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Improving the Health of Ourselves and Our Nation

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

March is National Nutrition Month. While the first impression we may get from hearing this is interpreting it as a challenge that seems simple and straightforward, the truth is that we as Americans are not great at nutritious eating.   

The U.S. Department of Agriculture (USDA), through its Healthy Eating Index reports,…“average diets in the U.S. do not conform to dietary recommendations.” The CDC reports that only small percentages of American adults consume the suggested amounts of fruits (12%) and vegetables (10%) daily. Poor nutrition can contribute to illness and death. Poor diets have been associated with nearly half of deaths from cardiometabolic diseases in the United States.

Developing healthier eating habits, while important, can be really challenging. These challenges are only further compounded for low-income families. Low-income households face additional challenges and tend to have fewer resources, less time for food preparation, and less access to healthy foods. Federal nutrition programs provide an opportunity to mitigate these challenges and support healthier diets.

The USDA defines nutrition security as consistent and equitable access to health, safe, affordable foods essential to optimal health and well-being. Nutrition security has become an important goal of federal nutrition programs alongside the long-standing goal of food security. We know that nutrition and food security are intertwined – a person cannot achieve nutrition security if they are food insecure. Unfortunately, food insecurity has been increasing.  Food insecurity increased sharply in 2022 across all populations. Across our country, an estimated 44 million people, including 13 million children, were living in food-insecure households.

Fortunately, most food-insecure households can turn to federal nutrition programs. These programs form a necessary food safety net, providing access to food and improving nutrition, health, household finances, academic outcomes for children and productivity for adults. They also have broad societal impacts such as supporting farmers and retailers, reducing healthcare costs and increasing gross domestic product.

Two key programs are the Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

SNAP is the largest federal nutrition program, with over 42 million people receiving a monthly shopping credit to be used at approved retailers including grocery stores, farmers markets, and online shopping. The size of the benefit depends on a variety of criteria, such as income and household size, and was recently raised to an average of approximately $5.45 per person per day.  This bump in the SNAP benefit was the result of a reevaluation of the Thrifty Food Plan, the basis of the SNAP benefit amount.

While the benefit is modest, it has a huge impact on program participants. SNAP helps families stretch their food budgets, putting nutritious foods within reach.  As reported by Center on Budget and Policy Priorities, “SNAP improves food security, offers benefits that enable families to purchase healthier diets, and frees up resources that can be used for health-promoting activities and needed medical care.” 

According to USDA, SNAP reduces the rate of food insecurity among participants by at least 30%, particularly among young children and the most food insecure families.  Participation in SNAP lays the foundation for greater nutrition security among participants. 

WIC differs from SNAP in specifically focusing on “nutritionally at-risk” mothers and children. In addition to offering health screenings and breastfeeding support, WIC families receive vouchers for foods meant to maximize healthy birth outcomes and child development.

WIC has demonstrated multiple nutrition and health benefits, including: decreasing fetal deaths and infant mortality; improving the growth of nutritionally at-risk infants and children; and significantly improving children’s diets. Children enrolled in WIC are more likely to have a regular source of medical care and up-to-date immunizations. WIC also prepares children for school by improving intellectual development.

National Nutrition Month is an opportunity to highlight the tremendous importance of these programs as we strive to improve the nation’s nutrition and health. It was great to see Congress recently invest an additional $1 billion in WIC to address growing need for this vital program.  Now Congress has another opportunity to help struggling families through continued protection of and investment in SNAP. We have the opportunity to use this month of action to not only look inwardly at our own nutritional choices, but also more broadly at what will make our nation as a whole healthier.

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.

        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.

        The highlight of our year: #March4Nutrition

        March is National Nutrition Month! Developed by our friends and colleagues at the Academy of Nutrition and Dietetics, every March we work to amplify the importance of nutrition for families in the first 1,000 days: the time between pregnancy and a baby’s second birthday.

        Throughout pregnancy, infancy and beyond, families need good nutrition, breastfeeding support, and nurturing care in order to thrive. Decades of research has shown that nutrition plays a foundational role in a child’s development and her country’s ability to prosper.

