How to Build Urban Food Systems for Better Diets, Nutrition, and Health in Low and Middle-Income Countries

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How to Build Urban Food Systems for Better Diets, Nutrition, and Health in Low and Middle-Income Countries Jef Leroy, IFPRI November 30, 2018, Bangkok

Side event agenda JEF LEROY Senior Research Fellow IFPRI CORINNA HAWKES Professor of Food Policy City University of London MATTHEW KOVAC Executive Director Food Industry Asia

Why focus on the urban poor? 100 Most people are in cities 8 especially in Africa and Asia % urabn 90 80 70 60 50 40 30 20 39% 68% World Europe LAC North America Africa Asia billion people 7 6 5 4 3 2 10 1 0 1980 1990 2000 2010 2020 2030 2040 2050 0 1980 1990 2000 2010 2020 2030 2040 2050 United Nations, Department of Economic and Social Affairs, Population Division (2018). World Urbanization Prospects: The 2018 Revision, custom data acquired via website.

Urban poor suffer from all forms of malnutrition NUTRITIONAL STATUS The urban poor suffer from all forms of malnutrition o o o Stunting: o 1 in 3 stunted children lives in a city o Rapid decline in rural areas but stable in urban areas Overweight and obesity: prevalence higher in urban areas Micronutrient deficiencies (very limited data)

Changes in urban diets drive nutritional status NUTRITIONAL STATUS

Changes in urban diets drive nutritional status NUTRITIONAL STATUS Poor-quality diets drive all forms of malnutrition Nutrition transition faster in urban than rural areas Traditional diets consisting of coarse grains, staple cereals, and pulses diets high in sugar, salt, saturated fat Increasing consumption of ultra-processed foods

Changes in urban diets drive nutritional status NUTRITIONAL STATUS Poor-quality diets drive all forms of malnutrition Nutrition transition faster in urban than rural areas Traditional diets consisting of coarse grains, staple cereals, and pulses diets high in sugar, salt, saturated fat Increased consumption of ultra-processed foods 25 % of total energy from free sugar 20 15 10 5 0 WHO guideline Q1 Q2 Q3 Q4 Q1 % of total energy from ultraprocessed foods (quintiles) The share of ultra-processed foods determines the overall nutritional quality of diets in Brazil (Costa Louzada et al, PHN, 2017)

Changes in urban diets drive nutritional status NUTRITIONAL STATUS Poor-quality diets drive all forms of malnutrition Nutrition transition faster in urban than rural areas Traditional diets consisting of coarse grains, staple cereals, and pulses diets high in sugar, salt, saturated fat Increased consumption of ultra-processed foods Nutrition transition contributes to the double-burden of malnutrition Coexistence of undernutrition with overweight, obesity, and diet-related noncommunicable diseases. NCDs are the leading cause of death globally (71% of all deaths in 2016)

Individual and household factors shape diets of the urban poor

Individual and household factors shape diets of the urban poor Urban dwellers purchase most of their food: Recent 18-country study: 40% of urban dwellers in low-income countries could not afford the recommended fruit and vegetable consumption Livelihoods often depend on unstable informal-sector employment Less access to social safety nets (compared to rural counterparts), leaving the urban poor more vulnerable to income and food-price shocks. Women engaged in the workforce in urban areas with limited childcare options Time constraints, housing conditions and limited access to cooking facilities: Drive urban dwellers toward the convenience of processed and ultraprocessed ready-to-eat snacks and foods, street foods, and quick meals Increase the risk of overconsumption of energy, added sugar, salt, and saturated fat

Urban diets are inextricably linked to the food environment

Urban diets are inextricably linked to the food environment The food environment in urban areas is rapidly changing Urban dwellers generally have access to a more diverse food supply than individuals in rural areas, but are exposed to aggressive marketing of ultra-processed foods modernizing food retail sector, accelerated spread of supermarkets supermarkets which increase access to energy-dense and nutrient-poor ultra-processed foods.

The urban food environment is part of the food system

The urban food environment is part of the food system Globalization and trade liberalization have changed urban food system Urban demand can drive rural transformation in periurban areas where foods are produced Informal food vendors and processors: Important source of food for the urban poor Poor governance threatens livelihoods of vendors, often women

Addressing the urban poor s nutrition problems requires better evidence? Diets What do poor urban dwellers eat (especially the poor)? Where do they procure their food/meals? What are the drivers of healthy and unhealthy food choices? Food environment How does it affect food choice? How can we map and characterize the quality of food environment? Food system What are the opportunities for leveraging food systems and food environments to improve urban diets? How can urban/rural linkages be strengthened to improve diets in urban areas and stimulate rural transformation?

Urban food systems for better diets, nutrition, and health a new IFPRI research program