Nutrition in emergencies: WFP experiences and challenges

WFP and its partners have made significant strides in the last decade towards tackling malnutrition in emergencies. Since malnutrition is an important determinant of mortality, food interventions play a key role in saving lives through their impact on the nutrition and health of affected populations. Humanitarian interventions aiming to prevent the deterioration, or promote recovery, of nutritional status have to be carefully tailored to the nature of each crisis and seek to address underlying causes. There are three elements crucial to successful action: Ensuring that a nutritionally-appropriate food basket is formulated to meet local needs, that it arrives on time and in coordinated fashion (not one commodity one month, another the next). Some food commodities are needed in small amounts (iodized salt and fortified blended foods) but their inclusion and delivery are often critical to positive nutrition outcomes. The importance of micronutrients in achieving the goals of emergency operations is increasingly well-understood and there is evidence of the need for greater use of fortified foods than in the past. Coupling food with essential nonfood inputs is important in nutrition programming. Cash resources are required by WFP for a variety of nutrition and public health activities, including local milling/fortification of cereals, local procurement of fortified blended foods, and support for complementary activities such as nutrition education, training, and deworming. An ability to offer sustained improvements in nutrition will depend on strong collaboration with partners skilled in nutrition and public health, including information management. Better linking of emergency programming with nonemergency activities is required so that underlying processes contributing to serious malnutrition are effectively tackled in the long run.     

The Costs of Local Food Procurement in Two Northern Indigenous Communities in Canada

Remote Northern Ontario First Nations communities face severe food insecurity. Prices of store foods are often unaffordable and not always in stock. Government programs have been implemented to subsidize some of the market food costs. Our objective is to illustrate the costs associated with procuring food from the land through hunting and fishing in an effort to present this as an alternate option to relying solely on store-bought foods. Northern Ontario is an area of the world undergoing a rapid nutrition transition leading to high levels of obesity and type 2 diabetes. Despite this knowledge, little has been done to reverse this trend using land based foods, widely promoted as nutritionally beneficial. We conclude that estimated cost of food from the land requires significant energy and time, but remains economically comparable to food available in-store. Further government support should be given to community hunters to make land-based food a viable option for a larger proportion of each community.     

Ethical and Ethnical Requirements in the Production of Food L. E. GRIVETTI

ABSTRACT: The presentation explores ethnic food and ethics aspects of food distribution and food security. Basic principles associated with human food selection and avoidance have been known for some time (since World War I). During intervening decades, however, persistent problems have remained, including mismatched food assistance, short-sighted economic policies, lack of political will, disrespect for women's labor and decision-making skills, and, more recently, debate over zero-risk and genetically modified foods (GMFs) to reduce hunger and malnutrition. Fieldwork investigations of regional food production systems where specific food security mechanisms are identified have improved and streamlined the distribution of food supplies during and after regional or local crises. Paradoxically, such studies raise an important ethical issue, given that these same data have been and can be used by insurgents to sabotage food supplies and disrupt relief efforts. The presentation concludes with personal perspectives on associations between ethnic foods, food-related ethics, and food security. Several approaches to improving food chain security are reviewed, including micro-finance, household gardens, selected GMF technology, and how to improve existing food-related programs.     

Nanoemulsions for Food Applications: Development and Characterization

The application of nanotechnology to food, medical and pharmaceutical industries has received great attention from the scientific community. Driven by the increasing consumers’ demand for healthier and safer food products and the need for edible systems able to encapsulate, protect, and release functional compounds, researchers are currently focusing their efforts in nanotechnology to address issues relevant to food and nutrition. Nanoemulsion technology is particularly suited for the fabrication of encapsulating systems for functional compounds as it prevents their degradation and improves their bioavailability. This review focuses on nanoemulsions and provides an overview of the production methods, materials used (solvents, emulsifiers, and functional ingredients) and of the current analytical techniques that can be used for the identification and characterization of nanoemulsions. Finally, nanotechnological applications in foods currently marketed are reported.     

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.     

