GLOSSARY: FOOD SYSTEMS

Food systems are complex, made up of many parts, processes, and actors. Below, A4NH has gathered definitions of key terms to help create a common understanding of these many elements. 

Food system: Based on the HLPE framework, A4NH defines a food system as that which gathers all the elements (environment, people, inputs, processes, infrastructures, institutions, etc.) and activities that relate to the production, processing, distribution, preparation, consumption and disposal of food, and the outcomes of these activities, including nutritional, food security but also socio-economic and environmental outcomes.

Food environment: the physical, economic, political and socio-cultural context in which consumers engage with the food system to make their decisions about acquiring, preparing and consuming food (HLPE, 2017). It includes food availability and physical access (proximity); economic access (affordability); promotion, advertising, and information; convenience and time savings, and food quality and safety (Herforth & Ahmed, 2015).

Consumer Behavior: considering the entire process from acquisition to consumption of food as reflective of all the choices and decisions made by consumers, at the individual, household or collective levels, on what food to acquire, store, prepare, cook and eat –and how to dispose the waste-, and on the allocation of food within the household (including gender repartition and feeding of children (HLPE, 2017). Food choices are determined by personal attitudes and motives, such as familiarity with the foods, taste preferences, convenience, perceived safety of foods, nutritional and health-related motives and desirability, as well as societal norms regarding the symbolic, cultural, and economic values of food. Nutrition knowledge, as well as skills and availability of time for food preparation can have an impact on consumer food choices and can lead people to opt for healthier foods.

Food availability and access (in the food environment): The quantity and diversity of the food items that are available in different food outlets (markets, stores, restaurants) and that can be physically accessed by the people living in the surrounding area. This concept can also be extended to other settings where people spend most of their time, such as offices, schools and universities, where food is often acquired through vending machines, canteens, nearby kiosks and street food vendors (FAO, 2016; HLPE, 2017).

Convenience and time savings (in the food environment): All the factors (time needed for food shopping, cooking and cleaning up, food preparation skills, availability of cooking equipment) that induce consumers to opt for foods that requires little or no time for preparation. In addition to these factors, convenience and time saving also includes the time required for consumers to reach different typologies of food outlets (produce markets, convenience stores, supermarkets, etc.) available in the surrounding area as a key factor (Herforth & Ahmed, 2015).

Promotion, advertising and information (in the food environment): The modalities through which food becomes attractive to consumers, such as promotional and advertising campaigns (discounts, product placement in stores, advertisements, branding etc.), including how the availability of nutrition information and messaging (food labels, FBDGs, health campaigns etc.) can drive consumers' food choices toward healthy -- or unhealthy -- eating (HLPE, 2017).

Food quality and safety (in the food environment): All the characteristics and attributes consumers value, and the perceived and actual safety associated with food products. Especially in LMICs, food safety issues can constrain food choices, since it mainly affects the consumption of nutritious, perishable foods, such as animal source foods (ASFs) and fresh produce (FAO, 2016; HLPE, 2017). Food quality also includes the nutrient density as well as the presence of healthy components such as vitamins and nutrients, and less healthy components such as trans-fats, refined sugars, salt, and additives (HPLE, 2017).

Healthy diets: A diet which promotes growth and development of children, and prevents malnutrition in all its forms for all people. A healthy diet addresses four main components: adequacy, diversity, moderation and safety. Different sources of information help to define healthy diets, including the WHO recommendations for healthy diets; the Global Burden of Disease NCD Risk factor study, and analyses of health outcomes associated with whole dietary patterns. These emphasize the importance of increasing intake of plant foods such as fruits, vegetables (excepting starchy root vegetables), legumes, nuts and whole grains; limiting the intake of energy from free sugars and total fats; consuming unsaturated rather than saturated or trans fats; and limiting intake of salt, while using salt that is iodized as a defense against iodine deficiency. The risks associated with high consumption of processed meat are pointed to, as well as the need to shift toward plant foods and away from animal foods, excepting fish and seafood (FAO, 2019).

