Welcome to the Interactive Programme of MNF 2023

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Though insufficient, increased consumption of healthy diets is necessary to eradicate persistent micronutrient deficiencies and slow rates of diet-related chronic diseases. A new suite of indicators known as the Cost and Affordability of Healthy Diets (CoAHD) uses retail food prices to calculate least-cost diets that meet food-based dietary guidelines, as a measure of physical and economic access to healthy diets. The affordability of least-cost diets helps diagnose issues of food access; where least-cost diets are unaffordable, low availability, high prices, and low incomes are critical barriers to improved diets. Where healthy diets are accessible and still not consumed, preferences and other costs, such as meal preparation, limit dietary improvements. We present evidence on the cost and affordability of healthy diets globally, their relationship to micronutrient adequacy, and how these metrics can inform national policies.

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Enhancing diet quality in low- and middle-income countries necessitates addressing knowledge, income and supply-related constraints. In recent years, considerable attention has been devoted to tackling supply-side issues with a specific emphasis on diversifying household own food production. This has often taken the form of promoting the cultivation of homestead garden plots and the establishment of small-scale dairy and poultry operations. A multitude of programs have been implemented to diversify household food production, and over forty studies have explored the links between household production diversity and the diversity of household diets.

Systematic reviews of this body of literature show limited evidence to support the conclusion that increasing farm production diversity is an effective strategy for improving diets. Concurrently, initiatives like home garden programs, which combine intensive behavioral change communication with agricultural training and input provision, have demonstrated mixed evidence regarding their effectiveness in improving diets. Furthermore, the success of the home garden programs has often been dependent on the involvement of highly proficient non-governmental organizations, predominantly in regions abundant in water resources, raisings questions about their scalability.

Is diversifying own-production essential for improving diets in areas where markets function relatively well? Recent estimates across Africa and Asia suggest rural households obtain most of their non-staple foods from markets rather than from own production, suggesting that food markets do work relatively well in many contexts. Therefore, substantial improvements in rural diets could instead hinge on improved access to high-quality markets that offer a wide range of nutritious foods at affordable prices – coupled with intensive behavioral change communication to improve knowledge.

The precise strategies for accelerating the development of enhanced rural food markets are not well understood. This line of research bears the promise of improving diets and other nutritional outcomes in the rural context of low- and middle-income countries.