Public Health Dimension of Food Security - Issue Papers
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Public Health Dimension of Food Security
Mathura P. Shrestha and Indira Shrestha
- People's Health Assembly - Issue Paper
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1. Food Security: What it is or should be
Food is an important part of life and living - ensuring and
sustaining life and development, and enriching the living. Food is also a part of
enjoyment. We have with us myriad of food cultures and traditions. Food is an essential
component for human growth and development. Roles of nutrients and micronutrients are well
known. For normal human development the assured and regular intake of balanced food in
adequate quantity and quality is essential. While undernutrition and malnutrition are the
result mainly of inadequate and low quality food intake, over-intake of food or
over-consumption of some components of food or nutrients may also cause severe problems of
malnutrition with log-term and lasting consequences of ill-health. Harmful contaminants
may cause sever malnutrition due to liver damage and interference in digestion and
absorption.
However, food can no longer be taken for granted. I would like to present some scenario
related to food security.
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We all have heard and experienced poverty, hunger and famine. These were and
are essentially preventable. Yet they are so much in and around the people of countries
like ours. These are issues of inequality, exploitation, and neglected management and
distribution of wealth and opportunities.
-
In addition to the scores of food related health hazards related to cultivation,
storage, processing, distribution and consumption food is getting `dosed up’ with
pesticides, harmful chemicals, hormones, bio-toxins, carcinogens and
mutagenes. We are
already exposed to `Genetically Modified Food’ (GMF). The long term consequences of
this could only be known and tackled after many generations of human race. Still worse,
the profit hunting multi-national companies are in process of active and aggressive
marketing of the seeds with `Terminal Genes’ (TG). These seeds probably would produce
more food but the sterile crop becomes useless for further propagation. Thus the
exploiters have with them the sure way to make the farmers and food growers to lose their
independence and choices, and enforce dependency.
-
Use of food for non-food industry is another headache for those who desire food
security. The policy makers are loudly yet randomly, promoting ‘cash crops’
without necessary research, information and evaluation. In addition, food continues to be
diverted to produce low-quality and junk foods, alcoholic beverages and bottled drinks or
even pseudo-foods or imitation-food. More tobacco leaves are cultivated to produce
`poison-sticks’ and chewable than the needed green-leafy-vegetables
(GLF) in most
parts of Nepal where prevalence of malnutrition is severe.
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Environmental impact and ecological stresses related to intensive food cultivation and
processing are getting serious. Intensive farming tend to make our air too heavy, the soil
too poisonous and water rather unfit for drinking and cleaning.
-
On the top of all these, food is now becoming an unwelcome tool of international power-
politics. With globalization around us, the food monopoly will add another dimension to
the colonization of body and mind - the colonization of living itself. Food-power is going
to pose more threats than guns and bombs.
In the face of all these challenges and problems, we have got be
sensitive. Since these are our own problems, we have got to find our solutions. At least
one can dream to have proper sociopolitical environment for food security with following
criteria or secured food that is:
In addition, the food security system should:
-
provide access to adequate and appropriate information and knowledge to
all leading to the community’s healthy food behavior,
-
ongoing and in-built research and surveillance for appropriate food policy decisions and
actions, and
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develop and enforce regulatory systems to prevent and to protect the people and
consumers from harms related to mystified advertisement or disinformation or
misinformation, illicit trades and harmful commercial practices, toxic additives, and
harmful food practices or unsanitary conditions of production, storage, distribution and
consumption, and
2. Food politics
Unfortunately, even today at the advent of twenty-first century,
food is used as a tool of power politics. So called food and trade embargo are unethical,
irresponsible and principle causes of human induced catastrophe, deprivation and famine.
Internationally and nationally, food is often victim of trade and price wars. Exploitation
on food has been historical event, yet it is continuing now in more sophisticated way
producing more severe trauma to the people. Because of food politics, farmers are not able
to produce what the people need or want, cash determines food distribution, and
substantial quantity of food and agricultural products are diverted to non-food
industries. Because of food politics even the primary producers do not get just return.
