BY CAROLINE TANGOREN
As the Millennium Development Goals (MDG), which are eight international development goals established by the United Nations, draw to a close, incredible progress has been made on a variety of issues from maternal health to extreme poverty to environmental sustainability. One particular topic of interest is the eradication of extreme hunger, as part of the 1st MDG. Five of the ten different regions of the world have seen progress in combatting hunger. Only two of those regions – Sub Saharan Africa and Southern Asia – still face high rates of hunger.
While this progress is laudable, issues of proper nutrition do not end here. Consider Ecuador, for example. Ecuador has almost met the MDG goal of halving the proportion of people who suffer from hunger. Approximately 11.2% of the population is undernourished, compared to 19.4% in 1991. Unfortunately, in the celebration of this success we see the limits and simplification of the MDGs. Now, Ecuador faces tremendous issues with obesity and chronic diseases related to diet. The prevalence of obesity is 7.5% in the entire nation and as high as 25% in certain regions. The prevalence of high blood pressure has been rising since 1994. Diabetes is currently the principle cause of death, and the World Health Organization estimates that death due to diabetes will double by 2030.
But what of these issues? Why do we focus on hunger, but not nourishment? Ecuador is not alone in its obesity and diet-related chronic diseases. In the US, 35% of adults are obese. Why do we focus on the “third world extremes,” rather than on issues of proper nutrition and healthy diets that plague developing and developed countries alike? Food access and caloric intake are the wrong targets. Food security and nutrient access, such as access to iron, vitamin A, or zinc, should replace our current markers. It focuses on the quality of food, not just its caloric content, as well as the larger psychosocial stresses of food shortages and coping mechanisms. Lack of food security and nutrient access is associated with serious health impacts such as heart attack, stroke, diabetes, and hypertension. Food security is one of the most comprehensive ways to address poor nutrition. Perhaps it doesn’t have the dramatic pull of “extreme hunger” but it is by far a more appropriate and worthwhile target for the world.
As we shape the post-2015 agenda, the international community must keep these thoughts in mind. We must not fall prey to oversimplification, sensationalist goals, or issues that seem rather removed from the developed world. Let’s talk about food quality, not quantity. Let’s talk about the “overnourished” and the undernourished. Let’s talk about the issues facing the exotic abroad, and the domestic backyard. Perhaps obesity does not have the same marketable traits as extreme hunger, but its impact on health is just as grave. Let’s be specific and thoughtful in shaping the post-2015 agenda for the international community’s most comprehensive goals yet.
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Australian International Food Security Research Center. (2012). Food security and why it matters.
Neira-Mosquera et al. (2013). Study on the mortality in Ecuador related to dietary factors. Nutricion Hospitalaria, 28(5), 1732 – 1740.
Seligman et al. (2010). Food insecurity is associated with chronic disease among low-income NHANES participants. The Journal of Nutrition.
Seligman et al. (2007). Food insecurity is associated with diabetes mellitus: results from the national health examination and nutrition examination survey (NHANES) 1999 – 2002.
United Nations. (2014, July). Millennium Development Goals: 2014 Progress. In Millennium Development Goals.
United Nations. (2014, October 22). Ecuador: Population Undernourished, Percentage. In Millennium Development Goals Indicators. Retrieved April 10, 2015.
World Health Organization (2013). Country Cooperation Strategy at a Glance: Ecuador.
World Health Organization (2014). Diabetes Programme.
World Health Organization. (2000). Obesity: Preventing and Managing the Global Epidemic.
Yale Global Health Review 
Great post — thanks for sharing. This is a thoughtful and critical review of the progress that has been made in regards to Millennium Development Goals. It’s important that we continue to focus on nourishment in areas such as Sub Saharan Africa and Southern Asia.
The unfortunate side effect of defining states such as “poverty” or “extreme hunger” is that public concern drops off so steeply once a population no longer fits within its bounds. It’s so easy, as this article eloquently points out, to believe that people who don’t fit some organization’s definition of states that demand our attention and compassion no longer need it. It’s hard to maintain our concern but reframing the issues around what we should really demand for people (not freedom from “extreme hunger” but actual nourishment), seems like a good approach.