"Obesity is a system problem, you don't have to treat it as an individual thing"

Malnutrition is an epidemic. Obesity grows around the world while people continue to be starving or don't get all the nutrients they need to develop. Spanish researcher Estefania Custodio (Madrid, 1974) is an expert in nutrition and global health and has focused her work on Sub-Saharan Africa and Latin America. She was one of the pioneers in jointly studying malnutrition and tropical diseases at the Carlos III Institute of Health. A topic that he will talk about this Wednesday in Avila at the Congress of the Spanish Society of Tropical Medicine and International Health. Custodian has been working at the European Commission's Community Research Centre since 2014. 

Ask, Is there anyone in the world who eats well?

Answer. Globally we all eat badly. Malnutrition affects all countries in the world, at all ages, regardless of social level. Collecting information about what people eat is very expensive and difficult, but for more than 20 years we know it is one of the fundamental factors of mortality and disease.&;

have we been looking at quantity more than quality for many years than in quality?

In certain contexts, such as food crises, the focus has been on the amount, basically, where there is food. But in developing countries we have also looked at the availability of food and not the variety. There have been many policies to increase agricultural production, but then we realized that malnutrition crises were not improving, because even if there was greater access to a crop, there was no diversity in the diet that would improve the growth of children.

Is malnutrition affecting the poor the most


A food transition has

taken place in the world: from a diet of self-sufficiency, with your crop and your animals at the doorstep, to one of consumption. This historic change has already occurred in Europe, but in developing countries it has occurred faster. When we abandoned self-sufficiency in Europe, we did not immediately have so many ultra-processed and cheap food at our disposal,

Are we putting in the tools to fight this malnutrition, especially in obesity?

the epidemic is here and we still lack tools. You don't have to put the focus on the individual, it's a food system problem. It's the industry, it's the production chain, it's advertising... It's a big challenge and I think we're not in a position right now that there can be a big change in this aspect,

Mothers already know that breastfeeding is best for their children. But they don't have an environment that makes it easy for them to put it into practice

What can governments do to counter these trends


Tools in the form of programs are already available. More than 80% of countries have national nutrition policy with programs that we know work. Some are undeveloped, some need more time... The hard part is often that they are funded and implemented. But this fight against malnutrition has to be given at all levels,

To what extent do cultural conditions influence to end up having a bad diet?

I think not so much anymore, that people are aware of what is good food. I always mean breastfeeding. In the research I've done, I've seen that mothers already know it's best for their children. But they don't have an environment that makes it easy for them to put it into practice. If you have to work in the city or in the countryside again it is impossible... This is where regulation comes in. Another example: people who know that it is healthiest to make you a lasagna of vegetables at home, but if you go to the supermarket and it costs you cheaper to buy it already made and also your schedules do not leave you time to cook it at home, people end up buying it packed. It's not a question of beliefs or habits, but of having possibilities,

You have developed much of his work in Sub-Saharan Africa, an area where the two problems come together: malnutrition and overweight. According to your research, especially in African countries, who decides at home what is consumed and how that influences the quality of the diet?

More than what is bought, what we study is how many resources are dedicated to food and that is usually man. The second step is to study how food is distributed at home and it is often women who consume the least nutrients. He's the man who's usually favored, because he's the one who goes out to work. Normally, he is given the animal protein. It also benefits children, who are in full development. We have just published a study conducted in a refugee camp in Somalia which concluded that when women make food decisions, children are better fed,

Without leaving Africa, Rwanda is an example of a country that has improved and much its indicators on food and child development


on the one hand they've made a political bet. They have a child development program that depends directly on the president. The plans they develop include many fronts: agriculture, education, health... Family policies have increased greatly, for example one of the most improved indicators is breastfeeding. This has been heavily influenced by women's empowerment in politics,