Food system innovations for healthier diets in low and middle-income countries

2019 ◽  
Author(s):  
International Food Policy Research Institute (IFPRI)
Keyword(s):  
Food System ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Large-Scale Food Fortification and Biofortification in Low- and Middle-Income Countries: A Review of Programs, Trends, Challenges, and Evidence Gaps

2018 ◽  
Vol 39 (2) ◽  
pp. 315-331 ◽  
Author(s):  
Saskia J. M. Osendarp ◽  
Homero Martinez ◽  
Greg S. Garrett ◽  
Lynnette M. Neufeld ◽  
Luz Maria De-Regil ◽  
...  
Keyword(s):  
Large Scale ◽  
Food System ◽  
Food Fortification ◽  
Micronutrient Deficiencies ◽  
Middle Income ◽  
Middle Income Countries ◽  
Essential Components ◽  
Quality Of Delivery ◽  
And Control ◽  
Low And Middle Income

Background: Food fortification and biofortification are well-established strategies to address micronutrient deficiencies in vulnerable populations. However, the effectiveness of fortification programs is not only determined by the biological efficacy of the fortified foods but also by effective and sustainable implementation, which requires continual monitoring, quality assurance and control, and corrective measures to ensure high compliance. Objective: To provide an overview of efficacy, effectiveness, economics of food fortification and biofortification, and status of and challenges faced by large-scale food fortification programs in low- and middle-income countries (LMIC). Methods: A literature review of PubMed publications in English from 2000 to 2017, as well as gray literature, targeting nongovernmental organizations whose work focuses on this topic, complemented by national reports and a “snowball” process of citation searching. The article describes remaining technical challenges, barriers, and evidence gap and prioritizes recommendations and next steps to further accelerate progress and potential of impact. Results: The review identifies and highlights essential components of successful programs. It also points out issues that determine poor program performance, including lack of adequate monitoring and enforcement and poor compliance with standards by industry. Conclusions: In the last 17 years, large-scale food fortification initiatives have been reaching increasingly larger segments of populations in LMIC. Large-scale food fortification and biofortification should be part of other nutrition-specific and nutrition-sensitive efforts to prevent and control micronutrient deficiencies. There are remaining technical and food system challenges, especially in relation to improving coverage and quality of delivery and measuring progress of national programs.

scholarly journals The Importance of a Food Systems Approach to Low and Middle Income Countries and Emerging Economies: A Review of Theories and Its Relevance for Disease Control and Malnutrition

2021 ◽  
Vol 5 ◽  
Author(s):  
Pablo Alarcon ◽  
Paula Dominguez-Salas ◽  
Eric M. Fèvre ◽  
Jonathan Rushton
Keyword(s):  
Public Health ◽  
Food Safety ◽  
Emerging Economies ◽  
Food Systems ◽  
Food System ◽  
Systems Science ◽  
Multidisciplinary Teams ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Our review explores the changing food production, distribution and consumption environment in low and middle-income countries and emerging economies as a basis for framing how to study food systems in order to address public health issues of food safety and nutrition. It presents the state of knowledge on existing food systems science and its use in terms of sustainable actions for food safety and public health. The review identifies a knowledge gap in food system mapping and governance, with value chain mapping of key commodities often missing. Despite a number of initiatives, the application of food systems methods is highly variable in scope and quality. Most analyses concentrate on specific commodities, rarely taking into account the need for a whole diet approach when looking at nutrition or the assessment of a range of infectious agents and their interactions when looking at food safety. Of the studies included in the review there is a growing observation of “informal” food systems, a term used inconsistently and one that requires revision. “Informal” food systems link to the formal sector to provide food security, yet with trade-offs between economic efficiencies and food safety. Efforts to improve food safety are hampered by inadequate food safety capacities and a lack of policy coherence leading to: inadequate investment; fragmented food quality control systems; weak or non-existent traceability mechanisms; weak foodborne disease surveillance; obsolete food regulation; and weak regulatory enforcement. In-depth food systems assessments can complement risk analysis to identify risky behaviors and understand institutional settings in order to improve codes of practice and enforcement. Methods for looking at food safety from a food systems perspective are emerging, yet existing nutrition and food systems science are not advancing sufficiently in response to nutritional public health problems. There is an urgency for improved understanding of the structure and drivers of the food systems, for better planning of changes that leads to nutrients access and healthy levels of eating. It is proposed that countries and international institutions provide an atlas of food system maps for the key commodities based on an agreed common methodology and developed by multidisciplinary teams.

scholarly journals Diet quality indices for research in low- and middle-income countries: a systematic review

