Geneva, Switzerland. ** The results show that compared with countries with a stable context, the cost of an energy sufficient diet is usually only slightly higher. Fresh shrimp should be refrigerated and consumed within four days or frozen for up to five months (20). The mention of specific companies or products of manufacturers, whether or not these have been patented, does not imply that these have been endorsed or recommended by FAO, IFAD, UNICEF, WFP or WHO in preference to others of a similar nature that are not mentioned. (also available at http://monographs.iarc.fr/ENG/Monographs/vol114/mono114.pdf). Without access to markets to absorb excess local supply, there is little incentive to increase production as this will only lead to lowering farm-gate prices.161 These lower prices in turn act as a disincentive to increased food production and technological innovation in the sector,161 ultimately leading to higher food prices. When recent food consumption data are available, the two series tend to converge more closely. v WFP (see WFP [2019]60 for published country data). Agricultural research in Africa: Investing in future harvests. Definition of overweight: Weight (kg) for height/length (cm) > +2 SD of the WHO Child Growth Standards median. 256 Herforth, A. Dietary reference intakes: the essential guide to nutrient requirements. Definition: [Haemoglobin] <110 g/L for pregnant women; [Haemoglobin] <120 g/L for non-pregnant women. In: UNICEF Data: Monitoring the Situation of Children and Women [online]. There are also considerable differences in income responsiveness across food items. 2 Barne, D. & Wadhwa, D. 2019. Micronesia: Kiribati, Marshall Islands, Micronesia (Federated States of), Nauru and Palau. In the benchmark diet scenario (BMK), which assumes that current food consumption patterns remain unchanged, the projected diet-related GHG emissions amounted to 8.1 GtCO2-eq in 2030 (adjusted for income and population changes). For the former, a set of emissions factors derived from life-cycle assessments were adopted, including a global life-cycle assessment with regional detail covering livestock products, which was undertaken by FAO,85 and a comprehensive meta-analysis of life-cycle assessments of other food products.86 The assessments included all main emissions (carbon dioxide, methane, nitrous oxide) and sources along the food supply chain from the farm gate to the retail point: production, processing, transport, including international trade, and, for livestock products, land use and feed production. According to the United Nation Office for South-South Cooperation (UNOSSC), the Global South includes Asia (with the exception of Hong Kong, SAR, Japan, Macau, SAR, Republic of Korea, Singapore and Taiwan, Province of China), Central America, South America, Mexico, Africa and the Middle East (with the exception of Israel).71, DESCRIPTION, DATA AND METHODOLOGY OF SECTION 2.2, For the analysis of Section 2.2, five dietary patterns are constructed to measure health and climate-change costs of baseline and alternative dietary consumption patterns. Furthermore, improvements in physical rural and urban market infrastructure increase access for agricultural producers to markets where they can sell their wares in a competitive and clean environment. The number of people affected by severe food insecurity, which is another measure that approximates hunger, also shows an upward trend. Data source: UNICEF & WHO. There isnt a single diet that eliminates eczema in everyone, but a good rule of thumb is to avoid any foods that seem to make your symptoms worse. 70 WFP. Asia has shown progress in reducing the number of hungry people in recent years, down by 8 million since 2015. Several tools for measuring dietary diversity have been developed for specific populations, including the Minimum Dietary Diversity for Women (MDD-W) indicator (Box 8) and the Minimum Dietary Diversity (MDD) indicator for infants and young children. energy sufficient, nutrient adequate and healthy) for the 15 countries with a protracted crisis situation for which price data are available. 235 Torero Cullen, M. 2020. Regional commodity prices were determined by market-clearing, i.e. National, regional, and worldwide estimates of low birthweight in 2015, with trends from 2000: a systematic analysis. Working group on food-based dietary guidelines for Thai people. The cost and affordability of the foods that form a healthy diet are important determinants of food choices. International Journal of Vegetable Science, 24(3): 274288. According to a recent analysis44,126 comparing current consumption with a number of different healthy diets that include sustainability considerations (i.e. 2019. Although obtained using different data and methods, the prevalence of severe food insecurity (FIsev) is conceptually comparable to the PoU. The findings presented in Figures 17, 18 and 19 are in line with other empirical evidence that shows that in recent decades, diets, particularly from upper-middle-income countries, have shifted away from staples towards more animal source foods, sugars, fats and oils.84,97. Table A5.2 shows own- and cross-price elasticities estimated by Green et al. 104 WHO. [Cited 28 April 2020]. In: World Bank [online]. (also available at www.fao.org/3/I9553EN/i9553en.pdf). Understanding them is critical to identify trade-offs and synergies for other SDGs. This important nuance is not well understood and is often missing from ongoing discussions and debates on the potential contribution of healthy diets to environmental sustainability. Coherently with WHO guidelines, the selected ten FBDGs recommend at least 400 g of fruits and vegetables, less than 10 percent of dietary energy from sugar and less than 5 g of salt, as all sugary and salty snack foods are excluded and treated as non-required foods. However, the publicly available CHNS data cover only 12 provinces and municipalities and are available for the years from 1990 to 2011 only. [Cited 15 April 2020]. 