Home-grown school feeding: promoting local production systems diversification through nutrition sensitive agriculture

The consumption of some non-staple crops such as legumes and dark, green leafy vegetables can address common deficiencies in key nutrients such as vitamin A and iron; however, limited markets and supply chain development impede their production and accessibility to consumers. This study investigates the pathways to promote agricultural production and dietary diversity for a local market intervention called Home-Grown School Feeding (HGSF). School feeding menus from 24 districts across 10 regions in Ghana during the 2014–15 school year were analysed in terms of food groups and several individual foods. The menus were then compared with food groups produced by households during the past year or consumed in the past seven days using data collected from a household survey. Greater inter-food group diversity in the menus was associated with higher production levels for tubers and dark, leafy green vegetables in the South and cereals in the North. A correspondence between the frequency in which a food group appeared in a menu and the share of households who consumed foods from the food group was also noted. Key issues, such as optimizing supply chains, enabling farm linkages and supporting diverse nutrient rich food groups, that underlie the success of Home-Grown School Feeding and other agricultural policies with similar goals of promoting production and dietary diversity are highlighted through commodity specific examples. The findings of this study may help strengthen operational linkages between agriculture production and nutrition for HGSF and other similar interventions.     

Coupling of soil regeneration,food security,and nutrition outcomes in Andean subsistence agroecosystems

To sustain the livelihoods of smallholder farmers globally, improved human nutrition must not sacrifice future agroecosystem productivity. We gathered environmental, agricultural management, food security (FS), and normalized child height for age (HAZ; children age < 2y) data from 297 farming households to test whether enhanced FS and nutrition goals can be aligned with agroecosystem maintenance in Andean farming systems that rely heavily on the local environment. Our results demonstrate many expected relationships between environment, agriculture, and nutrition in these communities’ households, for example between ecosystem biomass production and manuring rates, between total household crop production and FS, and between HAZ and child diet diversity. However, increased FS status evaluated by households was unrelated to HAZ as an indicator of nutrition status. By contrast, better child nutrition and feeding practices in some households were associated not with total production but with farming practices that sustain soils and secure higher per-hectare crop yields: longer fallows, greater crop diversity, and smaller cropped areas. These results may be explained by the tendency for agricultural practices correlated with household food insecurity (e.g. reduced manure inputs, greater cropped area) to increase labor and impede appropriate feeding and child nutrition while they accelerate environmental degradation. Crop production imperatives for food supply can thus degrade soils without delivering improved nutrition. Meanwhile, more sustainable practices in households with better child nutrition (e.g. smaller, better-manured crop areas) may address time barriers to effective care and feeding. We discuss challenges and opportunities based on these results for meeting both nutrition and environmental goals.     

Zum Kohlgemüseverzehr in der ehemaligen DDR — eine retrospektive Analyse

Consumption of Brassica in the former GDR — a retrospective analysis In the former GDR there was a consumption of Brassica amounting to 31 kg per capita and year in the average of the years 1984 to 1988. After deduction of all registered losses ? 46% in the average – the approximate consumption amounted to 16.7 kg per capita and year. White cabbage (37% of the Brassica consumption) as well as cauliflower, red cabbage, kohlrabi, Brussels sprout and savoy cabbage belonged to the dominating species of Brassica. The analysis as to the approximate consumption represents a constituent for the differentiated and exact calculation of the glucosinolate intake.     

