Effects of short birth spacing on birth-order differences in child stunting: Evidence from India.

Do firstborn children have a height advantage? Empirical findings have found mostly that, yes, second or higher-order children often lag behind firstborns in height outcomes, especially in developing countries. However, empirical investigations of birth-order effects on child height overlook the potential impact that birth spacing can have. We provide an explanation for the negative birth-order effect on stunting outcomes for young Indian children and show it is driven by short preceding-birth spacing. We find that firstborn children are taller than children of higher birth order: The height-for-age gap for third (or higher)-order children is twice the gap for children second in birth order. However, this pattern is observed when spacing between later-born children and their immediate elder siblings is fewer than 3 y. Interestingly, the firstborn height advantage disappears when later-born children are born at least 3 y after their elder siblings. Thus, our findings indicate that spacing length between children explains differences in height, over birth order. Although India's family planning policy has resulted in a substantial reduction in total fertility, its achievement in spacing subsequent births has been less impressive. In showing that spacing can alleviate or aggravate birth-order effects on attained height, our study fills an evidence gap: Reducing fertility alone may not be sufficient in overcoming negative birth-order effects. To reduce the detrimental effects of birth order on child stunting, policy responses-and therefore research priorities-require a stronger focus on increasing the time period between births.

Spatiotemporal assessment of post-harvest mycotoxin contamination in rural North Indian food systems.

The spatiotemporal trends in aflatoxin B1 (AFB1), fumonisin B1 (FB1), and deoxynivalenol (DON) accumulation were analyzed in a range of food commodities (maize, groundnut, pearl millet, rice, and wheat) in village settings in Unnao, Uttar Pradesh, India. Samples (n = 1549) were collected across six communities and six time points spanning a calendar year and were analyzed for mycotoxins using enzyme-linked immunosorbent assays. AFB1 and FB1 were common across surveyed villages, with moderate to high detection rates (45-75%) observed across commodities. AFB1 levels in maize and groundnuts and FB1 levels in maize and pearl millet frequently exceeded regulatory threshold levels of 15 µg/kg (AFB1) and 2 µg/g (FB1). DON was analyzed in wheat, with 3% of samples yielding detectable levels and none exceeding 1 µg/g. In rice, AFB1 levels were highest in the bran and husk and lower in the kernel. Commodity type significantly influenced AFB1 detection status, while commodity type, season, and visual quality influenced samples' legal status. Storage characteristics and household socioeconomic status indicators did not have significant effects on contamination. No significant effects of any variables on FB1 detection or legal status were observed. Data on mycotoxin contamination, combined with data on local dietary intake, were used to estimate spatiotemporal mycotoxin exposure profiles. Estimated seasonal per capita exposure levels for AFB1 (5.4-39.3 ng/kg body weight/day) and FB1 (~0-2.4 µg/kg body weight/day) exceeded provisional maximum tolerable daily intake levels (1 ng/kg body weight/day for AFB1 and 2 µg/kg body weight/day for FB1) in some seasons and locations. This study demonstrates substantial dietary mycotoxin exposure risk in Unnao food systems and serves as an evidentiary foundation for participatory food safety intervention in the region.

Seasonal time trade-offs and nutrition outcomes for women in agriculture: Evidence from rural India.

Women in agriculture are involved in agricultural activities and are solely responsible for household-level unpaid work. They face severe time trade-offs between agricultural and household activities across crop seasons. Recent literature suggests that these time trade-offs may negatively impact their nutrition. However, there is no quantitative evidence exploring this relationship within an agricultural context. This paper addresses this research gap by analyzing the relationship between women's time trade-offs and their nutritional outcomes. Using a unique ten-month primary panel data of 960 women from India, our findings show that women are severely time-constrained, as they contribute significantly to agricultural as well as domestic work. Our results show that during peak seasons relative to lean seasons, women's time trade-offs (rising opportunity cost of time) are negatively associated with the intake of calories, proteins, iron,zinc and Vitamin A. We show that this negative relationship is manifested severely among women who are landless and cultivate paddy alone (food crop) or paddy and cotton (mixed crop). This study highlights the gendered role of agricultural activities in rural households and the need to recognize time as a scarce resource when implementing policies and programs involving women in agriculture. We contribute to the literature of agriculture-nutrition linkages by examining the the time use pathway in detail. Besides providing novel metrics, we discuss several policy implications to reduce women's time constraints and enhance their nutrition.

Monitoring the world's agriculture.

To feed the world without further damaging the planet, Jeffrey Sachs and 24 foodsystem experts call for a global data collection and dissemination network to track the myriad impacts of different farming practices.

