Obesity could knock economic output as severely as malnutrition, which shaves as much as 3 percent off production in the poorest countries, a World Bank specialist said.

The World Health Organization estimates obesity has tripled in the past two decades and that one in 10 children and one in five adults will be obese in Europe and Central Asia by 2010 unless action is taken.

Dr. Meera Shekar, senior nutrition specialist with the World Bank, says malnutrition slices 2 to 3 percent off gross domestic product in the hardest-hit countries, and obesity could cost the same.

"We suspect that these estimates will be just as high," she said at a WHO-sponsored conference on obesity in Istanbul.

"If you're obese you're more likely to be sick, to be absent from work...the opportunity cost of not working, these are indirect costs," Shekar stated.

Already, six percent of health costs in the WHO's European region, which includes Central Asia, come from obesity in adults, the organization's data show.

In 1992 obesity cost France $12.1 billion in direct costs alone, while in 2000 obese and overweight people cost the state of California $22 billion, including indirect costs, Shekar said.

Obesity is also expected to reduce life expectancy, which could have a knock-on effect on the economy. A recent UK study forecast men would live five years less by 2050 if current trends were not reversed.

POOR HIT

"The important thing is that because the problem is increasing we would see an increasing drain on economies, particularly developing economies," she said, adding obesity had appeared recently in the Middle East and North Africa and was a big problem in Latin America.

As developing countries' economies grow, the prevalence of obesity shifts to the poor from the rich.

That has happened in rich countries, and in France obesity is five times more prevalent among low-income groups than high earners, WHO Regional Adviser Dr Franceso Branca said.

Speaking at the same conference, he said he would like to see economic incentives to encourage consumers to buy healthier food.

"Taxes on soft drinks, for example, should be considered," he stated, adding current European farming subsidies should also be re-examined.

"The whole problem is that consumers ... we are not completely free in deciding our own food choices," he said.