Nutrition Research Gaps & Opportunities: Creating a

Research Agenda for Nigerian Academics:

ARN-SUNN Monthly Lecture Series 2

By

Francis Aminu, PhD; FLEAD; FNSN; FIDMSS

Director of Health and Nutrition, Aliko Dangote Foundation, Lagos, Nigeria

Outline

1. Background Information
2. Research Agenda & it’s Importance
3. Nutrition Research Gaps/Needs & Priorities
4. Creating Nutrition Research Agenda
5. Nutrition Research Tools
6. Final thoughts

2
 Key historical events in modern nutrition science

Source: Dariush Mozaffarian et al. BMJ 2018;361:bmj.k2392

 Nutrition Agenda Revisited

• “Nutrition is not simply a science, it is an agenda.”

• Revisiting the science and policy underpinnings of the nutrition agenda
is appropriate for several reasons.

• Enormous progress has been made in the past 100 years in

improving diet and nutritional status. The job is not done.
• Nutrition agenda is more complex than it was 100 years ago.

• Complexity of modern nutrition necessitates using a systems

approach to identifying effective policies and programs.
• There’s a renewed interest in addressing the new nutrition agenda.
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Food system: a complex web of activities…

Source: https://localfood.ces.ncsu.edu/food-system-supply-chain/ 5
Food Systems: Cross-cutting factors and nutrition
outcomes

SOCIOCULTURAL POLICIES &

ENVIRONMENT GOVERNANCE

INFRASTRUCTURES &
MARKETS
HOUSEHOLD
RESOURCES

FINANCING INPUTS &

SERVICES

INFORMATION &
COMMUNICATION

6
Source: Adapted from SPRING. 2015 Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) Project.
Food Systems: a vision for diets that deliver the SDGs

7
Source: FAO. 2017. Food systems conceptual framework. HLPE, High Level Panel of Experts on Food Security and Nutrition
 Why do food systems need to be transformed?

• Urgency of food system transformation is now irrefutable

• Major problems – Climate Change, Conflict, COVID-19, & Cost-of-Living

Crisis

• Before and during COVID-19 pandemic: Situation is fluid and dynamic as food
systems faced enormous challenges.
• Hunger now affecting up to 811 million people as of 2020 (25 million in Nigeria)

• Healthy diets unaffordable for at least 3 billion (178 million (89.1%) in Nigeria).

• Climate change and production with increased concerns related to greenhouse gas
emissions and environmental footprint

• Emergence of new infectious diseases – loss of biodiversity

• 1 in 3 people in the world did not have access to adequate food in 2020 – an
increase of almost 320 million people in just one year.
 What needs to happen to transform our food systems?

1. Integrating humanitarian, development

and peacebuilding policies in conflict-
Country affected areas..
Context
Major drivers of food 2. Scaling up climate resilience across
insecurity & food systems. Transformation
malnutrition: of food
➢ Conflict 3. Strengthening resilience of the most systems for
➢ COVID-19
vulnerable to economic adversity. food security,
➢ Climate variability &
extremes access to
4. Intervening along the food supply
➢ Economic affordable
chains to lower the cost of nutritious
slowdowns & healthy diets,
foods.
downturns and improved
➢ Unaffordability of
5. Tackling poverty and structural
nutrition for all.
healthy diets inequalities, ensuring interventions
➢ Underlying poverty are pro-poor and inclusive.
6. Strengthening food environments and
changing consumer behaviour to
promote dietary patterns with positive
impacts on human health and the
environment.

Source: World Economic Forum (2020). Incentivizing Food Systems Transformation. https://www3.weforum.org/docs/WEF_Incentivizing_Food_Systems_Transformation.pdf
 Unlocking incentives for comprehensive food systems transformation

Key Actors Can support the behaviour shifts of consumers & farmers To achieve food systems
through 4 incentive pathways aspirations

Government Repurposing public Sustainable

investment and
policies pathway
Development
Nutritious
Partners Business model
innovation
pathway
Private Sector

Institutional investment
pathway Inclusive
Research/
Thought
Leaders Consumer behavioural
change pathway Efficient

Civil Society

Source: World Economic Forum (2020). Incentivizing Food Systems Transformation. https://www3.weforum.org/docs/WEF_Incentivizing_Food_Systems_Transformation.pdf
Barriers to incentivize the pathways

Repurposing public Consumer

Business model Institutional
investment and behavioural
innovation pathway investment pathway
policies pathway change pathway
• Siloed decision- • Innovation risk • Risk-return trade- • Deeply rooted
making • Economic returns offs consumer
• Lack of evidence for • Supply chain • Intermediation preferences
underlying challenges • Lack of • Affordability of
interventions • Corporate culture information for food
• Institutional capacity change decision-making
• Transition costs • Enabling
• Stakeholder environment
resistance to change challenges

Source: World Economic Forum (2020). Incentivizing Food Systems Transformation. https://www3.weforum.org/docs/WEF_Incentivizing_Food_Systems_Transformation.pdf