Food for nutrition: mainstreaming nutrition in WFP

Most preventable deaths among hungry people take place outside of emergency contexts. In countries not involved in conflicts or natural disasters malnutrition is directly implicated in the deaths of millions of children and mothers each year. Thus, WFP's great efforts focused on saving lives in emergencies should be mirrored by efforts aimed at tackling malnutrition, and hence saving lives, beyond emergencies as well. While food sufficiency is not the same as good nutrition, food is nevertheless an important part of the nutrition equation. New scientific evidence confirms that it is possible to have positive nutritional impacts with food aid. Consistent with Strategic Priority No. 3, WFP seeks to use food resources to achieve nutritional impacts in three complementary ways: a) enhancing the effectiveness and impact of targeted mother and child health and nutrition interventions (MCHN) that combine food and appropriate nonfood inputs; b) enhancing the nutritional value of WFP food (for instance, through micronutrient fortification); and c) enhancing the nutritional impact of other WFP (non-MCHN) interventions. These approaches represent a mainstreaming of nutrition across WFP's activities. Adoption of evidence-based programming, joint interventions with partners, and new project designs offer the promise of greater WFP effectiveness and impact in the coming years.     

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.     

Agricultural biodiversity, nutrition, and health: making a difference to hunger and nutrition in the developing world

BACKGROUND: In spite of the strides made globally in reducing hunger, the problems of micronutrient deficiencies and coexisting obesity and related cardiovascular and degenerative diseases constitute a formidable challenge for the future. Attempts to reverse this trend with single-nutrient intervention strategies have met with limited success, resulting in renewed calls for food-based approaches. The deployment of agricultural biodiversity is an approach that entails greater use of local biodiversity to ensure dietary diversity. OBJECTIVE: To outline a new strategy proposed by the International Plant Genetic Resources Institute (IPGRI) that employs agricultural biodiversity as the primary resource for food security and health. METHODS: The authors carried out a meta-analysis to review and assemble existing information on the nutritional and healthful properties of traditional foods based on a diverse set of case studies and food composition and nutritional analysis studies. The methods highlight particular examples of foods where analysis of nutrient and non-nutrient composition reveals important traits to address the growing problems of malnutrition associated with the rise of chronic diseases. Finally, the authors analyze social, economic, and cultural changes that undermine the healthful components of traditional diets. RESULTS: Based on this multidisciplinary and comparative approach, the authors suggest a holistic food-based approach that combines research to assess and document nutritional and healthful properties of traditional foods, investigating options in which nutritionally valuable traditional foods can contribute to better livelihoods, and ways that awareness and promotional campaigns can identify healthful components of traditional diets that fit the needs of urban and market-oriented consumers. CONCLUSIONS: There is an urgent need for agricultural research centers, national agricultural research systems, universities, and community-based organizations to work together under a shared policy framework with the aim of developing a strong evidence base linking biodiversity, nutrition, and health. Although these initiatives are still ongoing, the gains realized in small-scale and local pilot efforts have encouraged IPGRI to work with local partners toward the implementation of scale-up efforts in various regions.     

Food matrix impact on macronutrients nutritional properties

The food industry is aware of the consumer’s desire to purchase delicious, convenient and nutritious foods. Rapid development of functional foods has induced the food industry to evaluate and revise the composition of their processed foods as well as their processing conditions and methods to improve nutritional and health effects. The addition of new bioactive compounds to a food requires that the bioactive agent is in the active form by the time it reaches the gastrointestinal tract, where it is assimilated. However, the question is whether or not the processes and the composition of traditional foods are carefully balanced to ensure the optimal nutritional properties. This paper aims to review the concepts and facts that are the basis of the new area of research regarding the role of food structure on the nutritional properties of conventional and functional foods. Several original approaches have emerged, bringing together scientists from fields such as food science, nutrition and physiology, which bring enlightening new perspectives to the development of delicious and nutritional foods.     

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.     

Centrally processed weaning foods for use in developing countries

Abstract

Many approaches are needed to improve child survival and growth in developing countries. Among these are improved sanitation, breast‐feeding promotion, immunizations, diarrheal disease control, and the provision of safe and nutritious weaning foods. This review considers weaning food developments in the context of aggregate data on changes in the nutrition situation in developing countries. Infant and child mortality and growth data are reviewed. These data reveal that progress has been made in many regions of the developing world in reducing infant and child mortality over the last 20 years. Less success is apparent in reducing the prevalence of linear growth retardation of preschool children. The importance of breast‐feeding and improved sanitary practices is stressed. This review is focused on the important role weaning foods can play in addition to other cultural and health inputs in improving growth and child survival in the developing world. Following a brief introduction to the weaning period, breast‐feeding and weaning practices in all regions of the developing world are reviewed. Weaning food developments, including compositional and processing alternatives, are then discussed in the context of nutritional requirements. Particular attention is devoted to various technologies to increase the energy density of weaning foods. In the context of all these factors, product specifications for weaning foods, as promulgated by the Codex Alimentarius Commission, are presented and discussed. Finally, studies in which supplementary feeding programs have been evaluated are reviewed. The data discussed in this review suggest strongly that the timely introduction of properly prepared weaning foods has an important role to play in improving child survival and growth in the developing world. Emphasis in this review is placed on the advantages of centrally processed weaning foods, but clearly home/village‐prepared foods also have an important role to play. The review emphasizes elementary principles of home sanitation in the proper use of weaning foods. Also, other elements of successful child health programs need to be present, including encouragement of breast‐feeding, child spacing, immunization, growth monitoring, and provision of and instruction in the use of oral rehydration therapy when needed.     

