Nutrition
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EXPERT PAPERS


Biofortification: A new tool to reduce micronutrient malnutrition; Linking agriculture to nutrition – The harvest is near and how do we measure impact? Building the Evidence Base, and Building Partnerships for Food Based Approaches by Howarth Bouis

By Howarth Bouis, Director HarvestPlus;  Sherry A. Tanumihardjo, University of Wisconsin-Madison; Jan Low and Margaret McEwan

Provides answers to the following key questions, i. can breeding increase the micronutrient density in food staples to reach target levels that will have a measurable and significant impact on nutritional status? ii. when consumed under controlled conditions, will the extra nutrients bred into the food staples be bio­available and absorbed at sufficient levels to improve micronutrient status? and iii. related to dissemination and acceptance, will farmers grow the biofortified varieties and will consumers buy and eat them in sufficient quantities to improve nutrition?

Conclusions and policy recommendations

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Linking nutrition and agrobiodiversity

By G. B. Keding and B. Cogill- Bioversity International

A growing number of research and development institutions currently realise the urgent need for multi-sectoral approaches to bridge the gap between agriculture, nutrition and health, to jointly tackle the triple burden of malnutrition and, thus, creating nutrition-sensitive   food  and  agricultural  systems.  The  recent  “Synthesis  of  Guiding Principles on Agriculture Programming  for Nutrition” by FAO gives an overview and 20 main recommendations on how to make agriculture work for nutrition.

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Vitamin A: Moving the food-based approach forward

by Ted Greiner, Hanyang University

Food-based approaches, despite being the only proven sustainable way to improve nutritional status, continue to be largely ignored. Agencies responsible for normative work in the fields of agriculture and health (FAO and WHO) and governments need to take a more assertive approach in ensuring that food based approaches for improving the micronutrient content of diets in low-income populations become the norm. The case of vitamin A deficiency among young children in developing countries is used to argue that donors currently supporting vitamin A supplementation approaches could assist by providing additional funding specifically for food-based approaches and to gradually phase out supplementation programmes.

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Nutrition-sensitive interventions within ‘Feed the Future’ agriculture value chains: Four case studies of productivity, year-round access, and dietary diversity

by Kathleen Kurz, DAI, Bethesda, MD, USA

Reviews ‘Feed the Future’ (FTF) initiatives in DRC, Liberia, Malawi and Tajikistan to increase agricultural productivity and animal husbandry, improve market access for inputs and production, reduce post-harvest losses through storage and processing technologies, and grow and husband a nutritious variety of plant and animal food sources. Provides a  conceptual framework illustrating how agriculture and other interventions can contribute to household food consumption, child’s dietary intake and nutritional status, and outlines the nutrition-sensitive activities in the projects and lessons from the initial stages of implementation. Identifies agriculture value chain activities which are expected to have a positive  impact on nutrition outcomes including: agriculture demonstration plots with a variety of vegetables for home consumption and sale, promotion of dietary diversity, incorporation of food and nutrition messages into agriculture training, demonstration of labor-saving technologies, fortification of flours and processed foods, scaling up cultivation of biofortified seeds and production of processed complementary foods for infants and young children.

Conclusions and policy recommendations

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Farm production diversity is associated with greater household dietary diversity in Malawi: findings from nationally representative data

By Andrew D. Jones, Aditya Shrinivas, Rachel Bezner-Kerr

This paper examines cross-sectional data from the Malawi Third Integrated Household Survey (IHS3), a large, nationally representative sample of farming households in Malawi, implemented from March 2010 – March 2011. These data were used to 1) determine the relationship between the production diversity of household farms and household dietary diversity and 2) determine the potential importance of household dietary diversity on the nutritional status of young children. Three indicators of dietary diversity, the Household Dietary Diversity Score (HDDS), the Food Consumption Score (FCS), and a Food Variety Score (FVS) were calculated along with three indicators of farm production diversity.   Based on multivariate analyses, the research suggests that more diverse production systems may contribute to more diverse household diets which in turn could positively influence the nutritional status of household members. Yet, this relationship is complex; it may be influenced by gender, wealth, control of household decisions, the relative market-orientation of a household’s agricultural production, and the manner in which diversity is defined and measured.

