Session 7B: Tools and methods for solving agriculture, nutrition, and health challenges
byANH Academy
Academy Week Research Conference
| Agriculture, Nutrition, Public Health
Date and Time
From: 28 June 2019, 11:10
To: 28 June 2019, 13:15
BST British Summer Time GMT+1:00
Country: India
Open Full Event


Seven, 10-minute abstract-driven presentations.  

Speakers and Presentations:


  • Chair: Carol Levin, University of Washington
  • Anthony Wenndt, Cornell University/Tata-Cornell Institute
    Developing a participatory action research (PAR) approach for mycotoxin management and food spoilage prevention in rural Uttar Pradesh, India
    Slides/ Recording

  • Tulika Narayan, Abt Associates Inc.
    Is there a continuing role for biofortification to address micronutrient deficiencies? An agriculture-nutrition tool to identify contexts in which biofortification has an important role to play
    Slides/ Recording

  • Ana Laura Deaconu, Transnut WHO
    Agroecology-based alternative food networks may improve Ecuadorian farmers’ diets while promoting food sovereignty and ecological regeneration
    Slides/ Recording

  • Gaianne Bonis-Profumo, Charles Darwin University
    Mixed methods enable a nuanced understanding of the gender pathway from agriculture to nutrition outcomes: A case study in Timor-Leste
    Slides/ Recording

  • Hannah Holt, Royal Veterinary College
    Hazard prioritisation in resource scarce settings, case study of the Punjabi dairy industry in India
    Slides/ Recording

  • Ray-Yu Yang, World Vegetable Center
    Diversity and nutritional values of vegetables and staples in past and present diets in Taiwan
    Slides/ Recording

  • Sudha Nagavarapu, Sangtin
    Contested narratives of dietary transitions in India: Examining the incommensurability of macro and micro datasets
    Slides/ Recording



Developing a participatory action research (PAR) approach for mycotoxin management and food spoilage prevention in rural Uttar Pradesh, India

Anthony Wenndt, Cornell University/Tata-Cornell Institute

Introduction:  Aflatoxin contamination threatens food value chains globally, especially in tropical developing countries. Aflatoxin exposure is implicated in numerous human health deficits. Moreover, the associated economic and productivity losses can have marked food security implications. In northern India, resource-poor communities lack capacity to detect and ameliorate food safety threats that could compromise health and nutrition. Participatory action research (PAR) engages stakeholder communities in delineating research priorities and outcomes, and can bolster awareness and boost resilience to agricultural threats. Here, we report on the utility of PAR to address food safety concerns and promote healthy food systems in villages.

Method:  Since November 2017, we have engaged ~200 households across six farming communities in Unnao District, Uttar Pradesh, India, in a participatory action research (PAR) programme targeting diagnosis, monitoring, and experimental investigation of post-harvest food spoilage. The diagnostic process involved group-based exercises blending Farmer Field School (FFS) and Participatory Rural Appraisal (PRA) methods. We conducted a longitudinal survey monitoring mycotoxin (aflatoxin B1, fumonisin B1, and deoxynivalenol) accumulation in household grain storage systems. Each participating farmer enrolled 1-6 individual grain storage units (bags, bins, etc.), and participated in their surveillance and sampling over the course of storage time. The diagnostic process in the study area prompted investigation into the effectiveness of hermetic grain storage bags for reducing potentially mycotoxigenic food spoilage events. We disseminated two 50-kg hermetic storage systems and related training to each participating household, and collectively monitored uptake and effectiveness of the technology at each site. After one year of project involvement, a follow-up survey was administered to each participant to evaluate motives and involvement outcomes. We are presently evolving the project as a farmer research network (FRN) in these communities, aiming to empower farmers to diagnose and develop solutions to food spoilage concerns.

