Food crisis: An economic spiral towards malnutrition

The global food and agricultural systems are in the midst of a perfect storm. Due to the unending overlapping crises, the United Nations defines the situation as “the greatest cost-of-living crisis in a generation.”

Record high food prices have sparked a worldwide crisis that will push millions into severe poverty, exacerbate hunger and malnutrition, and threaten to reverse years of development progress. Sri Lanka is no exception, as the South Asian island nation suffered its worst financial crisis since independence in 1948. Thus, Sri Lanka's economic crisis has already spiralled into a food crisis.

In that background, the Daily Mirror sat down with Prof. K. K. D. S. Ranaweera, Department Head of Food Science and Technology of the University of Sri Jayewardenepura, to delve deeper into the looming food security crisis and its impact on the health of Sri Lankan citizens.

Q To what extent do you think the food inflation has affected the health of Sri Lankan citizens? 

The stability of food supply chains is crucial to people's food security in any community. Regarding food inflation in Sri Lanka, a month-on-month percentage change in the price of a standard basket of food can show us where we are heading and how we are suffering in every aspect. This present economic crisis, or food inflation, results from several years of mismanagement, corruption, short-sighted policymaking, peoples' negative attitudes, wrong trade policies, and the lack of good governance. 

Most of these drawbacks led to a loss of foreign reserves, access to international capital markets, and a reduction in foreign currency earnings.

Food inflation has drastically affected eating habits because it has made it difficult for people to afford basic food baskets.

Food is a basic physiological need for survival, growth, health and well-being. Therefore, Food inflation, in turn, has a devastating effect on the health of poor households. Food inflation is outpacing the families’ income levels, intensifying income disparities and making it difficult to make healthy food choices. High food inflation has negative consequences for people living in poverty and the middle-income group with a fixed source of income.

What people can afford within a crisis may not provide qualitatively and quantitatively sound nutrients for meeting nutritional requirements. This leads to health issues associated with nutritional deficiencies. 
Micronutrients include vitamins, minerals, and trace elements required in minute quantities but play a vital role in average human growth, development, and physiological functioning.

Micronutrient deficiencies (MND) are progressive and cannot be identified clinically until they are in their late stages; hence, MND is referred to as a “hidden hunger.”  

Macro and micronutrient deficiencies occur simultaneously. Most importantly, attention should be given to vulnerable groups such as pregnant and lactating women and the elderly, as well as children and adolescents. 
Supplementation and food fortification are the most commonly used strategies to alleviate Micronutrient deficiencies in Sri Lanka. But consuming vegetables, including leafy vegetables, can help resolve micronutrient deficiencies.  

Q What health hazards can occur due to food inflation and its impacts?

High food prices resulting from food can be an immediate threat to household food security, undermining population health, retarding human development, and lowering labour productivity for the economy in the long term.

Food security means availability, accessibility and affordability to all the country's citizens. 
Poor households are more vulnerable to food insecurity whenever there is a problem with the production or distribution of food crops. 
Food insecurity is also associated with poor educational attainment, mental health and social isolation, increasing the death rate.

The government has a significant role in controlling prices and helping poor people cope with higher food bills. The relationship between food prices and demand is more potent for all food groups in Sri Lanka. When the money is limited to purchasing the standard food basket, people may buy cheaper food which may be low quality, spoiled and contaminated. Poor affordability may encourage unhealthy, energy-dense foods relative to healthier, less-dense foods. This makes it hard to control diet-sensitive chronic diseases, including hypertension, hyperlipidaemia, and diabetes. 

Q What are your suggestions to reduce the dangerous health effects due to food inflation? 

Social media and main media can encourage people to cultivate a few commodities such as leafy vegetables, okra, chillies, and eggplants in vegetable beds, pots, or bags. Once they are grown, they can beautify the small space of the garden. In addition, plants like winged bean plants can also be cultivated. 

The government should make a proper policy on household agriculture using different methods, including indoor gardening, hydroponic, and AeroGarden, depending on the household income.

Q What are the alternatives to sustain a healthy diet for a lower price?

Everything is expensive; gas cylinder prices have almost doubled, and people cannot afford them anymore. When meat or poultry is not affordable, people may go for cheaper protein foods like eggs, soya, cowpea, chickpea etc. 

Q Do you think cutting meals down due to economic hardships can drastically impact one’s health?

Recommended Dietary Allowances (RDAs) are the amounts of essential nutrients that are adequate to meet the known nutrient needs of practically all healthy persons.

These amounts meet our nutritional requirements in keeping with our day-to-day activities, physiology, etc. We must maintain this balance. So, it can be divided into two or three meals. The critical factor is ensuring we get these amounts. If we overeat, that can also lead to certain health issues, and eating insufficiently will also have consequences. So, a balance should be maintained.

This present economic crisis, or food inflation, results from several years of mismanagement, corruption, short-sighted policymaking, peoples’ negative attitudes, wrong trade policies, and the lack of good governance

Q Children are skipping meals because of the economic crisis in Sri Lanka. What are the adverse effects on their health due to this?  

A growth problem means that a child falls below or above the average range of growth, depending on the child’s age, sex, family history or nutritional status. If skipping meals is unavoidable, attention must be given to providing children with proper breakfast.

