Publications by authors named "Lawrence Haddad"

25 Publications

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Reward food companies for improving nutrition.

Authors:
Lawrence Haddad

Nature 2018 04;556(7699):19-22

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http://dx.doi.org/10.1038/d41586-018-03918-7DOI Listing
April 2018

Coverage and Utilization in Food Fortification Programs: Critical and Neglected Areas of Evaluation.

J Nutr 2017 05 12;147(5):1015S-1019S. Epub 2017 Apr 12.

Global Alliance for Improved Nutrition, Geneva, Switzerland; and.

The need for evidence to inform nutrition program design and implementation has long been recognized, yet the generation and use of evidence for program decision making has lagged. The results of the coverage surveys reported in this supplement highlight some of the strengths and areas for improvement of current population-based (i.e., staple foods and condiments) and targeted (e.g., foods for infants and young children) fortification programs. Among other topics, the results identify a few striking successful fortification programs whereby the majority of the food vehicle used is fortifiable and fortified, and coverage is equitable among those classified as vulnerable and not. Other programs have great potential based on very high use of a fortifiable food vehicle, including in most cases among the vulnerable, but that potential is not currently reached because of low compliance with fortification requirements. Programs were also identified whereby the food vehicle has limited potential to make public health contributions to micronutrient intake, given the low proportions of the population who consume the food vehicle in general or who consume the fortifiable food vehicle. Four key lessons were learned: ) the potential for impact of food fortification depends on the appropriate choice of food fortification vehicle but also on the proportion of the food vehicle consumed that is fortifiable; ) the design of fortification programs should be informed by the magnitude and distribution of inadequate intake and deficiency and consumption of fortifiable foods, and part of micronutrient deficiency control strategies to ensure coordination with other programs; ) effective quality control of fortification levels in foods urgently needs strengthening, including the many governance and other policy factors that influence the capacity, resources, and commitment to do this; ) periodic review of the assumptions related to dietary patterns that underpin food fortification is needed to ensure continual safe and impactful programs.
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http://dx.doi.org/10.3945/jn.116.246157DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5404214PMC
May 2017

A new global research agenda for food.

Nature 2016 11;540(7631):30-32

Global Panel on Agriculture and Food Systems for Nutrition, London, UK.

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http://dx.doi.org/10.1038/540030aDOI Listing
November 2016

The Global Nutrition Report 2015: what we need to do to advance progress in addressing malnutrition in all its forms.

Public Health Nutr 2015 Dec;18(17):3067-9

3Institute of Nutrition,Mahidol University,Nakhon Pathom,Thailand.

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http://dx.doi.org/10.1017/S1368980015003158DOI Listing
December 2015

The Global Nutrition Report 2014: actions and accountability to accelerate the world's progress on nutrition.

J Nutr 2015 Apr 4;145(4):663-71. Epub 2015 Mar 4.

Public Health Foundation of India, New Delhi, India.

In 2013, the Nutrition for Growth Summit called for a Global Nutrition Report (GNR) to strengthen accountability in nutrition so that progress in reducing malnutrition could be accelerated. This article summarizes the results of the first GNR. By focusing on undernutrition and overweight, the GNR puts malnutrition in a new light. Nearly every country in the world is affected by malnutrition, and multiple malnutrition burdens are the "new normal." Unfortunately, the world is off track to meet the 2025 World Health Assembly (WHA) targets for nutrition. Many countries are, however, making good progress on WHA indicators, providing inspiration and guidance for others. Beyond the WHA goals, nutrition needs to be more strongly represented in the Sustainable Development Goal (SDG) framework. At present, it is only explicitly mentioned in 1 of 169 SDG targets despite the many contributions improved nutritional status will make to their attainment. To achieve improvements in nutrition status, it is vital to scale up nutrition programs. We identify bottlenecks in the scale-up of nutrition-specific and nutrition-sensitive approaches and highlight actions to accelerate coverage and reach. Holding stakeholders to account for delivery on nutrition actions requires a well-functioning accountability infrastructure, which is lacking in nutrition. New accountability mechanisms need piloting and evaluation, financial resource flows to nutrition need to be made explicit, nutrition spending targets should be established, and some key data gaps need to be filled. For example, many UN member states cannot report on their WHA progress and those that can often rely on data >5 y old. The world can accelerate malnutrition reduction substantially, but this will require stronger accountability mechanisms to hold all stakeholders to account.
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http://dx.doi.org/10.3945/jn.114.206078DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5129664PMC
April 2015

The double burden of malnutrition in SE Asia and the Pacific: priorities, policies and politics.