Findings:  Aflatoxin B1 detection rates (> 1 ppb) were 75%, 72%, 76%, 62%, and 60% in maize, groundnut, pearl millet, paddy (unmilled rice), and milled rice, respectively. Incidences of Fumonisin B1 and deoxynivalenol contamination were rare. Aflatoxin B1 contamination exceeding the Indian regulatory limit (15 ppb) occurred in 51%, 31%, and 26% of maize, groundnut, and paddy samples, respectively. PAR diagnostics indicated that storage, pests, and excessive moisture were the highest problem-solving priorities in the villages. We implemented a participatory trial of hermetic grain storage bags as an accessible, cost-effective solution. The technology prevented insect infestation and grain spoilage in 91% of households after 5-7 months of storage. A majority (90%) of respondents felt “very confident” in their understanding of the technology’s principles. Among respondents, 100% reported that they would like to continue using the technology in future seasons. We are working to bolster the local supply chain and enhance affordability of this technology by working with local shopkeepers. Knowledge gain was reported as a major motive for participation by 83% of respondents. Improved livelihoods (31%) and economic gains (18%) were also common motives. Only 12% of respondents reported the prospect of improved health and nutrition as a major motive.

Conclusions:  A FRN targeting health-threatening mycotoxin accumulation and food spoilage has been established. Participatory surveillance of mycotoxins and spoilage in key commodities suggests that dietary exposure levels are sufficient to warrant health and nutritional concern in the target communities. Hermetic grain storage bags were successfully trialed following diagnoses from participants, and are a viable, effective innovation on the existing sack-based storage system. Follow-up survey results elucidated important motivating factors that can be leveraged in scaling up food safety-promoting activities. Our findings illuminate a scalable model for community engagement that can ameliorate mycotoxin exposure and food spoilage.


Is there a continuing role for biofortification to address micronutrient deficiencies? An agriculture-nutrition tool to identify contexts in which biofortification has an important role to play

Tulika Narayan, Abt Associates Inc

Introduction:  Micronutrient deficiencies continue to afflict 1.5 billion individuals. Low intake and absorption of vitamins and minerals results in these deficiencies with consequent health impacts. There are several strategies to address micronutrient deficiencies, with supplementation as the recommended approach to reach vulnerable populations. Food-based interventions focus on improving the quality and diversity of diets, including biofortification, which is an agriculture-based method that increases the micronutrient density of crops through breeding. Food fortification, on the other hand is the process of adding fortificants to food. Yet, no tool exists to help programs determine the right mix of interventions for addressing micronutrient deficiency.

Methods:  This papers proposes a new tool – a Biofortification Fortification Assessment Coverage Tool (B-FACT) – that simultaneously considers the coverage potential of biofortification and fortification while accounting for consumption of nutrient-rich foods. In doing so it helps identify the most vulnerable sub-populations who are not being reached with nutrient-rich foods or fortification, but could be reached with specific biofortified crops. This tool, for the first time, provides a planning tool for agriculture and nutrition programs to jointly coordinate to determine the most efficient use of resources to reach micronutrient deficient populations. We apply the proposed B-FACT tool to newly available data from Nigeria and India to identify potential for biofortifiable crops. The household surveys were done in 2015 to 2016 in Nigeria and 2016 to 2017 in Uttar Pradesh with detailed information on consumption of nutrient-rich foods, fortification vehicles, biofortifiable crops, items harvested, and consumption of that harvest. Using these data, we identify the potential for biofortification and fortification by estimating the proportion of households that consume or have access to micronutrient-rich foods, fortifiable vehicles, and biofortifiable crops. We supplement this data with qualitative data from field visits to these countries and results from systematic review of literature.

Findings:  The results suggest that gains from scaling up PVA-biofortified crops in contexts with mandatory vitamin A fortification programs are reduced, and more so in contexts where easily accessible vitamin-A rich foods exist. In Nigeria, where PVA-biofortified crops have already been developed and released, there is still a role for PVA-biofortified crops, although the role is reduced given ongoing fortification implying the need for targeting its scale up. Further, the biofortification scale-up costs need to be weighed against the cost of improving implementation of ongoing sugar and oil fortification programs. Given poor coverage of iron fortification, we also found a role for iron-biofortified crops, if they are developed and released in Nigeria. In India, we found a clear role for scaling up zinc-biofortified crops, given very low consumption of zinc-rich foods and that fortification is not efficacious in addressing zinc deficiency. Again, we found a role for iron-biofortified crops, if they are developed and released in Uttar Pradesh.