Moderation (as component of a healthy diet): avoiding or limiting consumption of foods, food groups, and nutrients that can be unhealthy if consumed in excess, including foods high in fats (especially saturated and trans fat), sugar, (including sugar-sweetened beverages (SSB)), and sodium (Herforth et al, 2014).

Biofortification: the development of micro-nutrient (minerals and vitamins) rich staple crops using the best traditional plant breeding and agronomic practices and modern biotechnology. These solutions are aimed to increase the density of micronutrients such as vitamin A, iron and zinc in staple crops consumed widely as part of everyday diets.

Value chain (VC): the full range of activities which are required to bring a product or service from conception, through different phases of production to final consumers, and final disposal after use. In reality, VCs are a complex network of activities and linkages among different actors, and therefore the idea of “chain” should be considered as a metaphor for connectedness among them. The term “value” refers to the “value” that is generated along the chain as the commodity goes through the different phases, referring to both the value added to the product at each stage of the chain and the value captured by the different actors involved.

Nutrition-sensitive value chain: A value chain that focuses on making the food product more nutritious (De La Peña et al, 2018).

Nutrition-sensitive interventions or programs: those that address underlying determinants of fetal and child nutrition and development—food security; adequate caregiving resources at the maternal, household and community levels; and access to health services and a safe and hygienic environment—and incorporate specific nutrition goals and actions.

Nutrition-sensitive agriculture: Making agriculture more nutrition-sensitive requires identifying critical entry points where nutrition goals can be incorporated into agro-food systems. Six pathways are identified through which agricultural interventions can impact nutrition: (1) food access from own-production; (2) income from the sale of commodities produced; (3) food prices from changes in supply and demand; (4) women's social status and empowerment through increased access to and control over resources; (5) women's time through participation in agriculture, which can be either positive or negative for their own nutrition and that of their children; and (6) women's health and nutrition through engagement in agriculture, which also can have either positive or negative impacts, depending on exposure to toxic agents and the balance between energy intake and expenditure (Ruel and Alderman, 2013).

Food System Drivers: endogenous or exogenous processes that deliberately or unintentionally affect or influence a food system over a long-enough period so that their impacts result in altering durably the activities or actors, and subsequently the outcomes, of that system (Béné et al. 2019, p.152). Food system drivers can be grouped under three main categories: (i) Production/supply drivers (technological innovations, intensification and homogenization of agriculture, climate change, degradation in soils and other agro-ecological conditions, improved access to infrastructure, trade policies), (ii) Distribution/trade drivers (trade policies, internationalization of private investments, growing concerns for food safety); and (iii) Consumption/demand drivers (urbanization and related changes in life style, raise in consumers’ income, population growth, growing attention paid to diet and health).

Food security: A situation that exists when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life. Based on this definition, four food security dimensions can be identified: food availability, economic and physical access to food, food utilization, and stability over time

Nutrition security: A situation that exists when secure access to an appropriately nutritious diet is coupled with a sanitary environment and adequate health services and care, in order to ensure a healthy and active life for all household members. Nutrition security differs from food security in that it also considers the aspects of adequate caregiving practices, health and hygiene, in addition to dietary adequacy.

Malnutrition: An abnormal physiological condition caused by inadequate, unbalanced or excessive consumption of macronutrients and/or micronutrients. Malnutrition includes undernutrition (child stunting and wasting and vitamin and mineral deficiencies) as well as overweight and obesity.

Overweight and obesity: Body weight that is above normal for height as a result of an excessive accumulation of fat. It is usually a manifestation of expending less energy than is consumed. In adults, overweight is defined as a BMI of 25 kg/m2 or more, and obesity as a BMI of 30 kg/m2 or more. In children under five years of age, overweight is defined as weight-for-height greater than 2 standard deviations above the WHO Child Growth Standards median, and obesity as weight-for-height greater than three standard deviations above the WHO Child Growth Standards median.

Hunger: an uncomfortable or painful physical sensation caused by insufficient consumption of dietary energy. In this report, the term hunger is synonymous with chronic undernourishment.

