Is Food the Answer to Malnutrition? - The Oxford Topic of Food, Politics, and Society - page 409

cardiovascular disease in 2005, making it the main cause of death on a global scale.
As a point of comparison, 2.8 million people will die from HIV/AIDS during the
same period. Estimates are that overweight and noncommunicable diseases com-
prise approximately 60% of the global burden of deaths, and out of this, 79% occur
in developing countries (WHO https://apps.who.int/infobase/) .
One further paradox is the coexistence of undernutrition and overnutrition in
the same countries, communities, and even households, making clear that afflu-
ence is not the direct or even primary cause of overconsumption leading to over-
weight; conversely, poverty and the inability to command adequate access to food
(i.e., food security) is not necessarily the direct or primary cause of undernutrition.
This phenomenon, often referred to as the “dual burden” of overnutrition and under-
nutrition, is presented by displaying the high share of stunted children that exists
alongside the large numbers of overweight women. For example, in Cameroon, 29%
of the women are overweight, and 35% of the preschool-aged children are under-
nourished. In Bolivia, where nearly one-half of the women are overweight, nearly
one in four children are stunted.3
This phenomenon of undernutrition and overnutrition is not merely a story of
inequality in distribution across households—that is, the wealthier food secure, over-
consuming households residing in the same country or communities as the food inse-
cure poor households where undernutrition is present. Indeed, undernutrition and
overnutrition exist simultaneously within the same households. For example, in the
case of Malawi, among households where mothers were underweight, 47% of the chil-
dren were stunted; but 35% of the children were stunted in households in which the
children's mothers were overweight. In Burkina Faso, in 2003, in a household in which
the mother was overweight, nearly one in five of her children were stunted. Although
the share of stunted children was higher when the mother was of normal weight or
underweight, it is not unusual to find households in which children are suffering from
long-term and chronic malnutrition, despite the fact that their mothers are over-
weight or obese. Again, this pattern illustrates the multidimensionality of malnutri-
tion and the complex etiology that contributes to these deleterious outcomes. This, in
turn, has important implications for thinking about the role of food and food policy
in the production of, and as a solution to, the problem of malnutrition. It also sug-
gests the need to consider a more formal conceptual model for understanding these
relationships.
The Nutrition Production Function
A simple model of malnutrition is useful for understanding its causation and possi-
ble pathways to improving nutritional outcomes. Following Grossman's (1972) model
of health as a stock variable, and the discussion of the nutrition production function
by Strauss and Thomas (1995), assume that nutritional status is both produced and