by Hannah Meredith and Devon Paul
In Dr. Steinberg’s lecture,
we heard an overview of nutrition issues on a global scale.
Interestingly, these issues ranged from overnutrition to undernutrition with
both obesity and malnutrition being major causes of morbidity and mortality in
the world. With such a range of nutritional issues and they underlying
causes, how can we make meaningful dietary recommendations for people? Before
addressing this question, there are a number of interesting factors at play
that need to be understood.
The world is currently going
through a significant nutritional transition. There are 5 different
patterns associated with the nutrition transition: hunter gatherer, early
agriculture, end of famine, overeating and obesity-related diseases, and
behavior change. Currently, many low- and middle-income countries (LMICs) are
transitioning from the “end of famine” pattern to the “overeating,
obesity-related disease” pattern. This transition is happening as
Western-styled diets infiltrate different cultures and replace the traditional
diet. Couple this introduction of diet high in animal and partially
hydrogenated fats and low in fiber with a more sedentary lifestyle, and the
result is an obesity epidemic that is beginning to affect low- and
middle-income countries. These dietary and lifestyle changes in LMICs are an
effect of a recent demographic transition from a primarily rural, agrarian
society to an urbanized society centered on large cities. Migrants leave
behind a food safety net of family, friends, and farms for the promise of a
better life in the city; however, in the poorest countries, unemployment rates
are crushing, and people try to make a living on $1-2 per day. With that
money, the city workers not only have to pay for or build their own shelter,
but also have to buy the food that they once grew themselves. It is both a
curse and a blessing that large-scale production has decreased the price of
processed food and drink. On one hand, these foods are affordable to people who
do not have much income. On the other hand, these foods form an unhealthy bulge
in the top of the food pyramid for many.
I have seen plenty of soda bottles and potato chip bags being consumed
by children with evidence of protein malnutrition and stunting. Given the
struggle with food insecurity, economic hardship, and a ready supply of cheap junk
food and empty calories, how we can make meaningful dietary recommendations for
people?
In the US, we have tackled
the issue of food insecurity with a variety of piecemeal programs: food
subsidies for those living below a certain income threshold, subsidized school
lunches (and sometimes breakfast and dinners), food pantries, “soup kitchens”,
or community farmer’s markets that intend to provide low cost fresh fruits and
vegetables in food deserts. Yet even in our own country, we struggle to
meet the nutritional needs of the most vulnerable. What should a program look
like that addresses those living at risk of malnutrition?
