Human Nutrition: A Continuing Debate
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For instance, Dr. Mike Gibney and colleagues published a commentary last month in AJCN arguing that the system is not superior to using associations of nutrient intakes with disease 5. Further, changes to modern eating that relate to consuming more energy including increased portion sizes and energy density, may not necessarily be related to food processing. As such, processing can be used to formulate smaller portion sizes and reduce energy density.
Similarly, the American Society for Nutrition scientific statement on the nutritional role of processed foods by Dr.
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Connie Weaver and colleagues 6 takes issue with using the NOVA classification based on subjectivity, favoring instead IFIC definitions of processed foods as described below:. The statement addressed how processed foods contribute to the health and nutrition of populations, stakeholders in improving diet, and research still needed. Analysis of foods that provide nutrient enrichment and fortification added by processing indicates that much of the population would fall below adequate intakes for several nutrients.
On the other hand, on average they contribute to nutrients that are recommended to be limited such as added sugar, sodium, saturated fat, and calories. The paper also summarizes what the future of processed food should look like to better address nutritional and food security around the world, including more cross-discipline collaboration to improve upon processed products and better communication between consumers and relevant stakeholders 6.
It also remains to be seen whether the NOVA classification system would lead consumers to choose better diets compared to healthy diet patterns developed by nutrient epidemiology such as MyPlate, DASH, or Mediterranean-style diets, which can include foods with various levels of processing 7.
Thus, depending on how you define it, food processing can contribute necessary nutrients but also nutrients that should be reduced, and how different forms of processing may affect health is understudied. Many challenges exist that may prohibit effective research from being done, including defining and classifying processed foods, accurate recalling of foods in dietary surveys, utilizing suitable comparisons, getting study subjects to stay on an assigned diet for the necessary period of time, etc.
Instead of looking at processing, per se, as predictive of health effects, much research currently looks at individual aspects of food processing that may contribute to increased or decreased health risks. For example, my dissertation research focuses on dietary phosphorus, which is widely utilized as a food additive 8. Growing evidence suggests that excess phosphorus in the diet, particularly in the form that is added for processing purposes, may increase risks for cardiovascular and bone disease, particularly in those who have kidney disease.
For example, a human trial directly compared foods with elevated levels of phosphorus additives vs.
Food and Nutrition · Manchester Metropolitan University
For more, see recent reviews from our group 10, It is, however, difficult to definitively tease out the effect of individual components like phosphorus additives to long-term health from the whole food packages that they accompany. An upcoming trial by Dr. Like any nutrition guidance, we must rely on imperfect evidence to communicate dietary recommendations. This provides a benchmark for evaluating the possibilities of applying the NSA approach in this case.
It is also assumed that concepts support social actors practices, as well as disputes in the political ground that affect expected outcomes in this field. Secondary socio-economic and nutritional data have been collected to indicate the progress and challenges for the national policy. The process of data collection was based on a review of national and international studies on food and nutrition security, evaluation studies of federal programmes, documental analysis of policy proposals and federal legislation, and official documents of the National Council for Food and Nutrition Security CONSEA from to Empirical evidence was provided by discussing the possibilities and challenges to implementing an intersectoral and participatory perspective of three programs as well as agroecological experiences.
The paper is divided into four sections.
Optimal Human Nutrition? There, There...
First, conceptual and institutional matters related to FNSS and the RtF in Brazil and recent trends in socioeconomic and nutritional status. Secondly, main aspects of the relationship between agricultural models and access to adequate and healthy food. Thirdly, intersectoral programmes and initiatives related to FNSS and some experiences in bio-fortification.
Fourthly, lessons learned from the Brazilian experience. An innovative approach to food and nutrition security and sovereignty FNSS has been developed in Brazil over the last 20 years as a social construction gathering a wide range of social actors. The perspective of linking agriculture and nutrition in the very conceptualization of FNSS as well as in the systemic and intersectoral institutional framework for policy making stands out among the outcomes of this construction 1 , 2.
According to the law, food and nutrition security consists of realizing the right of all to regular and permanent access to good quality food, in sufficient quantity, without compromising the access to other essential needs, on the basis of food habits that promote health and respect cultural diversity and that are environmentally, culturally, economically and socially sustainable. The same law established that the realization of the human right to adequate food and the attainment of food and nutritional security require respect for sovereignty, which confers to countries primacy in their decisions regarding the production and consumption of food products 3 , 4.
