Re: Nutrition-enhancing agriculture and food systems

International Diabetes Federation International Diabetes Federation, Belgium

The International Diabetes Federation (IDF) is the unique global voice of the diabetes community. IDF’s strength lies in the capacity of our 220 national Member Associations – who connect global advocacy to local reality and deliver vital diabetes prevention, treatment and care in over 170 countries worldwide. As a founding federation of the NCD Alliance, IDF fully supports and reinforces all comments made in the NCD Alliance response. In these comments, IDF provides the diabetes perspective on nutrition-enhancing food systems.

The world is facing a diabetes crisis. The numbers are bleak and are becoming worse: more than 371 million people are living with diabetes today, a number that is expected to rise to 552 million in less than 20 years .  While previously considered a disease of the rich, evidence shows diabetes disproportionately impacts the poor and vulnerable. Today nearly two-thirds of people with diabetes live in low- and middle-income countries.

Diabetes and nutrition are closely linked; overweight and obesity are among the leading risk factors for diabetes, and undernutrition in early life has been shown to increase risk for diabetes later in life. Nutrition is a cornerstone in the fight against diabetes and obesity, and population nutrition is a function of the food system. The global food system supplies the world with food necessary to sustain life, but it is also responsible for an influx of highly processed foods full of saturated fats, sugars and salt, contributing to the global rise in diabetes and other noncommunicable diseases (NCDs).

We welcome the opportunity to contribute to the preparations for the Second International Conference on Nutrition (ICN2) and this discussion on Nutrition-sensitive agriculture. In particular, IDF acknowledges, welcomes and supports the Expert Paper contributed by Hawkes “Leveraging agriculture and food systems for healthier diets and noncommunicable disease prevention: The need for policy coherence”.

Key Messages

  • Globalisation of the food system has enabled availability, affordability and acceptability of unhealthy eating patterns. This makes a significant negative contribution to diabetes and its metabolic and behavioural risk factors, including overweight and obesity.
  • Today we face a triple burden of malnutrition: undernutrition, micronutrient deficiency and overnutrition/overconsumption, often in the same country, community or household.
  • Both under- and over-nutrition are contributing to the spiralling rise of diabetes and other NCDs. Maternal undernutrition increases the risk of the child developing obesity and type 2 diabetes later in life. Overweight and obesity, including childhood obesity, promote insulin resistance and are major drivers of the global type 2 diabetes epidemic
  • Nutrition-enhancing agriculture and food systems provide part of the solution to malnutrition in all its forms, including poor quality diets associated with diabetes. Improvements should include actions at the local level, notably to promote the production and market movement of plant-based foods.
  • IDF strongly supports the call by Hawkes et. al. that food and agriculture systems operate through “policy coherence”, and that policies for NCD prevention “directly interface with agriculture and foods systems…”
  • Nutrition policies for the prevention and control of diabetes must aim to increase fruit and vegetable consumption and decrease consumption of highly-processed foods which are high in salt, sugar, and saturated/trans fats. To achieve this, food and agricultural systems need to supply foods and beverages consistent with these goals. In many countries this will require a dramatic change in the types of products grown, produced, marketed and sold – which can only be achieved through collaborative, forward-thinking policy initiatives at all levels from local to international.
  • Diabetes and NCDs are multisectoral issues, which require multisectoral solutions, including policies on nutrition and agriculture. Active involvement of civil society will be a fundamental element of creating and sustaining nutrition-enhancing agricultural systems.
  • More attention and efforts are needed from civil society and others to encourage policy coherence between agriculture policy and policies aimed at the nutritional risk factors for overweight/obesity and diabetes.

For more information, please refer to the attached document