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1. Malnutrition in all its forms: a
double burden & a double duty for
food policy
Prof Corinna Hawkes, Director, Centre for Food Policy
Co-Chair, Global Nutrition Report
11. Malnutrition in all its forms is pervasive
• Malnutrition affects all 193 countries
• Malnutrition affects 1 in 3 people - will rise to 1 in
2 people if current trends continue
• 800 million are hungry, 2 billion have
micronutrient deficiency, 1.9 billion are overweight
or obese
• Overweight/obesity rates are rising in every country
• Undernutrition rates decreasing too slowly
12.
13. Malnutrition in Nordic countries
55 55 56 58 59
19 21 21 23 23
5 7 6 7 7
Denmark Finland Sweden Iceland Norway
Adult overweight, obesity and diabetes, 2014 (%)
Adult overweight
Adult obesity
Adult diabetes
All Nordic
countries are
OFF COURSE
for overweight
and obesity and
only Iceland is
ON COURSE
for diabetes
14. Women’s Anemia
rates ≥ 20% (2011)
Adult
Overweight
(BMI ≥ 25) rates
≥ 35% (2014)
Antigua and Barbuda,
Bahamas, Bahrain,
Barbados, Brunei
Darussalam, Croatia,
Cyprus, Czech Republic,
Estonia, Greece,
Hungary, Kuwait, Latvia,
Lithuania, Oman,
Poland, Qatar,
Seychelles, Slovakia,
Slovenia, United Arab
Emirates
Double burden in high-income countries
Andorra, Australia,
Austria, Belgium,
Canada, Chile,
Denmark, Finland,
France, Germany,
Iceland, Ireland,
Israel, Italy,
Luxembourg, Malta,
Netherlands, New
Zealand, Norway,
Portugal, Spain,
Sweden, Switzerland,
UK, USA, Uruguay
Japan, Singapore
Republic of Korea
15. Under 5 Stunting
Women’s Anemia
Adult OverweightEthiopia, Rwanda
Ghana, Japan, Senegal, Sri Lanka, Thailand
Argentina,
Australia,
Brazil, Chile,
Colombia,
Costa Rica,
Germany,
Mexico,
Paraguay,
Peru, FYR
Macedonia,
Tonga, USA,
Uruguay
Afghanistan,
Angola, Bangladesh, Benin,
Bhutan, Burkina Faso, Burundi,
Cambodia, Cameroon, Central
African Republic, Chad, Comoros,
Congo, Côte d’Ivoire, Democratic
People’s Republic of Korea,
Democratic Republic of the Con-
go, Djibouti, Eritrea, Gambia,
Guinea, Guinea-Bissau, India,
Indonesia, Kenya, Lao People’s
Democratic Republic, Liberia,
Madagascar, Malawi, Maldives,
Mali, Mauritania, Mozambique,
Myanmar, Nepal, Niger, Nigeria,
Pakistan, Philippines, Sao Tome
and Principe, Sierra Leone,
Somalia, Sudan, Timor-Leste,
Togo, Uganda, Tanzania, Zambia,
Zimbabwe
Honduras,
Nicaragua
Algeria, Azerbaijan,
Barbados, Belarus,
Belize, Bolivia, Bosnia
and Herzegovina, Brunei
Darussalam, Dominican
republic, El Salvador,
Gabon, Georgia,
Guyana, Iran, Jamaica,
Jordan, Kazakhstan,
Kuwait, Kyrgyzstan,
Malaysia, Mongolia,
Montenegro, Morocco,
Oman, Panama,
Republic of Moldova,
Saint Lucia, Saudi
Arabia, Serbia,
Seychelles, Suriname,
Tunisia, Turkey,
Uzbekistan, Venezuela
Albania,
Armenia,
Botswana,
Ecuador, Egypt,
Equatorial
Guinea,
Guatemala,
Haiti, Iraq,
Lesotho, Libya,
Namibia,
Papua New
Guinea,
Solomon
Islands, South
Africa,
Swaziland,
Syria,
Tajikistan,
Vanuatu,
Yemen
China, Republic of
Korea, Vietnam
Multiple burdens globally
27. § Folic acid supplementation or fortification
§ Universal salt iodization
§ Balanced energy-protein supplementation
§ Calcium supplementation
§ Multiple micronutrient supplementation
§ Promotion of breastfeeding (counselling)
§ Promotion of complementary feeding (education)
§ Feeding for children with moderate acute malnutrition
§ Therapeutic feeding for severely wasted children
§ Vitamin A supplementation
§ Zinc treatment for diarrhea
§ Preventive zinc supplementation
Direct nutrition interventions
28. Evidence in practice also shows crucial role of
addressing the “causes of the causes”
“In short, the causes of the impressive decline in child
malnutrition in Brazil appear to lie in the improvements in
coverage of essential public services and increases in
family income, both particularly favoring the poor”
(Monteiro, 2009)
2016 GNR success stories show key elements of
success are: political commitment; economic
growth/poverty reduction, education; female education;
water, sanitation and health; health systems; social
protection, supplementation as success factors in the
reduction of undernutrition (food and diets not mentioned)
35. “Researchers who work on all forms of malnutrition should
come together with the international agencies to identify
‘double-duty actions’ that can address undernutrition as well
as overweight, obesity and nutrition-related non-communicable
diseases simultaneously.”
B. Shift policy makers mindsets
to “doing double duty for the
double burden”
36. Examples of application to infants and young children
N Restrict misleading claims/labels of milks, complementary foods, foods >2
O Offer only healthy foods in pre-school settings
U Use conditional cash transfers to provide healthy eating incentives
R Restrict inappropriate marketing of BMS, complementary foods, foods >2
I Improve the nutritional quality (e.g. sugars) of complementary foods, foods >2
S Set zones for healthy food retail in places where young children gather
H Harness agricultural interventions to promoted backyard gardens with fruit-trees
I Inform people through public awareness about inappropriateness of “junk” food
as foods for infants/young children
N Nutrition counselling for pregnant women
G Give nutrition education (food literacy, skills) to families with young children
C. Introduce evidence-informed policies to encourage
“healthy diets for healthy growth”
38. City, University of London
Northampton Square
London
EC1V 0HB
United Kingdom
T: +44 (0)20 7040 5060
E: department@city.ac.uk
www.city.ac.uk/department
Corinna Hawkes
Professor of Food Policy
Director, Centre for Food Policy
Co-Chair, Global Nutrition Report
corinna.hawkes@city.ac.uk
@corinnahawkes
@FoodPolicyCity
@GNReport