Beyond food and nutrition: How can cities be made healthy?

Urbanization is one of the predominant demographic trends of the late 20th century, with populations in developing countries moving in ever greater numbers from the rural countryside to cities of all sizes. The nutrition community is logically mostly fixated on issues of intake of foods and determination by nutritional status, and see urbanization and urban populations through that prism. Aside from assorted positive implications for better nutrition and health of urbanization, urban residence can have negative trade-offs including: social deterioration with drugs, crime and homelessness; sedentarism; and chemical, radiation, noise and illumination pollution. Pollution interacts with diet to the extent that there is balancing to be accomplished between the freeradical damage of pollutants and dietary antioxidants. Environmental lead contamination continues to be a problem in Jakarta, Indonesia. Sedentarism and lack of solar exposure in cities has negative implications for bone health, and risks for osteoporosis. Moreover, the processes in rural areas to produce agricultural products for urban populations can produce airborne pollutants that flow to cities, affecting the quality of urban life. Given these considerations, pollution and environmental factors should be added to the alimentary and healthrelated determinants often placed into the causal models for malnutrition used for planning policy and programs by international agencies.