Children’s Diets in a Changing World

The term “Anthropocene” was coined in 2000 to describe a new epoch in which human activity has made a major impact on most of the earth’s systems and living organisms [1]. Whether we yet define this formally as a new geologic epoch, and whether we define the start time as the start of the industrial revolution (c1800) or as 1950 when the “Great Acceleration” took off, there can be no doubt that we live in a rapidly changing world that brings challenges to all human activities, including how we nourish and care for our children. For public health nutritionists, these challenges have a brief history of rapid dietary and anthropomorphic change (measured in decades), a pressing series of current problems, and a worrying future that will require careful navigation if we are to sustain the huge advances in childhood and lifelong health that have been achieved in the last hundred years.

The existing and predicted future threats of climate change are the topic of numerous debates across all domains of human activity; none less active than the issue of how human dietary choices contribute to greenhouse gas production and biodiversity through their impact on agriculture, livestock production, and fisheries. These issues were addressed by the EAT-Lancet Commission whose summary report captures many of the key topics and makes a clarion call for a radical transformation of human food systems to avoid a situation in which “today’s children will inherit a planet that has been severely degraded and where much of the population will increasingly suffer from malnutrition and preventable disease” [2].

In this volume, we focus on children’s diets and address some of the extant challenges and routes to ameliorate many of the adverse effects on children’s health. A combination of increasingly successful agriculture, industrial processes that concentrate energy in foods at the expense of micronutrients and dietary fibre, and increases in purchasing power has meant that, for many in the world, excess dietary calories can be purchased for a very small proportion of disposable incomes. Marketeers have exploited this to engineer fast-food sales methods driven by super-sizing and high energy density. They combine this with a plethora of energy-saving devices, mechanization of the workplace, and the temptations of sedentary past times, and it is little wonder that the world has got fatter. In 2019, the World Health Organization (WHO) estimated that 38 million children under 5 years worldwide were overweight or obese; almost half of whom live in Asia [3]. For children 5–19 years, WHO estimates that the prevalence of overweight and obesity rose from 4% in 1975 to 18% in 2016, now amounting to a total of 380 million children [3].

In their paper “Integrated Approaches to Combatting Childhood Obesity,” Elvira Verducia and colleagues discuss the individual components of the obesogenic environment of the Anthropocene [4]. They make individual recommendations for tackling each aspect but, in common with other commentators, stress that progress against obesity will not be achieved without adopting integrated approaches to simultaneously tackle all (or at least most) of the contributory drivers.

Mazzocchi and colleagues [5] tackle the issues of how children’s diets can be made more sustainable in their paper “Health and Sustainable Nutritional Choices from Childhood: Dietary Pattern and Social Models.” Whilst stressing the fact that ensuring adequate nutrient density from predominantly plant-based diets is more challenging for children’s diets, they provide encouraging evidence from the first trials of “sustainable” diets in school settings. These trials show that children’s dietary needs can be adequately met alongside very meaningful reductions in the greenhouse gas emission and water usage of the foods used, and at a lower cost.

In his paper on “Breastfeeding in the Modern World,” Prentice [6] provides a detailed synthesis of how the data on the benefits of breastfeeding grow stronger with every new meta-analysis that is published. He presents optimistic evidence that this knowledge is helping to drive a reversal in the steady decline in breastfeeding rates across the world in recent decades, albeit a slow reversal. The vigorous application of the WHO Code on Marketing of Breast-Milk Substitutes in many countries and the support of Baby-Friendly Initiatives at community and hospital level have helped support this recovery, but risks are undermined by small local formula producers with weak (or cavalier) governance processes.

Finally, Saavedra [7] draws these threads together in a global analysis entitled “The Changing Landscape of Children’s Diet and Nutrition: New Threats, New Opportunities.” He summarizes the many recent threats to the adequacy and sustainability of children’s diets, including the recent effects of the COVID crisis that contains warnings far beyond the specifics of that particular pandemic. He ends optimistically with the view that adaptation is possible but will require humankind to “correct course where needed, and to manage threats as they arise, to create a virtuous circle where human food production and consumption meet on a healthy, sustainable plane.”

Conflict of Interest Statement

The author is a member of the Global NNI Scientific Council of the Nestlé Nutrition Institute. The writing of this article was supported by Nestlé Nutrition Institute and the author declares no other conflicts of interest.

Funding Sources

None relevant to this paper.

Author Contributions

Andrew M. Prentice conceived and wrote the editorial.

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