Category: News

Why Improving Nutrition Overseas is an Inexpensive Way to Protect Americans

Written by Emma Feutl Kent

Strong Global Health Security (GHS) policies are essential to protect American borders from the spread of infectious diseases. While U.S. investments in GHS have supported partner countries with vaccination and disease surveillance, researchers are increasingly demonstrating the critical role malnutrition plays in spreading infectious diseases. Good nutrition fuels stronger immune systems that help protect people from getting sick and passing on diseases that threaten the United States. Nutrition interventions are also some of the most cost-effective global aid investments, generating up to $35 in economic returns on every dollar spent. Targeted nutrition programming is a low-cost, powerful tool in the effort to prevent and contain global health threats and should be a key component of our GHS strategy.

Malnutrition makes people sicker

Decades of evidence has established that malnourished people are much more likely to get sick and die from infectious diseases than those who are well-nourished. Malnutrition causes inflammation and severely weakens the body’s ability to produce antibodies and mount an effective immune response. This is especially true for children, whose developing immune systems are especially susceptible to malnutrition and disease. For example, malnutrition is the leading risk factor for tuberculosis and children with tuberculosis who are severely malnourished are four times more likely to die than their well-nourished peers. When malnutrition is widespread across a population, it also allows infectious diseases like measles and tuberculosis to take hold and spread more quickly from person to person. It can also undermine vaccine effectiveness and blunt their impact. In our interconnected world, the rapid spread of infectious diseases puts everyone at risk, even in places like the United States where severe malnutrition is rare. 

When sick people are malnourished, viruses are more likely to mutate

Perhaps most concerningly to the health security of Americans is the ways in which malnutrition can contribute to the ability of viruses to mutate, potentially making them more contagious and deadly. Researchers demonstrated this phenomenon in one study by infecting both healthy and malnourished mice with an influenza virus. Initially, the healthy mice remained unaffected by the virus while the malnourished mice got sick and died. However, when the researchers infected healthy mice with the virus taken from the malnourished mice, they found that the virus had mutated in a way that caused the healthy mice to get sick and die along with the malnourished ones. As the researcher concludes, poor nutritional status in the host may contribute to the emergence of new viral strains. This same phenomenon was found in humans when researchers studied the impact of micronutrient supplementation on polio virus mutations and found the number of mutations higher in malnourished patients. As we saw repeatedly during the COVID pandemic, mutations can cause illnesses to spread more quickly, be more deadly, and respond less well to treatment. Anything that increases the risk of mutations is therefore a significant concern that may prolong outbreaks globally and put lives and economic interests at risk here in the United States. 

Nutrition interventions overseas can protect Americans from getting sick

Though malnutrition is a force multiplier for global health threats, a suite of high-impact, cost-effective interventions could be affordably implemented today to dramatically improve our chances of preventing future outbreaks or pandemics. For example, a recent study in Jharkhand, India showed that providing inexpensive monthly food rations and micronutrients to vulnerable households reduced cases of tuberculosis by up to 48%. Similarly, vitamin A supplementation, which is one of the most cost-effective public health interventions, drastically reduces the risk of illness and death from diarrhea and measles. These and other targeted interventions can help act as a brake on the spread of infectious diseases and prevent them from reaching the United States. 

For these efforts to be most effective, however, we need to apply them where rates of malnutrition are highest. Many of the malnutrition hotspots exist in ‘development’ settings that won’t be reached by funding that is solely targeted at humanitarian disasters. Nutrition programs are some of the least expensive “best buys” in foreign aid and stand to generate massive returns in the form of American safety and prosperity. Incorporating targeted nutrition programming to complement the US Global Health Security strategy is a smart way to shore up these investments and generate the maximum returns for the American people.

 

The first 1,000 days: How early nutrition shapes health and development

Good nutrition in the first 1,000 days of life — from pregnancy to a child’s second birthday — is critical for a child’s health and development and economic prosperity. A well-nourished child is more likely to thrive in school, avoid illness, and escape poverty, bringing long-term benefits to families, communities, and economies.

