Lancet series reinforces importance of maternal and child nutrition to solve hunger and malnutrition
In 2008, The Lancet published five papers on maternal and child undernutrition that changed the landscape for policies and programmes in nutrition globally. This week marks another milestone with the launch of an update to The Lancet’s series titled Maternal and Child Nutrition.
In 2013, we are still dealing with hunger and undernutrition, but now there are also overweight, obese and micronutrient deficient people. As was reported in the 2013 series release by Marie Ruel, a 10% increase in GDP leads to a 6% reduction in child stunting but a 10% increase in GDP leads to a 7% increase in overweight people. Economic growth has its benefits, but also its costs. We are seeing the costs of malnutrition shift in the economy to the health sector, especially in low and middle-income countries.
Nutrition is a complex area and we can’t attribute the problems or solutions to single nutrients or foods. Diets throughout the world are changing in positive and alarming ways, which has significance for nutrition and our health. The dietary transition from coarse grains, legumes, small amounts of animal source foods, vegetables and fruits to high-energy, high-fat, high-sodium and fast food diets is resulting in higher rates of non-communicable diseases such as diabetes, cardio-vascular disease and cancer. We are seeing regions of the world experiencing significant increase in Type II diabetes for the first time.
Agricultural biodiversity in terms of species diversity and varieties of plants, animals and even fungi – the foundation of our food systems – is shrinking on farms, in forests, in the sea and in aquatic systems everywhere. The heavy reliance on a narrow diversity of food crops puts future food and nutrition security at risk. Over 60% of dietary energy comes from three foods: rice, wheat and maize. Coupled with disappearing varieties we see this as an example of reduced resilience and a risky food future, especially given known threats like climate change, resource depletion and population growth.
How do we find solutions or at least manage the risks?
The good news is that consumers are leading the way. They are asking governments, industry and researchers for help to identify healthy sustainable foods and to make better choices. They are looking for ways to reconcile choices based on the expense, how much time they have to buy or cook, how far food has travelled and how it was produced, where it’s coming from and the nutrients involved. Sometimes these factors compete with each other, and the choices become difficult. Sometimes we are confronted with dueling ways to understand ethical and sustainable choices about the foods we eat and the life we lead. Should we buy local, organic, sustainable food and what are the carbon, water, nitrogen and phosphorous costs of a food or ingredient? What are the health and nutrition benefits of a food or diet? Can we trust the government, industry or the Internet for advice? What makes sense for my family and my community?
The launch of The 2013 Lancet series is an important step to improve food, diets and nutrition. The issues raised in the series are central to conversations about the persistent and growing problem of hunger, obesity and hidden hunger, especially in women and children of low and middle income countries. The attention to good nutrition and health is timely and well deserved, but we still have tremendous needs to ensure the issues are tackled, as detailed in this series. These issues are also high on international agendas, from the post 2015 Millennium Development Goals consultation process, the Nutrition4Growth event in London to the upcoming world leaders’ G8 gathering.
The series links with research happening right now to improve nutrition and to give consumers information, especially in three important areas:
Dietary diversity: A variety of interventions makes a difference to save lives. For the first time, it’s encouraging to see that dietary diversity is one of several recommended strategies especially for infants and young children. This approach applies to all populations. A diverse diet – not only of different parts of the food pyramid, but also encompassing local and seasonal foods – is a contributor to good nutrition. We know this from the decades of research of the role of a healthy diet in reducing the risk of cancer, cardio-vascular disease and other issues. So much of nutrition guidance is familiar to us and is exemplified in the Mediterranean Diet, based around coarse grains, legumes and nuts, seasonal fruits and vegetables, minimal animal source foods, olive oil and modest amounts of wine.
Agricultural systems: For more than 30 years, evidence has shown that agriculture systems have a crucial role in our nutrition and the series makes this connection. Agriculture is the main occupation of 80% of low-income populations in rural areas and women are often the smallholder farmers in developing countries. Women in some countries carry the burden of malnutrition along with many demands of smallholder agriculture. Future challenges require a broader approach to agriculture, one that embraces agriculture as a system that needs to provide good nutrition, diversity, stable incomes, healthy ecosystems and long-term options for future generations. Within CGIAR, Bioversity International and partners are looking at nutrition at a landscape level, including studying issues of access, cost, culture, agriculture and seasonality in meeting dietary solutions. This is especially important in areas where agriculture, aquatic systems, forestry, and other productive land uses compete with resilience, sustainability, environmental and biodiversity goals. This 'spare and share' approach links good nutrition and health with the needs of the population and the landscape. A symbiotic relationship represents a more sustainable future.
Collaboration across sectors and groups: The series emphasizes that nutrition is part of a bigger picture in interventions to improve maternal and child nutrition and health at large scale, and has the potential to improve livelihoods and women’s empowerment. Nutrition solutions require multiple levels of engagement including policymakers, industry, and consumers. The cross-section of agriculture, environment, nutrition and health is becoming increasingly visible for policymakers, industry leaders, the scientific community and the general public. We no longer can rely on 'silver bullets' to solve the challenges of hunger, nutritional imbalance and the unintended consequences of the global shifts in diets. We have learned from the study of environments and complex systems that we need a learning agenda for a comprehensive approach to the factors that promote healthy diets and lifestyles. This is made more urgent by the fact that we need to feed 9 billion people by 2050 but sustainably without taxing our planet.
The Lancet series reminds us of the complexity – but also the multiple points of connection – between our food and our lives. Most importantly, the series will contribute to a greater chance for survival, disease prevention and more options for all of us.
This blog was cross-posted from Bioversity International.