Food Systems For Healthier Diets In Bangladesh Towards A Research Agenda

The national food system of Bangladesh has made substantial progress since experiencing famine in 1974, soon after independence. After the famine, the government placed a strong emphasis on policies required to attain grain self-sufficiency; since attaining self-sufficiency, the production system, policies related to it, and resulting diets have begun to diversify. Nonetheless, undernutrition remains a problem, and fruit and vegetable consumption are inadequate for most people relative to international recommendations. Moreover, as the food system has begun to transition towards a modern one, challenges related to food safety and perceived food adulteration have begun to rise. Further, increased processed food intakes are potentially associated with existing rising overweight and obesity status. Both government interventions and innovations are needed to help shift the national food system to improve nutrient-dense food availability, particularly among the poor, and to limit the increase in processed food consumption.

Vietnamese food systems are undergoing rapid transformation, with important implications for human and environmental health and economic development. Poverty has decreased, and diet quality and undernutrition have improved significantly since the end of the Doi Moi reform period (1986-1993) as a result of Viet Nam opening its economy and increasing its regional and global trade. Yet poor diet quality is still contributing the triple burden of malnutrition, with 25 percent stunting among children under age 5, 26 percent and 29 percent of women and children, respectively, anemic, and 21 percent of adults overweight. Agricultural production systems have shifted from predominantly diverse smallholder systems to larger more commercialized and specialized systems, especially for crops, while the ‘meatification’ of the Vietnamese diet is generating serious trade-offs between improved nutrition and sustainability of the Vietnamese food systems. The food processing industry has developed rapidly, together with food imports, resulting in new and processed food products penetrating the food retail outlets, trending towards an increase in the Westernized consumption patterns that are shifting nutrition-related problems towards overweight and obesity and, with it, an increase of non-communicable disease-related health risks. While regulatory policies exist across the food system, these are not systematically implemented, making food safety a major concern for consumers and policy makers alike. Where data exists, it is not easy to aggregate with data from across food system dimensions, making it difficult for Viet Nam to make an informed analysis of current and potential food system trade-offs. In our research, we reviewed existing literature and data, and applied a food systems framework to develop an initial food systems profile for Viet Nam and to identify a comprehensive set a of research questions to fill current data gaps identified through the review. Insights on these would provide the comprehensive evidence needed to inform policy makers on how to develop new food systems policies for Viet Nam, and further refine and improve existing policies to achieve better quality diets and more sustainable food systems in Viet Nam. Based on these, we then engaged with stakeholders to develop research priorities in the Viet Nam context and identified 25 priority research questions. This paper aims to stimulate such reflections by clearly outlining key areas for research, government policy, and development programs on priority investment to build the evidence base around inclusive food systems interventions that aim to result in healthier diets and more sustainable food systems for Viet Nam

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Malnutrition in all its forms is a major challenge everywhere in the world, and particularly in low and middle income countries. To reduce malnutrition, innovations in food systems are needed to both provide sufficient options for consumers to obtain diets with adequate nutritional value, and to help consumers make conscious and unconscious choices to choose healthier diets. A potential solution to this challenge is food systems innovations designed to lead to healthier diets. In this paper, we lay out a multidisciplinary framework for both identifying and analyzing innovations in food systems that can lead to improvements in the choices available to consumers and their diets from a health perspective. The framework identifies entry points for the design of potential food systems innovations, highlighting potential synergies, feedback, and tradeoffs within the food system. The paper concludes by providing examples of potential innovations and describes future research that can be developed to support the role of food systems in providing healthier diets.

Poor-quality diets are one of the leading causes of malnutrition and common non-communicable disease. In this study, we use nationally representative household survey data and food demand system estimations to analyze dietary change and changing consumer preferences for different foods in the context of urbanization in low- and middle-income countries. We estimate and compare income and price elasticities of total food demand and the demand for 15 food groups in rural, urban, and city areas of Bangladesh for 2010 and 2016. We then use Oaxaca-Blinder decomposition regressions to explore how much of the observed food consumption changes can be explained by changes in revealed consumer preferences vis-à-vis changes in household income and food prices. The results show that Bangladeshi diets shifted from coarse to refined rice, and consumer preferences for vegetables and pulses were relatively low, contributing to worsening dietary quality. On the other hand, the consumption of nutritious, animal-source foods including fish, poultry, and eggs increased due to high consumer preferences and declining food prices-partly thanks to governmental production support. Regarding the dietary implications of rapid urbanization, the analysis suggests that rural consumers’ diets will largely follow the trajectory of urban consumers in Bangladesh.