1. Feeding the world “healthily” in 2050 London School of Hygiene & Tropical Medicine (LSHTM), School or Oriental and African Studies (SOAS), Royal Veterinary College (RVC), School of Pharmacy (SoP). The London International Development Centre Leverhulme Centre for Integrative Research on Agriculture and Health (LCIRAH) Ricardo Uauy MD PhD

2. Population growth to continue, but at a slower pace Josef Schmidhuber FAO Head, Global Perspective Studies Unit Population growth is a key driver for long-term outlook on global food, agriculture and nutrition 0.0 3.0 6.0 9.0 12.0 1750 1800 1850 1900 1950 2000 2050 Total population (billions) 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 Annual increments (billions)

3. Germany: The Melander family of Bargteheide Food expenditure for one week US $500

4. Ecuador: The Ayme family of Tingo Food expenditure for one week US $31.55

5. Chad: The Aboubakar family of Breidjing Camp Food expenditure for one week US $1.23

7. Four crops represent 65% of food produced in the world Lentils Chick peas Lettuce Peppers Carrots Bean, dry Plantains Coconuts Cabbages Oranges Sorghum Tomatoes Oil Palm Fruit Soybeans Sweet Potatoes Barley Cassava Sugar Beets Potatoes Rice, Paddy Maize Wheat 0 100 200 300 400 500 600 100,000 metric tons Mann, C. (1997)

8. Kg per person per year

9. Kg per person per year

10. Deaths by Regions of the World Accidents Non-communicable Diseases Communicable diseases AFRICA Eastern Mediterranean EUROPE SE-ASIA W.PACIFIC AMERICAS 25 50 75 % Source: WHO, World Health Report 2004

11. Lancet Malnutrition Series 2008

13. Maternal & child undernutrition Immediate causes Underlying causes Basic causes Lancet Malnutrition Series 2008 Lack of capital: financial, human, physical, social and natural Social, economic and political context Income poverty: employment, self-employment, dwelling, assets, remittances, pensions, transfers, etc. Unhealthy household environment & lack of health services Inadequate care Household food insecurity Long-term consequences: Adult size, intellectual ability, economic productivity , reproductive performance, Diabetes & CVDs Short-term consequences: Morbidity, Disability, Death Inadequate dietary intake Disease

14. % of total DALYs lost Vit A deficiency Iron deficiency

15. % of total DALYs lost Blood Pressure Cholesterol

16. % of total DALYs lost Energy Imbalance Under nutrition

17. Malnutrition in all its forms Foetus / Infants / Children • LBW/IUGR • Stunting and Severe wasting • Micronutrient deficiency ( Vit A,I,Fe,Zn,Fol) • Infection (HIV/AIDS) Adults / Older People • Cardiovascular (CHD, Stroke ) • Obesity /Diabetes/ Dyslipidemia • Cancer related to Diet and Physical inactivity • Osteoporosis, Caries • Age related loss of function (vit D, B12, n-3 FAs)

18. Nutrition defines in great part how many will survive infancy & how they will live and die Years of age 20 40 60 80 100 120 1930 2000 Foetus / Infants / Children • LBW/IUGR • Stunting and wasting • Micronutrient deficiency ( Vit A,I,Fe,Zn ) • Infection (HIV/AIDS) Adults / Elderly • Cardiovascular (CHD, Stroke ) • Obesity /Diabetes/ dyslipidemia • Cancer related to diet • Osteoporosis • Aging Ideal % survival Nutrition-Infection interactions determine in great part, how we grow physically and develop mentally , Nutrition-Physical activity interactions define how we will age and die. 0 25 50 75 100 Disability Physical /Mental

19. Right to “Adequate food”: Quantity and Quality - macronutrient quantity and quality AND - micronutrient density per unit energy consumed Nutrient poor high energy foods displace nutrient rich foods Effect most marked at low levels of physical activity Leading to: - poor/abnormal fetal growth - low birth weight - stunting -increased risk of obesity

21. All cause Diabetes Cancer Heart Disease M. Franco et al AJE Sept 19, 2007