A Food Systems Perspective on Food and Nutrition Security in Australia, Indonesia, and Vanuatu

Inclusive diets within planetary boundaries

The urgent call to transform global food systems is well founded on the need to reduce the effects of food systems on human health, environment, peoples' rights, and creation of a just society. Unhealthy diets contribute significantly to the global disease burden and pose huge risks to morbidity and mortality. Efforts to transform diets are highly dependent on transformation of the food system. All countries are now affected by the various forms of malnutrition - undernutrition, overweight and obesity, micronutrient deficiencies - with progress often too slow and in some cases going into reverse. Concomitantly, the number of food insecure is increasing, and the prevalence of non-communicable disease is high. IPES-Food, in collaboration with the Global Alliance for the Future of Food, undertook a review of the scientific evidence covering a whole range of global health impacts associated with food systems. The review examined how food and farming systems affect human health, explored why the negative impacts are systematically reproduced and why we fail to prioritize them politically, and how we can build healthier food systems for all. Five categories of health impacts were examined: (i) occupational hazards; (ii) environmental contamination; (iii) contaminated, unsafe, and altered foods; (iv) unhealthy dietary patterns, and (v) food insecurity. The study confirmed that food systems affect health through multiple, interconnected pathways, generating severe human and economic costs. It also highlighted how prevailing power relations in the food system help to shape and sometimes obscure our understanding of the impacts. Five leverage points for building healthier food systems are recommended: (i) promotion of food systems thinking; (ii) reasserting scientific integrity and research as a public good; (iii) bringing the alternatives to light; (iv) adopting the precautionary principle, and (v) building integrated food policies under participatory governance.

The concepts of food security and food sustainability are two main paradigms in the food system discourse—however, they are often addressed separately in the scientific literature. We argue that this disconnect hinders a coherent discussion of sustainability transitions, which will be necessary to solve problems (environmental, social, economic, and health) generated by conventional food systems. Our review highlights linkages between sustainability transitions and food and nutrition security using the perspective of sustainable food systems. We explore the diversity of food security narratives and food sustainability paradigms in the agro‐food arena, analyze relations between food security and food systems sustainability, and suggest options to foster a transition toward sustainable food systems. It is widely acknowledged that food systems sustainability must entail long‐term food and nutrition security in its availability, access, utilization, and stability dimensions. For food systems to deliver food and nutrition security for present and future generations, all their components need to be sustainable, resilient, and efficient. These linkages between food sustainability and food and nutrition security intersect at global, national, local, and household levels. Different strategies can be pursued to foster sustainability transitions in food systems: efficiency increase (e.g., sustainable intensification), demand restraint (e.g., sustainable diets), and food systems transformation (e.g., alternative food systems). Creating sustainable food systems requires moving from an agriculture‐centered to a food system policy and research framework. This will be fundamental to foster the complex and holistic transformation necessary to achieve sustainable food systems, which is, in turn, a prerequisite to achieving sustainable food and nutrition security.

PROTOCOL: Impact of the food environment on diet-related health outcomes in school-age children and adolescents in low- and middle-income countries: a systematic review.

