United Nations System
Standing Committee on Nutrition

 

Working Group on Nutrition Throughout the Life Cycle

held during the SCN's 32nd Session, 16 March 2005, Brasilia

Co-Chairs: Ricardo Uauy (UNU/LSHTM, UK/INTA, Chile) and Ted Greiner (PATH)

Documentation and presentations:

Final Report

The Working Group meeting session was organized around the discussion of the case studies in light of the life course perspective, particular attention was given to the Brasil case study. Reports from UN agencies (WHO and FAO) and other groups on their activities relative to the life course were received. Since the SCN had allocated a plenary session on the double burden of disease in Latin America this area was not included in the Working Group meeting. Discussion of case studies focused on the health and nutrition of women of reproductive age, fetal growth/low birthweight, nutrition in early infancy including underweight and stunting. Some aspects covered interfaced with the SCN Working Groups on Breastfeeding and Complementary Feeding and Nutrition of School Age Children.

The contribution of the Brazilian Ministry of Health officials to the Group's discussion was vital for a good discussion of the case study. The group examined the summary conclusions of the case analysis and asked that Brazilian officials comment on the case analysis. All agreed that the case study process was extremely valuable yet the time constraints in preparing the reports and the need to rely on data available at the central national level, limited some of the conclusions. It is difficult for the case studies to capture the full dimension of ongoing efforts since the written record of policies normally does not include an explicit conceptual framework, although the activities undertaken clearly consider the principles that guides action. For example the existing Brazilian programmes on women's health and family health have a life course orientation yet this is difficult to identify from the written records. In reviewing present programmes and activities addressing the needs of women of reproductive age there was agreement that a greater effort should be placed in reducing low birthweight rates in Brazil (figures have remained high at around 10 % for the last couple of decades). This should include exploring not only potential nutrition interventions but also other conditioning factors (biological vulnerability of adolescent girls, pregnancy in socially vulnerable groups and those living under poverty conditions). In addition the rise in fertility of adolescent girls and the need to examine access to contraception required consideration.

In discussing the need to emphasize nutrition of infants the new growth standard will help to revisit the significance of linear growth. The need to extending the coverage of growth monitoring to include the three indicators W/age, L/age, and W/L. The appropriate interpretation and the programmatic implications of anthropometry needs to be strengthened. The need to improve nutrition to reduce risk of stunting amongst the poor while at the same time prevent obesity and related chronic disease was stressed.

There is also a need to look at hunger and malnutrition beyond food security, to include biological, social and nutritional vulnerability. The Group recommends that the definition of hunger in Brazil should include not only the food and poverty dimension but also the nutritional correlates, so the problem should not be addressed solely by income transfer policies, but programmes and policies that address biological vulnerability and the need to incorporate nutrition in order to secure greater impact. Fome Zero as presently being implemented does not adequately cover malnutrition nor biological vulnerability

The case studies should be seen as a continuous process, initial impressions and recommendations have already been modified since multiple aspects of the Brazilian programmes were not explicit at the time of writing the report. The dialogue and discussion established the need to continue learning from the country experiences. The Brazilian study should contribute significantly in making a case for greater investment in nutrition to enhance achievement of the MDGs, and continued work on the case studies should permit learning from them, highlighting successes and failures.

The Working Group welcomed the progress WHO/FAO and other agencies are making in advancing the life course approach to the achievement of the MDGs. Moreover, it noted that the SCN Secretariat had taken this approach in summarizing the case studies.

The Co-Chairs of the Working Group recommend the SCN Secretariat to:

1. Include the life-course perspective in the development of the four country case studies, the issues discussed in the session could serve to raise awareness of the need to take this approach in addressing nutrition issues.

2. Facilitate the implementation of the WHO/FAO strategy in the prevention of nutrition related chronic disease, both at the interagency and at the regional level through interaction with the relevant bilateral and NGO sectors present in the SCN.

3. Contribute in facilitating the interaction of the SCN Working Group on Nutrition, Ethics and Human Rights with the WHO Nutrition Division who are currently preparing an initiative to prevent and control Childhood Obesity. The right of children to healthy and safe food is potentially compromised by marketing and trading practices. This is particularly the case in developing countries.

The presentations made during the Working Group's meeting on the analysis of case studies, and the plenary addressing the double burden of disease in Latin America can be consulted on the Group's webpage: http://www.unsystem.org/scn/Publications/AnnualMeeting/lifecycle.htm.