In module 3.2., we will incorporate some of the basic information about healthy diets presented above in module 3.1 with the exploration of food systems that you have made throughout the course. In particular, we want to highlight (1) the challenges of malnutrition and low food access for impoverished populations around the world, which can represent a failure of adaptive capacity of human societies to providing a socially sustainable future; (2) the phenomena of low food access for marginalized areas of the "developed world", which can take the form of what are called ‘food deserts’ without easily accessible healthy foods; (3) The rise of so-called chronic and nutrition-related ‘diseases of affluence’ related to caloric overconsumption (which in fact also affect poor, urban populations worldwide as well). We also will examine the potential food-system responses to these challenges, and how different food system types contribute to these challenges and their solutions.
Food insecurity, or the inability to access sufficient, culturally appropriate food for adequate nutrition, is a major problem for the poorest segments of the world’s population, the 1 billion or so people who live on less than two dollars per day (Food Security and Insecurity are more fully addressed in module 11). These poorest members of society often face chronic malnutrition, which some call undernutrition to distinguish it from nutrition diseases of overconsumption or poor food choices, which are considered malnutrition of a different type. Undernutrition is sometimes coupled with nutrition-related illnesses and long work hours in paid employment or smallholder agriculture on small and/or degraded land bases that often accompany poorer farms in rural areas. Undernutrition represents a failure of human societies and food systems to create access to a minimum standard of diet quality that can allow all human beings to live to their potential. In addition, the difficulty posed by undernutrition may fall disproportionately on the most vulnerable members of society: women, children, and the disabled and elderly. A particular burden is faced by caregivers of children (women, and increasingly grandparents) to both provide adequate care and feeding and take on the role of earning money to farm or buy food.
Organizations who work with these populations have worked to identify barriers to better care and feeding practices because it has been recognized that if the allocation of food within households is not equitable, simply increasing farm production or access to food can sometimes fail to increase consumption of healthy foods by vulnerable groups in households. Increasing the direct involvement and knowledge of parents and other caregivers in nutrition practices, and focusing attention on children under five years of age can help to improve nutrition outcomes and child growth in many poor households. These aspects of care, feeding, nutrition, and harmonization with local culture are important parts of food security referred to as the utilization component (this will be further addressed in module 11.2). As an example of the sort of trade-off that can occur between agricultural and nutrition goals in improving livelihoods, agricultural methods that are introduced to improve soil quality or increase agricultural income can be labor-intensive and must take care not to place undue additional time burdens on caregivers, who may then neglect the care and nutrition needs of children.
The challenges of chronic malnutrition are often linked in rural food-producing households to small land bases and/or degraded soils, which is of concern to us because it is a highly problematic case that links human system factors in the form of poverty, and natural system factors in the form of the degradation of earth's ecosystems. As will be described further in module 10.2, the coupling of malnutrition and soil degradation can form a ‘poverty trap’ for rural households, where unproductive soils demand large amounts of labor for small yields, with limited alternative options for food production or employment because of inequality -- or lack of social sustainability -- in the local and global human system. In this way, degraded soils have particular bearing on malnutrition because of the additional work and expenditure of calories required to coax yields from degraded land, which both deepens issues of food deficit and malnutrition, and can translate to expansion of the land area under degrading practices, or contribute to continued production at the lowest level that soil will allow. These factors can trap households in poverty. Such a situation can also translate into the migration of a smallholder household in search of more lucrative activities, which often means a dramatic change in diet towards more urban and processed foods, even if it changes the overall income possibilities of a family and can be considered as an adaptive response to food shortage and vulnerability.
A second major issue facing modern food systems is chronic diet-related disease that results from calorie overconsumption, often linked to increasing rates of obesity in societies around the world. The major chronic conditions related to calorie overconsumption are heart disease and type II or “old-age” (later onset) diabetes (see Fig. 3.2.1 for a global map of diabetes incidence). These have been called “diseases of affluence” because they tend to increase in prevalence as countries increase in material wealth, with a combined increase in meat and calorie availability along with more sedentary jobs and lifestyles.
