Asia is home to nearly two-thirds of the world’s malnourished, with an estimated 87 million children under the age of five stunted. This article discusses the current trends and insights on Asia’s nutrition landscape, including what needs to be done to address the challenges for low to middle income groups, especially children. By Dr Femke Hannes
We are producing more food today to feed growing populations, but in many parts of Asia, we are still not providing the right quality of nutrition to those who need it the most.
Although governments, companies and not-for-profit organisations have ramped up efforts to improve nutrition and address its associated health burdens in recent years, nutrition remains a large-scale and universal problem with deep impact. Asia is the world’s largest food market today valued at US$1 trillion by 2030;1 however, despite the size of the food market, Asia is still home to nearly two-thirds of the world’s malnourished.
Too many people are missing out on the benefits of improved nutrition, and as often reported, children are the most vulnerable population in Asia. The latest edition of the Global Nutrition Report reveals that across this region alone an estimated 87 million children under the age of five are stunted and 20 million are overweight. One in five children in India are wasted and in Indonesia, one of the world’s fastest growing countries, approximately one in ten children are either wasted or overweight.2
The double burden of malnutrition
These opposing, but equally detrimental, outcomes represent the double burden of malnutrition. Affecting not just individuals, but households and entire populations throughout life, the co-existence of undernutrition (wasting, stunting and micronutrient deficiencies) as well as overnutrition (overweight and obesity) are associated with diet-related non-communicable diseases. The causes of obesity and undernutrition are inherently intertwined as well. A child whose growth was stunted in early childhood is also at greater risk of becoming overweight later in life.
Meanwhile continuing income growth in Asia is, inadvertently, fuelling this two-sided problem, driving changing patterns of food consumption which in turn impact the nutrition and health status of populations. Implications of these nutritional challenges, if left unmanaged, will most likely have far reaching economic implications (e.g., health care cost, productivity).
For children, daily food intake is the first line of defence against a variety of health risks, especially for those living in areas of poverty and in urban slums where sanitation and hygiene are poor. That is why it is vital that affordable, high quality nutritious products are available during childhood. It is not just stepping up food production anymore; we need to focus on getting the right nutritious solutions to the right groups.
So much rice, but still hungry
Rice is the staple food of more than half of the global population, with 90 per cent of the world crop grown and consumed in Asia.3 Yet rice contains few vitamins and minerals, and many of these are lost during milling and food preparation. The predominantly rice-based diet in Asia thus needs to be complemented by foods with very high nutrient density, and this is where stronger efforts must be concentrated.
More so especially, because the nutrient density requirements for children are much higher than for adults. Complementary foods for young children need to be far more nutrient-rich than foods consumed by adults in the household, yet often the opposite is the case in low to middle income households, where infants are typically fed watery rice-based porridges that are low in many of the key required nutrients.4
Pure white rice, i.e. when not consumed with other accompanying foods in a meal such as meat, oil or vegetables, also results in the high glycemic response, which then increases the risk of diabetes. For example, a survey of the distribution of type 2 diabetes across India from 2015 to 2016 revealed higher blood sugar levels in states where white rice was consumed primarily, as compared with states where wheat was the diet staple.5 It is clear that we cannot ignore the reality that beneath all that available rice, Asia’s children are still deprived from the lack of nutrients for proper growth and development.
Shifting the focus from what’s good to what’s appealing
A key step towards achieving this is first encouraging a social and behavioural change in those who provide the right foods to children – their mothers. When thinking about how we develop and market nutritious products, the needle must move beyond merely demonstrating what is good for them, to convincing these mothers about what is healthy, tasty and attractive to them. And this often means reminding ourselves that regardless of income levels, everyone is a consumer wanting to make their own purchasing decisions; so too do mothers and young women in low to middle income groups.
Enabling women to take control of their ability to be stronger and healthier – and more importantly, provide the same care for all children in their care – also means that external support from governments, companies and the industry must involve implementing more pragmatic and long-term strategies. Social safety nets, while still of huge importance for those at the bottom of the pyramid, are not the only answer.
Instead, commercially-viable nutritious, affordable and relevant products that speak directly to Asia’s many unique consumption and purchasing needs and preferences should be the way forward. Paired with better education and awareness on nutrition, we can empower these more than willing group of women to make the right nutritious and sustainable choices for their children and themselves.
Collaborate to accelerate
To that end, public-private partnerships will help to accelerate the development and delivery of such nutritious products for children in the low to middle income groups. Better collaboration between the public and private sectors will also help to bridge the information gap, addressing a lack of the right information around dietary health.
Policy actions taken in isolation are unlikely to achieve better population health or economic growth and development, especially against Asia’s backdrop of huge disparities in wealth and development. Collective effort must become an imperative for all. More local partnerships driven by relevant innovation and a path to true adoption – through sustainable and scalable business models – will bring affordable, accessible and nutritious food to where the need is greatest in this region.
Nutrition must become a priority on government, corporate and industry agendas. Those with the capabilities to develop and implement key nutrition interventions for low to middle income groups have the responsibility to ensure that these target groups are equipped with the right resources and information to make better quality diet-related decisions.
We all recognise that no other area of development can have as wide and deep an impact on society as nutrition. So, let us act on this knowledge and feed Asia’s children with the right nutritious products.
- Business & Sustainable Development Commission. Better Business Better World. June 2017. http://s3.amazonaws.com/aws-bsdc/BSDC_asia_web.pdf Accessed 12 Feb 2018
- Global Nutrition Report Stakeholder Group. Global Nutrition Report 2017: Nourishing the SDGs. November 2017. https://www.globalnutritionreport.org/files/2017/11/Report_2017.pdf Accessed 12 Feb 2018.
- Asia-Rice. About. http://www.asia-rice.org/ Accessed 13 Feb 2018.
- Dewey, Kathryn G. The Challenge of Meeting Nutrient Needs of Infants and Young Children during the Period of Complementary Feeding: An Evolutionary Perspective. J Nutr. 2013 Dec; 143(12): 2050–2054.
- Nutrition Atlas. Distribution of Diabetes (Tertiles): 2015-16 Blood sugar level >140mg/dl. Non-Communicable Diseases. http://126.96.36.199/nutritionatlas/dashbord/diabetes.php Accessed 13 Feb 2018.