Rethinking the Balance Between Future Obesity and Malnutrition with Climate Change


jeremy fisch headshot
Principal Investigator
  • Associate Professor, Health Policy
Senior Fellow, Emeritus
  • Professor, Economics, Emeritus
  • Senior Fellow, Stanford Woods Institute
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  • Gloria and Richard Kushel Director of the Center on Food Security and the Environment
  • Professor, Earth System Science
  • William Wrigley Fellow at the Stanford Woods Institute for the Environment
  • Senior Fellow at the Freeman Spogli Institute for International Studies
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Uma Chandra Mouli Natchu
Translation Health Science and Technology, Institute, India
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Bata Rajaratnam
Stanford University

As India's middle class has expanded, the nation's public health concerns have shifted. Obesity rates have risen, coinciding with a surge in diabetes. The number of Indians with type 2 diabetes is expected to double by 2030 to nearly 80 million. Meanwhile, 43 percent of children in India are underweight.

Developing countries will face the considerable and simultaneous challenges of over- and under-nutrition in the next decades. In India, for example, increases in obesity-related diseases are predicted to accelerate even as large segments of the population remain undernourished and at risk for malnutrition-related conditions like diarrheal illnesses. At the same time, climate change and groundwater depletion threaten to substantially alter past trends in food availability, with likely ramifications for India's future nutritional landscape, rural-urban migration patterns, and disease burdens.

Even more concerning than upward trends in average temperatures is the increase of volatility in which extreme temperatures and weather threaten massive crop failure for Indian States in which they occur. Although climate and health are linked, policies typically focus separately on over and under-nutrition and do not consider climate change, particularly the threat of increased volatility.

From a public health perspective I don't think that we can focus solely on undernutrition or on obesity. Both are important. Their interplay produces complex policy challenges.
- Jeremy Goldhaber-Fiebert

The goal of this project is to develop a framework to evaluate nutrition-related health policies that explicitly considers how climate change may alter the expected balance of over- and under-nutrition in the future. We aim to: 1) develop climate and agricultural production models to predict food availability and consumption in India, accounting for future climate change at a State level and at an annual time resolution; 2) extend nutrition and health models to cover malnutrition and obesity-related health in urban and rural India that are linked to models in Aim 1 and include rural-urban migration; 3) begin work on policy analyses with local stake holders to identify promising combinations of climate, agriculture, and health policies using the combined model.