Nutrition & Agriculture Linkages

In what ways do investments in agriculture achieve significant measurable impacts in nutrition? As a corollary, can pathways to impact be empirically demonstrated?

Recognition that “merely producing more food does not ensure food security or improved nutrition” (Herforth et al. 2012) begs questions about when, where and why does it, or does it not ensure food security or improved nutrition? These questions lie at the core of a better understanding of the reality of agriculture-to-nutrition linkages.

Overview & ActivitiesRelated Publications

The belief that “agriculture contributes not just to food production but also to human nutrition and health” (IFPRI 2012) underpins ongoing efforts to “make agricultural policies and programs nutrition-sensitive” (BMGF 2012; Ruel et al. 2013). Yet, despite the considerable rhetoric that agriculture holds the potential to support improved nutrition, there is scant empirical evidence of the kinds of actions in agriculture that achieve significant and measurable human outcomes. Thus, the search for empirical evidence of ‘what works’ in this arena has been stepped up.

Enhancing agriculture in ways that support improved nutrition is not simply about increasing yields. It is also about reducing costs, enhancing stability in output, strengthening resistance to weeds, pests and diseases, promoting more variety or new crops, stimulation of market and value chain activity, targeting efforts to at-risk regions and populations, securing greater female empowerment (in the agricultural realm and beyond), and promoting demand for a high quality, diverse diet. As a result, agriculture as a broad sector of activity must be unpackaged so that relevant components can be assessed for their relative contributions to nutritional enhancement. This means that pathways linking agriculture and nutrition need to be refined through a focus on plausible biological and other mechanisms over different timeframes, and potential gains need to be understood in net terms through a focus on factors that affect nutrition at the interface among soil, plant and human systems.

Recognition that “merely producing more food does not ensure food security or improved nutrition” (Herforth et al. 2012) begs questions about when, where and why does it, or does it not ensure food security or improved nutrition? These questions lie at the core of a better understanding of the reality of agriculture-to-nutrition linkages.

The Nutrition Innovation Lab seeks to delve deeper into the links between nutrition and agriculture through carefully designed primary data collection activities. “Poshan,” which means good nutrition in Nepali, involves two interlinked research studies being undertaken in Nepal. The research from the PoSHAN Project will link metrics of institutional and individual collaboration at national and district government (multiple line ministry) levels with metrics of program fidelity at local (sub-district) levels.

Read more about about the PoSHAN Project.

The output of this aspect of the research will be papers that empirically measure defined pathways from agriculture to nutrition. This research, conducted where marginal agricultural productivity, market diversity, food security and nutritional status co-exist with government and NGO programs, offers an opportunity to examine and establish conditional pathways that may help raise the nutritional impact of future agricultural and multisectoral policies and programs.

Household food production is positively associated with dietary diversity and intake of nutrient-dense foods for older preschool children in poorer families: Results from a nationally-representative survey in Nepal

Authors: Prajula Mulmi; William Masters; Shibani Ghosh; Grace Namirembe; Ruchita Rajbhandary; Swetha Manohar; Binod Shrestha; Keith West Jr. ; Patrick Webb November 2017
Nutrition-sensitive interventions supporting enhanced household food production have potential to improve child dietary quality. However, heterogeneity in market access may cause systematic differences in program effectiveness depending on household wealth and child age. Identifying these effect modifiers can help development agencies specify and target their interventions.
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Understanding pathways to better nutrition at district level: Lessons from Uganda

Authors: Edgar Agaba; Jeffrey Griffiths November 2017
For countries looking to implement multisectoral nutrition plans, it is critical to understand what works and how programs should be delivered and scaled-up in each context. Programs can learn from each other on how to adapt to new information, evidence and events related to scaling-up and district stakeholders can play important roles in implementation of this multisectoral plan. As part of “Pathways-to-Better Nutrition” (PBN) case study conducted by USAID/SPRING Project, this research set out to explore district leaders’ perceptions of the nutrition situation, programs and Continue reading →
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Determinants of anemia among women and children in Nepal and Pakistan: An analysis of recent national survey data

Authors: Kassandra Harding; Victor Aguayo; Grace Namirembe; Patrick Webb August 2017
Abstract: Anemia remains one of the most intractable public health challenges in South Asia. This paper analyzes individual-level and household-level determinants of anemia among children and women in Nepal and Pakistan. Applying multivariate modified Poisson models to recent national survey data, we find that the prevalence of anemia was significantly higher among women from the poorest households in Pakistan (adjusted prevalence ratio [95% CI]: 1.10 [1.04–1.17]), women lacking sanitation facilities in Nepal (1.22 [1.12–1.33]), and among undernourished women (BMI < 18.5 kg/m2) in both countries (Nepal: 1.10 [1.00–1.21] and Continue reading →
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Vitamin B-12 status in infancy predicts development and cognitive functioning 5 years later in Nepalese children

