Case Study #3-4 of the Program: ''Food Policy For Developing Countries: The Role Of Government In The Global Food System''

9 pp.©Cornell University, Ithaca, New York. All rights reserved. This case study may be reproduced for educational purposes without express permission but must include acknowledgment to Cornell University. No commercial use is permitted without permission.Deficiencies of micronutrients—particularly iron, iodine, vitamin A, zinc, and folic acid—wreak havoc on survival, health, and productivity around the world. Micronutrient deficiencies are often called “hidden hunger” because they do not manifest themselves in immediate physical signs but are insidious in causing disease. They are particularly problematic in India because of the sheer numbers of people affected: 35 percent of the world’s malnourished children live in India, and 42 percent of children in India are stunted. The Indian government has not met its current goals related to reducing micronutrient deficiencies. In order to increase the profile of programs aimed at eliminating micronutrient deficiencies on the policy agenda, the Micronutrient Initiative (an international nongovernmental organization, or NGO), created an India Micronutrient National Investment Plan (IMNIP), which laid out the rationale and costs for addressing the problems. This plan has been well received and appears to have significantly influenced likely funding allocations to micronutrient programs. Several features of the process by which the IMNIP was conceptualized, written, shared, and used were essential to influencing the national policy process; these features include relevancy, timing, stakeholder involvement, information, publicity, leadership, and saliency. The IMNIP has clearly addressed questions of why and when micronutrient programs should be increased, and it has made plausible suggestions concerning what programs best tackle the problems and how they should be carried out. It is debatable who should be responsible for planning, funding, carrying out, and monitoring micronutrient programs; possible parties include the national government, state governments, NGOs, and the private sector. A take-home message is that policy decisions are often ambiguous and that debate about the best way to administer policy continues even after policies or budgets are passed. As a staff member of an NGO that provides nutrition programming consulting, your assignment is to recommend to the Government of India how to address remaining questions about implementation, funding, monitoring, and enforcement of the micronutrient programs and to try to make sure the government takes note of your recommendations.Cornell University Division of Nutritional Science

How and where global food supplies fall short of healthy diets: Past trends and future projections, 1961-2020 and 2010-2050

Most of the world still lacks access to sufficient quantities of all food groups needed for an active and healthy life. This study traces historical and projected changes in global food systems toward alignment with the new Healthy Diet Basket (HDB) used by UN agencies and the World Bank to monitor the cost and affordability of healthy diets worldwide. We use HDB as a standard to measure adequacy of national, regional and global supply-demand balances, finding substantial but inconsistent progress toward closer alignment with dietary guidelines, with large global shortfalls in fruits, vegetables, and legumes, nuts, and seeds, and large disparities among regions in use of animal source foods. Projections show that additional investments in the supply of agricultural products would modestly accelerate improvements in adequacy where shortfalls are greatest, revealing the need for complementary investments to increase purchasing power and demand for under-consumed food groups especially in low-income countries

Environmental impacts, nutritional profiles, and retail prices of commonly sold retail food items in 181 countries: an observational study

Affordability is often seen as a barrier to consuming sustainable diets. This study provides the first worldwide test of how retail food prices relate to empirically estimated environmental impacts and nutritional profile scores between and within food groups. We use prices for 811 retail food items commonly sold in 181 countries during 2011 and 2017, matched to estimated carbon and water footprints and nutritional profiles, to test whether healthier and more environmentally sustainable foods are more expensive between and within food groups. We find that within almost all groups, less expensive items have significantly lower carbon and water footprints. Associations are strongest for animal source foods, where each 10% lower price is associated with 20 grams lower CO2-equivalent carbon and 5 liters lower water footprint per 100kcal. Gradients between price and nutritional profile vary by food group, price range, and nutritional attribute. In contrast, lower-priced items have lower nutritional value in only some groups over some price ranges, and that relationship is sometimes reversed. These findings reveal opportunities to reduce financial and environmental costs of diets, contributing to transitions towards healthier, more environmentally sustainable food systems

Concepts and critical perspectives for food environment research: A global framework with implications for action in low- and middle-income countries

Malnutrition in all its forms currently affects one in three people globally and is considered one of the greatest public health challenges of our time. Low- and middle-income countries (LMICs) are increasingly facing a double burden of malnutrition that includes undernutrition, as well as increasing overweight, obesity and diet related non-communicable diseases. The role of food environments in shaping transitioning diets and the double burden of malnutrition in LMICs is increasingly gaining policy attention. However, food environment research to date has predominantly been undertaken in response to obesity and associated diet-related non-communicable diseases in high-income countries (HICs). Empirical research in LMICs is in its infancy. There is a need to create a cohesive research agenda to facilitate food environment research and inform action across the globe, particularly with regard to LMICs. In this paper, we address three fundamental questions: First, how can the food environment be defined and conceptualised in a way that captures the key dimensions that shape food acquisition and consumption globally? Second, how can existing knowledge and evidence from HICs be leveraged to accelerate food environment research in LMICs? Third, what are the main challenges and opportunities in doing so? We conduct a brief synthesis of the food environment literature in order to frame our critical perspectives, and introduce a new definition and conceptual framework that includes external and personal domains and dimensions within the wider food environment construct. We conclude with a discussion on the implications for future research in LMICs

Food Environment Typology: Advancing an Expanded Definition, Framework, and Methodological Approach for Improved Characterization of Wild, Cultivated, and Built Food Environments toward Sustainable Diets