In contrast, nutrient deficiencies during early childhood can lead to stunting and lower lifetime earnings. “Every $1 invested in nutrition brings a $23 return,” said Toyin Adewale-Gabriel, senior technical adviser, policy and advocacy, at FHI360’s Alive & Thrive project in Nigeria. Despite some progress, food insecurity is rising, and the world is not on track to meet any of the six global nutrition targets set for 2025, with some indicators worsening. Nearly 1 in 4 children are stunted, anemia rates among women aged 15 to 49 have risen, and progress on low birthweight and childhood overweight has stalled. With malnutrition threatening future generations, urgent investment is needed in maternal and child nutrition to break the cycle of poverty.

In the above video explainer, 1,000 Days partnered with Devex to explore the crucial role of nutrition in the first 1,000 days of life — not only for a child’s future but also for the prosperity of their country. Read the full story on Devex here.

The Best Investment in Public Health? Nutrition

Few investments offer as high a return as nutrition. Ensuring that women and children receive adequate nutrition in the first 1,000 days—from pregnancy to a child’s second birthday—yields economic, social, and health benefits that far outweigh the cost. Prioritizing nutrition isn’t just a moral imperative—it’s a wise economic decision.

That’s why we’re glad to see the world come together this week to recommit to fighting the global malnutrition crisis.

At the Nutrition for Growth (N4G) Summit in Paris, global leaders and organizations pledged over $27 billion to combat malnutrition. Philanthropies stepped up to the challenge, pledging more than $2 billion in new commitments.

Proven Nutrition Interventions with High ROI

We know what works in nutrition. Decades of research have proven the efficacy of nutrition interventions like providing prenatal vitamins to pregnant women (multiple micronutrient supplementation or MMS), exclusive and prolonged breastfeeding, vitamin A supplementation, food fortification, access for everyone to an affordable healthy diet and to supplemental nutritional support (Ready-to-Use Therapeutic Foods or RUTFs) for malnourished children.

We know the problem is large. Half of all child deaths are caused by undernutrition. 1 in 3 people around the world cannot afford a healthy diet. Without sufficient protein, vitamins, and essential micronutrients, children remain at higher risk of illness, developmental delays, and long-term health issues.

And we know that nutrition is the smartest investment in public health, with the largest return on investment. Every $1 invested in nutrition yields $23 in economic returns. Malnutrition is a massive barrier to children achieving their educational and economic potential, but it also costs the world. Malnutrition can reduce a country’s GDP by up to 11% per year due to lost productivity, increased healthcare costs, and diminished human potential. Preventing malnutrition is also significantly more cost-effective than treating its consequences. Stunting and micronutrient deficiencies increase the risk of chronic diseases like diabetes and cardiovascular conditions, leading to billions in avoidable healthcare costs.

A Call to Action: Prioritize Nutrition Now

“Good nutrition is foundational to life and health, and it’s critical that we must marshal our resources to face this challenge.” – Dr. Nadra Franklin, Vice President of Global Nutrition at FHI 360

While the scale of the problem is large, there is cause for optimism: fewer children are dying from malnutrition than a few decades ago and the global stunting rate has halved since 1990. Investing in nutrition is an investment in stronger economies, healthier populations, and long-term stability. With continued investment, we can accelerate this progress.

During the Nutrition for Growth Summit, world leaders chose to commit to bold, evidence-based investments in nutrition. The choice is clear: investing in nutrition today builds a healthier, more prosperous tomorrow. The real question isn’t whether we can afford to invest in nutrition—it’s whether we can afford not to.

1,000 Days Statement on FY24 Minibus

Washington, D.C., March 25, 2024 –  Last Friday, Congress passed a fiscal year (FY) 2024 minibus spending bill, which includes funding for some key U.S. foreign assistance accounts that combat malnutrition. We applaud the passage of this bipartisan bill, while recognizing there is still work to be done to ensure all families have a happy and healthy first 1,000 days.

