Alessandra Carè Direttrice Centro di Riferimento per la Medicina di Genere Istituto Superiore di Sanità; Roberta Masella, Prima Ricercatrice; Direttrice Unità di Prevenzione e salute di genere del Centro di Riferimento per la Medicina di Genere Istituto Superiore di Sanità - Roma
Denise Giacomini, Dirigente medico, Ministero della salute, Segretariato Generale, Ufficio 2
Monica Gasperini, Psicologa, Ministero della salute, Segretariato Generale, Ufficio 2
Part 1- Introduction
5. It should be emphasized that guaranteeing optimal nutrition to women, especially during the reproductive age, represents an effective tool to ensure the health of the entire future generations. It is well known, indeed, that malnutrition affects the fertility and increases the risk of a number of pathologies in the offspring, with consequences also in the adult age.
1.2 objectives of the guidelines
10: In this point it should be mentioned that advancing in gender equality positively impact also health of women and girls, facilitate their access to healthcare and maternal health.
Part 2
23. Maybe appropriate to change ‘’ to :…… its impact on gender relations, lifestyles, roles and norms
Part 3
3.3.1
50/52 Besides the relevance of increasing knowledge and education degree in women and girls, it is of outmost importance to start as early as possible a specific education in health and nutrition. Health literacy is defined as “the degree to which individuals can obtain, process, and understand the basic health information and services they need to make appropriate health decisions”. It is a determinant of health as it favours the adoption of correct lifestyles, the adherence to therapies, and the appropriate access to health services. Furthermore, there is a growing interest about food literacy defined as a set of skills and knowledge related to food, which enables people to make informed choices about food and nutrition for improving their own health. The big challenge, therefore, is to start very early with nutrition education programs to encourage the adoption of adequate lifestyles. School appears to be the most eligible setting to implement strategies aimed at improving people’s diets and food choices that play a pivotal role in promoting health. However, nutritional education interventions in the entire population are mandatory to improve the quality of diet and the knowledge of the nutritional value of different foods.
3.3.2 it should be merged to 3.3.3, since it is already partly addressed in 63 and it is too general and strictly related to the 3.3.3.
58: too generic and poorly formulated. Better to include it in 65 ii
3.3.3 it should include also 3.3.2
3.3.4
68. ICT and digital devices represent important tools for disseminating information and knowledge. Thus, it should be considered the importance of e-learning to spread health and food knowledge as wide as possible.
3.5 as general comment is oriented almost entirely to the vegetables and crops production, and barely mentions livestock productions (including game meat). We suggest to expand 91 and 98 including the specific knowledge needed for farming livestock, and the role that women should have as livestock carers, in early detection and control of animal diseases and zoonoses. Moreover, basic educational needs in this sector should also be mentioned, to ensure sustainability, animal health and welfare and to reduce the risk of zoonoses (included those from wild animals and game meat) and epidemics.
3.8
114/115
It should be emphasized that consuming a healthy diet play a pivotal role in maintaining not only woman health but in guaranteeing and preserve the offspring health by meeting maternal and foetal needs. Maternal undernutrition, or, in general, malnutrition is a key determinant of infertility, abortion, poor pregnancy, poor perinatal outcomes. Furthermore, the increased risk for non-communicable diseases has been associated with epigenetic regulation of gene expression depending on early life environment, in turn, strongly influenced by maternal diet during pregnancy and also before. Thus, maternal diet by modifying the epigenome, may lead to persistent phenotypic changes and an altered risk for NCDs in later life of the offspring.
Lastly, concerning gender and nutrition it should be noted that multidisciplinary, multistakeholder and intersectoral interventions can also be carried out through multilateralism actions.
The G20 Health Forum in the final Declaration of September 2021 https://www.salute.gov.it/imgs/C_17_pagineAree_5459_8_file.pdf underlined that “The COVID-19 pandemic has disrupted people's livelihoods, increased food insecurity and malnutrition and exacerbated inequalities around the world leading to an increase in the levels of poverty, hunger, morbidity and mortality…. Progress towards achieving the SDGs is an important benchmark as we seek to shape a more inclusive and gender-sensitive response for a resilient and sustainable future, where communities in vulnerable situations should be empowered to overcome the long-term negative effects to end of this pandemic and similar effects from future pandemics”.
Dr. Denise Giacomini