Scientists have irrefutable evidence that malnutrition, which affects one in three people, increases the risk of disease and death and reduces productivity and socioeconomic development. Can they also point to proven interventions to help?
Displaying 1-15 of 15 key documents
Source: The Lancet | January 2008
This collection of articles, published by The Lancet, describes the burden of maternal and child undernutrition in the developing world and highlights proven effective interventions to reduce stunting and micronutrient deficiencies.
Undernutrition is entirely preventable yet causes more than 3.5 million child deaths. It produces stunting, wasting and intrauterine growth restriction among other problems and is particularly prevalent in Africa, Asia, the Middle East and western Pacific.
The window of opportunity for tackling undernutrition is short: from pregnancy to two years of age. After the age of two, the damage on health and brain development caused by undernutrition is irreversible.
But, as the collection shows, there are plenty of interventions that have been proved to improve child nutrition. The most effective include breastfeeding counselling, vitamin A supplementation and zinc fortification.
Source: Organogenesis | July 2008
This review article explores the evidence that inappropriate levels of certain nutrients before or just after birth can predispose some individuals to obesity and examines how this could be applied to a clinical setting.
The brain regulates appetite and food preferences and is highly sensitive to its nutritional environment in early life.
Newborn rats whose mothers were fed a low-protein, high-carbohydrate diet during pregnancy and lactation were more likely to choose high-fat food after weaning. These food preferences may be set during lactation. Tests on another group of rats revealed that newborns exposed to junk food such as doughnuts and crisps in the womb and during lactation were more likely to want that type of food. Newborns whose mothers switched from a junk-food to a healthier diet during lactation did not have this preference.
The authors suggest that hormones such as leptin — long thought to be a crucial factor in appetite regulation — are key in regulating the development of appetite in later life.
Source: Food Nutrition Bulletin | December 2006
This paper explains how interdisciplinary collaboration in health, nutrition, and agriculture has helped the Millennium Villages Project in 12 African villages meet the Millennium Development Goals.
Global science is increasingly under pressure to become more interdisciplinary. Econutrition is a good example of a cross-sector concept that joins environmental and human health, focusing on crosscutting areas such as agriculture and ecology.
Soil erosion and decreasing biodiversity causes environmental damage that lowers food production. A lack of food results in malnutrition and illness that, in turn, lead to poorer labour productivity and poorer agricultural management.
The Millennium Villages Project emphasises community engagement and leadership, and the case study from the Nyanza Province near Lake Victoria in Kenya illustrates that this can work well in improving nutrition.
One-fifth of adults in the area have HIV and many have malaria and TB. People in the region go hungry for up to seven months a year and are malnourished. The villagers constructed a health clinic and organised teams of community healthcare workers trained in nutrition.
Farmers receive fertilisers and plants if they donate ten per cent of their harvest towards a school lunch programme that concentrates on providing missing nutrients. For example, by adding local crops such as sweet potatoes common vitamin A deficiencies are eliminated. The key to success, say the authors, is to ensure that farmers are supported, especially in producing a variety of crops.
Source: American Journal of Clinical Nutrition | August 2006
This review examines the global 'nutrition transition', the ongoing shift in dietary patterns that results from socioeconomic and demographic change.
The author finds that while dietary changes are fairly well documented, other aspects such as how global media or activity-levels influence these changes are poorly recognised. For example, how the drop in manual labour that results as a society becomes more prosperous might affect activity levels.
The author takes an evolutionary view of the nutrition transition, acknowledging that populations have repeatedly striven to make food more plentiful and better tasting (which has often translated to more processed or higher calorie contents) and to expend as little physical energy in the process.
He argues that rapidly-developing countries must consider how to ensure that their richer, well-fed populations do not succumb to degenerative or chronic diseases. There is a strong economic incentive: sick populations drain the economy.
Source: Clinical Infectious Diseases | October 2009
This article unpicks the links between nutrition and HIV/AIDS, and looks how to break the cycle between the two. Every year millions of dollars are pumped into tackling HIV/AIDS including antiretrovirals and research for vaccines and drugs. But poor nutrition remains a major barrier to preventing sickness and death from the virus.