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 Imperatives for Research/ Thought Leaders
Repurposing public
Business model
investment and
innovation pathway
policies pathway
• Develop innovative • Research and create
policy solutions new ideas for business
• Support the analysis of model innovations
interactions and related • Promote and enable
trade-offs, at global and the transfer of
country level knowledge and
evidence-based
solutions supporting the
roll-out of appropriate
incentive mechanisms
Source: World Economic Forum (2020). Incentivizing Food Systems Transformation. https://www3.weforum.org/docs/WEF_Incentivizing_Food_Systems_Transformation.pdf
Institutional
Consumer behavioural
investment
change pathway
pathway
• Promote • Contribute knowledge of
collaboration in powerful and cost-effective
spheres of ways to influence
influence to create consumer behaviour based
investment vehicles on real-world examples
• Research ways to • Build interdisciplinary
create appropriate research and learning
market guidelines coalitions to share best
practice approaches and
lessons learned
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Research Agenda & it’s Importance

• At its basic:
✓ Research agenda = a programme of study

• Beyond that:
✓ Research agenda = a plan and a tool, roadmap, & formal plan of action

• Research agendas are adaptable, and you are likely to modify the contents as their priorities
shift.

• Why do we need a research agenda?

✓ To communicate interests

✓ To help focus

✓ To bridge the gap between academic and policy-oriented activities

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Bridging the gap between academic and policy-oriented activities

Laura Márquez-Ramos (2020) Bridging the gap between academic and policy-oriented activities in higher education institutions. 6th International Conference on Higher Education
Advances (HEAd’20) Universitat Polit`ecnica de Val`encia, Val`encia, 2020. DOI: http://dx.doi.org/10.4995/HEAd20.2020.11168 14
The policy-research-teaching trilemma in higher education institutions

Laura Márquez-Ramos (2020) Bridging the gap between academic and policy-oriented activities in higher education institutions. 6th International Conference on Higher Education
Advances (HEAd’20) Universitat Polit`ecnica de Val`encia, Val`encia, 2020. DOI: http://dx.doi.org/10.4995/HEAd20.2020.11168
15
Research Gaps/Needs & Priorities for Nutrition Science

• 3 topic areas as critical “Focus

Areas” on which to concentrate
future research:

1. Environmental and Societal Trends

Affecting Food and Nutrition
Among Vulnerable Groups

2. Unresolved Issues of Nutrition in

the Lifecycle

3. Delivery of Intervention and

Operational Gaps

The Sackler Institute for Nutrition Science (2013). A Global Research Agenda for Nutrition Science. Outcome of a collaborative process between academic and non-
profit researchers and the World Health Organization. New York, 17 pages. Authors: Mandana Arabi, Andrea Hsieh, and Mireille McLean
16 www.nyas.org/nutritionresearchagenda; www.nutritionresearchagenda.org
Focus Area 1: Environmental and Societal Trends affecting Food
and Nutrition among Vulnerable Groups

1. Modeling an enabling environment for health and nutrition

2. Measuring economic and sustainability trade-offs for nutrition and

health outcomes

3. Describing the interactions between the food system and nutrition

4. Integrating individual- and household-level factors underlying

economic vulnerability and food insecurity

5. Developing nutrition-centered approaches in climate change,

population trends, and environmental sustainability

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Understanding & Modelling the Relationship Between
Factors Outcomes
Food system and • Government policies affecting
nutrition production
• and trade, supply and demands
(content and delivery)
• Agricultural diversity—link with
dietary quality in various
contexts and consensus on
measurement
Individual- and • Dietary guidelines and
household-level factors recommendations and their Policies, guidelines, and
viability and sustainability interventions move these
• Incentives to spend resources to circles closer together or
obtain healthy diet farther apart.

Climate change, • Women’s economic empowerment

population trend (or lack of) How do we measure trade-offs,
• Modeling integrated predictions time-scales, and
and projections on nutritional opportunities?
outcomes
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Focus Area 2: Unresolved Issues of Nutrition in the Lifecycle
• Preconception to Early Childhood (First 1,000 Days And Beyond):
1. Role of nutrition in Developmental Origins of Health and Disease (DOHaD)
2. Characterizing normal growth during early life
3. Characterizing and assessing optimal growth and development during early life
4. Describing and understanding contextual factors
• Moving from Single Nutrients to a Systems Biology Food-based Approach:
5. Creating a food-based systems biology of nutrition and human health in mother and child
6. Describing and understanding contextual factors
• Malnutrition, Infection, Developmental, and Functional Outcomes and their
Interaction with Nutrition Interventions:
7. Relationship between markers of malnutrition (e.g., stunting in children, low height, or BMI in
women) and functional outcomes
8. Knowledge related to describing and understanding contextual factors
• Methodological Complexity of Addressing Systems-based Nutrition
Research:
9. Understanding and driving basic science related to the systems biology approach of nutrition 19
Focus Area 3: Delivery of Intervention and Operational Gaps

1. Knowledge Related to Inputs of Nutrition Intervention

2. Managing the Upstream, Midstream, and Downstream Processes

3. Outcomes in Terms of Service and Product Delivery and Utilization

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CREATING A NUTRITION RESEARCH AGENDA in the
Context of National Nutrition Strategies.

