Hidden Hunger World Review of Nutrition and Dietetics Vol. 115 Series Editor Berthold Koletzko Munich Hidden Hunger Malnutrition and the First 1,000 Days of Life: Causes, Consequences and Solutions Volume Editors Hans K. Biesalski Stuttgart Robert E. Black Baltimore, MD 24 figures, and 25 tables, 2016 Basel · Freiburg · Paris · London · New York · Chennai · New Delhi · Bangkok · Beijing · Shanghai · Tokyo · Kuala Lumpur · Singapore · Sydney Hans K. Biesalski Robert E. Black Institute of Biological Chemistry and Johns Hopkins Bloomberg Nutritional Science School of Public Health University of Hohenheim Baltimore, MD Stuttgart USA Germany Library of Congress Cataloging-in-Publication Data Names: Biesalski, Hans Konrad, editor. | Black, Robert E., editor. Title: Hidden hunger : malnutrition and the first 1,000 days of life : causes, consequences, and solutions / volume editors, Hans K. Biesalski, Robert E. Black. Other titles: Hidden hunger (Biesalski) | World review of nutrition and dietetics ; v. 115. 0084-2230 Description: Basel ; New York : Karger, 2016. | Series: World review of nutrition and dietetics, ISSN 0084-2230 ; vol. 115 | Includes bibliographical references and indexes. Identifiers: LCCN 2016012044| ISBN 9783318056846 (hard cover : alk. paper) | ISBN 9783318056853 (electronic version) Subjects: | MESH: Fetal Nutrition Disorders | Infant Nutrition Disorders | Developed Countries | Developing Countries | Socioeconomic Factors Classification: LCC RJ216 | NLM WQ 211 | DDC 362.1963/9--dc23 LC record available at http://lccn.loc.gov/2016012044 Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents® and Index Medicus. Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. © Copyright 2016 by S. Karger AG, P.O. Box, CH–4009 Basel (Switzerland) www.karger.com Printed in Germany on acid-free and non-aging paper (ISO 9706) by Kraft Druck GmbH, Ettlingen ISSN 0084–2230 eISSN 1662–3975 ISBN 978–3–318–05684–6 e-ISBN 978–3–318–05685–3 Contents VII Preface Biesalski, H.K. (Stuttgart); Black, R.E. (Baltimore, MD) Introduction 1 The 1,000-Day Window and Cognitive Development Biesalski, H.K. (Stuttgart) State of the Art: Malnutrition in High-Income Countries – What Is the Evidence? 16 Hidden and Neglected: Food Poverty in the Global North – The Case of Germany Pfeiffer, S.; Oestreicher, E. (Stuttgart); Ritter, T. (Munich) 24 Critical Dietary Habits in Early Childhood: Principles and Practice Kersting, M. (Dortmund); Alexy, U. (Bonn); Schürmann, S. (Dortmund) 36 Food Price Policies May Improve Diet but Increase Socioeconomic Inequalities in Nutrition Darmon, N. (Marseille); Lacroix, A.; Muller, L.; Ruffieux, B. (Grenoble) 46 Income Inequality and Child Mortality in Wealthy Nations Collison, D. (Dundee) 54 Understanding Food Insecurity in the USA and Canada: Potential Insights for Europe Gundersen, C. (Urbana, IL) Nutrition Transition and Nutritional Deficiencies in Low-Income Countries 61 Determinants of Child Malnutrition and Infant and Young Child Feeding Approaches in Cambodia Reinbott, A.; Jordan, I. (Giessen) 68 Nutrition Transition in Rural Tanzania and Kenya Keding, G. (Giessen/Arusha/Nairobi) 82 The Role of Breastfeeding in the Prevention of Childhood Malnutrition Scherbaum, V. (Suttgart); Srour, M.L. (Vientiane) Consequences of Hidden Hunger 98 A Vitamin on the Mind: New Discoveries on Control of the Brain by Vitamin A Stoney, P.N.; McCaffery, P. (Aberdeen) V 109 Current Information Gaps in Micronutrient Research, Programs and Policy: How Can We Fill Them? Allen, L.H. (Davis, CA) 118 The Importance of Adequate Iodine during Pregnancy and Infancy Zimmermann, M.B. (Zurich) 125 Zinc Deficiency in Childhood and Pregnancy: Evidence for Intervention Effects and Program Responses Lamberti, L.M.; Fischer Walker, C.L.; Black, R.E. (Baltimore, MD) Interventions to Improve Nutrition Security 134 The Second International Conference on Nutrition, as Seen by a Member State Eiden, H.