Some of the key lessons learned from this process include: a the importance of participatory pacts related to concepts and principles; b the appropriateness of the systemic and intersectoral approach; c the existence of formal spaces of social dialogue; d the necessary practice of intersectoral coordination of public policies 6. Although Brazil is still a highly unequal country, there have recently been significant improvements in extreme poverty reduction and income distribution.
Regarding malnutrition and infant mortality, Brazil also made recent outstanding improvements. Despite all these progress, Brazil is facing an increasing trend of overweight and obesity associated with micronutrient deficiency anaemia, hypovitaminosis A and malnutrition. Multiple stimuli to consumption of processed foods, including advertising and the cost-satiety-flavour ratio of these foods are also factors that contribute to this situation 7 — The NSA approach could be developed in quite distinct perspectives depending on existing conceptual matrices, institutional designs and political projects in each national context.
This section explores analytical aspects and policy implications of these perspectives and their joint manifestation as evidenced in the Brazilian case. Burlandy et al. Another perspective is based in the concept of food regime according to which the access to adequate and healthy food has many determinants reflecting the major trends in the world food system Large-scale and highly mechanized monocultures are interrelated with current trends towards monotonous and poor food diets.
Systemic linkages under private logics reflect the absence of sovereign food provisioning policies. This is the case of the argument that two food regimes are in contention and running in parallel, each of them serving a different global class of consumers. The second is based on industrial and even more chemically and genetically modified foodstuffs offered to the lowest income consumers This means dealing with nutrition through an industrial path, grounded in functional foods and genetic science, including practices such as fortification.
Accordingly, as transnational supply chains move into the global South, both farming systems and local markets are threatened, and the growing masses of the poor, who can no longer access fresh foods, tend to increase their consumption of industrial cheaper food, most probably the least healthy and most durable commodities.
The third perspective takes an appropriate conceptualization of food and nutrition security in order to promoting a systemic approach favouring an intersectoral design of public policies coordinating food production, commercialization and consumption while valuing short food supply chains 5. This approach leads to actions promoting both food production and provisioning and healthy food practices.
The premise is that the current nutritional and food status of the Brazilian population in its relation with social inequalities are strongly conditioned by the way food has been produced and commercialized in the country. Thus, alternatives for facing priority tasks in relation to nutrition obesity, micronutrient deficiencies, hunger and undernutrition reside, primarily, in transforming the food production model towards agroecological models, as well as in changing the patterns of food provisioning and accessing.
In this sense, a NSA would be one that simultaneously favours: a greater availability of fresh food produced in agroecological bases; b social, economic and environmental sustainability; c promotion of agrobiodiversity. Accordingly, the focus on NSA implies having a more comprehensive view of the food question involved in economic development, i.
Furthermore, the role of food providers played by rural families involves also specific relationships with nature and the territory, the valuing of biological and cultural diversity and the maintenance of the social and cultural tissue, amongst others 19 — The role of agricultural models in promoting adequate and healthy food is faced with challenges derived from the coexistence of distinct models of agriculture in Brazil, i.
According to the last Agricultural Census , 4,3 millions of family farmers occupy only The coexistence of the two models is marked by complementarities, tensions and contradictions. Notwithstanding the socioeconomic significance of family farming and its potential to contribute to a NSA, large-scale monoculture and livestock occupy an important place in the Brazilian economy and also in the domestic food supply Besides promoting the degradation of nature and compromising biodiversity, land concentration is considered as one of the main causes of Brazil's well-known social inequalities.
The concentration of land and other productive resources has contributed to the expansion of highly-technical agricultural models making extensive use of agrochemicals impacting the health of both rural workers and consumers One should add to this picture the control of food chains by large corporations, the impacts of developed countries' trade policies and the outcomes of the recent food price crises 25 , In summary, national food provisioning policies driven by the conceptual references assumed in this paper must take into account the types of goods and the circuits through which they circulate, the models of production and the food habits they promote, price formation, moving in the reverse direction of distancing of production and consumption, bringing these two elements closer instead The diversity of food habits and natural resources are important inputs to a diet rich in micronutrients which could be better promoted by decentralized food systems based on regional-local circuits of food production, distribution and consumption based on a diversified family farming.
Among the advantages of such a model are: a access to a healthier and diversified diet with a larger amount of fresh products; b avoid food losses and waste; c use of more sustainable methods that preserve food nutritional properties; d lower costs of transportation and logistics, besides saving energy. Food and nutrition policies began to be implemented in the s, but only in the middle of brought up, for the first time, the intention to integrate nutrition, food and agriculture Notwithstanding, the major step in terms of an integrated view was given by the adoption of an intersectoral and participatory focus of FNSS in the launching of Zero Hunger Program in The main innovation of the Brazilian strategy with regards to nutrition-sensitive agriculture is the articulation at local level of public spending with food assistance to the poor, to the guarantee of local markets to smallholder farmers.
