MAKING FOOD SYSTEMS WORK FOR CHILDREN
POLICY RECOMMENDATIONS AND SUCCESS STORIES
Good food and nutrition are not only the foundation of children’s health and the development of society at large, they are also a child’s basic human right.
We as communities, parents, governments, food corporations, marketers and global citizens have a collective responsibility to put children’s needs at the heart of our food systems.
This means responding to the challenges we are facing around the world – food deserts, the high cost of healthy foods, time pressures, the limited availability of healthy foods – and the pressure many children, adolescents and families feel from marketing and advertising.
We also need to make food systems work with all other systems that affect children’s lives (health, water and sanitation, education and social protection) to make widespread, long-lasting impact.
The following are actions that governments, civil society and the private sector must take to transform our current system from one that aims to simply feed children, into one that nourishes them.
Empower families, children and young people to demand nutritious food
Increasing demand for healthy foods is an important step towards increasing their supply, availability and affordability. But creating this demand requires a cultural shift: one where healthy diets are aspirational, where women have more household decision-making power, and families and children know more about making healthy food choices. This can be shaped through:
- Nutrition education at home, in schools, and through public communication campaigns
- Innovative and memorable communications that appeal to both parents and children (e.g. social media and pop culture)
- Legislation that has been proven to limit demand for unhealthy food, including sugar taxes
- Encouraging fathers and other family members to support women’s roles as both earners and caregivers
CASE STUDY
Sugar taxes in Mexico
In Mexico, one in three 5-to-11-year-olds are overweight, rising to 36 per cent among 12-to-19-year-olds. As part of a national plan to overcome obesity, in 2014 the Mexican Government implemented a tax on non-alcoholic beverages with added sugar.
The Government also introduced several complementary policies and programmes, including a mass-media information campaign to promote healthy habits, regulation of unhealthy food and drinks in schools, restrictions on marketing targeted to children, and increased access to drinking water.
Between 2014 and 2018, the tax generated a total of US$5.6 billion. Consumption of taxed beverages decreased 5.5 per cent in 2014 and 9.7 per cent in 2015, while consumption of untaxed beverages increased by 2.1 per cent over both years. Households in all socio-economic levels bought taxed beverages at a lower rate, with the reductions among the poorest at 11.7 per cent, compared to 7.6 per cent for the general population. In later national opinion polls, 52 per cent of respondents said they drank fewer sugary drinks in 2014 and had better understood how sugar-sweetened beverages can contribute to obesity.
Drive food suppliers to do the right thing for children
It’s not enough that children and families demand healthy food – it must also be available, affordable, safe and convenient. It should be produced in a way that won’t harm the environment or generate waste. Food producers and suppliers have a key role to play, and governments can set standards and incentives to encourage better practices.
- Provide economic incentives (e.g. reduced rents and tariffs) to increase production and availability of fruits and vegetables, particularly in low income areas
- Eliminate subsidies for foods high in sugar, refined grains or processed oils, and discourage junk food marketing, especially to young children.
- Invest in modern storage, packaging, processing and other infrastructure to reduce food waste and contamination
- Build more resilient food supplies in areas affected by crisis or climate shocks
- Reduce environmental impact of food production and encourage biodiversity in food systems
CASE STUDY
Locally produced ready-to-use therapeutic food in Cambodia
One in three children under five in Cambodia is stunted or underweight, but only 6 per cent of children suffering from severe acute malnutrition receive treatment. One proven way to help children threatened by malnutrition is ready-to-use therapeutic food -- a nutrient-dense paste that can be eaten right out of the packaging. These pastes are usually made from a mixture of peanuts and milk powder.
To make therapeutic food more appealing to Cambodian children and less expensive than imported milk-based products, the Cambodian Government’s Department of Fisheries, France’s Institut de Recherche pour le Développement and UNICEF developed Nutrix. The wafer snack is filled with micronutrients and locally produced from fish, rice and beans.
Because the ingredients in Nutrix are locally sourced, the flavour is more familiar to children than other more well-known, peanut-based therapeutic foods. And the fact that it is not imported means that it is also 20 per cent cheaper to produce.
Build healthy food environments for all children
Children and families shouldn’t have to face barriers to making healthy food choices. In fact, their environments should make it easier for them to eat nutritiously. Local and national governments can take the following steps to encourage families to buy, cook and eat healthier foods:
- Support policies that promote breastfeeding and complementary feeding, including the International Code of Marketing of Breast-milk Substitutes, maternity leave, and breastfeeding-friendly spaces
- Mandate front-of-package food labelling
- Regulate marketing of unhealthy foods to children
- Make school meals healthier, and restrict sales of junk food in and around schools
CASE STUDY
Labelling in Chile
In recent years, the number of overweight children in Chile has increased rapidly. Today, almost half of all children in the country are overweight. In an effort to improve children’s food environments, the Government launched a comprehensive programme aiming to encourage and support children, young people and caregivers to make healthier decisions.
