Agriculture, Food Systems, and Nutrition: Meeting the Challenge

Direct and indirect effects of economic sanctions on health: a systematic narrative literature review

BACKGROUND

Economic sanctions are defined as restrictions imposed by other countries against individuals, groups, or governments of other countries. These sanctions have a detrimental impact on the economies of countries and can also limit access to healthcare services for people as a secondary consequence. This study aims to systematically review the literature to examine the direct and indirect effects of economic sanctions on health through a narrative synthesis.

METHODS

This systematic literature review was limited to papers published between January 1990 and July 2023. Relevant documents published in English and Persian were searched for in databases including Cochrane Library, PubMed, Embase, Scopus, Web of Science, SID, Magiran, and Irandoc. The direct and indirect effects of sanctions on health were classified using two frameworks proposed by the World Health Organization (WHO): the Health System Building Blocks and "Social Determinants of Health".

RESULTS

Out of a total of 18,219 articles, 59 were selected based on inclusion criteria. The effects of sanctions were divided into direct and indirect groups. Direct effects encompassed seven main themes: access to essential medicine, medical products, vaccines and technologies; financing; health workforce; service delivery; research and health information systems; health outcomes; and financial risk protection. Indirect effects also were classified into six main themes: socioeconomic status; food and agricultural products; stress; early life conditions; high-risk behaviors and addiction; and transport. Most studies focused on the access to medicines, food, economic and social status.

CONCLUSIONS

Economic sanctions have had profoundly negative impacts on all aspects of the healthcare system. The international community must address these effects on health and take necessary measures to prevent or mitigate them, particularly in ensuring the provision of basic and essential healthcare needs for individuals and communities.

Measuring Community Urbanicity and Its Influence on Household Food Security Across Nepal's Agroecological Zones

Background

Urbanization influences food systems and food security, but research on these associations in low- and middle-income countries remain limited, partly because of the binary and unstandardized "urban compared with rural" classifications.

Objectives

To develop a community urbanicity scale, to assess its associations with household food security, and to explore whether agricultural occupation modifies this relationship across the 3 agroecological zones (mountain, hill, Tarai) of Nepal.

Methods

Data came from a nationally and agroecologically representative, multistaged 2013 agri-food system survey of 4285 households with children <5 y in 63 communities (wards) in Nepal. A novel community-level urbanicity scale was constructed using factor analysis that included 8 domains. Multilevel mixed effects logistic regression was used to assess associations between urbanicity and household food security (measured using the validated Household Food Insecurity Access Scale), and to investigate modifying effects of agricultural occupation.

Results

Urbanicity scores ranged between 13 and 69, of a possible 80 points. Most agricultural households in the mountains (67%) and hills (54%) were categorized food insecure. Increases in urbanicity were negatively associated with food insecurity, controlling for other factors (odds ratio [OR] per 10-unit urbanicity difference OR: 0.82; confidence interval [CI]: 0.71, 0.94; P ≤ 0.05). Agricultural occupation may have positively influenced this association though was not a statistically significant effect measure modifier (P = 0.07).

Conclusions

The novel scale shows more nuance within Nepal's agroecological zones, which had similar urbanicity-to-food security relationships as well as overlapping urbanicity score distributions. Research and policy efforts should consider using scales providing more precise urbanicity measurement, and thus informative assessments on its role in predicting food insecurity, especially in agriculturally reliant populations.

The costs of Suaahara II, a complex scaled-up multisectoral nutrition programme in Nepal

Limited evidence exists on the costs of scaled-up multisectoral nutrition programmes. Such evidence is crucial to assess intervention value and affordability. Evidence is also lacking on the opportunity costs of implementers and participants engaging in community-level interventions. We help to fill this gap by estimating the full financial and economic costs of the United States Agency for International Development-funded Suaahara II (SII) programme, a scaled-up multisectoral nutrition programme in Nepal (2016-2023). We applied a standardized mixed methods costing approach to estimate total and unit costs over a 3.7-year implementation period. Financial expenditure data from national and subnational levels were combined with economic cost estimates assessed using in-depth interviews and focus group discussions with staff, volunteers, community members, and government partners in four representative districts. The average annual total cost was US$908,948 per district, with economic costs accounting for 47% of the costs. The annual unit cost was US$132 per programme participant (mother in the 1000-day period between conception and a child's second birthday) reached. Annual costs ranged from US$152 (mountains) to US$118 (plains) per programme participant. Personnel (63%) were the largest input cost driver, followed by supplies (11%). Community events (29%) and household counselling visits (17%) were the largest activity cost drivers. Volunteer cadres contributed significant time to the programme, with female community health volunteers spending a substantial amount of time (27 h per month) on SII activities. Multisectoral nutrition programmes can be costly, especially when taking into consideration volunteer and participant opportunity costs. This study provides much-needed evidence of the costs of scaled-up multisectoral nutrition programmes for future comparison against benefits.

The Importance of Philanthropy Foundation for the Future Sustainability of Agriculture and Nutrition: An Opinion Study on Practical Applications, Policies, and Strategies

Food security, food sustainability, and malnutrition represent critical global challenges. Th urgency of comprehensive action is evident in the need for research collaboration between the food industry, agriculture, public health, and nutrition. This article highlights the role of philanthropy, of a non-profit organization, in supporting research and development and filling financial gaps. The article also explores the interplay of nutrition, agriculture, and government and policy, positioning philanthropy as a catalyst for transformative change and advocating for collaborative efforts to comprehensively address global food challenges. In addition, the discussion also underscores the ethical complexities surrounding charitable food aid, especially in terms of the dignity and autonomy of its recipients. The paper concludes by proposing future directions and implications, advocating for diversified intervention portfolios and collaborative efforts involving governments, businesses, and local communities. Apart from that, the importance of answering and alleviating ethical dilemmas related to food charity assistance needs to be a concern for future studies related to philanthropy because of the significant challenges faced by the contemporary food system, which include food security, health, and nutritional sustainability.

Enhancing children's nutrition: the influence of rural household technology under China's home appliances going to the countryside policy

This study explores the influence of household technological advancements on children's nutritional intake, specifically within the context of the Chinese government's "Home Appliances Going to the Countryside" (HAGC) initiative. Utilizing data from the China Health and Nutrition Surveys of 2006, 2009, and 2011, we employed a Propensity Score Matching Difference-in-Differences (PSM-DID) framework to ascertain the repercussions of enhanced household technology on the dynamics of children's nutritional consumption patterns. Our analysis reveals that the HAGC-inspired integration of household appliances, including color televisions, washing machines, and refrigerators, has beneficially reshaped the nutritional consumption patterns of children, with a pronounced effect among female children. This finding remains consistent even when employing alternate methodological robustness tests. A deeper examination of the HAGC policy's mechanisms underscores the pivotal roles of parental time allocation, improved food storage capabilities, and augmented information accessibility as significant drivers bolstering children's nutritional intake. These insights bear considerable significance for strategizing interventions aimed at elevating the nutritional wellbeing of children in rural settings, offering valuable input for shaping public health policies tailored for such demographies.

Utilising emerging perspectives at the global and regional level to frame multisectoral nutrition governance landscape in Kenya

OBJECTIVE

Multisectoral nutrition governance (MNG) is a vital enabling determinant of improved nutrition outcomes. Despite this, it remains to be a complex phenomenon that lacks adequate understanding, especially in developing countries like Kenya. This narrative review aims to discuss the evolution of MNG, the current state of MNG, barriers and challenges, and based on these identify entry points for improvement within the complex governance structure in Kenya.

DESIGN

The Peer Review of Electronic Search Strategies (PRESS) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to ensure rigorous and transparent identification of literature and interpretation.

SETTING

Kenya and developing countries with similar contexts.

PARTICIPANTS

The review included forty-five documents (peer-reviewed articles and grey literature) that reported on MNG in developing countries.

RESULTS

We acknowledge that MNG is a complex and evolving determinant of better nutrition outcomes. The paper highlights challenges Kenya and other developing countries face such as inadequate leadership, inadequate coordination, insufficient capacity, inadequate monitoring and evaluation systems, and limited financial resources, among others. For Kenya in particular, there is inadequate understanding of what MNG is and how it can be effectively operationalised and tracked.