Global Hunger: A Challenge to Agricultural,Food, and Nutritional Sciences

Hunger has been a concern for generations and has continued to plague hundreds of millions of people around the world. Although many efforts have been devoted to reduce hunger, challenges such as growing competitions for natural resources, emerging climate changes and natural disasters, poverty, illiteracy, and diseases are posing threats to food security and intensifying the hunger crisis. Concerted efforts of scientists to improve agricultural and food productivity, technology, nutrition, and education are imperative to facilitate appropriate strategies for defeating hunger and malnutrition. This paper provides some aspects of world hunger issues and summarizes the efforts and measures aimed to alleviate food problems from the food and nutritional sciences perspectives. The prospects and constraints of some implemented strategies for alleviating hunger and achieving sustainable food security are also discussed. This comprehensive information source could provide insights into the development of a complementary framework for dealing with the global hunger issue.     

Foodways Transmission in the Standing Rock Nation

Effective foodways transmission is critical to maintain the food sovereignty of indigenous peoples. In order to determine their own foodways, indigenous communities have developed diverse systems to convey knowledge related to the procurement, preparation, distribution, and consumption of food. In recent years, community organizations are taking a more active role in facilitating foodways transmission. In the Standing Rock Nation of the northern Great Plains, several community organizations, including tribal government agencies, are creating opportunities for elders to share their knowledge about traditional foods. The impetus for these activities comes from elders themselves, who attribute high rates of diet-related diseases to a loss of knowledge about traditional foods. We conducted eighteen semi-structured interviews with elders and organizers in the midst of these activities to reflect on processes of foodways transmission, including the implications of facilitation by community organizations. Interviews were focused on four human ecological concepts: perception and diversity; human ecological relations; context; and practical wisdom. Insights generated through our discussions were immediately applicable to the ongoing activities in Standing Rock and can inform elders and community organizations leading similar efforts in other communities.     

Relating Food Engineering to Cooking and Gastronomy

Modern consumers are increasingly eating meals away from home and are concerned about food quality, taste, and health aspects. Food engineering (FE) has traditionally been associated with the industrial processing of foods; however, most underlying phenomena related to FE also take place in the kitchen during meal preparation. Although chemists have positively interacted with acclaimed chefs and physicists have used foods as materials to demonstrate some of their theories, this has not been always the case with food engineers. This review addresses areas that may broaden the vision of FE by interfacing with cooking and gastronomy. Examples are presented where food materials science may shed light on otherwise empirical gastronomic formulations and cooking techniques. A review of contributions in modeling of food processing reveals that they can also be adapted to events going on in pots and ovens, and that results can be made available in simple terms to cooks. Industrial technologies, traditional and emerging, may be adapted to expand the collection of culinary transformations, while novel equipment, digital technologies, and laboratory instruments are equipping the 21st‐century kitchens. FE should become a part of food innovation and entrepreneurship now being led by chefs. Finally, it is suggested that food engineers become integrated into gastronomy's concerns about safety, sustainability, nutrition, and a better food use.     

Cultural relevance of a fruit and vegetable food frequency questionnaire.

PURPOSE: Canada's multicultural population poses challenges for culturally competent nutrition research and practice. In this qualitative study, the cultural relevance of a widely used semi-quantitative fruit and vegetable food frequency questionnaire (FFQ) was examined among convenience samples of adults from Toronto's Cantonese-, Mandarin-, Portuguese-, and Vietnamese-speaking communities. METHODS: Eighty-nine participants were recruited through community-based organizations, programs, and advertisements to participate in semi-structured interviews moderated in their native language. Data from the interviews were translated into English and transcribed for analysis using the constant comparative approach. RESULTS: Four main themes emerged from the analysis: the cultural relevance of the foods listed on the FFQ, words with multiple meanings, the need for culturally appropriate portion-size prompts, and the telephone survey as a Western concept. CONCLUSIONS: This research highlights the importance of investing resources to develop culturally relevant dietary assessment tools that ensure dietary assessment accuracy and, more important, reduce ethnocentric biases in food and nutrition research and practice. The transferability of findings must be established through further research.     

