A Jump-Start into the World of Nutrition

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On June 7th, 2018, only three-days after starting my summer internship with Sight and Life, I found myself on a long-haul flight traveling to Boston, Massachusetts, from Switzerland. I was invited to join the Sight and Life team at the American Society for Nutrition’s (ASN) Nutrition 2018 conference – what an incredible opportunity! I could not have been more excited for this perfect introduction into the world of nutrition, particularly since I am interested in applying my current academic background in economics and law to the field of nutrition.

Initiation as an Intern

On the first day, I participated in a team workshop where I met the global team of Sight and Life – such an interesting mix of people! As a complete newbie, I quickly observed that the team is held together by their passion for nutrition, as their backgrounds are quite diverse. Besides nutritionists and scientists, I was stunned to discover there is an assortment of business, communications, marketing, and architecture degrees amongst the group. Additionally, I gained insight on how Sight and Life operates. The team of twelve is spread across four different continents – India, Egypt, Switzerland, South Africa, and USA – completing the majority of their work remotely and therefore making team retreats of great importance.  


The workshop focused on ‘design thinking’ and was a great opportunity for everyone to learn a new method of problem solving. Additionally, having a team with a wide variety of knowledge and experiences presented interesting and rich discussions the during group exercises. The most valuable take aways, for me, were learning the importance of a broad stakeholder analysis, defining a high potential but underdeveloped stakeholder, and how you can engage with an assortment of stakeholders within a complex interdependent system. This mirrors the importance of a multi-sector and multi-stakeholder approach to solving the complicated malnutrition puzzle. The day culminated at Fenway Park cheering on the Boston Red Sox’s as they played the Chicago White Sox for a Sight and Life team outing. 

A Peek into Nutrition

For the next three days, I participated in ASN’s Nutrition 2018 at the Hynes Convention Center. As I have never been to a conference, let alone one focused on nutrition, and I was eager to see how it all worked. With over 3,500 participants registered, it was shaping up to be the largest ASN conference so far. When I walked through the main entrance for the first time, I thought something probably quite typical of a European in America, “Oh my god, this is so big!” Sight and Life showcased a booth in the gigantic exhibitors hall, but there was also several floors of meeting rooms where I would spend the coming days in listening to interesting presentations. 

ASN, Sight Life, Nutrition2018, conference, malnutrition

Eager to learn, I attended as many sessions as I could possibly fit into my schedule covering a wide variety of nutritional topics. I didn’t know what to expect when I saw the list of speakers for each session, naively I thought they would all sit in front and have a panel discussion. However, they were mostly individual presentations sharing the results from their recent research. I learned about behavior change communication, nutrition education, heard about different nutrition strategies and their implementation, and community health interventions that were completed in India and one in a refugee camp in Beirut.
 
For me, the most interesting session was “Demographics, Diversity and Disparities in Nutrition Science”. A few speakers presented research that was focused on a specific region in Hawaii, USA, and an ethnic group of American indigenous people while others presented nutrition issues and development on the global level. The most shocking session I attended was, without doubt, about the nutrition situation of Native Americans by Dr. Donald Warne, a member of the Oglala Dakota tribe from South Dakota, USA. He provided extensive evidence that one does not have to travel far to find health issues as they exist in native communities in the United States of America. He argued that it is almost perverse that in America you are automatically eligible for dialysis in the case of kidney failure; yet, a child is not automatically eligible for healthy food. An anecdote that resonated with me was a story Warne shared of three sisters illustrating the importance of targeting health problems at their roots.

As three sisters walk along a river, they see there are children in the river who cannot swim and are about to drown. One of the sisters says, “Something needs to be done.” She jumps into the river and tries to save the children. The second sister disagrees with the first one saying, “We just need to teach them how to swim!” The third sister has not said or done anything, and the other two are furious with her. “Why aren’t you helping us?” they exclaim, “These children need to be saved!” The third one turns away and starts to walk up the river saying, “I will find and stop the person who is throwing these children into the water.”

Experiencing the Conference

During the three days, my time spent at the Sight and Life booth was both busy and truly engaging. I found it most interesting to talk to students, researchers, journalists, and scientists from all over the world and explain what Sight and Life stands for. It was intriguing to visit the other exhibitors at the conference presenting a variety of nutrition topics from non-profit organizations fighting malnutrition to private corporations offering vitamin supplements. One booth representing a company called Allulite Rare offered samples of chocolate and gummys made with a new kind of sweetener that tastes just like sugar, but without all the disadvantages such as calories, glycemic effect or digestive upset. At the InBody exhibit, I had a body measurement analysis done free. This machine provides individual results for weight and body fat percentage as well as the distribution of lean muscle mass in less than a minute. 

Sight Life, Elevator Pitch Contest, EPC, Finalists 
A highlight for Sight and Life was the Elevator Pitch Contest, where selected students and young researchers presented their innovative ideas on nutrition assessment to a panel of experts. It was fascinating to hear about these cutting edge concepts and that many people my age share the passion for nutrition. Many of the presentations introduced fascinating new mobile applications for measuring food intake. One of my favorite pitches was from Andrea Spray of INATU, standing for ICT’s for Nutrition Agriculture and Time Use. By attaching a tiny camera to women’s clothing, the device provided in-depth research for nutrition assessment as the device automatically takes a picture every minute. Her project in Africa proved that the gadget was generally well received in communities and proved to be a good option for measuring nutrition behavior remotely without much paperwork – this was an interesting idea. It is impressive to see the tremendous progress that can be made in a relatively short time when one is focused on a goal and teams up with the right people.
 
After spending a sunny day sightseeing in Boston, I once again found myself onboard a flight back to Zurich. It was an incredible experience. I learned so much about nutrition, the broadness of the worldwide nutrition issues currently at hand and the importance of bringing all stakeholders to the table. I would like to thank the Sight and Life team and my boss, Klaus Kraemer, for making this possible and for welcoming me into the Sight and Life family.

Take a look through the picture gallery from ASN: 

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Where are they now?

Sight and Life Elevator Pitch Contest Finalists

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Ever wonder what happened to the first Sight and Life Elevator Pitch Contest finalists from 2016? Sight and Life had the privilege of catching up with four of the ten finalists from Elevator Pitch Contest to find out what they are up to now and reflect on their experience.

EPC, Elevator Pitch Contest

 
During this competition, graduate and post-doctoral students were invited to submit their ideas on the theme ‘The Future of Micronutrient Innovation’ across diverse categories in nutrition-related products, services and technologies. We received over 90 submissions from students in 18 different countries. With the support of a distinguished jury, we narrowed the selection to ten bold ideas for presentation. The finalists were sponsored by Sight and Life and Tata Trusts, who mentored them as they prepared to present their ideas to a panel of experts, in front of an audience of conference participants during the Micronutrient Forum in Cancun, Mexico. Read more about the 2016 Sight and Life Elevator Pitch Contest here

The first and second place winners, Muzi Na and Nicholas Myers, share their status and weigh in on the Elevator Pitch Contest along with finalists Nicholas Myers and Sambri Bromage. 
 
