This chapter provides an introduction to the many uses of data from food consumption surveys. Experiences from the Caribbean are used to demonstrate how the data and information derived from these surveys have been applied successfully in food and nutrition interventions. The chapter begins with a brief discussion of the food, nutrition and socio-economic conditions of the region as a backdrop to fully appreciate the utility of food consumption surveys in the Caribbean.
Over the last thirty years infectious diseases and malnutrition have declined significantly in the Caribbean. On average, prevalence rates of undernutrition have fallen from 50 percent in the 1950s to about 10 percent presently. However, pockets of malnutrition still exist in several countries, and the problem of iron-deficiency anaemia persists among pregnant women and children under five. Concurrent with these shifts has been a rapid increase of nutrition-related chronic diseases in the region.1 This epidemiological transition has brought into sharp focus the need for a closer analysis of food consumption patterns and their impact on nutrition and health status.
Periodic assessment of the nutritional status of the population can provide essential data to inform decision-making and policy development. While food balance sheet data for the Caribbean2 show a trend of increasing availability of food that is high in refined carbohydrates, sugars and fats and (for some countries) relatively low in fruits and vegetables, more detailed information of food consumption patterns are needed in order to develop sufficient food and nutrition and health policies and programmes. Regular assessment of the nutritional status of a country's population provides vital in the Caribbean information that can guide decision-making and policy development. These observations, and others below, provide compelling arguments for the necessity of food consumption surveys in the Caribbean.
Food consumption surveys can be used to obtain different types of information on how and what people eat. They can provide data on the:
amounts of different foods consumed by individuals and households;
the nutritional content and quality of diets;
the socio-economic and demographic characteristics of the population from which the sample is taken.
These data have several distinct but closely interrelated uses:
facilitating policy and programme development;
assessing the nutritional status of individuals and households;
supporting intersectoral coordination;
enhancing food security;
food and nutrition surveillance. Each of these uses is elaborated below.
FACILITATING POLICY AND PROGRAMME DEVELOPMENT
Regular assessment of a population's nutritional status using food consumption data provides vital information for:
planning, formulating and evaluating domestic food production and distribution policies;
regulating food imports and exports;
establishing priorities for food aid;
enhancing overall food security.
Food consumption surveys can provide detailed information that can facilitate the formulation and implementation of appropriate food and nutrition policies and targeted programmes. Policies are important because they require government concurrence and commitment and outlive specific programmes and projects. Information from food consumption surveys can also be used to design food and nutrition educational programmes and implement dietary guidelines aimed at reducing the risk of nutrition related diseases.
ASSESSING THE NUTRITIONAL STATUS OF INDIVIDUALS AND HOUSEHOLDS
Food consumption survey data can be used to assess the nutritional status of individuals and households by ascertaining existing food consumption patterns, habits, and the adequacy of food, energy and nutrient intakes; the data can then be compared to desired food and nutrition goals. This kind of assessment is particularly important for the Caribbean where nutrition-related chronic diseases such as obesity, diabetes, high blood pressure, stroke, heart diseases, and cancer have replaced malnutrition and infectious diseases as major public health problems. This epidemiological transition warrants a closer look at food consumption patterns and their impact on nutrition and health status. While food balance sheet data for the Caribbean provide some insights on macronutrient availability, much more disaggregated food consumption data are required regarding how these macronutrients are allocated among individuals and groups in the society.
SUPPORTING INTERSECTORAL COORDINATION
Governments that take diet-health relationships seriously can make considerable savings in health expenditures. In the past, the issues of health status, food security, diets and agricultural trade have been approached in the region sequentially, and as originating from disparate, unrelated sectors of the economy. This must be corrected in light of the major challenge currently facing Caribbean policy-makers: to improve and maintain the gains made in reducing malnutrition among children while at the same time addressing the rapid increases in nutrition-related chronic diseases.
Data from food consumption surveys (for example, information concerning macronutrient consumption [carbohydrates, protein and fats] or nutrient sources [fruits and vegetables, food from animal sources] etc.) can galvanize support for intersectoral coordination and demonstrate how efforts in different sectors can be linked to address the broad-based, multisectoral food and nutrition problems. Health and nutrition must be an integral part of policies and strategies of several sectors of the economy because there are strong links between and among these sectors, and recognizing and acting upon them can contribute to the enhancement of health status in the Caribbean.3, 4
ENHANCING FOOD SECURITY
Food security is an important goal for Caribbean governments. It includes not only the physical availability of food supplies but also the socio-economic and nutritional aspects of having adequate economic and physical access to safe and nutritious food. Food consumption data can facilitate decision-makers in designing appropriate food-price policies and other instruments that will enhance food security at the individual and household levels, and contribute to improvements in the nutrition and health status of the population. Food security policies and programmes should strive to fulfil population nutrient goals, whereby food and nutrient intakes for the population as a whole will lead to a low risk of inadequacy and a low risk of excess. The determination of food goals needs careful analysis, and must relate to the agricultural and trade policy, and economic opportunities in each specific country.
A major challenge facing the region is one of inadequate access and inadequate consumption, particularly among vulnerable groups. In this context, food consumption survey data provide the level of details for effective targeting of programmes to address food insecurity.
FOOD AND NUTRITION SURVEILLANCE
Food consumption surveys must be part of food and nutrition information systems and should be conducted regularly for effective planning and implementation of food and nutrition policies and programmes. From this perspective, data generated by these surveys can be used to:
identify the existence and extent of food and nutrition problems i.e. who are vulnerable to food insecurity, where they are situated, why they are food insecure and what form of interventions can be made;
monitor programmes, for example, school-feeding programmes, food coupons, agricultural projects aimed at improving household food security;
establish and monitor national nutrition goals.
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Box 1.1 Uses of food consumption and anthropometric surveys (Belize) In Belize, food consumption and anthropometric surveys were conducted in 1978, 1992 and 1997. The data were used to formulate national food and nutrition policy, school-feeding programmes and nutrition education in schools. In particular, the data from these surveys were used to:
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Box 1.2 Uses of food consumption and anthropometric surveys (Jamaica) In Jamaica, data on food consumption and anthropometry have been collected since 1988 as part of the Survey of Living Conditions. The data are used to design household level social interventions with a nutritional orientation, e.g. food stamps, safety nets, school feeding and other assistance programmes, and to monitor the effectiveness of these and other poverty-alleviation initiatives. |
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Box 1.3 Uses of food consumption and anthropometric surveys (Cuba) The Cuban experience with food consumption and anthropometric surveys could be grouped into three main categories according to their objectives:
The data collected were used to:
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Past experiences in the Caribbean indicate several applications of food consumption surveys and anthropometric information. Food consumption survey data have been used to identify food and nutrition problems (Belize); to guide policy construction and identify needed legislation (Cuba, Belize); and to select, design and target interventions and evaluate programmes (Jamaica, Belize, Cuba). Boxes 1.1-1.3 provide summaries of the main examples in different Caribbean settings
