Invest in Nutrition

Eden, a young boy of 3 years old, was just diagnosed with speech delay. This is one more illness that is affecting him. He also suffers from immune deficiency and deafness. All are related to his first year of life when he has faced severe chronic malnutrition. He looks normal, but the consequences are detrimental; this lack of food (hunger), at a critical moment in his early life, will hamper his ability to learn and hinder opportunities later in life.

This disturbing story may be the intolerable reality of children living in India or Ethiopia; but in fact, this story happens next door to us in America. Eden is one among other protagonists of a provoking documentary launched last month – A Place at the Table.

This documentary is thought-provoking mainly because it shows us that obesity and hunger are neighbours, our neighbours. Access to affordable nutritious foods in a world of plenty seems an unacceptable challenge for too many. In fact, this is increasingly the reality for many children living in both the developing and developed world, mainly because hunger and obesity are globally interconnected. We cannot pretend that it is not visible; it is in fact in our backyard. The burden of malnutrition is one major challenge in the context of the post-MDGs if we really want to achieve sustainable human development for every child in the world.

It is true that we have made significant progress over the past 50 years in the sector of population health. Life expectancies for men and women have increased. A greater proportion of deaths are taking place among people older than 70 years. The burdens of HIV and malaria are falling. Far fewer children younger than five years are dying. But this encouraging picture is being challenged by old and new threats. Africa remains the most afflicted continent, where maternal, newborn, and child mortality, along with a broad array of vaccine-preventable and other communicable diseases, are still urgent concerns. Malnutrition and stunting continue to be a long-term damaging stigma for children in Africa and South East Asia, with an estimated 75% of the world’s 165 million stunted children living there.

The link to extreme poverty is incontestable – as children in the poorest communities are more than twice as likely to be stunted, particularly in rural areas where as many as one third of children are affected.

On the other hand, more young and middle-aged adults in low and middle-income countries are suffering from obesity and diet-related non-communicable diseases (diabetes, hypertension, stoke and cardiovascular disease…). These diseases are driven primarily by phenotypic predisposition and high consumption of ultra-processed foods. With increasing urbanization and shifts in diet and lifestyle, the result could be an escalating epidemic of such conditions in many low- and middle-income countries. This would create new economic and social challenges, especially among vulnerable groups.

Fighting stunting is the emerging battle in the context of optimal human development. It is the irreversible impact of not receiving enough nutrient dense foods within the first 1000 days of life, from pregnancy to a child’s second birthday. But stunting is more than a problem of stature; this lack of nutritious food also impacts the overall physical (organ as well as immune cell function) and cognitive development, and determines the susceptibility to obesity and food-related non communicable diseases later in life.

During the first 1000 days, nutritional requirements to support rapid growth and development are very high, and the baby is totally dependent on others for nutrition, care and social interactions. For example, the first year of life is a time of astonishing change during which babies in normal conditions, on average, grow 55% in length, triple their birth weights and increase head circumference by 40%. Between 1 and 2 years age, an average child grows about 12 cm in length and gains about 3.5 kg in weight. During these crucial days as well as during fetal life, the body is putting together the fundamental human machinery (similar to hardware and software for computer). This process is done over a very short period of time and requires specific nutrients like vitamin A, iron, folic acid, zinc but also protein, long-chain polyunsaturated fatty acids and choline. The immune-system and brain-synapse development are particularly vulnerable. As a result, any disturbance of this frantic activity leaves a terrible mark. Smaller than their non-stunted peers, stunted children are more susceptible to sickness. In school, they often fall behind in class. They enter adulthood more likely to become overweight and more prone to non-communicable diseases. When they start work, they often earn less than their non-stunted co-workers. The drama of this situation is the fact that an undernourished mother is more likely to give birth to a stunted child, perpetuating a vicious cycle of high prevalence of premature death (an estimated 60-80% of neonatal deaths occur among low birth weight babies), undernutrition and poverty.

It is imperative to focus on the first 1000 days of a child’s life as the crucial window of opportunity for change. It is during this time that proper nutrition has the greatest impact on a child’s health and potential future wellbeing and opportunities. A recent publication in Lancet has reinforced this idea, and has showed that attaining optimal growth before 24 months of age is desirable; becoming stunted but then gaining weight disproportionately after 24 months is likely to increase the risk of becoming overweight and developing other health problems. UNICEF’s latest publication “Improving Child Nutrition: The achievable imperative for global progress” is closing the loop. It shows that there are proven low cost solutions for reducing stunting and other forms of undernutrition. These simple and proven nutrition activities need to be integrated together. They include improving women’s nutrition, early and exclusive breastfeeding, providing additional vitamins and minerals as well as giving appropriate nutrient dense foods, especially in pregnancy and the first two years of a child’s life.

