Implementing food-based strategies
Any programme that increases the production and consumption of micronutrient-rich foods is likely to have a beneficial effect on the micronutrient status of a population. Existing demand for fruits and vegetables often cannot be met, which results in high consumer prices. For producers, access to water, fertile soils and seed or seedlings of adequate quality may be limiting factors.
Small-scale vegetable and fruit gardens can significantly increase the production of micronutrient-rich foods. To improve micronutrient status, however, gardening projects must lead to increased consumption of the micronutrient-rich foods produced. Thus, gardening projects should be linked to nutrition education programmes Success requires a good
Small animals, poultry and fish can provide excellent food sources of essential micronutrients, including bioavailable iron and vitamin A. Cost constraints and education measures need to be addressed in promoting small livestock and fishery projects. Efficient, large-scale commercial production of fruits and vegetables, oil seeds, palm oil and certain beverages can supply micronutrient-rich foods at reasonable prices. Effective and competitive markets help ensure both low prices for the consumer and fair prices for the producer.
Post-harvest losses can be high for micronutrient-rich foods, which tend to be perishable. In commercial trade, improvements in marketing, grading, packaging, transport and cold storage facilities can reduce storage losses. At the household level, practical food processing and preservation methods such as solar drying can be adopted to increase the year-round availability of seasonal micronutrient-rich foods.
Improving the micronutrient content of soils and plant breeding can increase yields and produce plant foods with a higher micronutrient content. Research in gene modification of plant foods to increase the uptake of nutrients holds promising possibilities. Long-term food-based solutions to micronutrient deficiencies could benefit from improvements in the nutritional quality of grains through genetic modification and improved agricultural practices.
In developing countries, food fortification is increasingly recognized as an effective medium- to long-term approach to improving the micronutrient status of large populations. Some studies have shown fortification to be one of the most cost-effective methods of reducing micronutrient deficiencies, although effective monitoring regulation and enforcement are key to the success of fortification programmes
Fortification programmes require careful planning to ensure that appropriate food vehicles and fortificants are selected to enhance micronutrient status in the target population. In areas where there is no centralized processing, fortification in small mills or even household-level fortification might be considered. All fortification programmes must address quality assurance and safety concerns.
Fortification calls for a multisectoral effort involving the participation of government, private industry, NGO's, scientific expert groups and even consumer groups. Advocacy targeted at all of these groups is crucial to the success of a fortification programme.
Communication techniques have been used for more than two decades to help bring about changes in eating practices. Vitamin A has been the focus of more communication efforts than other micronutrients . Successful programmes from many countries demonstrate the importance of carefully planning communication interventions and of basing interventions on information obtained directly from the target population, for example, mothers and other people who influence food production, food purchasing and child feeding behavior.
Market surveys have found that dark green leafy vegetables are the least costly source of vitamin A in many countries. Programme managers, however, should include other sources, such as fruit, which is more expensive but often more palatable to children. This Singaporean woman has access to a variety of micronutrient-rich fruits and vegetables with which to feed her family.
In most countries, important improvements in the micronutrient status of the population can be achieved by changing food behavior at the household level and by protecting positive practices that are eroding because of factors such as urbanization and modernization. When incomes rise, people often reduce breastfeeding, stop gathering wild foods and eat fewer green leafy vegetables activities which are often considered to have low status. The mass media can be a powerful force in helping to preserve positive traditional practices by enhancing their status.
Even when micronutrient-rich foods are available, they may not be consumed in sufficient quantities to prevent deficiencies. Behavior changes to increase consumption of micronutrient-rich foods can be effectively promoted through communication methods. The least disruptive dietary change offers the best chance of success.