It is clear that social and economic factors determine much of our diet and physical activity patterns. What we eat, how much we eat and what we do and how much we move as part of our work and recreation likely depend on social and economic status. This has been observed as human society evolved from hunter-gatherer stage to agricultural phase to industrial age. Earlier periods were times when PEOPLE EAT LESS AND MOVE MORE, maybe followed by periods when PEOPLE EAT ENOUGH AND MOVE ENOUGH. As history has shown us, the shifting trends in economy are always paralleled by changes in eating and physical activity patterns, which in turn translate to different health problems. When food is scarce, as during famine and wars, malnutrition leads to rise in communicable diseases (infections like tuberculosis, pneumonia, diarrhea). When food is abundant, as seen in many societies today, over-nutrition leads to non-communicable diseases (diabetes, hypertension, heart disease, and stroke).

Nutrition-wise, what then is the challenge of the modern times? A modified modern day pattern would be that PEOPLE EAT RIGHT AND PEOPLE MOVE RIGHT. While over-nutrition (overweight and obesity) has become a modern-day epidemic worldwide, the problem of under-nutrition (protein-calorie deficiency) remains a problem in many poor countries. Interestingly, in some countries, particularly in developing countries like the Philippines, the extremes of malnutrition exist side by side. True, we are seeing more overweight children. Just check your children’s class pictures and compare them with your own class pictures and you get the picture of the problem of over-nutritition. But observe the people in the streets as you go through your daily routine. The street children personify the problem of under-nutrition, a reflection of the great divide, the socio-economic disparity that many developing countries have to deal with in the transition to building better, stronger societies. Adequate provision of basic necessities, food in particular, is part of good governance.

It is not as simple as seeing the problem of nutrition as either lack or excess. Either problem is malnutrition in the true sense and either problem carries characteristic health problems. Asking underweight people to eat more will not solve the problem of under-nutrition and the attendant public health problems of infections, limited productivity and shortened life span. Good government will include not only providing food supply for the economically disadvantaged but also ensuring opportunities for education and employment (as the saying goes, teach them how to fish). On the other hand, simply asking overweight and obese people to eat less will solve the problem of over-nutrition and the rising rates of heart disease and non-communicable, degenerative diseases. Good government, together with good medicine, should provide for community infrastructure for healthy living (public health campaign, national health screening, safe public parks and activity centers).

Behavior modification also needs to be part of addressing nutritional issues. Some studies have noted families where parents are overweight and children are underweight or vice versa. Obviously, telling such families to eat less and to lose weight will send mixed message. Especially in societies that seem to glorify the thin, model look, simplistic approach to the problem of overweight and obesity can promote the rise of eating disorders among the young members of the family. Clearly, healthy eating will not be as easy as going back to the bygone days when things are simpler and people were thinner. Moderation is still the key and good nutrition as part of healthy lifestyle should include adequate physical activity. Today, it is but appropriate that WE EAT RIGHT AND WE MOVE RIGHT.