Beyond the Food Systems Summit: Linking Recommendations to Action-The True Cost of Food.

A transformation of food systems is needed to achieve the 17 Sustainable Development Goals specified in the 2030 Agenda for Sustainable Development. Recognizing the true costs and benefits of food production and consumption can help guide public policy decisions to effectively transform food systems in support of sustainable healthy diets. A new, expanded framework is presented that allows the quantification of costs and benefits in three domains: health, environmental, and social. The implications for policy makers are discussed. Curr Dev Nutr 2023;x:xx.

Policy relevance and the ethical conduct of science.

Scientific enquiry and the communication of science are essential to achieving development goals. The demand for evidence-based policy poses a challenge to maintaining the ethical conduct of science. The modern scientist faces intense competition in light of the changing nature of collaborative efforts, the quickening pace and increasing complexity of research endeavours and a growing emphasis on commercialisation of research results. Academic performance criteria continually change, becoming more demanding and increasing complex to measure. The integrity of the scientific community is challenged by cases of falsification, fabrication and plagiarism. The mass production of science outputs, evidenced by the incredible rise of predatory journals, poses risks for the veracity of science. Yet, scientists are not the only ones driven by performance targets. Under the constant scrutiny of governing boards, research and development funders-both public and private-are increasingly pressed to demonstrate outputs, outcomes and impact. There is an urgent need for independent research but also a need for consensus with regard to policy guidance. Consensus studies expect scientists to make sense of the available science and find a way of presenting the controversies, contradictions and convergence of evidence to guide policy decisions. Policy consensus dialogues can valorise science guidance. These practices adopt multidisciplinary approaches, bringing top-rated scientists from a variety of disciplines around the table to contribute best practice examples, share experiences and lessons learnt against the background of solid critique of existing research.

"The role of the man is to look for food": Lessons from men's involvement in maternal and child health programmes in rural Central Malawi.

Many studies purport that in low-income countries, women are often responsible for producing, preparing and purchasing food. Consequently, policies related to food and nutrition overemphasise the role of women, underestimating the potential for cooperation and complementarity between men and women. This focus on women does not account for socially constructed expectations of women that undermine their decision-making in resource allocation. Using desk reviews, in-depth interviews and focus group discussions, our case study in Malawi sought to understand the complementary role of men in maternal and child nutrition. International agreements and Malawi's policies were reviewed to understand how men's involvement emerged on the nutrition policy agenda. Policymakers, stakeholders and men and women from rural Central Malawi were interviewed, sharing their experiences of men's role in maternal and child health. The study found that men's involvement in maternal and child health has been on the development agenda since as early as 1995. Malawi has made efforts to involve men in these areas through several policy actions and programmes. Contrary to literature suggesting that women are the main producers, procurers and preparers of food, this study found that men in rural Central Malawi are increasingly becoming responsible for providing and purchasing food. Men also play a supportive role in food preparation, helping women access diverse diets during and after pregnancy. They also take up a supportive role in household activities, providing women with assistance in housework and looking after children. The positive change in men's roles presents an opportunity for exploring how men can contribute to food security and nutrition. Opportunities exist for designing inclusive food and agriculture policies that promote cooperation between men and women in food and nutrition. These policies can challenge misinterpretations of women's role in food security and the underlying systems that reinforce gender inequalities.

A qualitative analysis of men's involvement in maternal and child health as a policy intervention in rural Central Malawi.

BACKGROUND: Men's involvement in maternal and child health presents an opportunity for the advancement of maternal and child nutrition as men often play a key role in decision-making particularly regarding women's reproductive health. While most research on men's involvement in maternal and child health has focused on men's participation in antenatal care, this study focuses specifically on men's involvement in maternal and child nutrition. The purpose of the study is to explore how men's involvement is conceptualised in rural Central Malawi, highlighting the key factors influencing men's involvement in maternal and child health. METHODS: Focus group discussions and in-depth interviews were conducted with 26 informants and 44 community members. Critical policy was used as the theoretical framework to inform the analysis of research findings. RESULTS: In this study, we identified several factors that facilitate men's involvement in maternal and child health, but we also identified several barriers. Facilitators of men's involvement included: recognition by men of the impact of their involvement, pride, advocacy, incentives and disincentives and male champions. Barriers included socio-cultural beliefs, stigmatisation and opportunity costs. The study also found that there were several limitations that had unintended consequences on desired programme outcomes. These included: discriminating against women, marginalisation of married women and reinforcing men's decision-making roles. CONCLUSION: The study findings highlight the importance of involving men in maternal and child health for improved nutrition outcomes. We emphasise the need for nutrition policy-makers to be aware that gender dynamics are changing. It is no longer just women who are involved in nutrition activities, therefore policy-makers need to revise their approach to ensure that they consider men's role in nutrition.

