4 issues that matter in nutrition

Nutrition is everybody’s business. Although individuals and their families ultimately decide on what they eat, it is the government that rules on what is safe and healthy to consume, the farmers who grow crops, and businesses that process these crops into items that would go on our tables.

Because it involves so many players, improving nutrition requires a multisectoral approach.

It's “a little bit more complicated” than other global development targets, Greg S. Garrett, director of large-scale food fortification at the Global Alliance for Improved Nutrition, told Devex.

Given today’s busy development agenda, though, nutrition, multifaceted as it is, may be at risk of taking a backseat to other areas where even one intervention can have an immediate impact, such as insecticide-sprayed bednets to prevent malaria. Indeed, if donor funding is any indication, there’s some truth to it: Official development assistance committed in 2012 for basic nutrition ($734.5 million) is just a little over half of that for malaria control (nearly $1.3 billion).

That being said, funding has grown over the last few years, helping to make a dent on nutrition-related challenges. From 2008 to 2011, when ODA commitment for basic nutrition rose from $261.7 million to $443.1 million, child mortality due to undernutrition went down from 3.5 million to 3.1 million. Progress, however, has been slow; stunting continues to be a major problem, as last year’s Nutrition for Growth summit in London made clear.

But there are reasons to feel optimistic about the future of global nutrition. Dozens of developing countries have pledged to dedicate funds to scale up successful interventions. Institutions like UNICEF or the Famine Early Warning Systems Network are compiling data on nutrition challenges; FEWS NET is in the process of compiling multiple datasets from governments, global development donors and nonprofits to allow its members to pinpoint emerging food security challenges more exactly than ever.

Evidence on what works or not is available, helping to inform decision-making at various levels, from donors, governments and corporations to civil society and consumers.

Here’s a look at some of the emerging issues that heat up conversations about nutrition.

Too much and too little

We’re grappling not only with the effects of undernutrition but also obesity.

On top of their clear health consequences, both are bad news for the economy: Malnutrition can trim a developing country’s gross domestic product by up to 3 percent, according to the World Bank.  

Several approaches have shown success in reducing malnutrition. Supplementing and enriching everyday food with micronutrients like iodine, iron, folate, vitamin A and zinc can go a long way to improve health outcomes. The consumption of iodine-fortified food during pregnancy can reduce the possibility of brain damage in children, for instance.

Considered the leading risk for global deaths like cancer, diabetes and cardiovascular disorders, obesity is not exclusive to the developed world — quite the contrary. In fact, nearly two thirds (62 percent) of overweight and obese people live in developing nations, with countries in the Pacific, Caribbean, Middle East and Central Asia reaching “especially high rates of overweight and obesity,” according to a study published in the Lancet this May.

Rapid urbanization gets a lot of the blame. It tends to not only reduce physical activity but also prompt dietary changes as former rural dwellers shift from the production of their own food to the purchase of processed foods and sugary drinks.

Countering obesity will require action at international and local levels. Authors of the Lancet study call for “urgent global leadership” that can help countries effectively address root causes, including food labeling and advertisement. In urban areas, local authorities can set policies and allot certain plots of land so residents can grow fresh fruits and vegetables, or follow the example of former New York City Mayor Michael Bloomberg, who during his recent term pushed restaurants and fast food chains to include calorie counts in their menus.

The more, the better — information, that is

Increasing awareness on what to eat is critical to changing behavior toward food. One way of doing so is through food labeling. Regulations on food labeling vary across the globe: Some countries don’t have any, others make these labels voluntary. But almost always, these labels — which can be used to inform consumers about nutrients contained in products and recommended daily allowances — are contentious.

Celebrities can have an immense pull with the public and thus serve as agents of change as well. Save the Children, for instance, has tapped football superstar Cristiano Ronaldo to promote healthy eating habits in rural America, where one in three children are poor and obese, and Hollywood actress Isla Fisher for its global breastfeeding campaign.

Yet to be successful, nutrition education has to be customized, experts agree.

For years, development implementers would provide the same message about nutrition to women and men but the latter would often show little interest, according to Ladd, senior technical director for nutrition at ACDI/VOCA.

“You've got to figure out what it is that makes them interested in nutrition, to care for their family, to make sure that there's proper food in the house,” Ladd said.

For instance, women may respond well to messages extolling the benefits of breastfeeding to their babies’ health whereas men may respond better to the prospect of their child growing up strong and becoming someone they look up to.

In farming households, men often have control of income and how to use it, Ladd observed. And as such, they have huge influence on the family’s nutrition.

“If they don't like green leafy vegetables, the woman's probably never going to cook green leafy vegetables,” she said. “So if you can influence men in that way, then you can influence family choices in a different way.”

The role of the private sector

The global development community has increasingly engaged the private sector in efforts to increase access to nutritious food. Scaling Up Nutrition, a country-led movement to expand the use of proven interventions for malnutrition, is one example of such a partnership.

Some members of civil society cast a wary eye on public-private collaborations, citing the possibility of conflicts of interest arising from them. If you ask Brian Thompson, chief nutritionist at the Food and Agriculture Organization, though, the risk is minimal and benefits immense for engaging businesses, so long as safeguards are in place.

“There’s a great deal of potential, lessons and guidance, advice and experiences from the large private sector that we would be foolish to miss out on,” said Thompson, who is also the coordinator for the hotly anticipated 2nd International Conference on Nutrition, to be held this November in Rome. “I think that public-private partnership is something that provides a way of harnessing this knowledge, this expertise for the common public good.”

The last few years have seen some of the world’s biggest corporations take steps to promote healthy diets.

Nestlé, for instance, has integrated nutrition into its core business and philanthropic programs. It’s also the only company among 25 listed on the Access to Nutrition Index 2013 which has set targets for cutting levels of sugar, salt, fat and trans fat and has made commitments to boost levels of whole grains, fruits, vegetables and fiber in its products. The Swiss company ranks third on the index; Danone ranks first.

“There's been really good momentum around multinational companies improving their own foods,” said Garrett, the food fortification expert at GAIN. “They do increasingly see themselves as part of the solution.”

Garrett sees the index as a good tool to incentivize businesses to do a better job on providing nutritious food.

An all-of-the-above menu?

There’s no silver bullet to provide nutritious food for all. In fact, it’s going to get harder as Earth’s population creeps toward an estimated 9.6 billion by 2050. Some observers may argue that the solution lies primarily in making better use of the food sources already available to us; others may push for a greater role of science to create new and more nutritious foods.

Techniques like the cross-breeding of plants and the fortification of food — as well as the elimination of food waste — can certainly help. But will it be enough?

The question has put a spotlight on genetically modified organisms, which remain highly controversial. Critics claim transgenic food poses serious health hazards, but companies like Monsanto, which are producing them, insist that bioengineered crops are proven safe and have better nutrient profiles than their conventional versions.

Governments differ as well on their approach to genetically modified food. Argentina, Brazil, Canada, China, India and the United States allow the cultivation of GMOs, while several European and African countries have imposed bans.

To be sure, there are natural — and nutritious — food sources out there which remain underutilized. Consuming edible insects, also known as entomophagy, for instance, can provide ample amounts of vitamins, minerals, fiber, protein and essential fatty acids.

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Feeding Development is an online conversation hosted by Devex in partnership with ACDI/VOCA, Chemonics, Fintrac, GAIN, Nestlé and Tetra Tech to reimagine solutions for a food-secure future from seed and soil to a healthy meal.