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To determine the prevalence of inadequate or excessive nutrient intakes in a population, repeated 24-hour dietary intake measurements per subject allow for adjustment of modeled usual nutrient intake distributions for the proportion of total variance attributable to within-individual variation (WIV:total). When only single-day dietary data are available, an external adjustment factor can be used, but there is no formal guidance for selecting this value. We compiled estimates of WIV:total to describe variation in estimates across populations and settings and consider the effect of this variation on estimates of the prevalence of inadequate or excess intake. Reported ratios of within- to between-individual variance components of nutrient intake (and WIV:total) were compiled from the literature, and new values were calculated from analyses of existing data sets using a linear mixed model, adjusting for weekend (where available) and interview sequence. Nutrients assessed included total energy intake, total vitamin A, retinol, carotenoids/beta-carotene, folate, vitamin B12, thiamin, vitamin C, iron, and zinc.

In 2010, the United Nations General Assembly recognized access to safe water and sanitation infrastructure a matter of human right. This right is reflected in Sustainable Development Goal 6, whose targets 1 and 2 point to universal access to safe and affordable drinking water and adequate sanitation by 2030, in a gender equitable way. Progress towards these targets has been recorded, building on successes achieved under the previous framework of the Millennium Development Goals (Target 7.c). These positive developments could be expected to spill over to other dimensions of human development, health and nutrition in particular. Yet, progress in either of these dimensions, particularly among young children (SDG target 2.2 on ending all forms of malnutrition), is not commensurate. In this paper, we advocate for a systemic approach to water management for improved health and nutrition. We focus on rural and peri-urban areas of the developing world, where multi-purpose water systems are particularly relevant. As competition for safe water resources intensifies, it is important to understand the trade-offs between specific uses and their implications for health and nutrition, based on the gender and age of individuals. We conduct statistical and econometric analyses of secondary, nationally representative data for four countries: Bangladesh, Ethiopia, Ghana and India. These data sets have been routinely used to report on progress toward SDG 6 (availability and sustainable management of water and sanitation for all) and SDG 2 (ending hunger and achieving food security and improved nutrition for all). Our cross-sectional analysis reflects the positive association between access to improved sanitation infrastructure and long-term child nutrition outcomes (height-for-age and weight-for-age). On the other hand, the analysis fails to demonstrate a positive association between access to improved drinking water sources and the same child nutrition indicators. In the next step, we investigate the associations between multi-use water systems, especially around agricultural activities, and health and nutrition. To that end, we compile data from four household surveys we collected in the same countries, including indicators on the type of irrigation system. The regression analysis of this pooled dataset is complemented by an in-depth, context-specific analysis of behavior around drinking water use and irrigation practices. The analyses reveal a low correlation between water quality at the point of source and water quality at the point of use, drawing attention to behavioral issues around water use. Similarly, the prevalence of open defecation seems much more important to health and nutrition than the existence of sanitation infrastructure. Finally, irrigation is not per se a detrimental factor for drinking water quality or nutrition, but the integration of waste water irrigation in particular needs to be carefully managed in order to avoid adverse nutrition and health effects.

