全球粮食安全与营养论坛 (FSN论坛)

Here are my responses to the questions posed. I do not pretend to bring any new information, but it is sometimes valuable to go back to the bascis.

1. How and why do diets change?

Diets change when there are changes in the determinants of food choice:

• Food supply – types of food, variety, extent of processing
• Economic condition
• Food prices
• Health condition
• Preferences, under the influence of advertising primarily
• Environmental, ethical and other types of social concerns
• Information on health and on food
• Social norms
• Lifestyle, including urban living, lack of facilities and limited time for cooking
• Migration
• ….

1. What are the links between diets, consumption and consumer habits and food systems?

Eating patterns are influenced by, and impact on, food systems. And therefore, consumers have an important role to play in shaping food systems. They would have to be more vocal.

1. How do changes in food systems affect changes of diets, and therefore health and nutritional outcomes?

Food systems impact on the food supply – food variety, quality, safety, nutritional value, extent of processing, prices…., and the food supply is one of the drivers of food choice. See also above, question 1.

1. What are the determinants of the changes in consumption?

The relative forces of the various determinants of food choices and changes will determine the nature and extent of the changes. Again, refer to Question 1.

1. How do the dynamics of food systems drive consumption patterns?

This question is  somewhat redundant with the previous ones.

1. How to shape and to address pathways to healthy nutrition?

Eating for health cannot be dissociated from eating for enjoyment (influence of advertising), eating as a social and even political deed (culture, beliefs, social concerns), eating according to what is available and affordable (food systems), and eating according to one’s needs and lifestyle (psycho-social factors). All these facets have to be addressed, and common sense for variety and moderation may be a better guide than science, which evolves. Consumption of eggs, for instance, used to be encouraged only in small quantities, which is no longer the case.

1. What is the role of public policy in promoting healthy, nutritious and culturally appropriate food for all?

This describes in essence food and nutrition security, which operationalises the right to food. States have to promote and defend this right through regulations and guidelines regarding food systems including advertising, nutrition communication and social safety nets.

Food sovereignty has to be regarded as a national goal.

1. How to build on the diversity of the existing food systems?

Various food systems coexist and this is healthy (much like biological diversity). Sustainable combinations should be sought and for this, the criteria are health of the people, of the environment and of the local economy. The optimal mix is location-specific and requires national sovereignty over food and food systems for its determination.

1. What is in practice the range of actionable solutions from farm to fork that enable better nutritional outcomes of food systems?

There are opportunities for nutritional value improvements all along the food value chains. Nutrition- sensitive production, transformation, marketing and distribution is central. Some examples are given to illustrate this:

• Production: Vegetable consumption is oftentimes insufficient for health: to promote local gardens, or subsidise large producers. In Benin (West-Africa), surveillance for cardiovascular and metabolic disease risk was coupled with producers’ markets. In Burkina Faso, the production, distribution and consumption of non-refined palm oil was promoted as a strategy to fight against vitamin A deficiency, while providing additional income for women and as a means of stabilising soil along rivers (however, external funding needed to implement this was not sustained, so that vitamin A capsules continue to be distributed).
• Transformation: In Mali, parboiling of locally grown rice was advocated as a means of preventing thiamine deficiencies in producing areas where diet is not diversified (but we do not know whether this process is now routinely implemented).
• Marketing: social marketing should be strengthened in order to posit healthy weights, physical activity and consumption of local foods as desirable and even social norms.
• Food preparation: Cooking with less fat, teaching one’s children how to prepare traditional foods, and reducing cooking time, for instance for vegetables are among the messages conveyed in the Food Guide that was developed in Benin.

1. What action should different stakeholders, including governments, civil society and the private sector, take?

• Large transnational corporations now rule the agro-food system worldwide. If states are to counteract such forces, they need to join in regional alliances to impose their food and health policies, for instance the ban on the introduction of GMOs in agriculture in sub-Saharan Africa.
• In the private sector, we tend to lump together small producers, large companies and international corporations. Small producers, women in particular, need to be supported and oriented toward producing diversified nutritious foods that the population needs for nutritional health. More farmers’ markets should be encouraged, and particularly in poor neighborhoods of cities. Large corporations are governed by profit and therefore, any value added may be meaningful to them. They are not the ones to recommend eating less food, less processed foods, less sugar, less salt, less saturated fat… The best that can be expected is for food processors to reduce the amount of salt, sugar and fat in their processed foods.
• Governments may impose tax on ultra-processed foods, but results up to now have been mitigated. The process and likely impact have to be carefully analysed beforehand for increasing the likelihood of positive impact on diets.
• Health and nutrition professional associations have an important role to play with governments (giving advice) and the population (nutrition and health communication for behaviour change; pressure on companies for more wholesome, nutritious and cheaper food [meaning less profit for them]).
• More nutritionists as health professionals are needed to help governments with their agro-food and health policy as regards nutrition, to act in the health as well as food system, to communicate with the population, to train other agents, and to plan and assess programmes.