Each year, malnutrition costs Ecuador the equivalent of 4.3% of its gross domestic product, as the resulting health burden and reduced potential productivity places an economic toll on society. That was the unsettling conclusion of the World Food Programmes 2017 report on the country, where stunting or chronic malnutrition in children under five has been persistently high for decades.
Malnutrition reached 25% between 2011 and 2015. Even so, Ecuadorian children have also been gaining too much weight. By 2014, just under 20% of school-age children in the country were overweight and another 12% were obese.
As a health-policy researcher who studies Ecuador, I know that these two problems are not as different as they seem. Malnutrition and obesity often go together, even in high-income countries like the US. Thats because insufficient sanitation, a lack of potable water, poor dietary habits and, critically, limited access to safe and nutritious foods all interact to affect peoples health status.
Ecuadorian officials must be unfamiliar with this global body of research, because they continue to offer public school kids largely unhealthy, pre-packaged snacks. If Ecuador is serious about putting the populations right to health first, as it recently declared in making ambitious commitments to the United Nations Decade of Action on Nutrition, it should start by improving school food.
Snack food nation
Heres what rural Ecuadorian children get to eat each morning at school: a couple artificially flavoured and sweetened energy bars, sugary cookies and a powdered drink mix.
Even for people who havent already had breakfast at home, this is a rather bleak menu.
Underinvestment is not the problem. In 2013, Ecuadors Ministry of Education spent US$82.5m to provide such snacks to 2.2m students in 18,000 schools. For the 2015-2019 period, it has designated US$474m roughly 3% of the countrys total education budget.
But spending does not automatically translate into well-being, nor does money alone develop valuable eating practices. The health fields traditional focus on caloric intake may have contributed to Ecuadors issue, because it has long emphasised calories over quality.
As such, Ecuadors Ministry of Public Health proudly maintains that its breakfasts for students age five to 14 provide 20% of recommended daily caloric intake.
But these averages do not account for individual childrens health statuses, body types and levels of physical activity. As a 2015 government report acknowledged, the current school snack translates into an energy overload for the youngest students and a nutritional deficit for older ones.
Theres also a strong correlation between access to processed foods which are cheap to produce and purchase but generally energy-dense and nutrient-poor and worse nutritional health among young people.
Not even students are happy with their breakfasts. Teachers and parents report that children dont like the granola bars, and they are tired of eating the same food over and over again.
With the cookie and the colada said one teacher, its just sweet and more sweet.
Food is a big business
The government defends its school food programme by arguing that it is designed to serve primarily as an educational incentive that is, it gives kids a reason to come to school and only secondarily as a source of nutrition.
But there is no scientific evidence that the school snack, alone or in combination with the free uniforms and textbooks that the government has provided since 2007, has contributed to improving educational statistics.
Ecuadors programme does, however, follow the advice of the World Bank, which asserts that meal programs are best viewed as a safety net a targeted transfer of food to the poorest or most vulnerable populations.
Well, sort of. The World Bank, a major school feeding player, has also said that school lunches can be the first line of defence against diabetes.
Amid these contradictory messages, the bank is clear on one thing: school meal programmes are big business globally. Considering that this industry is valued at US$75 billion every year, it is perhaps unsurprising that corporate interests play a role in what kids around the globe eat.
The promotional materials of TetraPak, a Swiss snack food manufacturer, features images of students from Peru and Vietnam sipping milk from their on-the-go containers. In Ecuador, top school food providers have included the international food and beverage giant Nestl, as well as Moderna Alimentos, an Ecuadorian firm 50% owned by the multinationals Seaboard and Contigroup.
These pre-packaged, one-size-fits-all foods are not just bad for kids, theyre also bad for the environment. Ecuadors government boasts of delivering cookies and energy bars to even the most remote rainforest villages, but help managing the massive new amounts of inorganic waste produced is evidently not included in the deal.
Thus, in a fragile, essential ecosystem like the Ecuadorian Amazon, garbage is now being buried or burned, or remaining in open air and waterways.
Teaching kids about food
School food is notoriously political. In the US, one of the earliest acts by Donald Trumps new Agriculture Secretary Sonny Perdue was to decelerate former first lady Michelle Obamas initiative to make public school lunches fresher and healthier.
Still, the scientific evidence is uncontested: what and how we eat as children influences dietary patterns for the rest of our lives. Ecuadors government would do better to comply with the Ministry of Public Healths basic recommendations for student nutrition, which requires food to be fresh and varied.
School menus arent just food theyre also an opportunity to teach children about food systems that are good for them and for their country. Ecuador is one of the worlds most biodiverse countries, but in 2014 it imported 64% of the raw materials for schools food offerings.
This foreign-sourced school-food assembly line sends a terrible message about how food can and should be produced, procured and served. In some US states and Europe, by contrast, government takes a more holistic and often localised approach to feeding students. In Italy, school menus nod to cultural tradition, local sourcing and food sovereignty.
Shifting away from pre-packaged handout snacks to fresher foods would help Ecuadorian students develop an appetite for healthful fare, as well as the knowledge and critical thinking skills that theyll need to push for positive change in Ecuadors delicate and unsustainable current food system.
Offering more fresh foods sourced from area farmers ideally fruits, vegetables and grains would reduce schools environmental impact, make meals healthier and boost local agricultural economies so that farmers, in turn, can invest in organic and other green growing practices.
The greatest risk factor for poor health is poverty. Its time for Ecuadors school menus to stop the snack food and start serving the future of its children.