IntroductionWorldwide around one billion people are un-dernourished, while two billion people are overweight. These alarming numbers show us how the available food is currently not equally reaching the dietary needs of humans (Stuck-ler and Nestle, 2012). Both over-nutrition and under-nutrition are aspects of the broader con-cept of malnutrition. These two aspects of mal-nutrition can occur in the same households, or even within one person, by the intake of excess calories of insufficient nutrition value (Stuckler, McKee, Ebrahim and Basu, 2012). The growing number of obese people is associated with gro-wing numbers of chronic non-communicable di-seases (NCDs).Recently, there has been increasing interest in the role of the multinational food and beverage companies in the alarming obesity numbers, commonly referred to as ‘Big Food’ (Brownell and Warner, 2009; Wiist, 2006). These com-panies can contribute to the globally spreading of the higher risk of NCDs (Stuckler, McKee, Ebrahim and Basu, 2012).Within this poster we would like to focus on the influence of ‘Big Food’ companies on food quality and malnutrition on a global scale.

The Power ofBig Food The food market on a global scale does not consists of small producers, but it could be con-sidered oligopoly; globally the ten largest food companies control about 15% of all food sales (Alexander, Yach & Mensah, 2011; Stuckler, Nestle, 2012).The market of ‘Big Food’ is an ever expanding market, however, saturation is almost reached in developed countries. The current and future growth of the Big Food market is expected to be due to increasing sales in low and middle income countries (LMIC), as shown by figure 1 (Stuckler, McKee, Ebrahim & Basu, 2012). The expansion into LMIC over the past years was mainly done by acquiring domestic com-panies (Alexande et al., 2011; Stuckler, Nest-le, 2012). Figure 2 shows that many smaller

labels are actually owned and controlled by one of the major food companies. In Figure 3 it becomes evident that companies within the International Food and Beverage Alliance (IFBA); which are the major Big Food compa-nies, have already a significant market share in emerging economies (Alexander et al, 2011).This raises global concerns, since the growing consuming of Big Food’s products, is close-ly related with growing levels of obesity and noncommunicable diseases. Furthermore, as proposed by the ‘dietary dependency’ theory, countries food systems become dependent of the big food industry. Consumers in LMICs are therefore more and more affected by changes in food price, availability food type (Stuckler et al, 2012).

Figure 1: Trends in per capita sales of unhealthy food and beverage commodities, 1997-2010 and projected to 2016

Figure 2: Global Big Food companies; tracking smaller companies back to major players. Figure 3: IFBA and top ten package food and soft drink company shares

Malnutrition and Food Quality on a Global Scale Faculty of Health, Medicine and Life SciencesCourse New Biology/ New Society

Marlieke Bouwmans (i403245)

Julia Stolz (i623997)Lies Steurs (i6053343)

Ava-Maureen Abdon (i6045196)

Change in Brazilian’s Traditional FoodHabit and Diet

Traditional Brazilian diet has high sugar and salt shares, which is resulting into high numbers of hypertension and cardiovascular illnesses. On top of that, Brazil has been penetrated by “Big food” companies which deliver ultra- pro-cessed food containing unhealthy supplements. These companies are becoming stronger in the Brazilian food market, leading the public eating habits away from the traditional food (Monteiro and Cannon, 2012).

Brazil government tries to protect the citizens by policies. Thus, by law, all Brazilian child-ren are entitled to one daily meal at school, of which at least 70% must be fresh or minimally processed, and a minimum of 30% of this food must be sourced from local family farmers.

However, advertising by television and internet plays a coercing role in promoting individual snacking. Although Brazil’s food tradition and the social habit of sharing meals remain stable, fast food is taking people steadily away from it. Monteiro and Cannon (2012) stated when these two diets combine, a higher sugar and salt intake develops, resulting into increased numbers of chronic diseases in the Brazilian public, which leads to a major problem of mal-nutrition.

ConclusionSince malnutrition is not only depending on food quantity but also on food quality; the food industry bares a huge responsibility in the spread of unhealthy food.

This food industry is dominated by the so-called “Big Food” companies that control the markets in developed countries and are currently also expanding to low and middle income coun-tries.

The quality of the food products processed by these companies does not satisfy, since they are often high in salt, fat and sugar. Approaches have been developed to tackle the problem but effects on changes have been slow with-held by the given power of “Big Food “compa-

nies which explains the slow reaction of global health experts and politicians.

However, finding feasible ways to deal with the influence of Big Food companies have to be considered in order to stop the spread of unhe-althy food. This is of great importance since mal-nutrition on a global scale is a major cause of non-communicable diseases, including cancer, diabetes and cardiovascular disorders.

