Nutrition, Health and
Food Safety

Recommendations
for Decision-Makers

• Consider the whole food system—farm to consumer, and links to other sectors, like education and infrastructure—when working to achieve sustainable healthy diets (accessible, affordable, safe, and equitable, while being culturally acceptable, with low environmental impact).
• Adopt an integrated mix of food-based strategies such as biofortification and increased dietary diversity to address nutrition, health, and food security. No single approach can effectively address the complex dietary needs of diverse populations and deliver whole diets that are healthy, affordable and sustainable.
• Make collaborative decisions across multiple sectors – no single actor can make the changes needed without finding synergies and identifying trade-offs, for example, between health, education, finance, social protection, and agriculture actors, and through engagement with both large and small agribusinesses.
• Take care when introducing alternative dietary options into diverse local food systems and population groups. Without considering consumer preferences, cultural acceptance, affordability, and market demand, efforts may fall short or, worse, disrupt livelihoods and food and nutrition security.
• Invest in improved aquatic foods and livestock breeds as well as local staple foods such as roots, tubers, bananas, and legumes. Along with greater access to fruits and vegetables, these staples can drive dietary, nutritional, and economic gains, especially in sub-Saharan Africa and large ocean states, where they are well-suited to a changing climate.
• Balance emergency responses to conflict and natural disasters that address acute hunger with long-term efforts to build resilient food systems that ensure nutritious, diverse, balanced, and safe diets.

What Food Systems Science Tells Us

Scientific food-based research underscores the need to address the challenges of nutrition, human health, and food security in food systems in an integrated way to ensure that healthy diets are accessible, affordable, desirable, available, and culturally relevant. This requires innovations across production, markets, food supply chains, and consumption in urban and rural centers that consider local economic and social conditions, supported by deeper structural drivers of poor diets and malnutrition, such as poverty. This is particularly important under climate change, which drives reduced food production due to changes in rainfall and temperature.

Science tells us that an mix of food-based strategies is crucial to help tackle malnutrition (Figure 16). No single approach can effectively address the complex nutritional needs of diverse populations. Many factors drive consumption, for example desirability, affordability, accessibility and availability of foods. Success comes from collaborating across a range of public sectors like health, education, finance, and agriculture, along with engagement with the private sector, including both large and small agribusinesses and the food industry. For instance, consumer dietary choices can be driven by government-led actions on nutrition education, subsidies, pricing, food safety standards, and labelling requirements. These, in turn, drive private sector investment and innovation to meet the resulting increased market demand for healthy foods.

Dietary diversification and biofortification are two complementary strategies for improving the nutrient status of populations and raising levels of nutrition, which are examined here.

In terms of dietary diversity, over the last 50 years, global diets have become more similar. For example, humans have historically cultivated approximately 6,000 plant species for food. Today, just 200 significantly contribute to global diets, with a similar decline in livestock breeds, and fish strain diversity (FAO, 2019). Reversing this trend requires a better understanding of the nutrient content of this treasure trove of food sources to identify promising options for future research and development, understanding their accessibility, such as through community mapping of local biodiversity, and the impacts that the changing climate may have on nutritional value.

Investing in diverse crops, livestock, and aquatic foods across production systems, markets, and diets is essential for promoting dietary diversity and resilience through agrobiodiversity. This approach helps overcome barriers at different decision-making and implementation levels (Figure 17).

Biofortification of staple foods—a food eaten often and in such quantities that it constitutes a dominant portion of a standard diet—is a complementary approach to diet diversification that can also enhance health. Biofortification is not intended to increase the consumption of staples but rather to substitute some or all non-biofortified major staple foods with better and more micronutrient-rich varieties.

Through CGIAR’s national agricultural research and extension systems (NARES) partnerships, we have introduced new varieties of biofortified crops to target specific micronutrient deficiencies. Examples include vitamin A-rich orange sweetpotato and maize, zinc-fortified rice and wheat, and high-iron and zinc sorghum, and high-iron beans. See Figure 18 for some global impacts from CGIAR’s crop biofortification work.

Animals produced for food or food-related products constitute 40% of the value of global agriculture and support the income and livelihoods of one in five people, mostly in low- and middle-income countries (WOAH). Foods derived from aquatic and livestock sources are particularly beneficial for maternal and infant nutrition during the critical first 1,000 days of life. These include the inclusion of indigenous small fish into local diets to deliver health benefits to communities facing malnutrition.