2020. Such actions should enhance efficiencies in food storage, processing, packaging, distribution and marketing, while also reducing food losses. www.who.int/gho/ncd/mortality_morbidity/en. If you eat too much mercury, it can be harmful to your unborn baby. However, increasing productivity may not accrue gains on its own. Oysters are considered a delicacy around the world. This rise in income leads to a well-documented change in diet composition, including a growing demand for animal source foods in the middle-income classes of those countries in both urban and rural areas.3,86,203,204 In addition, it is generally accepted that todays consumers increasingly care about the safety and quality of the food they eat, how their food is produced, and the impact that food production and consumption have on the environment and on society.205 The latter concern is particularly relevant to higher-income consumers. There are nearly 60 million more undernourished people now than in 2014, when the prevalence was 8.6 percent up by 10 million people between 2018 and 2019. European Journal of Clinical Nutrition, 64(12): 13931398. Commodity prices in the base year were based on data from the Agricultural Market Access Database of the Organisation for Economic Co-operation and Development,76,77 and estimates of export and import tariffs were adopted from the Global Trade Analysis Project (GTAP).78. Figure 8 shows that today, out of the 2 billion people suffering from food insecurity, 1.03 billion are in Asia, 675 million in Africa, 205 million in Latin America and the Caribbean, 88 million in Northern America and Europe and 5.9 million in Oceania. Central Asia, Eastern Asia and the Caribbean have the largest rates of reduction in the prevalence of stunting and are the only subregions on track to achieve the 2025 and 2030 stunting targets. Worldwide, governments support the production of sugar, rice and animal products the most through interventions, while penalizing the production of more nutrient-rich fruits and vegetables, such as tomatoes and bananas, the most (Table 12). Measuring food and nutrition security: An independent technical assessment and users guide for existing indicators. The cost and affordability analysis highlights the immense challenge in ensuring affordable healthy diets in these contexts. Growth in low-income countries evolution, prospects, and policies. Similarly, each place refers to the physical market locations at which prices were observed, where data used are typically an average over several vendors at open markets and grocery stores in each rural town or city. The crowded working conditions that characterize most dairy and meat processing plants also pose a challenge for meeting physical distancing needs. ISSN 2663-8061. Furthermore, imposing a classification on already existing data is circumscribed by the granularity of the data. That is, the cost of nutritious foods specifically is important in understanding economic access to healthy diets. A rising and ever more urbanized world population, combined with increasing levels of income, is placing tremendous pressure on the food and agriculture sectors to increase production to keep food prices from rising.103 In order to offset this upward pressure on prices and increase affordability of healthy diets, food and agricultural policies and incentives must help accelerate productivity and production of vegetables and fruits, and protein-rich foods. However, a nutrient adequate diet was more affordable in the urban south, even if it was more expensive, because incomes were higher. Mothers education and childrens nutritional status: new evidence from Cambodia. COVID-19: channels of transmission to food and agriculture. Yet, the PoU in the population for the region is 8.3 percent, below the world average (8.9 percent), and less than half of that of Africa. 124 Abila, R. 2003. This section has shown that the factors driving the cost of nutritious foods are found throughout food systems in the realms of food production, food supply chains, food environments, consumer demand and the political economy of food. There are many threats to progress. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 19902017: a systematic analysis for the Global Burden of Disease Stu. 230 Shively, G. & Thapa, G. 2017. Fragility and conflict: on the front lines of the fight against poverty. A study covering ten cities in nine countries found that adolescents ate half of the recommended amount of fruits and vegetables and less than two-thirds of the recommended amount of milk (and dairy products), but consumed much more meat (and meat products), fats and foods and drinks containing high amounts of sugars than recommended. Meeting these targets will only be possible if people have enough food to eat and what they are eating is nutritious. (2020)40 includes 173 countries, three countries are excluded from the analysis presented in Section 2.1 (Anguilla, Bonaire and Montserrat), since the World Banks classification of income is not available for them. Case study from Belgium, From 2000 to 2017, the global availability of fruits and vegetables and dairy products increased, while availability of staple foods remained stable, From 2000 to 2017, the global