Urbanization and Changing Consumer Preferences As part of a global trend, rising urbanization and sub- sequent changes in consumer preferences from tradi- tional cereal-based to protein-rich diets present new challenges, particularly for MICs that are facing or have faced rapid and at times massive urbanization.14 Rapid urbanization and shiſting diets have con- tributed to modernized food value chains,15 which have had implications for food safety. Inconsistent standards and poor monitoring along the food value chain, as well as inadequate capacity of small enter- prises, have also led to contaminated and unsafe food,16 which has consequently affected nutrition. Te modernized value chains that have resulted
from urbanization and shiſting consumer prefer- ences have also put stress on scarce natural resources used for agricultural production. Growing appe- tite for meat in MICs means higher resource-inten- sive production. Shiſting diets (with sugary, salty, and faty foods
having risen in popularity) have had implications for obesity and resource use. In many MICs, access to food has oſten increased through social protection policies, yet oſten this assistance is not balanced with enough nutrition education and advocacy to pro- mote balanced diets. Brazil’s new dietary guidelines are promising, as they encourage consumers to limit processed, ready-to-eat foods that are commonly high in sugar, salt, and saturated fats.17 Similarly, China’s high rates of obesity have led the govern- ment to introduce several guidelines to prevent and control overweight and obesity.18
Persistent Lack of Focus on Nutrition and Poor Targeting in Safety Nets While most MICs have social safety nets in place, many lack integration with nutrition. Poor targeting and leakage are costly issues that also can sometimes weaken these well-intended safety nets. Targeted food security programs can effectively increase the wealth of recipient households but too oſten have litle impact on child stunting and at times lead to increases in overweight and obesity.19 While access to food has increased through social protection pol- icies, more can be done to incentivize and promote the adoption of healthy diets.20
16 OVERCOMING HUNGER AND MALNUTRITION IN MIDDLE INCOME COUNTRIES
IMPROVING FOOD SECURITY AND NUTRITION IN MICs AND BEYOND
Middle income countries can learn from the expe- riences of other countries. South Korea and Chile have made great progress in eliminating hunger and malnutrition while promoting the kind of durable, inclusive growth that has helped them avoid being stuck in the middle income trap and moved them from middle- to upper-income status. Importantly, and as evidenced in this publication, success in working toward a more food-secure world is not the sole domain of high-income or developed countries; that is, MICs can and should learn from each other, as well as from other countries that have employed successful food security strategies and promoted inclusive growth. Economic growth is not enough to substantially
reduce hunger and malnutrition; efforts must also be made to reduce inequalities, improve human capital, and promote beter nutrition and health outcomes. To achieve these objectives, MICs should support the following strategies and approaches that can help to overcome hunger and malnutrition: X
Reshape the food system, especially agriculture, for nutrition and health. Te entire food system can make a greater contribution to nutrition and health.21 MICs should both increase incentives to produce, process, and market high-nutrient foods and reduce distorted incentives to pro- duce just low-nutrient staple foods. For acceler- ated improvements in nutrition, investments in nutrition-specific interventions (such as micro- nutrient supplementation) should be combined with investments in nutrition-sensitive interven- tions (such as biofortification).22 By fortifying powdered milk with micronutrients, including iron, Chile reduced the prevalence of anemia by around 80 percent in less than three years. Crucial will be adopting value chain
approaches that go beyond creating economic benefits for actors along the entire chain to increasing the availability, affordability, and qual- ity of nutritious foods for the poor.23 To improve the efficiency of food value chains and reduce food loss and waste, it will also be important to ease market access constraints, invest in food
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