Guest blog GAIN: Better nutrition in cities needs strong city governments and improved governance for nutrition
Cities are facing a steep challenge to provide adequate food for their populations and to tackle the consequences of poor diets. The ´double burden of malnutrition´, whereby over-nutrition and undernutrition occur simultaneously in a given area, population group, within a family and even within an individual, is especially relevant in cities. - by Laura Platenkamp
The challenge of healthy eating in cities
Although slightly lower than in rural areas, stunting rates are still high in urban areas (39% in Sub-Saharan Africa and 30% in Asia). Occurrence of obesity, however, is considerably higher in urban than in rural areas. This has everything to do with urbanization being an important factor in changing diets: from more plant-based diets to diets with a larger share of animal protein and processed foods high in sugar, salt, and fat. This increases not only overweight and obesity but also diabetes and heart disease (IFPRI, 2017), putting an additional strain on the economy and healthcare. People in cities face different challenges in eating healthy, for example they are more dependent on getting food through markets, and are more dependent on processed foods. The availability and affordability of healthy foods is often lacking.
Finding solutions to improve nutrition in cities
Not only is there a difference between food environments and consumption patterns in cities versus rural areas, cities often also require different approaches to rural areas. Nutrition-sensitive homestead farming might work in rural areas, but not in an urban environment. Whereas regulation of street food vendors or incentivising large scale food retailers can work in cities, this is less suitable for rural areas. There are of course also interventions that can be made in both rural and urban environments, such as implementing food price subsidies or food fortification.
At GAIN we work on many such interventions to improve the consumption of nutritious and safe food for all people, especially those most vulnerable to malnutrition. When it comes to cities we believe the growth of cities not only brings challenges, but also great opportunities. Urban populations have a closer proximity to powerful decision-makers, such as mayors. There is also a trend towards decentralization of power from the national and regional level, and therefore city governments can have a big impact on improving their citizens’ nutrition.
Working with cities for better governance
How can we work in cities to improve nutrition? City governments are very important actors and they have already been active in collaborating and improving governance for nutrition. They are working together on food systems and food policies in a whole range of alliances, including the Milan Urban Food Policy Pact, C40 and ICLEI; and recognise the importance of collaborating to improve their local food systems for healthy city populations and sustainable cities. However, we need to keep advocating for inclusion of nutrition in urban policies.
Nutrition problems are still being overlooked, for example when it comes to subsidisation policies purely based on food security. It is therefore very important that nutrition issues are not seen in isolation, for example as purely the terrain of the health department of a city government. Healthy diets lie at the heart of many problems. Out of the top ten risk factors for the global burden of disease, six are related to diets. Healthy diets therefore hugely impact the health, productivity and the general sustainability of a city.
Policies need to be considered within the framework of the local food systems, and will therefore need to involve multiple government departments. Think of measures ranging from improving access to clean water and electricity (for cooling) at fresh markets, logistical infrastructure to allow fresh foods from surrounding rural areas to come into the city, licenses for retail (that favour retailers providing fresh over highly processed ones) and out-of-home eating locations (for example concerning street food vendors, fast food chains and more affordable dining options that provide healthy traditional meals), to educating consumers, and developing school programs or providing school meals. Recognising these dynamics is the first step to effectively coordinating the next one.
City governments can’t do this alone. Identifying nutrition governance structures in cities, and bringing these actors around the table is hugely important, for more effective action for nutrition. Local retailers, community groups, hospitals, chefs, universities, and schools are all important actors who influence the foods that we eat. The process should be as inclusive as possible, and where necessary connect stakeholders and support efforts for more direct accountability.
GAIN is committed to working with all stakeholders, including city governments to strengthen governance around nutrition, providing nutrition expertise to improve consumption of safe and nutritious food for all.
Laura Platenkamp, Associate Urban Nutrition at GAIN
 Abajobir, Amanuel Alemu et al. The Lancet , Volume 390 , Issue 10100 , 1345 – 1422, 2017