Their choice and freedom grossly limited. They are forced to be mere tools in the system
out of food politics.
3. Demystifying effects of impact of malnutrition on intellectual
growth
Many different misconceptions related to food consumption or uses
are common. Some continued to pray human belief system in so called scientific or
psuedo-scientific umbrella. One such example, - many believe that malnourished or
undernourished person becomes intellectually inferior. The theory is not true or really
scientific. The body system protect the core central nervous system related to
intelligence so well by diverting the nutrients from other organ systems that physical
survival is not possible if that is grossly affected. Even the intellectual conditions
related to hypothyroidism and hypoparathyroidism is temporary and reversible. Amnesia and
defects in memory and perception associated with malnutrition resulting from chronic
alcoholism and toxic pathology are secondary to functional damage of other organs or
systems and aging. Many research conducted in Malaysia, Singapore, Hong Kong and US has
shown that intelligence is related to social and intellectual opportunity and stimuli, and
not related to class, ethnicity, race and social or economic affluence. Food needs taboos
and mysticism need to be demystified. Information on food should be rational and
evidence-based.
4. Public health problems related to food.
Endogenous
food toxins:
Certain food contains endogenous food toxins, anti-metabolites, allergens, carcinogens and
other harmful alkaloids and substances. The unprocessed fresh tapioca, wild yams like
‘Simal-tarul’(roots of bombax trees), gittha, Bhyakur, raw cashew nuts, and
certain species of taros contain rather high concentration of hydrocyanic acid
(HCN) - a
very poisonous substance. Gittha and Bhyakur also contain certain estrogen-like substances
that may retard human growth and fertility. The effects of poisonous mushrooms are well
recognized. The poisons like solanin, nicotine and several carcinogens in tobacco leaf and
stem is well established and known. Even unprocessed soybean contains urase and several
anti-metabolic substances which are however heat-labile or neutralized by fermentation.
The traditional ways of cooking and preparation detoxify or neutralize the most of but not
all endogenous-toxins or anti-metabolites in gittha, bhyakur etc. All these necessitate
the adequate provision of information related to food and food practices. Further research
on effective elimination of endogenous food toxins is necessary.
Inappropriate food processing
and handling:
It is well known that many important nutrients are denaturalized, altered or even
destroyed by faulty processing of food. Food gets contaminated during processing,
handling, distribution and consumption. Many undesirable or even harmful substances enter
the food as additives and toxic metabolites during food processing and preservation.
Appropriate education is to be developed for good kitchen practices, good food
manufacturing and trade practices, and good eating habits.
Food contamination
Food gets contaminated during all steps in food chain staring from cultivation to
consumption. Food contamination is preventable. However, an integrated and coordinated
policy and programs are necessary with adequate surveillance system for food safety. The
contaminants may be:
-
Micro-bacterial - viral
(enteroviruses like HvA, NANB, rota and adeno viruses causing diarrhea, polioviruses), bacterial (like salmonella, shigella, food-poisoning
bacteria, vibrio cholera, bacterial toxins), parasitological
(like nematodes, plathyhelminths, protozoals - mainly amoebiasis,
giardiasis, cryptosporidium, trychomonas -), and fungal
(mycotoxins including aflatoxin),
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Harmful metabolites and biological contaminants
like methyl alcohol, estrogen-like substances, hormones, biotoxins including mycotoxins
especially aflatoxins, allergens and carcinogens.
-
Chemical contaminants - like pesticide residues,
nitrates, nitrites, high-salinity, fluorides, arsenic compounds, lead and other heavy
metals. These have serious and long-term health hazards.
-
Food additives - like inedible coloring,
flavoring, taste-enhancer or modifiers, preservatives and softners.
