At the occasion of the Committee for World Food Security Week in Rome (October 13-18th 2014), Florence EGAL, Nutritionist, Independent Expert, Member of IUFN’s Strategic Advisory Board is sharing her point of view on the challenging links between Sustainable Diets and local governance.
Where are we at?
Market-driven modernization, basic and applied agricultural research, and subsidies have led agriculture to remarkable progress in two generations. Food systems have become more commercial, more global, and more complex. But achievements in terms of variety, quality, and availability of food products have been accompanied by declining localization and tradition, moving away from traditional production systems to commodity approaches aiming to maximize production of a limited number of species to supply mass distribution. Agriculture policies and programmes have concentrated on value chains, and monocultures of commodities such as soybeans, maize and palm oil have replaced what was once a diversity of food crops. At present, of more than 50,000 edible plant species in the world, only a few hundred contribute significantly to food supply and just a few crops dominate the energy supply. Current food systems face major limitations in terms of natural resources management (soil degradation and contamination, greenhouse gas emissions, water shortages, biodiversity loss, energy consumption) and social equity (industrial agriculture has emptied rural areas instead of providing decent jobs).
While the benefits of an increasingly globalized food system are apparent, the risks are increasingly apparent as well. Global commercialization provides a great variety of food and beverages to most people – and the affordability of modern diets, measured by cost per unit of energy, or kilocalorie, is indeed increasing -, but it offers more products in processed and packaged forms containing a wide array of ingredients, including salt, sweeteners, and oils. Consumption of excess amounts of those ingredients and products, combined with other lifestyle changes, generates adverse health outcomes. People around the world are indeed consuming more calories but their health is worsening. Changing dietary patterns and lifestyles—spurred by urbanization, the liberalization of markets, demographic shifts, and omnipresent marketing— have contributed to increased prevalence of overweight and the chronic diseases that accompany it. According to the 2011 Report of the Secretary-General on Prevention and control of non-communicable diseases (NCDs) – type 2 diabetes mellitus, cancer, and obesity – kill more people every year than any other cause of death. Most countries are now confronting a “double burden” of over nutrition (associated with rising diet-related chronic diseases) and under nutrition (nutrient deficiencies associated with infectious diseases and impaired development).
Urbanization is one of the key drivers of change in the world today, and nutrition is no exception. The world’s urban population currently stands at around 3.5 billion. It will almost double to more than 6 billion by 2050. This is a challenge not only for urban areas but also for rural areas, because rural economies are increasingly driven by urban demand and many people, especially the young, migrate from rural areas to urban areas in search of better opportunities.
Urban food supply is usually more connected to the outside market than to locally sourced supply. Although a wider variety of both local and imported food products is available year round in cities, access to food and other basic needs essentially depends on purchasing power. The food consumed in urban areas is not necessarily of better nutritional quality, and food safety is a growing concern in many urban environments. More jobs and social services can also be found in urban areas but not everyone is able to benefit equally. As the world’s population becomes increasingly urbanized, the proportion of persons living in poverty in cities increases and a growing number of urban poor face a daily struggle to feed their families adequately.
People who move to cities must adopt new methods of acquiring, preparing and eating food. Many city-dwellers have limited time for shopping and cooking and they rely increasingly on processed and convenience foods, including street foods. Poor shelter, lack of sanitation and hygiene, and insufficient social services in slum areas further compound the problems of the poor. With over half of the world’s population predicted to be living in urban areas by 2020, there is a pressing need to address how cities deal with service provision and city planning for healthy lifestyles.
The urban dimension of malnutrition has received so far limited specific attention, although under-nutrition and micronutrient deficiencies can still be found in most, if not all, cities. Excessive intake of energy, coupled with limited physical activity, lead to rising problems of obesity and diet-related chronic diseases. These problems are increasingly found among the poorer sectors of society, where it is not uncommon to find overweight and obese adults living with underweight children, amid widespread micronutrient deficiencies.
We must move from a supply to demand focus
The prevailing food system, in which 30% of the food produced is wasted, has lost sight of dietary needs and is leading to major environmental degradation and loss of biodiversity. It will therefore not provide a sustainable answer to tomorrow’s needs. We need a sustainable approach to offer healthy diets to the world’s population, without exhausting the planet’s natural resources. Policy-makers must move beyond the prevailing commodity approach and start thinking of whole diets and food systems, and seek to remove major obstacles to sustainable nutrition, such as policies that subsidize harmful practices (expansion of the agro-industrial model, including the production of biofuels) and socio-economic inequity (including gender discrimination and violation of human rights). In the decades to come, the food and agriculture system will need to change to meet the related challenges of rising demand, access and affordability of the variety of safe foods required for healthy diets, in a context of increased frequency of natural disasters, shifting climate patterns, and growing resource scarcity, particularly of arable land and water.
But this change can only happen of we adopt a different perspective and focus on demand (i.e. consumption) rather than supply (i.e. production). We need solutions that are sustainable in the broad meaning of the term: responding to ecological needs, culturally acceptable and economically viable. Failures in development projects are usually due to over-simplification and focus on a specific ministry. We need a holistic approach.It is time to move from linear to systemic thinking and aim for nutrition needs rather than productivity. The multi-functional role of agriculture (for nutrition and health, cultural diversity, incomes, resilience to climate change…) must be acknowledged and encouraged.
