AGENCIES REPORT ON NUTRITION ACTIVITIES
Canadian International Development Agency
On October 16 1998, World Food Day, Canada's Action Plan for Food Security: a Response to the World Food Summit (WFS) was released. The plan was prepared by a Joint Consultative Group representing both government (federal and provincial) and civil society. The latter included non-governmental organizations, representatives, farmer's unions, professional associations and universities. The plan follows the seven commitments endorsed by 187 countries as the WFS Plan of Action and details Canada's domestic and international response. Ten priorities are identified by the consultative group and include the right to food, poverty reduction, production and access to safe and nutritious food, Aboriginal and coastal communities' food systems, environmental sustainability and fair trade. The document is meant to be a flexible blueprint with specific actions, timing, roles and responsibilities defined over time. Civil society is a full partner in the plan with unique responsibilities in its design, implementation, and follow-up.
Of particular interest to nutritionists is the recognition that breastmilk is crucial to food security for infants, that both production and equitable access to food must be addressed, and that food must be not only be sufficient in quantity but must also be safe and nutritionally adequate. It is understood that ensuring access to food will have a limited impact unless individuals live under conditions that support the effective utilization of that food including education, primary health care, potable water and sanitation as well as sustainable access to fuel. Ensuring women's access to resources such as land, training, credit, inputs and time is an important part of the plan including implementation of the Platform for Action from the Fourth World Conference on Women.
Given its poverty reduction mandate and the high priority accorded to basic human needs, CIDA's current support to food security programming is extensive. Relevant multilateral programmes encompass breastfeeding promotion and protection (in the context of HIV), elimination of micronutrient deficiencies, developmental and emergency food aid, support to agricultural research, and microcredit. On the bilateral front, the Africa Branch has prepared a regional food security strategy and this theme is a key component of the country policy framework for Ghana and Ethiopia.
The Multilateral Programmes Branch and Policy Branch share the responsibility for monitoring implementation of the Action Plan. Initial efforts have been made to document and harmonize food security programming across the Agency. In addition, CIDA's Senior Agriculture Specialist is developing corporate guidelines for enhancing the effectiveness of food system programming and support has been provided to IFPRI for improving statistical methodologies associated with food security measurement.
Canada's Action Plan for Food Security may be found on the internet at: http://www.agr.ca/cb/fao/emain.html
Food and Agriculture Organization
Follow-up to the FAO/WHO International Conference on Nutrition
Seven years after the FAO/WHO International Conference on Nutrition was held in Rome, the strategies adopted at the conference continue to have a significant impact on nutrition policies and programmes throughout the world. Countries have formulated and implemented National Plans of Action for Nutrition (NPANs) to varying degrees, and as the end of the decade approaches, it is necessary to review progress in their development and implementation. It is important at this juncture to identify constraints as well as key elements of success in attaining the ICN goals, and to discuss additional actions and support which may be required. FAO, WHO and UNICEF are jointly sponsoring workshops on ICN follow up.
One was in Kuala Lumpur, Malaysia, 25-29 October 1999 and another will take place in New Delhi, 8-10 December 1999.
Participatory Approaches to Improving Nutrition
Community nutrition in Mauritania: FAO is assisting the Secretariat d'Etat à la Condition Feminine in Mauritania to prepare for a World Bank funded LIL (Learning and Innovation Loan) project. The project includes three main components: the promotion of a participatory nutrition approach (combining inter-institutional planning at regional and district level, and participatory appraisal and planning in selected communities); an inventory of natural resources according to their contribution to food security and nutrition and; support to communication and nutrition education activities. Project staff were trained in techniques to assist institutions in identifying causes of malnutrition and creating local strategies to address these problems. This provided the basis for a Participatory Rural Appraisal (PRA) training for food security and nutrition, which was carried out in Nouakchott. Project staff were trained in participatory communication as well. Such training is a prerequisite for the success of the LIL.