Research conducted on food systems by higher institutions can contribute to sustainable food security and nutrition at a local level and reduce the impact of societal challenges such as malnutrition. Unfortunately, malnutrition itself manifests as hidden hunger causing unintended consequences such as illness negatively affecting economic progress. Traditionally, research in agriculture has not taken a food systems approach which is looking at challenges of food systems from farm to fork (all stages from production to consumption). Therefore, as we embrace the compelling call to transition from agriculture to food systems research approaches, mapping studies at a local level are needed. However, studies on food systems have been carried out at a macro (global or regional level), a micro-perspective investigation is needed to inform future research. A systematic review on existing literature (journals and thesis) was conducted to identify gaps and opportunities in research on food systems undertaken by researchers at the University of Nairobi. Information collected included; 1. institutions (faculties and department at the university, national policy, and international institutions collaborating with university of Nairobi), 2. crop types (cereals, legumes, vegetables, roots and tubers, and nuts), 3. food systems activities (production, postharvest, processing, and preservation, value addition and branding, consuming foods, input and output markets, obtaining nutrients as well as logistics and distribution) driving research on food systems. The contribution of each of the components (institutions, food systems activity and crop type) was also investigated through citation scores. The findings show that low research outputs on food systems were generated by the university of Nairobi compared to selected universities in Africa and across the globe. Research was focused on carbohydrate rich crops (maize, sorghum, cassava, irish potato, sweet potato, and rice) as compared to protective bioactive vitamin crops (vegetables, mango, and beans). This demonstrated low crop diversity and dietary quality. Research priority was given mainly to maize compared to traditional crops such as sorghum, African Leafy Vegetables, cassava and millets. Faculties such as health, science and technology, engineering, and humanities were involved in research in food systems in addition to agriculture, a potential indication of transdisciplinary research. Additionally, there was more collaborative research between university of Nairobi with institutions at a global level than with local institutions. The involvement of policy institutions in research was low, mainly restricted to the discipline of agriculture, production food system activity and in a few crops such as maize, cassava, and medicinal plants. Disparities in research existed along the food systems activities as more attention was focused on production activities. Other food system activities such as harvesting, processing and preservation, consumption, value addition and branding, input and output markets, as well as logistics and distribution activities, received low research priority. Each component (food system activity, crop type and institution) demonstrated contribution to sustainable food security as shown by citation scores. The findings demonstrate skewed focus in food systems research at the university of Nairobi. Agricultural research investment within institutions of higher learning will need to consider all food systems activities, under-researched crops and collaborations that advance transdisciplinary studies to promote inclusive contribution of food systems to food security at a local level. Further studies can focus on developing frameworks to advance transdisciplinary research.

BackgroundMalnutrition in mothers and children is a significant public health challenge in developing countries such as Nepal. Although undernutrition in children has been gradually decreasing, the coexistence of various forms of malnutrition in mothers and children has continued to rise globally. There is a gap in knowledge of the coexistence of such multiple burdens of malnutrition in the Nepalese context. The aims of this study were to explore the coexistence of various forms of malnutrition and associated factors among mother-child pairs residing in the same household.MethodsA total sample of 2261 mother-child pairs from the Nepal Demographic and Health Survey (NDHS) 2016 were included in the study. Anthropometric measurements and hemoglobin levels of children and anthropometric measurements of their mothers were collected. Bivariate and multivariable logistic regression models were used to assess the factors associated with the double burden of malnutrition (DBM) and the triple burden of malnutrition (TBM).ResultsPrevalence of DBM and TBM was 6.60% (95% CI: 5.13–8.84) and 7.00% (95% CI: 5.42–8.99) respectively in the same households. In the adjusted multivariable logistic regression models, mothers with short stature (AOR = 4.18, 95% CI: 2.04–8.52), from the richest wealth quintile (AOR = 2.46, 95% CI: 1.17–5.15), aged over 35 years (AOR = 3.08, 95% CI: 1.20–7.86), and those who had achieved at least secondary level education (AOR = 2.05, 95% CI: 1.03–4.07) were more likely to suffer from the DBM. Similarly, mothers with short stature (AOR = 5.01, 95% CI: 2.45–10.24), from the richest wealth quintile (AOR = 2.66, 95% CI: 1.28–5.54), aged over 35 years (AOR = 3.41, 95% CI: 1.26–9.17), and those who had achieved at least secondary level education (AOR = 2.05, 95% CI: 1.00–4.18) were more likely to suffer from the TBM.ConclusionsOverall, there is a low prevalence of double and triple burden of malnutrition among mother-child pairs in Nepal. Older mothers with short stature and those from richer wealth quintiles were more likely to suffer from double and triple burden of malnutrition.