Participatory breeding programs—when farmers, breeders, and other relevant stakeholders work together to develop new varieties—help ensure that the resulting innovations suit local needs and are integrated into local diets, markets, and food supply chains. Closing the gender gap in vulnerable communities is also crucial for achieving sustainable nutritional outcomes. Women play a pivotal role in household nutrition and childcare decisions; empowering them with the knowledge, resources, and market access they need to grow, purchase, and prepare healthy foods has been demonstrated to have positive effects throughout communities. Increasing women’s capacity to grow food (e.g. by strengthening home garden production), and boosting their bargaining power (e.g. through cooperatives), create a strong foundation for broader nutrition, social, and economic benefits.

As urbanization increases, it is equally important to promote nutritious food production in cities. Community-based urban farming programs can support low-income households by enabling them to grow their own food, reduce household expenses, create additional livelihoods, and help reduce food deserts. To complement this, regulatory frameworks must focus on improving food safety and quality in informal markets through better food labelling, transparency, and traceability.

Finally, policy and investment efforts can incentivize the production of nutritious food by redirecting subsidies, while disincentivizing the consumption of ultra-processed foods through tax measures and regulations. Investing in initiatives that reduce food loss and waste across supply chains, for example, improving cold chain infrastructure for transport of fresh produce and improved seed systems, is also vital to overcoming barriers faced when transforming food systems and ensuring that sustainable, healthy diets are accessible and affordable to all. Additional efforts to provide nutrition education and encourage uptake include subsidies for healthy diets, public procurement programs, school feeding initiatives, and food system improvements such as cold storage, transport infrastructure for fresh produce, and improved seed systems.

Looking Ahead

Food and nutrition security challenges are expected to persist in sub-Saharan Africa, especially in regions where food systems are highly sensitive to climate change and many people depend on them for their livelihoods. This situation is worsened by supply chain disruptions in conflict-affected areas (ISDC, 2023). Emergency responses to conflicts and natural disasters, such as food and water aid to address acute hunger, can also divert resources from long-term efforts to build sustainable food systems that are resilient to these shocks. For example, it is important to provide consistent investment in staple crops (cereals), roots, tubers, and bananas that are expected to fare better in the changing climate, as well as foods from water and local foods that have the potential to contribute to healthy diets but often fall outside mainstream research and development efforts and budgets. Balancing long-term and short-term priorities requires planning based on sound science and cooperation among many different groups.

Investments in rural agricultural development also need to be balanced with meeting growing consumer demand in rapidly expanding cities for affordable, healthy diets. These investments can also offer a pathway to poverty alleviation by creating stronger links between rural food producers and creating job and enterprise opportunities along the value chain. Poverty is a key driver of malnutrition and food insecurity.

Urban food systems can support solutions through diversifying farming practices. These include:

• Diverse aquatic foods that emphasize the affordability of diets and reduce losses in perishable food chains.
• Fruit and vegetable production in hydroponic or aeroponic systems (when plants are grown without soil, using nutrient-rich water)
• Insect farming
• Vertical farming (where food is grown in stacked layers or tall structures, using controlled environments to maximize space and efficiency)

Support is also needed to improve food safety and quality in both formal and informal markets in low- and middle-income countries through better labeling, transparency, and traceability. This must be achieved without increasing costs for producers and consumers, as this can contribute to making healthy diets unaffordable.

Sustainable healthy diets promote all dimensions of an individual’s health and well-being. They are accessible, affordable, safe, and equitable, while being culturally acceptable and causing low environmental pressure and impact. Ensuring all of these characteristics is only possible if diets are considered within the wider context of the whole food system, from the farm to the consumer, and its links with numerous other sectors, from education to infrastructure. Nutrition efforts need to take a more comprehensive view of context to improve sustainable, healthy diets for the most vulnerable populations around the world.

Livestock and aquatic foods remain essential protein sources for both urban and rural communities. A promising area of work is to further understand how both can contribute to healthy diets, nutrition, livelihoods, and sustainability in food systems. Additionally, effective public and private sector partnerships are essential to expand and support public health efforts. These include reducing the consumption of sugar, oil, and salt, and cutting down on food waste.