Memo to the UN: Time to Drain the Food Swamp

Later this year, the United Nations will host a first-ever global Food Systems Summit, and the first “Action Track” at the Summit will be “Ensuring access to safe and nutritious food for all.”  Fortunately, this challenge is slowly being met: the share of individu­als in low- and middle-income countries who suffer from chronic undernourish­ment has fallen from 36 percent in 1970 to just 11 percent by 2018. But we have a new global food systems problem that keeps getting worse—excessive consumption of unhealthy food. 

Even low-income countries face this problem. The World Health Organization has reported that nearly half of the world’s overweight children now live in Asia, and the number in Africa has increased by almost half since 2000. Of the world’s six hundred million obese adults, two-thirds now live in the low- and middle-income countries. The UN Summit should continue to work on food access, but as we come out of the COVID-linked recession, they should also craft a global response to food excess.  

Delegates to the Summit can learn from the unhappy experience of the United States, where the adult obesity rate is now 42 percent, three times the level of the 1960s. This has brought a burden of chronic disease that now kills over 300,000 citizens a year according to the National Institutes of Health, an order of magnitude not so different from COVID. Obesity has not increased in America because of food access problems; prior to COVID nutritious foods were becoming more available and affordable than ever before. USDA data show that the total availability of fresh vegetables per per­son in the United States increased 21 percent between 1970 and 2014, while fresh fruit availability increased 40 percent. Retail prices for nutritious foods were also falling in real terms, at a nearly identical rate to the price of unhealthy foods when adjusted for quality and seasonality. In 2013 the USDA calculated that a four-person family following its “Thrifty Food Plan” could purchase foods satisfying all federal dietary guide­lines, including recommended quantities of fruits and vegetables, for less than two dollars per person per meal.

We are constantly surrounded by bad foods, in food swamps.

Some have tried to blame America’s unhealthy eating on physical distance from nutritious foods for those living in so-called “food deserts” without a nearby supermarket. In fact, our diets are unbalanced not because we lack access to good foods, but because we are now constantly surrounded by bad foods, in food swamps. One 2017 study defined a food swamp as a neighborhood with more than four unhealthy places to buy food for every one deemed healthy. This study found that the contribution of food deserts to obesity became statistically insignificant once we control for food swamps.

Supermarkets are actually part of the swamp, because they offer aisle after aisle of unhealthy processed products. A 2018 study funded by the Robert Wood Johnson Foundation found that only 30 percent of the product offerings from America’s ten largest food and beverage manu­facturers were healthy. Even department stores and pharmacies are part of the swamp. My local Target has a grocery section that sells thirteen different categories of chips, snacks, and cookies, and at my CVS I have to walk past crackers, ice cream, sugary breakfast cereals, and soda to get to the pharmacy counter. I can protect and ruin my health in a single visit.

The value modern eaters place on convenience is partly to blame for these unhealthy food environments. USDA’s “Thrifty Food Plan” assumes more than two hours of food preparation time every day, while average American households spend less than half that time cooking. But food product formulations intentionally designed to encourage excess consumption are a bigger part of the problem.

Ultra-processed foods are designed to make us crave more.   

Added sugars are found in nearly 70 percent of packaged food products today, including breads, yogurts, sauces, and even “health foods.” Added sugars cause insulin spikes that store calories in our fat cells without satisfying the appetite. Companies also make products with precise mixes of added salt and fat that trigger the reward circuit in our brain, hitting a “bliss point” that conditions us to crave more. Almost nine out of ten supermarket products are also ultra-processed, which speeds up eating. When exactly the same foods are ingested in ultra-processed versus minimally processed form, the average eater will consume more than 500 added calories a day and gain one pound a week.  

Food companies say we are personally responsible for what we put in our mouth, so if we consume too much it is not their fault. This fails to account for the fact that America’s obesity rate has tripled since the 1960s. Are eaters today really three times as irresponsible as they were back then?

Food companies are global actors, and they see emerging economies, with a rising urban middle class, as a lucrative marketing opportunity. Because the companies compete fiercely with each other, it will be hard for any one to go first in abandoning their current strategy of selling addictive, unhealthy foods. Government regulations and taxes, or at least guidelines, will be needed to move them together to a higher standard. Excise taxes on sugary beverages, plus at-a-glance nutrition guidance symbols on the front of packaged food products, and restrictions on advertising junk foods to children would be a good place for governments to start.

In Europe, where obesity prevalence is only half as high as in the United States, 18 different countries have already adopted one or more of these policies, while the United States, at the federal level, has adopted zero. When delegates gather for the UN Food Systems Summit, they should help other countries avoid America’s sad experience, by going beyond food access to add an “Action Track” on food excess.