1,000 Days was grateful to see a modest increase to the Nutrition Account, but was dismayed that overall State, Foreign Operations, and Related Programs funding levels fell short of FY23 levels. For the first time in history, annual deaths of children under 5 have dropped below 5 million, a staggering decrease from 1990 when nearly 13 million children under 5 died each year. While we celebrate this incredible progress, now is not the time to take our foot off the gas. Globally, there is still 1 child death every 6 seconds and nearly 1 in 4 children worldwide has had their growth stunted by malnutrition. U.S. global leadership has reached families across the world with low-cost, quality, and effective health services and continued commitment is needed to end preventable maternal and child deaths.

“Malnutrition is still the greatest threat to child survival worldwide. U.S. investments support delivery of cost-effective, proven, life-saving services in countries around the world and maintaining that investment is crucial”

Solianna Meaza, Acting Initiative Director, 1,000 Days

We look forward to working with the Administration and colleagues in Congress to strengthen our FY25 appropriations with stronger global investments, including:

  • $300 million in the Global Nutrition Subaccount;
  • $1.15 billion for Maternal and Child Health, including $340 million for Gavi; and
  • New and additional funding to support the United States’ flagship food security program, Feed the Future.

This IWD, #InvestInWomen by Closing the Gender Nutrition Gap

Around the world, more than a billion adolescent girls and women suffer from undernutrition, micronutrient deficiencies and/or anemia. Malnutrition is robbing women of their earnings and energy, adolescent girls of their educational opportunities, and young girls of the chance to grow up to reach their full potential. Without tackling malnutrition, we will never reach gender equality.

The Nutrition for Growth (N4G) Summit is a global pledging moment that brings together governments, philanthropies, businesses, and NGOs to accelerate progress against malnutrition. The next N4G Summit will take place in early 2025 in Paris, France and will be a critical opportunity to spotlight women and girls’ nutrition.

This International Women’s Day, we are calling on governments and donors to prioritize women and girls’ futures by investing in closing the gender nutrition gap at N4G 2025.

Here are five key nutrition issues threatening women and girls, and some concrete solutions governments and donors can pledge to scale at the next N4G summit:

1. Women and adolescent girls face unequal burdens of micronutrient deficiencies, especially anemia.

Anemia is the number one threat to the long-term health of adolescent girls and afflicts almost one-third of women of reproductive age. Progress against anemia lags other nutrition achievements, and only one country (Guatemala) is on track to meet the globally agreed 2030 target on anemia. Meanwhile, deficiencies in vitamin and mineral status, particularly of folate, iron, vitamin A, and zinc, affect 67% of all women of reproductive age (WRA) worldwide. Micronutrient deficiencies can be life-threatening and cause extreme fatigue and poor concentration, hindering learning potential, educational attainment, and productivity. By scaling interventions that target anemia, we can cure millions of women and girls of this debilitating condition.

    Here are two actions that can help: 

    • Fortify staple foods with essential nutrients to prevent, reduce, and control micronutrient deficiencies at the population level.
    • Supply all pregnant women with multiple micronutrient supplements (MMS) with a focus on increasing adherence through improving availability combined with nutrition counseling in ANC services and mid and mass media communications.

    2. Climate change poses a disproportionate threat to women’s nutrition and food security.

    Climate change is increasing extreme weather events like heat waves, droughts, and floods, which impact food quantity, quality, and diversity. These climate shocks will put growing stress on food and nutrition security in the years to come. The food that does grow will be less nutritionally dense, which can lead to deficiencies in certain vitamins and minerals. Women are most likely to bear the brunt of this climate-related food insecurity. Not only are women more susceptible to micronutrient deficiencies, but women and girls are more likely to reduce their food intake and eat last and least in their households. Additionally, poorer regions and disadvantaged adolescent girls and women already bear the brunt of undernutrition and anemia and will be least equipped to respond to the climate impacts likely to hit many of these same regions the hardest. By investing in strategies to build resilience to climate-related malnutrition, we can mitigate some of these effects.  