CONCLUSIONS

To enhance understanding of MNG in Kenya, a country-specific assessment of MNG processes and impact outcomes using standard tools and defined metrics is vital. Such assessment will generate evidence of progress, successes, and challenges that will compel the government and stakeholders to invest more in multisectoral nutrition approaches to achieve its nutrition goals.

Complementary feeding practices and associated factors among mothers of children aged 6 to 23 months in Sub-saharan African countries: a multilevel analysis of the recent demographic and health survey

INTRODUCTION

Malnutrition is a public health problem in sub-Saharan Africa with an increased morbidity and mortality rate than in other parts of the world. Poor complementary feeding practices are one of the major causes of malnutrition during the first two years of life. Therefore, this study aimed to determine the prevalence and associated factors of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan African countries.

METHODS

A multilevel mixed-effect analysis was carried out using recent demographic health survey data from 19 sub-Saharan African countries, which were conducted between 2015 and 2020. A total weighted sample of 60,266 mothers of children aged 6 to 23 months were included in the study. The demographic health survey employs a stratified two-stage sampling technique. Data extracted from the recent DHS data sets were cleaned, recorded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel mixed-effects logistic regression was used to determine the factors associated with complementary feeding practice. Variables with a p-value less than 0.05 and adjusted odds ratio (AOR) with a 95% confidence interval (CI) were reported as statistically significant variables associated with appropriate complementary feeding practices.

RESULTS

The prevalence of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan African countries was 13.02% (95% CI: 12.75-13.29%). Maternal educational level [AOR = 0.69, 95% CI (0.64, 0.74)] and [AOR = 0.52, 95% CI (0.47, 0.57)], marital status of the mother [AOR = 0.85, 95% CI (0.74, 0.96)], sex of household head [AOR = 1.78, 95% CI (1.09, 1.27)], total children ever born [AOR = 1.52, 95% CI (1.18, 1.96)], [AOR = 1.43, 95% CI (1.14, 1.81)], and [AOR = 1.31, 95% CI (1.04, 1.64)], media exposure [AOR = 0.74, 95% CI (0.69, 0.79)], ANC visits attended during pregnancy [AOR = 0.73, 95% CI (0.63, 0.80)] and [AOR = 0.67, 95% CI (0.62, 0.74)], place of delivery [AOR = 0.92, 95% CI (0.85, 0.98)], currently breastfeeding [AOR = 1.12, 95% CI (1.01, 1.23)], PNC checkup [AOR = 0.75, 95% CI (0.70, 0.80)], the current age of the child [AOR = 0.26, 95% CI (0.24, 0.28)] and [AOR = 0.14, 95% CI (0.13, 0.16)], birth order [AOR = 1.31, 95% CI (1.09, 1.58)], number of under 5 children in the household [AOR = 0.76, 95% CI (0.59, 0.97)], community illiteracy [AOR = 1.09, 95% CI (1.02, 1.18)], and country category [AOR = 1.62, 95% CI (1.18, 2.22)] were significantly associated with appropriate complementary feeding practices.

CONCLUSION

The prevalence of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan Africa was relatively low. Higher maternal educational level, female household head, having media exposure, attending more ANC visits, health facility delivery, currently breastfeeding, having PNC follow-up, low community illiteracy, and living in the West Africa region increase the odds of appropriate complementary feeding practices. Women empowerment, increasing maternal health services accessibility, promoting breastfeeding behavior, increasing media exposure of the household, and improving the proportion of health facility delivery are strongly recommended.

Adoption and impact of improved groundnut varieties on household food security in Nigeria

Improved agricultural technologies are promoted as cost-effective and sustainable ways of improving rural households' food security and reducing poverty in developing countries. This study evaluates the relationship between improved groundnut varieties (IGVs) and household food security using detailed household and plot level data from a sample of over 1300 farm households in Northern Nigeria. Endogenous switching regression models are employed to control for potential endogeneity biases. Results show that about 30 % of groundnut plots are planted with improved varieties, and the adoption of IGVs significantly increases the likelihood of household per capita groundnut consumption by about 13 % and reduces the probability of households' vulnerability to food (access) insecurity by 22 %. Counterfactual analyses show that non-adopting households could have enjoyed comparable benefits had they adopted IGVs. These results suggest that development interventions aimed at improving the diffusion and impacts of IGVs in Nigeria need to target farmers' access to information about the technologies while developing groundnut seed systems to make quality seeds readily available to smallholder farmers at affordable prices.

The role of orphan crops in the transition to nutritional quality-oriented crop improvement

Micronutrient malnutrition is a persisting problem threatening global human health. Biofortification via metabolic engineering has been proposed as a cost-effective and short-term means to alleviate this burden. There has been a recent rise in the recognition of potential that underutilized, orphan crops can hold in decreasing malnutrition concerns. Here, we illustrate how orphan crops can serve as a medium to provide micronutrients to populations in need, whilst promoting and maintaining dietary diversity. We provide a roadmap, illustrating which aspects to be taken into consideration when evaluating orphan crops. Recent developments have shown successful biofortification via metabolic engineering in staple crops. This review provides guidance in the implementation of these successes to relevant orphan crop species, with a specific focus on the relevant micronutrients iron, zinc, provitamin A and folates.

Physico-functional and nutritional characteristics of germinated pigeon pea (Cajanus cajan) flour as a functional food ingredient

The study investigated the effect of germination on pigeon pea flour's physico-functional (pH, color, water and oil absorption capacities, swelling and foaming capacities and bulk densities) and proximate, total polyphenols and antioxidant activity. The physico-functional and proximate parameters were determined using standard protocols. The color analysis showed that germination significantly increased the flour samples' lightness (L*) (70.7; p = 0.009) by almost 1.5-fold. Germination resulted in almost 1.1 times higher oil absorption capacity than the control (219.9%; p = 0.022). The foaming capacity of the germinated samples significantly (p = 0.015) increased by 6.4%. Germination significantly reduced the loose bulk density (0.54 vs 0.63; p = 0.012) but significantly increased the tapped bulk density (0.84 vs 0.77; p = 0.002). The germinated samples recorded significantly (1.62%; p = 0.010) lower crude fat, about 1.2 times lower than the raw flour. Germination significantly increased the flour's total ash (4.2% vs 3.6%; p = 0.003) and crude protein (11.6% vs 9.4%; p = 0.047) content. Germinated pigeon pea flour will perform better in formulating baked products, aerated foods and food extenders than non-germinated pigeon pea flour. Hence, the germination of pigeon peas should be encouraged because it harnesses the functional and proximate attributes measured.

Bringing down barriers to children's healthy eating: a critical review of opportunities, within a complex food system

This narrative review revises the scientific evidence of recent years on healthy eating in children and adolescents, making sense of promising avenues of action, from a food system perspective. A conceptual framework is provided to better understand how eating habits of children and adolescents are shaped to identify key multisectoral approaches that should be implemented to promote healthier diets. The following influencing factors are discussed: individual factors (physiological and psychological factors, food preferences and food literacy competencies), factors within the personal and socio-cultural food environments, external food environments, and the supply chain. In each section, the main barriers to healthy eating are briefly discussed focussing on how to overcome them. Finally, a discussion with recommendations of actions is provided, anchored in scientific knowledge, and transferable to the general public, industry, and policymakers. We highlight that multidisciplinary approaches are not enough, a systems approach, with a truly holistic view, is needed. Apart from introducing systemic changes, a variety of interventions can be implemented at different levels to foster healthier diets in children through fostering healthier and more sustainable food environments, facilitating pleasurable sensory experiences, increasing their food literacy, and enhancing their agency by empowering them to make better food related decisions. Acknowledging children as unique individuals is required, through interpersonal interactions, as well as their role in their environments. Actions should aim to enable children and adolescents as active participants within sustainable food systems, to support healthier dietary behaviours that can be sustained throughout life, impacting health at a societal level.