International audience; Background: Dietary diversity is a key element of diet quality, but diets of women of reproductive age (WRA; aged 15–49 y) in resource-poor settings are often deficient in a range of micronutrients. Previous work showed associations between simple food-group diversity indicators (FGIs) and micronutrient adequacy among WRA. For operational and advocacy purposes, however, there is strong demand for a dichotomous indicator reflecting an acceptable level of dietary diversity.Objective: The aim of the study was to develop a dichotomous indicator of dietary diversity in WRA.Methods: We performed a secondary analysis of 9 data sets containing quantitative dietary data from WRA in resource-poor settings (total n = 4166). From the raw dietary data, we calculated an individual “mean probability of adequacy” (MPA) across 11 micronutrients. Several candidate FGIs were constructed. Indicator performance in predicting an MPA >0.60 was assessed within each data set by using receiver-operating characteristic analysis and sensitivity and specificity analysis at various FGI cutoffs. The analysis was performed separately for nonpregnant and nonlactating (NPNL) women and for lactating women.Results: We identified 2 “best candidate” dichotomous indicators on the basis of 9- or 10-point food-group scores (FGI-9 and FGI-10) with a cutoff of ≥5 food groups. Both were significantly correlated to MPA in each site (P < 0.001). Areas under the curve were moderate, ranging from 0.62 to 0.82 among NPNL women and from 0.56 to 0.90 among lactating women. Comparisons of results slightly favored FGI-10 for all women.Conclusions: When resource-intensive dietary methods are not feasible, a simple dichotomous indicator based on a cutoff of ≥5 of 10 defined food groups reflects “minimum dietary diversity for women of reproductive age.” According to the conclusions of a consensus meeting of experts, this indicator is well suited for population-level assessment, advocacy, and possibly also for tracking of change in dietary diversity across time.

The Global Hunger Index (GHI) is a multidimensional measure of hunger that considers three dimensions: (1) inadequate dietary energy supply, (2) child undernutrition, and (3) child mortality. The initial version of the index included the following three, equally weighted, non-standardized (i.e. unscaled) indicators that are expressed in percent: the proportion of the population that is calorie deficient (FAO's prevalence of undernourishment); the prevalence of underweight in children under five; and the under-five mortality rate. Several decisions regarding the original formulation of the GHI are reconsidered in light of recent discussions in the nutrition community and suggestions by other researchers, namely the choice of the prevalence of child underweight for the child undernutrition dimension, the use of the under-five mortality rate from all causes for the child mortality dimension, and the decision not to standardize the component indicators prior to aggregation. Based on an exploration of the literature, data availability and comparability across countries, and correlation analyses with indicators of micronutrient deficiencies, the index is revised as follows: (1) The child underweight indicator is replaced with child stunting and child wasting; (2) The weight of one third for the child undernutrition dimension is shared equally between the two new indicators; and (3) The component indicators of the index are standardized prior to aggregation, using fixed thresholds set above the maximum values observed in the data set. The under-five mortality rate from all causes is retained, because estimating under-five mortality attributable to nutritional deficiencies would be very costly and make the production of the GHI dependent on statistics about cause-specific mortality rates by country and year that are published irregularly, while the expected benefits are limited.

Die globale Hungersituation hat sich seit 1990 verbessert, wie der Welthunger-Index 2013 anhand von Daten aus dem Zeitraum 2008–2012 zeigt. Der WHI ist um ein Drittel gesunken. Dennoch ist die weltweite Hungersituation nach wie vor "ernst". 870 Millionen Menschen hatten laut Schatzungen der Ernährungs- und Landwirtschaftsorganisation der Vereinten Nationen (FAO) im Mittel der Jahre 2010–2012 nicht genug zu essen. Südasien und Afrika südlich der Sahara haben die höchsten WHI-Werte. Südasien hat seinen WHI-Wert zwischen 1990 und 1995 deutlich verbessert, vor allem durch einen großen Rückgang des Untergewichts bei Kindern. Der schnelle Fortschritt in dieser Region konnte jedoch nicht aufrechterhalten werden. Soziale Ungleichheit und der schlechte Ernährungszustand, das geringe Bildungsniveau und der niedrige gesellschaftliche Status von Frauen tragen nach wie vor zu einem hohen Anteil von Untergewicht bei Kindern unter fünf Jahren bei.

The 2013 Global Hunger Index (GHI) report—the eighth in an annual series—presents a multidimensional measure of national, regional, and global hunger. It shows that the world has made some progress in reducing hunger since 1990, but still has far to go. The 2013 GHI report focuses on resilience in theory and in practice. The relief and development communities have long struggled to understand why some people fare better than others when confronting stresses or shocks. Given that world hunger remains “serious†according to the index, resilience-building efforts are much needed to help poor and vulnerable people cope with hunger seasons, droughts, and other natural and manmade disasters both short-term and long-term. Building resilience will involve boosting food and nutrition security. In order to achieve that goal, the humanitarian and development communities must work together.

