Post on 27-Jan-2017
Shaping Sustainable Food Systems
for Healthy Diets and Improved Nutrition:
Implementing the ICN2
Framework for Action Recommendations
Patrick Webb
Friedman School of Nutrition Science and Policy
Tufts University
United States of America
1990 2015
Poverty
Mortality
Illiteracy
Malnutrition
Communicable diseases
Famine deaths
Many improvements in human well-being
Today
30% people
affected by
malnutrition
By 2035
Malnutrition
could affect
50% people
Source: Global Panel (2016) Foresight Report
Malnutrition now found in 193 countries.
790 million undernourished, c.2 billion have
micronutrient deficiencies, 2 billion overweight/obese.
Most malnutrition not in low income countries!
Malnutrition pervasive and increasing
Source: IFPRI (2015) Global Poverty Report 2014/15. Washington, D.C.
Most malnourished people live in Middle Income Countries
Top Risk Factors for Global Burden of Disease
Source: Mozaffarian (2016) Circulation
China: 32% overweight & obese adults in 2012; likely rise to 51% by 2030.
Nigeria: adults with diabetes could double by 2030 to reach 3 million.
Ethiopia: adults with diabetes could double by 2030 to reach >6 million.
Bangladesh: more adults with diabetes by 2030 than Mexico or Indonesia.
Business as usual will generate a
catastrophic health crisis
Malnutrition is rising globally.
Low diet quality is common to all malnutrition.
Business as usual will bring huge nutrition and health crisis – its already started...
Tweaking at the margins won’t suffice. We need
a radical transformation of our food systems –to nourish not just feed 9 billion.
Summary so far…
ICN2 framework is good starting point
Develop, cost national plans - [R2]
Increase domestic finance for nutrition - [R4]
Develop guidelines for healthy diets - [R13]
A voluntary framework, addressed mainly to
government leaders.
Strengthen local food production - [R9]
Promote farm diversification - [R10]
Build capacity of frontline workers - [R20]
Needs specificity on how, and more ambition!
Go big…or go home!We need to be more demanding and aspirational
1. Fully implement known evidence-based actions
2. Re-direct agricultural subsidies
3. Re-focus agriculture research priorities
4. Re-think global food trade for year-round access
5. Industry incentives/taxes for healthier products
6. Consumer incentives for healthier choices
7. Dietary guidelines to guide policy
8. Metrics and data on global diet quality needed
9. Game-changing climate change opportunities
1. Fully implement evidence-based actions
1,000 days are key. In utero nutrition/health!
Small for Gestational Age accounts for 30%
of stunting age 3y.
10 targeted interventions can cut 20% of
child stunting in high burden countries.
US$7 billion/year to achieve 2025 targets
for stunting, anemia, exclusive breastfeeding,
severe wasting (not obesity, MN deficiencies):
The cost of targeted actions?
50 countries spent US$585 billion annually to
support agricultural production since 2013, plus
US$87 billion on services supporting the sector.
Almost 70% provided as market price support.
“Little support provided directly addresses the
recognized challenges…of the sector.”
2. Agricultural subsidies
Source: http://www.oecd.org/tad/agricultural-
policies/producerandconsumersupportestimatesdatabase.htm
Total government support to agriculture (% GDP 2015)
Direct subsidies for animal products and feed
Source: Global Panel on Agriculture and Food Systems (2016)
3. Focus of agriculture research must change!
The evidence for
policy decisionsNew studies do support hypothesis that
agriculture can be correlated with better
diets and nutrition.
Homestead gardens, farm diversification and
production of fruits, vegetables, aquaculture
“can potentially improve nutrient intake.”
But…we have to go beyond home gardens
and single nutrients to system-wide change.
Exports from India of processed
foods FY16 (US$ million)
4. Global food trade to support access to
nutrient-rich foods
622.1 566.4Among broad sectors of the U.S. economy,
agriculture and food would see greatest
gain; output would rise $10 billion by 2032.
Trans-Pacific Partnership would benefit
trade in fresh fruits, vegetables and nuts
which is currently hampered by sanitary
and phytosanitary restrictions.
Global food retail industry valued at >US$4 trillion
(2015); rising to US$7.5 trillion by 2020.
Source: https://www.ers.usda.gov/topics/international-markets-trade/global-food-markets/global-food-industry.aspx; http://www.reportlinker.com/p03549658-summary/Analyzing-the-Global-Food-Retail-Industry.html;
5. Incentives for food industry must change
6. Consumer incentives for healthy choices?
Stuckler D, McKee M, Ebrahim S, Basu S (2012) Manufacturing Epidemics: The Role of Global Producers in Increased Consumption of Unhealthy
Commodities Including Processed Foods, Alcohol, and Tobacco. PLOS Medicine 9(6): e1001235. doi:10.1371/journal.pmed.1001235
http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001235
Average Annual Price Change since
1990 for middle-high income countries
(China, Mexico, Brazil, Korea, UK)
Source: Wiggins and Keats (2015) ODI
7. Dietary guidelines to frame policy actions
Food-based dietary guidelines missing from low-
income countries (present only in 2 out of 31)
Need dietary guidelines, but to guide food policy
decisions, not just to inform consumers
8. Metrics and data (for accountability
and transparency)
Urgent need for better data and metrics
for diet quality and the food system.
Diet is No. 1 risk factor for global
burden of disease…but
UN has no global database on diets
Not an SDG target!
Policymakers should demand much more of their food systems – as vehicles to protect health, productivity.
What needs to happen right away?
Start with nutrition/diet quality problems, and work
backwards to modify food systems to be fit-for-purpose.
Quantify complex trade-offs and synergies among diet
quality, sustainable agriculture, GHG emissions. Climate
change is a major challenge, but also opportunity.
Malnutrition has re-emerged as a global public health issue, not just in low income countries. Low quality diets contribute to all forms of malnutrition.
Diet is a modifiable risk factor for ill health – so modify!
Healthy food systems must nourish us, not just feed us.
Needs policy, investment and behaviour shifts throughout the food system – i.e. a radical transformation. Requires huge commitment on scale of HIV/AIDS, tobacco, malaria.
Take-Away Messages
Thank-you.