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Systematic evidence and gap map of research linking food security and nutrition to mental health

Thalia M. Sparling ORCID: orcid.org/0000-0002-8071-3232 1 ,
Megan Deeney ORCID: orcid.org/0000-0002-4817-1170 1 ,
Bryan Cheng 2 ,
Xuerui Han 2 ,
Chiara Lier ORCID: orcid.org/0000-0003-0868-1384 2 ,
Zhuozhi Lin 3 ,
Claudia Offner 1 ,
Marianne V. Santoso 4 ,
Erin Pfeiffer 5 ,
Jillian A. Emerson 6 ,
Florence Mariamu Amadi 7 ,
Khadija Mitu 8 ,
Camila Corvalan 9 ,
Helen Verdeli 2 ,
Ricardo Araya 10 &
Suneetha Kadiyala ORCID: orcid.org/0000-0002-9101-1471 1

Nature Communications volume 13 , Article number: 4608 ( 2022 ) Cite this article

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Epidemiology
Risk factors

Connections between food security and nutrition (FSN) and mental health have been analytically investigated, but conclusions are difficult to draw given the breadth of literature. Furthermore, there is little guidance for continued research. We searched three databases for analytical studies linking FSN to mental health. Out of 30,896 records, we characterized and mapped 1945 studies onto an interactive Evidence and Gap Map (EGM). In these studies, anthropometry (especially BMI) and diets were most linked to mental health (predominantly depression). There were fewer studies on infant and young child feeding, birth outcomes, and nutrient biomarkers related to anxiety, stress, and mental well-being. Two-thirds of studies hypothesized FSN measures as the exposure influencing mental health outcomes. Most studies were observational, followed by systematic reviews as the next largest category of study. One-third of studies were carried out in low- and middle-income countries. This map visualizes the extent and nature of analytical studies relating FSN to mental health and may be useful in guiding future research.

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Introduction.

Food security and nutrition (FSN) are key components of global health and development. Internationally, healthy diets are increasingly reported to be out of reach 1 and unaffordable 2 for people of lower socioeconomic status, leading to undernutrition (e.g., wasting, underweight, micronutrient deficiency, growth faltering) in low- and middle-income countries (LMIC) and nutrition-related chronic diseases (NRCD) in both LMIC and high-income countries (HIC) 3 . Despite progress in reducing overall hunger and food insecurity (especially in Asia and Africa), one in ten people were exposed to severe levels of food insecurity in 2019, with areas or populations experiencing much higher prevalence 4 . However, in most regions, improvements in food security have slowed (including West Asia and North Africa) or reversed (including Latin America and the Caribbean) in recent years 5 . Linear growth measures are slow to reduce in line with global development goals 6 , and one in every three people are overweight or have obesity 7 .

Mental health has also been identified as a major cause of disability 8 , although efforts to address global mental health burdens in low-resource settings is not commensurate with the magnitude of that burden 9 . Depressive disorders alone are thought to be the single-most contributor to health loss globally (7.5% of all Years Lived with Disability—YLD) 10 . Anxiety and stress, which along with depression are the common mental health disorders, are also leading causes of disability 11 . Despite improvements in measuring global mental health burdens, estimating the true burden remains a serious challenge. Transcultural identification and underreporting (especially due to stigma and differing social constructs) hinder the ability to make accurate global estimates 12 .

Each of these fields has evolved in the last several decades. Both have shifted from clinical and continuum of care frameworks to include influential factors of wider environments and contexts, leading to an understanding of complex and systems-driven aetiologies 12 . Furthermore, the connections between FSN and mental health have been increasingly investigated. Food insecurity has been shown to lead to poor mental health in many contexts 13 , 14 . There is mixed or poor quality evidence linking distinct nutrients to mental health 15 , 16 , 17 . Dietary patterns and diet quality have been shown to be related to depression and in some instances anxiety, although heterogeneity of different measures and indices hampers the inferences we can make 18 , 19 , 20 , 21 . The association between BMI and mental health has perhaps been the longest-standing topic of inquiry, although this literature is dominated by research carried out in HIC settings 22 , 23 . Poor mental health of parents, particularly mothers, has been associated with low dietary diversity, lack of micronutrients, anthropometric outcomes, and other illness and care measures of their children in several settings 23 , 24 , 25 , 26 , 27 , but not in others 28 , 29 . Mental health, for instance depression, has also been shown as a factor influencing nutritional risk and malnutrition (the nutritional aspects of frailty) in older adults 30 , 31 . Each of these investigations are further nuanced by their varying populations of interest and settings.

Systematic reviews on these topics are often (by nature) narrow in scope–usually in specific populations, using a particular subset of FSN and mental health indicators. Primary studies are often post-hoc or ad-hoc analyses derived from observational studies where FSN and mental health relationships are not primary outcomes. This limits the breadth and quality of the available evidence. Taking stock of the literature across interrelated aspects of FSN and mental health overall will allow for better identification and use of the strongest available evidence and more systematic efforts to research these intersections. It will also offer the possibility of creating an empirical framework that can guide hypothesis testing and causal identification going forward.

We aimed to systematically identify and map analytical studies associating FSN with mental health resulting in an interactive Evidence and Gap Map (EGM) that can offer both broad and granular views of this diverse body of literature. Our objectives were to describe the nature and range of evidence on (a) a wide range of constructs of food security and nutrition (food security, nutritional risk, diets, nutrient intakes, nutrient biomarkers, infant and young child feeding [IYCF], birth outcomes, and anthropometry), (b) linked to all types of common mental health problems (depression, anxiety, stress, and mental wellbeing), (c) across most healthy populations, settings, and study designs.

Search and screening results

The study selection process is shown in the PRISMA Flowchart (Fig. 1 ). A search of three databases retrieved 40,192 results total, 30,896 of which remained after removing duplicates and were screened on title and abstract. Of these, 3771 were included for full-text review. Most articles excluded at this stage were excluded on FSN measurement, in populations with underlying health conditions, were not analytical, or were non-systematic reviews, theses, comments, or abstracts. Finally, 1945 studies met the inclusion criteria and were mapped, as shown in the HTML map linked to this article . The cells in the EGM are segmented into population groups: children (green), pregnant women and mothers (blue), adults (yellow), and mid- to later-life populations (red). Summary statistics presented here forth are not additive to the total number of reports included, as many studies included multiple measures, populations, and settings. A simplified heat map of FSN and mental health studies is shown in Fig. 2 .

Number of identified studies from search at each stage of screening.

Rows are measures of mental health, columns are measures of food security and nutrition.

Food security and nutrition measures

Proportionally, the FSN measures in studies by group were comprised of: anthropometry (40%), diets (24%), nutrient intakes (14%), birth outcomes (13%), food scarcity (12%), nutrient biomarkers (10%), and IYCF indicators (6%).

Overall, BMI was the main indicator in 703, or 36% of all mapped studies, and was measured in almost 90% of studies including anthropometry. Studies measuring dietary patterns and quality (16%) and specific food groups (12%) were both prevalent. Of the studies measuring nutrient intake – via foods or supplements (14%), most were about macronutrients ( n = 152/273), of which 94/152 were about polyunsaturated fatty acids (PUFA). The second largest group was vitamin intake ( n = 110/273 studies). Of 110 studies on vitamins, various B vitamins (65%), calcium (40%), and vitamin C (29%) were most common. Of all nutrient intake studies, 87 measured supplement intake. Studies on nutrition-related birth outcomes ( n = 245) primarily measured birth weight (84%). The majority of studies on food scarcity ( n = 230) measured food security (71%) via many different indices. The most popular was the United States Department of Agriculture (USDA) scale used in national surveys in the US or adapted to other countries such as Canada or Korea ( n = 70 including all versions). A small number of studies measured food scarcity through famine exposure ( n = 9), and nutritional risk was mostly assessed in older populations ( n = 70). Of the nutrient biomarkers in studies ( n = 202), about half were on vitamins (55%), particularly for vitamin D (66%), folate (25%), and vitamin B12 (20%). Breastfeeding (including initiation, duration, or exclusivity) was the main FSN measure for nearly all IYCF studies ( n = 114/124). A count of studies in each category is listed in Supplementary results 1 .

Mental health measures

Depression was by far the most common mental health measure, assessed in 61% of included studies. Hybrid domains of mental health—defined as capturing more than one aspect of mental health (e.g., a combination of depression and anxiety, a clinical interview for all common mental disorders)—were assessed in 26% of studies. Stress (12%), mental well-being (12%), and anxiety (10%) linked to FSN were the least studied.

Most studies (82%) used screening questionnaires to ascertain mental health status. Mental well-being and stress have no clinical diagnosis, so almost all of these were based on established indicators via questionnaires. For depression screening, the Center for Epidemiological Studies-Depression scale (CES-D) was the most common tool ( n = 332), followed by the Edinburgh Postpartum Depression Scale (EPDS) ( n = 183), the Geriatric Depression Scale ( n = 105) and the Patient Health Questionnaire (PHQ) ( n = 104). For hybrid domains, the Global Health Questionnaire (GHQ) was the most used screening tool ( n = 76), as well as the Child Behavior Checklist (CBC) for measuring mental health in children ( n = 41), the Hopkins Symptom Checklist (HSCL) ( n = 36) and the Depression and Anxiety and Stress Scale (DASS) ( n = 33). The State-Trait Anxiety Inventory (STAI) was by far the most common screening tool for anxiety ( n = 64), and the Perceived Stress Scale (PSS) and Kessler Stress Inventory (KSI) were the most common stress measures used ( n = 84 and n = 46, respectively). For mental wellbeing ( n = 229), 83 used the Short Form-36 questions, (also known as the Rand questionnaire). Many of these tools have been translated, adapted, and validated for cross-cultural use in LMIC contexts, and some tools have been developed specifically for these settings rather than adapted.

Clinical and diagnostic interviews were carried out in 9% of all studies, almost all of which (96%) were on depression or a general psychological or psychiatric interview which is used to diagnose multiple common mental health problems (hybrid domains). Some studies used a self-reported diagnosis, prescription medication as a proxy for diagnosis or medical records (8% of all studies). Only 14 studies investigated mental health using qualitative or mixed methods. There were 89 reviews or meta-analyses on depression, 58 on hybrid domains, 14 on anxiety, eight on stress, and three on mental wellbeing.

Relationships between FSN and mental health

The number of studies in each FSN and MH category and the proportion investigating linkages between them are presented in the Sankey diagram in Fig. 3 . The largest groups of BMI studies within anthropometry (90%) and overall (36%) were those examining BMI with: depression ( n = 401, 21%), hybrid mental health measures ( n = 192, 10%) and mental wellbeing ( n = 109, 6%). The second largest intersection was diets (food groups, patterns, quality) with: depression ( n = 278; 14%), hybrid mental health measures ( n = 121, 6%) and mental wellbeing ( n = 69, 4%).

Categories of FSN measures on the left are linked to corresponding groups of MH measures listed on the right, with the width of the bands indicating the proportional number of studies connecting the groups.

Despite anthropometry and depression being the largest category, measures other than BMI and mental health besides depression were far less researched. Although there are some studies on child stunting, wasting, and underweight related to depression ( n = 45 with depression, n = 23 with hybrid domains), studies reporting relationships with other common mental health disorders such as anxiety and stress were few ( n = 5).

Although studies measuring nutrient intake were the third largest FSN group, 75% of these were analyzed for their relationship to depression, and an additional 18% to hybrid domains. Most of these studies linked macronutrients and vitamins to depression ( n = 117 and n = 77, respectively), while few studies linked to anxiety, stress, or mental well-being ( n = 56 altogether). Eighty-nine studies linked PUFA intake to depression or hybrid domains, and 32 studies to vitamin D intake and depression. There was almost an identical distribution for nutrient biomarkers, where proportionally almost all studies on biomarkers were linked to depression and hybrid measures. Vitamin D ( n = 66) was the most common biomarker linked to depression.

Almost 50% of studies about birth outcomes ( n = 245 total) were about birth weight with depression, and an additional 35% with hybrid domains. Many studies measured multiple nutrition-related birth outcomes (31%) such as birth length and head circumference, however only 28/245 of these included mental health measures other than depression. Only 10 of these studies investigated foetal growth restriction in relationship with mental well-being or stress, for example.

