The 2017 Global Nutrition report was released last week. It describes a world where people are eating the wrong things. While it is true that far too many people lack access to food, almost everyone seems to lack access to food that actually nourishes them. Globally, 52 million children are “wasted” – too skinny for their height. At the same time, 41 million children under five are overweight.
These are indicators of a global economy where the food systems are failing to provide the nutrition that we need – even when they provide plenty of calories.
The Numbers on Malnutrition
2 billion people lack key micronutrients like iron and vitamin A
155 million children are stunted (too small for their age)
52 million children are wasted (too thin for their height)
2 billion adults are overweight or obese
41 million children are overweight
88% of countries face a serious burden of either two or three forms of malnutrition
This isn’t a minor issue. Aside from the sheer scale of the problem, nutrition is firmly linked into human development at the individual, the national, and the global scale.
Malnutrition – whether undernutrition or overconsumption of foods that cause obesity and hypertension – is caused by structural factors that include food production, physical infrastructure, inclusion and social equity, health systems, and overall peace and stability. Nutrition is an important component of a larger system. Good nutrition supports peace, economic growth, stronger health systems, and stability. Malnutrition undermines everything from education to governance to GDP.
The relationship also goes the other way. Malnutrition gets worse in the face of inequity, instability, poor health systems and inadequate physical infrastructure. One grim example: 38 million people are facing severe food insecurity in Nigeria, Somalia, South Sudan and Yemen because of conflict and political instability. Health systems that don’t support exclusive breastfeeding contribute to infant malnutrition and child obesity. Bad roads make it difficult to distribute food with strong nutritional content, pushing diets toward processed, nutritionally empty, shelf-stable foods.
This means that addressing malnutrition takes more than a focus on food. Delivering nutrition interventions that address stunting directly would only reduce stunting globally by 20%. On the other hand, the prevalence of stunting declines by an estimated 3.2% for every 10% increase in income per capita.
The report makes it clear that addressing malnutrition needs to happen right now, not at some hazy point in the future. The countries that are currently making progress on addressing malnutrition aren’t doing it fast enough. Global progress to reduce malnutrition is unlikely to meet internationally agreed nutrition targets, including the Sustainable Development Goal target to end all forms of malnutrition by 2030. Many countries aren’t making progress at all. 815 million people around the world are now are going to bed hungry – an increase from 777 million in 2015.
Take anemia, for example. Not one country in the report is making progress in reducing the number of women affected by anemia, a condition which harms women and makes pregnancies more dangerous. During pregnancy, iron-deficiency anemia is linked to low birth weight, premature births, and an increased risk of maternal death. The number of women with anemia has increased since 2015, to 613 million.
The other impact of inadequate access to foods with high nutritional content is chronic illnesses. Diets heavy in salt, sugar, and simple carbohydrates lead to populations with high rates of diabetes, hypertension, and obesity. That is exactly what the report identifies.
The data show that overweight and obesity are on the rise in almost every country. Two billion of the world’s seven billion people are now overweight or obese. At least 41 million children under five are overweight, and the problem affects both rich and poor countries. At least ten 10 million children in Africa are now classified as overweight. One-third of North American men (33%) and women (34%) are obese.
These kinds of numbers don’t come from access to excessive amounts of good quality food. They happen when populations have access to lots of processed carbohydrates and not a lot else. They speak to diets heavy in bread made from white flour, processed snack food like potato chips and instant noodles, and sugar. Delving deeper into the numbers, more women than men are overweight or obese. This is very often the case in patriarchal cultures where men have first access to household foods, especially high status perishable foods. Women and children are more likely to have diets that ae dominated by affordable carbohydrates like bread.
The Global Nutrition Report does offer recommendations to get us out of this food crisis. It calls for global shared action on five initiatives: 1) sustainable food production, to maintain and increase the diversity of agricultural landscapes; 2) better infrastructure systems to more effectively take food from farm to fork; 3) stronger health systems, to promote infant and young child feeding, supplementation, therapeutic feeding, nutrition counseling to manage overweight and underweight, and screening for diet related NCDs in patient, 4) support to equity and inclusion for marginalized populations, including women; and 5) promote peace and stability.
These are big goals, especially those last two. But they are also goals with benefits that go far beyond nutrition. A coordinated global focus on food, infrastructure, health systems, equity, and peace would create a better world in ways that go far beyond food.