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Unhealthy adulteration. - The adulteration law in
Nepal needs modification. Informed addition of beneficial or non-harmful natural
substances should not be categorized as adulterated. For example, practice of mixing wheat
flower with corn and millet flower has benefit of multi-mix cereal.
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Irradiated food - for prolonged preservation is
never tested for safety but yet practiced.
5. New food sources
This is interesting area and a lot of money is spent in this. The
major aspects in the area includes:
Utilization of food sources
which were previously wasted or not used.
This is mainly to enrich fodder thus ensuring better recovery for human consumption
indirectly. According to one estimate in 1963, global losses were as high as 32-75% for
grains, 53% for potatoes, 34-44% for eggs, fish and meat, and 35% for fruits. A lot of
investment is made to minimize the loss since then. In addition, untapped resources of
‘quality food’ from wasted skimmed milk, blood, and low-grade meat and fish
products are being generated. In addition, maximization of food recovery with better
processing and storage technique or extensive use of antioxidants, preservatives and other
substances (eg. tocopherol and glutamic acid) are made. The production of food by
converting plant food sources into animal product is now very efficient. Traditional loss
of food from the fodder used to be very high with total loss in protein being as high as
90%, fats about 80%, carbohydrate 60%. With the use of enzymes and harmless bacteria these
inert food in fodder can now be hydrolized industrially for better recovery by the
animals. Use of carbamides, non-protein nitrogen including ammonia and urea (used for
artificial manure), synthetic and plant-based hormones, fattening agents, antibiotics and
other artificial substitutes are also used extensively and in ever increasing proportion
to natural fodder. The practice would impose serious impact on human health through human
food chain. The safety of these is to be evaluated and rigorously monitored and regulated.
However, survey or research on traditional and ethnic recipes or culinary practices
nationally and globally would generate many potential food sources that are safe, tasty
and wholesome. Lost traditional menus also may be rediscovered.
Microbiological production of
food:
Microbes (single cells) are efficient converters of proteins directly from raw materials.
Conversion rate to a standard protein according to a chemical score in the following table
provides relative advantage of single cell:
TABLE 1: RELATIVE RATE OF PROTEIN ACCUMULATION
| Cows |
1 |
| Pig |
10 |
| Chicken |
25 |
| Cereals/Beans |
30 |
| Single Cells |
18000 |
(Source: Skryabin GK, Belikov
VM. New food sources. (in) Rajki S,
Bruce A (ed). Round table conference on food production, nutrition and health. Budapest:
Akadémiai Kiadó; 1983: 17-25.)
However, despite these advantages, the single cell (or microbiological) production of food
protein and consumption has physiological, psychological, hygienic and technical risks and
problems. Yeast (single cell) constitutes a substantial proportion of diet of a person
consuming bread (about 0.001%). Higher consumption than that has a health risk because of
high content of nucleic acids. Substantial use of yeast or other single cells or their
protein extracts would expose the person to high content of nucleic acids, and possible
presence of toxic proteins and peptides. Consumers would not be able to evaluate the risks
without a sophisticated laboratory backups or experts. Thus this will curtail the autonomy
of the consumers.
Artificial Foods
Examples of artificial food developed are artificial rice and other cereals, noodles,
pastas, potato, meat and meat extenders, caviar, beverages and confectionery.
International norm to produce artificial food is actually to be based on non-synthetic
processing using high quality natural products or wastage. The product is to be so
balanced or enriched that biological and nutritional values including essential amino
acids, technological properties (look, texture, taste and roughage contents), and
wholesomeness in relation to health outcomes and psychosocial satisfaction after
consumption should be better or, at least, not worse than natural products. For example,
the production of artificial rice is aimed at reincorporating the peripheral layers of
natural rice (kernel, external tegument and barn), containing high biological values, that
get lost during milling and polishing, and enriching with essential amino acids and other
micronutrients. The method of producing artificial rice is supposed to be based on rice
flour from crushed rice, containing rice grits and barn, with addition of milk proteins.
