The nutritional security imperative

Global food security can be achieved in the coming years, but nutritional security needs attention as well

Global food and nutrition security is an important issue to consider, both now and for 2050. The world population is likely to reach 9.6 billion in 2050, from 7.3 billion at present. This means sufficient nutritious food needs to be available for an additional 2.3 billion people within the next 35 years.

In addition, provision has to be made for 795 million people, approximately one in nine of the global population, who do not have access to adequate food.

India, which is likely to be the most populous country in the world by 2022 with a population of 1.4 billion, produces enough food to combat hunger. However, poverty, creaking supply chains, rampant food waste, and poor farming yields lead to millions being malnourished. The existing underperforming policies need to be reviewed and reformulated.

India currently has 194.5 million malnourished people, or about one in every four such people of the world. Between 1990-92 and 2015, this number was reduced by only 15.5 million. This is in spite of the fact that per capita income has more than tripled during the past two decades. Despite economic growth and self-sufficiency in food grains production, minimum dietary intake has actually fallen during this period.

China, during the same period, has managed to reduce the number of its malnourished people from 289 million to 133.8 million, a significant achievement.

Global food security can be achieved in the coming years with implementation of proper policies, strong political will, continued advances in science and technology and good agricultural and food management practices. This piece will focus primarily on nutritional security, which has not received similar levels of attention.

Two pillars of nutritional security

There are two important aspects of nutritional security: obesity and malnutrition. Globally there has been a steady increase in number of obese people. Equally, in developing countries malnutrition remains a very serious concern.

According to the U.S. Centers for Disease Control and Prevention, 34.9 percent of American adults are now obese. In 2014, adult obesity rates exceeded 30 percent in 22 states and not a single state had a rate below 20 percent. In contrast, not even a single state had a rate of 20 percent in 1991.

Obesity contributes to heart disease, stroke, and type 2 diabetes. In the United States, estimated annual medical costs of obesity are $147 billion in 2008 dollars. Medical costs for obese people are $1,429 higher than for those of normal weight.

Obesity has now become a global problem. There are twice as many obese people in developing countries as in developed ones. Increased consumption of food that has high sugar and saturated fat content but is nutrient-poor and energy-rich, as well as reduced physical activities have contributed to three-fold increase in obesity rates in some parts of the U.S., U.K., Eastern Europe, Middle East, China and Australasia.

Increasing rural-urban migration in developing countries is aggravating obesity. Rural people are self-reliant in obtaining food and eat traditional diets that are rich in grains, fruit and vegetables, but low in fat and sugar. When they migrate to urban areas, they lack physical activity and increase intakes of sugar, refined grains and fats. Their dietary profile moves from traditional and more nutritious diets to a more aspirational urban diet. Communication and information revolutions have contributed to globalization of an aspirational, ill-conceived “Western” diet after 1980.

The labor practices of a migrant often account for a decline of as much as 1,000 calories per day, a reduction in 50 per cent or more of physical activity. This reduction and change in diet results in weight gain and eventually obesity.

In terms of nutritional security, numerous developing countries are facing an equally serious problem in terms of malnutrition. According to UN estimates, some 795 million people in the world, one in every nine persons, do not have enough food to eat to lead a healthy life. Nearly two thirds of the world’s malnourished people are in Asia. The highest prevalence is in Sub-Saharan Africa, where one in four is malnourished.

Some 3.1 million children under five die each year due to poor nutrition, accounting for 45 per cent of child mortality. One in four children is stunted (short for their age) and one in six is underweight. In India, a decade ago, 42.5 per cent of all children below five were underweight. The situation has since improved: Today, it is 29.4 per cent.

There are of course wide variations over the country. A state like Maharastra has been doing better, reducing underweight children from 37 per cent to 25 per cent by better and more frequent feeding, improved care of pregnant women, increasing household incomes, and higher ages at which women start having children. What is noteworthy is that even among the richest fifth Indian households, more than quarter of the children are stunted.

Over 50 per cent of girls in 15-18 age brackets have a low body-mass index. This implies they are likely to have undernourished babies, and the cycle may continue.

The problems in the developing world are not only because of malnutrition, gender discrimination, poor health education, and literacy, they also reflect other public health factors.

For example, open defecation is still widely practiced in many countries. This contributes to an unhealthy environment in which children live and play.Open defecation spreads diarrhea and other diseases, as well as worms and parasites. These make it difficult for children to absorb nutrients even when food is plentiful. The evidence shows strong correlation between open defecation and underweight children.

China has made remarkable progress in combating malnutrition. The just released “2015 Report on Chinese Nutrition and Chronic Diseases,” based on data from 2002-2012, shows adult malnutrition was 6 per cent in 2012, a decline of 2.5 per cent over a decade. Stunted growth for children and adolescents between 6 and 17 years, was 3.2 per cent, a reduction of 3.1 per cent over the decade. Wasting was somewhat higher at 9 percent, a decline of 4.4 per cent over 2002-12.

Anemia has been historically a serious problem in China. This showed remarkable reduction, from 20.1 per cent to 9.7 percent during the decade. Malnutrition, however, continues to be serious in rural areas.

A commonly held – and erroneous – view has been food security is the main, or even the sole cause, of malnutrition. Thus, the policy focus to ensure that nutrition security has often been based primarily on food-based interventions. This has not been very effective.

Countries need to give proper emphasis to nutrition security based on observed facts and analyses. In most developing countries, progress in achieving nutritional security has been slow because of misconceptions, gender discrimination, corruption, taboos, and national pride. No country can reach its full potential if the bodies and minds of its young people are stunted because of a lack of nutrients.

Peter Brabeck-Letmathe is the Chairman of the Board of Nestlé, Vevey, Switzerland. Asit K. Biswas is the Distinguished Visiting Professor at Lee Kuan Yew School of Public Policy, Singapore. This article was first published in The Diplomat. 

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