Q&A: The greatest challenges for global nutrition and health

Alessandro Demaio, CEO at the EAT Foundation. Photo by: Crawford Fund

CANBERRA — At the Crawford Fund Annual Conference in Canberra on Aug. 14, Alessandro Demaio, CEO at the EAT Foundation, presented a keynote address highlighting the health and nutrition challenges facing the world — and the challenges consumerism creates.

It is a topic he is passionate about; Demaio advocates for food system changes in both developed and developing countries.

Demaio spoke with Devex on the sidelines of the conference, about his work, food system disruption, and what actions must be taken to improve health now.

Here is the interview, edited for length and clarity.

You have shown today a range of statistics on the obstacles facing global nutrition needs. How are governments stepping up to the challenge?

A lot of governments are stepping up to the challenge — but we still see still a lack of leadership across the broad spectrum of the Sustainable Development Goals. It really is a menu for development, and has allowed countries to select and prioritize goals and also converge different goals.

Great examples are Chile with their very progressive food labelling laws, Brazil with their dietary guidelines that integrate environmental, health, and cultural dimensions, and Mexico with a tax on sugary drinks — we’ve seen the government there step up and take action, despite fierce opposition from the private sector.

Different jurisdictions — countries, states and cities — taking action and responsibility across important aspects of the food agenda.

Devex is running a miniseries on how cities are tackling NCDs in the line up to the third United Nations high-level meeting on NCDs.

Cities and NCDs: Montevideo's menu for reducing sodium intake

Cities and NCDs: The growing threat of childhood obesity in Quito

Cities and NCDs: Curbing excess salt consumption in Ouagadougou

The emergence of city-based solutions is an exciting area. We’re not often seeing the level of leadership we would like at the national level, often because of this complex interplay between policymakers and the private sector, with the latter’s interest being at odds with public health priorities. Still, great leadership is emerging at the city level on issues of health and nutrition, and with more people living in cities by mid-century, this is an important avenue to solve some of the growing health issues we are facing.

In your work with the EAT-Lancet Commission on Food, Planet, Health, you are aiming for mid-century targets for global health and nutrition challenges. How important is it to look beyond the 2030 goals of the SDG with health and nutrition?

The reason we are looking at mid-century is because that is as far as we have good projections on population growth.2030 is just 12 years away, and to try and transform the global food system in this time does not seem feasible to most government.

You need the extra time to transition economies, transition food systems, transition consumer demand, taste preferences, and those types of things.

Having said that, if we don’t achieve the SDGs we will not achieve our targets. It’s why we purposely integrate everything we do into the concept of leaving no one behind. That is, achieving the SDGs by 2030 to ensure we achieve a healthy food system for a healthier population.

You also discussed the gap between nutrition needs and what we produce. What are the factors creating this gap?

To understand why we eat what we eat, that’s a reflection largely on the environment around us and the food that is available, accessible, affordable, and that we actually enjoy. A lot of the foods we eat these days are products, not raw foods — so you’re using a constellation of ingredients that are commonly delivered by major multinational food companies. The priority for them is often efficiency — using the cheaper ingredients, with an increase in fats, salt, and sugar.

Those creep into our food systems not just because people like it, but because they are great ways of stabilizing foods and increasing shelf life.

“We have created the perfect storm to drive the obesity epidemic.”

— Alessandro Demaio, CEO at the EAT Foundation

But then the question becomes why we grow what we grow, and in many parts of the world we subsidize sugar and corn for many different reasons — most of them historical.

It is the cheap nature of these raw, commodity staple foods that drive much of what we produce upstream. If the cheapest product to produce is sugar or even high-fructose corn syrup and if we are able to produce meat very cheaply — because another cheap use of corn and soy is in livestock production — they come to market cheaply.

We have created the perfect storm to drive the obesity epidemic.

There are business benefits in creating new industries with healthy options — how can this be communicated?

