Rising obesity rates are in the headlines – with increasing recognition of the major role that agriculture and food systems play in the epidemic. As agriculture economists interested in human nutrition, we wanted to take a look at what it all means, to look at how agriculture and food systems are part of the problem and how they are part of the solution. While conducting research for a recent report, a few things stood out to us.
Holidays for me have always been about family and food. A time to relax, catch-up with loved ones and eat good food. When it’s our turn to cook, my husband and I take time to plan the menu. A central part of our meals are vegetables and fresh fruits but we have also learnt over the years that a good meal needs fresh ingredients, all procured as close to the preparation of the meal as possible.
Sri Lanka has not disappointed in its array of fruits and vegetables. I am still discovering the names of many; some of which I will never be able to pronounce for sure. Despite that, I love eating them!
Amongst my favourites are papaya, mangoes and kankun, the last for which I share a passion with my two pet turtles. But getting these vegetables and fruits from the same supplier on a constant basis is a challenge. Even common produce like onions, tomatoes, and cucumbers can be discoloured or squishy – not at all appetizing or conducive for a salad or other such type of fresh dish.
The price, of course, is the same whatever the quality. Fresh produce can be expensive, and regularly buying a variety of fruits and vegetables does strain the budgets of many families in Sri Lanka. Needless to say, this shouldn’t be the case in a country with such rich soils and plentiful sunshine.
The question of access to fresh and healthy food goes beyond our holiday tables. According to the World Health Organisation, 1 in 5 premature deaths in Sri Lanka are due to a non-communicable disease (NCD) such as diabetes, cardiovascular disease or cancer. Tobacco use, unhealthy diets, harmful use of alcohol and physical inactivity have all been identified as risk factors.
Robert Allen’s recent AER paper on “Absolute Poverty: When Necessity Displaces Desire” is a fascinating read, on many levels. The paper uses linear programming (LP) to compute (four variants of) least-cost diets for twenty countries, using prices from the International Comparisons Project (ICP) microdata. To the resulting least-cost food budgets, estimates of non-food costs covering housing, fuel, lighting, clothing and soap are added, generating “basic need poverty lines” (BNPL) for each country.
Yet, these deficiencies -- often referred to as ‘hidden hunger’ -- go largely unnoticed and affect large populations.
Night blindness, a condition afflicting millions of pregnant women and children, stems from low intake of foods rich in essential nutrients like Vitamin A.
Budget constraints limit access to nutrient-rich foods for many families, who are unaware or unable to afford a nutritious diet.
National programs help supplement diets with Iron and Vitamin, but their scope is too narrow to adequately address these deficiencies.
Fortified Milk Helps Increase Vitamins Intake
When fortified with vitamin A and D, milk, which remains a staple for many Indians, can help alleviate dietary deficiencies when supplementation is not available.
Food fortification is a relatively simple, powerful and cost-effective approach to curb micronutrient deficiencies. It is in general socially accepted and requires minimal change in existing food habits.
The process is inexpensive and costs about 2 paisa per liter or about one-tenth of a cent. And because it only adds a fraction of daily recommended nutrients, the process is considered safe.
For these reasons, food fortification has been successfully scaled up in some emerging economies.
However, except for salt fortification with iodine, India has not yet achieved large-scale food fortification.
With India’s rapidly growing dairy industry, large-scale milk fortification of Vitamins A and D is a robust vehicle for increasing micronutrients intake across the population.
One year ago, we did not know how many Somalis were poor and how programs and policies could help to reduce poverty or at least build resilience against falling deeper into poverty. We knew that Somalis receive an estimated $1.4 billion (24 percent of GDP) in remittances every year. But we did not know whether the poor received the remittances and whether they helped mitigate the impact of poverty. To overcome this dearth of information, we implemented the Somali High Frequency Survey and established a near real-time market price monitoring system.
Co-author: Sophie Durrans, Research Uptake Officer at London School of Hygiene & Tropical Medicine
A child who is stunted early in life – who fails to grow as tall as expected for their age – often has reduced physical and mental development. Water supply, sanitation, and hygiene (WASH) influences a child's growth in multiple ways. Evidence across low and middle-income countries demonstrates that higher open defecation rates are associated with stunting and higher overall incidence of poverty.
Beatrice Montesi, GAIN
Martin P. Gambrill, The World Bank
Rebecca Jean Gilsdorf, The World Bank
Crowded slums, poor sanitation and unhealthy diets. It’s a potent cocktail and for too many families across the world, a daily reality. Right now, an estimated one billion people live in slums and that number is expected to double by 2030. Slums are where the many deprivations facing the urban poor collide, including lack of access to clean drinking water, sanitation, safe and nutritious foods, sufficient living space, durable housing and secure tenure (UN Habitat). They’re where human waste is routinely emptied into streets, canals, and garbage dumps. And where overcrowding and low rates of immunization and breastfeeding combine to exacerbate the already perilous problems children face.
Children growing up in these surroundings are at a higher risk of death and disease and are more likely to be chronically malnourished (Ezeh et al. 2017). For example, forthcoming World Bank research from Bangladesh shows that children living in slums are 50 percent more likely to be stunted than children living in other urban areas. This doesn’t just have implications for today - , and face a higher risk of chronic disease as they grow older. Tragically, these effects are often passed on to offspring, trapping families in poverty and malnutrition for generations, as per findings in a forthcoming World Bank report called Uncharted Waters.
“If breastfeeding did not already exist, someone who invented it today would deserve a dual Nobel Prize in medicine and economics.” - World Bank Vice President of Human Development, Keith Hansen
This is a sentiment long-shared by many of us in the nutrition community and as the global movement in nutrition grows, so does our body of evidence supporting how powerful nutrition interventions are for individuals and for societies.
The state of Madhya Pradesh in India is largely vegetarian with limited consumption of eggs and meat.
While these dietary preferences are commonplace in other Indian states, Madhya Pradesh is facing a protein deficiency epidemic which threatens the long term health of its population.
How did it get there?
In 2015 I spent five weeks in rural and tribal areas of Madhya Pradesh evaluating the World Bank’s Madhya Pradesh District Poverty Intervention Project (MPDPIP II), with the support of the South Asia Food and Nutrition Security Initiative (SAFANSI)
Across the 8 districts I visited, families shared how they had improved their agricultural productivity, started backyard kitchen gardening, and supplemented their income through dairy and poultry farming, collective procurement and small scale enterprises.
As I examined local village level health records, Anganwadi Center (AWC) registers, Auxiliary Nurse and Midwife (ANM) registers and Primary Health Center (PHC) documents, I noticed a reduction in severe malnutrition and severe anemia among pregnant women and under 5-year-old children.
However, this decrease did not extend to moderate or mild malnutrition and anemia.
“Why would I want to?” Because in poor countries, chickens are everywhere, they are pooping wherever they want, and chicken feces is dangerous for young children.