by Marion Nestle

Currently browsing posts about: International

Oct 2 2015

Weekend Reading: Emily Yates-Doerr’s “The Weight of Obesity”

Emily Yates-Doerr.  The Weight of Obesity: Hunger and Global Health in Postwar Guatemala. University of California Press, 2015.

Emily was a student in NYU’s anthropology department and I’ve admired her work for a long time.  Her book is based on her remarkable dissertation work, and I was happy to be asked to blurb it:

Emily Yates-Doerr gives us an anthropologist’s tough analysis of how one resource-poor Guatemalan population responds to an increasingly globalized food supply as it transitions rapidly from widespread hunger and malnutrition to the increasing prevalence of obesity and its health consequences.  The Weight of Obesity views this “nutrition transition” from the unusually revealing perspective of an insider who experienced it personally with eyes wide open.

For me, the most riveting parts of her book are the transcribed conversations between clinic nutritionists and patients newly diagnosed with type 2 diabetes—a case study in the cultural gap between nutrient-based advice (“nutritionism”) and the way people actually eat.  The effects of the rapid influx of “ultra-processed” products on the health of the populations studied here are also painfully clear.  This is an ethnography of the nutrition transition caught just as these cultural and dietary shifts were occurring.

Jul 13 2015

Nuclear negotiations with Iran: the food politics

My dear friend, the food writer, cookbook author, and restaurant consultant Joyce Goldstein, is also a careful analyst of today’s global political scene.

She points out that the New York Times account (exceptionally clear, by the way) of the ongoing nuclear talks with Iran suggests one reason why they are going on endlessly:

To sustain itself during its marathon meetings, the United States negotiating team has since the beginning of June consumed at least 10 pounds of Twizzlers, 30 pounds of mixed nuts and dried fruit, 20 pounds of string cheese and more than 200 Rice Krispie Treats, according to its informal count.

Fruits and vegetables anyone?

Let’s join in a chorus of “Give Peas a Chance.”

Mar 30 2015

Another picture worth many words: Coca-Cola in Myanmar

Except for Cuba, Myanmar used to be the only country in the world where Coca-Cola could not be sold.  The Burmese (now Myanmar) military junta kept Coke out for more than 60 years.

No more.  In 2013, Coca-Cola opened its first bottling plant in Myanmar as part of a $200 million investment in that country.

To do that, the company had to face many challenges: unfamiliarity with cold drinks, lack of refrigeration, and substantial labor and human rights issues.

But, as Coca-Cola explains:

For the people of Myanmar, this was more than the return of a delicious, refreshing beverage. To them, Coca‑Cola embodies the bright promise of better days and better lives ahead. And we look forward to being part of their journey.

When an NYU nutrition graduate, Catherine Normile, MS, RD, told me she was working on development projects in Myanmar, I asked her to take a look and see if she could send me photos of how Coca-Cola’s incursion into that country was proceeding.

Here’s one:


And here’s another:


She sent many more, but these will give you the idea.

Coca-Cola seems well established in Myanmar after just under two years.

I wonder how the country’s health statistics are coming along?

Jan 8 2015

Food politics, Indonesian style

Food Politics is back from vacation in Indonesia where its president, Joko Widodo (“Jokowi”) made this announcement:


His program particularly aims to support rice production, but also corn, soybeans, and sugar, all of which are currently imported.

Much Indonesian rice is still produced on small terraced farms, like this one on Bali.


The government plans to distribute hand tractors and seeds to thousands of farmers across the various islands.

The Jakarta Post also ran a long story about a program promoting organic farming and seed-saving methods, particularly for rice.  Rice productivity has been falling as a result of over-fertilization and exhausted soils.

The food movement seems alive and well in Indonesia.  It has Slow Food chapters and Bali Buda restaurants (“real food by real people”) are multiplying.  Interest is starting early.


This will  be fun to watch.

Dec 8 2014

Sugary drink advocacy, Mexican style

The creatively active Mexican advocacy group, El Poder del Consumidor, launched a new video take-off on Coca-Cola ads—“Haz feliz a alguien” (“Make someone happy”)—with a demonstration on Mexico City’s Zocalo in front of the National Cathedral.



They sent along a translation of the video:

What would make you happy this Christmas?

That my dad were here with us.

PLAY SPORTS/EXERCISE (posted at the bottom of the screen to mimic Coke ads here)

That my mom could see her grandson.


