For many years it has been understood that three different factors contribute to malnutrition in poor populations – a lack of nutritious foods, diseases, such as diarrhoeal disease in infants, and a lack of care. While we associate agriculture most closely with the first, agricultural practices may also contribute to disease, as livestock and humans share many similar pathogens, while the role which women play in providing agricultural labour may compete with the care of infants. However, most efforts by agricultural researchers to address malnutrition have focused on improving food production, and specifically the supply of calories to populations, by improving yields of high energy crops like cereals. Meanwhile, in the health sector, nutritionists have been focusing on identifying and delivering the right set of nutrients to malnourished populations, through food supplementation and fortification of staple energy foods with key micronutrients like vitamin A, zinc and iron.
It is now clear that addressing malnutrition cannot be achieved with these specific interventions alone, and we must turn back to agriculture to ensure that the diet of the poor is not only sufficient in calories, but nutritious as well. In principle, this is possible: pulses, vegetable, fruits and animal products are rich in micronutrients, and even cereal crops can be bred for greater nutritional value. But agricultural and health research directed at malnutrition has been separated and isolated for many years, as has the policy built on its results. Bringing these communities together around a common objective will be challenging. It will require finding a common approach and methods to understand how agricultural interventions affect health. The cross-sectoral and multidisciplinary Leverhulme Centre for Integrative Research on Agriculture and Health (LCIRAH) was established for this purpose.
In the past few years, we have seen a dramatic growth in research on agriculture for improved nutrition. An analysis just completed by LCIRAH for the UK Department for International Development (DFID), found 150 current research projects on this problem. Many of these projects are aimed at increasing the nutritional value of specific nutritious foods, like maize, sweet potato and sorghum, by improved breeding. Others are aimed at diversifying local agriculture, by including more vegetable, fish, milk or meat production through homestead gardens or keeping livestock. While some of these projects actually bring together agriculture and health researchers to develop the research projects, most still represent just agricultural innovations designed with an expectation of improving nutrition, but no means to measure this. So that is a challenge for the future.
We also found that current research is firmly focused on the rural poor, who are themselves mostly farming households, and their own food production and consumption. This bias reflects appropriately the distribution of poverty, but increasingly the poor in low income countries will be living in urban areas, where their food and nutrition is delivered through markets and longer food chains which are often poorly stocked in perishable sources of micronutrients like vegetables and animal products. In urban areas we are also seeing a dietary transition, from traditional to more energy dense, micronutrient-poor foods, often processed, which is causing malnutrition of a different kinds, and contributing to chronic disease amongst the poor. Improving agriculture for nutrition will need therefore to address challenges not only of production but of access and affordability of nutritious foods for rural and urban populations.
Contributed by Prof. Jeff Waage, Director, LIDC