Food scarcity was linked to depression in many studies as well, especially in the studies examining nutritional risk in the elderly ( n = 56/70). Food security was often studied in relationship to depression ( n = 72/163), however as food security is also associated with worry, stress, and anxiety, other measures of mental health were relatively more common in the studies than in other groups of FSN (40% measured hybrid domains, 19% measured stress, 9% measured anxiety and 9% measured wellbeing).

Breastfeeding and depression were examined in 91 studies. There were especially few studies on any IYCF measure with anxiety ( n = 28), stress ( n = 11), and mental well-being ( n = 4). Child diets and complementary feeding was linked to depression or hybrid domains in six out of eight child diet studies. For instance, only three studies compared any measure of mental health with child dietary diversity.

Study methods

Hypothesis testing.

We included studies that hypothesized the relationship between FSN and mental health in either direction: with FSN constructs as the ‘exposure’ or independent factor and mental health as the ‘outcome’ or dependent factor and vice versa (shown in each iteration, segmented proportionally by study design, in Fig. 4 ). Most studies ( n = 1291, 66%) hypothesized FSN constructs as the exposure or equivalent, including cross-sectional studies. Almost 28% of these studies were about BMI associated with depression or hybrid domains of mental health outcomes. Another 25% were about diets related to depression or hybrid domains of mental health.

The top panel is the number of studies with food security and nutrition (FSN) as the hypothesized exposure and mental health as the studied outcome. The middle panel is the number of studies with mental health as the exposure and FSN as the outcome, and the bottom panel is the number of studies where both hypotheses were investigated.

Mental health was treated as the exposure in 31% of studies ( n = 600). Of these studies, 39% investigated mental health related to BMI as an outcome, of which 121 studied depression as an exposure, 69 studied hybrid domains of mental health, 60 studied stress, 27 studied anxiety, and 9 studied mental wellbeing. Birth outcomes were the second-largest group of mental health exposure studies, where 119/147 were about birth weight. Where IYCF was the outcome ( n = 75), almost all were about breastfeeding ( n = 67). There were relatively fewer studies on diets, nutrient intakes, and biomarkers than in either the EGM overall or where mental health was the outcome.

In a small number of studies ( n = 54), investigators tested the hypothesis for relationships in both directions over time. For instance in a longitudinal cohort where dietary patterns could be isolated as an exposure among people who develop mental health problems, or alternatively within the same study population, those whose dietary patterns change over time linked to preceding mental health problems. Most of these studies investigated BMI and mental health ( n = 31/54). These characteristics can be selected through the filter function on the interactive EGM.

Study design

The majority of studies were observational (83%), with 46% cross-sectional and 37% longitudinal (Supplementary results 2 ). An additional 3% of studies were case-control design. There were 142 systematic reviews, of which 48 offered a meta-analysis. Experimental studies were not common —only 65 Randomized Controlled Trials (RCTs) were identified, along with 20 quasi-experimental studies (12 of which used Mendelian Randomization or genetic instrumental variable methods). Only ten qualitative studies were identified, and 4 mixed methods studies, despite explicitly including qualitative eligibility and coding parameters.

Cross-sectional studies followed a similar pattern to the EGM as a whole on mental health measures, although regarding FSN there were proportionally more studies on food scarcity and BMI and fewer on birth outcomes and IYCF. There were proportionally more longitudinal studies on birth outcomes (double across all but one mental health category) and more IYCF studies, and less on nutrient intake, nutrient biomarkers, and food scarcity, although mental health measures were similar proportionally to the full EGM.

Systematic reviews and meta-analyses on diets linked to depression or hybrid domains were most common (reviews without meta-analysis = 28; reviews with meta-analysis = 9, meta-analysis without review = 4), and nutrient intakes with depression or hybrid domains were the second most common (systematic reviews = 42; 15 of these with meta-analyses). Almost all (14/15) meta-analyses on nutrient intakes were about supplements. There were 18 reviews on BMI and depression or hybrid domains (seven of these with meta-analysis), while nine others focused on child growth measures. There were 22 systematic reviews on mental health related to birth outcomes, 17 of which were about mental health of mothers and birth outcomes of their offspring. Of all 69 meta-analyses, 59 of them focused on depression or hybrid domains.

Most experimental studies were RCTs of nutrient intake exposures and mental health outcomes ( n = 46/65 experimental studies), namely depression ( n = 26) and hybrid domains ( n = 16). Half of experimental studies included anxiety, stress, or mental well-being. Nutrient intakes were primarily measuring supplement intake ( n = 38/47), especially those on B vitamins, Vitamin D, Zinc, and fatty acids. Sixteen RCTs exposed people to fatty acids, and 12 to Vitamin D. Several studies also exposed people to Vitamins A, C, or E and magnesium or manganese minerals. The second most common type of RCTs were those randomizing people to diets and measuring various measures of mental health (six on depression, 10 on hybrid domains, three on anxiety, seven on well-being, but none on stress). Sixteen studies intervened on: Mediterranean diet pattern ( n = 4), low fat or low-calorie diet ( n = 4), the DASH diet, high-protein diet, healthy diet, or fish/animal source foods ( n = 2 each), low glycaemic diet, high protein diet and vegetarian diet ( n = 1 each). Only three studies had mental health interventions with FSN outcomes: two on stress reduction interventions and BMI or food intake, and one on antenatal depression interventions and birthweight/child growth.

The geographic distribution of studies by country, defined by where the participants were located, is shown through a choropleth map in Fig. 5 . The most saturation (number of studies) was in the United States, Australia, and the United Kingdom, 521 studies came from across Europe, 418 from Asia, and 81 from Africa. Central and South America were represented in fewer studies ( n = 18 and n = 67 respectively). Overall, 23% ( n = 446) were set in low- and middle-income countries (LMIC). Eight percent ( n = 160) were ‘global’ studies, such as those in five or more nations across regions, or those using global datasets, such as the Gallup poll or World Bank data.

The bar plot on the left shows the number of studies by region and political category, and the map on the right shows number of studies by country.

Heat maps segregated into HIC and LMIC evidence is provided in Supplementary results 3 . Overall, there were proportionally more studies on nutrient intakes in HIC (15% vs. 9% of FSN measures), and proportionally more studies on food scarcity in LMIC (18% vs. 10%).

For instance, there were proportionally more studies of BMI in HIC (95% of 611 studies) compared to LMIC (72% of 172 studies). In LMIC studies, there were more studies on relative height (20% vs. 1%) and relative weight (11% vs. 2%) in children. For mental health measurement, 82% of studies using validated diagnostic tools were from HIC. Studies including measures of anxiety, stress, and mental well-being were more common in HIC than LMIC (13% vs. 7% for mental well-being).

Almost all reviews and meta-analyses were global in nature. Eighty percent of experimental studies and 90% of quasi-experimental studies came from HIC. Populations of interest in studies from HIC were proportionally more focused on general or representative adult populations (52% vs. 42% in LMIC studies). LMIC studies shift focus to women (particularly pregnant women and mothers—35% of LMIC studies vs. 26% HIC studies), although only slightly more on children (39% of LMIC studies vs. 35% HIC studies). Studies on mid-to-later-life populations were similar in both HIC and LMIC contexts (21%).

Populations

The EGM linked to this paper is segmented in each cell by broad population categories. We also offer a more granular classification of populations of children, women, men, and pregnant women and mothers (available as filters). Figure 6 shows a bubble diagram proportional to the population groups of included studies. Almost half of studies in the EGM were conducted in general or representative adult populations (49%). Studies including only mid- to later-life populations (usually 60 or 65 years of age and older) made up 21% of the EGM. Of the studies that included children of any age ( n = 695), 433 included children under 5 years, 221 included children 5 to 12 years old, and 248 focused on adolescents 13 to 18 years old. Children under 5 were not commonly assessed on their mental health status ( n = 106 vs. 423 studies of under-five measurements of FSN) as these measures are difficult to obtain and not reliable in very young children. Pregnant, perinatal women, mothers, and fathers were studied in 28% of all studies. Far more studies in pregnant women and mothers measured mental health as the exposure than FSN (26% vs. 8%). Pregnant and postpartum women were assessed more on their mental health status (9% pregnant and 5% postpartum) than on their FSN status (3% pregnant and 1% postpartum). Studies with women-only populations (not including perinatal women or mothers) made up an additional 8% ( n = 158). Studies focusing only on men were fewer ( n = 42, 2%).

Bubbles are proportional to the frequency of analyses based on each population group. Bubbles for ‘Children’ ( n = 257), ‘Adolescents’ ( n = 214), ‘Pregnant Women and Mothers’ ( n = 149), ‘Adults’ ( n = 735) and ‘Mid Later Life populations’ ( n = 408) refer to studies in which the relationship between FSN and mental health is examined within the same study population group. The bubble for ‘Cross-cutting populations’ shows studies in which the FSN measure in one group is hypothesized to affect the mental health of another group or vice versa, this includes interactions between households, parents, and/or children.

Some studies measured FSN in one group (e.g., children) and mental health in another (e.g., parents) (Fig. 7 ) . Amongst these ( n = 484), the mental health of pregnant women and parents and the FSN of their children through adolescence has been studied the most: 355 total studies, 329 on FSN of children under five years, 44 on FSN of children 5–12, and 17 on FSN of adolescents. Fathers, however, are only included in eight of these studies. Mental health of pregnant women and mothers has mostly been hypothesized as the exposure for FSN outcomes in children ( n = 314), though far fewer considered an association whereby FSN in children is the exposure and mental health of pregnant women and parents is the outcome ( n = 54). The association between food security measured in the household with mental health in individuals was reported in 107 studies, most of which were in general adult populations ( n = 51) and pregnant women and mothers ( n = 38).

The size of the bubbles and width of the links between them is scaled according to the number of studies and frequency of hypothesized relationships in the literature. The direction of the arrows indicates the hypothesized direction of effect according to the studies, a double arrow in opposite directions shows that both directions have been hypothesised in different studies.

Time trends

Our analysis shows clearly that the overarching body of literature linking FSN to mental health has steadily grown since 2000 (Fig. 8 ). As we concluded our search half-way through 2020, the number of these studies is likely to increase annually, marking a continued interest in this cross-section of fields.

The plotted line shows the increase in studies from 2000 until 2020. The search concluded half-way through 2020, which accounts for the drop off in this year.

Evidence is steadily growing about links between many of the FSN and mental health constructs measured by included studies, and the EGM makes this clear. Studies on depression and studies on BMI dominated the map overall. Anxiety, stress and mental wellbeing, and IYCF were the least represented in the literature. Given that food insecurity, inaccessibility of healthy, diverse diets, and poor clinical nutrition are all likely to exacerbate worry and stress, the dearth of studies linking FSN to dimensions of anxiety, stress, and well-being, rather than depression alone, is notable. There may be strong evidence on how food security, certain nutrients (e.g., Vitamin D), dietary patterns, and BMI are associated with depression. On the other hand, evidence seems sparse on the relationships between other nutrients (e.g., selenium, antioxidants), IYCF practices, or child growth related to mental health, or vice versa.

Regarding study design, experimental studies were mostly about nutrient intakes; very few intervened on other FSN measures or mental health interventions with FSN outcomes. Overall, experimental, quasi-experimental studies, and systematic reviews with meta-analyses were far less common than the plethora of cross-sectional and cohort studies. Only 34% of systematic reviews were accompanied by a meta-analysis. There was much less qualitative or mixed methods evidence.

Geographically, studies with paticipants from the United States, Australia, and United Kingdom dominated the evidence. Although almost a quarter of studies were carried out in LMIC, 77 of these 446 were conducted in China and 75 in Iran, with few in Arab countries or Latin America. The studies with participants from Africa ( n = 81) were mostly carried out in three countries (South Africa, Ghana, and Ethiopia). Three-quarters of studies carried out in South America were from Brazil. Of the LMIC countries represented in the EGM, evidence is largely based in industrialised countries, which suggests that the LMIC literature does not capture the diversity of less industrialized, poorer, or more rural countries. It is an especially important gap, given that food insecurity and undernutrition are the highest in the countries least represented by the literature base.

Most studies that measured FSN in one population group and MH in another were about mothers’ mental health and their children’s nutrition or growth status. Very rarely were FSN indicators in children investigated for their effect on parents’ mental health. Fewer studies still focus on fathers or parents together. As studies among women in LMICs can sometimes focus on reproduction, and without sufficient attention to other aspects of womens health, we highlight the lack of studies from LMICs that examine mental health impact on women’s nutritional status and vice versa.