      Here are two actions that can help: 

      • Promote long-term, climate-resilient food and nutrition security and protect the livelihoods of woman farmers by developing diverse, climate-resilient crop varieties. Contribute to initiatives like the Vision for Adapted Crops and Soils (VACS) Multi-Donor Fund hosted by IFAD.
      • Expand conditional cash transfers (CCTs) targeted to women to allow for greater flexibility in the face of humanitarian emergencies like natural disasters.

      3. Every year, millions of girls miss out on the opportunity to grow, learn, and earn to their full potential because of malnutrition they experience in early childhood.

        As we strive to address inequities in adult women’s nutrition, we must keep in mind the life-changing impact good nutrition can have on young girls today. Girls who are well-nourished are healthier, more productive, and more likely to finish and excel in school, be economically independent, and have healthy babies. Targeted nutrition interventions are a cost-effective way to give girls today a bright future and boost their chances of overcoming poverty and reaching their educational goals.  

        Here are three actions that can help: 

        • Protect large-scale Vitamin A supplementation to prevent vision problems, illness, and death.
        • Ensure children and their parents have access to quality nutrition counseling to promote dietary diversity and the consumption of animal-sourced foods.
        • Expand access to specialized foods (eg. RUTF and SQ-LNS) to prevent and treat child wasting 

        4. Women who choose to breastfeed often face workplace barriers and lack the support they need to be successful.

        Breastfeeding provides numerous benefits to both mothers and their babies. Breastfeeding gives all children the healthiest start in life and promotes cognitive development and acts as a baby’s first vaccine, providing critical protection from disease and death. It also reduces the burden of childhood and maternal illness, lowering health care costs, creating healthier families, and strengthening the development of nations. Family-friendly workplace policies promote gender equity and women’s economic participation, while strengthening the economy. By giving women the information and space they need to breastfeed successfully, they can be empowered to make an informed choice about how to feed their children.  

        Here are three actions that can help: 

        • Enact and promote adequate paid family leave, including maternity and parental leave, and breastfeeding breaks for women who chose to breastfeed.
        • Support breastfeeding mothers with one-to-one and group breastfeeding counseling.
        • Promote greater male engagement in infant and young child feeding (IYCF) to lessen the care burden for mothers.

        5. Commitments made at large pledging moments often lack accountability mechanisms.  

        Large pledging moments are critical for raising the profile of nutrition interventions, but they can only be truly successful if governments, philanthropies, businesses, and NGOs are held accountable for the commitments they make. This accountability requires commitment makers to invest in clear, quality data on spending, outputs, and outcomes.

        Here are three actions that can help:

        • Invest in strong nutrition data systems that ensure routine collection of data on girls and women to support effective policies and programs and to advocate for nutrition investment across sectors.
        • Improve accountability by tracking how global and national actors are currently investing in nutrition data and information systems.
        • Invest in global nutrition financing tracking system to improve coordination, resource mobilization, and resource allocation and regularly track progress on commitments made in the Nutrition Accountability Framework.

        Uniting to close the Gender Nutrition Gap

        Happy #March4Nutrition!

        As part of 1,000 Days’ annual #March4Nutrition campaign and alongside the Commission on the Status of Women, we’re excited to announce The Gender Nutrition Gap will be hosting an X (formerly Twitter) Chat on Wednesday, March 13th at 9:00 ET/14:00 CET.

        To participate, please create answers to our predetermined questions and be ready to tweet during the specified event time. Make sure your answers are posted either by a retweet or as a reply to the question. Be sure to include the hashtags #March4Nutrition and #GenderNutritionGap so your answers don’t get lost!

