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Europe/Asia: ‘Triple burden’ on nutrition, FAO

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Economic growth and rising per capita incomes have all but wiped out hunger in Europe and Central Asia.

As countries become more affluent, changing consumption patterns are giving rise to other health threats.

This ‘food insecurity transition’ is documented in a new FAO report.

Regional Overview of Food Insecurity: Europe and Central Asia analyzes a wealth of country data: on dietary energy supply, undernourishment indicators such as stunting and wasting, anaemia, overweight and obesity, and what people on average are eating.

The report points to a pattern whereby countries progress from dealing predominantly with undernutrition and micronutrient deficiencies, to coping with degenerative diseases associated with increased dietary fat, sugar, meat and dairy, and processed foods.

This transition is often accompanied by a more sedentary lifestyle.

“As we trace the structure of diets as incomes increase,” said economist and report author David Sedik.

“We find that the portion of total calories derived from sweeteners, vegetable oils and animal products increases, while that derived from cereals declines.”

“There are important nuances, but the general tendency is clear.”

In other words, the data show a progression towards a diet high in sweeteners, vegetable and animal fat, and low in grains.

This means that undernutrition issues have largely been overcome in the region – a stunning achievement.

Only 7% of the population in Europe and Central Asia live in countries where the predominant nutrition problems are undernutrition and micronutrient deficiencies.

However, malnutrition caused by deficiencies in micronutrients such as iron, Vitamin A and zinc, and over nutrition issues measured by overweight and obesity, have remained and increased.

Today, 13% of the population of the region lives in countries suffering from a ‘triple burden’ of all three nutrition problems (undernutrition, micronutrient deficiencies and over nutrition).

More worryingly, 57% of the region’s population live in countries where the main nutrition problem is over nutrition.

According to the report, 70% of the population in the region suffer from malnutrition characterized predominantly by a triple malnutrition burden or by over nutrition.

The situation is not static, however.

Countries in the undernutrition group are on track to join the triple-burden category in the years ahead.

“As more countries transition into the triple-burden category,” Sedik said.

“Health expenditures will need to rise rapidly and substantially to deal with the higher healthcare costs associated with more diabetes, heart disease, and other diet-related non-communicable diseases.”

Solutions

While Part 1 of the report presents the problem, Part 2 is devoted to solutions.

It explores several promising policies for addressing and eventually eradicating food insecurity, tailored to the income and nutrition profile of each country.

These are policies that have been tried and proven effective.

Food fortification is offered as a policy option for countries in the undernutrition and micronutrient deficiencies grouping.

Fortification of milk with vitamin D, salt with iodine, wheat flour with iron, folic acid and thiamine are examples of this approach, which has been a critical driver of improvements in micronutrient consumption in children in Central Asia.

Similarly, bio-fortification uses plant breeding to increase the micronutrient content of crops.

Bio-fortified crops could be used to offset the relatively low micronutrient content of wheat in Central Asia and the Caucasus, where cereals supply more than 50% of dietary energy.

Other policy recommendations include:

– Reformulating popular convenience foods to improve their nutritional value;

– Taxes and subsidies designed to change the relative prices of foods depending on their healthfulness;

– Nutrition education to inform people on what constitutes a healthful, balanced diet;

– More effective food safety systems, and standardization of food safety, sanitary, phytosanitary and hygiene regulations;

– Better nutritional labelling of food products; and

– Food assistance programs including vouchers and food subsidy programs, food transfer and cash transfer programs.