Nutrition-sensitive agriculture – a South African perspective

As environmental and social sustainability becomes more urgent, and the resilience of the industrial food system is under threat, addressing nutrition through food systems must go hand in hand with restructuring these systems for greater resilience. South Africa is a middle-income country with a highly dualistic agro-food system, dealing with the burden of undernutrition, diet-related chronic diseases and widespread micronutrient malnutrition. In South Africa, agriculture must maintain national food security while contributing to improving household food security through employment and production for own consumption; and providing access to a more diverse range of safe and quality foods at affordable prices. Agricultural activities can contribute to improved nutrition, if implemented in conjunction with direct nutrition interventions. This study gives an overview of the nutritional status of the South African population, and the history and current operations of the agro-food system. It identifies entry points for nutrition-sensitive agriculture (NSA) to begin to address food and nutrition security challenges. Case studies were identified using grey literature. With few exceptions, these cases were not NSA initiatives per se, yet demonstrated efforts that could inform actions to strengthen the nutrition-sensitivity of the South African food system. NSA is not an all-encompassing solution to food and nutrition insecurity in South Africa, but offers a way of strengthening the nutrition-sensitivity of agricultural initiatives. Viable entry points include linking small scale production and nutrition education; combining low external input farming and nutrition education; strengthening alternative marketing channels and local food economies; monitoring food prices; and developing appropriate governance and institutional arrangements.     

Entry points into a nutrition-sensitive agriculture

Nutrition-sensitive agriculture is a concept that aims to narrow the gap between available and accessible food and the food needed for a healthy and balanced diet for all people. It explicitly incorporates nutrition objectives into agriculture and addresses the utilization dimension of food and nutrition security, including health, education, economic, environmental and social aspects. Based on this concept, the present paper presents a synthesis of a recent desk study which took stock of innovative approaches to improve the positive nutrition-related impacts of agriculture and related food systems and provides recommendations for future programmes. By providing an overview on specific cross-cutting themes relevant to nutrition-sensitive agriculture and presenting examples from various countries on how nutrition objectives can be incorporated into the agro-food systems, the paper identifies commonalities and parameters that are entry points into a system within which local nutrition-sensitive agriculture approaches will have a realistic chance of success. The variables in the system are interlinked and contribute to a balanced nutrition of the population. By changing or fine-tuning one or more of the entry points, the whole system can be improved. The paper also highlights the current fragmentation in approaches towards more nutrition-sensitivity in agriculture and concludes that, where collaborative approaches are undertaken, there is a greater likelihood that shared projects will be implemented and/or be successful.     

Biofortification of sweet potato for food and nutrition security in South Africa

South Africa has a diverse population, with some pockets of society being in a first world setup and other pockets in a third world impoverished setup. Food provision in impoverished societies is particularly crucial. Sweet potato (Ipomoea batatas (L.) Lam.) is a hardy crop and prominent in ensuring household food security; through its rich supply of energy, high yield potential and market value. In addition, orange-fleshed cultivars in particular are prominent in combating vitamin A deficiency due to high content of naturally bio-available β-carotene. This paper reviews interventions with regard to biofortification of sweet potato in South Africa towards addressing food and nutrition security. The focus was on the development of biofortified (high β-carotene content) cultivars and screening procedures for desired varietal traits; assessment of β-carotene, anti-oxidant and mineral content and the processing potential of orange-fleshed cultivars. Efficacy of orange fleshed sweet potato to improve vitamin A status was shown and positive effects of household production of orange-fleshed sweet potato, in conjunction with other β-carotene rich vegetables, on dietary intake, vitamin A status and food security were recorded. Dissemination efforts were initially focused on home gardens, which gradually expanded to subsistence production and enterprises. During 2014/15, over 1 million cuttings were disseminated and 5 to 40 small-scale commercial farmers in six provinces planted 0.25 to 1 ha of orange-fleshed sweet potato as means for income generation. In order to exploit the nutritional benefits of sweet potato and its potential to reduce vitamin A malnutrition and food insecurity, it is recommended that policy makers set directives to incorporate orange-fleshed sweet potato in government programs related to health, rural development, social development and agricultural production. There is a great need for investment in promotion of orange-fleshed sweet potato, particularly to consumers and retailers. Private–public partnerships and investment by private companies will be crucial for upscaling the impact of orange-fleshed sweet potato on food and nutrition security.     

