Transforming the food system to fight non-communicable diseases

Abstract

Malnutrition and unhealthy diets are important risk factors for non-communicable diseases. Francesco Branca and colleagues call for changes in both what and how food is produced, marketed, and consumed

Fig 1

Food systems and how they affect diet and nutrition. A food system is defined by the High Level Panel of Experts on Food Security and Nutrition of the Committee on World Food Security as including “all the elements (environment, people, inputs, processes, infrastructure, institutions) and activities that relate to the pre-production, production, processing, distribution, preparation, and consumption of food and the outputs of these activities, including socioeconomic and environmental outcomes.” Food systems are influenced by sociocultural, economic, political, and environmental contexts. There are many different types of food systems—from long chain, high value, and industrial to short chain, low value, traditional, and rural—and different systems may exist within a country at the same time. The food environment can be defined as “the interface that mediates people’s food acquisition and consumption within the wider food system. It encompasses external dimensions such as the availability, prices, vendor and product properties, and promotional information and personal dimensions such as the accessibility, affordability, convenience, and desirability of food sources and products.”

Fig 2

Contribution of behavioural, metabolic, and environmental risk factors to death and disability (Global total disability adjusted life years, both sexes, all ages, 2017). Maternal and child malnutrition comprises (in descending order of DALYs lost) low birth weight and short gestation, child growth failure (stunting, wasting, and underweight), iron deficiency, suboptimal breastfeeding, vitamin A deficiency, and zinc deficiency. Dietary risks include low whole grains; low fruit; low nuts and seeds; high sodium; low vegetables; low omega-3; low fibre; low legumes; low polyunsaturated fatty acids; high trans fat; low calcium; high processed meat; low milk; high red meat; high sweetened beverages

Fig 3

Risk factor contribution to deaths. Global deaths by risk factor for all ages, both sexes, 2017. Dietary risks include low whole grains; low fruit; low nuts and seeds; high sodium; low vegetables; low omega-3; low fibre; low legumes; low polyunsaturated fatty acids; high trans fat; low calcium; high processed meat; low milk; high red meat; high sweetened beverages

Fig 4

Specific dietary risk factor contribution to disease burden. Total DALYs lost by dietary risk factor, global, all ages, both sexes, 2017

Fig 5

The ballooning costs of health impacts in food systems. Recent estimates of the costs of impacts associated with food systems IPES-Food. Unravelling the food-health nexus: addressing practices, political economy, and power relations to build healthier food systems. Global Alliance for the Future of Food and IPES-Food, 2017