Green revolution: impacts, limits, and the path ahead.

A detailed retrospective of the Green Revolution, its achievement and limits in terms of agricultural productivity improvement, and its broader impact at social, environmental, and economic levels is provided. Lessons learned and the strategic insights are reviewed as the world is preparing a "redux" version of the Green Revolution with more integrative environmental and social impact combined with agricultural and economic development. Core policy directions for Green Revolution 2.0 that enhance the spread and sustainable adoption of productivity enhancing technologies are specified.

Paths of convergence for agriculture, health, and wealth.

This special feature calls for forward thinking around paths of convergence for agriculture, health, and wealth. Such convergence aims for a richer integration of smallholder farmers into national and global agricultural and food systems, health systems, value chains, and markets. The articles identify analytical innovation, where disciplines intersect, and cross-sectoral action where single, linear, and siloed approaches have traditionally dominated. The issues addressed are framed by three main themes: (i) lessons related to agricultural and food market growth since the 1960s; (ii) experiences related to the integration of smallholder agriculture into national and global business agendas; and (iii) insights into convergence-building institutional design and policy, including a review of complexity science methods that can inform such processes. In this introductory article, we first discuss the perspectives generated for more impactful policy and action when these three themes converge. We then push thematic boundaries to elaborate a roadmap for a broader, solution-oriented, and transdisciplinary approach to science, policies, and actions. As the global urban population crosses the 50% mark, both smallholder and nonsmallholder agriculture are keys in forging rural-urban links, where both farm and nonfarm activities contribute to sustainable nutrition security. The roadmaps would harness the power of business to reduce hunger and poverty for millions of families, contribute to a better alignment between human biology and modern lifestyles, and stem the spread of noncommunicable chronic diseases.

Leveraging men's education as an effective pathway for improving diet quality: Evidence from rural India.

Investing in nutrition sensitive sectors such as education can be an effective strategy for combatting malnutrition. In this paper we analyze the role that men's education plays in determining dietary diversity outcomes using primary data from 3600 households across four districts of India. Dietary diversity scores were calculated to reflect the quality of food intake, for households and women. Men's education level was considered as the primary driver of diet diversity. To establish a causal link between men's education and diet diversity, the education level of parents and siblings were used as instrumental variables. We find that men's education levels are associated with significantly higher diet diversity scores both for the household and for women. The role of men's education continues to be a significant determinant of diet quality after controlling for household and individual- level confounding factors including the education level of the woman. The results are consistent across different definitions of the diet diversity score and reference period. Methodologically we extend the evidence on the education-nutrition pathway from being associational to causal in nature. Results from this study point to the benefits of leveraging men's education as an effective pathway for improving nutritional outcomes within households.

Effective monitoring of agriculture: a response.

The development of effective agricultural monitoring networks is essential to track, anticipate and manage changes in the social, economic and environmental aspects of agriculture. We welcome the perspective of Lindenmayer and Likens (J. Environ. Monit., 2011, 13, 1559) as published in the Journal of Environmental Monitoring on our earlier paper, "Monitoring the World's Agriculture" (Sachs et al., Nature, 2010, 466, 558-560). In this response, we address their three main critiques labeled as 'the passive approach', 'the problem with uniform metrics' and 'the problem with composite metrics'. We expand on specific research questions at the core of the network design, on the distinction between key universal and site-specific metrics to detect change over time and across scales, and on the need for composite metrics in decision-making. We believe that simultaneously measuring indicators of the three pillars of sustainability (environmentally sound, social responsible and economically viable) in an effectively integrated monitoring system will ultimately allow scientists and land managers alike to find solutions to the most pressing problems facing global food security.

Food loss of perishable produce from farm to retail: evidence from tomato supply chains in South India.