availability of pulses and nuts, and poultry and fish increased, while availability of red meat increased largely in upper-middle-income countries, From 2000 to 2017, the global availability of processed meat, eggs and fats increased, while availability of sugar decreased, The proportionS of different food groups available for human consumption differ across country income groups: a snapshot of 2017, Potential impacts of COVID-19 pandemic on availability and access to nutritious foods and overall diet quality, Minimum dietary diversity for women: evidence from three countries, Children living in urban households and those from richer families have better dietary diversity, Percentage of children 623 months of age eating foods from minimum number of food groups. Globally, enough food is being produced or in stock to meet dietary energy needs. The Lancet, 395(10218): 156164. Project reports with published results are available for El Salvador, Ghana, Lao Peoples Democratic Republic, Madagascar, Mozambique, Niger, Pakistan, Philippines, Sri Lanka and Tajikistan. Geneva, Switzerland. Though shrimp is nutritious, there are concerns about its cholesterol content and shrimp farming practices. The health impacts associated with poor diet quality are significant. Other estimates from UNU-WIDER place the figures much higher and suggest that about half a billion people worldwide could be pushed into poverty due to COVID-19.142,143. This prevalence is more than twice the world average (8.9 percent) and is the highest among all regions. Box 4 presents some of the ways COVID-19 might impact malnutrition. The expected recovery in 2021 would bring the number of undernourished down, but still above what was projected in a scenario without the pandemic. In the analysis below, SUA data are used to depict trends in availability of 10 selected food groups, and 3 meat subgroups, by region and by country income group for the years 20002017.e The contribution of all food groups (combined into 7 groupings) to total food and dietary energy supply in 2017 is also presented by country income group. Rome, IFAD. At the time of writing, few countries had reported significant rises in food prices, except for a number of local markets because of temporary food shortages. i The three HCES used in this analysis (from Kenya, Samoa and Sudan) collected information on food consumed at the household level (i.e. 114 FAO. For people who are less physically active, energy needs and therefore costs are lower, and for people who are more physically active, energy needs and therefore costs are higher. Eczema is most common in children younger than age 2, but it can also affect older children and adults. As seen in this section, some of the factors driving the cost of nutritious foods are a result of environmental degradation and climate change challenges. 167 USDA. CMI Report 8. IFPRI IMPACT Webtool. The National - UAE, 2 January 2019. This, along with the hidden environmental costs discussed in the previous section, provides further justification in addressing the environmental externalities associated with current food systems. & Murphy, S.P. Over half of the population in Africa, almost one-third in Latin America and the Caribbean and more than one-fifth in Asia are food insecure, 8 Over half of the people affected by moderate or severe food insecurity in the world live in Asia and more than one-third live in Africa, 9 Globally and in every region, the prevalence of food insecurity is slightly higher in women than in men, 10 Despite some progress for most indicators, only the 2025 target for exclusive breastfeeding is on track to be achieved. Penang, Malaysia and Washington, DC, The WorldFish Centre and IFPRI. Low-income countries rely more on staple foods, and less on fruits and vegetables and animal source foods than high-income countries. Rome, FAO. Small Island Developing States: Estimates for child stunting, wasting and overweight, adult obesity, exclusive breastfeeding and low birthweight exclude American Samoa; French Polynesia; Puerto Rico; Anguilla; Aruba; Bonaire, Sint Eustatius and Saba; British Virgin Islands; Curaao; Guam; Montserrat; New Caledonia; Northern Mariana Islands; Sint Maarten (Dutch part); and United States Virgin Islands. In: United Nations Department of Economic and Social Affairs (UNDESA) [online]. Worldwide, less than a third of young children are eating foods from the minimum number of five food groups needed to meet their energy and nutrient needs. The environmental costs do not account for other negative environmental impacts and the health costs do not account for the negative impacts of undernutrition due to data constraints. Medford, USA, Tufts University. The availability of staple foods for the world has changed little between 2000 and 2017 (Figure 17). Most of the global increases in animal source foods were observed in lower- and upper-middle-income countries. Best buys recommended by WHO for promoting healthy diets include reducing salt intake through programmes that encourage reformulation of food products and introducing front-of-pack nutrition labelling.320. Proceedings of the National Academy of Sciences of the United States of America, 113(15): 41464151. The global average cost, converted to international dollars using purchasing power parity (PPP), of meeting calorie needs using the cheapest starchy staple at each time and place the energy sufficient diet was USD 0.79 per person per day in 2017q (Table 7). Refinements to the FAO methodology for estimating the prevalence of undernourishment indicator. Rome. Climatic Change, 125(2): 179192. The poorest in Northern Africa have a prevalence which is only 1.4 times higher than the richest, the smallest relative difference of all subregions in the world. 