Despite studies showing that FSN and mental health are related in many ways, there are still large gaps across the EGM of studies investigating causal mechanisms of these relationships. There were many studies showing relationships between FSN and mental health, but less with the combined design, contextual factors, and analysis to provide information most needed to design effective programs and policies. For example, there were few qualitative studies identified, even though the ethnographic lens of lived experience can provide important insights into why and how mental health is related to FSN, without relying on nosological distinctions that may be less important in certain contexts. Some of the qualitative studies raised interesting findings, for example the mental health toll from weighing trade-offs in types of food purchases (e.g., healthier options versus volume or calories) 32 , how rising food prices affect not just food security and nutrition, but contribute to multi-fold mental health consequences from constraining cultural practices like funerals and other ceremonies 33 , and the varied role of social support related food insecurity: in some contexts social connectedness increased shame and stigma, whereas in others it helped buffer the negative effects of food insecurity through shared resources 34 .

That said, there is scope to further investigate the shared and underlying determinants of FSN and mental health. From the existing literature, these include poverty (although interestingly poverty alone does not account for these burdens 35 ), lack of women’s agency, other health conditions, environment, and climate change, as well as conditions of violence, conflict, instability, and social strife 36 , 37 , 38 , 39 . Most of these factors have been identified through the respective bodies of literature on each, but some new work on the topic has tried to understand common determinants and mechanisms between FSN and mental health through innovative theoretical framing, study design, and more advanced statistical models 28 , 40 . Recent interventions that at the least measure and at the most include programmatic components of both FSN and mental health have begun to give insight into some of these mechanisms as well 41 .

Through this systematic synthesis and mapping, we were able to combine various intersections of measures, populations, study types, and cross-cultural settings into an interactive resource. This is the first paper to systematize the body of evidence linking FSN to mental health. The EGM can be used in various ways by selecting and describing the nature and extent of literature on this topic.

We employed rigorous, expert-led screening and coding processes, including a search strategy designed by an information specialist using an index list of known literature. We followed state-of-the-art guidance on creating EGMs, which stop short of offering a synthesis effects observed but do include interactive filters to sort evidence according to study characteristics. Conducting a meaningful and feasible quality assessment of almost 2000 studies or pool results was beyond the scope of this EGM.

We also created parameters that limited our analysis in certain ways. We searched only papers published from 2000, did not search non-English repositories or include grey literature, and our chosen databases may not have been as likely to include qualitative reports, all which may have introduced some bias. That said, we are confident that collectively, the large number of studies identified and included serve as a basis from which to draw conclusions about trends, gaps, and characteristics of the available evidence on FSN and mental health.

The most important exclusion criteria were for studies in populations with underlying health problems, such as diabetes, cardiovascular disease, HIV, tuberculosis, or hospitalized patients, as well as niche characteristics (e.g., female endurance athletes or male textile factory workers). Although there is literature relevant for these populations, we aimed to identify evidence that minimized the confounding nature of other health conditions or characteristics. We also excluded FSN measures that were not direct measures of food security, intake, or nutrition status, such as eating behaviours, stimulant foods, or breastfeeding intentions.

In line with current trends to measure mental health globally through a symptom-based framework rather than a diagnostic criterion (which can bias and confound locally appropriate constructs of mental health) 42 , 43 , 44 , we included mental well-being and mental health quality of life measures. We also included qualitative literature on the topic, which might not fit within the traditional depression, anxiety, and stress groupings. For instance, a systematic review of qualitative literature about depression experience globally found that DSM model and standard instruments derived from the DSM fall short of capturing the experience of depression worldwide or regionally. Specifically, half of the 15 features of depression identified in non-western populations were not captured in current diagnostic tools 42 . However, measures of mental well-being were often difficult to disentangle from general happiness, life satisfaction, or other physical health quality of life measures. Many were mixed across these domains. We thus relied on expert guidance from Teachers College Global Mental Health Lab, who assessed each measure identified across all categories for eligibility and classified them.

We propose that this EGM is a tool to navigate a diverse literature base that will be primarily driven by the interests and expertise of the user. It can identify key gaps in the literature and thus direct novel efforts in research. This might include planning new primary studies or synthesis of existing primary research. When interpreting cells with fewer studies, it is important to carefully examine the quality of those studies and the clinical or practical relevance of research efforts to fill the gaps. Some research may be less strategic from a policy and planning perspective, for instance conducting new studies on IYCF related to anxiety and stress may have more application than new studies on minerals related to mental wellbeing, both of which appear as gaps on the EGM.

Furthermore, a cluster of studies in a cell (particularly certain study types—such as RCTs and reviews—commonly deemed further up on the hierarchy of evidence) still might prove worthy of further investigation. For instance, the most common subject of studies in the EGM is adiposity and depression, and there are several large, rigorous reviews with meta-analyses included on this topic. However, there is no pooled analysis of this relationship in low-income settings, where the observed effects may be quite different. This example highlights that the EGM as a whole can bring focus to understudied regions or populations: if used to highlight broad contextual factors, this might spur research that changes the conclusions we draw from either combining all available evidence (which may not all act in the same direction) or making assumptions based on the most prevalent literature (e.g., from high-income settings).

The overarching goal of building the EGM was to lay the groundwork for an evidence-based, empirical framework highlighting linkages that are known and hypothesized between FSN and mental health. This would entail selecting and synthesizing the strongest evidence within each cell, insofar as combining certain groups of studies is appropriate. This will serve to direct and support future inquiries into these relationships, as well as systematize our knowledge on the topic (Supplementary discussion 1 , Box 1). Furthermore, a new understanding of and emphasis on these relationships can become part of advocacy, programs, strategic planning, and policy to support progress towards health goals such as the SDGs and others.

Through a systematic literature search, we comprehensively identified analytical studies investigating relationships between a broad array of FSN and mental health constructs. We mapped 1945 eligible studies onto an interactive EGM which can provide visualization of this diverse field of literature. The EGM overall allows readers to step back and take stock of the body of literature, as well as dive into specific intersections of food security, nutritional risk, diets, nutrients, nutrition-related birth outcomes, IYCF indicators, and anthropometry with depression, anxiety, stress, and mental wellbeing. The EGM also allows for narrowing of each intersection through an extensive list of filters that can be combined in various ways to select characteristics of interest.

The analysis and map highlight thematic trends (such as the proliferation of evidence linking BMI and depression) as well as gaps (stress and mental well-being related to nutrients or child diets). It also shows the nature of the literature—an increasing number of studies on the topic that are dominated by observational designs in high-income countries. Studies from Central and South America, Arab nations, and Africa are less prevalent, as well as studies using qualitative, mixed, quasi-experimental and experimental methods. Many different populations are investigated through this wide array of studies, although studies comparing associations between populations are dominated by mothers and their children.

We imagine that this analysis and EGM will serve as a basis for future inquiry, whether it be original research, evidence synthesis, and analysis, funding priorities, or the development of synergistic and integrated public health programmes and policies.

This systematic Evidence and Gap Map, including accompanying analysis, relied on publicly accessible documents as evidence, without including personal, sensitive, or confidential information from participants, thus complying with current ethical standards.

Search strategy

Following PRISMA guidelines, we conducted a systematic search of three published literature databases: Web of Science, CAB Global Health, and PsychInfo, searching from January 1 2000 until July 28, 2020. We chose the year 2000 as a cut-off as preliminary searches revealed diminishing returns in the eligibility and relevance of previous studies in this area. Broadly, the search was operationalized by including synonyms for mental health, stress, distress, anxiety, depression, or mood disorders, and synonyms for food security, micronutrients, diet, nutrition, or anthropometry, as well as all kinds of study designs. Results from the searches were deduplicated and loaded into EPPI Reviewer 4 and web-based software. All analysis and graphics were produced in Excel version 16 or the web-based Flourish Studio. The full search strategy, designed by an information specialist, is specified in Supplementary methods 1 . The screening and coding guidelines are listed in Supplementary methods 2a–d .

Eligibility—Inclusion

We included only papers published in peer-reviewed journals and in English, from 2000 until July 28, 2020, that presented empirical links between measures of food security and nutrition and mental health in human populations from anywhere in the world. We only included analytical research (studies associating mental health to FSN), excluding descriptive or prevalence studies. We included population-based quantitative and qualitative studies of any design. We included systematic reviews based on their eligibility criteria; to be included, at least one study in the review had to fit our overall eligibility criteria.

We included any quantitative indicator for: food scarcity (including food security, exposure to famine or hunger, and nutritional risk [usually in the elderly]); diets (specific food groups and dietary patterns or quality); nutrient intake (including vitamins, minerals, macronutrients, polyphenols/antioxidants via food intake or supplements); nutrient biomarkers (vitamins, minerals, macronutrients, and polyphenols/antioxidants measured through blood, urine, fat); Infant and Young Child Feeding (standard WHO indicators as well as breastfeeding initiation, duration or exclusivity); nutrition-related birth outcomes (e.g., birth weight, birth length, intrauterine growth restriction [IUGR] or small-for-gestational age [SGA], head circumference); and nutrition-related anthropometry (e.g., BMI, body composition, body ratios, relative weight, relative height). We used ‘relative weight’ as an umbrella group for wasting and weight-for-height z-scores (WHZ) and ‘relative height’ as a group including stunting, height-for-age z-score (HAZ), growth faltering, and other height measures of child growth. We also included studies that measured these elements of food security and nutrition through qualitative methods.

For mental health, we included studies that measured common mental disorders (CMDs) under the International Classification of Diseases version 10 (ICD-10), as well as general distress and mental well-being in order to capture transcultural and qualitative literature on the intersections of mental health and FSN. We used the following broad categories: depression; hybrid domains; anxiety; stress; and mental wellbeing (e.g., mental health-related quality of life). These could be assessed through qualitative interviews, screening questionnaires, self-report of diagnosis, prescription medication (as a proxy for diagnosis), or clinical and/or diagnostic interviews. The list of eligible screening measures was assessed and categorized by the mental health specialists at the Global Mental Health Lab.

Eligibility—Exclusion

We did not include grey literature in our search. Studies in populations with comorbid health conditions, such as hypertension, diabetes, HIV, or surgical patients were excluded as both the nutritional and mental health correlates of these populations is likely to be unique. We also excluded studies in populations where all participants were already identified as overweight or having obesity, low birth weight, or having mental illness. We excluded case reports ( n < 10), theoretical or simulation-based modelling, studies in solely clinical setting, non-systematic reviews, theses, commentaries, and abstracts.

On FSN, we excluded studies on: dietary practices and attitudes without intake measures (e.g., eating family dinners, dieting); amino acids, hormones, single, specialized or stimulant foods (e.g., arginine, seaweed, walnuts only, coffee, caffeine, alcohol); proprietary or specialized supplement or food formulas; attitudes or preferences related to infant and young child care; preterm birth (as often an outcome of non-nutritional factors); and weight change, loss or trajectories. A full list of included and excluded measures with examples and justification are included in Supplementary methods 3a, b .

On mental health, we excluded mental illnesses other than CMDs (e.g., compulsive disorders, trauma-related stress disorders, phobic anxiety disorders, and developmental disorders). Measures that had no experiential component were excluded. Measures of cortisol were excluded as this hormone fluctuates for various reasons besides experience of stress (e.g., early in the morning, during birth, during exercise), as well as stressful event inventories or circumstances without ascertainment of perceived impact. General happiness or satisfaction measures were excluded as they are not direct measures of mental health, rather an indication of heightened risks or protective factors. We also excluded general health-related quality of life focusing only on physical health without mental health components separated. Lastly, we excluded studies where common mental illness could not be disentangled from other mental illness such as psychosis, bipolar disorder, substance use, eating disorders, or other mental health problems.

Some of our FSN or mental health measures (especially BMI) were included as covariables in studies for which they were not the main outcome or exposure of interest. Studies that did not report results directly linking FSN to mental health were therefore excluded.

Screening and study selection

A team of screeners were trained and double-screened reports on title and abstract until 85% agreement rate was reached, whereafter 85% of reports were single-screened and at least 15% (sometimes more with sensitivity checking) were double-screened by a senior researcher. Patterns and disagreements were discussed and additional written guidance offered. Eligible reports based on title and abstract were reviewed in full text. We undertook a similar training process, whereby once agreement rates were reached, screeners were allowed to single screen. A third of records were double screened to ensure good sensitivity. In addition to this, several iterations of backchecking and targeted searches were re-screened throughout the process.