2019 ◽  
Vol 77 (8) ◽  
pp. 515-540 ◽  
Author(s):  
Laura Trijsburg ◽  
Elise F Talsma ◽  
Jeanne H M de Vries ◽  
Gina Kennedy ◽  
Anneleen Kuijsten ◽  
...  
Keyword(s):  
Diet Quality ◽  
Food System ◽  
Data Extraction ◽  
High Income ◽  
Dietary Guidelines ◽  
Food Groups ◽  
Quality Indices ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Context Dietary intake research has increasingly focused on improving diet quality in low- and middle-income countries (LMICs). Accompanying this is the need for sound metrics to assess diet quality. Objective This systematic literature review aims to describe existing diet quality indices for general populations and highlights recommendations for developing such indices for food system research in LMICs. Data sources Three electronic databases were searched for papers published between January 2008 and December 2017. Data extraction Articles published in English and describing the development of an index to measure overall diet quality, irrespective of whether they were for high-income countries or LMICs, were included. Data analysis Eighty-one indices were identified, over two thirds were based on national dietary guidelines from high-income countries. Of the 3 key diet quality dimensions, “diversity” was included in all 18 indices developed for LMICs, “moderation” was captured by most, and “nutrient adequacy” was included 4 times. Conclusions Indices need to be developed that include all dimensions, include foods and/or food groups rather than nutrients, use an optimal range for individual components in the score, and express the intake of healthy and unhealthy components separately. Importantly, validation of the index should be part of its development.

scholarly journals Metrics to analyze and improve diets through food Systems in low and Middle Income Countries

Food Security ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1085-1105
Author(s):  
Mequanint B. Melesse ◽  
Marrit van den Berg ◽  
Christophe Béné ◽  
Alan de Brauw ◽  
Inge D. Brouwer
Keyword(s):  
Food Systems ◽  
Food System ◽  
Systems Approach ◽  
Analytical Framework ◽  
Data Availability ◽  
Middle Income ◽  
The Sustainable Development ◽  
Middle Income Countries ◽  
Public Data ◽  
Low And Middle Income

Abstract Taking a food systems approach is a promising strategy for improving diets. Implementing such an approach would require the use of a comprehensive set of metrics to characterize food systems, set meaningful goals, track food system performance, and evaluate the impacts of food system interventions. Food system metrics are also useful to structure debates and communicate to policy makers and the general public. This paper provides an updated analytical framework of food systems and uses this to identify systematically relevant metrics and indicators based on data availability in low and middle income countries. We conclude that public data are relatively well available for food system drivers and outcomes, but not for all of the food system activities. With only minor additional investments, existing surveys could be extended to cover a large part of the required additional data. For some indicators, however, targeted data collection efforts are needed. As the list of indicators partly overlaps with the indicators for the Sustainable Development Goals (SGDs), part of the collected data could serve not only to describe and monitor food systems, but also to track progress towards attaining the SDGs.

scholarly journals Ze Lekòl: Contextual Factors Affecting Use of Eggs in School Feeding in Cap-Haïtien, Haiti

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 635-635
Author(s):  
Melissa Chapnick ◽  
Michael Galvin ◽  
Sherlie Jean-Louis ◽  
Henri-Claude Saintelmond ◽  
Emmanuel Gyimah ◽  
...  
Keyword(s):  
Focus Groups ◽  
Egg Production ◽  
Food System ◽  
Dissemination And Implementation ◽  
Preparation Methods ◽  
Middle Income ◽  
Middle Income Countries ◽  
Feeding Programs ◽  
School Feeding ◽  
Low And Middle Income

Abstract Objectives Eggs are a rich source of bioavailable nutrients for children, yet have been underutilized in school feeding programs in low- and middle-income countries. The purpose of the Ze Lekòl Project was to identify contextual facilitators, barriers, and resources needed at both the school and food system levels to link local egg value chains to school feeding programs in Cap-Haïtien, Haiti. Methods Key stakeholder interviews (n = 23) were conducted with school principals, representatives from the Ministry of Health and Ministry of Agriculture, domestic egg producers, and egg vendors. Focus groups (n = 4) were conducted with school staff and child caregivers. Interviews and focus groups were transcribed into Haitian Creole or French, and translated into English. Using inductive and deductive coding, interviews were analyzed for factors that facilitate or hinder the potential for incorporating locally produced eggs in school feeding programs. The approach to data collection and analysis was informed by the EPIS Implementation Science framework. Results School administrators and staff described facilitators (i.e., desire for nutritious foods, acceptability of eggs), barriers (i.e., preparation methods, national school feeding program structure) and potential benefits (i.e., improved student focus, reduced caregiver burden) for including eggs in school feeding programs. Local egg producers and vendors expressed facilitators (bulk purchases, customer preference for domestic eggs) and barriers (local availability of supplies, veterinary care, political disruption) to producing and selling locally produced eggs in Cap-Haïtien. Conclusions Locally produced eggs are an acceptable food to include in school feeding programs in Cap-Haïtien, Haiti. However, lack of sufficient infrastructure for domestic egg production prevents the ability to consistently provide the quantity of eggs needed for such programs without additional investments in domestic agriculture and school feeding programs. Findings from this study will inform interventions aimed at linking local agriculture to school feeding programs in low and middle-income countries. Funding Sources The Washington University in St. Louis Institute for Public Health–Center for Dissemination and Implementation funded this study.