2019. This is also broadly consistent with recent trends in the PoU in the world and across regions, as noted in the previous section of this report. The final report underwent a rigorous technical review by senior management and technical experts from different divisions and departments within each of the five UN agencies, both at headquarters and decentralized offices. Moving towards healthy diets through these enhancements will contribute to reducing the cost of producing and consuming nutritious food because, as shall be seen in the next section, it simultaneously addresses some of the factors driving the cost of food. own production, distance to markets, availability in markets, natural resources and biodiversity that provide wild foods) and economic or financial access (e.g. This revision is significant, given that China has one-fifth of the global population, and hence we sought independent assessment on the integrity of our approach and methodology from four leading experts: Joachim von Braun, Professor for the Department of Economic and Technological Change and Director of Center for Development Research (ZEF) at Bonn University, and Chair of the Scientific Committee of the 2021 Food Systems Summit; Christopher Barrett, Professor of Applied Economics and Management, international professor of agriculture at the Charles H. Dyson School of Applied Economics and Management at Cornell University; David Laborde, Senior Research Fellow and Theme Leader on Macroeconomics and Trade at the International Food Policy Research Institute; and Maria Ana Lugo, Senior Economist with the Poverty and Equity Global Practice at the World Bank. However, given the inter-connectivity of different actions in a food systems context, only concerted efforts across sectors will be helpful. For poor and vulnerable people in most low-income countries, and for population groups with higher nutrient requirements, such as infants and women of reproductive age, a small increase in meat and other animal source foods can greatly improve the nutritional adequacy of their diets, because they are good sources of quality protein and important micronutrients.95 However, a high consumption of red and processed meat can contribute to high saturated fat and/or salt intakes, and is associated with higher risk of certain types of cancer and other diet-related NCDs.93,96 Furthermore, diets high in animal source foods, particularly beef, lamb, milk and other dairy products have a higher environmental impact than plant-based diets (see Section 2.2). Malnutrition includes undernutrition (child stunting and wasting and vitamin and mineral deficiencies) as well as overweight and obesity. 2017. All rights reserved. 2020. Rome, IFAD. & Cai, Y. Hence, progress for this target is not assessed in this report. 163 Bachewe, F.N. Beyond hunger, a growing number of people have had to reduce the quantity and quality of the food they consume. Policy actions across food supply chains are critical in reducing the costs of nutritious foods. Under this measure, affordability is defined when the cost of each diet per person per day is lower or equal to the average food expenditure in each country. According to current estimates, in 2019, 21.3 percent (144.0 million) of children under 5 years of age were stunted, 6.9 percent (47.0 million) wasted and 5.6 percent (38.3 million) overweight. To lower the excess energy intake levels, a substantial reduction in rice consumption would also be needed, even though rice has been at the forefront of the countrys food security policy. *** Preliminary analyses are presented here to assess the association between food security status and diet quality (see Annex 2 for more details). 2018. Public policy needs to create the right incentives for producers to cut food losses and for consumers to reduce food waste in order to maximize social benefits and reduce the cost of nutritious foods. Global Environmental Change, 20(3): 451462. Low- and middle-income countries will likely be the most affected, as they do not have the contingency mechanisms and funds to stimulate their economies and protect the most vulnerable. abbreviations, Executive Users wishing to reuse material from this work that is attributed to a third party, such as tables, figures or images, are responsible for determining whether permission is needed for that reuse and for obtaining permission from the copyright holder. 103 Farrell, P., Thow, A.M., Abimbola, S., Faruqui, N. & Negin, J. Geneva, Switzerland. Food Policy, 35(4): 265273. Furthermore, dietary shifts to healthy diets can play an important role in increasing the environmental sustainability of food systems. Expenditures that benefit consumers (e.g. Policy brief: a disability-inclusive response to COVID-19. & Su, Y.X. They are what economists call negative externalities, and they can lead to market failures, overconsumption, and production of energy-dense foods and diets that are harmful to environmental sustainability. Journal of Health, Population and Nutrition, 31(2): 202210. This puts healthy diets beyond the reach of those living in poverty or just above the poverty line. 220 Ligon, E. & Sadoulet, E. 2018. It showed that poverty and inequality reduction is critical to improving peoples capacity to access sufficient and nutritious food, pointing to concrete policy recommendations, some of which are revisited in the last section of this part of the report. Refers to the ability of people to buy foods in