The effects of poor nutrition on HIV status are clear: malnourishment weakens the immune system. But it also has indirect non-biological effects. For example, a lack of food can trigger dangerous coping strategies such as selling sex for food or selling assets, both of which lead to economic instability and a higher risk of HIV infection.
People with HIV are less able to absorb nutrients. And crucially, undernutrition also affects the ability of HIV-infected people to process antiretrovirals such as nevirapine.
The authors call for better targeting of food aid to HIV-infected people.
Source: Springer | 2008
The author list for this collection of chapters, with names like Cesar Victora and Carine Ronsman, reads like a 'Who's Who' in nutrition and health for the developing world. The chapter topics are wide-ranging and include subjects such as the economics of nutrition programmes, the extent to which scientific data influences nutrition policies, and the challenge of providing food aid during humanitarian emergencies.
Each chapter is organised as a scientific paper. Most usefully perhaps, the authors of each chapter include both their conclusions, and a separate list of recommendations for researchers and policymakers.
Source: Food and Agriculture Organization (FAO) | 2009
This set of documents, written and published by the Food and Agriculture Organization's (FAO) Right to Food Unit, is intended as a practical guide to implementing the human right to adequate food.
This six-part guide includes background information on legislating for the right to food, as well as detailed outlines of methods to monitor the human right to adequate food.
It also includes a guide to conducting a right to food assessment, and establishing a budget for the right to food.
A common theme throughout the documents is the need to raise public awareness about these issues.
The toolbox offers policymakers background and contextual information they may not have — such as different legal options for governing the right to food — and provides practical advice on increasing access to food.
Source: Nature | November 2003
This feature article examines some of the key debates around the role of genetically modified (GM) technology in Africa.
The technology promises much to malnourished populations on a continent that climate change threatens to make even more inhospitable to crops. But anti-GM campaigners maintain that Africa's hunger crisis will not be solved by biotechnology.
US agri-biotech corporations such as Monsanto who lobby African governments to buy into such technology also have a large financial stake in rolling out GM over such a large continent. The anti-GM lobby, traditionally made up of environment charities such as Greenpeace, are now seeing aid charities such as Oxfam join its ranks.
The real stand-off, however, is between the largely pro-GM United States and a cautious Europe. The US Agency for International Development (USAID), which is pro-GM, has provided millions of dollars to support biosafety policymaking and research in the developing world.
European countries meanwhile do not rule out introducing GM technology to Africa but want GM products labelled and traceable to their source. The deciding factor may be how effective GM is in improving nutrition — and that remains under debate.
Source: Nature | August 2007
The one bright note in global warming is seemingly that higher carbon dioxide levels will make food crops grow faster. More crops should equal more food. But, as this feature article emphasises, the story is not that simple.
Initial tests have shown that plants grown in high carbon dioxide environments could be less nutritious — with lower protein levels and a different type of protein produced. Other scientists have found a drop in key micronutrients such as chromium, selenium and zinc in high carbon dioxide environments.
Mitigating these changes can involve increasing nitrogen levels to offset protein deficiency, although not all scientists agree on this.
What is clear is that there is very little research in this area and past studies have only looked at carbon dioxide concentrations of 550 parts per million, which is lower than levels predicted by the end of this century.
Source: Federation of American Societies for Experimental Biology Journal (FASEBJ) | October 2005
This paper reviews the emerging fields of nutrigenetics and nutrigenomics to explain how new analytical tools can investigate the link between diet and genes. Nutrigenetics studies single gene interactions, whereas nutrigenomics studies how genes interact with each other or with proteins and nutrients.
In the post-genomic era, nutrition is more than just eating well and getting a balance of vitamins and minerals — our genes significantly influence our nutritional needs and the way we process nutrients. The authors argue that understanding these fields is vital to improving nutrition worldwide.
An introduction to the basics of genomics explains how it has been used by pharmaceutical companies to create the field of pharmacogenetics, which has the potential to produce personalised therapies based on an individual's genes.
Some dietary links with illness — food allergies, for example — are straightforward. Others, such as in heart disease or obesity are more complex. The authors offer a fairly comprehensive overview of known links in both cases.
The health implications of studying the link between genes and diet are great, say the authors. For example, cancer or heart disease management relies on dietary modifications but patients often respond differently. A greater understanding of nutrigenetics could lead to better-tailored treatment.
