Forum global sur la sécurité alimentaire et la nutrition (Forum FSN)

One main issue of Nutrition Decade is to end hunger and all forms of malnutrition, undernutrition and obesity will be mainly considered  due to the fact that micronutrient malnutrition deserves specific actions nor always feasible. Undernutrition and obesity are quite different or even antagonist situations but their origin is the same: inappropriate nutrition which enables us to deal with both in a general and individual preventive frame. In high-income countries (HIC) overweight and obesity are the predominant form, in low-and middle-income countries (LMIC) traditionally undernutrition in all its forms has been the foremost one, but presently this coexists with a steady trend in obesity , ie the ‘double burden’. Because of the long term consequences of malnutrition adequate nutrition should be a target in the first 1000 days of life that could be extended to all children under five.

As said by the FAO Director-General (UN General Assembly, 20th September 2016, New York) the preventive action ‘start at country level’. This is a crucial point and many of the individual four preventive points that should be carried out by the primary health care provider acting directly on malnourished people are hardly impaired without this national support.

There have been significant advances related to malnutrition in the last decades (UN Agencies) as is the pediatric undernutrition recoil (1990 30.2%; 2015 19.3%)  (1), although this not occurring with obesity. It is worth considering that if there are good preventive programs why has obesity been increasing until now and will continue up to 2030 or even 2060 (2): Probably the reasons are: Too many plans/ guidelines not all with the desirable quality and wide covering, the flow from global directions to individual level is slow moving even in HIC with integrative approaches, the difficulty of applying evidence criteria for assessing preventive effectivity. Therefore the continuous evaluation of the applied procedures is far from generalized. Labeling (Flabel in EU), fast food advertising, taxes for sugary drinks, school-lunch programs for malnutrition, epigenome-wide association study (EWAS) and so many others, still have an unknown impact on obesity reduction. In HIC the specific budget for prevention is considerably lower than that of acute care. In LMIC nothing is done apart from punctual and small actions, consequently in a few decades obesity there will be an added problem to the treatment lag of these regions. The country-driven plans are probably the top priority.

1. Unicef, WHO, World Bank Group. Levels and trends in child malnutrition. Key findings of the 2015 edition. Unicef/jmedashboard 2015.
2. Sabin MA, Kao KT, Juonala M, Baur LA, Wake M. Viewpoint article: Childhood Obesity-looking back over 50 years to begin to look forward. Journal of Pediatrics and Child Health S1 (2015) 82-86. Doi: 10.1111/ipc.12819.               

Open discussion on the first draft work programme of the UN Decade:  

Goals such as the ending hunger or malnutrition in all their forms seem to be not really compelling. Also should be different approach between hunger, malnutrition and food security in terms of nutrition and food availability.

Nutrition Decade addresses to important topics but tools for SMART achievements on the engagement and support all thereof are generally. For instance, at paragraphs 17 and 18 is pointed out that an approach will ensure that solutions are equitable and people-centred and in the same time the priorities and specific actions will depend on the interest expressed by potential actors. What happens if stakeholders have not resources or interests to do it?

 

Overall I positive appreciate the areas of the actions, which are comprehensive and succeed many of problems related sustainable food system, health and nutrition, social protection and education to be carried out for changing/improving food consumption models.

Regards,

Alexandrina Sirbu

Professor, PhD -

"Constantin Brancoveanu" University

FMMAE Ramnicu Valcea

39 Nicolae Balcescu Bld.

240210 Ramnicu Valcea, Valcea County - Romania

Dear FSN Forum,

Below are my comments on the workplan, together with tracking comments on the text itself (which are much the same).

Best regards,

Jane Sherman

___

Most of the following comments fall under Question 2 of the suggested areas for comment: What are your general comments to help strengthen the presented elements of the first draft work programme of the UN Decade of Action on Nutrition?