their local environment. Value chain focus on food and nutrition security. As of October 2019, four selected wholesalers extended USD 460 000 worth of credit monthly to small shops in Kakuma Camp.278. It also presents evidence on what people are eating around the world including global trends in food availability and assessments of diet quality at the global and national levels. The statistics from HCES data were obtained using the ADePT-FSM software.31,32 Using Mexicos data set, estimates were obtained applying the National Cancer Institute (NCI) method for usual intake of episodically consumed foods and for usual dietary energy intake,33 implemented through the Mixtran and Distrib SAS macros.34. (forthcoming)120 for a full description of the methodology and the results). The analysis shows that the adoption of any of the four alternative healthy diet patterns (FLX, PSC, VEG and VGN)ak could potentially contribute to significant reductions of the social cost of GHG emissions, ranging from USD 0.7 to 1.3 trillion (4174 percent) in 2030 (Figure 37). New York, USA. 291 Burchi, F., Scarlato, M. & DAgostino, G. 2018. The prevalence of wasting for the African region is 6.4 percent, with only the Southern Africa subregion having a prevalence below 5 percent. Sugar-sweetened beverages and weight gain in children and adults: a systematic review from 2013 to 2015 and a comparison with previous studies. 134 FAO. Infant and young child feeding: exclusive breastfeeding. Monitoring low birth weight: An evaluation of international estimates and an updated estimation procedure. 295 Alderman, H. 2016. Taxation of energy-dense foods and beverages with minimal nutritional value. Heres how to stop it. Squids and octopuses produce black or bluish-black ink, while some cephalopods produce brown or red ink. In: United Nations Department of Economic and Social Affairs [online]. A/72/829. * The ten food groups are: 1) grains, white roots and tubers, and plantains; 2) pulses (beans, peas and lentils); 3) nuts and seeds; 4) dairy; 5) meat, poultry and fish; 6) eggs; 7) dark green leafy vegetables; 8) other vitamin A-rich fruits and vegetables; 9) other vegetables; and 10) other fruits. The analysis in this report shows that the poverty line, which includes a provision for basic food needs, does not support a nutrient adequate or a healthy diet in most countries. Overall, a healthy diet is not affordable for more than 70 percent of the countries in Africa (35 out of 50). More than half (57 percent) of these are direct healthcare costs as they are associated with expenses related to treating the different diet-related diseases. (forthcoming)90 for an expanded description of the methodology, results and limitations of SUA and FBS data). 43105. The 2017 edition of this report defines protracted crisis situations as characterized by recurrent natural disasters and/ or conflict, longevity of food crises, breakdown of livelihoods and insufficient institutional capacity to react to the crises. There are three criteria used to define a country with a protracted crisis: (i) longevity of the crisis; (ii) humanitarian aid flow to the country; and (iii) the countrys economic and food security status. Compared to the adjusted baseline diet, the definition of plant-forward diets includes a reduction of sugar intake to less than 10 percent of total energy per capita per day, and the consumption of at least five servings of fruits and vegetables per capita per day. 2015. 106 PAHO. Section 1.2 was prepared by Elaine Borghi with Elisa Dominguez (WHO), Chika Hayashi, Julia Krasevec, Richard Kumapley, Roland Kupka and Vrinda Mehra (UNICEF), with inputs from Katrina Lundberg, Lisa Rogers, Zita Weise Prinzo and Marzella Wstefeld (WHO). A healthy diet ensures that a persons needs for macronutrients (proteins, fats and carbohydrates including dietary fibres) and essential micronutrients (vitamins and minerals) are met, specific to their gender, age, physical activity level and physiological state. When the NRP is positive, this indicates that trade protection, through import tariffs or quotas, and price support policies have sustained domestic prices, thus subsidizing the agricultural sector. Rome. (also available at https://openknowledge.worldbank.org/handle/10986/7409). (2020),40 based on ICP data.ay, Income distributions from the World Bank's PovcalNet tool are available for year 2018 (not for year 2017), and are based on household surveys across 164 economies. The model used a weighted average of various bell-shaped densities to estimate full haemoglobin distributions, which might themselves be skewed. UNICEF-WHO-The World Bank: Joint child malnutrition estimates Levels and trends (March 2020 edition) [online]. The assignment of countries or areas to specific groupings is for statistical convenience and does not imply any assumption regarding political or other affiliation of countries or territories by the United Nations. Dietary Reference Intakes for Sodium and Potassium. Even given the option of low-cost imports, these only offer limited scope to bring down prices.7, Indeed, high prices are already seen in many countries due to poor productivity in the dairy and poultry sectors. The nutrient adequate diet includes, per person, the average energy needs and the recommended intake for protein, fat, four minerals and nine vitamins. Availability of fats and oils increased steadily for all regions and country income groups from 2000 to 2017 (see Figure 19). Celiac disease and dermatologic manifestations: Many skin clue to unfold gluten-sensitive enteropathy. 