Nutrition 3: World Nutrition Problems

World Nutrition Problems

• Double burden of malnutrition or Triple burden of malnutrition: a major concern
• Strategies to reduce the risk of malnutrition:
  • Front-of-Package Labelling of foods (FOPL)
  • Restrictions on marketing unhealthy products to children
  • Improvement in school food standards and options
  • Taxation on sugar sweetened beverages (SSBs)
  • Reformulation of ultra-processed foods to improve nutrient content
  • Retail environment changes such as menu labelling, corporate voluntary efforts and social investment
  • Utilising digital technology for weight awareness and management
  • Programmes for increased physical activity

Government Strategies

• National Department of Health Strategy to reduce the risk of overweight and obesity:
  • Vision: "All South Africans lead a healthy lifestyle and maintain a healthy weight"
  • Mission: "Empower South Africans to make healthy choices by enabling equitable access to healthy food, physical activity opportunities and a capacitated health care system that supports the prevention and management of obesity"
  • Goal: "Reduce the prevalence of obesity and diet-related non-communicable disease in the South African population"
  • Six strategic objectives:
    • Healthy food is available and easily accessible in government workplaces and in schools
    • An enabling environment is in place to facilitate equitable access to physical activity opportunities
    • Education and communication at different levels is evidence-based to prevent and manage obesity
    • The health care system is equipped to address obesity prevention and management
    • An effective monitoring, evaluation and research system is in place
    • Policy and legislation support a healthy food environment

Private Sector Strategies

• Food Manufacturing:
  • Mars Nourishing Wellbeing
  • Nestlé's approach to balanced diets
  • Unilever's Positive Nutrition and Planet & Society initiatives
• Food Retailer:
  • Collaboration for Healthier Lives (CHL) Progress Report 2024
• Industry Associations:
  • Global: Consumer Goods Forum
    • Commitments:
      • Product formulation to meet consumer's needs and public health priorities
      • Implementation of reliable product information on pack and on digital platforms
      • Responsible marketing and stopping targeted advertising to children under 12
      • Expanding awareness and delivery of employee health and wellness programs
  • Local: Consumer Goods Council of South Africa (2016-2020, 2023-2027)
    • Voluntary commitments by sector:
      • Dairy Sector
      • Grains, Cereals and Bread Sector
      • Snacks, Treats, Fats, Canned Fruits & Baked Goods Sector
      • Quick Service Restaurant (QSR) Sector
      • Non-alcoholic Beverage Sector
      • Wholesale & Retail Sector

World Nutrition Problems

• Malnutrition affects food selection, eating habits, dietary adequacy, nutritional status, and health of consumers.
• UNICEF Conceptual Framework on Maternal and Child Nutrition identifies causes of malnutrition.

Causes of Malnutrition

• Poverty
• Inadequate access to nutritious food
• Infections
• Inadequate breastfeeding
• Poor maternal health
• Lack of education
• Limited access to healthcare

Nutrition Transition

• Economic and political development lead to changes in lifestyle and eating habits
• Urbanization contributes to increased homelessness, unemployment, and divorce
• Traditional foods are replaced by 'western' foods, leading to health concerns
• Snack foods, such as soft drinks, chocolate, and crisps, become more prevalent

Stages of Nutrition Transition

• Stage 1: Poor nutrition and high mortality rates
• Stage 2: Decrease in mortality rates, increase in chronic diseases
• Stage 3: Chronic diseases become major health problems
• Stage 4: Epidemiological transition, with a shift from infectious to chronic diseases

Triple Burden of Malnutrition

• Undernutrition: wasting, stunting, and micronutrient deficiencies
• Overnutrition: overweight and obesity
• Micronutrient deficiencies: vitamin and mineral deficiencies

Food Insecurity

• Exists at community, household, and individual levels
• Examples: stunted child and overweight mother (SCOWT), over/underweight with anemia

Consequences of Undernutrition

• Impaired growth and development
• Increased risk of infections and mortality
• Decreased productivity and cognitive function

Diagnosis of Undernutrition

• Mid Upper Arm Circumference (MUAC) measurement
• Growth charts and classification of SAM (Severe Acute Malnutrition) and MAM (Moderate Acute Malnutrition)