Investing in children’s and women’s nutrition is not only the right thing to do from a human right point of view; it is also a cost-effective investment. It can increase a country’s gross domestic product (GDP) by at least 2-3% annually. Every US$1 spent on nutrition activities to reduce stunting will have a return on investment of US$30. This integrated nutritional strategy as proposed by UNICEF and other international stakeholders is the locomotive that can accelerate economic growth and pull millions of people out of poverty.

Let’s work all together to be sure that every children around the world has a place at the table. This is our responsibility!

This article was publish in the Ottawa Citizen last week. This is the link:

http://blogs.ottawacitizen.com/2013/04/26/francoise-briet-invest-in-nutrition/

Don’t bring me the food that western people love!

Over the past few months, I was busy writing articles for different magazines and newspapers.

This is one of them: Don’t bring me the food that western people love!

OCIC article

This is part of a series of articles on food in the context of global development.

All the articles are really interesting. It will give you a different perspective on some key issues. But not only this, there is more. 

This is the link:

http://content.yudu.com/A24lyd/iAMVol4/resources/index.htm?referrerUrl=http%3A%2F%2Focic.on.ca%2Fiam

Hope you will enjoy the voyage…  

Focusing on linear growth and relative weight gain during early life – a winner ticket for human capital development and future adult health

We have seen in the previous blog that the children who are suffering from stunting (short stature) may look normal but the consequences of becoming and remaining stunted can be detrimental. In fact, we can observe an increased risk of morbidity and mortality, but also delays in cognitive (ability to think and understand) and physical development, which result in a decreased ability to learn and capacity to work.

In fact, stunted height (and not underweight) is a dreadful marker of multiple deprivations regarding food intake, care and play, clean water, good sanitation and health care. It is an important indicator of child well-being – not only physical growth but also cognitive and socio-emotional development.

These days, not only in the context of post Millennium Development Goals (MDGs) but also because of the importance to focus on sustainable human development, the key questions for nutritionists, pediatricians and policy makers are:

  • What is the optimum age for promotion of growth for enhanced survival and human capital?
  • Will this promotion necessarily lead to an increase in cardio-metabolic disease later in life?  

These aspects have their importance knowing that a lot of feeding programs in developing countries are aimed at older children, at a time where optimal linear growth is already compromise. For example, traditional school feeding programs that increase BMI with little effect on height might be doing more harm than good in terms of future health.

Why?

According to a study published in Lancet last month (see reference below), patterns already observed in the Western world are starting to be seen in low- and middle-income countries: i.e. putting on too much weight in relation to height in middle and late childhood (after 2 years old) can increase the risk for chronic diseases, such as diabetes, in later life.

This scientific analysis that involved five prospective birth cohort studies from Brazil, Guatemala, India, the Philippines, and South Africa showed that it is important to focus on improved nutrition in the first few years of life, i.e. the 1,000 days from the start of a woman’s pregnancy until her child’s 2nd birthday.

Their analysis showed that:

  • Higher birth weight is associated with an adult BMI of greater than 25 kg/m² (mostly lean body mass – muscle, which is good), and a reduced likelihood of short stature and of not completing secondary school,
  • Fast linear growth during the first 2 years of life is associated with increased adult height and amount of schooling,
  • Weight gain earlier in infancy is not associated later with any increased risk of chronic disease. In fact, it is good for the child, good for survival, giving some protection from adult chronic disease and better educational attainment,
  • Faster relative weight gain after the age of 2 years has little benefit for human capital, and weight gain after mid-childhood could lead to large adverse effects on later cardiovascular risk factors like elevated blood pressure. Notably, this is particularly true for weight gain that is not accompanied by height gain,
  • In fact, rapid weight gain should not be promoted after the age of 2–3 years in children who are underweight (weight for age) but not wasted (weight for height)

This study shows the importance to promote nutrition and linear growth during the first 1,000 days of life (from conception to age 2 years), and also reinforces the importance of prevention of rapid relative weight gain after age 2 years.

These findings have implications for present practices in low-income and middle-income countries, particularly emphasizing the need to monitor linear growth as well as weight, and to avoid promotion of excess weight gain in children older than 2 years. Optimum growth patterns in early life are likely to lead to less undernutrition, increased human capital, and reduced risks of obesity and non-communicable diseases, thus addressing both components of the double burden of nutrition.