2011年北京市顺义区居民膳食营养摄入状况调查

调查2011年北京市顺义区居民膳食营养摄入状况。方法 采用分层整群抽样的方法,按全区经济发展程度和地理位置分为城区、经济发达农村、经济欠发达农村三层。每层随机选取两个社区或乡村,在每个社区或乡村随机选取463户1761人作为研究对象,研究每个调查户所有成员食物消费、营养素摄入以及营养素的食物来源情况。结果 顺义区居民谷类、豆类、蛋类、蔬菜摄入较合理,水果、奶类和鱼虾类食物摄入偏低,分别为建议摄入量的50%、17%和13%。肉类、油和盐的摄入量偏高,分别超出推荐值的2%、88%和78%。能量摄入下降趋势明显,维生素A、B₁、B₂、钙的摄入量占推荐摄入量(RNI)的百分比偏低,分别为72.3%、64.3%、57.1%和50%,脂肪供能比偏高,蛋白质质量有待提高。结论 北京市顺义区居民部分营养素摄入不足,需优化膳食结构。     

Raising chickens for increased egg consumption in a rural highland Bolivian population

In highland Bolivia a three-year nutrition-sensitive agricultural intervention was carried out with rural families in which chicken rearing was promoted in order to increase egg consumption. Here we report on the impact of the intervention on participants’ diets. The non-randomized intervention took place in 21 rural communities in the province of Tapacarí in the department of Cochabamba, Bolivia. Intervention communities had staggered start times, with two communities starting in 2013, three communities starting in 2014 and sixteen communities starting in 2015. Twenty-four hour dietary recall data were collected from all individuals in 22 households in two communities in February/March 2013, 33 households in three communities in February/March 2014, and 66 households in fourteen communities in February/March 2015. We tested for changes from 2013 to 2014 to 2015 in consumption of 10 food groups in children under 6 years, adult men and adult women. By endline, egg production was established in ~80% of the intervention households. From baseline to endline egg consumption increased to approximately one-half egg/person/day: in children from 7 to 33 g/day, in women from 6 to 33 g/day, and in men from 6 to 39 g/day. Despite the increased intake in eggs, intake of most nutrients did not change. Higher egg consumption would be required to produce observable average increases in nutrient intake.     

Nutrition knowledge and practices, and consumption of vitamin A--rich plants by rural Nepali participants and nonparticipants in a kitchen-garden program

Food-based nutrition interventions, including kitchen gardens and nutrition education, offer a potentially sustainable approach to reducing multiple nutritional deficiencies, but they have been poorly evaluated in developing countries. In a poor region of the terai (the flat, subtropical agricultural region that borders on India) in rural Nepal, we developed and evaluated the impact of a nutrition program added to the Market Access for Rural Development (MARD) Project. The primary objective of the MARD Project was to augment household income by increasing the production of high-economic-value crops. The objective of the nutrition program was to increase vitamin A and iron intakes by promoting kitchen gardens (training, technical assistance, and seed distribution) and nutrition education. One-third of the kitchen-garden program participants also attended nutrition education or agricultural training sessions that were part of the MARD Project. The program was evaluated after 36 months by a cross-sectional nutrition survey in 430 MARD households with kitchen gardens and 389 non-MARD control households. The lack of knowledge about nutrition, including the causes, prevention, and treatment of night-blindness and anemia, was remarkable. However, compared with control households, the kitchen-gardens group had significantly more nutrition knowledge (38% vs. 13% knew one of the causes of night-blindness, and 17% vs. 3% knew one of the causes of anemia), were more likely to feed special complementary foods to infants and to preserve food, and consumed more of 16 types of home-produced micronutrient-rich vegetables and fruits. Although the cross-sectional nature of the study limits our ability to attribute these differences to the program, we observed a striking lack of nutrition knowledge in these communities, and a clear opportunity to increase the intake of vitamin A through home production of vitamin A-rich plants.     

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.     

Food and agriculture policy: issues related to prevention of noncommunicable diseases

Good nutrition depends on access to a healthful food supply. Although a great deal of attention has been paid to food intake as a determinant of nutrition and overall health, little attention has been paid to the food supply system, health risks embedded in it, and its effect on people's choices. Most national governments intervene in their agricultural sectors in order to provide benefits to producers and consumers; however, these interventions are not designed with public health in mind. Governments should consider population nutrition and chronic disease risk when devising and implementing agricultural and food policies. They should seek opportunities to adjust agricultural and trade policies to be consistent with national health and nutritional priorities and guidelines. Although the paper gives several examples, country-specific policy changes can be determined only through analysis of individual country policies and nutrition conditions.     

