The economics of malnutrition: Dietary transition and food system transformation

Rapid increases in food supplies have reduced global hunger, while rising burdens of diet-related disease have made poor diet quality the leading cause of death and disability around the world. Today's "double burden" of undernourishment in utero and early childhood then undesired weight gain and obesity later in life is accompanied by a third less visible burden of micronutrient imbalances. The triple burden of undernutrition, obesity, and unbalanced micronutrients that underlies many diet-related diseases such as diabetes, hypertension and other cardiometabolic disorders often coexist in the same person, household and community. All kinds of deprivation are closely linked to food insecurity and poverty, but income growth does not always improve diet quality in part because consumers cannot directly or immediately observe the health consequences of their food options, especially for newly introduced or reformulated items. Even after direct experience and epidemiological evidence reveals relative risks of dietary patterns and nutritional exposures, many consumers may not consume a healthy diet because food choice is driven by other factors. This chapter reviews the evidence on dietary transition and food system transformation during economic development, drawing implications for how research and practice in agricultural economics can improve nutritional outcomes.