Time to shift from 'food security' to 'nutrition security,' say policy experts
Writing in the journal JAMA, researchers comment that in the past the "nutritious" part has been overlooked or lost in national policies and solutions – an omittance that may’ve contributed to the rise of diet-related diseases.
“It's the right time for this evolution," states Sheila Fleischhacker, adjunct professor at Georgetown Law School in Washington and co-author of the article.
"By prioritising nutrition security, we bring together historically siloed areas -- hunger and nutrition -- which must be tackled together to effectively address our modern challenges of diet-related diseases and disparities in clinical care, government food and food assistance policies, public health investments, and national research."
Along with colleagues from Tufts University, the article attempts to define nutrition security as having consistent access to and availability and affordability of foods that promote well-being, while preventing -- and, if needed, treating -- disease.
According to the authors, nutrition security provides a more inclusive view that recognises that foods must nourish all people.
The authors also wish to see the definition of nutrition security as broad enough to address the harsh legacy of inequities that has resulted in nutritional disparities among marginalised minority groups.
‘Wholesome, healthful food & drink’
“Nutrition security incorporates all the aims of food security but with additional emphasis on the need for wholesome, healthful foods and drinks for all,” explains first author Dariush Mozaffarian, Dean of the Friedman School of Nutrition Science & Policy at Tufts University.
“COVID-19 has made clear that Americans who are most likely to be hungry are also at highest risk of diet-related diseases including obesity, diabetes, heart disease, and many cancers -- a harsh legacy of inequities and structural racism in our nation.
“A new focus on nutrition security for all Americans will help crystallise and catalyse real solutions that provide not only food but also well-being for everyone.”
The authors, which includes Chef José Andrés, founder of World Central Kitchen, a not-for-profit non-governmental organisation that providing meals in the wake of natural disasters, use clinical care as an example of how nutrition security would work in this setting.
Here, the approach could foster new goals and investments in nutrition-relevant interventions for lower-income patients, such as produce prescription programs and medically tailored meals, as well as nutrition education for health care professionals.
Additionally, Government food policies and food assistance programs could update their screening tools, metrics of success, and corresponding actions to prioritise nutrition security.
The authors also call for a focus on nutrition security that could accelerate the food bank trend and charitable food networks to provide healthier foods and beverages through new metrics, standards, and processes that provide greater emphasis on nutrition.
The FAO & WHO
The team also highlight the need for public health investments and national research, that antihunger, clinical, public health, and business groups increasingly recognise the need for a stronger evidence base to accelerate food and nutrition solutions.
“From a societal standpoint, because poverty and food insecurity are closely associated, efforts must be made to reduce the level of poverty in the US,” they write.
“The Food and Agricultural Organisation and the World Health Organisation, among others, could embrace the concept of nutrition security through guidance and policy documents, with review of whether and how member states are integrating this new emphasis.”
They go onto to point out that to maximise success and avoid adverse consequences, this shift to focus on nutrition security must be accompanied by careful evaluation of validity, reliability, and feasibility of appropriate screening tools and metrics of success, as well as of the effectiveness, equitability, and costs of corresponding interventions.
“Food is essential both for life and human dignity,” says Andrés. “Every day, I see hunger, but the hunger I see is not only for calories but for nourishing meals. With a new focus on nutrition security, we embrace a solution that nourishes people, instead of filling them with food but leaving them hungry."
Published online: doi:10.1001/jama.2021.1915
“Prioritizing Nutrition Security in the US.”
Authors: Dariush Mozaffarian et al.