General points

• In several action areas (e.g. paras 22, 23, 30) the problems are laid out but no program of action is indicated.
• Throughout, the document should emphasize the critical importance of M&E in guiding the choice of interventions and ensuring their success, and the essential criteria of (a) cost-effectiveness, and (b)  sustainability of impact, especially in interventions which depend on establishing practices and attitudes.
• In this light, a really useful document would be a guide for governments, NGOs and aid organizations on how to choose between, or mix, interventions to get the best long-term results at the lowest cost. It could link to an accumulating database of
  • models of working interventions (preferably institutionalized),
  • tools and instruments, policy outlines, regulatory measures, etc.,
  • evidence for effectiveness and cost-effectiveness
  • protocols for program design
  • existing training materials

Points on specific paragraphs

Para 13.  Full support for inclusiveness and for making use of existing skills and expertise in the population, but can we also ask that nutrition education pay due attention to

• people’s/consumers’ existing understanding, practices, attitudes and motivations, resources, capacities and influences
• building consumer capacity, maintenance and resilience with regard to diet and food practices and the professional capacity to promote them
• the choice, mix and balance of strategies adopted, on the criteria of cost, durability/long-term impact, evidence of success, context, history and country capacity

Para 16.2    Does “essential nutrition actions” refer to the ENAs (i.e. for infant and young child feeding), or does it mean essential nutrition actions in general, for all the population?

Paras 16 and 28.  In line with the framework of action developed by ICN2, nutrition education cannot be simply included with social protection in point 3.  Nutrition education (which includes behavior change interventions)  is integrated across the sectors in nutrition-sensitive interventions, and has shown impact at scale in several of them, in particular in home gardening and maternal and infant feeding as well as social protection.  It has also shown impact in income generation schemes and is recommended at all levels of school education by the ICN2.  It should therefore be seen as an intervention cutting across all sectors. There is also a great need for capacity in the field of nutrition education (quite distinct from expertise in nutrition), for understanding at all social and political levels, and for expression in national policy and programming.   It is suggested therefore that nutrition education should stand a 7th action area headed “Food and nutrition education and professional training at all levels and in all sectors”.

Para 18.  Add “including civil society organizations and consumer movements” after “other potential actors”, to balance the top-down emphasis. 

Para 19.   “A food system approach – from production to processing, storage, transportation, marketing, retailing and consumption – is thus important to promote healthy, sustainable diets and improve nutrition as isolated interventions have a limited impact.”  If “consumption” includes “acquisition”, well and good.  If not, “acquisition” needs to appear, otherwise the consumer has no role except to eat and the food system is presented as entirely supply-side.

Paras 20 and 21  need more attention to consumer demand:  there are suggested tracking changes in the text.  The paragraphs should also insist on the importance of implementing food-based dietary guidelines and evaluating impact as well as developing them.

Para 22.  The description of food safety problems should be extended with suggestions on what to do about them, especially in the light of the high cost of refrigeration/regulation/inspection in low-income countries.

Paras 24-16 on health services.  The emphasis here is mainly technical.  The strength of  health systems is not only determined by what they treat, or the evidence base for the treatments, but by the quality of the service in terms of (e.g.) training, numbers, presence, accessibility (is this the same as access?), consumer service (including respectful handling, follow-up and education) and accountability  to communities.  There is a body of action  and expertise in these areas, and also on low-cost strategies for improving health services, which could be acknowledged here.

Para 27  Suggest expanding the role of the health services in nutrition education with a new para,  e.g. “Health ministries are usually responsible for national campaigns to promote better nutrition and food practices, for advising the education and food security sectors on food and nutrition.  They therefore need expertise in direct nutrition education, in training frontline workers in nutrition education, and in integrating nutrition and nutrition education into interventions in other sectors.

Paras 30 and 32   “Knowledge” and “education” appear to be treated as distinct.  Does education not include knowledge?  If “education” here does not mean “learning” by whatever means, perhaps its meaning can be defined.  Alternatively, in some cases “education and knowledge” could be replaced by e.g. ““learning about food and  how to improve diet”.

