5. 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
6. 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) .
9. “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
11. Global risk factors contributing to early deaths
(Source: GBD 2013; Lancet 2015)
12. 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 Evaluation
Authority on Global Health Diseases
13. 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)
14. 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, about
US$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
15. 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)
16. 16
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.”
18. 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
19. 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
20. Food from Japan
“Food of systems of
indigenous peoples
show the important
role of a diversified
diet based on local
plant and animal
species”
Biodiversity and Nutrition: a common
Path (FAO)
21. 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.
22. 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
23. Food System
Production, processing,
retail, consumption
Food Environment
Availability, access,
convenience, desirability for
consumers
Individual Diet Quality
Diversity, adequacy, safety
Sources: Herforth & Ahmed, 2015;
Global Panel on Agriculture & Food
Systems for Nutrition, 2015, SOFA,
2013
WHAT INFLUENCES DIET QUALITY OR HEALTHY DIET?
FOOD ENVIRONMENTS
24. 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
25. Food System
Production, processing,
retail, consumption
Food Environment
Availability, access,
convenience, desirability for
consumers
Individual Diet Quality
Diversity, adequacy, safety
Sources: Herforth & Ahmed, 2015;
Global Panel on Agriculture & Food
Systems for Nutrition, 2015, SOFA,
2013
WHAT INFLUENCES DIET QUALITY OR HEALTHY DIET?
FOOD ENVIRONMENTS
26. to create fovourable food
environment to ensure that their
citizens have access to healthy
diets
Governments responsibility:
27. Ways in which Governments can influence
the food environment for Healthy Diet
29. 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
31. 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)
32. USING FOOD LABELLING TO INFLUENCE FOOD ENVIRONMENTS
THE 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.
33. 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
34. 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
35. 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.
36. 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;
37. 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
38. 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
Editor's Notes
To date, there are a number of published definitions of the food environment and there is no consensus on which one is the best, I’ve chosen a hybrid for this presentation: simply “a space in which a range of food options open up to consumers based on food availability, affordability, convenience, and desirability.
The food environment mediates between what happens in terms of broader food systems, and what happens in terms of individual diets.
Food systems can be thought of as the food supply chain, beginning with agricultural inputs and ending with food products, as well as the public and private sector actors which shape that chain’s trajectory. Examples of what I mean by “public and private sector actions” include national dietary guidelines, government and private sector support of diversified food production, promotion of food safety via regulations and market support, and social marketing campaigns to increase consumer awareness.
Individual diet quality, which is of course an outcome of high interest in terms of nutrition assessment, is usually defined in terms of diversity, micronutrient content, and safety.
Before I go any further, I do want to acknowledge the simplicity of this graphic. …..
What is behind the multiple burden of malnutrition trends? The short answer is, “a lot”, namely rapid socioeconomic, demographic, and technological changes, most of which are linked to globalization. These include changes in technology re. how food is processed , marketed and prepared; and changes in meal patterns. Many of these changes are reflected in the food environment, that is, what foods are available to consumers at a given point and place in time, with subsequent implications for diet quality at the individual level.
To date, there are a number of published definitions of the food environment and there is no consensus on which one is the best, I’ve chosen a hybrid for this presentation: simply “a space in which a range of food options open up to consumers based on food availability, affordability, convenience, and desirability.
The food environment mediates between what happens in terms of broader food systems, and what happens in terms of individual diets.
Food systems can be thought of as the food supply chain, beginning with agricultural inputs and ending with food products, as well as the public and private sector actors which shape that chain’s trajectory. Examples of what I mean by “public and private sector actions” include national dietary guidelines, government and private sector support of diversified food production, promotion of food safety via regulations and market support, and social marketing campaigns to increase consumer awareness.
Individual diet quality, which is of course an outcome of high interest in terms of nutrition assessment, is usually defined in terms of diversity, micronutrient content, and safety.
Before I go any further, I do want to acknowledge the simplicity of this graphic. …..
Lack of availability and affordability is the most basic level of the food environment that affects dietary choices. Agrifood polices such as those described in previous slides have effectively raised the “price” of diet quality over the last decades. How can these trends be reversed to move us closer to a food system which supports healthy food environments and diet quality?
At FAO, we are working with countries to develop, revise, implement and disseminate FBDGs. These are all the countries that have communicated their official FBDGs to us.