Can Central America and the Dominican Republic Overcome Malnutrition in All Its Forms?

Abstract

Malnutrition impairs many forms of human development. In order to tackle nutritional deficiencies and excesses, the science of evidence-based nutrition needs rapid transformations to scale up pro-poor and sustainable actions. The aims of this article are to briefly outline the nutritional challenges faced in Central America and the Dominican Republic, highlight new evidence produced by the Institute of Nutrition of Central America and Panama during the last decade, and foster the implementation of feasible solutions in limited-resourced settings.

I am really convinced that it is possible. Achieving this goal will require a solid base of compelling scientific evidence in addition to the participation of all possible actors in society, from the family to the state.

Fifty years ago, a group of Institute of Nutrition of Central America and Panama (INCAP) scientists did studies on human nutrition with the purpose of reducing protein–energy undernutrition in preschool children. ¹ This effort was the basis of numerous years of investigation to understand the role of good nutrition and its impact on health and well-being, from conception through the first 2 years of life and beyond. The findings of this inspiring research are the foundation of many global strategies in the field of nutrition and food, and INCAP is recognized for that valuable contribution. ^2,3

Malnutrition in all its forms is one of the most urgent issues in this century. ^4,5 In the countries of Central America and the Dominican Republic, the persistence of malnutrition is accompanied by an increase in overweight and obesity from childhood to adulthood. ⁶ The effects of these nutritional imbalances in society promote the early onset of noncommunicable diseases such as hypertension, diabetes, and cancer. ⁷ The future of nutrition in Central America and the Dominican Republic brings a major challenge: malnutrition in all its forms. Nutritional deficiencies have decreased, and some are no longer a public health problem. However, they have not fully disappeared. In certain populations faced with social injustice, lack of development opportunities, and climatic crises, undernutrition problems remain prevalent. ⁸ In addition, the region is undergoing nutritional transition, and the problems of nutritional excesses are already part of our society. ^9,10

Nowadays, the nature of nutrition problems demands the development of new paradigms and methods in the science of nutrition. Therefore, strategic actions derived from scientific evidence should lead us ever closer to the goals of guaranteeing universal access to adequate health, food, and nutrition, while striving for environmental sustainability. Overcoming these challenges will allow the Central American region to set development priorities in which nutrition has a relevant role in the well-being of human beings in all stages of life.

The lessons learned from the science of nutrition, as applied by INCAP, have led to an immeasurable wealth of discoveries, not only to understand the biological and metabolic mechanisms of the relationship between diet quality and health but also to deepen understanding of the social forces that condition it. We have understood that good early nutrition benefits the individual and the family. ¹¹ The ideas highlighted in the articles of this supplement of the Food and Nutrition Bulletin, about “The INCAP Longitudinal Study: 50 Years of History and Legacy,” are a road map for future generations. It can provide us with guidance on how to transform the interactions of malnutrition within poverty, inequality, and environmental destruction from vicious to virtuous cycles, thus enabling development, opportunities, and sustainability for the population.

New tools in science and technology are now available to foment innovation. In the coming decades, the future of our field is encouraging the application of these resources. Implementation science promises a framework for the use of what we know really works in our environments. ¹² Food science—a pioneering theme of INCAP—is allowing us to assemble these combinations of nutritional benefits of local foods and turn them into sustainable-impact foods to reduce malnutrition and support climatically vulnerable settings where nutritious foods are limited.

With no data, the facts remain unknown. The race for success toward a region without malnutrition in any of its forms requires substantial investments in food and nutrition surveillance systems and scientific research. An information system that delivers good quality data with rigorous and reliable standards is imperative to advance the status of human capabilities in region.

Finally, I wish to emphasize that food and nutrition is a human right, not a confusing statistic. Our greatest efforts must recognize the nutritional needs of people, while valuing, respecting, and protecting foods’ flavors and the knowledge of the food and nutritional culture of the region. This is where INCAP’s vision for the coming years begins: to work toward the promotion of healthy food and nutrition that derives from a socially fair and sustainable food system.