Undernourishment: the condition in which an individual’s habitual food consumption is insufficient to provide the amount of dietary energy required to maintain a normal, active, healthy life. The prevalence of undernourishment is an estimate of the proportion of the population that lacks enough dietary energy for a healthy, active life. It is FAO’s traditional indicator used to monitor hunger at the global and regional level, as well as Sustainable Development Goal Indicator 2.1.1. It is a measurement of food available for consumption.

Undernutrition: the outcome of poor nutritional intake in terms of quantity and/or quality, and/ or poor absorption and/or poor biological use of nutrients consumed as a result of repeated instances of disease. It includes being underweight for one’s age, too short for one’s age (stunted), dangerously thin for one’s height (suffering from wasting) and deficient in vitamins and minerals (micronutrient deficiency).

Stunting: low height-for-age, reflecting a past episode or episodes of sustained undernutrition. In children under five years of age, stunting is defined height-for-age less than -2 standard deviations below the WHO Child Growth Standards median.

Wasting: low weight-for-height, generally the result of weight loss associated with a recent period of inadequate dietary energy intake and/or disease. In children under five years of age, wasting is defined as weight-for-height less than -2 standard deviations below the WHO Child Growth Standards median.

Multiple burden of malnutrition: the coexistence of forms of undernutrition (child stunting and wasting and vitamin and mineral deficiencies) with overweight and obesity in the same country, community, household, or individual.

Double-duty actions: interventions, programs and policies that have the potential to simultaneously reduce the risk or burden of both undernutrition (including wasting, stunting, and micronutrient deficiency or insufficiency) and overweight, obesity or diet-related NCDs (including type 2 diabetes, cardiovascular disease and some cancers). Double-duty actions leverage the coexistence of multiple forms of malnutrition and their shared drivers to offer integrated solutions.

Food-based dietary guidelines: national food-based dietary guidelines (FBDGs) provide context-specific advice and principles on healthy diets and lifestyles, which are rooted on sound evidence, and respond to a country’s public health and nutrition priorities, food production and consumption patterns, sociocultural influences, food composition data, and accessibility, among other factors. Typically, FBGDs propose a set of recommendations in terms of foods, food groups and dietary patterns to provide the required nutrients to promote overall health and prevent chronic diseases. FBDGs can serve to guide a wide range of food and nutrition, health, agriculture and nutrition education policies and programs; therefore representing a unique opportunity to favorably impact diets and the food system, from production to consumption.

Dietary diversity: the consumption of a variety of nutritionally desirable foods or food groups (including plenty of plant foods such as fruits, vegetables, legumes and whole grains). There are two validated indices to assess dietary diversity. The Minimum Dietary Diversity score for women of reproductive age refers to the number of food groups (out of 10 food groups) consumed by a woman 15-49 years of age in the previous 24 hours. Consuming five or more food groups indicates a low risk of nutrient inadequate diet (Martin-Prével et al, 2015 ; Arimond et al, 2010). The Minimum Dietary Diversity for young children refers to the number of food groups (out of 7 food groups) consumed by a child (6-23 months of age) in the previous 24 hours. Consuming four food groups or more indicates a low risk of a nutrient inadequate diet (Jones et al, 2014).

Ultraprocessed foods: industrial formulations typically with five or more and usually many ingredients. Such ingredients often include those also used in processed foods such as sugar, oils, fats, salt, anti-oxidants, stabilizers, and preservatives. Ingredients only found in ultra-processed products include substances not commonly used in culinary preparations, and additives whose purpose is to imitate sensory qualities of unprocessed foods or of culinary preparations of these foods, or to disguise undesirable sensory qualities of the final products (Monteiro et al, 2013). A practical way to identify ultra-processed products is to check if its list of ingredients contains at least one item characteristic of the NOVA ultra-processed food group, which is to say, either food substances never or rarely used in the kitchen, or classes of additives designed to make the final product palatable or more appealing (Monteiro et al, 2019).