Q What are malnutrition and undernutrition and their impact on brain development?

At its core, malnutrition is a dietary deficiency that results in poor health conditions. It can result from the deficiency, excess or imbalance of a wide range of nutrients. However, in the context of current food inflation in the country, reduced dietary intake is probably the single most crucial factor leading to disease-related malnutrition.
In the present situation, there can be several significant factors that contribute to malnutrition in children:

• Inadequate food intake 
• Poor quality of diet
• Household low-income levels 
• Poor sanitary conditions 
• Poor socio-economic status
• Conflict situations

In Sri Lanka, we did not have particular issues with claiming national-level malnutrition status in children. We may face a situation where we may see children suffering from chronic malnutrition or stunting (i.e., when children are too short for their age because they have not been adequately nourished) due to the abovementioned factors. These issues can leave a devastating and permanent impact on a child’s physical and cognitive capabilities.
New research into neuroscience and early childhood development sheds light on how our brains develop and how our capacities are either nourished or thwarted. Together with stable, responsive relationships with caregivers and safe and nurturing environments.

The nutrition during a child’s first 1,000 days builds the foundation for their development. When this requirement is not met adequately, a child’s physical, social, emotional and cognitive development can suffer, resulting in the loss of every child’s birthright opportunities. The first 1,000 days can be divided into three crucial stages: pregnancy, infancy, and toddlerhood. If a pregnant mother is not fed adequately, the child will suffer to a certain extent. During pregnancy, the child’s brain develops because it begins to grow very early, at an astonishing speed. Malnutrition and undernutrition can result from poverty, unawareness, negligence and many psychosocial (relating to the interrelation of social factors and individual thought and behaviour) conditions, including age, depression, and the like. 

Malnutrition can result in measurable adverse effects on body composition, function and clinical outcomes. Therefore, it can refer to individuals who are either over- or under-nourished. Conversely, malnutrition can result from insufficient intake or nutrition uptake, leading to altered body composition (decreased fat-free mass) and body cell mass. This, in turn, can lead to diminished physical and mental function and impaired clinical outcomes from disease.

Consequences of malnutrition

Malnutrition occurs for psychosocial reasons and as a consequence of disease. In the long run, it can lead to a reduction in cardiac muscle mass. Chronic malnutrition results in changes in pancreatic exocrine function (exocrine pancreas is responsible for the secretion of digestive enzymes, ions and water into the duodenum of the gastrointestinal tract), intestinal blood flow (Intestinal blood flow is critical for digestion, as well as being an essential element of overall blood pressure control), and intestinal permeability (the junctions in the gut epithelial wall lose their integrity which causes gut leaking).

Several factors can contribute to malnutrition in the elderly. They include poor appetite, dentition, loss of taste and smell, difficulties accessing and preparing food and cognitive impairment. These are divided into three main types: medical, social, and psychological.

The most common forms of malnutrition seen in older adults can be the conditions like chronic diseases. Acute disease or injury-related malnutrition, inflammatory responses such as orthopaedic fractures. Bone health is closely associated with Calcium and Vitamin D taken from foods. Therefore, they are essential to consume in adequate amounts to minimise bone loss rate with ageing and reduce fracture risk in both men and women over 65 years. 

It is important to note that bone turnover depends on continuous dietary protein intake. Given this, it is surprising that the role of protein intake in bone health has primarily been viewed in terms of how it may negatively influence calcium balance as opposed to maintaining bone density and health. Research has suggested that dietary protein is an essential nutrient to bone health throughout our lifetime and may not be harmful to the bones.

Q  What are your views on the ban on chemical fertiliser? If we are to adopt organic fertiliser cultivation, how should it be done? 

Chemical fertilisers are produced synthetically from inorganic materials and are added to soil to sustain plant growth. However, as they consist of inorganic materials, they may have some harmful acids, which naturally suppress the growth of soil microorganisms that are helpful for plant growth.

Organic fertilisers are substances derived from the remains or by-products of natural organisms that contain the essential nutrients for plant growth. The words “organic” or “natural” mean that the product is only minimally processed, and the nutrients remain bound in their natural forms rather than being extracted and refined. Organics also feed beneficial soil microbes, making the soil easier to work. 

But organic fertilisers may cost more than chemicals. Sri Lanka one day should go for organic farming confining to a manageable extent because no country is found to have 100% organic farming on their soil. The proportion of organic farming to conventional agriculture should be decided considering many socio-economic factors, agro-ecological factors, consumer preferences etc. But, what we as a country should do is go for good quality mineral fertilisers in place of low-quality counterparts with vast amounts of impurities which would cause health issues such as cancers.

In the case of fertiliser, “organic” does NOT refer to the standards of processing associated with food.

Chemical fertilisers are produced synthetically from inorganic materials. Since they are prepared from inorganic materials, they may have some harmful acids, which stunt the growth of microorganisms found in the soil helpful for plant growth naturally. On the other hand, they’re rich in the three essential nutrients needed for plant growth. Some examples of chemical fertilisers are ammonium sulphate, ammonium phosphate, ammonium nitrate, urea, and ammonium chloride.