The importance of plant health to food security

Rapid food price rises have highlighted serious concerns about food security globally and have had a huge impact on achieving Millennium Development Goal 1. Since 2007, an estimated 100 million more people have fallen into absolute poverty. Most live in developing countries where low incomes (less than $1 per day) make it difficult to access food. Access to sufficient food for dietary needs and food preferences defines food security. However, whilst price rises have brought food security into sharp focus, underlying problems need to be addressed. Over the last three to four decades, there has been chronic under-investment in agriculture at all levels. Development aid to agriculture has declined and often in-country policies do not support the sector. Low crop yields are common in many developing countries and improved productivity is vital to reducing rural poverty and increasing food security. Whilst the causes of low productivity are complex, one major contributory factor is crop losses due to plant health problems. Often accurate information on the extent of these losses is missing but estimates of 30–40% loss annually from “field to fork” are common. Any future solution regarding improved global food security must address these losses and that means improving plant health. Two trans-boundary diseases, wheat stem rust race Ug99 and Coffee Wilt Disease of Coffea are highlighted. CABI has a number of plant health initiatives and one radical approach (Global Plant Clinic) involves partnership with in-country services to deliver plant health advice to farmers at the point of demand. Such innovations are entirely consistent with a proposed new “Green Revolution” which would need to be “knowledge intensive”.     

Mining maize diversity and improving its nutritional aspects within agro‐food systems

Agro‐food systems are undergoing rapid innovation in the world and the system's continuum is promoted at different scales with one of the main outcomes to improve nutrition of consumers. Consumer knowledge through educational outreach is important to food and nutrition security and consumer demands guide breeding efforts. Maize is an important part of food systems. It is a staple food and together with rice and wheat, they provide 60% of the world's caloric intake. In addition to being a major contributor to global food and nutrition security, maize forms an important part of the culinary culture in many areas of Africa, the Americas, and Asia. Maize genetics are being exploited to improve human nutrition with the ultimate outcome of improving overall health. By impacting the health of maize consumers, market opportunities will be opened for maize producers with unique genotypes. Although maize is a great source of macronutrients, it is also a source of many micronutrients and phytochemicals purported to confer health benefits. The process of biofortification through traditional plant breeding has increased the protein, provitamin A carotenoid, and zinc contents of maize. The objective of this paper is to review the innovations developed and promoted to improve the nutritional profiles of maize and outcomes of the maize agro‐food system.     

Nutritional status in postconflict Afghanistan: evidence from the National Surveillance System Pilot and National Risk and Vulnerability Assessment

BACKGROUND: Two large-scale studies, the National Surveillance System (NSS) Pilot Study (2003-2004) and the National Risk and Vulnerability Assessment (NRVA) 2003, were conducted by government, United Nations, and nongovernmental organizations in Afghanistan, as part of wider efforts characterizing Afghan livelihoods in relation to particular outcomes of interest: vulnerability to poverty, food insecurity, and malnutrition. OBJECTIVE: To present the data from these two surveys with nutrition as the key outcome of interest, and to further construct the understanding of the underlying causes of malnutrition, thus providing public health practitioners and other sector specialists with insight into how a variety of sectoral programs can impact nutritional outcomes in Afghanistan. METHODS: The NSS gathered information on livelihoods, food security, and nutrition from 20 to 40 randomly selected households in each of 26 purposively selected sentinel sites (representative of livelihood zones) during November-December 2003 and May-June 2004. The NRVA gathered information nationally from households selected with a two-stage sampling (based on livelihood zone and then socioeconomic group) during July-September 2004. RESULTS: Acute malnutrition is below emergency levels for children under five. The level of chronic malnutrition in children under five indicates a problem of public health importance. Dietary diversity in Afghanistan is not as low as expected but still shows room for improvement, particularly in remote areas and with respect to food groups associated with adequate micronutrient intake. The findings also suggest that in addition to lack of adequate household food intake, recurrent illness and suboptimal infant and young child feeding and hygiene practices contribute to poor nutritional outcomes in this age group. The survey also found poor access to health care, markets, and water for household use. CONCLUSIONS: Improving nutritional status requires a multipronged approach, directly targeting malnutrition, coupled with economic growth, household livelihood security, social protection, access to public health services, and water and sanitation. Nutrition policy, programming, and monitoring need to reflect the immediate and underlying causes of malnutrition. Future research needs to be designed to quantify the relative contribution of underlying causes of poor nutrition, allowing practitioners to prioritize responses aimed at improving nutritional outcomes.     

