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Climate change, obesity, and undernutrition are massive global challenges. As the climate continues to change and damage the environment, it also has a direct impact on obesity and undernutrition. In January 2019, The Lancet issued a report on The Global Syndemic of Obesity, Undernutrition, and Climate Change stating that these three problems represent a synergistic epidemic or syndemic and for real change to occur these problems need to be tackled through synergistic actions. A syndemic is a synergy of epidemics that co-occur, interact and share common underlying causes (Lancet 2019). The report written by 43 experts from 14 countries finds that obesity and undernutrition interact with climate change in a feedback loop which represents a massive threat to humans and the planet (Lancet 2019). Malnutrition, which includes undernutrition, obesity, and other dietary diseases is the biggest cause of global health issues and any future effects of climate change will significantly increase these health challenges (Lancet 2019).
Obesity is one of the largest contributors to poor health and even though some developed countries have experienced a slight decline in childhood obesity, no country has been able to decrease its obesity rate across its population (Lancet 2019). In 2015, there was a total of 107.7 million children and 603.7 million adults suffering due to obesity; a high BMI (Body-mass Index) was the cause of 4 million deaths globally, 70 percent of which occurred because of cardiovascular diseases due to a high BMI and more than 60 percent of those deaths occurred among people with obesity (NEnglJMed 2017). Obesity is most commonly associated with food excess however it can also occur due to micronutrient deficiencies such as zinc, iron, and vitamins A, C, D, and E (BMJ 2018). One of the most difficult challenges that people with obesity face is the bias and stigma that accompanies the disease. In western cultures, people who are obese are judged and shamed for their disease, it is considered a personal failure. When in fact obesity is the consequence of people interacting with the physical, economic, and sociocultural environment that promotes obesity, referred to in The Lancet report as obesogenic environments (Lancet 2019). However, in most low to middle-income countries where undernutrition is more prevalent and a bigger threat to life, fatter children are valued because being obese means that a person is free of disease. Understanding how people experience obesogenic environments will allow for modifications to be made to decrease the global syndemic of obesity, undernutrition and climate change (Lancet 2019).
In 2017, 2 billion people had micronutrient deficiencies and roughly 815 million were undernourished (FAO 2018). A diet lacking a sufficient amount of calories, vitamins, protein and minerals contributes to maternal undernutrition which in turn impedes fetal, infant and child growth and increases the risk for child stunting and wasting (FAO 2018). Poor food access combined with the rising costs of healthy food and stress due to food insecurity (FAO 2018) are just some of the reasons why families are experiencing undernutrition and obesity. Child wasting occurs due to acute malnutrition which can be influenced by factors other than food insecurity such as infection and diseases because there is a lack of safe clean drinking water and quality sanitation (FAO 2018). The Lancet reported that economic losses due to undernutrition were approximately $3.5 trillion annually; the World Bank then estimated that to achieve SDG goals related to undernutrition an investment of $70 billion over 10 years would need to be made that would result in an economic return of approximately $850 billion (2019).
Meanwhile, increased human activity continues to add more greenhouse gases in the atmosphere, while contributing to rising temperatures globally and causing changes in the hydrologic cycle. These effects then contribute to health issues, cause climatologic instability such as an increase of heatwaves and droughts; while also increasing food-borne diseases, other infections and civil unrest (Am J Prev Med 2008). However, the health impacts of climate change are not evenly distributed in fact the American Journal of Preventive Medicine reported that the distribution of the most severe health burdens is almost inverse to the global distribution of greenhouse gas emissions (2008). Climate change is disrupting the hydrologic cycle, resulting in more severe and frequent precipitation events and droughts; flooding can impact the health of a population by causing population displacement, infrastructure destruction, crop losses that result in food insecurity, and by causing an increase in respiratory and diarrheal diseases (AmJPrevMed 2008).
However, The Lancet report (2019), does suggest that by tackling the three epidemics together it will create an urgency for action that will overcome the existing policy inertia that has been the cause of patchy progress on obesity, undernutrition, and climate change. The Lancet commission believes synergistic actions will occur once stakeholders accept that obesity, undernutrition and climate change, The Global Syndemic, are the dominant causes of human and planetary ill-health (2019). Food production is one of the largest climate change contributors, the total contribution of food to emissions which includes food production, food system processes and food waste is 29% (Lancet 2019). The effect of climate change on fruit and vegetable production will cause these products to become more expensive therefore shifting the eating habits of the population towards more mass-produced processed foods that are high in fats and sugars and low in nutrients, proteins and vitamins. Recognition of the problems by all stakeholders such as governments, municipalities and individuals is the first step addressing The Global Syndemic.
Among its recommendations, The Lancet commission is calling for double-duty and triple-duty actions to produce win-win or win-win-win results; for example, the Nations dietary guidelines allow for the development of nutrition and food policies, to reduce obesity and undernutrition there is public education (2019). This double-duty action can be extended to include sustainability by getting people to move towards consuming a more plant-based diet (Lancet 2019) therefore creating a win-win-win result. While promoting a more plant-based diet is a great step towards sustainability, a reduction in meat consumption will also help reduce obesity and cardiovascular diseases by cutting methane production due to livestock. Governments can begin by cutting subsidies to fossil fuel and food industries so that funding can go towards sustainable energy and transportation and local-food production systems (Lancet 2019). The meat, food and fossil fuel industries are fighting the changes; to counter the large food and industrial conglomerates The Lancet report strongly recommends for more transparency between large food corporations and the general population (2019). For transparency to occur there needs to be pressure coming from civil society and grassroots organizations demanding it; these important stakeholders play a large role in monitoring progress towards meeting SDG goals and in strengthening government and corporate accountability.
The Lancet commission concludes the report with actions that maximise impact on The Global Syndemic over the next decade: think syndemically , create coalition alliances at the national, regional, and international levels, strengthen civil society engagement by creating a global Food Fund from philanthropic investments, strengthen accountability systems and focus research on The Global Syndemic determinants and actions (2019). A food system that secures a healthier more sustainable diet for the current population and future generations will not only save millions of lives but will also help save the planet.
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