BACKGROUND: Reducing food loss and waste (FLW) may narrow gaps between fruit and vegetable production and recommended intake. However, FLW estimates are inconsistent due to varying estimation methods. OBJECTIVES: Using multiple estimation approaches, we examined the extent and determinants of FLW along tomato supply chains in South India, from farm to retail. We also explored tomato quality assessments. METHODS: We surveyed 75 farm households and 83 tomato traders in the Chittoor district, Andhra Pradesh, and 52 vegetable traders and 50 vegetable retailers in Hyderabad, Telangana, on harvest and market days. We calculated declared FLW values using participant-reported losses to estimate the preharvest quality FLW and quantitative FLW values at the farmer, vegetable-trader, and vegetable-retailer stages. We calculated the destination FLW based on counted crates diverted to loss destinations, using participant-reported destinations (animal feed, field discard), to estimate the postharvest FLW from farm to retail. We used pile sorting with farmers to explore on-farm quality assessments. RESULTS: The average preharvest quality FLW was 13.9% of harvested tomatoes. From farm to retail, the quantitative FLW was greatest at the postharvest, farm level. Among all harvests, the median postharvest, farm-level FLW was 0.0% (IQR, 0.0%-7.9%) using the destination FLW approach (tomatoes diverted to nonfood uses) and 2.3% (IQR, 0.0%-12.5%) using the declared FLW approach (P < 0.05). Among harvests with a non-zero postharvest, farm-level FLW, the median FLW was 9.1% (IQR, 2.4%-16.7%) using the destination FLW approach (tomatoes diverted to nonfood uses) and 10.0% (IQR, 2.9%-16.7%) using the declared FLW approach. Harvesting during peak season was a determinant of postharvest, farm-level and preauction, market-level FLW values. Farmers prioritize color/ripeness attributes while harvesting and tomato size while grading. CONCLUSIONS: Single-point estimates may obscure FLW patterns for perishable, indeterminate crops and depend on data collection and estimation methods. Reducing FLW of perishables requires the integration of quantitative and qualitative FLW estimation methods.

COVID-19 and women's nutrition security: panel data evidence from rural India.

In response to the COVID-19 pandemic, India implemented a stringent nationwide lockdown. Although food value chains and allied activities were exempted from the lockdown, there were widespread disruptions in food access and availability. Using two panel-datasets, we distinguish the pandemic's impact on non-staples versus staples in relation to household food availability and women's diet diversity at the national, state, and district levels in four economically backward districts of Uttar Pradesh (Maharajganj), Bihar (Munger), and Odisha (Kandhamal and Kalahandi). Both the primary and secondary data indicate a decline in household food expenditures and women's dietary diversity in May 2020 compared to May 2019, particularly for non-staples like meats, eggs, vegetables and fruits. This occurred despite special PDS, direct benefit transfer, and ration from aanganwadis rations reaching 80%, 50%, and 30% of surveyed households, respectively. While national and state-level expenditures recovered to the pre-lockdown levels by June 2020, the district-level expenditures did not recover. Our findings contribute to the growing body of evidence of women's disproportionate vulnerability to economic shocks, the impact of a staple grain focused safety net program, and restricted markets on the access and availability of diverse nutritious foods. This paper makes a case for policy reforms towards PDS diversification to include nutrition-rich foods and market reforms to remove supply-side bottlenecks and expansion of direct benefit transfers for healthy food access. We also highlight the importance of gender-responsive safety nets and their increased coverage for improving intrahousehold nutritional disadvantages.

Transitioning to an obese India: Demographic and structural determinants of the rapid rise in overweight incidence.

India, which has long suffered from undernutrition, has seen a rapid rise in overweight incidence in the last decade and a half. These changes are characterized by significant within-country differences in overweight incidence that vary by gender and regional development levels. In this paper, we provide an integrative framework, linking the income-gradient hypothesis of obesity with biological, obesogenic, and environmental factors to provide an explanation on the emergence of within-country differences in overweight patterns. We utilize measured body mass index (BMI), along with individual- and household-level data of over 800,000 men and women surveyed in the National Family Health Surveys of 2005-06 and 2015-16 to identify correlates of within-country differences in overweight incidence. A decomposition analysis reveals that among women, in addition to increasing access to obesogenic technologies, biological factors are associated with overweight incidence. Among men, obesogenic factors related to technology use and health behaviors are associated with the rise in overweight incidence, but biological factors are not. At lower levels of regional development, overweight incidence is associated with greater access to obesogenic technology such as motorized transport, which reduces physical activity among men at higher rates than women. At higher levels of economic development, obesogenic behaviors, such as watching more television and reducing smoking, are associated with overweight incidence. Our results corroborate the call by public health experts for group-specific policies to stem the rise of overweight incidence in developing countries.

Ground truthing the cost of achieving the EAT lancet recommended diets: Evidence from rural India.

