The pandemics of obesity, undernutrition, and climate change are interlinked and represent the paramount challenge for humans, the environment and our planet, says a Lancet report, that presses the need for urgent action.

The report of the "Lancet Commission on Obesity", based on 14 countries including India, demonstrates the need to take a hard line against powerful commercial interests and rethink global economic incentives within the food system in order to tackle these joint pandemics termed as 'The Global Syndemic'. "We are already late, sitting at the pinnacle and action is needed at the national level as well as ground level," Shifalika Goenka, Professor at Public Health Foundation of India.

"We need our own national monitoring framework with specific indicators which help monitor the targets at ground level for drivers of undernutrition, overnutrition and climate change," added Goenka, who is also the Commissioner on the Lancet Obesity Commission. Malnutrition in all its forms, including undernutrition and obesity, is by far the biggest cause of ill health and premature death globally. Both undernutrition and obesity are expected to be made significantly worse by climate change.

"Until now, undernutrition and obesity have been seen as polar opposites of either too few or too many calories," said Professor Boyd Swinburn of the University of Auckland.

"They are both driven by the same unhealthy, inequitable food systems, underpinned by the same political economy that is single-focused on economic growth, and ignores the negative health and equity outcomes.

"Climate change has the same story of profits and power ignoring the environmental damage caused by current food systems, transportation, urban design and land use," Swinburn said.

The report explained that obesity, under nutrition, and climate change also interact with each other. For example, climate change will increase under nutrition through increased food insecurity from extreme weather events, droughts, and shifts in agriculture. Likewise, foetal and infant undernutrition increases the risk of adult obesity and the harms caused due to obesity.

Climate change may also affect prices of basic food commodities, especially fruit and vegetables, potentially increasing consumption of processed foods. Driving these 'The Global Syndemic' are food and agriculture policies, transportation, urban design and land use systems -- which in turn are driven by policies and economic incentives that promote overconsumption and inequalities. 

The report calls to establish a Framework Convention on Food Systems (FCFS) -- similar to global conventions for tobacco control and climate change -- to restrict the influence of the food industry in policy making and to mobilise national action for healthy, equitable and sustainable food systems. 

"The prevailing business model of large international food and beverage companies that focus on maximising short-term profits leads to overconsumption of nutrient-poor food and beverages in both high-income countries and increasingly in low and middle-income countries," said Richard Horton, Editor-in-Chief, The Lancet.

Led by the University of Auckland (New Zealand), the George Washington University (US), and World Obesity Federation (UK), the report is the result of a three-year project led by 43 experts from a broad range of expertise from 14 countries.