Conclusions:  These results highlight the importance of a tool that assesses coverage potential of two major micronutrient interventions jointly rather than separately.  Without this tool we found that so far PVA crops have been released in Nigeria when in fact the potential was greater for zinc iron crops given the ongoing Vitamin A fortification programs and the lack of efficacy of zinc fortification itself.


Agroecology-based alternative food networks may improve Ecuadorian farmers’ diets while promoting food sovereignty and ecological regeneration

Ana Laura Deaconu, Transnut WHO

Introduction:  Globally, organizations increasingly advocate for "agroecological" production owing to evidence for its environmental benefits and construction of resilience. Many such initiatives concurrently encourage alternative food networks (AFNs), such as farmers’ markets, to connect farmers and consumers that share an interest for equitable, environmentally-sustainable food systems. In Ecuador, the development community increasingly promotes agroecological AFNs to regenerate ecosystem biodiversity and improve livelihoods among marginalized rural populations, where stunting persists while overweight increases, indicating a double burden of malnutrition. Considering this double burden, we assess how participation in agroecological AFNs affects farmers’ diet quality, emphasizing the role of food acquisition practices.

Methods:  Following participatory consultation with local AFN leadership in Ecuador’s Imbabura province, where the double burden of malnutrition is among the country’s highest, we identified the need to empirically assess nutrition outcomes of agroecological AFNs. We thus applied a mixed-methods approach to complement profound qualitative inquiry with broader quantitative examination. This included immersive ethnography through homestays with four agroecological families, nine key informant interviews, participant observation in AFN spaces, and a cross-sectional comparative survey of 61 agroecological AFN farmers and 30 farming neighbors that do not participate in agroecological AFNs. The survey compared farmers on diet, production, and socioeconomics. We assessed diet quality using a dietary diversity score (DDS) and the NOVA index for the nature and level of food processing, both using quantitative 24-hour dietary recalls. We used the reported source of each food consumed in the recall (conventional market purchase, direct purchase from other farmer, own production, barter) to generate a separate DDS-by-source score and thus examine how food acquisition from distinct sources affects diet quality. Data analysis included bivariate methods as well as linear regression to identify determinants of higher total DDS, with income, production diversity (species richness) and AFN participation status (AFN vs neighbor) as independent variables.

Findings:  AFN farmers credit AFNs for encouraging diverse diets with increased consumption of vegetables and whole grains, and fewer ultra-processed foods. They identify a relationship between the diversity on their farms and on their plates, noting that agroecology has increased their diversity in both spaces. Key informants highlight that AFNs encourage practices aligned with food sovereignty ideals by sourcing food from own production, barter or direct purchase from other farmers. Quantitative results mirror these findings. Despite equivalent socioeconomics, AFN farmers have higher production diversity and perform better on DDS than their neighbors. They consume a greater share of their caloric intake from fresh or minimally processed foods, and less from culinary ingredients (sugar, oil). Moreover, AFN farmers have lower food expenditure, meaning they obtain healthier diets at lower prices. While the association between production diversity and DDS is marginal, AFN participation status is a strong predictor, suggesting that AFNs may impact diet by means beyond production diversity. Further, AFN farmers obtain higher DDS than their neighbors from own production, direct purchase and barter, and lower DDS from conventional markets. This may help explain the dietary differences between AFN farmers and their neighbors, meaning that AFN promotion of food sovereignty may support healthier diets.

Conclusions:  Our results illustrate a unique pathway by which agroecological AFNs appear to increase dietary quality among vulnerable farmers. While we expected this impact to occur via agroecology investments in production diversity, it appears instead that AFN social capital is more important in this context, particularly by encouraging food acquisition practices aligned with food sovereignty ideals. For initiatives promoting agroecological AFNs, this research clarifies the complex pathways by which programming may address the double burden of malnutrition, emphasizing the importance of social capital. More broadly, it highlights how integrated agricultural interventions can simultaneously promote ecological regeneration, food sovereignty and human health.