The food environment is a critical place in the food system to implement interventions to support sustainable diets and address the global syndemic of obesity, undernutrition, and climate change, because it contains the total scope of options within which consumers make decisions about which foods to acquire and consume. In this paper, we build on existing definitions of the food environment, and provide an expanded definition that includes the parameter of sustainability properties of foods and beverages, in order to integrate linkages between food environments and sustainable diets. We further provide a graphical representation of the food environment using a socio-ecological framework. Next, we provide a typology with descriptions of the different types of food environments that consumers have access to in low-, middle-, and high-income countries including wild, cultivated, and built food environments. We characterize the availability, affordability, convenience, promotion and quality (previously termed desirability), and sustainability properties of food and beverages for each food environment type. Lastly, we identify a methodological approach with potential objective and subjective tools and metrics for measuring the different properties of various types of food environments. The definition, framework, typology, and methodological toolbox presented here are intended to facilitate scholars and practitioners to identify entry points in the food environment for implementing and evaluating interventions that support sustainable diets for enhancing human and planetary health

SUSTAINABLE, RESILIENT FOOD SYSTEMS FOR HEALTHY DIETS

Sustainable, resilient food systems for healthy diets has been identified as the first of the six pillars for action during the UN Decade of Action on Nutrition. It is now THE defining issue for public health nutrition. A sustainable food system is one ‘that ensures food security and nutrition for all in such a way that the economic, social and environmental bases to generate food security and nutrition of future generations are not compromised'. Resilience refers to the capacity of a food system to achieve this same objective ‘in the face of various and even unforeseen disturbances’ including environmental, economic or socio-political shocks. Sustainable food systems are essential if we are to nourish a projected global population of nearly 10 billion in 2050 within planetary boundaries. However, today’s food systems are far from sustainable. Not only are dietary risk factors and malnutrition in all its forms the leading contributors to the global burden of disease, but also food systems are not operating within some planetary boundaries and are contributing to widespread and potentially irreversible environmental breakdown degradation, including potentially irreversible disruption. Understanding the impact of population dietary intake has extended beyond health and the ability of food systems to provide sufficient quantity, quality and diversity of safe, affordable and nutritious foods, to interlinkages of diets and food systems with climate change, water and land pollution, deforestation and biodiversity loss and other forms of environmental degradation. The focus on healthy diets from sustainable food systems connects all parts of food supply chains (from food production to consumption) and the social, economic and environmental outputs of those systems

Diagnosing the performance of food systems to increase accountability toward healthy diets and environmental sustainability

To reorient food systems to ensure they deliver healthy diets that protect against multiple forms of malnutrition and diet-related disease and safeguard the environment, ecosystems, and natural resources, there is a need for better governance and accountability. However, decision-makers are often in the dark on how to navigate their food systems to achieve these multiple outcomes. Even where there is sufficient data to describe various elements, drivers, and outcomes of food systems, there is a lack of tools to assess how food systems are performing. This paper presents a diagnostic methodology for 39 indicators representing food supply, food environments, nutrition outcomes, and environmental outcomes that offer cutoffs to assess performance of national food systems. For each indicator, thresholds are presented for unlikely, potential, or likely challenge areas. This information can be used to generate actions and decisions on where and how to intervene in food systems to improve human and planetary health. A global assessment and two country case studies—Greece and Tanzania—illustrate how the diagnostics could spur decision options available to countries

The cost and affordability of preparing a basic meal around the world

All countries have a rising burden of diet-related disease from the consumption of unhealthy foods. About three billion people around the world cannot afford the diverse foods needed for a healthy diet. This chapter aims to extend previous work on diet cost and affordability to address the hidden costs of meal preparation inside the home. Costs of a basic meal based on market prices for the most affordable items are estimated in 168 countries. Also, the hidden costs of meal preparation are considered, taking account of environmental or social externalities from the production and distribution of food, as well as the health externalities involved in food consumption. The data shown here reveal that even the simple raw ingredients for a basic plate are often unaffordable for the poorest, and the added cost of time and fuel can make such meals prohibitively expensive. Results suggest two main avenues for policy action. First, governments should use the information on the least costly way to meet dietary standards to inform poverty lines and provide targeted assistance so as to ensure that citizens can acquire safe and nutritious items in sufficient quantities for an active and healthy life, using locale-appropriate safety nets. Second, food policies should recognize the hidden costs of meal preparation that often put healthier, more sustainable diets out of reach. Overcoming the hidden barriers to preparation of healthy meals will require support for helpful forms of food processing that preserve or enhance nutritional values, while taking action to limit potentially harmful forms of ultra-processing associated with diet-related disease. Food-based safety nets and improvements in the food environment can make healthy diets affordable for all people at all times, to help every country reach global development goals.https://link.springer.com/book/10.1007/978-3-031-15703-5hj2024Agricultural Economics, Extension and Rural DevelopmentSDG-01:No povertySDG-02:Zero Hunge

Measuring what the world eats: Insights from a new approach

Diet quality is critical for human health. Current diets are the main drivers of ill health and premature mortality, with negative spillover effects on the environment and economy. Monitoring diet quality globally is thus essential for holding decision makers accountable for progress toward global nutrition, health, and development goals. Yet there has been no way of monitoring diet quality in a credible, affordable, and timely way. Gallup, Harvard University, and the Global Alliance for Improved Nutrition teamed up to overcome this challenge by initiating the Global Diet Quality Project. Through this project we have created a new approach that enables countries to track diet quality year to year, seasonally, or even more frequently. The new approach allows users to investigate both people’s overall dietary adequacy and their consumption of foods that protect against or increase risk for noncommuni-cable diseases (NCDs). The project has worked with the Gallup World Poll data collection platform to provide the first round of diet quality data from 2021 for 41 countries, representing two-thirds of the world’s population. The project aims to collect data for 140 countries in the future