Uzi Na, Elevator Pitch Contest FinalistMuzi Na
Location: China
Concept: Empower Grandparents – A mobile application using SMART feeding messages that empower senior caregivers, such as grandparents, to better feed their grandkids in rural China.
 
Na was the first place winner of the 2016 Elevator Pitch Contest with her innovative mobile phone application and persuasive pitch. Today, the idea is on paper with plans to write grant allowing her to collect data about acceptability regarding the idea among the target population. Currently, Na is on faculty at Penn State University as an Assistant Professor in Nutritional Epidemiology.

EPC, Elevator Pitch Contest, Philip James

Philip James
Location Gambia
Concept: Next Generation Supplement Design – A novel nutritional supplement to optimize the mother’s micronutrient status in early pregnancy to better regulate infant epigenetics and decrease future disease risk.
 
A future full of potential, James caught the attention of the jury panels with his inventiveness in 2016. The nutritional supplement has now been designed and is currently in the process of setting up a clinical trial in Gambia to test its effectiveness in correcting micronutrient deficiencies. James and histeam is also looking at how nutrition in pregnancy, particularly at the time of conception, has the potential to influence the way an infant’s genes are expressed, and the implication this may have for the health of that child over his or her life.
 
EPC, Sight and Life, Elevator Pitch Contest Nicholas Myers
Concept: Paper Analytical Devices – A lab-on-paper that measuresiodine levels in salt and urine samples to monitor iodized salt programs at a low cost in real time. 
 
Myers has found support through The Black Lion Hospital, in conjunction with the Ethiopian Food, Medicine, and Health Care Administration and Control Authority, and is performing an implementation study in Ethiopia. If the study is successful, health agencies and governments may use the test card to monitor the quality of iodized salt in marketplaces.
 
With a shift from the nutrition field to public health, Myers has adapted the chemistry of his iodine test card to instead quantify the amount of penicillin-class antibiotics present in finished pharmaceutical pills with greater than 95% accuracy. His hopes are that the test card becomes a field-friendly technology that governments use to detect breaches in medicine compliance.

EPC, Elevator Pitch, Sabri BromageSabri Bromage
Location: Mongolia
Concept: Leveraging Academic Networks for Dietary Survey (LANDS) – A global student-centered network for collecting, analyzing, sharing, and applying dietary data from populations in low-and middle-income countries.
 
Today LANDS is used in Mongolia with interest to expend it internationally. Bromage is currently finishing his dissertation on “Epidemiology of dietary and micronutrient deficiencies in Mongolia” and beginning the search for a post-doc position or job. In tandem, he is working on new and interesting projects that he will be able to share in the future.

1. What did participating in the Sight and Life Elevator Pitch Contest mean to you personally and your innovation?

Na – The Sight and Life Elevator Pitch Contest meant a lot to me! Personally, the contest provided an opportunity for me to meet and know manyyoung innovators working in diverse fields all over the world. From the innovation’s perspective, the elevator pitch style is very different from writing a proposal or a manuscript, as there is a short window of time to articulate an idea, including the rationale behind the idea and the potential impact. I really want to thank Sight and Life for organizing this fantastic event, in which I discovered new possibilities to share and sell novel ideas that aim to tackle nutrition problems. 
 
James – It was a privilege to be short-listed for the contest. Being able to attend the contest at the Micronutrient Forum enabled me to meet so many people from different fields in nutrition, to network with people who were interested in my team’s project and to be able to benefit from everything else happening at the Forum.
 
Myers – As an inventor, I welcome any chance to disseminate information about my invention. At the competition, I pitched an idea about an inexpensive paper test card that quantifies iodine levels in fortified salt with greater than 90% accuracy and how it can be used in low- and middle-income countries. At the time of the contest, my invention was making its way through the “Valley of Death,” which is a relatively low funding period between R&D and commercialization. The contest provided a platform on which I, a chemist, reached hundreds of experts in the micronutrient sector, and these multi-disciplinary connections are critical to push an invention through the “Valley of Death” and to commercialization.
 
Bromage – Participating in the Sight and Life Elevator Pitch Contest helped me realize the international potential of my innovation. Personally, it exposed me to nutrition innovation, a part of nutrition I have not had much experience with as I mostly work in research.

2. What was the biggest challenge you experienced through the creation process of your innovation?

Na – I guess there were many challenges but the biggest one for me probably was to identify the ‘big’ problem that maybe solved by a ‘small’technology, which I understood. Once a niche target population was identified, the process to identify and design an intervention, applying feasible technology to serve the population was straightforward.
 
James – The field of nutritional epigenetics is still rapidly developing, so consolidating the evidence base to design a supplement was an interesting but challenging piece of work. 
 
Myers – The biggest challenge for me was overcoming small but daily setbacks. I had to rapidly prototype dozens of devices with relatively minor changes, most of which did not work. I came to term this ‘Edisoning’ as Thomas Edison had to follow a similar process as he trialed 2000+ materials to develop the light bulb. My technology and I survived the research and development phase because I saw the benefits of the final product outweighing the emotional, physical, and monetary costs to create it.
 
Bromage – My biggest challenge is getting other people interested in my innovation because I am not really a natural born salesperson.

3. What was the most memorable moment from the Sight and Life Elevator Pitch Contest?

Na – It was the moment I decided to stay among the audience and not to give the pitch behind the podium. It was a completely random thought, mostly because I was very nervous. Once I started my pitch right next to the first row of listeners, I immediately felt a connection with the audience. It was an amazing feeling and my nerves immediately disappeared.
 
James – The session when we delivered our presentations was a great experience. It was so good to hear everyone’s pitches, get inspired by the creativity in the room, and to have the support of a room full of interested people. It was also encouraging afterwards to network with people who had further questions and advice.  
 
Myers – The moments I enjoyed the most happened behind the scenes when all the innovators had the opportunity to get to know each other personally. We are not just a bunch of mad scientists- we are a group of seemingly ordinary people with a shared desire to improve health, and with the motivation to do so.
 
Bromage – Getting to meet the other contestants and the Sight and Life team including Kalpana Beesabathuni, Kesso Gabrielle van Zutphen, and of course Klaus Kraemer.

4. What lesson(s) did you learn from your experience?

Na – Be bold, be confident. No idea is too small to share. Lastly, but not least, it is important for any speech-based contest to practice, practice, and practice. 
 
James – It was a great opportunity to learn how to explain an idea succinctly and avoiding technical jargon. An elevator pitch is a very different style of communication than I was previously used to and this was the ideal setting to learn more about how to develop those skills.
 