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.     

Promotion of the feeding minds and fighting hunger initiative in selected rural schools in Andhra Pradesh, India

BACKGROUND: Schoolchildren are good agents of change and need to be educated and sensitized to specific issues of hunger and malnutrition through a question-and-answer process. Feeding Minds and Fighting Hunger (FMFH), a global project initiated by the Food and Agriculture Organization and partner organizations, attempts to help schoolchildren learn about these issues by introducing concepts in the prevention of hunger and malnutrition to teachers, and by facilitating transfer of knowledge to the children through a set of model lessons. OBJECTIVE: To test the feasibility of the FMFH approach to improve the nutrition knowledge of rural schoolchildren in three rural schools in Medak District of the South Indian state of Andhra Pradesh. METHODS: Participatory workshops for teachers were conducted to facilitate knowledge transfer to the children through interactive classroom teaching and other activities. The change in knowledge and thinking of children in the seventh and eighth grades was assessed by a ques- tionnaire administered before and after the intervention. The questionnaire also assessed, in part, the status of local food security based on the sources of different food items in the households. RESULTS: The responses to the questionnaire suggested that the children's knowledge of nutrients and their functions was not good initially but improved after the intervention. However, their understanding of the social factors responsible for hunger and malnutrition was fairly good prior to the intervention. Improvement in responses to the question of what should be done to combat malnutrition also occurred after intervention. The community had village-level food security for rice and maize but depended partially or fully on outside sources for pulses, fruits and vegetables, and animal products. CONCLUSIONS: The FMFH approach can be applied in rural schools where "the poorest of the poor" children can improve their understanding of balanced diets, better nutrition, the causes of malnutrition, and approaches to combat malnutrition.     

Addressing the challenges of climate change and biofuel production for food and nutrition security

More than one billion people are suffering hunger and malnutrition in 2009. Food security has deteriorated since 1995 and reductions in child malnutrition are proceeding too slowly to meet the Millennium Development Goal (MDG) target of halving hunger by 2015. Three major challenges threaten current and future efforts to overcome food insecurity and malnutrition: climate and global environmental change and the consequent loss of ecosystems’ services, the growing use of food crops as a source of fuel and the food and financial crises. This paper reviews and analyses the current and projected effects of climate change and bioenergy on nutrition and proposes policy recommendations to address these challenges. The first section of the review lays out the public health and socio-economic consequences of malnutrition and explores causes and costs. The paper then analyses the implications of climate and global environmental change and biofuel production for food security and nutrition, addressing strategies for adaptation and mitigation. This analysis includes a number of important socio-economic factors, besides climate change and biofuel production, that are currently impacting food and nutrition security, and that will likely contribute to future effects. The paper concludes with a series of policy proposals and recommendations to adapt to and mitigate the impacts of climate and global environmental change placing human rights in the centre of decision making. These proposals include a number of options for improving sustainability and food and nutrition security while addressing the links between climate change and bioenergy demand.     

The nutrition transition and indicators of child malnutrition

This study examines how the nutrition transition, which involves a westernization of diets and increased consumption of calorie-dense, processed foods, affects child malnutrition in developing countries. It is often assumed that the nutrition transition affects child weight but not child growth, which could be one reason why child underweight decreases faster than child stunting. But these effects have hardly been analyzed empirically. Cross-country panel regressions show that the nutrition transition reduces child underweight, while no consistent effect on child overweight is found. Against common views, our results also suggest that the nutrition transition reduces child stunting. Further research is required to confirm these findings.     

Sustainable diets: Harnessing the nutrition agenda

There has been rapid growth in the global population over the last century and estimates for 2050 are a global population of over 9 billion. These mouths need to be fed and the nutritional quality of the food received will be a key determinant of future health. Alongside this expansion in the world’s population, rapid economic growth in China, India and South America is increasing demand for protein-rich foods, especially meat and dairy products, causing concern about the impact this may have on green house gas emissions. As economies strengthen and dietary and lifestyle patterns become more westernised, the so-called diseases of affluence are becoming ever more evident, often alongside malnutrition. This paper considers these challenges and the need to embed thinking about nutrition into discussions about sustainability of the food supply.