Authors: Ingrid Kvestad; Mari Hysing; Merina Shrestha; Manjeswori Ulak; Andrew Thorne-Lyman; Sigrun Henjum; Per Ueland; Oyvind Midttun; Wafaie Fawzi; Ram Chandyo; Prakash Shrestha; Tor Strand March 2017
We measured the associations between vitamin B-12 status in infancy (2–12 mo) and the development and cognitive functioning in Nepalese children 5 y later. Vitamin B-12 status was assessed in infancy with the use of plasma cobalamin, total homocysteine (tHcy), and methylmalonic acid (MMA). At 5 y of age, we measured development with the use of the Ages and Stages Questionnaire, 3rd edition (ASQ- 3), and cognitive functioning by using the Developmental Neuropsychological Assessment, 2nd edition (NEPSY II), in 320 children. In regression models, we estimated Continue reading →
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Charting the cost of nutritionally-adequate diets in Uganda, 2000-2011

Authors: George Omiat; Gerald Shively March 2017
Although malnutrition rates have been on the decline in Uganda over the past two decades, they remain high. Challenges to achieving nutritional improvements result, in part, from high staple foods prices, which raise the cost of the food basket and increase the risk of food and nutrition insecurity, especially for poor households who are net buyers of staple foods. Nearly two-thirds of Ugandan households are net buyers of staples, a pattern that highlights the potential importance of food prices as a key driver of food Continue reading →
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Erythrocyte fatty acid composition of Nepal breast-fed infants

Authors: Sigrun Henjum; Oyvind Lie; Manjeswori Ulak; Andrew Thorne-Lyman; Ram Chandyo; Prakash Shrestha; Wafaie Fawzi; Tor Strand; Marian Kjellevold January 2017
Essential fatty acids play a critical role in the growth and development of infants, but little is known about the fatty acid status of populations in low-income countries. The objective was to describe the fatty acid composition of red blood cells (RBC) in breastfeed Nepali infants and a subsample of their mothers and to identify the main sources of fatty acids in the mother’s diet, as well as the fatty acid composition of breast milk.
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Nutrition Smoothing: Can Proximity to Towns and Cities Protect Rural Children against Seasonal Variation in Agroclimatic Conditions at Birth?

Authors: Amelia F. Darrouzet-Nardi; Willliam A. Masters January 2017
A large literature links early-life environmental shocks to later outcomes. This paper uses seasonal variation across the Democratic Republic of the Congo to test for nutrition smoothing, defined here as attaining similar height, weight and mortality outcomes despite different agroclimatic conditions at birth. We find that gaps between siblings and neighbors born at different times of year are larger in more remote rural areas, farther from the equator where there are greater seasonal differences in rainfall and temperature. For those born at adverse times in Continue reading →
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Food insecurity, but not HIV-infection status, is associated with adverse changes in body composition during lactation in Ugandan women of mixed HIV status

Authors: Elizabeth Widen; Shalean Collins; Hijab Khan; Claire Biribawa; Daniel Acidri; Winifred Achoko; Harriet Achola; Shibani Ghosh; Jeffrey Griffiths; Sera Young January 2017
A cohort of 246 women [36.5% of whom were HIV positive (HIV+) and were receiving ART] were followed to 12 mo postpartum. Repeated measures included weight, fat mass, fat-free mass, mid upper arm circumference, triceps skin fold thickness [which allowed for the derivation of arm muscle area (AMA) and arm fat area (AFA)], breastfeeding, and individual food insecurity. Longitudinal regression models were constructed to assess associations between HIV and food insecurity and changes in body composition over time.
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Individual, household, and community level risk factors of stunting in children younger than 5 years: Findings from a national surveillance system in Nepal

Authors: Jamie Dorsey; Swetha Manohar; Sumanta Neupane; Binod Shrestha; Rolf Klemm; Keith West January 2017
Stunting (height‐for‐age z‐score [HAZ] < −2) affects close to a quarter of the world’s child population younger than 5 years, with South Asia bearing over half of the childhood‐stunting burden. Stunting both reflects chronic undernutrition and sustained resource‐constrained environments and is often associated with an increased risk of impaired cognition, reduced economic productivity, poor health outcomes throughout the life cycle, and poor survival overall. In recent years, efforts to prevent stunting have been among the leading priorities of governments, donors, and civil society organizations, reflected Continue reading →
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Markets, transportation infrastructure and food prices in Nepal