Para 30.  The program for nutrition education, again in line with the recommendations of ICN2, needs to be expanded, for example by adding the following words:

“It (NE) also maximizes the impact of nutrition-sensitive interventions in food security, health, social protection, which may all need some element of FNE/SBC.  Achieving such results requires specialist capacities in the relevant services, beyond technical knowledge of nutrition, health or agriculture, which should be recognized in training curricula for educators, agriculture and health professionals.  FNE/SBC requires an enabling physical and institutional environments, and hence calls for action at several levels of society, including policy and programming.  It is also enabled by a supportive social environment and a general climate of interest in food and health, hence the importance of an extensive action-oriented school curriculum, well-publicised government actions (e.g. labeling, subsidies, taxes), and ongoing media attention.   In all cases where FNE/SBC is an important arm of a program, allowance should be made for some form of impact evaluation.” 

Para 37 should be followed with some recommendations on (a) the information and communication environment, e.g.  the control of deceptive information/advertising, food advertising to children,  free access to information on good diet and the role of the media and (b) the food environment – guidance for institutions, workplaces etc on how to create nutrition-friendly environments

38.  Is a multi-sectoral umbrella committee essential?  Have we any evidence of success with such committees or of the demands they pose (e.g. costs, time, transport),  the necessary level and quality of communications, and the time-span (e.g. for collaborative training, curriculum change)?  Outside projects can do this, but in the end the praxis has to be institutionalized . The answer would seem to be to do things bit by bit, but I have not seen this recommended anywhere.  When giving counsel of perfection, there should be some attention to the challenges.

Jane Sherman 11.02.17

Dear FSN Moderator

Thank you for the opportunity to comment on on the first draft work programme of the UN Decade of Action on Nutrition. I write to comment specifically on the second posed question, ‘What are your general comments to help strengthen the presented elements of the first draft work programme of the UN Decade of Action on Nutrition?’

I fully endorse the programme’s Action area 1: Sustainable, resilient food systems for healthy diets and its recognition in points #19 and #20 of the need for sustainable food systems that promote healthy and safe diets. However, it is a concern that the programme also includes in certain places a focus on a reductionist approach to nutrition science, i.e. a focus on nutrient-based interventions, in potential conflict with the systems and dietary patterns approach emphasised in Action area 1. For example, Table 1: Potential topics for the development of commitments and the establishment of action networks, lists ‘Food reformulation’ as one of its first mentioned topics.  In this context, food reformulation, an intervention in which the nutrient profile of food products is manipulated, is being proposed as a solution to nutrition problems that are predominantly a consequence of dietary excesses and imbalances and which in turn are predominantly determined by social and ecological circumstances. Such an intervention is a simplistic response to complex food and nutrition problems.

Also, food reformulation has risks because it has the potential to undermine the promotion of food systems and food-based dietary guidelines. Not only does it risk diverting attention away from dietary pattern, and food systems approaches, but also it risks framing potential solutions to the benefit of ultraprocessed (junk) foods and to the detriment of nutritious whole foods. For instance, in Australia we have a flawed front-of-pack labelling system (the ‘Health Star Rating’ system) that inappropriately rewards the reformulation of ultra-processed foods with so-called health stars. Here the problem is that the manufacturers of ultraprocessed foods such as high-sugar snack foods can reformulate their products by moderately reducing the product’s sugar content to attract a relatively high star rating despite the product remaining an ultraprocessed food.

Perversely, whole foods such as fresh fruits and vegetables which the Programme highlights as core components of a healthy diet, are less able to be reformulated and as a consequence, less able to compete against ultraprocessed foods in the implementation of many food reformulation interventions. In certain circumstances food reformulation may have a limited role, e.g. supporting the reduction on the salt content of bread, but it is a relatively low priority intervention and requires careful management to avoid being exploited for non-nutrition agendas.

Professor Mark Lawrence

Deakin University

Australia

Thank you to everyone who has contributed so far. This is a great start to the discussion.

