Puntarelle. Punto.

Ever hear of Puntarelle? I didn’t until I came to Italy, and more specifically Rome. It is a type of chicory, a bit bitter, and often served only from November to January. You can still find it served in a few restaurants or in the markets this time of year, but it is harder to come by.

IMG_6069

Puntarelle served in Rome

It is a strange but delicious food. Not sure of its nutritional content. The leaves are often cut off leaving the shoots, which have the same texture as watercress. The are served with anchovies, olive oil, lemon and salt, oh, and a lot of garlic. Really delicious and so beautifully Roman.

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My little anthro experiment

For the last two months, we have been traveling in Asia: first Indonesia, Malaysia, then India and Nepal. Funny, I always thought I was more of a nutrition specialist focusing on east Africa, but these days, my effort sits in south and east Asia. The last time I really set a significant foot imprint in Africa was in 2011. Since then, just short trips to Ethiopia or Uganda. I haven’t been back to Kenya, once what I considered home, since 2010.

If I compare the nutrition challenges between south Asia and sub-Saharan Africa, they are quite distinct. One major determinant that seems to contribute to undernutrition in sub-Saharan Africa is vast food insecurity. It just seems like there is less food grown and available, less access to nutritious and diverse foods, and less infrastructure. In Asia, the major determinant of undernutrition seems more to be sanitation and hygiene with the practice of open defecation (OD) as a huge sociocultural hurdle. Both suffer from infectious disease burden largely due to their geography – oh the tropics.

Now I know this is a generalization and I don’t have solid evidence for the comparison. We know OD is a big problem in countries like India, but this observation is just my anecdotal experiences. Call me a wannabe nutrition anthropologist, but if the experiment could be done, I bet I wouldn’t be too far off the mark.

I am not belittling the complexity of undernutrition in either place and of course, there is local context to be taken into consideration when considering these vast continents. Both places have their own issues, as does the U.S. and the UK when it comes time to the food environment, the health and food systems and the placement and status of women. Everyone suffers from complex challenges….And we know conflict, in all its facets, is a game changer regardless of the food or sanitation situation.

Anyone have thoughts on whether studies have been done on this?

Posted in african foods, agriculture, anthropology and culture, diets, diversity, environment, undernutrition | Tagged , , , , , , , , | 2 Comments

Quietly Keepin’ On

Another year has come and gone, and I barely blogged this year as much as I promised to. Not sure why.

Maybe everyone is saying so much, so often, that there is really nothing left to say.

Maybe I don’t want to say anything.

Maybe I just don’t have shit to say or even if I do, maybe it is better sometimes to keep quiet.

Maybe it’s just laziness.

I find that social media makes being lazy that much easier. While I appreciate the internet’s grandness, the amount and frequency of information is dizzying. I find myself more and more defaulting to tweeting interesting things I am reading, which often say what I want to say, in a much better way than I could ever convey. Or, instagraming (is that even a verb?) interesting things I am seeing. I find Instagram so much easier than posting photos on a blog. So much so, that I pulled my photo site, jessfanzo.com. It now links to this site. I still keep two tumblr accounts, one personal, the other professional, but I find myself not using them so much either. We keep our goatrodeo blog, because, well, goats are worthy of a blog.

We have a lot to say about goats

We have a lot to say about goats

It was a quiet year for me amongst a goat rodeo-esque year, that being 2014. A year when the world was essentially on its knees. Or do I say that every year? My anthem: “It’s the end of the world as we know it, and I feel fine.” Or at least I keep trying to convince myself of that. There were crises all over the world – Syria, CAR, South Sudan, Ukraine, and now Pakistan, again. More natural disasters leaving places like the Philippines reeling. EBOLA. In America, we are back to what most felt in the 1960s. Broken, divided, unequal and lacking in civil liberties. But we carry on, with a heavy burden in our hearts and a hopeless sense of profound resolution.

Sorry to be depressing but I do leave 2014 wondering what the next year will hold. 2015. Seems like something big should happen, and I hope whatever that is, is a positive shift. It seems to be a goal marker for many things. The Millennium Development Goals are coming to an end in December of 2015 – a significant milepost for many of us working in development who are hoping to end poverty and all its consequences. It is also the end of my teenage married years (celebrating 20 years in 2016) and my entrance into my late forties (turning 45 in 2016). As of January, this will be the first time that we will have lived in the same apartment in new york city for more than 2 years. The norm is to move every one or two years…What is wrong with us? Maybe we are settling down? Perhaps, but let’s hope not.