That my dad could play soccer with me.


Make someone happy this Christmas.

50,000 people in Mexico are blind because of diabetes.

Someone’s limb is amputated every 7 minutes because of diabetes.

In Mexico, 66 people die each day from drinking sugary drinks.

Make someone happy.

Share this video and remove soda from your table.

Dec 1 2014

Second International Congress of Nutrition: little progress, ongoing frustration, alas

The Second International Conference on Nutrition took place in Rome a week ago.  It brought together a wide range of people from government, nongovernmental organizations, international agencies, and donors to consider how world leaders could join forces to end malnutrition in all its forms.

The First such conference took place 22 years ago.  I wrote a disheartening account of it at the time.  In reading it over (it is only two pages), I am struck by how little has changed.

The conference produced two documents of note:

Corinna Hawkes, now at the World Cancer Research Fund, reported on the meeting.

The documents were adopted in a matter of minutes at the commencement of the conference. And then they somehow disappeared…So, my conclusion on ICN2? It’s only going to make a real difference if it is seen as the initiation of a process rather than its conclusion—the start, not the end. And if this helps prevent malnutrition—in all its forms—then we can safely say it will indeed have made a difference.

ICN2 elicited a collection of documents, among them:

  • WHO Global Nutrition Targets 2025
  • WHO non-communicable disease targets.
  • IFPRI’s Global Nutrition Report: “Under existing assumptions, projections from the World Health Organization (WHO) and UNICEF show that the world is not on track to meet any of the six WHA nutrition targets. Globally, little progress is being made in decreasing rates for anemia, low birth weight, wasting in children under age five, and verweight in children under age five. Progress in increasing exclusive breastfeeding rates has been similarly lackluster.”
  • Public Interest Civil Society Organizations: Statement: “22 years after ICN1, this conference is taking place without properly evaluating progress or failures and without significant participation of civil society, in particular those most affected by hunger and malnutrition in all its forms. We deplore that ICN1 has sunk without trace and we do not want this to happen for ICN2…The conclusion of the ICN2 negotiations is a welcome step, in particular its focus on malnutrition in all its forms. However, we consider it inadequate to confront the scale of the global malnutrition challenge.”

This last statement concludes with a call to action:

22 years – an entire generation – have passed since the first ICN. It is unacceptable that millions of people continue suffer from and die of preventable causes of malnutrition in all its forms. This violence must stop immediately.

We call upon Member States to make clear and firm commitments at both national and international levels to ensure the full realization of the human right to adequate food and nutrition and related rights. We will not watch idly as another 22 years pass by.

We stand ready to play our part and take up our responsibilities. We demand that Member States and the UN system live up to their obligations.

We hereby declare a worldwide People’s Decade of Action on Nutrition.

The time for action is now!

I’m for that.  May it succeed.







2014 Global Nutrition Report: Actions and Accountability to Accelerate the World’s Progress on Nutrition

From the point of view of the authors, the report itself is an intervention against malnutrition: it is designed to help reframe malnutrition as a global challenge, to raise ambitions about how quickly it can be reduced, and to reenergize actions to reduce it.

Almost all countries suffer from high levels of malnutrition.  Countries should make a common cause and exploit opportunities to learn from each other. It is clear that the low-income countries do not have a monopoly on malnutrition problems and that the high-income countries do not have a monopoly on nutrition solutions. Failure to intensify action and find solutions will cast a long shadow, bequeathing a painful legacy to the next generation. Our generation has the opportunity—and the ability—to banish those shadows. To do so, we must act strategically, effectively, in alliances, and at scale. And we need to be held to account.



Apr 11 2013

Food aid reform is up against intense lobbying

International food aid has long been fraught with politics.

Since 1954, our system for donating food for emergencies and aid has worked like this:

  • The government buys U.S. farm commodities.
  • It requires at least 75% of these commodities to be transported on U.S. ships.
  • The commodities are given to governments for emergency relief, or
  • They are given to American charitable organizations to sell so the groups can use the money to finance development projects (this is called “monetization”).

Other countries that donate food buy it internationally so it doesn’t have to be shipped long distances.

The U.S. is the only major donor country that uses food aid to benefit U.S. farmers, U.S. shipping companies, and U.S. charitable groups, and does not buy food aid internationally.

This system has long been known to undermine local agriculture and food systems, and to fail to get to those who need it most.   It takes months to get food aid where it is needed, and the entire enterprise is inefficient and unnecessarily expensive, according to a 2011 report by the Government Accountability Office.