94 Hall, J.N., Moore, S., Harper, S.B. 99 Tremmel, M., Gerdtham, U.G., Nilsson, P.M. & Saha, S. 2017. Even in some peaceful settings, food security has deteriorated as a result of economic slowdowns threatening access to food for the poor. Cairo, FAO. FAO is not responsible for the content or accuracy of this translation. 138 FAO. This trend started in 2014 and extends to 2019. Nutrient composition and dietary diversity of on-site lunch meals, and anthropometry of beneficiary children in private and public primary schools in Ghana. For the former, we adopted a set of emissions factors derived from life-cycle assessments, including a global life cycle assessment with regional detail covering livestock products that was undertaken by FAO and a comprehensive meta-analysis of life cycle assessments of other food products. The Sixth World Food Survey, pp. Nonetheless, Table 9 summarizes additional evidence from the literature on the impact of current dietary patterns on these other environmental impacts, and the estimations of potential impacts from shifting to healthy diet patterns that include sustainability considerations. Food insecurity can affect diet quality in different ways, potentially leading to undernutrition, including micronutrient deficiencies, as well as overweight and obesity. Dollar a day revisited. Many producers will continue growing what they know best, largely staple foods, rather than venture into more risk-prone products or other commodities of higher nutritional content.167, Those smallholders who have successfully engaged in vegetable production have had several factors in common: access to markets, enhanced access to credit, irrigation infrastructure, technology and knowledge.168 For many, contract farming is an instrument that can provide certainty in expected returns on production. In low-income countries, major causes of mortality are more related to the multiple forms of communicable, maternal, neonatal conditions and undernutrition. ISSN 2663-8061 (PRINT)ISSN 2663-807X (ONLINE)ISBN 978-92-5-132901-6 FAO 2020. Hence the importance of policy coherence and coordination across all relevant sectors and involving all stakeholders of which we made reference at the beginning of this section. Further income increases are typically associated with acquisition of more diverse foods, often achieving higher levels of most nutrients but using more expensive ingredients than the least-cost nutrient adequate diet in an effort to achieve higher levels of palatability, convenience and other attributes beyond essential nutrients. Harvesting prosperity: technology and productivity growth in agriculture. Our conviction that an update of the PoU for China was needed was reinforced further by a recent assessment on the state of nutrition in China, the Report on Chinese Residents Chronic Diseases and Nutrition, published by the Chinese National Health and Family Planning Commission on 30 June 2015. & Alderman, H. 2013. Similarly, 2019 estimates were developed using the most recent estimate available for each country between 2014 and 2019. Without food, there can be no exit from the pandemic. 2018. Countries should eliminate existing export restrictions, including export taxes and export bans, while also reducing tariffs to facilitate imports.139, Evidence of impact on food prices. The distance to food marketplaces and the time required to prepare a healthy meal in times of rapid urbanization and increasing involvement of women in economic activities can also be seen as cost drivers because people who try to overcome them would have to accept an additional cost on top of the cost of food itself. A penny-per-ounce tax on sugar-sweetened beverages would cut health and cost burdens of diabetes. & Cafiero, C. 2013. No matter what the policy objectives are, there will be winners and losers in the population from each of these interventions, and the affordability of healthy diets will be affected as well. The coexistence of forms of undernutrition (child stunting and wasting and vitamin and mineral deficiencies) with overweight and obesity in the same country, community, household or individual. ** Potatoes, sweet potatoes, cassava and other starchy roots are not classified as fruits or vegetables. 301 Zenebe, M., Gebremedhin, S., Henry, C.J. Policies and investment in nutrition-sensitive handling and processing. Poor road networks or long distances between production and consumption areas are also barriers to domestic trade that prevent well-functioning markets from existing. The unaffordability of healthy diets is due to their high costs relative to peoples incomes, a problem likely to be exacerbated by COVID-19. 45 Otten, J.J., Hellwig, J.P. & Meyers, L.D., eds. Why invest, and what it will take to improve breastfeeding practices? For example, the healthy diet in this analysis was on average more costly per person per day in lower-middle-income countries, estimated at USD 3.98, but the cost across these countries ranged from USD 2.85 to USD 5.00. In: Chinese Nutrition Society [online]. The most disadvantaged and vulnerable groups are often adolescents, women and children living in poorest households in rural areas but also urban areas. The prevalence of stunting among children residing in rural areas was 34 percent, 1.7 times higher than children in urban areas. Addis Ababa and Washington, DC, Federal Democratic Republic of Ethiopia Policy Studies Institute and IFPRI. The next most costly healthy diet was in upper-middle-income countries (USD 3.95, range USD 2.805.60) and low-income countries (USD 3.82, range USD 2.775.72). Policies and investments to reduce food losses. Rome. 68 WHO. More specific policy recommendations for governments are presented in Box 21. Healthy diets that reflect global guidelines and include foods from several groups and have greater diversity within food groups are unaffordable for more than 3 billion people, and more than 1.5 billion people cannot even afford a diet that only meets required levels of essential nutrients. Simulation results in this box are shown for Central America countries, under the assumption that trade distortions (protection) are removed, meaning that the NRP is made equal to zero. To generate national level three-year averages for 20172019 and annual values at regional and global level in 2019, projections are needed. