WASHINGTON, March 29 — The equator is not the only place where the earth is bulging these days. In the United States, 55 percent of adults are overweight by international standards, and a whopping 23 percent are considered obese. But this is not just an American problem; even in developing nations, overeating is occurring side-by-side with persistent widespread hunger.
While the world’s underfed
population has declined slightly since 1980 to 1.1 billion, the
number of overweight people has surged to 1.1 billion.
FOR EXAMPLE, 41 percent of
Colombia’s adult population is overweight; in Brazil, 36
percent of adults weigh too much. For the first time in human
history, the number of overweight people rivals the number of
underweight people. While the world’s underfed population
has declined slightly since 1980 to 1.1 billion, the number of
overweight people has surged to 1.1 billion.
THE BURDEN OF DISEASE
Both the overweight and the underweight suffer from malnutrition,
which physicians define as a deficiency or an excess in a
person’s intake of nutrients and other dietary elements
needed for healthy living. Both groups share high levels of
sickness and disability, shortened life expectancies, and lower
levels of productivity — all of which are a drag on a
country’s development. More than half of the world’s
disease burden — measured in "years of healthy life
lost" — is attributable to hunger, overeating, and
widespread vitamin and mineral deficiencies.
The specific consequences of hunger and being overweight can be
very different. Hunger hits children the hardest, increasing
their vulnerability to infectious diseases or conditions such as
diarrhea, which often lead to permanent mental and physical
impairment or even death. Excess weight gain, on the other hand,
takes its greatest toll in adulthood, leading to chronic, but
reversible, conditions such as heart disease and diabetes.
PAYING THE PRICE
Both developed and developing nations are paying a high price for
malnutrition. The World Bank estimates that hunger cost India
from 3 percent to 9 percent of its GDP in 1996, greater than its
budgets for nutrition, health, and education combined. And
obesity cost the United States 12 percent of the national health
care budget in the late 1990s, $118 billion, more than double the
$47 billion attributable to smoking.
As western diets and lifestyles
spread to Africa, Asia, and Latin America, nations are often
simply trading hunger for obesity, and diseases of poverty for
diseases of excess. Still struggling to eradicate infectious
diseases, many developing nations’ health care systems could
be crippled by growing caseloads of chronic illness.
Most countries simply do not make nutritional well-being a
priority. It is a myth that hunger results from a scarcity of
food. Some 80 percent of the world’s hungry children live in
countries with food surpluses. The common threads that run
through nearly all hunger, in rich and poor nations alike, is
poverty.
EDUCATION HELPS Malnutrition hits children hardest, while
obesity takes its greatest toll in adulthood.
Even countries struggling with difficult economic and political
circumstances can significantly reduce the number of underweight
people with the right policies. Cuba and the Indian state of
Kerala, for example, have been remarkably successful at reducing
malnutrition by targeting nutritionally vulnerable populations
such as women and children for special attention. Both
governments provide broad access to health care, an important
partner to food intake in ensuring good nutrition.
In nations where overeating is a problem, policymakers need a
different set of tools. All too often, techno-fixes like
liposuction or olestra attract more attention than the behavioral
patterns like poor eating habits and sedentary lifestyles that
underlie obesity. Liposuction is now the leading form of cosmetic
surgery in the United States, for example, at 400,000 operations
per year. While billions are spent on gimmicky diets and food
advertising, far too little money is spent on nutrition
education.
IS THERE A SOLUTION? Why not levy taxes on unhealthy food, and
make fruits and vegetable tax-free?
One obvious place to start is the school environment. U.S. school
districts have been cutting back on physical education while at
the same time negotiating lucrative cafeteria contracts with
fast-food vendors and soda companies. By contrast, the Trim and
Fit Scheme in Singapore has reduced obesity among children by 33
to 50 percent, depending on the age group, through changes in
school catering and increased nutrition and physical education
for teachers and children.
In the absence of a strong
government educational effort on nutrition issues — in
schools, on product labels, and through the regulation of food
advertising — most people get their nutrition cues from food
companies. In the modern food environment of unprecedented access
to unhealthy foods that are low in cost, heavily promoted, and
good tasting, we’re like children in a candy shop, every day
of our lives.
A serious effort to end overeating could be modeled on the
successful campaign to discourage smoking, including the use of
"high fat" or "high sodium" warning labels
and taxes to deter purchases. Consumption of nutrient-poor foods
could be further reduced using a tax on food based on the
nutrient value per calorie. Fatty and sugary foods low in
nutrients and high in calories would be taxed the most, while
fruits and vegetables might escape taxation entirely.
In an age of unprecedented global prosperity, it is wholly
unnecessary that malnutrition should exist on such a massive
scale. Poorly nourished people are a sign of progress gone awry:
prosperity has either bypassed them and left them hungry, or
saturated them to the point of overindulgence.
Gary Gardner is a senior researcher and Brian Halweil a staff researcher at The Worldwatch Institute, a Washington, DC-based research organization. They are the authors of "Underfed and Overfed: The Global Epidemic of Malnutrition.