Authors: Gerald Shively; Ganesh Thapa December 2016
We study transportation infrastructure and food markets in Nepal over the period 2002 to 2010, combining monthly price data from 37 local and regional markets and 7 Indian border markets. We use a series of autoregressive models to study price determination, spatial and temporal price transmission, and price variance. We account for district-level agricultural production, correcting for bi-directional causality between output and prices using ground station rainfall data. In addition, to test hypotheses regarding the importance of transportation infrastructure we incorporate information on road and Continue reading →
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Climatic conditions and child height: Sex-specific vulnerability and the protective effects of sanitation and food markets in Nepal

Authors: Prajula Mulmi; Steven Block; Gerald Shively; William A. Masters December 2016
Abstract Environmental conditions in early life are known to have impacts on later health outcomes, but causal mechanisms and potential remedies have been difficult to discern. This paper uses the Nepal Demographic and Health Surveys of 2006 and 2011, combined with earlier NASA satellite observations of variation in the Normalized Difference Vegetation Index (NDVI) at each child’s location and time of birth to identify the trimesters of gestation and periods of infancy when climate variation is linked to attained height later in life. We find Continue reading →
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Low Prevalence of Vitamin D Insufficiency among Nepalese Infants Despite High Prevalence of Vitamin D Insufficiency among Their Mothers

Authors: Johanne Haugen; Manjeswori Ulak; Ram Chandyo; Sigrun Henjum; Andrew Thorne-Lyman; Per Magne Ueland; Oivind Midtun; Prakash Shrestha; Tor Strand December 2016
Describing vitamin D status and its predictors in various populations is important in order to target public health measures. Objectives: To describe the status and predictors of vitamin D status in healthy Nepalese mothers and infants. Methods: 500 randomly selected Nepalese mother and infant pairs were included in a cross-sectional study. Plasma 25(OH)D concentrations were measured by LC-MS/MS and multiple linear regression analyses were used to identify predictors of vitamin D status. Results: Among the infants, the prevalence of vitamin D insufficiency (25(OH)D <50 nmol/L) Continue reading →
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The Nutrition Transition and Agricultural Transformation: a Preston curve approach

Authors: William A. Masters; Anaya Hall; Elena M. Martinez; Peilin Shi; Gitanjali Singh; Patrick Webb; Dariush Mozaffarian November 2016
The nutrition transition in diets and health is closely tied to other aspects of economic development, including agricultural transformation and urbanization as well as demographic change and epidemiological transition from infectious to noncommunicable disease. Over time, dietary patterns typically shift from widespread inadequacy of many foods and nutrients, especially for children and mothers, into surplus energy intake and rising obesity with continued inadequacy of healthier foods. Diet-related diseases remain the largest single cause of premature death and disability in all regions. This article combines food Continue reading →
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Nutrient composition of premixed and packaged complementary foods for sale in low‐ and middle‐income countries: Lack of standards threatens infant growth

Authors: William A. Masters; Marc D. Nene; Winnie Bell November 2016
Premixed flours for infant porridge are increasingly produced and sold in developing countries to complement continued breastfeeding. Such complementary food (CF) products have known efficacy against malnutrition in children from 6 to 24 months of age, but ingredient ratios and production processes may vary. This study provides the first systematic measurement of their actual nutrient composition. We purchased samples of 108 premixed CF products in 22 low‐ and middle‐income countries, and commissioned blind laboratory measurement of each product’s macronutrients and micronutrients. We compared measured contents Continue reading →
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Infrastructure mitigates the sensitivity of child growth to local agriculture and rainfall in Nepal and Uganda

Authors: Gerald Shively November 2016
Incorporating agriculture into nutrition policy requires an understanding of how agricultural performance, rainfall, and the economic and physical environments in which children reside relate to linear growth and weight gain. This paper combines anthropometric data from children below the age of 5 y in Nepal and Uganda with rainfall data and other information to measure these connections. Anthropometric outcomes are positively correlated with rainfall prior to birth, during the first year, and during agricultural growing seasons preceding child measurement. High rainfall is found to be Continue reading →
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PoSHAN Community Studies: Panel 3 Report

