To review the impact of agriculture interventions on nutritional status in participating households, and to analyse the characteristics of interventions that improved nutrition outcomes.
We ...identified and reviewed reports describing 30 agriculture interventions that measured impact on nutritional status. The interventions reviewed included home gardening, livestock, mixed garden and livestock, cash cropping, and irrigation. We examined the reports for the scientific quality of the research design and treatment of the data. We also assessed whether the projects invested in five types of 'capital' (physical, natural, financial, human and social) as defined in the Sustainable Livelihoods Framework, a conceptual map of major factors that affect people's livelihoods.
Most agriculture interventions increased food production, but did not necessarily improve nutrition or health within participating households. Nutrition was improved in 11 of 13 home gardening interventions, and in 11 of 17 other types of intervention. Of the 19 interventions that had a positive effect on nutrition, 14 of them invested in four or five types of capital in addition to the agriculture intervention. Of the nine interventions that had a negative or no effect on nutrition, only one invested in four or five types of capital.
Those agriculture interventions that invested broadly in different types of capital were more likely to improve nutrition outcomes. Those projects which invested in human capital (especially nutrition education and consideration of gender issues), and other types of capital, had a greater likelihood of effecting positive nutritional change, but such investment is neither sufficient nor always necessary to effect change.
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•Agroecological farmers have more nutritious and balanced diets.•Agroecology may improve nutrient adequacy through higher production diversity.•Agroecology may improve dietary ...moderation through non-market food consumption.•Social and human capital, but not income, may mediate agroecology's diet effects.•Agroecological farmers have healthier diets despite spending less money on food.
Agroecology has received much attention as a sustainable production strategy that may leverage agriculture-nutrition linkages to positively impact farmer nutritional health, but its potential has not been thoroughly established through empirical assessment. This mixed methods study uses survey data from Ecuador to assess how farmers' participation in agroecological associations may impact their diets. Our results suggest that agroecological farmers outperform reference farming neighbors on both nutrient adequacy (i.e. meeting key nutrient needs) and dietary moderation (i.e. avoiding dangerous excesses). Stronger nutrient adequacy is likely related to agroecological farmers' higher production diversity as well as the social and human capital developed within their networks, while stronger dietary moderation is likely related to their greater consumption of foods obtained through own-production and the social economy (e.g. barter). Dietary differences between agroecological and reference farmers occur despite similar incomes and other socioeconomic characteristics, and in fact, agroecological farmers achieve healthier diets while spending less money to purchase foods. Agroecology-based famers' networks may thus hold promise for integrating nutritional health priorities into sustainable food systems.
Background
The selection of food vehicles and fortification levels in food fortification programs may be made on the assumption of equitable intrahousehold distribution of food. There are concerns ...that biased intrahousehold distribution of food will make food-based interventions ineffective or unsafe.
Objective
To review available data documenting intrahousehold energy intake (as a proxy for food distribution) in low- and middle-income countries, and discuss the relevance for food fortification programs.
Methods
A literature search was done, selecting reports from low- and middle-income countries that included dietary data from adults and children. The references of relevant reports and all citations of relevant reports were scanned. Intrahousehold distribution of dietary energy was compared with individual energy requirements.
Results
Twenty-eight studies were identified covering 18 countries with as few as 20 and as many as 3,000 households per study. Intrahousehold distribution of food in most countries is relatively equitable, within a 20% margin.
Conclusions
Within the limits of the available data, and in the absence of contrary data, it is reasonable to assume equitable intrahousehold distribution of food when designing food fortification programs; however, for program evaluation, individual assessment of intake is still needed.
Objective
To describe the prevalence of food insecurity in First Nations households across Canada while identifying barriers and enablers to traditional food (TF) consumption.
Methods
The First ...Nations Food, Nutrition and Environment Study is a cross-Canada participatory study of on-reserve First Nations from 2008 to 2018. The Household Food Security Survey Module was used to capture income-related challenges experienced by First Nations households. Households were classified as food secure, or marginally, moderately, or severely food insecure. Barriers and enablers to TF access and use were identified describing the Indigenous experience.