Double burden of malnutrition among women of reproductive age in Bangladesh: A comparative study of classical and Bayesian logistic regression approach

Although the prevalence of undernutrition among women of reproductive age has declined in Bangladesh, the increase in the prevalence of overnutrition remains a major challenge. To achieve Sustainable Development Goal 2.2, it is important to identify the drivers of the double burden of malnutrition on women in Bangladesh. The Bangladesh Demographic and Health Survey, 2017-2018 was used to model the relationship between the double burden of malnutrition among women and the risk factors using a logistic regression model under the classical and Bayesian frameworks and performed the comparison between the regression models based on the narrowest confidence interval. Regarding the Bayesian application, the Metropolis-Hastings algorithm with two types of prior information (historical and noninformative prior) was used to simulate parameter estimates from the posterior distributions. The Boruta algorithm was used to determine the significant predictors. Almost half of reproductive aged women experienced a form of malnutrition (12% were underweight, 26.1% were overweight, and 6.8% were obese). In terms of the narrowest interval estimate, it was found that Bayesian logistic regression with informative priors performs better than the noninformative priors and the classical logistic regression model. Women who were older, highly educated, from rich families, unemployed, and from urban residences were more likely to experience the double burden of malnutrition. This study recommended using the historical prior as the informative prior rather than the flat/noninformative prior to estimating the parameter uncertainty if historical data are available. The double burden of malnutrition among women is a major public health challenge in Bangladesh. This study was to determine the impact of effective risk factors on the double burden of malnutrition among women by applying the Bayesian framework. Using both informative and noninformative priors, "historical prior" was proposed as informative prior information. The main strength is that the proposed prior (historical prior) provided improved estimation as compared to the flat prior distribution.

Agricultural and Socioeconomic Factors Associated with Farmer Household Dietary Diversity in India: A Comparative Study of Visakhapatnam and Sonipat

Using primary data from 479 farmer households, this study examined the associations between agricultural and socioeconomic factors and farmer household dietary diversity in Visakhapatnam and Sonipat. Cropping intensity was positively associated with farmers' household dietary diversity score (HDDS), suggesting that higher cropping intensity may expand the gross cropped area and improve food security among subsistence farmers. Distance to food markets was also significantly associated with farmer HDDS, which suggests that market integration with rural households can improve farmer HDDS in Visakhapatnam. In Sonipat, wealth index had a positive association with farmer HDDS, targeting the income pathway by improving farmer HDDS in this region. Considering the relative contribution of these factors, distance to food markets, cropping intensity, and crop diversity were the three most important factors affecting farmer HDDS in Visakhapatnam, whereas wealth index, cropping intensity, and distance to food markets emerged as the top three important factors contributing to farmer HDDS in Sonipat. Our study concludes that the associations between agricultural and socioeconomic factors and farmer HDDS are complex but context- and location-specific; therefore, considering the site- and context-specific circumstances, different connections to HDDS in India can be found to better support policy priorities on the ground.

Disappearance and survival of fermented beverages in the biosphere reserve Tehuacán-Cuicatlán, Mexico: The cases of Tolonche and Lapo

Traditional fermented products are disappearing from the local foodscapes due to social pressures and ecological changes that affect their production; it is therefore crucial to document local knowledge, which is crucial to maintain and recover local biocultural heritage and to contribute to food security. This study aims to document and foster the production of local traditional beverages by registering recipes of fermented beverages in the Tehuacán-Cuicatlán biosphere reserve in central Mexico, a region recognized for its great biocultural diversity. We conducted a search of peer-reviewed literature. Additionally, we included ethnographic research and participatory methods to engage residents in different steps of the production process. We identified five main fermented beverages in the research area, the most common beverages are those produced by agave species which include, mescal, pulque and an almost extinct beverage known as lapo which involves sugar cane as main substrate. We also identified a fermented beverage produced with several cacti fruits known as nochoctli and a traditional a fermented beverage produced with fruits of Schinus molle known as tolonche. We highlight the production of lapo and tolonche since these involved the incorporation of foreign substrates into the region after the Spaniard conquest and to their restricted distribution and almost extinction. The beverages tolonche and lapo are nowadays almost lost and only a few producers still prepare them to follow modified versions of the original recipe. Lapo and tolonche were once important in the research area but almost became extinct until local people started to recently recover them. Traditional fermented beverages in Mexico play an important role in cultural identity and contribute to the local diet; nevertheless, several fermented beverages have not been recorded and have even become extinct. This work is an effort to promote and conserve traditional fermented beverages as valuable biocultural heritage by empowering people to make decisions about the use of locally available resources, which is crucial in times when food systems are highly vulnerable.

Misinformation and Disinformation in Food Science and Nutrition: Impact on Practice

Food and nutrition are popular topics in the media and on social media. The ubiquity of social media has created new opportunities for qualified or credentialed experts in the scientific community to connect with clients and the public. It has also created challenges. Health and wellness gurus, or self-proclaimed experts, utilize social media platforms to garner attention through compelling narratives, build audience followings, and influence public opinion by sharing (often) misleading information about food and nutrition. The consequence of this can be the perpetuation of misinformation, which not only undermines a well-functioning democracy but also diminishes support for policies that are science or evidence based. Nutrition practitioners, clinician scientists, researchers, communicators, educators, and food experts need to encourage and model critical thinking (CT) to participate in our world of mass information and mitigate misinformation. These experts can play a vital role in the evaluation of information about food and nutrition against the body of evidence. This article explores the role of CT and ethics of practice in the context of misinformation and disinformation by providing a framework for engaging with clients and offering a checklist for ethical practice.

Embodied HANPP of feed and animal products: Tracing pressure on ecosystems along trilateral livestock supply chains 1986-2013

The global livestock system puts increasing pressures on ecosystems. Studies analyzing the ecological impacts of livestock supply chains often explain this pressure by the increasing demand for animal products. Food regime theory proposes a more nuanced perspective: it explains livestock-related pressures on ecosystems by systemic changes along the supply chains of feed and animal products, notably the liberalization of agricultural trade. This study proposes a framework supporting empirical analyses of such claims by differentiating several steps of livestock supply chains. We reconstructed "trilateral" livestock supply chains linking feed production, livestock farming, and final consumption, based on the global flows of 161 feed and 13 animal products between 222 countries from 1986 to 2013. We used the embodied Human Appropriation of Net Primary Production (eHANPP) indicator to quantify pressures on ecosystems linked to these trilateral livestock supply chains. We find that livestock induced 65 % of agriculture's pressure on ecosystems, mostly through cattle grazing. Between 1986 and 2013, the fraction of livestock-related eHANPP that was traded internationally doubled from 7.1 % to 15.6 %. eHANPP related to the trade of feed was mostly linked to soybean imported for pig meat production, whereas eHANPP associated to traded animal products was mostly linked to cattle meat. eHANPP of traded animal products was lower but increased faster than eHANPP of feed trade. eHANPP was highest at the feed production level in South and North America, and at the consumption level in Eastern Asia. In Northern Asia and Eastern Europe, eHANPP was lowest at the animal products production level. In Western Europe, the eHANPP was equal at the animal products production and consumption levels. Our findings suggest that options to reduce livestock's pressures on ecosystems exist at all levels of the supply chain, especially by reducing the production and consumption in high-consuming countries and regulating international supply chains.

What Opportunities Exist for Making the Food Supply Nutrition Friendly? A Policy Space Analysis in Mexico

BACKGROUND

As part of a global policy response for addressing malnutrition, food system actions have been proposed. Within food system interventions, policies directed to supply chains have the potential to increase the availability and affordability of a healthy diet. This qualitative study aimed to identify opportunities to integrate nutrition as a priority into the food supply policy space in Mexico.

METHODS

Data were collected through analysis of 19 policy documents and 20 semi-structured stakeholder interviews. As an analytical framework, we used policy space analysis and embedded the Advocacy Coalition Framework (ACF) and the steps of the food chain of the conceptual framework of food systems for diets and nutrition.