There was overwhelming support for the opportunity provided by the UN Decade of Action on Nutrition to enhance coordination and cooperation amongst all actors, and drive integrated action across multiple sectors. With this, however, several asked for the lines of responsibility to be better defined, and for more explicit information about who is expected to do what. 

Some contributors suggested structural changes to make the work programme more coherent and efficient, including the need to better distinguish between aspirations and concrete goals (i.e. “our ends and means”) to avoid confusion. This dynamic was also challenged with questions about what is achievable, such as our ability to end hunger and all forms of malnutrition. Others pointed to essential sectors that are missing, such as water, hygiene and sanitation, the nexus between humanitarian and development, and the challenges posed by climate change on food variability and nutrition security. 

A strong case was made for a transparent, inclusive, open-ended participatory processes throughout the Decade to ensure that all actors feel a sense of ownership, togetherness and to ensure that the voices and commitments of all actors are heard. Online consultations were given as an example, as was a publically accessible repository of commitments to strengthen accountability. An online dashboard would allow for targets and performance to be tracked. It would also help to ensure that double counting of nutrition sensitive actions are avoided. 

Today in Rome, the Committee on World Food Security’s Open Ended Working Group on Nutrition is meeting at FAO HQ to discuss its contribution to the Decade. We welcome you to consider an answer to that in the contributions to follow, and on broader observations on the Decade. 

Thank you again for the thoughtful input and the commitments made to the Decade through this forum. 

I look forward to continuing the conversation. 

Christine 

Dear Sir,

I would like to add that serious, high and deep focus for all international institutions & food/nutrition related think-tanks, in the matter needs to be a comparison between the amount of total global food production as compared to requirements of total global population (mouths to eat). To me there  is more than sufficient food available (but not reachable) for each mouth in the world. This fact is not entering the minds of most of the people in the world.

Keeping this point in view at all levels, all stages, in all strategies, in all plans, so much so in every way of thought process would be very helpful. Rather a slogan should be effectively and promptly be promoted & propagated internationally saying that,

“ It is not global food production rather food deliverance to every human on earth is the cause of hunger, malnutrition, all other food/nutrition related problems of the world.”

I sincerely believe that it will payback / add heavily & effectively toward any / all efforts made for better food / nutrition in the world.

Yours Sincerely,

Hamid Ahmad

Ex-Chairman,

Pakistan Society of Food Scientists & Technologists (PSFST),

Lahore Chapter,

Islamabad, Pakistan.

International Livestock Research Institute Response

Does the work programme present a compelling vision for enabling strategic interaction and mutual support across existing initiatives, platforms, forums and programmes, given the stipulation of Res 70/259 that the Decade should be organized with existing institutions and available resources?

The proposed Work programme fulfills well the onerous task of putting together most relevant issues to nutrition for the next 10 years. Given the need to work with existing institutions and available resources the most challenging task would seem the coordination; this is briefly mentioned but might require more specific thought/content. Similar for the leadership needed to make it happen.

Research needs to have an important role here, all the more important because much nutrition research has over-relied on cross-sectional or cohort data which has proven misleading in the past. Evidence is presented as an appreciated input for practice and advocacy but not so much emphasis is given to the reverse i.e how practice/policy can contribute to build the body of evidence. Only for NCD, ‘targeted programme and policy evaluations are encouraged’; however the need for robust monitoring and evaluation should be promoted in a widespread manner, given the important evidence gaps existing at present.

What are your general comments to help strengthen the presented elements of the first draft work programme of the UN Decade of Action on Nutrition?

How could this draft work programme be improved to promote collective action to achieve the transformational change called for by the 2030 Agenda for Sustainable Development and the ICN2 outcomes? What is missing?

The document focuses in ‘all countries’ and ‘all people’, and maybe does not spell out enough the challenges of the contradictory needs and contexts. Given the urge for sustainable diets and the environmental footprint of crop and livestock production, a delicate balance is needed between eating too much and too little, particularly when it comes to animal-source foods (ASFs), for which there are populations (namely poor women and children with diets little diverse) who would benefit substantially from extra ASFs, while more high-income populations should reduce its consumption. Similarly, special attention needs to be given to food losses and wastage, not only at consumer level, as included in the document under a point on education, but also throughtout the food systems. Fixing inefficiencies alont the value chains to reduce wastage is an essential part. Then, the importance of food environments, which provide too much access to unhealthy foods (not only to children, but to all age groups), and unhealthy lifestyles has not been considered in the document, despite the key role in nutrition.

