Horticulture-based food varieties, namely fruit, vegetables and nuts, are important for the daily diet as these contain micronutrients, fibre, vegetable proteins and bio-functional components. Consumption of fruits and vegetables is vital for a diversified and nutritious diet. Increasing dietary diversification is the most important factor in providing a wide range of micronutrients and this requires an adequate supply, access to and consumption of a variety of foods. However, food surveys1 show continuing low consumption of fruits and vegetables in many regions of the developing world.
Horticultural interventions combined with extensive nutrition education offer a long-term, food-based strategy to control and eliminate micronutrient malnutrition. Horticultural production, relatively easy for unskilled people, can play an important role in poverty alleviation programmes and food security initiatives, providing work and income opportunities.
Fruits and vegetables can be produced on a small scale to meet a substantial part of dietary nutrient needs at the household and community level, health centres, refugee camps and related situations. Global demand for horticultural produce is expected to grow with population, rising standards of living and awareness of the health benefits of fruit and vegetables. Dietary patterns will also change with the expected increase in per capita consumption of fruits and vegetables. Developing countries may find new opportunities for trade in fruits and vegetables, offering a comparative advantage in the context of globalization.
The Food and Agriculture Organization of the United Nations (FAO) is implementing horticulture-based programmes through field operations and normative activities. A variety of direct interventions are being implemented through field projects to improve nutrition levels and household food security in Latin America, the Caribbean, Africa, the Middle East and Asia.
The Integrated Horticulture and Nutrition Development Project (BGD/97/041), funded by the United Nations Development Programme (UNDP) and the Government of Bangladesh (GoB), was implemented by the Ministry of Agriculture (MOA) with the Department of Agricultural Extension (DAE) as the Government Executing Agency. The project demonstrated and validated the use of food-based strategies to promote food and nutritional security.
By its nature, the project was technology driven, with an emphasis on “training and demonstration” at the horticulture development and training centres (HDTCs) as well as village sites. A total of 31 400 men and women benefited directly from the training, including marginal, landless and women farmers, homestead owners, school teachers, adolescent schoolchildren, unemployed rural youth and NGOs. The project supported the formation of small, relatively homogeneous farmers’ groups in the project villages to act as a critical mass for technology transfer. This was seen as central to the project’s grassroots intervention strategy.
Cereals, largely rice, are the main food in Bangladesh. Nearly two-thirds of the daily diet consists of rice, some vegetables, a little amount of pulses and small quantities of fish if and when available. Milk, milk products and meat are consumed only occasionally and in very small amounts. Fruit consumption is seasonal and includes mainly papaya and banana which are cultivated round the year. The dietary intake of cooking oil and fat is meagre. The typical rural diet in Bangladesh is, reportedly, not well balanced.2
Traditional dietary habits often do not meet good nutritional requirements, with a preference for polished rice and leafy vegetables of poor nutritional quality. In addition, cultural norms dictate a better diet for males over females with the male head of the household getting the best meal portions. Persistent poverty, inadequate nutrition information and gender inequity cause pervasive malnutrition among women, especially pregnant women and lactating mothers.
While food habits vary at regional and even individual household levels, in general, food preparation methods result in significant nutrient loss. Minerals and vitamins, especially B-complex vitamins are lost (40 percent of thiamine and niacin) even during the washing of rice before cooking. Boiling rice and then discarding the water results in even more nutrient losses. The manner of washing and cooking vegetables leads to considerable loss of vitamin C and B-complex vitamins.
Household food consumption studies3 show that cereals make up the largest share (62 percent) of the diet, followed by non-leafy vegetables, roots and tubers, which together comprise more than four-fifths of the rural people’s total diet. Protein and micronutrient-rich foods like fish, meat, eggs, milk, milk products, fats and oils account for less than 10 percent of the rural person’s diet, and the consumption of vegetables and fruits is declining steadily.
Rural consumption of leafy and non-leafy vegetables has remained more or less the same over the past two decades after increasing over the preceding 30 years. Fruit consumption has declined in rural areas after more than doubling in the 1970s. With an average national per capita consumption of 23 g of leafy vegetables, 89 g of non-leafy vegetables and 14 g of fruit, the average Bangladeshi eats a total of 126 g of fruit and vegetables daily. This is far below the minimum daily consumption of 400 g of vegetables and fruit recommended by FAO and the World Health Organization (WHO).4
Despite considerable improvement in the national rural health status, the nutritional well-being of rural people continues to be neglected.5 Children and women in Bangladesh suffer from high levels of malnutrition and micronutrient deficiencies such as low birth weight (LBW), undernutrition (underweight, stunting and wasting), vitamin A deficiency, iodine-deficiency disorders (IDD) and iron-deficiency anaemia (IDA). At the same time, new health problems related to over-nutrition such as obesity are emerging.
Maternal undernutrition (body mass index less than 18.5 kg/m2) in non-pregnant women in the country, while declining from 54 percent in 1996–1997 to 38 percent in 2003, is still very high.6, 7 Undernutrition, both before and during pregnancy, causes intrauterine growth retardation and is one of the major reasons for the high LBW (36 percent) prevalence in the country.
