Changing Diets in the NENA countries: Implications for Nutrition and Food Security

Fatima Hachem Senior Nutrition and Consumer Protection Officer

Food and Agriculture Organization of the United Nations Regional Office for the Near East and North Africa

Cairo, Egypt

Workshop on Agricultural Trade and Food Security in the Euro-Med Area September 25-26, 2014

Antalya, Turkey

The Near East and North Africa Region (NENA)

NENA cannot structurally feed its people

Driest region in the world Avg annual precipitation 135 mm (Vs over 800 mm global)

15 of the 19 countries in the region are categorized as being in critical water shortage

From 1950 to the present, per-capita renewable water resources have fallen by approximately 75 percent

downward trend will probably be accelerated by climate change

Limited arable land (0.22 ha/caput arable lands) Desertification and land degradation

Prone to natural disasters

Growing Food Demands

31.8

41.4 42.8 45.2

54.9 56.7

66.4 66.5 67.3 69.5 71.7 77.9 78 78.5

83.6 87.2 88.6

95.8 98.4

0

10

20

30

40

50

60

70

80

90

100

110

120

2010

• Rapidly growing population (2.6%) • Urbanization

• For Ensuring Food Security the Region has to rely heavily on imports - A NET FOOD IMPORTER REGION

Food Security

• Food security is built on four pillars: availability, access, utilization, and stability.

• It is a complex development issue linked to health, nutrition, economic development, environment, and trade.

• Food insecurity and malnutrition (undernutrition, over-nutrition, and micronutrient malnutrition) problems as well as the social, economic and environmental impacts of food consumption patterns and diets highlight the inadequacy of the food system.

NATIONAL, SUBNATIONAL AND COMMUNITY LEVEL HOUSEHOLDS INDIVIDUALS

Socio-economic, Political, Civil, Institutional and Cultural

Environment

Food Economy

Population

Education

Macro-economy including

foreign trade

Policies and laws

Natural resources endowment

Basic services

Market conditions

Technology

Climate

Civil strife

Household characteristics

Livelihoods systems

Social institutions

Cultural attitudes and gender

FOOD AVAILABILITY

domestic production

import capacity

food stocks, food aid

ACCESS TO FOOD

poverty purchasing power, income

Transport and market infrastructure

HOUSEHOLD LIVELIHOOD STRATEGIES, ASSETS &

ACTIVITIES

HOUSEHOLD FOOD ACCESS

HEALTH & SANITATION Health care practices Hygiene, Sanitation

Water quality Food safety & quality

FOOD CONSUMPTION

Energy intake Nutrient intake

FOOD UTILISA-TION BY THE

BODY

determined

by

Health status

CARE PRACTICES Child care

Feeding practices Nutritional knowledge

Food preparation Eating habits

Intra-household food distribution

FAO-FIVIMS conceptual framework

NUTRITIONAL STATUS

STABILITY

weather variability price fluctuations

political factors economic factors

Food Insecurity and Malnutrition in NENA

• Countries’ economic development • Geographic, climatic and environmental conditions • Social and cultural specificities • Political environment and stability.

Food and Nutrition Situation varies in NENA according to:

A heterogeneous region

Based on geographic and hydro-climatic similarities, NENA can be divided into three sub-regions: North Africa Algeria, Egypt, Libya, Mauritania, Morocco, Sudan, Tunisia Arabian Peninsula Bahrain, Kuwait, Oman, Qatar, Saudi, Arabia, United Arab Emirates, Yemen Middle East Iran, Iraq, Jordan, Lebanon, Syria

• Wheat • Grain legumes, mainly chickpeas, broad beans, lentils and

sesame • Fruits and vegetables

From a traditional diet high in fiber and roughage:

Changing diets

To a diet high in calories, fat, sugar, and refined wheat flour. ….. driven by very rapid social and economic changes in the last four decades

Changing diets

• The energy intake in the region increased by 30% and fat intake by 45%.

• The largest increases in food commodities were seen in sugar, fat and vegetable oil and meat, especially poultry.

Sugar consumption doubled in some countries and increased by more than 50% in others.

• The consumption of vegetable oils tripled in certain countries.

• There was a slight increase in consumption of milk, fruits and vegetables.

• Big variations exist among and within the countries.

Impact of Changing Diets Nutrition

Improved Dietary Energy Adequacy (%)

High food availability does not always guarantee high food security. In Egypt, DEA is 45 percent higher than the average requirement but stunting affects 31 percent of children under five years of age.

• Double burden of nutrition: problems of under-nutrition coexist with overweight, obesity and food-related chronic diseases.