RESULTS

Policy issues relevant to nutrition were viewed differently in the economic and agricultural sectors versus the health sector. Overall, the main policy objective related to nutrition within the economic and agricultural sectors was to contribute to food security in terms of food quantity. Nutrition was an objective in itself only in the health sector, with a focus on food quality. Our policy space analysis reveals an opportunity to promote a new integrated vision with the recent creation of an intersectoral group working on the public agenda for a food system transformation. This newer integrative narrative on food systems presents an opportunity to shift the existing food security narrative from quantity towards considerations of diet quality.

CONCLUSION

The political context and public agenda are favorable to pursue a food system transformation to deliver sustainable healthy diets. Mexico can provide a case study for other low- and middle-income countries (LMICs) for putting nutrition at the center of food policy, despite the ongoing constraints on achieving this.

Evolution of energy and nutrient supply in Zambia (1961–2013) in the context of policy, political, social, economic, and climatic changes

An adequate supply of energy, micronutrients and macronutrients is essential to achieve food and nutrition security to prevent malnutrition. Socio-economic, political, and climatic events, however, can affect the supply of food and nutrients. We assessed country-level supply trends of food and nutrients and their sources within the context of policy changes and political, socio-economic and climatic events from 1961 to 2013 in Zambia. Due to the lack of national food consumption data, food supply data from the FAO food balance sheets, matched to food composition tables, were used to estimate the energy, macronutrient and micronutrient content of 264 food items available to Zambia. We calculated historical nutrient supplies based on demographic characteristics and population-level dietary requirements. Results showed that Zambia was nutrition insecure from 1961 to 2013 for key micronutrients vitamin A, folate, riboflavin, vitamin B12, calcium, zinc, iron, and energy-deficient from the late-1980s. The diet has not substantially changed over time, with maize being the dominant food source. However, refined energy-dense food has steadily increased in the diet coupled with a reduction in fibre. These nutrient supply and dietary pattern trends coincide with specific socio-economic, policy, political, and climatic events from the 1970s to the early-mid 2000s, such as population growth, maize subsidy and crop diversification policies, regime change and drought. This study shows how policy, political and climatic events have been central features shaping nutrient supplies and the consequences for nutrition security. The study provides a context to inform future food policies to improve food and nutrition security.

Contextual factors and spatial trends of childhood malnutrition in Zambia

BACKGROUND

Understanding the national burden and epidemiological profile of childhood malnutrition is central to achieving both national and global health priorities. However, national estimates of malnutrition often conceal large geographical disparities. This study examined the prevalence of childhood malnutrition across provinces in Zambia, changes over time, and identified factors associated with the changes.

METHODS

We analyzed data from the 2013/4 and 2018 Zambia demographic and health surveys (ZDHS) to examine the spatial heterogeneity and mesoscale correlates of the dual burden of malnutrition in children in Zambia. Maps illustrating the provincial variation of childhood malnutrition were constructed. Socio-demographic and clinical factors associated with childhood malnutrition in 2013 and 2018 were assessed independently using a multivariate logistic model.

RESULTS

Between 2013/4 and 2018, the average prevalence of stunting decreased from 40.1% (95% CI: 39.2-40.9) to 34.6% (95% CI:33.6-35.5), wasting decreased from 6.0% (95% CI: 5.6-6.5) to 4.2% (95% CI: 3.8-4.7), underweight decreased from 14.8% (95% CI: 14.1-15.4) to 11.8% (95% CI: 11.2-12.5) and overweight decreased from 5.7% (95% CI: 5.3-6.2) to 5.2% (95% CI: 4.8-5.7). High variability in the prevalence of childhood malnutrition across the provinces were observed. Specifically, stunting and underweight in Northern and Luapula provinces were observed in 2013/14, whereas Lusaka province had a higher degree of variability over the two survey periods.

CONCLUSION

The study points to key sub-populations at greater risk and provinces where malnutrition was prevalent in Zambia. Overall, these results have important implications for nutrition policy and program efforts to reduce the double burden of malnutrition in Zambia.

Identifying effective message-framing techniques in behaviour change communication for healthy diets: An experimental study of promoting biofortified maize adoption in Ethiopia

There is an increasing interest in using insights from behavioural economics and psychology to influence people's decisions. However, little is known as to how to leverage these insights to inform educational campaigns in the context of nutrition-sensitive agriculture. We help to fill this void by investigating the effect of framed messages (gain vs loss) in stimulating demand for nutritionally enhanced crops. We conducted a field experiment with 648 farmers and found the following key results. First, nutrition education stimulates demand for nutritionally enhanced crops among smallholder farmers. Without nutrition education, farmers are less likely to switch from producing conventional maize to nutritionally enhanced maize. Second, gain-framed messages are slightly more effective: they result in a higher willingness to pay for nutritionally enhanced maize than loss-framed messages. Third, motivational orientations and risk perceptions of individuals moderate the effect of the framed messages.

Nutritional composition and sensory Properties of wheat muffins enriched with Gonimbrasia zambesina, walker caterpillar flour

Sub-Saharan Africa still bears the greatest forms of malnutrition. Attention is shifting to the use of edible insects in forms which are acceptable to people irrespective of their social status and level of civilization in efforts to alleviate protein malnutrition. Gonimbrasia zambesina (Lepidoptera: Saturniidae) caterpillars emerge seasonally in the coastal part of Kenya and despite their rich nutritional profile, their consumption is low. This study was thus undertaken to evaluate the effect of substituting wheat flour with G. zambesina caterpillar flour at 0%, 5%, 10%, 15% and 20% substitution levels on the nutritional composition and sensory properties of wheat muffins. Substituting wheat flour with G. zambesina caterpillar flour resulted in significantly high protein, fat and fibre contents of enriched wheat muffins. There was also an increasing trend in the ash, minerals and tocopherol content. Invitro protein digestibility significantly decreased from 10 to 20% substitution levels. There was a significant difference (p < 0.05) in the carbohydrate contents of enriched wheat muffins. The sensory scores for colour, texture, aroma and the overall acceptability of wheat muffins decreased with increasing substitution levels. At 10% substitution level, wheat muffins had significantly higher nutritional content than control wheat muffins (0%) and were comparable to muffins enriched with 5% G. zambesina caterpillar flour in terms of overall acceptability. Thus, enriching wheat muffins with G. zambesina caterpillar flour at 10% substitution level has the potential to contribute to improved protein nutrition since they have a higher protein content than the control wheat muffin and are 88.8% digestible (in vitro).

Prospects and potentials of underutilized leafy Amaranths as vegetable use for health-promotion

Climate change causes environmental variation worldwide, which is one of the most serious threats to global food security. In addition, more than 2 billion people in the world are reported to suffer from serious malnutrition, referred to as 'hidden hunger.' Dependence on only a few crops could lead to the loss of genetic diversity and high fragility of crop breeding in systems adapting to global scale climate change. The exploitation of underutilized species and genetic resources, referred to as orphan crops, could be a useful approach for resolving the issue of adaptability to environmental alteration, biodiversity preservation, and improvement of nutrient quality and quantity to ensure food security. Moreover, the use of these alternative crops will help to increase the human health benefits and the income of farmers in developing countries. In this review, we highlight the potential of orphan crops, especially amaranths, for use as vegetables and health-promoting nutritional components. This review highlights promising diversified sources of amaranth germplasms, their tolerance to abiotic stresses, and their nutritional, phytochemical, and antioxidant values for vegetable purposes. Betalains (betacyanins and betaxanthins), unique antioxidant components in amaranth vegetables, are also highlighted regarding their chemodiversity across amaranth germplasms and their stability and degradation. In addition, we discuss the physiological functions, antioxidant, antilipidemic, anticancer, and antimicrobial activities, as well as the biosynthesis pathway, molecular, biochemical, genetics, and genomic mechanisms of betalains in detail.

Food Insecurity Among the Adult Population of Colombia Between 2016 and 2019: The Post Peace Agreement Situation

BACKGROUND

In 2016, a Peace Agreement, explicitly addressing the right to food, was signed, marking the end of more than 50 years of armed conflict and the longest war in the Americas. The expectation was that the years to follow would be marked by rapid social and political change, with the potential to improve food security.