-C.; Welte, S. (Bonn) 142 The Second International Conference on Nutrition: Implications for Hidden Hunger Amoroso, L. (Rome) 153 Genetically Modified Organisms and the Future Global Nutrient Supply: Part of the Solution or a New Problem? Phillips, P.W.B. (Saskatoon, SK) 164 SAFO: A Systematic Partnership to Reduce Vitamin A Deficiency in Tanzania Tewes-Gradl, C. (Cambridge, MA/Berlin); Bluethner, A. (Lampertheim/Mannheim) 175 Genetically Engineered Crops and Certified Organic Agriculture for Improving Nutrition Security in Africa and South Asia Pray, C. (New Brunswick, NJ); Ledermann, S. (Zurich) 184 Behavioral Change Strategies for Improving Complementary Feeding and Breastfeeding Osendarp, S.J.M.; Roche, M.L. (Ottawa, ON) 193 Rights-Based Approaches to Ensure Sustainable Nutrition Security Banerjee, S. (New Delhi) 203 What Political Framework Is Necessary to Reduce Malnutrition? A Civil Society Perspective Walter, B. (Berlin) 211 The Role of Food Fortification in Addressing Iron Deficiency in Infants and Young Children Spieldenner, J. (Lausanne) 224 How to Achieve Transparency in Public-Private Partnerships Engaged in Hunger and Malnutrition Reduction Eggersdorfer, M. (Basel); Bird, J.K. (Delft) 233 Public-Private Partnerships and Undernutrition: Examples and Future Prospects Hoddinott, J. (Ithaca, NY/ Washington, DC); Gillespie, S.; Yosef, S. (Washington, DC) 239 Author Index 240 Subject Index VI Contents Preface Hidden Hunger describes a state of deficiency in humans of essential vitamins and minerals (referred to collectively as micronutrients) that occurs largely without signs and symptoms of micronutrient deficiency diseases. There is a long history of discov- ery of essential vitamins and minerals, and considerable success has been made in the prevention and treatment of related classic deficiency disorders (e.g. rickets, scurvy, and anemia). Only more recently has it been appreciated that an inadequate intake of micronutrients may have health consequences even without overt signs of disease. The 1,000-day window, from conception till the end of the second year of life, is a very critical period for growth and development requiring an adequate supply of micro- nutrients. Hidden hunger during this period is a problem not only in low-income countries but also in middle- and high-income countries. Poverty and poor knowl- edge of the importance of dietary diversity are the basic conditions leading to food insecurity and a poor-quality diet. Hidden hunger during pregnancy results in intra- uterine growth restriction with consequences for the development of the child. Babies who are too small for their gestational age, as well as premature births, are the visible consequences of maternal malnutrition. Growth restriction of several organs may have an impact on the development of diseases in a child’s later life. Poor-quality complementary feeding limited in calories and micronutrients, suboptimal breast- feeding, and an inadequate diet of the preschool child will adversely impact physical and cognitive development with consequences for adult health and productivity. The articles in the book describe the causes and consequences of hidden hunger during the 1,000-day window, as well as possible interventions and program-based respons- es. Knowledge about hidden hunger may help to detect, prevent, and treat these avoid- able conditions and improve the health and prosperity of the next generation. Hans K. Biesalski , Stuttgart Robert E. Black , Baltimore, MD VII We thank the Food Security Center, University Hohenheim, the German Academic Exchange Service (DAAD) and the German Ministry of Cooperation and Development for their generous support for the 2nd International Congress Hidden Hunger. VIII Introduction Biesalski HK, Black RE (eds): Hidden Hunger. Malnutrition and the First 1,000 Days of Life: Causes, Consequences and Solutions. World Rev Nutr Diet. Basel, Karger, 2016, vol 115, pp 1–15 DOI: 10.1159/000442377 The 1,000-Day Window and Cognitive Development Hans Konrad Biesalski Institut für Biologische Chemie und Ernährungswissenschaft, Institut Hohenheim, BIO I, Stuttgart , Germany During the first