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Shaping Sustainable Food Systems for Healthy Diets and Improved Nutrition: Implementing the ICN2 Framework for Action Recommendations

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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

Published in: Education
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Shaping Sustainable Food Systems for Healthy Diets and Improved Nutrition: Implementing the ICN2 Framework for Action Recommendations

  1. 1. 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
  2. 2. 1990 2015 Poverty Mortality Illiteracy Malnutrition Communicable diseases Famine deaths Many improvements in human well-being
  3. 3. Today 30% people affected by malnutrition By 2035 Malnutrition could affect 50% people Source: Global Panel (2016) Foresight Report
  4. 4.  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
  5. 5. Source: IFPRI (2015) Global Poverty Report 2014/15. Washington, D.C. Most malnourished people live in Middle Income Countries
  6. 6. Top Risk Factors for Global Burden of Disease
  7. 7. Source: Mozaffarian (2016) Circulation
  8. 8. 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
  9. 9.  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…
  10. 10. 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!
  11. 11. 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
  12. 12. 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.
  13. 13. US$7 billion/year to achieve 2025 targets for stunting, anemia, exclusive breastfeeding, severe wasting (not obesity, MN deficiencies): The cost of targeted actions?
  14. 14.  50 countries spent US$585 billion annually to support agricultural production since 2013, plus US$87 billion on services supporting the sector.  Almost 70% provided as market price support. “Little support provided directly addresses the recognized challenges…of the sector.” 2. Agricultural subsidies
  15. 15. Source: http://www.oecd.org/tad/agricultural- policies/producerandconsumersupportestimatesdatabase.htm Total government support to agriculture (% GDP 2015)
  16. 16. Direct subsidies for animal products and feed
  17. 17. Source: Global Panel on Agriculture and Food Systems (2016) 3. Focus of agriculture research must change!
  18. 18. The evidence for policy decisionsNew studies do support hypothesis that agriculture can be correlated with better diets and nutrition. Homestead gardens, farm diversification and production of fruits, vegetables, aquaculture “can potentially improve nutrient intake.” But…we have to go beyond home gardens and single nutrients to system-wide change.
  19. 19. Exports from India of processed foods FY16 (US$ 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.
  20. 20. 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
  21. 21. 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
  22. 22. Average Annual Price Change since 1990 for middle-high income countries (China, Mexico, Brazil, Korea, UK) Source: Wiggins and Keats (2015) ODI
  23. 23. 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
  24. 24. 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!
  25. 25. 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.
  26. 26.  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
  27. 27. Thank-you.

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