There are worrying trends in the patterns of diet that are increasingly lifestyle-related, and of non-communicable diseases such as heart disease, obesity and diabetes in developing countries.
Where the number of people suffering undernourishment is declining, there are increasing concerns that those in low-income countries are consuming diets high in sugar and fat — shifting health problems from those of malnutrition to obesity through overconsumption of a cheap Western diet.
The International Diabetes Foundation already estimates that four out of five women with diabetes now live in developing countries. Apart from the impact of poor health on the individuals involved, the treatment costs are escalating across the globe. In the Pacific region alone, it is estimated that around 75 percent of all deaths are a result of NCDs, the region’s health ministers concluded earlier this month.
Restricted access and options
The causes of these health issue changes include increasing urbanization, sedentary lifestyles and the availability of cheap processed foods.
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Many communities are not in a position to grow their own food as a result of restricted access to cultivable land or negative climatic conditions. The majority of communities have shifted away from subsistence to cash-based economies and have abandoned traditional diets of tubers, roots and pulses for purchased foodstuffs that are often processed with a high proportion of fat, sugar and salt.
The options available for adopting a healthy diet are therefore restricted. There is also a financial constraint, whereby the healthier options are often more expensive — further curtailing the availability of a healthy diet for lower-income households.
Income distribution has long been an indicator of “development” but in relation to nutrition we are now seeing problems arising at both ends of the economic spectrum. Undernutrition is still a pressing issue in some localized areas — to the point of famine in extreme cases. However, economic development in itself does not necessarily ensure a corresponding improvement in health.
A 'significant shift'
Recent studies by the Overseas Development Institute indicate that as income increases, so does calorie intake. In some cases this is clearly to be welcomed, but as this trend develops further we are seeing a significant shift in dietary patterns and preferences.
In Asia-Pacific, for example, there is a marked shift toward consumption of meat and dairy products. More generally, the so-called “health transition” is seeing a shift of medical conditions that are making malnutrition an issue of micronutrient deficiency, rather than a lack of calories.
The issue is difficult to address — few governments have the appetite to attempt to influence diets through regulation and price manipulation. Education and training is more palatable and can provide clear benefits, but evidence from the U.N. Food and Agriculture Organization shows that although campaigns can raise awareness, actually changing behavior is much more difficult.
One example of successful education and training can be seen in South Korea, where a scheme to train women to prepare traditional meals low in fat and high in vegetables has helped to improve the nation’s health. Indeed, the population has a lower incidence of obesity than expected for the income levels.
Innovative urban solutions
As urbanization often reduces the opportunity for communities to grow their own food, local authorities could provide plots of land in urban areas for vegetable growing and also provide training for cultivation skills to enable families to grow fresh fruit and vegetables at low cost, with entrepreneurial opportunities to sell surplus at local markets.
Since increasing numbers of younger people are growing up in urban environments, there is a greater risk that they will not be enabled by — or perceive the benefit of — the passing on of food cultivation skills from older generations.
A mixed economy of cash income and semi-subsistence via very small vegetable plots and the keeping of chickens — and possibly pigs — is still commonplace in many developing countries. However, this is less likely to occur in larger urban concentrations where population density makes it more difficult to allocate land for such a purpose. That said, there are also numerous examples of innovative urban farming techniques being deployed around the world, including projects such as Urban Farming Guys and another growing crops in South Bronx, New York.
The latter makes important connections between improving nutrition and both physical and intellectual development. It also highlights the connections between urban planning, civil society engagement and the empowering of individuals to adopt healthier lifestyle opportunities.
Government support for initiatives to shift cultural awareness and acceptance of healthy diets and exercise — as well as the promotion of preventative medical interventions — can all contribute towards enabling pro-nutrition lifestyles. There are clearly identifiable differences in approaches that might be taken within various habitats, communities and income groups. However, to be successful such policies would need to be flexible enough to accommodate a broad range of scenarios and stakeholders.
That said, an important starting point is to recognize the scale of the problem associated with changing patterns of diet and not only to educate but also enable individuals to opt for healthier, more food-secure lifestyles.
Feeding Development is an online conversation hosted by Devex in partnership with ACDI/VOCA, Chemonics, Fintrac, GAIN, Nestlé and Tetra Tech to reimagine solutions for a food-secure future from seed and soil to a healthy meal.