I think that 2014 brought a quietness to my life and I hope to carry that momentum into 2015. Maybe slowing down, doing less, focusing more, and striving for better quality in all that we do is better. Enjoying the quiet. Continuing to flâneur. We walked over 300 miles in our MaPhattan project and will continue to do so next year. It revived my tired feelings of New York, after over a decade of living here.

Maphattan project cheatsheet

Maphattan project cheatsheet

But no matter what happens in 2015, as Curtis Mayfield soulfully sang, I will “Keep on, keepin’ on” and hope that 2015 brings more quiet moments amongst the chaos.

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Addressing chronic malnutrition through multi-sectoral, sustainable approaches

My colleague Kris and I just published a paper in Frontiers in Nutrition. The paper examines the chronic undernutrition in children, also known as stunting and what interventions and approaches could be instituted to tackle it. Sadly, there are currently 162 million children who are stunted. Hopefully this paper sheds some light on the causes and consequences of stunting and potential solutions. The abstract is below and the paper can be downloaded here.

Chronic malnutrition, including stunting, is an important example of a global challenge that spans multiple sectors, specifically health, agriculture, and the environment. The objective of this paper is to review current knowledge on the causes and consequences of chronic malnutrition and their relationship with multiple sectors. Understanding the causes includes approaching chronic malnutrition from the basic, underlying, and immediate levels. The causes reach from macro-level environmental influences to specific micronutrient intake. In order to effectively address stunting, it is important to understand the timing of stunting and the ability of individuals to catch up in terms of linear growth, cognitive ability, and immune function. The consequences of chronic malnutrition are transgenerational and they have an impact at the individual, community, and national level in the short- and long-term. There are still many gaps in knowledge regarding both the causes and consequences of chronic malnutrition, particularly when it comes to the interaction with agriculture and the environment, and understanding these gaps is important to addressing the burden of chronic malnutrition through evidence-based interventions.

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Scorin’ like a bandit ’til the bubble burst – Suddenly it got to be September First.

Today is August 31st. Today is my last day of freedom. The image of that movie “Endless Summer” kept lingering in my mind’s eye all of August.

endless summer

endless summer

Then in Williamsburg two nights ago, I saw this.  😦  Sad.

endless bummer

endless bummer

Alas, school starts on Tuesday, always, the day after Labor Day. Except, I wasn’t laboring all that much this summer and certainly don’t deserve the rest and celebration of the said holiday. Took the whole summer off, didn’t go anywhere. Just hung out in new york city, doing strange projects. Well that is sort of a lie. We did visit Maine, Vermont and Mass. But indeed I did not step on a plane. And it felt good. Probably one of the nicest summers we have had in a while.

But today feels a bit more bummer. I keep humming the song “Back to School” from that god-awful movie Grease 2 (with young, unknown Michelle Pfeiffer). And I know the lyrics, sadly.

Somebody put me out of my misery now…

With that said, I am looking forward to getting back. Being busy again. Stickin’ to a schedule. Gettin’ some discipline. Teaching two classes this Fall: Growth and Development and Global Nutrition at Columbia University. Excited to mingle with a new batch of millennials

As Nelson Mandela said: “A good head and good heart are always a formidable combination. But when you add to that a literate tongue or pen, then you have something very special.”

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Study highlights the potential contribution of agriculture and public health on children’s nutritional status

This is a reposted from original post here.

The Importance of Context in Programme Decision Making: An analysis of Public Health and Agriculture Contributions to Nutrition Outcomes
Jessica Fanzo, Roseline Remans, Patrizia Fracassi (07th July 2014)

Malnutrition is the single largest contributor to child mortality worldwide underlying 45% or 3.1 million child deaths a year (Black R. et al 2013). The immediate determinants of foetal and child nutrition are adequate food and nutrient intake, feeding, caregiving and parenting practices and low burden of infectious diseases (UNICEF 1991). However, if specific interventions that address immediate determinants are scaled to 90% coverage, they would eliminate only one quarter of child under-nutrition as they deal with the problems rather than underlying causes (Bhutta et al. 2013). Beyond these specific interventions, mainly implemented by the public health sector, sectors like agriculture, social protection, education, and employment have a crucial role to play by addressing underlying causes of foetal and child nutrition, such as reducing poverty and producing more adequate nutritious foods (Ruel M. et al. 2013, World Bank 2013).

