Secondary Cities as Catalysts for Nutritious Diets in Low- and Middle-Income Countries

The world is facing a malnutrition crisis in the midst of rising rates of urbanization; more than half of the world’s population lives in urban areas, a number that is expected to reach two-thirds by 2050, consuming 80% of the world’s food. Instead of the development of existing cities into ‘mega-cities, ' urbanization is creating a patchwork of smaller urban areas. In 2018, close to half of the world’s urban residents lived in settlements or towns with less than 500, 000 inhabitants. These settlements are classified as secondary cities and are, in terms of population, the fastest growing urban areas. Poor diets among city inhabitants are the consequence of a combination of forces. These include changes in types of occupation, particularly for women; food-environment factors; shifts in norms and attitudes regarding food; globalization of food supply chains; lack of infrastructure; post-harvest food loss and waste, etc. Secondary cities offer entry points for food system transformation. Secondary cities are characterized by strong urban-rural linkages and the opportunity for localized food production and consumption. These cities could also play a key role in enhancing resilience to food security shocks. This chapter discusses the challenge of the growing triple burden of malnutrition in urban contexts and argues for the important role of secondary cities in transforming urban food systems. Through three case studies of secondary cities in LMICs, these cities are shown as emerging players in nutrition-centered food system interventions.