Childhood malnutrition-in both its declinations, undernutrition and obesity-causes deficits, incurable and chronic diseases. The ‘Once Upon a Time Dinner‘ initiative is worth reflecting on one of the most serious public health problems, offering excellent example of what can be done by starting from the ground up.
Malnutrition, the two weights of a sick scale
‘
Child malnutrition
in Italy and the World’
, 2018 report edited by
Helpcod
e
and the Children’s Hospital
Gaslini
of Genoa, (1) shows the two weights of a sick scale:
– malnutrition afflicts 7.7 percent of the planet’s children. The lives of 51 million children are at risk, while another 155 million suffer growth delays and deficits,
–Child and youthobesity affects 124 million children (ages 5-19) and has increased more than 11-fold in the past 40 years, from 11 to 124 million. (2)
More than half of the undernourished peoples
live in countries plagued by conflict and social instability, of which Yemen today represents the most scandalous
emergency (85,000 children starved to death in 3 years of external war aggression). 55 percent of the world’s hungry live in rural areas, whose economies are based on agriculture and are exposed to extreme weather events (droughts and floods, ‘
climate change
‘
).
Economic woes and obesity
are related, despite what one might imagine, as resource scarcity induces the poorest to buy ultra-processed foods with nutritional profiles
deteriorating. It is a recent phenomenon, to be attributed to the senseless and immoral policies of Big Food. The 10 big sisters
of food have been moving toward LIMC countries (
Low and Middle-Income Countries
) as ideal markets where to speculate on junk food. Staggering numbers and aggressive business policies (low prices and deceptive advertising), in the total absence of control by authorities and third sector bodies.
Obesity, what costs?
14% of the global population is obese, 9% have type 2 diabetes (2016). Projections of these data to 2045 indicate a progression of obesity to 22% and diabetes to 14%. (3) The 650 million obese individuals are joined by 1.9 billion overweight individuals. Planetary obesity continues to run rampant as an epidemic-with a peak of 28 percent in the adult population in North America, Europe and Oceania-and claims 2.8 million lives a year. In Italy, the 57,000 deaths each year (i.e., 1,000 deaths per week, 1 every 10 minutes) are attributed to ‘obesity-related causes.’ (4)
Obesity is a disease, even more serious if it arises in childhood, dragging with it a wide range of chronic noncommunicable diseases. Type 2 diabetes, cardiovascular disease and cancer, metabolic dysfunction and inflammation, etc. Obesity and overweight in school-age children continue to rise, in North America-where 13% of children are obese-but also in Europe, where there are more than 400,000 new cases each year. (5)
The social cost of obesity is immense, hard to estimate in its actual magnitude. In some European countries, where monitoring is effective and efficient, direct costs alone are estimated to reach 6 percent of public health spending and 1 percent of GDP. To which must be added indirect costs, which in countries such as Sweden are already considered to be three times as high as direct costs. In Italy-where a national monitoring plan is still lacking. – the direct costs of obesity on national health spending are estimated at about 4.5 billion euros per year.
Childhood malnutrition in Italy
In Italy, there are about 1.3 million children living in absolute poverty. The grip of malnutrition, since the economic crisis of 2008, has tightened even on the now ‘former’ middle class, who have been forced to tighten their consumption belts and ‘deplete’ their diets. Breakfast is absent for 8% of Italian children, inadequate for 33%. Between economic hardship and unawareness of its crucial value.
From one excess to another, 36% of minors consume carbonated and sugary drinks every day., 53% exaggerate in off-meal consumption (between ‘snacks’ and ‘snacks’, junk food a go-go), 20% abstain from regular consumption of fruits and vegetables.
The Mediterranean diet is lost, Italy is second in the pole position European https://www.greatitalianfoodtrade.it/salute/dieta-mediterranea-e-obesit%C3%A0-infantile-l-europa-sottosopra
of
childhood obesity
in the men’s sector, fourth place in the women’s sector. It also leads in sedentariness, along with France and Denmark, with the lowest levels of physical activity in childhood.