A comparative evaluation of dietary indicators used in food consumption assessments of at-risk populations

BACKGROUND: Easy-to-collect dietary indicators have been used increasingly for planning and evaluation of food security interventions. Various indicators have been employed, but rarely has a full set of indicators been compared using a common framework. OBJECTIVE: This paper evaluates the performance of five dietary indicators for the assessment of household energy consumption using a common framework and recent data from Mozambique. METHODS: Data were analyzed from a 2004 household survey, Current Vulnerability Analysis in Seven Provinces of Mozambique. Households (n = 4,358) were sampled from 42 rural districts using a two-stage design, and a quantitative 24-hour dietary recall was employed. Household energy intake ratios were calculated as the food energy consumed by household members divided by the sum of the members' recommended intakes. Five proxy indicators of household consumption in the previous day were developed: the number of meals, the number of food groups, the number of food items, a score based on a simple weighting of food groups consumed, and a predicted energy intake ratio based on weighting of food groups consumed with previously estimated regression coefficients. The performance of these indicators was assessed using correlations with energy intake, receiver operator characteristic analysis, efficiency of predictions, and prevalence estimate comparisons. RESULTS: Although the predicted energy intake ratio performed best on all these performance criteria, and the simple food-group-weighted score performed second best, differences among the indicators on many of the criteria were relatively small. CONCLUSIONS: New assessment systems could take full advantage of easy-to-collect information by using one of these best-scoring indicators, although established systems could continue to use some of the other indicators explored here, such as the food item count, without much loss in accuracy.     

Assessment of the nutritional impact of agricultural research: the case of mungbean in Pakistan

BACKGROUND: Evaluation of agricultural research often neglects consumption and nutrition aspects. Yet agricultural research can address micronutrient malnutrition by improving both quantity and quality of food intake. OBJECTIVE: To briefly review the conceptual linkages between agriculture and nutrition, to estimate the strength of the relationship between iron intake and productivity outcomes, and to estimate the nutritional benefit of improved mungbean varieties in terms of net present value. This paper presents a methodology for assessing the nutritional impact of mungbean, and summarizes current impact evidence on the path from mungbean research to consumption. METHODS: A consumption study was conducted among female piece-rate workers in Pakistan to analyze the impact of iron consumption on productivity, measured in wages. A two-stage least-squares analysis was used to estimate the elasticity of iron intake on wages. The results derived from this study were extrapolated to country level using secondary data sources. RESULTS: We found that anemia among women was widespread. Approximately two-thirds of women suffered from mild or severe anemia (Hb < 12 g/dL). We found the elasticity of bioavailable iron on productivity measured in wages was 0.056, and the marginal effect was 9.17 Pakistani rupees per additional mg of bioavailable iron consumed. Using the model results we estimated the impact of mungbean research on nutrition, in terms of productivity effects, and found it was substantial, ranging from US dollar 7.6 to 10.1 million cumulative present value (in 1995 US dollar at 5% discount rate). CONCLUSIONS: Agriculture certainly plays an important role in the reduction of malnutrition. Agricultural research has greatly contributed to the reduction of hunger and starvation by providing millions of hungry people with access to low-cost staple foods. Now, as the challenge shifts to the reduction of micronutrient deficiencies, more efforts must be directed toward crops high in micronutrients, such as pulses and vegetables.     