Women of reproductive age living in resource-poor settings are at high risk of inadequate micronutrient intakes when diets lack diversity and are dominated by staple foods. Yet comparative information on diet quality is scarce and quantitative data on nutrient intakes is expensive and difficult to gather. We assessed the potential of simple indicators of dietary diversity, such as could be generated from large household surveys, to serve as proxy indicators of micronutrient adequacy for population-level assessment. We used 5 existing data sets (from Burkina Faso, Mali, Mozambique, Bangladesh, and the Philippines) with repeat 24-h recalls to construct 8 candidate food group diversity indicators (FGI) and to calculate the mean probability of adequacy (MPA) for 11 micronutrients. FGI varied in food group disaggregation and in minimum consumption required for a food group to count. There were large gaps between intakes and requirements across a range of micronutrients in each site. All 8 FGI were correlated with MPA in all sites; regression analysis confirmed that associations remained when controlling for energy intake. Assessment of dichotomous indicators through receiver-operating characteristic analysis showed moderate predictive strength for the best choice indicators, which varied by site. Simple FGI hold promise as proxy indicators of micronutrient adequacy.

"The objective of this study is to validate the World Food Programme's (WFP) method of establishing the prevalence of food insecurity. WFP's method has two parts: (1) the construction of a Food Consumption Score (FCS) and (2) the classification of food security status based on the FCS. Our validation work has the following components: (1) collecting and analyzing survey data from three countries—Burundi, Haiti, and Sri Lanka—that contain information about calorie consumption at the household level and information needed to construct the FCS; (2) establishing the extent to which an assessment of food security status based on the FCS mimics food security status based on household calorie consumption; and (3) assessing whether changes to the construction of the FCS would improve its predictive power and whether such changes are feasible, given the environment in which these assessments are typically conducted. To achieve the third objective, alternative dietary diversity and food frequency indicators are constructed by either modifying WFP's calculation method for the FCS or following a different approach, such as that for the Household Dietary Diversity Score developed by the Food and Nutrition Technical Assistance Project. By comparing indicator performance, we can answer the questions of whether the FCS could be simplified by using food group diversity instead of food frequency by food group, if further disaggregation of food groups would improve its validity, and what the merits and demerits of other aspects of WFP's standard method are. Based on our findings about the validity of the FCS and the results for alternative proxy indicators, we then suggest changes to the construction of the FCS. Our findings on the usefulness of the FCS are encouraging. The same holds true for the alternative indicators of dietary diversity and food frequency we considered. There are positive and statistically significant associations with calorie consumption per capita, particularly when small quantities are excluded from food frequencies. In two out of three study sites, food frequency scores are clearly superior to simpler measures of diet diversity (food or food group count). Higher levels of disaggregation are advantageous, but with diminishing marginal returns. We note, however, that the provision of food aid seems to weaken the association of the FCS with calorie consumption. All of these observations support the use of WFP's FCS for food security assessments. However, the cutoff points used by WFP to define poor, borderline, and adequate Food Consumption Groups are too low when the FCS classification is compared to estimates of calorie deficiency from our survey data and other sources. As a food security classification device, the FCS could be improved by excluding foods consumed in small quantities from the FCS and, even more important, adjusting the cutoffs used to classify households as having poor, borderline, or acceptable food security. Minor gains in the validity of the FCS could be achieved by making several technical adjustments to the calculation of the FCS, for example, using a 12-group food classification instead of an 8-food group classification. This study has several limitations. We did not validate the proxy indicators against diet quality, because this would have required the collection of individual 24-hour recall data for all household members, which was beyond the scope of our study. The use of seven-day household recall data is a limitation for our analysis; information on dietary intakes from individual 24-hour recalls is generally considered more accurate. The lack of precise information on the effects of excluding small quantities from food frequencies is another constraint." from authors' abstract