Developing technical guides in Madagascar. As part of the World Bank funded project, Surveillance et Education de Ecoles et des Communautés en matière d'Alimentation et des Nutrition Elargie (SEECALINE), the government of Madagascar has asked FAO to prepare technical material in the field of food and agriculture. FAO will hold workshops to allow the different development institutions operating in each district to share experiences and information and agree on a local strategy to improve the food and nutrition situation. Communities will then be selected to test the interventions identified. These tests will be developed as part of a participatory process, which will involve field workers from different sectors (education, health, and agriculture). The project was launched in October 1999 with an initial workshop in which project staff were trained to facilitate inter-institutional workshops using techniques to understand the causes of malnutrition for food insecure groups and to create local strategies to improve food security and nutrition. The district level phase will be followed in early December with PRA training for food security and nutrition prior to the community level phase starting in January 2000. The project is expected to contribute to the re-orientation of food habits through the better use of existing food sources in the different agro-ecological zones (through diversification of food production, food processing at household and community level and food preparation, including child feeding) and to add to SEECALINE Information Education Communication strategy.
International Atomic Energy Agency
The IAEA is about to start a new Coordinated Research Programme (CRP) on "The use of isotopic techniques to examine the significance of infection and other insults in early childhood to diarrhoeal morbidity, malabsorption and failure to thrive". IAEA wants at least 2 or 3 African countries to participate. Immediately contact Dr G Venkatesh Iyengar, Head, Nutrition & Health Related Environmental Studies, IAEA, PO Box 100 A-1400 Vienna, Austria; tel 43 1 2600 21756; fax 43 1 26007; email firstname.lastname@example.org
Isotopic Evaluations of Maternal and Child Nutrition to Help Prevent Stunting
The concept for this CRP was a consequence of discussions held between IAEA staff (Ms Carla Fjeld and Ms Hinke Haisma), and participants in a regional training course on "Isotope Techniques in Human Nutrition" held in Lima, Peru in June 1996. The intention then was to develop research on factors influencing the success of lactation and the consequent effects on the breastfed child. The project would have Latin American participants to promote regional exchange of expertise and ideas. Initial participation was from Argentina, Chile, Mexico, Peru and Venezuela. Brazil and Pakistan have now been added to these. The Pakistan participant, Rakhshanda Bilal, was working at U. Sao Paulo at the time of this meeting so the Latin American principal can be said to remain.
Isotopic ratio mass spectrometry (IRMS) has been used for work in hydrology at The Chilean Centre for Nuclear Energy (CChEN) for many years. In the '80s Carlos Infante Barros, a physicist at U Chile, and Fernando Vio del Rio (U Chile/INTA) realised that these facilities could be used to apply newly developed methods for measuring breast-milk intake and in the next few years several publications emerged. This was the start of INTA's transition from a traditionally oriented nutrition institution to a site employing the best of modern scientific tools, including mass spectrometry for nutrition research. IAEA has assisted in many of these developments including the recent purchase of IRMS equipment for both U Chile and CChEN. A potentially similar opportunity for linking facilities originally acquired for hydrology to nutrition work also exists at PINSTECH in Pakistan but for all the other groups in this CRP, both the technology and application in the measurement of breastmilk intake are new. There are, therefore, three specific research objectives:
1. To develop stable isotope methods for measuring breastmilk intake using regionally available equipment;
2. To apply the methodology in the assessment of milk intake in infants in relation to maternal nutrition, socioeconomic status and education, and infant nutrition and intake of macro- and micronutrients;
3. To use information gathered at 2) to determine the need for supplementation programmes for mothers and/or infants, and educational programmes for the mothers.
"It is not by muscle, speed, or physical dexterity that great things are achieved but by reflection, force of character, and judgement; in these qualities old age is usually not only not poorer, but is even richer."
- Cicero (106-43 BC) -
International Food Policy Research Institute
Linking Agriculture and Nutrition
IFPRI recently organized an interdisciplinary workshop, "Improving Human Nutrition Through Agriculture: The Role of International Agricultural Research", held 5-7 October 1999 in Los Banos, the Philippines, and hosted by the International Rice Research Institute (IRRI). This workshop brought together 90 agricultural and nutrition scientists from around the world to discuss the merits of breeding staple food crops for micronutrient density and the need for greater attention to existing food-based approaches for reducing malnutrition. Eleven international agricultural research centers belonging to the Consultantive Group on International Agricultural Research (CGIAR) presented their research that is explicitly driven by concerns for human nutrition. Scientists from outside of the CGIAR and representatives of multilaterals, bilaterals, and NGOs also attended.