Health Policy Plan 2015 Nov 15;30(9):1193-206. Epub 2014 Oct 15.

Institute of Development studies, Brighton BN19RE, UK.

The double burden of malnutrition is defined by the co-existence of serious levels of under- and overnutrition.(1) Nowhere have overweight rates risen as fast as in the regions of South East Asia and the Pacific. The regions are also burdened with high and often stagnant levels of undernutrition. For countries for which data are available, the regions contain nearly half of the individuals, world wide, suffering from a double burden of malnutrition. This article reviews the trends and their consequences and for nine countries in these two regions it reviews the drivers of the problem and attempts to manage it. The article concludes with an analysis of the political challenges and opportunities presented by the double burden and some suggestions for a leadership agenda within the region to address it.
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http://dx.doi.org/10.1093/heapol/czu110DOI Listing
November 2015

Association between economic growth and early childhood nutrition.

Lancet Glob Health 2014 Sep 27;2(9):e500. Epub 2014 Aug 27.

TANGO International, Tucson, AZ, USA.

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http://dx.doi.org/10.1016/S2214-109X(14)70266-9DOI Listing
September 2014

Which aid spending categories have the greatest untapped potential to support the reduction of undernutrition? Some ideas on moving forward.

Food Nutr Bull 2014 Jun;35(2):266-76

The financial resource needs for the reduction of undernutrition are significant, while the returns from reducing undernutrition are large. Yet the share of public resources allocated to the reduction of undernutrition remains disproportionately small. For overseas development assistance, the investment in nutrition-specific and nutrition-sensitive categories amounts to less than 3% of the total. What is the potential for other categories of public resource investments to reduce undernutrition, and in which sectors are these investments to be found? This paper proposes a framework for addressing this question and ventures some suggestions as to which of the categories of overseas development assistance beyond the well-known "nutrition-specific" and "nutrition-sensitive" categories are most likely to yield improvements in nutrition status if they could be redesigned with this in mind. We conclude that policy makers should look widely within the underlying and basic determinant intervention space for investments that, when changed at the margins, could result in significant improvements in nutrition.
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http://dx.doi.org/10.1177/156482651403500213DOI Listing
June 2014

Postgraduate education in nutrition in south Asia: a huge mismatch between investments and needs.

BMC Med Educ 2014 Jan 7;14. Epub 2014 Jan 7.

Public Health Foundation of India, 14 Community Centre, Panchsheel Park, New Delhi 110016, India.

Background: Despite decades of nutrition advocacy and programming, the nutrition situation in South Asian countries is alarming. We assume that modern training in nutrition at the post graduate level is an important contributor to building the capacity of individuals to think and act effectively when combating undernutrition. In this context, this paper presents a regional situation analysis of master's level academic initiatives in nutrition with a special focus on the type of programme we think is most likely to be helpful in addressing undernutrition at the population level: Public Health Nutrition (PHN).

Methods: This situational analysis of Masters in nutrition across South Asian countries viz. India, Pakistan, Bangladesh, Sri Lanka, Afghanistan, Maldives, Nepal, Bhutan was conducted using an intensive and systematic Internet search. Further, detailed information was extracted from the individual institute websites and library visits.

Results: Of the 131 master's degree programmes we identified one that was in PHN while another 15 had modules in PHN. Most of these universities and institutions were found in India with a few in Bangladesh and Sri Lanka. In the rest of the countries, neither nutrition nor PHN emerged as an academic discipline at the master's level. In terms of eligibility Indian and Sri Lankan programmes were most inclusive, with the remaining countries restricting eligibility to those with health qualifications. On modules, no country had any on nutrition policy or on nutrition's interactions with agriculture, social protection, water and sanitation or women's empowerment.

Conclusion: If a strong focus on public health nutrition is key to reducing undernutrition, then the poor availability of such courses in the region is cause for concern. Nutrition master's courses in general focus too little on the kinds of strategies highlighted in the recent Lancet series on nutrition. Governments seeking to accelerate declines in undernutrition should incentivize the delivery of postgraduate programmes in nutrition and Public Health Nutrition (PHN) that reflect the modern consensus on priority actions. In the absence of PHN type programmes, the competence to scale up nutrition capacity is likely to be impaired and the human potential of millions of infants will continue to be squandered.
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http://dx.doi.org/10.1186/1472-6920-14-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3893432PMC
January 2014

Maternal and child nutrition - Authors' reply.