According to one of the authors, Dr Fall: One of the challenges we are facing is the fact that we need to find ways to get very small children to be taller, and we don’t really know how to do it. More work is needed on imaginative interventions to specifically promote height growth, instead of weight gain. These could include exclusive breast-feeding, long-chain polyunsaturated fatty acids like DHA, high-quality protein, and micronutrients.

Mortality and undernutrition are falling substantially in most parts of the world, except for Sub-Saharan Africa, and new targets are being formulated to replace the present set of 2015 MDGs. A new goal for optimum linear growth that is expressed as a reduction in stunting can replace the present target of a reduction in underweight alone, which is one of the indicators for the first MDGs towards the eradication of extreme poverty. This new target can be associated with the assessment of developmental functioning using a set of indicators based on the Psychomotor Development Index (PDI) and Mental Development Index (MDI) of the Bayley Scales of Infant Development. This integrated approach will help to evaluate appropriately physical as well as cognitive and socio-emotional development, which is so important when building human capital.

 

References:

http://www.medscape.com/viewarticle/781535

Associations of linear growth and relative weight gain during early life with adult health and human capital in countries of low and middle income: findings from five birth cohort studies. Adair LS et al, Lancet 28th March 2013 (http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673613601038.pdf?id=a02f57d1811fcb77:524f7ce2:13db1412973:-60f11364479623359)

 

Save the child …. Give breast milk!*

The World Breastfeeding Week is celebrated every year (August 1st to 7th) in more than 170 countries to encourage breastfeeding and improve the health of babies around the world. It commemorates the Innocenti Declaration made by WHO and UNICEF policy-makers in August 1990 to protect, promote and support breastfeeding (http://www.unicef.org/programme/breastfeeding/innocenti.htm).

As we all know, the first two years of a child’s life are particularly important, as optimal nutrition during this period will lead to reduced morbidity and mortality, to reduced risk of chronic diseases and to overall better development. Indeed, infant and young child feeding is one key area (or the cornerstone) to improve child survival and promote healthy growth and development.

The situation

Malnutrition is responsible, directly or indirectly for about 33% of deaths among children under five. Well above two thirds of these deaths, often associated with inappropriate feeding practices, occur during the first year of life. In fact, despite compelling evidence that exclusive breastfeeding prevents diseases like diarrhea and pneumonia that kill millions of children every year, global rates of breastfeeding have remained relatively stagnant in the developing world, growing from 32% in 1995 to 39% in 2010 (see map below to get an idea of the level of exclusive breastfeeding per country).

In reality, breastfeeding rates in the developing world have been declining until recently. This decline has been attributed to changing socioeconomic factors and the perception that infant formula is superior to breast milk. To give you a concrete example and according to UNICEF Pacific Representative, Dr. Isiye Ndombi: “In the Pacific, breastfeeding rates dropped for a number of reasons, either because mothers were being integrated into the workforce, were not supported by their spouses or were not making informed decisions about the long-term benefits breastfeeding would bring to their children. Exclusive breastfeeding (i.e breastfeeding from birth to six months) are about 40% in Fiji, Tuvalu and Vanuatu, and 31% in the Republic of Marshall Islands.”

“It’s a global trend”, says Elisbeth Sterken, national director of INFACT Canada, a non-profit agency concerned with issues around breastfeeding (http://www.infactcanada.ca/). The impact of bottle-feeding infants is different culture to culture but the long-term impact would be the same – a high incidence of obesity and metabolic diseases. Why?

For example, “in Western cultures, bottle-fed babies begin life with nutritional deficiencies that may lead to health and obesity issues later in life”, she said.

In fact, it was a real surprise to read in a book entitled “Let them eat junk” that baby formula can contain 60% more sugars than regular milk. In fact, a bottle-fed baby consumes 30,000 more calories over its first eight months than a breast-fed one. That’s the calories equivalent of 120 average chocolate bars. Given how early our tastes are formed, it is not surprising that “several research studies have shown correlations between bottle-feeding and subsequent obesity. And the problem continues in baby foods, against efforts to limits the high level of added sugars.

Is it possible to advocate for an improvement of the nutritious value of baby formula and change the current trend?

The task seems tricky. Lobbying power from food companies is huge! The battle is unequal, something similar to the idea developed by Jean de la Fontaine in one of his poems. What union can there be between a clay pot and an iron pot? Because when they collide against each other, the clay pot will be broken.

Just one example to demonstrate this unequal battle: the Thai introduced a proposal to reduce the levels of sugars in baby foods from the existing maximum of 30% to 10%, as part of the global fight against obesity. The proposal was blocked by the US and the EU, where the world’s largest sugar corporations have their home offices. This is one among other examples of the lobbying power of the sugar companies.

And what happens in the developing countries?