Myers – Even though I was one of the winners, investors and buyers are not knocking down my door to advance the technology. The lesson I learned is that perseverance is needed at all steps of product development and that I will have to keep pushing just as hard as I did through the research and development stage to survive the commercialization phase of my invention. It took a lot of hard work and gumption to achieve what I have so far, and it will take at least as much to reach the next level.
 
Bromage – Some of the greatest innovations are not devices but rather new ways of thinking about the world.

5. Where do you see the future of nutrition?

Na – I see a lot of potential for the future of nutrition is from the interdisciplinary perspective, where technology, engineering, biology, and other disciplines interact with nutrition making groundbreaking discoveries as well as solving critical nutrition and health problems.
 
James – I see a future where nutrition continues to be integrated with other sectors and disciplines. In my field that means analyzing nutritional biomarkers together with metabolomics, genomic, and epigenomic data to broaden our understanding of the complexities of human metabolism. 
 
Myers – The future of nutrition relies on all of us being citizen scientists making information-based health decisions. Ordinary people need to be provided easy-to-use and robust technologies to help them with these choices. We saw this at the competition, especially with the technologies presented by the three winners.
 
Bromage – Dealing with the effects of climate change.

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Expand your Knowledge

Recommended Reading on Behavior Change Communication

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At Sight and Life, we are pleased to share knowledge and recommend resources that we find useful in our work. This is certainly the case with behavior change communication (BCC).

To expand your knowledge about the steps in the Sight and Life BCC Process we shared during the webinar “Assessing the Situation: What you need to know” in our BCC webinar series, we have collated an array of books, websites, and papers that are valuable resources. This is just our opinion but we hope these recommendations can deepen your knowledge on BCC and provide though-provoking ideas and inspiration as it did for us.

During this second webinar in the series, we discussed Step 2 and Step 3 in the Sight and Life BCC Process; the desk review and client research.

Bcc Process Cycle, behavior change, nutrition

The key takeaways from this webinar are:
– The BCC principle ‘know your audience’ lies at the core of developing successful nutrition communication campaigns. 
– Defining your knowledge needs, or simply what you need to know, is the first critical consideration.
– Step 2 in the BCC process isabout assessment, analysis, and synthesis of information to effectively answer questions on the broader context, thedrivers and constraints for the target behavior and communication efforts previously employed to change the desired behavior.
– Client research, step 3 in the BCC process,involves gaining valuable insights from the target audience and communities that you seek to change. 

Watch the video of webinar 2 below and find the complete slide deck from the second Sight and Life webinar HERE.

Our Recommended Resources on BCC from Webinar 2

 

Research Paper
1.
Download the paper by Population Services International (PSI). A Qualitative Research for Consumer Insights: One Organization’s Journey to Improved Consumer Insight HERE

In this paper, PSI, a leading social marketing and behavioral change communication NGO describe how they improved the use of research to gain better consumer insights and plan better interventions. It offers a practical perspective through the lens of an organization where research is core of the business.

Why do we like this?
We think this paper is insightful for any organization wishing to strengthen their qualitative research capacity for improved target audience insight generation. The paper lays out how an organization focusing on behavioral change, has sophisticated their approach to qualitative research to improve their programmes over time.

Useful Websites
2.
The Health COMpass
The Health COMpass is a platform offering a wealth of useful resources from different proven sources, for researchers, from specific guides on data collection methodsfor the field to more comprehensive guides on how to conduct formative research. It is funded by USAID and managed by Johns Hopkins University Bloomberg School of Public Health.
 
Why do we like this?
The Health COMpass provides evidence based, easy to understand tools – ready to take and apply to a real-life context for beginner and specialists in behavioral change alike.
 
3. The UK National Social Marketing Center
This former non-profit and now agency offers a comprehensive step-by-step guide on developing a behavioral change intervention. Of specific interest is the section on generating insights, in their planning guide as well as the real-life examples of behavioral change interventions, in the show case section, you can learn how insights were derived from research to development. 

Blog
4.
Innovative Research Methods – Roleplay
As we often conduct research on topics that can be sensitive such as personal health or child feeding practices, creating an environment where the interviewee feels comfortable and at ease enough to open up to the interviewer is often a challenge. The choice of a research method which best fits the environment is key. Using roleplay for research is an innovative way to allow the interviewees to ‘act-out’ their behaviors, concerns, beliefs, and barriers with others rather than be interviewed. IDEO, a social innovation consultancy, uses this method successfully and provides free tools to download.

Another interesting blog post about the use of role play in research is “Candy Wrappers and Stethoscopes: Role-play in the user testing environment” written by Estee Liebenberg, a service design consultant.
 
Why do we like this?
Innovative research methods to tailor how we approach our audience and adhere to their needs and contexts is an important part of ‘knowing your audience’. Roleplay provides an applicable research method and in this blog post the author and practitioner of roleplay provides great insight into how this methodology works in practice.

Book
5.
Thinking Fast and Slow by Daniel Kahneman
 Drawing on decades of research in psychology that resulted in a Nobel Prize in Economic Sciences, Daniel Kahneman takes readers on an exploration of what influences thought example by example. System 1 and System 2, the fast and slow types of thinking, become characters that illustrate the psychology behind things we think we understand but really don’t, such as intuition.
 
Why do we like it?
In webinar 2 we talked a lot about the BCC principle ‘know your audience’ and this book is an interesting examination of human behavior and how we think. It is a comprehensive explanation of why we make decisions the way we do and how the decision-making process can be improved. An interesting tidbit is our decisions are strongly colored by how we frame questions in our minds. Simply re-framing a question can easily cause people to reverse decisions. We need to understand these framing issues in order to avoid bad decisions. This provides useful insights for BCC interventions aiming to influence the decision-making process.

Webinar 2 Sources
And lastly check out these great sources our experts referred to during webinar 2! 

6. Merritt, RK. Bsc, D.Phil  (2011). Developing your  Behaviour Change Strategy ‘How To’ Guide.  On behalf o f NHS East London & the city.  Tower Hamlets PCT. 
 
7. Dickin, Kate and Marcia Griffiths, The Manoff Group, and Ellen Piwoz, SARA/AED. Designing by Dialogue. Consultative Research to Improve Young Child Feeding. Support for Analysis and Research in Africa: Washington, D.C.: AED for the Health and Human Resources Analysis (HHRAA) Project, June 1997 
 
8. Focused Ethnographic Study of Infants and Young Children Feeding Manual

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Assessing the Situation

What you Need to Know 

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Recently listening to TEDxCSU Talk on behavior change led by Professor Jeni Cross from Colorado University, I was immediately struck by how we routinely rush the planning stage of a behavior change communication (BCC) intervention. Taking time to understand where we are, where we want to go, and what will enable us to reach our goal is essential in devising a successful nutrition communication campaign. Resonating with this topic is the second webinar in Sight and Life’s Webinar Series “Assessing the Situation: What you Need to Know.” It is a valuable and timely reminder on the importance of understanding your target audience during the BCC planning process. 

