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Putting the “mal” in Malnutrition

Bronskvinnorna sculpture, Sweden

(Bronskvinnorna sculpture, Sweden)

Despite a decent knowledge of Latinate prefixes and years studying the food system, I am still someone who thinks of malnutrition as undernutrition. It’s hard to shake. That’s all we heard about when I was growing up. I knew something of the evils of sugar and fast food, but overdoing those things didn’t lead to malnutrition. Malnutrition was something people in poor countries suffered from, something that came out of insufficiency.

Malnutrition, of course, just means bad nutrition. It could be too much, too little, or the wrong foods. The most recent global nutrition report shows that 40% of adults are overweight or obese. That’s not just in the US or Australia: 40% of the adult world: two billion people. That’s the same number of people who suffer from micronutrient deficiencies, btw. Paradoxically, the same people can fall into both categories. And while child obesity is also climbing, half of all children suffer from one or more micronutrient deficiencies. The percentage of underweight children worldwide has dropped significantly, but death from all non-communicable, diet-borne diseases now exceeds mortality rates from infectious diseases (IPES p8). Take that, Ebola & AIDS! Or how about this one: “the risk that poor diets pose to mortality and morbidity is now greater than the combined risks of unsafe sex, alcohol, drug and tobacco use.” What the heck is going on?

What’s going on is a myopic focus on starvation, with little attention to global nutrition. Increasing caloric intake is not usually hard (war zones are an exception) and showcases Big Food and “feeding the world.” But throwing money or calories at the problem of malnutrition has clearly changed it, not fixed it. If we’re just hoisting people up one side of the hill to hurl them down the other, what’s the point? Today, “most of the world’s population live in countries where overweight and obesity kills more people than underweight.” The world does not look the way we have been led to imagine it.

Any second-grader will tell you that fat is the opposite of thin. But in a nutritional sense, overweight and underweight are both the opposite of healthy, and both are largely the product of global food policies and practices. When we fail to recognize them as two peas in the same deep-fried, shriveled pod, we create policies that address only the most obvious insufficiencies, and make no progress in solving the actual problem. The overweight problem is difficult not just because it’s harder to fix: it’s harder to care about. Who doesn’t feel bad for a starving kid who is clearly “not to blame” for her condition. But a fat adult? We tend to perceive overweight as a matter of inadequate will, indulgence, gluttony. But that simply doesn’t stand up to facts. Every one of us knows someone who can eat with abandon and never gain weight. Every one of us knows strong, committed people who can’t manage to lose weight. Clearly their physical form is not a reflection of their moral successes or failings. The more we learn about how our bodies react to sugar and saturated fats, about genetics, about addiction and subconscious decision-making, about stress and hormones and chemicals in the brain, the clearer it becomes that we really don’t have much control over our weight.

Yes, we’ve always had stress and impulsiveness. The difference now is the ubiquity of processed, calorie-dense foods that don’t give us the vitamins we need for proper biological and mental functioning. Global agribusinesses have changed where people live, how people work, and the food they eat, and fresh foods have become a luxury for many poor people. For one specific example, diminished vegetable and pulse production has contributed to a recent increase in iron deficiencies in many regions of Asia and the Americas.

If we want to stop this killer, we have to take a holistic approach to food, everywhere. As Nature magazine concluded in their article about the epidemic, “the era of commodity research aimed at feeding a starving world is over. A new era has begun that requires us to nourish everyone in ways that can be sustained environmentally, economically and culturally.”

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