United Nations agencies have just released their annual report on world food insecurity.
Its main unhappy conclusion:
Food insecurity has increased since 2014:
So has worldwide obesity:
What is to be done?
Alas, that’s not what this report is about.
If you want an overview of the current status of nutrition problems in the world, what is being done about them, and what needs to be done about them, this report is required reading (to get to the download button for the entire report, scroll to the end of the page).
The report is chock full of useful facts, figures, case studies, and recommendations. A massive undertaking, it
was produced by the Independent Expert Group of the Global Nutrition Report, supported by the Global Nutrition Report Stakeholder Group and the Secretariat at Development Initiatives. The writing was led by the co-chairs Jessica Fanzo and Corinna Hawkes, supported by group members and supplemented by additional analysts and contributors.
For a quick overview, go right to the slide deck and then to the graphics in the executive summary.
The report deals both with problems of malnutrition (undernutrition) and obesity (overnutrition), especially in children.
It also deals with adult obesity:
It identifies measurable nutrition indicators that can be used to track progress:
It recommends actions to reduce the prevalence of malnutrition and obesity.
What stands in the way of implementing these steps? Political will, alas.
These reports have come out annually since 2014. Let’s hope this one gets the attention it deserves.
My email inbox was flooded last week with The Obesity Society’s call for more research on the value of taxes on sugar-sweetened beverages.
“Although taxing SSBs might generate revenue that can be used to promote other healthy food items, the net outcome may not necessarily decrease overweight and obesity rates in the United States or worldwide,” said Steven B. Heymsfield, MD, FTOS, President-Elect of The Obesity Society (TOS) and professor and director of the Body Composition-Metabolism Laboratory at the Pennington Biomedical Research Center at Louisiana State University in Baton Rouge.
Why would a professional society that represents people who ostensibly care about obesity science, treatment, and prevention issue a statement aimed at casting doubt on a demonstrably effective public health measure? (Soda companies know the taxes are effective; that’s why they fight them so hard).
The Obesity Society (TOS), alas, often appears far more favorable to the interests of food and beverage companies than those of public health. Could funding of the society and its members have anything to do with this?
Here is the TOS position on corporate funding:
TOS recognizes the value in providing any donor that wishes to support our mission to find solutions to the obesity epidemic the opportunity to provide financial support.
The current TOS policy expressly eliminates all forms of evaluation or judgment of the funding source (other than the stipulation that funding is reasonably assumed not to be derived from activities deemed ‘illegal’).
TOS chooses instead to focus its ethical mission on transparency in disclosing the sources of funding, clear stipulations outlining our commitment to the ethical use of funds, and a commitment to non-influence of the funding sources over the scientific aspects of funded projects and TOS as a whole.
Translation: We will take money from any company, regardless of the effects of its products on public health.
The TOS rationale is that disclosure takes care of the problem and that funding won’t influence the science. Unfortunately for this view, research demonstrates that disclosure does not eliminate the influence of funding, and the influence of funding is considerable—though often unrecognized, as is apparent in this case.
TOS has a disclosure policy, and discloses its officers’ conflicts of interest. These are considerable.
In 2013, Dr. Yoni Freedhoff resigned his TOS membership over the society’s sponsorship policies. In his comment on the current TOS statement, Freedhoff points out that “sugar-sweetened beverage taxes decrease sugar-sweetened beverage consumption and increase healthier beverage consumption while providing the greatest potential health benefits to low income consumers.”
TOS members who care about creating a healthier food environment should consider joining Dr. Freedhoff. lf not, they should insist that TOS leadership take vigorous pro-public health stances on matters affecting their patients’ health.
Additional comments, October 31, 2018
Yesterday I received a message from Liz Szabo, a reporter for Kaiser Health News, who is writing a piece on TOS’s relationships with food companies. She questioned Steve Heymsfield, the group’s current president, who responded at length with a message that included this paragraph:
Marion Nestle, on the other hand, is professor “emeritus” and our understanding is that she no longer reports directly to a dean at New York University. That created a hurdle for us when trying to manage Dr. Nestle’se false and misleading blog related to this matter on her website. Even after learning her comments were misleading from Dr. Popkin, and unlike Popkin who has a high ethical standard, she failed to take down that post.
This surprised me, because nobody from TOS or anywhere else had written me to correct the post, Dr. Popkin’s corrections were to something he—not I—had written, and my ongoing relationship with NYU is readily evident from the information posted under About on this site.
I pointed this out to Dr. Heymsfield, who replied with annotations to my post. Most of these deal with opinion and interpretation rather than fact. The one thing I got “completely false” is my interpretation that TOS lacks standards for deciding which donors are acceptable. Dr. Heymsfield says it does. I am happy to hear that and stand corrected on that point.
Since September, the New York Times has been investigating how the food industry markets its products in the developing world, and how this marketing is encouraging a rising prevalence of obesity and its health consequences. The series is called Planet Fat. This is the complete set to date, in reverse chronological order.
If you haven’t read them, this week is a good time to catch up. Enjoy!
India is “sitting on a volcano” of diabetes. A father’s effort to ban junk food sales in and near schools aims to change what children eat.