The artificial food is at present widely used in breakfast and precooked food packets.
However, in developing countries like Nepal where food inspection and regulatory systems
are lacking production and consumption of artificial food may have serious impact in
health and development beside the higher cost. Recently, even in US the episode of high
dioxin content in animal feed and human food chain, resulting from the use of artificial
food and additives, should bear a strong lesson to all of us here and the policy makers.
In addition, the socioeconomic impact on the nation’s agrobased development programs,
health and environment should be thoroughly studied before licensing. The cost of such
product is highly inflated, partly to meet the cost of aggressive marketing practices.
It must be however mentioned here that most of the commercially available bottled-,
tinned- or packaged-foods are far inferior compared to balanced natural products as far as
wholesomeness, health benefit, price and environment cost are concerned.
6. Genetically Modified Foods
(GMF)
There has been incredible progress in new biotechnology with
commercialized products of insulin, human growth hormones, interferon, and recombinant
vaccines using human cell culture or ‘novel’ bacteria. Now there is with us a
rough draft map of entire human gene. Prospects of developing ‘novel bacteria’
producing like diary animals (rather manufacturing like a factory) the desired nutrients,
foods, pharmaceutical products including vaccines and therapeutic recombinant DNA
[rDNA]
and cells or organs for graft appear to be high in agenda of so called scientific
community. But the concern for safety of humans and environment was so high that in US
during early 1970’s a moratorium was declared on all rDNA research until very
stringent guidelines were developed by rDNA Advisory Committee (RCA). But the research
continued using attenuated or non-pathogenic organisms in spite of the moratorium.
Similarly, the prospects of commercialization of GMFs are high in agenda of commercial
giants. Countries in West are reviewing the moratorium or modifying the restricting
guidelines. At present it is very difficult to project the future scenario resulting from
widespread use of GMF. We would like to project some hypothetical scenario:
Suppose, because of leak in laboratory or faulty evaluation what will happen if following
conditions or calamities are surfaced?
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If human immune system is so altered that body systems or immunity failed in recognizing
the antigen or pathogens which, so far, were normally resisted by human’s natural
immunity or acquired immunity with conventional vaccines?
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If human body system is so modified that it becomes resistant to most of the presently
available antibiotics, chemotherapy and important life-saving drugs? Are we to keep on
depending on new generations of drugs produced by multinational companies?
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If the vaccines or biologically active substances or life saving drug itself undergoes
changes in body due to GMF and that would not produce desired or expected results?
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If the long term risk or cost to human health and environment would be high or even
catastrophic?
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If mutagenecity of GMF would produce the person described in Aldus Hauxley’s
‘Brave New World’ - efficient and desired human giants with programmed (or
authorized) intelligence?
7. Food industry and hygiene
Food industries are growing rapidly. In addition to the need for
development of appropriate policy related to health, agriculture, trade, manufacture and
licensing, and consumer protection rational regulatory systems are to be developed and
enforced. Any food industry must be subjected to constant and ongoing supervision by food
and sanitary experts with appropriate laboratory backups to monitor safety. Participatory
approach to develop policy and evaluation systems with involvement of representatives from
consumer forums, human rights groups, health and municipality (or local-self-government)
authorities, food and nutrition experts, industrialists and researchers or academicians is
necessary. This concept goes well with the current management culture and concept of
participatory democracy.
8. Role of Junk Food, bottled/tinned foods, Infant Food formula
Junk and fast food industries belong to high-risk category.
High-pressure steaming, high-temperature-baking and frying are extensively used in
addition to other processes like thawing, blanching, rendering, proofing and sterilizing.