Based on the FNSS approach, new programmes were designed and old programmes were redesigned aimed at linking different dimensions and sectors of the food system, especially agriculture, health and education. The Food Procurement Programme PAA was established in by the Federal Government and it is considered an example of virtuous articulation between agricultural policy and the food and nutrition perspective. Its main objectives are: i to strengthen small-holder family farmers, promoting their economic and social inclusion; ii to encourage the consumption and recovery of foodstuffs traditionally produced by small-holder farmers; iii to promote regular access to food for the population in food and nutrition insecurity; iv to promote regular food supply; v to constitute public stocks of food produced by small-holder farmers; vi to support the constitution of stocks by cooperatives of small-holder farmers; vii to strengthen local and regional circuits and local marketing networks; viii to promote and enhance biodiversity and the organic and agroecological food production, ix to encourage healthy eating inhabits at local and regional level; x to stimulate cooperatives and other forms of association The government buys food directly from small-holder family farmers or their organizations, in a decentralized manner and with little bureaucracy involved.
The food is distributed through social organizations to those in food insecurity or directed to compose strategic public stocks. The institutional format and the operational design of the program reflect its intersectoral perspective with a Managing Group formed by 5 Ministries of State. Various evaluations conclude that PAA has an important role in linking the dimensions of production, supply and food consumption, as well as the strengthening of small-holder farmers 30 — The programme stimulates the diversification of food production and the conservation of biodiversity, just as much as it values regional food.
Many foodstuffs of high nutritional value from Brazilian main biomes that were seriously threatened by the advance of monocultures and had little commercial value, started to be acquired with PAA. In addition, the acquisition and distribution of local varieties of seeds traditional or creole has helped to generate greater autonomy to family farmers, and to rescue varieties of seeds that were being lost.
Greater visibility is given to the production of rural women, strengthening their economic autonomy and self-esteem Nonetheless, the program still has a limited coverage 36 and it efficiency also depends on dealing with challenges related to land access and territorial rights, the transition to sustainable forms of production, support for infrastructure, among others Greater access to healthy food and the strengthening of local family farming was also promoted by the recent remodelling and expansion of the PNAE — a programme originally launched in Since PNAE has undergone changes in the programme-design aiming at strengthening its strategic role in promoting the SAN, such as: the establishment of guidelines for promoting healthy eating in schools; the redefinition of the criteria for the formulation of menus aiming at articulating the nutritional dimension with respect to food culture of each region and prioritization of fresh raw or semi-processed food.
In , a new law established a set of a new regulation in the programme-design. One of them must be highlighted considering that it exemplifies the comprehensive approach of FNSS. The programme offers daily around 46 million free-meals in public schools all over the country.go
Although most of the municipalities are meeting or exceeding the minimum percentage of local acquisition, the purchase from family farmers in big cities and metropolitan areas still represents a major challenge. It is also necessary to fit the structure of schools for the reception and proper preparation of foods Aiming at integrating existing sectoral actions to prevent and control obesity. Obesity is considered as a multidimensional and complex phenomenon and a strategy to overcome the problem requires the adoption of healthier ways of eating and living and also changes in the food system given the close relationship between models of production, consumption patterns and nutritional aspects.
The strategy aims to increase the consumption of healthy fresh and regional foods and decrease the consumption of processed foods strengthening local circuits of food production, provisioning and consumption reinforcing the interaction between agriculture and nutrition trough several initiatives encompassing the dimensions of production, marketing, supply and consumption.
Regarding the regulation and control of food quality, the main focus is on the abusive use of pesticides In Brazil, initiatives bringing together agriculture and nutrition are not restricted to government programs and actions. Several concrete experiments in food production are gaining political expression This is particularly the case of experiences in agroecology.
Such experiments articulate agroecological practices and FNS strategies involving a wide range of activities from the rescue and conservation of local seeds and animal breeds, the diversification of production systems to the recovering of regional food and self-consumption The systemic vision of agroecology intends to articulate agricultural, ecological and socio-economic aspects, being an important way of linking agriculture and nutrition 46 — A brief review of a set of agroecological experiences in the various biomes testifies their potential in the promotion of a nutrition-sensitive agriculture involving at least three dimensions First, the diversification of food production and agro-biodiversity promoted mainly through family farmers' production and mutual exchange of native-species seeds.