Indicators, methods, metrics and tools: Indicators combine one or various derived variables and evaluate them against an objective. Methods refer to procedures, techniques or processes to attaining data. Metrics refer to parameters or indicators used for measurement, comparison or tracking performance (for example, the Women’s Empowerment in Nutrition Index, or the Household Water Insecurity Experience Scale). A tool is a vehicle or aid to collect information and data to arrive at the metric or aid decision-making (for example, accelerometers to measure energy expenditure; interactive platforms such as Optifood, to design nutrition sensitive interventions for agriculture projects; or a low-cost and field friendly diagnostic tool to assess micronutrient deficiencies). (IMMANA)

Food supply chain: encompasses all activities that move food from production to consumption, including production, storage, distribution, processing, packaging, retailing and marketing. The flow of food can be direct and local through subsistence production, but globally the bulk is indirect through (short to long) national food supply chains involving a range of transformations and distribution networks, and international networks of food export and import. The nutrient content and composition of (un)healthy components can be modified along the food supply chain through contamination, degradation, leakages and losses, processing, fortification and a range of other factors. The level of nutrition-sensitivity of value chains is subject to processes along the food supply pipelines. The food supply chain has four components namely food production, food storage and distribution, food processing and packaging and retails and markets (HLPE, 2017).

Dietary energy supply (DES): food available for human consumption, expressed in kilocalories per person per day (kcal/person/day). At the country level, it is calculated as the food remaining for human use after deduction of all non-food utilizations (i.e. food = production + imports + stock withdrawals − exports − industrial use − animal feed – seed – wastage − additions to stock). Wastage includes loss of usable products occurring along distribution chains from farm gate (or port of import) up to retail level. These data are used to calculate the prevalence of undernourishment.

References

Arimond M, Wiesmann D, Becquey E, et al. Simple food group diversity indicators predict micronutrient adequacy of women's diets in 5 diverse, resource-poor settings. (Supplement: Developing simple measures of women's diet quality in developing countries: methods and findings.). J Nutr. 2010;140(11):2059S-2069S.

Béné C., Prager S.D., Achicanoy H.A.E., Alvarez Toro P., Lamotte L., Bonilla Cedrez C., Mapes B.R. 2019 Understanding food systems drivers: A critical review of the literature Global Food Security 23: 149–159.

De La Peña I, Garrett J and Gelli A (2018). Nutrition-sensitive value chains from a smallholder perspective. A framework for project design. IFAD, Rome.

FAO (2016). Influencing food environments for healthy diets. Rome (available at http://www.fao.org/3/a-i6484e.pdf).

FAO (2019). Sustainable healthy diets. Guiding principles. FAO, WHO, Rome (available at http://www.fao.org/3/ca6640en/CA6640EN.pdf).

Herforth, A., & Ahmed, S. (2015). The food environment, its effects on dietary consumption, and potential for measurement within agriculture-nutrition interventions. Food Security, 7(3), 505-520.

Herforth, A., Frongillo, E.A., Sassi. F., et al. (2014). Toward an integrated approach to nutritional quality, environmental sustainability, and economic viability: research and measurement gaps. (A global research agenda for nutrition science.). Annals of the New York Academy of Sciences.

HLPE (2017) Nutrition and food systems. A report by the High Level Panel of Experts on Food Security and Nutrition of the Committee on World Food Security, Rome.

Jones AD, Ickes SB, Smith LE, et al. World Health Organization infant and young child feeding indicators and their associations with child anthropometry: a synthesis of recent findings. Matern Child Nutr. 2014;10(1):1-17.

Martin-Prével Y, Allemand P, Wiesmann D, et al. (2015) Moving forward on choosing a standard operational indicator of women’s dietary diversity. Rome2015.

Monteiro, C. A., Moubarac, J. C., Cannon, G., Ng, S. W., & Popkin, B. (2013). Ultraprocessed products are becoming dominant in the global food system. Obesity Reviews, 2(14 Suppl).

Monteiro C, Cannon G, Levy RB et al. Ultra-processed foods: what they are and how to identify them. 2019. Public Health Nutrition. 22(5), 936-941.

Ruel, M.T., Alderman, H., 2013. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? Lancet 382, 536–551. http://dx.doi.org/10.1016/S0140-6736(13)60843-0.