Human Nutrition Discussion

Hello Friends. I wanted to share this recent publication from the Academy of Nutrition and Dietetics. The research is led by an organization ECHO has had the privilege of partnering with, the Mayan Health Alliance. You may already be aware of their excellent work.

https://www-sciencedirect-com.libezproxy2.syr.edu/science/article/pii/S2212267221002306

ALSO

Making the links between human nutrition and agriculture may seem intuitive and obvious, but I’ve found that in practice it’s not always so simple. I’d love to hear anyone’s reflections on this research.

In this project they compared two groups of families where children were experiencing stunting. The first group received a “standard care” intervention, provided by the Guatemalan government, which included supplementation, home nutrition visits, and nutrition education. The second group received the same, but also received home garden training.

In comparing the two groups the family that received the garden training had improved dietary diversity and decreased food security (the findings were not statistically significant).

This made me wonder if any ECHO community members are using measurements to assess diet within the communities they work with. If so, what are they?

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A fantastic issue for discussion and one that Food Plant Solutions (who I represent) is focused on. From our experience we have found that there is often a disconnect between nutrition and agriculture. Ask any agronomist what the nutritional value of the food plants they grow is, and most (if not all), will not be able to answer you. Likewise, ask a nutrition specialist how to sustainably grow nutritious plants and often they may not be able to answer you. Contrary to popular belief, there is a wealth of edible food plants in the world, over 32,000. Each country has hundred, (some have thousands) of edible plants know to grow there. And yet, worldwide we only eat a small portion of these.

We create educational materials that identify local food plants for a country or region that are high in the most beneficial nutrients (Iron, Zinc, Protein, Vit A, Vit C) and we include starchy staples. Our materials explain how to grow these plants, what parts are edible, photos, how to use the parts and nutritional information. We also include information on sustainable and ecologically sound growing practices.

Food Plant Solutions never sends people to a country, instead linking in with existing providers - they best know their communities and how to empower them. Changing diet is difficult and it’s a world-wide issue. We have found through our program partners that most parents want what is best for their children. And most will be doing what they think is best. Using our materials, in-country organisations explain what nutritious food is, why human bodies need it (and how they use it) and then what to grow and eat that will meet nutritional needs. Our materials are science based (our information comes from Bruce French’s Edible Plants of the World Database), and all materials are written in plain English. There are various levels of materials that are suited to varying degrees of literacy.

This approach is gradual but is proven to work, Many people now want quick fixes to everything; a supplement (as an example) for things missing from the diet. That only provides a short-term answer. What happens when the supplement is ceased, has the participants learnt anything that will enable them and their families to prosper in years to come? Our approach is long-term and sustainable.

All our materials are available free from our website www.foodplantsolutions.org or of course through ECHO.

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I’m not sure how I missed this important discussion. I’m Stacia Nordin, a Registered Dietitian working on environment, culture, and agriculture through permaculture design in Malawi since 1997. I met ECHO in 2013 because of nutrition.

I have caught up on a year of your posts and connect with so many - its a whole food system that needs to shift - not just the raising or processing or eating - all of it!

I cringe when I hear ‘Nutrition-Sensitive Agriculture’ and think - Absolutely NOT! Agriculture is the primary source of our nutrition and should not be relegated to something merely sensitive. Sensitive sounds secondary. The Lancet’s health centric research approach took us in a wrong direction when they divided up nutrition into specific and sensitive. It’s ok for research but not ok for life. We need language and actions that put nutrition central to our agriculture and food systems. What we say, and how we frame things, does matter.

For me the heart of the matter is mindset. I am disappointed at the way organisations promote their own species in foreign lands instead of celebrating and raising the status of indigenous foods. I am also dismayed about bio-fortification and fortification; seeds do not need to change - people and systems need to change. Organizations keep developing approaches that avoid the root causes of the issues instead of working on the issues.

Sure, it isn’t easy, it takes working closely with people, starting with them where they are (as Mark raises), but the excitement on health food systems for people, environment and economy is infectious and does grow. Joel touches on this with the point on nostalgia.

