Healthy Diets and our Food environment?

Healthy Diets and our Food environment?

A presentation at the SCN 10 June 2016 (FAO, Rome, Italy)

Anna Lartey, PhD

Director of Nutrition,

FAO, Rome

• 63 countries have reached the hunger target of MDG-1.

• 25 countries have achieved the more stringent WFS target.

(FAO,WFP,IFAD-SOFI 2015)

Undernutrition declining, but not fast enough

Source: UNICEF, WHO, World Bank. Joint Child Malnutrition Estimates. 2012

Overweight, obesity rising rapidly

Source: FAO, SOFA, 2013

Source: Lancet Vol 387, April 2, 2016

If trends continue, the probability of meeting global obesity target is virtually zero; Severe obesity will surpass underweight in women by 2025

Warning on Global Obesity trends:

Men Women

NUTRITION IN TRANSITION IN THE MEDITERRANEAN AREA

Specification Overweight 2011 (%)

(WHO, 2011)

Obesity 2011 (%)

(WHO, 2011)

Undernourishment 2010-2012 (%)

(FAO, WFP and IFAD; 2012)

Albania 54.4 21.3 -

Algeria 45.5 16.0 <5

Egypt 67.9 33.1 <5

Iraq 62.3 27.0 26.0

Israel 60.9 26.2 -

Jordan 64.1 30.0 <5

Lebanon 61.8 27.4 <5

Libya 61.9 27.8 <5

Morocco 46.8 16.4 5.5

Syria 61.2 27.1 <5

Tunisia 53.7 22.3 <5

Turkey 61.9 27.8 <5

Table. 1. Obesity, overweight and malnutrition (undernourishment) in selected Mediterranean countries.Source: CIHEAM-Bari’s elaboration using data from WHO 2011 and FAO-WFP-IFAD 2012 (FAO, WFP et al. 2012) .

Our Diet:

FEB. 23, 2015

HealthFood Habits Getting Worse Around the World

“Our diet is killing us”

By Peter Whoriskey February 2015

America, please eat more fruits and vegetables

Washington Post By Peter Whoriskey February 2015

Washington Post February 2015

September 2015

THE GUARDIAN

Global risk factors contributing to early deaths (Source: GBD 2013; Lancet 2015)

September , 2015

Poor diet: “Eating too few fruits and vegetables, nuts and whole grains, too much sodium (salt) and cholesterol are taking a toll on health across the globe”

Institute of Health Metrics and EvaluationAuthority on Global Health Diseases

Specific Dietary risks

Diets low in: Fruits

Vegetables

Whole grains

Nuts and seeds

Milk

Fiber (legumes, pulses)

Sea food (w3 Fatty acids)

Low in PUFA

Diets high in Red meat

Processed meat

Sugar sweetened beverages

Trans fatty acids

Sodium (salt)

Economic costs of malnutrition unacceptably high @ 5% of GDP• Under-nutrition, micronutrient deficiencies cost

2-3% of global GDP• Total output loss, healthcare costs due to NCDs,

for which obesity is key risk factor, aboutUS$47 trillion over next 2 decades • Total costs of malnutrition may be as high as 5%

of global GDP, equivalent to US$3.5trn or US$500/person/year

• Poorer countries -> higher malnutrition costs

Economic costs of obesity by McKinsey Global Institute (2014)

About 1.9~2.1 bn people overweight or obese),

i.e. 30% of global population

Comparative economic burden armed conflicts ($2.1 trillion) smoking ($2.1 trillion)obesity ($2.0 trillion)

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At ICN2 countries committed to reform their food systems:

”we commit to enhance sustainable food

systems by developing public policies from production

to consumption and across sectors to provide year-

round access to food that meets people’s nutrition

needs and promote safe and diversified healthy

diets.”

What is a Healthy Diet?

WHO Healthy diet fact sheet:Healthy diet contains:

Fruits, vegetables, legumes, nuts, and whole grains At least 400g (5 portions of F&V) Less than 10% of total energy from free sugars (¬ 50g); Less than 30% of total energy from fats; Less that 5 g of salt (¬ 1 teaspoon) per day

Healthy Diets through the lens of two famous traditional diets: Declared World Intangible Cultural Heritage by UNESCO 2013

“Washoku” Traditional diet of Japan: Well-balanced through use of

foods that vary in colour and texture;

Diversity and freshness of seasonally-available ingredients;

Fish as major animal protein; Use of natural spices High use of fermented foods

Mediterranean Diet High use of fruits and

vegetables, whole grains, legumes and nuts (Diversity);

Use of olive oils; Limited use of red meat and

processed meat; Consumption of fish and

poultry; Use of herbs and spices for

flavouring

Food from Japan

“Food of systems of indigenous peoplesshow the important role of a diversified diet based on local plant and animal species”Biodiversity and Nutrition: a common Path (FAO)

What then is a Healthy diet?

