This document discusses several studies on the impact of agricultural interventions on nutrition outcomes. It finds: 1. Interventions that increased access to animal source foods like milk, meat and eggs led to improvements in child growth, cognitive development, and nutritional status. 2. A study in Ghana that provided microcredit loans, nutrition education and promoted small livestock saw reductions in food insecurity and improvements in height, weight, and intake of proteins, calcium, zinc and iron. 3. Home garden projects in Bangladesh that grew nutrient-rich plants and supported small livestock led to increased vegetable production, income, food security and consumption of micronutrient-rich foods for over 5 million people.

1. Agricultural research and
nutrition: what we know and
don’t know
Lindsay H. Allen
USDA, ARS
Western Human Nutrition Research Center
Davis, CA

2. Masset: nutrition outcomes
• Change in intake –
– in 13/19 was ↑ intake of targeted food,
– but few measures of total daily nutrient intake.
– diet diversity is poor measure – need quantity.
• Anthropometry
– very little effect of most foods; need 5000 to
detect 10% ↓ in stunting or underweight (i.e.
not sensitive outcome). True for supplements.
• Nutritional status
– only effect on serum retinol (4/9 studies).
– no effect iron intake; Zn not measurable.
– there are few MN-rich foods.

3. MMN: effect sizes for change in growth (by age)
-1
-0.5
0
0.5
1 Overall Daily Weekly Daily, non-placebo control Weekly, non-placebo control
Supp
All Food
Olney, Pearson & Allen, 2009

4. Animal source foods do improve
child growth and development!

5. Milk vs. meat intervention trial in schoolers,
Embu, Kenya (n=554, 2 years)
30% stunting, famines, low ASF, 30-90% prevalence various deficiencies

6. Outcomes in ASF intervention
groups vs. controls
• Meat supplementation (60-80 g/d)
improved:
cognitive performance (Raven’s, math)
school test scores
physical activity
initiative and leadership behaviors
arm muscle mass (due to higher activity?)
• Milk supplementation (1 cup/d) improved:
linear growth of stunted children
• Milk or meat supplementation improved:
vitamin B-12 status

7. Meta-analysis of dairy products and
physical stature (de Beer et al., 2012)
12 studies, n ≅ 3500.
7 countries/regions (including wealthier).
Mix RCTs (recent) + observational.
+750 mL milk →→→→ 0.4 cm ↑↑↑↑ height.

8. The agricultural community’s approach
to improving nutrition
Biofortification
≈5 key cereal,
legume, root
crops: to
reduce hunger,
for income,
biofuels, etc.
2005 2010 2015
ASF
Small holders

9. The nutrition community’s approach?
“Complementary” micronutrient interventions
Diet quality
improvement
Fortification
2-5 MN
Supplementation
MN powders
2005 2010 2015
Peanut-based MN

10. Current micronutrient policies and strategies
Preg-
nancy
Lact-
ation
0-6 mo 6 mo-5 y Women, children
Fe +
folic
acid
Breast
milk
Vit. A capsules, Fe.
“Nutrient dense HH
foods”
MMN (powders, lipid-
based, fortified
complementary
food)*
Fe if anemic
Staples fortified with
Fe, A, Zn,
folic acid, B12
Biofortification
with A, Fe, Zn*
* Not official WHO policy

11. Coordinate agriculture, fortification and
supplementation to meet nutrient needs
Goal: <5 % population group <EAR and
>UL, key nutrients. Status normalized.
Food intake (n=100/group, 2 day subsample)
Nutrients
% people <EAR & >UL, each nutrient
1. Plant sources
Gaps
2. Animal sources
Traditional, local
Regional/new
Biofortification
Traditional, local
New
A, Fe,
Zn
B12, B2
Ca, D, E
Energy
A, C, fol
(Fe, Zn)
3. Fortification,
supplements

12. Planning agriculture for nutritional needs
1. The ENAM project in Ghana
Enhancing child Nutrition through Animal source food Management
WID
Univ. Ghana
Iowa State
McGill
2 Intervention
+
2 Control
communities
per zone

13. Phase 1: developed problem model for key
constraints on ASF (interviews, focus groups, workshops).
Income
Marketing
linkages
Processing
and storage
Feeding skills
and nutrition
knowledge
Household
food allocation
Cultural beliefs
and attitudes
ASF
Availability
Accessibility
Utilization
Financial services
Seasonality
Pests and diseases
Caregiver
empowerment
Household size
Number of extension
field staff

14. Nutrition
education
Microcredit loans & savings
$50
(fish smoking and sales,
poultry and eggs, sale of
yams and cooked foods)
Entrepreneurship
education
ENAM phase 2: Interventions to improve food
security and use of ASF for children
Weekly
meetings

15. Results
In intervention vs control or non-participant
households:
• 50% reduction in food insecurity previous month.
• 0.12 Z increase in height, 0.26 Z increase in
weight.
• Higher intake of protein (30%), calcium (50%),
zinc (30%), iron (20%).

16. Example 2
Homestead production in Bangladesh
“Diversifying into healthy diets”
Iannotti et al. 2010
• Helen Keller International
• Small-scale home gardens with MN-rich plants →
small livestock, nutrition education.
• Scale-up implementation by >70 local NGOs,
government.
– Tripled veg. production, increased income
– ↑ consumption of MN-rich foods
– ↑ food security for 5 million, very sustainable

17. Additions: what we do don’t know
• What strategies best to improve DQ of poor?
• How and why diets are changing with and across HH,
countries? How to influence this.
• How effective longer-term ag. interventions are for
improving nutrient status and growth vs. CD risk.
• Unintended effects on diet (food sold & purchased;
earlier breastfeeding), BMI, water quality, food
security and safety.
• How best to integrate MN interventions.

18. Additions: what we do know
• Few interventions ↑ growth directly; ASF, MILK.
• Growth is an insensitive outcome.
• Anemia also insensitive status outcome (use breast
milk MN? Serum B12? Match to intervention.
• Ag. should impact whole household, not focus on
only pregnancy, young children.
• Ag. interventions should be planned to meet nutrient
gaps. If not, little effect will be seen.
• Impact on whole diet should be well measured, for
several HH members.
• IMPORTANT: Education, behavior change, micro-
credit, women, local practices…..

19. Thank you

20. Animal and plant foods provide different nutrients
(relative amount/100g)
Cereal Leg-
umes
Veg Fruit MFP Eggs Dairy
Prot + ++ + +++ ++ ++
A (++) (++) + +++ ++
Fe (+) +
(soy)
+++ +
Zn (+) + +++ + +
B12 ++ ++ +++
Ribo + (+) (+) ++ +++
Fol +++ (++) (++) + +++
D + +

21. -10
0
10
20
30
40
Meat* Milk Energy Control
Changeintotalexamscore
Change in end of term test scores
MEAT group improved most
*