By Matthew M. Graziose, MS, Doctoral Student at Teachers College, Columbia University studying nutrition, Research Assistant at the Laurie M. Tisch Center for Food, Education, & Policy, and 2015 Next Generation Delegate. The already demanding challenge of alleviating malnutrition will become more difficult in the coming years. Climate variability, urbanization, population growth, industrialization of the food chain, and extreme poverty threaten any progress we have already made and may contribute to a shift in the burden of disease and an increase in food insecurity. In light of this challenge, we need cooperation across relevant sectors, such as agriculture, health, education, and sanitation, to develop interventions that are sensitive to nutrition outcomes.
Several interventions, if widely implemented, could improve nutrition and save lives across the globe. Included on this list is nutrition education (also called behavior change communication), which aims to increase knowledge, motivation, and skills to facilitate behavior change and create supportive environments. The behaviors that can be targeted span the promotive, curative, and preventive, and the interventions can be delivered in homes, villages, schools, workplaces, and community health centers.
A forthcoming paper in the Journal of Nutrition details a randomized-controlled trial in Burkina Faso combining agricultural production activities and nutrition education for seven health-related behaviors. Women who participated in the intervention increased production of nutrient-rich fruits and vegetables and their children saw improved hemoglobin status and reductions in anemia and diarrhea. The study is an important proof of concept for a nutrition-sensitive, multisectoral approach.
Together with colleagues at Columbia University, I am helping to develop a nutrition education intervention for smallholder farmers in Senegal to be delivered alongside an existing intensified horticultural project. This intervention is unique, because it will use text and voice messaging as a delivery mode for nutrition education. Focus groups are currently being conducted with men and women in the study regions in order to better understand the local context. We hypothesize that participants will improve dietary quality and infant and young child feeding behaviors, as the new crops will provide both nutrition and livelihoods for vulnerable families.
At the Laurie M. Tisch Center for Food, Education, & Policy, I am working to evaluate the effects of a national program that fosters healthy school food environments through a combination of school gardens, nutrition education, and access to healthy foods in the cafeteria. Children who participate in the program are hypothesized to have a higher consumption of fruits and vegetables due to increased exposure to and experience with these nutritious foods. Similar programs have been shown to improve physical activity and dietary behaviors – both important in preventing obesity.
These new and intentionally multisectoral approaches to malnutrition demonstrate that nutrition can be complementary (and perhaps synergistic) to investments in agriculture and education. Nutrition education is one strategy that should be prioritized to improve the health of the world’s citizens as we begin to face many new challenges. To do so, it must be supported through research, policy, and practice, and in the training of the next generation workforce.
References:
- Bhutta, Z.A., J.K. Das, A. Rizvi, M.F. Gaffey, N. Walker, S. Horton, P. Webb, A. Lartey, R.E. Black, et al. “Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost?” Lancet, 382 (2013): 452–77.
- Contento, Isobel R. Nutrition Education: Linking Research, Theory and Practice, 2nd Edition. Burlington, MA: Jones & Bartlett, 2011.
- Olney, Deanna K., Abdoulaye Pedehombga, Marie T. Ruel, and Andrew Dillon. “A 2-Year Integrated Agriculture and Nutrition and Health Behavior Change Communication Program Targeted to Women in Burkina Faso Reduces Anemia, Wasting, and Diarrhea in Children 3–12.9 Months of Age at Baseline: A Cluster-Randomized Controlled Trial.” Journal of Nutrition, 114.203539 (2015).
- Robinson-O'Brien, Ramona, Mary Story, and Stephanie Heim. “Impact of Garden-Based Youth Nutrition Intervention Programs: A Review.” Journal of the American Dietetic Association, 109 (2009): 273-80.
- Ruel, Marie T., and Howard Alderman. “Nutrition-Sensitive Interventions and Programmes: How Can They Help to Accelerate Progress in Improving Maternal and Child Nutrition?” Lancet, 382 (2013): 536-51.
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Healthy Soils, Healthy People: Integrating Soil Science into Nutrition Security, Andrew Margenot, PhD Candidate in Soil Science & Biogeochemistry, University of California, Davis
The Importance of Understanding Urban Food Flows, Dana Boyer, PhD candidate in Science, Technology and Public Policy, University of Minnesota
Genetic Engineering: A Tool to Strengthen Global Food Security, Megan Fenton, PhD Student in Agronomy - Plant Breeding and Genetics, Purdue University
Edible Insects as an Integrated Component of Sustainable Food Systems, Afton Halloran, GREEiNSECT and Social Science and Humanities Research Council Doctoral Fellow, University of Copenhagen