WASHINGTON, Jan. 15, 2013 – A new report by Oxfam America ranks the United States 21st out of 125 on its index of best countries to eat in around the world. The group’s Good Enough to Eat Index is meant to give “a rounded picture of how well people across the globe eat,” the international development organization said in report, while noting both developed and developing countries often fall short of providing their residents with healthy food. “Few countries are deserving of silver service status, with obesity, food prices and nutrition rates undermining the records of many of the richest countries – a burden which often weighs heaviest on their poorest citizens,” Oxfam said.

Using data from the United Nations’ Food and Agriculture Organization (FAO), the World Health Organization (WHO) and the International Labor Organization, Oxfam found that while Americans generally have enough to eat and benefit from some of the best quality and cheapest food in the world, the country suffers from high rates of obesity and diabetes. According to the Centers for Disease Control and Prevention, more than a third of U.S. adults are obese.  About 10.9 million U.S. residents aged 65 or older, or almost 27 percent of that population, had diabetes in 2010.

The rankings point to a tricky balancing act within U.S. food policy. Farming subsidies – like those authorized by recent farm bills – are at least partially responsible for the low-cost, high quality food that many Americans enjoy. But some argue that same subsidy system lowers the production costs for commodities like corn and soybeans, making the highly processed foods created from those products cheaper and more readily available than healthier options.

The best places to eat, according to Oxfam America: Netherlands, France and Switzerland. And the bottom three: Ethiopia, Angola and Chad, all of which suffer from severe undernourishment, poor food quality and inflation.

In Angola, for example, “high and unstable inflation across the whole economy over the past decade [makes] it harder for Angolans to save and pay for basic needs, including food,” the report’s authors write. “In Angola, 60 percent of people’s diet is made up of simple carbohydrates and almost half of the population does not have access to clean water in order to prepare their food in safe and hygienic conditions.”

Oxfam used four metrics to determine their rankings: whether people have enough to eat; whether people can afford to eat; whether the food available is clean and safe; and if people's diets lead to unhealthy outcomes like obesity and diabetes. Oxfam estimates 840 million people, or about one in eight, suffer from chronic hunger.

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