HLPE REPORT 12 Nutrition and food systems A report by The High Level Panel of Experts on Food Security and Nutrition September 2017 HLPE High Level Panel of Experts HLPE Reports series #1 Price volatility and food security (2011) #2 Land tenure and international investments in agriculture (2011) #3 Food security and climate change (2012) #4 Social protection for food security (2012) #5 Biofuels and food security (2013) #6 Investing in smallholder agriculture for food security (2013) #7 Sustainable fisheries and aquaculture for food security and nutrition (2014) #8 Food losses and waste in the context of sustainable food systems (2014) #9 Water for food security and nutrition (2015) #10 Sustainable agricultural development for food security and nutrition: what roles for livestock? (2016) #11 Sustainable forestry for food security and nutrition (2017) #12 Nutrition and food systems (2017) All HLPE reports are available at www.fao.org/cfs/cfs-hlpe 2 HLPE Steering Committee members (September 2017) Patrick Caron (Chair) Carol Kalafatic (Vice-Chair) Amadou Allahoury Louise Fresco Eileen Kennedy Muhammad Azeem Khan Bernardo Kliksberg Fangquan Mei Sophia Murphy Mohammad Saeid Noori Naeini Michel Pimbert Juan Ángel Rivera Dommarco Magdalena Sepúlveda Martin Yemefack Rami Zurayk HLPE Project Team members Jessica Fanzo (Team Leader) Mandana Arabi Barbara Burlingame Lawrence Haddad Simon Kimenju Gregory Miller Fengying Nie Elisabetta Recine Lluís Serra-Majem Dipa Sinha Coordinator of the HLPE Nathanaël Pingault This report by the High Level Panel of Experts on Food Security and Nutrition (HLPE) has been approved by the HLPE Steering Committee. 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A report by the High Level Panel of Experts on Food Security and Nutrition of the Committee on World Food Security, Rome. 3 Contents Foreword ............................................................................................... 9 Summary and Recommendations ..................................................... 11 Summary ........................................................................................................................ 11 Recommendations ......................................................................................................... 17 Introduction ......................................................................................... 21 1 Setting the stage: approach and conceptual framework ............ 23 1.1 Definitions and overview of the conceptual framework .................................... 23 1.2 The constituent elements of food systems ........................................................ 24 1.2.1 Food supply chains ................................................................................................... 24 1.2.2 Food environments ................................................................................................... 28 1.2.3 Consumer behaviour................................................................................................. 31 1.3 Diets ...................................................................................................................... 32 1.3.1 Healthy and sustainable diets ................................................................................... 32 1.3.2 The nutrition, health, environmental, economic and social outcomes of diets ......... 34 1.4 A food system typology ....................................................................................... 35 1.4.1 Traditional food systems ........................................................................................... 38 1.4.2 Mixed food systems .................................................................................................. 39 1.4.3 Modern food systems................................................................................................ 40 1.5 Conclusion ........................................................................................................... 41 2 The multiple burdens of malnutrition ........................................... 43 2.1 The current burdens of malnutrition ................................................................... 43 2.1.1 Malnutrition: situation and trends .............................................................................. 44 2.1.2 Malnutrition: regional patterns .................................................................................. 46 2.1.3 Vulnerability to malnutrition ....................................................................................... 48 2.2 The consequences of malnutrition ..................................................................... 50 2.2.1 Health consequences ............................................................................................... 50 2.2.2 Economic and social consequences ......................................................................... 52 2.3 Nutrition outcomes across food system types .................................................. 53 2.4 Conclusion ........................................................................................................... 54 3 Diets in transition .......................................................................... 55 3.1 Changing diets ..................................................................................................... 55 3.1.1 Current food consumption trends and dietary patterns ............................................ 55 3.1.2 Shifts in dietary patterns: the nutrition transition ....................................................... 58 3.1.3 Projected future dietary trends and sustainability ..................................................... 60 3.2 Diets of vulnerable groups .................................................................................. 61 3.3 Territorial influence of diets ................................................................................ 64 4 3.4 The role of income on diets ................................................................................. 65 3.5 Conclusion ........................................................................................................... 66 4 Drivers of food system changes ................................................... 67 4.1 Biophysical and environmental drivers .............................................................. 67 4.1.1 Natural resources and ecosystem services .............................................................. 67 4.1.2 Climate change ......................................................................................................... 69 4.2 Innovation, technology and infrastructure drivers ............................................ 70 4.2.1 Innovation and technology ........................................................................................ 70 4.2.2 Infrastructure ............................................................................................................. 71 4.3 Political and economic drivers ............................................................................ 72 4.3.1 Leadership ................................................................................................................ 72 4.3.2 Globalization and trade ............................................................................................. 72 4.3.3 Food, agriculture and nutrition policies ..................................................................... 73 4.3.4 Food prices and volatility .......................................................................................... 75 4.3.5 Land tenure ............................................................................................................... 75 4.3.6 Conflicts and humanitarian crises ............................................................................. 76 4.4 Socio-cultural drivers .......................................................................................... 78 4.4.1 Cultures, rituals and social traditions ........................................................................ 78 4.4.2 Women’s empowerment ........................................................................................... 79 4.5 Demographic drivers ........................................................................................... 80 4.5.1 Population growth and changing age distribution ..................................................... 80 4.5.2 Urbanization .............................................................................................................. 80 4.5.3 Migration and forced displacement ........................................................................... 81 4.6 Conclusion ..........................................................................................................