Developments in food processing and increasing gaps in consumers competence of food handling––the challenge for nutrition policy in Europe

Human evolution is accompanied by innovations in food processing. The results are remarkable: there is food security, as there is surplus on cheap, safe and high quality food. Despite this situation nutritional studies reveal that there are still nutritional problems in the world. Food security is only a precondition but no guarantee for nutrition security.The causes of nutritional problems are complex. In industrialised societies the importance of the last links of the food chain, being the competence of consumers regarding food and nutrition, is ignored. Whereas the global knowledge on food processing is increasing continuously, a reverse trend regarding consumer competence can be observed. The consequences of these trends have to be observed and studied. People with less food and nutrition competence are susceptible to disorientation and misguided behaviour. It is likely that the trend accelerates since the traditional ways to learn food and nutrition competence are diminishing; even in the case of food professionals, like cooks or bakers, there is clear evidence of lack of practical experiences.Nutrition and food policy has to focus on this gap. The most important nutritional problems are no longer those of food quality, but related to consumer behaviour. Today’s consumers need high qualification to use all the opportunities to manage the everyday tasks. Without fostering such training (not only for the general population, but also for food professionals) we in Europe are in danger of becoming a food illiterate population.     

Health,Wellbeing and Social Sciences

For social interventions aimed at improving nutrition behavior evidence from randomized trials is essential but cannot be the only approach of research activities. Interventions on dietary habits require considerations on food security, economic and environmental sustainability, and a broad meaning of wellbeing which includes, but also goes beyond, health effects. The model of research in nutrition requires a new consideration of observational studies, mainly through different analytical models. Nutrition and food studies need research programs where medical (nutrition and health), psychology (how we behave), economics (how resources are used and their impact on wellbeing) and sociology (how social determinant shape behavior) collaborate.     

Metabolomic approach to identifying bioactive compounds in berries: advances toward fruit nutritional enhancement

Plant polyphenolics continue to be the focus of attention with regard to their putative impact on human health. An increasing and ageing human population means that the focus on nutrition and nutritional enhancement or optimisation of our foodstuffs is paramount. Using the raspberry as a model, we have shown how modern metabolic profiling approaches can be used to identify the changes in the level of beneficial polyphenolics in fruit breeding segregating populations and how the level of these components is determined by genetic and/or environmental control. Interestingly, the vitamin C content appeared to be significantly influenced by environment (growth conditions) whilst the content of the polyphenols such as cyanidin, pelargonidin and quercetin glycosides appeared much more tightly regulated, suggesting a rigorous genetic control. Preliminary metabolic profiling showed that the fruit polyphenolic profiles divided into two gross groups segregating on the basis of relative levels of cyanidin-3-sophoroside and cyanidin-3-rutinoside, compounds implicated as conferring human health benefits.     

Research Needs to Supply Milk Protein in the Human Diet

Emergence of government action to define a national policy on food and nutrition implies increased emphasis on programs for food production and marketing. Optimal policy will rely upon information from targeted basic and applied research. Dairy cattle are discussed in the context of their comparative advantage among livestock species for providing high quality protein in the human diet Research needs are suggested to supply economical milk protein by improving biomass efficiency, economic efficiency, milk pricing, and aggregate analyses of systems of dairy production.     

