Supermarkets not directly linked to obesity, but rather help reduce child undernutrition in Africa, new research suggests

03 Dec 2019 --- New research shows that supermarkets are not linked to obesity in children, but that they instead contribute to reducing child undernutrition. Hunger and undernutrition continue to pose significant societal problems in Africa, while adjunctly, obesity and related chronic diseases are also on the rise. While previously studies only looked at data from adults, a study suggests that the growth of supermarkets is contributing to obesity in Africa, because supermarkets tend to sell more processed foods than traditional markets.

“While overweight and obesity are increasing rapidly in many countries in Africa, child undernutrition remains widespread. There is increasing recognition that food environments influence people’s dietary choices. Given that supermarkets are rapidly expanding in many African countries, it is important to understand what this means for the different forms of malnutrition,” Dr. Matin Qaim, leader of the research project, tells NutritionInsight.

In this study published in the journal Global Food Security, agricultural and food economists from the University of Göttingen in Germany, collected data from over 500 randomly selected children in Kenya over a period of three years. The data shows that children from households with access to a supermarket are significantly better nourished than children in the reference group. Purchasing food in a supermarket has particularly positive effects on child growth and height, even after age, income and other factors. The most widely used indicator of chronic child undernutrition is child “stunting,” which means impaired growth and development as shown by low height for their age.

“At first, we were surprised by the results because it is often assumed that supermarkets in Africa primarily sell unhealthy snacks and convenience foods,” says Dr. Bethelhem Legesse Debela, the study’s first author. “However, our data shows that households using supermarkets also consume healthy foods, such as fruits and animal products more regularly.”

Dr. Qaim further adds that not all processed foods are automatically unhealthy. “Processing can improve the hygiene and shelf-life of foods. Poor households in Africa in particular often have no regular access to perishable fresh produce,” he notes.

The modernization of the food retail sector can have multilayered effects on nutrition.Modernization of the food retail systems
The findings clarify that modernization of the food retail sector can have multilayered effects on nutrition, which need to be analyzed in the local context. The UN pursues the goal of eradicating global hunger in all its forms by 2030. According to the study authors, “this can only be achieved when we better understand the complex relations between economic growth, nutrition and health, and identify and implement locally-adapted policies.”

“In terms of obstacles, to conduct an impact evaluation with observational data is always somewhat challenging, because one needs to control for a number of factors that could otherwise bias the results. We collected panel data with two rounds of data collection over a period of three years. Panel data help to control for a number of confounding factors, so that the results are more reliable than results with cross-section data,” says Dr. Qaim.

In November, a survey of over 6,000 sub-Saharan family households published in the Frontiers in Sustainable Food Systems journal revealed that nearly 40 percent of homes in this region experience severely unreliable access to food, while nearly 50 percent have inadequate diversity in their diet. This puts them at risk for micronutrient deficiencies. Nutrition-specific interventions are crucial to guaranteeing sufficient dietary intake, the study concludes. The researchers also found that promoting crop and livestock diversity, as well as nutrition education was more beneficial to securing food and nutritious diets than merely increasing household incomes.

Action is needed across public and private sectors
As overall research has highlighted, there is much that can be done to stem the tide of malnutrition through the appropriate allocation of resources. According to a UNICEF report, malnutrition affects at least one in three children under the age of five. Meanwhile, a study published in the journal Nature revealed that people living in tropical coastal areas suffering from malnutrition could improve their health if they were able to incorporate just a fraction of the fish caught nearby into their diets. 

The World Health Organization (WHO) has also advocated for the inclusion of iron and folic acid supplements as part of antenatal care, while underscoring that health services must integrate a stronger focus on ensuring optimum nutrition at each life stage.

“The private sector should view improving nutrition as a business opportunity, not just a moral duty,” Lauren Landis, Director of Nutrition at the World Food Programme (WFP), tells NutritionInsight. “Companies can tap into local networks and associations, such as the Scaling Up Nutrition (SUN) Business Network, to explore sustainable opportunities to invest in nutrition and healthy diets.

Historically, the public sector has not tapped into the expertise that the private sector has to offer, and the private sector has not taken public health into account, adds Landis. “Food fortification – when foods are fortified with nutrients using the technical expertise of the private sector and in response to a micronutrient deficiency – is an example of how when these sectors do align, the result is good for business and good for people. WFP has been working with DSM for several years to fortify rice, which has a massive potential to combat micronutrient deficiencies, particularly in Asia.”

“The food industry will need to rethink the formulation of their products so that they are better aligned with nutritional guidelines while reducing their environmental footprints,” affirms Fatima Hachem, Senior Nutrition Officer, Nutrition and Food Systems Division at Food and Agriculture Organization (FAO).

By Benjamin Ferrer