In developing countries the impact is more dramatic”, Sterken said. An estimated 1.5 million formula-fed babies die each year because families in developing countries can’t afford the formula and dilute it, use contaminated water to mix it, can’t properly sterilize bottles, or supplement with sugared tea, thereby depriving their children of nutrition, and introducing deadly bacteria into their food.

Another important problem is related to the high level of urbanization in sub-Saharan Africa.

Slums in sub-Saharan Africa are expanding at a fast rate, and the majority of urban residents now live in slum settlements. And in fact, urban poor settlements or slums present unique challenges with regards to child health and survival.  The slums are characterized by poor environmental sanitation and livelihood conditions. Contrary to the long-held belief that urban residents are advantaged with regards to health outcomes, urban slum dwellers tend to have very poor health indicators. Then it is not a surprise to observe thaturban mothers are less likely than rural ones to breastfeed -and more likely to wean their children early if they do begin. Low rates of breastfeeding may be attributed in part to cultural practices, access to and utilization of health care facilities, a lack of knowledge about the importance of the practice, but more importantly to the reality that poor women in urban settings who work outside the home are often unable to breastfeed.

This is an important point, how can we help women who work in developing countries to act sppropriately?  It is a necessity for them to be able to breastfeed because it is good for their babies but they also need to economically survive. A dilema!

Does malnutrition affect the quality of mother’s milk?

The 2008 Lancet Nutrition Series highlighted the remarkable fact that a non-breastfed child is 14 times more likely to die in the first six months than an exclusively breastfed child. Breast milk meets a baby’s complete nutritional requirements and is one of the best values among investments in child survival as the primary cost is the mother’s nutrition. In this context and knowing the high incidence of food insecurity in the developing countries, it seems important to ask if malnutrition (or poor nutrition) can affect the quality of mother’s milk and compromise the potential benefit of breastfeeding where it is most needed, i.e. the developing countries.

In fact, a review of the literature showed that mild or moderate malnutrition rarely affects the amount or quality of breast milk that a woman produces. The mother’s dietary intake will not generally increase how much breast milk she can produce in a day. Her nutritional status before and during pregnancy are important for milk content, but generally this has only of marginal impact since her body will ensure that the breast milk receives the available vitamins and minerals. If her diet remains inadequate for a long time, the milk may contain fewer vitamins and fats as her own body stores are used up. However, her breast milk continues to be nourishing for her child, and provides anti-infective factors that help to protect the child against infections. No breast milk substitute contains these protective factors.

The response at the micro and macro levels

It’s hard to believe that something as natural, healthy and cost-free as breastfeeding needs to be promoted by health and nutrition specialists. But as World Breastfeeding Week began on Aug. 1, breastfeeding specialists want to draw attention to the many benefits of breastfeeding to mother and baby and curb the trend toward bottle-feeding infants with commercially prepared formula.

In 2002, the WHO and UNICEF have developed a Global Strategy for Infant and Young Child Feeding (http://www.who.int/nutrition/publications/infantfeeding/9241562218/en/), which recommends that infants start breastfeeding within one hour of life, are exclusively breastfed for six months, with timely introduction of adequate, safe and properly fed complementary foods while continuing breastfeeding for up to two years of age or beyond.

Moreover, the WHO and the United Nations Children’s Fund jointly developed a code for marketing infant formula to curb aggressive marketing campaigns, especially in developing countries (http://www.who.int/nutrition/publications/code_english.pdf). However, its impact over the past 30 years has been limited because of a series of alleged violations and boycotts.

What do we need to do to reinforce exclusive breastfeeding globally?

An international governance is needed to step in and replace the voluntary marketing code. It will help to address and correct unethical marketing that could be put in place by makers of breastmilk substitutes.

It is also necessary to develop national policies that support maternity leave, not only in developed, but also in developing countries.

And finally, it is important to work at the community level. One of the strategies could be to train low-income mothers as breastfeeding counselors and assist communities in forming mother-to-mother support groups (something similar to Saving Help Group). This strategy will increase the understanding of the risks of not breastfeeding and finally, it will reinforce the practice of exclusive breastfeeding among mothers.

In fact, if the exclusive breastfeeding rate was increased significantly, as much as 13% of all deaths of children younger than 5 years could be prevented that could represent around 1 million children under five in the developing world each year. Moreover, the promotion of breastfeeding could avert 21.9 million disability adjusted life years (8.6%).

What do we mean by exclusive breastfeeding?

“Exclusive breastfeeding” is defined as giving no other food or drink – not even water – except breast milk. It does, however, allow the infant to receive oral rehydration salts (ORS), drops and syrups (vitamins, minerals and medicines). Breast milk is the ideal food for the healthy growth and development of infants; and it’s also an integral part of the reproductive process with important implications for the health of mothers.

