Changing Diets in the NENA countries: Implications for Nutrition and Food Security
Fatima Hachem Senior Nutrition and Consumer Protection Officer
Food and Agriculture Organization of the United Nations Regional Office for the Near East and North Africa
Cairo, Egypt
Workshop on Agricultural Trade and Food Security in the Euro-Med Area September 25-26, 2014
Antalya, Turkey
The Near East and North Africa Region (NENA)
NENA cannot structurally feed its people
Driest region in the world Avg annual precipitation 135 mm (Vs over 800 mm global)
15 of the 19 countries in the region are categorized as being in critical water shortage
From 1950 to the present, per-capita renewable water resources have fallen by approximately 75 percent
downward trend will probably be accelerated by climate change
Limited arable land (0.22 ha/caput arable lands) Desertification and land degradation
Prone to natural disasters
Growing Food Demands
31.8
41.4 42.8 45.2
54.9 56.7
66.4 66.5 67.3 69.5 71.7 77.9 78 78.5
83.6 87.2 88.6
95.8 98.4
0
10
20
30
40
50
60
70
80
90
100
110
120
2010
• Rapidly growing population (2.6%) • Urbanization
• For Ensuring Food Security the Region has to rely heavily on imports - A NET FOOD IMPORTER REGION
Food Security
• Food security is built on four pillars: availability, access, utilization, and stability.
• It is a complex development issue linked to health, nutrition, economic development, environment, and trade.
• Food insecurity and malnutrition (undernutrition, over-nutrition, and micronutrient malnutrition) problems as well as the social, economic and environmental impacts of food consumption patterns and diets highlight the inadequacy of the food system.
NATIONAL, SUBNATIONAL AND COMMUNITY LEVEL HOUSEHOLDS INDIVIDUALS
Socio-economic, Political, Civil, Institutional and Cultural
Environment
Food Economy
Population
Education
Macro-economy including
foreign trade
Policies and laws
Natural resources endowment
Basic services
Market conditions
Technology
Climate
Civil strife
Household characteristics
Livelihoods systems
Social institutions
Cultural attitudes and gender
FOOD AVAILABILITY
domestic production
import capacity
food stocks, food aid
ACCESS TO FOOD
poverty purchasing power, income
Transport and market infrastructure
HOUSEHOLD LIVELIHOOD STRATEGIES, ASSETS &
ACTIVITIES
HOUSEHOLD FOOD ACCESS
HEALTH & SANITATION Health care practices Hygiene, Sanitation
Water quality Food safety & quality
FOOD CONSUMPTION
Energy intake Nutrient intake
FOOD UTILISA-TION BY THE
BODY
determined
by
Health status
CARE PRACTICES Child care
Feeding practices Nutritional knowledge
Food preparation Eating habits
Intra-household food distribution
FAO-FIVIMS conceptual framework
NUTRITIONAL STATUS
STABILITY
weather variability price fluctuations
political factors economic factors
Food Insecurity and Malnutrition in NENA
• Countries’ economic development • Geographic, climatic and environmental conditions • Social and cultural specificities • Political environment and stability.
Food and Nutrition Situation varies in NENA according to:
A heterogeneous region
Based on geographic and hydro-climatic similarities, NENA can be divided into three sub-regions: North Africa Algeria, Egypt, Libya, Mauritania, Morocco, Sudan, Tunisia Arabian Peninsula Bahrain, Kuwait, Oman, Qatar, Saudi, Arabia, United Arab Emirates, Yemen Middle East Iran, Iraq, Jordan, Lebanon, Syria
• Wheat • Grain legumes, mainly chickpeas, broad beans, lentils and
sesame • Fruits and vegetables
From a traditional diet high in fiber and roughage:
Changing diets
To a diet high in calories, fat, sugar, and refined wheat flour. ….. driven by very rapid social and economic changes in the last four decades
Changing diets
• The energy intake in the region increased by 30% and fat intake by 45%.
• The largest increases in food commodities were seen in sugar, fat and vegetable oil and meat, especially poultry.
Sugar consumption doubled in some countries and increased by more than 50% in others.
• The consumption of vegetable oils tripled in certain countries.
• There was a slight increase in consumption of milk, fruits and vegetables.
• Big variations exist among and within the countries.
Impact of Changing Diets Nutrition
Improved Dietary Energy Adequacy (%)
High food availability does not always guarantee high food security. In Egypt, DEA is 45 percent higher than the average requirement but stunting affects 31 percent of children under five years of age.
• Double burden of nutrition: problems of under-nutrition coexist with overweight, obesity and food-related chronic diseases.