Data coding and analysis

Data was classified through a mix of a priori and iterative coding strategies. Fields that were decided a priori (e.g., groups of FSN and mental health measures, countries, study designs, etc.) served to identify both trends and gaps. Iterative coding included the specific measures within FSN and mental health groups. For example, although we had pre-identified a list of common and validated measures of anxiety or depression, or food security, there were many more measures that emerged beyond initial lists. These were grouped into a code if more than one study employed the measure. We used a coding form built in EPPI Reviewer to extract data on eligible reports. Only analytical comparisons and their characteristics were considered for data extraction.

We extracted information on publication year, country (or countries) and regions, study design, hypothesized direction of association between FSN and mental health (exposure-outcome relationship) and specific categories of measures and indicators, study population characteristics and sample size, and whether the analysis was adjusted or not (with at least two covariables). For the hypothesized relationship, we coded based on the authors’ stated aims and methods even for cross-sectional and qualitative studies. The ‘adult’ population category included any age range over 18, whereas studies with populations limited to older people (usually 60 or 65+ years old) were coded with ‘mid- to later-life populations only’.

Data extraction was carried out by single coding of included studies with a full review of all data extraction forms by a second researcher and targeted sensitivity checks. Given the breadth of evidence included and the aims of an evidence and gap map, quality appraisal of individual studies was not feasible or meaningful at this stage.

>All studies that met the inclusion criteria were mapped into an EGM using standard methods 45 . The EGM framework consists of columns of categories and sub-categories of FSN constructs, and rows of mental health constructs as well as measurement categories. These rows and columns are collapsed (as the map opens) and then expanded to see all sub-categories. The cells can be segmented into four groups indicated by different colours. The bubbles scale proportionally to the number of studies in the group. The user can scroll over a cell to see a summary of studies or click on the cell to see a classified bibliography of selected studies. There is also a list of filters (codes), which can be used to select studies with specific characteristics for which data was extracted. A full coding structure is provided in Supplementary results 1 .

Reporting summary

Further information on research design is available in the Nature Research Reporting Summary linked to this article.

Data availability

All scientific reports included in the Evidence and Gap Map were identified via Web of Science, PsychInfo, and CAB Abstracts Global Health repositories. The dataset (essentially included studies) generated during the current study are available within the HTML Evidence and Gap Map, and analysed within the manuscript and supplementary files. The full database (including initial search results and screening codes) can be accessed upon reasonable request from the corresponding author, as this is contained within EPPI Reviewer software which requires a user account.

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Acknowledgements

We thank the IMMANA team for their ideas, logistical and dissemination support, especially Sylvia Levy for supporting the ANH Academy Mental Health Working Group. Maria Palar, Lambert Felix, Venus Mahmoodi, Vildana Hodzic, Pema Payang, Srishti Sardana, Elliot Golden, and Justine Wright each contributed to the screening and coding of articles and we wholeheartedly thank them for their contributions. Herbert Aimiani and Nadine Seward also contributed to the ANH Academy Working Group on Mental Health which produced this work. Funding for this study was provided by the Innovative Methods and Metrics for Agriculture, Nutrition and Health Actions (IMMANA) Programme, funded by FCDO and the Bill and Melinda Gates Foundation, which specifically funded the time of TS, MD, CO, and SK. We received in-kind support from the Global Mental Health Lab at Teachers College, Columbia University.

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TS conceived of the EGM and led the review, along with support from the ANH Academy Mental Health Working Group, consisting of TS, BC, MD, MS, EP, JE, FMA, KM, CC, HV, RA, and SK. TS, MD, and BC oversaw the methods and training for study identification. Screening and coding of studies was carried out by MD, TS, XH, CL, ZL, CO, and BC. TS drafted the manuscript, map, and figures, supported by CO and MD. The manuscript was reviewed by all authors, with further editing and revision support from CO, MD, BC, and SK.

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Sparling, T.M., Deeney, M., Cheng, B. et al. Systematic evidence and gap map of research linking food security and nutrition to mental health. Nat Commun 13 , 4608 (2022). https://doi.org/10.1038/s41467-022-32116-3

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A research vision for food systems in the 2020s: Defying the status quo

Jessica fanzo.

a Berman Institute of Bioethics, Nitze School of Advanced International Studies (SAIS) and Bloomberg School of Public Health Johns Hopkins University 1717 Massachusetts Ave NW 730 Washington DC 20036 USA

Namukolo Covic

b International Food Policy Research Institute, Poverty, Health and Nutrition Division, Addis Ababa, Ethiopia

Achim Dobermann

c International Fertilizer Association, Paris, France

Spencer Henson

d University of Guelph Department of Food Agricultural and Resource Economics, Guelph, Ontario, Canada

Mario Herrero

e Commonwealth Scientific and Industrial Research Organisation (CSIRO), Brisbane, Queensland, Australia

Prabhu Pingali

f Cornell University Charles H Dyson School of Applied Economics and Management, Ithaca, New York, United States

Steve Staal

g Kuala Lumpur, Malaysia

• Research and science should not only inform food and environmental policy but should be adopted and mainstreamed into actions at all levels.
• Food systems are faced with grander and interconnected challenges and constraints that bring about new research questions.
• Research has a vital role in charting a positive and sustainable direction for global food security, nutrition, and health.
• The status quo must be challenged to shape food systems transformation to deliver sustainable, healthier diets.
• Global Food Security provides a platform where evidence is shared in an accessible manner for those who need to act on it.

1. Vision for a future food systems research agenda

As we enter the third decade of the 21st century, the world is at a crossroads. As the Editors of the journal Global Food Security , we share our perspectives on the food security challenges that face humanity and lay out our vision and call for stronger food systems research and science in this decade. The challenges and opportunities for food systems research that lay ahead are significant, requiring that high-quality science be translated into policy and action faster than ever before. Our vision is one in which research and science, and the evidence stemming from their application, not only inform food and environmental policy, but are adopted and mainstreamed into actions at the national, regional, and global levels. Global Food Security provides a platform where such evidence is shared in an accessible manner for those who need to use it and act on it.

2. Food security and nutrition: the path to sustainable development

Food security and nutrition have been prominent features of the international development agenda for decades ( Byerlee and Fanzo, 2019 ). However, over time, development priorities and challenges have fluctuated, and the needed investment has not been sustained ( Fukuda-Parr, 2012 ; Hulme et al., 2015 ). A broader consensus has emerged. One that ensures food security and eliminates hunger and malnutrition in all its forms to achieve thriving economies, human and planetary health, and sustainable development ( Baye, 2017 ; Blesh et al., 2019 ; Schipanski et al., 2016 ). Following the Millennium Development Goal (MDG) era, the Sustainable Development Goal (SDG) 2030 agenda has given the global community a renewed opportunity to end hunger and all forms of malnutrition by integrating related objectives into a more comprehensive and actionable development agenda ( Gödecke et al., 2018 ). Furthermore, tackling global food insecurity and malnutrition can only be achieved in the context of broader food systems thinking and policymaking ( Ericksen et al., 2012 ; Haddad et al., 2016 ; Ingram, 2011 ), particularly in a world that will be increasingly affected by inter-connected, multi-sectoral risks.

The FAO et al., 2019 report Food Security and Nutrition In the World: Safeguarding Against Economic Slowdowns And Downturn highlights that after decades of steady declines, world hunger prevalence remains unchanged, whilst the actual numbers of people suffering from hunger are increasing ( FAO et al., 2019 ). It seems to presage the current global downturn due to the COVID-19 pandemic and highlights the importance of policies and plans to counteract the adverse effects of such shocks ( Barrett, 2020a , Barrett, 2020b ).

Several recent landmark reports focusing on food systems have amplified the message that if we do not address the stark food insecurity and multiple forms of malnutrition that many people still experience, the world will have significant challenges in moving sustainably forward. Numerous bodies including, for example, the Global Panel on Agriculture and Food Systems for Nutrition and UN High-Level Panel of Experts on Food Security and Nutrition (HLPE), have produced seminal reports that arrive at similar conclusions and have informed the global nutrition and the food system action agenda ( GNR, 2020 ; Haddad et al., 2016 ; High Level Panel of Experts, 2017 ).

The environmental pressures exerted by food systems have increasingly dominated the research agenda on food security, focusing on agricultural and livestock production practices and related sustainability and welfare considerations. On the back of the increased attention to climate change and the momentum of the Convention of Parties (COP), more integrated views of food systems have featured in the reports produced by the Intergovernmental Panel on Climate Change (IPCC), the EAT-Lancet Commission Report on Healthy Diets from Sustainable Food Systems , the Food and Land Use Coalition's Growing Better and the World Resource Institute's Creating a Sustainable Food Future ( FOLU, 2019 ; Searchinger et al., 2019 ; Watson et al., 2000 ; Willett et al., 2019 ). The recent FAO/WHO Sustainable Healthy Diets Guiding Principles have added to these voices ( FAO and WHO, 2019 ). Each of these reports recognizes the need to transform food systems holistically, including addressing all forms of malnutrition without transgressing vital planetary boundaries. Environmental sustainability is now seen as critical to sustaining food security, nutrition and health in the long term, and essential to achieving the Paris Agreement's emissions targets.

Some influential research and development ‘think tanks,’ including the Institute of Development Studies (IDS), Overseas Development Institute (ODI), Brookings Institution and World Economic Forum (WEF), have furthered the case for mainstreaming food security and nutrition in development. The global network of international agricultural research institutes, the CGIAR, is undergoing reform towards a “One CGIAR” approach. Several proposals have advocated for the CGIAR's research agenda to be more inclusive, more focused on nutrition and more sustainable ( Barrett, 2020a , Barrett, 2020b ; Haddad, 2020 ; Lobell, 2020 ).

There are also moments and movements, such as the UN Decade of Action on Nutrition and the Scaling Up Nutrition Movement, that have served to increase attention to food security and nutrition in the UN system. The UN Food Summit in 2021 will hopefully be a pivotal moment within the broader UN system as well as global, regional and country commitments to address food system challenges head-on and with urgency. The theme of the 53rd Session of the UN Commission on Population and Develop for 2020 is “Food Security, Nutrition and Sustainable Development.” The UN Committee of World Food Security has held consultations across the different UN regions on developing Voluntary Guidelines on Food Systems and Nutrition that will hopefully be adopted at the 2020 Committee on Food Security and taken seriously by member states. In Africa, the Comprehensive Africa Agriculture Development Program, that many African Union member states are implementing, has a strong sustainability component and has diet diversity as a critical outcome area.

The current COVID-19 pandemic has cast a new light on the governance, efficiency, resilience and functionality of food systems, with potentially long-lasting implications. The pandemic has also highlighted the strong interconnections between food and health. What began as a health crisis quickly became an economic, employment, energy, and social crisis, highlighting the inherent interdependencies of global risks. While it exposed significant vulnerabilities, it may also provide an opportunity for reimagining the system, if bold policies are chosen that accelerate economic, societal, and technological transformations towards a more socially just and sustainable global economy ( WEF, 2020 ). At minimum, there is an urgent need for agri-food policies to be consistent with the goals and objectives of the ‘One Health’ approach.

Food systems and their health, economic, environment and sociocultural outcomes are high on the sustainable development agenda. The key question for research communities then is how to exploit the opportunities that this attention presents? And are we getting the right people's attention? Where are the crucial gaps in knowledge and influence that we still do not understand that stymie policy action? Where can evidence make a difference? How do we generate quality evidence faster as the solution space becomes broader while dealing with grander and more interconnected challenges across food systems?

3. Grander and interconnected challenges and constraints

We are heading on a trajectory that is far from ideal. The global population is forecast to grow by as much as five billion by the end of the century ( UN, 2018 ). At the same time, more people now live in urban rather than rural areas; 55 percent of the world's population resided in urban areas in 2018, rising to a projected 68 percent being urban by 2050 ( UN, 2018 ). Some of the poorest countries will experience high and sustained growth rates, particularly in sub-Saharan Africa (SSA). On the other hand, Asia's population growth is slowing, while some countries are beginning to see negative population pressure and aging populations as a threat to sustained economic growth ( Bai and Lei, 2020 ; Espenshade and Serow, 2013 ). Food systems will have to feed this ever-growing and shifting population using the same resources that are on hand, but with additional pressure from climate change, environmental degradation and loss ( EU European Commission, 2011 ; Willett et al., 2019 ). Food systems are further challenged by a global pandemic that is like nothing we have witnessed before.