I"m heartened at the strategies I read in your posts on improving eating habits and the Rotary example I’d never heard of. I got on their site and downloaded resources and contacted them already. My work is most like yours and I can’t believe we’ve not yet met!

I have a few hats as a Dietitian and Permaculturists.

Our Permaculture home is open to anyone to visit and we regularly get groups coming to learn about sustainable design. We wrote a book with the World Food Programme titled the Sustainable Nutrition Manual which is in its second edition. It focuses on learning about why to eat healthy and then how to eat healthy using sustainable design. There are 600 foods highlighted in the books (Plants, trees, fungi, animals, and insects).
http://www.NeverEndingFood.org/Sustainable-Nutrition-Manual

I currently work with University of Illinois on the Feed the Future Strengthening Agricultural and Nutrition Extension activity - we are just wrapping up 5 years of work. We maintain a dropbox of resources from our work as well as what we’ve collected along our learning journey: USAID-funded Feed the Future Malawi Strengthening Agricultural & Nutrition Extension (SANE) Agriculture Extension Resources (inclusive of Nutrition, Environment, Gender and COVID-19),

Looking forward to interacting with you all!

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Stacia, I am delighted to meet you.
Karalyn Hingston, great to hear from you here!

Thank you for your post, Stacia. I am new to this field, but very interested in learning. I currently have a project underway with Food Plant Solutions for Togo, so that is how Karalyn and I are acquainted! We met by God’s grace, and through His plan, I am sure.

I would be delighted to check out the book you referenced, the Sustainable Nutrition Manual. And I will check out your Dropbox resources. Thank you so much!

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I’m not sure how I missed this important discussion. I’m Stacia Nordin, a Registered Dietitian working on environment, culture, and agriculture through permaculture design in Malawi since 1997. I met ECHO in 2013 because of nutrition.

I have caught up on a year of your posts and connect with so many - its a whole food system that needs to shift - not just the raising or processing or eating - all of it!

I cringe when I hear ‘Nutrition-Sensitive Agriculture’ and think - Absolutely NOT! Agriculture is the primary source of our nutrition and should not be relegated to something merely sensitive. Sensitive sounds secondary. The Lancet’s health centric research approach took us in a wrong direction when they divided up nutrition into specific and sensitive. It’s ok for research but not ok for life. We need language and actions that put nutrition central to our agriculture and food systems. What we say, and how we frame things, does matter.

For me the heart of the matter is mindset. I am disappointed at the way organisations promote their own species in foreign lands instead of celebrating and raising the status of indigenous foods. I am also dismayed about bio-fortification and fortification; seeds do not need to change - people and systems need to change. Organizations keep developing approaches that avoid the root causes of the issues instead of working on the issues.

Sure, it isn’t easy, it takes working closely with people, starting with them where they are (as Mark raises), but the excitement on health food systems for people, environment and economy is infectious and does grow. Joel touches on this with the point on nostalgia.

I"m heartened at the strategies I read in your posts on improving eating habits and the Rotary example I’d never heard of. I got on their site and downloaded resources and contacted them already. My work is most like yours and I can’t believe we’ve not yet met!

I have a few hats as a Dietitian and Permaculturists.

Our Permaculture home is open to anyone to visit and we regularly get groups coming to learn about sustainable design. We wrote a book with the World Food Programme titled the Sustainable Nutrition Manual which is in its second edition. It focuses on learning about why to eat healthy and then how to eat healthy using sustainable design. There are 600 foods highlighted in the books (Plants, trees, fungi, animals, and insects).
http://www.NeverEndingFood.org/Sustainable-Nutrition-Manual

I currently work with University of Illinois on the Feed the Future Strengthening Agricultural and Nutrition Extension activity - we are just wrapping up 5 years of work. We maintain a dropbox of resources from our work as well as what we’ve collected along our learning journey: USAID-funded Feed the Future Malawi Strengthening Agricultural & Nutrition Extension (SANE) Agriculture Extension Resources (inclusive of Nutrition, Environment, Gender and COVID-19),

Looking forward to interacting with you all!