Food-coping strategy index applied to a community of farm-worker households in South Africa

BACKGROUND: In South Africa, households living in informal urban settlements, in rural areas, and on commercial farms experience various levels of dietary variety, food intake, and household hunger. Low incomes, poor food production and availability, and low spending power characterize these households. Households employ various food-coping strategies to alleviate food stress or poor food availability. OBJECTIVE: To apply an existing food-coping strategy (FCS) index to assess household hunger and its usefulness in identifying the level of food stress and the patterns of food coping in farm-worker households. METHODS: A cross-sectional survey was conducted. Data were gathered from women (18 to 57 years of age) responsible for food provision in a small farm-worker community in Fouriesburg, South Africa. A structured food-coping questionnaire and a standardized FCS index were used to gather data. RESULTS: The two most common FCS used were relying on cheaper food (chicken feet, diluted soya-mince soup) or less preferred food (meat bones) and employing food-seeking strategies (gathering wild foods), followed by consumption of seed stock (maize) and reduced portion sizes (protein foods and side dishes), resulting in starch-based diets of poor variety. Seasonal strategies varied according to the level of food stress experienced. Patterns of food coping were identified. CONCLUSIONS: Negative FCS (limiting food choices, only consuming starchy staples) may cause poor health status. The FCS index was effectively used to assess farm-worker household food-coping behavior (early, clear signals of the level of food distress). These results could be used to allocate appropriate food aid (type of food) and to design nutrition education programs focused on positive FCS (food gathering or bartering) in a particular community to prevent suboptimal nutritional status.     

中国2020年食物与营养发展目标战略分析

系统分析了我国食物与营养发展新特点,总结出我国生产结构与消费结构不衔接、消费目标和营养目标不协调、营养改善与健康需求不匹配等食物与营养发展新问题,阐述了资源环境压力增大、流动人口扩大、老龄化社会来临、非传染性慢病呈高发条件下食物与营养发展面临的新需求,提出了我国食物与营养发展的＂协调、优化、干预＂三大战略选择,预测了2020年我国粮食、肉类、蔬菜等8种主要农产品生产与消费需求量目标,提出了全面小康社会建设时期促进食物与营养发展的若干战略对策与措施。     

Effect of food intake on protein quality measured in chicks by traditional or biochemical methods

Previous studies have shown that the activities of the hepatic enzymes xanthine dehydrogenase and nucleoside phosphorylase, as well as the uric acid excreted, can be used to determine the quality of the protein consumed in chickens, in a short time and using a small amount of the test protein. A common observation in protein quality evaluation is that the food intake of the control animals is considerably greater than that observed in those receiving proteins of low quality. Since this can affect the results, this study measured the quality of garbanzo bean and black bean proteins in chickens fed these beans ad libitum, feeding the bean diets at the level observed in the controls (soy protein+methionine) by enteral intubation or pair feeding the controls with the amount of food consumed by the chickens receiving the bean diets. In every case, protein quality was determined by protein efficiency ratio, net protein utilisation or the biochemical methods used in this study. The results showed that, when fed ad libitum, the animals assigned to the bean diets exhibited a lower food intake than the controls but, by tube feeding, food intake was made equal in both groups. Equal consumption, between these groups, was also obtained by reducing the amount of food offered to the controls to the levels measured in the groups assigned to the bean diets (pair feeding). These feeding strategies had a marked effect on growth, carcass protein content, protein catabolism and also in the results of protein quality. Thus, the control whose intake was reduced grew less, accumulated less protein in tissues and catabolised more of the protein consumed than the control fed ad libitum. In contrast, the chickens assigned to the bean diets, but whose food intake was increased by tube feeding, grew better, accumulated more protein in tissues and catabolised less protein. In general, the results of these experiments confirm the effectiveness of the biochemical methods for estimating protein quality and indicate that the protein quality of both garbanzo beans and black beans increased when it was measured at a food intake equivalent to that measured in the control animals. Since the overall purpose of this study was to evaluate techniques for protein quality determination meant to be applicable to humans nutrition rather than poultry nutrition, single proteins were used instead of combinations of proteins. © 1998 Society of Chemical Industry.     