scholarly journals Reverse thinking: taking a healthy diet perspective towards food systems transformations

Food Security ◽  
2021 ◽  
Author(s):  
I. D. Brouwer ◽  
M. J. van Liere ◽  
A. de Brauw ◽  
P. Dominguez-Salas ◽  
A. Herforth ◽  
...  
Keyword(s):  
Food Environment ◽  
Food Systems ◽  
Food System ◽  
Unintended Consequences ◽  
Healthy Diet ◽  
Middle Income ◽  
Middle Income Countries ◽  
Conflicting Objectives ◽  
Healthy Diets ◽  
Low And Middle Income

AbstractFood systems that deliver healthy diets without exceeding the planet’s resources are essential to achieve the worlds’ ambitious development goals. Healthy diets need to be safe, accessible, and affordable for all, including for disadvantaged and nutritionally vulnerable groups such as of smallholder producers, traders, and consumers in low- and middle-income countries. Globally, food systems are experiencing rapid and drastic changes and are failing to fulfil these multiple duties simultaneously. The international community therefore calls for rigorous food systems transformations and policy solutions to support the achievement of healthy diets for all. Most strategies, however, are essentially supply- and market-oriented. Incorporation of a healthy diet perspective in food system transformation is essential to enable food systems to deliver not only on supplying nutritious foods but also on ensuring that consumers have access can afford and desire healthy, sustainable, and culturally acceptable diets. This paper argues that this should be guided by information on diets, dietary trends, consumer motives, and food environment characteristics. Transformational approaches and policies should also take into account the stage of food system development requiring different strategies to ensure healthier diets for consumers. We review current knowledge on drivers of consumer choices at the individual and food environment level with special emphasis on low- and middle income countries, discuss the converging and conflicting objectives that exist among multiple food-system actors, and argue that failure to strengthen synergies and resolve trade-offs may lead to missed opportunities and benefits, or negative unintended consequences in food system outcomes. The paper proposes a menu of promising consumer- and food-environment- oriented policy options to include in the food systems transformation agenda in order to shift LMIC consumer demand towards healthier diets in low- and middle income countries.

scholarly journals Vegetables for Healthy Diets in Low- and Middle-Income Countries: A Scoping Review of the Food Systems Literature

2022 ◽  
pp. 037957212110686
Author(s):  
Jody Harris ◽  
Winson Tan ◽  
Jessica E. Raneri ◽  
Pepijn Schreinemachers ◽  
Anna Herforth
Keyword(s):  
Scoping Review ◽  
Low Income ◽  
Food Systems ◽  
Food System ◽  
Food Group ◽  
Middle Income ◽  
Middle Income Countries ◽  
Scoping Reviews ◽  
Healthy Diets ◽  
Low And Middle Income

Background: Vegetables are an essential element in healthy diets, but intakes are low around the world and there is a lack of systematic knowledge on how to improve diets through food system approaches. Methods: This scoping review assessed how studies of food systems for healthy diets have addressed the role of vegetables in low- and middle-income countries. We apply the PRISMA guidelines for scoping reviews to narratively map the literature to an accepted food systems framework and identify research gaps. Results: We found 1383 relevant articles, with increasing numbers over 20 years. Only 6% of articles looked at low-income countries, and 93% looked at single-country contexts. Over half of articles assessed vegetables as a food group, without looking at diversity within the food group. 15% looked at traditional vegetables. Issues of physical access to food were among the least studied food system topics in our review (7% of articles). Only 15% of articles used a comprehensive food system lens across multiple dimensions. There is also a research gap on the impacts of different policy and practice interventions (13% of articles) to enable greater vegetable consumption. Conclusions: Food system studies necessarily drew on multiple disciplines, methods and metrics to describe, analyze, and diagnose parts of the system. More work is needed across disciplines, across contexts, and across the food system, including understanding interventions and trade-offs, and impacts and change for diets particularly of marginalized population groups. Filling these gaps in knowledge is necessary in order to work toward healthy vegetable-rich diets for everyone everywhere.

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