Authors: Nutrition Innovation Lab November 2016
The goal of PoSHAN Community Studies is to understand the factors that link agriculture to nutrition. This involves researching the determinants of household food security, dietary intake, and nutritional status of children under 5 years of age and their mothers in relation to changes in agriculture and exposure to agricultural and microeconomic extension, as well as nutrition and health programs in Nepal. This descriptive report summarizes the main findings of the third panel survey.
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PoSHAN Community Studies: Panel 2 Report

Authors: Nutrition Innovation Lab October 2016
The goal of PoSHAN Community Studies is to understand the factors that link agriculture to nutrition. This involves researching the determinants of household food security, dietary intake, and nutritional status of children under 5 years of age and their mothers in relation to changes in agriculture and exposure to agricultural and microeconomic extension, as well as nutrition and health programs in Nepal. This descriptive report summarizes the main findings of the second panel survey conducted between May – July 2014.
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Duration of programme exposure is associated with improved outcomes in nutrition and health: the case for longer project cycles from intervention experience in rural Nepal

Authors: Laurie Miller; Neena Joshi; Mahendra Lohani; Beatrice Rogers; Meghan Kershaw; Robert Houser; Shibani Ghosh; Jeffrey Griffiths; Shubh Mahato; Patrick Webb September 2016
Economic growth and poverty reduction are not always sufficient to improve child health and nutritional status. Heifer International promotes livestock introduction and related training for community development and poverty alleviation. These programmes do not directly address child health or nutrition. To determine effects of its activities on these important outcomes, Heifer conducted a 4-year longitudinal investigation in rural Nepal. The intervention was associated with significantly improved child anthropometry (related to the duration of intervention exposure) and child health. Heifer activities represent a viable ‘nutrition sensitive’ Continue reading →
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What Does It Cost to Improve Household Diets in Nepal? Using the Cost of the Diet Method to Model Lowest Cost Dietary Changes

Authors: Erin Biehl; Rolf Klemm; Swetha Manohar; Patrick Webb; Devendra Gauchan; Keith West September 2016
In Nepal, limited availability and affordability of nutritious foods contribute to malnutrition. To identify nutrient deficiencies in commonly consumed diets and model lowest cost changes that could improve diet quality in 3 agroecological zones of Nepal. The modeled lowest cost diet commonly eaten in 3 Nepalese communities lacks key nutrients. Policies and interventions that increase market availability and consumption of vitamin B12- and calcium-rich fish and dark green leafy vegetables could improve local diets, particularly in the mountains and hills.
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Child nutrition and local food prices in Nepal

Authors: Ganesh Thapa; Gerald Shively September 2016
Abstract: This paper studies the connections between child nutrition and food prices in Nepal. Data from a number of sources are combined, including the 2006 and 2011 Nepal Demographic Health Surveys and monthly retail food price data collected over the period 2002 to 2010 from 34 districts of Nepal. A total of 4,038 children are used for the analysis (2,765 from 2006 and 1,273 from 2011). Price data are selected for six food commodities important for child nutrition outcomes: coarse rice, wheat flour, sugar, ghee, soybean Continue reading →
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Relationship of Stunting and Overweight in Egyptian children under five years of age: Trends and associated risk factors.

Authors: Shibani Ghosh; Grace Namirembe; Marwa Moaz; Ashish Pokharel; Elizabeth Marino-Costello; Jeffrey Griffiths; Patrick Webb September 2016
Egypt’s emerging economy faces a dual burden wherein there is coexistence of under and over nutrition, either in the same population, community, household or same individual. The dual burden of disease can be extremely variable in its manifestation. It can, for example, be manifested as stunted children who are concurrently obese, or as stunted children who may not be currently obese but who are at risk of early onset chronic diseases. Secondary Analysis provided by the Nutrition Innovation Lab.  
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The association between food insecurity and depressive symptoms severity among pregnant women differs by social support category: a cross-sectional study

Authors: Barnabas Natamba; Jane Achan; Rebecca Stoltzfus; Sera Young August 2016
Abstract Common mental disorders, such as depression and anxiety, affect approximately 16% of pregnant women in low- and middle-income countries. Food insecurity (FI) has been shown to be associated with depressive symptoms. It has also been suggested that the association between FI and depressive symptoms is moderated by social support (SS); however, there is limited evidence of these associations among pregnant women living in low-income and middle-income countries. We studied the association between FI and depressive symptoms severity and assessed whether such an association varied Continue reading →
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Fostering reflective trust between mothers and community health nurses to improve the effectiveness of health and nutrition efforts: An ethnographic study in Ghana, West Africa