During this enlightening dialogue Professor Cross spoke candidly about the existing myths regarding behavior change. For example, does education change behavior? What we know about education is how the information is presented, rather than the information itself, creates behavior change. Making learning tangible, personalized, and incorporating social interaction provides the greatest impact in behavior change.  

Another misconception is that one needs to change attitudes to change behaviors. Attitudes do not predict behavior! A more effective strategy is to connect to people’s values to set behavior expectations. The last myth is that people know the triggers that motivate them. Professor Cross argues this is not the case, as social norms have, by far, the greatest influence on human behavior. For instance, if you see someone select a healthy option at lunch, then you are more likely to follow suit. Understanding these constructs in human behavior is important because they are the core of developing successful nutrition communication campaigns.  Watch the TEDxCSU Talk below: 

Keep this principle thought in mind as you embark on the next steps in the BCC process presented in Sight and Life’s second webinar in the BCC Webinar Series. 

The Journey to Understanding your Audience 

Here are the questions to ask as you embark on step 2 and 3 in the BCC process:   
– What is it that I really need to know about my audience and the environment in which they live? 
– What works and does not? 
– How do I get to the core of what matters to my target audience? 

Webinar 2 walks through the typical knowledge needs required for a BCC intervention in nutrition, examines how to get the most out of each knowledge source and suggests approaches that enable a deep understanding of the target audience.  

BCC Process Step 2. The Desk Review 

Before beginning the desk review, be sure to answer the question, what is the purpose of this information and how do you plan to use it?  

The desk review encompasses three elements: 
– Exploring the broader context
– Reviewing the effectiveness of past experiences
– Understanding program context (reaching your target audience) 

In summary, elements 1 through 3 of the desk review help define the scope of your communication strategy. These identify the broad parameters and constraints to use when designing and delivering the intervention while also supporting the critical decisions when creating a communication strategy.  

BCC Process Step 3. Client Research 

The next step in the BCC process involves acquiring valuable insights from the target audience and communities you seek to change. We are again reminded of the BCC principle; know your audience!  

BCC, Nutritional Status, conceptual Model, behavior communicationDuring webinar 2 we share three key components in client research which support the gathering of comprehensive information on the target audience and factors that influence behaviors and practices; the inquiry framework (what do you need to know about the behaviors), applicable research methods (how to extract that information), and insight generation (moving from understanding behavior to finding deep, shared truths). 
BCC, Nutritional Status, conceptual Model, behavior communication
Consider the questions posed at the start of this blog: what do I need to know about my audience and the environment in which they live, what works or does not, and how do I get to the core of what matters to my target audience? Steps 2 and 3 help you answer these questions.  

Key Takeaways from Webinar 2 

– The BCC principle ‘know your audience’ lies at the core of developing successful nutrition communication campaigns.  
– Defining your knowledge needs, or simply what you need to know, is the first critical consideration.  
– Step 2 in the BCC process is about assessment, analysis, and synthesis of information to effectively answer questions on the broader context, the drivers and constraints for the target behavior and communication efforts previously employed to change the desired behavior.
– Client research, step 3 in the BCC process, involves gaining valuable insights from the target audience and communities that you seek to change. 

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Essential Reading on Behavior Change Communication (BCC)

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At Sight and Life, we are pleased to share knowledge and recommend resources that we find useful in our work. This is certainly the case with behavior change communication (BCC)! To continue learning about BCC while waiting for the upcoming webinar, we have collated an array of books, websites, and e-learning modules that are valuable resources. This is just our opinion but we hope theses recommendations can deepen your knowledge on BCC and provide though-provoking ideas and inspiration as it did for us. 

During the first webinar in the Sight and Life Webinar Series focusing on behavior change communication (BCC), we examine integrating BCC into nutrition programs. The key learnings are:

– BCC is a communication approach with distinct underlying principles, which make it a valuable part of nutrition programming.
– It is complicated but can be managed by taking a systematic approach.
– Consider the Sight and Life BBC process cycle as a tool to support planning your nutrition communication campaign.

Find the video and the complete slide deck here from the first Sight and Life webinar People eat food not nutrition: Integrating BCC into nutrition programs HERE.
Behavior change communications, BCC, SBCC 
On May 15th we will be hosting our second webinar Assessing the situation: What you need to know (please register HERE). In this webinar we will identify the typical knowledge needs for BCC intervention in nutrition. We will discuss how to get the most out of the knowledge sources, including written material (program reports, scientific papers), experienced program stakeholders, knowledgeable service providers, and of course, your target audience. Additionally, learn tips for tailoring formative research to generate insights on the factors driving eating behaviors.

Our Recommendations on BCC

E- learning:

1. This interactive course by Strengthening Partnerships, Results, and Innovations in Nutrition Globally project (SPRING) will guide you through narrated slides, quizzes, exercises, handouts, videos, and links to helpful resources. This course will help you understand agriculture’s role in improving nutrition, learn how to use behavior change methods to prioritize and promote nutrition-sensitive agriculture practices, and develop a behavior change strategy for current and future agriculture projects. Find it HERE.

Reading

2. Read this work SPRING; Evidence of Effective Approaches to Social and Behavior Change for Preventing and Reducing Stunting and Anemia to learn the findings from a systematic literature review. 

Lamstein, S.,T. Stillman, P. Koniz-Booher, A.Aakesson, B. Collaiezzi,T.Williams, K. Beall, and M.Anson. 2014. Evidence of Effective Approaches to Social and Behavior Change Communication for Preventing and Reducing Stunting and Anemia: Report from a Systematic Literature Review. Arlington,VA: USAID/ Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) Project.

Toolkit

3. Behavior Change Toolkit  – for International Development Practitioners
This behavior change toolkit is a useful, well written and simple introduction to BCC. A great resource for those starting their learning journey on BCC. The toolkit can be downloaded HERE.

Books

4. Nudge: Improving Decisions about Health, Wealth, and Happiness, Richard H. Thaler, and Cass R. Sunstein.
A book from the winner of the 2017 Nobel Prize in Economics, Richard H. Thaler, and Cass R. Sunstein: it is a revelatory look at how we make decisions. The authors examine the process of how people think, and suggest that we can use sensible “choice architecture” to nudge people toward the best decisions for ourselves, our families, and our society, without restricting our freedom of choice. Nudge is really about the small, subtle pushes that our modern-day world makes to sway one’s opinion or real-world choices.