The process of developing a nutrition-sensitive agriculture intervention: a multi-site experience

Nutrition-sensitive agriculture (NSA) interventions are of increasing interest to those working in global health and nutrition. However NSA is a broad concept, and there are numerous candidate NSA interventions that could be implemented in any given setting. While most agriculture interventions can be made “nutrition-sensitive”, there are few guidelines for helping to decide what agriculture component should be tried in an NSA intervention. Based on previous models, we developed a framework with explicit questions about community factors (agricultural production, diets, power and gender), project factors (team capacity, budget, timelines) and external factors that helped our team of agriculture scientists, nutritionists and local officials identify NSA interventions that may be feasibly implemented with a reasonable chance of having positive agricultural and nutritional impacts. We applied this framework to two settings in upland Vietnam, and one setting in upland Thailand. From an initial list of nineteen interventions that have been tried elsewhere, or may reasonably be expected to be appropriate for NSA, five or six candidate interventions were chosen per site. Based on the criteria, three to four interventions were selected per site and are being implemented. Poultry rearing and home gardening were selected in each site. They and the other selected interventions, hold promise for capitalizing on underused agricultural potential to improve diets, while working with (or improving) existing gender relationships and power structures. The process for identifying NSA interventions was thorough and identified reasonable candidates, but it was very time consuming. Further efforts should focus on streamlining the process, so that promising and appropriate NSA interventions can be identified quickly and reliably.     

Crops that feed the world 6. Past successes and future challenges to the role played by maize in global food security

Maize is one of the most important food crops in the world and, together with rice and wheat, provides at least 30% of the food calories to more than 4.5 billion people in 94 developing countries. In parts of Africa and Mesoamerica, maize alone contributes over 20% of food calories. Maize is also a key ingredient in animal feed and is used extensively in industrial products, including the production of biofuels. Increasing demand and production shortfalls in global maize supplies have worsened market volatility and contributed to surging global maize prices. Climatic variability and change, and the consequent rise in abiotic and biotic stresses, further confound the problem. Unless concerted and vigorous measures are taken to address these challenges and accelerate yield growth, the outcome will be hunger and food insecurity for millions of poor consumers. We review the research challenges of ensuring global food security in maize, particularly in the context of climate change. The paper summarizes the importance of maize for food, nutrition and livelihood security and details the historical productivity of maize, consumption patterns and future trends. We show how crop breeding to overcome biotic and abiotic stresses will play a key role in meeting future maize demand. Attention needs to be directed at the generation of high yielding, stress-tolerant and widely-adapted maize varieties through judicious combination of conventional and molecular breeding approaches. The use of improved germplasm per se will not, however, be enough to raise yields and enhance adaptation to climate change, and will need to be complemented by improved crop and agronomic practices. Faced with emasculated state extension provision and imperfect markets, new extension approaches and institutional innovations are required that enhance farmers’ access to information, seeds, other inputs, finance and output markets. Over the long-term, large public and private sector investment and sustained political commitment and policy support for technology generation and delivery are needed to overcome hunger, raise the incomes of smallholder farmers and meet the challenges of growing demand for maize at the global level.     

Linking rural livelihood resilience and food security: an international challenge

In many parts of the world, rural livelihoods are characterized by a high degree of vulnerability to climate change, market volatility, and political unrest. Increasingly, the concept of resilience is being used to inform development initiatives aimed at building the capacity of rural households and communities to cope, adapt, and transform in the face of diverse shocks and stressors. There remain, however, significant challenges to mainstreaming resilience thinking into food and nutrition security policy and programming, primarily because the concept is best understood as being embedded within dynamic and highly contextual processes that can be interpreted differently by various parties. This Special Section of Food Security presents international case studies exploring the vulnerability of rural livelihoods and the initiatives proposed to build resilience, providing valuable insights into the practical challenges to assessing resilience in different contexts. Through different applications of the resilience concept, these case studies highlight the key roles played by broader social, institutional, and governance contexts in affecting food and nutrition security. The need to better supplement the development of reliable metrics for assessing resilience with richer and more context-specific narratives is also highlighted.     

