Author: Allyson Garner

U.S. Breastfeeding Committee’s Statement on the Formula Shortage

The following guidance is also available from the Academy of Breastfeeding Medicine and HealthyChildren.Org.

Dear Members,

It’s been a long week/month/year (already, here in May). We see you. We are you. Much love.

As the United States faces a serious shortage of infant formula, we know that no baby should ever go hungry. Families are scared and stressed, and like every other crisis facing our nation, BIPOC and economically vulnerable communities are pressed even harder. This is a national crisis.

Long standing public health advocates know this was predictable and thus preventable. The USBC-Affiliated COVID-19 Infant & Young Child Feeding in Emergencies Constellation published a Statement at the start of the pandemic outlining actions needed to prevent the formula shortage and care gaps seen at that time from growing to a dangerous level. Being prescient is only valuable in the context of investment, action, and policy change to ensure every family has access to care. Yet here we are.

A robust infrastructure to support infant and young child feeding in emergencies includes both inventories of available commercial milk formula and lactation support and resources in every community. Public officials are currently calling for increased production of formula – which is desperately needed – yet without also investing in lactation support in every community. This exacerbates existing gaps, and as such feels short-sighted. Thank you to all the organizations lifting up resources and information on boosting milk supply, re-lactation, human milk donation, informed consent for safer milk sharing, all while calling out the systems failure that caused this to be necessary.

Long term, this is still a call to action to build systems and infrastructure to ensure that breastfeeding/human milk feeding is the easy and obvious feeding choice for most families. This includes routine skin to skin at birth; continuity of care from trained lactation support providers; family paid leave; workplace accommodations; a regulated commercial milk formula industry that invites formula-feeding parents to the table as valued stakeholders; a national network of milk banks; and IYCF-E infrastructure for disaster relief. Systems, in other words, that hold us all in care. Collectively we can build the resiliency to support a single community during a flood, a region during a power outage, or a nation during a pandemic or supply chain crisis. Dear choir – we know you know this sermon.

As the nation grapples with the immediate and present impact of this emergency, we need to do everything we can to support infant nutrition, including ensuring access to lactation support, supplies, and accommodations, donor milk, and infant formula. Organizations and agencies from across the nation are mobilizing in response to the shortage, offering support and messaging response according to the scope, stance, and capacity within their reach.

Throughout its history, the U.S. Breastfeeding Committee has worked to ensure food security for our nation’s infants by addressing gaps in the policy landscape with policy, systems, and environmental change solutions that include building an infrastructure for infant and young child feeding in emergencies. We remain committed to this cause and will continue to curate and amplify resources from the field, for the field, so that you are equipped to support the families you serve.

Thank you for all you are doing, including taking respite as you need.

Focus on Nutrition During National Women’s Health Week

By:  Blythe Thomas, Initiative Director, 1,000 Days of FHI Solutions

Minerva Delgado, Director of Coalitions & Advocacy, Alliance to End Hunger

Not nearly enough time or attention is spent discussing and acting upon when “good nutrition” for an individual should start. The answer? Before the individual is even born. This week is National Women’s Health Week and marks an important time for the nutrition and anti-hunger community, individuals, and policymakers, to reflect on what we can do to promote and improve the health of women, children and families. We must focus on supporting policies that build a healthier and more equitable future for all pregnant, birthing, postpartum, and parenting people and their children.  

The 1,000-day window, which spans from pregnancy to age 2, marks one of the most crucial times to provide vital maternal and infant nutrition interventions. The nutrition community has coalesced around this critical window working to ensure mothers, children and families have access to the nutrition they need for vibrant futures. This goal is unfortunately – but unsurprisingly – difficult to achieve across the board. Factors such as race or where a child is born should not affect health and well-being; however, this is a reality in many communities. In particular, families of color and low-income families are more often overburdened with barriers to accessing nutrition and are under-resourced. As a result, there are glaring disparities in the health and well-being of women and children from these households. 