Conclusions and policy recommendations


Designing Nutrition-Sensitive Agriculture Programs

By Ladd, ACDI/VOCA – Food Security

How to design or refocus agriculture/livelihood projects to be more nutrition-sensitive and to determine what affects the agriculture and livelihood programmes have on nutrition of the most vulnerable. Can we monitor nutrition-sensitive agriculture and its impact on nutritional status? Do agriculture projects not working directly with households have an effect on nutritional status of individuals? Can agriculture focused projects affect the underlying determinants of nutrition?  Is that an acceptable intermediate step to impacting nutrition status?

Conclusions and policy recommendations

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An analysis of the food system landscape and agricultural value chains for nutrition: Two case studies from Sierra Leone

By Joyce Njoro, Nyahabeh Anthony, Iris de Hoogh, Jessica Fanzo, Nawal Chahid, Daniel Fornah, Matthew L. S. Gboku, Momodu Kamara, Alimamy Kargbo, Aminata Koroma, Bjorn Ljungqvist, John J. Momoh, Alisia Osiro, Memuna Sawi, Edward Rhodes, Sylvetta Scott, Senoe Torgerson, Marianne van Dorp, and Esther Wiegers - Njala University, Sierra Leone Agriculture Research Institute, Wageningen University and Research Centre, REACH, and Columbia University

The paper summarizes findings from operational research conducted in Sierra Leone which explored opportunities and challenges for linking agriculture and nutrition. The research included a mapping of stakeholders involved in agriculture and nutrition, and an analysis of two value chains –rice and vegetables. The aim was to understand the role markets and value chains play in improving nutrition and diversification both directly, through an increase in the supply of nutritious foods, and through an increase in income for smallholders. Findings showed that  rice and vegetables value chains currently have limited impact on nutrition, due to the prioritization of sale over consumption, low incomes, the prioritization of non-food purchases, the high price of nutritious foods, poor/absent storage and processing, limited knowledge on food preparation, as well as several constraints related to women’s status, workload and access to productive resources.  Recommendations are provided to encourage greater involvement of all stakeholders involved in food systems and for increasing the nutritional impact of rice and vegetable value chains through production, processing, storage, marketing, consumer education and school-based programmes.

Conclusions and policy recommendations

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Enhancing the role of smallholder farmers in achieving sustainable food and nutrition security

By B. M. Dioula, Action Contre la Faim

One of the agricultural pathways towards sustainable food and nutrition security is through local production of nutritious food, activity in which smallholder farmers play a crucial role. As food consumers, all rural and urban people in developing countries count heavily on the efficiency of their local smallholder farmers to satisfy their food needs. The purpose of this paper is to provide background information on the potential role smallholder farmers in sustainable food and nutrition security; The paper identifies and synthesizes key literature concerning the effectiveness of small-scale agricultural interventions in improving nutrition outcomes and highlight some national and international policy recommendations aiming at improving the productivity of smallholder farming systems with the objective of ensuring food and nutrition security. The overall objective of the paper is to contribute to the ‘nutrition-enhancing agriculture and food systems’ organized by FAO’s Food Security and Nutrition team in the framework of the ICN2 process.

Conclusions and policy recommendations

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Opportunities for Latin America and the Caribbean to mainstreaming nutrition into agriculture

By Diego Arias Carballo and  Barbara Coello , World Bank

With a population of 590 million, food and nutrition security is an important challenge for Latin America and the Caribbean (LAC) region. Although the average prevalence of undernutrition in the region has decreased during the last decade, the rate of reduction is unequally distributed across countries and across households. Furthermore, the countries that have been the most successful in reducing undernutrition are now facing high rates of overweight and obesity.
Agriculture is a key economic and social sector for most LAC countries. Recently, however, the rise in demand for non-food products, such as biofuels, combined with higher market potential for LAC food products in developed countries has changed the dynamics of the sector. We show that countries in LAC where agriculture makes up a large part of the economy score poorly in terms of nutritional status of the most vulnerable groups, hence creating a nutritional-agricultural paradox.
Improving the nutritional status of the most vulnerable populations in LAC requires re-thinking the agricultural and food systems, to turn local agriculture and food production into a pathway to mitigate food insecurity in a sustainable manner. Expanding agricultural incomes and food production is necessary but not sufficient for food security; to achieve the latter, high quality food (in terms of diversity, nutrient content and safety) should be made both accessible and affordable for the most vulnerable. This paper presents evidences, cross-cutting principles, lessons learned, best practices and a set of tools to help policy makers to mainstream nutrition into agricultural sector policies and investments in LAC.

