The Vital Role of Nutrition in Climate Resilience and Food Security in Southeast Asia

INTRODUCTION

While Southeast Asia is famous for being a culinary powerhouse, the region is increasingly food insecure due to climate change. Several Southeast Asian nations are already increasing food supplies by increasing staple food production, stockpiling, securing imports, and, in some cases, banning exports. While these can contribute much-needed calories, further attention needs to be paid to the effects of climate change on nutrition – not only carbohydrates and proteins, but also vitamins, minerals and roughage – to sustain the resilience and health of its people.

The 2016 ASEAN Regional Report on Nutrition Security found that “an alarming proportion of children, adolescents and adults in the region suffer from malnutrition and consume poor-quality diets in the region”. While Southeast Asia has benefited from decades of social and economic progress, it is estimated that 46 per cent of its population cannot afford a healthy diet. Many Southeast Asians still face economic, social, physical and cultural barriers to their consumption of nutritious diets, particularly minorities, women and children. 

In response to the sobering aforementioned Report, ASEAN leaders adopted the Declaration of Ending All Forms of Malnutrition in 2018, and also the ASEAN Strategic Framework and Action Plan on Nutrition 2018-2030. As part of the latter, an ASEAN Food and Nutrition Security Report is to be published every five years; the first was completed in 2022, which considered progress among ASEAN Member States to be “too slow” to meet the 2025 Global Nutrition target (to improve maternal, infant and young child nutrition) or the Sustainable Development Goal (SDG) 2 (Zero Hunger) by 2030.

While Southeast Asia has benefited from decades of social and economic progress, it is estimated that 46 per cent of its population cannot afford a healthy diet.

THE STATE OF MALNUTRITION IN SOUTHEAST ASIA

Malnutrition is generally defined as not getting the right amount or balance of food and nutrients. There are two main types of malnutrition: undernutrition and overnutrition.

Undernutrition relates to deficiencies in vitamins and minerals, being underweight (low weight for age), stunting (too short for age), wasting (too thin for height) and micronutrient deficiencies or insufficiencies (a lack of important vitamins and minerals). 24 per cent of Southeast Asians – or one in four – do not consume enough essential vitamins, minerals and trace elements. Segments of Southeast Asians hold food taboos that affect the diversity of their consumption; they avoid meat, fruit, vegetables or other nutritious foods.

Overnutrition relates to imbalanced nutrition resulting from caloric intake from food and drinks exceeding energy requirements, leading to overweight, obesity and non-communicable diseases (NDCs) such as heart disease, stroke, diabetes and cancer. Those overweight at a young age are at higher risk of NDCs later in life.  

Malnutrition among infants and children is a particularly worrying condition since it has lifelong consequences. Children affected by stunting may never reach their potential in growth, motor development, or brain/cognitive capacity; this impacts “school readiness, earning potential as adults and ability to fully participate and contribute to society.” UNICEF has found that “Every dollar spent on nutrition in the first 1,000 days of a child’s life saves $45 USD on average” in health-related costs. Gender inequality contributes to generational malnutrition, with women facing challenges in accessing health and nutrition services for themselves and their children.

People in the ASEAN region have a high prevalence of underweight and overweight populations — the double burden, albeit that this differs across countries. Overweight rates among adolescents (5-19 years old) in Malaysia, Brunei, Singapore, Thailand, and Vietnam are higher than the global rates, while Myanmar, Vietnam, and Cambodia show higher than global average underweight rates in the same age group (Figure 1).

Figure 1: Percentage of overweight or thinness in children and adolescents in SE Asia

The causes of malnutrition are varied and multifaceted. While conflict remains the primary cause of hunger globally, in Southeast Asia, food price inflation is the primary cause of lack of access to a diversity of nutritious food. Food prices have been on an upward trend in Southeast Asia (Figure 2). This remains the case even while GDP per capita remains relatively stagnant. In recent years, the COVID-19 pandemic is estimated to have resulted in nearly three in four households experiencing a decline in income due to lockdowns, mobility restrictions, and border closures. According to the Food and Agriculture Organization of the United Nations (FAO), in 2021, 55 per cent of Southeast Asians were unable to afford nutritious whole foods. One indication is the low uptake of vegetables (figure 3), with only Vietnam and Laos consuming a quantity of vegetables above World Health Organisation (WHO) recommendations (see Figure 3). This has implications for malnutrition; according to a recent study, a 5 per cent increase in real prices increases the likelihood of wasting and severe wasting by 9 and 14 per cent, respectively, particularly among children under five years old.

Climate change is also emerging as a cause of chronic hunger. Locations most susceptible to its effects are those already grappling with elevated levels of hunger or malnutrition. In Southeast Asia, populations that experience devastations, such as typhoons or prolonged heat waves, are increasingly facing higher food insecurity.

Figure 2: Inflation rate in Southeast Asia between 2017 and 2023

Figure 3: Intake of vegetables annually (2021 data)

Another contributing factor of malnutrition in Southeast Asia is the high incidence of foodborne diseases (FBD). Two out of five diarrhoeal infections in the region are due to food, and approximately 52 million people in the region fall ill annually due to unsafe foods. Toxins and pathogens in food can arise across the supply chain. For example, crops can be contaminated before harvest if fields are irrigated with contaminated water, while livestock may be infected by various parasites and pathogens. Poor hygiene, limited awareness, and food fraud worsen the risks. High use of antibiotics in livestock farming has built antimicrobial resistance, impeding recovery in human populations. FBD escalates undernutrition’s impact on immunity and disease susceptibility. Thus, food safety is essential to ensure the efficient utilisation of nutrients in food. Unsafe food in informal markets is the largest source of FBD across low- and middle-income countries and needs to be improved, especially since such markets are frequented by 70 to 90 per cent of the population across emerging Asia.