Any flaw in any of these processes may generate risks. In addition to the problems related
health and hygiene, clusters of risks are common in fast food preparation. These are
related to the use of low-grade food, destruction of or degradation in nutrients or food
quality due to high heat during fast-cooking, altered palatability due to non-enzymatic
browning (Maillard) reaction or other process to have off-flavors and off-colors, and
production of potentially toxic and mutagenic compounds. In addition, these foods are too
fatty with low roughage. Maillard reaction is deliberately sought by the manufacturers to
improve taste and look. But the reaction produce inert and water-insoluble polymers of
carbohydrates and proteins substantially reducing bioavailability of the food. There is
disproportionate nutrient density especially of fats, protein and sugar. Obesity,
diabetes, hypertension, and brain, heart and kidney problems tend to be common among those
addicted to junk foods and bottled/tinned foodstuffs.
WHO and many international agencies actively discourage Infant-Food-Formula
(IFF). During
early 80’s all the governments of the world except US came together in UN to give YES
vote to ban infant food formula. But one NO vote backed by TNCs became more powerful. Mere
availability coupled with aggressive promotion of IFF tends to change the present trend
away from breast-feeding of infants with serious health consequences. Improper dilution or
admixture coupled with difficult cleaning or poor hygienic conditions common in bottle
feeding result in too many infant deaths and diseases. Infant food formula or so-called
baby foods are inferior even as weaning food compared to traditional weaning food
fortified with diary milk and gheeu or butter or vegetable oil. Commercial baby foods may
produce plump and flabby babies but not healthy or strong babies.
9. Environmental impact of intensive agriculture
Though stressed by many countries as their development policy the
environmental cost of intensive farming is too high. It tends to pollute seriously water
and soil directly and air indirectly. It depreciates the agriculture socially and
ecologically. What is needed is agricultural self sufficiency based upon eco-friendly,
intensive and self-sustaining small farming technology practiced in Kathmandu fifty years
ago or traditional Chinese ‘gardening’ technique. The Japoos in Nepal and the
Chinese grew 10-12 vegetable and grain crops a year, since time immemorial. In Nepal that
culture is now dying.
10. Environmental impact of food waste
Food waste going directly to environment or sewage has a serious
impact in health and ecosystem. In cities where municipality operated composting and
anaerobic biodegradation facility, for the production of compost and bio-energy, is absent
this aggravates the pollution of rivers, ground water and soil. Wastage from food
industries if not treated and managed properly by the industrialists prior to release in
environment, particularly the sewage systems or river would erode health and environment.
Such practice should be dealt as criminal offense.
11. Food Intolerance/Allergy
Some people are allergic to some food. Diarrhea and vomiting in a
few babies may be due to milk allergy (related to lactose or milk-protein) although the
prevalence of milk intolerance is far less in developing countries compared to developed
ones. A reliable system of diagnosis and management of infant’s milk intolerance
exists in all countries. Allergy to natural food is less common and less serious compared
to additives in food and untraditional or inedible varieties.
12. Conclusion
Food security needs be expressed in holistic context. The world
produces food far above the needs of the global requirement. It is not only the question
of quantity of food production. When we carefully analyze the history of famine - from
potato famine of Ireland to present famine in Somalia - the cause becomes mainly human
made one rather than crop failure. Proper and judicious food management including
universal access and distribution system becomes more important. Diversity in food culture
with opportunity to have healthy and balanced multi-mix diet with a lot of fresh green
vegetables and fruits must be encouraged. People’s individual right to
self-determination, health, education, clean environment is related to issues of food
safety. Any prescribed culture or myth related to food for the benefit of some (corporate)
is violation of human rights and must be resisted.
Kathmandu, October 6, 2000
Biodata summary
Mathura P. Shrestha
Chairperson Resource Center for Primary Health Care, PO Box 117, Bagbazar,
Kathmandu,
Nepal. Email: mathura@healthnet.org.np
Indira Shrestha
Pediatrician and Honorary Member Secretary and Coordinator, ENHR Nepal Network, PO Box
117, Bagbazar, Kathmandu, Nepal.
