Having met to consider the global magnitude and significance of micronutrient malnutrition (often called "hidden hunger"), we from the public, private and academic sectors of 29 countries meeting in Salt Lake City, Utah, USA, Nov. 6-9, 1995, find that…

Inadequate intakes of micronutrients (e.g., vitamin A, iron, iodine and other vitamins and essential mineral elements) continue to be major problems affecting more than one-third (2,000,000,000) of the world’s people; and

These nutritional deficiencies impair growth, physical and intellectual development, activity and survival predominantly among women, infants and children in developing nations.

We also find that….

Micronutrient intakes have not kept pace with improvements in staple food production that have been realized over the past 25 year in many parts of the world; and Micronutrient content has not been a goal of agricultural systems in any part of the world.

In consideration of these findings, it is our opinion that…

Food-based systems offer sustainable solutions to malnutrition including the health problems caused by micronutrient deficiencies, thus, making material improvements to the health, well-being and productivity of millions of people.

To exploit the potential of food-based systems, we call for process-related and knowledge-generating research in the following priority areas:

1. Increasing the effectiveness of foods as sources of micronutrients;
2. Increasing the supply of micronutrient-rich foods and increasing the micronutrient densities of foods;
3. Developing effective information, education and communication methods to promote food-based micronutrient interventions;
4. Developing programs and policies that influence the choices of consumers and producers to increase the supply and consumption of micronutrient-rich foods.

affirmed unanimously by all participants

Food-Based Approaches to Preventing Micronutrient Malnutrition Workshop

Salt Lake City, Utah, USA
November 9, 1995

Ninety scientists, technical experts, program developers and development specialists from the public, private and academic sectors of 29 countries met for three and one-half days to identify opportunities offered by food systems for the development of sustainable solutions to the prevalent problems of micronutrient malnutrition that affect, in particular, women and children in developing nations. Six working groups, identified priority research both for overcoming the barriers and limitations to using currently available knowledge, and for generating the new knowledge needed to develop sustainable, food-based approaches to preventing micronutrient malnutrition. This report presents the consensus agenda for action and research that was developed in the workshop.

Action Items

Several actions, requiring no further research, can and should be taken to reduce micronutrient malnutrition in many parts of the world:

1. The need for multi-disciplinary food system-based approaches to alleviate micronutrient malnutrition should be communicated clearly and with emphasis to policy makers and donor agencies.
2. A comprehensive database of the micronutrient compositions of crops, vegetables and fruits of local/regional importance, including indigenous species, should be developed. These data should be included in nutritional balance sheets for use by policy makers and governments to assess progress relative to national agricultural production goals.
3. Nutritional objectives should be incorporated into national and international agricultural research and health programs. This should be done in conjunction with nutritionists and local communities.

Research Needed to Make Better Use of

Currently Available Knowledge

Food Technology. Research is needed to improve household/community storage of fruits and vegetables; to identify foods appropriate for fortification that will target vulnerable groups (women, infants and children); and micronutrient needs appropriate to local situations.

Farming Systems. Research is needed to increase cropping system diversification, including integrated crop-livestock (including birds, small mammals and fish) systems. Efforts should also emphasize fruits and vegetables, and should include the development of appropriate technologies for preserving and storing foods to overcome seasonal variations in availability and to prevent waste. Research is also needed to increase the use of edible indigenous plants.

Communication. Research is needed to develop more effective information, education and communication methods to promote food-based micronutrient interventions. These should address with appropriate methodologies multiple targets including households, communities, non-governmental organizations, governments, public and private sectors, etc. There is a need to improve the documentation of results (both successes and failures) of interventions and to enhance the dissemination of those results to other potential users (e.g., farmers, communities, policy-makers) both within and between countries.

Household Resource Allocation. Research is needed to improve understanding of household decision-making about the production, acquisition, distribution and utilization of foods. This should include broad evaluations of impacts (nutrition/health, economic, environmental) of interventions.

Policy. Research is needed to improve understanding of the ways in which policies (agricultural, health, economic) are developed and to identify ways of promoting desirable nutrition outcomes through such means as land tenure, types of agriculture system (e.g., monoculture vs. diverse production), financial decisions (credit, risk, incentives, subsidies), regulation and monitoring energy/fuel and education (including nutrition education). No policy is in place to encourage the production of micronutrient-rich foods.

Research Needed to Generate New Knowledge

Micronutrient Bioavailability. Research is needed to develop simple, effective techniques appropriate for field use for assessing the bioavailability for humans of micronutrients from foods, including fortified products, in the context of the mixed diets in which they are consumed. Such efforts should include assessments of the variation of micronutrient bioavailability within and between food crop species, including indigenous and new foods; they should address the effects of nutrient interactions and nutritional status. Research is needed to characterize factors that can reduce/promote micronutrient bioavailability and to evaluate the effects of food processing and preparation (including novel and traditional methods) on micronutrient bioavailability.

Micronutrient Enrichment of Crops. Research is needed to improve bioavailable micronutrient contents of major crops; approaches should be adapted to local conditions. Efforts should be directed towards crops that are widely consumed in developing countries and should include staple grains and legumes. Research is needed to develop appropriate technologies for preserving and storing fruits and vegetables to reduce waste, post-harvest losses and the effects of seasonality.

Farming Systems. Research is needed to develop integrated farming systems that maximize the production of micronutrient-rich crops and/or small-scale, low-input, environmentally sustainable, livestock enterprises on limited land space both in rural and urban areas. This should include research to develop agroforestry techniques, including inter-cropping systems, for the production of both food and fuel.

Food Technology. Research is needed to develop technologies for the multiple nutrient fortification of foods in ways that retain and/or promote micronutrient balance and bioavailability. This should include the evaluation of innovative fortificants for various food groups and the assessment of micronutrient bioavailabilities of fortified foods. Research is needed to develop novel, household food preparation techniques that optimize the nutritional value of foods and reduce demands on women’s time.

For a full reprint of this article please contact: mn15@cornell.edu