Structure of breeding programs to capitalize on reproductive technology for genetic improvement.

Potential rates of genetic progress are limited by biological constraints, which along with genetic parameters determine the structure of breeding programs to be employed for maximum genetic improvement. The objective here is to determine whether current progeny-testing programs in dairy cattle, which have been dictated and constrained by low female reproductive rates, need to be changed to capitalize on new reproductive technologies and how these changes should be implemented. Many differences between breeding programs diminish when selection on animal model genetic evaluations across all age and population groups is adopted as a strategy. Progeny-testing schemes then evolve toward dispersed open nucleus breeding schemes when multiple ovulation and embryo transfer is used on bull-dams. Nucleus breeding schemes have been advocated to capitalize on embryo transfer technology. In nucleus breeding schemes utilizing high reproductive rates, inbreeding, rather than reproductive rate, poses a limit to genetic progress, and strategies that maximize response to selection while limiting inbreeding need to be employed. One strategy is mating each dam to several sires rather than only one sire. In vitro embryo production techniques can be used to facilitate such mating strategies. Large-scale in vitro embryo production programs, in which large numbers of embryos per female are tested in the commercial population, offer the greatest potential for genetic gain with low rates of inbreeding. Cloning has an impact mainly on methods for dissemination of genetic improvement. Breeding herds, genetically inferior to marketed clones, are needed for continuous genetic gain. Reproductive technologies offer the potential for genetic improvement. Whether new breeding programs require changes in population structure, e.g., by creation of nucleus breeding herds, depends mainly on logistics and on quantity and quality of field information.     

Leveraging agriculture to improve nutrition in the Philippines

The typical Filipino diet mainly consists of rice, fish and vegetables, with rice being the greatest source of calories. The consumption of a maize, starchy roots and tubers as rice substitutes or supplements, and vegetables and fruits has generally declined, while the consumption of fats, oils and meats has increased. Stunting is the most prevalent form of malnutrition among Filipinos. Vitamin A Deficiency, Iodine Deficiency Disorder, and Iron Deficiency Anemia remain public health problems for children and pregnant and lactating women. The link between nutrition and agriculture in the Philippines has focused on leveraging agriculture to improve nutrition. The programs that had been initiated by the government, NGO/CSO or private sector were conceptualized and implemented before the elements of a nutrition-sensitive agriculture framework were identified. These programs were implemented to address food production and the nutritional needs of individuals, families, and communities only with reference to nutrition security. Many of these programs have been successful as they implemented best practices that could be applied to forge a superior approach that optimizes the agriculture-nutrition nexus. This study identified these best practices or elements of success. The elements that have been noted as reasons for the success of some of these programs are: presence of strong political will and enabling policy environment; forging of new forms of partnerships, strategic collaboration, sound coordination and structures; exploiting the best that science and technology could offer; democratizing community participation; strong capacity building component and access to reliable technical expertise; knowledge and sensitivity to local cultures, beliefs and practices; professionalized promotion and ‘messaging’; use of catchy terms for easy recall; availability of sustainable funding; use of the life cycle approach in nutrition; holistic community nutrition perspective; practice and promotion of biodiversity-based agricultural production system; and control of the means of production.     

Activating the community for nutritional improvement

This presentation provides information on community-oriented action research conducted under the leadership of Dr. Rajammal P. Devadas, the recipient of the IUNS International Nutrition Award for 2001. Educating, activating, and energizing the community with empowerment have been the focus of the action-oriented research. In the four decades of work presented, massive efforts have been made in the areas of infant and preschool child nutrition; nutritious noon meal programs for children; integration of nutrition, health, and sanitation concepts in the primary school curriculum; use of local foods to eradicate malnutrition; introduction of novel and underexploited foods; food-based approaches to overcome micronutrient malnutrition; equipping women for food and nutrition security; and nutrition education. These efforts have been activated through development of relevant food and educational materials, their introduction to the community, impact evaluation, follow-up, and implementation of the concepts in relevant national programs with massive training efforts. Many of the efforts outlined have formed the basis for regional and nationwide nutrition intervention strategies. The experiences gained and training efforts developed have gone beyond the country-level exposure to training and equipping nutrition workers in other countries.     