While levels of hunger and undernutrition remain high in many of the world's poorer countries, diets are changing in rapidly-developing parts of the world along with income growth, urbanization, and shifting demographics ( Popkin et al., 2020 , 2012 ). Unhealthy diets are considered a top global risk factor for deaths and disability-adjusted life-years (DALYs) lost, surpassing other risks such as air pollution, tobacco smoking and high blood pressure ( Afshin et al., 2019 ). Most of these deaths are from non-communicable diseases (NCDs) and are occurring in low- and middle-income contexts ( Ezzati et al., 2018 ; Miranda et al., 2019 ). Many countries, including low- and middle-income countries (LMICs), now face challenges of rapidly increasing rates of overweight, obesity, and diet-related non-communicable diseases alongside persistent undernutrition ( Popkin et al., 2020 ). These multiple burdens of malnutrition are wreaking havoc on already weak health systems. This further limits the capacity to move towards more sustainable development, with crippling consequences for human health, the environment, and social cohesion ( Swinburn et al., 2019 ; Willett et al., 2019 ).

In the context of these broad global trends, food production will need to increase by upwards of 50 percent to meet the nutritional needs of the world's population in 2050 ( FAO, 2018 ). Additionally, rising incomes will likely increase the demand for animal-source foods, some of which tend to have higher negative environmental impacts ( Herrero and Thornton, 2013 ; Keating et al., 2014 ; Perry and Grace, 2015 ). These projections indicate that without new technology and significant transformation towards more sustainable food production practices, less waste and healthier diets, food systems will continue to exert high pressure on critical environmental functions and their currently known boundaries ( Clark et al., 2019 ; Springmann et al., 2018 ). Transgressing these boundaries could constrain food systems' resiliency and the ability to provide safe and sufficient food for all, particularly in times of disturbances and shocks ( Gaupp et al., 2019 ; Steffen, 2016 ). With the COVID-19 pandemic, there are significant new uncertainties and profound implications for achieving and maintaining this resiliency and sustainability across the globe ( Barrett, 2020a , Barrett, 2020b ; Gaupp et al., 2019 ).

Food systems are constantly bombarded by shocks, including climate-related natural disasters, global and local market distortions, and political upheavals and conflict, and now, the COVID-19 pandemic ( Barrett, 2020a , Barrett, 2020b ). The long, insidious shock of climate change is coming into sharp focus ( Hoegh-Guldberg et al., 2018 ; Watson et al., 2000 ). Climate change means that the fundamental realities of how the global food system operates will and must shift ( Mbow et al., 2019 ). Every component of food systems, from farm to waste, contributes to climate change and environmental degradation ( Aiking, 2019 ). Food systems account for 21 to 34 percent of global emissions, taking into account land-use changes ( FAOSTAT, 2020 ; Rosenzweig et al., 2020 ; Watson et al., 2000 ). Expanding agricultural land use, in particular, is a significant contributor to rising atmospheric carbon dioxide levels and biodiversity loss due to deforestation and the draining of wetlands ( Foley et al., 2005 ).

The intensification paradigm, which has been in place since the 1950s, has been tremendously successful in increasing agricultural productivity and keeping food prices low. However, it also led to a global imbalance, including many unintended consequences for the environment and health. During 1960–2000, in the developing countries across the world, every half-ton increase in staple yields generated a 14 to 19 percent higher GDP per capita and a 4.6 to 5.6 percent lower labor share in agriculture five years later, suggesting a strong role for agricultural productivity as a driver of structural change ( McArthur and McCord, 2017 ). Increases in agricultural productivity have helped save some forests and vulnerable land, but the reality is also that deforestation and land-use change is accelerating ( WRI, 2019 ).

Substantial progress has been made in many countries to increase nutrient efficiency in agriculture, while in others, this has not happened yet ( Zhang et al., 2015 ). In most of SSA, the lack of fertilizer is the primary driver for insufficient crop yields and continuing mining of soils for nutrients. On the other hand, in other world regions, the excessive use of fertilizers or manure is responsible for nutrient pollution of rivers, lakes, or marine estuaries ( Glibert et al., 2018 ; Nixon et al., 2008 ). Eutrophication can cause toxic algae blooms and hypoxia resulting in substantial environmental harm to aquatic wildlife and reducing water quality ( Hester et al., 1996 ; O'Neil et al., 2012 ).

Impacts on the health system can have dramatic consequences for food systems as the world is currently witnessing in the COVID-19 pandemic ( Fanzo, 2016 ). At the same time, we must contend with shifting biosecurity and emerging diseases and pests that can present new risks to public health and threaten food production ( Drummond et al., 1978 ; Evans and Inglesby, 2019 ). Examples of threats include Fall Armyworm, African Swine Fever, and the desert locust infestation in the Horn of Africa. As the pandemic has demonstrated, a crowded, more connected, more mobile world provides a perfect ground for the faster spread of such biotic threats ( Gilbert, 2020 ). This is further complicated by insufficient preventative measures to contain the spread, which presents a challenge for many people not accustomed to their freedoms being limited.

The broader economic and political context is a critical influence on the operation of food systems. Some of the worst food insecurity problems today are seen in countries under conflict or conditions of political instability ( Breisinger et al., 2015 ; FAO, 2018 ; Hendrix and Brinkman, 2013 ). Indeed, much of the increase in undernutrition in recent years can be attributed to acute food insecurity in unstable situations, for example in Central and West Africa and the Middle East ( Dunn, 2018 ; Dureab et al., 2019 ; Kah, 2017 ). Furthermore, many countries are currently struggling with large-scale migration. Because food and nutrition insecurity can be both a cause and a consequence of instability and conflict, global chronic undernutrition has become increasingly concentrated in fragile countries ( Harttgen and Klasen, 2013 ; Taylor et al., 2015 ).

Food systems are under pressure not only to deliver adequate quantity, safe, and quality food, but to also help address poverty by creating jobs and sustainable livelihoods ( Mullen et al., 2020 ). Poverty remains the leading underlying cause of persistent hunger. While rural poverty is expected to decline faster than urban poverty due to the rural-urban migration, there are significant pockets of poverty in poorly designed urban slums which often go uncounted ( Glaeser, 2014 ; Lucci et al., 2018 ). Many of the extremely poor are the producers of food; particularly smallholder farmers living in rural places where two out of three people are living in extreme poverty ( Kharas et al., 2019 ; World Poverty Clock, 2020 ). In addition to farming, many of the resource-poor are involved in other roles in food systems, such as processing and packaging, transport, and retail and marketing ( Tomich et al., 2019 ). In poorer countries, many of these roles and the markets they operate within are informal, lack investment or training, and are atomized ( Dorward, 2006 ; Grace et al., 2014 ; Poulton et al., 2006 ). The foods needed to improve dietary quality in LMICs are also the ones that have increasingly become unaffordable to the poor ( Headey and Alderman, 2019 ; Hirvonen et al., 2020 ). Food systems must ensure healthy foods are affordable even for the poor by improving supply chain infrastructure and supporting the competitiveness of smallholder farmers and fishers.

Modernizing food systems with targeted public support and partnership with private actors can increase the human capital of all participants, which is a primary means out of poverty. Rapid innovations in mobile data systems and technology, and financial services and partnership models are beginning to accelerate this change, and these new learnings need to be better understood and replicated with inclusivity in mind ( Reardon et al., 2012 ; Reardon and Berdegué, 2002 ; Reardon and Hopkins, 2006 ).

The role of the private sector and the large role of multinational agri-food corporation voices and actions in the global food system is an important issue, although it tends to be clouded by entrenched positions and ideological perspectives ( Swinburn et al., 2019 ). Global corporations have indeed played a role in the selling of unhealthy, highly-processed foods globally, and both their past and continuing behaviors in the nutrition space are issues of contention ( Stuckler et al., 2012 ). At the same time, however, small rural farm and agricultural enterprises and large corporations often work closely together and are significant contributors to food system functioning and rural livelihoods and thus food security through various forms of contract farming. For many in the research community addressing food and nutrition, however, there is a reluctance to engage with the private sector due to real or perceived conflicts of interest ( Brownell and Warner, 2009 ; Haddad, 2018 ), but often also due lack of knowledge about what the private sector actually does and their motivating factors. Such a lack of trust does not provide fertile grounds for partnership with the private sector in research or in practice ( Brownell, 2012 ; Freedhoff and Hébert, 2011 ; Garrett et al., 2019 ). Research must support continued evolution of positive food corporation impacts on diet quality and consumption patterns, and positive innovative arrangements on food production and value chain developments for smallholder farmers. This support should, together with public service partners, lead to more constructive and balanced engagement and impacts across food systems.

We encourage researchers working in the public or ‘not-for-profit’ world in food and nutrition to become better informed about the private sector and its role as an agent of change concerning sustainability standards and practices, and the behavior of billions of people across the world. Whilst it is right that researchers should question the motivations and behaviors of commercial enterprises and highlight transgressions, they also need to be open-minded in order to find desirable solutions in areas of contention. Arguably, it will be difficult to achieve the true transformation of global or national food systems without more public-private collaboration ( Fanzo et al., 2020 ). Many of the major companies operating in the food sector have already embraced the new SDGs as a framework for transforming their businesses, often in the face of consumer and investor demand. While we are yet to see the concrete impacts of many of these commitments, they do present new opportunities for researchers to engage with both small and large enterprises within the private sector.

4. Turning challenges into moments of opportunity

Ensuring food systems are equitable, sustainable, and healthy on all counts is impossible if the status quo is not significantly challenged. While the world often seems to be on its knees, when we look at the whole picture and try not to react to the sensationalized news feed that inundates us 24/7, things have improved for many people in the world.

Steven Pinker, the author of The Better Angels of Our Nature , argues that we are doing better than we did 30 years ago and that the number of conflicts and genocides has declined since the end of the Second World War ( Pinker, 2011 ). Furthermore, several countries have recovered since the end of the conflict. At the height of the Rwandan genocide in 1994, for example, the child mortality rate was 282 children per 1000 live births. The child mortality rate has since declined enormously, to 35 deaths per 1000 births in 2018 ( UNICEF, 2019 ). In the book Factfulness: Ten Reasons We're Wrong About the World--and Why Things Are Better Than You Think , Hans Rosling, likewise, argues that there are reasons to be hopeful. He contends that, by looking at data over time and in the right way, one can see that the world is making huge strides overall ( Rosling et al., 2018 ). It is just a matter of looking at the bigger picture and the broader trends over time. Indeed, many argue that there has never been a time in history as there is now when progress can be made towards a better world in the context of communication and other technologies, innovation, big data, and global integration.

Pre-COVID 19, the number of extremely poor people (those that live on less than $1.90 a day) had declined from 36 percent of the global population in 1990 to 10 percent in 2015 (The World Bank estimates that 40 million to 60 million people will fall into extreme poverty in 2020 as a result of COVID-19, depending on the magnitude of the global economic shock) ( Bank, 2019 ; Mahler et al., 2020 ; Maloney and Taskin, 2020 ). Over the same period, premature mortality amongst children under the age of five has fallen by more than half from 93 per 1000 live births in 1990 to 38 in 2018 (Unicef, 2019). Chronic undernutrition, as indicated by rates of stunting, has also been declining. In 2000, 33 percent of children under the age of five were stunted, compared to 21 percent in 2019 ( UNICEF et al 2019 ). However, this progress is too slow for the 2030 SDG to be met for many LMICs, especially in SSA. Research must provide innovative policy and program actions to accelerate progress.

Of course, progress in food security and nutrition is far from a finished agenda, even when there is sustained and substantial economic development, it is often distributed unevenly. Hunger numbers have risen over the last three years, and overweight and obesity continue to increase around the world ( FAO et al., 2019 ; GNR, 2020 ). The gains of economic growth are diverge greatly. As a result, inequality has increased almost everywhere, suggesting that even more considerable progress would have occurred if the gains of economic development had been shared more equally. Indeed, in many contexts, these inequities come to bear in food systems - resulting in the poorest of the poor, the disadvantaged and marginalized, taking on the brunt of food insecurity and malnutrition ( GNR, 2020 ).