Adequate nutrition is fundamental to the overall well-being of a community because good nutrition impacts more than just physical health. Good maternal nutrition during pregnancy fuels the development of a baby’s rapidly growing brain so by the time that a baby is born, their brain will contain 100 billion neurons. We also know, for example, that children with access to healthier, more nutritious meals are better able to concentrate in school and enjoy better educational outcomes. Similarly, adults who can easily access and maintain a healthy diet benefit from improved health and economic opportunities. Addressing inequities in access to healthy and nutritious foods cannot be ignored. We must prioritize interventions that give every family the opportunity to be healthy.  

To that end, there are a number of programs that merit continued support and strong expansions, such as the Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the Child and Adult Care Food Program (CACFP). For example, WIC has bridged the gap between medicine, food, and nutrition better than almost any federal program, leading to improved nutrition intake, healthier pregnancies and improved birth outcomes. Congress has temporarily increased the overall value of WIC’s fruit and vegetable benefit (or Cash Value Benefit (CVB)) through the end of September 2022. So far, this has led to better access to nutritious foods for over 4.7 million WIC participants. Making the increased benefit permanent will significantly close nutrition gaps for women and their children. 

Improving nutrition also means supporting programs like the recently expired monthly Child Tax Credit (CTC). The revamped CTC monthly payment proved to have an astonishing impact on lifting children and families out of poverty. In 2021, Congress expanded the CTC and made the full credit available to low-income families who previously did not qualify because their earnings were too low. Families were allowed to receive the credit in monthly increments, which was vital in helping families with their everyday expenses like buying nutritious food. It is estimated that 3.7 million children were kept out of poverty in December 2001 when the last child tax credit payments were made. Further, nearly half of families who received the tax credits used the extra funds to purchase food helping to address nutrition insecurity around the country. In January, the first month without the deposits, those gains were lost and 3.7 million children again fell into poverty. 

But we must support the overall health and well-being of women and families with comprehensive approaches to address the root causes of poverty and malnutrition. Employers must implement family-friendly policies and programs in workplaces and communities to support women at home and at work. This includes providing workers with sufficient paid family leave, as well as ensuring equitable access to the lactation services and support women need to meet their breastfeeding goals. These policies help make the workplace and our society a safe and enabling environment. The recent pandemic and subsequent inflation have highlighted not only the critical nature of poverty and nutrition programs, but also the vulnerabilities and gaps in supporting those who need it most. All future policies must prioritize making programs more equitable and effective. While Congress has many competing priorities, we know that voters across all demographics deeply care about ensuring women and their children have access to the nutrition they need to be healthy. For example, a recent bipartisan poll by ALG Research/McLaughlin & Associates, on behalf of the National WIC Association and Alliance to End Hunger, reveals strong support for WIC among likely 2022 voters – 83% total support for the program, and approximately 75% support for expanding the value of the WIC food package, expanding postpartum eligibility, and modernizing WIC services.  

This week, let’s reflect once again on the fundamental importance of nutrition for women and girls across the country, and urge Congress to make access to healthy foods and investment in nutrition programs a priority. Ensuring the health and well-being of those who are pregnant and their children is critically important to our nation’s future and requires both focus and determination of policymakers and advocates. 

1,000 Days, an initiative of FHI Solutions, fights to win support for policies and investments in the wellbeing of mothers, babies and toddlers in the U.S. and around the world. 

Alliance to End Hunger unites diverse sectors to address today’s hunger and malnutrition needs and to solve the root causes of hunger at home and abroad. 

Paid Family Medical Leave Remains Critical for Low-Income Pregnant and Postpartum Women

By: Daphna Dror, PHD, RD

The lack of national, comprehensive, and paid family medical leave in the United States has significant consequences for low-income women, especially those who are pregnant or have recently given birth. Many women risk their own or their child’s health to continue working throughout pregnancy and the early postpartum period in order to pay bills and provide for dependents. Only seven states and the District of Columbia have passed their own paid leave programs, meaning far too many new mothers must choose between caring for themselves and bonding with their newborn or making ends meet. 

