As we know, diet is a powerful determinant of health.

Eating habits and lifestyles can significantly affect health and quality of life. Today, the global situation is characterized—according to the FAO—by a paradox in food and nutrition.

On the one hand, food scarcity affects many developing countries, and undernutrition causes the death of millions of people each year, especially children. On the other hand, particularly in high-income countries—but increasingly also in low-resource settings—overweight and obesity represent a serious public health issue, as they are linked to the rise of non-communicable diseases.

The most common situation in low-income countries is the coexistence of a still high prevalence of child malnutrition alongside a growing increase in overweight and obesity among adults. In particular, child malnutrition remains a current and extremely serious problem in developing countries, especially in Asia and sub-Saharan Africa.

Since its inception in 2002, the DREAM program of the Community of Sant’Egidio has been designed as a program to combat HIV/AIDS while also addressing malnutrition.

A key priority of DREAM has been—and continues to be—breaking the vicious cycle that links AIDS and malnutrition.

Improving the nutritional status of people living with HIV also improves their survival. Protecting patients’ nutritional status slows disease progression. DREAM pays special attention to preventing and treating malnutrition in affected individuals and in children born to HIV-positive women, through the distribution of food packages to those who are malnourished or at risk of malnutrition. These distributions take place at DREAM centers, in conjunction with patients’ medical appointments, and also serve as a tool to strengthen adherence to treatment.

The food packages consist of staple foods that can be used by the whole family, and nutritional support is always accompanied by individual or group sessions on healthy eating, mainly conducted by non-medical staff.

Special attention, also in the nutritional field, is given to the mother-child pair.

Improving the quality of nutrition in pregnant women reduces the percentage of low birth weight babies, lowers rates of child malnutrition, and decreases mortality in the early years of life. Specific sessions on child feeding, sometimes accompanied by practical demonstrations, help teach mothers how to properly feed their children during weaning—a critical phase in which malnutrition often arises.

To help many children grow and eat in a healthy way, DREAM has established four nutritional centers (two in Malawi and two in Mozambique), where more than 1,200 preschool and school-age children receive a complete and nutritious meal every day. These are vulnerable children, often orphans or street children.

In recent years, however, DREAM has had to face new challenges: the increase of overweight and obesity in Africa as well, particularly among urban populations and those with greater economic means. It is a challenge that requires addressing both undernutrition and overnutrition within the same societies.

DREAM 2.0 is fully positioned within this context, focusing on the fight against non-communicable diseases and therefore on promoting healthier eating behaviors among the adult population—such as the consumption of high-quality fats, reducing refined carbohydrates while increasing whole grains, boosting fruit and vegetable intake, and encouraging physical activity—all of which are key factors in the prevention and control of chronic diseases.

Education and health promotion remain fundamental aspects, both for patients and for healthcare workers themselves.