The future of human malnutrition: rebalancing agency for better nutritional health.
Agency
Dual burden of malnutrition
Food systems
Obesity
Social inequality
Stunting
Undernutrition
Journal
Globalization and health
ISSN: 1744-8603
Titre abrégé: Global Health
Pays: England
ID NLM: 101245734
Informations de publication
Date de publication:
09 10 2021
09 10 2021
Historique:
received:
10
01
2021
accepted:
15
09
2021
entrez:
10
10
2021
pubmed:
11
10
2021
medline:
13
10
2021
Statut:
epublish
Résumé
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.
Identifiants
pubmed: 34627303
doi: 10.1186/s12992-021-00767-4
pii: 10.1186/s12992-021-00767-4
pmc: PMC8500827
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
119Informations de copyright
© 2021. The Author(s).
Références
Proc Nutr Soc. 2007 Aug;66(3):423-34
pubmed: 17637095
Public Health Nutr. 2019 Apr;22(5):936-941
pubmed: 30744710
Int J Epidemiol. 2009 Feb;38(1):63-71
pubmed: 18820320
Prog Cardiovasc Dis. 2021 Jan-Feb;64:105-107
pubmed: 32653438
Clin Infect Dis. 2020 Jul 28;71(15):896-897
pubmed: 32271368
Obesity (Silver Spring). 2019 Aug;27(8):1225-1238
pubmed: 31339001
Health Hum Rights. 2008;10(1):5-19
pubmed: 20845827
Obes Rev. 2005 May;6(2):133-42
pubmed: 15836464
Nature. 2019 May;569(7755):260-264
pubmed: 31068725
Matern Child Nutr. 2018 Apr;14(2):e12516
pubmed: 28944990
Am J Epidemiol. 2009 Jul 15;170(2):181-92
pubmed: 19465744
Public Health Nutr. 2009 Nov;12(11):2150-8
pubmed: 19433005
J Urban Health. 2020 Jun;97(3):332-335
pubmed: 32504251
Philos Trans R Soc Lond B Biol Sci. 2012 Jun 19;367(1596):1628-46
pubmed: 22566672
Glob Public Health. 2020 Aug;15(8):1130-1143
pubmed: 32248738
Lancet Diabetes Endocrinol. 2019 Mar;7(3):231-240
pubmed: 30704950
AIDS Behav. 2020 Oct;24(10):2766-2769
pubmed: 32385677
Am J Primatol. 1993;30(2):149-161
pubmed: 31937018
Appetite. 2020 May 1;148:104602
pubmed: 31953143
Soc Sci Med. 2015 Feb;126:169-76
pubmed: 25576997
Lancet Glob Health. 2016 Dec;4(12):e895-e896
pubmed: 27855860
J Epidemiol Community Health. 2016 Mar;70(3):312-8
pubmed: 26424847
Appetite. 2016 Feb 1;97:49-57
pubmed: 26593100
Int J Health Serv. 2010;40(1):165-78
pubmed: 20198810
Nutrients. 2020 Jul 07;12(7):
pubmed: 32645970
PLoS Med. 2012;9(6):e1001242
pubmed: 22723746
Public Health Nutr. 2011 Jan;14(1):5-13
pubmed: 21211100
Food Nutr Bull. 2018 Jun;39(2):315-331
pubmed: 29793357
J Am Diet Assoc. 2007 Nov;107(11):1966-72
pubmed: 17964317
Am J Epidemiol. 2007 Apr 1;165(7):828-37
pubmed: 17244635
Nutrients. 2020 Jun 03;12(6):
pubmed: 32503173
BMC Pediatr. 2019 Oct 25;19(1):382
pubmed: 31651267
Global Health. 2019 Jun 3;15(1):36
pubmed: 31155001
Front Public Health. 2019 Jul 31;7:206
pubmed: 31417889
Indian J Med Res. 2009 May;129(5):515-9
pubmed: 19675378
Lancet. 2014 Feb 15;383(9917):630-67
pubmed: 24524782
Lancet. 2019 May 11;393(10184):1958-1972
pubmed: 30954305
Cell Metab. 2018 Jul 03;28(1):33-44.e3
pubmed: 29909968
PLoS Med. 2017 Sep 11;14(9):e1002387
pubmed: 28892496
Foods. 2020 May 25;9(5):
pubmed: 32466106
BMJ. 2018 Jun 13;361:k2426
pubmed: 29898890
Nutr Rev. 2012 Jan;70(1):3-21
pubmed: 22221213
Global Health. 2019 May 14;15(1):35
pubmed: 31088499
Am J Clin Nutr. 2019 Aug 1;110(2):498-507
pubmed: 30753251