Paid leave:

  • Supports healthier pregnancies. Financial concerns due to lost wages may prevent low-income women from seeking regular prenatal care, which itself is associated with better pregnancy and birth outcomes. Paid leave reduces the risk of preterm birth, low birthweight, and infant mortality (1). 
  • Increases breastfeeding initiation and duration. The American Academy of Pediatrics recommends exclusive breastfeeding for 6 months followed by a combination of complementary foods and breastmilk for at least 12 months (2), yet new mothers who plan to return to work before 12 weeks or to work full time are less likely to opt for exclusive breastfeeding (3). A recently published study of participants in the USDA Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) found that amongst women who had worked prenatally, returning to work within 3 months postpartum significantly decreased the odds of breastfeeding for the first year (4). Paid time off can alleviate the financial stress of combining work and breastfeeding (5,6).
  • Improves the physical and mental health of mother and baby postpartum. While postpartum depression (PPD) occurs in approximately 11% of all US mothers, a qualitative study in low-income women found that 35% experienced PPD or sadness (1). Nearly one third of low-income mothers who returned to work reported that employers were not understanding of postpartum needs, most commonly requiring more time off (1). Mothers who have access to paid leave and other work accommodations can minimize financial strain and career disruptions while improving their own health, their baby’s health and their bond with their baby.
  • Reduces maternal and infant racial and ethnic disparities. Women of color are disproportionately affected by lack of access to paid leave, exacerbating perinatal health disparities (7). Compared with Caucasians, African-American mothers in the United States are more than three times as likely to die of pregnancy-related causes (8); infants born to African-American mothers have more than twice the mortality rate of infants born to Caucasian mothers (9). Women of color are overrepresented in part-time, seasonal, and low-wage jobs, employment categories least likely to offer paid leave (7).

Of 41 high- and middle-income countries, the U.S. is unique in lacking nationwide paid maternity leave, paternity leave, or parental leave (10). Only 19% of U.S. workers have access to paid family medical leave, with even lower access amongst those who work part-time, in low-wage industries, at small firms, or who are not unionized (11). Universal access to paid family leave is imperative to ensure that all families in the United States have a healthy first 1,000 days and a strong foundation to thrive.

References

1.     McClanahan Associates, Inc., 1,000 Days. Qualitative Paid Leave Report: Furthering our Case for Paid Leave in the United States.

2.     Eidelman AI, Schanler RJ. Breastfeeding and the Use of Human Milk. Pediatrics. 2012 Mar;129(3):e827-41.

3.     Mirkovic KR, Perrine CG, Scanlon KS, Grummer-Strawn LM. In the United States, a Mother’s Plans for Infant Feeding Are Associated with Her Plans for Employment. J Hum Lact. 2014 Aug;30(3):292–7.

4.     Hamner HC, Chiang KV, Li R. Returning to Work and Breastfeeding Duration at 12 Months, WIC Infant and Toddler Feeding Practices Study-2. Breastfeed Med. 2021 Dec;16(12):956–64.

5.     Rojjanasrirat W, Sousa VD. Perceptions of breastfeeding and planned return to work or school among low-income pregnant women in the USA. J Clin Nurs. 2010 Jul;19(13–14):2014–22.

6.     Johnson AM, Kirk R, Muzik M. Overcoming Workplace Barriers: A Focus Group Study Exploring African American Mothers’ Needs for Workplace Breastfeeding Support. J Hum Lact. 2015 Aug;31(3):425–33.

7.     Goodman JM, Williams C, Dow WH. Racial/ethnic inequities in paid parental leave access. Health Equity. 2021 Oct 13;5(1):738–49.

8.     Howell EA. Reducing disparities in severe maternal morbidity and mortality. Clin Obstet Gynecol. 2018 Jun;61(2):387–99.

9.     Ely DM. Infant Mortality in the United States, 2018: DataFrom the Period Linked Birth/Infant Death File. National Center for Health Statistics; 2020 Jul.