Mixed methods enable a nuanced understanding of the gender pathway from agriculture to nutrition outcomes: A case study in Timor-Leste

Gianne Bonis-Profumo, Charles Darwin University

Introduction:  In Timor-Leste, the majority of rural populations are semi-subsistence farmers who raise livestock as a livelihood strategy, yet diets consistently lack protein and child malnutrition is high. This PhD study aims to examine gender relations, particularly women’s agency, related to livestock production, sale and consumption among smallholder households in rural Timor-Leste through mixed methods research. The Abbreviated Women’s Empowerment in Agriculture Index (A-WEAI) was complemented with interviews to assess household decision-making concerning livestock production, sale and uses of income; animal source foods (ASF) purchases and their intra-household allocation; and assessing women’s nutrition outcomes and that of her children.

Methods:  This longitudinal mixed-methods study comprises a cohort of 200 mothers and their 6-59 month old children participating in a nutrition-sensitive agricultural programme. The research was conducted from September 2017 to September 2018 in four least developed villages in eastern Timor-Leste. Data presented includes seasonal animal production and selected questions from the A-WEAI, which was contextualised, expanded and administered to mothers and male adults living in the same household (n=282). Semi-structured interviews with mothers, husbands and families (n=30) enabled to further explore gender and social norms around the intra-household distribution of ASF. Participants of the qualitative component were selected on the basis of highest and lowest  child dietary diversity. Seasonal child and maternal ASF intake and dietary diversity quantified their nutrition outcomes. Dietary diversity was estimated through 24-hour recall tools: the Minimum Dietary Diversity for Women of Reproductive Age and the Infant and Young Child Minimum Dietary Diversity. Scores were computed for each indicator, with ten and seven food groups respectively. Surveys were conducted with mothers or the primary caretaker using open recall and list-based food groups to increase accuracy. Protein foods intake was assessed through weekly consumption.

Findings:  Most households owned poultry, used for income and consumption, and pigs, which satisfied cultural requirements and income to a smaller degree. Quantitative results showed that most women and men make decisions on livestock jointly with their respective partner and/or family members. Compared to other productive activities, raising livestock displayed the highest efficacy for women. However, many more men felt they could make all or some choices, demonstrating power differences in decision-making. Women were more autonomous to sell eggs and chickens than pigs. Control over income from livestock sales was shared, with more men often deciding on its use. Despite women frequently reported as the sole deciders for small ASF purchases, qualitative findings suggest that the disparity in control over household resources is greater than what quantitative data indicated. Interviews revealed processes of negotiation with lower agency among women. Many interviewees described eating meat only during ceremonies, from hunting or when animals die. Differences in ASF allocation according to gender were not commonly portrayed. Eggs were often prioritised to children, corroborated by longitudinal dietary data. Mothers and children 6 to 23 months old presented very poor diets with 15% and 24% achieving the minimum dietary diversity respective thresholds.

Conclusions:  The A-WEAI is a valuable yet limited method to assess decision-making differentials between women and men. When this tool was complemented with qualitative methods among farming households in Timor-Leste, nuanced processes of negotiation emerged that the survey tool alone was not able to capture. Mixed methods studies provide more accurate portrays of decision-making in agriculture and the gender pathway from agriculture to nutrition outcomes


Hazard prioritisation in resource scarce settings, case study of the Punjabi dairy industry in India

Hannah Holt, Royal Veterinary College

Introduction:  Foodborne hazards (pathogens, toxins and chemicals) impose a vast global burden on public health. There is little adoption of risk-based food safety approaches in many low- and middle-income countries and few data to inform resource allocation and policy development for food safety. India is the world’s leading milk producer. Within India, Punjab State has the highest per capita production of cattle and buffalo milk of all Indian states. Here the majority of milk flows through informal channels with little regulation. In the absence of testing, raw milk contaminated with zoonotic pathogens or chemical hazards may enter the food chain.

