Understanding sustainable diets: a descriptive analysis of the determinants and processes that influence diets and their impact on health, food security, and environmental sustainability.

The confluence of population, economic development, and environmental pressures resulting from increased globalization and industrialization reveal an increasingly resource-constrained world in which predictions point to the need to do more with less and in a "better" way. The concept of sustainable diets presents an opportunity to successfully advance commitments to sustainable development and the elimination of poverty, food and nutrition insecurity, and poor health outcomes. This study examines the determinants of sustainable diets, offers a descriptive analysis of these areas, and presents a causal model and framework from which to build. The major determinants of sustainable diets fall into 5 categories: 1) agriculture, 2) health, 3) sociocultural, 4) environmental, and 5) socioeconomic. When factors or processes are changed in 1 determinant category, such changes affect other determinant categories and, in turn, the level of "sustainability" of a diet. The complex web of determinants of sustainable diets makes it challenging for policymakers to understand the benefits and considerations for promoting, processing, and consuming such diets. To advance this work, better measurements and indicators must be developed to assess the impact of the various determinants on the sustainability of a diet and the tradeoffs associated with any recommendations aimed at increasing the sustainability of our food system.

Agricultural biodiversity, social-ecological systems and sustainable diets.

The stark observation of the co-existence of undernourishment, nutrient deficiencies and overweight and obesity, the triple burden of malnutrition, is inviting us to reconsider health and nutrition as the primary goal and final endpoint of food systems. Agriculture and the food industry have made remarkable advances in the past decades. However, their development has not entirely fulfilled health and nutritional needs, and moreover, they have generated substantial collateral losses in agricultural biodiversity. Simultaneously, several regions are experiencing unprecedented weather events caused by climate change and habitat depletion, in turn putting at risk global food and nutrition security. This coincidence of food crises with increasing environmental degradation suggests an urgent need for novel analyses and new paradigms. The sustainable diets concept proposes a research and policy agenda that strives towards a sustainable use of human and natural resources for food and nutrition security, highlighting the preeminent role of consumers in defining sustainable options and the importance of biodiversity in nutrition. Food systems act as complex social-ecological systems, involving multiple interactions between human and natural components. Nutritional patterns and environment structure are interconnected in a mutual dynamic of changes. The systemic nature of these interactions calls for multidimensional approaches and integrated assessment and simulation tools to guide change. This paper proposes a review and conceptual modelling framework that articulate the synergies and tradeoffs between dietary diversity, widely recognised as key for healthy diets, and agricultural biodiversity and associated ecosystem functions, crucial resilience factors to climate and global changes.

Assessing the potential of wild foods to reduce the cost of a nutritionally adequate diet: an example from eastern Baringo District, Kenya.

BACKGROUND: Wild foods and their actual and potential contributions to nutrition security have rarely been studied or considered in nutrition and conservation programs. OBJECTIVE: To study the role of wild food biodiversity in achieving a cost reduction of a nutritionally adequate diet for women and young children in Kenya using linear programming. METHODS: An ethnobiological inventory of available food biodiversity was carried out by means of focus group discussions, and five wild foods were selected for further modeling. A market survey assessed available food prices by season. Diets were modeled to minimize cost and maximize nutrient adequacy using the Cost of Diet linear programming tool. Modeling was done without and with wild foods. RESULTS: The modeled diets without wild species were deficient in iron for all age groups during the dry season, deficient in vitamin B6 and calcium for infants aged 6 to 8 months during the dry season, and deficient in iron and zinc for infants aged 6 to 8 months over the whole year. Adding wild foods, especially Berchemia discolor, to the modeled diets resulted in a lower-cost diet, while meeting recommended iron intakes for women and children between 12 and 23 months of age. Even after integrating wild foods into the model, targeted approaches are needed to meet micronutrient requirements for infants from 6 to 8 and from 9 to 11 months of age. CONCLUSIONS: An application of linear programming to screen available wild foods for meeting recommended nutrient intakes at a minimal cost was illustrated. This type of study helps to objectively assess the potential of biodiversity to contribute to diets and nutrition.

