This report compiles the latest evidence, country case studies, and resources to support implementers and country governments in introducing and scaling-up MMS.

Focusing on Multiple Micronutrient Supplements in Pregnancy: Second Edition

In the past decade, significant technological advances have increasingly made a case against the use of a one-size-fits-all approach in public health nutrition. Instead, new concepts, including Precision Nutrition, have surfaced in high-income countries with considerable potential to transform current public health nutrition interventions and improve nutritional outcomes. But where do low- and middle-income countries (LMIC) fit in the picture?
The latest Sight and Life Special Report is a first attempt to bring awareness to Precision Nutrition through the following three objectives:
<ol>
	<li style="font-weight: 400;" aria-level="1">Provide a Precision Nutrition definition suitable for the LMIC context.</li>
	<li style="font-weight: 400;" aria-level="1">Build a narrative on Precision Nutrition and shed light on its relevance and potential for public health nutrition in LMIC.</li>
	<li style="font-weight: 400;" aria-level="1">Stimulate a debate and galvanize action within the scientific community and beyond to consider accessible and affordable Precision Nutrition solutions for LMIC.</li>
</ol>
We hope this report will inspire you to join forces with us to make Precision Nutrition a solution for all populations, especially those who need it most.
<meta name="citation_doi" content="10.52439/PRCJ5543" />
<meta name="dc.identifier" content="10.52439/PRCJ5543" />

Precision Nutrition for Low - and Middle-Income Countries: Hype or Hope?

We are thrilled to share the 35th Anniversary issue of the Sight and Life Magazine, celebrating achievements in nutrition to drive the global agenda forward and explore innovations over the last decade. Through these pages, we turn back time on topics including maternal nutrition, vitamin A dosing, and data visualization, and then follow up with the latest perspectives from experts in the fields.

Celebrating our 35th anniversary

This challenging issue catalyzed Sight and Life’s current work on nutrient profiling in low- and middle-income countries (LMICs), and stimulated the idea for this Special Report. In particular, it was in the context of our work on the <a href="https://dev.sightandlife.org/our-work/obaasima">OBAASIMA</a> project in Ghana that we saw a willingness on the part of SMEs to engage in developing more affordable, nutritious foods, but where we quickly came to realize the many obstacles to achieving this aim. 
One such challenge was the use of nutrient profiling models that were developed initially to prevent obesity in high-income countries (HICs) but were not necessarily applicable in a country such as Ghana. In this Special Report, Adam Drewnowski shares how nutrient profiling models tend to penalize dietary energy by giving lower ratings to foods containing excessive calories, fat, sugar, and salt. Such energy-driven nutrient profiling models need to be reconceptualized for use in LMICs, where hunger, undernutrition, and micronutrient deficiencies persist as major public health concerns.

Nutrient Profiling: Designing a Healthier Future for Global Benefit

This Sight and Life Special Report | Micronutrient Forum 5th Global Conference CONNECTED 2020 aims to serve as an important resource for all in the nutrition community. It provides an in-depth review of the five tracks: Micronutrient Biology and Status Assessment, Efficacy and Safety of Micronutrient Interventions, Program Effectiveness, Designing an Enabling Environment for Micronutrients, and Food Systems.
 
Visit the <a href="https://www.eventscribe.com/2020/MNF-CONNECTED/">Micronutrient Forum CONNECTED platform</a> for free access to the on-demand sessions and recorded content

Micronutrient Forum 5th Global Conference CONNECTED

The Sight and Life Special Report: Focusing on Multiple Micronutrient Supplementation (MMS) in Pregnancy compiles and curates the latest evidence, experience from the field, and resources for scale-up. It aims to serve as an important resource for decision-makers and implementers, thereby driving the introduction and adoption of MMS.

Focusing on Multiple Micronutrient Supplements in Pregnancy

This edition explores the various dimensions and applications of consumer insights. Through these pages we look at innovative methods and tools by using behavioral science as the foundation for generating consumer insights and identifying trends. There are examples of how consumer insights have been applied to design products and services, using different approaches such as social and behavior change communication, human-centered design, social marketing, and so much more!

