Food systems are being transformed at an unprecedented rate as a result of global economic and social change. Urbanisation, foreign direct investment in markets of developing countries and increasing incomes are prime facilitators for the observed changes, while social changes, such as the increased number of women in the workforce and rural to urban migration, provide added stimulus. Changes are also facilitated in concrete ways by food production based on intensive agriculture, new food processing and storage technologies, longer product shelf-life, the emergence of food retailers such as fast food outlets and supermarkets and the intensification of advertising and marketing of certain products. The sum of these changes has resulted in diverse foods that are available all year for those who can afford them, as well as a shift in home-prepared and home-based meals to pre-prepared or ready-to-eat meals, often consumed away from home. These food system and lifestyle changes are in turn having an impact on the health and nutritional status of people in developing countries. There is an indication of rapid increases in overweight and obesity, particularly among adults, and an increasing prevalence of diet-related non-communicable diseases. At the same time, social inequalities are increasing, particularly in urban areas. The papers appearing in this publication were first presented at the workshop Globalisation of food systems: Impacts on food security and nutrition held at FAO headquarters in Rome from 8 to 10 October 2003. The chapters are arranged in two parts. The first contains overview chapters providing a synthesis of findings from 11 country case studies, an overview of issues related to urban food insecurity, a review of nutritional change in developing countries and some policy options to address these changes. The second section gives a detailed account of the changes in food systems and health and nutrition problems in 11 case study countries, representative of different regions throughout the world.