Nutrition and the Millennium Development Goals – Let’s get real

It is well worth reading the recent statement from the UN Standing Committee on Nutrition.

It is true that close to a billion people still suffer from hunger. It is also true that malnutrition has implications for all eight of the Millennium Development Goals.

The problem I have with the recommendations is that they include nebulous statements like:

‘Scale-up and adapt direct nutrition interventions that have proven effective. It is urgent to build on existing efforts and experience, to review and disseminate good practices and to ensure integration of relevant sectoral interventions’.

What on earth does this mean?

If we are serious about improving nutrition, at a minimum we need to:

  • Remunerate producers on the nutritional content of the food they produce. Currently they are remunerated on the yield.
  • Eat fresh, eat local and eat seasonal. Home grown is best.
  • Stop refining grain.
  • Ban trans fats.
  • Seriously reduce our consumption of sugar, high fructose corn syrup, fat and salt.
  • Traffic light label all processed foods. The Food Standards Agency in the UK supports this. The European Commission, most manufacturers and many supermarket chains reject it. I can guess why.
  • Stop filling the bellies of hungry children in the third world with corn soya blend (refined cereal), Plumpy’Nut (high fat, high sugar) or XanGo Meal Pack (non dairy creamer).
  • Stop using mid upper arm circumference (MUAC) and body mass index (BMI) as a measure of nutritional status – unless we believe that fatter kids are healthier kids.
  • Stop believing that we can correct micronutrient deficiencies by adding these to food in the form of chemical isolates, courtesy of the pharmaceutical industry.

Unfortunately, these basic measures involve trampling on the toes of vested interest, so are unlikely ever to be implemented.

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2 Comments

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2 responses to “Nutrition and the Millennium Development Goals – Let’s get real

  1. Preeti Sagar

    Interesting take on things. Many of the first points on your list have merit. But I think you put the strongest points up front.

    “Plumpy’Nut (high fat, high sugar) or XanGo Meal Pack (non dairy creamer).”

    Show me something with demonstrated evidence from field based trials better than plumpy nut for curing severe acute malnutrition and saving children’s lives. Miracle stores from studies with a sample size of two will not convince most people.

    Noting the endorsement of ‘E’Pap’ on your website I went to Pubmed and searched for it…response: “The following term was not found in PubMed: E’pap.” If it is such an amazing product, how about doing some rigorous testing on it and showing the world that it works.

    “Stop using mid upper arm circumference (MUAC) and body mass index (BMI) as a measure of nutritional status – unless we believe that fatter kids are healthier kids.”

    I’m sure many people would be happy to do so if you could find them a superior, field-friendly, easy to use predictor of child mortality due to lack of food than MUAC.

    “Stop believing that we can correct micronutrient deficiencies by adding these to food in the form of chemical isolates, courtesy of the pharmaceutical industry.”

    I think I kind of agree with you on this one..maybe. And yet many indicators of micronutrient deficiency do respond to supplementation in the form of “chemical isolates”. How do you think countries in the North and West got rid of vitamin A deficiency or rickets? (hint: It wasn’t through eating more liver, fish, or spinach)

    • gdouglas

      We have supported the use of Plumpy’Nut for short periods in the emergency care of severe acute malnutrition (SAM), as recommended by its developer, André Briend. I have not seen any evidence that it improves nutritional status in moderate acute malnutrition (MAM), other than increasing Body Mass Index (BMI). On the other hand, there is a vast amount of scientific data showing that high fat, high sugar foods are unhealthy for children.

      We take your point about rigorous testing. We certainly need such evidence showing the benefit of the feeding programmes of the World Food Program and World Vision and the fortification programmes of GAIN. I have been told that evidence is not required because they are following ‘accepted practice’ – whatever that means.

      You are right that MUAC is a useful indicator of impending death. What we need are useful indicators of nutritional status. It is interesting that you and everyone else expect me to provide them.

      We are sponsoring research in these areas, so watch this space. Meanwhile, reading your comments, I feel inspired to enlarge on my earlier blog.

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