The dominant role of the globalized, corporate food system in these societies (see module 10.1 for the typology of food systems) means that processed foods (e.g. mass-produced “non-food” snacks and sweetened beverages, prepared frozen meals, fast food, pasta) occupy a larger and large part of the diet of typical consumers in these societies. To save cost and maintain demand, processed fats, sugar, and salt, are used as low-cost ingredients in these foods (e.g. corn syrup, oil by-product from the cattle and cotton industries) As has been described by food writers such as Michael Pollan, the prevalence of these diet choices means that consumers eat a large proportion of “empty calories” without fiber, high-quality fats, sufficient vitamins, and minerals, or in some cases adequate protein. Although high-calorie and fatty restaurant foods have been common for generations, at a whole food system level the prevalence of these foods, and the way they have been normalized in such concepts as “the American diet” (which upwardly mobile consumers in many other countries aspire to) are of great concern because they provide a dominant range of food choices that are not consistent with human health. This is especially so as consumers become more urban and many (though not all) expend fewer calories in manual labor related to farming. The increased prevalence of calorie excess has produced increasing rates of obesity in North America and Europe. (Fig. 3.2.2 below)
The “double burden”: chronic diseases in poor economies: Moreover, the term “diseases of affluence” is misleading because it is, in fact, poor people in industrialized countries as well as the developing world that face the greatest impact of these diseases. Empty calories are often very cheap calories for poorer sectors around the world, so the consumption of processed or dominantly carbohydrate diets with insufficient whole grains, fruits, and vegetables is more common among the poor. In addition, poorer households often are less able to pay for the expensive consequences of these diseases in the middle-aged and elderly (e.g. insulin provision for diabetics, the consequences of heart attack and stroke in the elderly). Ironically the same poorer sectors in poorer parts of the world and even within the United States can simultaneously face the issues of “traditional malnutrition” (i.e undernutrition, insufficient consumption of vitamins, iron, zinc, calories), especially among children and women, as well as diseases of overconsumption of empty calories. This ironic pairing of food system dysfunction has been called the “double burden” on developing countries by food policy experts. It also acts, at a national level, to reduce the overall income of a country by impairing the productivity of its human population (Figure 3.2.3, below).
Food deserts: Within industrialized countries, food system analysts have noted that the marketing model of the globalized food system has focused on suburban supermarkets that are able to capture profits from middle and high-income consumers. This model is profitable for food distribution companies but has the effect of not adequately serving either inner-city poor populations and the rural poor, who face difficulties in physically getting to distant supermarkets. Fast food and high-priced, smaller food markets with a preponderance of processed and unhealthy foods are the only food options in many poorer parts of the United States and other industrialized countries. These areas of low food access for healthy, reasonably priced foods are called food deserts. You will explore these more with a mapping tool in the summative assessment for this module.
For more information on the "double burden" around the world, you can read the online resource from the World Health Organization, " The Economic Impact of Chronic Diseases [1] "
Although the modern globalized food system is highly dynamic and able to move enormous quantities of food and generate economic activity at a huge scale in response to global demand, the issues of poor diets, malnutrition and constrained food access we have described here are sobering issues that human societies need to confront. From the earliest days of civilization, food has been at once (1) a fundamental human requirement and human right; (2)a source of livelihood and a business as well as (3) the common property of cultures and ethnicities. The rise of a globalized food system, however, has brought new patterns into play because food has become an increasingly fiscalized commodity and experience.“Fiscalized” means that the provision of a fast food item, a food service delivery to a restaurant, or a supermarket buying experience (vs. a traditional regional open-air market, for example) are increasingly not only interactions among farmers, truckers, shopkeepers, and consuming households. Instead, the activities of production, distribution, and consumption within food systems become more and more integrated into the trade and investment patterns of the global economy. Food production, trade, and sales have been absorbed into the purview of profit-driven corporations that seek maximum value for stockholders. These stockholders are in turn citizens, organizations, and even governments that also participate by profiting from the functioning of the global system, demonstrating the involvement of common citizens in this system as well. Food activists, policymakers, and advocates of concepts like “agriculture of the middle” (see module 10.1) have argued that this new corporate character of the food system increasingly creates a food system that has an incentive to ignore important values like food access equity, just treatment of producers and workers, healthy diets, and environmental sustainability as the elements of the three "legs" of sustainability (see Module 1). However, reform movements within the globalized food system also demonstrate that it is able to pay attention to human nutrition goals and environmental sustainability.