Authors: Nana Ackatia-Armah; Nii Antiaye Addy; Shibani Ghosh; Laurette Dube June 2016
As the global health agenda shifts from the Millennium Development Goals (MDGs) to Sustainable Development Goals (SDGs), the need for effective preventive health efforts has gained prominence, particularly in low-income regions with poor health and nutrition outcomes. To address needs in communities with limited access to health services and personnel, it is important to develop strategies that can improve the effectiveness of nurses as they interact with the populations they serve. We contribute to informing such strategies by explaining how mothers’ “reflective trust” in community Continue reading →
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Child dietary quality in rural Nepal: Effectiveness of a community-level development intervention

Authors: Amelia F Darrouzet- Nardi; Laurie C Miller; Shubh Mahato; Mahendra Lohani; Beatrice L Rogers May 2016
Nutrition-sensitive agricultural interventions have the potential to improve child dietary quality in rural households, as evidenced by a growing body of work which concurrently measures agricultural and nutrition indicators. Our objective was to investigate whether children in rural farming communities of Nepal participating in a community-level, nutrition-sensitive development intervention had improved dietary quality compared with children living in non-participating matched rural communities. Six rural communities of Nepal where livelihoods were predominantly agricultural were selected to participate in the phased implementation of a community-level development intervention Continue reading →
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Protein Quality in the First Thousand Days of Life

Authors: Shibani Ghosh May 2016
The aim of this article is to provide an overview of the role of protein quality within the first 1000 days of life. The article outlines the importance of protein quality in pregnancy and early growth and examines the potential of high-quality protein in prevention of stunting and treatment of severe and moderate acute malnutrition. The article also provides a summary of the recent changes in protein quality evaluation and the development of a new index, the Digestibility Corrected Amino Acid Score, examining the opportunities Continue reading →
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Vitamin Status among Breastfed Infants in Bhaktapur, Nepal

Authors: Manjeswori Ulak; Ram Chandyo; Oivind Midttun; Prakash Shrestha; Lauren Graybill; Tor Strand March 2016
Vitamin deficiencies are known to be common among infants residing in low- and middle-income countries but relatively few studies have assessed several biochemical parameters simultaneously. The objective of the study was to describe the status of vitamins (A, D, E, B6, B12 and folate) in breastfed infants. We measured the plasma concentrations of trans retinol, 25 hydroxy vitamin D, α-tocopherol, pyridoxal 5′-phosphate, cobalamin, folate, methylmalonic acid, homocysteine, hemoglobin and C-reactive protein from 467 randomly selected infants. One in five (22%) was deficient in at least Continue reading →
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Sustaining healthy diets: The role of capture fisheries and aquaculture for improving nutrition in the post-2015 era

Authors: Shakuntala Haraksingh Thilsted; Andrew Thorne-Lyman; Patrick Webb; Jessica Rose Bogard; Rohana Subasinghe; Michael John Phillips; Edward Hugh Allison February 2016
Fish production and trade contribute significantly to global agricultural output. Fish production in 2012 exceeded 158 million metrictons, while the value of international fish trade amounted to USD129 billion. An increasingly large share of fish entering global markets derives from aquaculture (the farming of aquatic animals and plants); the world’s fastest growing food production sector for more than four decades.  Much of fish produced and traded within low-income countries derives from capture fisheries (non-fed fish harvested from undomesticated ecosystems). These two production systems have important complementary roles in meeting rising demand for Continue reading →
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Global dietary quality, undernutrition and non-communicable disease: a longitudinal modelling study

Authors: Rosemary Green; Jennifer Sutherland; Alan D Dangour; Bhavani Shankar; Patrick Webb January 2016
The objective is to determine the relationship between global dietary energy availability and dietary quality, and nutrition-related health outcomes.
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The prevalence of anemia and iron deficiency is more common in breastfed infants than their mothers in Bhaktapur, Nepal

Authors: R.K. Chandyo; Sigrun Henjum; P. Shrestha; L. Locks; Wafie Fawzi; Tor Strand December 2015
Iron deficiency anemia is a widespread public health problem, particularly in low- and middle-income countries. Maternal iron status around and during pregnancy may influence infant iron status. We examined multiple biomarkers to determine the prevalence of iron deficiency and anemia among breastfed infants and explored its relationship with maternal and infant characteristics in Bhaktapur, Nepal.
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UNICEF: Timor-Leste Food and Nutrtion Survey 2013- Final Report