Food security exists when all people at all times have physical, social and economic access to sufficient, safe and nutritious food. Food security is built on four pillars: availability, access, utilization and stability. Food and nutrition security embraces meeting energy, protein and nutrient needs for healthy life. Food systems overlap with agricultural systems in the area of food production, but also comprise the diverse set of institutions, technologies and practices that govern the way food is marketed, processed, transported, accessed and consumed. The food system activities are grouped into four categories: producing food, processing and packaging food, distributing and retailing food, and consuming food. The review paper aims at highlighting the connections and linkages between food sustainability and food security. There are very strong linkages between food and nutrition security, responsible environmental stewardship and greater fairness in food management. They intersect in agricultural and food systems at the global, national and local levels. Today, the main concern for the food and agricultural sector is to provide simultaneously enough food, in quantity and quality, to meet the nutritional needs of a growing population and to conserve natural resources for future generations. A sustainable food system supports food security, makes optimal use of natural and human resources, is culturally acceptable and accessible, environmentally sound and economically fair and viable, and provides the consumer with nutritionally adequate, safe, healthy and affordable food for present and future generations. Changes in both food consumption and food production are important to ensure more sustainable food systems and to achieve food and nutrition security in the Mediterranean region. Since diets sustainability is of paramount importance for achieving food and nutrition security, there is an urgent need to design and implement appropriate policies to improve the economic, environmental and social sustainability of the current food consumption patterns.

The paradox of persistent under-nutrition and food insecurity; as well as the increasing the incidence of over nutrition is particularly observed in middle -income countries experiencing rapid westernisation such as South Africa (SA). Values of household Food insecurity remains high, whereas overweight and obesity are increasing at a rapid rate. Agriculture and the food system play a key role in nutrition, health and food security. It provides for the primary sources of energy along with essential nutrients, while simultaneously being a source of income, creating jobs and earning foreign exchange. This case study presents the current nutrition sensitivity of the South-African agriculture and food systems (including governmental prioritization) and highlights the importance of this for future development towards improved food and nutrition Security and nutritional status. Since 2013, discussions on a single, comprehensive, food security and nutrition policy and implementation plan for South Africa have been in process with the aim to coordinate the improvement of both food security and all forms of malnutrition. Yet, the case study findings indicate an unfortunate lack of understanding about nutrient density and dietary diversity and the role which this could play in combating non-communicable diseases in addition to food insecurity and hunger.

Food systems determinants of nutritional health and wellbeing in urban informal settlements: A scoping review in LMICs

The triple burden of malnutrition (undernutrition, overnutrition and micronutrient deficiency) or TBM among under-five (U5) children is an increasingly recognised public health challenge. A literature search was conducted to identify studies published from 1976 to 2022, which had focused on information regarding different factors of child malnutrition. The findings were analysed and contextualised from policy and programmatic perspective. There is a high burden of various forms of malnutrition in India. Insufficient dietary intake and illnesses are immediate and most common causes of triple burden of malnutrition(TBM): (undernutrition, overnutritionand micronutrient deficiency). The other key factors associated with the TBM are lifestyle, nutritional practices, unsafe water, food insecurity, lack of sanitation & basic hygiene, unhealthy feeding & caring practices, inadequate health infrastructure, and suboptimal implementation of government nutrition schemes etc. There is scientific evidence that TBM has long term consequences on physical and mental development of children and has high cost to any society. The situation of TBM persists inspite of multiple ongoing government programs to tackle these challenges. The health service provision needs to move from the first 1,000 d to the first 3,000 d as well as focus on the interventions aimed at early childhood development. Multi-sectoral interventions through Anganwadi centres and schools (through education department) need to be conducted. The public health programs and primary healthcare services need to be realigned and health interventions should be implemented along with tackling social determinants of health and sustained community engagement and participation. Tackling TBM should be made a political priority. The life cycle approach for healthier children and society needs tobe fully implemented.

