nutrition in a global perspective: a nutrition sdg, what does it entail?
TRANSCRIPT
Nutrition &
Sustainable Development
Eva-Charlotte Ekström
Professor Global Nutrition
Internationell mödra- och barnhälsovårdKvinnor och Barns Hälsa
Uppsala University
SIANI ANNUAL MEETING 2015: Moving forward, networking towards sustainable development goals
Perspective on nutrition?
• Food
• Cooking
• Eating
Nutrition as an outcome
• Of poverty in the 80’s
UndernutritionPoverty
Nutrition as an outcome
• Of poverty in the 80’s
• Structural adjustmentUndernutritionPoverty
Nutrition as an outcome
• Of poverty in the 80’s
• Structural adjustmentUndernutritionPoverty
UNICEF 1987
Nutrition as an outcome
• Of poverty in the 80’s
• Structural adjustment
• Nutrition interventions
UndernutritionPoverty
UNICEF 1987
Nutrition as an outcome
• Of poverty in the 80’s
• Structural adjustment
• Nutrition interventions
• Of development (MDG 1)
UndernutritionPoverty
UNICEF 1987
Nutrition as means
• Human Right
• Sustainable development
SDG 2End hunger, achieve food security and improvednutrition, and promote sustainable agriculture
- Progress on WHA nutrition targets, stunting and wasting promotesnutrition security
- A well-nourished workforce supports productive agriculture
NUTRITION
SustainableDevelopment
goals
- Sustainable agriculture supports appropriate diet, income and resource use
P Webb UNSCN 2014
Investment in nutrition pays off
Horton et al 2014 Copenhagen consensus
SDG 3Ensure healthy lives and promote well-being at all ages
- Good nutrition reduces the risk ofsickness and mortality
NUTRITION
SustainableDevelopment
goals
- Enhancing health in pregnancy and early life support child growth whilereducing risk of NCD later in life
P Webb UNSCN 2014
SDG 12Ensure sustainable consumption and production
patterns
- Falling poverty and improvednutrition raises demands for higherquality and more diverse diets
- Change of dietary patterns i well off settings will reduce greenhouse gas emission (and reduce the risk ofNCDs)
NUTRITION
SustainableDevelopment
goals
- Product diversity and moreproductivity supports diet diversityand food quantity
P Webb UNSCN 2014
Life-cycle emission of GHG for different foods
Tilman 2014 Nature
MINIMatMaternal and Infant Nutrition Interventions, Matlab
Aim to improve
• maternal nutrition
• newborn nutrition• pre-schooler’s nutrition• pre-puberty nutrition
Maternal interventions (RCT n=4436)
• Food (govn prog)– Usual (stand)– Early
• Micronutrients– Fe60F (stand)– Fe30F– MMS
Bangladesh
Maternal and newborn nutrition
Mothers
• Height 150 cm (123-169)
• Weight 45 kg (25-90)
• 27% malnourished
Newborn
• Birthweight 2694 g
• 31% <2500g
• No difference between– Type of micronutrients
– Early or usual timing foodsupplement
Infant mortality
Infant mortality/1000 born
0
10
20
30
40
50
60
70
80
90
100
Early food Usual food
Fe60F
MMS
Fe30F
62% reduction!
Combination of Early food supplement and ”multi” supplement reduced infant mortality 62%
Persson LA et al. JAMA 2012;307:2050-2059
Mortality, stunting and metabolic risk markers at 5y
Early food– Blood lipids favourable– Stunting favourable
MMS – Stunting unfavourable
Early food + MMS- 66% reduction in mortality
Bangladesh
Khan 2001; Ekström ms
Role of health system and women’s caring capacity inCommunity based management of
Severe Acute Malnutrition (SAM)
Research question• Can children with SAM be treated
successfully at home?
• Ready-to-use-therapeutic food”plumpy nut”
Design• Qualitative study
• HEW• Community Volounters• SAM caregivers
• Quantitative study• SAM cohort (n≈1100)• Population survey (n≈4000) Health extension workers Feb 2011
ACIPHEthiopia
Findings qualitative study
Some quotes by
• Community Volounters• SAM caregivers
ACIPHEthiopia
Balla 2015 Health Policy & Planning (forthcoming)
Young child diet and nutrition in a society undergoing nutrition transition.
Design
• Survey 1500 mother child pair
• DHS system in rural Nicaragua
• Assessed infant and child feeding• Good practices
• Exclusive breastfeeding• Diet diversity, meal frequency
• Bad practices • Sugar-sweet beverage• Highly processed snacks
Nicaragua
The diet (24h)
How can imported ”junk food” be more accessable thanlocally produced foods?
Nicaragua
Contreras 2014
9-11 m infants
• 19% vit A rich fruit/veg
• 41% min acceptable diet
• 34% sugar-sweet beverage
• 42% highly processed snacks
Nicaragua
A nutrition SDG, what does it entail?
Actions!
A nutrition SDG, what does it entail?
Action!
- Nutrition specific interventions
- Nutrition sensitive interventions
A nutrition SDG, what does it entail?
Nutrition as means