A person’s relationship to food and nutrition is often seen in the context of needing to be in balance; too much food leads obesity, too little leads to malnutrition. Obesity and malnutrition are seen as binary opposites, however, in the neoliberal context of public health and economic development policies: malnutrition is often seen as a structural problem, caused by poverty, marginalization, and lack of resources, whereas obesity is moralized and seen as an individual choice, caused by irresponsible personal behavior. Poverty alleviation policies worldwide tend to focus on economic development and consumption, whereas weight management campaigns center around lifestyle changes and moderation.

China, for example, has pulled millions out of poverty by speedy economic growth over the last 30 years, and has decreased the incidence of malnutrition (defining malnutrition as underweight or stunting) to less than 10 percent of the population. Obesity rates, of course, have increased concurrently (along with diabetes, high cholesterol, and high blood pressure), especially in urban areas. Non-communicable diseases such as those related to ones caused by obesity have now overtaken infectious causes as the main cause of death in China.

China’s model of economic development has focused on consumerism and advancements in agriculture. This capitalistic “China model” has been wildly successful in improving access to capital, education, expanding the labor market and ameliorating malnutrition in urban areas. Rural areas, on the other hand, remain impoverished and economically underdeveloped. Malnutrition, especially among infants and children, remains commonplace. In order to understand why this nutritional divide exists in China, one must stop thinking about food as nutrition, and must instead start to think of it as part of the larger economic system.

Why We Eat What We Eat

The availability and types of foods consumed are rarely about health. Food is about demand and what people have the ability to pay for, and farmers will grow food they can sell. Agricultural land, therefore, is seen only as valuable as the goods it can produce because it is used to supply high demand commodities. Because of this, farmers do not necessarily grow food that is nutritious, but food for which there is a market.

In this way, we see large gaps between the obese and the hungry of the world. When food is treated as another commodity, one that should be packaged, marketed, sold, and consumed, markets will begin to become dependent on the growth of these commodities. These economic systems can’t grow unless people consume more, and those who cannot afford these commodities are left out.

Food Systems

In China, with speedy economic growth has come an even speedier demand for “luxury” food items such as meat and convenience foods. They are doing their part to grow the economy, but unchecked, this growth is creating a public health mess.

As urban Chinese are enjoying more economic successes, their consumption patterns are changing from a primarily vegetable and cereal based diet with few animal foods, to one that is richer in meat and calories. With increased consumption of meat comes a host of other new demands; corn, soy, water, land. Farmers must keep up with this demand, so land that was previously used for a wide variety of agricultural products to feed people is now being used to keep up with the demand for meat for the urban elite.

A Lesson in Contradictions

The argument of the necessity of unchecked economic growth is not specific to food systems. Developing economies often use this argument in terms of environmental degradation as well. It is impossible to grow an economy in this world now without ruining the environment, and it is impossible to maintain economic growth without providing people the commodities they want. Commodities include housing, air conditioning, and cars; McDonalds, packaged snack food and fancy ice cream.

Unfortunately at this time in history, we face enormous conflicts of interest in this economic growth model. Grow your economy and alleviate poverty by promoting consumption, but this consumption is ruining the planet and a causing an unprecedented decline in health.

This is difficult because growth is good for the poor. A country stuck in a pattern of low growth is stuck in poverty. China’s rapid growth and consumption has improved the lives of millions. But problems arising now include a very real coexistence between obesity and malnutrition (not to mention the gap between the wealthy and the poor).

In rural areas of China, malnutrition rates continue to be high, especially among vulnerable groups such as children and girls. Iron deficiency rates in some areas are as high as 60% among school children due to lack of meat in their diet. How ironic is it that the overabundance of one commodity among urban resident’s is causing an under-abundance among those in rural, while causing the downfall of both.

Surely good nutrition cannot be defined by the absence of malnutrition alone. An upwards of above 50% of people in urban areas are now obese. Everyday in China 3,000 new cases of type 2 diabetes are diagnosed, costing the country billions each year. But these diabetics continue to consume and help the economy grow as a whole. So where should our paradigm shift take place?

In the context of current economic growth models centered around consumption for those with capital, we will continue to see a rise in obesity simultaneous with malnutrition. But does changing this paradigm mean changing our idea of economic success? Changing our models of public health? If our only successful model of economic growth leads to a public health tragedy, where do we go from here? How can anthropologists begin to link development efforts with those of public health and nutrition?