Today, 4th March 2021, marks World Obesity Day. There is mounting evidence that our food system – the way we grow, harvest, process, transport, market, consume, and dispose of food – is making us ill and is contributing towards our ecological crisis. Our food system is negatively impacting on climate change, biodiversity loss and the double burden of obesity and malnutrition. We need a sustainable nutrition transition to shift food systems, so they support nutrient rich foods with governments and the food industry reorienting their policies and practices to support this transition. Without this transition, we will fail to reach the 2030 sustainable development goal ‘to ensure healthy lives and promote well-being for all at all ages.’
Despite obesity being preventable, worldwide obesity has nearly tripled since 1975. Globally there are now 677.6 million obese adults and 1 in 3 people are now overweight,[i] including 38 million children under the age of five.[ii] Many LMICs are now facing a ‘double burden’[iii] of malnutrition and are having to confront FBDs, undernutrition, whilst experiencing a rapid upsurge in overweight, obesity and diet-related NCDs – with 422 million people having diabetes and a further 1.1 billion people suffering from high blood pressure.[iv]NCDs are responsible for 41 million of the world’s 57 million total deaths (71%) of which diet was one of the four leading risk factors.[v]
Food systems are the largest cause of anthropomorphic greenhouse gas (GHG) emissions (28% between 2007 and 2016). Agriculture uses 34% of all land on the planet, withdraws 70% of freshwater and is responsible for 68% of total biodiversity lost since 1970 (70% on land and 50% in freshwater), with an estimated one million species now facing extinction within the next few decades.
A sustainable nutrition transition
There is an urgent need for I would call a sustainable nutrition transition to shift food systems that support the production of and diets containing unhealthy foods (high in saturated fats, sugars, salts, and low in fibre) to food systems that incentivise the production and consumption of healthy, nutrient rich foods, containing a variety of fruit, vegetables, legumes (e.g., lentils and beans), nuts and whole grains (e.g., unprocessed maize, millet, oats, wheat, and brown rice), tap or potable water and breast milk for infants. A basket of policies that support this sustainable nutrition transition, such as fiscal incentives (taxation of unhealthy foods or agricultural subsidies that support the production of nutrient rich foods), food based dietary guidance, procurement policy and/or marketing restrictions for unhealthy foods, should be a priority for governments to tackle malnutrition in all its forms (hunger, obesity, nutrient deficiencies).
Food businesses need to be doing more
In March 2020 , the charity Access to Nutrition Initiative , published its second report which analysed the disclosure of the UK’s 10 largest supermarket chains on diet, nutrition and health. The report sheds light on the commitments and contributions of the ten largest UK food and drink retailers in regards to promoting healthy food and helping consumers to move away from high fat, salt, sugar products. The report sheds light on the commitments and contributions of the ten largest UK food and drink retailers regarding promoting healthy food and helping consumers to move away from high fat, salt, sugar products. They found that all the retailers are not doing enough. Retailers such as Tesco are coming under increasing fore from investors and shareholders who claim that the UK’s largest supermarket chain is exacerbating the country’s obesity crisis.[vi] These retailers need to make it easy for customers to make healthy and sustainable choices.
Governments need to be doing more
Governments, at local, regional and national level have a crucial role to play in tackling the root causes of both the human and ecological health crisis. They should be using multiple policies to create enabling food environments, ensuring citizens have access to affordable, culturally relevant, and healthy foods where they live. Planning and economic development policies should enable citizens to grow, purchase, prepare, and cook a diverse range of healthy foods, including fresh produce, within any given food environment. A coherent approach is required across planning, zoning schemes, regulations, and by-laws to promote the emergence of healthy food environments. This should include restricting the marketing and sales of ultra-processed foods that are high in calories and with minimal nutritional value.
The Chilean government is a great example of what governments can do to tackle obesity – In 2016, with a focus on tackling childhood obesity, introduced stringent legislation to reduce exposure to marketing of unhealthy foods, prohibited the selling of unhealthy foods in schools/nurseries and encouraged forced the food industry to prominently display black warning logos in the shape of a stop sign on items high in sugar, salt, calories, or saturated fats. Further details on the Chile case study can be found here.
Governments should also be doing more to develop culturally appropriate, sustainable, and health-promoting food-based sustainable dietary guidelines (FBSDGs) and ensure public food procurement standards align with these, promoting safe, healthy, sustainable, and nutritious foods within and around public institutions, including schools and healthcare facilities (hospitals, medical centres, care centres, prisons, social protection programs, etc.). National governments should reflect human, animal, and ecological health within their FBSDGs and with specific recommendations focusing on adequate consumption of fresh fruits, vegetables, wholegrains, legumes, nuts, etc. FBSDGs should discourage the consumption of ultra-processed foods high in unhealthy fat, sugars, and salt/sodium, for example.
The 2020s are often referred to as the ‘decade of action’ which will in turn determine whether we are successful in delivering on the global 17 Sustainable Development Goals. Change is never easy but now is the time for governments and businesses to show real leadership and enact policies and practices which support a sustainable nutrition transition and tackle the root causes behind the obesity and ecological crisis.
[i] 2020 Global Nutrition Report: Action on equity to end malnutrition. Bristol, UK: Development Initiatives.
[ii] UNICEF, WHO, World Bank. 2020. Levels and trends in child malnutrition. https://www.unicef.org/reports/joint-child-malnutrition-estimates-levels-and-trends-child-malnutrition-2020
[iii] Hawkes C, Ruel MT,Salm L, Sinclair B, Branca F. 2019.Double-duty actions: seizing programme and policy opportunities to address malnutrition in all its forms. Lancet. 2019; 395: 142-155
[iv] Development Initiatives.2018. 2018 Global Nutrition Report: Shining a light to spur action on nutrition.
[v] WHO 2018.Noncommunicable diseases https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
This is a great article and will hopefully encourage us all to question what we eat and how it affects our health and the planet. I have recently decided to change my diet and adopt what my grandparents eat in rural Zimbabwe (millet, sorghum, rapoko) instead of white rice and refined wheat and maize. At the moment it’s not easy getting these to the UK. It would be so much easier if these grains were routinely stocked in local supermarkets.