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Community-based nutrition security

By George Kent, University of Hawai’I

“The argument developed is that the poor can be empowered through the creation of strong communities. In strong communities, where people care about one another’s well being, and do not exploit one another, people don’t go hungry. This is true even where people have little money.
Strong communities can develop self-reliance, based on local control. Such communities protect people from exploitation by outsiders, and they can establish local food systems that are sensitive to nutritional needs. Finding ways to design and strengthen existing or new communities might be an effective means for reducing hunger in the world.
National and international should then just create the conditions for strengthening local communities, especially to connect agriculture and nutrition.”

Conclusions and policy recommendations

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New Business Models to Help Eliminate Food and Nutrition Insecurity - Roadmap for Exploration

By J.B. Cordaro, Global Food and Nutrition Business Advisor, Consultant to Mars, Inc. and Adam Adams, Vice President, Marketing, Health and Nutrition, Mars USA

Starting from core global statistics on hunger and malnutrition and global food insecurity, the paper focuses on the human and economic impacts of malnutrition in Sub-Saharan Africa and on Africa’s food and nutrition needs to address hunger and malnutrition by 2050. The authors analyze the role of fortified and nutritious food as one of the tools to eradicate hunger and malnutrition. In this regard, the paper addresses the potential of the private sector in providing affordable, acceptable and cost-effective solutions at the benefit of the most vulnerable. In particular, the study highlights the added value of multistakeholder partnerships to address global food and nutrition security in a sustainable way, specifically through developing, marketing, and distributing fortified food products for daily consumption to populations in need.

Conclusions and policy recommendations

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Improving nutrition through secondary livestock products of milk and eggs: A pastoralist case study in Kenya

By Lora L. Iannotti and Carolyn Lesorogol

Describes the potential of small livestock production, eggs and milk products to improve nutrition. Existing evidence is presented and data from a case study in Kenya described. Concludes that decisions by pastoralists determine health outcomes, with potential for positive or very negative outcomes depending on decisions made. Nutrition-sensitive programmes should promote the consumption of milk and eggs and other high quality foods such as legumes, fruits, and vegetables through both education and improved access interventions. Recommendations for programming, policy, and research are presented to improve nutrition and to generate income.

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Building Effective Nutrition Policy on Demands Strong Scientific Base

By Chunming Chen, Pat Crawford, Omar Dary, Adam Drewnowski , Hanifa Namusoke, Barbara Schneeman, Marilyn Towsend,

The article aims at making the case for the need for sound evidence in informing nutrition policies. It shall provide an overview of the how sound evidence, rooted in scientific grounds, has or has not been used in informing the selection of nutrition policies. Examples of public health policies that have been demonstrated effective and the data used to sustain those conclusions will be given, to the purpose of identifying what are the effective data needs for countries to identify effective policies.

Conclusions and policy recommendations

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Monitoring and Evaluating the Food Security and Nutrition Effects of Agricultural Projects

By F. James Levinson, Tufts University and Anna Herforth, Cornell University

The paper presents a feasible approach for monitoring the achievement of agriculture-nutrition objectives within agricultural projects, without encumbering project managers. The approach involves the use of geographically representative sentinel sites, where data is collected on: (a) the extent to which households have been reached/affected by the project; (b) data on household food insecurity levels and on the diversity of food consumption; (c) data on young child stunting (collected annually); (d) information which might indicate harm to food security or nutrition, and (e) data on a subset of essential data of primary interest to project managers. Methodologies for developing prototypes of the proposed monitoring and evaluation approach are presented, and potential application are described, with specific reference to the potential role of the Agriculture-Nutrition Community of Practice (Ag2Nut CoP).