Time trends in the intrafamily distribution of dietary energy in rural India

The intrafamily distribution of dietary energy in 5,458 households from seven states in India was assessed from 24-hour dietary recall data collected by the National Nutrition Monitoring Bureau during 1996-97. The energy consumption, expressed as percentage of recommended dietary intake (%RDI), of preschool children, schoolchildren, and adolescents was compared with that of adult men and women in the same households. Time trends in the intrafamily distribution of dietary energy were assessed by comparing the data with those collected in 1975-80 using the same procedures in the same villages. About one-third of the preschool children had an inadequate intake of energy, even when their adult counterparts had an adequate intake, whereas only about 7% of the preschoolers and their parents were consuming inadequate amounts of energy. The extent of energy inadequacy was much less in adolescents and school-age children than in preschool children. This was true even when the adults in the same households had an adequate energy intake. In 1996-97, there was a significant increase in the proportion of households with preschool children consuming inadequate energy, although both adult men and women were consuming energy-adequate diets as compared with the dietary data collected in the same villages in 1975-80. The results indicate the need to provide effective nutrition education for parents regarding the nutritional needs of their children.     

Farm production diversity and dietary quality: linkages and measurement issues

Recent research has analyzed whether higher levels of farm production diversity contribute to improved diets in smallholder farm households. We add to this literature by using and comparing different indicators, thus helping to better understand some of the underlying linkages. The analysis builds on data from Indonesia, Kenya, and Uganda. On the consumption side, we used 7-day food recall data to calculate various dietary indicators, such as dietary diversity scores, consumed quantities of fruits and vegetables, calories and micronutrients, and measures of nutritional adequacy. On the production side, we used a simple farm species count in addition to looking at the number of different food groups produced. Regression models showed that production diversity measured through simple species count is positively associated with most dietary indicators. However, when measuring production diversity in terms of the number of food groups produced, the association turns insignificant in many cases. Further analysis revealed that diverse subsistence production often contributes less to dietary diversity than cash income generated through market sales. If farm diversification responds to market incentives and builds on comparative advantage, it can contribute to improved income and nutrition. Yet, increasing the number of food groups produced on the farm independent of market incentives may foster subsistence, reduce income, and thus rather worsen dietary quality. The results suggest that improving the functioning of agricultural markets and smallholder market access are key strategies to enhance nutrition.     

68例非住院高龄卧床管饲患者营养状况调查

目的:评价非住院高龄卧床管饲患者营养状况。方法:以驻沈干休所68名长期卧床高龄休干为调查对象,记录被调查对象每天摄入的所有食物的种类和数量,计算每人每天摄入的热能、蛋白质、脂肪、碳水化合物等供能营养素以及膳食纤维数量,采集人体测量指标及实验室指标综合评价高龄患者的营养状况。结果:老年患者管饲匀浆中食物种类比较齐全,但在数量上有个别品种不能达到建议值;能量摄入偏低(16.2kcal/kg),三大供能营养素中碳水化合物供能比36%,而蛋白质和脂肪供能比分别为26%、35%;膳食纤维摄入9.2g(8.4g/1 000kcal),是RNI的60%。血清白蛋白和前白蛋白降低者最多,有48.5%患者的BMI处于低限值以下。结论:高龄患者管饲饮食配方中有不尽合理之处,营养不良发生率较高,高龄患者的肠内营养支持不仅要保证能量摄入,尚需维持三大供能营养素的合理比例。     

Dietary interview. I. Comparison between dietary history versus repeated daily recalls]

In the course of 12 months, 43 men and 53 women aged 30-40 years were subjected to 14 24-hours recalls and one dietary history concerned with their individual dietary habits. The mean values yielded by the first and the second method for energy, 4 nutrient groups and 8 food groups were statistically evaluated and compared with each other, from which the following conclusions can be drawn as to the reliability and the precision of the dietary history: 1. The dietary history permits the quantitative estimate of the energy and nutrient intake in groups of about 50 subjects with an error of less than 10%. Underestimation of the actual food intake is more likely than overestimation. 2. The same holds true for the quantitative estimate of the consumption of foods from great food groups. The method is considerably less precise in case of single food or irregularly consumed foods. The differences between the results from the two methods ranged from 0 to 25%. 3. The precision of the individual results obtained for energy and nutrient intake from the dietary history was +/- 20% with a probability of 80-90%. In 75% of the cases, the differences in the consumption of food groups as determined by the two methods were smaller than 20%. As to single foods, however, individual misestimations ranging from 30 to 50% are to be expected.     