• Phenomenon is shared by all countries: poor, middle, and high-income Poor Countries: High levels of undernutrition especially among

children – stunting

High-income countries: Very high levels of over-nutrition, both over weight and obesity among adults.

• Micronutrient deficiencies; anemia in particular

• Serious consequences on human and economic capitals – nutrition is one of the drivers of economic growth

Nutrition Transition in NENA

Four Countries with high burden of Stunting

Egypt (30.7%) Sudan (37.9%) Mauritania (23%) Yemen (57.7%)

• Because of the established health risks (diabetes, heart disease, gallstones and arthritis) and substantial increases in prevalence, obesity has become a major health challenge in some countries in NENA.

Increasing Obesity

Prevalence of obesity in NENA

• Not a phenomenon of rich countries only

• 5 countries among the first ten in the world

Country Prevalence of

obesity among

adults (%)

Country

Prevalence of

obesity among

adults (%)

2008 2008

Algeria 17.5 Morocco 17.3

Bahrain 32.6 Oman 22.0

Egypt 34.6 Qatar 33.1

Iran 21.6

Saudi Arabia 35.2

Iraq 29.4 Sudan 6.6

Jordan 34.3 Syria 31.6

Kuwait 42.8 Tunisia 23.8

Lebanon 28.2 U.A.E 33.7

Libya 30.8 Yemen 16.7

Mauritania 14.0 Developing 8.7

World 11.7 Developed 22.2

Nutritional implications of changing diets

The Case of the GCC Countries

Compositional Changes: • Decrease in some oils • Introduction of new oils

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1969-1971 1979-1981 1989-1991 1999-2001 2009-2011

Kca

l/d

ay

Changes in the composition of Vegetable Oils Group

Oilcrops Oil, Other

Maize Germ Oil

Olive Oil

Sesameseed Oil

Coconut Oil

Palm Oil

Palmkernel Oil

Cottonseed Oil

Rape and Mustard Oil

Sunflowerseed Oil

Groundnut Oil

Soyabean Oil

The Case of the GCC Countries

0%

5%

10%

15%

20%

25%

30%

35%

40%

1969-1971 1979-1981 1989-1991 1999-2001 2009-2011

Kca

l/d

ay

Contribution of Olive Oil and Palm Oil to caloric intake in GCC countries

Palm Oil

Olive Oil

-

50.0

100.0

150.0

200.0

250.0

1969-1971 1979-1981 1989-1991 1999-2001 2009-2011

(10

00

me

tric

To

nn

es)

Imports of Palm Oil to GCC countries

Palm Oil

The Case of Egypt

Compositional Changes: • Sharp increase in imported olive oil • Disappearance of cotton seed oil

-

100.0

200.0

300.0

400.0

500.0

600.0

700.0

800.0

1969-1971 1979-1981 1989-1991 1999-2001 2009-2011

Import Trend of Vegetable Oils 1969-2011 (1,000 Metric Tons)

Soyabean Oil

Groundnut Oil

Sunflowerseed Oil

Rape and Mustard Oil

Cottonseed Oil

Palmkernel Oil

Palm Oil

Coconut Oil

Sesameseed Oil

Olive Oil

Maize Germ Oil

Oilcrops Oil, Other

The Case of Tunisia

Compositional Changes: • Substitution of Olive Oil by Soyabean Oil

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1969-1971 1979-1981 1989-1991 1999-2001 2009-2011

Contribution of Vegetable Oils to caloric intake in Tunisia

Oilcrops Oil, Other

Maize Germ Oil

Olive Oil

Sesameseed Oil

Coconut Oil

Palm Oil

Palmkernel Oil

Cottonseed Oil

Rape and Mustard Oil

Sunflowerseed Oil

Groundnut Oil

Soyabean Oil

Fat Type and Health

• Consumption of palmitic acid increases risk of developing cardiovascular diseases, placing it in the same evidence category as trans fatty acids

• Excessive intake of palmitic acid, which makes up 44 percent of palm oil, increases blood cholesterol levels and may contribute to heart disease

0 20 40 60 80 100

Cotton seed

Olive Oil

Palm Oil

Soyabean oil

Fatty Acid Composition of Some Vegetable Oil

Saturated fatty acids Monounsaturated fatty acids

Polyunsaturated fatty acids

• Nutrition sensitive policies: agriculture, social protection, food production and trade policies

• Legislation on food labelling

• Public Health Tax on Food

• Establishing National Strategy for the Prevention and Control of Overweight and Obesity including awareness-raising for behavioral change, health care, regulatory and fiscal measures.

Policy Options