OBJECTIVES

(i) Ascertain changes in the prevalence of food insecurity in Colombia between 2016 and 2019; (ii) examine which population subgroups (eg, urban women, rural women, urban men, and rural men) were most vulnerable; and (iii) determine significant individual-level factors predicting food insecurity in these 2 years.

METHODS

This study used the Gallup World Poll 2016 and 2019 nationally representative samples of Colombian adults aged 15 and older for the analyses (n ≈ 1000 per year). Food insecurity was measured using the Food Insecurity Experience Scale. Descriptive statistics and logistic regression analyses were conducted using IBM SPSS Complex Samples (version 26).

RESULTS

Food insecurity in Colombia increased by 7 percental points between 2016 and 2019 (from 33% to 40%); women living in rural areas in 2019 reported the highest prevalence (50%). Results from logistic analysis confirm low income, unemployment, and lack of social support were significant predictors of food insecurity in both years. In 2019, gender, low education, and lack of autonomy were also significant predictors. Further research on the determinants of food insecurity is necessary to inform Colombian policies and programs that address food insecurity. The urgency to act is more apparent than ever, given the country's worsening food security profile.

Food Systems’ Transformation to Address Malnutrition in Selected Countries—Panel-Data Analysis on Undernourishment and Obesity

Global awareness of the 2030 Sustainable Development Goals (SDGs) has heightened the importance and role of food systems’ transformation in accelerating countries’ progress to achieve such goals in a timely manner. The agricultural and food systems’ transformation goal is to build resilience to vulnerabilities, shocks, and diseases such as undernourishment and obesity. The objective of this study is to specify the agricultural and food systems’ factors that contribute to reducing the impacts of undernourishment and obesity in selected populous and high-income countries. This study used panel data from 2000 to 2020, applying fixed and random-effect econometrics models to conduct the analyses. Results indicated that the per capita Gross Domestic Product (GDP), level of urbanization, and flood losses at food retail from a food systems perspective were the most influential factors in the prevalence of undernourishment. Meanwhile, the supply of fatty food was the significant nutrition variable affecting undernourishment. The cereal import dependency, per capita GDP, percentage of food imports from the value of food export, and value of domestic food production factors were the influential food system variables affecting the prevalence of obesity. Cereal import dependency and dietary energy supply are the significant factors affecting the prevalence of obesity. This study recommended a set of policy actions to address malnutrition, including sustainable and balanced food and nutrition systems’ transformation, food trade openness, and efforts to reduce adversary impacts of urbanization.

Leveraging National Germplasm Collections to Determine Significantly Associated Categorical Traits in Crops: Upland and Pima Cotton as a Case Study

Observable qualitative traits are relatively stable across environments and are commonly used to evaluate crop genetic diversity. Recently, molecular markers have largely superseded describing phenotypes in diversity surveys. However, qualitative descriptors are useful in cataloging germplasm collections and for describing new germplasm in patents, publications, and/or the Plant Variety Protection (PVP) system. This research focused on the comparative analysis of standardized cotton traits as represented within the National Cotton Germplasm Collection (NCGC). The cotton traits are named by 'descriptors' that have non-numerical sub-categories (descriptor states) reflecting the details of how each trait manifests or is absent in the plant. We statistically assessed selected accessions from three major groups of Gossypium as defined by the NCGC curator: (1) "Stoneville accessions (SA)," containing mainly Upland cotton (Gossypium hirsutum) cultivars; (2) "Texas accessions (TEX)," containing mainly G. hirsutum landraces; and (3) Gossypium barbadense (Gb), containing cultivars or landraces of Pima cotton (Gossypium barbadense). For 33 cotton descriptors we: (a) revealed distributions of character states for each descriptor within each group; (b) analyzed bivariate associations between paired descriptors; and (c) clustered accessions based on their descriptors. The fewest significant associations between descriptors occurred in the SA dataset, likely reflecting extensive breeding for cultivar development. In contrast, the TEX and Gb datasets showed a higher number of significant associations between descriptors, likely correlating with less impact from breeding efforts. Three significant bivariate associations were identified for all three groups, bract nectaries:boll nectaries, leaf hair:stem hair, and lint color:seed fuzz color. Unsupervised clustering analysis recapitulated the species labels for about 97% of the accessions. Unexpected clustering results indicated accessions that may benefit from potential further investigation. In the future, the significant associations between standardized descriptors can be used by curators to determine whether new exotic/unusual accessions most closely resemble Upland or Pima cotton. In addition, the study shows how existing descriptors for large germplasm datasets can be useful to inform downstream goals in breeding and research, such as identifying rare individuals with specific trait combinations and targeting breakdown of remaining trait associations through breeding, thus demonstrating the utility of the analytical methods employed in categorizing germplasm diversity within the collection.

Measurement of benefits in economic evaluations of nutrition interventions in low‐ and middle‐income countries: A systematic review

Economic evaluation of nutrition interventions that compares the costs to benefits is essential to priority‐setting. However, there are unique challenges to synthesizing the findings of multi‐sectoral nutrition interventions due to the diversity of potential benefits and the methodological differences among sectors in measuring them. This systematic review summarises literature on the interventions, sectors, benefit terminology and benefit types included in cost‐effectiveness, cost‐utility and benefit‐cost analyses (CEA, CUA and BCA, respectively) of nutrition interventions in low‐ and middle‐income countries. A systematic search of five databases published from January 2010 to September 2019 with expert consultation yielded 2794 studies, of which 93 met all inclusion criteria. Eighty‐seven per cent of the included studies included interventions delivered from only one sector, with almost half from the health sector (43%), followed by food/agriculture (27%), water, sanitation and hygiene (WASH) (10%), and social protection (8%). Only 9% of studies assessed programmes involving more than one sector (health, food/agriculture, social protection and/or WASH). Eighty‐one per cent of studies used more than one term to refer to intervention benefits. The included studies calculated 128 economic evaluation ratios (57 CEAs, 39 CUAs and 32 BCAs), and the benefits they included varied by sector. Nearly 60% measured a single benefit category, most frequently nutritional status improvements; other health benefits, cognitive/education gains, dietary diversity, food security, knowledge/attitudes/practices and income were included in less than 10% of all ratios. Additional economic evaluation of non‐health and multi‐sector interventions, and incorporation of benefits beyond nutritional improvements (including cost savings) in future economic evaluations is recommended.

Current economic evaluations often underestimate the total sum of benefits that can arise from nutrition interventions. Comprehensive benefit measurement of some nutrition programmes may require further methodological research.

In the near‐term, economic evaluations of multi‐sectoral nutrition interventions should include potential cost savings from improved nutrition in their calculations and assess the potential for benefits unrelated to nutrition. If the range of benefits is diverse and can be monetised, benefit‐cost analysis may be the preferred evaluation method.

Economic evaluations of nutrition‐sensitive interventions from agriculture, water, sanitation and hygiene (WASH), and gender empowerment sectors, are needed to fill an evidence gap on costs and benefits of multisectoral approaches to improved maternal and child health and nutrition.

Maternal Time Use Drives Suboptimal Complementary Feeding Practices in the El Niño-Affected Eastern Ethiopia Community

Ethiopia is affected by recurrent drought and food-insecurity crises, including El Niño. El Niño started in mid-2014, worsened in 2015, and continued in 2016, leading to a widespread food-insecurity emergency resulting in a surge in the rate of acute malnutrition in infants due to suboptimal feeding practices. This study explored how El Niño influenced complementary feeding practices in the eastern Ethiopia community from March to September 2016. It was an exploratory qualitative study with a basic interpretative qualitative approach. A general inductive approach was used for the analysis. The study involved 11 focus group discussions (FGD) with a total of 76 people, including three with mothers, three with Health Development Army (HDA) leaders, two with fathers, two with traditional birth attendants, and one with religious leaders. El Niño resulted in failed crops and loss of livestock, resulting in reduced dietary diversity and meal frequency. El Niño resulted in suboptimal complementary feeding practices by reducing food access and altering livelihood and coping strategies, reducing the time mothers allocated to child feeding, keeping them away from home, and stressing community health services. The maternal suboptimal time allocation is central to the poor complementary feeding practices. Thus, the women should be supported with climate-resilient livelihood options in their villages, allowing them to feed their children and attend education sessions with HDA leaders.

