Q&A: The need for an affordable nutrition revolution

Nutrition is one of the best investments to make in the development sector. That is according to Yannick Foing, global lead of partner engagement in the nutrition improvement unit at DSM, a science-based multinational involved in nutrition, health, and sustainable living.

“It consistently delivers one of the highest returns on investment in social development than any other area of development. If you invest $1 in nutrition, you can expect $16 in return,” Foing said.

Currently, 2 billion people worldwide suffer from hidden hunger — a form of malnutrition where, despite getting enough calories, the diet lacks essential vitamins and minerals, also known as micronutrients. Malnutrition kills 3 million children each year and prevents many more from reaching their full potential.

Micronutrient deficiencies, in particular, are often to blame for the 1 in 4 children who are currently stunted, meaning that they can’t grow or develop properly. The majority of these children live in low- and middle-income countries.

“Stunted children will struggle at school, they could miss school, and develop into physically and cognitively disadvantaged adults with fewer chances of landing a good job. This means these individuals will not reach their full potential and this will have a huge impact on the economy,” Foing said, adding that India, in particular, could lose 2.5% of its gross domestic product — equivalent to $46 billion by 2030 — because of malnutrition.

“An affordable nutrition revolution within the next 10 years is imperative in order to meet the Sustainable Development Goal of achieving zero hunger by 2030.”

— Yannick Foing, global lead of partner engagement in the nutrition improvement unit, DSM.

Speaking to Devex, Foing explained why tackling hunger such a priority investment to make, why food fortification is one of the best solutions available, and why it’s time for an affordable nutrition revolution.

This conversation has been edited for length and clarity.

Undernutrition accounts for 11% of the global burden of disease and is considered the No. 1 risk to health worldwide. Is enough being done to address it?

I would love to say “yes,” but unfortunately, if you look at the statistics, I have to say “not really.” In places like Indonesia, Nigeria or India, the statistics are not getting better fast enough, meaning that we definitely need to do more.

Investing in nutrition is a good investment to make for businesses and governments, but we need more political will, more funding to support the existing interventions and bring them to scale, more affordable nutritious products on the shelves, and lastly, we need to ensure that governments, the United Nations agencies, global donors, and businesses are all contributing to investing in nutrition to ensure that the food that consumers throughout the base of the pyramid are getting is healthy, tasty, nutrient-dense, affordable, and accessible in a sustainable way.

What are some of the top solutions tackling malnutrition?

The first solution that has been around for many, many years: food fortification. That's basically adding or replacing vitamins and minerals that have been lost during the process — like in rice, maize, and wheat flour for instance — or that are needed to address specific deficiencies in the targeted population.

It's a very effective way of addressing micronutrient deficiencies because it reaches entire populations and doesn’t impact color, taste, or appearance of a product so it doesn’t change the dietary habits of consumers and it’s therefore very well accepted. Moreover, it’s extremely cost effective with a compelling return on investment.

The estimated cost by the World Health Organization to fortify staple food is less than 30 cents per person per year, meaning that it's a really low-cost investment, but what you can get in return is enormous.

It's been highlighted by many agencies that there’s probably no other technology available offering such a large opportunity to improve lives at such a low-cost and in such a short time as fortification.

If you look at the fortification of flour — done over many years in North America, Europe, Asia, and in Latin America mainly with iron and folic acid — some of the results around public health are very good.

In Venezuela, anemia was reduced by 47% thanks to the fortification of flour. In Chile, spina bifida — a neural tube defect during fetal development caused by maternal folic acid deficiency 

which leads to complications such as an inability to walk and problems with bladder or bowel control — was reduced by 40% in newborns.

The fortification of rice at scale could now also be a game changer in the fight against malnutrition. Rice is consumed by more than 3 billion people worldwide, many of whom are in Asia, Africa, and Latin America where the majority of people have deficiencies in micronutrients.

Then there’s supplementation and what we call home fortification, where micronutrient powders — distributed for the longest time by UNICEF, World Food Programme, and other NGOs — are providing 100% of the daily needs of essential micronutrients to children.

In addition, the public health community is looking into improving the current standards for antenatal supplementation. Many women today lack access to essential micronutrient supplementation. To help meet women’s increased nutritional demands during pregnancy, WHO recommends iron [and] folic acid supplements as the current standard for pregnant women, but over 20 major studies show that taking multiple micronutrient supplements during pregnancy, instead of iron and folic acid alone, reduces the risk of maternal anemia, the likelihood of a child being born too small, and the risk of infant mortality and preterm births.

What are some of the challenges in tackling malnutrition?

When WHO puts together standards for fortified food or new public health maternal supplements, they act as a guidelines for countries to choose to adopt, follow, monitor, and enforce, but this is not always the case. Some governments make fortification mandatory for given staple foods, but the implementation is not always effective.  

Then there’s funding. Investing in nutrition does not always look attractive because, while with medicine or pharmaceuticals you see a public health impact almost right away, with nutrition, you have to wait for a longer period of time, up to 6 months usually being the minimum. It's a long-term investment from government, consumers, and beneficiaries. The challenge is ensuring that there are more smart investments that go toward nutrition to really have a strong impact. 

The last point is that everything starts with consumers or beneficiaries. We need to identify who they are, where they live, what their deficiencies are, and what their dietary habits and tastes are, otherwise we might be pushing out a nutritious product that they don't like, can’t afford, can’t use, or can’t access because they’re too far away from the distribution channel.

Then there'll be no impact on public health and we miss out on a big opportunity to address hidden hunger.

What would your call to action for the global health community be with regard to galvanizing more investment around malnutrition?

An affordable nutrition revolution within the next 10 years is imperative in order to meet the Sustainable Development Goal of achieving zero hunger by 2030.

To do that, we need more unlikely collaborations with the objective of bringing sustainable and affordable, science-based innovations to the dining table to improve nutrition for all. We've been talking for years about public-private partnerships: we must stop talking now and just make it happen.

Companies can bring innovation and develop products that are nutritious, tasty, and affordable. They do need to collaborate with governments, communities, donors, and NGOs to ensure that these products reach the consumers who need them the most, in a sustainable way.

Only together can we tackle and eradicate hidden hunger.


Yannick Foing is the global lead of partner engagement in the nutrition improvement unit, DSM. This blog was originally published on devex.com and reproduced here with permission from the authors.