Why it’s on our Kindle’s
To succeed in behavioral change we must be able to offer people better, more favorable and less costly choices to what they are currently doing. To reduce the consumption of junk food in teenagers for example, we must be able to design alternatives that are equally desirable. Therefore, we must build an architecture that will encourage people to change their habits and follow our behavioral goals. We loved reading the real life examples in this book and learning how simple, thoughtful ‘nudges’ can help people change a variety of behaviors. Find it HERE
 
5. The Power of HabitWhy We Do What We Do in Life and Business, Charles Duhigg 
In The Power of Habit, award-winning New York Times business reporter Charles Duhigg takes us to the edge of scientific discoveries that explain why habits exist and how they can be changed. It uses research to explain how habits are formed and changed. At its core, The Power of Habit contains an exhilarating argument: The key to exercising regularly, losing weight, raising exceptional children, becoming more productive, building revolutionary companies and social movements, and achieving success is understanding how habits work. 

Why we think it’s an essential read for BCC
We recommend The Power of Habit as an easy and fun to read introduction into the science of habit formation and the art of attempting to change them. As nutrition program managers, most of the time, our challenges go beyond changing people’s behaviors. Changing what and how people eat requires us to understanding people’s daily habits and then help them to adopt new routines. This book an excellent foundation to understand the particulars of habits. Buy your copy HERE.  

6. The Tipping Point, Malcolm Gladwell
The tipping point is that magic moment when an idea, trend, or social behavior crosses a threshold, tips, and spreads like wildfire. The Tipping Point explains the phenomenon of why some products, businesses, authors, etc. become hugely successful (tip) while others never seem to break apart from the masses as anything special. Buy your copy HERE.

Why we think it’s relevant to BCC
We think The Tipping Point is a great read to understand how change happens and what makes a behavior tip. Successful interventions and campaigns aimed at changing people’s routines have certain critical characteristic in common: They manage to gain followers, naturally mobilize the audience, and make the behavior contagious instead of imposing it. These initiatives succeed in making the behavior desirable, the message exciting and memorable – like a jingle that naturally ‘sticks’ – and they understand that ‘little things’ in people’s lives matter.

Happy reading!

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Incorporating Behavior Change Communication (BCC) into Nutrition Programs

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If you are reading this blog then, in one way or another, you are interested in changing people’s behavior for better health outcomes. The Sight and Life Inaugural Webinar Series on behavior change communication (BCC) might be just the informative source you are looking for to expand your knowledge. 

What is BCC? 

BCC is a communication approach, one of many communication approaches available to nutrition professionals. It is distinct from other approaches, such as nutrition education or health promotion, for the following reasons:

– It is an emergent process that culminates with the implementation of a BCC strategy 
– The process draws heavily on research and evidence
– The BCC strategy is focused on what the audience needs to do (versus what the audience must know)
– The BCC strategy is integrated with programs and services.

Interested in learning further? Join our first webinar in the series “People eat food not nutrition: Integrating BCC into your nutrition program” to understand more about these principles underlying BCC.  

It’s a Process

For a program manager, BCC might seem like a complicated undertaking, and for many of you, it is about managing others to do this work. BCC is complicated but it can be mastered if you have a systematic approach. Throughout this webinar series we follow an 8-step process cycle for BCC and share tips, checklists, tools, and resources to help you succeed in managing BCC. Completing the webinar series will not make you a BCC expert, however, it will make you BCC literate.

Behavior change communications, BCC, SBCC, process cycle, nutrition

The first webinar introduces step one of the BCC process, setting your BCC goals and behavior objectives. Straightforward, right? An important learning, from our experience, is to separate your program goal from your BCC goal, as they are not necessarily the same. Your BCC goals will focus on practices or behaviors while program goals might focus on a specific health outcome, such as anemia.

Another learning has been to distinguish between “practices” and “behaviors”; practices consist of multiple behaviors and actions. Once you have distinguished practices from behaviors, setting your BCC goal and behavior objectives is easy. We have developed a behavior chain tool to help you detect the multiple behaviors in a practice.

Behavior chain is a simple tool used to identify the factors or activities required to achieve a target behavior. 

For example a micronutrient powder (MNP) intervention, where the BCC goal might be appropriate use of MNP (a practice), the behavior chain tool would look like this:

[START] 1. Aware of MNP 2. value the MNP 3. get to distribution point 4. ask for MNP at distribution point 5. mix MNP with child meal (at the right consistency) (as per frequency indicated on package) [FINISH]. 

Asking for MNP at a point of distribution would be a behavior, as would mix with meals. Voila – two behavior objectives emerge. The objectives are not set in stone. You can modify them as you gather evidence and clues about your target audience in steps 2 and 3. Remember- only set a few objectives because less is more!

Next Steps 

So how do you feel about BCC after reading this blog – empowered to tackle BCC? Eager to learn more? Register for the Sight and Life Webinar Series on BCC below:

Webinar 1 | Tuesday April, 24 at 14:00 CET
People eat food not nutrition: Integrating BCC into nutrition programs

Some key learnings as we begin our first webinar in the series: 

– BCC is a communication approach with distinct underlying principles, which make it a valuable part of nutrition programming. 
– It is complicated but can be managed by taking a systematic approach. 
– This series provides a high-level analysis of BCC that enables you, the participant, to become BCC literate. 

Webinar 2 | Tuesday, May 15 at 14:00 CET
Assessing the situation: What you need to know

Webinar 3 | Tuesday, June 5 at 14:00 CET
BCC Strategy and Roll out: The devil’s in the detail 

Webinar 4 | Tuesday, June 26 at 14:00 CET
Monitoring the Process: Does it work?

****Note you need to sign-up for each individual webinar. Therefore, if you would like to attend each of the four webinars in the series you must register four times. ****

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An Eye-Opening Research Experience through India

Learning Along the Way

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Hello, my name is Shannon King and I am working with Sight and Life as an intern while completing my Masters of Science in Public Health with a focus in human nutrition at Johns Hopkins Bloomberg School of Public Health.

The Assignment in India

During the late summer of 2017, I spent 2 months in India where I was working with our local partner, Karuna Trust, to conduct research on the implementation of the PATH “Feeding the Future through Fortified Rice Program”. Within this intervention Sight and Life has designed three school-based nutrition and WASH strategies to develop healthy eating habits while improving hygiene and sanitation behaviours. The intervention uses peer role modeling and cues to action; games and helper crews; and problem-based learning within the school environment to promote behaviour and attitude change.

The study required visiting 50 schools in four different areas of Karnataka in order to understand how the program is being implemented. Our observations allowed for us to examine to what extent each school had executed program activities- such as having soap available for the students, and how the program materials are being used around the school. Further, in-depth discussions with the implementing teachers provided detailed descriptions of how the program is being used and their experiences thus far.