Food systems in Eastern Equatoria State, South Sudan, are in dire crisis because of multiple shocks and stressors, persisting conflict and violence, climate change, and natural resource deterioration. However, building upon South Sudan’s National Food Systems Dialogue ample opportunities exist to build food systems resilience in EE through strengthening the capacity of people to produce and access nutritious and culturally acceptable food over time and space in the face of natural and/or man-made shocks and stressors. This report provides a rationale for building food systems resilience in South Sudan by introducing its concept and operationalisation (part 1 of this report), presenting the main findings of the food systems resilience dialogue that took place in EE State (part 2), and introducing the main pathways identified to build food systems resilience in the State (part 3). Food systems approaches are increasingly seen as a way forward to develop sustainable food systems in protracted food crisis as highlighted by the UN Food Systems Summit, the Global Network Against Food Crises and the Fighting Food Crises along the Nexus Coalition. It is therefore most opportune to act now by investing in an urgently needed transformation towards equitable, inclusive, and sustainable food systems for improved outcomes, in particular food and nutrition security in protracted food crises contexts. For South Sudan this means, in line with the outcomes of its National Food Systems Dialogue, to address four strategic challenges to transform the country’s food systems: 1) strengthening the resilience of food systems in face of current and future shocks and stressors; 2) developing food systems that contribute to social cohesion and peace; 3) ensuring that food systems are based on sustainable use and management of natural resources and produce healthier diets, and; 4) promoting sustainable food supply systems through inclusive value chains and agribusinesses with an eye on youth employment. Governance of food systems takes place at multiple levels and scales but transformation of local food systems will only succeed if communities, civil society organisations, small producers, farmers, and indigenous groups – with their local knowledge, and lived-in experiences – can shape how food is governed. The EE’s Food Systems Resilience Dialogue & Pathway Development (FoSReD-PaD) provides an approach to strengthen local governance of food systems for improved food systems resilience and outcomes. The State-Level Dialogue envisaged a total of nine pathways which together form a roadmap to transform EE’s food systems to become more resilient; better serve the needs of all stakeholders (in particular smallholder farmers/agri-pastoralists and herders); and improve food and nutrition outcomes for all.

Food systems in Western Bahr el Ghazal (WBeG) State, South Sudan, are in dire crisis because of multiple shocks and stressors, persisting conflict and violence, climate change, and natural resource deterioration. However, building upon South Sudan’s National Food Systems Dialogue, ample opportunities exist to build food systems resilience in WBeG through strengthening the capacity of people to produce and access nutritious and culturally acceptable food over time and space in the face of natural and/or man-made shocks and stressors. This report provides a rationale for building food systems resilience in South Sudan by introducing its concept and operationalisation (part 1 of this report), presenting the main findings of the food systems resilience dialogue that took place in WBeG State (part 2), and introducing the main pathways identified to build food systems resilience in the State (part 3). Food systems approaches are increasingly seen as a way forward to develop sustainable food systems in protracted food crisis as highlighted by the UN Food Systems Summit, the Global Network Against Food Crises and the Fighting Food Crises along the Nexus Coalition. It is therefore most opportune to act now by investing in an urgently needed transformation towards equitable, inclusive, and sustainable food systems for improved outcomes, in particular food and nutrition security in protracted food crisis contexts. For South Sudan this means, in line with the outcomes of its National Food Systems Dialogue, addressing four strategic challenges to transform the country’s food systems: 1) strengthening the resilience of food systems in face of current and future shocks and stressors; 2) developing food systems that contribute to social cohesion and peace; 3) ensuring that food systems are based on sustainable use and management of natural resources and produce healthier diets, and; 4) promoting sustainable food supply systems through inclusive value chains and agribusinesses with an eye on youth employment. Governance of food systems takes place at multiple levels and scales but transformation of local food systems will only succeed if communities, civil society organisations, small producers, farmers, and indigenous groups – with their local knowledge, and lived-in experiences – can shape how food is governed. WBeG’s Food Systems Resilience Dialogue & Pathway Development (FoSReD-PaD) provides an approach to strengthen local governance of food systems for improved food systems resilience and outcomes. The State-level Dialogue envisaged a total of nine pathways which together form a roadmap to transform WBeG’s food systems to become more resilient; better serve the needs of all stakeholders (in particular smallholder farmers/agri-pastoralists and herders); and improve food and nutrition outcomes for all.

