Thread by @TyRBeal

🚀 Now launched!

New supplement by @GAINAlliance & @UNICEF provides evidence-based findings on nutrient gaps & affordability

Read it here 👉🏼 academic.oup.com/nutritionrevie…

Read this thread for the key findings & implications 👇🏼

@UNICEFAfrica @UNICEFEthiopia @UNICEFROSA @UNICEFIndia

First, check out the related country briefs

Comprehensive Nutrient Gap Assessment (CONGA)
👉🏼 gainhealth.org/resources/repo…

Affordability analysis
👉🏼 gainhealth.org/resources/repo…

I won't bore you with the methods, but there's an entire paper on the CONGA method, if interested
👉🏼 academic.oup.com/nutritionrevie…

The methods for the affordability analyses are in the same papers as the results

Eastern and Southern Africa
👉🏼 academic.oup.com/nutritionrevie…

South Asia
👉🏼 academic.oup.com/nutritionrevie…

There are clear nutrient gaps in Eastern and Southern Africa, but most nutrients (except iron and vitamin A) are based on low-certainty evidence

Read the paper here
👉🏼 academic.oup.com/nutritionrevie…

Similar gaps in South Asia (but also vitamin C for some countries), and the evidence certainty is stronger for several nutrients

Read the paper here
👉🏼 academic.oup.com/nutritionrevie…

Animal source foods like liver, small dried fish, beef, and eggs are the best sources of commonly lacking nutrients

This just shows the breakdown by nutrient and average share of requirements per 100 g portion for South Asian countries

Read the paper here
👉🏼 academic.oup.com/nutritionrevie…

The most nutrient dense foods are also typically more affordable, but add in dark leafy greens and milk as affordable sources of key nutrients in most countries

The next figures are at the country level, which make it easier to see the most affordable sources of key nutrients in each country

Read the briefs here
👉🏼 gainhealth.org/resources/repo…

Notice eggs and milk are less affordable in Mozambique
👉🏼 gainhealth.org/resources/repo…

Dark leafy greens do not appear to be affordable in South Africa
👉🏼 gainhealth.org/resources/repo…

Many nutritious foods are affordable in Tanzania, including beef
👉🏼 gainhealth.org/resources/repo…

Many affordable nutritious foods in Uganda, too
👉🏼 gainhealth.org/resources/repo…

Affordability seems to be a much bigger issue in Zambia
👉🏼 gainhealth.org/resources/repo…

Note that small fish are also likely affordable sources of key nutrients where available in Bangladesh (although not shown here)
👉🏼 gainhealth.org/resources/repo…

Several affordable nutritious foods in India, but flesh foods are less affordable
👉🏼 gainhealth.org/resources/repo…

Many affordable nutritious foods in Pakistan, too
👉🏼 gainhealth.org/resources/repo…

However, in most countries, iron and zinc are particularly unaffordable in large enough quantities to meet requirements

Even the most affordable sources (often dark leafy greens for iron and pulses for zinc are unaffordable to many households)
👉🏼 gainhealth.org/resources/repo…

The obvious take-away

This is difficult to do and sometimes has trade-offs (eg, may reduce income of poor rural farmers if not properly designed)

Obvious, but not always clear which households can afford which foods (that's why we did this analysis)

This has been shown to work in many contexts

It doesn't always increase consumption (sometimes households sell the nutritious foods produced), but it generally has positive impacts

This is essential as long as there is a high burden of poverty

While it's ideal to obtain nutrients through whole foods, fortification & supplementation play a role because they are affordable sources of key nutrients

Note that biofortification just means crops that are bred to have higher nutrient density (eg, orange-fleshed sweet potato)

This is challenging but necessary

These nutrients are critical for child growth and development

Animal source foods are the optimal sources of key nutrients

Several animal source foods are considered affordable when taking nutrient-density into account

Dark leafy greens are also affordable sources of key nutrients

But food sources of iron and zinc are not affordable for many households in adequate quantities to meet needs

Key take-away from these analyses

All of these strategies may be warranted to varying degrees depending on the context

Congrats to all coauthors @rycktessman @SaulMorris19 @StellaNordhagen @aashi073 and others not on Twitter

And special thanks to the funders @DutchMFA @gatesfoundation

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