Global Health. 2006 Mar 28;2:4
pubmed: 16569239
Public Health Nutr. 2008 Jul;11(7):662-74
pubmed: 17956641
Elife. 2016 Jul 26;5:
pubmed: 27458798
Econ Hum Biol. 2013 Dec;11(4):551-62
pubmed: 23562520
Global Health. 2014 Sep 12;10:66
pubmed: 25213212
Nutrients. 2018 Oct 23;10(11):
pubmed: 30360485
Ann N Y Acad Sci. 1987;499:29-46
pubmed: 3300488
BMJ Open. 2014 Apr 14;4(4):e004549
pubmed: 24732242
Lancet. 2013 Aug 3;382(9890):427-451
pubmed: 23746772
Lancet. 2005 Mar 19-25;365(9464):1099-104
pubmed: 15781105
Am J Phys Anthropol. 2021 Jan;174(1):103-116
pubmed: 33166434
Soc Sci Med. 2021 Mar;272:113701
pubmed: 33508657
Lancet. 2020 Jan 4;395(10217):75-88
pubmed: 31852605
Nutrients. 2020 May 28;12(6):
pubmed: 32481594
BMJ. 2013 Oct 22;347:f5934
pubmed: 24149519
Pediatrics. 2018 Sep;142(3):
pubmed: 30143567
J Biosoc Sci. 2005 Mar;37(2):185-91
pubmed: 15768773
J Psychopharmacol. 2017 Nov;31(11):1503-1508
pubmed: 29132230
Public Health Nutr. 2020 Apr;23(6):1076-1086
pubmed: 31619309
Global Health. 2016 Jun 02;12(1):24
pubmed: 27255275
Nutr Res Rev. 2019 Dec;32(2):282-293
pubmed: 31298176
J Health Econ. 2016 Jan;45:176-96
pubmed: 26620830
Eur J Clin Nutr. 2005 Sep;59(9):1002-6
pubmed: 15970943
BMC Public Health. 2019 Jul 4;19(1):882
pubmed: 31272435
Nutrients. 2020 Jun 10;12(6):
pubmed: 32531892
Sci Rep. 2019 Jul 19;9(1):10515
pubmed: 31324875
Front Nutr. 2020 May 04;7:48
pubmed: 32432122
Front Med (Lausanne). 2020 Apr 23;7:146
pubmed: 32391367
Front Endocrinol (Lausanne). 2020 May 21;11:325
pubmed: 32508752
PLoS Negl Trop Dis. 2018 Jan 19;12(1):e0006205
pubmed: 29351288
BMJ. 2013 Aug 23;347:f5261
pubmed: 23974807
Nutr Rev. 2009 May;67 Suppl 1:S40-6
pubmed: 19453677
Sci Adv. 2018 May 23;4(5):eaaq1012
pubmed: 29806023
Global Health. 2011 Jul 04;7:21
pubmed: 21726434
Soc Sci Med. 2020 Dec;267:112496
pubmed: 31515082
Diabetes Care. 2020 Jul;43(7):1392-1398
pubmed: 32409502
Int J Epidemiol. 2006 Jun;35(3):648-56
pubmed: 16567342
Lancet. 2015 Jun 13;385(9985):2400-9
pubmed: 25703111
Public Health. 2008 Jul;122(7):681-90
pubmed: 18207475
Public Health Nutr. 2018 Jan;21(1):114-124
pubmed: 29032787
Lancet. 2007 Jan 6;369(9555):60-70
pubmed: 17208643
J Hum Nutr Diet. 2021 Feb;34(1):3-12
pubmed: 32337779
Int J Obes Relat Metab Disord. 2004 Sep;28(9):1181-6
pubmed: 15211362
J Am Coll Cardiol. 2009 Sep 29;54(14):1249-55
pubmed: 19778665
Eur J Clin Nutr. 1988 Dec;42(12):969-81
pubmed: 3148462
Ecol Food Nutr. 2020 Jan-Feb;59(1):79-103
pubmed: 31573333
Appetite. 2017 Jan 1;108:512-520
pubmed: 27825941
Br J Nutr. 2015 Jan 28;113(2):366-71
pubmed: 25567475
Nutrients. 2019 Oct 22;11(10):
pubmed: 31652523
Obes Rev. 2014 Mar;15(3):183-91
pubmed: 24588967
Lancet Glob Health. 2019 Dec;7(12):e1644-e1654
pubmed: 31708145
Matern Child Health J. 2015 Jun;19(6):1284-91
pubmed: 25500760
Lancet. 2012 Jul 21;380(9838):247-57
pubmed: 22818937
J Physiol Anthropol. 2007 Mar;26(2):109-12
pubmed: 17435352
Lancet. 2020 Oct 24;396(10259):e58
pubmed: 33038948
Int J Environ Res Public Health. 2019 Oct 03;16(19):
pubmed: 31623366
Br J Nutr. 2015 Jun 14;113(11):1828-34
pubmed: 25885785
Agric Human Values. 2020 May 12;:1-2
pubmed: 32398894
Obesity (Silver Spring). 2014 Jan;22(1):277-86
pubmed: 23512679