In this paper, we quantify the divergence in the cost of current diets as compared to EAT Lancet recommendations at the subnational-level in India. We use primary data on food prices and household food purchases, and secondary data on food expenditures for a period of 12 months in 2018-19. The cost of the EAT Lancet dietary recommendations for rural India ranges between $3.00- $5.00 per person per day. In contrast, actual dietary intake at present is valued at around $1.00 per person per day. In order to get to the EAT Lancet recommendations individuals will have to spend nearly $1.00 per person per day more on each of meat fish poultry, dairy foods and fruits. The deficit in current diets relative to recommendations is marked by seasonal variations driven by volatility in the underlying food prices. This paper extends the evidence base for the affordability of the EAT Lancet diet to a subnational-level in India, using the most recent data on prices and expenditures, over time. We highlight the need for tracking rural markets at the subnational level, over time for their nutritional quality and ability to provide affordable, nutritious diets to the poor. Crop diversification, investments in rural infrastructure and well-functioning markets can move rural India towards more nutrition sensitive food environments.

Pandemics and food systems - towards a proactive food safety approach to disease prevention & management.

Recent large-scale pandemics such as the covid19, H1N1, Swine flu, Ebola and the Nipah virus, which impacted human health and livelihoods, have come about due to inadequate food systems safeguards to detect, trace and eliminate threats arising from zoonotic diseases. Such diseases are transmitted to humans through their interaction with animals in the food value chain including through the consumption of bush meat. Climate change has also facilitated the emergence of new zoonotic diseases. The lack of adequately enforced food-safety standards in managed agricultural production systems creates the necessary conditions for diseases to mutate into highly contagious strains. The lack of food safety measures in handling, packaging and sales of food increases risks of cross-species contamination. Finally, increasing anti-microbial resistance, combined with rapid urbanization and global interconnectedness allows diseases to spread rapidly among humans. Thus, part of the reconstruction efforts, post covid19, should include prioritizing proactive investments in food safety. The key to stave off another such pandemic lies in integrating one-health knowledge on zoonotic diseases along with food safety measures along the food value chain. Refocusing policy priorities from disease control to prevention will improve international coordination efforts in pandemic prevention. Implementing such proactive actions will cost a very small fraction of the reconstruction budgets. However, the expected benefits of the food-safety approach will include preventing global economic losses due to pandemics.

Are Women in Rural India Really Consuming a Less Diverse Diet?

BACKGROUND: It is widely considered that women have less diverse diets than other household members. However, it has been challenging to establish this empirically since women's diet diversity is measured differently from that of other household members. OBJECTIVE: In this article, we compare women's dietary diversity with that of their respective households and thereby generate a measure of "dietary gap." METHODS: We measure women's "dietary gap" by using the difference of homogenized household and woman dietary scores (using the same scales). This is done using primary data on 3600 households from 4 districts in India. Additionally, we show the robustness of our results to variations in scale and recall periods used to construct the diet diversity scores. RESULTS: Mean difference tests indicate that women consistently consume 0.1 to 0.5 fewer food groups relative to other household members, with the results being statistically significant at the 1% level. The food groups driving this dietary gap are nonstaples like Vitamin A-rich fruits and vegetables, meat/fish/poultry, and dairy. CONCLUSIONS: Results point toward the discrimination faced by women in the variety of the food consumed, the importance of considering comparability in creating indices of diet diversity, and the need to collect more detailed information on diets. To our knowledge, this is one of the first studies to examine dietary discrimination faced by women using common scales.

Market Access, Production Diversity, and Diet Diversity: Evidence From India.

BACKGROUND: Recent literature, largely from Africa, shows mixed effects of own-production on diet diversity. However, the role of own-production, relative to markets, in influencing food consumption becomes more pronounced as market integration increases. OBJECTIVE: This paper investigates the relative importance of two factors - production diversity and household market integration - for the intake of a nutritious diet by women and households in rural India. METHODS: Data analysis is based on primary data from an extensive agriculture-nutrition survey of 3600 Indian households that was collected in 2017. Dietary diversity scores are constructed for women and households is based on 24-hour and 7-day recall periods. Household market integration is measured as monthly household expenditure on key non-staple food groups. We measure production diversity in two ways - field-level and on-farm production diversity - in order to account for the cereal centric rice-wheat cropping system found in our study locations. The analysis is based on Ordinary Least Squares regressions where we control for a variety of village, household, and individual level covariates that affect food consumption, and village fixed effects. Robustness checks are done by way of using a Poisson regression specifications and 7-day recall period. RESULTS: Conventional measures of field-level production diversity, like the number of crops or food groups grown, have no significant association with diet diversity. In contrast, it is on-farm production diversity (the field-level cultivation of pulses and on-farm livestock management, and kitchen gardens in the longer run) that is significantly associated with improved dietary diversity scores, thus suggesting the importance of non-staples in improving both individual and household dietary diversity. Furthermore, market purchases of non-staples like pulses and dairy products are associated with a significantly higher dietary diversity. Other significant determinants of dietary diversity include women's literacy and awareness of nutrition. These results mostly remain robust to changes in the recall period of the diet diversity measure and the nature of the empirical specification. CONCLUSIONS: This study contributes to the scarce empirical evidence related to diets in India. Additionally, our results indicate some key intervention areas - promoting livestock rearing, strengthening households' market integration (for purchase of non-staples) and increasing women's awareness about nutrition. These are more impactful than raising production diversity.