Results
Almost half of on-reserve First Nations households were food insecure and the prevalence was higher than that for non-Indigenous households in Canada. On-reserve food insecurity prevalence was higher in western regions of Canada. First Nations households with children experienced greater food insecurity than those without children. More adults experienced severe food insecurity than children. Most adults would like to have more TF in their diet but state that factors such as financial and household constraints, industrial activities, government regulations, climate change, and fear of contamination impede greater access. Food costs were substantially higher in remote First Nations communities, but remoteness was not associated with food security in multivariable analysis.
Conclusion
Existing systems have been unsuccessful in curbing the food insecurity in First Nations households. Improving food security hinges on achieving Indigenous Food Sovereignty, the key to long-term conservation and stewardship of the land and the co-management of these by Indigenous Peoples. Studies investigating the feasibility of increasing TF from an Indigenous perspective are required.
Objective To investigate whether children in households involved in a participatory agriculture and nutrition intervention had improved growth compared to children in matched comparable households ...and whether the level of involvement and length of time in the project had an effect on child growth. Design A prospective quasi-experimental study comparing baseline and follow-up data in ‘intervention’ villages with matched subjects in ‘comparison’ villages. Mixed model analyses were conducted on standardized child growth scores (weight- and height-for-age Z-scores), controlling for child age and testing for effects of length of time and intensity of village involvement in the intervention. Setting A participatory agriculture and nutrition project (the Soils, Food and Healthy Communities (SFHC) project) was initiated by Ekwendeni Hospital aimed at improving child nutritional status with smallholder farmers in a rural area in northern Malawi. Agricultural interventions involved intercropping legumes and visits from farmer researchers, while nutrition education involved home visits and group meetings. Subjects Participants in intervention villages were self-selected, and control participants were matched by age and household food security status of the child. Over a 6-year period, nine surveys were conducted, taking 3838 height and weight measures of children under the age of 3 years. Results There was an improvement over initial conditions of up to 0·6 in weight-for-age Z-score (WAZ; from −0·4 (sd 0·5) to 0·3 (sd 0·4)) for children in the longest involved villages, and an improvement over initial conditions of 0·8 in WAZ for children in the most intensely involved villages (from −0·6 (sd 0·4) to 0·2 (sd 0·4)). Conclusions Long-term efforts to improve child nutrition through participatory agricultural interventions had a significant effect on child growth.
Rural Ecuadorians are experiencing a double burden of malnutrition, characterized by simultaneous nutrient inadequacies and excesses, alongside the social and environmental consequences of ...unsustainable agriculture. Agriculture can support farmer nutrition by providing income for market purchases and through the consumption of foods from own production. However, the nutritional contributions of these food acquisition strategies vary by context. We surveyed smallholder women farmers (n = 90) in Imbabura province to assess the dietary contributions of foods obtained through market purchase, own production, and social economy among farmers participating in agroecology—a sustainable farming movement—and neighboring reference farmers. We found that foods from farmers’ own production and the social economy were relatively nutrient-rich, while market foods were calorie-rich. Consumption of foods from own production was associated with better nutrient adequacy and moderation, whereas market food consumption was associated with a worse performance on both. Food acquisition patterns differed between farmer groups: agroecological farmers obtained 44%, 32%, and 23% of their calories from conventional markets, own production, and the social economy, respectively, while reference neighbors obtained 69%, 17%, and 13%, respectively. Our findings suggest that, in this region, farmer nutrition is better supported through the consumption of their own production than through market purchases, and sustainable farming initiatives such as agroecology may be leveraged for healthy diets.
