Food systems are a means to an end rather than ends in themselves. They exist to help people and societies meet a variety of goals, including but not limited to, good nutrition. There are multiple pathways through which the food system affects human nutrition. Understanding these pathways and how they operate is essential to design agricultural and other food system policies to achieve nutrition goals. While much is said about the links between agriculture and nutrition, the fact is that each of the components of a food system: natural resource management and input use; primary production (agriculture); transport, storage and exchange; secondary production (food processing); and consumption shown in Figure 1 may influence nutrition.
Irrespective of their starting point in the food system, most pathways work through food availability and household access to available food. Both are necessary but not sufficient. The extent to which changes in the availability of food affects nutrition (positively or negatively) will be influenced by household incomes, food prices, time limitations, household behavior, tastes and preferences, intra-household food allocation and the importance of non-food factors such as access to clean water, good sanitation and good hygiene. The behavior of food system agents, including consumers, farmers, and traders, mitigate the nutrition effects. By being the entry points, food availability and access are key components of the pathways through which food systems may affect nutrition. However, as shown in Figure 2, the nutrition effect of changes in these factors will depend on several other components of the pathways. Thus, merely pursuing changes in food availability and access will not assure the desired nutrition effects. The complete pathway must be understood to help guide the food system for nutritional benefits.
It matters what kinds of food are available. Trade liberalization may increase the availability of imported foods with undesirable characteristics such as processed foods with a high content of fats and sweeteners. Investments in research and processing may develop new products beneficial or harmful to nutrition. Public and private investments in the food marketing sector may also improve food safety and quality. Availability of protein-dense plant-based foods, meat, dairy products, fruits and vegetables may reduce nutrient deficiencies while availability of fats, oils, sugar, sweeteners and energy-dense, nutrient-poor foods may contribute to overweight, obesity and chronic diseases. A high degree of diversity in the food supply, whether from own production or the market, may facilitate consumption diversity and better nutrition.
Enhancing consumption diversity, and in that way reducing nutrient deficiencies, are particularly important on semi-subsistence farms and isolated local wet markets where the diet may consist of one or two basic staples. Research and policy interventions to promote the production, marketing and consumption of so-called “orphan crops”, i.e., food crops for which little or no attention has been paid by researchers and policy-makers, offer interesting opportunities. Support of home gardens would be another initiative to be considered as would the promotion of the production, marketing and consumption of animal products such as beef, poultry, pork, goat and sheep meat, and milk and plant-based foods with high density of nutrients such as grain legumes. In locations where water resources are available, the promotion of aquaculture may help improve diet diversity and improve nutrition both through fish and seafood consumption and income-generating sales.
The nutrition value of foods may be improved by industrial fortification and biofortification. Indistrial fortification may increase the price of food and make it less affordable. On the other hand, the impact of biofortification depends on farmers’ adoption of the fortified seed, and consumers’ acceptance, ability and willingness to pay a higher price if necessary. In addition to processing and fortification, the nutritional quality and safety of foods may be improved or deteriorated by action or lack of action in storage, transportation and other food system activities. Finally, waste and losses in the food supply chain are large. A recent assessment found that about one-third of the food supply is wasted or lost. Adding production lost to plant and animal diseases and pest attacks in farmers’ fields, the large opportunities for expanding the food available for actual consumption become obvious.
So, while food availability is necessary for good nutrition, changes in food availability will not have any impact on nutrition unless the actual or potentially malnourished people have access. As shown in Figure 2, access, or the ability of households to acquire the food available, is influenced by incomes, own production, food prices, availability and prices of nonfoods and social safety nets. These factors and the related behavioral aspects are discussed below.
Changes in the food system may affect incomes of the actual or potentially malnourished people in several ways. First, research and technology may generate an economic surplus by improving productivity of land, water or labor, not only in agriculture but in other parts of the food system. Depending on supply and demand, elasticities and market structure, conduct and performance, the surplus may result in higher incomes (in cash or kind) for farmers, traders and other food system agents, lower prices for consumers or, most likely, a combination of the two as exemplified by the effects of the Green Revolution. Research and technology may also improve the nutritional quality of foods as exemplified by the above mentioned biofortification. A second pathway through incomes, that will change access, relates to changes in labor demand, wages and access to productive resources, e.g., land and water, through labor-using technology, investments in rural infrastructure, changes in land tenure and water policies, and other fiscal and monetary policies. Third, changes in the food system may change the gender-specific income control as well as the composition of household incomes (cash or production for own consumption), and the cash flow over time. Those changes will, in turn, influence household food acquisition behavior and the extent to which access is converted to acquisition. It is also likely to influence the allocation of food within the household. Increasing income and budget control by women is likely to increase the portion of household incomes dedicated to food, particularly as it relates to child feeding.
