well as trade and marketing practices. These forces have influenced dietary patterns throughout the developing world. Longitudinal case study data from China indicate that consumption patterns closely reflect changes in availability, and that potentially obesogenic dietary patterns are emerging, with especially large changes in rural areas with high levels of urban infrastructure and resources. Recent data on women from 36 developing countries illustrate that these dietary shifts may have implications for overweight/obesity in urban and rural settings. These data emphasize the importance of developing country policies that include preventive measures to minimize further adverse shifts in diet and activity, and risk of continued rises in overweight.