Then, what are the benefits? Just a recap….

Exclusive breastfeeding for six months has many benefits for the infant and the mother, says the WHO. “Chief among these is protection against gastro-intestinal infections which is observed not only in developing but also in industrialized countries. Early initiation of breastfeeding, within one hour of birth, protects the newborn from acquiring infections and reduces newborn mortality. Finally, the risk of mortality due to diarrhea and other infections can increase in infants who are either partially breastfed or not breastfed at all.”

Breast milk is also an important source of energy and nutrients in children 6 to 23 months of age. It can provide one half or more of a child’s energy needs between 6 and 12 months of age, and one third of energy needs between 12 and 24 months. Breast milk is also a critical source of energy and nutrients during illness and reduces mortality among children who are malnourished.

Adults who were breastfed as babies often have lower blood pressure and lower cholesterol, as well as lower rates of overweight, obesity and type-2 diabetes.

Breastfeeding also contributes to the health and well-being of mothers. It reduces the risk of ovarian and breast cancer and helps space pregnancies — exclusive breastfeeding of babies under six months has a hormonal effect which often induces a lack of menstruation. This is a natural (though not fail-safe) method of birth control known as the Lactation Amenorrhea Method.

Moreover and from a sustainable point of view, exclusive breastfeeding contributes both directly and indirectly to sustainable development. Evidence has clearly shown that exclusive breastfeeding for the first six months of a baby’s life not only improves their future growth and educational achievement, but also significantly reduces national health costs and helps prevent chronic malnutrition. Breastfeeding helps to prevent a number of diseases in childhood and later in life. It offers protection from infections, allergies and adult-life chronic conditions like hypertension, diabetes, obesity, cardiovascular diseases and cancer that rob the national budgets of millions of dollars.

Breastfeeding needs to be valued as a benefit which is not only good for babies, mothers, and families, but also as a saving for governments in the long run.

* The theme for this year’s celebration is “Understanding the past, planning the future: Celebrating 10 years of WHO/UNICEF’s Global strategy for Infant and Young Child Feeding”. It has the slogan “Save the Child, Give breast milk”.

Resources:

http://allafrica.com/stories/201208060231.html http://allafrica.com/stories/201207051232.html

http://www.scoop.co.nz/stories/GE1208/S00003/make-breastfeeding-easier-for-mothers-says-unicef.htm

http://www.guelphmercury.com/news/local/article/771868–world-breastfeeding-week-aims-to-promote-benefits-curb-bottle-trends

http://www.unicef.org/nutrition/index_emergencies.html http://helid.digicollection.org/en/d/Js8230e/1.3.1.html

http://www.biomedcentral.com/1471-2458/11/396/

http://www.nbcchicago.com/investigations/series/target-5/target-5-sugar-baby-formula-139339308.html

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812877/

http://www.nutraingredients.com/Industry/Infant-formula-marketing-code-has-failed-says-expert

Book: Let them eat junk, how capitalism creates hunger and obesity – Robert Albritton

Hunger and Obesity Are Food Security Issues ….

…. Or we can also define them as the visible outcomes of the failure of our global Food Security System…

The U.N. says nearly a billion people go to bed hungry every night. At the same time, hundreds of millions of others are obese. To solve those twin crises, we will need to know who is wielding the power over food and marketing.

Raj Patel (http://rajpatel.org/), author of Stuffed and Starved: The Hidden Battle for the World Food System (http://rajpatel.org/2009/10/27/stuffed-and-starved/) says hunger and obesity are not just a matter of eating too little or too much. It has to do with what people are eating and the systems and institutions driving consumption.
To summarize his analysis and to add some of our thoughts:

There’s growing investment in agriculture around the world to feed an expected population of 9 billion by 2050. But as emerging economies grow in Africa and Asia, consumers in those regions are switching to a more Western diet. It’s a diet many blame for obesity, as well as diabetes and cardiovascular disease. However, many others say that people have a choice as to what to eat. They don’t have to buy foods rich in fat, salt and sugar.

And are we really having the choice?

Patel said that’s no.

“When you look at the amount of money that is spent promoting food, the ratio of good food to junk food marketing is about 1 to 500. In other words, for every dollar that’s spent promoting fresh fruits and vegetables 500 is spent promoting junk food,” he said.

And this discrepancy means so much to us with the London Olympic Games that is approaching. All the big food companies are partners of this major event…. Sport is associated with junk food and not with healthy food or healthy eating behaviors.

