Keystones affecting sub-Saharan Africa's prospects for achieving foodsecurity through balanced diets

Abstract

Socio-economic dynamics determine the transition from diets characterized by the risk of famine, to thosecharacterized by the risk of diet-related non-communicable disease (DR-NCD). This transition is of particularconcern in Sub-Saharan Africa (SSA) in which key socio-economic interactions that influence diet includeeconomic growth and rapid urbanization; inequality and a growing middle class; and obesogenic food en-vironments and an increasing prevalence of DR-NCD. In each case, countries in SSA are among those experi-encing the most rapid change in the world. These interactions, styled as‘keystones’,affect the functioning ofother components of the food system and the diets that result. Data from the wealthiest quartile of countries inSSA suggest that these keystones may be increasing the risk of DR-NCD, widening inequalities in health out-comes due to unbalanced diets. To address this, new consumer and government capabilities that address thesekeystones are required. Food sensitive urban planning, supporting food literacy andfiscal management ofconsumption are examples.