Policy Innovations Digital Magazine (2006-2016): Commentary: How Much More Processed Food Can We Eat?

What sort of food policy does the world really need? Does good nutrition mean ensuring that the whole world gets access to an American-style food supply? World Food Day on October 16, 2015 marks exactly 70 years since the foundation of the Food and Agriculture Organization of the United Nations. But are we still stuck with a 20th Century model of food security while facing 21st Century problems?

In September 2015, we saw the publication of a report on processed food and obesity from the World health Organization's regional office for the Americas, in which highly processed food products, such as snacks and sugary beverages, were identified as a major source of obesity and chronic diseases. A few days later, the 2015 Global Nutrition Report was published which gave both good and bad news. The good news is a decline in childhood under-nutrition—not as rapidly as hoped for, but the statistics are certainly travelling in the right direction. The bad news is the continuing rise in childhood overweight and obesity—the statistics are travelling very definitely in the wrong direction, and most noticeably in the newly emerging economies of Latin America, the Middle East, and Southern Asia.

Then October 11 saw the launch of the first World Obesity Day and an assessment of how well governments were meeting their agreed target of "halt the rise in obesity" from 2010 levels, to be achieved by 2025. Progress was not good: in 2010, obesity prevalence stood at 11.5 percent of adults—equivalent to some 565 million people. By 2014, the figures had increased to 13 percent, or some 670 million people. If nothing is done and trends from 2010 to 2014 continue at the same rate, the target will certainly not be met, and indeed will spectacularly fail. The World Obesity Federation predicts the numbers will rise to 17 percent of all adults, or some 995 million people. If you add in the number of people who are overweight but not obese, the total comes to 2.7 billion adults with excess weight by 2025, up from 2.0 billion in 2014.

These figures assume that things carry on just as they are. But everything points to an escalating problem. While the levels of obesity in many westernized economies seem to be stabilizing, in developing economies obesity levels have shown a rate of increase never seen in Europe or North America. Some 18 countries from the Caribbean, to the Middle East, to the Pacific Islands have already overtaken the United States in the obesity league tables.

The Committee on Food Security says "Food security exists when all people, at all times, have physical, social, and economic access to sufficient safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life." This is a narrative which speaks of the need to reduce under-nutrition, prevent deficiency diseases, reduce the risk of famine and food shortages, and ensure—as they say—access to a range of choices. Put in a different language, this is a narrative of expanding commercial markets, developing cheap, perhaps fortified, processed foods, and promoting these to new population groups: the poor and the remote. It matches the philosophy of the world's biggest food company, Nestlé, who have built a "floating supermarket" to take soft drinks, cookies, candy, and infant formula to remote communities in the upper Amazon. It speaks of Coca-Cola's plans to enhance "women's empowerment" by offering training and small loans to help women set up distribution points and roadside stalls to sell company beverages in Africa and Asia.

Dietary surveys in developing countries around the world show the nutrition transition and its effects on population diets: for example, in Mexico, in 2012, the two largest contributors to children's energy intake were milk (much of it sweetened milk drinks) and sugar-sweetened soda, for all children aged 1-19 years. A survey among pre-school children in Jordan found more than 50 percent consumed carbonated sugary beverages, 71 percent regularly consumed biscuits and cakes, and 76 percent confectionery. These children also consumed other sugar-sweetened soft drinks, a high quantity of desserts, and tea with sugar.

As long as concerns about child nutrition remain dominated by the language of under-nutrition and the adequacy of food supplies, these problems will only get worse. A focus on nutrient deficiency serves to justify the expansion of markets for processed food, especially food products with added fortification. But there is an urgent need to re-frame the discourse to take account of excess consumption of fats, salt, sugars, and over-processed products, and for these products the message is now "eat less." Such a message fits with improved health, with better environmental sustainability, less degrading agriculture, less atmospheric pollutants, reduced global warming—but it does not fit with continued market freedom.

Food security is half the issue, nutrition security is the other half. While nutrition security depends on food security (sustainable and adequate supplies, widespread availability, and affordable and accessible to all), nutrition security means that a healthy diet is not only available but actually eaten and so must take account of consumer behavior, cultural practices, education and skills, information, product labeling, product promotion, and persuasive marketing practices. These all determine what is actually eaten, and hence the health outcome.

Nutrition security depends critically on whether markets and marketing activities are promoting or impeding healthy dietary behavior, and supporting or undermining optimum nutrition for each individual. Experience from the promotion of infant formula products suggests that, while marketing practices might have the potential to support nutrition security, in practice they can make matters much, much worse.

Food policies for the 21st century will be about the purpose of markets and the need to hold marketers to account for their activities. We don't need more processed food. Wherever we live, we need less.