10.     Chzhen Y, Gromada A, Rees G. Are the World’s Richest Countries Family Friendly? Policy in the OECD and EU. Florence, Italy: UNICEF Office of Research; 2019.

11.     National Compensation Survey: Employee Benefits in the United States. U.S. Department of Labor, U.S. Bureau of Labor Statistics; 2019 Mar.

Three Big Things a White House Conference on Nutrition Must Deliver

Image credit: Diego Cambiaso

After more than 50 years, a White House Conference on Food, Nutrition, Hunger and Health is within our grasp. The first conference in 1969 resulted in some of today’s most critical programs to improve food security and nutrition such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), Supplemental Nutrition Assistance Program (SNAP), and the National School Breakfast and Lunch Program. Revisiting this pivotal conference gives us an additional opportunity to build upon gains over the last five decades to continue to create conditions for families to thrive. And there is no better place to start than from action at the People’ House.

The next White House Conference, to be held in 2022, provides an opportunity to align government, industry, academia, civil society, health care providers, public health and philanthropy around a roadmap to end hunger and improve nutrition and health.

1,000 Days works every day to create a healthier and more equitable future for all pregnant, birthing, postpartum, and parenting people and their children. We lead the fight to build a strong foundation for mothers, children, and families to thrive. The first 1,000 days from pregnancy to age 2 offer a window of opportunity to create a healthier and more equitable future for all.

What three things should this White House conference deliver to fully realize this opportunity for parents and children?

1.  Unity. The science and interventions known to have the greatest return on investment must be prioritized. We know that poor nutrition in the first 1,000 days can cause irreversible damage to a child’s growing brain, affecting their ability to do well in school and earn a good living—and making it harder for a child and their family to rise out of poverty. It can also set the stage for obesity, diabetes, and other chronic diseases which can lead to a lifetime of health problems. The government, philanthropy, private sector and civil society together must embrace and unify around the irreputable science that nutrition for the mother during pregnancy, while breastfeeding and the right nutrition through infancy and toddlerhood, is the most impactful, critical time.

2.  Equity. Factors such as the color of our skin or the neighborhood we live in should not affect our health and well-being; however, this is a reality in many communities. Social determinants of health, which are conditions in the places where people live, learn, work, and play – as well as the chronic stress that comes from issues of inequity, like racism – mean that some families do not have access to the resources and support they need to be healthy and prosper during the first 1,000 days and beyond. In particular, families of color and low-income families are more often overburdened and under-resourced. As a result, there are glaring disparities in the health and well-being of moms and babies from these communities. Addressing inequity in access to healthy and nutritious foods cannot be ignored. We must prioritize interventions that support every family to have an opportunity to be healthy.

3.  Action. There is no time to lose. The last White House conference yielded some of the greatest nutrition programs that have continued to save and enhance lives through generations. A focus on identifying specific actions across various sectors must be built into the conference goals from the start. We must be bold, think big, reach across the aisle and not be afraid do whatever it takes to put families on a better path. The White House conference can convene leaders who have the power and influence to drive action for immediate and long-term benefits to families and children.

We stand ready to support a strong, unifying, equitable and action-focused White House Conference on Nutrition and help serve as a voice for the millions of families whose lives are impacted every day by a lack of access to healthy and nutritious foods during the critical 1,000 days.

Nutrition Bills We Support that Protect Families in their 1,000-day Window

The nutrition that people receive leading up to and throughout their pregnancy, as well as the nutrition their babies receive in the earliest years of life, has a profound impact on a child’s ability to grow, learn, and thrive. This month, in honor of National Nutrition Month and as part of our annual #March4Nutrition campaign, 1,000 Days is highlighting some of the nutrition (including breastfeeding-related) legislation that we support. It is our hope that, with these bills enacted, moms, babies, and their families here in the U.S. and around the world will receive the support and resources they need to begin to build a healthier future.

