As a pharmacist, one of the most frustrating feelings is being able to treat a person for their symptoms, knowing you're powerless to address the root cause of their problem.
Working in some very remote locations around the world, it happens to me regularly. We might be treating one patient with diabetes as a result of over-nutrition, knowing that the next person who walks through the door will need treatment for mineral deficiencies resulting from under-nutrition. While we often think of over and under-nutrition as being at the opposite ends of the spectrum, both have the same root cause: food.
With World Food Day today, countries around the world are looking at what can be done to improve access to and education around nutritious and affordable food. My experience is just a glimpse into the consequences people face when healthy and inexpensive food is not available to them. When a population faces both under and over-nutrition, this is a manifestation of what we call 'the double burden of disease' and it's an issue that many developing countries experience while they are in a period of economic transition.
Lower income countries tend to lack clean water and sanitation, and people generally live in more densely populated conditions, leading to a higher incidence of 'communicable' diseases. These are diseases which can be passed from one person to another, such as pneumonia, tuberculosis or malaria. As a country becomes wealthier, there's normally a decline in 'communicable' diseases, and an increase in 'non-communicable diseases'. These are illnesses which can't be passed from one person to another, such as diabetes or heart disease, and tend to result from greater access to food, a more sedentary lifestyle and increased consumption of cigarettes and alcohol.
Yet among some of our Pacific neighbours, far from being transitory, this double burden of disease is becoming entrenched. While it's a complex problem influenced by socio-economic status, geography and lifestyle choices, experts can agree on one common factor among countries experiencing the double burden: nutrition is at its heart.
Most commonly, the issue isn't so much to do with the number of calories being consumed, but the fact that the calories aren't coming from the right foods at the right time. For example, nutrition is particularly important during childhood. A child's future is not mapped out from birth. Rather, a baby's physical and mental development, height, weight, susceptibility to disease and life expectancy are all affected by the nutrients their body receives in its formative years. The phrase 'you are what you eat' might sound trite, but it's true.
Under-nutrition isn't always manifested as emaciation; in fact, most forms of malnutrition occur on a micronutrient level. For example, a lack of zinc in children's diets increases the risk and severity of diarrhoea, which is the second biggest killer of children under the age of five around the world. Similarly, 25 percent of children under the age of five suffer from vitamin A deficiency. As well as causing blindness, a lack of vitamin A in children's diets can make vaccinations less effective, so that even with a vaccination children's immune systems are unable to protect them from diseases such as measles.
This issue is not limited to children, but affects whole families and communities across the globe. In fact, 30 percent of all people on the planet are currently suffering from one or more forms of malnutrition. There's a knock-on impact when a mother has an insufficient protein intake during pregnancy, when a family cannot afford to buy fruit and vegetables, or adults lead by example in developing unhealthy attitudes towards food.
While we usually treat nutritional deficiencies with supplements, it's expensive, inconsistent and disempowering to do so. It perpetuates the myth that medicines can solve people's health problems, rather than enabling people to make healthy and conscious decisions about the food they eat.
These micronutrients can be found in leafy vegetables, red meat, fish, root vegetables and some fruits. Eggs are rich in iodine, cabbages are packed with vitamins and zinc is present in most varieties of beans. Eating only rice or potatoes two or three times a day might provide a person with enough calories, but they will lack the micronutrients they need to remain healthy.
Slowly but surely, the world is waking up to the scale of this issue. LAUNCH Food is just one new global initiative which tackles the issue head-on. Supported by the Australian Department for Foreign Affairs and Trade's (DFAT) InnovationXchange and the US Department of State, LAUNCH Food is putting out a call to innovators and entrepreneurs with big ideas that will enable people to make healthy food choices. It brings together a network of people to share ideas and resources in pursuit of a common goal: encouraging and enabling the conscious consumption of adequate, nutritious food.
As the world's population continues to grow, it will no longer be feasible for pharmacists to treat the consequences of under and overnutrition. Rather, it's time we acknowledge that it's in all of our interests for people to have access to nutrient-rich, sustainable and affordable food that gives them the best chance in life.
Visit www.launch.org/food to learn more about LAUNCH Food or to submit your solution to the challenge.