Positive change comes through an almost unnoticed series of multiple, small changes as often as large-scale and dramatic advances that are instantly noticeable. Failures that counteract historic gains are also a frequent occurrence, although all too often, these are disguised and rarely diagnosed and analyzed. The task of researchers is to seek out where and how progress has (or has not) been made, to learn from what has (or has not) worked, and to make valid extrapolations to other contexts. Arguably, we know a lot about what has worked and why, particularly in places where hunger and undernutrition have rapidly declined; China, Brazil, and Ethiopia are all examples of where significant progress has been made to reduce hunger and malnutrition, yet much remains to be done ( Chen et al., 2015 ; Headey and Others, 2014 ; Monteiro et al., 2009 ; Singh, 2014 ; Yosef and Pandya-Lorch, 2016 ).

We can also point to the success of policy efforts to tackle poor diets to combat overweight and obesity, including a tax on sugary beverages in Mexico ( Colchero et al., 2017 ) and front of the pack labels on unhealthy foods in Chile ( Taillie et al., 2020 ). There are other successes across food systems to improve food security, nutrition and livelihoods. In China, new agricultural policies focus on a greener development model with millions of smallholder farmers changing their management practices towards more sustainable crop production ( Cui et al., 2018 ). In Western Europe and North America, productivity gains in crop production in the past 20–30 years have largely been achieved without parallel increases in fertilizer consumption ( Cui et al., 2018 ). There have been advances in biofortification and the wide acceptance of its potential contribution to addressing selected micronutrient deficiencies ( Bouis and Saltzman, 2017 ).

Shifts in aquaculture towards low-trophic species, those feeding lower on the food chain, have increased efficiency of resource use ( Waite et al., 2014 ). A recent paper by Belton and colleagues ( Belton et al., 2020 ) proposes three pillars of action to support sustainable commoditization of the current and future supply of seafood including sustainable intensification, supply chain transformation, and policy and regulation that the Global North and South could invest and scale.

The Comprehensive Africa Agriculture Development Programme (CAADP) of the African Union now includes dietary indicators in the Results Framework ( NEPAD, 2015 ). This means that the 44 member states currently implementing CAADP must ensure that agriculture works to improve dietary quality providing an opportunity for research to support the desired progress. The world is changing rapidly and there are essential contextual differences that need to be taken into account when translating evidence into policy and program actions.

We also have the tools, innovations and knowledge that are backed by decades of research on how to adapt to and mitigate climate change, and how to protect natural resources and biodiversity ( Herrero et al., 2020 ; Rosenzweig et al., 2020 ). The Food Systems Dashboard is a tool that brings together 170 plus indicators representing most countries and territories in the world, to better describe, diagnose and decide on actions to improve food systems ( Fanzo et al., 2020a , Fanzo et al., 2020b ). FAO has developed two innovative tools, SmartForms and Calipseo, that collect and review fishery data and integrate and streamline fisheries data along the national data supply chain respectively ( FAO, 2020 ). These are just a few of the many tools and databases available to better inform decision making. Innovations extend to circular economy thinking and technologies to reduce food loss and waste, nutrition value chains, and agriculture technologies such as artificial intelligence, robotics, drones, algae feedstocks and bioplastics ( El-Gayar and Ofori, 2020 ; Jurgilevich et al., 2016 ; Klerkx and Rose, 2020 ). Cultivated meats, crowd farming and 3D printing are no longer future technologies but “now” technologies. These innovations could be game-changers for food security and nutrition when responsibly implemented ( Downs and Fanzo, 2016 ; Neff et al., 2015 ). We cannot forget about the importance of knowledge, in particular, indigenous peoples’ expert traditional knowledge on ecosystems, biocultural and biodiversity. It is a matter of translating their evidence into practice and scaling up solutions, focusing on food system actors who need the most technical assistance for rapid transformation ( Reardon et al., 2019 ).

While we tend to think of technological advancements in high-income countries (HICs), there are many advances in LMICs that improve the lives of the poor. Kenya, for example, is a demonstrated leader within SSA in electronic transactions using mobile telephones, where the M-Pesa service has addressed many of the common challenges that the poor face in accessing banking services ( Deichmann et al., 2016 ). The recent and widespread uptake of cellular telephones across SSA as a whole has been phenomenal. When technology meets a recognized need and is cost-effective for the intended beneficiary, uptake can be rapid. This should challenge researchers to foster innovation to bring about the positive transformation of food systems and related livelihoods.

Women are essential players in food systems, especially in LMICs. They not only make up a significant proportion of the food system labor force but are also the care custodians including the preparation of food for families and feeding of infant and young children ( Quisimbing et al., 2000 ; Quisumbing et al., 2005 ; van den Bold et al., 2013 ). Attention to women's empowerment is an important element in fostering household food security and nutrition ( Meinzen-Dick et al., 2019 ; Sraboni et al., 2014 ). The #MeToo and the Black Lives Matter movements that began in the United States could serve as powerful vehicles to address systemic injustices across food systems. Extending their message to address equity across resources, including land, extension and finance as well as education, law and health services, is critical ( Rasanathan and Rasanathan, 2020 ). Cutting-edge research could highlight the interrelated and compounded nature of disadvantages and inequities that perpetuate across food systems. For example, food and nutrition policies and interventions should effectively address inequities faced by women and not only women as mothers, but also women across the life course and as entrepreneurs ( Fox et al., 2019 ).

Food safety and zoonotic borne diseases are critical issues for food security, as COVID-19 has so vividly demonstrated. The world has seen several zoonotic disease outbreaks; HIV-AIDS, MERS, SARS and now the COVID-19 pandemic that is thought to have emanated from a wet market in China ( Wu et al., 2020 ). Zoonotic diseases are infectious diseases that cross over from animals to humans or vise-versa. For some time, One Health advocates warned of the need to consider the interrelationship between humans and animals on zoonotic diseases ( National Research Council et al., 2010 ). They have called for addressing food safety concerns around animal source foods. Scaling up a “One Health” approach is one way to prevent future pandemics by integrating animal, human and environmental connections. Humans coexist with animals - as companions for our overall well-being, as producers of food, and as a source of livelihoods. This interface between animals and humans and their shared environments can be a source of disease too ( Deem et al., 2019 ). There is a need for smart crop and animal solutions grounded in agroecological and food systems thinking ( Di Marco et al., 2020 ).

5. Research and innovation remain essential

Given the above information, it is clear that research has a vital role in charting a positive and sustainable direction for global food security, nutrition, and health. The needed research will require a creative, holistic approach across disciplines, bringing knowledge together into publications that inform action at different levels from sub-national, national, regional, global.

At a time when facts, science, and evidence are under ever greater scrutiny, and even openly disregarded as suspect by some political and business leaders, the rigors of research have never been more critical ( Oreskes and Conway, 2011 ). It is also important not to become disheartened by the slow speed of change in policy and practice, even when the appropriate course of action is clear ‘to us.’ Research can and does bring about wholesale changes in attitudes, political thought, and action, but change takes time ( Higgins, 2019 ). We have seen this with climate change science. It may have taken 40 years for scientists to convince political leaders, but we are now approaching consensus at a global level on the need for near-term action to combat climate change and many countries have taken some positive actions that would have been unthinkable in the not too distant past to change the behavior of their citizens ( Rich, 2018 ). Researchers must continue to generate evidence that can help speed progress in time to sustain planetary integrity and human development.

At the same time, researchers need to better communicate their research findings to the wider world ( Miller et al., 2006 ; Rowe, 2002 ). For too many researchers, the sole focus is on academic publishing. Researchers need to see their role in terms of knowledge generation and the translation of this knowledge into a form that is understandable and relevant to decision-makers in government, business, and civil society. Those who design, shape and enact policies and practices at the subnational, national and international levels need to access the research they need in a digestible and accessible way. Failure to achieve this brings a very considerable risk of being ignored. Researchers must learn to sit at policy dialogue tables not set for them, but for the users of their research – that is, the policymakers. By listening to challenges policymakers face, the research community can better design studies that result in practical and relevant findings that policymakers look forward to receiving and using ( Fracassi et al., 2020 ; Sogoba et al., 2014 ).

Food systems is often viewed as a source of problems needing innovative solutions ( Béné et al., 2019 ). This view belies the fact that food systems themselves can be a source of innovations, and that many of the fundamental food security and nutrition problems facing the world are behavioral and require systemic change, including the perspective of the social sciences ( Tallis et al., 2019 ). Embracing this more inclusive perspective on solutions to food security and nutrition challenges requires a fundamental cultural shift on the part of researchers, funders and business and policy decision-makers, and shifts in incentives ( Karp et al., 2015 ). There is a need for research to be problem-focused and systems-based. Research and their funding agencies should embrace multiple perspectives (including those of individuals who live and work within food systems), and integrate natural and social science, innovation, policy, institutions and practice ( Herrero et al., 2020 ). Taking this approach requires consideration for both quantitative and qualitative research methods. Generalizability is not always what is most desired in research, as many food system challenges require contextual solutions.

One of the most significant weaknesses in research on food security, nutrition, and food systems across the globe is the muted voice of LMIC researchers ( Lachat et al., 2014a , 2014b ). A simple scan of any of the key academic journals in this area will reveal the considerable bias towards researchers coming from HICs and contexts and universities with substantive resources. Indeed, much of the diagnoses of food security and nutrition problems facing poorer parts of the world come from researchers from HICs or work in institutions funded by HIC donors. Many LMIC researchers struggle to gain access to these journals, lack support or incentive systems to publish refereed journal articles, or simply do not have the infrastructure or resources to undertake cutting-edge research ( Van Royen et al., 2013 ). The reality is that we very much have an elite HIC view of food security and nutrition for those living in LMICs. This situation presents not only huge questions over democracy and equity of research in this area, but also serves to ignore LMIC knowledge, experiences, and perspectives of their challenges ( Lawrence et al., 2016 ). HIC bias has also meant that there has been significant underinvestment in research and technology development for crops and livestock important to poor farmers living in low-income contexts. Advances made in some institutions in sub-Saharan Africa and South Asia, for example, have not been as well recognized globally or have been under-funded. This must change.

Accessing cutting edge research is also problematic. The Global Food Security offers two options to publish. One is gold access in which open access is immediate and permanent to everyone to read and download. The article publishing costs are covered by the author or by their institution on their behalf. The other option is the green access in which an article published under a subscription model in which no fee is payable by the author because publishing costs are covered by subscriptions and only subscribed readers can access these articles. As the editors, we acknowledge that the high cost of subscribing to the Journal excludes many in poorer parts of the world from accessing the work that we publish. Furthermore, the high cost of fully open access prevents many researchers from ensuring their publications are available to all. This situation both maintains and perpetuates the North-South divide in research on food security and nutrition we highlight above. The Global Food Security, which belongs to an Elsevier, has not found an equitable way with the parent company in which to overcome these barriers. As editors, however, we remain committed to reducing these barriers, for the good of all in the research community, and wider society.

Perhaps the most welcome and vital trend in research related to food security and nutrition is the breaking down of disciplinary silos and the shift to more multi-disciplinary, multi-sectoral research. There is also evidence that this multi-sectoral approach is influencing policy and development practice. For example, efforts to promote nutrition and agricultural development and environmental sustainability are arguably better aligned today than ever before. Nevertheless, there are still knowledge gaps in how to scale-up and improve the cost-effectiveness and sustainability of interventions and programs that bridge nutrition and agriculture ( Pingali, 2015 ; Ruel et al., 2018 ).

6. Challenging the status quo to shape food systems transformation

While the challenges we face are daunting, the opportunities are also vast. Food systems must adapt and transform to deliver sustainable, healthier diets, and durable livelihoods without decimating the planet. The research community should rise to this challenge, and we provide a platform to challenge the status quo and take food system transformation in a direction we have not yet imagined.

Global Food Security strives to publish evidence-informed strategic views of experts from a wide range of disciplinary perspectives on prospects for ensuring food security, nutrition, and health across food system issues. We wish to publish reviews, perspectives articles, and debates that synthesize, critique and extend findings from the rapidly growing body of original publications on global food security, nutrition, food systems, and related areas; and special issues on critical topics across food security, food systems, and nutrition including how these are impacted by climate and environmental dynamics.

There are still many areas that require more research, evidence, and knowledge. Some of these topics need a jumpstart or a fresh look. The Journal has had several special calls on high-tech agriculture 4.0, sustainable diets, and zoonotic diseases during the COVID-19 pandemic. The Journal has also hosted several special issues including price volatility and food security; social protection and agriculture; ethics and global food security; food security governance in Latin America; stories of change in nutrition; measuring food and nutrition security; biofuels and food security, drivers of dietary choice; and biodiversity, ecosystem services, and food security.