Dec. 26, 2017
Dec. 23, 2017
Dec. 11, 2017
Nov. 13, 2017
Oct. 2, 2017
Oct. 2, 2017
Sept. 16, 2017
Sept. 17, 2017
HLPE [High Level Panel of Experts on Food Security and Nutrition]. Nutrition and food systems. A report by the High Level Panel of Experts on Food Security and Nutrition of the Committee on World Food Security, Rome, 2017.
This report takes a food systems approach to recommendations for reducing the double burden of malnutrition—obesity in the presence of widespread hunger and its consequences.
This report aims to analyse how food systems influence diets and nutrition. It offers three significant additions to previous frameworks. First, it emphasizes the role of diets as a core link between food systems and their health and nutrition outcomes. Second, it highlights the central role of the food environment in facilitating healthy and sustainable consumer food choices. Third, it takes into account the impacts of agriculture and food systems on sustainability in its three dimensions (economic, social and environmental). 2. A food system gathers all the elements (environment, people, inputs, processes, infrastructures, institutions, etc.) and activities that relate to the production, processing, distribution, preparation and consumption of food, and the outputs of these activities, including socio-economic and environmental outcomes. This report pays specific attention to nutrition and health outcomes of food systems. It identifies three constituent elements of food systems, as entry and exit points for nutrition: food supply chains; food environments; and consumer behaviour.
Where are we in obesity prevalence? The Robert Wood Johnson Foundation (RWJF) and Trust for America’s Health (TFAH), are keeping score for us. Their report gives figures state by state. Since I live in New York, I’m highlighting its figures.
This looks like good news. The increase is slowing down and maybe trends are leveling off at long last.
CHILDREN’S PREVALENCE OF OVERWEIGHT AND OBESITY
This also looks hopeful. The prevalence is level or declining in most states.
But, as Richard Besser of the Robert Wood Johnson Foundation and John Auerbach of Trust For America’s Health explain in an editorial in The Hill,
One of the best ways to bring down those adult obesity rates in every state is to prevent children from becoming overweight or obese in the first place…Unfortunately, there are signs that we are moving in the wrong direction—and not just on school meals…These kinds of threats put at grave risk the progress our nation has achieved. To accelerate progress in addressing obesity, we urge policymakers to support proven programs like school meals and SNAP that put kids on a healthier track for their entire lives, and maintain full funding for agencies like the Centers for Disease Control and Prevention that are responsible for protecting the health of kids and adults nationwide.
The World Health Organization (WHO) has just published a series of papers on “double-duty” actions needed to end world malnutrition. By this, it means addressing not only classic undernutrition and its consequences (stunting and wasting of children, nutrient deficiencies and starvation in adults) but also obesity and its risks for chronic disease.
In a commentary on the WHO site and in The Lancet, Fracesco Branca, Alessandro Demaio, and Corinna Hawkes say:
This is the potential of “double-duty actions”—interventions, programmes, and policies that have the ability to simultaneously reduce the risk or burden of both undernutrition and overweight, obesity, or diet-related NCDs (noncommunicable diseases). Double-duty actions offer an integrated approach to addressing malnutrition. WHO proposes three levels for increasing the efficiency of nutrition actions through a double-duty approach.
The three levels are:
The WHO expands on these ideas in a policy brief.
They describe the interventions that can and should be taken in an action policy brief.
These are useful resources for anyone interested in and concerned about doing something about the double burden of malnutrition.
I visited the AC supermarket in Utqiagvik, the town formerly known as Barrow.
It could be anywhere USA, with anything you could possibly want, including fresh blueberries from Argentina. How’s that for food miles?
Remember: all of this, no exceptions, comes in by cargo plane.
The produce section was lovely, with remarkably fresh foods at equally remarkable prices.
Would you believe the green leaf lettuce is $3.50, the baby carrots $7.29, and the romaine $4.69? New York prices on steroids.
How about white potatoes at $3.29, red ones at $2.79, and baking potatoes at $18.99 for 10 pounds.
Or the reason I was so concerned about the tossed out school lunch milk cartons: $7.11 on sale.
How about bread on sale for $5.98 a loaf?
Just to make me feel at home, here are the sugary drinks down one entire aisle. The 12-packs were on sale for $10.98, which must not be enough to discourage sales.
Are soft drinks a problem in Utqiagvik/Barrow?
Yes, they are.
The prevalence of obesity and diabetes is low, but rising steadily, and the Indian Health Service dentists told me that they see plenty of little kids with rotted teeth from drinking sodas and sweet juices in baby bottles.
The nutrition transition is taking place in America too, and for the same reasons that obesity and diabetes are becoming problems in the developing world.
Join NYU Libraries for an insightful discussion with some of our most esteemed panelists about how the conversation, study, and action around food has evolved over the last two decades. Together, we’ll reflect on 20 years of the Critical Topics in Food event series and examine the role that thoughtful community gatherings like these have played in shaping our collective dialogue about food. The Critical Topics in Food event series is a partnership between NYU Special Collections, NYU Steinhardt Department of Nutrition & Food Studies, and Clark Wolf.