BackgroundIndigenous communities retain knowledge of the land and food resources rooted in historical continuity within their region of residence. Food systems research can be leveraged to identify strategies to encourage sustainable use of complex multi-species agroforestry systems by indigenous communities contributing to nutritional needs while simultaneously preserving the ecosystems and their benefits to society. Till date, the analyses of food systems have predominantly focused on high income countries often overlooking the alternatives (dietary and production) that would be most relevant to low and middle income countries (LMIC). Thus, innovative methodological approaches are needed to comprehensively characterize diverse food systems in LMICs with special reference to indigenous communities.DesignThis protocol paper describes a food systems approach that will be employed to understand diverse and dynamic food systems of vulnerable tribal communities of Jharkhand, India and leverage their agroforestry systems to improve dietary diversity, nutrition status and address food security. Four tribal groups namely Santhal, Ho, Munda and Sauria Paharia of Godda, West Singhbhum and Khunti districts of Jharkhand would be studied.This will be an exploratory cross-sectional study design, along with a longitudinal component to capture seasonality in dietary intake and agricultural diversity. A mixed methods approach will be used based on a conceptual framework on drivers of food systems, food supply chain, food environment (both wild & cultivated, and market food environments), as well as consumer behaviour and maternal and child health outcomes in tribal communities. The quantitative surveys will be conducted on socio-economic, demographic profile of households, their availability of, access to and utilization of food environment and nutritional status of reproductive age group women and children under 5 years. Qualitative enquiries will examine barriers and facilitators to increase sustainable production, procurement and consumption of indigenous foods. The final outcome would be development of interventions to promote indigenous food consumption.DiscussionBy utilizing a combination of value chain analysis and ‘Optifoods linear programming software’ that will use above information on indigenous community, dietary intake, nutritional status and food environment, evidence based interventions promoting indigenous food systems aimed at addressing food and nutritional security of tribal communities will be developed.

Innovations within global food systems have contributed to the predicament known as the triple burden of malnutrition – the co-existence of hunger and micronutrient deficiency with the diseases of overnutrition, such as obesity, diabetes and hypertension. We use the case of the triple burden in South Asia to demonstrate analytically that innovation is a double-edged sword, with positive and negative potential, rather than a simple good. To achieve the Sustainable Development Goals that target food and nutrition security and sustainable agriculture (e.g. SDGs 2, 3 and 12), the countries of South Asia need more innovation, but, first, they would also benefit from some intelligent reflection about what innovation means, the directions it should take, and its risks and downsides alongside its benefits. In the present juncture, South Asian countries have an opportunity to learn from the experiences of other developing nations, and choose from alternative options to steer their own course. In this paper, we discuss how innovation has contributed to the present situation and ask how alternative kinds of innovation may enable South Asian countries to escape from the triple burden. We describe a conceptual framework that may be useful for thinking about how innovation pathways can be created and directed towards the goal of improving nutritional outcomes in South Asia. The framework draws attention to the direction of socio-technical change, the distribution of technologies and their risks and benefits, and the diversity of possible innovation pathways (STEPS Centre, 2010). We illustrate these points using examples of innovations in the areas of agricultural production, value chain interventions, and policy and institutional reforms.

As food and agricultural systems become increasingly globalized, the policy and governance issues related to food and nutrition security are becoming more complex. New and growing complexities require more systematic, coordinated, and evidence-based responses. Among these complexities is the need for diplomacy and security interventions to prevent hunger in conflict- and war-affected zones. Another complexity is the triple burden of malnutrition— undernutrition, micronutrient deficiencies and other diet quality problems, and obesity in an increasingly urban world—all three requiring simultaneous attention but different policy responses. A third is posed by the need to address production constraints and environmental risks, including low agricultural productivity growth, climate change, increased soil and land degradation, and loss of biodiversity. Finally, food and nutrition policy must account for the complexity related to global integration through trade and investment, most notably contested positions on fair and free trade, risks of market and price volatility, food industries’ international roles, and the protection of food safety. These interwoven challenges call for global governance to improve food and nutrition security. This chapter argues that a redesign of the current global food and agricultural governance system is needed to facilitate actions for accelerated reduction of undernutrition and malnutrition.