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The future of human malnutrition: rebalancing agency for better nutritional health

The major threat to human societies posed by undernutrition has been recognised for millennia. Despite substantial economic development and scientific innovation, however, progress in addressing this global challenge has been inadequate. Paradoxically, the last half-century also saw the rapid emerge...

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Autores principales: Wells, Jonathan C. K., Marphatia, Akanksha A., Amable, Gabriel, Siervo, Mario, Friis, Henrik, Miranda, J. Jaime, Haisma, Hinke H., Raubenheimer, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8500827/
https://www.ncbi.nlm.nih.gov/pubmed/34627303
http://dx.doi.org/10.1186/s12992-021-00767-4
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author Wells, Jonathan C. K.
Marphatia, Akanksha A.
Amable, Gabriel
Siervo, Mario
Friis, Henrik
Miranda, J. Jaime
Haisma, Hinke H.
Raubenheimer, David
author_facet Wells, Jonathan C. K.
Marphatia, Akanksha A.
Amable, Gabriel
Siervo, Mario
Friis, Henrik
Miranda, J. Jaime
Haisma, Hinke H.
Raubenheimer, David
author_sort Wells, Jonathan C. K.
collection PubMed
description The major threat to human societies posed by undernutrition has been recognised for millennia. Despite substantial economic development and scientific innovation, however, progress in addressing this global challenge has been inadequate. Paradoxically, the last half-century also saw the rapid emergence of obesity, first in high-income countries but now also in low- and middle-income countries. Traditionally, these problems were approached separately, but there is increasing recognition that they have common drivers and need integrated responses. The new nutrition reality comprises a global ‘double burden’ of malnutrition, where the challenges of food insecurity, nutritional deficiencies and undernutrition coexist and interact with obesity, sedentary behaviour, unhealthy diets and environments that foster unhealthy behaviour. Beyond immediate efforts to prevent and treat malnutrition, what must change in order to reduce the future burden? Here, we present a conceptual framework that focuses on the deeper structural drivers of malnutrition embedded in society, and their interaction with biological mechanisms of appetite regulation and physiological homeostasis. Building on a review of malnutrition in past societies, our framework brings to the fore the power dynamics that characterise contemporary human food systems at many levels. We focus on the concept of agency, the ability of individuals or organisations to pursue their goals. In globalized food systems, the agency of individuals is directly confronted by the agency of several other types of actor, including corporations, governments and supranational institutions. The intakes of energy and nutrients by individuals are powerfully shaped by this ‘competition of agency’, and we therefore argue that the greatest opportunities to reduce malnutrition lie in rebalancing agency across the competing actors. The effect of the COVID-19 pandemic on food systems and individuals illustrates our conceptual framework. Efforts to improve agency must both drive and respond to complementary efforts to promote and maintain equitable societies and planetary health.
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spelling pubmed-85008272021-10-12 The future of human malnutrition: rebalancing agency for better nutritional health Wells, Jonathan C. K. Marphatia, Akanksha A. Amable, Gabriel Siervo, Mario Friis, Henrik Miranda, J. Jaime Haisma, Hinke H. Raubenheimer, David Global Health Review The major threat to human societies posed by undernutrition has been recognised for millennia. Despite substantial economic development and scientific innovation, however, progress in addressing this global challenge has been inadequate. Paradoxically, the last half-century also saw the rapid emergence of obesity, first in high-income countries but now also in low- and middle-income countries. Traditionally, these problems were approached separately, but there is increasing recognition that they have common drivers and need integrated responses. The new nutrition reality comprises a global ‘double burden’ of malnutrition, where the challenges of food insecurity, nutritional deficiencies and undernutrition coexist and interact with obesity, sedentary behaviour, unhealthy diets and environments that foster unhealthy behaviour. Beyond immediate efforts to prevent and treat malnutrition, what must change in order to reduce the future burden? Here, we present a conceptual framework that focuses on the deeper structural drivers of malnutrition embedded in society, and their interaction with biological mechanisms of appetite regulation and physiological homeostasis. Building on a review of malnutrition in past societies, our framework brings to the fore the power dynamics that characterise contemporary human food systems at many levels. We focus on the concept of agency, the ability of individuals or organisations to pursue their goals. In globalized food systems, the agency of individuals is directly confronted by the agency of several other types of actor, including corporations, governments and supranational institutions. The intakes of energy and nutrients by individuals are powerfully shaped by this ‘competition of agency’, and we therefore argue that the greatest opportunities to reduce malnutrition lie in rebalancing agency across the competing actors. The effect of the COVID-19 pandemic on food systems and individuals illustrates our conceptual framework. Efforts to improve agency must both drive and respond to complementary efforts to promote and maintain equitable societies and planetary health. BioMed Central 2021-10-09 /pmc/articles/PMC8500827/ /pubmed/34627303 http://dx.doi.org/10.1186/s12992-021-00767-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Review
Wells, Jonathan C. K.
Marphatia, Akanksha A.
Amable, Gabriel
Siervo, Mario
Friis, Henrik
Miranda, J. Jaime
Haisma, Hinke H.
Raubenheimer, David
The future of human malnutrition: rebalancing agency for better nutritional health
title The future of human malnutrition: rebalancing agency for better nutritional health
title_full The future of human malnutrition: rebalancing agency for better nutritional health
title_fullStr The future of human malnutrition: rebalancing agency for better nutritional health
title_full_unstemmed The future of human malnutrition: rebalancing agency for better nutritional health
title_short The future of human malnutrition: rebalancing agency for better nutritional health
title_sort future of human malnutrition: rebalancing agency for better nutritional health
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8500827/
https://www.ncbi.nlm.nih.gov/pubmed/34627303
http://dx.doi.org/10.1186/s12992-021-00767-4
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