• Phenomenon is shared by all countries: poor, middle, and high-income Poor Countries: High levels of undernutrition especially among
children – stunting
High-income countries: Very high levels of over-nutrition, both over weight and obesity among adults.
• Micronutrient deficiencies; anemia in particular
• Serious consequences on human and economic capitals – nutrition is one of the drivers of economic growth
Nutrition Transition in NENA
Four Countries with high burden of Stunting
Egypt (30.7%) Sudan (37.9%) Mauritania (23%) Yemen (57.7%)
• Because of the established health risks (diabetes, heart disease, gallstones and arthritis) and substantial increases in prevalence, obesity has become a major health challenge in some countries in NENA.
Increasing Obesity
Prevalence of obesity in NENA
• Not a phenomenon of rich countries only
• 5 countries among the first ten in the world
Country Prevalence of
obesity among
adults (%)
Country
Prevalence of
obesity among
adults (%)
2008 2008
Algeria 17.5 Morocco 17.3
Bahrain 32.6 Oman 22.0
Egypt 34.6 Qatar 33.1
Iran 21.6
Saudi Arabia 35.2
Iraq 29.4 Sudan 6.6
Jordan 34.3 Syria 31.6
Kuwait 42.8 Tunisia 23.8
Lebanon 28.2 U.A.E 33.7
Libya 30.8 Yemen 16.7
Mauritania 14.0 Developing 8.7
World 11.7 Developed 22.2
Nutritional implications of changing diets
The Case of the GCC Countries
Compositional Changes: • Decrease in some oils • Introduction of new oils
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1969-1971 1979-1981 1989-1991 1999-2001 2009-2011
Kca
l/d
ay
Changes in the composition of Vegetable Oils Group
Oilcrops Oil, Other
Maize Germ Oil
Olive Oil
Sesameseed Oil
Coconut Oil
Palm Oil
Palmkernel Oil
Cottonseed Oil
Rape and Mustard Oil
Sunflowerseed Oil
Groundnut Oil
Soyabean Oil
The Case of the GCC Countries
0%
5%
10%
15%
20%
25%
30%
35%
40%
1969-1971 1979-1981 1989-1991 1999-2001 2009-2011
Kca
l/d
ay
Contribution of Olive Oil and Palm Oil to caloric intake in GCC countries
Palm Oil
Olive Oil
-
50.0
100.0
150.0
200.0
250.0
1969-1971 1979-1981 1989-1991 1999-2001 2009-2011
(10
00
me
tric
To
nn
es)
Imports of Palm Oil to GCC countries
Palm Oil
The Case of Egypt
Compositional Changes: • Sharp increase in imported olive oil • Disappearance of cotton seed oil
-
100.0
200.0
300.0
400.0
500.0
600.0
700.0
800.0
1969-1971 1979-1981 1989-1991 1999-2001 2009-2011
Import Trend of Vegetable Oils 1969-2011 (1,000 Metric Tons)
Soyabean Oil
Groundnut Oil
Sunflowerseed Oil
Rape and Mustard Oil
Cottonseed Oil
Palmkernel Oil
Palm Oil
Coconut Oil
Sesameseed Oil
Olive Oil
Maize Germ Oil
Oilcrops Oil, Other
The Case of Tunisia
Compositional Changes: • Substitution of Olive Oil by Soyabean Oil
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1969-1971 1979-1981 1989-1991 1999-2001 2009-2011
Contribution of Vegetable Oils to caloric intake in Tunisia
Oilcrops Oil, Other
Maize Germ Oil
Olive Oil
Sesameseed Oil
Coconut Oil
Palm Oil
Palmkernel Oil
Cottonseed Oil
Rape and Mustard Oil
Sunflowerseed Oil
Groundnut Oil
Soyabean Oil
Fat Type and Health
• Consumption of palmitic acid increases risk of developing cardiovascular diseases, placing it in the same evidence category as trans fatty acids
• Excessive intake of palmitic acid, which makes up 44 percent of palm oil, increases blood cholesterol levels and may contribute to heart disease
0 20 40 60 80 100
Cotton seed
Olive Oil
Palm Oil
Soyabean oil
Fatty Acid Composition of Some Vegetable Oil
Saturated fatty acids Monounsaturated fatty acids
Polyunsaturated fatty acids
• Nutrition sensitive policies: agriculture, social protection, food production and trade policies
• Legislation on food labelling
• Public Health Tax on Food
• Establishing National Strategy for the Prevention and Control of Overweight and Obesity including awareness-raising for behavioral change, health care, regulatory and fiscal measures.
Policy Options