Consumer insights

In this issue of the Sight and Life Magazine, we used the data value chain as the organizing framework and invited authors who are thought leaders and practitioners not just to highlight the challenges along each step of the value chain but also to offer viable solutions that are pushing the envelope.

Data in Nutrition

This edition of the Sight and Life Magazine focuses on food product innovation and the huge potential it has to help us address key challenges in the journey to a sustainable planet that is free from all forms of malnutrition.

Product Innovation

Double Burden of Malnutrition

Over the past decades, scaling up of rice fortification has been hampered by technological limitations. Today, affordable technology exists to produce fortified rice kernels that look and taste like non-fortified rice. Advances in coating and extrusion technologies allow micronutrients to be retained effectively even after long washing and cooking processes, which makes rice fortification an effective and affordable strategy.

Sight and Life Supplement: Scaling Up Rice Fortification in Latin America and the Caribbean

This edition of the Sight and Life Magazine navigates various approaches in which technology and entrepreneurship can improve the nutrition landscape around the world. Technology plays an increasingly important role in enabling the implementation of high-quality public health nutrition interventions. Similarly, innovative entrepreneurial solutions are required to improve access to proven nutrition solutions and ensure sustainability. We are grateful to the innovators and entrepreneurs who have contributed to this technology and entrepreneurship-focused issue, providing ideas and pragmatic perspectives on how to leverage technology and entrepreneurship in order to reduce the extent of malnutrition in all its forms facing our world today.

Technology and Entrepreneurship

This issue of Sight and Life Magazine focuses on food culture and we have curated contributions that explore the social and cultural domains of food choices and food experiences more broadly. We acknowledge that this is only part of the story. We promise to explore cognition (psychology, brain) and biology (evolution, genes, biochemistry) – factors that also drive food choices – in a future issue of the magazine. For some of our readers trained in biology or chemistry, culture may seem a fuzzy, perhaps non-scientific, topic. Be assured, however, that culture is as much part of nutrition as are biology, biochemistry, chemistry, and genes, and there is a rich body of research on nutrition and culture.

Focus on Food Culture

While optimal nutrition for older infants and young children is currently a global focus, we must not forget that women’s nutrition is also critical. Thus, this edition of Sight and Life Magazine focuses on women’s nutrition.  According to Preetu Mishra and Jee Hyun Rah, from the United Nations Children’s Fund (UNICEF) in New Delhi, India, scientific evidence shows that a large proportion of pregnant adolescents are still growing in height during and following pregnancy. In the article, “Closing the Nutrient Gap During Adolescent Pregnancies,” they recommend strategies to prevent early and frequent pregnancies until adult height is reached and explain the importance of implementing reproductive nutrition and health programs and policies for adolescents. An exciting public-private partnership in Ghana, known as Affordable Nutritious Foods for Women (ANF4W), is looking at establishing a market-based solution to improve the nutritional status of women of reproductive age with fortified food products. Dr Eva Monterrosa, Senior Scientific Manager at Sight and Life Foundation, describes in “Improving the Nutritional Status of Women of Reproductive Age,” how the project aims to provide considerable amounts of the RNIs of 18 vitamins and minerals during the critical period of pregnancy and lactation when nutrient needs are elevated. Continue reading these articles and more about women’s nutrition from leading experts through the pages of the Sight and Life Magazine.

Women's Nutrition

A food system considers the multiple activities, resources, and actors engaged in producing, processing, distributing, and consuming food. These are all shaped by, and interact with, everything from soup to nuts – i.e., all the environmental, social, political, and economic boundary conditions that determine what type of food can be produced where, how it is used, and by whom. All these elements are strongly influenced by global change drivers such as population growth, changing consumption patterns, biodiversity loss, and climate change. Given that our food systems are already struggling to bring home the bacon (i.e., to deliver on their intended outcomes of global food and nutrition security) these increasing pressures will catapult our tasks out of the frying pan and into the fire.