The theoretical case to improve nutrition through an approach that catalyzes the contribution from multiple sectors rather than an individual sector has been widely documented and reviewed by many studies (IFPRI 2012, Pinstrup-Anderson P. 2011 and 2013, World Bank 2007, Hoddinott J. 2012, Herforth A. et al 2013). Yet, in practice, non-health sectors struggle to fully appreciate their potential contribution for improved nutrition.

This study draws on the Lives Saved Tool (LIST tool) developed at Johns Hopkins University to quantify the impact of specific interventions on child mortality and morbidity. It identifies five intermediate outcome areas linked to child stunting: complementary feeding, diarrhea incidence, family planning, maternal nutrition and breastfeeding behaviors. The LiST Tool outputs are based on impact and calculated from randomized control trials. The work between Columbia University and the SUN Movement Secretariat goes one step back. It uses regression analysis from multiple data sources to look at statistically significant associations between sectoral contributions and the intermediate outcome areas. Findings from the study underline the importance of contextual factors[1] in determining the possible impact of nutrition sensitive sectors to nutrition outcomes.

Two different models were used in the research: one for public health interventions and another for agriculture. Among public health interventions, where there are meta-analyses results of effects, an important association was found between contextual factors and the uptake of the different interventions. For instance, girls’ education (as a contextual factor) was strongly linked to relevant nutrition outcomes such as uptake of family planning, complementary feeding and maternal nutrition. As another example, peer counseling, an intervention to increase the prevalence of exclusive breastfeeding, was shown to be more successful in specific contexts (in a rural setting, lower educational attainment of mothers and mothers who are not highly engaged in labor).

women and child under bednet

women and child under bednet

In the agricultural model, three indicators for dietary patterns were strongly associated to reduced child stunting prevalence: 1). Percentage of energy from non-staples in supply, as an indicator for diet diversification; 2) Calories available per capita as an indicator for food quantity; and 3) Iron availability from animal products, as an indicator for micronutrient availability. Agricultural production diversity, increased access to finance for farmers and strengthened agriculture research and development were all found to be positively associated with diversification of the food supply and iron availability from animal products. On the contrary, mechanization and extensification of agriculture were negatively associated with diet diversification as well as complementary feeding, possibly showing trade-offs between quantity and quality of food sources. Contextual factors again play an important role in this sector and are mostly linked to macro-economic issues. For example, increased exports as percentage of GDP was negatively associated with diversification, quantity and iron availability of supply but per capita income and road infrastructure were shown to have a positive association with all three outcomes.

rwanda maize farmer

rwanda maize farmer

 

This study highlights how sectoral decisions can potentially contribute to improved nutrition outcomes and mitigate potential harms from macro-economic issues and contextual factors. This study shows how important it is to continuously frame the relationships between factors and intermediate outcome areas to identify potential pathways towards child stunting. The assumptions used to define the conceptual frameworks should be tested through quantitative methods and qualitative analysis. While the approach is grounded in evidence from scientific literature, the end product is expected to be useful for a decision maker, who ultimately is the one dealing with highly political and context-specific issues.

[1] Contextual factors are characteristics of the ecology/environment that are related to the effectiveness of an association or outcome.

A full download of the entire report can be found here.

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Wicked Lobster city

I have been in Woods Hole, Cape Code the last few days staying at a friend’s and am immensely enjoying the laid back atmosphere and beauty that surrounds me. I have also been feasting on lobster. Lobster rolls, lobster tacos, lobster chowdha. Delicious. I feel a bit bad about eating lobsters because they are such special creatures, but I have to tell you, they are damn delicious. Those of you who know me well, know my obsession with all things clams. But the steamed clams up here in the east coast just aren’t the same as those awesome steamers you get in the Pac Northwest. I am not really into muddy long-necked guys. But the Lobsta, rules here. Anyways, some photos to share on our wicked cape code lobster meals…I didn’t get any photos of the two rolls I ate. I devoured instead…

chowda

chowda

lobster taco

Lobster taco

 

 

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