Conclusions and policy recommendations

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The role of forests, trees and wild biodiversity for improved nutrition-sensitivity of food and agriculture systems

By B. Powell, CIFOR/CGIAR

Examines the role of forests and trees for enhancing both sustainability and nutrition sensitivity of food and agricultural systems. The paper argues that nutrition-sensitive approaches are important in forestry and conservation, in addition to sectors such as agriculture, development, health and education. This is in part because land use is an often overlooked determinant of diets, nutrition and food security, especially for rural communities. The paper reviews the contributions of forests and wild biodiversity to dietary diversity and nutrition (through provisioning of foods, fuelwood, income and supporting resilience). The paper examines the role of forest and tree products in the nutrition-sensitivity of global food systems (approximately 53% of the fruit available for consumption globally is produced by trees). Forests and trees also provide an array of ecosystem services essential for the sustainability of agricultural systems. Combined, the role of forests and trees for sustainability and nutrition-sensitivity, suggests that forests and trees play an important role in local and global food systems.

Conclusions and policy recommendations

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Prevalence of Obesity: A Public Health Problem Poorly Understood

By Theresa A. Nicklas and USDA/ARS Children’s Nutrition Research Center at Baylor College of Medicine, Department of Pediatrics, Houston, Texas and Carol E. O’Neil, School of Human Ecology, Louisiana State University, Baton Rouge, Louisiana

Discusses dietary guidelines in support of a total diet approach to achieving diet and health goals. Considers recommendations that single out one food or one nutrient to solve the obesity problem as simplistic and unlikely to be effective. Acknowledges discrepancies in the literature and lack of consensus from systematic reviews. Failure to consider the evidence as a whole can lead to inaccurate statements which may inappropriately influence clinical practice, public policy, and future research. Where is the line to be drawn between individual choice and responsibility and public regulation? Using sugar sweetened beverages as an example, considers the lack of association between added sugars and weight, calls for policy recommendations to be based on science and the need for evidence-based policies rather than policy-based evidence.

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Case Study of Participatory Agriculture and Nutrition Program in Malawi

By  Rachel Bezner Kerr, Cornell University, Ithaca, USA

Provides a case study of a participatory agriculture and nutrition programme in northern Malawi that through innovative educational strategies led to adoption of sustainable agricultural methods, greater crop diversity, and improved food security and child growth. Key factors included increased knowledge of agroecological methods, farmer-to-farmer teaching, unequal social relations and integration of child nutrition and local knowledge. Understanding ways to improve child nutrition using food and agricultural-based approaches that at the same time empower marginalized and nutritionally vulnerable groups in this difficult context makes Malawi a useful case study to apply to other relevant sites.

Conclusions and policy recommendations

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Impact Pathways from Agricultural Research to Improved Nutrition and Health: Literature Analysis and Research Priorities

Patric Webb

This paper contributes to ongoing work at many institutions aimed at identifying priority knowledge gaps, determining the best research approaches needed to fill those gaps, and exploring how to better support policy and programme implementation with sound empirical evidence of ‘what works’. The paper has four parts. First, a discussion of approaches used in conceptualizing causal pathways from agriculture to nutrition and health. Second, an overview of research-based evidence on agriculture impacts on nutrition and health. Third, a discussion of knowledge gaps and associated priority research questions. Finally, conclusions on proposed priority research questions.

Conclusions and policy recommendations

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Nutritional Deficiencies as Driver for Agriculture Value Chain Development: Lessons from the Field

By Paul Sommers, California State University Fresno, Center for Agricultural Business

This paper presents actual field experiences where using nutrition as the driver for agricultural value chain does result in lasting change. The policy implications of this approach are also discussed. Nexus points are identified, messages are designed jointly and are mutually enforcing. Field activities are no longer implemented in isolation and at cross purposes.
This paper presents actual field experiences where using nutrition as the driver for all sizes of agricultural supply chains  does result in lasting change. The policy implications of this approach are also discussed.

Conclusions and policy recommendations

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Maximizing the contribution of fish to human nutrition

By David James, FAO

A paper on maximizing the contribution of fish to human nutrition is being prepared for the ICN2 Preparatory Technical Meeting, 13-15 November 2013. Participants in the web discussion in July are invited to contribute ideas, suggestions and references to amplify the outline. In considering how the contribution of fish to diets, particularly those of the poor, can be maximized, it is proposed the paper will provide general background information on fisheries production and fish consumption, analyze constraints to increasing consumption, and conclude by suggesting possible interventions involving international organizations, governments and civil society organizations, industry and academia and by giving the needs of poor rural people’s nutrition a voice in national policy formulation including highlighting the needs for improved hygiene and food safety.