Authors: Nutrition Innovation Lab October 2015
UNICEF Report: The data collection for this survey was carried out between May and September 2013 among children aged 0-59 months and their non-pregnant mothers (aged 14 – 60 years). The survey assessed the risk factors for undernutrition based on Conceptual Framework of Malnutrition (UNICEF, 1990) which is being used for nutrition programming worldwide for the past 25 years. The prevalence of micronutrient deficiencies (vitamin A, iron, zinc, and iodine deficiency), and the iodine content of household iodised salt and aflatoxin exposure among children (aged 6 – 59 Continue reading →
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Agricultural Diversity and Child Stunting in Nepal

Authors: Gerald Shively; Celeste Sununtnasuk September 2015
This article investigates empirical connections between agriculture and child nutrition in Nepal. We augment the standard approach to explaining child nutrition outcomes by including information about household level agricultural production characteristics, including indicators of agricultural diversity. Data from the 2010/2011 Nepal Living Standards Survey (NLSS) are used in a series of regression models to explain stunting outcomes and variation in height-for-age Z-scores among 1,769 children 0–59 months of age. Results highlight the relative importance of overall agricultural yields, specific crop groups, and the consumption of own-production as factors correlated Continue reading →
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Does Ethiopia’s Productive Safety Net Program improve child nutrition?

Authors: Bethelhem Legesse Debela; Gerald Shively August 2015
In this paper, we use data from Northern Ethiopia to study the links between a social protection program and child nutrition. Child malnutrition is one of the many challenges that pose a threat to economic growth in developing countries. It undermines educational attainment, lowers non-cognitive skills, leads to low labor productivity during adulthood, and  diverts attention and resources away from other development objectives. Ultimately, under-nutrition during childhood can lead to intergenerational poverty.
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Environmental Variability and Child Growth in Nepal

Authors: Gerald Shively; Celeste Sununtnasuk; Molly Brown June 2015
Data from the 2011 Nepal Demographic Health Survey are combined with satellite remotely sensed Normalized Difference Vegetation Index (NDVI) data to evaluate whether interannual variability in weather is associated with child health. For stunting, we focus on children older than 24 months of age. NDVI anomaly averages during cropping months are evaluated during the year before birth, the year of birth, and the second year after birth. For wasting, we assess children under 59 months of age and relate growth to NDVI averages for the Continue reading →
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Urbanization, market development and malnutrition in farm households: evidence from the Demographic and Health Surveys, 1986–2011

Authors: Amelia Darrouzet-Nardi; William Masters May 2015
A principal effect of agricultural productivity growth is to accelerate urbanization by supplying food, labor and other resources to urban services and industry. Towns and cities may also grow for their own reasons, pulling food and resources out of rural areas. Whether pushed or pulled, the development of markets creates new opportunities for agricultural households. This study tests whether, on balance, proximity to older towns and cities has improved or worsened malnutrition among farm households in 43,850 survey clusters in 46 developing countries between 1986 Continue reading →
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UNICEF: Timor-Leste Food and Nutrtion Survey 2013- Summary of Key Findings and Recommendations

Authors: Nutrition Innovation Lab April 2015
UNICEF Report: The data collection for this survey was carried out between May and September 2013 among children aged 0-59 months and their non-pregnant mothers (aged 14 – 60 years). The survey assessed the risk factors for undernutrition based on Conceptual Framework of Malnutrition (UNICEF, 1990) which is being used for nutrition programming worldwide for the past 25 years. The prevalence of micronutrient deficiencies (vitamin A, iron, zinc, and iodine deficiency), and the iodine content of household iodised salt and aflatoxin exposure among children (aged 6 – 59 Continue reading →
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Microbial Decontamination of Fresh Produce (Strawberry) Using Washing Solutions

Authors: Naresh Shahi; Byungjin Min; Eunice A. Bonsi March 2015
This Tuskegee University study was carried out to determine the effect of natural antimicrobial washing solutions against microbial growths on fresh produce specifically strawberries. Selected washing solutions used for strawberry washing, and treatments were sterile water (control), white vinegar (VI), crude lemon juice extract (LE), VI+Origanum oil (VIO), LE+Origanum oil (LEO), and VI+LE+Origanum oil (VILEO).
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Low dietary diversity and micronutrient adequacy among lactating women in a peri-urban area of Nepal