Advantages and disadvantages of the three approaches of self-regulation, partnership and public regulation have to be identified and un-derstood by politicians and global health ex-perts, so appropriate policies can be made and implemented all over the world.

ReferencesDavid Stuckler. (2012). Big food, food systems, and 1. global health. PLoS Medicine, 9(6).

David2. Stuckler, Martin McKee, Shah Ebrahim, San-jay Basu. (2012). Manufacturing epidemics: The role of global producers. Plos Medicine, 9(6).

Eleanore3. Alexander, Derek Yach and George A Mensah. (2011). Major multinational food and beverage companies and informal sector contribu-tions to global food consumption: implications for nutrition policy. Globalization and Health.

KELLY4. D. BROWNELL, KENNETH E. WARNER. (2009). The perils of ignoring history: Big tobacco. Informally published manuscript, Center for Food Policy and Obesity, Yale University, New Haven.

WHO. (2004). Global strategy on diet, physical 5. activity and health

William6. H. Wiist, DHSc, MPH, MS. (2006). Public health and the anticorporate movement:. American Journal of Public Health, 96(8), 1370-1375

United7. Nations Human Rights Council, (2011). Pro-motion and protection of all human rights, civil, (A/HRC/19/59)

Carlos8. A. Monteiro, Geoffrey Cannon. (2012). The impact of transnational ‘‘big food’’ companies on the south: A view from brazil . Plos Medicine, 9(7),

The Quality of FoodProduced by Multinati-onal Food Companies

The quality of food which has its offspring in one of the big food multinationals, can to a great extend be labeled as insufficient.The word “insufficient” here describes, that the quality does actually not meet the recommen-ded global dietary needs. This, on the one hand leads to the phenomenon, that about one billi-on people have to face hunger while other two billion getting obese (Stuckler, Nestle 2012).

On the other hand it can be stated that most of the food which is produced by this multinatio-nal food companies (so called processed food) such as Nestle, Danone et cetera contain very low amounts of valuable and healthy nutrients such as proteins or fibers, but contain a lar-ge amount of unsaturated fatty acids, sugars and easily metabolized carbohydrates. Fur-thermore, “big food companies” are to a gre-at extend responsible for a high consumption of sugar sweetened beverages, which increase global levels of chronic diseases such as dia-betes and cardiovascular diseases (Stuckler, Nestle 2012).

In addition, the products this text refers to, can to a high degree be stated as substances which are extracted from whole foods (e.g. offcuts of animal products, refined starches). The con-sumption of such processed foods, leads to a satisfactory feeling of the human body because it pretends to have a healthy and nutritious ap-pearance (Monteiro, 2012).

Discussion“The right to food cannot be reduced to a right not to starve”Olivier De schutter, Special UN Rapporteur on the Right to food

The global health response against bad food quality has been slow in developed and even slower in developing countries. This slow res-ponse is due to several reasons.Firstly, for a long time, malnutrition was linked to a lack of calorie intake, so the focus was more on quantity than on quality (De Schut-ter, 2011). Secondly –and perhaps even more importantly- the problem is that any action on food quality requires dealing with the Big Food industry, which is quite challenging as they are powerful and have huge influences on govern-ments (Stucker & Nestle, 2012).

However, recently the attention for the issue has increased and global health experts are trying to address the social, political and economic conditions that affect the global distribution of malnutritious food.

Illustrations of this are the WHO Global Strate-gy on Diet, Physical Activity and Health (2004), and a report of the Special UN Rapporteur on the Right to food (2011), which both address the responsibility of the food industry and make specific recommendations to the companies.

Nevertheless, more action is still needed and hereby it will be of great importance to de-cide how to involve the big food companies.

Overall, there are three approaches (Stuckler & Nestle, 2012, p. 2):

Selfregulation: Well-informed individuals 1. will chose whether to eat unhealthy, market-effects will make the industry to act more responsible, but no further engagement by the public health community is needed.Partnerships2. with the industry: Global he-alth advocates might work together with Big Food companies to make healthier products and act more responsible.Public3. Regulation: This third approach is critical about self-regulation of and partner-ships with the industry, since it addresses the conflicting interests between the food com-panies, whose concern is making profit, and global health advocates, whose concern is to create a healthy environment. Therefore, the only meaningful action would be public regulation, such as restrictions on marketing and improved food labeling.

Global health officials should take into account the pros and contras of these three approaches and make appropriate and effective policy de-cisions. The main challenge in this will be to align the Big Food’s profit motives with global public health goals.