Barriers and Facilitators in Preparation and Consumption of African Indigenous Vegetables: A Qualitative Exploration From Kenya

Malnutrition and food security continue to be major concerns in sub-Saharan Africa (SSA). In Western Kenya, it is estimated that the double burden of malnutrition impacts 19% of adults and 13–17% of households. One potential solution to help address the concern is increased consumption of nutrient-dense African Indigenous Vegetables (AIVs). The objectives of this study were to: (i) document current methods used for preparation and consumption of AIVs; (ii) identify barriers and facilitators of AIVs consumption and preparation; and (iii) identify a package of interventions to increase the consumption of AIVs to promote healthy diets. This study used qualitative data collected from 145 individual farmers (78 female and 67 male) in 14 focus group discussions (FGDs) using a semi-structured survey instrument. Most farmers reported that they prepared AIVs using the traditional method of boiling and/or pan-cooking with oil, tomato, and onion. However, there were large discrepancies between reported cooking times, with some as little as 1–5 min and others as long as 2 h. This is of importance as longer cooking times may decrease the overall nutritional quality of the final dish. In addition, there were seasonal differences in the reported barriers and facilitators relative to the preparation and consumption of AIVs implying that the barriers are situational and could be modified through context-specific interventions delivered seasonally to help mitigate such barriers. Key barriers were lack of availability and limited affordability, due to an increase cost, of AIVs during the dry season, poor taste and monotonous diets, and perceived negative health outcomes (e.g., ulcers, skin rashes). Key facilitators included availability and affordability during peak-season and particularly when self-produced, ease of preparation, and beneficial health attributes (e.g., build blood, contains vitamins and minerals). To promote healthy diets within at risk-populations in Western Kenya, the findings suggest several interventions to promote the preparation and consumption of AIVs. These include improved household production to subsequently improve affordability and availability of AIVs, improved cooking methods and recipes that excite the family members to consume these dishes with AIVs, and the promotion of the beneficial heath attributes of AIVs while actively dispelling any perceived negative health consequences of their consumption.

Reshaping Food Policy and Governance to Incentivize and Empower Disadvantaged Groups for Improving Nutrition

The coronavirus disease 2019 (COVID-19) pandemic has exacerbated global malnutrition challenges, disrupted food supply chains, and left poor and vulnerable people unable to produce and access safe and affordable food, especially in developing countries. Food policy and governance are currently malfunctioning, despite their recognized roles in improving food security and public nutrition in many local and national contexts. This article reviews existing food policies and governance with implications for disadvantaged groups in the food systems, particularly smallholder farmers, women, and small- and medium-sized enterprises (SMEs), highlighting the importance of reshaping food policies and governance. To end malnutrition in the post-COVID era, multiple sectors, including health, agriculture, social protection, education, and infrastructure, must make greater collaborative efforts to develop and implement food and nutrition policies. Several recommendations for reshaping food policy interventions and governance are summarized.

Connecting the food and agriculture sector to nutrition interventions for improved health outcomes

To achieve the Sustainable Development Goal of zero hunger, multi-sectoral strategies to improve nutrition are necessary. Building towards this goal, the food and agriculture sector must be considered when designing nutritional interventions. Nevertheless, most frameworks designed to guide nutritional interventions do not adequately capture opportunities for integrating nutrition interventions within the food and agriculture sector. This paper aims to highlight how deeply connected the food and agriculture sector is to underlying causes of malnutrition and identify opportunities to better integrate the food and agriculture sector and nutrition in low and middle income countries. In particular, this paper: (1) expands on the UNICEF conceptual framework for undernutrition to integrate the food and agriculture sector and nutrition outcomes, (2) identifies how nutritional outcomes and agriculture are linked in six important ways by defining evidence-based food and agriculture system components within these pathways: as a source of food, as a source of income, through food prices, women’s empowerment, women’s utilization of time, and women’s health and nutritional status, and (3) shows that the food and agriculture sector facilitates interventions through production, processing and consumption, as well as through farmer practices and behavior. Current frameworks used to guide nutrition interventions are designed from a health sector paradigm, leaving agricultural aspects not sufficiently leveraged. This paper concludes by proposing intervention opportunities to rectify the missed opportunities generated by this approach. Program design should consider the ways that the food and agriculture sector is linked to other critical sectors to comprehensively address malnutrition. This framework is designed to help the user to begin to identify intervention sites that may be considered when planning and implementing multi-sectoral nutrition programs.

Challenges to joint planning, monitoring, and evaluation for nutrition-sensitive agriculture in Ethiopia: an exploratory qualitative study

Background

Nutrition-sensitive agriculture is an effective multi-sectoral approach to address the underlying causes of malnutrition. However, successful implementation requires the involvement of different sectors to jointly plan, monitor, and evaluate key activities, which is often challenged by contextual barriers. Previous studies in Ethiopia have not adequately explored these contextual barriers. Hence, the current study aimed to qualitatively explore the challenges to joint planning, monitoring, and evaluation for nutrition-sensitive agriculture among sectors in Ethiopia.

Methods

A qualitative exploratory study was conducted in Tigray and Southern Nations, Nationalities, and Peoples (SNNP) of Ethiopia regional states in 2017. Ninety-four key informants were purposively selected from government agencies primarily in health and agriculture, from local (kebele) to national levels, and ranging from academic organizations, research institutions, and implementing partners. Researchers developed a semi-structured guide and conducted key informant interviews which were audiotaped, transcribed verbatim in local language, and translated to English. All transcriptions were imported into ATLAS.ti Version 7.5 software for coding and analysis. The data analysis followed an inductive approach. Transcriptions were coded line by line; then similar codes were grouped into categories. Subsequently, non-repetitive themes were identified from the categories using thematic analysis methodology.

Results

The following themes were identified as challenges that hinder joint planning, monitoring, and evaluation to link nutrition to agriculture: (1) limited capacity, (2) workload in home sector (agriculture or nutrition), (3) lack of attention to nutrition interventions, (4) inadequate supportive supervision, (5) problematic reporting system, and (6) weak technical coordinating committees.

Conclusions and recommendations

Gaps in human and technical resources, limited attention from different sectors, and absence of routine monitoring data hindered joint planning, monitoring, and evaluation activities for nutrition-sensitive agriculture in Ethiopia. Short-term and long-term training for experts and intensification of supportive supervision may address gaps in capacity. Future studies should address whether routine monitoring and surveillance in nutrition-sensitive multi-sectoral activities provides long-term improvement in outcomes.

Are You Happy to Be a Farmer? Understanding Indicators Related to Agricultural Production and Influencing Factors: GAP-Şanlıurfa, Turkey

Recently, agricultural production areas and farmer numbers have been decreasing in Turkey, which has started to cause concern. This study aimed to analyze the satisfaction levels of farmers in different irrigation areas in the Southeastern Anatolia Project (GAP)-Şanlıurfa region, based on indicators related to agricultural production and influencing factors. The data were obtained through face-to-face surveys with farmers in 2020 and analyzed by logistic regression in STATA. According to the results, 43.3% of the farmers are happy to be farmers in the current situation, and 35.6% want their children to continue farming activities. It was determined that the area of irrigation, education level, income, and farming experience were statistically significant at different rates in terms of the happiness of the farmers. On the other hand, livestock, number of households, and land size were not statistically significant. While 27.5% of the participants were fully satisfied with the given public support, 15.7% were satisfied with the market selling prices of their products, and 43.5% stated that effective organizations are needed to live well. To ensure agricultural sustainability in the research area, there is a need for more agricultural support, effective extension services, and the development of rural tourism with the participation of the public and private sectors. This study was the first of its kind to be conducted in Turkey.