Again for this Olympic Games, we won’t see an encouragement for healthy nutrition and how this combination – sport and good nutrition – can have a dramatic impact on health. So important for the future of children… Unbelievable!

The battle seems to be lost in advance…

Just a handful of corporations control much of the global food market. It raises the question of what’s considered normal eating?
It is true. “You have kids growing up who think it is normal to be drinking 32 ounces of soda, basically sugar and empty calories. Children who are disconnected from where their food comes from and who are being raised in some very unhealthy eating habits.” Patel said.

Evidence can clearly be found in the United States as well as in some emerging countries like Mexico, India and South Africa.

For example:

• “One in three children who were born in the year 2000 will develop type 2 diabetes. And if we’re talking about children of people of color then that’s near a one in two children will develop type 2 diabetes,”

• “India is a country that’s suffering [from] an epidemic of hunger at the same time as an epidemic of the kinds of disease that used to only happen in rich economies”.

And this is an interesting question …… what can we consider as normal eating?

Is it the same everywhere in the world or do we have major differences based on food tradition, culinary culture as well as genetic background? Can we have a universal approach to this concept?

And finally, if we take the example of Canada, country where CKi is located – what is the legitimacy of having one unique food guidance policy in a country where there are so much different ethnic groups? Recent studies have shown a dramatic level of metabolic diseases in the new immigrant population in Canada. These are some of the questions we ask and we try to answer.

In fact, modern diets are often very different from what our ancestors ate and a lot of people around the world are currently eating. Diversity in food, respect of the tradition around food as well as the culinary culture are keen and we need to value them.

There is hope for better nutrition.

“There’s an amazing kind of rebirth of the food movement in the United States and around the world of people who are excited to be reconnecting with growing their own food, with eating locally and sustainably and organically. And that’s a fight that’s well worth talking about as well, because it’s a way of reducing some of the problems associated with diabetes – the diseases of the modern food system,” he said.

Personally, I was amazed to find a local organization in Port-au-Prince – Buy Local Haiti (Kore Pwodiksyon Lokal – http://www.youtube.com/watch?v=npvx4F9JZyo) that advocates for good food and educates people to eat well based on their culture and tradition and this, despite the socio-economic difficulties in Haiti.

I met these people and I learnt a lot about the importance of the food movement, dignity and human rights, more importantly in countries like Haiti overwhelmed by American rice. In fact before 1970s, Haitian people ate rice only one time/week (mostly on Sunday); nowadays and as a result of the cheap American rice availability, it became the unique daily dish.

Buy Local Haiti has made a video showing a weekly menu based on Haitian culture and tradition. This weekly menu contains only one-time meal with rice. This was a great success on the Haitian TV….. People had water in their mouth!  It reminded them their childhood. They saw that it is possible to eat differently.

Consumers and communities around the world are realizing they have a health and economic crisis on their hands linked to diet. Patel says they’re taking action by defining their own food and agriculture policies. Haiti is also part of this movement! There is hope for a better future….

Source: http://www.voanews.com/content/decapua-food-power-27jun12/1253203.html

To read more about Raj Patel: http://www.theglobeandmail.com/news/world/who-says-raj-patel-is-the-messiah/article566168/

http://www.guardian.co.uk/books/2007/sep/15/healthmindandbody.health

Developing World Are Rapidly Consuming More Unhealthy Food

Big Food is making a big headway in the developing world, highlighting the need for researchers and policymakers to examine how the food and beverage industry markets unhealthy products implicated in chronic conditions like diabetes and heart disease.

In an interesting article, David Stuckler and al (Manufacturing Epidemics: The Role of Global Producers in Increased Consumption of Unhealthy Commodities Including Processed Foods, Alcohol, and Tobacco, June 2012; PLOS medicine – http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001235) from the University of Cambridge examined market data on processed food and soft drink sales for up to 80 countries between 1997 and 2010.

These are the key points as highlighted:

• The rate of increase in consumption of “unhealthy commodities” (soft drinks and processed foods that are high in salt, fat, and sugar, as well as tobacco and alcohol) is fastest in low- and middle-income countries (LMICs), with little or no further growth expected in high-income countries (HICs).

• The pace at which consumption is rising in LMICs is even faster than has occurred historically in HICs.

As a result, the developing world is also set to match the First World’s unhealthy commodity consumption rates within three decades.

•  Multinational companies like PepsiCo, Netsle and Danone have now achieved a level of penetration of food markets in middle-income countries similar to what they have achieved in HICs.

• Higher intake of unhealthy foods correlates strongly with higher tobacco and alcohol sales, suggesting a set of common tactics by industries producing unhealthy commodities.

