Just like any hot topic, the solution to malnutrition has two dominant schools of thought. Many believe in the power of supplements and fortified foods for tackling undernourishment. Others stand behind agriculture-based approaches, which advocate that real food is the best source of the nutrients we need. Which is the best way to end malnutrition?
Supplement-based strategies can seem sensible when populations do not have access to a well-balanced diet. Micronutrient sachets are lightweight, easy to store, and can be transported quickly in emergencies. They also have a long shelf life, even in hot conditions (up to 2 years).
As a stop-gap, supplements can be life savers, but as a long-term strategy, they don’t have a good track record. Vitamin A supplementation programs to reduce childhood mortality, for example, have been in place since the 1990s, but recently researchers have begun questioning their effectiveness. When they looked at the evidence, the researchers found that childhood mortality was decreasing, but not in the countries with supplementation programs. In fact, they found that programs based on food were far more successful in treating malnutrition. Some nutrition scientists are concerned that the presence of supplementation programs interferes with efforts to promote breast-feeding, and other initiatives aimed at achieving a healthy and sustainable food supply.
The agriculture-based approach takes into account that the right to food is a human right. Proponents say it is not realistic or even ethical to ask communities to get their nutrients from a packaged product rather than from the real food that other countries take for granted. The foods people eat are part of their identity and sense of self, and people who follow traditional food ways tend to be healthier than those who consume a processed-food diet. Fortified bars and sprinkles, in this light, cannot be seen as meeting a person’s right to adequate, nutritious and culturally appropriate food.
In a collection of 19 different studies around the world, researchers found that food overwhelmingly improves nutrition better than supplements and fortification. Several studies on the effectiveness of supplements show that they can even cause problems not associated with vitamins found in real foods.
Few would argue about the benefits of supplements or fortified foods in emergencies, but reliable food systems can help to reduce the need for these and make communities more resilient and self-sufficient. A community that lives on the foods it can produce is a healthy community. One that lives on food from packages is a dependent community.
Perhaps we need both, but we need to be clear about where one is superior to the other. When there is an emergency and people need food right away, it’s hard to beat fortified biscuits. But as a long-term strategy, everyone deserves to eat real food.
Sembrar la vida
