Let’s explore the connection between these topics.
It has been exciting to read the recent study released in The Lancet that has documented the changes in Body Mass Index (BMI) by age group across world regions over the past decades.
The report by the NCD Risk Factor Collaboration has for the first time described global estimates of mean BMI and underweight prevalence for children and adolescents. This study describes the decline in the prevalence of children and adolescents with malnutrition, and an increasing prevalence of obesity (Figure 1).
It is an outstanding outcome to see this change in the prevalence of underweight and malnutrition in children and adolescents in south and east Asia, despite significant population growth over the past three decades. But it is difficult to understand some of the other trends:
- After decades of comparable BMI growth rates between children/adolescent and adults, these increases have uncoupled in some areas. Child/adolescent overweight/obesity has plateaued in many high-income western countries, but continues to rise in adults
- There has been a rapid transition of some regions from high prevalence of child and adolescent underweight to high prevalence of overweight/obesity (Latin America, East Asia, Caribbean)
- The double burden of nutritional disease in some regions, with high prevalence of BOTH underweight and obesity in children.
So, what is going on here?
The reasons for the growth in global obesity is a product of many factors. Of these, it is important to consider how much of this is due to the increase in animal agriculture and animal protein consumption?
The Food and Agriculture Organisation of the World Health Organisation (WHO) has, for some time, reported the considerable increase in per capita food intake in most world regions (50 per cent increase in the kcal per capita in East Asia in the three decades to 2000, compared with a 15 percent in industrialised countries). As part of this is the shifting dietary balance between animal and vegetable proteins, with a greater proportion of dietary energy coming from meat and dairy consumption in both industrialised and developing countries – with this increase greatest in developing countries.
The link between animal protein, obesity and chronic disease is well studied. High consumption of red and processed meat and low consumption of fruits and vegetables are important factors contributing to the substantial chronic disease growth globally, with processed meat such as sausages now listed on the WHO carcinogen list.
If this isn’t bad enough, what about the global climate impacts?
These changing diet patterns are now a significant contributor to global climate change, with data from the International Panel on Climate Change identifying that animal agriculture is responsible for more greenhouse gas emissions than all transportation modes combined.
Despite this, the contribution of the agricultural sector to global greenhouse gas emissions and climate change has been getting little airtime in the recent national discussions of climate policy and energy security. It is sexier (and safer) to plan for the next solar farm, than talk about reducing meat consumption and the potential health gains that could be realised.
But perhaps Margaret Mead was onto something decades ago when she proposed that “it is easier to change a man's religion than to change his diet”.
The data shows us that we are at a crossroads on this wicked issue. The health and environmental responses are being considered in relative isolation. Is to time to propose a new policy discourse that links these two global challenges through tackling the obesity epidemic while also addressing greenhouse gas emissions and climate change? That’s something to think about while you wander past the seemingly innocuous sausage sizzle.
Stephen Gow is the founder and Managing Director of Open Advisory Pty Ltd which a specialist health system planning advisory service based in Melbourne. Open Advisory works with clients to explore system planning, workforce, and design questions, drawing from professional insights derived from extensive work across Australia and internationally. Stephen Gow can be contacted at firstname.lastname@example.org and followed on twitter at @gow_stephen.
 NCD Risk Factor Collaboration (2017) Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. The Lancet. Published on line 10 October 2017, DOI: http://dx.doi.org/10.1016/S0140-6736(17)32129-3
 Joint WHO/FAO Expert Consultation on Diet, Nutrition and the Prevention of Chronic Diseases (2002: Geneva, Switzerland) Diet, nutrition and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation, Geneva
 Lim SS, et al. (2012) A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet 380 (9859):2224–2260.
 Steinfeld H, et al. (2006) Livestock’s Long Shadow (FAO, Rome).