Impacts of HIV / AIDS on food consumption and wild food use in rural South Africa

HIV/AIDS can affect household food consumption in many ways, including through reductions in availability and quality of labour, reductions in earned income, and increased expenditure on medications. In rural South Africa, these negative effects can be buffered by social safety net programs provided by government and collection of wild foods. Despite some acknowledgement of the potential safety net role of wild foods, however, their contribution relative to other food sources in the context of HIV/AIDS remains underexplored. Here we report empirical findings from two rural communities in the Eastern Cape province of South Africa. Qualitative and quantitative methods were used to characterise food sources, intake and calories from 68 HIV/AIDS afflicted households and 87 non-afflicted households every quarter over 12 months. Results show that diets were moderately well-balanced though limited in variety, with cereal items contributing 52 % to total calorie intake. The bulk of food consumed by households was purchased, with supplementation from own production, collected wild vegetables and collected wild fruits. Up to 20 % of respondents from both HIV/ AIDS afflicted and non-afflicted households had insufficient daily caloric intake. Multivariate analyses show that, all else equal, individuals living in households afflicted by HIV/AIDS consumed fewer calories, had less diverse diets, and were more dependent on wild foods than those living in non-afflicted households. Given the detrimental effects of HIV/AIDS on income and home production, wild foods represent a free and readily available food source for vulnerable households.     

Nutritional impacts of an increasing fuelwood shortage in rural households in developing countries

Developing countries face the problem of an increasing fuelwood shortage. For rural households, fuelwood is the main source of energy. As energy is essential to make food suitable for human consumption by means of cooking, the present fuelwood crisis could jeopardize the nutritional situation of rural households. This article reviews and analyses available data and information on the relationship between the availability of fuelwood and the nutritional situation of rural households. Based on analysis of emperical studies, three main strategies evolved by rural households, especially by the women within these households, to cope with a shortage of fuelwood can be distinguished: (i) increase in time and energy spent on fuelwood collection, (ii) substitution of fuelwood by alternative fuels and (iii) economizing on the consumption of fuelwood and alternative fuels. These coping-strategies affect food supply, food preservation, preparation and distribution, income generating activities and food consumption, all of which result in a decrease in quality and quantity of food consumed and in a deterioration of physical condition, especially women and their young children. Available data on fuelwood availability and nutrition are rather diffuse and incomplete. The presence of several confounding variables in the studies analysed make it difficult to establish the nutritional impact of a growing shortage of fuelwood. Nevertheless, it is concluded that a shortage of fuelwood plays at least an important role in changes in nutritional situation of rural households. If current trends continue, this role will become more important and evident. The impact of a growing fuelwood shortage should be a point of concern for rural development.     

The impact of agricultural input subsidies on food and nutrition security: a systematic review

Agricultural input subsidies, a form of social protection, are often considered an important means of improving agricultural productivity in low- and middle-income countries. However, their effectiveness and efficiency remains contentious with respect to productivity, economic and consumer welfare measures, as well as food and nutrition security. This is exacerbated by a weak evidence base, including no review focused on the impact of agricultural input subsidies on food security and nutrition. Further, where studies have considered nutritional outcomes of agricultural input subsidy interventions, this has often been in regard to changes in consumption of the targeted staple food, measured in terms of calorie consumption or a similar measure of changes in energy availability, ignoring other aspects of malnutrition, including impacts from dietary diversity. This wider consideration of impacts from dietary diversity is important, given the increasing recognition in nutrition policy of its importance. We address this gap in the literature with a review of the evidence on the impact of agricultural input subsidy programmes on nutrition and nutrition-related health in low- and middle-income countries, mapping this evidence against a conceptual framework of the mediating pathways.