        See you on X!

        Find all the questions we’ll be asking and some suggested social media here!

        You can find the Gender Nutrition Gap on X, LinkedIn and Instagram, and on our website.

        Maximizing Potential: The Impact of Multiple Micronutrient Supplementation (MMS) for Improved Maternal and Child Health

        In the quest for improved maternal and child health and gender equality, we often overlook a fundamental intersection with the importance of good nutrition. The unique biological needs of women, gender disparities in access to food and services, and harmful social norms contribute to an ever-growing gender nutrition gap. During pregnancy, increased nutritional needs due to physical changes and the needs of a growing baby further exacerbate this gap. Micronutrient deficiencies during pregnancy put both mothers and babies at risk of birth complications, small vulnerable newborns, and even death, and the lack of nutrients in this critical period can prevent children from reaching their full physical and mental potential. Multiple Micronutrient Supplementation (MMS) during pregnancy provides a transformative solution to mitigating a wide array of harmful micronutrient deficiencies. During #March4Nutrition, we want to highlight MMS as a proven solution to meet the increased nutritional needs of women during pregnancy and further children’s growth, learning, and overall well-being.

        From Cradle to Career: The Lifelong Impact of Early Nutrition on Minds and Futures

        In the intricate dance of human development, the first 1,000 days emerge as a period of unparalleled significance, shaping the destinies of individuals and the key to unlocking potentials that extend far beyond childhood. During this crucial period, nutrition takes center stage, weaving a narrative that profoundly shapes not only the health and well-being of individuals but also the trajectory of entire generations. 

        Cognitive Development and IQ

        Scientific evidence consistently underscores the foundational role nutrition plays in cognitive development and education, making the profound impact on future generations ever clearer. A child’s brain begins to grow very early on in pregnancy and develops at an astonishing speed. At the 4th week of pregnancy, the brain has an estimated 10,000 cells—by the 24th week, it contains 10 billion. The nutrition that a baby gets from its mother through her diet is the fuel that drives much of this incredible transformation.

        The occurrence of malnutrition in the first 1,000 days can hinder brain development, leading to long-term cognitive impairment. Studies show that malnutrition-related delays in cognitive development are associated with up to an 18-point reduction in expected IQ. Additionally, peers. This isn’t a just statistical figure; it translates into tangible consequences for individuals, societies, and economies.

        Importantly, these differences persist from adolescence through mid-life, even for those who physically recover from malnutrition. An 18-point reduction in IQ is more than an entire standard deviation (IQ SD = 15 points), equating to a significant impact on an individual’s ability to contribute to society long-term.

        Investing in nutrition during the first 1,000 days becomes a strategic move to unlock the full cognitive potential of the next generation. It’s an investment in future creators, inventors, workers, and problem solvers who can drive societal progress and innovation. The implications of this investment ripple across sectors and economies, transcending individual outcomes to shape the very fabric of a nation’s intellectual capital. 

        “When you’re well nourished in your first 1,000 days, you grow taller, your brain development is better, you therefore complete more schooling and you add to your country’s economy. Across a population, this means huge shifts in better health and productivity, lifting families out of poverty, and boosting the prosperity of entire communities and nations.”

        Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation

        Education: The Bridge to a Brighter Tomorrow

        Nutrition isn’t just about physical health; it’s a cornerstone of educational success. Well-nourished children not only exhibit better concentration and cognitive abilities but also demonstrate increased attendance and participation in educational activities. The nexus between malnutrition and educational outcomes is a critical aspect that demands our attention. Children who undergo severe malnutrition, especially during the first 1,000 days, complete an average of 4.64 fewer years of schooling than their well-nourished peers. Those who experience severe malnutrition and remain in school often face challenges, performing more poorly and taking longer to complete each grade.