Methods:  This study was a risk ranking exercise to prioritise public health hazards associated with the consumption of cow and buffalo milk and dairy products in Punjab and identify data gaps precluding a formal risk assessment. The risk-ranking framework was based on the principles of the Codex Alimentarius Commission (2015) and contained these steps: hazard identification, exposure assessment and hazard characterisation. Data used to populate the framework were obtained via a structured literature review, consultation of relevant legislation and formal expert elicitation with representatives of the dairy industry and researchers in veterinary public health and dairy science. Data gathered covered three themes: i) description of dairy producers, supply chains and the regulatory framework within which they exist; ii) presence of milk borne hazards in Punjab and factors influencing their presence; and iii) common processing and consumption practices. For each primary step in the dairy supply chain (farm, processor, consumer) each identified pathogen was assigned a qualitative risk score for exposure based on available data. Scores were combined using a pre-defined risk combination matrix. Exposure estimates for biological hazards were combined with a severity index calculated as a function of dose-response and Disability Adjusted Life Years (DALYs) per 1000 cases.

Findings:  Priority chemical hazards identified in both the formal and informal sector were pesticides, aflatoxins, antimicrobials and veterinary drugs (moderate to high exposure). These hazards have been detected above maximum recommended limits in milk in Punjab and are heat resistant, therefore unlikely to be destroyed by pasteurisation. Long-term exposure to pesticides, aflatoxins and certain adulterates may be carcinogenic. Antimicrobial residues in foodstuffs may have a role in the development of antimicrobial resistant infections in humans. Adulteration is extremely common in Punjab either by farmers or milk traders and likelihood of exposure was considered moderate via the informal route. Even though the formal sector routinely tests for adulterates, exposure for this sector was considered very low. The majority of milk or dairy products consumed in Punjab are pasteurised or boiled prior to consumption. However, there are reportedly exceptions and considering the volume of dairy products consumed and opportunities for external contamination, priority biological hazards identified were Brucella abortus, Coxiella burnetti, Cryptosporidium parvum, pathogenic Escherichia coli, Campylobacter spp., Leptospira spp. and Listeria monocytogenes. When combined with consequence score, pathogenic E coli (e.g. VTEC), Campylobacter spp. and L. monocytogenes were ranked highest priority.

Conclusions:  Ensuring the safety of milk and dairy products is essential not only for public health but also to enable producers to access emerging export market opportunities and safeguard the sustainability of the Punjabi dairy industry. There is a need to strengthen food quality and safety assurances in the Punjabi dairy industry. However, the industry is heavily reliant on smallholders and it is estimated that 70 million rural families derive income from milk production. Therefore, any mitigation strategies should ensure smallholders are not excluded from the market. This approach is now being applied to the dairy sector of Andhra Pradesh.


Diversity and nutritional values of vegetables and staples in past and present diets in Taiwan

Ray-Yu Yang, World Vegetable Center

Introduction:  Nature provides diverse plant foods rich in phytonutrients for human consumption and health. Due to its unique geography and environment, Taiwan, an island in sub-tropic Asia, hosts rich plant biodiversity, including plants for food. Presently, the most consumed plant foods in Taiwan are mainly globally-important crops including staples - rice and wheat, and vegetables - cabbages and cucumbers. Many plant foods previously important in traditional diets are neglected. It is possible that the health benefits of plant food consumption may have reduced due to modern diets with fewer species, lower varietal diversity and imbalanced phytonutrient profiles.

Methods:  The study compared the species and nutritional values of staples and vegetables used in the past (before 1950s) and current food systems in Taiwan. Plant foods and their traditional uses in the past were summarized based on the reviews of ethnobotanical studies and the data from the recalls of edible plants and purposes of uses. Plant foods in the current food system were summarized from the national consumption survey in Taiwan (years 2005-2009). Nutrient content data were retrieved from the WorldVeg nutrient database ( and other composition databases. Reported functional properties (anticarcinogenic, antimicrobial, antioxidative, anti-diabetic and anti-inflammatory activities and others) with study methods (test-tube, cell, animal, and human models) were reviewed for the traditional vegetables. Information on folk medicinal uses or herbal remedies were retrieved from the open-access “Database of Common Medicinal Plants in Taiwan”.