Exploring aflatoxin contamination and household-level exposure risk in diverse Indian food systems.

The present study sought to identify household risk factors associated with aflatoxin contamination within and across diverse Indian food systems and to evaluate their utility in risk modeling. Samples (n = 595) of cereals, pulses, and oil seeds were collected from 160 households across four diverse districts of India and analyzed for aflatoxin B1 using enzyme-linked immunosorbent assay (ELISA). Demographic information, food and cropping systems, food management behaviors, and storage environments were profiled for each household. An aflatoxin detection risk index was developed based on household-level features and validated using a repeated 5-fold cross-validation approach. Across districts, between 30-80% of households yielded at least one contaminated sample. Aflatoxin B1 detection rates and mean contamination levels were highest in groundnut and maize, respectively, and lower in other crops. Landholding had a positive univariate effect on household aflatoxin detection, while storage conditions, product source, and the number of protective behaviors used by households did not show significant effects. Presence of groundnut, post-harvest grain washing, use of sack-based storage systems, and cultivation status (farming or non-farming) were identified as the most contributive variables in stepwise logistic regression and were used to generate a household-level risk index. The index had moderate classification accuracy (68% sensitivity and 62% specificity) and significantly correlated with village-wise aflatoxin detection rates. Spatial analysis revealed utility of the index for identifying at-risk localities and households. This study identified several key features associated with aflatoxin contamination in Indian food systems and demonstrated that household characteristics are substantially predictive of aflatoxin risk.

A research vision for food systems in the 2020s: Defying the status quo.

•Research and science should not only inform food and environmental policy but should be adopted and mainstreamed into actions at all levels.•Food systems are faced with grander and interconnected challenges and constraints that bring about new research questions.•Research has a vital role in charting a positive and sustainable direction for global food security, nutrition, and health.•The status quo must be challenged to shape food systems transformation to deliver sustainable, healthier diets.• Global Food Security provides a platform where evidence is shared in an accessible manner for those who need to act on it.

Nutritional outcomes of empowerment and market integration for women in rural India.

Over half of all women of reproductive age are affected by anaemia in India. In this paper we study the role that both household market integration and women's empowerment in agriculture can play in determining women's dietary diversity. Our analysis is based on primary data from 3600 households across India on agriculture, nutrition and anthropometric outcomes. We account for market integration by way of per capita household purchases (quantity) of cereals and non- cereal food groups, such as pulses, meat/ fish/ poultry, fruits and vegetables, eggs and dairy. We construct an adapted version of the Abbreviated Women's Empowerment in Agriculture Index (A-WEAI) that is context- specific and agriculture- oriented. After controlling for individual, household and village- level explanatory factors, we find that - for a given level of per capita market purchases - women who are empowered in their agricultural decisions have significantly higher dietary diversity scores relative to women who are disempowered of such decisions. More specifically it is women's empowerment in two areas: input in production decisions and membership in self- help groups that supports this result. Women's empowerment also enhances dietary diversity in the presence of disaggregated per capita purchases of non-cereals such as pulses, meat, dairy and eggs. This highlights the importance of reorienting India's agricultural price and procurement policies beyond staple grains to ensure better dietary diversity.

Understanding nutritional outcomes through gendered analysis of time-use patterns in semi-arid India.

The objective of this paper is to understand individual nutritional outcomes through an examination of gendered time use patterns. The analysis of the data from eight villages in the Semi-Arid Tropics (SAT), India confirm previous conclusions about the gendered influence of agricultural interventions, especially time demands on the rural poor. Agricultural interventions in the harsh, drought-prone environment of the SAT tend to increase the time burden on women. Sociological perspectives indicate that changes in time use patterns are also due to changing agricultural practices such as cropping patterns, type of productive work (farm to non-farm) among other factors, leading to variations in outcomes like nutrition for different members of the household. These changes demand innovative gender-responsive approaches and policies to leverage agriculture for nutrition and health. The paper concludes that empowering women through more information and control over income, assets and resources enhances their agency to make decisions for efficient time use, food consumption, sanitation and healthy practices. The authors opine that the context is important and policies must be based on sound data and rigorous analysis, including social and gender considerations.