United Nations System
Standing Committee on Nutrition

Working Group on Nutrition Throughout the Life Course: Contribution to Millennium Development Goals (MDGs)

held during the ACC/SCN's 31st Session in New York, United States, 25 March 2004

Chairs: Ricardo Uauy, London School of Hygiene and Tropical Medicine and INTA, Chile, and Ted Greiner, Sweden

Annex 1: NUTRITION THROUGHOUT THE LIFE COURSE AND ACHIEVEMENT OF THE MDGs

MDG	Targets	Contributions of Nutrition (from SCN 2003)	Contribution of LIFECOURSE NUTRITION	List ACTIVITIES OF LIFECOURSE NUTRITION to reach this goal
Goal 1: Eradicate extreme poverty and hunger	a. Halve, between 1990 and 2015, the proportion of people whose income is less than $ 1 a day. b. Halve, between 1990 and 2015, the proportion of people who suffer from hunger.	Substantial and strong evidence that malnutrition increases the risk of disease and decreases the ability to respond, impairs physical and intellectual potential and hence economic productivity. Target 1a is unattainable without significant and rapid improvement in nutritional status and thus human capital. Target 1b clearly implies that all forms of malnutrition, both macro and micronutrient, are progressively eliminated. Household food security improvement, particularly in HIV/AIDS affected families and communities is crucial.	Reducing and or eradicating poverty and hunger is dependent on investments on health, nutrition and education. These are requisites for economic growth Nutrition in this context refers to access to adequate quantity of good quality foods, health care and sanitation and child care to meet the needs of all members of the community. Good nutrition, health and care during fetal life, infancy, childhood and adolescence promote optimal growth and development. This is of critical importance for school performance, capacity for physical work, and labor productivity (physical and metal abilities)	Example: Covering the nutritional and care needs of women from the moment of conception, since an optimal distribution of birth weights and early infant growth are critical to good health and nutrition in later life. Support exclusive breastfeeding to 6 months and combined breastfeeding + adequate complementary foods after that. Assure care and good nutrition [P/E and micronutrients (I, Fe, Zn, EFA)] to promote optimal growth and development (weight and length). Secure good nutrition and care during childhood and adolescence; this contributes to learning and to keep children in school. All activities should consider Equity and Gender equality issues.
Goal 2 Achieve universal primary education	Ensure that by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary education.	Good nutrition in early life (I, Fe, Zn, EFA, Folate) are crucial for optimal growth and mental development. Breastfeeding and adequate complementary feeding are prerequisites for readiness to learn and significantly contribute to cognitive development. Deficiencies in iodine or iron reduce intellectual capacity School attendance and learning capacity both improve with improved nutrition of the pre-school and school-age child, including those affected by HIV/AIDS.	Reducing all forms of malnutrition and assuring good growth and development Exclusive breastfeeding to six months and combined breast feeding and adequate complementary feeding support brain development WHO/UNICEF GSIYCF includes guidance on this issue. School feeding programs contribute to better learning and help keep children in school.	Example: Standards for food served in schools. Remove vending machines, junk food shops from schools Link MoH and MoE Abolish debt repayment—invest in schools
Goal 3 Promote gender equality and empower women	Eliminate gender disparity in primary and secondary education, preferably by 2005 and in all levels of education no later than 2015. (Break the intergenerational cycle.)	Improving nutrition, including reducing anemia, amongst adolescent girls and pregnant and lactating women is a prerequisite to women’s achieving their full physical and mental capacity and their right to participate as equal citizen. The necessary capacity development for nutrition empowers women and enhances their participation in society.	The life-cycle approach emphasizes the importance of women’s health and nutrition for the health and nutrition of all in society.	Example: Sanitary facilities in schools for girls—water and sanitation Supporting breastfeeding includes support to the breastfeeding rights of working women, emphasizing the need for maternity protection Need to get ILO involved; advocate for governments to ratify ILO Maternity Protection Convention 183 Structural adjustment often has led to girls dropping out of school to work Establish and protect the right to childhood without teenage pregnancy. Use growth charts Raise awareness of and strive to reduce gender inequalities in the provision of food, health, and care to children
