By María José Patiño Valiente*
Diet plays a fundamental role in the development of chronic non-communicable diseases (NCDs). Scientific evidence shows that a diet rich in saturated fats with low intake of fruits or vegetables influences population health and impacts the development of obesity, diabetes and blood pressure. By analyzing the prevalence and economic cost of these diseases in their populations, several countries have designed and implemented initiatives to improve eating habits and promote a healthier lifestyle. Table A (see the end of the text) presents a summary of these initiatives.
Most of these initiatives have been implemented in high-income countries, motivated to mitigate the high prevalence of NCDs. The World Health Organization in the Global Report on NCDs has mentioned that measures to promote a healthier lifestyle and achieve a more equitable provision of health care throughout the population have contributed to the mitigation and reduction of NCDs in target populations. In addition, they saw reductions in the health cost of treating NCDs, resulting in savings in the health budgets of these countries. These international experiences show that strategies focused on empowering local consumption generate greater benefits at the population level. For example, it has been estimated that a diet based on healthier foods would help the Canadian government save $ 19 billion per year, approximately 20% of the health budget for the treatment of these diseases. However, in low- to middle-income countries, the implementation of similar initiatives has been hampered by a lack of financial resources and insufficient data on the number of people affected by these diseases.
Paraguay has its food guide. It aims to promote healthy diets and lifestyles, in order to prevent NCDs and malnutrition due to nutrient deficiencies or excesses of certain foods. However, according to the National Institute of Food and Nutrition of Paraguay (INAN), despite having this guide, other factors affect the population’s healthy food choices such as culture, lack of access to healthier options, the lack of knowledge about the nutritional content of fruits and vegetables, and the economic cost among other elements. The FAO – Paraguay office indicates that about 20% of the population does not have access to a balanced diet because they cannot afford it. This translates into undernourishment, which leads to the consumption of more affordable, but high calorie foods, heavy in fats and carbohydrates, resulting in overweight and obesity. This reality contributes to the result that 1 in 4 Paraguayans presents some degree of overweight or obesity, according to the results of the first National Survey of Risk Factors 2011.
Paraguay could make better strategic use of its natural resources in order to benefit the health of its citizens while reducing the expense of caring for them. For example, as a recent FAO report explains, the country ranks first in soybean and beef exports; however, the import value of vegetables and legumes has increased by 300% and that of fruits by more than 400%, increasing external dependence on these products. These percentages reflect the country´s inability to sustain itself agriculturally due to shortcomings in technical assistance for small rural farms, infrastructure and logistics for access to these foods. The current pandemic has shown that small scale rural agriculture has been able to contribute to the country’s food security. As mentioned in the following analysis, food produced in rural areas has been able to supply regional urban centers, shortening the supply chain of these foods and mitigating their exclusive dependence on the central market of Asunción.
Shifting to a healthier diet in order to mitigate and prevent NCDs is quite complex. It not only requires a change in the eating habits of the population, but also changes in the existing food supply. For example, some short-term, small-scale actions could involve the nutritional improvement of fat laden local products. Without changing the appearance or taste, food products could be supplemented with key micronutrients such as oils, protein blends, or healthy fibers, and allow for changes in processing. This could then lead to a clinical study where the benefits of these interventions could be evaluated in order to apply directly to the whole population.
Paraguay can make better strategic use of its natural resources in order to benefit the health of its citizens while reducing the expense of caring for them. For example, as a recent FAO report explains, the country ranks first in soybean and beef exports; however, the import value of vegetables and legumes has increased by 300% and that of fruits by more than 400%, increasing external dependence on these products.
Merely having food guides is not enough. There must also be an integrated multisectoral approach including the different parts of the government, the food industry, the media and other relevant entities so that the general population can choose a healthier diet. The agricultural sector must have a strategic role and take charge of addressing the health crisis caused by these diseases. Guaranteed food quality will reduce medical costs in health care.
* María José Patiño Valiente is an economist, graduated with honors from the National University of Asunción, Paraguay, and has a master’s degree in Agribusiness and Agricultural Economics from the University of Manitoba, Canada. She has more than 10 years of experience working for government institutions, academia and the private sector. She is currently working as an International Consultant for different companies, especially in the agri-food sector.
Illustration: Roberto Goiriz