A/71/282 social, economic, political and cultural determinants. Poverty, social exclusion, gender inequality, low socioeconomic status and lack of control over productive resources, for example land-grabbing and seed patenting, are all major contributors to malnutrition. Similarly, malnutrition is aggravated by poor sanitation and the absence of safe drinking water and adequate housing, as well as a lack of education, health and social protection services. 19. Poverty and inequality are drivers of obesity and micr onutrient deficiency, in addition to undernutrition. Low-income populations are particularly vulnerable to obesity. Processed foods tend to be highly accessible and relatively cheap and can be stored for long periods without spoiling. In the United States of America for instance, low-income neighbourhoods often lack food retailers that sell fruits, vegetables, whole grains and alternative low-fat options. 18 Unable to afford healthier food options, individuals may become overreliant on poor -quality foods, essentially being forced to choose between economic viability and nutrition and exposed to “double malnutrition”. 19 20. Women are responsible for much of the food cultivation and preparation of family meals, but they disproportionately lack access to adequate food and are more vulnerable to malnutrition. In its general recommendation No. 34, the Committee on the Elimination of Discrimination against Women noted that rural women were among those most exposed to malnutrition and hunger. Patriarchal norms contribu te to gender inequality, with women facing systemic discrimination in accessing land and natural resources, decision-making, education and health-care services and experiencing increased vulnerability to violations of their sexual and reproductive rights. Such factors impede their ability to provide adequately nutritious foods for themselves and their families, leading to intergenerational cycles of malnutrition. 20 B. Impact of food systems 21. In the Rome Declaration on Nutrition, it was acknowledged that current food systems were being increasingly challenged to provide adequate, safe, diversified and nutrient-rich food for all that contributed to healthy diets due to, inter alia, constraints posed by resource scarcity and environmental degradation, a s well as by unsustainable production and consumption patterns, food losses and waste, and unbalanced distribution. 22. Food systems include production, processing, transport and consumption of food and are shaped by political, environmental, cultural, and socioeconomic factors. The industrial food system currently dominates the world. It focuses on increasing __________________ 18 19 20 16-13441 Lucy M. Candib, “Obesity and diabetes in vulnerable populations: reflection on proximal and distal causes”, Annals of Family Medicine, vol. 5, No. 6 (November 2007); Food Research and Action Center, “Why low-income and food-insecure people are vulnerable to obesity”, available from http://frac.org/initiatives/hunger-and-obesity/why-are-low-income-and-food-insecurepeople-vulnerable-to-obesity. Michael Via, “The malnutrition of obesity: micronutrient deficiencies that promote diabetes ”, ISRN Endocrinology, vol. 2012 (2012). Mafalda Galdames Castro and Maria Daniela Nuñez Burbano de Lara, “Gender and food sovereignty: women as active subjects in the provision of food and nutrition ”, in Right to Food and Nutrition Watch 2015: Peoples’ Nutrition Is Not a Business (2015); WFP, “Women and hunger” (see footnote 7); Save the Children, State of the World’s Mothers 2012: Nutrition in the First 1,000 Days (2012), p. 11. 7/24