The World Health Organization estimates that 3.3 billion people around the world will be overweight by 2030. Will non-communicable diseases related to malnutrition and obesity be the major health challenge of the 2020s?
Eighty-six percent of obese children live in low- and middle-income countries, according to the joint 2019 report by UNICEF, the World Health Organization (WHO) and the World Bank. Previously limited to developed countries, obesity and associated non-communicable diseases (NCDs) are becoming a global problem.
Eating too little, but too much junk
People in developing countries are affected by both hunger and obesity. For example, although 24% of the population in sub-Saharan Africa are undernourished, 12% of adults are obese according to the UN Food and Agriculture Organization (FAO). Overweight and undernutrition problems exist together in households, as highlighted in the 2017 report by the Malabo Montpellier Panel, Nourished. In many developing countries, children have been diagnosed as being both overweight and having delayed growth.
Women and children are especially vulnerable to this problem. In West Africa, 38% of women of childbearing age are overweight and 15% are obese. In the world, 40.1 million children under the age of five are obese, including 18.8 million in Asia alone. According to the WHO, obesity in childhood obesity is “one of the most serious public health problems of the 21st century. ”
Coke more affordable than water
The apparent paradox of this situation is the result of globalization and the urbanization of developing countries. The existence of a burgeoning urban middle class, with lower levels of physical activities than rural populations, has altered eating habits.
José Graziano da Silva, Director General of the FAO, blames the globalized food system. “Unfortunately, commodities and industrialized cheap food are much easier for international trade,” he explains. Supermarkets full of processed foods, sugary products (like sodas) for ridiculously low prices and the overrepresentation of fast food brands in urban centers are all feeding the junk food cycle. Researchers J. Correia, Z. Pataky and A. Golay highlight the positive sociocultural image linked to being overweight in many African countries, where weight gain is associated with wealth and good health.
Obesity and non-communicable diseases: the origin of the health crisis
Contrary to what this image conveys, malnutrition and obesity cause non-communicable diseases (NCDS), such as type 2 diabetes and hypertension. 71% of deaths around the world are caused by NCDs and, over the past 15 years, no progress has been made to stop childhood obesity at the global level. As Stéphane Besançon, Director of the NGO Santé Diabète explains, “there is no access to healthcare for people with diabetes […] in almost all African countries. ”
Due to under-equipped centers and a lack of specialized staff, healthcare systems in developing countries are unable to deal with the diseases associated with malnutrition and the explosion of NCDs. Several NGOs are sounding the alarm: malnutrition is the number one risk of mortality in Africa, “ greater than the combined risks of unsafe sex, alcohol, and drug and tobacco use,” according to the 2017 report Nourished.
Treating malnutrition as a health emergency
According to Stéphane Besançon, the solution is to first raise awareness of the urgency among global decision-makers: “Most donors and NGOs develop programs that combat undernutrition rather than malnutrition.” Health partners only allocate 2% of total funding to NCDs–which are preventable diseases. Yet a recent report by the OECD demonstrates that investing in obesity prevention is profitable: “every dollar spent generates up to six dollars in return on investment. ”
Taxes on the production of unhealthy food products along with massive awareness-raising campaigns: in 2018, José Graziano da Silva (FAO) recalled the responsibility of countries and economic systems in the emergence of these diseases: “Countries should have in place laws that protect healthy and local diets, and encourage the private sector to produce healthier food.”