A continental contradiction: Addressing the double burden of stunting and obesity in Africa

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Aerial view of Lagos, Nigeria.

Political unrest and economic instability have long plagued Africa, making the continent nearly synonymous with poverty.

Today, Africa contains 75 percent of the world’s poorest countries. According to the World Bank Group’s latest data, more than 40 percent of people in sub-Saharan Africa live in extreme poverty, surviving on less than $1.25 per day.

For many, access to food is still uncertain, and UNICEF indicates that one in three stunted children worldwide reside on the continent. Poor nutrition can result not only in physical stunting but cognitive impairment as well.

The past two decades, however, have seen momentous change. Urban areas ballooned, and after a long stagnation or decline, per capita incomes finally began to rise.

This resulted in some of the most rapidly growing economies in the world. More stable governments and investment in the region point to progress, despite continued challenges for some.

David Tschirley, a professor in the Department of Agricultural, Food and Resource Economics (AFRE) at Michigan State University (MSU), is studying the economic changes taking place and how they are altering traditional African diets.

This transformation has left those who have navigated their way up the economic ladder facing a seemingly unfathomable obstacle: obesity.

“When we think of Africa and food, we often think of people not consuming enough calories,” Tschirley said. “Africa’s double burden of malnutrition refers to the simultaneous struggle to ensure sufficient consumption for many while avoiding rapid growth in obesity and all the problems it brings, such as heart disease, diabetes and hypertension.”

Tschirley explained that access to animal protein and processed foods has climbed dramatically as incomes have risen.

“There are still the major problems of malnutrition and food insecurity,” Tschirley said. “But as many people acquire greater purchasing power, they are demanding food that is more processed, more packaged, more adapted to their lives. There are a plethora of elements at play, and that’s one of the things we’re looking at through our work.”

A changing landscape

For more than 30 years, researchers in the MSU Food Security Group within AFRE have been conducting field work in Africa.

They are collecting and analyzing household expenditure data and monitoring the spending trends for families in countries such as Ethiopia, Malawi, Mozambique, Nigeria, Tanzania and several others.

Roughly five years ago, Tschirley began examining the changes in African diets with AFRE colleagues Thomas Reardon and Saweda Liverpool-Tasie. The research functions with support from the Feed the Future Innovation Lab for Food Security Policy (FSP) at MSU.

The FSP lab is funded by the U.S. Agency for International Development and seeks to promote the growth of agrifood systems through policy influence in developing countries. Tschirley and his team didn’t initially approach the work from a nutrition angle.

Instead, they focused on how changing consumer behavior was creating opportunities and challenges in the supply chain.

“I think we’re taking an innovative approach to the situation, and MSU is really on the frontlines of dealing with this topic,” Tschirley said. “We’re approaching this from the perspective of asking questions. What do consumers want to eat? How do they want to obtain this food? What opportunities are these changes creating for local entrepreneurs, especially in food marketing and processing? The answers to these questions are important because this is what is shaping the agrifood industries in Africa.”

Tschirley emphasizes that Africa’s diet transformation is not occurring exclusively in cities, nor is it limited to middle- or upper-income people. He characterizes the evolution in three ways: Foods are becoming more purchased, perishable and processed.

Data gathered by the research team suggests that 50 percent of food in rural areas is now purchased, rather than grown for consumption by the consumer. Increasingly, what is purchased is not traditional grains such as corn and rice but processed foods such as maize meal, bread and even snack foods.

This also includes perishable foods such as meat, dairy and fresh produce. In fact, 50 to 65 percent of all food in urban and rural locations is processed. When it comes to purchased food, that figure vaults to nearly 80 percent.

“Snack foods are now ubiquitous in African cities, and not just in supermarkets,” Tschirley said. “Whether locally made ‘corn puffs’ in markets of Lilongwe, Malawi, or potato chips being sold by young men patrolling the streets of Maputo, Mozambique, you find them everywhere now. I’ve observed these foods being purchased by low-income people as snacks for children. They are loaded with fats and salt. That tells me that these foods are really making inroads, and we need to make healthier options available and affordable.”

Though not all processed foods are bad, Tschirley is quick to point out that the nutritional aspects of these options need to be further inspected.

Additionally he said that countries are currently ill-equipped to manage the market demands, not only from a policy perspective but also because of a lack of modern physical infrastructure.

“We think there are massive opportunities for agribusinesses to bridge the gap between supply and demand,” Tschirley said. “The question is whether it will be through foods being imported or whether local businesses can compete. Local businesses mean more food for more people — and more job opportunities. We need to work with people, businesses and governments to help foster an environment that offers healthy foods at a reasonable price for an evolving market.”

Food safety is also a mounting concern in the promotion of local businesses. Regulations need to be put in place to ensure that food is being produced using appropriate quality and safety standards.

This will also build public trust in the agrifood system, Tschirley noted.

But it is important that these regulations not be so burdensome that they force small businesses — which are largely run by individuals still considered poor — out of the market.

“Food quality and safety are critical, but governments are still primarily concerned about not having enough food throughout Africa,” Tschirley said. “They are still focusing most of their efforts on assuring sufficient production of staple foods such as corn, rice and cassava. But through some of our efforts, along with many others, awareness of these diet issues is growing.

“Countries in Latin America have gone through this process already, and they have some of the highest obesity rates in the world today. We’re trying to work with our partners to get out in front of it in Africa and ideally help to avoid some of the pitfalls that historically come along with economic growth.”