Lancet 2013 Nov;382(9904):1551-2

Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD 21205, USA. Electronic address:

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http://dx.doi.org/10.1016/S0140-6736(13)62320-XDOI Listing
November 2013

The economic rationale for investing in stunting reduction.

Matern Child Nutr 2013 Sep;9 Suppl 2:69-82

Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA.

This paper outlines the economic rationale for investments that reduce stunting. We present a framework that illustrates the functional consequences of stunting in the 1000 days after conception throughout the life cycle: from childhood through to old age. We summarize the key empirical literature around each of the links in the life cycle, highlighting gaps in knowledge where they exist. We construct credible estimates of benefit-cost ratios for a plausible set of nutritional interventions to reduce stunting. There are considerable challenges in doing so that we document. We assume an uplift in income of 11% due to the prevention of one fifth of stunting and a 5% discount rate of future benefit streams. Our estimates of the country-specific benefit-cost ratios for investments that reduce stunting in 17 high-burden countries range from 3.6 (DRC) to 48 (Indonesia) with a median value of 18 (Bangladesh). Mindful that these results hinge on a number of assumptions, they compare favourably with other investments for which public funds compete.
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http://dx.doi.org/10.1111/mcn.12080DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6860695PMC
September 2013

Can nutrition be promoted through agriculture-led food price policies? A systematic review.

BMJ Open 2013 Jun 25;3(6). Epub 2013 Jun 25.

London School of Hygiene & Tropical Medicine, and Leverhulme Centre for Integrative Research on Agriculture and Health, London, UK.

Objective: To systematically review the available evidence on whether national or international agricultural policies that directly affect the price of food influence the prevalence rates of undernutrition or nutrition-related chronic disease in children and adults.

Design: Systematic review.

Setting: Global.

Search Strategy: We systematically searched five databases for published literature (MEDLINE, EconLit, Agricola, AgEcon Search, Scopus) and systematically browsed other databases and relevant organisational websites for unpublished literature. Reference lists of included publications were hand-searched for additional relevant studies. We included studies that evaluated or simulated the effects of national or international food-price-related agricultural policies on nutrition outcomes reporting data collected after 1990 and published in English.

Primary And Secondary Outcomes: Prevalence rates of undernutrition (measured with anthropometry or clinical deficiencies) and overnutrition (obesity and nutrition-related chronic diseases including cancer, heart disease and diabetes).

Results: We identified a total of four relevant reports; two ex post evaluations and two ex ante simulations. A study from India reported on the undernutrition rates in children, and the other three studies from Egypt, the Netherlands and the USA reported on the nutrition-related chronic disease outcomes in adults. Two of the studies assessed the impact of policies that subsidised the price of agricultural outputs and two focused on public food distribution policies. The limited evidence base provided some support for the notion that agricultural policies that change the prices of foods at a national level can have an effect on population-level nutrition and health outcomes.

Conclusions: A systematic review of the available literature suggests that there is a paucity of robust direct evidence on the impact of agricultural price policies on nutrition and health.
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http://dx.doi.org/10.1136/bmjopen-2013-002937DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3696869PMC
June 2013

From Nutrition Plus to Nutrition Driven: how to realize the elusive potential of agriculture for nutrition?

Authors:
Lawrence Haddad

Food Nutr Bull 2013 Mar;34(1):39-44

Institute of Development Studies, Brighton BN1 9RE, UK.

Background: Agriculture has the potential to have a bigger impact on nutrition status than it currently does. The pathways between agriculture and nutrition are well known. Yet the evidence on how to increase the impact of agriculture on nutrition is weak.

Objective: To outline some of the possible reasons for the weak evidentiary link between agriculture and income and to highlight some approaches to incentivizing agriculture to give nutrition a greater priority.

Methods: A review of literature reviews and other studies.

