The world is seriously off track to meet global nutrition targets. In fact, in some countries, statistics are moving in the wrong direction.
Stunting remains a widespread problem, with nearly 148 million children affected, while at the other end of the spectrum, millions of adults are either struggling with obesity or suffering from non-communicable diseases (NCDs). A staggering 1.6 billion young children and women suffer from the lack of one or more essential vitamins or minerals. This doesn’t just impact their health, it also has dire consequences for their growth, learning, productivity, with lasting impacts at the community and country level.
Malnutrition has many causes—such as lack of clean water or access to healthcare—but diets are always a central driver. Yet in 2023, 2.8 billion people could not afford a healthy diet. That same year, child undernutrition and micronutrient deficiencies cost $761 billion – the equivalent of 1 percent of global GDP – while adult overweight and obesity added another 2.2 percent to global GDP losses.
What are the concrete implications for developing economies, and how can they respond? To move from analysis to action, the Food and Agriculture Organization (FAO) and the World Bank have developed a methodology to assess the direct and hidden costs of unhealthy diets, and tested it in two countries.
A closer look at diets
Our new report, “Uncovering the Cost of Unhealthy Diets: A New Methodology and Country Applications in Ethiopia and the Philippines”, calculates the costs of unhealthy diets isolated from known factors such as lack of sanitation or access to clean water.
The test countries, Ethiopia and the Philippines, are both characterized by early childhood undernutrition and increased exposure to NCDs. While their development contexts and dietary patterns are different, stunting remains high in both contexts, with obesity and related non-communicable diseases (NCDs) on the rise.
We collaborated with national research institutes and policymakers in Manila and Addis Ababa to characterize what people eat using a holistic score of diet quality— known as the Global Diet Quality Score (GDQS). We used existing dietary intake surveys in each country to calculate the GDQS which considers both what people eat and how much.
Both good and bad news emerged from the data. For example, in Ethiopia, intake of traditional whole grains was high and consumption of sugary foods and drinks comparatively low, but diets lacked diversity of other foods such as fruits and vegetables. In the Philippines, while diet diversity was slightly higher, diets were dominated by refined rice, a less healthy alternative to whole grains, and there was higher consumption of sweet and processed meat in cities around the country. Consumption of fruits, vegetables and other nutrient dense foods were also low in the Philippines.
“The Philippines stands at a crossroads: While our economy surges, ensuring every Filipino has consistent access to affordable, nutritious food remains a key focus. That’s why we are committed to tapping into our natural wealth, forging strong partnerships, and championing policies that make food security and resilience a reality for all.”
Secretary of Agriculture, Francisco Tiu Laurel, Jr., The Philippines
What are the hidden costs of these diets?
We then estimated the potential economic losses resulting from unhealthy diets. We factored in productivity losses, treatment costs, and premature deaths from causes such as stunting and from obesity and diet-related risk factors such as high blood pressure and high fasting blood glucose, which reflects blood sugar levels after several hours without eating.
Updated estimates using the new method revealed significant economic costs. The diet-related cost of stunting was 0.85 percent of GDP in the Philippines and 3 percent in Ethiopia in 2023. The cost of NCDs due to overweight and obesity, high blood pressure, and high blood glucose was 6.3 percent of GDP in the Philippines in 2021 and 1.7 percent of GDP in Ethiopia in 2019.
While factors beyond diets—such as public health and nutrition services—accounted for half of the losses linked to child stunting, the other half was driven solely by poor diets, making the latter a major driver of undernutrition and its associated costs in both Ethiopia and the Philippines.
Our findings highlight how the economic costs associated with unhealthy diets shift as the nature of malnutrition changes in countries. In Ethiopia, where stunting is still much higher than in the Philippines, the economic costs still far outweigh costs of NCDs attributable to diets. In contrast, the Philippines has made progress in reducing stunting but faces higher rates of obesity—resulting in the costs of NCDs surpassing those linked to stunting.
While addressing all forms of malnutrition is essential, these differences in economic costs can help inform agrifood system priorities to improve access to and consumption of healthy diets. In Ethiopia, for example, promoting crop diversification and strengthening connections between rural producers and urban markets might favor the availability and affordability of diverse nutritious foods. In the Philippines, on the other hand, combatting the widespread availability of cheap ultra processed foods could result in cost savings for individuals, households, and the health industry.
In March 2025 the United Nations Statistical Commission accepted minimum dietary diversity as a new indicator to track progress for SDG2. That is a step in the right direction. Collecting more detailed dietary intake data is another important tool to inform the transformation of agrifood systems, so that everyone, everywhere has access to a healthy diet. Now is the time to act!.
Source : World Bank