The trade-offs of formal and informal food systems also need careful consideration, particularly as informal (wet) markets supply most of poor households purchased food. This links with urbanisation, which will be a major challenge in developing countries to adequate food supply, due to the pressure for rapid growth of value chains. We welcome the inclusion of food safety as a specific point, given the existing gaps in knowledge and the emerging evidence on the very high burden of food borne disease (FBD) and its major impacts on human health, nutrition, market access, and livelihoods. In 2015, the first global assessment of the burden of FBD was published by the World Health Organisation. The method used was very conservative. Still, the burden was similar to that caused by malaria, HIV/AIDs or tuberculosis, making FBD a major public health issue. Developing countries bear most of the burden of FBD, but these are often poorly measured, and therefore their impact underestimated. Effort is needed to improve FBD surveillance and reporting, starting with risk-targeting the most high risk products (ASF and fresh produce). Water and sanitation are touched upon in the document but not profusely covered; in particular, the role of environmental contamination from animals in rural areas needs attention.

It is also worth noting that food systems are not only a source of nutrients for consumers, but also form the livelihood of some of the most vulnerable households, who are agents in the food systems. For these households, the food systems may represent a pathway out of poverty and ultimately to improved nutrition. Value chain analysis can be useful to identify opportunites and barriers to act upon and build fairer food systems.

The current proposal is maybe weak in highlighting the mainstreaming role of women in improving nutrition. Women are not only a key nutritionally vulnerable group, but they also are a driver of change in the communities through empowerment and decision-making, that directly impact on nutrition and food saftey.

Do you feel you can contribute to the success of the Nutrition Decade or align yourself with the proposed range of action areas?

Yes, this aligns with ILRI’s areas of work, particularly the area of sustainable, resilient food systems for healthy diets, and we would be in a position to support action networks and contribute to building new evidence on nutrition-sensitive agricultural interventions, particularly in the area of livestock value chains and ASFs.

Do you have specific comments on the section on accountability and shared learning?

No

The online public consultation on the UN Decade of Action on Nutrition’s Work Programme

Thank you very much for the opportunity given to me. It is pleased to understand about the efforts taken by the world community to eradicate the malnutrition and hunger. It is also known that the FAO had accepted the fact of having enough food for all in the International Conference on Nutrition held in 1992.

The world community is already having nine priority themes in the Plan of Action for Nutrition announced in the International Conference on Nutrition, held in 1992.

I submit below my poor contribution in this online consultation by considering the following 5 questions:

Q1. Does the work programme present a compelling vision for enabling strategic interaction and mutual support across existing initiatives, platforms, forums and programmes, given the stipulation of Res 70/259 that the Decade should be organized with existing institutions and available resources?

The work programme can be executed to achieve the aim of the world community even before the stipulated time, if our steps are measured intact.

Q2. What are your general comments to help strengthen the presented elements of the first draft work programme of the UN Decade of Action on Nutrition?

The world community has to expect the real health of mankind, not mere through good foods, by simply ignoring good deeds. Both the good foods and the good deeds are playing a vital role with the human health.

Everyone is having two themes:

1.       Human body 

2.       Soul. 

The Creator created man [Adam] from sounding clay like clay of pottery. The soul [the Spirit] is one of the things, the knowledge of which is only with The Creator. Even after the great research no one can specifically find out about the soul that of what it is! Still the mankind is able only to realize the soul; like air and electricity.

How to promote the human body:

 The human body is hardware. The body is used to grow with the help of the natural foods from the earth. If our foods are adulterated with synthetic chemicals & synthetic enzymes knowingly or unknowingly, the routine function of our valuable body will get interrupted. 

