The double burden of malnutrition (DBM) is a concept that describes the increasing prevalence of both undernutrition and overnutrition within the same communities, especially in low and middle income countries (LMICs).
In China, despite rapid economic development, tens of millions of people living in rural poor communities lack food diversity and are frequently nutrient deficient, whilst urban populations show a rapid rise of obesity owing to unhealthy diets and imbalanced energy intake. Such micronutrient deficiencies (MND) associated with DBM are particularly problematic in children.
Food is a key part of Chinese culture. Some foods that are considered to be healthful, such as sweet potato, millet, etc. have gone out of fashion and are seen as food for the poor.
On the other hand, there may be an inherent resistance to unfamiliar food items for children, such as Ying Yang Bao (YYB) which is a soybean based micronutrient supplementation package, as well as concerns about the safety of food and biofortification.
This project will test the acceptance of context specific interventions in children in different age groups. In children from deprived areas, the benefits of early exposure to YYB for enhanced acceptance will be tested in children aged six months to two years old.
Acceptance of biofortified foods (zinc+/iron+ wheat and b-carotene+ sweet potato) will be tested in nursery and school children based on the early exposure and uptake hypothesis. For urban school children at risk of obesity, the intervention will focus on increasing the diversity and optimising the nutrient content of their diet.
Feasibility testing of enhanced diet diversity, food supplementation and biofortification, and nutritional knowledge education, will be studied using a survey method at school, family and community levels.
The research will engage with local communities, families and particularly mothers, to explore the determinants of malnutrition and MND, and the social and cultural barriers to uptake of nutrition interventions.
When barriers to and drivers of uptake have been identified, photographic exhibitions using a storytelling approach to highlight positive messages will be used to promote the interventions in local communities, with social media campaigns to spread the word and promote engagement.
The project will develop a scalable food system based intervention package for malnutrition/MND, and build this into the national food and health policies and guidelines. It will also broaden the potential beneficiaries of the nutrition interventions by engaging with experts in Vietnam through communication and capacity building activities.
Long term impacts will include:
- Improved health in rural and urban poor communities.
- Improved child development and education.
- A healthier future society with more productive adults bringing economic gains.
- Reduced burden on resources of health systems.
- Greater implementation of sustainable and diverse nutritious food crops.
- Reduced burden of MND and DBM across LMICs in Asia.
- Principal Investigator: Professor Yun Yun Gong, University of Leeds
- Co-Investigator: Professor Louise Dye, University of Leeds
- N8 Co-Investigators: Dr Wes Lin, University of York; Dr Samantha Caton, University of Sheffield
- External Principal Investigator: Professor Junsheng Huo, Director of Central Laboratory National Institute for Nutrition and Health (NINH), Chinese Center for Disease Control and Prevention (China CDC), Beijing
- Funded value: £1,006,949
- Funded period: 01/02/2020-30/01/2023
- Funder: Biotechnology and Biological Sciences Research Council (BBSRC) Global Challenges Research Fund (GCRF)