Now, says the New York Times, the Obama administration wants to fix these longstanding problems.

The Agency for International Development (USAID) wants the U.S. to:

  • Buy food in local countries (although 55% would still go to U.S. farmers)
  • End “monetization” to U.S. charitable organizations.

The mere suggestion of reform has elicited intense lobbying by—surprise!—shipping companies, agricultural trade organizations, and some, but by no means all, charitable groups.

Some aid groups, Oxfam, for example, strongly favor such changes.

But food aid is part of the farm bill (Title III).  This means that any changes to current programs would have to be passed by Congress.

Good luck with that in the present political environment.

Food aid, along with SNAP (food stamps), are key issues to watch as Congress tries again to write and pass a farm bill.  Stay tuned

Resources: The excellent discussion of this issue in the Hagstrom Report (April 10) provided links to relevant documents.




Mar 7 2013

Lancet series on chronic diseases, many of them diet-related

The Lancet has just published a series of articles on non-communicable diseases (NCDs) the collective term for heart disease, type 2 diabetes, and other chronic conditions caused in large part by poor diets, lack of physical activity, or cigarettes or alcohol.

Since food politics is a big part of this discussion, these papers are worth a look.  For example, as editor Richard Horton explains in his editorial:

So where are the global conferences on NCDs, the research meetings, the task forces, the grand challenges initiated by funders and foundations? They don’t exist. We, the global health community, understand that chronic diseases are a present danger to the health of our societies. Yet we are unable to translate that understanding into real political action. We cannot quite bring ourselves to put heart disease, stroke, cancer, chronic respiratory disease, diabetes, or mental ill-health, together with their associated risk factors, on an equal footing with childhood pneumonia and diarrhoea, preventable maternal death, or epidemics of AIDS, tuberculosis, and malaria. The disconnect between the reality of people’s lives in countries and the concerns of professional and political leaders has rarely been greater.

Here are the papers in this series.  Read them and ponder.

Independent global accountability for NCDs

Robert Beaglehole, Ruth Bonita, Richard Horton

Full Text | PDF

NCDs: a challenge to sustainable human development

Helen Clark

Full Text | PDF

Embedding non-communicable diseases in the post-2015 development agenda

George Alleyne, Agnes Binagwaho, Andy Haines, Selim Jahan, Rachel Nugent, Ariella Rojhani, David Stuckler, for The Lancet NCD Action Group

Summary | Full Text | PDF

Country actions to meet UN commitments on non-communicable diseases: a stepwise approach

Ruth Bonita, Roger Magnusson, Pascal Bovet, Dong Zhao, Deborah C Malta, Robert Geneau, Il Suh, Kavumpurathu Raman Thankappan, Martin McKee, James Hospedales, Maximilian de Courten, Simon Capewell, Robert Beaglehole, on behalf of The Lancet NCD Action Group

Summary | Full Text | PDF

Inequalities in non-communicable diseases and effective responses

Mariachiara Di Cesare, Young-Ho Khang, Perviz Asaria, Tony Blakely, Melanie J Cowan, Farshad Farzadfar, Ramiro Guerrero, Nayu Ikeda, Catherine Kyobutungi, Kelias P Msyamboza, Sophal Oum, John W Lynch, Michael G Marmot, Majid Ezzati, on behalf of The Lancet NCD Action Group

Summary | Full Text | PDF

Profits and pandemics: prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries

Rob Moodie, David Stuckler, Carlos Monteiro, Nick Sheron, Bruce Neal, Thaksaphon Thamarangsi, Paul Lincoln, Sally Casswell, on behalf of The Lancet NCD Action Group

Summary | Full Text | PDF

Promotion of access to essential medicines for non-communicable diseases: practical implications of the UN Political Declaration

Hans V Hogerzeil, Jonathan Liberman, Veronika J Wirtz, Sandeep P Kishore, Sakthi Selvaraj, Rachel Kiddell-Monroe, Faith N Mwangi-Powell, Tido von Schoen-Angerer

Summary | Full Text | PDF

Improving responsiveness of health systems to non-communicable diseases

Rifat Atun, Shabbar Jaffar, Sania Nishtar, Felicia M Knaul, Mauricio L Barreto, Moffat Nyirenda, Nicholas Banatvala, Peter Piot

Summary | Full Text | PDF

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