"This paper uses data from national household expenditure surveys to explore whether food insecurity is more severe in South Asia or Sub-Saharan Africa. It employs two indicators of the diet quantity dimension of food insecurity, or the inability to access sufficient food: the prevalence of food energy deficiency and the prevalence of severe food energy deficiency. It also employs two indicators of the diet quality dimension, indicating lack of access to nutritious food: the prevalence of low diet diversity and the percent of energy from staple foods. It finds the regions' food energy deficiency prevalences to be quite close (51 percent in South Asia, 57 percent in Sub-Saharan Africa). However, the prevalence of severe food energy deficiency, which is more life threatening, is higher in Sub-Saharan Africa (51 percent versus 35 percent in South Asia). From a diet quality standpoint, the regions appear to suffer from a comparable and high reliance on staple foods in the diet to the neglect of foods rich in protein and micronutrients, but that Sub-Saharan Africa may be doing worse, as reflected in less diverse diets. The results confirm that both regions suffer from deep food insecurity problems but point to Sub-Saharan Africa as the region with the more severe problem, particularly when it comes to the diet quantity dimension of food insecurity. In deciding which region should be given greater emphasis in the international allocation of scarce development resources, the fact that the numbers of people affected by food insecurity are higher in South Asia should be taken into consideration." from Authors' Abstract

"Progress in combating hunger and undernutrition has been lagging for decades. Best practices to fight hunger and undernutrition have been available for a long while, but lack of political will among leaders and a lack of political power among the poor have hampered their implementation. Since indices have proven to be powerful tools for advocacy and are able to capture multifaceted phenomena, the Global Hunger Index (GHI) was developed to increase attention to the hunger problem and mobilize the political will to speed up urgently needed progress in the fight against hunger. The GHI captures three dimensions of hunger: insufficient availability of food, shortfalls in the nutritional status of children, and child mortality, which is to a large extent attributable to undernutrition." -- from Author's Abstract

"Indices can be powerful tools for international monitoring and advocacy, and if used in international rankings, can help foster a sense of healthy competition among countries. With this in mind, IFPRI's Global Hunger Index (GHI) was designed to help mobilize political will and promote good policies by ranking countries and illustrating trends. It captures three dimensions of hunger: insufficient availability of food, shortfalls in the nutritional status of children, and child mortality, which is to a large extent attributable to undernutrition. Accordingly, the index includes the following three equally weighted indicators: the proportion of people who are food energy deficient as estimated by the Food and Agriculture Organization of the United Nations, the prevalence of underweight in children under the age of five as compiled by the World Health Organization, and the under-five mortality rate as reported by UNICEF" from Text

This article explores the characteristics of food security in the context of economies in transition. These special characteristics derive from the “legacies” of socialist systems, both economy-wide ones and others specific to the agriculture and the food sector. Food insecurity in transition countries is considered predominantly “transitory”, while social safety nets dating back to the socialist years provide some cushion. Market failures and other institutional constraints are prevalent, inhibiting the process towards improvement of the food security situation. Conflict takes a heavy toll in terms of hunger and malnutrition in economies in transition and macro level factors are at work to determine food security outcomes. At the same time, socialist legacies determine differences in food security outcomes between transition and developing countries beyond what would be explained by income differences.

