This article is part of our special report Nutrition and Child Survival.
SPECIAL REPORT / Developing nations that are struggling with food supply uncertainty and malnutrition increasingly face a health challenge that is all too well known in Europe: obesity.
The World Health Organization identifies obesity as “one of the most serious public health challenges of the 21st century” and the problem is expected to grow as countries emerge from poverty, although obesity is still overshadowed by headline-making famines and severe malnutrition in developing regions.
The European Commission in March issued a new communication on child and maternal nutrition, outlining plans to target overseas development aid more towards boosting dietary education and the food needs of pregnant women and infants. The document makes no mention of poor nutritional habits that can lead to excess weight and chronic obesity.
“This problem of obesity all over the world obviously is linked to the change in the environment that we are facing today in the Western as well as in the developing countries,” said Dr Gabriele Riccardi, a member of the Barilla Centre for Food and Nutrition advisory board and medical professor at the University of Naples.
“The availability of food which is cheap and is not nourishing, that’s the main problem,” Riccardi said in a telephone interview, identifying food companies as a culprit for selling cheap, prepared foods that are high in calories but low in vitamins, fibre and minerals.
Demographic trends show that children and adults in developing countries are already following the western model of sedentary urban lifestyles and diets of fatty, prepared foods and snacks.
“What is happening is that in the developing countries, we are going to track the same route that we have faced in our countries in the Western world. You are moving from a condition of undernutrition to a condition of malnutrition and obesity,” Riccardi said.
The fight against hunger was one of eight priorities set out in the United Nations Millennium Development Goals (MDGs), which call for halving world hunger by 2015.
Despite the greater emphasis the MDGs put on fighting poverty, 868 million people are poorly nourished today, most of them in sub-Saharan Africa and South Asia, and the figures have been on the rise since the millennium began. Globally, more than 1.5 billion people are obese or overweight, according to new report by the Barilla Centre.
Some development advocates have called for nutrition to be included in the successor to the MDGs, which expire in 2015. Discussions are now under way to develop new goals.
Jan Vandemoortele, a former UN official who helped draft the MDGs in 2001, said recent proposals from the European Commission and independent panel of experts risked “overload” and recommended the post-2015 framework should be simple and focus on a few global challenges, not just those of the developing world. He recommended that nutrition be one of those global goals.
“When we talk about nutrition, we should not rely only on talk about hunger and the underweight, but about obesity and overweight,” he told a 9 April conference on development policy organised by the European Commission.
There are also growing international calls to reverse the shrinking investment in developing country’s farms to address both food supply needs and production of more locally grown, healthful foods.
Commission focuses on nutrition
The Commission’s new nutrition communication proposes a more robust emphasis on the long-term nutritional needs of pregnant women and infants. Released on 9 April, it came a year after European auditors criticised the EU’s response to food insecurity and lack of support for the nutritional needs of developing nations.
The communication recommends working with governments receiving food aid to increase spending on nutrition and dietary education.
Health experts say the first 1,000 days of a child’s life are critical in setting good eating practices throughout life. Inadequate vitamin and mineral intake in infancy can cause wasting, stunting and other serious long-term health problems.
Data show that for every overweight child in developing countries, there are nearly two who are wasted and at least five who are stunted. Wasting is the gradual erosion of the body and its functions due to severe malnutrition, while stunting is a condition of slow physical growth.
“Stunting can kill opportunities in life for a child and kill opportunities for development of a nation,” Anthony Lake, director of the UN children’s agency Unicef, said in a releasing a new global nutrition report. “Our evidence of the progress that is being achieved shows that now is the time to accelerate it.”
Some 165 million children under the age of five suffer from stunting, according to the global Scaling Up Nutrition initiative backed by the EU. Unicef figures show that an estimated 80% of the children live in just 14 developing countries.
Rising levels of obesity
While these health conditions are mostly the province of poor nations in sub-Saharan Africa and Asia, obesity is catching up. WHO estimates there are 42 million children under the age of five who are obese, 35 million living in developing countries.
Four sub-Saharan African countries are near the top in global rankings with highest percentages of obese and overweight children. Four of the top five countries with the highest numbers of severe malnutrition are also in sub-Saharan Africa.
Overweight children invite future health problems, including higher rates of cardiovascular disease, diabetes and high blood pressure, the Barilla study shows. Overweight children tend to be more lethargic and extra weight can hamper worker productivity in adult life.
The Barilla Centre’s report, “Eating in 2030: Trends and Perspectives,” challenges policymakers to rethink nutrition, including shifting to agricultural policies that promote healthful and nutritious foods.
Riccardi, meantime, urges Europe to take a closer look at its own health challenges as it works with developing nations.
“We are not able learn from the mistakes we have done in the Western world and to transmit them to these countries,” Riccardi said.
“And so the problem will be how to be able in these countries, once the economic conditions are improving, to have the opportunity to approach in a correct way nutritional problems and give emphasis to fruit and vegetables and whole grain cereals and healthy foods, rather than fast food that people are getting today and probably [will] get more and more in the future.”
World Health Organization figures show that number of obese people has doubled since 1980, while WHO estimates that in 2010, there were 42 million children under the age of five who were overweight, nearly 35 million living in developing countries.
The Barilla Centre for Food and Nutrition in Italy estimates that though there are nearly twice as many obese people as those who are undernourished, 36 million people die from being malnourished each year compared to 29 million who die from diseases linked to being overweight.
Weight definitions are based on WHO body mass index calculations that factor weight and height:
- Less than 18.5: underweight;
- Between 18.5 and less than 25: normal weight;
- Between 25 and less than 30: overweight;
- Equal or greater than 30: obese.
- 14-15 May: Unicef holds its undernutrition conference in Paris
- 20–28 May: Sixty-sixth World Health Assembly
- 8 June: G8 Forum on food and nutrition in Britain
- 13-15 Nov: Food and Agriculture Organisation-World Health Organisation International Conference on Nutrition in Rome
- Barilla Centre for Food and Nutrition: Eating in 2030: Trends and perspectives
- Eurostat: Overweight and obesity statistics for Europe
- European Court of Auditors: Effectiveness of European Union Development Aid for Food Security in Sub-Saharan Africa
- European Commission: Enhancing Maternal and Child Nutrition in External Assistance: an EU Policy Framework