Feeding the world “healthily” in 2050

London School of Hygiene & Tropical Medicine (LSHTM), School or Oriental and African Studies (SOAS), Royal Veterinary College (RVC), School of Pharmacy (SoP).

The London International Development Centre

Leverhulme Centre for Integrative Research on Agriculture and

Health (LCIRAH)

Ricardo Uauy MD PhD

Population growth to continue, but at a slower pace

0.0

3.0

6.0

9.0

12.0

1750 1800 1850 1900 1950 2000 2050

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(b

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0.2

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0.7

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0.9

An

nu

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ts (

billion

s)

Josef Schmidhuber FAO Head, Global Perspective Studies Unit

Population growth is a key driver for long-term outlook on global food, agriculture

and nutrition

Germany: The Melander family of BargteheideFood expenditure for one week US $500

Ecuador: The Ayme family of Tingo Food expenditure for one week US $31.55

Chad: The Aboubakar family of Breidjing Camp Food expenditure for one week US $1.23

LentilsChick peas

LettucePeppers

CarrotsBean, dry

PlantainsCoconuts

CabbagesOranges

SorghumTomatoes

Oil Palm FruitSoybeans

Sweet PotatoesBarley

CassavaSugar Beets

Potatoes

Rice, PaddyMaize

Wheat

0 100 200 300 400 500 600

100,000 metric tonsMann, C. (1997)

Four crops represent 65% of food produced in the

world

Kg per person per year

Kg per person per year

Deaths by Regions of the World

Accidents Non-communicable DiseasesCommunicable diseases

AFRICA EasternMediterranean

EUROPESE-ASIA W.PACIFIC AMERICAS

25

50

75

%

Source: WHO, World Health Report 2004

Lancet Malnutrition Series 2008

• More than 3 million deaths, one third of the disease burden in children less than 5 years old can be attributed to maternal and child undernutrition.

• Stunting, severe wasting and intrauterine growth restriction account for > 20% of global deaths and DALYs in children < 5 yrs old, malnutrition in all its forms is the greatest risk factor for this age group.

• Vitamin A and zinc deficiencies, by far have the largest remaining disease burden.

• 1.4 million deaths and 10% of the disease burden in children <5 y can be attributed to sub-optimal BF especially non-exclusive BF in the first 6 m of life.

Lancet Malnutrition Series 2008

Maternal & childundernutrition

Immediatecauses

Underlyingcauses

Basiccauses

Lack of capital: financial, human, physical, social and natural

Social, economic and political context

Income poverty: employment, self-employment, dwelling, assets, remittances,

pensions, transfers, etc.

Unhealthy household environment & lack of health

services

Inadequate care

Household food

insecurity

Long-term consequences: Adult size, intellectual

ability, economic productivity, reproductive performance, Diabetes & CVDs

Short-term consequences:Morbidity, Disability, Death

Lancet Malnutrition Series 2008

Inadequate dietary intake Disease

% of total DALYs lost

Vit A deficiency

Iron deficiency

% of total DALYs lost

Blood Pressure

Cholesterol

% of total DALYs lost

Energy Imbalance

Under nutrition

Malnutrition in all its forms Foetus /Infants / Children

•LBW/IUGR •StuntingandSevere wasting•Micronutrientdeficiency(VitA,I,Fe,Zn,Fol)•Infection (HIV/AIDS)

Adults / Older People

•Cardiovascular (CHD, Stroke )• Obesity/Diabetes/Dyslipidemia• Cancerrelated toDiet and Physical inactivity•Osteoporosis, Caries•Age related loss of function (vit D, B12, n-3 FAs)

Nutrition defines in great part how many will survive infancy & how they will live and

die

Years of age0

25

50

75

100

20 40 60 80 100 120

1930

2000

Foetus /Infants / Children•LBW/IUGR •Stuntingandwasting•Micronutrientdeficiency(VitA,I,Fe,Zn) •Infection(HIV/AIDS)

Adults / Elderly•Cardiovascular (CHD, Stroke)•Obesity/Diabetes/dyslipidemia•Cancerrelatedtodiet•Osteoporosis•Aging

Ideal

% su

rviv

al

Nutrition-Infection interactions determine in great part, how we grow physically and develop mentally,

Nutrition-Physical activity interactions define how we will age and die.

DisabilityPhysical/Mental

Right to “Adequate food”: Quantity and Quality

- macronutrient quantity and qualityAND

- micronutrient density per unit energy consumed

Nutrient poor high energy foods displace nutrient rich foods

Effect most marked at low levels of physical activityLeading to:

- poor/abnormal fetal growth - low birth weight- stunting-increased risk of obesity

How do food prices affect health ?

Higher food prices limit the access to food by the poor and most vulnerable.

The challenge is not only to prevent a reduction in the quantity of food energy but to preserve the quality of the food consumed

Agriculture/food/nutrition scientists must call for international action to prevent a food crisis.

We need a second HEALTHIER and GREENER food revolution

M. Franco et al AJE Sept 19, 2007

All cause

DiabetesCancer

Heart Disease