Source: Royal Society | October 2009
Food security is a major challenge in global health. Agriculture will need a significant boost if we are to feed the expected global population of nine billion people in 2050. This detailed report outlines the case for 'sustainable intensification'.
Climate change is already putting pressure on existing agricultural systems and will likely continue to alter rainfall patterns, temperatures and soil quality. But climate change isn't the only culprit — agricultural output has also fallen through growing pesticide resistance and low crop diversity.
The report argues that crop management must take these biological factors into account. But to be sustainable it must also support poor farmers and rural populations. This will require technological approaches underpinned by robust science, says the report.
The authors provide a detailed overview of how climate change will affect food production and the latest genetic techniques available to boost output. No single approach is going to work, and splitting agriculture into different camps — genetically modified or not, for example — will have no traction. The key is to consider the problem holistically and see how different approaches could be combined for the best results.
The report calls for agricultural sciences to be placed at the forefront of innovation, and supports its position in university courses, arguing that if agriculture is to see a revolution, it will need talented scientists.
Source: African Journal of Food Agriculture Nutrition and Development
This review article, published in the African Journal of Food Agriculture Nutrition and Development, considers how policy interventions can protect vulnerable African nations from the increasing nutrition insecurity caused by the global economic crisis.
The author, Suresh Babu from the International Food Policy Research Institute, argues that the global recession has reduced foreign investment in, and demand for exports from, developing countries.
This has resulted in unstable commodity prices, lower earnings and reduced access to food, forcing people to adopt cheaper and less balanced diets that lead to higher levels of malnutrition.
Babu reviews past crises, including Indonesia in the aftermath of El Niño in 1997, to build a framework of potential policy interventions.
In the short-term, this includes subsidising fertilisers, distributing nutrition supplements and providing income support. In the medium to long-term, social safety net programmes, investment in research, and institution building are needed, says Babu.
Source: Center for Global Development
This paper, published by the Center for Global Development, describes the institutional hurdles to increasing funding for nutrition policies and programmes.
Drawing on a series of interviews with key stakeholders in the field of global nutrition, the authors identify the major institutional strengths, weaknesses and opportunities in global nutrition. They point to donors' growing awareness of nutrition and an increase in national planning and engagement in some countries including Uganda, as well as the birth of partnerships such as the Global Alliance for Improved Nutrition.
But, say the authors, there is no obvious leader with adequate resources and a clear mandate to improve nutrition in the international community. International players are also disconnected from country policymaking and implementation.
The authors suggest that donors create a shared set of principles for coordinating nutrition funding. They also call on leaders within UN agencies to increase the agenda of nutrition security within the UN itself.
Source: PLoS Medicine | May 2005
Cardiovascular diseases are set to rise dramatically in developing countries, partly because of an increase in risk factors for the diseases, which include diet, physical activity, smoking. The authors looked at cardiovascular disease risks such as being overweight or obese, systolic blood pressure, and total cholesterol, and related them to national income, food purchase constraints, and urbanisation. Body mass index (BMI) and cholesterol increased as national income increased, then flattened, and eventually declined. BMI also rose with increasing urbanisation.
The authors suggest that cardiovascular disease risks will increasingly be concentrated in low-income and middle-income countries. Thus, preventing obesity should be considered a priority in these countries, along with measures to control blood pressure, cholesterol, and tobacco use.
Source: Overseas Development Institute | August 2006
In June 2006, the UN emphasised the crucial role of food and nutrition in mitigating the effects of HIV/AIDS. This briefing paper explains how these issues are intertwined, and analyses why there has been little action in this area so far.
When food is scarce, women tend to get the smallest portion, leading them seek food elsewhere. This might include selling sex for food, putting them at a higher risk of HIV infection. Malnutrition can also weaken the immune system, making it easier to pick up infections but harder to get rid of them.
According to the report, health and food authorities each see it as the other's responsibility to integrate nutrition into HIV programmes. Donors and national policymakers have also been reluctant to support initiatives for integration. The first challenge, says the report, is raising awareness of the UN endorsement to secure action. Donors and governments should work to strengthen links between policies — the responsibility to reduce HIV/AIDS must not rest with the health sector alone. Finally, nutrition indicators should be included in clinical surveillance and reporting.