Low birth weight is more common among adolescent mothers. Marriage at very young age has serious consequences for pregnancy, future survival, health, growth and development. When combined with positive energy balance (adequate energy intake) in later life, LBW increases the risk of obesity, diabetes, high blood pressure and coronary heart disease. Between 1990 and 2004, underweight levels among children fell from 67 to 48 percent and child stunting fell from 66 to 43 percent,8, 9 but the levels are still unacceptably high.
The consumption of vitamin A-rich foods is still low, suggesting that the underlying causes of vitamin A deficiency require further attention. The diets of pregnant women in low-income groups are deficient not only in micronutrients but also in energy. Anaemia is a severe public health problem affecting pre-school children (49 percent) and pregnant women (47 percent), and a moderate public health problem among non-pregnant women (33 percent) and adolescents (29 percent).10 Anaemia caused by iron deficiency impairs the growth and learning ability of children, lowers resistance to infectious diseases and increases the risk of maternal death and LBW. Children are malnourished by inadequate dietary intake or infectious diseases.
The underlying causes include (i) household food insecurity resulting from inability to grow or purchase a nutritionally adequate amount and variety of food; (ii) lack of dietary diversity; (iii) inadequate maternal and child care due to inappropriate hygiene, health and nutrition; (iv) low rates of exclusive breast feeding; (v) inadequate access to quality health services; (vi) poor environmental hygiene and sanitation along with low levels of income and maternal formal education. Malnutrition early in life has long-lasting and negative effects on overall growth, morbidity, cognitive development, educational attainment and adult productivity.11
Because of this, the nutritional status of children, particularly below five years of age, is seen as one of the most sensitive indicators of a country’s vulnerability to food insecurity and overall socio-economic development. Women of child-bearing age are also highly vulnerable to nutritional deficiencies because of increased need for food and nutrients during pregnancy and lactation.
Most people have a mixed diet of plant and animal food. Potatoes also form an important part of the diet being an important source of energy. Root and tuber crops together with bananas can supplement a cereal or rice-based staple diet. Starch is the main component of root and tuber crops, and plantain and green bananas. Oils and fats, also a source of energy, occur only in small amounts in fresh produce except for coconut and avocado.12 Most fresh fruits contain simple sugar ranging between 50 to 100 kcal per 100 g.
Proteins are essential to the building and repair of muscles and organs and are needed in increasing amounts by growing children. Although fresh horticulture produce has low protein content, on a dry weight basis, some food types such as beans have between 15 and 20 percent of protein.
Small amounts of micronutrients (minerals and vitamins) are needed for good health along with energy food and protein. Sodium, potassium, iron, calcium, phosphorus and many trace elements are essential for the body. Vegetables, especially leafy, have significant amounts of calcium, iron and some other minerals including vitamins A and C. Vitamins are vital in the control of body chemical reactions. Fresh horticultural produce also has large amounts of fibre or “roughage” which, although indigestible, plays an important part in digestion. A diet with high fibre content reduces susceptibility to disease.
Inadequate consumption of fruits and vegetables is estimated to cause about 31 percent of ischaemic heart disease and 11 percent of strokes worldwide.13 Overall, it is estimated that up to 2.7 million lives could be saved every year with a sufficient increase in fruit and vegetable consumption. Dietary diversification through horticultural food intake and supported by nutrition education is, therefore, seen as a sustainable approach to fighting micronutrient malnutrition.
1 FAO. (2002). World agriculture towards 2015/2030. Summary report. Rome, Food and Agriculture Organization of the United Nations.
2 Jahan, K. & Hossain, M. 1998. Nature and extent of malnutrition in Bangladesh, Bangladesh National Nutrition Survey, 1995–1998. Dhaka, Institute of Nutrition and Food Science, Dhaka University, Bangladesh.
3 Bangladesh National Nutrition Survey (1995–1996).
4 FAO/WHO. 2003. Diet, nutrition and the prevention of chronic diseases. Report of a joint FAO/WHO. Expert Consultation. WHO Technical Report Series 916. Geneva. World Health Organization.
5 World Bank. 2005. Maintaining Momentum to 2015? An impact evaluation of interventions to improve maternal and child health and nutrition in Bangladesh. Washington, The World Bank.
6 Bangladesh Demographic and Health Survey, 2000.
7 Helen Keller International/IPHN, 2004.
8 BBS. 1989/90. Child Nutrition Surveys. Dhaka, Bangladesh Bureau of Statistics.
9 Bangladesh Demographic and Health Survey 2004.
10 Bangladesh Bureau of Statistics/United Nations Children’s Fund, 2004.
11 UNICEF, 1998.
12 Coconut has 40 percent fat and avocados, 15–25 percent oil.
13 WHO. 2002. World Health Report. Reducing risks, promoting healthy life. Geneva, World Health Organization.