A systematic review of sub-national food insecurity research in South Africa: Missed opportunities for policy insights.

Food insecurity is an intractable problem in South Africa. The country has a tradition of evidence-based decision making, grounded in the findings of national surveys. However, the rich insights from sub-national surveys remain a largely untapped resource for understandings of the contextual experience of food insecurity. A web-based search identified 169 sub-national food insecurity studies conducted in the post-apartheid period between 1994 and 2014. The systematic review found that the studies used 27 different measures of food insecurity, confounding the comparative analysis of food insecurity at this level. While social grants have brought a measure of poverty relief at household level, unaffordable diets were the root cause of food insecurity. The increasing consumption of cheaper, more available and preferred 'globalised' foods with high energy content and low nutritional value lead to overweight and obesity alongside child stunting. Unless a comparable set of indicators is used in such surveys, they are not able to provide comparable information on the scope and scale of the problem. Policy makers should be engaging with researchers to learn from these studies, while researchers need to share this wealth of sub-national study findings with government to strengthen food security planning, monitoring, and evaluation at all levels.

What are we measuring? Comparison of household food security indicators in the Eastern Cape Province, South Africa.

The development of national food security information systems is constrained by a lack of guidance on which indicators to use. This paper compares food security indicators across two seasons (summer and winter) in one of the most deprived areas of the Eastern Cape province of South Africa. The results show that only anthropometric indicators are sensitive enough to differentiate levels of food insecurity. The lack of consistent classification across indicators means that surveys must use a combination of food consumption and experience of hunger measures backed up by anthropometric measures. Targeting interventions is difficult if the measures cannot be relied on. Further investigation is needed to identify a suite of appropriate indicators for a national information and surveillance system.

Measuring household food security using food intake indicators in rural Kwazulu Natal, South Africa.

Estimation of micronutrients intake in food consumption surveys has generally been ignored. Focusing on similar households, a household food consumption survey (n = 200) was carried out in November 2004 (period of less) and March 2005 (period of plenty) in rural KwaZulu Natal, South Africa. Diet diversity, energy, protein and micronutrient intakes were proxies of household food security. Principal Component Analysis was used to estimate household food adequacy and strength of the variables (nutrients) in determining household intake variation amongst the community. On average, variation in household intake was contributed by energy (62.8%), iron (20.2%), protein (11.8%), vitamin E (3.8%), vitamin A (1.0%), and dietary diversity (0.3%). Linking food intake to household variables can generate plausible variables for measuring household food security.

Do food quality and food quantity talk the same? Lesson from household food security study in Embo, South Africa.

OBJECTIVES: Relating food diversity, quality, and intake is one of the key aspects in understanding household food security. This paper aimed at marying food intake and quality, both being measurement for food security. METHODS: A household food consumption survey (n=200) exploring food diversity, quality of foods, and their relation to food intake in Embo, a poor farming community in rural KwaZulu-Natal was carried out in November 2004 (period of insufficiency) and repeated in March 2005 (period of plenty). Household food intake strata were developed using matrices obtained from the Household Food Intake Index and nutritional adequacy ratios. Food quality was measured using food count and later using 5 food groups, namely, starches, vegetables and fruits, animal sourced foods, fats, and legumes. RESULTS: Single food count showed dietary diversity to be significantly different across households with different food intake during the period of plenty (P≤0.000). During the period of plenty, vegetable and fruits contributed significantly different proportions of energy (P≤0.000), protein (P≤0.006), iron (P≤0.020), and vitamin E (P≤0.006) to household food intake strata. Intake of vitamin A was more elastic as its intake variation from legumes, fats, and animal sourced foods was (P≤0.000), from starches (P≤0.008) and from vegetable and fruits (P≤0.064) during the second round. Starches are the most important food group to the community, whereas fats and animal sourced food groups are less important. CONCLUSIONS: The current study has been able to include food quality in food security studies. Seasonality accounts for variation in food quality. The South African food-based dietary guidelines are relevant to the Embo community.