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Dear Stacia, I completely concur with your statement, particularly the paragraph about being dismayed at those who bring in seeds from the outside without taking the Indigenous seeds seriously. I also am wary of biofortification when native seeds can provide sufficient nutrition as they are.

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I am a missionary agriculturalist working in South Sudan. If you are working with permaculture designs you need to connect with Roland Bunch in Malawi. I am planning a trip to Malawi myself to work with Roland. There are few people who understand how to maximize a permaculture design for a given environment and so you see little adoption/diffusion in Africa. Roland has been able to achieve remarkable adoption/diffusion. FMNR has many limitations but Roland’s systems of perennial legume intercropping or green manure cover cropping do not have these limitations and is suitable for widespread application. There are a lot of socio-economic factors that must be addressed that create barriers to rapid development or prosperity. High-value crops are key to increasing income and broadening the diet. Higher income leads to more time to study nutrition and make more wise life choices that reduce risks. I commonly teach the local people to try to include as many of the edible weeds in the diet (even dried in the shade for year-round consumption) and try to take as many of the vegetables to the market as possible to increase income and then later in a few years there are more options due to income savings and reinvestment. I could help you with some designs for permaculture that are most likely to have broad application. I did a great deal of research on alley cropping and living fences and also am researching tiered vegetable production (differential use of light resources) and planting at higher density at the edges of beds (reorienting taller vegetables to a slight angle) and capturing more light between beds.

I think we need to take into consideration taste. Studies show that people are more healthy and eat more fruits and vegetables when they find they look appealing and they like the taste. I used to work for a Buy Local initiative and the people I worked with were a little “nuts”. They told me that they expected people to eat out of the freezer in the winter than buy something imported from another country. Can you imagine a child having more healthy eating habits if it has some choices or if he only has the thawed things from the freezer option? I don’t think it makes too much difference where we take important vegetables as long as they fit the climate. People have been moving around the vegetables and fruits for thousands of years, even very long distances and even across the oceans and so most things produced have no connection to being of local origin. What you think is a local vegetable may not be a local vegetable from that location of origin and many species are naturalized from other areas at some point in the past or at some point in the past a culture brought in a highly selected form and it degraded to the local weed. Amaranth is a blessing to all who need a complete protein and trying to grow a vegetable in a rainfed environment. Just because the amaranth is not native does not mean that another local native vegetable is better. There is nothing more “biofortification” about a native plant in general than a plant brought from another location. Everything must be evaluated on very specific criteria that probably has little to do with origin but sometimes a local weedy species that is related may give some indication of how the more highly selected vegetable will perform. However then you may have problems of that being a host for a disease that may be problematic or cross polinate and cause drift in maintaining a good seed line.

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I partly agree with you.

We don’t limit ourselves or our teaching to indigenous resources - BUT - if we put as much effort into promotion of indigenous resources as we did to the exotic ones (in Malawi’s case massive amounts of attention are given to maize, soy, carrots, orange fleshed sweet potato, exotic beans, bio-fortification, fertigation, fertilisers, hybrids, etc) - we would likely see a lot different attitude toward indigenous foods.

One of many examples - I was hired by FAO to help an 8-year project in its last 2.5 years because it wasn’t thriving on the nutrition integration. When I observed the work being done, it was only promoting exotic foods in both pictures, words, and actions. They only gave exotic inputs and only mentioned and pictured exotic foods in their materials and then lumped all other foods into ‘wild foods’ as if they were less worth of being named. At their midline review the use of indigenous resources had gone down. When the families were asked they said that other foods were encourage so they were including those instead.

We turned things around. All examples we gave for the food groups listed local foods in local languages first, food demos were local foods (not always indigenous but we encouraged and used them ourselves, too), and we printed food cards of local foods (a mix of indigenous and others available). By the end of the project, indigenous foods were named much more.

You can read about the work (IFSN) in our public dropbox, there are documents/flyers in several folders, but these are the main reports and overviews:

The materials are in the Chichewa files, the pictures are labelled in local, English and Scientific:

The FAO site about the project is:
http://www.fao.org/nutrition/education/iycf/researchandlessonslearned/en/

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Interesting - I didn’t know Roland is in Malawi. I’ve read some of his work and interacted with his work in other countries, but not Malawi.

