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Solutions to the double burden of malnutrition also generate health and environmental benefits

Nature Food volume 4, pages 616–624 (2023)Cite this article

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Abstract

Present food consumption patterns will intensify pressure on natural resources, while poor nutrition is expected to prevail at both low and high levels of calorie consumption. To better understand the interplay between food security, environment and health, we use an integrated framework that allows for the analysis of the dynamics of the double burden of malnutrition and its health and environmental impacts by 2050. We find that excessive caloric intake will be key in rising body mass index levels, particularly in emerging economies. Because higher levels of body mass index will be reached at younger ages, future cohorts will increase their exposure to health risks, including coronary heart disease, stroke, site-specific cancers and type 2 diabetes. This framework also offers insights into the health, food and environmental security impacts of changing food demand behaviour. We find that reductions in food purchasing—associated with the mitigation of food waste and excessive food intake—are more important than changes in dietary composition in increasing food affordability and reducing pressure on cropland expansion, whereas dietary composition is critical in driving greenhouse gas emissions.

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Fig. 1: The excessive calorie availability and adult BMI.
Fig. 2: Projections of the age-specific average adult BMI and PAFs.
Fig. 3: Projected changes in BMI for men and women.
Fig. 4: Shifting towards healthy dietary intake levels reduces caloric undernutrition and land use.
Fig. 5: Shifting towards healthy dietary intake levels reduces greenhouse emissions.
Fig. 6: Extension of the PoU methodology to encompass overacquisition of calories.

Data availability

Correspondence and requests for materials should be addressed to E.L.B. All data needed to replicate results from econometric model 1, model 2 and the weight-related factors calculations are available at https://doi.org/10.18738/T8/GFT756 (Replication Data for: Solutions to the double burden of malnutrition also generate health and environmental benefits). The bulk of input data used for calorie availability are derived from the statistics of FAO, available at http://www.fao.org/faostat/en/#data. The bulk of input data used for adult BMI are derived from the statistics of the NCD Risk Factor Collaboration available at https://ncdrisc.org/data-downloads.html. The remaining data needed to evaluate the conclusions in the paper are present in the paper and/or the Supplementary Information or upon request to the authors.

Code availability

The code developed in the study is available from the corresponding author upon reasonable request.

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Acknowledgements

We thank M. Springmann and V. Restrepo for their comments on this work. This work is funded by Purdue Collaboratory Systems; INFEWS/T2: Identifying Sustainability Solutions through Global-Local-Global Analysis of a Coupled Water-Agriculture-Bioenergy System; USDA-AFRI grant no. 2019-67023-29679 Economic Foundations of Long Run Agricultural Sustainability.

Author information

Authors and Affiliations

  1. Department of Agricultural Economics, Texas A&M University, College Station, TX, USA

    Emiliano Lopez Barrera

  2. Department of Agricultural Economics, Purdue University, West Lafayette, IN, USA

    Thomas Hertel

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  1. Emiliano Lopez Barrera
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Contributions

E.L.B. and T.H. contributed to conceptualization, methodology, formal analysis, investigation, writing the original draft and reviewing and editing the final paper, visualization, supervision and funding acquisition.

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Correspondence to Emiliano Lopez Barrera.

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Nature Food thanks Dragan Miljkovic and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Extended data

Extended Data Fig. 1 Projected changes in BMI for men and women.

The bars represent the mean projected percentage changes with respect to the 2050 baseline case caused by shifting towards diets following intake recommended in the flexitarian diets pathway (FLX) in those regions. Omitted regions are not subjected to diet changes. Error bars represent the 95% confidence intervals resulting from n = 1000 simulations. In these simulations, the “shocks” on key exogenous inputs are drawn from a pool of potential values generated using a triangular distribution centered around the mean of their respective expected changes (See Supplementary Section 2.2 for details in the methodology).

Extended Data Fig. 2 Shifting towards healthy dietary intake levels reduce caloric undernutrition and land use.

Bars represent percentage changes in 2050 baseline outcomes caused by shifting towards diets following flexitarian diets pathway (FLX) in the regions in italic and marked with asterisk starting with Central Asia and ending with Japan and Korea. Regions exogenously shifted to the FLX are in italic and marked with an asterisk, food demand patterns in the remaining regions are endogenous. Panel a represents the percentage change in global crop price, panel b represents reductions in undernutrition headcounts in those regions where diets are endogenously determined as a function of prices, and panel c represents changes in cropland use. Coloured segments of each bar decompose the total change into three different components of the shift from current food demand levels: the change within the food basket composition (that is, the FLX scenario implies reductions in livestock demand with respect to the baseline case), reductions in food intake, and reductions in food waste3.

Extended Data Fig. 3 Shifting towards healthy dietary intake levels reduces Green House Emissions.

The GHG emissions associated with crop and livestock production include the direct “farmgate” emissions. Indirect emissions include emissions due to the conversion of natural lands into crop production (See Supplementary Information for details). Bars represent percentage changes with respect to the 2050 baseline case, caused by shifting towards diets following healthy dietary guidelines (HDG). Results represent the breakout between three different components within the shifts in food demand: the change within the food basket composition (that is, the HDG scenario implies reductions in livestock demand with respect to the baseline case), reductions in food intake, and reductions in food waste59. (Fig. 5 presents results on flexitarian diets pathway).

Extended Data Fig. 4 Shifting towards Healthy Dietary Guidelines and Flexitarian Diets levels reduce food waste and excessive intake.

We developed counterfactual dietary scenarios based on the Healthy Dietary Guidelines (HDG) and the Flexitarian Diet scenario (FLX) proposed by Springmann et al. in 2018. These scenarios involved exogenous shifts in the average consumer’s behaviour, moving from 2015 consumption levels towards a projected scenario for 2050. The bars in the chart represent the mean of overall calorie purchases projected for 2050. The green portions of the bars represent the quantity of calories recommended under a healthy (flexitarian) intake level. The orange portion of the bars represents the reduction in excessive intake necessary to transition from current projections to a healthy (flexitarian) diet. Finally, the grey portion of the bars represents the reduction in food waste at the consumer level necessary to transition from current projections to a healthy (flexitarian) diet.

Supplementary information

Supplementary Information

Supplementary Figs. 1–9, Discussion and Tables 1–9.

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Lopez Barrera, E., Hertel, T. Solutions to the double burden of malnutrition also generate health and environmental benefits. Nat Food 4, 616–624 (2023). https://doi.org/10.1038/s43016-023-00798-7

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