Research findings from the IFPRI research project -Identifying Agricultural Strategies for Reducing Micronutrient Malnutrition - provided a focus for many of the discussions. IFPRI and research institutes in Columbia, Mexico, the Philippines, Australia and the United States have collaborated on inter-disciplinary projects to develop micronutrient-dense staple food crops (rice, wheat, maize, beans, and cassava) using traditional breeding techniques based on genetic material contained in international germ plasm banks. The most progress has been made on rice - a high-yielding, iron-dense, aromatic rice variety has been identified. Human nutritionists are planning a feeding trial to test for the bioavailability of the extra iron in this specific variety. At the same time they are working with the plant breeding community to look at further modifications of crops which could lead to greater intake of bioavailable minerals and vitamins. The expectation is that by getting plants to be self-fortifying, a breeding strategy will provide a low-cost, sustainable intervention to reduce micronutrient malnutrition.
Food-based approaches to improving vitamin and mineral intakes that already exist were also discussed. Extensive research is underway to strengthen their impact on dietary quality and human health. Researchers presented work on the benefits of diversifying diets and the need to support research efforts to increase the supply and consumption of non-staple foods such as vegetables, fish and livestock and to reduce the negative effects of naturally occurring toxins in the food system that inhibit nutrition and consequently, human growth and development. Participants agreed that more emphasis should be placed on agriculture's role in the fight against micronutrient and other forms of malnutrition among the poor. To that end, workshop participants agreed to pursue an effort to establish a transdisciplinary CGIAR systemwide initiative on human nutrition that would involve collaborative partners both inside and outside of the CGIAR. Research efforts within that initiative would involve plant breeding and other food-based activities to reduce malnutrition in developing countries.
Contact B McClafferty, Food Consumption & Nutrition Division, IFPRI, 2033 K St NW, Washington DC 20006-1002 USA; tel: 202 862 5600; fax: 202-467 4439: email email@example.com website http://www.cgiar.org/ifpri
[Ed. Note: The next issue of SCN News will focus on the topic 'Nutrition and Agriculture' - this inspiring news should encourage readers to send us articles, materials and publications related to this theme.]
International Union of Nutrition Scientists
The IUNS in collaboration with the UN University is playing a lead role in capacity building - nutrition expertise and operational capacity - including strengthening the infrastructure for nutrition policies and implementing national strategies in developing countries. A workshop for that purpose was held in June 1999 in Cape Town, South Africa. The major part of the workshop was devoted to issues related to the types of professionals needed to implement the growing knowledge base available to the nutritional sciences. It also devoted some time to evaluate the supplementary role that short term training plays in the recruitment and preparation of professionals for specific purposes or upgrading and/or broadening of skills. The enhancement of national and regional research capacities was also a part of the discussions. The anticipated outcome of the workshop is a regional plan including training, research, and establishing linkages between regional and global expertise and centers of excellence. The plan of action will provide a framework for investment by donor agencies. It is expected that participants will take stock of progress in developing human and institutional capacity for nutrition in southern Africa. They will also examine the disciplinary and interdisciplinary competencies essential to meet specified regional needs. They will explore the possibilities for strong collaborative relationships among training and research institutions and policy and program implementing agencies in the region, and discuss appropriate collaborative South-South, South-North, and North-South relationships. A follow-up action group was established to elaborate the plan.
The International Council for Science (ICSU) met for the 26th Session of ICSU's General Assembly in Cairo, Egypt from 26-30 September 1999. Their symposium on "Sciences and Food Security" included several speakers on various aspects of food security. Dr. Osman Galal, Secretary-General of IUNS, gave a presentation on "Food Safety and Food Health." IUNS is engaged in organizing the home page that was developed recently. Reports from committee and task-force activities and highlights in nutrition information will be published on the home page as well as important scientific issues that are of interest to worldwide nutritionists. Refer to http://www.iuns.org for information on IUNS structure and functions.