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. In addition to the trends on improving nutrition in China from the 2015 report mentioned above, further validation for the revision comes from comparing the revised global estimates of PoU with the recent estimates of the prevalence of severe food insecurity based on the Food Insecurity Experience Scale (FIES). At the country level, it is calculated as the food remaining for human use after deduction of all non-food utilizations (i.e. School meals provided to millions of children worldwide also represent an important contribution to reducing the cost of food, in particular for low-income families, who already cannot afford healthy diets. 2018. School closures leading to missed meals and nutrition education normally provided through school food and nutrition programmes.36, Deterioration of childcare practices. 2010. Nonetheless, median total daily energy intake was estimated to be nearly in line with the recommendations.79. Research is mixed, but evening primrose oil might be able to help eczema symptoms. food = production + imports + stock withdrawals exports industrial use animal feed seed wastage additions to stock). In spite of the high potential for technological advances, in many low- and middle-income countries, investment in agricultural sector R&D is currently insufficient.159 For example, in a sample of 70 LMICs, the average number of public sector researchers per million in the countrys population is 45 in cereal research, with only 1 researcher each in the cultivation of fruits and vegetables.160 The focus on staples is a reason for continued high prices, in particular for more perishable food commodities like fruits and vegetables and livestock and fisheries products. At the time of going to press (June 2020), the COVID-19 pandemic was spreading across the globe, clearly posing a serious threat to food security. Voices of the Hungry. Global Nutrition Policy Review 2016-2017: country progress in creating enabling policy environments for promoting healthy diets and nutrition. refuse factors). Dietary guidelines for Americans 20152020. In making the connection between FIsev and CV, only the fraction of changes in the PoU values that could be attributed to changes in food consumption inequality were considered. Methodology: National representative surveys, summary statistics from WHOs Vitamin and Mineral Nutrition Information Systems, and summary statistics reported by other national and international agencies are used. The diet-related social cost of GHG emissions related to current food consumption patterns are estimated to be around USD 1.7 trillion for 2030 for an emissions-stabilization scenario. The prevalence of stunting is higher in rural populations than in urban ones. Adult obesity continues to rise, from 11.8 percent in 2012 to 13.1 percent in 2016 and is not on track to reach the global target to halt the rise in adult obesity by 2025. 63 Scarborough, P., Appleby, P.N., Mizdrak, A., Briggs, A.D.M., Travis, R.C., Bradbury, K.E. Technical Briefing Paper: The relationship between wasting and stunting: policy, programming and research implications. 178 Willenbockel, D. 2011. p The World Food Programmes Fill the Nutrient Gap project has recently conducted analyses of the cost and affordability of diets in a number of lower-middle-income countries (LMICs) and in fragile/refugee settings. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the Arbitration Rules of the United Nations Commission on International Trade Law (UNCITRAL) as at present in force. 77 OECD. At this time, however, only about a third of countries with FBDGs specify quantities, which presents challenges for assessing adherence to the guidelines and for research aimed at global and regional analyses. https://beta.sfda.gov.sa/en/news/1961, 319 Saudi Food and Drug Authority. A 3-percentage point increase in the PoU is projected for Central America. The cost of hunger: social and economic impact of child undernutrition in the Plurinational State of Bolivia, Ecuador, Paraguay and Peru. Washington, DC, USDA. Snchez and Cicowiez354 have added analysis to demonstrate that, in the very long run, the payoff of past policies will depend on labour market changes and the efficiency of service delivery. The update is based on the trend in FIsev from 2015 or the year of the last available food consumption survey, if the latter is more recent. Most evidence currently available on the cost of nutritious foods, however, relates to the cost comparisons of individual food items and/or food groups. Among others, the nutrition-sensitive approach aims to address growing malnutrition and health costs due to the emergence of and preference for more energy dense and highly processed foods; significant levels of food loss and waste; increased incidence of food safety issues and trans-boundary diseases, as well as environmental and natural resource degradation.175 In another