Advancing Use of Nutrition Knowledge to Improve Practice by Policy and Program Communities in India During a Political Transition

Models are needed for how to advance use of knowledge by programs and policy officials to make evidence-based decisions about nutrition. How to advance use of nutrition knowledge in India from 2011 to 2015 during a political transition was investigated through studying a knowledge initiative led by the International Food Policy Research Institute. Semistructured interviews were conducted with 37 diverse participants, and 1091 news articles, 318 Twitter and 175 Facebook posts, 12 YouTube events, 65 knowledge products, and 130 engaging events were assessed. Open-axial coding, content and themes analysis, triangulation, and process tracing were used. The knowledge initiative analyzed the landscape, made knowledge available, mobilized it, and engendered its use. After political transition, knowledge was readied for the reassembled nutrition technical community, including timely responses to governmental information needs. Making nutrition knowledge available, mobilizing it, and engendering its use can be advanced through knowledge initiatives in large, complex countries during political transitions.

Analysis of Food System Topics from the Consumers' Perspective in a Developing Country Context: Key Insights from ANRS Metropolitan Cities, Ethiopia

Background

The food system is an interdisciplinary global issue with substantial social and economic challenges. These challenges are most pronounced in developing countries, where chronic under-nutrition is prevalent. The long-standing notion has been to solve malnutrition and undernutrition primarily from the supply side through improving productivity and production. Nevertheless, addressing the nutrition paradox requires understanding consumers’ food choices and its drivers.

Methods

This study forms a part of a research project conducted in the ANRS, Ethiopia, in both urban and rural settings. To select study participants and collect data from the ANRS metropolitan cities, we used a household-based cross-sectional study and a multistage sampling technique. Data were collected using a structured questionnaire, and the study used a descriptive research method and a quantitative research approach in its analysis. PCA was used to identify which topics in the food system are most important to consumers.

Results

To identify widely held consumer interests, respondents were asked to report their interest in several relevant topics. The results show that food systems’ external impact, food safety, food nutrition, impact of other bodies on the food system, and food supply sustainability are the most crucial food topics where consumers are interested.

Conclusion

Concerned stakeholders who can help enhance household dietary practices in the study area; producers and other stakeholders who care about environmental sustainability and/or social values might use this information to adjust their production and marketing decisions to align with the food system topics that consumers identified as their priority.

Limitations

While the PCA allows for the reduction of multiple indices into a single composite index, it may restrict the targeting of a particular aspect of the food system topic. As a result, the indices’ meaning, and implications should be made while keeping the downsides in mind.

The Application of Systems Science in Nutrition-Related Behaviors and Outcomes Implementation Research: A Scoping Review

Use of systems science can improve the dissemination and implementation (D&I) process. However, little is known about use of systems science in nutrition D&I research. The purpose of this article is to synthesize the ways in which systems science methodology is applied in nutrition D&I research. Scoping review methodology involved searching 6 academic databases for full-text, peer-reviewed, English articles published between 1970 and 2020 that employed systems science within nutrition D&I research. Data extraction included intervention type, population, study aim, methods, theoretical approach, outcomes, and results. Descriptive statistics and qualitative thematic analysis followed. Thirty-four retained articles qualitatively identified benefits (successful planning and organization of complex interventions) and challenges (limited resources, trainings, and lack of knowledge) to utilizing systems science in nutrition D&I research. Future research should work toward building knowledge capacity among nutrition practitioners by increasing available trainings and resources to enhance the utilization of systems science in nutrition D&I research.

Corticosterone and chlorpyrifos oxon exposure elicits spatiotemporal MAPK phosphoprotein signaling in a mouse brain

Chlorpyrifos (CPF) is one of the most widely-used pesticides globally for agricultural purposes. Certain occupations (e.g., farmers, military) are at an increased risk for high-dose exposure to CPF, which can lead to seizures and irreversible brain injury. Workers with the highest risk of exposure typically experience increased circulating cortisol levels, which is related to physiological stress. To better represent this exposure scenario, a mouse model utilized exogenous administration of corticosterone (CORT; high physiologic stress mimic) in combination with chlorpyrifos oxon (CPO; oxon metabolite of CPF); this combination increases neuroinflammation post-exposure. In the present study adult male C57BL/6J mice were given CORT (200 μg/mL) in drinking water for seven days followed by a single intraperitoneal injection of CPO (8.0 mg/kg) on day eight, and euthanized 0.5, 2, and 24 h post-injection. Ten post-translationally modified proteins were measured in the frontal cortex and striatum to evaluate brain region-specific effects. The spatiotemporal response to CORT + CPO sequentially activated phosphoproteins (p-ERK1/2, p-MEK1/2, p-JNK) involved in mitogen-activated protein kinase (MAPK) signaling. Observed p-ZAP70 responses further integrated MAPK signaling and provided a spatiotemporal connection between protein phosphorylation and neuroinflammation. This study provides insight into the spatiotemporal cellular signaling cascade following CORT + CPO exposure that represent these vulnerable populations.

Understanding Pathways Between Agriculture, Food Systems, and Nutrition: An Evidence and Gap Map of Research Tools, Metrics, and Methods in the Last 10 Years

New tools, metrics, and methods in agriculture, food systems, and nutrition (A&N) research proliferated in the decade following the 2007-2008 food price crisis. We map these developments across themes derived from conceptual A&N pathways and expert consultations. We created an interactive Evidence and Gap Map (EGM) from a systematic search of published and gray literature since 2008, following Campbell Collaboration guidelines. We retrieved over 30,000 reports from published literature databases, and individually searched 20 online repositories. We systematically screened 24,359 reports by title and/or abstract, 1577 by full report, and included 904 eligible reports. The EGM consists of rows of thematic domains and columns of types of tools, metrics, and methods, as well as extensive coding applied as filters. Each cell of the map represents research surrounding a type of tool, metric, or method within a given theme. Reports in each cell are grouped by stage of development, which expand to a corresponding bibliography. Users can filter EGM reports by various characteristics. The 4 most populated domains were: diets, nutrition, and health; primary food production; water, sanitation, and hygiene; and environment and sustainability. The 4 most common types of metrics, methods, and tools were: diet metrics; footprint analysis (especially water); technology applications; and network or Bayesian analysis. Gaps represent areas of few or no reports of innovation between 2008 and 2018. There were gaps in reports and innovations related to: power or conflicts of interest; food environments; markets; private sector engagement; food loss and waste; conflict; study design and system-level tools, metrics, and methods. The EGM is a comprehensive tool to navigate advances in measurement in A&N research: to highlight trends and gaps, conduct further synthesis and development, and prioritize the agenda for future work. This narrative synthesis accompanies the EGM, which can be found at https://www.anh-academy.org/evidence-and-gap-map.

Foliar Zinc-Selenium and Nitrogen Fertilization Affects Content of Zn, Fe, Se, P, and Cd in Wheat Grain

The grain yield and concentrations of Fe, Zn, Se, Cd, and P in two winter wheat genotypes and in vitro bioaccessibility of Fe and Zn under the effect of different nitrogen fertilization and Zn-Se foliar application were evaluated. The total grain Fe, Zn, and Se concentrations, as well as Fe and Zn concentrations, after in vitro digestion were under the strongest effect of foliar Zn-Se application. On the other hand, Fe and Zn bioaccessibility (%) were under the most substantial effect of genotype. Regarding the need to increase concentrations of essential micronutrients in wheat grain, foliar Zn-Se application is a reliable and accepted agricultural practice, but to improve mineral bioaccessibility in human nutrition, foliar Zn-Se application should be combined with the most responsive genotypes. For this reason, further research on the genotype specificity of wheat regarding micronutrient bioaccessibility should be carried out.

Agricultural production diversity and child nutrition in Ethiopia

This study investigates how two aspects of agricultural production diversity – farm production diversity and composition of production – relate to child height-for-age and weight-for-height in Ethiopia. We use longitudinal data on child anthropometric measurements, household farm production diversity and farm production composition from the Ethiopia Socioeconomic Survey for 2011, 2013, and 2015 available through the World Bank. Using longitudinal fixed effects models, we show that an increase in farm production diversity reduces the risk of chronic food insecurity (child height-for-age) but has no impact on acute measures of food insecurity (child weight-for-height). Results also suggest that, in a context of poor rainfall, more diversity in farm production can adversely impact child height-for-age, although livestock sales might mitigate that detrimental effect. These findings highlight the importance of considering the relationship between farm-level food production and child nutrition in a context of climate change.