Impact of my Experience

Overall, it was an incredible experience allowing me to engage first-hand in the entire research process from protocol design, to ethics review, data collection, and data analysis. As a graduate student, I have had the opportunity to work on studies in the past; however, this was the first time I have been given ownership of a study and the ability to work on it from initiation to conclusion. It has been very rewarding to work through each step of the process and overcome all the associated challenges and roadblocks.

During my time in the field, I found it fascinating to see a wide range of implementation processes used in the schools despite the fact that each school was provided with the same program materials and instructions. As researchers, a better understanding of the factors influencing implementation allows us to develop programs in a manner that will optimize delivery.

While the research did not involve any formal data collection from the school children, I will always cherish the moments I was able to engage and play with them. The opportunities were few and far between, however, at one school we arrived early and the teachers were having lunch so the facilitators and myself played one of the nutrition and WASH games with the children. Despite needing a translator to help facilitate the process, it was an hour filled with laughter and joy. It was also an incredible opportunity to see the program in action and how much the children were enjoying to learn.

Working through Barriers

The biggest challenge, and the most eye-opening experience of the trip, was working as a young female researcher. In several different contexts and settings, comments and suggestions made by females were treated less seriously than those put forward by males. Or sometimes women’s opinions were simply ignored, and it was eye-opening and aggravating to experience. Witnessing an individual’s esteem being judged primarily on their gender and seniority is quite the contrast to a working environment where your capabilities are judged primarily on your education, experiences and work ethic. It provided me with an even stronger appreciation of the efforts made to promote gender equality. India has an incredible, young female population with the potential to be strong leaders and change-makers, if given the opportunity.  

Lastly, this experience highlighted the need for implementation research to better understand how the nutrition community can optimize the delivery of nutrition interventions rather than purely conducting before-and-after data collection to assess the success of a program. I look forward to sharing the results with both project partners, in the hopes of allowing for mid-course corrections to improve program implementation, and sharing the findings with the greater research community to help build the literature base of implementation research in nutrition.

Enjoy this gallery of pictures showcasing my visit to Indian schools.

Photo credits: Prachi Katre

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Cracking the Egg Potential

Working to Reduce Child Stunting and Improve Rural Livelihoods

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Eggs are among “nature’s first foods”, designed to holistically support early life and development. They are among the richest sources of essential amino acids, protein, choline, and long- chain fatty acids (DHA).  They are also an important source of some vitamins and minerals, including vitamin A, B2, B5, B12, selenium, phosphorous and zinc, and contain other bioactive factors. In a symposium chaired by Chessa Lutter from RTI International and the University of Maryland School of Public Health and Saul Morris from the Global Alliance for Improved Nutrition (GAIN), and sponsored by the Child Investment Fund Foundation (CIFF) at the International Congress of Nutrition (ICN 2017) in Buenos Aires, the potential of eggs to improve child nutrition and rural livelihoods was debated. 

Eggs

The Science Behind the Egg

For a full-packed symposium hall, Lora Iannotti from Washington University, presented findings from the Lulun Project, a randomized controlled trial in Ecuador, where eggs were given to children 6 to 9 months of age.  After only 6 months, linear growth was improved and stunting was reduced by 47% in the group receiving eggs –  an effect larger than those of any other complementary feeding interventions to date. The trial also showed significant  improvements in concentrations of biomarkers associated with cognitive development including  choline, betaine, methionine and DHA.  Currently, a replication study is on its way in Malawi that also includes assessments of child development.

In rural Ghana, poultry-based income generation activities embedded in an integrated agricultural and nutrition education intervention also led to improved egg consumption, dietary diversity and linear growth among young children. Dr Grace Marquis from McGill University presented the preliminary results of this intervention, in which households with infants up to 12 months of age received multiple agricultural and infant feeding interventions, including education and training on poultry, home gardens and beekeeping. Dr Marquis and her team are currently working with district partners on the sustainability of the intervention by helping women form farmer associations, opening opportunities for access to credit from the local rural bank, and strengthening technical assistance from government health and agriculture extension services.

Creation of demand and overcoming social and cultural taboos preventing mothers and caregivers from giving eggs can be major barriers to overcome when promoting the use of eggs for young child feeding. A key element of the previously described RCT in Ecuador — an intensive social marketing strategy — was described by Carlos Andres Gallegos Riofrío of Washington University. The project was branded as “Lulun”, which translates into ‘egg’ in the local indigenous language, and symbolically tied the practice of giving eggs to young children with indigenous worldviews. The strategy followed a structured process targeting all the six P’s in successful marketing: people, product, place, price, promotion and policy change. Creating a successful brand, brand loyalty and empowerment of mothers and caregivers to take decisions on their child feeding were critical for the successful and continued behavior change and central to the success of the study in improving egg consumption and child growth.

Availability of Eggs

To make eggs available and affordable to low-income households, small holder poultry business models need to be viable. Klaus Kraemer of Sight and Life presented the findings from a scoping study in Kenya, Ethiopia, Malawi and India demonstrating the potential of four types of business models to be viable at-scale:  

(1)  Micro-Financing institutions that provide a small credit to underserved poultry entrepreneurs coupled with peer group support, technical, and business skill training. Such credit helps backyard poultry farmers set-up and operate micro-enterprises.

(2)  The Out-Grower Model: a partnership between smallholder poultry farmers and commercial players to improve the productivity of hens.  

(3)  In the Enterprise Development Model, an established local input supplier organizes smallholder farmers into groups and helps them invest in mid-size poultry enterprises. With relevant training, market support and funding, they manage businesses that not only generate profits, but also succeed in improving the availability of high quality eggs in their community.

(4)  The One-Stop Hub Model is a distribution and aggregation platform tailored for a rural environment. It is a combination of the above three models, and goes one-step further by providing a marketing channel for eggs to be accessible even in hard-to-reach rural areas.

All of these models were successful and in some contexts even hugely profitable. In Malawi, for instance, women farmers in the Enterprise Development Model, can each earn an average income of US$1130 per year!

Chicken

Finally, Emily Lloyd of the One Acre Fund demonstrated the importance of rigorous piloting before moving to scale to tackle issues with selection of the most appropriate chicken-breed in a particular setting, appropriate housing and vaccinations of chickens to prevent spread of poultry-related infectious diseases in the participating households, as well as distribution and financing challenges.

The Challenges

In a lively discussion, some important suggestions were raised by the audience. These included the potential to improve egg consumption in other vulnerable target-groups, in particular pregnant and lactating women, the need for behavioral change strategies and other interventions to prevent the spread of poultry-related infectious disease to the household, concerns about allergies, considerations of equity when rolling-out poultry business models and how to improve sustainability when these programs and interventions are further scaled-up.