• Contrary to findings from studies undertaken several decades ago, urbanization no longer seems to be a strong risk factor for greater consumption of risky commodities at the population level, with the exception of soft drinks.

• Rising income has been strongly associated with higher consumption of unhealthy commodities within countries and over time, but mainly when there are high foreign direct investment and free-trade agreements. Economic growth does not inevitably lead to higher unhealthy-commodity consumption.

o A free-trade agreement with the U.S. is associated with about a 63.4% higher level of soft drink consumption per capita for low- and middle-income countries.


o For example, Mexico experienced a rapid rise in soft drink consumption after the 1994 North American Free Trade Agreement dramatically reduced barriers for trade with the United States. As a result, the % of the Mexican population aged 15 and above who is overweighed or obese is superior to 69% (http://www.oecd-ilibrary.org/sites/factbook-2011-en/12/02/03/index.html?contentType=&itemId=/content/chapter/factbook-2011-109-en&containerItemId=/content/serial/18147364&accessItemIds=&mimeType=text/html).


o In contrast, Venezuela – which does not have a similar trade agreement with the U.S. – has maintained steady soft drink consumption rates despite high levels of economic growth.

Unfortunately, all the people in this world are not treated in the same way!

While many companies have pledged to eliminate trans fats and reduce salt, sugar and fat in foods sold in wealthy countries, these nutritional improvements are often not implemented in poorer markets.

There is a need to identify population-level social, economic and political interventions that could stem the rise of unhealthy commodity consumption, and overcome the political barriers to their implementation, as has been done for tobacco control.

It is also imperative to associate these strategies to the current initiative on food security and nutrition that was proposed during the latest G8. A focus on sustainable farming is currently a hot spot but this battle can’t have a real impact in the long term if people see “junk food” like sexy (the food that people living in developed countries love – see one of our previous blog on the same topic) or as the only affordable choice.

Their results and analysis were is part of the journal’s “Big Food” series, which is examining the influence of the food and beverage industry on public health (http://www.ploscollections.org/article/browseIssue.action?issue=info:doi/10.1371/issue.pcol.v07.i17).

Source: http://www.ibtimes.com/articles/356675/20120626/soda-big-food-developing-world-processed-nafta.htm

The Global Food Security Index – A needed tool that integrates nutrition as a key parameter

According to the UNs, the world will need at least 50% more food to feed a growing population by 2030, (expected to swell from 7 billion to 9 billion people by 2050). Another important deadline is the millennium development goal – to halve the proportion of people who suffer from hunger between 1990 and 2015. Unfortunately, the progresses for this specific goal are so far really disappointed.

In this context, global food security is more and more a top concern of many governments as illustrated by the recent G8 and G20 summits. The New Alliance for Food Security and Nutrition, announced at the Camp David G8 Summit in May, highlights the shared commitment among G8 and African leaders, private business and non-governmental organizations to achieve global food security.

Consequently, a food security index is becoming increasingly important given the growing world population and the potential limits on our ability to provide food in coming years. So any additional and long-term measures than can give an overall picture of food security are seemingly useful.

Why improving food security (and indirectly nutrition) so important?

The truth is that food security is a prerequisite to economic growth and job creation. You cannot educate a hungry child, and you cannot hope for productive employment if citizens are going without food. Moreover, according to the latest analyses that focused on child and maternal health, there is a critical window of opportunity for improving child nutrition; it goes from pregnancy through the first 24 months of life. The deficits acquired by this age are difficult to reverse later and can affect dramatically the possibility for each child to achieve his or her full potential.

As claimed by the World Bank a few years ago, it is time to reposition nutrition as central to development and part of an global food security strategy (http://siteresources.worldbank.org/NUTRITION/Resources/281846-1131636806329/NutritionStrategy.pdf).

Who takes the lead on this new set of indicators?

DuPont, a developer of genetically altered crops, commissioned the Global Food Security Index to measure hunger worldwide, and identify areas for improvement and where reforms are most urgently needed. This new index was launched by the Economist Intelligence Unit, an advisory and forecasting research firm (http://www.multivu.com/players/English/56895-eiu-global-food-security-index-dupont/) a few days ago.

As highlighted by DuPont in their press released: “We share a common goal of food security; we do not share a common language. To truly address the root cause of hunger, we must have a common path forward to tackle such pressing issues as food affordability, availability, nutritional quality and safety. Literally billions are being invested to address food security, but until today, we had no comprehensive, global way to measure food security and the impact of investments and collaborations at the local level.”