Good governance for nutrition in the Philippines: elements, experiences, and lessons learned

Malnutrition is a multifactorial problem that needs a multisectoral solution. This article reviews the role of good governance in nutrition programs, citing the Philippines as an example. In the Philippines, these efforts are reflected in the partnership between the public and private sectors in the establishment of the country's capability in research, policy-making, and program implementation. The establishment of the different public institutions engaged in research and policy-making is discussed, highlighting the role of political will through legislation. The evolving tasks of the nutrition program are discussed by citing the tasks in two eras. In the 1970s, the challenges were limited national nutrition data, man-power, tools, and health infrastructure. The public and private institutions were able to respond by legislating national nutrition surveys and dedicated nutrition workers in each village. The challenges in the current era are improved implementation of health programs, given the devolution of health services, and the gathering of an evidence base to further strengthen and refine the strategies of supplementation, fortification, breastfeeding, and food security. In responding to these challenges, multisectoral solutions and collaboration are critical in providing an evidence base to formulate policy. The role of the private sector, with the Nutrition Center of the Philippines used as an example, is that of a supportive and collaborative partner in good governance. Finally, the lessons learned from the past decades of implementing a national nutrition program, given changes in political and economic circumstances, are summarized.     

Incorporating nutritional considerations when addressing food insecurity

Addressing the challenges of global food security will benefit from the simultaneous incorporation of nutritional priorities that contribute to the good health of populations. Inclusion of nutritional considerations, when increasing availability and access to food, broadens the scope and objectives of agriculture and food production and thus contributes to an integrated concept of food and nutrition security. The poor quality of food and lack of diversity in the habitual diet of many who live in the developing world imposes enormous costs on societies in terms of ill health, lives lost, reduced economic productivity and poor quality of life. Micronutrient deficiencies are a problem that is much greater than hunger and is a prime example of the need to integrate both food and nutrition security. Sustainable food-based approaches to enable adequate consumption of micronutrients include dietary diversification and biofortification. Agriculture and agricultural biotechnology not only offer the opportunity of increasing crop yields, thereby increasing food security, but also have the potential to improve the micronutrient content of foods, thus contributing to the achievement of both food and nutrition security. Ensuring food and nutrition security will facilitate the attainment of the targets set for the Millennium Development Goals.     

Policy integration in the EU governance of global food security

The global food price spikes of 2007–8 and 2010 led to increased awareness of the complexity of food (in)security as a policy problem that crosscuts traditional sectoral, spatial and temporal scales. At the European Union (EU) level, this awareness resulted in calls for better integrated approaches to govern food security. This paper addresses the question of to what extent these calls were followed by an actual shift towards better integrated EU food security governance. We address this question by applying a processual policy integration framework that distinguishes four integration dimensions: (i) the policy frame, (ii) subsystem involvement, (iii) policy goals, and (iv) policy instruments. The empirical body of evidence for assessing shifts in these dimensions draws upon an extensive analysis of EU documents complemented with interview data. We find that policy integration advanced to at least some degree: the policy frame expanded towards new dimensions of food security; a wider array of subsystems started discussing food security concerns; food security goals diversified somewhat and there was an increased awareness of coherence and linkages with other issues; existing instruments, including internal procedural instruments, were expanded and made more consistent; and new types of instruments were developed. At the same time, significant differences exist between policy domains and policy integration efforts seem to have come to a halt in recent years. We conclude with various policy recommendations and suggestions for follow-up research.     

Food security: definition and measurement

The term “food security” has been used over time to mean different things. This brief article discusses the various meanings attached to the concept and suggests that it can be a useful measure of household and individual welfare, particularly if combined with estimates of household food aquisition and allocation behavior. If nutritional security is the goal of interest, estimates of access to food should be combined with estimates of access to clean water and good sanitation. Anthrometric measures are likely to be more appropriate than food security estimates to target policies and programs to improved child nutrition.