In fact, the food system is not a completely unfettered capitalist enterprise.& Examining any food packaging shows the degree to which food is subject to regulation and oversight by the government. Food safety scares and health inspections of restaurants show the close attention paid to the acute impact (if not always the chronic impact over time) of unhealthy food. Education efforts promoting healthy choices in diet and exercise are regularly heard from both government organizations and private advocacy organizations: for example, state cooperative extension agencies, universities, and public service announcements. The efforts to label calories on restaurant menus and the movement of food service companies and local restaurants towards healthy options in menus show the growing awareness and movement of food demand towards healthy options. And many supermarket chains are making substantial efforts to include more local and regionally produced foods and promote healthy diets and nutrition as part of the communication to consumers.
In part, these changes show the changing awareness of the problems in the modern “American diet” among the public, brought on by food activists and authors about the food system. And on-the-ground marketing initiatives for values-based value chains such as those promoted by local and regional food system advocates include improving access to healthier foods like whole grains, fruits, and vegetables. For middle- and higher-income consumers with access to the abundance of foods in typical supermarkets and farmer’s markets around the world, this can incentivize better choices about well-rounded diets. In many cases, these healthier diets also include less reliance on meat because of its water footprint and adverse impacts on health when eaten in excess. One essential question, however, is how these efforts to improve food choices and access can expand their reach to poorer consumers and those who live in food deserts, either by improving geographic access, low-cost alternatives, or income opportunities to these consumers. You’ll explore this question of food equity more in the summative assessment for this module, regarding food deserts and examples of organizations in your capstone regions that are promoting healthy food choices and production.
The capstone project, which is introduced at this time in the course and requires you to begin thinking about the food system of a particular focus region, is an opportunity to think about food access and nutrition in your example region. As part of this project, you may want to see some examples of how local governments and organizations of citizens are promoting healthier diets. This may help you to propose similar strategies for food systems. One example you may look into is the website for the Toronto Food Strategy [2] (a part of the municipal government of Toronto, Canada) and the way that their activities are coordinated with the Toronto Food Policy Council [3] (a volunteer study/action and advocacy organization). Many states, counties, and cities in the United States have organizations and government efforts similar to these examples.
At the end of module 2, you read about alternative food systems and the relocalization of food production and distribution as one of the emerging future proposals in the history of food. These efforts, which will be revisited in a typology of current food systems in module 10, are an important source of ideas and initiatives to increase sustainable food production methods and equitable relations between consumers and producers. Local and regional food systems and initiatives have been promoted as ways to retain economic benefits and jobs within regional contexts. Organic and sustainable production methods often form a part of these movements and seek to reduce the environmental impacts of food production. Organic food is, in fact, a documented way to reduce exposure to pesticide residues in foods, which is of concern to many consumers. Food such as fruits and vegetables, which is fresher when it is consumed, which can be the case for locally produced food, is also likely to have a greater content of vitamins and other health-promoting components. However, others have pointed out that at a global level, the optimal freshness of produce, or a complete absence of pesticides, can be of smaller benefit to health in the overall food supply than would be, say, orienting diets away from processed fats or towards greater vegetable consumption or plant-based oils. This more incremental approach suggests that it is important to target low-hanging fruit like availability of lower-cost vegetables and higher-fiber diets to more of the worlds' population, rather than just playing up potential benefits from foods that are local or produced with fewer or no pesticides. It is also important to point out that there can be much confusion among consumers on whether all organic food is locally produced (it's not) or whether local food is always organically produced (also not true).