Making the most of food aid to help prevent child and maternal deaths.

Advances in child nutrition over the last several decades are creating momentum for a programmatic push to reduce undernutrition worldwide. The contribution of food aid may be small, but, nonetheless, U.S. food aid policy should be revamped to benefit more effectively and more efficiently the children and mothers in need.

Maternal and young child nutrition adversely affected by external shocks such as increasing global food prices.

Rising food prices, resulting from the ongoing global economic crisis, fuel price volatility, and climate change, have an adverse impact upon the poor, especially those in food-importing, resource-limited countries. The conventional approach by large organizations has been to advocate for increased staple crop yields of mainly cereals. High food prices are predicted to continue to at least 2015. Past shocks and their known impacts upon nutrition were reviewed. Price instability and increases have long been an existing global problem, which has been exacerbated by recent macroeconomic shocks such as acute emergencies due to war and civil strife, acute climatic events, increase in food prices, fuel price volatility, dysfunction of the global financial systems, long-term climate change, and the emergence of failed states. The FAO estimated that there were 815 million "hungry" people in 2006, with a now additional 75-135 million with increased vulnerability, and currently it is estimated that there are one billion people at risk of food insecurity. The shocks initially compromise maternal and child nutrition, mainly through a reduction in dietary quality and an increase in micronutrient deficiencies and concomitant increases in infectious disease morbidity and mortality. A further reduction in the quantity of diet may follow with greater underweight and wasting. Recent macroeconomic shocks have greatly increased the number of people who are vulnerable to hunger in developing countries. Nutritional surveillance systems need to be strengthened and expanded to inform policy decisions.

Effective international action against undernutrition: why has it proven so difficult and what can be done to accelerate progress?

Many transnational organisations work to support efforts to eliminate maternal and child undernutrition in high-burden countries. Financial, intellectual, and personal linkages bind these organisations loosely together as components of an international nutrition system. In this paper, we argue that such a system should deliver in four functional areas: stewardship, mobilisation of financial resources, direct provision of nutrition services at times of natural disaster or conflict, and human and institutional resource strengthening. We review quantitative and qualitative data from various sources to assess the performance of the system in each of these areas, and find substantial shortcomings. Fragmentation, lack of an evidence base for prioritised action, institutional inertia, and failure to join up with promising developments in parallel sectors are recurrent themes. Many of these weaknesses can be attributed to systemic problems affecting most organisations working in the field; these are analysed using a problem tree approach. We also make recommendations to overcome some of the most important problems, and we propose five priority actions for the development of a new international architecture.

Solutions to nutrition-related health problems of preschool children: education and nutritional policies for children.

OBJECTIVE: By reviewing the literature, lessons learned and experience regarding the nutrition-related health problems of preschool children, draw conclusions and make recommendations on education and nutrition policies for young children. RESULTS: The most common causes of under-5 mortality in low-income countries have been identified as neonatal disorders, diarrhoea, respiratory infections, malaria, measles, and in some developing countries, AIDS. More than half (56%) of all child deaths have underlying malnutrition and undernutrition as a contributing factor. Children must have optimal growth and physical and intellectual development to learn and achieve their potential in society. Solutions include both preventive and curative interventions at all levels and include both improved health and education systems. Recent focus has been on health systems interventions that address averting deaths by cause for the 42 countries that account for 90% of worldwide under-5 deaths (the majority in sub-Saharan Africa). However, parallel or multisectoral interventions must be addressed to all children at risk for death, poor health and compromised growth and development. Adequate health care and nutrition is a human right, legally established in the Convention on the Rights of the Child. CONCLUSIONS: Improved health and nutrition will lead to enhanced economic development, but having a poverty focus appears to be essential, if poor people are not to be marginalized further. The HIV/AIDS pandemic illustrates this challenge clearly. The role of education, especially girls' education, in improved health and nutrition status of children and birth-spacing is now clear, as is improving women's status. Increases in female status and education have been estimated to account for half of the reduction in child malnutrition rates during the past 25 years.