This healthspan–lifespan gap reflects the global rise in non-communicable diseases (NCDs), including obesity, type 2 diabetes, cardiovascular disease, and neurodegenerative disorders.  These conditions reduce quality of life, increase healthcare expenditures, and limit economic productivity.  The burden of this gap is distributed unevenly across regions, reflecting differences in developmental history, nutritional status, and health system capacity ².

Recent therapeutic advances, particularly GLP-1 receptor agonists (GLP-1 RAs), represent a major breakthrough in the treatment of metabolic disease ³.  However, their effectiveness depends not only on biological efficacy but also on affordability, accessibility, and underlying nutritional conditions.  At the same time, the drivers of disease—and therefore the strategies required for prevention—differ substantially across income settings ⁴.  Nutrition, therefore, occupies a central position at the intersection of treatment, prevention, and economic development.

Drivers of NCDs Across Economic Contexts

A central paradox in global health is that clinical management of major NCDs has become increasingly standardised worldwide, yet the underlying causes of these conditions differ substantially across levels of economic development.  While pharmacological treatments such as GLP-1 RAs act on conserved biological pathways, disease risk is shaped by developmental, nutritional, and environmental exposures that vary across populations ⁵.

In high-income countries, metabolic disease is driven primarily by long-term exposure to unhealthy food environments, sedentary lifestyles, and population ageing.  In middle- and low-income countries, however, metabolic disease risk is strongly influenced by early-life undernutrition, including foetal growth restriction and childhood stunting.  These developmental constraints permanently impair metabolic capacity, increasing vulnerability to obesity, diabetes, and cardiovascular disease later in life ^6,7.

Importantly, early-life undernutrition also impairs cognitive development, physical capacity, and long-term productivity, thereby contributing to intergenerational cycles of poverty, disease, and reduced economic growth.  These differences demonstrate that while treatment mechanisms may be biologically universal, the developmental origins of disease—and, therefore, prevention strategies—must be fundamentally differentiated across economic contexts ⁸.

How Nutrition Shapes Therapeutic Outcomes

Pharmacological treatment of obesity and type 2 diabetes follows broadly similar clinical principles worldwide.  GLP-1 RAs improve metabolic health through appetite regulation, improved insulin sensitivity, and reductions in cardiometabolic risk.  However, treatment effectiveness depends strongly on nutritional status and dietary quality.  GLP-1-induced weight loss frequently includes reductions in lean body mass, particularly in older adults and nutritionally vulnerable populations.  Without adequate protein intake and micronutrient sufficiency, treatment may accelerate sarcopenia and functional decline ⁹.

Although pharmacological treatment is biologically universal, access to both treatment and adequate nutrition vary substantially across income settings ¹⁰.  In high-income countries, access is constrained primarily by cost and lack of insurance coverage.  In middle-income countries, access is limited by both affordability and health system capacity.  In low-income countries, access remains severely restricted due to structural economic constraints, nutrition conditions, and competing health priorities.

How Nutrition Shapes NCD Prevention Across Economic Contexts

In high-income countries, prevention focuses primarily on reducing chronic exposure to unhealthy food environments that promote sustained positive energy balance, obesity, and metabolic dysfunction.  Nutritional prevention strategies emphasise increased consumption of nutrient-dense foods, dietary fibre, and high-quality protein, alongside structural interventions such as food system reform, improved urban design, and promotion of physical activity.  Because early-life undernutrition is uncommon, NCD prevention focuses primarily on mitigating the cumulative effects of excess energy intake and preserving physiological function across the lifespan ¹¹.

In middle-income countries, prevention must address the co-existence of early-life undernutrition and adult overnutrition.  Childhood stunting and foetal growth restriction permanently alter metabolism, body composition, and insulin sensitivity, increasing susceptibility to metabolic disease later in life.  These developmental adaptations result in earlier disease onset and greater disease severity.  NCD prevention, therefore, requires a life-course approach that simultaneously protects early-life nutrition and improves adult dietary quality through increased access to nutrient-dense foods and reduced reliance on foods high in fat, salt and/or sugar ⁵.

In low-income countries, NCD prevention begins with addressing persistent undernutrition and micronutrient deficiencies.  Early-life undernutrition impairs organ development, immune function, and metabolic capacity, increasing vulnerability to chronic disease later in life.  These effects also impair cognitive development and reduce economic productivity.  Prevention strategies must therefore prioritise adequate nutrition during pregnancy, infancy, and childhood, alongside food fortification, supplementation, and improved dietary diversity.  These interventions improve both immediate health outcomes and long-term metabolic resilience ¹².