There is more of a focus on this issue through a consciousness of policymakers, in theory, of shifting food focus away from quantity and a small number of staples. But the reality of achieving that is difficult. There is both an inertia due to lobbying in the political sphere and the influence of advertising,

There is a consciousness — the evidence is clear that we should be eating much more fruit and vegetables — but the incentives in the marketplace and food environment still push consumers in the other direction. To reverse that is very difficult. But not impossible.

You have mentioned advertising. Social media provides an avenue for advertising that is less blatant to consumers and social media is growing in developing countries. How can you respond to these challenges in developing health and nutrition strategies?

“The worrying thing is that the most profitable forms of food are the ones that are least healthy.”

This is a deep concern for me.

The digitalization of our food systems, the fact that the place where we learn about or purchase, consume, interact, and waste food is increasingly on the small screen in our pocket. It accelerates and amplifies all the challenges, because suddenly you have a billboard in your pocket. You have advertising that is purposely and perfectly curated for a person’s tastes, preferences, income, geographic location, and friends.

The worrying thing is that the most profitable forms of food are the ones that are least healthy. They have the largest advertising budgets; the largest advertising budget gives you the greatest reach; the greatest reach gives you the greatest influence.

So social media, digital media, and having this system in your pocket combined with the likes of Uber Eats [a food delivery platform] and buying groceries online — this is the way we are moving, and the threat is that it has the potential to amplify this trajectory we are on.

But it also has the opportunity to do the opposite

At this conference the senior nutrition officer with the Food and Agriculture Organization, Jessica Fanzo, called for urgent disruption in this space — what disruptive ideas do you have?

I co-host a TV show on the ABC [Australian Broadcasting Corporation], I have just launched a book, I have a few board positions in various places, and I donate all of the money from those sources to a small foundation in Melbourne [NCDFREE] to develop innovative ideas to solve these challenges.

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It is a small startup with an impact hub that is focused on developing disruptive policy for nutrition-related public health challenges. There is a great group of young people who run that platform.

I don’t know what the answers are, but it is partly about these disruptive technologies and partially about having a realistic view of the economic model in which we work. Hoping x and y will step up is probably not going to happen in the timeline we need — so what are the other avenues to influence large corporations, for example, apart from policy — which I vehemently believe in but can’t wait for it to happen.

We are working on the investor community — how can we use the investor community to disrupt larger multinationals to produce more sustainable food and healthy options? And how can we work with food retailers who, at the end of the day, have less of an interest in certain products but want to sell certain products at scale over time? If we can change what they are selling to healthier options, then we can spur reformulation in the market and get consumers to eat healthier options.

The digitalization of our society should be an opportunity — how can we use social media, film, Facebook Live, Instagram, and these kinds of things to deliver health promotion?

We are working in Melbourne with Uber Eats to use the 13,000 restaurants that are member of Uber Eats and the millions of meals that are served each year through that platform. We want to use their data to understand the food environment and where unhealthy food environments are.

They can say to us, “these are the four or five suburbs that need healthier options.” And we can work with government and other partners to try and bring healthier options in, and then work back with Uber Eats or another food aggregator to make sure that those healthier options look good and are delivered in a way consumers are going to like.

They know how to sell food to consumers and they have the platform and data. All we need to do is piece that together.

For more coverage of NCDs, visit the Taking the Pulse series here.

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About the author

  • %25257b6eb61a8f df39 4ae1 bb29 9056d33aa739%25257d

    Lisa Cornish

    Lisa Cornish is a Devex Reporter based in Canberra, where she focuses on the Australian aid community. Lisa formerly worked with News Corp Australia as a data journalist for the national network and was published throughout Australia in major metropolitan and regional newspapers, including the Daily Telegraph in Melbourne, Herald Sun in Melbourne, Courier-Mail in Brisbane, and online through news.com.au. Lisa additionally consults with Australian government providing data analytics, reporting and visualization services. Lisa was awarded the 2014 Journalist of the Year by the New South Wales Institute of Surveyors.