        We invite you to follow #March4Nutrition on Facebook, Instagram, LinkedIn, and Twitter all month long and join the conversation. Every week in March, we’ll dive deep into a new theme and explore how nutrition lays the foundation for brighter, healthier futures.

        Week 1 March 4-10: Thriving families – What if … families had access to quality nutrition services before, during and after pregnancy?  

        Week 2 March 11-17: Women’s nutrition and gender equity – What if … nutrition was seen as a key piece of achieving gender equity?  

        Week 3 March 18-24: Nutrition & food (in)security – What if … families had access to safe, affordable and nutritious foods? 

        Week 4 March 25-31: What we can do? – What if … our work could support moms, babies, and families in the United States and around the world to access nutritious food?

        At 1,000 Days, we believe that every family, everywhere deserves the opportunity to have a healthy 1,000-day window and beyond – and that starts with access to good nutrition.

        Join us this month as we #March4Nutrition for moms and babies!

        Find the social media toolkit here.

        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.

        1,000 Days Statement on Increased U.S. Infant Mortality Rates

        At 1,000 Days, we are deeply concerned by the recent CDC data revealing an increase in infant mortality in the United States for the first time in two decades. Our nation has one of the highest infant and maternal mortality rates of any wealthy country. This disheartening increase is a stark reminder of the urgent need for collective action to address the critical challenges facing maternal and child health in the United States.

        The CDC found that the overall infant mortality rate increased by 3% with significant increases for mothers aged 25-29. Mortality rates also climbed for preterm babies, male infants, and for infants born in Georgia, Iowa, Missouri and Texas. The data also shows a deepening divide along racial and ethnic lines with infant mortality rates for American Indian or Alaska Native women increasing by over 20%, from 7.4 deaths to over 9 deaths per 1,000 births, while rates for White women increased by about 3% from 4.36 deaths to 4.52 deaths per 1,000 births. Infant mortality rates for infants of Black women did not drastically increase but they continue to experience the highest overall rates of mortality with nearly 11 deaths per 1,000 births, or over double the mortality rate of White infants. The significant disparities in infant mortality rates among different racial groups highlight the pervasive impact of systemic inequities on health outcomes.

        1,000 Days remains dedicated to our mission of making the health and well-being of women and children in the first 1,000 days, from pregnancy to two years of age, a policy and funding priority. We call on Congress to continue investing in maternal and child health and services, recognizing that it is critical during the 1,000-day window to deliver nutrition and support for women and infants. Access to proper nutrition and comprehensive maternal health services is a right for all women and families, and it is imperative to ensure that no one is left behind. Strong policies and investments in this critical window are not only about saving lives today but also about nurturing healthier generations.

        A strong start in life is every child’s right, and we are committed to working alongside partners, communities, and policymakers to create a world where all children can thrive. The CDC’s findings reinforce the urgency of our mission, and we stand ready to collaborate and advocate for the changes needed to ensure better outcomes for everyone.

        Together, we can strive for a future where infant mortality is a rare and unacceptable tragedy. Join us in making a difference and securing a brighter future for the next generation.

        For more insights and information, please visit the CDC report here.

        1,000 Days Statement on Senate Finance Committee Paid Leave Hearing

        Senate Finance Committee Holds Hearing on Paid Leave

        This week, the Senate Finance Committee held a hearing on paid leave, highlighting the critical need for family and medical paid leave and how our current patchwork of paid leave policies falls short of supporting all infants and families. It also confirmed the importance of paid leave for workers, businesses, and the country.

        While there have been some gains in paid family leave over the past five years, the Bureau of Labor Statistics shows that only about 1 in 4 employees (27 percent) in the private sector workforce have access to paid family leave. Access to paid family leave is lower among those receiving lower wages or working part-time. People of color also have less access to paid family leave than their white counterparts.