Obes Rev. 2014 Jul;15(7):564-77
pubmed: 24735161
J Transl Med. 2020 Jun 8;18(1):229
pubmed: 32513197
Int Breastfeed J. 2020 Apr 8;15(1):22
pubmed: 32268902
Obesity (Silver Spring). 2020 Oct;28(10):1815-1825
pubmed: 32602202
Science. 2019 Jul 12;365(6449):
pubmed: 31296738
Public Health Nutr. 2018 Jun;21(8):1529-1537
pubmed: 29388531
Health Place. 2009 Mar;15(1):364-73
pubmed: 18722151
Pers Soc Psychol Bull. 2004 Sep;30(9):1186-97
pubmed: 15359021
Appetite. 2018 Jan 1;120:100-108
pubmed: 28843974
Lancet Child Adolesc Health. 2019 Nov;3(11):831-834
pubmed: 31521500
PLoS One. 2019 Jan 9;14(1):e0208937
pubmed: 30625159
Lancet. 2008 Jan 26;371(9609):340-57
pubmed: 18206223
Eur J Clin Nutr. 2013 May;67(5):507-12
pubmed: 23443827
Eur J Clin Nutr. 2018 Nov;72(11):1524-1536
pubmed: 29358603
Food Policy. 2015 Oct;56:59-66
pubmed: 26538793
Am J Hum Biol. 2010 Sep-Oct;22(5):631-8
pubmed: 20737610
Am J Clin Nutr. 2000 Mar;71(3):682-92
pubmed: 10702160
Public Health Nutr. 2018 Aug;21(12):2271-2279
pubmed: 29642958
Food Policy. 2015 Aug 1;55:92-100
pubmed: 26217068
Tob Control. 2018 Mar;27(2):185-194
pubmed: 28336521
Soc Sci Med. 2012 Aug;75(3):482-90
pubmed: 22580078
Global Health. 2019 Mar 15;15(1):21
pubmed: 30876446
Lancet. 2019 Feb 23;393(10173):791-846
pubmed: 30700377
Global Health. 2015 Oct 12;11:41
pubmed: 26455446
Eur J Clin Nutr. 2019 Feb;73(2):302-310
pubmed: 30154534
Obesity (Silver Spring). 2020 Sep;28(9):1578-1579
pubmed: 32441869
Nutrients. 2020 Jul 30;12(8):
pubmed: 32751721
Lancet. 2019 Feb 2;393(10170):447-492
pubmed: 30660336
Ann Nutr Metab. 2019;75(2):123-126
pubmed: 31743928
Cell Metab. 2013 Jun 4;17(6):851-859
pubmed: 23747244
BMJ Nutr Prev Health. 2020 Dec 1;3(2):295-307
pubmed: 33521541
BMJ. 2015 Apr 08;350:h1775
pubmed: 25854525
Pediatr Infect Dis J. 2012 Mar;31(3):263-6
pubmed: 22315005
Glob Health Epidemiol Genom. 2016 Mar 23;1:e6
pubmed: 29868199
Obes Surg. 2007 Jan;17(1):112-6
pubmed: 17355779
Lancet Glob Health. 2019 Nov;7(11):e1482-e1483
pubmed: 31607454
Am J Prev Med. 2011 Feb;40(2):113-21
pubmed: 21238858
Lancet. 1999 May 22;353(9166):1767-8
pubmed: 10347999
Am J Hum Biol. 2010 Jan-Feb;22(1):1-17
pubmed: 19844897
Am J Clin Nutr. 2020 Aug 1;112(2):251-256
pubmed: 32559276
Horm Metab Res. 2009 Apr;41(4):261-70
pubmed: 19156597
Nature. 2009 May 14;459(7244):248-52
pubmed: 19444215
Soc Sci Med. 2017 Aug;187:306-311
pubmed: 28359581
Am J Hum Biol. 2017 Mar;29(2):
pubmed: 28117514
Med Anthropol. 2003 Apr-Jun;22(2):87-130
pubmed: 12745636
Public Health Rev. 2017 Jul 10;38:13
pubmed: 29450085
Asia Pac J Clin Nutr. 2012;21(4):558-67
pubmed: 23017314
Matern Child Nutr. 2018 Apr;14(2):e12534
pubmed: 29052943
Am J Public Health. 2018 Sep;108(9):1167-1170
pubmed: 30024808
Lancet. 2017 Dec 16;390(10113):2627-2642
pubmed: 29029897
Nutrients. 2020 Jun 17;12(6):
pubmed: 32560550
PLoS Med. 2012;9(6):e1001235
pubmed: 22745605
Int J Obes (Lond). 2012 Aug;36(8):1114-20
pubmed: 21912397
Physiol Behav. 2018 Aug 1;192:23-29
pubmed: 29289613
Lancet. 2020 Jan 4;395(10217):65-74
pubmed: 31852602
J Hum Nutr Diet. 2010 Oct;23(5):494-501
pubmed: 20831708
Proc Natl Acad Sci U S A. 2017 Jun 20;114(25):6492-6497
pubmed: 28507158
Psychoneuroendocrinology. 2001 Jan;26(1):37-49
pubmed: 11070333