Saul Morris, GAIN’s Director for Policy and Planning, concluded that the potential of egg and poultry interventions to impact child’s nutrition and improve rural livelihoods is ‘egg-citing’ and has been underexplored and appreciated. The symposium clearly demonstrated that together, interventions to improve young child egg intake and household and community egg production could radically reduce the global prevalence of stunting and improve livelihoods of the rural poor. The next challenge will be to bring these interventions to scale, and fulfill the promise that by 2020, 10 million eggs will be delivered to young children annually, as a key component of complementary feeding.

Watch the complete ‘Cracking the Egg’s Potential to Improve Child Growth and Development’ presentation from the 2017 ICN IUNS and access the linked research here on SecureNutrition’s website. For additional information on eggs read ‘Cracking the Egg Potential During Pregnancy and Lactation‘ featured in the Sight and Life magazine on Women’s Nutrition and ‘Eggciting Innovations‘ on our blog. 

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Understanding Food Purchase Decisions in Low-income Populations

The Importance of the Consumer

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Dr Hannah Theobald, nutrition and country support manager of the Scaling Up Nutrition Business Network (SBN) and the Global Alliance for Improved Nutrition (GAIN)  is the author of “Consumer Insight for Improved Nutrition: Why consumer research is required to develop demand for nutritious foods among low-income consumers”, published in the ‘Focus on Food Culture’ edition of Sight and Life magazine.

Theobald’s expounds upon the SBN’s vision for more businesses to responsibly leverage consumer insight and data in their production of nutritious foods, particularly for low-income consumers, and its hopes that businesses will develop marketing and communications approaches making nutrition more exciting, relevant and aspirational to the consumer. 

“One third of the world’s population is consuming a poor diet, the world is facing a huge public health and economic challenge,” notes Theobald. “Improving the diets of more than two billion people requires, among other things, engaging food businesses to improve the nutritional content of foods and make nutritious foods more desirable. To reach the ‘bottom of the pyramid’, food businesses need to develop a deep understanding of low-income consumers and their food purchase decisions.”

A bit of background information, the Scaling Up Nutrition (SUN) Movement was established in 2010 and supports national leadership and collective action to scale up nutrition. The SBN is one of four global networks that support SUN countries, along with the United Nations (UN), civil society and donor networks. It is convened by GAIN and the UN World Food Programme (WFP), but is also further supported by an advisory group comprising senior business leaders. The SBN advocates for and supports business investment in nutrition in order to help reduce all forms of malnutrition through innovation and responsible and sustainable initiatives, actions and operations.

The SBN’s wider remit is to facilitate partnerships and linkages with organizations that provide technical assistance, business development support and access to finance, in order to support business to better address malnutrition in all forms. As such, where possible, SBN undertakes and/or collates consumer and market research and shares findings with its business members at the national level.

In this interview, Theobald shares how SBN advocates and supports businesses to act on the issue surrounding malnutrition. The SBN’s Global Coordinator, Jonathan Tench; Uduak Igbeka, the Team Lead of SBN Nigeria, which is convened by GAIN; and Ralf Siwiti, Programme Manager, SBN Zambia, which is convened by the WFP also contributed to the Q&A session. 

Sight and Life (SAL): Tell us a little bit about your background, and how you got involved in Scaling-Up Nutrition Network.

Hannah Theobald (HT): I’m a BSc and PhD qualified nutritionist, and have spent the majority of my career working as a nutritionist in the private sector, mainly focusing on emerging markets. In the last few roles within business I was involved in more corporate social responsibility (CSR) work. I’d been thinking about working in international development for some time so, when the opportunity arose, I took it. I had been aware of and inspired by the work of GAIN and the SUN Business Network for a while. Working on the SBN has been a great way of utilizing my nutrition and business background for social good and sustainable nutrition improvement.

Uduak Igbeka (UI): My background is in agricultural economics. I have been working at GAIN for six years now, focusing on regulatory agencies in industry on a food fortification program before the opportunity to join the SBN team presented itself. It was quite a natural fit, seeing as I had been working closely with business in Nigeria already. I found the opportunity to engage with businesses beyond the food sector exceptionally exciting.

Ralf Siwiti (RS): I am a marketer at heart. My career has taken me from managing relationships in sales to developing marketing communications campaigns for large multinationals in the food industry, as well as non-profit campaigns. My journey with the SUN Movement began with participation as a representative of a well-known consumer goods company at the launch of the SUN Business Network in Zambia in November 2014. Five months later, I was at the helm of this budding project, which has now developed into one of the most successful SUN country networks working to generate private sector investment in nutrition. I am currently leading SBN Zambia into its next phase, which will see it directing focus on making nutrition aspirational for consumers in Zambia.

SAL: What are the SBN’s main objectives?

HT: As the world’s only dedicated, global platform for business and nutrition, we have three main objectives. First, to mobilize business to contribute to reducing malnutrition in all forms. Secondly, we aim to make nutrition more aspirational, accessible, affordable – and available to the consumer. Finally, we are building the case for greater business engagement in nutrition amongst all stakeholders. We achieve this with the support of more than 400 members, which includes both multinational and national companies that are committed to improving nutrition throughout the world.

SAL: How do other stakeholders, who are part of the SUN network, perceive consumer research? 

UI: In Nigeria, the research that was shared with business was commissioned by the Bill & Melinda Gates Foundation, and was originally intended for civil society and shared with them in the first instance. Because formative research is a big part of development, it is perceived that this type of research would help in shaping the development of more nutritious product for target populations in Nigeria.

RS: In Zambia, most stakeholders in the SUN network hold a positive view of consumer research and insight, as undertaken by the national SBN. The country has a widespread lack of data, including that on consumers. As a result, most sectors are eager to learn of the availability of usable data. Consumer insights form an increasingly powerful tool in terms of the implementation of programmes, particularly those relating to behaviour change communications (BCC).

SAL: What challenges are you faced with, to have others − both in and out of the SUN network − accept consumer research and apply the work?

Jonathan Tench (JT): Businesses face two common challenges when it comes to scaling up investment and action on nutrition. First, investment in nutrition is seen to be too expensive – returns on investment can be low if scale is also low and this can be seen as risky by business and investors alike. Second, there is little demand for nutrition at present, especially from low-income consumers, so it is hard for companies to make a case for investing more, as they don’t see a market. There’s also quite a poor understanding of what we mean by nutrition, which in part explains the low demand for nutritious foods. It’s important to do more to raise consumer awareness; we have to educate both consumers and businesses about nutrition.  

There are lots of ways that companies globally address this issue, alone or as part of public-private partnerships, for example around consumer behavior change. We want to encourage more of that type of action and partnership. Businesses can take other actions to raise awareness of and demand for nutritious foods, such as employing social marketing techniques where consumers are taught about the benefits of nutrition. Companies are often very good at marketing aspiration and employ a huge range of marketing strategies, so we’d be keen for businesses to employ these skills to make nutrition more aspirational and desirable.  

