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Food Security and Nutrition in the World THE STATE OF FOOD SECURITY AND NUTRITION IN THE WORLD TRANSFORMING FOOD SYSTEMS FOR AFFORDABLE HEALTHY DIETS This flagship publication is part of THE STATE OF THE WORLD series of the Food and Agriculture Organization of the United Nations. Required citation: FAO, IFAD, UNICEF, WFP and WHO. 2020. The State of Food Security and Nutrition in the World 2020. Transforming food systems for affordable healthy diets. Rome, FAO. https://doi.org/10.4060/ca9692en The designations employed and the presentation of material in this information product do not imply the expression of any opinion whatsoever on the part of the Food and Agriculture Organization of the United Nations (FAO), the International Fund for Agricultural Development (IFAD), the United Nations Children’s Fund (UNICEF), the World Food Programme (WFP) or the World Health Organization (WHO) concerning the legal or development status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The mention of specific companies or products of manufacturers, whether or not these have been patented, does not imply that these have been endorsed or recommended by FAO, IFAD, UNICEF, WFP or WHO in preference to others of a similar nature that are not mentioned. The designations employed and the presentation of material in the maps do not imply the expression of any opinion whatsoever on the part of FAO, IFAD, UNICEF, WFP or WHO concerning the legal or constitutional status of any country, territory or sea area, or concerning the delimitation of frontiers. All reasonable precautions have been taken by FAO, IFAD, UNICEF, WFP and WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall FAO, IFAD, UNICEF, WFP and WHO be liable for damages arising from its use. ISSN 2663-8061 (PRINT) ISSN 2663-807X (ONLINE) ISBN 978-92-5-132901-6 © FAO 2020 Some rights reserved. This work is made available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, this work may be copied, redistributed and adapted for non-commercial purposes, provided that the work is appropriately cited. In any use of this work, there should be no suggestion that FAO endorses any specific organization, products or services. The use of the FAO logo is not permitted. If the work is adapted, then it must be licensed under the same or equivalent Creative Commons licence. If a translation of this work is created, it must include the following disclaimer along with the required citation: “This translation was not created by the Food and Agriculture Organization of the United Nations (FAO). FAO is not responsible for the content or accuracy of this translation. The original English edition shall be the authoritative edition.” Any mediation relating to disputes arising under the licence shall be conducted in accordance with the Arbitration Rules of the United Nations Commission on International Trade Law (UNCITRAL) as at present in force. Third-party materials. Users wishing to reuse material from this work that is attributed to a third party, such as tables, figures or images, are responsible for determining whether permission is needed for that reuse and for obtaining permission from the copyright holder. The risk of claims resulting from infringement of any third-party-owned component in the work rests solely with the user. Sales, rights and licensing. FAO information products are available on the FAO website (www.fao.org/publications) and can be purchased through [email protected]. Requests for commercial use should be submitted via: www.fao.org/contact-us/licence-request. Queries regarding rights and licensing should be submitted to: [email protected]. COVER PHOTOGRAPH ©Mint Images THAILAND. Floating market on a canal in Bangkok, where local boats are laden with fresh food. ISSN 2663-8061 2020 THE STATE OF FOOD SECURITY AND NUTRITION IN THE WORLD TRANSFORMING FOOD SYSTEMS FOR AFFORDABLE HEALTHY DIETS Food and Agriculture Organization of the United Nations Rome, 2020 CONTENTS FOREWORD viii ANNEX 1A METHODOLOGY xi Statistical tables to Part 1 164 ACKNOWLEDGEMENTS xii ACRONYMS AND ABBREVIATIONS xiv ANNEX 1B KEY MESSAGES xvi Methodological notes for the food security and nutrition indicators 190 EXECUTIVE SUMMARY xviii PART 1 ANNEX 2 FOOD SECURITY AND NUTRITION Methodologies Part 1 202 AROUND THE WORLD IN 2020 1 1.1 Progress towards hunger and ANNEX 3 food insecurity targets 3 Description, data and methodology of Section 2.1 214 1.2 Progress towards global nutrition targets 26 1.3 The critical link between food security ANNEX 4 and nutrition outcomes: food consumption and National food-based dietary guidelines (FBDGs) diet quality 40 used to compute the cost of a healthy diet 231 1.4 Conclusions 60 ANNEX 5 PART 2 Additional tables and figures to Section 2.1 236 TRANSFORMING FOOD SYSTEMS TO DELIVER AFFORDABLE HEALTHY DIETS FOR ALL 63 ANNEX 6 2.1 The cost and affordability of healthy diets Definition of country groups 241 around the world 65 ANNEX 7 2.2 The hidden health and environmental costs Description, data and methodology of what we eat 93 of Section 2.2 242 2.3 What is driving the cost of nutritious foods? 