Food and Nutrition Bulletin

Macronutrient and micronutrient deficiencies continue to have a detrimental impact in lower-income countries, with significant costs in morbidity, mortality, and productivity. Food is the primary source of the nutrients needed to sustain life, and it is the essential component that links nutrition, agriculture, and ecology in the econutrition framework.

To present evidence and analysis of food-based approaches for improving nutritional and health outcomes in lower-income countries.

Review of existing literature.

The benefits of food-based approaches may include nutritional improvement, food security, cost-effectiveness, sustainability, and human productivity. Food-based approaches require additional inputs, including nutrition education, gender considerations, and agricultural planning. Although some forms of malnutrition can be addressed via supplements, food-based approaches are optimal to achieve sustainable solutions to multiple nutrient deficiencies.

The recent rise in agricultural commodity prices has been dramatic, and food prices are likely to follow an upward trend, at least in the medium term. Moreover, the recent financial crisis has also lowered incomes and increased food prices. Not only does this reduce dietary quality, but expenditures for health, sanitation, and education will decline, all of which will have a detrimental effect on health and nutrition outcomes.

To provide some perspectives on the role of major socioeconomic factors in driving health and nutrition outcomes.

We use demand elasticity parameters estimated from household-level survey data to simulate an increase in food prices, which is then mapped into energy and nutrient intakes. Furthermore, we also use house-hold-level data to analyze the implications of unequal intrahousehold distribution of food for the nutritional status of adult women and female children.

A 50% increase in food prices results in a decrease in energy intake of 5% to 15% and in a decrease in iron intake of 10% to 30%, depending on the strength of the induced income effect. In a country like the Philippines, this would be equivalent to an increase of 25 percentage points in the proportion of women not meeting their requirements for iron intake.

Increasing food prices will make fighting micronutrient malnutrition in developing countries more difficult. In societies where preference is given to males in the intrahousehold distribution of nonstaple foods, this objective will be even more challenging.

The prevalence of micronutrient deficiencies, in particular those of iron, vitamin A, iodine, and zinc, is unacceptably high, especially among infants, children, and women of childbearing age in developing countries. Effective food-based strategies to combat these public health problems are therefore urgently needed.

As only a fraction of dietary iron, zinc, and provitamin A carotenoids is absorbed and utilized, i.e., bioavailable, access to information on micronutrient bioavailability is crucial in the development of food fortification strategies and interventions based on dietary diversification.

Review of literature

This overview highlights the usefulness of stable isotope techniques to assess the bioavailability of nonheme iron and provitamin A carotenoids and the importance of generating data on micro-nutrient bioavailability to move the agenda forward.

The density of minerals and vitamins in food staples eaten widely by the poor may be increased either through conventional plant breeding or through the use of transgenic techniques, a process known as biofortification.

HarvestPlus seeks to develop and distribute varieties of food staples (rice, wheat, maize, cassava, pearl millet, beans, and sweet potato) that are high in iron, zinc, and provitamin A through an interdisciplinary, global alliance of scientific institutions and implementing agencies in developing and developed countries.

In broad terms, three things must happen for biofortification to be successful. First, the breeding must be successful—high nutrient density must be combined with high yields and high profitability. Second, efficacy must be demonstrated—the micronutrient status of human subjects must be shown to improve when they are consuming the biofortified varieties as normally eaten. Thus, sufficient nutrients must be retained in processing and cooking and these nutrients must be sufficiently bioavailable. Third, the biofortified crops must be adopted by farmers and consumed by those suffering from micronutrient malnutrition in significant numbers.

Biofortified crops offer a rural-based intervention that, by design, initially reaches these more remote populations, which comprise a majority of the under-nourished in many countries, and then penetrates to urban populations as production surpluses are marketed. In this way, biofortification complements fortification and supplementation programs, which work best in centralized urban areas and then reach into rural areas with good infrastructure.

Initial investments in agricultural research at a central location can generate high recurrent benefits at low cost as adapted, biofortified varieties become available in country after country across time at low recurrent costs.

Malnutrition affects a large number of people throughout the developing world. Approaches to reducing malnutrition rarely focus on ecology and agriculture to simultaneously improve human nutrition and environmental sustainability. However, evidence suggests that interdisciplinary approaches that combine the knowledge bases of these disciplines can serve as a central strategy in alleviating hidden hunger for the world's poorest.

To describe the role that ecological knowledge plays in alleviating hidden hunger, considering human nutrition as an overlooked ecosystem service.

We review existing literature and propose a framework that expands on earlier work on econutrition. We provide novel evidence from case studies conducted by the authors in western Kenya and propose a framework for interdisciplinary collaboration to alleviate hidden hunger, increase agricultural productivity, and improve environmental sustainability.

Our review supports the concept that an integrated approach will impact human nutrition. We provide evidence that increased functional agrobiodiversity can alleviate anemia, and interventions that contribute to environmental sustainability can have both direct and indirect effects on human health and nutritional well-being.

Integrated and interdisciplinary approaches are critical to reaching development goals. Ecologists must begin to consider not only how their field can contribute to biodiversity conservation, but also, the relationship between biodiversity and provisioning of nontraditional ecosystem services such as human health. Likewise, nutritionists and agronomists must recognize that many of the solutions to increasing human well-being and health can best be achieved by focusing on a healthy environment and the conservation of ecosystem services.