An analysis of the multiple burdens of malnutrition: food systems and drivers

The recently published issue of Sight and Life Magazine analysed the issues related to food and nutrition security, and offered a number of contributions to the topic of food systems. This article summarises the most important messages from the chapter “The Multiple Burdens of Malnutrition”:

A food system is the network comprising producers, industry and institutions. Government policies can affect all parts of the network and are able to influence the shift towards healthier food choices:


·       Restricts marketing to children

·       Taxes unhealthy foods

·       Legislates consumer-friendly nutrition labelling

·       Sets food standards in schools

·       Subsidises the cost of healthy foods

·       Legislates food fortification

·       Regulates to prevent positioning of unhealthy foods

Malnutrition is either under-nutrition (hunger or inadequate nutrition) or over-nutrition (obesity and overweight). Well-functioning food systems are essential in ensuring that people do not suffer from either one, or both. A well-functioning food system provides sufficient safe, high quality and accessible foods for all people.

It is also important that food systems are resilient to shock, such as that of bad harvests. The most important factor here is to understand the resilience of each individual value chain.

Sustainability of food systems

Environmental and human health are equally important – a healthy environment is linked to human health and well-being. There has been an increase in social, political and business pressures to develop more sustainable food systems. These pressures are driven by a growing demand for food over the coming decades, combined with the already well-recognised environmental impacts of the ways in which we produce and consume food.

Sustainability covers these three pillars: 1. Environmental, 2. Economic and 3. Social. The social pillar should include nutrition and health outcomes, and the economic one should include the issue of business sustainability.

Food systems and the Sustainable Development Goals (SDGs)

Two major goals, SDG2 and SDG3, relate to nutrition. The previous Millennium Development Goals (MDGs) fell short of the objective to eradicate under-nutrition. At the same time, the number of non-communicable diseases (NCDs) and the rate of obesity have increased. Contrary to the MDGs, overweight and obesity is now a focus of the SDGs. Still, however, the goals lack target indicators to track overweight and obesity.

If progress can be achieved, it is essential that health and food systems be connected on a country level. This will take funding and support from health and agriculture ministries. If food systems are inadequate, effects on health can be negative. There is a need to better understand what people are eating, the economic costs of their diets, where they get their food from, and their food preferences.

Food system drivers and solutions: the multiple burdens of malnutrition

The global food systems are changing, and this has led to shifts in availability, affordability and acceptability of food. This has led, too, to increased consumption of food of low nutritional quality, and high intake of refined carbohydrates, added sugars and fats. Globalisation and trade liberalisation have led to an influx of highly processed foods.

Addressing eating habits, and specifically targeting the first 1,000 days of life (from the day of conception to 2 years of age, including the first six months of exclusive breastfeeding) can help to reduce the risk of both under-nutrition and overweight. The food system, therefore, needs to be equipped to provide nutrient-rich foods at affordable prices to adolescent girls, as well as pregnant and lactating mothers.

Providing healthy school meals is vital in securing school attendance, improving nutritional status and cognitive development, as well as supporting adolescent girls’ school attendance.

Food systems that support cereals and cash crops, over fruits and vegetables, is one reason why processed foods have become so affordable cost-wise. In Asia, the wide use of palm oil, which is high in saturated fat, has become the most consumed type of oil. Half of all packaged food items contain palm oil – this has negative implications on health, as well as the environment.

Setting new frontiers for the 21st century with food systems

There is a growing interest in making agriculture and other development sectors more nutrition-sensitive. The diets of the low-income population often lack in portions of fruits and vegetables. Low- and middle-income countries increasingly emphasise the role of agriculture and food in their development plans. Likewise, food businesses can improve food security and shape the food habits of entire populations.

Some last thoughts

In the past, the areas of trade and nutrition have been treated as separate domains. A coherence between trade and health sectors needs to be guaranteed, policy dialogues between both sectors need to be promoted, and health professionals should be part of trade committees.

A food policy to improve nutritional status of low-income populations should include the fortification of affordable staples like flour and rice, as food variety can be too costly. It is important to include the B-Vitamins in such strategies, as they guarantee the proper functioning of the human brain cells; this means that flour and rice need to be reconstituted to their natural nutritional portfolios.

Click here to download the full, most recent issue of Sight and Life Magazine.

Article by Bruno Kistner. Bruno, who leads the ARoFIIN Secretariat, has over 37 years of experience in the areas of food and nutrition. Prior to joining FIA, Bruno served as Commercial Director for the Asia region at Glanbia Nutritionals Singapore Pte Ltd. Before that, he spent almost 32 years with Roche Vitamins and DSM Nutritionals in marketing and commercial functions responsible for emerging markets in India, Eastern Europe, Middle East and Africa, where he also focused on health and nutrition issues. During his tenure at DSM, he established the organisation’s Nutrition Improvement Program.

Bruno has significant experience working in NGOs and UN organisations to drive efforts in the areas of food fortification, nutrition and public health. His passion for improving health and nutrition standards led him to take up the role of founding member of the DSM-World Food Program (WFP) partnership, to combat hidden hunger and malnutrition in the developing world, as well as the Amsterdam Initiative against Malnutrition (AIM).

Published on 19 Aug 2016