Results: Agriculture does not have a strong poverty and nutrition impact culture, the statistical links between aggregate agriculture and nutrition data are weak, literature reviews to date have not been sufficiently clear on the quality of evidence admitted, and the evidence for the impact of biofortification on nutrition status is positive, but small. Some tools are proposed and described that may be helpful in raising the profile of nutrition outcomes, building nutrition outcomes into impact assessments of agriculture, measuring the commitment to undernutrition reduction, and helping to prioritize nutrition-relevant actions within agriculture. Leadership in agriculture and nutrition is also an understudied issue.

Conclusions: Agriculture has a vast potential to increase its impact on nutrition outcomes. We don't know if this potential is being fully realized as yet. I suspect it is not. Tools that help promote the visibility of nutrition within agriculture and the accountability of agriculture toward nutrition can possibly contribute to moving "from Nutrition Plus to Nutrition Driven" agriculture.
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http://dx.doi.org/10.1177/156482651303400105DOI Listing
March 2013

The politics of reducing malnutrition: building commitment and accelerating progress.

Lancet 2013 Aug 6;382(9891):552-69. Epub 2013 Jun 6.

International Food Policy Research Institute, Washington, DC 20006-1002, USA.

In the past 5 years, political discourse about the challenge of undernutrition has increased substantially at national and international levels and has led to stated commitments from many national governments, international organisations, and donors. The Scaling Up Nutrition movement has both driven, and been driven by, this developing momentum. Harmonisation has increased among stakeholders, with regard to their understanding of the main causes of malnutrition and to the various options for addressing it. The main challenges are to enhance and expand the quality and coverage of nutrition-specific interventions, and to maximise the nutrition sensitivity of more distal interventions, such as agriculture, social protection, and water and sanitation. But a crucial third level of action exists, which relates to the environments and processes that underpin and shape political and policy processes. We focus on this neglected level. We address several fundamental questions: how can enabling environments and processes be cultivated, sustained, and ultimately translated into results on the ground? How has high-level political momentum been generated? What needs to happen to turn this momentum into results? How can we ensure that high-quality, well-resourced interventions for nutrition are available to those who need them, and that agriculture, social protection, and water and sanitation systems and programmes are proactively reoriented to support nutrition goals? We use a six-cell framework to discuss the ways in which three domains (knowledge and evidence, politics and governance, and capacity and resources) are pivotal to create and sustain political momentum, and to translate momentum into results in high-burden countries.
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http://dx.doi.org/10.1016/S0140-6736(13)60842-9DOI Listing
August 2013

Effectiveness of agricultural interventions that aim to improve nutritional status of children: systematic review.

BMJ 2012 Jan 17;344:d8222. Epub 2012 Jan 17.

Institute of Development Studies, University of Sussex, Brighton BN1 9RE, UK.

Objective: To assess the effectiveness of agricultural interventions in improving the nutritional status of children in developing countries.

Design: Systematic review.

Data Sources: Published and unpublished reports (after 1990) in English identified by searching 10 databases (Agris, Econlit, Eldis, IBSS, IDEAS, IFPRI, Jolis, PubMed, Web of Science, and World Bank), websites, previous systematic reviews, and reference lists and by contacting experts.

Study Selection: Included studies assessed effects of agricultural interventions aiming at improving the nutritional status of children (bio-fortification, home gardens, small scale fisheries and aquaculture, dairy development, and animal husbandry and poultry development). Only studies that used a valid counterfactual analysis were included. Before/after studies and participants/non-participants comparisons affected by selection bias were excluded. Data analysis Results were analysed for four intermediate outcomes (programme participation, income, dietary diversity, and micronutrient intake) and one final outcome (prevalence of under-nutrition). Analysis was by summary tables of mean effects and by meta-analysis (for vitamin A absorption).

Results: The review included 23 studies, mostly evaluating home garden interventions. The studies reviewed did not report participation rates or the characteristics of participants in programmes. The interventions had a positive effect on the production of the agricultural goods promoted, but not on households' total income. The interventions were successful in promoting the consumption of food rich in protein and micronutrients, but the effect on the overall diet of poor people remains unclear. No evidence was found of an effect on the absorption of iron, but some evidence exists of a positive effect on absorption of vitamin A. Very little evidence was found of a positive effect on the prevalence of stunting, wasting, and underweight among children aged under 5.