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National Nutrition Strategy

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CREATING A NUTRITION RESEARCH AGENDA in the Context of
Nutrition implementation Framework
PAT H W AY T O I M PA C T

INPUTS P RO CE S S E S O U TC O M E S I M PA C T S
IN PU TS
Domain 1

Intervention design Domains 2, 3 Domains 2, 3 Domain 4 Domain 5 Domain 7

& implementation Upstream Midstream Downstream Midstream
Quality, scale

Domains 5, 6 Coverage/
plans, training Supervision & Frontline equity of service
content, training Management management capacities, delivery, access to Improved
plans capacities, processes work leads products and food nutrition
training behaviors
Local supply
Choice of food/ processes,
Supply chain chain/stock

Adherence
MN interventions, motivations Domain 6
for foods/ issues, local Improved
production/ Production MNS product Utlization/ nutritional
procurement capacities promotion demand of status
services, foods
and products
Contextual factors at national and
Strategies for organizational level affecting
demand implementation and sustainability,
creation, including stakeholders
sensitization, Contextual factors at community and household
advocacy,
levels affecting demand, utilization, adherence and
sustainability
sustainability, including individual capacities of user
communities
Precision Nutrition

Source: https://dpcpsi.nih.gov/sites/default/files/2020NutritionStrategicPlan_508.pdf 24
Ongoing Research Cycle of Nutrition Science

EVALUATE EXPAND
PROCESSES AN D COLLABORATION AN D
OUTCOMES 6 SCALE-UP SUPPORT
Dissemination of results and Policy and strategy development
contribution to the knowledge base and enhanced management
Formative and summative evaluations
5 Revisit and revise evidence
that support adjustments, improvements, 5
and assess public health value Determine emerging gaps

1
IMPLEMENT INTERVENTIONS,
4 IDENTIFY R E S E AR C H
POLICIES, AND GUIDELINES GAPS Development of A
Research Agenda in Nutrition
Stakeholder participation, grounded in
Science, reflecting the current
delivery science evidence
3 2 landscape of nutrition research

DESIGN, FUND, AND

CREATE EVI DENCE - BASED
C O N D U C T R E S E AR C H
INTERVENTIONS,POLICIES,
STUDIES
AND GUIDELINES
Complementary to conventional
Support translation from research
research methodologies, explore
to practice
trans-disciplinary approaches that
are pragmatic, contextual, and
methodologically diverse

4 Bhutta, Z.A., et al., Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? The Lancet, 2013. 382(9890):
p. 452-477.
Tools to Advance Nutrition Research

Nutrition Modelling Consortium: https://www.nyas.org/programs/nutrition-modeling- 26

consortium/#:~:text=What%20is%20Nutrition%20Modeling%3F,available%20policy%20or%20program%20alternatives .
Tools to Advance Nutrition Research

• Omics: e.g. genomics, proteomics and metabolomics

• Bioinformatics:.

• Food and Nutrient Databases:.

• Biomarkers:

• Cost effectiveness analysis:

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Final Thoughts

We must act NOW and AMBITIOUSLY!

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Comments/ Feedback / Contributions / Questions
References
1. Dariush Mozaffarian et al. BMJ 2018;361:bmj.k2392
2. The Sackler Institute for Nutrition Science (2013). A Global Research Agenda for Nutrition Science. Outcome of a collaborative
process between academic and non-profit researchers and the World Health Organization. New York, 17 pages. Authors:
Mandana Arabi, Andrea Hsieh, and Mireille McLean www.nyas.org/nutritionresearchagenda; www.nutritionresearchagenda.org
3. Series on Maternal and Child Nutrition. The Lancet. 2013. Available at: http://www.thelancet.com/series/maternal-and-child-
nutrition
4. Fanzo et al. A research vision for food systems in the 2020s: Defying the status quo. Global Food Security Volume
26, September 2020, 100397 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366074/pdf/main.pdf
5. American Society for Nutrition Excellence in Nutrition Research and Practice www.nutrition.org/researchagenda
6. Busie Maziya-Dixon, et al. Food Systems for Healthier Diets in Nigeria: A Research Agenda Article · May 2021
https://www.researchgate.net/publication/351590489
7. See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/263207241
Strengthening Implementation and Utilization of Nutrition Interventions through Research: A Framework and Research Agenda
8. Nutrition Modelling Consortium: https://www.nyas.org/programs/nutrition-modeling-
consortium/#:~:text=What%20is%20Nutrition%20Modeling%3F,available%20policy%20or%20program%20alternatives
9. https://dpcpsi.nih.gov/sites/default/files/2020NutritionStrategicPlan_508.pdf .
10. Eileen Kennedy, Patrick Webb, Peter Walker, Edward Saltzman, Dan Maxwell, Miriam Nelson, and Sarah Booth (2011). The
evolving food and nutrition agenda: Policy and research priorities for the coming decade. Food and Nutrition Bulletin, vol. 32, no.
1 © 2011, The United Nations University. https://journals.sagepub.com/doi/pdf/10.1177/156482651103200107
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