Food Strategies for Better Nutrition to Tackle NCDs

A new FAO study estimates food systems cost over eight trillion dollars in health costs due to unhealthy diets worsening non-communicable diseases (NCDs), such as heart disease, strokes, and diabetes.

Meanwhile, there has been little progress in tackling the triple burden of malnutrition – the coexistence of undernutrition, overeating and micronutrient deficiencies – all related to poor dietary intake.

Annually, 2.4 million child deaths are due to malnutrition. Childhood stunting, which impairs physical and cognitive development, affects almost a quarter of the world’s children and a third in developing countries.

Meanwhile, three billion people were overweight, with over a billion obese and more vulnerable to serious NCDs. Over two billion lack adequate micronutrients – vitamins and minerals – essential for physical and mental well-being. Vitamin A, iodine, iron and zinc deficiencies are pervasive.

What should we do?

Overcoming malnutrition – undernourishment, micronutrient deficiencies, and obesity – requires appropriate interventions in food systems, public health, education and social protection.

Better food systems are key to enabling more diversified and healthier diets. Improved food systems should also ensure affordable, nutritious foods.

Food systems should meet the special nutritional needs of mothers and young children. Malnutrition during the critical first thousand days from conception can permanently damage children’s and mothers’ health.

Complementary policies are needed to ensure everyone has informed access to nutritious foods so that they can make healthy choices. Enhancing regulation, education, information, and other interventions can achieve this.

Food-based strategies

Malnutrition is better understood now, and options to address it are increasingly known. Efforts to improve nutrition should prioritize food intake rather than rely on supplements.

Food-based strategies promote consuming foods naturally rich in micronutrients or enriched by ‘fortification’. Other approaches – including production and dietary diversification – offer sustainable ways to improve human nutrition.

Where acute micronutrient deficiencies threaten, supplements have a useful but temporary role for high-risk groups and during emergencies until the food system can sustainably serve dietary needs.

An exclusive reliance on supplements distracts from addressing the deeper causes of malnutrition. However, most efforts to overcome three significant deficiencies of public health concern – vitamin A, iron, and iodine – focus on supplementation.

Supplementation offers business opportunities, which deter alternative means of addressing malnutrition on a more affordable and sustainable basis.

Supplement-based interventions should generally be short-term while enabling food-based efforts for the long term. Such longer-term interventions, including school meals, can offer both immediate benefits and long-term gains.

Some supplements are more impactful when delivered through food systems. Mineral soil supplementation, a key component of most agricultural systems, can help address plant and even animal nutrition, addressing dietary micronutrient deficiencies, as in Turkey.

Micronutrient supplementation cannot be effective without adequate food intake. Depending on the deficiency and other conditions, supplements should be targeted.

Some micronutrients, such as iron and folic acid, are often given to pregnant women as supplements. Others, such as iodine fortification of table salt, improve nutrition more broadly. Nevertheless, delivering micronutrients via nutrition-optimized food systems should be prioritized.

Multilateral efforts

Food security and nutrition should be high on the international development agenda. In June 2012, the UN Secretary-General called for setting the ambitious but feasible goal of zero hunger and no more stunting.

In November 2014, the World Health Organization (WHO), FAO and others in the UN system organized the inter-governmental second International Conference on Nutrition (ICN2), 22 years after the first in 1992.

ICN2 articulated how sustained international cooperation and policy coordination could help overcome malnutrition, acknowledging poor progress against hidden hunger.

Sustained and coordinated international support has long been needed. By cooperating effectively, we have a real chance of ending this blight on humanity within a generation.

In 2016, the UN General Assembly declared a Decade of Action against Malnutrition, including ICN2 follow-up efforts, but no progress has been reported.

Tackling malnutrition requires strong political commitment, leadership at the highest levels, and unprecedented cooperation and coordination among various ministries and civil society partners at all levels.