Authors: Sigrun Henjum; Liv Elin Torheim; Andrew L Thorne-Lyman January 2015
The main objectives were to assess the adequacy of the micronutrient intakes of lactating women in a peri-urban area in Nepal and to describe the relationships between micronutrient intake adequacy, dietary diversity and sociodemographic variables. Breast-feeding is one of the most important factors that can influence child health in low- and middle-income countries. During lactation, women have increased requirements for energy and micronutrients. An inadequate maternal intake of certain nutrients during this period may have consequences for both the mother’s health and nutritional status, as well as those of the breast-fed Continue reading →
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The 3rd Annual Scientific Symposium: Agriculture, Food Systems, and Nutrition: Connecting the Evidence To Action

Authors: Nutrition Innovation Lab December 2014
Briefing from the 3rd Annual Scientific Symposium The Nutrition Innovation Lab’s partner, Johns Hopkins University, in collaboration with the Institute of Medicine and the Nepal Agriculture Research Council, hosted its 3rd annual Scientific Symposium in Kathmandu, Nepal on November 18-20, 2014. The question driving this symposium was simple: how can agriculture improve household food security and nutrition outcomes? Yet the work of understanding the agriculture to nutrition pathway is complex. Building sustainable systems that promote food security, nutrition, and health in Nepal requires the utilization of high-quality, empirical evidence. The Continue reading →
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Cover-Brown et al 2014

Using satellite remote sensing and household survey data to assess human health and nutrition response to environmental change

Authors: Molly E. Brown; Kathryn Grace; Gerald Shively; Kiersten B. Johnson; Mark Carroll September 2014
Climate change and degradation of ecosystem services functioning may threaten the ability of current agricultural systems to keep up with demand for adequate and inexpensive food and for clean water, waste disposal and other broader ecosystem services. Human health is likely to be affected by changes occurring across multiple geographic and time scales. Impacts range from increasing transmissibility and the range of vectorborne diseases, such as malaria and yellow fever, to undermining nutrition through deleterious impacts on food production and concomitant increases in food prices. Continue reading →
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Cover Image: Impact of tissue culture banana technology on farm household income and food security in Kenya

Impact of tissue culture banana technology on farm household income and food security in Kenya

Authors: Nassul S. Kabunga; Thomas Dubois; Matin Qaim April 2014
While tissue culture (TC) technology for vegetative plant propagation is gradually gaining in importance in Africa, rigorous assessment of broader welfare effects for adopting smallholder farm households is lacking. Using survey data and accounting for selection bias in technology adoption, we analyze the impact of TC banana technology on household income and food security in Kenya. To assess food security outcomes, we employ the Household Food Insecurity Access Scale (HFIAS) – a tool that has not been used for impact assessment before. Estimates of treatment-effects Continue reading →
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Cover Image: Impacts of agriculture on nutrition: Nature of the evidence and research gaps

Impacts of agriculture on nutrition: Nature of the evidence and research gaps

Authors: Patrick Webb; Eileen Kennedy March 2014
Demand for empirical evidence of “what works” for nutrition through agriculture has arguably never been higher. In the past few years, there has been a proliferation of interest in how to leverage agriculture to maximize its impacts on nutrition, particularly among mothers and children. The belief that “agriculture contributes not just to food production, but also to human nutrition and health” is widely held, and it underpins ongoing efforts globally to “make agricultural policies and programs nutrition-sensitive”. However, the search for solid empirical findings on Continue reading →
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Cover Image: Agriculture, nutrition, and health in global development: typology and metrics for integrated interventions and research

Agriculture, nutrition, and health in global development: typology and metrics for integrated interventions and research

Authors: William A. Masters; Patrick Webb; Jeffrey K. Griffiths; Richard J. Deckelbaum February 2014
Despite rhetoric arguing that enhanced agriculture leads to improved nutrition and health, there is scant empirical evidence about potential synergies across sectors or about the mix of actions that best supports all three sectors. The geographic scale and socioeconomic nature of these interventions require integration of previously separate research methods. This paper proposes a typology of interventions and a metric of integration among them to help researchers build on each other’s results, facilitating integration in methods to inform the design of multisector interventions. The typology Continue reading →
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Agricultural correlates of linear growth and key modifiers among children under two years in rural Uganda

Authors: Nilupa Gunaratna February 2014
Many sources have recently called for agricultural programs and policies to become more “nutrition-sensitive”, with the aim of harnessing agriculture to improve nutrition and health. Several researchers have described potential causal pathways through which agriculture could impact the nutrition and health of vulnerable populations. Stunting, or poor linear growth, particularly in young children is a key indicator. Reflecting chronic undernutrition, stunting can begin in utero, and studies have shown that it can be difficult to recover from faltering in linear growth during gestation and the Continue reading →
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Cover Image: Letter to the Editor: Is the strength of association between indicators of dietary quality and the nutritional status of children being underestimated?