In summary, given the much smaller size of these local and alternative food initiatives in comparison to the global food system, and also the scale of the problems of malnutrition and unhealthy diets, it may be important to put potential benefits of local and/or organically produced foods in the context of the overall challenges of the food system. For example, in the case of an urban food desert where only low dietary quality processed foods are available, increasing the availability of vegetables, fruits, and whole grains consumed using a number of strategies may be a more viable food system strategy to pursue than promoting locally or organically produced foods as a sole strategy. These multiple strategies could, in fact, rely on greater supermarket access and food streams from the globalized food system along with seasonal access to farmers' markets for local produce. Home and community gardens can also complement and reinforce strategies for healthy eating. In addition, organizations of farmers using organic and other more sustainable methods have often acted as important allies in local food system settings for promoting healthier diets. As we will see throughout this course, the nutrition and sustainability outcomes emerging from the interacting parts of the food system are complex, and we can't always go with a single alternative to provide the best outcomes.
Please view this short video from the "Feeding the nine billion" project of Professor Evan Fraser at the University of Guelph. He argues for the importance of local, alternative food systems but also acknowledges the issues of scale that make global food systems an important aspect of diet and nutrition for the foreseeable future. This is not just about nutrition -- he is also reviewing many of the themes of food and sustainability we will be covering in the course and the relationships between human and natural systems as part of feeding humanity.
Hello, my name is Evan Fraser and I work at the University of Guelph in Ontario, Canada. This video series shows that climate change, population growth, and high energy prices mean that farmers may struggle to produce enough food for all of humanity over the next generation. This video looks at how strong local food systems can help us overcome this problem. Many argue that because modern farms use a lot of energy and cause a lot of pollution, our food systems will prove unable to meet the rising demands of the global population.
These arguments go like this. Today a handful of large corporations control the vast majority of the world's food trade. In doing so, they make a huge amount of money by using farming systems that damage the environment, exploit workers, and displace traditional farmers. By contrast, food systems based on local, diverse, and small farms that use few chemical inputs like pesticides or fertilizers, are more sustainable, equitable, and democratic. This is because when producers and consumers know each other and interact, then the entire community has a say in how food is produced. This should mean that farmers receive a decent income since they will receive a higher percentage of the value of the food they produce. And they should also protect the environment better because consumers will be okay with paying more for food they know isn't covered with polluting sprays. Also, because food is produced and consumed in the same region, the amount of fossil fuels burned for transportation should go down. Goodbye processed cheese and vegetables from the southern hemisphere. And hello locally produced seasonal dishes.
Those of us in the rich parts of the world probably associate these ideas with the 100-mile diet. In the developing world, these ideas are often described as food sovereignty and are promoted by La Via Campesina, an international movement advocating that consumers and small-scale producers work together to take control of their food. Many, however, question whether this vision of alternative food systems can provide a viable food security strategy for humanity's growing population. For instance, while there is a huge disagreement among scientists, many point out that farms using alternative methods tend to have lower yields when compared with conventional farms. This means that many scientists worry that if we're going to feed a growing population using the alternative farming practices promoted by the local food movement, we’ll either need more farmland or we'll have to find ways of cutting down on our consumption and waste.
A second common criticism leveled against the promoters of alternative food systems is that whenever alternative farms try to grow bigger, they end up looking just like conventional farms. But do these criticisms mean alternative local food systems have no place in the 21st Century? I don’t think so. Even if local alternative food systems don’t feed all of us all of the time, it doesn’t mean there is no role for such systems as a component of a secure and resilient food security strategy. Local alternative systems add diversity to our farming landscapes and diversity is very important because alternative farming practices often provide the template to help improve the design of more mainstream systems. Alternative food systems, especially in poor regions of the world, provide a buffer between consumers and the volatility of the international market, while also empowering people by giving them some control over their food.
Finally, having local farms integrated into the fabric of urban life connects city dwellers with their food, making them more aware of the ecosystems on which we all depend. They provide habitat for wildlife, they trap stormwater before it damages people’s homes, and they should be beautiful. Therefore, my own reading of the debate around alternative farming systems tells me that to be sustainable, we must support local food systems that use alternative agricultural practices. We need to do this as consumers, as well as through policy that should foster local food systems by making sure farmers have access to processing facilities and markets. But we must also realize that local and alternative won’t feed us all. We’ll be relying on conventional farming systems that produce huge amounts of food in the world’s breadbaskets for the foreseeable future, albeit with high fossil fuel inputs. So what we need is a balanced approach. Our food security will be enhanced if all of us are able to draw from both global and local systems.