The Permaculture Network in Malawi has just been registered and the spread of the ideas are growing faster than the network can keep up with demand. There are hubs in almost every district now.

It is still small and strategies are always welcome. I’ll email Roland as well and see what he is doing here to see if we can discuss.

Thanks Dan!

Great that we partly agree. That is good. Maize is definitely over-produced but it is highly productive and it does produce high amounts of carbohydrates that I am sure to have saved a lot of lives when production skills were less than ideal. Many times maize is grown following maize with no rotation and also the input costs can be more than the income, particularly if sold immediately at harvest time, or at least the income per hour can be so low as to be negligible. I think sweet potatoes, particularly colored ones or the purple ones at best should be promoted everywhere, soy is good because it is a complete protein and great for lactose intolerant situations like myself, carrots are incredibly nutritious and great for adding nutrition (vitamin A and sweetness) to so many cooking options. Indigenous vegetables… Have you thought about encouraging people to grow more indigenous vegetables between rows of maize or sorghum? If it is a rainfed situation then the indigenous vegetables can perform better in some cases because they could be more drought tolerant. You can push at the base of sorghum and maize after a rain and open up the row centers a little and you can also pull off lower leaves to get more light down. These are tricks for intercropping that almost no one knows about or practices but they are a part of potential “excellence” in maximizing production. I am trying some traditional undeveloped varieties of eggplant that I am hoping will be drought tolerant. In this case they are not local but they are more “wild”. The fruit is smaller. Also there is a crop called skirrit that I am going to try this year because it can tolerate more excessive moisture (wet feet). So yes you are on to something by broadening the diet and production options.

Benefits of exotic species are more known as they have been researched, but unfortunately as much effort has not been put into researching the qualities of our local foods, though this is changing as people realise the benefits of biodiversity for climate, resilience, and nutrition.

Comparing systems and risks, sorghum, millet, yams, plantains and other bananas are much more productive than maize systems which are annuals while the others are perennial, reducing work and increasing resilience. But it will always need an analysis of the local situation to know what is best.

Permaculture is about designing and rotations and integration are key to keeping a system healthy and productive. It was a common practice in Malawi to trim maize and sorghum leaves and mulch with them - we picked the idea up from around us, though I don’t see it done as often as I used to.

Yes, the indigenous foods often grow on their own without humans - the rainy season especially has a number of greens, eggplants like you describe (I’m assuming zimpwa, mabunzo, nthula, mabilinganya, etc.), tubers, beans, and fruits germinate. There is so much that can be done if we embrace biodiversity.

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Dan, have been thinking about this post for a few days, and would really like to reply. The issues are complex. It is too tempting to break them down simply. What I meant by not bringing in outside crops and replacing the native crop is, to state over simply, don’t come in with a colonizer attitude. What the people I work with in Ecuador suffered under for centuries was being told that quinoa and amaranth as well as other native grains were “Indian food” and not worth cultivating, not worthy of study and experimentation. They were encouraged, that is only helped, when they planted grains supported by the National department of agriculture and the international organizations. When the international community discovered the value of the native grains, and they became trendy, the people who had been using these foods for millennia were encouraged to grow them for export.
Yes, plants move as people find them useful. This has happened since the beginning of agriculture. There is evidence in the Americas of movement and adaptation of quinoa, corn, tomatoes, peanuts, and others. The question is if these adaptations were spread by domination or by choice. It is a matter of historical curiosity what happened in the past, but what is happening now is a question of abuse that results in malnutrition and inequality. The community I am involved with is improving native crops through participatory scientific research as well as bringing in seeds from the outside on their own terms to fulfill their own nutritional and food security needs.
About biofortification, I am referring to the practice of adding nutrients to seeds of the same old basic rice, wheat, etc. when these nutrients are likely to be present in the native seeds that may be unknown to the researchers coming in to impose improved crops.
However, it is all very complex, and the community being affected must analyze all of the factors carefully. Right now, in our community in Ecuador, we are sending native seeds to a university lab to see if they actually have the food value we say they have. Maybe they can be improved.
But, my point is, the community effected by these innovations is in control of these innovations.

