# **3. Food consumption**

What do people in Pakistan eat? We discuss household food consumption in the country, mainly based on studies that convert quantities of purchased, received, and produced food items as reported by households into calories and nutrients.<sup>10, 11</sup> The studies examine the level and composition of household food consumption. While the international evidence is inconsistent, studies find that both the amount of calories consumed and the degree of dietary diversity are associated with child nutrition status (Pangaribowo, Gerber, and Torero 2013; Arimond and Ruel 2004). We recognize that household access to sufficient food is considered to be just one factor that influences child nutrition status indirectly through adequate nutrient intake (United Nations Children’s Fund [UNICEF] 1998). However, we provide a separate treatment of food consumption here to bring in a literature that is at times under-discussed in reviews of the evidence related to nutrition.

_Level and source of food consumption_ : Based on 2013–14 national Household Integrated Economic Survey (HIES) data, World Bank (2016a) finds that the average daily household caloric consumption per adult equivalent is 2,033 calories, which is 13% lower than the officially recommended level of 2,350 calories. Average caloric consumption of households in the poorest consumption expenditure quintile (the poorest households), at 1,570 calories, is 23% lower than the recommended level, and 27% lower than the average caloric consumption of households in the richest consumption expenditure quintile (the richest households), at 2,501 calories. Average caloric consumption of urban households is 10% lower than that for rural households (1,987 versus 2,105 calories).<sup>12</sup> Using national Pakistan Social and Living Standards Measurement (PSLM) survey data from 2005–06 and 2007–08, Friedman, Hong, and Hou (2011) find that, depending on which quarterly period the data are from, between 15% to 20% of calories are from own-produced food, with between 33% to 47% of households consuming some own-produced food. They also find using 2005–06 data that, on average, 47% of dairy and 34% of wheat consumed by a rural household are from own production (the corresponding statistics are 14% for meat, 2% for fruit, and 4% for vegetables).

_Composition of food consumption_ : Cereals are the main source of calories for Pakistani households. World Bank (2016a) finds that, for the poorest households, 60% of calories are from cereals, followed by 12% from oils, and 10% from sugars. The study also finds that the distribution of calories across food groups for the poorest households is similar for rural and urban areas, and that, compared to the richest households, the poorest households consume proportionately more calories from cereals and proportionately less from milk and yoghurt, meat and eggs, and fruit.

Among cereals, households obtain the most calories from wheat, followed by rice as a distant second (Malik, Nazli, and Whitney 2015; Friedman, Hong, and Hou 2011). The highly skewed

> 10 All the studies use the 2001 Food Composition Table for Pakistan for the conversions.

> 11 While we use the term household food _consumption_ in this section, household food _availability_ , through purchase, transfers, or own production, is more accurate. Household food consumption may fall below food availability because of food loss and waste.

> 12 These patterns are corroborated by Malik, Nazli, and Whitney (2015), using 2010–11 national HIES data.