Food Systems as Drivers of Optimal Nutrition and Health: Complexities and Opportunities for Research and Implementation

The Sustainable Development Goals (SDGs) are intricately linked to food systems. Addressing challenges in food systems is key to meeting the SDGs in Africa and South Asia, where undernutrition and micronutrient deficiencies persist, alongside increased nutrition transition, overweight and obesity, and related chronic diseases. Suboptimal diets are a key risk factor for mortality and 3 billion people cannot afford a healthy diet; in addition, food systems are not prioritizing environmental sustainability. Optimizing food systems and increasing agricultural productivity beyond calories, to nutrient-rich vegetables and fruits, legumes, and livestock, and sustainable fishing, are required. Strengthening of research around food systems-on pathways, value chains, and development and validation of metrics of diet quality-is required. The development of new technology in crop management and pest control and addressing natural resource degradation is key. Engaging with the public and private sectors, outreach to donors and policymakers, and strengthening cross-disciplinary collaborations are imperative to improving food systems.

Viewpoint: Agri-nutrition research: Revisiting the contribution of maize and wheat to human nutrition and health

Research linking agriculture and nutrition has evolved since the mid-20th century. The current focus is on child-stunting, dietary diversity and 'nutrient-rich' foods in recognition of the growing burdens of malnutrition and non-communicable diseases. This article concerns the global dietary and health contribution of major cereals, specifically maize and wheat, which are often considered not to be 'nutrient-rich' foods. Nevertheless, these cereals are major sources of dietary energy, of essential proteins and micronutrients, and diverse non-nutrient bioactive food components. Research on bioactives, and dietary fibre in particular, is somewhat 'siloed', with little attention paid by the agri-nutrition research community to the role of cereal bioactives in healthy diets, and the adverse health effects often arising through processing and manufacturing of cereals-based food products. We argue that the research agenda should embrace the whole nutritional contribution of the multiple dietary components of cereals towards addressing the triple burden of undernutrition, micronutrient malnutrition, overweight/obesity and non-communicable diseases. Agri-nutrition and development communities need to adopt a multidisciplinary and food systems research approach from farm to metabolism. Agriculture researchers should collaborate with other food systems stakeholders on nutrition-related challenges in cereal production, processing and manufacturing, and food waste and losses. Cereal and food scientists should also collaborate with social scientists to better understand the impacts on diets of the political economy of the food industry, and the diverse factors which influence local and global dietary transitions, consumer behavioural choices, dietary change, and the assessment and acceptance of novel and nutritious cereal-based products.

Urban Food Systems: A Bibliometric Review from 1991 to 2020

The increase of urbanization is affecting the urban food system (UFS) in many areas, primarily production, processing, and consumption. The upgrading of the urban food consumption structure not only puts forward higher food production requirements, but also poses a challenge to resource consumption and technological innovation. Considerable case or review studies have been conducted on UFS, but there is no bibliometric review attempting to provide an objective and comprehensive analysis of the existing articles. In this study, we selected 5360 research publications from the core Web of Science collection from 1991 to 2020, analyzing contributions of countries, institutions, and journals. In addition, based on keyword co-occurrence and clustering analyses, we evaluated the research hotspots of UFS. The results show that global research interest in UFS has increased significantly during these three decades. The USA, China, and the UK are the countries with the highest output and closest collaborations. UFS research involves multiple subject categories, with environmental disciplines becoming mainstream. Food security, food consumption, and food waste are the three main research areas. We suggest that food sustainability and resilience, food innovation, and comparative studies between cities should be given more attention in the future.

Implications of a food system approach for policy agenda-setting design

A call to governments to enact a strategy for a sustainable food system is high on the global agenda. A sustainable food system presupposes a need to go beyond a view of the food system as linear and narrow, to comprehend the food system as dynamic and interlinked, which involves understanding social, economic and ecological outcomes and feedbacks of the system. As such, it should be accompanied by strategic, collaborative, transparent, inclusive, and reflexive agenda-setting process. The concepts of, directionality relating to an agreed vision for a future sustainable food system, and, reflexivity which describes the capacity for critical deliberation and responsiveness, are particularly important. Based on those concepts, this paper proposes an evaluative framework to assess tools and instruments applied during the agenda-setting stage. We apply the evaluative framework to recent food policy processes in Finland and Sweden, revealing that their agenda-setting design cannot be assessed as fully addressing both directionality and reflexivity, thus possibly falling short of the policy design needed for enable more transformative policy approaches.

The Burden of Malnutrition and Fatal COVID-19: A Global Burden of Disease Analysis

Background: Although reasonable to assume, it is not yet clear whether malnourished countries are at higher risk for severe or fatal coronavirus disease 2019 (COVID-19). This study aims to identify the countries where prevalent malnutrition may be a driving factor for fatal disease after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods: Using estimates from the Global Burden of Disease 2019, country-level burden of malnutrition was quantified using four indicators: death rates for child growth failure (underweight, stunting, and/or wasting) and years lived with disability (YLD) attributed to iron and vitamin A deficiencies and high body mass index (BMI). Global mortality descriptors of the ongoing COVID-19 pandemic were extracted from the European Centre for Disease Prevention and Control, and case fatality ratios (CFRs) were calculated introducing a lag time of 10 weeks after the first death of a confirmed case. Bivariate analyses for 172 countries were carried out for malnutrition indicators and fatal COVID-19. Correlations between burden indicators were characterized by Spearman's rank correlation coefficients (ρ) and visually by scatterplots. Restricted cubic splines and underlying negative binomial regressions adjusted for countries' age-structure, prevalent chronic comorbidities related to COVID-19, population density, and income group were used to explore non-linear relationships. Results: Stratified by the World Bank income group, a moderate positive association between YLD rates for iron deficiency and CFRs for COVID-19 was observed for low-income countries (ρ = 0.60, p = 0.027), whereas no clear indications for the association with child growth failure, vitamin A deficiency, or high BMI were found (ρ < 0.30). Countries ranking high on at least three malnutrition indicators and presenting also an elevated CFR for COVID-19 are sub-Saharan African countries, namely, Angola, Burkina Faso, Chad, Liberia, Mali, Niger, Sudan, and Tanzania, as well as Yemen and Guyana. Conclusions: Population-level malnutrition appears to be related to increased rates of fatal COVID-19 in areas with an elevated burden of undernutrition, such as countries in the Sahel strip. COVID-19 response plans in malnourished countries, vulnerable to fatal COVID-19, should incorporate food security, nutrition, and social protection as a priority component in order to reduce COVID-19 fatality.

The Potato of the Future: Opportunities and Challenges in Sustainable Agri-food Systems

In the coming decades, feeding the expanded global population nutritiously and sustainably will require substantial improvements to the global food system worldwide. The main challenge will be how to produce more food with the same or fewer resources and waste less. Food security has four dimensions: food availability, food access, food use and quality, and food stability. Among several other food sources, the potato crop is one that can help match all these constraints worldwide due to its highly diverse distribution pattern, and its current cultivation and demand, particularly in developing countries with high levels of poverty, hunger, and malnutrition. After an overview of the current situation of global hunger, food security, and agricultural growth, followed by a review of the importance of the potato in the current global food system and its role played as a food security crop, this paper analyses and discusses how potato research and innovation can contribute to sustainable agri-food systems comparing rural and industrial agri-food systems with reference to food security indicators. It concludes with a discussion about the challenges for sustainable potato cropping enhancement considering the needs to increase productivity in rural-based potato food systems that predominate in low-income countries, while promoting better resource management and optimization in industrial-based agri-food systems considering factors such as quality, diversity of products, health impacts, and climate change effects. Research and innovation options and policies that could facilitate the requirements of both rural and industrial potato-based agri-food systems are described.