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC):

H.R. 2011 / S. 853, the Wise Investments in our Children (WIC) Act (Rep. Rosa DeLauro, D-CT, and Rep. Jenniffer Gonzalez-Colon, R-PR; Sen. Robert Casey, D-PA, and Sen. Susan Collins, R-ME)

These bills extend WIC eligibility, for women to two years postpartum and allow children to receive benefits through their sixth birthday. It also extends the program certification to two years, which makes it easier for people to continue to receive WIC benefits.

H.R. 4455, the WIC for Kids Act (Rep. Jahana Hayes, D-CT, and Rep. Jenniffer Gonzalez-Colon, R-PR)

This bill makes it easier for families to participate in WIC by providing automatic eligibility to pregnant and postpartum people and children who participate in SNAP, CHIP, Head Start, or Food Distribution Program on Indian Reservations. It also extends postpartum eligibility and aligns family certification windows.

H.R. 6781/ S. 3326, the MODERN WIC Act (Rep. Andy Leven, D-MI, and Rep. Jaime Herrera Beutler, R-WA; Sen. Kirsten Gillibrand, D-NY, and Sen. Roger Marshall, R-KS)

These bills make it easier for families to apply for WIC by revising in-person application requirements to allow for video or telephone certifications. It also allows for remote benefit issuance and provides an annual investment in technology upgrades to support the WIC program.

Child and Adult Care Food Program (CACFP):

S. 1270, the Access to Healthy Food for Young Children Act (Sen. Robert Casey, D-PA)

This bill supports improved nutritional value of meals and snacks in child and adult care settings by increasing CACFP reimbursement values by 10 cents per meal.  It also streamlines paperwork requirements for child care centers in high poverty areas, making it easier for centers to participate in the program and provide nutritious meals and snacks.

H.R. 5919, the Early Childhood Nutrition Improvement Act (Rep. Suzanne Bonamici, D-OR, and Rep. Jaime Herrera Beutler, R-WA)

This bill allows for CACFP providers to serve an additional meal or snack to children in care for a full day and streamlines the certification progress for new providers, expanding access to the program.

 Breastfeeding:

H.R. 3110 / S. 1658, the Providing Urgent Maternal Protections (PUMP) for Nursing Mothers Act (Rep. Carolyn Maloney, D-NY, and Rep. Jaime Herrera Beutler, R-WA; Sen. Jeff Merkley, D-OR, and Sen. Lisa Murkowski, R-AK)

These bills would expand access to accommodations for expressing breast milk in the workplace, extending protections in the 2010 Break Time law to 9 million currently excluded workers, including teachers and nurses.

H.R. 804 / S. 248, the Family and Medical Insurance Leave (FAMILY) Act (Rep. Rosa DeLauro, D-CT; Sen. Kirsten Gillibrand, D-NY)

These bills would provide comprehensive paid family and medical leave of up to 12 weeks to all workers in the United States. Categorically recognizing paid leave as a public health imperative, this bill has the potential to transform the lives of moms and babies. As research shows, paid leave supports breastfeeding initiation and duration in a number of ways. For example, a mother is more than twice as likely to stop breastfeeding in the month she returns to work compared to a mother who has not yet returned to work.

Global Malnutrition:

H.R. 4693 / S. 2956 the Global Malnutrition Prevention and Treatment Act of 2021 (Rep. Gregory Meeks, D-NY, Rep. Michael McCaul, R-TX, Rep. Chrissy Houlahan (D-PA), and Rep. Young Kim, R-CA; Sen. Chris Coons, D-DE, Sen. Roger Wicker, R-MS, Sen. Tim Kaine, D-VA, and Sen. John Boozman, R-AR)

These bills will bolster the federal government’s efforts to address global malnutrition and build resilience, particularly as the world continues to respond to and recover from COVID-19 and other global shocks. Additionally, it will authorize USAID to advance targeted interventions to prevent and treat malnutrition around the world, ensure a continued focus on multi-sectoral nutrition programs, and require robust monitoring of these interventions to ensure effective use of taxpayer dollars.