        Children who experience stunting, a consequence of malnutrition, score significantly lower on math and English tests, even when controlling for cognitive ability. The impact on learning processes, likely due to reduced focus and micronutrient deficiency, underscores the holistic nature of the challenge. Even mild episodes of malnutrition in utero, even in developed countries, can lead to significantly lower educational performance.

        Amidst the intricate tapestry of this narrative lies a pivotal thread on gender equality. Education becomes the key for girls aspiring towards a brighter future, representing one of the most critical investments in building a world where gender equality flourishes. Each additional year of schooling not only enhances a woman’s earnings by 10-20%, but it also acts as a catalyst for achieving financial independence, gradually closing the gender-based earning gap. A stark reality persists today, with over one billion women and girls lacking access to the adequate nutrition essential for their survival and flourishing. Bridging this “gender nutrition gap” becomes not only a matter of nourishing bodies, but also of empowering minds towards a more equitable future.

        The Economic Toll of Malnutrition

        Malnutrition is not just a health concern; it is an economic imperative. Research from the World Bank reveals a staggering reality – individuals facing malnutrition can lose up to 10 percent of their annual earnings due to reduced education and productivity. More alarmingly, they are 33 percent less likely to escape poverty as adults. This revelation underscores the urgent need for a paradigm shift in our approach to nutrition, viewing it not only as a health intervention but as an economic driver, the key to unlocking the cycle of poverty and the lifelong consequences rooted in malnutrition.

        The linkage between nutrition and future development outcomes is profound. Nutrition programming, particularly during the first 1,000 days, becomes the cornerstone for lifelong health, educational attainment, wages, and livelihoods. It is a holistic investment that not only improves individual well-being but also fortifies economies, fosters resilience to global shocks, and builds grey matter infrastructure – that is the infrastructure our children’s bodies and minds need to grow, learn, and thrive.

        Investing in nutrition in the first 1,000 days is not just a moral imperative; it is a strategic move to ensure that children reach their educational potential. By addressing the root causes of malnutrition and fostering an environment conducive to learning, we pave the way for a brighter and more educated future generation that can positively impact our society and economies. As we invest in the nutrition of the youngest members of society, we are, in essence, investing in the intellectual capital of our future workforce and leaders.

        In conclusion, the first 1,000 days represent a unique and invaluable opportunity to shape the trajectory of individuals, societies, and economies. Nutrition, as the linchpin connecting health, cognitive development, and education, becomes the catalyst for a brighter tomorrow. As we navigate the complexities of global development, let us recognize the transformative power of nourishment in building minds, nurturing futures, and fostering resilience in the face of global challenges. We call on everyone to join us and invest in nutrition.

        Understanding Nutrition in the First 1,000 Days: Black Moms and Birthing People

        To improve our advocacy and nutrition education efforts, 1,000 Days strove to understand sources of nutrition information during the first 1,000-day window and gaps in culturally relevant communications about healthy diets. Through a combination of qualitative research methods, including surveys and an environmental scan, we listened to over 225 Black pregnant and birthing people about their perceptions of their health, when and how they received nutrition information related to their pregnancy, and their preferred sources of information.

        Building Momentum for Nutrition

        Nutrition affects every aspect of human development: from children’s performance in school, to our ability to fight off diseases, to a nation’s health, and economic advancement.

        The 2021 Lancet Series on Maternal and Child Undernutrition Progress builds on previous research and provides an evidence-based agenda for how the global health and development community can improve the health and nutrition of today’s generation and all the generations ahead. The 2021 Lancet Series on nutrition presents updated information and builds on the 2008 and 2013 Lancet Series to set forth an evidence-based, global agenda for tackling undernutrition.

        Read More

        These critical 1,000 days lay the foundation for all the days that follow. How mothers and children are nourished and cared for during this time profoundly impacts a child’s physical growth, cognitive development, and lifelong health. Improving women’s and girls’ diets, access to nutrition services, and nutrition counseling – before and during pregnancy and while breastfeeding – are critical to preventing malnutrition among families and communities everywhere.