Healthy Diets and our Food environment? United Nations System Standing Committee on Nutrition, 10 June 2016, FAO © FAO: http://www.fao.org

1. Healthy Diets and our Food environment?
A presentation at the SCN
10 June 2016 (FAO, Rome, Italy)
Anna Lartey, PhD
Director of Nutrition,
FAO, Rome

2. • 63 countries have
reached the hunger
target of MDG-1.
• 25 countries have
achieved the more
stringent WFS target.
(FAO,WFP,IFAD-SOFI 2015)

3. Undernutrition declining,
but not fast enough
Source: UNICEF, WHO, World Bank.
Joint Child Malnutrition Estimates. 2012

4. Overweight, obesity rising rapidly
Source: FAO, SOFA, 2013

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) .

7. Our Diet:

8. FEB. 23, 2015
Health
Food Habits Getting Worse
Around the World

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

10. September 2015
THE GUARDIAN

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.”

17. What is a Healthy Diet?

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

28. THROUGH AGRICULTURAL POLICIES:
INCREASING AVAILABILITY AND AFFORDABILITY OF NUTRITIOUS, HIGH
QUALITY FOOD

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

30. Countries with official FBDGs in FAO’s
site
30

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