October 16th, 2020 marks World Food Day 2020, and the 75th Anniversary of FAO, the Food and Agriculture Organization of the United Nations. This year, the theme ‘Grow, Nourish, Sustain. Together.’ encourages awareness of sustainable agricultural practices, celebrates the ‘Food Heroes’ who work to provide food for the world, and calls for global solidarity in ensuring adequate access to nutritious food for all despite the COVID-19 pandemic. Additionally, the UN has set ending hunger, achieving food security and improved nutrition, and promoting sustainable agriculture as one of its sustainable development goals.
In this blog we will look at some of the studies registered with the ISRCTN registry that are tackling malnutrition and food insecurity, particularly in early life.
Malnutrition is a condition that results from a diet in which one or more nutrients are either insufficient or excessive to the body’s needs, such that the diet causes health problems. This may be due to issues in the consumption of, or access to, the appropriate amount of calories, protein, carbohydrates, fat, vitamins, or minerals. The FAO calculates that over 2 billion people do not have regular access to safe, nutritious, and sufficient food.
With the COVID-19 pandemic and restrictions that have been put in place to reduce the spread of the virus, there has been a decrease in food access. Additionally, the outcomes following SARS-CoV-2 infection may be worse for those who are malnourished.
The UN sustainable development target 2.2 aims to meet the internationally agreed targets on stunting and wasting in children under 5 years of age by 2025. Currently, around 45% of deaths among children under 5 years of age are linked to undernutrition.
Low height-for-age is known as stunting. It is the result of chronic or recurrent undernutrition, usually associated with poor socioeconomic conditions, poor maternal health and nutrition, frequent illness, and/or inappropriate infant and young child feeding and care in early life. Stunting holds children back from reaching their physical and cognitive potential and may lead to poorer health outcomes in later life.
One method that is being investigated in an ISRCTN-registered trial to prevent stunting among infants is the provision of ready-to-use supplementary foods sachets. These supplements are designed for different stages of life and growth and will be given to pregnant and lactating women, and children aged under 5 years in Pakistan. Similarly, a number of lipid-based nutrient supplements, some of which contain milk products, will be investigated for their impact on the growth and development of stunted children in Uganda in the MAGNUS study.
The UN sustainable development target 2.2 also aims, by 2030, to end all forms of malnutrition, including addressing the nutritional needs of adolescent girls, and pregnant and lactating women. Maternal undernutrition and infections in pregnancy are important causes of poor birth outcomes, including low birth weight and preterm birth, which in turn can have consequences for the child in later life.
The ENAT Study (Enhancing Nutrition and Antenatal infection Treatment for maternal and child health) aims to determine the effectiveness of a program to improve maternal nutritional status and management of infections during pregnancy for pregnant women in Ethiopia, where one in three mothers are malnourished and infections in pregnancy are common. The program will include an iodized salt and a corn soya blend supplement to the women’s diet.
Similarly, a study based in Pakistan is testing the effect of oral high-energy nutritional supplements on appetite, pregnancy, and fetal outcomes in underweight women during their first pregnancy.
The FAO states that “we need to grow a variety of food to nourish people and sustain the planet” and that “future food systems need to provide affordable and healthy diets for all and decent livelihoods for food system workers, while preserving natural resources and biodiversity and tackling challenges such as climate change”. Community-based approaches to develop sustainable food provision and investigate the feasibility of farming and distributing new food sources are key to the aims from the FAO.
The UN sustainable development targets 2.3 and 2.4 respectively aim to promote local small-scale food production and the implementation of sustainable and resilient agricultural practices. One study registered at ISRCTN is looking to improve dietary quality, food security, and livelihoods using farming and wild biodiversity using an integrated community-based approach in Kenya and Ethiopia. This study had community involvement from the design stage of the study and includes the development of community participation and communication to promote social and behavior change.
The SE LEVER study will be evaluating the impact of an integrated poultry value chain and nutrition intervention in Burkina Faso. In Burkina Faso, high rates of child stunting and wasting, maternal undernutrition, and anemia have been noted and infant and young child feeding practices are particularly poor. The study aims to expand poultry-based income generation for rural households, and chicken and egg consumption for young children and their mothers.
This also supports the UN sustainable development target 2.3’s aim to increase the agricultural productivity and incomes of small-scale food producers, in particular women, indigenous peoples, and family farmers. The intervention involves women’s empowerment activities and behaviour change communications (BCC) strategy to promote improved diets and feeding, care, and hygiene practices.
A combined sanitation and nutrition program in Cambodia involves community initiatives such as maternal support groups and caregiver peer groups to discuss feeding practices, agricultural cooperatives, conditional cash transfer (CCT) and vouchers program for mothers, and links to technical experts to facilitate access to diverse foods. Such programs aim to reduce food poverty and food insecurity of people in vulnerable situations, including infants, and allow access to safe, nutritious, and sufficient food all year round, and support the UN sustainable development target 2.1.
Community settings such as schools are an important site for targeting interventions for children. The KaziAfya study will investigate the effects of a physical activity and multi-micronutrient supplementation intervention on the growth, health, and well-being of schoolchildren in Cote d’Ivoire, South Africa and Tanzania, in addition to classroom-based health education that includes topics of nutrition and sanitation.
Innovative measures to combat malnutrition are also being investigated. The SAM photo diagnosis app is an easy-to-use smartphone tool that can quickly and accurately diagnose nutritional status in children aged 6-59 months by means of a photo using body shape analysis. It is hoped that this tool will allow for the identification of acutely malnourished children.
Access to adequate nutrition is as important as ever during the COVID-19 pandemic. Find out how you can take action against malnutrition on #WorldFoodDay. You can also find out more about the UN’s sustainable development goals and what we at Springer Nature are doing to support these goals.