At the crossroads of agriculture, nutrition and health

Like many women of my age, my weekly encounter with the weight scales yields an upward trend – yet I still consider myself to be fortunate to be overweight, rather than obese. But I do have a special link with the growing societal problem of obesity through my work as an international civil servant. I actually deal with agriculture; more precisely, I manage the United Nations Food and Agriculture Organization’s programme on horticulture. Together with our UN sister agency, the World Health Organization, we started looking at the health implications of the global obesity epidemic more than ten years ago. We saw that developed and developing countries alike were facing increasing rates of obesity and we agreed that we had to advocate for a food-and-lifestyle-based response which can be summed up simply as promoting balanced diets that include plenty of fruit and vegetables, combined with increased physical activity.

Since then, we have met with agriculture and public health practitioners from more than 80 countries to consider different facets of the problem, along with strategies for dealing with it. I think the most disconcerting examples I’ve taken away from this experience would have to be from the island countries of the Pacific. Tonga, for example, has been widely reported to have one of the most overweight populations on earth, and the islanders are acutely aware of their predicament. Unhealthy eating patterns, together with more sedentary lifestyles, are having profound effects on the incidence of non-communicable diseases (NCDs), such as cardiovascular disease and diabetes, and driving up the social and economic costs that come with them. Across the Pacific region the pattern is the same, and it is apparent that food consumption has shifted over time, away from traditional diets based on tropical staples, local vegetables and fish towards a strong preference for rice, refined wheat flour, canned fish and fatty tinned meat. There are many cases where overeating, leading to obesity, is locking children especially into a vicious circle of social exclusion, making them even more likely to shun the organised physical activity that they really need to help them break out of the tubbiness cycle.

I have learned that there can be negative stigmas or low status associated with eating fruit or vegetables; for example, in some places teenagers think it’s definitely uncool to eat fruit. I also picked up that when you mention fruit and vegetables, many people are so used to seeing the produce shipped in from Australia or New Zealand that they think of apples, pears, celery and carrots – things that are difficult or impossible to grow in their climates and expensive to ship there as fresh produce. Yet in many of those island countries there are local leafy vegetables and tropical fruits that can grow well with a minimum of effort.

There are many reasons why local diets have switched away from fresh food. For one, the active farming population is getting older and older, and there are few incentives for younger people to stay in or to get into farming. To make matters worse, systems of customary land title and a high number of absentee land owners can make it extremely difficult to rent or buy land for growing produce, even when there is a lot of land lying idle. On top of all that there is often social pressure on young people to leave and look for work overseas so that they can send remittances to their families back home. So people find themselves wondering who will be left to grow and market the fresh produce that the islanders so badly need to get their diet and lifestyle back on track.

I have outlined just a few of the features of a very complex problem which merits a collective and coordinated response. Practically all the Pacific Island countries have strategies in place for combatting NCDs, and while many governments are valiantly trying to address the diet problem through integrated approaches, still the obesity epidemic continues unabated. Everyone agrees that there should also be a prominent role for local agriculture and reinvigorated supply chains in changing consumption habits, if the goal is enabling ordinary people to choose more fresh fruit and vegetables. Lots of good ideas came out of our discussions with agriculture, health and education practitioners from around the region during a recent workshop in Suva. Some governments have set a great example by introducing standards for food provided in schools and preventing purveyors of junk foods from having access to students during school hours. Others are running go-local campaigns to try to rekindle enthusiasm for locally grown and traditional fresh foods. Public service departments are showing the way in some countries by getting employees to engage very visibly in regular physical activity. Many countries are already onto the idea of leveraging the influence of popular islander sporting heroes to spread messages about healthy eating and physical activity.

A job for us now is to partner with the countries’ agriculture departments and support their efforts to foster a renewed focus on local agriculture and supply chains, while UN-WHO works with governments to monitor changes in dietary patterns and health outcomes. We are consulting and working with communities to learn what would work best for them, organising field days to promote local food production, facilitating the supply of seed, encouraging the adoption of organic methods for good soil resources management, helping women to emerge as fruit and vegetable growers. We now also know that nurturing youth entrepreneurship in market gardening, and connecting local farmers with consumers are vital steps that still need to be addressed with government and non-state partners, in order to create an enabling pathway for interested local youth to be able to build good livelihoods working with the land and the markets. I also believe that social protection mechanisms such as food security vouchers and cash transfers, if adequately managed, could play a powerful role in fostering positive changes in fruit and vegetable production and consumption patterns.