RS: The use of the term consumer can sometimes be interpreted as an attempt to commercially exploit the vulnerable. It is often important to highlight the fact that vulnerable people, or so-called beneficiaries of development programmes, are still capable of making choices. The choices they make can be a huge factor in attempts to support them and this is sometimes ignored in development programmes. The sensitization of stakeholders is important in relation to the need, use, and application of consumer insights as, by the nature of most development work, the consumer is often seen as a beneficiary who is vulnerable and must be protected.

UI: Businesses in Nigeria have found the information very useful for identifying product development opportunities. They find the information most useful where a business opportunity also addresses a public health need. Having access to market data through SBN provides access to a resource that many SMEs cannot afford. It helps stimulate innovation, and helps business better understand the consumer.   

SAL: What do you find most exciting and challenging in your work − and what do you hope to see in future?

HT: As a nutritionist from a private sector background, the need to understand the consumer well has been instilled in me. Before joining GAIN and the SBN, I therefore had an understanding of how consumer insight worked and the important role that it plays in product development and communication. It was very important for the network to get involved in this in order to help the Network develop effective consumer awareness campaigns and support business to deliver sustainable nutrition solutions. For example, in Tanzania, we didn’t understand the level of awareness of food fortification. Now that we do, we have a good understanding of consumer’s beliefs and knowledge it will be a lot easier to tailor messages around fortification.

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Introducing Vitamin B7

What are the Benefits of this Water-soluable Vitamin?

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Look at the ingredients in cosmetic products and you may be surprised to see that vitamin B7 or biotin is a key component! Thanks to vitamin B7’s role in a multitude of cellular reactions, particularly interactions keeping your hair, finger nails, and skin healthy, it is often recommended for strengthening hair and nails. Vitamin B7 is involved in metabolism as a coenzyme that transfers carbon dioxide, an important step in breaking down food including carbohydrates, fats and proteins into energy. This role is critical.

The Primary Sources of Vitamin B7

Vitamin B7 can be found in: vegetables; cereals; nuts such as almonds, walnuts, peanuts; yeast; and soybeans. It is also sourced from animal products such as eggs, milk, liver, and kidney or synthesized by intestinal bacteria.

Bioavailability of Vitamin B7

In foods, biotin is found as the free form or bound to dietary proteins. The bioavailability of biotin depends on the ability of protein enzymes in the stomach to convert protein-bound biotin to free biotin. Biotin is not sensitive to light, heat, or humidity.

Risks Related to Inadequate or Excess Intake of Vitamin B7

Experts have yet to quantify the amount of biotin in natural foods. Deficiency due to lack of dietary intake is rare in healthy populations. Symptoms of deficiency include general fatigue, nausea, neurological problems, poor skin, and hair quality. No adverse effects have been reported with excessive intakes of biotin.

Find more information on vitamins and micronutrient deficiencies though our partner, Vitamin Angels or download our complete vitamin and mineral guide here. Here is a delicious way to incorporate biotin into your diet – enjoy!

Banana and Walnut Loaf*

Ingredients

100g softened butter plus a little extra for greasing
140g caster sugar
1 beaten egg
225g plain flour
2 tsp baking powder
4 very ripe bananas
85g chopped walnuts
50ml milk

Method

Pre-heat the oven to 180C (fan) and 160C (gas). Grease a 2lb loaf tin with some butter and line the base with baking parchment, and then grease this as well.

In a large bowl, mix the butter, sugar, and egg together and then slowly mix in flour and baking powder. Peel, then mash the bananas. Now mix everything together, including the nuts. Pour the mixture into the tin and bake for 1 hour, or until a skewer comes out clean. Allow the cake to cool on a wire rack before removing from the loaf tin. The loaf can now be wrapped tightly in cling film and kept for up to 2 days, or frozen for up to 1 month. Defrost and warm through before serving. Serve in thick slices topped with vanilla ice cream and drizzled with a little chocolate sauce for a dessert.

*Adapted from BBC food Online
 

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Introducing Vitamin B6

Interacting in the Majority of Biological Reactions

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While looking at diet and cardiovascular disease risk many of us immediately consider our saturated fat intake however Vitamin B6 should not be overlooked. Together with folate and vitamin B12, vitamin B6 is required for maintenance of normal blood homocysteine levels. Raised homocysteine is a risk factor for cardiovascular disease.

Vitamin B6, comprises 3 forms: pyridoxine, pyridoxal and pyridoxamine. All three forms of B6 can be converted to the coenzyme PLP. Vitamin B6 in its coenzyme form is involved in more than 100 enzyme reactions, many concerned with protein metabolism. 

Along with its central role in the metabolism of amino acids (protein), it is fair to say that Vitamin B6 is required for the majority of biological reactions in our body including neurotransmitter synthesis, red blood cell formation and metabolism and transport of iron.

Vitamin B6 is stored in muscle tissue.

The Primary Sources of Vitamin B6

There are many good sources of vitamin B6, including chicken, liver (cattle, pig), fish (salmon, tuna) from animals.

In addition, chickpeas, maize and whole grain cereals, green leafy vegetables, bananas, potatoes and other starchy vegetables are ideal sources from fruits and vegetables. Vitamin B6 can also be found in nuts and chickpeas. 

Bioavailability of Vitamin B6

If consuming a mixed diet, the bioavailability of vitamin B6 is about 75%. Vitamin B6 is destroyed by heat but it remains stable during storage.

Risks Related to Inadequate or Excess Intake of Vitamin B6

Deficiency of vitamin B6 alone is uncommon; usually it occurs in combination with a deficit in other B-vitamins. Individuals at risk for poor intakes are alcoholics and those taking tuberculosis medication. Signs of vitamin B6 deficiency include microcytic anemia due to inadequate synthesis of hemoglobin, depression, nerve problems, and irritability. No adverse events have been observed with high intakes of vitamin B6 (from food or supplements).

Find more information on vitamins and micronutrient deficiencies though our partner, Vitamin Angels or download our complete vitamin and mineral guide here

Incorporate vitamin B6 into your next dinner with this delicious recipe below. 

Casserole Roast Chicken with Autumn Herbs*

(Serves 4-6)

Ingredients

1 chicken (3½ lbs (1.575kg) free range if possible
1 oz (30g) butter
4-6 teasp. chopped fresh herbs eg. Parsley, Thyme, Tarragon, Chervil, Chives, Marjoram
¼ pint (150ml) light cream
¼ pint (150ml) home-made chicken stock
*Roux, optional
1-2 tablespoons freshly chopped herbs
1 oval casserole

Method

Remove the wish bone and keep for the stock. Season the cavity of the chicken with salt and freshly ground pepper and stuff a sprig of tarragon inside. Chop the remaining tarragon and mix with two-thirds of the butter. Smear the remaining butter ov