By focusing on hidden hunger and the double or multiple burden of malnutrition in all its forms, the congress made it clear that a broader perspective is needed. This means a wider perspective in terms of countries, since it became clear again that malnutrition is a problem for every country in the world, no matter if the country is rich or poor. Furthermore, as was also highlighted in many presentations, malnutrition is verifiably linked to economic conditions. It is linked to poverty in rich as well as in low- and middle-income countries, which leads to the need to focus on the economic dimension, but also on the social and cultural aspects of this problem – a fact that inevitably means a broader disciplinary perspective is also required. It was emphasized several times that it is very valuable to look at the problem from the molecular up to the macroeconomic level. Based on questions and discussions, it was apparent that participants benefited from learning from different disciplines. The Congress Hidden Hunger could thus show again the great value of its objectives, which among others was to bring together different disciplines, a function that is important not only for the congress itself, but also for the respective broader field of study.
The congress also highlighted that as soon as the double or multiple burden of malnutrition is looked at, the different types of actors should be considered as well, not just the consumers or producers of food, such as farmers or agriculture operators. All actors along the value chain must be considered, in particular the food industry. Thus, when looking at the transformation of food systems, it is important to involve all actors in the debate.
Focusing on the solutions, it became clear that a very broad range of possibilities should be considered. A big topic of the congress dealt with the question: “What do we know about different types of strategies?” Leading authors and scientists who have published important work on strategies presented their findings and gave good insights into the different types of approaches, such as food-based methods that still remain very important, educational approaches, nudging, as well as the possible need to use regulatory approaches or taxes when looking at the overweight issue.
The final and most difficult point to emerge was that there is a considerable hurdle in terms of required political and economic changes. Regarding the worldwide double or multiple burden of malnutrition as well as hidden hunger and malnutrition in all its forms, political and economic changes are urgently required. The “big economy problem” is, however, to get these topics on the agenda and to make sure that sufficient attention, action, and resources are invested in the long term. Political opposition against certain types of strategy is also conceivable. As a result, it may be difficult to establish them on the agenda. Last but not least, the discussion showed that ideas in the various areas differ widely, which makes political and economic changes especially difficult.
The 4th Congress Hidden Hunger showed that the dialogue should be continued and the above points need to be considered. Many things are known about hidden hunger and the double burden of malnutrition. Political action has to follow. However, there are also many things which are unknown – a reason why research and the interdisciplinary debate on “Hidden Hunger and the Transformation of Food Systems: How to Combat the Double Burden of Malnutrition?” should be continued. The present book aims to contribute to this by summarizing the abovementioned focal topics as scientific papers. In 24 chapters, the book summarizes the main focus of the congress. It not only discusses questions about the causes of the double burden problem, but also considers solutions and current issues of sustainability.
The previous and present books on the various causes of hidden hunger, its consequences, and description of methods of early detection and intervention provide an ideal basis for dealing with this still often overlooked problem. It is not about providing enough calories, because being satiated is not enough. If micronutrients are missing, and this is mostly independent of the energy supply, there are consequences for the entire later life of children, who are mostly affected. This begins with physical and cognitive developmental disorders and continues with an increased risk of non-communicable diseases (diabetes, hypertension, metabolic syndrome). The occurrence of obesity, especially in children living in poverty, is a consequence of the nutrition transition and should not hide the fact that malnutrition – hidden hunger – can be associated with it. The focal points of the congress can be found as individual chapters in this book and thus allow the current focus of science to be identified.
Hans Konrad Biesalski, Stuttgart
References
1Biesalski HK, Black RE (eds): Hidden Hunger. Malnutrition and the First 1,000 Days of Life: Causes, Consequences and Solutions. World Rev Nutr Diet. Basel, Karger, 2016, vol 115.
2Biesalski HK, Birner R (eds): Hidden Hunger: Strategies to improve Nutrition Quality. World Rev Nutr Diet. Basel, Karger, 2018, vol 118.
Published online: October 6, 2020
Biesalski HK (ed): Hidden Hunger and the Transformation of Food Systems. How to Combat the Double Burden of Malnutrition? World Rev Nutr Diet. Basel, Karger, 2020, vol 121, pp 1–8 (DOI:10.1159/000507497)
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Unravelling the Food-Health Nexus to Build Healthier Food Systems
Olivia YambiaCecilia Rochaa,bNicholas Jacobsa International Panel of Experts on Sustainable Food Systems (IPES-Food)
aIPES-Food, Brussels, Belgium; bSchool of Nutrition, Ryerson University, Toronto, Ontario, Canada
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Abstract
The urgent call to transform global food systems is well founded on the need to reduce the effects of food systems on human health, environment, peoples’ rights, and creation of a just society. Unhealthy diets contribute significantly to the global disease burden and pose huge risks to morbidity and mortality. Efforts to transform diets are highly dependent on transformation of the food system. All countries are now affected by the various forms of malnutrition – undernutrition, overweight and obesity, micronutrient deficiencies – with progress often too slow and in some cases going into reverse. Concomitantly, the number of food insecure is increasing, and the prevalence of non-communicable disease is high. IPES-Food, in collaboration with the Global Alliance for the Future of Food, undertook a review of the scientific evidence covering a whole range of global health impacts associated with food systems. The review examined how food and farming systems affect human health, explored why the negative impacts are systematically reproduced and why we fail to prioritize them politically, and how we can build healthier food systems for all. Five categories of health impacts were examined: (i) occupational hazards; (ii) environmental contamination; (iii) contaminated, unsafe, and altered foods; (iv) unhealthy dietary patterns, and (v) food insecurity. The study confirmed that food systems affect health through multiple, interconnected pathways, generating severe human and economic costs. It also highlighted how prevailing power relations in the food system help to shape and sometimes obscure our understanding of the impacts. Five leverage points for building healthier food systems are recommended: (i) promotion of food systems thinking; (ii) reasserting scientific integrity and research as a public good; (iii) bringing the alternatives