Conclusions: The question posed by the review cannot be answered with any level of confidence. The data available show a poor effect of these interventions on nutritional status, but methodological weaknesses of the studies cast serious doubts on the validity of these results. More rigorous and better designed studies are needed, as well as the establishment of agreed quality standards to guide researchers in this important area.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3259800PMC
http://dx.doi.org/10.1136/bmj.d8222DOI Listing
January 2012

Why India needs a national nutrition strategy.

Authors:
Lawrence Haddad

BMJ 2011 Nov 11;343:d6687. Epub 2011 Nov 11.

Institute of Development Studies, Brighton BN1 9RE, UK.

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http://dx.doi.org/10.1136/bmj.d6687DOI Listing
November 2011

The future of the global food system.

Philos Trans R Soc Lond B Biol Sci 2010 Sep;365(1554):2769-77

Department of Zoology and Institute of Biodiversity at the James Martin 21st Century School, University of Oxford, South Parks Road, Oxford OX1 3PS, UK.

Although food prices in major world markets are at or near a historical low, there is increasing concern about food security-the ability of the world to provide healthy and environmentally sustainable diets for all its peoples. This article is an introduction to a collection of reviews whose authors were asked to explore the major drivers affecting the food system between now and 2050. A first set of papers explores the main factors affecting the demand for food (population growth, changes in consumption patterns, the effects on the food system of urbanization and the importance of understanding income distributions) with a second examining trends in future food supply (crops, livestock, fisheries and aquaculture, and 'wild food'). A third set explores exogenous factors affecting the food system (climate change, competition for water, energy and land, and how agriculture depends on and provides ecosystem services), while the final set explores cross-cutting themes (food system economics, food wastage and links with health). Two of the clearest conclusions that emerge from the collected papers are that major advances in sustainable food production and availability can be achieved with the concerted application of current technologies (given sufficient political will), and the importance of investing in research sooner rather than later to enable the food system to cope with both known and unknown challenges in the coming decades.
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http://dx.doi.org/10.1098/rstb.2010.0180DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2935131PMC
September 2010

Food security: the challenge of feeding 9 billion people.

Science 2010 Feb 28;327(5967):812-8. Epub 2010 Jan 28.

Department of Zoology and Institute of Biodiversity at the James Martin 21st Century School, University of Oxford, South Parks Road, Oxford OX1 3PS, UK.

Continuing population and consumption growth will mean that the global demand for food will increase for at least another 40 years. Growing competition for land, water, and energy, in addition to the overexploitation of fisheries, will affect our ability to produce food, as will the urgent requirement to reduce the impact of the food system on the environment. The effects of climate change are a further threat. But the world can produce more food and can ensure that it is used more efficiently and equitably. A multifaceted and linked global strategy is needed to ensure sustainable and equitable food security, different components of which are explored here.
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http://dx.doi.org/10.1126/science.1185383DOI Listing
February 2010

What can food policy do to redirect the diet transition?

Authors:
Lawrence Haddad

Food Nutr Bull 2005 Jun;26(2):238-40

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http://dx.doi.org/10.1177/156482650502600209DOI Listing
June 2005

Assessing the impact of large scale nutrition interventions.

Authors:
Lawrence Haddad

Forum Nutr 2003 ;56:385-6

International Food Policy Research Institute, USA.

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July 2005

No longer off the menu: the welcome re-emergence of food on the nutrition agenda.

Authors:
Lawrence Haddad

Forum Nutr 2003 ;56:383-5

International Food Policy Research Institute, USA.

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July 2005

Feeding the world in the coming decades requires improvements in investment, technology and institutions.

J Nutr 2002 Nov;132(11):3435S-6S

Food Consumption and Nutrition Division, International Food Policy Research Institute, Washington, D.C. 20006, USA.

The world is food secure at the global level, yet nearly 800 million are food insecure. "Business as usual" is not going to bring us close to meeting the Millennium Development Goal of halving the proportion of the population consuming less than the minimum energy requirement. So what has to change? The three papers in this session offer clues in three broad areas: (a) increased investment-by developing and developed countries-in public goods such as agricultural research, education, and clean water, (b) technologies to boost agricultural productivity for the poor and institutions that guide the diffusion and application of technology that need to be developed and (c) national-level institutions and governance structures to be strengthened and held accountable for protecting and respecting human rights, for providing the right types of national-level public goods to those that most need them and for preserving peace and stability.
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http://dx.doi.org/10.1093/jn/132.11.3435SDOI Listing
November 2002