The way people behave and consume eventually drives food systems, and is ultimately a major determinant of production and ecosystem management. Consumers and citizens in urban areas are able through their daily purchases, and through policy and procurement by agencies of local authorities, to make a significant impact on the food system and improve the livelihoods of both rural and urban people. They therefore have a key role to play in the transformation of agriculture and food systems, and can generate a WIN-WIN dynamic which would improve both health and environmental management. Moderating meat consumption would for example decrease greenhouse gas emissions as well saturated fat intake, cardiovascular diseases and certain types of cancer. Existing dietary guidelines should therefore be updated into sustainable dietary guidelines as the basis for agriculture and food security policies and programmes, as well as consumer information.
Nutrition is an ecosystem service and needs to be considered as such along with other ecosystem services such as water and clean air. An agriculture anchored in basic ecological principles and respectful of its footprint can provide an alternative in terms of crop and animal production, employment, and use of natural resources (energy, land, water and forests). Biodiversity offers a wealth of untapped potential for livelihoods, health, nutrition and environments and there is much to learn from traditional and local food systems in terms of sustainability. Protection and management of biodiversity (plants, including trees, and animals) is therefore key to locally appropriate diets, sustainable food systems and resilient environments.
In order to be sustainable, diets must be healthy, compatible with sustainable management of natural resources and social equity. They should therefore benefit both producers and consumers rather than pitch them against each other.
‘Sustainable Diets are those diets with low environmental impacts which contribute to food and nutrition security and to healthy life for present and future generations. Sustainable diets are protective and respectful of biodiversity and ecosystems, culturally acceptable, accessible, economically fair and affordable; nutritionally adequate, safe and healthy; while optimizing natural and human resources.’
The concept of sustainable diets must be operationalized; and the contribution of food production to livelihoods from farm to fork, and their impact on the health of both producers and consumers must be assessed and monitored.
Such a shift will require policy and institutional changes and more attention to political economy. Given the impact of food and agriculture systems on nutrition and health, it comes as no suprise that health system professionals are shifting towards a food system perspective. Urban food policy and planning efforts are increasingly addressing obesity and NCDs at local level. From cities in India to New York in the USA and in many other parts of the world, local authorities, working with NGOs, national and international agencies have developed policy and programmes to access more fresh, whole and minimally processed food.
There is no good health without good nutrition, and healthy diets depend on agriculture. Yet public agriculture and health agencies interact little, and are guided by distinct and sometimes contradictory objectives. Agriculture agencies and ministries aim for greater food and feed production with available resources and technology, while health ministries focus on disease control. Nutrition objectives and outcomes play a role in both agencies but are often secondary to the main political and technical concerns in those two sectors. Policy makers must be challenged to better leverage agriculture to produce desirable health and nutrition outcomes and the commercial food system must be encouraged—and even directed where necessary—to meet society’s food and health needs.
Providing healthier foods to urban as well as rural populations will require a reorientation of food systems and policies, from production-driven to demand-driven. Urban and rural authorities, producers and consumers, civil society and social movements must engage together to simultaneously address social, economic and environmental challenges to improve and protect people’s health and ensure resilience through the promotion of sustainable diets. Consumers, and consumer associations, have a key role to play through reorienting demand and reporting on the impact of supply policies.
Urban decision makers can help create a more diversified food supply and there is increasing awareness and experience in food system planning among local governments, civil society and the private sector. In the near future, more cities will be forced to re-examine the mix of food supply sources to respond to people’s needs and demand, adapt to climate change and economic volatility. There is a wealth of innovative and promising solutions at local level to guide them. Policy and programmes linking food and nutrition security with economic development, biodiversity conservation and climate change adaptation can and must become more integrated.
Institutional set-up and procedures have to be revisited accordingly from the local level upward, and people reconnected to policy makers. The key to successful policies is local empowerment and multi-stakeholder ownership of the policy decisions. We need more partnerships, multi-stakeholder discussions and the reform of institutions to address the complexity of nutrition and sustainability. Priority should be given to policy dialogue and coherence, as well joint action-learning in a multidisciplinary context. Practice-based evidence, knowledge management and networking are essential to operationalize and accelerate the shift towards sustainable food systems and diets, with production and consumption within environmental limits.
Conclusion: sustainable diets require and can contribute to local governance
Food and nutrition are at a crossroads. If we aim for sustainable development, we will need to bring together economics, social equity, and environmental management. We cannot avoid any longer the need to deal with complexity and this can best be done at decentralised level where local institutions have to face concrete issues and develop pragmatic approaches. Governance at all levels is key to bring all stakeholders to respond to local needs and opportunities, support geographic alignment and integration of productive and social programmes, foster intersectoral collaboration and harmonize policy-making. Territorial planning based on agroecological zoning can help us find answers and learn together.
Local authorities are key players in this context, however, urban actors have often not considered the food system an important issue when designing, planning and managing cities. Many became aware of the issue in 2008, when food prices peaked. More than 20 countries around the world experienced food riots in urban areas.
Nutrition and sustainability must be central in our efforts to reduce poverty and hunger. These issues are complex and need a holistic, human-centered approach. Focusing on food security, nutrition and livelihoods in urban and peri-urban areas will help city-dwellers attain a healthier life. It will also allow municipalities to broaden their strategies and contribute to the post-2015 agenda. A diverse, nutritious and safe diet offers the opportunity for increased resilience, sustainability, and advances in human health, nutrition, productivity and livelihoods.
Hunger estimates today remain around 840 million. While the persistent burden of under-nutrition is seen as the unfinished health agenda of the 20th Century, poor diets and unhealthy lifestyles are the emerging threat for the 21st century. WHO estimated in 2011 that more than 40 million children under the age of five were overweight and at least 2.8 million adults die each year as a result of being overweight or obese. Health is a strong motivating factor for people to change their behavior. There are therefore big opportunities for triple wins of health, environment and development.