Healthy eating is most expensive in Latin America and the Caribbean, finds UNBMJ 2023; 380 doi: https://doi.org/10.1136/bmj.p174 (Published 23 January 2023) Cite this as: BMJ 2023;380:p174
In Latin America and the Caribbean 131 million people cannot afford to buy the foods necessary to consume enough calories each day while gaining the recommended nutrition, a United Nations report has found.
That number has gone up by eight million since 2019, according to the United Nations Overview of Food Security and Nutrition 2022.1
The average cost of a balanced, nutritious diet from the cheapest available ingredients is $3.89 per person a day in Latin America and the Caribbean, followed by Asia ($3.46), Northern America and Europe ($3.19), and Oceania ($3.07).
Unhealthy diets are contributing not only to growing undernutrition in the region but also obesity, which disproportionately affects the most vulnerable groups and deepens existing inequalities in a region with some of the highest socioeconomic disparities in the world.
“We are talking about the region of the world with the most expensive healthy diet, which particularly affects vulnerable populations—small farmers, rural women, and indigenous and Afro-descendant populations—who allocate a greater percentage of their income to the purchase of food,” said Rossana Polastri, director of the International Fund for Agricultural Development. “To reverse this situation, we must promote innovative solutions that diversify production and increase the supply of healthy food, and that improve small producers’ access to markets and quality food, including digital solutions that articulate food supply and demand.”
There is a strong relationship between the ability to afford a healthy diet and key economic metrics, such as levels of income, poverty, and inequality. Those metrics for Latin America and the Caribbean have long been unfavourable and were exacerbated by a rise in international food prices since 2020, driven by the pandemic, war in Ukraine, and climate change. Nearly a quarter (22.5%) of people in Latin America and the Caribbean cannot afford a healthy diet. In the Caribbean this figure reaches 52%; in Mesoamerica, 27.8%; and in South America, 18.4%.
A diet is healthy, according to the Food and Agriculture Organisation (FAO), when it totals 2330 calories a day while including different food groups, meeting micronutritional recommendations, and fat content does not exceed 30% of calories consumed.
The cost of a healthy diet is highest in the Caribbean, where it costs $4.23 a day, followed by South America ($3.61), and Mesoamerica ($3.47).
Those costs will probably continue to rise because of ongoing food and fuel price surges, warned Lola Castro, regional director for the World Food Programme. One way to protect populations is for governments to expand social protection networks. “The pandemic once again demonstrated that social protection is useful to improve the affordability of a healthy diet, preventing crises like this from hitting affected populations even more,” Castro said.
Mario Lubetkin, FAO assistant director and regional representative for Latin America and the Caribbean, said that a sustainable solution must be more ambitious and wider in its scope. Governments should not only bolster social security systems but launch a multisectoral strategy to help people to put healthy food on the table more easily, which targets everything from education to food production. “To contribute to the affordability of healthy diets, it is necessary to create incentives for the diversification of the production of nutritious foods aimed mainly at family farming and small scale producers, take measures for the transparency of the prices of these foods in markets and trade, and actions such as cash transfers and improving school menus,” Lubetkin said.
While Latin America and the Caribbean had made progress in reducing malnutrition in past decades, hunger and food insecurity have increased since 2014 and peaked during the pandemic. The proportion of people who are overweight and obese has also increased in the past two decades.
The only recent progress made towards meeting the region’s 2030 nutrition targets has been for exclusive breastfeeding for infants under 6 months of age, and in child stunting.
Carissa F Etienne, director of the Pan American Health Organisation, said, “We must redouble efforts to tackle malnutrition in all its forms by promoting public policies to create healthy food environments, eliminate industrially produced transfats, implement front end warning labelling, regulate advertising of unhealthy foods, tax sugary drinks, and support healthy eating and physical activity in schools. Understanding the factors that determine poor dietary practices is key to finding solutions and ensuring that everyone in the region has access to healthy foods.”