LET's DEBATE: International Union for Health Promotion and Education Position Paper: Advancing Health Promoting Food Systems

Published date01 March 2015
Date01 March 2015
World Food Policy - Volume 2, Number 1 - Spring 2015
In early 2013, Associate Professor Jane
Dixon, Australian National University,
was asked by the International Union
for Health Promotion and Education
(IUHPE) executive to develop a position
paper on food systems and health
promotion. e paper was intended
to provide background material to
guide the directions of the IUHPE
executive and membership as they play
a role in addressing one of the more
critical political, social, health, and
environmental problems of the twenty-
rst century: the capacity to provide a
healthy and sustainable diet to a growing
population in an increasingly resource
constrained bio-physical environment.
IUHPE and its partners, in
particular, Health Promotion Switzerland,
had already made a solid contribution to
the debate through an earlier White Paper
entitled: e Food System: A Prism of
Present and Future Challenges for Health
Promotion and Sustainable Development
(Kickbusch 2010). at paper adopted
an eco-system perspective: a model for
understanding the interrelationships
between environmental conditions,
food supply issues, diet-related non-
communicable diseases (NCDs), and
health equity. e White Paper framed
healthy food system dynamics through
a health promotion and sustainable
development lens, arguing that “in many
cases, the best choices for health are also
the best choices for the planet; and the
most ethical and environmental choices
are also good for health” (Kickbusch
2010, 7).
Professor Dixon subsequently
discussed her dra paper during the 21st
IUHPE World Conference on Health
Promotion held in Pattaya, ailand,
in August 2013. Based on feedback she
produced a version that was approved by
the IUHPE Board in 2014 (Dixon 2013).
In brief, the paper argued that food
security cannot be addressed within
the food system alone—the production,
trade, retailing, advertising, and
consumption of food—but is the outcome
of what also happens within the human
security and development systems
which govern household incomes/
employment opportunities, education,
healthcare, housing, gender relations,
exposure to crime, resource conicts,
and environmental hazards. us,
food security needs to be reframed as a
feature of national human security and
development policies in all countries,
whether high, medium, or low income.
As an editorial Board Member
of World Food Policy (WFP), Associate
Professor Dixon has provided us with
a shortened and updated version of the
Jane DixonA
LET’s DEBATE: International Union for Health
Promotion and Education Position Paper:
Advancing Health Promoting Food Systems
A Associate Professor; Public health social scientist, National Centre for Epidemiology and Population
Health, the Australian National University
World Food Policy
paper. Over the coming three issues,
WFP would be delighted to gather
feedback on the arguments contained in
the IUHPE Position Paper and to solicit
further debate regarding (a) the capacity
of dierent types of food system to
provide food security now and into the
future; (b) which actors and what factors
are responsible for any blockages and
solutions; and (c) ideas for the evolution
of appropriate global and national food
system governance mechanisms going
e problem being addressed in the
Food Systems Position Paper: multiple
forces within and outside the food
system are undermining global food
and nutrition security
I - e magnitude of food insecu-
rity1 and related health problems
Food insecurity, or malnourishment,
takes three main forms: under-
nutrition, over-nutrition, and micro-
nutrient deciencies. Underweight2 aects
close to 1 billion people, with a further 1.4
billion adults, 20 years and older, classied
as overweight or obese3. According to the
WHO (2013), almost two thirds of the
world’s population live in countries where
illnesses directly related to overweight
and obesity kill more people than
illnesses related to being underweight.
Furthermore, micro-nutrient deciencies
can occur in people who are underweight,
overweight, as well as those of healthy
weight. Inadequate iron intake results
in iron-deciency anemia, the most
common micro-nutrient deciency,
aecting 2 billion people worldwide; and
for this reason, the WHO claims anemia
to be a major global epidemic (WHO nd).
e health and social equity
issues arising from the dominant food
system model—a food system based on
industrial-scale production, corporate
control, and international trade—are
While the global food system
produces sucient calories to meet
the energy requirements of the current
population, there is an uneven distribution
of adequate micro-nutrients and food
considered safe from a toxicological
1 e terms “food insecurity”, “poor nutrition”, and malnutrition are oen used interchangeably and
can be dened narrowly or broadly. e narrow denition refers to insucient calories or food energy
to maintain health (also dened as hunger). e broader denition, and the one adopted in this paper,
refers to insucient calories/food energy, an abundance of calories/food energy, and micro-nutrient de-
ciencies (lack of basic vitamins and minerals). e WHO considers both under-nutrition and over-nu-
trition to be conditions of food insecurity.
2 Underweight is the most common indicator of under-nutrition, and it refers to abnormal or insu-
cient fat accumulation so as to impair health.
3 Overweight and obesity are dened as abnormal or excessive fat accumulation that may impair health,
resulting in a body mass index of equal to or greater than 25 kg/m2 (overweight) and 30 kg/m2 (obese)
(WHO 2013).

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