Food security, nutrition and health in the Arab World

The case of marginalized populations in Lebanon

Hala Ghattas Department of Nutrition and Food Sciences

American University of Beirut

Food Secure Arab World Conference

IFPRI-UN-ESCWA

6-7 February 2012

Outline

• Nutrition is a key component of food security

• Main nutrition and health challenges in the Arab World

• Examples from marginalized populations in Lebanon

• Knowledge gaps and research opportunities

Nutrition security is at the core of food security

• The definition of food security

World Food Summit 1996: food security exists “when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life.”

Key challenges to food security and nutrition in the Arab world

• From a macro perspective the region is considered to be highly vulnerable to food insecurity

• From a hunger perspective – this is not necessarily the case

• Triple burden of malnutrition: energy deficiency, micronutrient deficiency and energy excess appears in food insecure subpopulations

Net Cereal imports (MMT) by region, 2007

North America

Former Soviet Union

Oceania Latin America and the Caribbean

Europe Sub-Saharan Africa

Asia Arab Countries

Source: FAO, 2008

Vulnerability due to high reliance on cereal imports

Global Hunger Index

Source: IFPRI, 2011

Proportion of population below the minimum level of dietary energy consumption by sub-region

The diversity of the Arab region

Source: ESCWA, 2007

Prevalence of underweight in children under 5 (%) in selected Arab Countries

Nutrition transition The triple burden across and within Arab countries

Energy deficits

Compiled from various sources

Prevalence of stunting in children under 5 (%) in selected Arab Countries

Energy/nutrient deficits

Compiled from various sources

Risk of overweight according to height for age

Source: El Taguri et al, 2009

Adult obesity BMI>30 in selected Arab countries

Source: Sibai et al., 2010 ; Hwalla et al. (unpublished)

Energy excess

16.3 17 17.4

21 23.3

25.4 27.7

36.3 39.3 39.6

0

5

10

15

20

25

30

35

40

45

Tunisia(1997)

WestBank

(1998)

Algeria(2008)

Oman(2001)

Iran(2001)

Lebanon(2007)

Qatar(2008)

Jordan(2006)

KSA(2000)

UAE(2005)

Prevalence of Metabolic Syndrome among adults in selected Arab

countries

Non- communicable disease

Source: Sibai et al, 2010

Source: Musaiger 2011, citing Mason, 2005; data from 1990-2000

Micronutrient deficiencies

Examples from household food security studies in Lebanon

• A culturally adapted household food security tool – in 3 subpopulations in Lebanon

1. Tyre (n= 822) + <5yo anthropometry

2. Bedouin (n=83) + whole sample anthropometry (n= 461)

3. Palestinian refugees in Lebanon (n=2501) + multidimensional poverty survey

Prevalence of household food security

50.6

30.0

7.35.4 6.7

9.6

6.0

10.813.5

11.0

32.5

41.0

31.1

12.7

31.7

0

10

20

30

40

50

60

Food Secure Vulnerable FI Mild FI Moderate FI Severe FI

Tyre (n=822)

Bedouin (n=83)

Palestinians (n=2501)

Pockets of food insecurity Prevalence of severe food insecurity by village (Tyre)

7.9

37.4

26.7

33.3

0

5

10

15

20

25

30

35

40

Prevalence of stunting Prevalence of overweight

Non severely food insecure

Severely food insecure*

Manifestations of food insecurity Prevalence of stunting and overweight in <5yo -Tyre

Manifestations of food insecurity

31.3

24.6 25

33.3

0

5

10

15

20

25

30

35

Prevalence of overweight Prevalence of obesity

Non severely food insecure

Severely food insecure

Prevalence of overweight and obesity in Bedouin adults

Palestinian refugees in Lebanon - the severely food insecure

Food quality – diversity and safety

• Significant reductions in fruits, vegetables, meat and dairy with increasing severity of food insecurity

• Data from our qualitative studies points to compromises in terms of food safety as well as dietary diversity

Conclusions

1.Pockets of food insecurity

2.Predictors include education, gender and chronic disease

3.FI Manifests as low dietary diversity, stunting and overweight and obesity

Implications for targeted programs, nutrition education, improved access to health care and education, targeting women

Gaps • Nutrition Surveillance

– Data on micronutrient deficiencies

– Identification of pockets of vulnerability

– Changes in response to shocks

• Nutrition Programs

– NGOs and civil society – who is doing what where?

– Monitoring and Evaluation

– Room for governments to include nutrition in their food security policy

Acknowledgements

• Nadine Sahyoun – University of Maryland

• Nahla Hwalla - AUB

• Rami Zurayk - AUB

• Jad Chaaban – AUB

• Karin Seyfert – AUB/SOAS

• Aida El Aily – AUB

• Field teams on the various projects

• Amel Association

• Funding: – AUB

– UNRWA

– Heinrich-Boll Foundation

– WHO-EMRO