One part of the programme was a new and innovative food labelling law. The law addresses five main areas: new and striking front of package warning labels; restrictions on food advertising (especially towards children under 14); incorporation of messages promoting healthy lifestyle habits in food advertising; restrictions on the sale of food with excess sodium, sugar and saturated fats in schools; and incorporation of activities in all schools that contribute to developing healthy eating habits and an active lifestyle
Evaluations of the law and its implementation show that the public, especially children, support and easily understand these new messages. Most consumers take the warning labels on food products seriously and prefer to buy foods with fewer or no labels. And a number of industries have reformulated ingredients in their food products to stay within government regulations.
Mobilize supportive systems to scale up nutrition results for every child
A child’s nutrition level is influenced by more than just what he eats – it is hugely impacted by whether he has safe water and sanitation, access to healthcare, education, and overall social protection. In order to make widespread, sustainable impact on children’s nutrition, the food system must integrate with these other systems to provide services and support for children who need it most.
- Health: Invest in health workers, pre- and post-natal nutrition education (including breastfeeding), and screening for micronutrient deficiencies and severe malnutrition
- Water and sanitation: Construct safe, convenient latrines and water source points, and encourage hygienic practices like handwashing
- Education: Promote nutrition education in schools and school environments that make it easy for children to eat healthy foods
- Social protection: Providing food vouchers, cash transfers, school meals and emergency food supplies to protect the most vulnerable families
CASE STUDY
Integrating water, sanitation and nutrition interventions in Pakistan
By causing conditions such as diarrhoea and dysentery, which prevent children from absorbing nutrients, poor water and sanitation are major factors in malnutrition. Improving the water, sanitation and hygiene (WASH) system can therefore play a critical role in preventing stunting and other forms of malnutrition.
In Pakistan, more than one third of children under 5 are stunted – and access to basic sanitation services is still a major national concern.
To address both problems, UNICEF Pakistan and its partners introduced an integrated package of WASH and nutrition interventions focused on the crucial first 1,000 days of a child’s life. The WASH activities aimed to reduce infection and control environmental enteropathy, a chronic inflammation of the gut. Interventions included maintaining safe water supplies, encouraging community-based approaches to eliminate open defecation, improving hygiene behaviour, and developing service provider capacity.
Although there are still challenges, there has been significant progress. Community health workers have been mobilized, and WASH clubs have been formed in schools to empower children to promote positive practices like handwashing with soap. In total, an estimated 922,000 children aged under 5 and women have been reached with packages of nutrition services, including micronutrient supplementation.
Collect, analyse and use good-quality data and evidence regularly to guide action and track progress
We need accurate, quality data not only to understand the problem of child malnutrition, but also to take informed actions. Yet, data on children’s diets and food systems are remarkably lacking. The following actions will help improve data systems, collection and transparency:
- Setting global and national targets to measure progress on infant feeding, tracking both healthy and unhealthy feeding patterns
- Improving data collection on diets and nutrition for school-age children and adolescents to understand where (societally and geographically) children are eating poorly and why
- Support new tools and innovation for tracking food systems
- Integrate data on nutrition services delivered through related systems (health, WASH, ed., social protection)
CASE STUDY
Nutrition surveys in India
India’s Comprehensive National Nutrition Survey, which ran from 2016 to 2018 across all states, was the biggest ever nationwide effort to gather data on the nutritional status of pre-schoolers, school-age children and adolescents. For the first time, the extent and severity of micronutrient deficiencies, information on fat distribution and nutritional risk factors for non-communicable diseases, and links between children’s nutritional status and their cognitive development were assessed in a single survey.
The findings paint a more nuanced picture of child nutrition in India, including seasonal variations in vitamin A deficiency, a large disparity in anaemia prevalence between girls and boys, and evidence that overweight and obesity, as well as the threat of diabetes, are on the rise among school-age children.
The Government has used these findings to inform its ambitious child nutrition programmes. The survey results also provide the basis for potential new policy recommendations, including improving dietary diversification and food fortification to address vitamin A deficiency, tackling the triple burden of malnutrition and starting programmes in the early years to develop lifelong healthy eating habits.
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