For the countries in the South Caucasus, health hidden costs amount to 87%, 88%, and 92% of the total quantified hidden costs of agri-food systems. In terms of the share in GDP, they subsequently comprise 18%, 16%, and 22%, respectively. These health-related hidden costs stem from labour productivity losses due to obesity and non-communicable diseases (NCDs) caused by unhealthy dietary patterns (FAO, 2023).

The occurrence of obesity among adults is similar across Armenia, Azerbaijan, and Georgia, with approximately one in every five individuals suffering from obesity in all three countries. The age-standardized death rate due to cardiovascular disease, cancer, diabetes, or chronic respiratory disease in adults aged between 30 and 70 is the lowest in Armenia (19.9), as opposed to Azerbaijan with the highest death rate of 27.2 and Georgia with a rate of 24.89. For western European countries, this indicator ranges from 8 to 12, thus indicating that South Caucasus death rates are almost double the values in Western Europe, and slightly higher than in Eastern Europe where the rate ranges between 16 and 26.

All three countries are dependent on food imports and maintain a negative trade balance for agri-food products. In light of their import dependency, and the predominant focus on the availability and affordability of basic food staples in the South Caucasus, prioritizing nutrition within policy agendas remains limited. Despite the consensus among stakeholders regarding the detrimental impact of unhealthy diets on obesity and non-communicable diseases, concerted efforts to address this issue are still inadequate. Currently, there is also a noticeable absence of collective action among stakeholders across the three countries to tackle the challenge of unhealthy dietary patterns.

Moreover, a notable gap in understanding persists among stakeholders regarding the interconnectedness of various sectors, beyond healthcare, for the promotion of healthy diets. The potential role of transforming agri-food systems to advance nutrition and healthy diets, and alleviate concealed health costs, remains largely unexplored in all three countries.

The dietary patterns observed across the three countries equally share commonalities, with cereals serving as a significant contributor to the energy intake of their populations. Traditional staples such as lavash, a type of salty flatbread, hold cultural significance in these regions, thereby contributing to the challenge of altering local dietary habits.