While the blogosphere erupts in response to Covid-19 with articles on a range of food concerns including, food security, hunger, and food supply chains, the pandemic’s risk to increase obesity and overweight rates remains largely undiscussed.
Obesity and undernutrition: a global crisis
A person can be overweight or obese and still be malnourished as a result of a diet that’s high in fat and sugar but low in essential vitamins and minerals. It is the only category of malnutrition that is increasing globally. The recently released 2020 Joint Child Malnutrition Estimates, suggest that 38 million or 5.6 per cent of children globally, under the age of five, are overweight. In 2016, 1.9 billion or 39 per cent of adults (18 years and older) were overweight, with 13 per cent being obese.
What was once considered solely a high-income country public health crisis has moved through the catalyst of nutrition transition and rapid urbanisation to a malnutrition crisis in lower- and middle-income countries, where 45 per cent of overweight children live. While policymakers’ attention continues to focus on stunting and wasting, more individuals are obese or overweight than underweight globally. More deaths occur globally from overweight and obese complications than from the other forms of malnutrition. With the Covid-19 pandemic, will we see an exacerbation of overweight malnutrition?
We are physically less active
As increasing swaths of the global population are directed to stay home to reduce Covid-19 transmission rates, sedentary activities and screen time increase; data shows that online video game time has increased by up to 75 per cent on some sites. The risk of weight gain is higher for those living in urban small apartment settings; whose existing economic and racial disparities confronted by an inequitable society invoke comorbidity. Limited physical activity is directly correlated with an increase in weight gain and an increased risk of metabolic diseases. The closure of facilities that foster physical activity, such as gyms, parks, playgrounds and group weight-loss programmes, also contributes. In the United States, the anticipated doubling in length of summer recess this year due to social distancing measures, has led Public Health scientists to predict the Covid-19 pandemic will foster increased rates of childhood obesity.
We are consuming more high-calorie, low-nutrient foods
In response to overwhelming demand and initial fear stockpiling, UK supermarket sales are up 20.6 per cent, with shelf-stable and frozen food purchasing up 28 per cent, in year-to-year comparisons of March, rationing on certain staple goods is in effect at many supermarkets across the UK. The pandemic is fuelling dependence on shelf-stable ultra-processed products and canned foods. These products often contain significant portions of the daily recommended levels of sodium, fat, and sugar. The relationship between decreases in physical activity and increases in consumption of food and beverages that exceed individual energy requirements sets the stage for increased risk of overweight and obesity. Additionally, should social isolation and stay-at-home measures extend on a global scale, fractures and stresses to long supply chains may result in decreases in the availability of fresh produce, a key to successfully managing weight. The Covid-19 pandemic is fostering an obesogenic environment by prompting an increase of consumption of high-caloric, low-nutritionally dense ultra-processed convenience foods.
This problem can be compounded when households lack decent food storage systems, equipment and cooking knowledge. With many restaurants and fast-food chains closed in quarantined locations, reliance on home-cooking is at an all-time high. Access to appropriate food storage facilities, refrigerators, and adequate cooking equipment is unfortunately not commonplace. Cooking is an area of concern as it is too commonly a lost knowledge form; attributed to the rise of heat-and-serve products as women, generally the preparers of food, face double burdens of working outside of the home and caring for the family, and the influx of residential microwaves fostering ease and reduced burden of cooking scratch meals. These alterations in social lifestyles dramatically intensify dependence on pre-cooked foods or ultra-processed products; products that are associated with increased weight gain.
We are snacking more in response to trauma
The health concerns of Covid-19 coupled with the mental load and increased weathering of collective stress, grief, and fear, is resulting in an increase in the frequency of snacking on convenience foods. In China, 90 per cent of consumers bought snacks during the pandemic, with 50 per cent of consumers increasing their snack purchases. Particularly, purchases of ultra-processed cookies, salty snacks, and ice cream are at an all-time high. While this is a predicted physiological response, as brain chemicals alter as a response to high stress and uncertainty, the side-effect can be eating in excess of individual energy requirements prompting concern for growing overweight malnutrition.
What can be done to mitigate increasing rates of overweight and obesity during the Covid-19pandemic ?
- Governments deploying food boxes to protect those shielding at home or confined to low-income housing with no access to fresh food markets should consider including public health nutritionists and registered dieticians in decision making.
- Social media can be used to encourage healthy behaviour of at-home physical activities and nutritious food consumption.
- Local food suppliers no longer supplying local businesses are encouraged to deploy local purchasing and community-supported agriculture boxes containing fresh produce and whole processed foods.
- To address the heightened risk of childhood overweight and obesity, schools can consider including physical activity programming as part of the virtual school day. However, success depends on the luxury of stable internet connectivity and extra-screens for children.
- Chain and corner grocers can prominently display fresh, frozen and unprocessed produce and processed whole foods to promote purchase over ultra-processed shelf-stable products; and influence the behaviour of purchasing.
- Cash donations should be made to charities and food banks, as the purchasing power of these entities goes farther than individual food donations.
- Actions taken in local communities (such as providing free or low-cost food through food banks) and globally (such as multilateral, coordinated responses to improve health systems) should be reviewed for transferability.
As the Covid-19 pandemic exacerbates vulnerabilities and increases malnutrition concerns, the obesogenic environment fostered by increased physical inactivity, deterioration of mental health, and consumption of ultra-processed shelf-stable products must be addressed. If we fail, the global obesity pandemic will flourish.
Sarah Stever is currently studying an MA in Food and Development at the Institute of Development Studies.