Through this vision paper, we are making a call to action to researchers to challenge the status quo and bring forth knowledge syntheses that can inform the desired actions across food systems. We encourage strategic reviews and perspectives submissions that synthesize lessons and recent learnings, ask critical questions that challenge the status quo, and foster new ways of thinking that can propel new research questions to drive progress. We are looking for key research papers that will disrupt and move the field forward and impact policies and programs.

Positively transforming food systems to ensure that the food we produce is accessible, sustainable, safe, healthy, and equitable for all is our moral imperative. At the same time, food systems should continue to be a vehicle to reduce poverty, directly improving food security for everyone. Current food system transformation is creating significant sustainability and equity gaps that will make future food security and continuity of life on the planet difficult. As global citizens, we will have to fill in those gaps: We all have a role to play in ensuring we meet the demands of a growing population sustainably while co-existing in amity with the planet. We need to find the stitched pockets of progress and small glimmers of hope as the basis of our knowledge to move forward; ever-changing and ever-evolving in the remarkable pattern of human endeavor.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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The state of food security and nutrition in the world 2022

Repurposing food and agricultural policies to make healthy diets more affordable

The challenges to ending hunger, food insecurity and all forms of malnutrition keep growing.

The COVID-19 pandemic has further highlighted the fragilities in our food systems and the inequalities in our societies, driving further increases in world hunger and severe food insecurity. Despite progress in some regions, global trends in child malnutrition continue to be of great concern, including stunting and wasting, deficiencies in essential micronutrients, and overweight and obesity. Trends in maternal anaemia and obesity among adults especially also continue to be alarming.

This report shows that governments can invest in food systems equitably and sustainably, even with the same level of public resources. Governments’ support for food and agriculture accounts for almost USD 630 billion per year globally. However, a significant proportion of this support distorts market prices, is environmentally destructive, and hurts small-scale producers and Indigenous Peoples, while failing to deliver healthy diets to children and others who need them the most.

The evidence suggests that if governments repurpose the resources they are using to support producers and consumers, to incentivize the sustainable production, supply and consumption of nutritious foods, they will contribute to making healthy diets less costly and more affordable for all.

In all contexts, reforms to repurpose support to food and agriculture must also be accompanied by policies that promote shifts in consumer behaviours, along with safety net policies to mitigate the unintended consequences of reforms for vulnerable populations. Finally, these reforms must be multisectoral, encompassing health, environmental, transport and energy policies.

Full report

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Food Security

USDA supports global food security through in-country capacity building, basic and applied research, and support for improved market information, statistics and analysis. With 870 million people around the world who do not have access to a sufficient supply of nutritious and safe food, establishing global food security is important not only to hundreds of millions of hungry people, but also to the sustainable economic growth of these nations and the long-term economic prosperity of the United States.

As we help countries become more food secure and raise incomes, we also expand markets for American producers. U.S. agricultural exports to developing countries in Southeast Asia, Central America, and Sub-Saharan Africa have grown at more than twice the annual rate as compared to developed countries. U.S. poultry meat exports to Sub-Saharan Africa expanded 180 percent from 2009 to 2011.

Given population growth and rising incomes, it is estimated that the demand for food will rise by 70 to 100 percent by 2050. To meet this need, the United Nations estimates that production in developing countries will need to almost double.

Building Local Capacity, Increasing Productivity, and Improving Markets and Trade

USDA is strategically placed in over 80 countries constantly monitoring agricultural matters globally. Since 2010, USDA has aligned appropriate programs to Feed the Future plans to support agriculture development in target countries and regions: Ghana, Kenya, East Africa, Bangladesh, Haiti, Guatemala and Central America. plans to support agriculture development in target countries and regions: Ghana, Kenya, East Africa, Bangladesh, Haiti, Guatemala and Central America. Our international food aid programs benefited about 34 million individuals globally with assistance valued at nearly $1.6 billion.

The McGovern-Dole International Food for Education and Child Nutrition Program supported the education, child development, and food security of more than 16 million of the world's poorest children. The program provides U.S. agricultural products, as well as financial and technical assistance, for school feeding and maternal and child nutrition projects.

The Borlaug Fellowship Program brought 272 scientists to the U.S. and focuses on research topics such as food safety, soil fertility, post harvest technology, biotechnology, animal health, and rural development.

The Cochran Fellowship Program trained 1,732 individuals worldwide in topics such as regulatory and certification systems, agricultural production, biotechnology, and plant and animal disease control.

In 2011, the annual Food Security Assessment was expanded to include 77 countries; completed assessments of agricultural statistics and market information in 10 Feed the Future countries and identified key areas where improvement is needed; and conducted in-depth assessments of the capacity of the statistical systems of Ghana, Haiti, Tanzania, and Bangladesh.

We have undertaken significant efforts to build local in-country capacity to confront food security, including:

Training small farmers and foreign officials on plant and animal health systems, risk analysis, and avoiding post harvest loss;
Completing assessments on climate change;
Increasing agricultural productivity.

In the targeted Feed the Future countries and regions, nearly 60,000 individuals have received USDA agricultural productivity or food security training, 7 critical policy reforms have been adopted with USDA assistance, and $20 million in microloans have been disbursed.

Feed the Future - A Government-Wide Effort to Combat Global Hunger

In 2009, G8 nations committed to "act with the scale and urgency needed to achieve sustainable global food security" and to be accountable and coordinate with country development plans. In the subsequent three years, the United States invested over $3.7 billion to address global food security, exceeding the President's commitment, and launched his Feed the Future Initiative.

In 2010, the U.S. helped launch the Global Agriculture and Food Security Program, an international, multilateral trust fund that has already awarded $658 million to finance country development plans in 18 low-income countries, with 8.2 million beneficiaries.

Driving Innovative Research and Technologies

Under Feed the Future, research investments specifically designed for global food security have more than doubled, from $50 million in 2008 to $120 million in 2011. The Feed the Future Research Strategy, developed by USAID and USDA, focuses on the four agro-climatic zones where global poverty and hunger are concentrated, and targets two-to-four major problems in each zone to maximize impact on poor families.

In 2010, the USDA and USAID Norman Borlaug Commemorative Research Initiative launched a new era of partnership on research. Under this initiative, USDA is conducting research on wheat rust, a major threat to wheat production worldwide, and on aflatoxin, a toxic fungus that infects groundnuts and other crops, and causes illness in humans. Other research includes developing a vaccine for East Coast fever, a major killer of cattle in East Africa, and supporting research to enhance animal, grain and legumes production. In Guatemala, Haiti, Bangladesh, Kenya, and Ghana, USDA has a number of new technologies under research, 12 of which are being field tested and 4 have been introduced locally.

USDA researchers sequenced the genome of the wheat, as well as the wheat stem rust pathogen which threatens to destroy wheat crops worldwide and distributed new wheat germplasm globally to ensure productive harvests. USDA researchers have also released 1,575 genetic variations in beans.

Learn more about agriculture and food security efforts underway at the U.S. Agency for International Development .

Tools and Resources for Food Security

Community Food Security Assessment Toolkit
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Selected Regional & National Resources

Food, Agriculture and Natural Resources Policy Analysis Network (FANRPAN) FANRPAN is based in South Africa and deals with several thematic issues including food systems and nutrition, agriculture, and environment.
Food and Nutrition Security Platform (CELAC) This organization provides food security and nutrition resources for Latin American and Caribbean countries.
US Food Sovereignty Alliance (USFSA) USFSA works to end poverty, rebuild local food economies, and assert democratic control over the food system.
Centro Internazionale Crocevia Crocevia is an Italian public interest NGO founded in 1958. Crocevia works on environmental and agrarian issues, with specific focus on community alternatives.
DanChurchAid (DCA) A Danish humanitarian and development NGO that focus on advocacy for oppressed, neglected and marginalised groups in poor countries, including fighting hunger .
Comprehensive Africa Agriculture Development Programme (CAADP) CAADP is Africa’s policy framework for agricultural transformation, wealth creation, food security and nutrition, economic growth, and prosperity for all.
ASEAN Sustainable Agrifood Systems The ASEAN Sustainable Agrifood Systems aims at providing solutions for long-term food security in the Asian region through development of regionally coordinated policies and strategies for sustainable agriculture.
Food Tank Food Tank is a non-profit organization focused on building a global community for safe, healthy, food.
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Parul Christian, DrPH '96, MSc, studies how to improve maternal and child nutrition and prevent micronutrient deficiencies with effective solutions in low-income settings.

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Roni Neff, PhD '06, ScM, researches ways to cut food waste and address climate change through more resilient, equitable, and healthy food systems.

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Keeve Nachman, PhD ’06, MHS ’01, aims to generate the scientific evidence needed to support decisions that mitigate human exposures to chemical and microbial hazards associated with food production.

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Enhancing Food Security and Trade Resilience in Sustainable Agricultural Systems

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Food security is a critical global challenge, influenced by complex interactions between agriculture, trade, and market dynamics. As countries navigate the impacts of climate change and economic fluctuations, sustainable agricultural practices become essential for ensuring a stable food supply. International ...

Keywords : Food security, sustainable agriculture, international trade, agricultural policies, food sovereignty

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Food Security and Access

Learn more about food access in the U.S and explore resources including food assistance programs, food availability, nutrition security and hunger.

Learn about how USDA supports global food security through building local capacity, improving markets, funding research and more.

Get information on food assistance programs for certain individuals and groups. Programs include SNAP , WIC, the National School Lunch Program and more.

Find tips for eating healthy on a budget and saving money when food shopping.

Call the USDA National Hunger Hotline at 1-866-3-HUNGRY or 1-877-8-HAMBRE to speak with a representative who will find food resources near you.

Get ideas of budget-friendly foods and ways to prepare them. Plus, find savings and stores that accept Supplemental Nutrition Assistance Program (SNAP) benefits near you.

Download this guide for tips on what to donate to a food pantry and how to organize a community food drive.

Learn about factors contributing to lack of food access and programs that support local food access.

Learn what to expect at a food pantry or food bank and how to select nutritious foods while you are there.

Enter your address to identify local food services, including soup kitchens, food pantries, and meal delivery. Filter results by availability in Spanish, for seniors, for Halal or Kosher diets, or other options.

NIFA advances food and nutrition security through their programs. Review program information, learn about general food and nutrition security, and listen to NIFA’s webinar series.

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How do we feed the planet without destroying it? At Friedman, we take a “whole systems” approach to research that sits at the intersection of food systems, climate change, and health.

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Hsrc, sacnasp to host a dialogue on science for inclusivity, innovation, food security, nutrition and social justice.

Cape Town, Sunday, 4 December 2022 – The Human Sciences Research Council (HSRC) in partnership with the South African Council for Natural Scientific Professions (SACNASP) will host a dialogue titled, Science for Inclusivity, Innovation, Food Security, Nutrition and Social Justice, at the World Science Forum (WSF) on Monday, 5 December 2022 at 9h00.

The dialogue which forms part of a series of pre-WSF events will focus on the following three sub-themes:

Theme 1: Food Security and Nutrition: Support Areas for Policy Coherence Through Africa Regional and International Cooperation Framework

The session will address the following key questions:

What are the critical findings and recommended actions for food security and nutrition?
What is the regional status of food security and nutrition and how should regional policy mechanisms respond to rapid impact?
What is the government’s response to the international cooperation framework and resources for improving food security and nutrition status in South Africa?