The Impact of MMS on Moms and Babies

Official title: Modifiers of the effect of maternal multiple micronutrient supplementation on stillbirth, birth outcomes, and infant mortality: a meta-analysis of individual patient data from 17 randomised trials in low-income and middle-income countries

Published: November 2017

Publication: The Lancet Global Health

Authors: Emily R Smith, Anuraj H Shankar, Lee S-F Wu, Said Aboud, Seth Adu-Afarwuah, Hasmot Ali, Rina Agustina, Shams Arifeen, Per Ashorn, Zulfiqar A Bhutta, Parul Christian, Delanjathan Devakumar, Kathryn G Dewey, Henrik Friis, Exnevia Gomo, Piyush Gupta, Pernille Kæstel, Patrick Kolsteren, Hermann Lanou, Kenneth Maleta, Aissa Mamadoultaibou, Gernard Msamanga, David Osrin, Lars-Åke Persson, Usha Ramakrishnan, Juan A Rivera, Arjumand Rizvi, H P S Sachdev, Willy Urassa, Keith P West Jr, Noel Zagre, Lingxia Ze

Read the original paper here.

Summary 

  • Pregnant women need extra nutrition for themselves and their babies.
  • Many pregnant women don’t get enough nutrients from the food they eat.  
  • Micronutrient deficiencies during pregnancy put both mothers and babies at risk of birth complications and death.
  • Lack of nutrients in this critical period can prevent children from reaching their full physical and mental potential.
  • To help avoid this, nutrition programs often give pregnant women iron and folic acid (IFA) to supplement the nutrients they get from the food they eat.
  • Recent research has suggested that women might be better off if they got a multiple micronutrient supplement (MMS) instead of just iron and folic acid (IFA). 
  • Researchers have been trying to figure out if MMS is safe, effective, and cheap enough to recommend switching out IFA and replacing it with MMS
  • This paper analyzed 17 different studies testing MMS and IFA.
  • The analysis found that compared to IFA, MMS:
    1. Reduced the risk of low birthweight babies, preterm babies, and small babies.
    2. Reduced the number of infant deaths in the days after birth, especially for girls. 
    3. Reduced the number of kids who were born to anemic mothers and died before 6 months.
    4. Reduced the number of preterm births.
  • Researchers also discovered something they hadn’t known before: The benefits of taking MMS during pregnancy instead of IFA were even bigger if moms were malnourished. Malnourished women who took MMS while they were pregnant saw an even greater decrease in low bithweight, preterm, and small births compared to malnourished women who only took IFA while they were pregnant. 
  • The studies didn’t find any negative effects of taking MMS

 

Conclusions

  • MMS is safe and more effective than IFA at preventing multiple conditions and death in newborns and babies, especially when moms are malnourished. 
  • The WHO should consider updating its guidelines to reflect the benefits of MMS

1,000 Days Statement on President’s FY 2023 Budget

This week, the Biden Administration released their budget proposal for fiscal year 2023. While we are thankful for the Administration’s prioritization of investments in programs that support families living in the United States, we are disappointed with their proposed investments in accounts that support global maternal and child health and nutrition.

These investments, both domestically and globally, greatly contribute to the reduction of child mortality and support long-term health, cognitive development, physical growth, and school and work performance later in life. A child’s first 1,000 days are shaped not only by the decisions made by their parents and caregivers, but also by broader societal and economic factors. We are compelled to demonstrate a sense of urgency for policymakers to act during a child’s first 1,000 days, because we know that failure to do so can have lasting, irreversible consequences for children, their families and society.

