Other Diseases

Different types of malnutrition can coexist within a country, a household or even an individual. Malnourished women are more likely to give birth to smaller babies, who start life with a higher risk of physical and cognitive impairment. In fact, it is said:

 

Malnutrition causes lost productivity and higher direct health care costs, which could account for as much as 5 percent of global income. That is equivalent to US$3.5 trillion per year or US$500 per person. Wiping out malnutrition worldwide is a daunting challenge, but the return on investment would be high. If the global community invested US$1.2 billion per year for five years on reducing micronutrient deficiencies, for example, the results would be better health, fewer child deaths and increased future earnings. It would generate annual gains worth US$15.3 billion – a benefit-to-cost ratio of almost 13 to 1.

 

The immediate causes of malnutrition are complex. They include:

 

The food can be accessed through a system of handling, an environment, people, institutions and processes by which agricultural products are produced, processed and brought to consumers. Every aspect of the food system has an effect on the final availability and accessibility of diverse, nutritious foods – and therefore on consumers’ ability to choose healthy diets.

 

Of course, there are other factors, too, such as household income, prices, and consumer knowledge, for example. What is more, policies and interventions on food systems are rarely designed with nutrition as their primary objective. Even when they are, impacts are difficult to attribute and researchers sometimes conclude that food system interventions are ineffective in reducing malnutrition. In contrast, the effectiveness of medical actions – such as giving vitamin supplements which address specific nutrient deficiencies – is more easily observed. But medical interventions cannot substitute in the long term for the broader nutritional benefits offered by healthy and balanced diets from a well-functioning food system.

 

All over the world, the first recommendation of nutritionists is “eat a variety of foods”. This simple slogan represents one of the key principles for ensuring dietary quality. Quantity – the amount of food and its energy content – is still important. Dietary energy needs to be enough, but not too much, and must be balanced by activity level. A diverse diet containing balanced amounts and combinations of fresh fruits and vegetables, cereals, fats and oils, legumes, and animal-source foods, is likely to provide the full range of nutrients needed by most people to lead healthy and active lives.

 

Agriculture depends heavily on natural resources. It can cause environmental harm, but it can also provide environmental benefits. Agriculture is a dominant force behind many environmental threats, including climate change, land scarcity and degradation, freshwater scarcity, biodiversity loss, degradation of forest and fishery resources, and contamination from agricultural chemicals. The crop and livestock sectors use 70 percent of freshwater resources and, together with forestry, occupy 60 percent of the Earth’s land surface. Livestock alone uses 80 percent of global crop and pasture area. Oceans cover 70 percent of the planet’s surface and sustain fisheries and aquaculture, given that aquaculture uses a growing share of land and freshwater. Approximately 60 percent of the world’s ecosystems are degraded or used unsustainably, which poses serious threats to food security and nutrition.

 

SUSTAINABLE FOOD SYSTEMS

By definition, sustainable food systems produce nutritious diets for all people today while also protecting the capacity of future generations to feed themselves.

 

Sustainable food systems use resources efficiently at every stage along the way from farm to fork. Getting the most food from every drop of water, plot of land, speck of fertilizer and minute of labor, saves resources for the future and makes systems more sustainable. Turning waste products like manure and food scraps into valuable fertilizer or energy can improve sustainability. Pests and diseases damage crops and animals, and reduce the quantity and quality of food available for humans. Using safe and effective methods to control these losses in production, processing and storage help making food systems more sustainable. Consumers can do their part by choosing balanced diets and minimizing food waste.

 

Agriculture is a dominant force behind many environmental threats, including climate change, land scarcity and degradation, freshwater scarcity, biodiversity loss, degradation of forest and fishery resources, and contamination from agricultural chemicals. The crop and livestock sectors use 70 percent of freshwater resources and, together with forestry, occupy 60 percent of the Earth’s land surface. Livestock alone uses 80 percent of global crop and pasture area. Oceans cover 70 percent of the planet’s surface and sustain fisheries and aquaculture, given that aquaculture uses a growing share of land and freshwater. Approximately 60 percent of the world’s ecosystems are degraded or used unsustainably, which poses serious threats to food security and nutrition.

 

The root causes of malnutrition are even more complex and encompass the broader economic, social, political, cultural and physical environment. Addressing malnutrition, therefore, requires integrated actions and complementary interventions in the field of agriculture and the food system, in natural resource management, in public health and education, and in broader policy domains. Because the necessary actions typically involve several government institutions, high-level political support is needed to motivate a coordinated effort.

 

Higher productivity in agriculture contributes to better nutrition by raising incomes – especially in countries where agriculture accounts for a large share of the economy and employment – and by reducing the cost of food for all consumers. It is important to realize, though, that the impact of agricultural growth is slow and may not be enough to bring about a rapid reduction in malnutrition. Steady increases in agricultural productivity will continue to be crucial in the coming decades. Production of basic staple foods will need to increase by 60 percent to meet the expected growth in demand. But healthy diets are more than staple foods. They are diverse, containing a balanced and adequate combination of energy and nutrients.

 

For these reasons, the priorities in the field of agricultural research and development must become more nutrition-sensitive, with a stronger focus on nutrient-dense foods such as fruits, vegetables, legumes and animal-source foods. Greater efforts must be directed towards interventions that diversify what small-scale farmers produce – with integrated farming systems, for example. Another promising area of work involves raising the micronutrient content of staple foods – either through “Biofortification”, or by encouraging the use of varieties with higher nutrient content, or by taking a second look at underutilized, nutrient-rich staple crop species. Interventions involving agriculture are generally more effective when combined with nutrition education and implemented with sensitivity to the different gender roles.

 

Making systems more nutrition-enhancing so that food is available, accessible, diverse and nutritious is a key, but so is the need to help consumers make healthy dietary choices. Promoting behavior change through nutrition education and information campaigns – while also addressing household sanitation and ensuring appropriate foods for all ages and life stages, has proved effective. Even in locations where nutrition and micronutrient deficiencies persist as the primary problems, it is important to also act to prevent a rise in overweight and obesity, especially in the long run. Behavior change can also reduce waste and contribute to the sustainable use of resources.

 

The “International Conference on Nutrition 2” will take place in Rome from 19 to 21 November 2014. The Conference will review progress made since the previous nutrition conference in 1992, and tackle the challenges and opportunities for improving nutrition in a new global environment. The Conference will explore how governments and others can better work together to address the multiple burdens of malnutrition, and offer a forum for sharing practical tools, guidelines and experiences in improving nutritional outcomes. Organized by FAO and WHO, this high-level ministerial conference will seek to propose a flexible policy framework to meet the major nutrition challenges of the next decades.