The recent Borlaug Dialogue and World Food Prize given to Dr. Akin Adesina, President of the African Development Bank, focused on the importance of helping the continent become self-sufficient in food production.

There was also a very interesting panel discussion, however, on urbanization and obesity that was particularly fascinating given some of the nutrition discussions going on here in the U.S. The basis of the panel discussion was the release of a report by the Global Panel on Agriculture and Food Systems for Nutrition. The report is entitled “Urban diets and nutrition: Trends, challenges and opportunities for policy action.”  

The report focuses attention on the global trend toward urbanization and its relationship to diet. The key takeaway for me was twofold:  1. Hunger and malnutrition is a rural and urban problem; and 2. the nutrition problems we are facing in the United States are in fact a worldwide phenomenon. “The greater wealth in urban centers, relative to rural areas, does not necessarily lead to healthier diets, with excessive consumption of highly-processed foods that are high in calories but low in nutrients.” 

According to the World Health Organization, 124 million children and adolescents are now obese – a tenfold increase in the last four decades. Adult overweight and obesity is rising in most low-and middle-income countries, not just in developed countries.

Urban populations are growing most rapidly in Africa and Asia. Urban dwelling is associated with less undernutrition than rural populations but more diet-related obesity and chronic disease.

While the urban poor experience low-quality diets and food safety risks, they have potentially good access to fresh produce and products fortified with micronutrients. The challenge is to find ways of strengthening the positive links between urbanization and diet quality while maintaining its ability to help reduce hunger and undernutrition.

The report goes on to summarize what constitutes a high quality diet according to a range of sources. According to the World Health Organization, healthy diets should:

  • Start early in life – notably with breastfeeding.
  • Balance intake and expenditure of energy (calories).
  • Include fruit, vegetables, legumes, nuts and wholegrains.
  • Include at least 400g of fruits or vegetables per day (excluding starchy roots such as cassava and potatoes).
  • Limit fat to no more than 30% of total energy intake.
  • There should also be a shift from saturated to un-saturated fats and towards the elimination of industrial trans fats.
  • Limit free sugars to less than 10% of total energy intake – or less than 5% for additional health benefits.
  • Limit salt to less than 5g per day – to reduce the incidence of hypertension, heart disease and stroke in adults.

The recommendations of the report are broad in scope but generally consistent with the Department of Agriculture (USDA)-Health and Human Services (HHS) Dietary Guidelines for Americans. (The USDA-HHS Dietary Guidelines do not address infant nutrition and includes a goal of moderate alcohol consumption.)              

The recommendations are also coupled with Policy Recommendations. Recommendation #1 is that Policymakers need to urgently rebalance their efforts to make high-quality diets a priority for both urban and rural populations. The Policymakers referred to are those at all levels--the federal, state and local level-- working with health care providers, health organizations and all appropriate stakeholders. The goal must be to work with Americans in all life situations to choose the healthier foods that are available. In the final analysis, food manufacturers will respond to consumer demand and market what people want.

As USDA and HHS starts planning for the 2020 Dietary Guidelines for Americans, and selecting an Advisory Panel, the Urban Diets and Nutrition report could be a valuable resource and guide.

The US food system is wonderfully unique in many ways….it produces a safe, ubiquitous food supply at the lowest cost in the world. Yet, we also share some worldwide challenges. Six of the top eleven risk factors driving our most serious diseases are related to diet. Overweight and obesity are major causes of strokes, diabetes and cardiovascular disease.

Again, according to the report, “Overall, the risk that poor diets pose to mortality and morbidity is now greater than the risks of unsafe sex, alcohol, drug and tobacco use combined.” That demands our attention. We tend to focus our attention and our resources on curing disease, rather than preventing disease. Increasing our attention on preventing disease with a special emphasis on nutrition education would pay dividends.

The USDA-HHS Dietary Guidelines, first published in 1980, was originally a short thematic document. The Guidelines, published every five years, has gotten longer and more technical with each edition. Perhaps the 2020 USDA-HHS Advisory Committee should include experts in communication as well as nutritionists and other scientists. The Dietary Guidelines for Americans is intended for the general public who need simple, clear and concise advice.

About the author: Marshall Matz specializes in agriculture, food security and nutrition policy at OFW Law. He was formerly General Counsel to the Senate Select Committee on Nutrition and serves on the Boards of several nutrition and anti-hunger organizations.