Urbanisation is another factor worsening malnutrition. Since 2019, more than half of Southeast Asia’s 600 million people have been living in cities, and this number is expected to grow by another 90 million by 2030. While urban dwellers generally have greater access to a diversity of foods, according to the International Food Policy Research Institute (IFPRI), cities are increasingly facing the double burden of both under-nutrition and over-nutrition due to the intake of cheap, high calorie, high sugar foods. Many extremely poor urban households spend more than half their budget on these foods and have limited means to pay for dearer, healthier whole food options. As more women work, dependence on purchased and convenience food increases, making households more vulnerable to food price shocks. Mass media and marketing are also more prevalent in urban areas, influencing consumer preference toward energy-dense sugary/oily/salty foods that promote low-quality diets. Poor social and informal safety nets in cities also impact the urban poor. The urban poor also have limited access to safe drinking water, sanitation and healthcare.

GOOD NUTRITION VERSUS CLIMATE CHANGE

Nutrition resilience can be defined as “the capacities that enable multiple systems to prepare for, respond to and recover from crises in ways that safeguard diets, services and practices and contribute to equitable nutrition outcomes, with a focus on the most vulnerable.” Individuals with good nutrition have better health outcomes and stored energy, and are able to increase their educational achievements, their earning potential, and their ability to cope with stresses. In turn, households that are nutrition-secure are better at handling crises and recovering from external shocks. Reaching the 2030 Sustainable Development Goals, particularly SDG2: Zero Hunger, hinges on the capacity to enhance the resilience of individuals, communities, and the systems they depend on.

Climate change is undermining nutrition resilience in different ways. The increasing levels of carbon dioxide in the atmosphere, sea level rise, and frequency and severity of extreme weather events affect crop yields, soil fertility, pest resistance, and losses along the whole value chain. Beyond the destruction or decline of agriculture production and disablement of the value chain infrastructure, changes in carbon dioxide content and temperature levels are expected to reduce the availability of micronutrients in food, particularly zinc, iron and vitamins. Rice grown under higher carbon dioxide concentrations, for example, has been found to be more deficient in B vitamins by 17-30 per cent. Thus, climate change is projected to reduce not only the quantity but also the quality of food available.

Furthermore, climate change has resulted in internal displacement, leading to loss of livelihoods, agricultural land and community resilience. Between 2010 and 2021, the Asia Pacific region documented 225.3 million internal displacements triggered by disasters.

Southeast Asia’s displacement of persons has been considerable as well. In 2021 alone, natural disasters forced a high number of displacements in the Philippines (5,681,000), Indonesia (749,000), Vietnam (780,000) and Myanmar (158,000). The impact of displacement on nutrition levels in Southeast Asia is challenging to quantify, but one study in Nigeria found that displacement is associated with a 57 per cent increase in likelihood of acute malnutrition. Floods and storms are the primary drivers of disaster-induced displacements in the region, accounting for over 80 per cent of such occurrences between 2008 and 2020.

Climate change is undermining nutrition resilience in different ways. The increasing levels of carbon dioxide in the atmosphere, sea level rise, and frequency and severity of extreme weather events affect crop yields, soil fertility, pest resistance, and losses along the whole value chain.

Even for those not displaced, climate change-related impacts such as floods, heat waves and drought impact nutrition levels. Households have been found to have lower food quality and quantity, poorer hygiene practices leading to foodborne diseases, higher food prices and increased cases of water-borne diseases. Women’s time and work burden also increases, which impacts the care and feeding practices of infants and young children.

PROPOSALS FOR GREATER RESILIENCE

Policy recommendations to improve nutrition in Southeast Asia are extensively covered in the ASEAN Secretariat’s ASEAN Food and Nutrition Security Report 2021. They include recommendations to scale up nutrition delivery services to vulnerable and disadvantaged groups (particularly mothers and children), enhance multi-stakeholder coherence, resource mobilisation and regulations, build multi-sectoral capacity to improve nutrition advocacy, research, surveillance and service delivery, and improve monitoring and evaluation through the ASEAN Nutrition Surveillance System.

Beyond these, and in recognition of climate change impact on agriculture and the food system, more measures are needed:

1. Transporting, storing and marketing of perishable whole foods, or facilitating options for healthy light processing to improve shelf life of foods are necessary, and may include training on safe post-harvest handling methods to preserve the shelf-life and quality of foods.
2. This is to ensure that vulnerable communities have access to more than just calories, and to well-balanced diets that include healthy whole foods, fortified food rations, and micronutrient supplements. It could include school meals, vouchers or other conditional transfers that include access to nutritious foods.
3. to enhance nutrition literacy and reduce agriculture-sourced-carbon. Home or community gardens can be cashless sources of nutritious foods.
4. Agriculture products that have nutrients bred into them, such as folate, zinc, vitamin K etc, and that can be re-sown the following season should be promoted. This would ensure that micronutrients are available through various staple foods such as high-zinc rice/ wheat varieties or high-iron beans.

Southeast Asia’s hard-won reductions in malnutrition rates can rapidly be upended by increasingly frequent and worsening hazards brought on by climate change. Besides battling food price inflation, as many countries in the region have been doing, governments need to take a broader view on food and health. Addressing foodborne diseases, and improving healthy farming practices and child and maternal health all contribute to public health. Beyond that, governments should continuously ensure their residents are able to adapt to external shocks. Future food security or resilience policies should also take into account nutrition in its conceptualisation and implementation.

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This is an adapted version of ISEAS Perspective 2024/60 published on 7 August 2024. The paper and its references can be accessed at this link.