Progress in combating hunger and undernutrition has been lagging for decades. Best practices to fight hunger and undernutrition have been available for a long while, but lack of political will among leaders and a lack of political power among the poor have hampered their implementation. Since indices have proven to be powerful tools for advocacy and are able to capture multifaceted phenomena, the Global Hunger Index (GHI) was developed to increase attention to the hunger problem and mobilize the political will to speed up urgently needed progress in the fight against hunger. The GHI captures three dimensions of hunger: insufficient availability of food, shortfalls in the nutritional status of children, and child mortality, which is to a large extent attributable to undernutrition. Accordingly, the index includes three equally weighted indicators: the proportion of people who are food energy deficient as estimated by the Food and Agriculture Organization of the United Nations (FAO), the prevalence of underweight in children under the age of five as compiled by the World Health Organization (WHO), and the under-five mortality rate as reported by the United Nations Children’s Fund (UNICEF). The GHI has been calculated for 1981, 1992, 1997, and, most recently, for 2003. The latest round ranks 97 developing countries and 22 countries in transition. Nine out of the 12 worst-ranking countries were engaged in wars between 1989 and 2003. The hot spots of hunger and undernutrition are in South Asia and Sub-Saharan Africa. While favorable trends prevailed in South Asia and Southeast Asia during the past two decades, progress has been sluggish in Sub-Saharan Africa. To identify those countries that do notably better or worse with regard to hunger and undernutrition than would be expected from their Gross National Income (GNI) per capita, a regression analysis of the GHI on GNI per capita is run. Controlling for the variation in GNI per capita, the GHI is 22 percent higher in war countries than in non-war countries, which is attributable to a higher proportion of people who are food energy deficient and a higher prevalence of underweight children. Likewise, in countries with an HIV prevalence greater than 10 percent, the GHI is 23 percent higher than in countries with lower prevalence rates, which can be traced back to a higher proportion of the population being food energy deficient and to a higher under-five mortality rate.

Indices can be powerful tools for international monitoring and advocacy, and if used in international rankings, can help foster a sense of healthy competition among countries. With this in mind, IFPRI's Global Hunger Index (GHI) was designed to help mobilize political will and promote good policies by ranking countries and illustrating trends. It captures three dimensions of hunger: insufficient availability of food, shortfalls in the nutritional status of children, and child mortality, which is to a large extent attributable to undernutrition. Accordingly, the index includes the following three equally weighted indicators: the proportion of people who are food energy deficient as estimated by the Food and Agriculture Organization of the United Nations, the prevalence of underweight in children under the age of five as compiled by the World Health Organization, and the under-five mortality rate as reported by UNICEF.

Most methodological materials and analyses of food security pertain to the classical developing countries of the world. In this paper we discuss the question what pattern of food insecurity has developed across the transition countries? And, are there specific characteristics of food insecurity in the transition economies which can be attributed to the legacy of the socialist era? We argue that various legacies from the socialist system are decisive for today's economic and social environment in which food insecurity in these countries arises and has to be tackled. We discuss how the standard conceptual framework for the analysis of food security has to be adapted to take the specific characteristics of transition countries into account. Furthermore, we investigate if these legacies explain any significant differences in food security between transition and developing countries. We concluded from the analysis that on the macro-level similar basic factors determine food insecurity in transition countries and in developing countries. However, various legacies from the socialist era explain why transition countries have patterns, levels and trends of food insecurity distinct from developing countries. For instance, socialist legacies have contributed to the disproportionate decrease of the agricultural sector in most countries in transition in the 90s, and they still influence the pattern of food supply and consumption. Micro-studies would be needed to identify more precisely which affect the legacies have on food security at the household level.

Despite falling per capita incomes in these countries, globalization has probably not led to a deterioration of food security in Russia, Ukraine and Belarus. Measures of food inadequacy in these countries are significantly lower than in developing countries. The majority of the most severe nutritional problems in the Russian Federation'overweight and obesity in adults and various micronutrient deficiencies in both adults and children'are the same as they were during the Soviet era and are linked to diets. For children, these are low rates of breast feeding, possible deficiencies in weaning practices, a lack of vitamin C and iron deficiencies. For adults, the most severe problems are caused by a high-fat, high cholesterol, low fiber diet. This includes low consumption of fruits and vegetables, high consumption of dairy and meat and sugar and higher than recommended alcohol (for males) consumption., FAO Document Repository: http://www.fao.org/3/a-ae037t.pdf