Changes in food and nonfood prices will influence a household’s purchasing power and as such its access to food. Changes in relative prices are also important. Lower prices for one food commodity relative to the price of another will usually increase consumption of the former and reduce the consumption of the latter. Unit-cost reducing technological change in food production, processing and marketing as well as commodity-specific taxes and subsidies and trade restrictions such as export restrictions and import duties are examples of policy interventions that may change relative prices. Before such commodity-specific policies are proposed, it is important to clearly specify the nutrition problem to be solved: Is it dietary energy deficiencies, nutrient deficiencies or obesity-related chronic diseases?
Most developing countries experience all three of these problems. This makes the choice of price-related policies difficult. For example, taxes on meat, vegetable oil, sugar and sweeteners may reduce the risks of chronic disease among low-and high-income people while increasing the deficiency of iron, essential fatty acids and dietary energy in low-income population groups. If these foods are highly preferred by low-income households, such taxes may also reduce purchasing power and the consumption of other foods which are beneficial for nutrition such as fruits and vegetables. Subsidies on fruits and vegetables may release purchasing power that could be used to acquire foods of lesser or negative nutrient value such as drinks high in sweeteners. Increasing productivity and lower unit-costs of production and marketing as well as price subsidies for foods such as fruits, vegetables and animal source foods may reduce nutrient deficiencies.
Improved knowledge regarding nutrition and its relations to the food system is needed for all food system agents, including consumers, farmers, traders and policy-makers. Nutrition education for consumers has been a commonly used tool to improve nutrition with limited success. As might be expected, free-standing nutrition education programs will only be successful where lack of knowledge is the most limiting factor for good nutrition. Educational efforts with all the right messages may be of no value if the new knowledge cannot be implemented because of time or income constraints. On the other hand, increased incomes, improved production diversity or reduced pressures on time may be of little or no nutrition value in the absence of the relevant knowledge. Therefore, nutrition education should in most cases be combined with other efforts to remove constraints to good nutrition.
Improved knowledge regarding food storage, processing and transportation may be effective in improving nutrition and food safety. In some cases, the achievement of nutrition goals may imply trade-offs with other goals but win-wins are common and often overlooked. Examples of win-wins include investments in rural infrastructure (e.g., feeder roads and irrigation facilities), agricultural research, food processing technology and market information, which may increase food production, reduce unit-costs of production and marketing, reduce consumer prices, increase farmer incomes, and improve nutrition.
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Thus, changes in the food system should consider the net effect of changes in women’s time before introducing new demands for women’s work. Introduction of labor-saving and productivity-enhancing technologies for the work traditionally done by women, such as herbicides to replace weeding, improved equipment for food processing, better access to water and fuel and rural infrastructure to improve food marketing and the time needed to bring food to the market as well as child care facilities appropriate for the particular situation, are examples of actions that could be considered.
Concluding Notes
Neither availability of sufficient food, nor household access to it, assures good nutrition. The extent to which food access is translated into actual food consumption by at-risk household members is determined by household behavior and the allocation of the food within the household. In addition to the nutritional content of the food allocated to the individual and the extent to which it matches the needs, the nutrition effect of the allocated food depends on the quality of the available water, sanitation, the prevalence of infectious diseases and other nutrition-related factors. Therefore, the impact of changes in the food system on household food security (access) alone may not be a good indicator of nutrition impact. Poverty reduction, or changes in income, women’s time allocation, prices and knowledge may likewise be poor nutrition indicators. These factors serve as entry points for the food system – nutrition pathways, but do not themselves serve as proxies for nutrition impact.
Efforts to enhance the nutrition impact of food systems should never forget that the food system is driven by economic demand and production possibilities and not nutrition goals. Thus, to be successful, such efforts should aim to change either economic demand or production possibilities or both.
Figure 1. A conceptual framework of a food system.
Source: Pinstrup-Andersen, P. & Watson, D. 2011. Food Policy in Developing Countries: The Role of Government in Global, National, and Local Food Systems. Ithaca, New York, Cornell University Press.
Figure 2. A simplified conceptual framework linking food availability, food security, and nutrition.
Source: Pinstrup-Andersen, P. & Watson, D. 2011. Food Policy in Developing Countries: The Role of Government in Global, National, and Local Food Systems. Ithaca, New York, Cornell University Press.
Summary of presentation at the 2012 WISHH & World Soy Foundation Conference, Washington, D.C. , March 15, 2012.