Findings:  Around 380 edible plants traditionally used as staples, vegetables, fruits, spices, and others from approximately 800 plant species were reported by 10 selected ethnobotanical studies covering 8 out of 9 major indigenous people groups in Taiwan. A high diversity of primary/staple foods (> 30 species of cereals, grains/legumes, roots, tubers) in the past was recorded, but rice (42%) and wheat (34%) have become the major staple foods over the past 50 years. Traditional staples could provide similar amounts of energy as rice and wheat but with more nutrients. About 150 species were used as vegetables, mainly collected from the wild or fields according to seasons, for home consumption. Only 12-14% of these species overlap with the priority vegetables recorded in Plant Resources of Tropical Africa and Southeast Asia. About 75 traditional vegetables were used as both food and herbal remedies; >120 species were mentioned in one or more studies reporting either one or several functional properties. Anti-oxidant activity was most often mentioned, followed by anti-inflammatory, anti-diabetic, anti-carcinogenic and anti-microbial properties. Compared to the vegetables in present diets, traditional vegetables had higher contents of dry matter and nutrients and lower sugar contents.

Conclusions:  The study compiled a comprehensive list of traditional plant foods used by different Taiwan indigenous people groups in the past based on collective ethnobotanical studies. Over time, a relatively small number of cultivated crop species and varieties have dominated production, market and dietary patterns among Taiwanese. The study lays out the plant foods native to the island and their potential to enrich our current food systems for healthier diets and reclaim part of its cultural heritage.

Contested narratives of dietary transitions in India: Examining the incommensurability of macro and micro datasets

Sudha Nagavarapu, Sangtin

Introduction:  Studies drawing upon national surveys on consumption in India have argued that diets have diversified between 1983 and the present. In contrast, location-specific studies, including our two-year mixed-methods study on diets in western Avadh, Uttar Pradesh, indicate a drop in dietary diversity among specific rural populations over time. In this paper, we examine the differences in how data on diets is obtained and analysed at the macro and micro level, and seek to situate our own study within these contested narratives of dietary transitions in India.

Methods:  We begin by reviewing studies that use data from NSSO (National Sample Survey Organisation) and NNMB (National Nutrition Monitoring Bureau) surveys to draw conclusions about historical diets and dietary shifts in India. We also review location-specific studies that examine diets in certain geographies such as forests and wetlands; or that look at food practices among particular communities, especially related to the use of indigenous and wild foods. Our two year, mixed-methods research has mapped historical diets through 25 focus group discussions (~200 people) and 30 oral history interviews, supplemented with district-level data on agricultural production and historical accounts of agriculture in the Sitapur District Gazetteer. We obtained data on current diets through a four-season diet and consumption survey using 24-hour recall for a representative sample of 100 households in Sitapur district. This is further examined in relation to region-specific NSSO data for central Uttar Pradesh. We contextualise data on diets by mapping the agrarian transition of the region, the selective commodification of foods, and the transformation of agro-commodity chains through interviews with 59 traders, processors, government officials and others in Sitapur. In this manner, we attempt to build a narrative of dietary transition in the region.

Findings:  Studies analysing NSSO data on rural dietary intake from 1983 to the present show a decline in per capita consumption of cereals (especially nutritious millets) and pulses, and a diversification to milk, meat, fruits and vegetables, although the shift is not sufficient to meet nutritional requirements. Also, there is an overall decline in protein and micronutrient intake, and growing anaemia in women. Location-specific studies, instead, document a variety of foods that used to be grown for self-consumption (pulses, millets, oilseeds, spices) and collected by communities in forested areas, near wetlands, and from cultivated fields in the past (leafy greens, fruits, mushrooms, small game, fish, etc.), but which has declined significantly over time due to agricultural intensification and disappearance of the commons. Further, ethnographic studies have documented the declining consumption of milk and milk products among rural families due to their commodification. Our own study finds a similar trend of shrinking dietary diversity with current diets mainly comprising of wheat, rice, potatoes and sugar.

Conclusions:  While large scale surveys in the past may have captured consumption sourced from diversity on the farm, foods gathered from the surrounding common property resources may have been under-reported due to their seasonality and the overwhelming regional and local diversity of such foods. However, there is a need to explore why the data on milk consumption is entirely contradictory across macro and micro studies. By using the learnings from our own study, we seek to examine this incommensurability between macro and micro datasets, and hope to contribute further to the understanding of dietary transitions in India.


Transnut WHO Collaborating Centre in Nutrition Changes and Development at the Université de Montréal
Login or Join ANH Academy to be part of the conversation