115 2.4 Policies to reduce the cost of nutritious foods ANNEX 8 and ensure affordability of healthy diets 138 Health and climate-change costs related to dietary risks 248 ANNEX 9 Glossary 253 | ii | TABLES, FIGURES AND BOXES TABLES 9 Shifting to healthy diets that A2.1 Monitoring rules and include sustainability considerations classification of progress towards 1 Prevalence of undernourishment can contribute to reductions in achieving the nutrition targets at (PoU) in the world, 2005–2019 9 environmental impacts on land, the regional and global levels 2 Number of undernourished energy and water use 105 used in this report 204 people in the world, 2005–2019 11 10 Fruits and vegetables show A2.2 Data sources used to 3 Prevalence of food insecurity at the highest levels of food price assess diets: strengths and severe level only, and moderate seasonality in seven selected limitations for global assessment 208 or severe level, measured with the countries in Africa (2000–2012) 123 A2.3 Food group classifications Food Insecurity Experience Scale, 11 Agricultural production in used in the analysis 210 2014–2019 20 low-income countries is A3.1 Nutrient intake values for a 4 Number of people penalized, while in middle- representative 30-year-old experiencing food insecurity at and high-income countries it is woman 216 severe level only, and moderate supported (2005–2016) 132 or severe level, measured with the A3.2 Cost and affordability of 12 Worldwide, governments Food Insecurity Experience Scale, the three diets by country support the production of sugar, 2014–2019 21 (170 countries), by region, country rice and animal products the most income group and population 5 The global nutrition targets through interventions, while (millions) in 2017 223 endorsed by the World Health penalizing the production of more Assembly and their extension to nutrient-rich fruits and vegetables A3.3 Lower- and upper-bound 2030 26 (2005–2016) 133 estimates of the percentage and number of people (in millions) 6 Most regions are making some A1.1 Progress towards the who cannot afford the cost of progress, but not enough to Sustainable Development Goals each diet, by region and country achieve global targets; no (SDGs) and global nutrition income group in 2017 229 subregion is on track for the low targets: Prevalence of birthweight target, and adult undernourishment, moderate or A4.1 Food-based dietary obesity is worsening in all severe food insecurity, selected guidelines used to compute the subregions 30 forms of malnutrition, exclusive cost of a healthy diet 233 breastfeeding and low birthweight 164 7 The cost of a healthy diet is A5.1 Average estimates of 60 percent higher than the cost of A1.2 Progress towards the own-price elasticities by food the nutrient adequate diet, and Sustainable Development Goals group 236 almost 5 times the cost of the (SDGs) and global nutrition A5.2 Predicted own- and energy sufficient diet in 2017 77 targets: Number of people who cross-price elasticities by food are affected by undernourishment, 8 More than 3 billion people in group and country income group moderate or severe food insecurity the world cannot afford a healthy in 2008 237 and selected forms of malnutrition; diet in 2017 85 number of infants exclusively breastfed and number of babies born with low birthweight 177 | iii | TABLES, FIGURES AND BOXES A 7.1 Summary description of 4 PoU in Latin America and the 10 Despite some progress for baseline current food consumption Caribbean by subregion, with most indicators, only the 2025 (BMK) and four alternative healthy projections to 2030. Projections target for exclusive breastfeeding diet patterns that include point to convergence between is on track to be achieved. sustainability considerations Central America, where Childhood overweight and adult (FLX, PSC, VGT and VGN) 243 undernourishment is projected to obesity trends need to be increase, and the Caribbean, reversed 28 A 7.2 Overview of per capita where it is projected to decline 15 food consumption (g/day) and 11 Most regions
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