Malnutrition and Food Systems in South-East Asia: Emerging Trends Katrien Ghoos Sr. Regional Nutrition Advisor Disclaimer
1. Malnutrition 2
Malnutrition Trends in SEA Source: Joint Child Malnutrition estimates UNICEF- WHO-WB 3
Nutritional Situation in SEA Source: figure adapted from GNR 2015 4
Trends in the number of obese and severely obese people by region Copyright 2016 NCD Risk Factor Collaboration. Open Access article distributed under the terms of CC BY Terms and Conditions 5
Malnutrition Trends: Example from Indonesia Source: Aizawa and Helble, ADBI working paper, 2016 6
Summary Malnutrition Trends in SEA The same individual can be affected by multiple forms of malnutrition simultaneously. Under-nutrition is reducing but remains a public health concern despite economic gains; overweight & obesity are still lower than under-nutrition but increasing more rapidly than under-nutrition is decreasing: Wasting is above the threshold of public health significance (5%) in 8 out of 10 ASEAN Member States (not Brunei Darussalam and Singapore). The prevalence of stunting is still high (Philippines, Cambodia, Myanmar and Indonesia) or very high (Lao People s Democratic Republic) in many ASEAN Member States. Some ASEAN Member States have exceptionally high rates of overweight/obesity in children under five, such as Indonesia (12%) and Thailand (11%). Overweight and obesity for children and adults are increasing in all ASEAN Member States. All population groups are affected (rich, poor; children, adults, esp. women). Obesity is not only a problem of the urban rich, but also rural poor. Wasting, stunting, MND S are not only the problems of rural poor, but also urban rich. All SEA countries are affected by at least one form of malnutrition, most countries have multiple problems, incl. Double Burden of Malnutrition. 7
2. Food Systems & Malnutrition The rise of obesity and nutrition-related noncommunicable diseases in the context of persistent undernutrition places a greater emphasis than ever on the centrality of food systems as a driver of nutrition outcomes. Key finding 1, GNR 2015, Chapter7 8
Food Systems & Malnutrition 9
The Different Food Systems Source: Investments for Healthy Food Systems, UNSCN,2014 10
The Different Food Systems: Change in Consumption of processed foods Source: GNR 2015 11
NCD s in SEA Source: figure adapted from GNR 2015 12
Infant and Young Child Feeding practices Breastfeeding (0 6 m) Source: Regional Report on Nutrition Security, ASEAN, 2016 13
Infant and Young Child Feeding practices Complementary Feeding (6-23 m) Source: Regional Report on Nutrition Security, ASEAN, 2016 14
Summary Most of the food systems in SEA most probably in rural, emerging & transitioning. In these food systems, it is expected that the high levels of under-nutrition will be accompanied by increasing level of overweight. 15
3. Nutrition friendly Policy Options 16
Policy mapping and policy options 17
Political Economy of Food Systems: Power and Politics Industrial food systems, based in industrial agriculture Objective: make cheap food widely available Highly consolidated: horizontal, vertical, global Lock-in: 1: Path Dependency 2: Export Orientation 3: Expectation of Cheap food 4: Compartmentalised Thinking 5: Short-term thinking 6: Feed the World Narrative 7: Measures of success 8: Concentration of Power 18
4. Main conclusions 19
Conclusions Urgent need to prioritise nutrition actions in SEA, incl. through nutrition friendly food systems. Promotion of healthy diet expected to contribute to reduction of both under- & over-nutrition. 20
5. References & Background Reading 21
References Aizawa, T., and M. Helble. 2016. Socioeconomic Inequity in Excessive Weight in Indonesia. ADBI Working Paper 572. Tokyo: Asian Development Bank Institute. Available: http://www.adb.org/publications/socioeconomic-inequity-excessive-weight-indonesia/ ASEAN/UNICEF/WHO (2016). Regional Report on Nutrition Security in ASEAN, Volume 2. Bangkok; UNICEF. Haddad, L. 2013. Ending Undernutrition our legacy to the post 2015 generation. Institute of Development Studies, Children s Investment Fund Foundation. International Food Policy Research Institute (IFPRI). 2015. Global Nutrition Report 2015. Actions and Accountability to Advance Nutrition and Sustainable Development. Washington, D.C. : International Food Policy Research Institute (IFPRI). Available at:http://globalnutritionreport.org/the-report/ [Accessed on 17/06/2016] International Food Policy Research Institute (IFPRI). 2016. Global Nutrition Report 2016. Actions and Accountability to Advance Nutrition and Sustainable Development. Washington, D.C. : International Food Policy Research Institute (IFPRI). Available at:http://globalnutritionreport.org/the-report/ [Accessed on 17/06/2016] United Nations Children s Fund (UNICEF).2013. Improving Child Nutrition. Available at:http://www.unicef.org/gambia/improving_child_nutrition_- _the_achievable_imperative_for_global_progress.pdf [Accessed on 17/06/2016] United Nationas Children s Fund (UNICEF), World Health Organization (WHO), the World Bangk (WB). UNICEF-WHO-The World Bank: Joint Child malnutrition estimates: Levels and trends. Available athttp://data.worldbank.org/child-malnutrition/compare-regional-prevalence [Accessed on 17/06/2016] United Nations Standing Committee on Nutrition (UNSCN). 2014. Discussion Paper 2. Investments for Healthy Food Systems: A framework Analysis and Review of Evidence on Food Systems for Improving Nutrition. Available at:www.unscn.org [Accessed on17/06/2016] 22
Photo Credits for Cover Slide From top left to top right: 1) WFP/Cornelia Paetz 2)WFP/Rein Skullerud 3)WFP/Photo Archive 4) Sight and Life Photo Archive 5)WFP/Liz Loh-Taylor 23