Then our body will used to give some signal as warning to the owner of the body to stop the consumptions of such synthetic chemicals & synthetic enzymes. If we stopped forthwith, our body will restore itself, achieving and, wherever necessary, reestablishing the natural equilibrium of bodily processes, a state referred to as homeostasis. 

It is these inborn mechanisms which usually cure us while we are ill, not physicians, nor even prescription medication. Everyone should know that the body of every mankind is the best doctor.  Whereas we are not minding the signal of our body and keep on in taking such synthetic chemicals & synthetic enzymes, our health will change from “ease state” to “disease state”. If we continue the same habit, the health of the body will become worse. 

So, everyone can justify that more or less 7500 millions best doctors are living in this world at present.

Everyone should try to consume proper and timely food:

1.       First food early in the morning: little solid food with water which is beneficial than 1000 medicines. 

2.       Breakfast in between 7 am & 9 am. In full as the fuel for vehicle.

3.       Natural de-worming twice in a month. 

Eat 2 ripe bananas an hour before lunch on empty stomach which is the special food to the worms. At that time, worms residing in the stomach will be expecting their normal food we used to intake regularly. Immediately the worms will intake that special food in full and get a kick. Then we should intake our lunch at the scheduled time.

After our lunch the digestive organs will work.

The worms will not be able to intake that food, because they already consumed the special food in full and got kick. So, while the digesting process they will not be able to take effort to survive to remain in the stomach itself.

 They will be eliminated along with the process through small intestine, large intestine and rectum. While the evacuation of stool, the worms will also be eliminated naturally. We can take this natural treatment 2 or 3 continuous days in a month. This is an ancient and natural system of medicine.

4.       Lunch –moderate both for tongue and stomach. 

5.       Refreshment- in a saucer, either natural food or cooked food.

6.       Supper- It will be super, if it is a measure to compensate the lunch. 7. Always eat one type of food, either cooked food or nature food such as fruits and raw vegetables to avoid fermentation.   

7.       Don’t eat too hot and too cold.

8.       Eat to live & don’t live to eat.

9.       Shouldn’t eat unclean & harmful foods.

10.   Eat good nutritious & healthy foods.

11.   Eat only when real hungry.

12.   When eat do not over eat, but stop eat before hunger is fully satisfied.

How to promote the human soul:

The human soul is software. The soul is used to grow only with the help of good deeds. 

"The reward of deeds depends upon the intentions”. As all the men are the children of only one father Adam [AS], all are equal. Everyone is second to none. No one is entitled to prefer over other, by claiming colour, country, continent, language and region, but based on the deeds one does. Everyone must try to listen and understand the universal reality. Everyone must try to depend on the reality to construct brotherhood among the nation and away from the materiality to avoid enmity among the nation. Though the human body will be destroyed one day or other, the human soul will never be destroyed. 

Even the minutest good deed with good intention becomes the greatest act due to its dedication and even the biggest good act can become worse due to bad intention. All men should be united and integrated with love, affection and broad mindedness to spread the humanitarian equality among the world community.

Everyone must wish for the welfare of the Ruler because of whom the development of citizen and its survival is possible. It is always good for entire mankind as well as our self and our family welfare.

If the world community will try to consider both the human body and human soul as the two wings of the bird, the entire world can fly joyfully for ever till the day of resurrection.

The life project of the Creator is:

“We have certainly created man in the best stature:

And made the sleep [a means for] rest: And made the night as clothing:

And made the day for livelihood”

So, everyone should have adequate sleep in every night. Lesser than required sleep will lead the man to get confusion in day today duties.  Similarly everyone should utilise the day time for livelihood.

A challenge to entire world: If the above life project is followed properly the necessity of the medical treatment will definitely reduce considerably with no doubt.

Q3. Do you feel you can contribute to the success of the Nutrition Decade or align yourself with the proposed range of action areas?