If you’re interested in learning more about this and other topics on feeding 9 billion, you can check out the other videos in this series. Also, my recent book “Empires of Food”, goes into these topics in detail and you can, of course, find me on Facebook and Twitter, where I regularly post news on global food security. Finally, if there’s anything in this video that you want to follow up on, head over to www.feedingninebillion.com [4], where I’ve posted all the scripts I’ve used in these videos, along with background references, and opened up an online discussion where you can weigh in with your own thoughts on anything you’ve just heard.
By now you may be forming the correct impression that a better diet and nutrition around the world is a matter of finding a “happy medium” for consumers between food shortage on the one hand, and excessive consumption of unhealthy foods on the other hand. That is, consumers in poorer sectors and societies eat too little fruits, vegetables, high-quality fats and proteins and in the worst case even insufficient calories. Meanwhile, wealthier consumers and even some of the urban poor eat excessive quantities of low-quality calories and fats in relation to relatively sedentary lifestyles. The results are serious chronic malnutrition (undernutrition and nutrient deficiencies, specifically) at one end of the diet spectrum and chronic diseases such as heart disease and diabetes at the overconsumption end of the same spectrum. In addition, a high-meat diet and millions of acres in crops to feed beef cattle and pigs creates a water-consuming and polluting food sector of the economy to support these diets, as seen in previous modules. Therefore, increasingly there has been a movement to unite concerns about the environmental impacts of food with the problematic diet and nutrition outcomes from modern high meat and processed food diets. The reading below from food columnist Michael Pollan addresses these principles for a happy medium in diets.
Additional Reading
Michael Pollan, Unhappy Meals [5] New York Times Magazine, January 28, 2007. This reading starts with Pollan's by now somewhat famous recipe for a healthy diet: "Eat food. Not too much. Mostly Plants." and then expands on this principle.
In order to address the need for this "happy medium", a number of scientists and activists globally have enunciated the interesting principle of the demitarian diet [6]1, in which consumers commit to reducing their consumption of meat products, short of adopting vegan and vegetarian diets. The prefix demi- comes from French for “half” and reflects the principle that consumers in high-income societies and sectors need to at least halve their consumption of meats, to produce better health and environmental impacts, especially the impacts on nitrogen pollution and greenhouse gases from fossil fuels in agriculture (more on this in the following modules). The demitarian diet and its proponents are primarily focused on the environmental sustainability of first-world diets. Nevertheless, we can extend this concept to the third world to say that populations eating diets of poverty will receive benefit from increasing their intake of legumes, fish, meat, vegetables, and other high-quality nutrient sources. Populations at risk from undernutrition may see dramatic positive effects from even slight increases in consumption of these high-quality foods that are often lacking in circumstances of poverty. This is because even small quantities of meat, eggs, and other animal products along with legumes, fruits, and nuts, can be very high-density sources of protein, Iron, Zinc, Vitamin A, and high-quality fats. Because of this nutrient-density, animal protein (e.g. poultry, fish, eggs) as well as legume crops (e.g. bean, pigeon pea), vegetables (e.g. sweet potato, collards, carrots), and fruits (e.g. papaya, mango, avocado) therefore feature prominently in nutrition interventions of government and other organizations.
1 The Barsac Declaration [7] highlights the demitarian diet concept.
Links
[1] https://web.archive.org/web/20220223175956/https://www.who.int/chp/working_paper_growth%20model29may.pdf?ua=1
[2] https://www.toronto.ca/community-people/health-wellness-care/health-programs-advice/toronto-food-strategy/
[3] http://tfpc.to/
[4] http://www.feedingninebillion.com
[5] http://michaelpollan.com/articles-archive/unhappy-meals/
[6] http://www.nine-esf.org/node/281/index.html
[7] http://www.nine-esf.org/files/Barsac%20Declaration%20V5.pdf