This page contains a Flash digital edition of a book.
Latin America and the


Caribbean In Latin America hunger overlaps with over- weight and obesity, sometimes even in the same family, so efforts are needed to deal with both undernutrition and health problems related to overnutrition. Argentina, for example, has rec- ognized that overweight is concentrated among its poor citizens. Joint public and private action is needed to help reduce sugar, salt, and saturated fat in manufactured food products.34


Some countries are beginning to find innova-


tive ways to exploit the links among agriculture, nutrition, and health. Brazil, for example, has one of the world’s largest school feeding pro- grams, which brings together agriculture, nutri- tion, and health. School feeding is just one of many social programs that have helped cut pov- erty and hunger in Brazil, but these programs still have not reached all poor and marginalized groups, so more remains to be done.35


Central American countries have also come


together to make use of the linkages among agriculture, nutrition, and health. Multisectoral approaches are underway at both the regional and national levels. In all of these efforts, par- ticipatory communication is key to achieving results, and monitoring and impact assessment are essential.36


High-Income Countries One needs to look no farther than the high- income countries, where overweight and obe- sity are reaching epidemic levels, to see that adequate food supplies are not synonymous with good nutrition and health. Governments in many of these countries have adopted policies that maximize the export value of crops and en- able low food prices at home. Four decades ago, when a “cheap food” policy in the United States pushed down the percentage of income spent on food by nearly 50 percent, the amount spent


on healthcare more than tripled. Much of the increase was tied to dietary disease.37


To avoid the more deleterious health out-


comes apparent in the high-income countries, more policy coherence is needed across the health, nutrition, and agriculture sectors. Un- fortunately, no examples exist of cost-effective country-wide approaches to decreasing over- weight and obesity. Unlike some interventions with proven effectiveness—such as breast- feeding or micronutrient interventions—the preliminary evidence suggests that preventing overweight and obesity will require approaches that are much more multisectoral. Educational programs on nutrition and health in schools and communities can build awareness, but they must also take into account the psychology of consumers and the difficulty of changing their behaviors.38


These experiences point to lessons for other


countries with rising incomes: it is crucial to think about nutrition policies now to ensure that income growth does not lead people to shift from eating nutrient-rich foods, grains, and vegetables to eating foods high in fat and sugar. Once obesity sets in, it is extremely difficult to reverse.


STRENGTHENING THE EVIDENCE BASE


The development community currently has an enormous appetite for impact evaluation. More than ever before, donors want to know whether the programs and projects they are funding are bearing fruit—in short, they want to know what works. Evaluations are valuable because they serve two main purposes: they provide account- ability, and they offer a chance to learn how well particular approaches work in meeting their goals.


The idea that development activities can ex-


ploit the links among agriculture, nutrition, and health still suffers from a weak evidence base.


“There is a tendency to ask the question, ‘Should we invest in agriculture, or nutrition, or health, to improve nutrition?’ This is the wrong question. It’s not either/or. We need to invest in agriculture and in the complementary types of investments in other sectors that will bring about improvements in nutrition.”


—Marie T. Ruel, International Food Policy Research Institute 11


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20