We were pleased to see significant funding for several 1,000 Days’ key priorities for families living in the United States, including:

  • $6 billion for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), including funding to continue the enhanced Cash Value Benefits for fruits and vegetables and investment in critical research on maternal mortality as well as infant and toddler feeding.
  • $470 million to reduce maternal mortality and morbidity rates, expand maternal health initiatives in rural communities and address the highest rates of perinatal health disparities, including by supporting the perinatal health workforce.
  • Extending and increasing funding for the Maternal, Infant, and Early Childhood Home Visiting Program, which serves families at risk for poor maternal and child health outcomes each year and is proven to reduce disparities in infant mortality.
  • $97 million for the Office of Nutrition Research to advance nutrition science to promote health and reduce the burden of diet-related diseases.

Investments for families outside of the United States fall short. Globally, the FY23 President’s Budget Request of $879.5 billion for Maternal and Child Health and of $150 million for Global Nutrition programs are insufficient and inconsistent with the Administration’s stated priorities. These funding levels are lower than the funding allocated by Congress in the FY22 Omnibus. We are experiencing growing food and nutrition crises that are being exacerbated by global conflict, including in Ukraine, as well as disruptions from the COVID-19 pandemic, and the effects of climate change, which are all driving up food and fertilizer prices and disrupting health services. Now more than ever, we need robust investments in these core health and food security accounts that support fundamental development programming and work to make vulnerable countries more self-reliant and resilient to these unanticipated shocks.

We look forward to working with the Administration and colleagues in Congress to strengthen our FY23 appropriations with stronger global investments including:

  • $300 million in the Global Nutrition Subaccount
  • $1.1 billion for Maternal and Child Health, including $290 million for Gavi and $165 for polio
  • New and additional funding to support the United States’ flagship food security program, Feed the Future

The importance of food systems and the environment for nutrition

Published: 24 November 2020

Publication: The American Journal of Clinical Nutrition

Authors: Jessica Fanzo, Alexandra L Bellows, Marie L Spiker, Andrew L Thorne-Lyman, and Martin W Bloem

Read the original paper here.

Summary 

  • Food systems contribute to and are vulnerable to ongoing climate and environmental changes that threaten their sustainability
  • We’re going to need more research to tell us what food policy changes we should make to ensure everyone has access to nutritious food despite the impacts of climate change.
  • We need to think about this key question: how can both human and planetary health thrive while meeting the demands of a growing human population, and if we can’t have it all, what trade-offs are we willing to live with?

Background

  • Food systems involve the production, processing, packaging, distribution, marketing, purchasing, consumption, and waste of food.
  • By “transforming” (improving) food systems, we could make healthy food more accessible and reduce environmental impact 
  • We need a lot more research to figure out how best to structure this transformation
  • Silos within the field make this research harder

Research Gaps

The impact of climate change on food systems

  • The link between climate and food systems is getting more and more attention, but there are still a lot of gaps in our knowledge. Specifically, we need more research on:
    •  The “missing middle” of the food supply chain (aka anything other than people’s diets and agricultural production) 
    • How climate change will affect non-staple crops (most research to date has only looked at staple crops).
    • How to create context-specific policies (eg. financial incentives, targeted messaging campaigns etc.) that encourage/allow people to eat sustainable diets and how to measure whether these policies are working:

Food systems 

  • Diets. We need more information on:  
    • The best way to measure how sustainable someone’s diet is
    • How people’s diets are changing as incomes rise
    • Healthy, locally appropriate, and sustainable diets are sometimes at odds with one another. How should we prioritize?
      • “One of the shortcomings of the EAT–Lancet Commission report was that it provided a single healthy reference diet for the world, and did not take into account that healthy and sustainable diets may differ in their availability, accessibility, and cost at the global, regional, and individual levels. Even more so, what is considered healthy is not always sustainable, and what is considered a sustainable diet is not always a healthy one.”
  • Food safety. We need more information on:
    • The danger of using pesticides and chemicals, and whether these dangers affect consumer purchases.
    • The danger of plastics (in food packaging, production etc.).
  • Food loss and waste.  We need more information on:
    • How to measure and reduce food waste/loss.