Goal 4 Reduce child mortality	Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate.	Substantial and strong evidence that malnutrition increases disease and decreases the ability to respond and impairs physical and intellectual potential of functioning and hence economic productivity. Target 1a is unattainable without significant and rapid improvement in nutritional status and thus human capital. Target 1b clearly implies that all forms of malnutrition, both macro and micronutrient, are progressively eliminated. Household food security improvement, particularly in HIV/AIDS affected families and communities is crucial.	Breastfeeding significantly reduces early childhood feeding costs, and exclusive breastfeeding halves the cost of breastfeeding. Continued breastfeeding for two years is an excellent source of high quality protein, micronutrients and calories. Better complementary feeding will reduce growth faltering that occurs from about 6-24 months of age. The WHO/UNICEF GSIYCF includes guidance on this issue. The prevention of low birth weight is necessary for reducing IMR but requires attention to the nutrition of adolescent girls and pregnant women.	Example: Improve nutrition throughout the lifecycle Prevent/treat malnutrition–twin strategies bf/cf Improve micronutrient status before pregnancy child-care Reduction of risk factors Prevent anemia BEFORE pregnancy
Goal 5 Improve maternal health	Reduce by three-quarters, between 1990 and 2015, maternal mortality	Undernutrition and anemia of girls and women contribute significantly to maternal morbidity and mortality and to low birth weight infants, more likely to be malnourished and continue the cycle. Significant improvement in macro- and micronutrient status of girls, adolescents and women is urgently needed. Breastfeeding can reduce iron losses, breast cancer and osteoporosis, and lengthen birth intervals, reducing maternal mortality risks. Support mothers’ nutritional and social needs.	Optimal breastfeeding is associated with reduction in excess weight gain during pregnancy. More attention to the nutrition and health of girls at all ages will result in better pregnancy outcomes and thus better health for all. The most neglected group from the life-course perspective, is probably adolescent girls.	Provide nutritional support to adolescent girls who need it. Take all possible measures to prevent and delay teenage pregnancy. Cooperate with the family planning sector to increase birth spacing, including offering the lactation amenorrhea method to women who choose it Continue exploring effective ways of reducing rates of low birth weight, particularly through providing nutrition and health care support to girls.
Goal 6 Combat HIV/AIDS, malaria, and other diseases	Have halted by 2015 and begun to reverse the spread of HIV/AIDS	Malnutrition may increase susceptibility to HIV infection, accelerates the progression from HIV to AIDS and reduces the lifespan of people living with HIV/AIDS. This in turn reduces the possibility for rural parents to teach their children how to run their farm, leading to increased poverty and orphans. Malnutrition and lack of food decrease the likelihood of compliance with ARV and other treatment which then increases the likelihood of drug resistance. Nutrition improvement and support are key to reducing the impact of the epidemic, and increasing the effectiveness and safety of ARV’s. Malnutrition has long been recognized as a major factor in both TB incidence and morbidity. A major effort to improve nutrition should accompany the DOTS strategy.	WHO/UNICEF GSIYCF includes guidance on this issue. The promotion of exclusive breastfeeding as a social norm may lead to lower rates of mother to child transmission of HIV, especially in Africa where testing is unavailable to the vast majority. HIV programs, including voluntary counseling and testing, should include stronger family planning components to prevent the birth of additional unwanted children.	The life-cycle approach reemphasizes the importance of both ensuring the nutritional status and preventing HIV at all stages of life, particularly for women.
Goal 7 Ensure environmental sustainability	Have halted by 2015 and begun to reverse the spread of HIV/AIDS	Environmental sustainability requires active community demand and involvement and the involvement of many sectors. Community based nutrition programmes contribute to awareness of the need for water and a clean environment and also build community capacity and involve sectors crucial to environmental improvement. Breastfeeding is associated with decreased environmental degradation and decreases pressure of human populations on the environment.	Environmental toxins impact on human beings throughout the life cycle but are particularly harmful to the fetus and young infant. Good nutrition can reduce the harm done by toxins. A good diet can reduce the absorption of some toxins. Breastfeeding, while it can increase exposure to some environmental toxins, also protects against many others, particularly in water (fluoride, nitrates, etc).	Join the environmental movement in reducing toxic exposures to the fetus and breastfeeding child Help protect against over-reactions to environmental threats leading to fears to breast-feed Help pregnant and lactating women to choose diets lower in environmental toxins
Goal 8 Develop a global partnership for development		Community based nutrition programmes contribute to awareness of the need for water and a clean environment and also build community capacity and involve sectors crucial to environmental improvement. Nutrition during the lifecycle play an important role in prevention of diet related chronic diseases. LBW is associated with chronic diseases as diabetes, high blood pressure and cardiovascular diseases. Lack of breastfeeding is associated with obesity in children and increased risk of some forms of cancers in mothers.