The Jan. 27 release of the paper “The Global Syndemic of Obesity, Undernutrition and Climate Change: The Lancet Commission report” provides another serving of alarmist activism orchestrated by the agenda-driven ‘ivory tower’ superiorites.
Ironically the paper seeks to make the case for a global ‘Framework Convention on Food Systems’ in part due to the failure of the United Nations’ (U.N.) and the World Health Organization’s (WHO) ability to address the growing global obesity epidemic. The paper headline reads, “The Global Syndemic represents the paramount health challenge for humans, the environment and our planet in the 21st century.”
Reading the paper one must ponder why link obesity, undernutrition and climate change all together? Is it to advance the climate change agenda? Is to advance the anti-meat and anti-ultra-processed food agenda? Is it to truly address obesity and undernutrition? Or is it to create a crisis sufficiently large enough to mobilize governments and resources to establish an agenda-driven U.N. Framework Convention on Food Systems that seeks to dictate global policy, action and accountability?
Key points in the ‘opinion’ paper are derived from personal communication, an unpublished working paper and stories for examples of success; rather than derived from evidence-based scientific peer-reviewed data. The paper talks about obesity as a societal versus individual responsibility. It scapegoats ‘big ag’ and ‘big food’ as the cause of many societal ills, changes and norms. It uses many loaded terms, including double-duty action, triple-duty actions, food deserts, food swamps, food sovereignty, consumptogenic economic systems, complex adaptive systems and the right of wellbeing.
The paper defines key points, “… a syndemic is two or more diseases with three characteristics: they co-occur in time and place, they interact with each other at biological, psychological, or societal levels, and they share common underlying societal drivers.” It notes that, “Obesogenic environments are the collective physical, economic, policy and sociocultural surroundings, opportunities and conditions that promote obesity.” And that, “Sustainable food systems promote the global outcomes of human health, ecological health, social equity and economic prosperity. They have a low environmental impact, support biodiversity, contribute to food and nutrition security and support local food cultures and traditions.” Note the all-encompassing scope of the definitions and the agenda-driven words within each definition.
It builds their case noting, “The major systems driving The Global Syndemic are food and agriculture, transportation, urban design and land use.” Paraphrasing, it postulates that the food value chain and its feedback loops intrinsically leading to more processed and ultra-processed foods. As an example, it notes, “Milk as a basic food has less added value (in profit terms) than baby formulas, yogurts, and ice cream. These products fulfil consumers’ desire for taste, variety, choice and shelf life, and create greater profits for the food providers. Unfortunately, such a focus also results in a food supply that is high in ultra-processed foods and is associated with higher rates of chronic diseases.” Of course, it adds, “Reducing the consumption of red meat is a cornerstone for healthy, sustainable diets, but achieving this will be formidable given the current supply and demand dynamics. Western-style fast foods might also be part of aspirational diets for some populations in low-income countries.”
The crisis is framed as, “In 2015, obesity was estimated to affect 2 billion people worldwide. Obesity and its determinants are risk factors for three of the four leading causes of non-communicable diseases (NCDs) worldwide, including cardiovascular diseases, type 2 diabetes and certain cancers.” And, “The current costs of obesity are estimated at about $2 trillion annually from direct health-care costs and lost economic productivity. These costs represent 2.8% of the world’s gross domestic product (GDP) and are roughly the equivalent of the costs of smoking or armed violence and war.” Further, “Economic losses attributable to undernutrition are equivalent to 11% of the GDP in Africa and Asia, or approximately $3.5 trillion annually.”
To solve the crisis and overcome policy deadlock and inertia, the paper proposes that, “A Framework Convention on Food Systems would provide the global legal structure and direction for countries to act on improving their food systems so that they become engines for better health, environmental sustainability, greater equity, and ongoing prosperity.” It proposes the system be modelled on the WHO Framework Convention on Tobacco Control as it moves beyond legal frameworks to provide specific policy guidance and would strengthen the ability of nations to act. It recognizes food clearly differs from tobacco because it is a necessity to support human life, but that unhealthy food and beverage products are not a necessity. Ultimately, they submit equating controls for tobacco to the controls needed in the food systems – an amazing overreach to drive an agenda that would define policy actions to strengthen their definition of food systems for health and social equity, sustainability and prosperity.
However, their activist agenda shines with proposed ideas for interventions (underline added), “National dietary guidelines serve as a basis for the development of food and nutrition policies and public education to reduce obesity and undernutrition and could be extended to include sustainability by moving populations towards consuming largely plant-based diets.” And the blame, “Changes in the dietary patterns of populations include increasing consumption of ultra-processed food and beverage products and beef and dairy products, whose production is associated with high greenhouse-gas emissions. Agricultural production is a leading source of greenhouse-gas emissions.” Also, “The Commission proposed the use of international human rights law and to apply the concept of a right to wellbeing, which encompasses the rights of children and the rights of all people to health, adequate food, culture, and healthy environments.” The paper also ties in the implementation of the UN Decade of Action on Nutrition 2016–2025, achieving Sustainable Development Goals and the Paris Agreement on Climate Change as umbrella frameworks to galvanize actions.
One does need to acknowledge the paper offers some good points including empower consumers to make informed healthy dietary choices, improve the labelling of products, introduction of nutrition in primary school curriculums and increased physical activity.
The “Ivory Tower’ idealism does recognize their dream utopia will not come to fruition unless: there is a fundamental reorientation of food systems; business models shift from a profit-only to a more social and environmental model; synergistic pandemics that constitute a syndemic can be leveraged to unite previously disparate stakeholders toward systemic actions; the need for profiling the shared societal determinants for obesity and climate change; and of course gratuitously leading with the need to protect the most vulnerable groups including children, the poor and the socially disadvantage.
The Global Syndemic paper is alarmist and concerning in that it appears the commission believes in their superiority to all. It references that partnerships between the corporate food sector and the government are deemed a risk to public health; it touches on the concept of stealth interventions to show that other social movements for action such as climate change, sustainability, animal rights, and food sovereignty have the potential to contribute to obesity prevention; and suggests the potential need to explicitly excluded some from the policy development and implementation for a global treaty for food systems.
Yes, there is an urgent need to more effectively globally address obesity and undernutrition as specific epidemics. Leveraging the existing U.N. organizations and structures of WHO and FAO (Food & Agriculture Organization) seems most appropriate. WHO needs a laser focus on addressing obesity via encouraging adoption of healthy diets and increased physical activity. FAO needs a laser focus on increasing food productivity, including of nutrient rich and diverse foods that include food animal sources, and having it available to all consumers globally. Such focused efforts would seem to be more effective than a diluted approach that seeks to change the world’s food systems.
The worldwide estimated 2 billion people with obesity and the estimated 821 million people that are undernourished deserve our immediate attention. A collaborative ‘double-duty’ approach with intergovernmental and non-governmental stakeholders hopefully can yield nearer term results for the benefit of individuals and society.