Interesting Stats

  • “Some models suggest that changes in food availability due to climate change, specifically reduced availability of fruit and vegetables, are estimated to result in an additional 529,000 deaths by 2050.”
  • “Globally, agriculture and livestock production utilize ∼40% of arable land account for ∼70% of fresh water withdrawn for human purposes, and are responsible for ∼11% of GHG emissions (although some estimates range from 11% to 24% depending on what is counted).”
  • “​​Food wasted at the retail and consumer levels alone averages 1217 calories, 33 g protein, 6 g fiber, and 286 g Ca per person per day.”

Figure: Link between food systems and the environment

The COVID-19 crisis will exacerbate maternal and child undernutrition and child mortality in low- and middle-income countries

Published: July 2021

Publication: Nature Food

Authors: Saskia Osendarp, Jonathan Kweku Akuoku , Robert E. Black , Derek Headey, Marie Ruel , Nick Scott , Meera Shekar, Neff Walker, Augustin Flory , Lawrence Haddad, David Laborde , Angela Stegmuller , Milan Thomas  and Rebecca Heidkamp

Read the original paper here.

Summary:

  • COVID-related disruptions to food and health systems mean cases of malnutrition around the world are likely to get worse.
    • People also have less money and therefor are turning to less expensive sources of calories such as starchy staples and eating fewer nutrient-dense foods.
  • The study authors used statistical models to predict what these disruptions would do to malnutrition rates.
  • They calculated “optimistic”, “moderate” and “pessimistic” outcomes.
  • After the paper’s publication, the authors stated the pessimistic outcomes are the most likely.
  • Using the pessimistic model as the authors recommend, they predict that by the end of 2022, COVID-19-related disruptions could result in an additional:
    • 13.6  million wasted children 
    • 3.6 million stunted children 
    • 283,000 additional child deaths
    • 4.8 million maternal anaemia cases
    • 3 million children born to women with a low BMI 
    • US$44.3 billion in future productivity losses due to excess stunting and child mortality.
  • To make up for the demands of the projected undernutrition increases, the authors predict we will need an additional $1.7 billion per year.
  • The report also predicts that ODA for nutrition will be 19% less through 2030 than it would have been without COVID, accompanied by a similar decrease in domestic health budgets.
  • We could save a lot of babies from being born small, preterm or stillbirth by a) switching the prenatal vitamins we give out from iron folic acid (IFA) to multiple micronutrient supplements (MMS) and b) Give balanced energy and protein supplements to malnourished pregnant women.
  • The report argues1 that fewer children would be impacted if we move funding away from providing complementary foods and instead allocate resources toward:
    • Balanced energy protein supplementation
    • Breastfeeding promotion
    • IYCF counseling at 6–23 months of age in food-secure households
    • Wasting treatment
    • Vitamin A supplementation

  • These numbers should make it clear to decision makers that the pandemic is causing levels of undernutrition to rise in LMICs and that we need to urgently increase ODA and domestic funding to address this crisis.

Key Quotes:

  • “The COVID-19 pandemic has created a nutritional crisis in LMICs. Without swift and strategic responses by subnational, national, regional and international actors, COVID-19 will not only reverse years of progress and exacerbate disparities in disease, malnutrition and mortality, but will also jeopardize human capital development and economic growth for the next generation.”
  • “While women of reproductive age and young children are largely spared COVID-19’s direct effects (that is, serious disease and death), our projections demonstrate that, regardless of the scenario, the COVID-19 crisis is expected to have dramatic indirect effects on maternal and child undernutrition and child mortality in the current generation.”
  • “The nutritional impacts of the COVID-19 crisis could have massive, long-term productivity consequences that could extend to future generations. Poor nutrition during early life stunts both physical and cognitive development, affects schooling performance and adult productivity, increases the risks of overweight/obesity and diet-related non-communicable diseases later in life, and triggers the intergenerational transmission of malnutrition.”

1 The article notes that “The optimal results and allocative efficiency gains will vary across countries, depending on demographics, epidemiological factors and baseline intervention coverages, as well as context-specific costs, priority targets, delivery platforms and other constraints.”