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Alan, “The question is if these adaptations were spread by domination or by choice”. I am wondering what you mean by this? I see several problems in your area but I don’t think I see the same problems that you see so I am eager to learn about the domination aspect since I am not from that part of the world, although I have spent most of my years with Latin Americans working with them and know the Mexican culture well, I speak Spanish, and I have spent months in the Andes mountains working with several indigenous people groups in Colombia and also visited lowland in Peru.

Now what I see of the problems of domination that could be referenced are these:

We must understand that there is the Latifundia feudal system where the large land grants given to Spanish nobility which caused the local indigenous and even those of Spanish descent to become serfs since the best land was given to the Spanish “Lords” or grantees of the land. This undermined the potential of the local people to be optimally productive since the large grants resulted in large plantations of agronomic cash crops such as sugar cane, or etc. instead of the types of crops that would be grown on smaller crops or at least smaller plots would allow more people to benefit. And perhaps the biggest problem is it removed the local people from the best and most productive land. Then there is the influence of demand for quinoa which in some ways may have initiatively reduced nutrition because quinoa is a complete protein so other cheaper grains would not be as complete. Increased income, however, from increased income from sales, should have worked to mitigate that problem eventually and that is not taken into account in most of the studies done on this.

Then you have the influence of the early Jesuit work like early missionaries in many different denominations, was very paternalistic, particularly the Jesuit order. See book Secret History of the Jesuits. This was another sort of domination.

Now in the West in the north, i.e. in the US and other Western countries you have the “dominion” of the “nutrition police” (see book The Food Police by Jayson Lusk). That is where I mainly see “dominion” these days over people’s nutrition. Discipling people with Christian worldview (Programs like CHE: Community Health Evangelism are phenomenally effective) is the best way to get transformation and that is more effective than policies or education or nutrition programs.

Also the best biofortified foods such as GMO Golden Rice have been targeted for exclusion by those who are biased or lacking a scientific basis for criticism. How can anyone who is desiring of human flourishing give any reasonable excuse why Golden Rice should not have been allowed to prevent the needless blindness, particularly in India where the lowest caste are so poor they eat rice almost exclusively. Rejection of that biofortification is perhaps one of the insidious evils of our century considering the amount of blindness it could have averted. In my book there is absolutely no excuse for that! That is immoral to n’th degree. Those are interested in biofortification should start with Golden Rice and then work their way down to lesser priorities. I know what I am saying is not all that popular but I don’t care and I guess Jesus did not care if his message was not popular. He was out to bless people with truth that would transform lives and he healed many and he said to us, “you will do greater things that these”. When I reflect on that I am thinking about Golden Rice as one of the “greater things than these”. It has the potential to heal many times more blindness than Jesus did. What a foregone blessing.

Just catching up with this thread and am grateful for all of the thoughtful contributions. Thank you Karalyn, Sharon, Stacia, Dan, and Alan.

Karalyn I remember connecting with Food Plant Solutions back when I worked with ECHO Asia. You all are doing very important work and thank you for adding it to this thread as a resource for those interested.

Stacia, I am always delighted to meet Registered Dietitians in this field. I am doing my MS in Nutrition Science at the moment with the plan to become an RD. My research has to do with the application of “Nutrition Functional Diversity” measures. You’ve included some excellent resources and I look forward to digging into the Sustainable Nutrition Manual, thank you.

Some of the sentiments that have come up in this conversation remind me of this paper by Beltrame et al, “Mainstreaming biodiversity for food and nutrition into policies and practices”(http://www.b4fn.org/resources/publications/publication-item/mainstreaming-biodiversity-for-food-and-nutrition-into-policies-and-practices-methodologies-and-les/). Of course making the connection between good research, community-driven work, and policies is incredibly nuanced and complicated. However, the connection between human nutrition, culture, food production, and biodiversity is compelling. Perhaps more acute, I am increasingly aware of the damage that is done when we fail to make those connections in our interactions with communities and in our work. From a research standpoint, Beltrame et al. found that where there is insufficient data for local species, markets and policy makers more easily replace traditional food items with commodity crops, promoting uniformity in regional food systems and increasing vulnerabilities. I often return to that statement as a reminder to myself. While I mentioned “Nutrition Sensitive Agriculture” earlier, I think we diverged more on semantics than anything else, Stacia. Focusing on local food plants is such a critical component and the foundation of community health and agriculture work, in my opinion.