        This lack of paid family leave means parents are often forced to choose between taking time off from work to care for their young children and earning the income they need to support their families. It means that 1 in 4 women in America return to work just 2 weeks after giving birth, putting their health and that of their infant at risk. Policies that enable parents to spend time nurturing and caring for their babies—particularly in the early weeks after birth and for babies that are born pre-term, low birthweight or with illness—are critical to the healthy cognitive, social, and emotional development of children.

        We applaud state, local and business-level efforts to increase access to paid family leave, but it is not enough to address this public health crisis. We need a national paid family and medical leave program that is comprehensive and covers all workers, including small business employees and the self-employed. Paid leave is the biggest obstacle to working women in the U.S. in the 1,000-day window and can reduce racial and ethnic health disparities. Our 2020 qualitative paid leave report highlights real stories from families without access to paid leave and the detrimental impacts it had on their family, including their health and the health of their baby.

        We appreciate the Senate Finance Committee’s thoughtful attention to this issue. We call on Congress to take the next step, moving legislation to enact a comprehensive national paid leave policy that supports mothers and families and ensures children get the strongest start to life.

        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.

        Advocating for Nutrition, Maternal and Child Health Funding

        From left to right: Dorothy Monza (RESULTS), Stephanie Hodges (1,000 Days), Andrew McNamee (Food for the Hungry), John Goetz (Legislative Correspondent for Sen. Tim Scott), Daren Caughron (Bread for the World)

        Each year, there is an appropriations process that determines the budget for the federal government and the programs that it carries out. The President releases a budget, which provides insight into an administration’s priority, but ultimately, it is up to Congress to draft and pass the budget for the federal government each fiscal year. 1,000 Days, an initiative of FHI Solutions, raises awareness of this process and engages every year to advocate for robust funding to support and promote maternal, newborn, and child health and nutrition.

        In partnership with the Maternal, Newborn, and Child Health Roundtable (MNCH RT), and representing the 1,000 Days Advocacy Working Group (AWG), 1,000 Days led and attended Hill meetings in both the House and Senate to advocate for funding increases for the Maternal and Child Health Account and the Nutrition account within the United States Agency for International Development (USAID). We conducted nearly 40 meetings and secured sign-ons to Dear Colleague letters from Democrats and Republicans in the House and Senate supporting these funding increases.

        In FY23, the nutrition account was funded at $160 million, and the maternal and child health account (MCH) was funded at $910 million. To address the malnutrition crisis and to meet the moment of increased health and nutrition needs, our International Non-Governmental Organization (INGO) community is requesting $1.15 billion for the MCH account, which includes $340 million for Gavi, the Vaccine Alliance, and $300 million for the nutrition account within USAID. 

        These additional investments can help close the food and nutrition insecurity gaps and pick up the pace on progress toward ending malnutrition which has slowed over the past 12 years. In 2021, 5 million children under age five died from mainly preventable and treatable diseases, with malnutrition as the underlying cause of roughly half of these deaths. Additionally, 300,000 women die annually of preventable causes related to pregnancy and childbirth. 

        The Nutrition account within USAID supports nutrition programs for women and children, focusing on the 1,000-day window, the time between pregnancy and a child’s second birthday. It is crucial to reach children and their caregivers early in life with interventions like breastfeeding support and vitamin A supplementation to prevent malnutrition. When children are malnourished, early detection and access to therapeutic foods can save lives. Severely malnourished children are much more likely to have weakened immune systems and are at risk of permanent physical and mental stunting, which prevents them from reaching their full educational, social, and earning potential. Malnutrition costs the world $3.5 trillion in lost productivity and healthcare costs each year. The current global food crisis, fueled by conflict, climate shocks and the threat of a global recession, continues to threaten the lives of women and children globally. Full funding of the nutrition account is critical for saving lives and reaching USAID’s goal of ending preventable child and maternal deaths.

        As Congress establishes budget levels for FY24, we urge them to include the increased funding levels for USAID and we will continue to advocate for these funding increases. If investments are not made in preventing and treating malnutrition and improving maternal and child health, we will continue to see backsliding of the progress made and lives lost. Now is the time to act to ensure mothers and children have the health and nutrition supports they need within the first 1,000 days and beyond.