BELFAST, Northern Ireland — From misunderstandings about what malnutrition is to misconceptions about how best to fight it, myths about nutrition and healthy eating can hinder the efforts of those trying to tackle these problems.
“There are a myriad of myths and misconceptions about food and nutrition across the world. We all grew up with them, from our grandmothers’ tales about cures for the common cold to ‘an apple a day keeps the doctor away,’” said Lauren Landis, the World Food Programme’s director of nutrition. While not all myths are harmful, there are some that need to be dispelled, she explained.
“When you come in as a development agency and you boost production of crops, milk, or any other thing and assume ‘now we have addressed household nutritional needs,’ that is incorrect.”— Faith Owuor, project coordinator, Farm Africa
According to the World Health Organization, 462 million adults are underweight while 1.9 billion are overweight or obese. Just under half of all deaths among children under 5 years of age can be attributed to undernutrition.
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Thomas Cole, senior technical adviser at African Women Rising — a nonprofit that empowers women after war and works with refugees to grow vegetable gardens — said many of the myths are global misconceptions, including the belief that there is a lack of food available and that malnutrition is the same as hunger.
“Many of us working in the sector go up against these when trying to raise money and mobilize resources,” Cole said.
Devex asked experts what other misconceptions they feel pose the biggest challenges in the nutrition sector and how to overcome them.
1. Green food is poor people’s food
Traditional green vegetables that can be grown at home are full of nutrients, yet these are underutilized in parts of Africa and South Asia, said Ray-yu Yang, a nutritionist with research and development nonprofit World Vegetable Center. This is due to a belief that green leafy food is only for those with a lower income who must grow their own produce. Those with more money prefer to buy food from markets — but these often offer processed foods that are not so nutritious, Yang said.
That traditional vegetables are seen as a class symbol and that those with a higher income want to eat different types of food poses a challenge for organizations working to promote home-based production and consumption of vegetables for improved nutrition.
“[People] are not interested in trying or consuming [home-grown vegetables] and it creates some problems. We really need to promote, demonstrate, and convince them that these are nutritious and traditionally used in their diet,” Yang said.
2. Higher income leads to better nutrition
This ties into a second myth: that income-generating programs lead to better nutrition. While this can be true in some circumstances, Yang said, the World Vegetable Center tends to see an increase in levels of obesity and overweight as income rises.
“Once lower-income countries have more household income for food expenditure, they might not make the healthy choice,” she said, so the link between income and nutrition is not automatic.
She recommended that income-generation and nutrition programs work together to educate people about what foods they should be spending their money on as their income increases.
3. The best way of improving nutrition is by providing people with food
Most development projects focus on food security and livelihood interventions to increase agricultural production, with the assumption that once food is available, malnutrition has been addressed, said Faith Owuor, project coordinator at Farm Africa. That often includes an assumption that beneficiaries know how to grow their own food and can do so if provided with the right tools and seeds, Cole added.
But it’s a lack of nutrients and education on what foods to eat and how to grow and cook them that is the bigger problem.
“In most of the countries we are working in, particularly in the rural areas, this is a big, big problem,” Owuor said. “When you come in as a development agency and you boost production of crops, milk, or any other thing and assume ‘now we have addressed household nutritional needs,’ that is incorrect.”
As Rwanda battles to overcome high levels of malnutrition, one program is helping village mothers train each other on how to feed their children well.
Owuor recommended that an element of nutritional education be integrated into all nutrition-focused development projects so that, as access to food increases, so does the knowledge around it.
Alison Greig, technical director of the global technical services unit at Nutrition International, pointed to a similar issue around anemia, a condition that is diagnosed in around 40% of expectant mothers, but is also prevalent in teenage girls. While iron and folic acid supplements can help prevent the condition, “girls and their parents often assume that pregnant women are the only people who require it,” Greig said, believing their existing diets to be adequate.
Increasing knowledge is key to improving acceptance of nutrition programs and understanding of why they are necessary, she said.
4. Obesity is not a form of malnutrition
According to WHO, levels of overweight and obesity are increasing in low- and middle-income countries, particularly in urban areas. This can be attributed to the rising availability of “western foods” that are higher in fat and sugar, and are affordable.
Greig said many people in these countries don’t consider being overweight or obese as a form of malnutrition. “In many contexts, children who are overweight are considered healthy,” Greig said.
More than 1 in 3 low- and middle-income countries now face the double burden of high levels of obesity and undernourishment.
“While underweight and wasted children have a high risk of dying before their fifth birthday, overweight children have a higher risk of developing noncommunicable diseases and facing health issues throughout their life,” Greig said.
Such a belief, alongside limited resources, makes it challenging to advocate for governments to devote equal attention to both ends of the spectrum. “While there are clear protocols in place for underweight children to be referred to for nutrition support, families of overweight children are falling through the cracks of the health system,” Greig added.
She believes that policy frameworks at both global and national levels to regulate marketing and advertising of unhealthy foods — such as Mexico’s introduction of a sugar tax — could help in dispelling the misconception.
5. There’s a silver bullet to fix everything
Organizations are often searching for a singular action to solve hunger when the issue is multifaceted, Cole said. This might include fortification, school feeding programs, or access to more food.
Adriane Seibert, a senior technical adviser for nutrition at Catholic Relief Services, explained that malnutrition is closely associated with poverty and food insecurity, as well as women’s status in society.
“Nutrition is compromised when women are not able to make decisions or exercise control over household resources,” Seibert explained.
Social and cultural attitudes and beliefs also influence the way people use food, which in turn influences nutrition. Solutions therefore should be a multisectoral effort that is tailored to specific contexts, she said.
All the experts highlighted increased access to information and nutrition education as key in tackling misconceptions. But as they are usually deeply ingrained in cultures and communities, WFP’s Landis said it also requires patience.
“To change an eating culture, you need to include community leaders, religious leaders, and local and national governments,” she said.
“We can address misconceptions by using appropriate and accurate terminology with all audiences and providing people with data and evidence,” Seibert added. “It’s about building relationships with individuals and decision-makers and gaining the trust to work with them to address their situation.”
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