March 25, 2016 | By Roger Thurow

Turning Nutrition Knowledge Into Action

A mom in Uganda prepares lunch for her family. Photo by Anne Thurow.

Most everywhere I traveled reporting on my new book, The First 1,000 Days, new mothers and moms-to-be talked about the price of apples. India, Guatemala, Chicago. Urban and rural. “Do you know how much apples cost?,” went the global refrain.

These women were involved in community-based programs providing nutrition education. It was essential, they were told, to eat foods rich in vitamins and minerals during the 1,000 days from the beginning of pregnancy to the second birthday of their child. These vital nutrients would aid healthy physical growth and cognitive development; they would prevent malnutrition and stunting. Proper nutrition during these days can profoundly influence an individual’s ability to grow, learn and work—and determine a society’s long-term health and prosperity.

The moms learned about a balanced, nutritious diet, and the importance of fruits and vegetables and animal-source protein. The teaching material—basically the same everywhere—featured pictures of bananas, oranges, sweet potatoes, eggs, milk, beans, peas, lettuce and…apples.

“Now I’m aware of nutritious foods. But I have difficulty in buying them,” Seema, one of the moms in India, told me.  “We know to take milk, beans, vegetables, be diverse in our diet.  That’s important. We know we should eat fruit, and maybe we do once a week when they are ripe….But otherwise we can’t afford them on the market.”

Seema asked the community health worker providing the nutrition advice: “Do you know how expensive apples are?”

At the time, apples were costing as much as 150 rupees for one kilogram (2.2 pounds).  Seema’s husband usually worked at 100-rupee a day manual labor jobs.  A kilo of apples would eat up one and half days of wages.

The market experience of these moms in the Indian state of Uttar Pradesh was confirmed by a report from the International Food Policy Research Institute (IFPRI) in Washington, D.C. that chronicled how quickly food prices in India were rising, “especially for high-nutrient foods.”  IFPRI’s food price index for India had been climbing steadily, going from a base of 100 in 2007 to nearly 160 by the middle of 2013. India’s vegetable price index spiked even more dramatically in 2013, nearly tripling in the course of one year.

Similarly, moms in Guatemala—in the villages of the Palajunoj Valley in the country’s western highlands—were feeling the price pressure. They had just finished an exercise where they filled up a cardboard bowl with food-shaped stickers at the prompting of a nutritionist.

Photo by Anne Thurow“Where do you get iron?,” the nutritionist asked.

“Meat. Green vegetables. Spinach. Beans,” the women replied as they added each ingredient to their bowls.  There was spirited participation and laughter as the bowls filled. They applauded their teacher, and themselves.

“Thank you for all you are teaching us,” Yolanda, one of the moms, said. Then she turned somber. Something had been bothering her as she filled the bowl. “We now know the foods to eat so our children can be healthy, but often we can’t afford them.”

Reality crashed the gathering. The moms talked about how meat was a rare treat in their homes, how milk, eggs, carrots and apples—apples again—strained their budgets. Most of them worked in fields owned by other families, cultivating all manners of vegetables. Mainly the produce was destined for big city markets or for export. The women of the Palajunoj Valley needed to buy the vegetables they harvested, and often it was difficult to afford very much.

Moms in Chicago were as sensitive to nutrient-rich food prices as were women in India and Guatemala—particularly those receiving benefits from the SNAP (food stamps) and WIC (women and infant children) government nutrition programs. Most often those monthly benefits stretched for only two or three weeks, placing regular purchases of vegetables and fresh fruits like apples beyond reach. As was the case in India, the cost of nutritious food had been on a steady rise in the United States. In the previous decade, the price of fruits and vegetables had increased by about 16 percent, according to the US Department of Agriculture.  Over the same time period, prices for sugar and sweets had decreased by more than 7 percent.  Calories were cheap, nutrients more expensive.

In northern Uganda, the fourth place where I followed moms and their children through the 1,000 Days, the concern was less for apples (which weren’t widely grown) but more for other fruits and vegetables that were scarce because of bad harvests, or meat of any kind which was always expensive. The moms were all farmers, and outside income to purchase foods they didn’t grow was scarce.

At all stops in my reporting, moms found that poverty trumped knowledge. Nutrition information is vital; it is sorely lacking everywhere, including in the United States. But equally important is the ability to put that information into action. Otherwise, knowledge becomes a burden.

For a healthy 1,000 Days, families need food systems that encourage production of fruits, vegetables, and highly nutritious foods so that increased availability can hold down prices.  They need improved access to these foods, which means efficient transport, storage, and distribution. And they need higher incomes to increase their food budgets. With all this, their knowledge won’t be a burden, but power.

The First 1,000 Days: A Crucial Time for Mothers and Children—And the World will be released on May 3, 2016, ahead of Mother’s Day. Preorder now at your favorite local or online bookstore. 

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The Global Food and Agriculture Program aims to inform the development of US policy on global agricultural development and food security by raising awareness and providing resources, information, and policy analysis to the US Administration, Congress, and interested experts and organizations.

The Global Food and Agriculture Program is housed within the Chicago Council on Global Affairs, an independent, nonpartisan organization that provides insight – and influences the public discourse – on critical global issues. The Council on Global Affairs convenes leading global voices and conducts independent research to bring clarity and offer solutions to challenges and opportunities across the globe. The Council is committed to engaging the public and raising global awareness of issues that transcend borders and transform how people, business, and governments engage the world.

Support for the Global Food and Agriculture Program is generously provided by the Bill & Melinda Gates Foundation.


1,000 Days Blog, 1,000 Days

Africa Can End Poverty, World Bank

Agrilinks Blog

Bread Blog, Bread for the World

Can We Feed the World Blog, Agriculture for Impact

Concern Blogs, Concern Worldwide

Institute Insights, Bread for the World Institute

End Poverty in South Asia, World Bank

Global Development Blog, Center for Global Development

The Global Food Banking Network

Harvest 2050, Global Harvest Initiative

The Hunger and Undernutrition Blog, Humanitas Global Development

International Food Policy Research Institute News, IFPRI

International Maize and Wheat Improvement Center Blog, CIMMYT

ONE Blog, ONE Campaign

One Acre Fund Blog, One Acre Fund

Overseas Development Institute Blog, Overseas Development Institute

Oxfam America Blog, Oxfam America

Preventing Postharvest Loss, ADM Institute

Sense & Sustainability Blog, Sense & Sustainability

WFP USA Blog, World Food Program USA


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