In highland Bolivia a three-year nutrition-sensitive agricultural intervention was carried out with rural families in which chicken rearing was promoted in order to increase egg consumption. Here we ...report on the impact of the intervention on participants’ diets. The non-randomized intervention took place in 21 rural communities in the province of Tapacarí in the department of Cochabamba, Bolivia. Intervention communities had staggered start times, with two communities starting in 2013, three communities starting in 2014 and sixteen communities starting in 2015. Twenty-four hour dietary recall data were collected from all individuals in 22 households in two communities in February/March 2013, 33 households in three communities in February/March 2014, and 66 households in fourteen communities in February/March 2015. We tested for changes from 2013 to 2014 to 2015 in consumption of 10 food groups in children under 6 years, adult men and adult women. By endline, egg production was established in ~80% of the intervention households. From baseline to endline egg consumption increased to approximately one-half egg/person/day: in children from 7 to 33 g/day, in women from 6 to 33 g/day, and in men from 6 to 39 g/day. Despite the increased intake in eggs, intake of most nutrients did not change. Higher egg consumption would be required to produce observable average increases in nutrient intake.
To examine dietary adequacy in the Andean area, including macro- and micronutrient intakes, with a particular focus on rural communities; to highlight nutrition priorities in the Andes; and to ...identify opportunities for improvement.
A comprehensive literature search was conducted, identifying published and grey literature in English and Spanish related to diet in the central Andean countries of Bolivia, Colombia, Ecuador, and Peru. Articles reporting data from dietary surveys or nutrition interventions were included. Thirty-four papers or reports published in 1969-2011 were included in the final review. The mean and variation in intakes by sex and age group of all presented nutrients were collated and the mean of means were calculated.
Thiamin, niacin, and vitamin C intakes were usually adequate. Intakes of most other micronutrients, including iron, zinc, vitamin A, riboflavin, vitamin B12, folate, and zinc were low, likely resulting in high levels of inadequacy. Energy intakes were lower than requirements, but it is unlikely to be a common problem, rather, this result was probably due to the known tendency of most dietary survey tools to underreport intake. However, energy from fat intakes was very low, usually less than 20% of the total, and in some settings, less than 10%.
The inadequate intake of some micronutrients is common in many developing countries, but the extremely low intake of dietary fat found in the central Andes is not. Increased consumption of animal-source foods would increase fat intakes, while addressing micronutrient deficiencies; however, the impact on the fragile ecosystem of the Andes needs considering. Indigenous crops, such as lupine bean, quinoa, and amaranth are also rich in fat or micronutrients.
Information is needed on dietary adequacy of Arctic indigenous populations in Canada. Extensive work has been completed on composition of Arctic food and food use, and dietary reference intakes are ...available.
To complete the first comprehensive dietary adequacy assessment of three populations of adult Arctic indigenous people.
Dietary assessment interviews were conducted with randomly selected indigenous adults during two seasons in 44 representative communities of Yukon First Nations (n = 797), Dene/Métis, (n = 1007) and Inuit (n = 1525).
Twenty-four-hour recalls were used to derive adjusted distributions of usual nutrient intakes in four age/gender groups for assessment of dietary adequacy for carbohydrate, dietary fibre, protein, n-3 fatty acids, n-6 fatty acids, calcium, copper, iron, magnesium, manganese, phosphorus, selenium, zinc, vitamin A, riboflavin, folate, vitamin B6, vitamin C, vitamin D and vitamin E.
Nutrients with high prevalence of adequacy for most age/gender groups in all three cultures were protein, carbohydrate, n-3 fatty acids, iron, copper, zinc, manganese, selenium, riboflavin and vitamin B6; some individuals exceeded the upper intake level for iron, zinc, selenium, vitamin A and vitamin D. Estimated average requirement nutrients of concern for adequacy were magnesium, folate, vitamin A, vitamin C and vitamin E; however, a few age/gender groups were exceptions. Prevalence of inadequacy for AI nutrients which may be undesirably high were fibre, n-6 fatty acids and calcium. Vitamin D was more adequate in Inuit women and men than for Yukon First Nations or Dene/Métis.
Unique patterns of dietary adequacy exist among Arctic indigenous peoples. Local wildlife food sources and market food sources should be maximised for their nutrient contributions to Arctic diets.
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