Food Systems

Nutrition has come a long way since the Millennium Development Goals (MDGs) came into being in 2000 following the adoption of the United Nations Millennium Declaration. It was a slow process, but nutrition has come to be recognized by the World Bank as being core to development, and we have seen its critical role underscored by the prestigious medical journal The Lancet and the respected Copenhagen Consensus. Nobel laureates, economists, high-profile politicians and even His Holiness the Pope have spoken up for nutrition. And now we have the Scaling Up Nutrition (SUN) Movement, launched by US Secretary of State Hillary Clinton and Irish Foreign Minister Micheál Martin, that has really generated attention, commitments, and actions. So there was some sense of sadness as we said goodbye to the opportunity the MDGs gave nutrition – a sadness compounded by the harsh reality that the world did not achieve the goals that were set and that, despite some progress being made, there is much work left unfinished.

Goodbye MDGs Hello SDGs

“The aim of Frontiers in Nutrition is to integrate major scientific disciplines in this vast field in order to address the most relevant and pertinent questions and developments.” At the dusk of the Millennium Development Goals (MDGs) and the dawn of the Sustainable Development Goals (SDGs) we wanted to give leading thinkers in nutrition science the opportunity to share with our readers where they think the Frontiers are located. You will find the products of their thought in this edition of the magazine, in whose pages you can explore a wide variety of topics including multiple micronutrients in pregnancy, epigenetics, biomarkers and bio-indicators, benefit-risk assessment, inflammation, nutrigenetics and nutrigenomics, proteomics and metabolomics, mobile health, systems nutrition, and food systems, as well as early life nutrition and the developmental origins of adult disease.

Frontiers in Nutrition

Nutrition Evidence – the Challenge of Moving to Implementation Assessment. It’s with some irony that this India special of Sight and Life Magazine coincides with the publication of the Deworming and Enhanced Vitamin A (DEVTA1) study. While the DEVTA study rep-resents an earnest attempt to evaluate a large Government of India program delivering vitamin A to children, it contradicts the results of a number of randomized controlled trials (RCTs) carried out in different regions, which have conclusively demonstrated that vitamin A supplementation to children under the age of five every four to six months results in a 24% reduction in under-five mortality. DEVTA, however, showed only a non-significant 4% reduction in child mortality. The reasons for this lack of effect are likely to be found in how the program was run and evaluated – the problems it experienced are common in large intervention strategies and point to the urgent need for us to consider how scaled-up implementation research should best be undertaken. It is legitimate that governments and donors demand the best possible scientific evidence to make informed decisions regarding nutrition programs. But how much and what kind of evidence is required before going forward with interventions that potentially reduce morbidity and mortality? Should such decisions always be based on RCTs and meta-analyses? In a paper published last year, we emphasized the totality of evidence gathered from epidemiology, basic science, and meta-analyses to inform policy and guideline development for program implementation, with close collaboration between program planners and scientists.

Focus on India

It is an exciting time to be a nutritionist in Africa – in a profession that is “IN”, working in a continent that has an opportunity to show that it can turn the negative into a positive; that it can deliver. Ke Nako. But I also have a deep-seated fear that we might only continue with the endless talk and eloquent orations of the past few years and not turn the promises and commitments into actions. This opportunity – just as we refer to the 1,000 days window of opportunity – will not come again. We in nutrition in Africa have this one opportunity to turn words into actions. At a recent meeting, I was challenged by Mrs Graça Machel not to lump Africa, especially sub-Saharan Africa, together, and to acknowledge that some countries are making good progress towards the Millennium Development Goals, while others are seriously lagging behind. The difference between those moving forward and the laggers lies in true leadership that knows, quoting the words of John Ruskin, that “What we think or what we know or what we believe is in the end of little consequence – the only consequence is what we do.”

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