Accordingly, the Global Food Security Index addresses the underlying factors of food insecurity in 105 countries and points to areas for improvement and reforms. We hope that the Global Food Security Index will be used appropriately to promote collaboration, make better informed decisions and stimulate action necessary to feed our growing population and impact positively the growing epidemic of malnutrition, i.e hunger and obesity.

What does this new index measure?

The Global Food Security Index measures levels of food security by answering a central question: “How can consumers in each country easily access sufficient amounts of safe, high-quality and affordable food?” said Leo Abruzzese, Economist Intelligence Unit Global Forecasting Director.

This new index seems to a comprehensive tool that will help to move from rhetoric to results. It is based on 25 global indicators that measure specific aspects of food affordability, accessibility, availability, nutritional value and safety. Because food security is a politically sensitive issue, the project tries to keep these indices are independent, credible and transparent that it is possible.

What we find really important is the fact that this index uses a multidisciplinary approach and measures at different levels (micro to macro) affordability, availability as well as quality and safety (see above).  Another aspect that we really like it is the big emphasis on the quality of the diet consumes by people in the different countries. Some aspects that resonate positively to us are diet diversification, micronutrient availability and not the last, protein quality (see below the result for Ghana).

This panel of indexes will not only measure affordability and availability but it will position nutrition as a vibrant and essential component of the overall food security strategy.    

Go and explore the Global Food Security Index website at http://foodsecurityindex.eiu.com/, it is part of the public domain.

You will be amazed by the large range of graphical representations that presents the data generated for the 105 countries. It is user friendly and you will be able to create your own representation using the Food Security Index data tool (see below).

When you click on a circle that represents one country, you get of course the name of the country but also some key information on food security for this country.    In the example above, the overall score for this new index is represented in function of the overall food consumption as a share of the household expenditure. France is in orange, the other European countries are in purple and the rest of the world in Grey.

What we see? France has one of the higher overall score and food consumption represented more than 20% of the household expenditure (which is significantly superior to USA that got the highest overall score). We all know that food or “le bien manger” is really important in France.  We also can see that there is a big difference among the European countries, that includes also East Europe and Central Asia countries.

What are the first results?

• The results show that the U.S., Denmark, Norway, France and the Netherlands are the most food-secure countries in the world. • The five most impoverished nations at the bottom of the Index, indicating they are have extensive food security problems, are Madagascar, Haiti, Burundi, Chad, and Congo.

• The good news is that several of the countries at the very bottom of the index, notably Mozambique, Ethiopia, Rwanda and Nigeria, are also ones with strong economic growth, suggesting that their food situation may improve as living standards rise and as sound policies are hopefully put in place.

• The index also indicated that China experienced the least volatility of agricultural production during the last 20 years (explained by generous subsidies that create a floor for food commodity prices), while the North African countries of Morocco, Tunisia and Algeria had some of the most variance.

• The landlocked countries show only a modest increase in food insecurity, on average seven points lower on a scale to 100.

• Residents of wealthy nations have 55% more food available than people in poorer countries:  3,400 calories a person per day compared with the daily intake of 2,300 calories recommended by the United Nations to live a healthy and active life.

• People in the United States and other advanced nations consume an average of 1,200 calories per day more than those in low-income countries, but even in these wealthy nations food supplies lack enough micro-nutrients. In fact, an abundant food supply doesn’t guarantee that a nation will have the healthiest or safest diet. This is an interesting result – quantity doesn’t mean quality at all!

• Another interesting result is a strong correlation between women’s economic opportunity and access to affordable, safe food. The Global Food Security Index shows a hefty 0.93 correlation with the EIU’s Women’s Economic Opportunity Index, which measures female economic participation. “The FAO estimates that if women had access to the same productive resources as men—better seeds, fertilizers and fungicides—they could increase their yield by 20% to 30%. As women make up 43% of the world’s farmers, this would increase total agricultural output in developing countries by 2.5% to 4%, and reduce hunger globally by 12% to 17%, according to the FAO.”

• Interestingly, the correlation between food security and EIU’s Democracy Index was only 0.77, a much weaker link than with women’s labor equality. This result may suggest that what happens in the political sphere is a bit less important than what happens on the social sphere, in terms of food and nutrition security.

Great job! They validate some important evidences.

Stay in contact with us …..

Resources:

http://www.marketwatch.com/story/dupont-calls-for-common-food-security-metrics-2012-07-10

http://www.reuters.com/article/2012/07/10/us-food-report-idUSBRE8690KR20120710

http://www.guardian.co.uk/news/datablog/2012/jul/10/food-security-index#data

http://www.businessweek.com/news/2012-07-10/nations-with-most-food-may-lack-best-diets-study-finds

http://www.economist.com/blogs/graphicdetail/2012/07/global-food-security