Making Healthy Diets Accessible: The Covid-19 Recovery Calls for Moving beyond Hunger

The Reset the Table essay series is published weekly, describing today’s challenges to global food security and proposing U.S. government responses.

In a world of plenty, nobody should go to bed hungry. Yet the 2020 Report of the State of Food Security and Nutrition in the World (SOFI 2020) reports that global hunger has been on the rise since 2014. Beyond hunger, we have a bigger problem looming over our heads: poor diet, which is now the biggest contributor to disease and death. SOFI 2020 presented the grim statistic that 3 billion of the world’s population cannot afford the cheapest healthy diet and must depend on poor-quality diets. While this is a major problem in low-income regions of the world, even in some middle- to high-income countries poor-quality diets containing highly processed foods; excessive consumption of calories; and excessive intakes of sugar, fat, and salt are driving overweight and obesity prevalence and its associated noncommunicable diseases (NCD), such as diabetes, heart diseases, and some types of cancer.

Covid-19 Makes the Case for Healthy Diets

The link between healthy diets and human health is well established. The 2019 report of the EAT-Lancet Commission on Food, Planet, Health asserts that by changing diets we can prevent 11 million premature deaths from diseases such as diabetes, heart diseases, and some types of cancer. Consuming a healthy diet is critical to boosting the immune system against illness. Now, in 2020, Covid-19 has elevated the importance of maintaining a strengthened immune system, especially through healthy diets.

Covid-19 is a converging point for NCDs and infectious diseases. First, poor diets have been linked with the rising global prevalence of obesity and its associated noncommunicable diseases. And we know that persons with underlying conditions such as obesity and diabetes are more likely to have severe outcomes and a higher risk of death from Covid-19. After adjusting for risk factors, Americans with obesity are four times more likely to be hospitalized for Covid-19, and those with severe obesity are six times more likely.

Furthermore, Covid-19 has revealed the gaps in our food systems. Within two to three months of its emergence, millions were pushed into a deeper state of poverty. At the same time, we saw massive disruptions in food systems. Nutritious foods, such as fruits, vegetables, and animal-source foods, were particularly affected: without any buyers, a glut of these nutritious foods remained with producers, resulting in many farmers destroying perfectly marketable foods. A sudden increase in poverty, combined with a reduction in the availability of nutritious foods, means food-insecure populations have limited access to healthy foods when they need them most. As such, a majority of the world’s vulnerable population is exposed to malnutrition and NCDs and is at increased risk of morbidity and mortality from infectious diseases like Covid-19.

Our Food Systems Have Failed to Provide the Healthy Diets We Need

Food systems involve the entire range of activities by which food finally reaches the table: production, harvesting, storage, processing, distribution, retailing, consumption, and disposal. There are many institutions and businesses that comprise food systems; consumers are also a significant part. Food systems determine the foods available in the environments from which we select food. Our likes and dislikes, food habits, availability, affordability, accessibility, and advertising all influence the decisions we make and, ultimately, the quality of our diets and our health and disease status. If food systems are delivering poor-quality diets at low costs, most likely that is what people can afford and will buy. People can afford highly processed foods that are high in sugar, salt, and fat, so that is what they buy, driving the rising prevalence of obesity and NCDs.

Moving beyond Hunger to Delivering Healthy Diets?

Healthy diets sit at the interface of food systems and health systems. The 2020 Global Nutrition Report highlights inequities in all aspects of food and health systems and called on governments to build equitable, resilient, and sustainable food and health systems. To do so, governments should:

  • Ensure that food and agriculture policies are aligned with a production system that favors nutritious crops such as fruits and vegetables. Governments have been successful in making staple foods available and accessible year-round. They should apply the lessons learned from this process and invest in nutritious food production to make such foods available and affordable.

  • Support small-scale farmers who produce nutritious foods by providing incentives, extension services, access to credit facilities, and facilitate their access to markets.

  • Build resilience into food systems by protecting local food value chains, which are most critical in times of shocks, pandemics, and border closures. Governments can protect local food value chains by maintaining the logistical flow of agriculture commodities from the farm to consumers while maintaining the integrity of the food chains.

  • Protect the health and welfare of food systems workers by creating good working conditions and fair wages.

  • Build efficiency into the entire food system to reduce food loss and waste. Foods most susceptible to loss and waste are the nutritious foods (fruits and vegetables and foods from animal sources) that can contribute to healthy diets.

  • Put in place social protection measures and safety nets for the poor and vulnerable to access diets that are healthy, not just diets that fulfil caloric needs.

  • Protect school feeding programs, a source of healthy meals for millions of school children, particularly amid Covid-19. The Home Grown School Feeding initiatives, which link local small-scale farmers with school meal procurement, of the UN World Food Programme and Food and Agriculture Organization of the United Nations are a win-win for both producers and children.

  • Restrict advertising of unhealthy foods to children. Consumers should be empowered to use the huge influence they have in demanding healthy diets. Businesses follow consumer desires.

  • Put in place better and more timely data needed to monitor performance toward national efforts being made to make healthy diets available and accessible.

2021 presents many global opportunities to make commitments to “build back better” toward a transformed food system that not only addresses hunger but delivers on healthy diets. The United Nations Food Systems Summit and the Nutrition for Growth Summit in Japan provide the global impetus to make our food systems resilient to withstand shocks—such as global pandemics—and equitable to ensure no one is left behind. Overall, governments should put in place long-term measures to increase incomes among the poor and vulnerable, such as youth employment, education, linking producers to markets, improved infrastructure, and women’s empowerment. But the food systems transformation called for will be mere rhetoric if governments do not work at reducing these inequities, especially in access to healthy diets.

Anna Lartey is the director of nutrition at the Food and Agriculture Organization of the United Nations.

Commentary is produced by the Center for Strategic and International Studies (CSIS), a private, tax-exempt institution focusing on international public policy issues. Its research is nonpartisan and nonproprietary. CSIS does not take specific policy positions. Accordingly, all views, positions, and conclusions expressed in this publication should be understood to be solely those of the author(s).

© 2020 by the Center for Strategic and International Studies. All rights reserved.

Director of Nutrition, Food and Agriculture Organization of the United Nations