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New French Nutritional Recommendations for fatty acids

By Philippe Legrand, Laboratoire de Biochimie-Nutrition, Agrocampus-INRA

This paper describes the rationale underlying the 2010 update of the French Food Safety Agency (ANSES) recently published recommendations for reference intakes ‘Apports Nutritionnels Conseillés’ (ANC) for fatty acids for the French adult population. A comprehensive review of the science underlying each recommendation are discussed. Reference intakes (ANC) are provided for each fatty acid based on considerations regarding both minimum physiological requirements and possible physiopathological aspects. The paper discusses concerns regarding the proportion of total fat in the diet, the proportion of total saturated fatty acids in the diet and the differential effects of different saturated fatty acids, interactions between linoleic and alpha-linolenic acids, promoting adequate intakes of EPA and DHA, and understanding the roles of non-essential fatty acids with the goal of helping to build a credible diet, both qualitatively and quantitatively. A comparison with other guidelines is provided.

Conclusions and policy recommendations

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Linking Agricultural Production Practices to Improving Human Nutrition and Health

By Ross M. Welch, Department of Crop and Soil Sciences, Cornell University, Ithaca, NY, USA, Robin D. Graham, School of Biological Sciences, Flinders University of South Australia, Australia and Ismail Cakmak Sabanci University, Istanbul, Turkey

Dysfunctional food systems are the basis of malnutrition in many poverty stricken human populations. Food systems are dependent on agricultural systems as the primary source of nutrients entering food systems thus, agricultural systems play a major role in the development of malnutrition. However, focusing on caloric needs alone is not sufficient. Agriculture and food systems should provide all the nutrients needed by resource-poor families dependent on staple food crops for nourishment. “Nutrient security” should be one of the primary goals of food security programs and producing enough nutrients in agricultural systems to meet nutritional needs of all people during all seasons should be the focus. A healthy agricultural industry is crucial for providing nutrients to humans.  Soil quality and soil fertility have a direct influence on the nutrient levels in food crops. Well-nourished food crops grown on fertile soils contain more macronutrients, vitamins and micronutrient minerals than nutrient-stressed crops grown on infertile soils. A number of agricultural tools and practices can be utilized to increase the output of nutrients from farming systems. Clearly, agriculture production practices must be closely linked to human nutrition and health goals if we are to find sustainable solutions to malnutrition, including overt nutrient deficiencies and diet-related chronic diseases. Policies to improve nutrition and health need to include agricultural strategies as primary tools in finding sustainable solutions to malnutrition.

Conclusions and policy recommendations

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Leveraging agriculture and food systems for healthier diets and noncommunicable disease prevention: the need for policy coherence

Corinna Hawkes, Anne Marie Thow, Shauna Downs, Suparna Ghosh-Jerath, Wendy Snowdon, Emily Morgan, Ismail Thiam, Jo Jewell

 This paper focuses on nutrition and diet-related non-communicable diseases (NCD), as a key component of the global burden of malnutrition. It focuses on the need for coherence between agricultural and food system policies and policies that aim to promote healthy eating. On the basis of a series of examples from “short” and “long” food value chains, it explores three ways in which healthy eating policies directly interface with agriculture and food systems. That is:

 (1) Policies implemented to promote healthy diets have repercussions upstream for the actors and activities in the agriculture and food systems;

(2) Existing agrifood policies influence the effectiveness of policies to promote healthy eating (by reinforcing them, or presenting barriers/undermining them);

(3) Policy actions may be implemented with the explicit intention of leveraging agriculture and food systems to promote healthy diets (i.e. through their downstream implications for food education skills and the market environment).

While examples are emerging that shed light into the policies and tools through which agriculture and food systems could help prevent NCDs, the area is at a relatively early stage of development. Research is needed to provide more insights, and research methods need to be tested. Emerging methods of analysis available to identify specific points for policy intervention for more policy coherence between agriculture, food systems and healthier eating are participatory multistakeholder analysis, consumption-oriented food supply chain analysis and value chain analysis.

Conclusions and policy recommendations

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