Speakers include:

Dr Shingi Mutanga, Research Group Leader: Climate Services, Council for Scientific and Industrial Research (CSIR)
Dr Tshilidzi Madzivhandila, Chief Executive Officer and Head of Mission: Food, Agriculture and Natural Resources Policy Analysis Network (FANRPAN)
Dr Mmboneni Muofhe is the Deputy Director-General, Socio-Economic Innovation Partnership, Department of Science and Innovation (DSI)

Theme 2: Institutional Partnerships and Arrangements for Improving the Farmer–Scientist-Industry Interface

Key questions to be addressed in this theme include:

What institutional partnerships and arrangements are required for improving the Farmer–Scientist-Industry Interface from the perspectives of your organisations?
What has been the institutional support in terms of practice and framework tools from your organisations towards farmers and scientists in the industry?
What are the experience-based challenges and success factors?
What would you recommend as possible pathway(s) to impact the industry, especially for food security and promotion to accessing nutritious food?
Mr Kudakwashe Koke – Consultant at Business Sweden Embassy
Dr Nompumelelo Obokoh – Chief Executive Officer: South African Council for Natural Scientific Professions (SACNASP)
Dr Simphiwe Ngqangweni – Chief Executive Officer: National Agricultural Marketing Council (NAMC)

Theme 3: Designing and Strengthening Social Inclusion Mechanisms In Science For Policy Impact: Improving Health For All Through Food Systems

This panel will be targeting poverty and inequality reduction through food systems approach. The session will address the following key questions:

What evidence has influenced progressive inclusivity in communities?
How can one health be achieved through a proactive food systems policy?
What are the gaps and successes in improving health for all through food systems?
What recommendations can be made for improving one health for all through food systems?
Mr Harry May, Manager, Cape Town Team, Surplus People Project
Dr Peter Jacobs, Research Director (Strategic Lead): Inclusive Economic Development (IED) division at Human Science Research Council (HSRC)
Prof Joseph Francis, Director: Institute for Rural Development, University of Venda

The overall objective of the dialogue is to identify existing and emerging intervention models that are embedded in system designs towards an integrated application of science and practice innovations and policy for enhanced socio-economic conditions.

According to Dr Palesa Sekhejane (Strategic Partnership Director, HSRC), a couple of factors are inherent to a functional food system. “For example, better access to land and production resources, stakeholders support, a conducive policy environment, innovation and knowledge all contribute to systems critical for enhancing favourable socio-economic conditions.

“In low-resource settings, science and innovation needs to be adopted. However, without targeted key actors and an integrated stakeholder approach, it is a challenge to apply knowledge and promote science and innovation-led interventions informed by local context and conditions,” said Dr Sekhejane.

She added that promoting and supporting the inclusion of marginalised communities such as women, children and rural populations or those on the margins of economic and policy benefits requires coordinated inter-governmental efforts, strengthened networks and partnerships that support inclusivity.

For session specific information visit the WSF website https://worldscienceforum.org/programme

Details of the event

Date: 5 December 2022

Time: 9h00 to 11h00

Venue: Cape Town International Convention Centre, WSF venue, Meeting Rooms 1.43 – 1.44

For media inquiries:

Dr Lucky Ditaunyane, Cell: 0832276074, Email:

Adziliwi Nematandani, Cell: 0827659191, Email:

Join the conversation:

#ScienceforSocialJustice

#WSF_ZA2022 #science

#SouthAfrica

Notes to the Editor

About the South African Council for Natural Scientific professions (SACNASP)

SACNASP is the legislated regulatory body for natural science practitioners in South Africa. The natural sciences encompass a wide range of scientific fields covering all of the basic sciences and many of their applied derivatives. For a complete list of the current fields of practise recognised by SACNASP, please click here .

Our mission is to establish, direct, sustain and ensure a high level of professionalism and ethical conscience amongst our scientists. Their conduct should be internationally acceptable and in the broad interest of the community as outlined in the SACNASP Code of Conduct .

SACNASP’s main objectives are to:

Promote the practice of the natural science professions in South Africa.
Ensure and administer the mandatory registration of natural scientists as required in terms of The Natural Scientific Professions Act of 2003.
Exercise control over the standard of conduct of professional natural scientists.
Monitor the standard of education and training of natural scientists.
Set standards for the recognition of education and training of natural scientists.
Ensure that prospective registrants meet the educational standards required for registration.

About the Human Sciences Research Council (HSRC)

The HSRC was established in 1968 as South Africa’s statutory research agency and has grown to become the largest dedicated research institute in the social sciences and humanities on the African continent, doing cutting-edge public research in areas that are crucial to development.

Our mandate is to inform the effective formulation and monitoring of government policy; to evaluate policy implementation; to stimulate public debate through the effective dissemination of research-based data and fact-based research results; to foster research collaboration, and to help build research capacity and infrastructure for the human sciences.

The Council conducts large-scale, policy-relevant, social -scientific research for public sector users, non-governmental organizations, and international development agencies. Research activities and structures are closely aligned with South Africa’s national development priorities.

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COMMENTS

Household Food Security in the United States in 2023
An estimated 86.5 percent of U.S. households were food secure throughout the entire year in 2023, with access at all times to enough food for an active, healthy life for all household members. The remaining households (13.5 percent, statistically significantly higher than the 12.8 percent in 2022) were food insecure at least some time during ...
Food Security in the U.S.
Selected USDA, ERS resources on numerous topics central to food and nutrition security are available on the Nutrition Security Research Resources page. In 2015, USDA, ERS released the 20th year of statistics on household food security in the United States. ... The purpose of the program was to foster research related to the past 25 years of U.S ...
The state of food security and nutrition in the world 2024
286. This report is the annual global monitoring report for Sustainable Development Goal (SDG) 2 targets 2.1 and 2.2 - to end hunger, food insecurity and malnutrition in all its forms. It presents the latest updated numbers on hunger, food insecurity and malnutrition, as well as new estimates on the affordability of a healthy diet.
Food Security Research
Food Security Research - PLOS. Research topics. Selected research. Collections. Journals. About PLOS. PLOS is a nonprofit 501 (c) (3) corporation, #C2354500, and is based in San Francisco, California, US. Home. Resources.
PDF The State of Food Security and Nutrition in The World
FOOD SECURITY AND NUTRITION AROUND THE WORLD IN 2020 1 1.1 Progress towards hunger and food insecurity targets 3 1.2 Progress towards global nutrition targets 26 1.3 The critical link between food security and nutrition outcomes: food consumption and diet quality 40 1.4 Conclusions 60 PART 2 TRANSFORMING FOOD SYSTEMS TO DELIVER
Food and Nutrition Security
Research and evaluation. USDA's work on nutrition security is driven by research and grounded in science. In addition to the extensive research performed by the Food and Nutrition Service, the Agricultural Research Service has six human nutrition research centers, the Economic Research Service studies numerous topics central to food and nutrition security, and the National Institute of Food ...
The state of food security and nutrition in the world 2021
Overview. This report presents the first global assessment of food insecurity and malnutrition for 2020 and offers some indication of what hunger might look like by 2030, in a scenario further complicated by the enduring effects of the COVID-19 pandemic. It also includes new estimates of the cost and affordability of healthy diets, which ...
USDA ERS
Nutrition Security Research Resources. Nutrition security is an emerging topic in Federal food assistance and nutrition policy discussions. It encompasses several aspects of nutrition—including acquisition, consumption, and education. Nutrition security and food security are closely linked. USDA defines food security as access by all people ...
Food Security and Nutrition
The State of Food Security and Nutrition in the World Date: 2022 This annual flagship report jointly prepared by FAO, IFAD, UNICEF, WFP and WHO to inform on progress towards ending hunger, achieving food security and improving nutrition and to provide in-depth analysis on key challenges for achieving this goal in the context of the 2030 Agenda ...
The Global Food and Nutrition Security Dashboard
The Global Food and Nutrition Security Dashboard, a platform of the Global Alliance for Food Security (GAFS), offers the latest global and country-level data on food crisis severity, global food security financing and innovative research to strengthen crisis response and resilience. The Dashboard provides timely, quality information to help ...
Systematic evidence and gap map of research linking food security and
Food security and nutrition (FSN) are key components of global health and development. Internationally, healthy diets are increasingly reported to be out of reach 1 and unaffordable 2 for people ...
Food security and nutrition and sustainable agriculture
The State of Food Security and Nutrition in the World (SOFI) 2023 Launch. On 12 July 2023 from 10 AM to 12 PM (EDT), FAO and its co-publishing partners will be launching, for the fifth time, the State of Food Security and Nutrition in the World (SOFI) report at a Special Event in the margins of the ECOSOC High-Level Political Forum (HLPF).
Food Insecurity, Neighborhood Food Environment, and Health Disparities
The NOSI encourages 1) research on the efficacy of interventions that address nutrition security and the mechanisms of food insecurity on various health outcomes and 2) the development of new measures for nutrition security and assessing food insecurity . However, overall workshop discussions emphasized the need for greater conceptual clarity ...
A research vision for food systems in the 2020s: Defying the status quo
One of the most significant weaknesses in research on food security, nutrition, and food systems across the globe is the muted voice of LMIC researchers (Lachat et al., 2014a, 2014b). A simple scan of any of the key academic journals in this area will reveal the considerable bias towards researchers coming from HICs and contexts and ...
Introduction
In chapter 2 of the FAO publication, Trade Reforms and Food Security: conceptualizing the linkages, the definition of the term Food Security is presented as a flexible concept which has evolved over time. The Committee on World Food Security in document CFS 2012/39/4 has provided further official definition to Food Security and related terms.
Research priorities for global food security under extreme events
A key focal point for research on food security in the face of extreme events is at the farm level. This is because, despite being food producers, many of the world's farmers, herders, hunters, and fishers, are themselves food insecure. This brings a double benefit to research focused on enhancing resilience to extreme events at the farm ...
The state of food security and nutrition in the world 2022
This report shows that governments can invest in food systems equitably and sustainably, even with the same level of public resources. Governments' support for food and agriculture accounts for almost USD 630 billion per year globally. However, a significant proportion of this support distorts market prices, is environmentally destructive, and hurts small-scale producers and Indigenous ...
Food Security
Under Feed the Future, research investments specifically designed for global food security have more than doubled, from $50 million in 2008 to $120 million in 2011. The Feed the Future Research Strategy, developed by USAID and USDA, focuses on the four agro-climatic zones where global poverty and hunger are concentrated, and targets two-to-four ...
Food Security and Nutrition
The International Food Policy Research Institute (IFPRI) provides research-based policy solutions to sustainably reduce poverty and end hunger and malnutrition in developing countries. Founded in 1975, IFPRI's vision is "a world free of hunger and malnutrition". For more information, visit: IFPRI's Food Security web page.
USDA ERS
Food Assistance Data & Collaborative Research Programs. The U.S. Department of Agriculture (USDA) administers food and nutrition assistance programs that affect the lives of millions of people and account for roughly two-thirds of USDA's annual budget. ERS is the primary source for economic studies and evaluations of domestic food and ...
364 questions with answers in FOOD SECURITY
Food Security - Science topic. Food security refers to the availability of food and one's access to it. A household is considered food-secure when its occupants do not live in hunger or fear of ...
Food/Nutrition
April 19, 2024. Recent research has highlighted disparities in research between Type 1 and Type 2 diabetes, with Type 1 long—and mistakenly—associated only with childhood onset. Elizabeth Selvin and Michael Fang challenge previously held assumptions about Type 1 diabetes.
Enhancing Food Security and Trade Resilience in Sustainable
Keywords: Food security, sustainable agriculture, international trade, agricultural policies, food sovereignty . Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements.Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at ...
Food Security and Access
USDA National Hunger Clearinghouse. USDA, Food and Nutrition Service. Call the USDA National Hunger Hotline at 1-866-3-HUNGRY or 1-877-8-HAMBRE to speak with a representative who will find food resources near you.
USDA ERS
Download chart data in Excel format.. Food insecure—At times during the year, these households were uncertain of having or unable to acquire enough food to meet the needs of all their members because they had insufficient money or other resources for food.Food-insecure households include those with low food security and very low food security. 13.5 percent (18.0 million) of U.S. households ...
Research Themes
How do we work together to build and scale a healthy accessible food system? All people should have the opportunity to consume healthy, affordable, and culturally relevant foods that enable them to thrive. We work to test, disseminate, and scale evidence-based strategies that enable all people to live their healthiest lives with proper nutrition.
Participants Needed for a Time-Restricted Feeding Study
The Department of Food Science and the Center for Human Nutrition are recruiting adults between the ages of 23-65 years to participate in a nutrition study related to time-restricted feeding (eating for eight hours and fasting for 16 hours each day).
HSRC, SACNASP to host a dialogue on Science for Inclusivity, Innovation
Cape Town, Sunday, 4 December 2022 -The Human Sciences Research Council (HSRC) in partnership with the South African Council for Natural Scientific Professions (SACNASP) will host a dialogue titled, Science for Inclusivity, Innovation, Food Security, Nutrition and Social Justice, at the World Science Forum (WSF) on Monday, 5 December 2022 at 9h00. The dialogue which