On a global scale, the world is struggling with 2 nutritional crises: feast and famine. The first world is struggling with an obesity epidemic. This epidemic is costing lives, and despite many billions of dollars spent on weight-loss initiatives and diet products, it shows no signs of coming under control.[1] At the same time, the developing world is struggling to feed its children. Some 800 million people in the third world are left hungry and undernourished. This number includes 200 million children under 5 years of age; a child dies of malnutrition every 5 seconds. Another 2 billion are estimated to be deficient in some nutrients and vitamins.[2] Much of this malnutrition is chronic and happens every day out of sight of the cameras of the world's media.
Has medicine as a profession adequately addressed these challenges? Despite the enormous efforts of a small minority, it would be difficult to answer this question in the affirmative. As a subspecialty, nutritional medicine is in its infancy. The conventional forces of western medicine seem more concentrated on breaking new ground on the basic science issues of obesity.[3] Progress has undoubtedly been made in relation to understanding the molecular biology of obesity and its potential pharmacologic manipulation. However, while these advances may reduce the health risks of overeating and obesity in the developed world, millions within the developing world will still go to bed hungry.
The fundamental causes of obesity in the developed world are well recognized: overconsumption of high-energy, nutritionally poor foods, and reduced levels of exercise, ie, an excess of calorie intake over expenditure. The fundamental cause of malnutrition in the third world is a low-calorie diet, ie, a deficiency of calorie intake over expenditure. What unites the 2 halves of the global nutritional crisis into a single issue are these 2 simple realities.
So what can be done? The challenge is to create sustainable initiatives that can help those in the west to lose weight and create sustainable initiatives for food production and distribution in the third world. Calorie Transfer (http://www.calorietransfer.com) is an initiative that is looking to achieve just this and is based on a very simple concept:
For every calorie removed from a diet in the first world, 1 or more calories should be added to someone's diet in the third world.
For every dollar spent on slimming products or vitamins, a cent should be contributed to third-world nutrition.
Two mechanisms are proposed to implement this concept. At a personal level, the concept will serve to motivate individuals wanting to improve their own diet and eating habits and encourage them to try to improve the lot of someone else in the third world. This will be achieved by the Calorie Transfer Web site, which will allow direct access for people to sign up and keep a running total of the calories that they have foregone. The amount of calories that can be bought for the third world with that amount of money is also calculated and shows in the user's account. Every month the user has the option of donating that amount and can therefore see how much impact one can have on the third world.
Second, in an analogy to the Fair Trade movement, which provides endorsement for consumer products that properly support farmers in the third world, Calorie Transfer will endorse food and nutritional products that meet the terms of the Calorie Transfer charter, allowing these items to carry the Calorie Transfer logo. This charter will require the product to be ethically sourced and nutritionally sound, and will demand that a small percentage of the purchase price be donated to alleviate world hunger and promote improved nutrition in the third world.
The aim is to generate interest in world hunger at a personal level for as many people as possible, and also to provide mechanisms by which funds can be generated on a regular basis for hunger relief and development programs. As Dr. Jones noted in the introductory editorial to this eSection,[4] it is a startling statistic that the United States spends 50 times more on weight-loss products than the United Nations has for spending on hunger and famine relief.
The Calorie Transfer Organisation has simple but challenging goals:
To enhance global nutritional health by helping the first world to tackle overeating while helping to alleviate world hunger;
To increase corporate responsibility towards world hunger;
To empower individuals to promote their own health and the health of others;
To promote a healthy approach to eating in the first world;
To support sustainable food production in the developing world; and
To advocate food as a basic human right for all.
Calorie Transfer is a fledgling not-for-profit organization that is seeking support from industry, consumers, and the medical profession to achieve these goals. These are not simple challenges, but the medical profession could play a hugely beneficial role.
Readers are encouraged to respond to George Lundberg, MD, Editor of MedGenMed, for the editor's eye only or for possible publication via email: glundberg@medscape.net
References
- 1.Hedley AA, Ogden CL, Johnson CL, et al. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA. 2004;291:2847–2850. doi: 10.1001/jama.291.23.2847. [DOI] [PubMed] [Google Scholar]
- 2.Food and Agriculture Organisation of the United Nations. The State of Food Insecurity in the World 2003. Rome: United Nations Viale delle Terme di Caracalla; 2003. Available at: http://www.fao.org/documents/show_cdr.asp?url_file=/docrep/006/j0083e/j0083e00.htm Accessed January 26, 2006. [Google Scholar]
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- 4.Jones VA. Clinical Nutrition & Obesity eSection Editor's Welcome. Medscape General Medicine. 2005;7(3):79. Available at: http://www.medscape.com/viewarticle/507628 Accessed January 26, 2006. [Google Scholar]