The personal cost of youth obesity and overweight is expressed in physical and health, psychological and social barriers. With a negative impact that can reverberate on various functions, including learning. So too on educational achievement, prospectively on employment and earning capacity. (6) But Italian parents tend to underestimate the problem, 37 percent of mothers of obese or overweight children consider their children to be normal-weight or even underweight.
‘Once upon a time dinner’
, solidarity and prevention
‘
Once Upon a Time Dinner
‘
is the awareness and fundraising campaign
sponsored by Helpcode and Gaslini Hospital of Genoa. For the specific purpose of offering assistance on the ground to children who experience the risk of malnutrition due to economic hardship. Families of beneficiaries who decide to join the project will be able to receive vouchers for a free basket of products selected by Gaslini Hospital nutritionists and participate in a program to monitor their health.
Prevention assumes a key role, in malnutrition as in all diseases in relation to which there is no direct pharmacological response. It is essential to adopt a multi-pronged strategy, investing in culture and social support. Since malnutrition is always the result of the sum of educational poverty and economic hardship.
Countering malnutrition requires serious commitment now from all social stakeholders (the so-called stakeholders), bar none:
– governments and administrations
, at the international and European level
, national and local must guarantee the basic human rights of access to food (nutritious and balanced) and education. Under the auspices of social equity,
– schools and families. School education should include education on healthy lifestyles and balanced diets by including specialized figures (pediatricians and dietitians) in school communities. It is necessary to share the value of food and limit food waste,
– the private sector and the media. One must move from the sterile stage of promises (
commitment
) to the operational one of concrete commitment (
engagement
). (7) To contribute to a shared and essential social value such as precisely the health and well-being of children. (8) Food chain operators must reformulate ultra-processed foods.
to improve their nutritional profiles, which are still poor on many HFSS products (
High in Fats, Sugar and Sodium
). Ensure effective nutritional information (also making use of schemes such as the NutriScore, already applied in France, Spain and Belgium). And introduce ethics into marketing, once and for all,
– civil society Must in turn take action. Responsible choices of consumption and solidarity, the only salvation for the human species. To affirm the values of a fair and sustainable supply chain in an inclusive society, where children and youth must always come first. Facts and resources, not words. #NoOneLeftBehind.
#Égalité!
Dario Dongo and Giulia Baldelli
Notes
(1) Cf.
NCD Risk Factor Collaboration
(NCD-RisC), ‘
Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults
‘ (2017). The Lancet, https://doi.org/10.1016/S0140-6736(17)32129-3
(2) See Helpcode, ‘
Child malnutrition in Italy and the world, 2018 report
‘,
https://helpcode.org/wp-content/uploads/2018/10/Report_alimentazione_201820-20Helpcode.pdf
(3) See studies ‘
Cities Changing Diabetes
‘, Novo Nordisk, at
http://www.citieschangingdiabetes.com/home.html
(4) A recent study, however, shows that about half of obesity cases are still undiagnosed and ‘
follow-up’
. Cf. Lee M. Kaplan et al, ‘Perceptions of Barriers to Effective Obesity Care: Results from the National ACTION [Awareness, Care, and Treatment in Obesity maNagement] Study‘ (2017). Wiley Online Library, https://doi.org/10.1002/oby.22054
(5) See footnote 2
(6) Cf. Nan Li, Kimberly Yolton et al, ‘Impact of Early Life Weight Status on Cognitive Abilities in Children‘ (2018). Obesity, https://doi.org/10.1002/oby.22192
(7) An encouraging example in this regard is the ViviSmart initiative.
(8) And this is precisely the role that enterprises, including cooperatives, must play. Enter the
CSV
(
Contributing to Social Values
) in each organization’s strategy. Putting aside once and for all the ‘
greenwashing
‘ disguised as CSR (
Corporate Social Responsibility
). V. https://www.greatitalianfoodtrade.it/idee/editoriale-expo-2015-milano-marchi-e-sostenibilità-in-cerca-di-un-nuovo-paradigma-dalla-csr-alla-csv
Dario Dongo, lawyer and journalist, PhD in international food law, founder of WIISE (FARE - GIFT - Food Times) and Égalité.
Graduated in nutritional chemistry and pharmaceutical technologies, expert in quality management systems, social responsibility and supply chain