Characteristics of a Healthy Diet:

CFS Vision for nutrition:

access to adequate food and enjoy diversified, balanced (and healthy diets) for an active and healthy life.

Health Effects of Healthy Diet: * Reduced prevalence of nutrient deficiencies• Reduced prevalence of obesity;• Reduced incidence of non-communicable diseases- diabetes,

heart diseases, etc.

Modern day challenges to Healthy diets

Fast pace of life:

• People do not have the time to cook;

• Issue of affordability

• People should be able to do what we want them to do

Food System Production, processing,

retail, consumption

Sources: Herforth & Ahmed, 2015; Global Panel on Agriculture & Food Systems for Nutrition, 2015, SOFA, 2013

WHAT INFLUENCES DIET QUALITY OR HEALTHY DIET?FOOD ENVIRONMENTS

WHAT ARE “FOOD ENVIRONMENTS”?

The foods that are available in the spaces around people as

they move through their daily lives, & how affordable,

convenient & desirable they are

Food System Production, processing,

retail, consumption

Sources: Herforth & Ahmed, 2015; Global Panel on Agriculture & Food Systems for Nutrition, 2015, SOFA, 2013

WHAT INFLUENCES DIET QUALITY OR HEALTHY DIET?FOOD ENVIRONMENTS

to create fovourable food environment to ensure that their citizens have access to healthy diets

Governments responsibility:

Ways in which Governments can influence the food environment for Healthy Diet

THROUGH AGRICULTURAL POLICIES: INCREASING AVAILABILITY AND AFFORDABILITY OF NUTRITIOUS, HIGH QUALITY FOOD

Food-based Dietary Guidelines (April 2016)(FAO and Oxford University)

FBDG: Communication tool to promote healthy diets and nutritional well-being.

“.. They provide an official, accessible and easy to understand steer on how people should eat and the direction of travel needed.”

Some are building sustainability issues in their FGDB by cautioning on meat consumption.

http://www.fao.org/3/a-i5640e.pdf

Countries with official FBDGs in FAO’s site

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China is encouraging its citizens to eat less meat — and that could be a big win for the climate

An updated set of dietary guidelines just released by the Chinese government could be a boon not only for public health, …but also for the environment. (April 11, 2016: www.washingtonpost.com)

USING FOOD LABELLING TO INFLUENCE FOOD ENVIRONMENTSTHE CHILI EXPERIENCE In Chile, one out of three children under 6 years

of age is overweight. Starting from June 27th, 2016, a law of food labelling and advertising will be active to curb the ongoing epidemic increase of obesity and non-communicable diseases. It includes:

• incorporating easy-to-understand front-of-packages labelling and specific messages addressing critical nutrients:

• decreasing children’s exposure to unhealthy foods by restricting marketing, advertising and sales, in particular in schools.

Policies to address food safety

Food environments in many developing countries are characterized by unsafe foods and are the cause of high rates of food bourne diseases;

Issues of Anti-microbial resistance is a major problem in many countries

Trade Policies can influence foods available

CONSEQUENT IMPACT ON FOOD ENVIRONMENTS & DIET QUALITY AROUND THE WORLD:• Increased availability and intake of artificially sweetened

beverages, processed foods and refined carbohydrates ,• Decreased fruit, vegetable and legume availability and intake

Looking for Healthy Diet? Go to Africa!

A 2015 study published by The Lancet Global Health journal looked at the consumption of food (both healthy and unhealthy items) in 187 countries in 1990 and in 2010. The aim was to determine which countries had the world’s healthiest diets.

…of the ten countries with the healthiest diets on earth, nine of them are in Africa.

What’s more, the three countries with the very best diets are some the world’s poorest.

Global Community: A charge to keep, we have

ICN2 Rome Declaration on Nutrition: “Eradicate hunger prevent all forms of malnutrition”

Agenda 2030

SDG Goal2: Commitment to end all forms of malnutrition (target 2.2) and provide safe, nutritious and sufficient food all year round;

Time to protect Traditional diets

Traditional diets, in many parts of the world are being displaced due to neglect by policy makers;

and over processed low nutrient foods are becoming cheaper

Conclusion

Governments working with food systems actors must steer the food system to deliver on healthy diets

Protect traditional healthy diets through the creation of conducive food environment

E.g. policies in place to make healthy diet available, accessible, convenient and desirable to the consumer