Affordability Shapes Both Treatment and Prevention

Affordability represents a fundamental determinant of both treatment implementation and prevention effectiveness.  In high-income countries, healthier dietary patterns are often more expensive than unhealthier alternatives, contributing to socioeconomic disparities in disease risk.  In middle-income countries, affordability constraints limit access to both adequate early-life nutrition and healthy adult diets.  In low-income countries, affordability remains the primary barrier to achieving nutritionally adequate diets.  Improving the affordability of nutrient-dense foods represents one of the most cost-effective strategies for reducing disease burden and extending healthspan globally ¹³.

The biological mechanisms underlying metabolic disease and its treatment are broadly universal.  However, treatment effectiveness is constrained by affordability, access, and nutritional infrastructure.  In contrast, prevention strategies must differ fundamentally across income settings due to differences in developmental history, nutritional status, and metabolic capacity.  Nutrition, therefore, serves as both a determinant of treatment effectiveness and a foundational driver of prevention.

Conclusions and Future Perspectives

Closing the global healthspan–lifespan gap requires aligning therapeutic innovation with nutritional equity and affordability.  Pharmacological treatments such as GLP-1 RAs offer unprecedented opportunities to improve metabolic health.  However, their long-term effectiveness depends on access, affordability, and integration with adequate nutritional support.  NCD prevention strategies must address the developmental origins of disease, particularly the long-term effects of early-life undernutrition on metabolic capacity and human capital formation.  Future efforts must integrate pharmacological innovation, nutritional policy, and economic reform to extend healthspan and improve global health outcomes.

The Kerry Health & Nutrition Institute (KHNI) in celebration of a decade of innovation and scientific discovery, hosted a webinar on Friday, January 24th, 2025, broadcasted from Singapore.  This special event showcased key health and nutrition trends shaping consumer preferences in the South East Asia region, and explored the Future of Sustainable Nutrition with discussions led by renowned experts within the region.

The discussion focused on how the food industry can address challenges like rising food costs, changing demographics, and evolving consumer preferences.  This discussion included the following key topics:

• • Accessible Nutrition: The speakers emphasised the UN’s sustainability goal of ending hunger and addressed the rising cost of food, particularly staples like cocoa.  They discussed the need for diverse and affordable options, with a focus on reducing food waste and supporting local, sustainable agriculture.
  • Aging Population: With a focus on the growing aging population in Asia, the panel discussed the nutritional needs of older adults and how to combat age-related health issues through diet.  They highlighted the importance of nutrient-dense foods and convenient, healthy options.
  • Women’s Health: The experts explored the unique nutritional needs of women throughout their life stages, from pregnancy and lactation to menopause.  They stressed the importance of tailored nutrition strategies to support women’s health and well-being.
  • Sodium Reduction: The panel discussed the global health concern of high sodium intake and its link to non-communicable diseases.  They explored innovative approaches to reducing sodium in food products while maintaining taste and consumer satisfaction, particularly focusing on how to balance those efforts with the strong flavours and taste preferences common in Southeast Asia.

The panel also provided valuable insights on other important trends, including the role of the food industry in promoting sustainable practices, the importance of taste and convenience in food choices, and the potential of innovation and technology in addressing nutritional challenges.

Watch the full webinar above to learn more about the future of sustainable nutrition and be part of this celebration 10 years in the making!

Milk provides high‑quality protein for growth, along with calcium for bone development, B vitamins, and vitamin A for eye health.  However, ensuring access to safe milk in school lunches—particularly in developing countries—can be difficult.  When milk is unsafe, children cannot benefit from its nutritional value.

Honduras is one of the poorest countries in Latin America, where one in four children suffer chronic malnutrition.  Recurrent natural disasters and a susceptibility to the effects of climate change contribute to food insecurity.  Weather extremes such as prolonged drought and hurricanes severely affect the ability of subsistence farmers to produce enough food to feed their families.

Project Leche was a pioneering 2017-2020 partnership between Kerry Group and the United Nations World Food Programme (WFP) focused on improving school meals in Honduras by integrating sustainably produced dairy, enhancing local dairy farming, and boosting community incomes.

Image: WFP/Hetze Tosta

Kerry shared expertise in dairy, nutrition, and processing, helping create a safer milk supply and supporting WFP’s Home Grown School Meals (HGSM) program to combat malnutrition and build economic resilience.

To promote good practice at farm level, a peer-to-peer learning model was established similar to that used among Kerry’s own milk suppliers in Ireland.

In essence, “Project Leche” was Kerry’s initial flagship project with WFP, demonstrating how expertise in dairy and nutrition can support food security and economic development in vulnerable communities, a model continued in subsequent projects like Amata

In essence, Project Leche was Kerry’s initial flagship project with WFP, demonstrating how expertise in dairy and nutrition can support food security and economic development in vulnerable communities.  This program later evolved into Project Amata in Burundi.