As more data become available on food security (food access), dietary intake and nutritional outcomes
, integrated analysis of these data will yield better information to shape policies that address the multiple forms of malnutrition.
Existing evidence supports the need for implementing and scaling up interventions aimed at guaranteeing access to nutritious foods and breaking the intergenerational cycle of malnutrition. The 1 000 days between conception and a child’s second birthday is a window of unsurpassed opportunity to both prevent child stunting and overweight and promote child nutrition, growth and development with lasting effects over the child’s life. The origins of growth faltering begin as
early as before and during pregnancy, with short- as well as long-term consequences. Child undernutrition can cause impaired cognitive development in children, with dramatic consequences in terms of self-realization and productivity. This can result in an intergenerational cycle of malnutrition, perpetuated by undernourished girls becoming undernourished mothers at risk of giving birth to infants with low birth weights. Exclusive breastfeeding in the first six months and adequate complementary foods and feeding practices up to two years of age are key to ensuring normal child growth and development during this crucial window of opportunity.
Given this evidence, policies must pay special attention to the food security and nutrition of infants and children under five, school-age children, adolescent girls and women. These groups have been identified as the most vulnerable to the harmful consequences of poor
food access. The ICN2 Framework for Action outlines relevant sets of recommended actions for improving food security and nutrition, which countries are committed to implementing under the umbrella of the UN Decade of Action on Nutrition.
“Double-duty actions” have been proposed by WHO that can simultaneously reduce undernutrition and overweight and obesity.
They highlight the need to be careful so that strategies to address undernutrition in early life do not exacerbate overweight and obesity later in life. Existing programmes should be redesigned and leveraged, and new interventions should be developed, to reduce the risk of multiple forms of malnutrition. Trade, investments and agriculture policies must be nutrition-sensitive and improve access to healthy diets, rather than promoting commodity crops that provide a cheap source of starch, fat and sugar in the food supply.
The discussion illustrates why it is so important – especially in the context of the UN Decade of Action on Nutrition and the 2030 Agenda – to improve the way hunger and food insecurity are conceptualized and measured. Food insecurity can exist in all countries, and it can contribute to multiple forms of malnutrition – undernutrition and micronutrient deficiencies as well as overweight and obesity. Experience-based metrics of food insecurity like the FIES, and
awareness of the different pathways from food insecurity to malnutrition, can contribute to the design of more effective interventions and policy coherence across sectors. The consequences for people´s health, well-being and productivity are far-reaching.
In conclusion, evidence continues to point to a rise in world hunger and food insecurity in recent years. Progress is being made on child stunting – though too slow to meet global targets and with significant interregional and intraregional disparities. Simultaneously, rates of anaemia in women of reproductive age and obesity in adults are increasing. It will not be possible to end all forms of malnutrition without ensuring access to safe, nutritious and sufficient food all year round. This will require expanding the reach of social protection policies to address inequalities and ensuring that they are nutrition- and gender-sensitive in terms of: targeting; design; and in the identification of complementary health care and agriculture interventions to enhance nutrition outcomes. At the same time, a sustainable shift must be made towards nutrition-sensitive agriculture and food systems that can provide safe and high quality food for all promoting healthy diets in line with the recommended action of the ICN2 Framework for Action and the Work Programme of the UN Decade of Action on Nutrition. 53 Market regulations that discourage consumption of unhealthy foods are also called.