Letter to the Editor: Is the strength of association between indicators of dietary quality and the nutritional status of children being underestimated?

Authors: Andrew Thorne-Lyman; Donna Spiegelman; Wafaie W. Fawzi January 2014
The World Health Organization’s infant and young child feeding (IYCF) indicators were developed to fill multiple needs: to facilitate the assessment and comparison of IYCF practices across settings, to identify populations at risk and to evaluate the impact of interventions and measure progress towards achieving targets (World Health Organization 2008). Under- standing the relationships between these indicators and child anthropometric outcomes, as described in a recently published paper in Maternal & Child Nutrition (Jones et al. 2014), is relevant to many of these objectives because Continue reading →
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Cover Image: The prize and the price of good nutrition

The prize and the price of good nutrition

Authors: Patrick Webb December 2013
The global burden of disease is shifting rapidly. While in 1990, the top-ranked contributor to the global burden was child underweight, twenty years later we find that cancers and circulatory diseases contribute the most– accounting for 19% of global disability-adjusted life years (DALYs), with about a third of the total deriving from other non- communicable diseases (NCDs), including chronic respiratory, digestive, neurological, mental, endocrine, and other disorders1. By 2010, child underweight had dropped to 8th place in the ranking of contributors to the overall disease Continue reading →
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Uganda Baseline Report: Assessing the Linkage Between Agriculture, Food Security, Nutrition and Health Among Women and Children in Rural Ugandan Households.

Authors: Nutrition Innovation Lab October 2013
This report provides baseline and nationally representative data regarding nutritional and health issues in Uganda, particularly in terms of maternal and child health. Areas of assessment include livestock, malaria, aflatoxin exposure, water access, sanitation, and dietary information
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PoSHAN Community Studies: Baseline Report

Authors: Swetha Manohar; Rolf Klemm; R. Rajbhandary ; Patrick Webb; Shibani Ghosh; Keith West October 2013
Baseline findings of this nationally representative study reveal variations in nutritional status, household food security, agricultural production and practices, and sanitation between the agro ecological zones of Nepal. Undernutrition in under-five children and women was found to be consistently worse in the terai (with the exception of under-five stunting rates being approximately 36%). Household food insecurity was 40% across the PoSHAN sample during the May – July 2013 season; with terai households found to be least food insecure. The utilization of innovative agricultural practices were Continue reading →
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Cover Image: Afterword: Now is the time

Afterword: Now is The Time

Authors: Patrick Webb September 2013
Chapter in The Road to Good Nutrition: A Global Perspective Does the world really need this book? Do the shelves of analysts and policymakers need the weight of yet another compendium of ideas, statistics and rhetoric? The answer, perhaps surprisingly, is yes. Such a book is needed now, more than ever, because it reflects the rapid convergence of opinion around priority problems and likely pathways towards solutions.
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Comprehensive Assessment of the Peanut Value Chain for Nutrition Improvement in Ghana

Authors: Shibani Ghosh; William Masters September 2013
The goal was to identify opportunities for new investment and interventions to improve nutrition and livelihoods on a commercial scale (through agriculture linking to commercial enterprises). This enhances our understanding of crop value chains particularly relevant to women, and to the issues around value chains involving aflatoxin-free foodstuffs.
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Impact Pathways from Agricultural Research to Improved Nutrition and Health: Literature Analysis and Research Priorities

Authors: Patrick Webb June 2013
This paper contributes to ongoing work at many institutions aimed at identifying priority knowledge gaps, determining the best research approaches needed to fill those gaps, and exploring how to better support policy and programme implementation with sound empirical evidence of ‘what works’.
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Integrating Agriculture and Nutrition Actions to Improve Maternal and Child Nutrition: Research on Program Impact Pathways

Authors: Patrick Webb June 2012
From a LCIRAH Workshop, June 21-22, 2012, London. There is a need to establish solid, empirical knowledge of the effects of integrated programs targeting agriculture, health and nutrition, which are often complex, multi-sector interventions. In particular, there is a need to develop metrics and measures that will allow researchers within the realm of agriculture-to-health to understand the barriers, facilitators and drivers of nutrition impact- and to be able to rigorously say why and how a program succeeded or failed, as well as draw more generalizable Continue reading →
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