Though hunger and malnutrition are inevitable in the world normally, the world community is capable to overcome them by taking three types if efforts;

1. Appropriate efforts

2. Required efforts, 

3. Possible efforts.

The Creator creates 18000 varieties of creations in this vast universe.12000 varieties are living in water portion & 6000 varieties are living in earth portion. The Creator selects the mankind as the best among those creations & declares the mankind as His representatives, because of our sixth sense which is not non-sense.

The animals without sixth sense such as goat, sheep, cow, rabbit, deer & horse etc., are used to consume green grass, vegetables, fruits and leaves. They are not facing the problems such as malnutrition etc., why? They are able to choose their correct food. They have no facilities to cook their food by adding salt, spices and oils. They are capable to live healthy manner by consuming only natural food.

Malnutrition can often be very difficult to recognise, particularly in patients who are overweight or obese to start with. Malnutrition can happen very gradually, which can make it very difficult to spot in the early stages. Some of the symptoms and signs to watch out for include:

•      Loss of appetite

•      Weight loss – clothes, rings, jewels, dentures may become loose

•      Tiredness, loss of energy

•      Reduced ability to perform normal tasks

•      Reduced physical performance – for example, not being able to walk as far or as fast as usual

•      Altered mood – malnutrition can be associated with lethargy and depression

•      Poor concentration

•      Poor growth in children

Whenever a patient find one or more than one symptoms and signs, he/she may practice the following food schedule: 

1.       Initially he/she should drink 300/400 ml. of normal water early in the morning on empty stomach daily.

2.       After 30 minutes he/she should eat by chewing 200 grams of tender carrot/ ripe carrot and few soaked almond seeds.

3.       After an hour he/she should drink 300/400 ml. of green vegetable juice mixed with 10/15 ml. of bee honey on empty stomach continuously till get cured as breakfast. Use available green juicy vegetables and juicy green leaves such curry leaves, coriander leaves, mint leaves and few greens.

4.       In between breakfast and lunch eat 100/150 grams of sprouted seeds such as Green gram seeds, Bengal gram seeds, soya bean seeds, sesame seeds and whole wheat grains.

5.       Then have the regular lunch with cooked rice, whole wheat chapatti/ roti , cooked vegetables, semi cooked vegetables, white meat & red meat etc., [no uncooked raw vegetables & fruits]

6.       In between lunch and supper eat 100/150 grams of cooked pulses seeds such as Green gram seeds, Bengal gram seeds, soya bean seeds

7.       Then have the regular supper.

8.       Add available fruits & dry fruits as salad separately not with cooked food.

9.       Always avoid ice water, ice cream, tinned foods, biscuits, bakery products, white sugar, fine white flour, fried junk foods.

10.   Reduce oils, salt and spices as much as possible.

Q4. How could this draft work programme be improved to promote collective action to achieve the transformational change called for by the 2030 Agenda for Sustainable Development and the ICN2 outcomes? What is missing?

I humbly submit my few suggestions in my draft “the online public consultation on the UN Decade of Action Nutrition’s Work Programme” about the both cultivations;

1. To cultivate the intention to enable the people to have proper food &

2. To generate the awareness to enable the people to cultivate the possible food crops and medicinal plants with available source.

The constitution of mankind is made up of seven constituents:

1.Elements, 2.Temperaments, 3.Humours, 4.Fundamental organs, 5.Spirits, 6.Faculties & 7.Functions.

There are three states of the body that are possible:

 1. Health, 

2. Disease & 

3. A condition, which is neither health nor disease, that is, convalescence and old age.

Everyone must learn & have hygiene. What is meant by hygiene? Hygiene is the art of self healing, or health maintenance and disease prevention. The art of hygiene is solely affordable, if it is cultivated. Proper hygiene practices build good health; faulty or improper hygiene breeds suffering and disease.

The art of hygiene has two sides.

 First, you have to give your body all the good, wholesome things it needs: a healthy, nutritious food, adequate exercise and activity, sufficient regenerative sleep and rest, and a healthy constructive lifestyle. 

