"Obesity is a problem of the system, it should not be treated as something individual ”

[Inkriql]

MORE INFORMATION

    Cheap calories
    If you are born in the Central African Republic you have a 2,500% more chance of dying in childhood than in Cuba
    Four committed questions for food businesses

Malnutrition is an epidemic. Obesity grows throughout the world while there are still people starving or not receiving all the necessary nutrients to develop. The Spanish researcher Estefania Custodio (Madrid, 1974) is an expert in nutrition and global health and has focused her work in Sub-Saharan Africa and Latin America. She was one of the pioneers in jointly studying malnutrition and tropical diseases at the Carlos III Health Institute. An issue that will be discussed precisely this Wednesday in Ávila at the Congress of the Spanish Society of Tropical Medicine and International Health. Custodio works since 2014 in the Community Research Center of the European Commission.

Question. Is there anyone in the world who eats well?

Reply. Globally we all eat badly. Malnutrition affects all countries of the world, at all ages, regardless of social status. Collecting information about what people eat is very expensive and difficult, but for more than 20 years we know that it is one of the fundamental factors of mortality and disease.

Have we spent many years looking at quantity rather than quality?

In certain contexts, such as food crises, the focus has been on the amount, basically, of food. But in developing countries we have also looked at the availability of food and not the variety. There have been many policies to increase agricultural production, but then we realized that malnutrition crises did not improve, because, although there was greater access to a crop, there was no diversity in the diet that would improve the growth of children.

Is malnutrition affecting the poor more?

In the world there has been a food transition: from a diet of self-sufficiency, with your crop and your animals to the door of the house, to one of consumption. This historical change has already taken place in Europe, but in developing countries it has occurred faster. When we abandoned self-sufficiency in Europe, we didn't immediately have so many ultra-processed and cheap foods at our disposal.

Are we putting the necessary tools to fight this malnutrition, especially in obesity?

The epidemic is here and we still lack tools. It is not necessary to focus on the individual, it is a problem of the food system. It is the industry, it is the production chain, it is advertising ... It is a big challenge and I believe that right now we are not in a position to have a great change in this aspect.

What can governments do to counter these trends?

There are already tools in the form of programs. More than 80% of countries have national nutrition policy with programs that we know work. Some are undeveloped, others need more time ... The hard part is that they are financed and implemented. But this fight against malnutrition must be given at all levels.

To what extent do cultural conditions influence to end up having a bad diet?

I believe that not so much, that people are aware of what is good food. I always refer to breastfeeding. In the research I have done, I have seen that mothers already know what is best for their children. But they don't have an environment that makes it easy for them to put it into practice. If they have to go back to work in the city or in the countryside it is impossible ... This is where the regulation comes in. Another example: clear people who know that it is healthier to make a vegetable lasagna at home, but if you go to the supermarket and it costs you cheaper to buy it already made and in addition your schedules do not leave you time to cook it at home, people will just buying packaged. It is not a matter of beliefs or habits, but of having possibilities.

You have developed much of your work in Sub-Saharan Africa, an area where the two problems meet: malnutrition and overweight. According to his research, especially in African countries, who decides what is consumed in the home and how does that influence the quality of the diet?

More than what is bought, what we study is how many resources are dedicated to food and that is usually man. The second step is to study how food is distributed at home and many times it is women who consume the least nutrients. He is the man who is usually favored, because he is the one who goes to work. Normally, he is given animal protein. It also benefits children, who are in full development. We have just published a study conducted in a refugee camp in Somalia in which we conclude that when women make decisions about food, children are better fed.

Without leaving Africa, Rwanda is an example of a country that has greatly improved its indicators on food and child development. What can we learn from that example?

On the one hand they have made a political commitment. They have a child development program that depends directly on the president. The plans they develop include many fronts: agriculture, education, health ... Family policies have increased greatly, for example one of the indicators that has improved the most is breastfeeding. This has been greatly influenced by the empowerment of women in politics.