I look forward to continuing to connect with you all, here.

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One really has to ask oneself about adoption/diffusion. What determines adoption/diffusion of nutrition? I say the highest levels of adoption/diffusion which are going to have the most impact on nutrition are taste (that is number 1), and arguably a close second is the ease of production. Moringa which everyone is so “hyper” about in the West, bottoms out in “taste” and that is why we don’t see it going very far in many places unless there is a really strong Christian worldview component of training because for many it is a “discipline” to eat Moringa rather than a “drawn to because of the taste”. Moringa is everywhere here in South Sudan but I don’t see people eating it much. It is known as “the tree you eat when you get sick” so some people, (1 out of 10,000 perhaps) have a tree or two but that is about all. Chaya on the other hand in my opinion tastes great and it is drought tolerant. The difference in taste can determine if you are “pushing rope” or “causing an addiction to a good habit”. If we promoted watermelon, melons of all types, and currant tomatoes (the white/yellow ones are the best tasting tomatoes in the world in my opinion), diversified juice production from the Latin American solanaceous fruits (start a diverse juice business), and cape gooseberries/ground cherries/ochua (pastries, raisins) and we suggested that people get others to market them for them at the street corners, etc., then street children and others could have a small business of selling and people could snack as they drive or take them home to the family. That in my opinion is one of the easiest ways to target the excellence gap. Also teaching delayed gratification or self-sacrifice concepts and “preserve (drying?) eat the edible weeds, take the vegetables we grow to the market” where we are skimping so we same in massive ways. Refill the water container at the borehole instead of buying. Taking food with you to town instead of buying food in town on your trips. Many a business could have been started if people had these types of disciplines. Cut back on weddings/funerals/Christmas pridefully flaunting their wealth (or going into years of debt) to “keep up with he Jones”. People who save and reinvest in more lucrative business opportunities are likely to eat more diversified food and improve their nutrition. That is the “low hanging fruit” of nutrition, I don’t think you get very far very fast by emphasizing local indigenous foods. It is a lot like trying to get local people to use their local instruments when they want to bring in keyboards and sound equipment into their churches. Yes it is a good idea to emphasize local instruments and sometimes they will respond to your encouragement but the local people are motivated by other factors and the modern musical instruments can praise God too. It is not bad for people to have both the exotic and local from which to choose and if you encourage the choices and expand them (even bringing in more exotics from other countries) I can guarantee you that people will eat more nutritiously when they have more choices. That is not a popular message here in Africa or in the West but I felt it is what needs to be said because I am about “human flourishing”. The pendulum is always swinging in the direction of some “ideology” or bias but we have to retune or reset our thinking sometimes and be as objective as possible if we want “human flourishing”.

Dear Rebecca, thank you for starting this discussion thread and for the opportunity to learn from others. I have learned from each person’s viewpoint. Your work, and that of others here, interests me because it is squarely at the intersection of the sciences of biology, agriculture & nutrition, the politics and economics involved in the real-world integration of scientific knowledge on the macro level, the human and cultural components related to changing nutritional habits at the community level, and the spiritual/Christian worldview component that is critical to any real change taking place in communities. I look forward to learning so much more. I pray that God will direct my paths and allow me to be an instrument for His glory.

So true Adam. We at Food Plant Solutions very much support your view.

Hey Rebecca,

When I clicked on the link just now, it asked me for sign-in information. There is a pay wall, maybe?

Hi Mark (and others), apologies for this and that it’s taken me far too long to respond.

I accidentally linked the article from my library’s website. However, the Mayan Health Alliance has the article published directly on their website, as well: https://www.wuqukawoq.org/wp-content/uploads/2021/05/Guzmán-Abril-2021-Academy-of-Nutrition-and-Die.pdf