Improving sustainability to address global malnutrition

With so many challenges facing the global food system — such as climate change, urbanisation and an ageing population — there has never been a better time to think and act with sustainable development in mind

Nutritionists, agriculturists and public health professionals alike are faced with a wide range of complex challenges when it comes to global nutrition.

This is, in part, derived from the rapid speed at which the world’s population is growing; reports indicate that it is projected to reach 9.6 billion by 2050, with more than two billion people aged 60 or older.1

However, changes in diet and physical activity levels, which have played a significant role in facilitating an increase in nutrition-related chronic diseases, must also be taken into account.

Experts conclude that consumer food choices are driven by purchasing power and socioeconomic status and, whereas calories have become cheap, nutrients remain expensive. Eating more calories once meant obtaining more nutrients, but this is no longer the case.

With empty calories now available in excess, particularly in more westernised, developed countries, hidden hunger and obesity are no longer mutually exclusive; in fact, it is quite common to be both undernourished and overweight.

One option for developed countries is to return to diets based predominantly on plant foods, with less processing and a restricted proportion of refined carbohydrates.

In comparison, however, plant food based diets are not considered to be adequate for vulnerable populations in developing countries. It is increasingly clear that stakeholders, including governments, nutrition societies, academia and industry, must engage to deliver good nutrition to all.

It is the responsibility of the food industry to ensure that the world’s food supply remains of high quality, affordable, sustainable, safe and nutrient-rich.

Economic status, good nutrition and public health

Nutritional status can no longer automatically be expected to improve with GDP growth. Even high-income countries face issues of hidden hunger and the growing rate of obesity is a one-world issue.

For many people, nutritious foods are more widely available and affordable than ever before; yet, malnutrition remains the world’s leading cause of impaired health, disability and death.

Furthermore, poor nutrition can play a significant role in increasing the risk of nutrition-related diseases — also called non-communicable diseases (NCDs) — such as diabetes and cardiovascular disease (CVD).

These conditions are globally prevalent and remain major public health concerns in many countries across the globe; it is estimated that 17.5 million people die from CVD per year, representing 31% of all global deaths, and reports suggest that approximately 422 million adults worldwide are living with diabetes.2,3

If no action is taken, these figures are only expected to rise, so lifestyle-altering interventions and targeted public health investments are necessary to mitigate this risk and enhance the nutritional status of populations around the world. To reduce the prevalence of NCDs, public health professionals must engage more actively in the shaping of policies that influence health through more public health-sensitive food systems, whereas the food industry should be encouraged to offer a portfolio of nutritious food products and food supplements to fill nutrient gaps.

The traditional Mediterranean diet, for example, characterised by an intake of vegetables, fruits, legumes, olive oil and fish, offers a range of potential health benefits, including reducing susceptibility to cardiovascular disease and supporting the prevention of a variety of NCDs.4

No other dietary pattern has such a strong evidential base to support its benefits on cardiovascular disease, diabetes and other major chronic diseases. However, even in the Mediterranean region, many people no longer follow this dietary tradition.

Sustainable food systems for the projected population of 2050

Climate change is seen as one of the biggest global food and nutrition security threats of the 21st century. Current food production methods are contributing to severe environmental problems and there is an urgent need for the development of incentives and training to encourage farmers to grow food in a more sustainable way.

At the same time, it is important to ensure that consumers are sufficiently educated to make informed choices about what foods are healthy for themselves, their families and for the planet.

Today, 30–50% of all food produced is either lost or wasted.5 Food waste can, and does, occur throughout the lifecycle of a product, from production and transportation through to when it reaches the market and is purchased for consumption.

Steps must be taken to reduce food waste at every stage and protect the food-growing environment, beginning with solutions such as intelligent engineering, which uses surpluses for heat, power and fertiliser.

More large-scale measures, such as changes in consumer behaviour, are also necessary to reduce discarded food in developed countries, whereas less waste in combination with good engineering practices can lead to better access to food for those in developing countries.

With the resources we currently have available, the projected 2050 population of 9.6 billion could be fed today, but it is vital to change attitudes, behaviours and technologies to ensure that everyone in the world benefits.

From capacity building to collaborative solutions

One of the biggest current challenges and opportunities is how to change eating and behaviour patterns to produce better health in any given individual.

Nutrient requirements are frequently not met because of the limited availability and affordability of an adequately diverse diet that includes plant-source, animal-source, fortified foods and supplements.

Various monitoring, evaluation and surveillance frameworks exist to guide the development, implementation and evaluation of nutrition programmes and systems. Focusing on capacity building, innovation and investment to support a nutrition data revolution are strategic opportunities to improve nutrition and health worldwide.

Today’s global food supply chains make the food safety landscape more complex and challenging than ever before. Management of the issue has not kept pace with its development and new threats continue to emerge. Unsafe food cannot sustain human health and can have tragic social and economic consequences.

Improving levels of food safety globally requires the development of new technologies, sustainable commitments and both human and institutional capacity, especially among farmers. Collaboration amongst all stakeholders is necessary to leverage the right knowledge, risk management methods and interventions across the global food supply.

Without safe food, the world cannot achieve global food security and improved nutrition.

Good Nutrition: Perspectives for the 21st Century provides the latest perspectives on the nutrition challenges that are now common to all societies worldwide. The book argues that the case for good nutrition for all people, in all parts of the globe and throughout the entire lifecycle, is growing stronger.

Contributions come from some of the world’s leading experts in the field, at organisations including the Universities of Colombia, London and Washington, and the Global Alliance for Improved Nutrition.6


1. World Health Organization, Ageing and Health (2015):

2. World Health Organization, Cardiovascular Diseases Fact Sheet (2016):

3. World Health Organization, Global Report on Diabetes (2016):

4. R. Estruch, et al., “Primary Prevention of Cardiovascular Disease with a Mediterranean Diet,” The New England Journal of Medicine 368(1), 1279–1290 (2013).

5. Institution of Mechanical Engineers, Global Food: Waste Not, Want Not (2013):