Food, Nutrition and Health: making a link

Moderators Summary - Food, Nutrition and Health, 22nd April 2003, By John van Camp

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Internet Forum - Discussion
Food Health & Nutrition - 11-14th April

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Health and nutrition forum: overall summary (8-17 April 2003)- John Van Camp

In the health and nutrition forum, we have been presenting the following subjects for discussion:

1) Nutrition in relation to HIV/AIDS in Sub Saharan Africa (SSA)
2) Nutrition for vulnerable groups in African societies (children, pregnant women)
3) How to tackle (micro)nutrient deficiencies in SSA
4) Malnutrition in SSA

There were questions on the nutrient requirements for HIV/AIDS infected people, and on the types of labor saving technologies that can be used to secure the food in households affected by HIV/AIDS. Sources for finding more information on this topic have been identified, e.g. ProNUTRITION, and relevant addresses have been given on the website of the forum.

It has been confirmed that micronutrient deficiencies, including vitamin A, iron and zinc, are important for SSA, and actions are needed to improve the current situation. The discussion was mainly directed towards vitamin A deficiency (VAD). The question on which intervention to choose highly depends on the type of nutrient, the target group involved, and the area (country) envisaged. Food-based strategies are sustainable and should be applied when target populations are difficult to reach or are located in politically unstable regions. Examples were given like orange-fleshed varieties of sweet potato that may form a valuable and acceptable source of vitamin A for rural households. However, these food-based strategies require an interdisciplinary approach , and should involve the whole food production and distribution chain, including the consumer attitudes (knowledge on nutrition, food preferences) and local government policies. Communication and collaboration among specialists in different fields (e.g. bring together plant breeders and nutritionists) should be further stimulated.

There was also the concern that diffusion of scientific data to the rural communities is difficult, and efforts should undertaken to facilitate the application of scientific findings in practice (e.g. vulgarisation of laboratory practices near the target groups in developing countries). More attention should also be given to nutrition in school programs, at undergraduate levels as well as academic levels. Especially the medical programs should include more issues on nutrition, which is important for future health personnel to target better on the links between malnutrition and diseases.

The low bio-availability of micronutrients in vegetable foods has been recognized. However, in the case of vitamin A, some tropical vegetables and fruits do form a useful source of carotenoids, that contribute to the dietary supply of vitamin A. In addition, more attention should be given to the influence of food preparation techniques. E.g. for vitamin A, cooking oils added during preparation can increase the bio-availability.

Attention has also been given to the interaction between nutritional value (the presence of nutrients and bioactive compounds) and food safety (the absence of unwanted contaminants). Traditional technologies in SSA should receive further attention since they are already familiar to local populations. If necessary, these techniques require further optimisation hereby reducing the losses in nutritional value of foods, and improving the final products in terms of food safety. Introducing new (modern) technologies may be difficult to accept in view of importance of traditions, low degree of education, and poverty. However, there was also a view that advanced technologies like genetic engineering should receive further attention to improve the nutritional value (e.g. richer in nutrients, lower in antinutrients) of the freshly harvested products in SSA.

The issue on the role of animal products in SSA was mainly directed towards how to improve the supply of protein by the diet, both in terms of quantity and quality. Animal products are generally speaking very expensive for local communities and the majority of the population relies on vegetable products to obtain both macro- and micronutrients. Alternative means rather than animal products to obtain protein from the diet should be further investigated, including the development of suitable post-harvest technologies and supplementation of the diet with vegetable foods rich in protein. Some examples of vegetable foods that need more attention have been given, like the leaf powder of Moringa oleifera, a fast growing leguminous shrub, that can be a good source of micronutrients. The leaves of cassava may also be a valuable source of nutrients, including protein. These products should be used in interventions like food to food fortification, which is now already practiced in other areas of the world (e.g. Asia). Some communications also stressed the changes in food habits among populations in SSA. The use of readily available high energy foods increases at the expense of more traditional foods (including traditional leafy vegetables). Less diversification of diets further increases the risk of micronutrient deficiencies.

Finally, there was also the declaration of intent from the ANLP2002 (1st African Nutrition Leadership Programme 2002), in which these young researchers engaged themselves to be effective people in improving the nutritional status of the population in Africa. This declaration of intent, together with the list of participants in the programme, has been given on the forum website. We stimulate these initiatives among young scientists and hope that also further links will be achievable with other nutrition leadership programmes (e.g. ENLP).

The key action points identified in the nutrition and health forum were:

- use an interdisciplinary approach to study food-based strategies
- give attention to food to food fortification in combating nutrient deficiencies in SSA
- gain more knowledge on the nutritional value of indigenous food sources in SSA
- optimise traditional technologies to improve the nutritional value and the safety of foods in SSA
- study more the local preparation techniques for foods in SSA
- learn more about consumer habits in SSA
- introduce more nutrition education in school programs
- make strategies to evaluate and to counteract nutritional transition in SSA
- give attention to the practical application of scientific findings, taken into account the local context of SSA

Finally, it became clear that more networking among scientists, field workers, and policy makers should be established. Initiatives like the ANLP are highly acknowledged and should be further stimulated in the future.

John Van Camp
Moderator Health and Nutrition forum