Double Fortified Salt (DFS)
Two key micronutrients, iron and iodine, are present in inadequate quantities in the diet of more than a billion people in developing countries. Salt has been chosen as a vehicle for fortification as a staple food that is widely consumed and available for central processing to be fortified with nutrients. DFS is a high purity, dry, table salt, fortified with ferrous fumarate and encapsulated with potassium iodate. The iodate is encapsulated with dextrin using a spray drying technique. The Ml has tested the salt on four different levels:
Stability: Over one year of storage in various conditions such as high density polyethylene bags, paper bags, polyethylene jars and low density polyethylene bags has found the salt stable with very mild colouration, not objectionable by consumer acceptability tests.Contact T Guay, MI, tel 613 236 9579; email firstname.lastname@example.org
Consumer Acceptability: Products made with local and iodized salt were acceptable to consumers with the exception of certain vegetable dishes such as plantain, which darkened when cooked with DFS. Encapsulation is expected to overcome this problem.
Efficacy: A double-blind placebo controlled study was con ducted in Ghana to test the efficacy of the DFS in preventing anaemia and IDD in mildly anaemic women and their families. The use of DFS proved to be as efficacious as a weekly iron supplement in preventing anaemia in women. DFS also prevented and alleviated anaemia in children, and iodine deficiency in both women and children.
Production Feasibility: The feasibility was explored through refinement of technology developed to date, and reduction of its complexity in order to effectively transfer the technology to local salt suppliers. The technology used for encapsulation (spray drying), though effective, is too complex to be widely introduced in developing countries. A similar technology involving encapsulation/agglomeration is sought to (a) develop a simple agglomeration technology for enclosing the iodine in a moisture resistant capsule, and (b) simplify and refine the technology that will enable centralized facilities in developing countries to manufacture a pre-mix for distribution to local salt suppliers to mix with the local salt. To this end, trials are underway at Guelph Food Technology Centre (GFTC). Ml expects to go to country implementation of DFS trials within the coming six months in India, Nigeria and Ghana.
Nutrition fop Health and Development
Nutrition in Adolescence
Dr. Hélène Delisle, professor at the Department of Nutrition of Université de Montréal's Medical Faculty, spent part of her sabbatical leave with the Nutrition for Health and Development Department (NHD), WHO. She prepared a review and discussion paper on Nutrition in Adolescence in collaboration with the Department of Child and Adolescent Health. She also drafted a review paper on Foetal Nutritional Programming. The purpose of the discussion paper on Nutrition in Adolescence was to lay out in specific terms what is known - or not known - on the subject, and to spell out action recommendations for WHO, and to clarify the evidence base for them. The review concludes that adolescents are nutritionally vulnerable and deserve more attention. Priority nutritional areas are: iron deficiency anaemia and other micronutrient deficiencies, particularly in adolescent girls; severe undernutrition in adolescents in emergency situations; obesity and other nutrition-related chronic disease risks. The nutritional, health, and socio-economic consequences of adolescent pregnancy, are also underlined. It is felt that explicit policies for adolescents' nutrition are needed at country level in order for the specific nutrition issues of this lifecycle group to be adequately addressed. Well designed programmes to improve nutritional status of girls, with particular emphasis on micronutrients, before (and during) their first pregnancy, are regarded as critically important. Food-based approaches are emphasized, although they will often need to be complemented by nutrient supplementation schemes using various channels. Promoting healthy lifestyles and eating patterns among adolescents is considered crucial, particularly in urban settings and in schools, in order to halt the progression of obesity and reduce nutrition related chronic disease risks. The development of culturally acceptable and location-specific dietary guidelines appear significant for this purpose. In emergency settings, adolescents may be seriously affected by malnutrition and yet be neglected. Better anthropometric assessment and management of severe malnutrition in adolescents is deemed important. Research needs are to: define anthropometric standards; better document eating patterns and determinants; assess their micronutrient status and the implications; and to measure the effectiveness and impact of dietary improvement in adolescent girls before and during pregnancy.
Contact: Dr G Clugston, WHO/NHD; email: email@example.com