example, the Smallholder Livelihood Development Project in eastern Indonesia has adopted a nutrition-sensitive value chain approach to address a nutrition gap found to be particularly severe for adolescent girls. Where cheap energy-dense foods of minimal nutritional value are available, the poor will buy these foods, as healthy diets are still too expensive for them.20,21 Many high-income countries, notably the United States of America and Europe, have for some time been in that stage of the obesity-transition where the prevalence of obesity among those with lower socio-economic status surpasses that of those with higher socio-economic status. (2015)48 by country economic development. Agricultural (dis)incentives and food security: is there a link? Our use of the term consumption differs from that of economists who refer to consumption as food and non-food expenditures.133. For estimating the climate-change costs of diets, we first calculated the GHG emissions associated with food consumption and then paired those with cost estimates of climate damages. These mechanisms can be particularly important in the face of adversity, as we are seeing today during the COVID-19 pandemic. The above is one example of the delicate balancing act between producer and consumer interests. Obesity: health and economic consequences of an impending global challenge. The recommended reduction in rice consumption is substantial and would require major changes in dietary practices and food production patterns. Rather, they are the outcome of a complex decision-making process that can be influenced by a variety of objectives and interests. In addition, the confidence limits of the regional and global estimates may be artificially small given that about half of the modelled countries had a country-specific effect generated at random for each bootstrap prediction, some of which were positive and others negative, making the relative uncertainty at the regional and global level tend to be less than that at the individual country level. Cost of a healthy diet: Given that the exact make-up of a healthy diet varies by local context, countries have developed national food-based dietary guidelines (FBDGs) to reflect their specific cultural context, locally available foods and dietary customs. The cost analysis of a healthy diet above shows that the poverty line, which includes provision for basic food needs, does not provide for having either a nutrient adequate or a healthy diet in most countries. A senior advisory team consisting of designated senior managers of the five UN publishing partners guided the production of the report. Public expenditure is a powerful instrument by which governments can shape and develop their food systems.220,221,222 Public spending can be used as an equity tool in reallocating resources in favour of the poorest family farmers and smallholder producers or to address market failures or overcome the under provision of public goods in the food and agriculture sectors.222. Rome. Note that while, on average, 16.5 percent of avoided deaths were related to the combination of all dietary risk factors, this percentage is smaller than the sum of individual percentages by food group, since it accounts for co-exposure of risks. Their populations face frequent food price fluctuations and spikes, disruptions in food supply and access to functioning markets, and greater uncertainties, risks and inefficiencies in food systems. Fill the Nutrient Gap Lao DPR: summary report. 122 Popkin, B.M., Corvalan, C. & Grummer-Strawn, L.M. Global, regional, and national trends in hemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 19952011: a systematic analysis of population-representative data. Equally important, given rapid rates of urbanization and the increasingly complex web of food supply chains expected to deliver safe and nutritious foods to rising numbers of urban consumers, strong rural-urban linkages are critical. A brief description of the methods and baseline data for this estimation are provided in Box 14, with a more comprehensive description of the data and methodology provided in Annex 7. z The analysis has been carried out in collaboration with the University of Oxford, and is an update to a previous analysis on the valuation of the health and climate-change benefits of dietary change.84 In particular, the new analysis of this report increases the number of dietary risk factors covered in the health analysis and valuation; uses more recent emissions data in the environmental analysis; and updates the diet scenarios to a standardized set of healthy diets that include sustainability considerations that are analysed as a means of reducing the negative health and climate-change costs imposed on society. The analysis of cost drivers in Section 2.3, shows that the factors driving the high cost of nutritious foods are found throughout the food systems, related to food production, the food supply chains, the food environments, as well as consumer demand and the political economy of food. Challenges and limitations: Despite a high proportion of countries having nationally representative survey data available for anaemia, there is still a lack of reporting on this indicator, especially in high-income countries. 37 Mayn, A.L., Marques-Vidal, P., Paccaud, F., Bovet, P. & Stringhini, S. 2014. The State of Food Insecurity in the World 2010. A shift towards healthy diets that also include sustainability considerations will require significant transformations in food systems, and there is no one-size-fits-all solution for countries. 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