The other side involves eliminating all the undesirable impurities, residues and superfluities from the body by cleansing to keep the body clean, both inwardly and outwardly. 

Disease flourishes where filth and impurities accumulate. Most traditional healing systems are built upon the art of proper hygiene. At its core, the traditional systems of medicine are essentially a very elaborate and sophisticated system of hygiene.

Sometimes it's more important to know that," what kind of person has a disease than what kind of disease a person has." 

 Q5. Do you have specific comments on the section on accountability and shared learning?

A. To cultivate the intention to enable the people to have proper food:

Health education through primary school , secondary school and college in creating real awareness among the people & pupil to have access to nutritionally adequate and safe foods besides adequate rest since childhood to enable the pupil to maintain adequate health.

How to cultivate intention:

Normally the energy in our body is used to exhausts while every movement such as working, playing, walking, running, seeing, singing, standing, talking etc., Even without movement such as in mere sitting without doing any kind of work and sleeping the energy in our body is also used to exhausts because of our blood circulatory system, respiratory system, digestive system and excretory system. 

But our body is getting energy only through the in taking of food. To compromise and compensate everyone must in take adequate food. Through the pre-school and the primary school, the teachers must teach about the importance of in taking of proper food to everyone.

The school authorities should take care about the teaching process.

The government authorities should take proper efforts to reach the same knowledge to one all including parents, through amicable ways.

Hospital authorities may also take care of all the patients while sick. Then after recovery, they should take much care in creating real awareness among the patients to have access to nutritionally adequate and safe foods besides adequate rest.

World Health Organization says:

4 things cause the well being > Physical state, Financial state, Mental state & Spiritual state:

4 things cause the ill being > Biological state, Environmental state, Chemical state [handling & in taking] & Psychological state.

What is disease?

ORDER x DISORDER

COMFORT x UNCOMFORT

BALANCE x IMBALANCE

NORMAL x ABNORMAL/ SUBNORMAL

EASE x DISEASE

The Creator certainly created the mankind in the best stature. The body of every mankind is the best doctor. The adequate rest is the best medicine. Our body is an amazing creation. It provides us with all the components it needs not just to maintain itself, but additionally to give rise to new life.

Each and every normal and balanced body possess an innate capability to control and restore itself, achieving and, wherever necessary, reestablishing the natural equilibrium of bodily processes, a state referred to as homeostasis. It is these inborn mechanisms which usually cure us while we are ill, not physicians, nor even prescription medication.

Our bodies are entirely able to regenerating themselves therefore we should be ultra cautious whenever using terms like “incurable”. Physicians who identify an illness as incurable are actually proclaiming that they have reached the limit of their experience and knowledge as medical experts.

If anything happens in the human body, that is a turn to the abnormal or to the subnormal state, three types of people [1.himself /she, 2.well wishers 3.physicians] should take efforts to set it to right, that is return again to normal state.

Generally a wrong concept is prevailing among the nation: “Medication alone will do the purpose”. Never! Three things are compulsorily required to get “ease state” from the “disease state”:

I.        Adequate rest to the affected organs.

II.     Required consumption of easily digestible nutrient food.

III.   Acceptable and affordable medication.

Nowadays, in the noble medical field, we can hear the word “Terminal” often, which is a term that simply spreads fear. It suppresses and lessens our body’s innate defense mechanism and also proves the ungratefulness of the grateful mankind. The mankind is absolutely capable to terminate the terminology such as “Terminal” which simply spreads unwanted fear among the nation.

Excess nutrition is required while exhaust energy:

The government, especially the medical authorities should take much care in creating real awareness among the people to have access to nutritionally adequate and safe foods besides adequate rest in the following states;

 a.       Recovery after sick.

 b.       In accidents.

 c.       During the periodical menses & in irregularities of every female.

 d.       During the conceived period of every female

 e.       During child birth of every female.

 f.        During the tenure of breast-feeding.

 g.       During the adolescent of everyone -person between   childhood and manhood [14 to 25 in the case of a male            and  12 to 21 in the case of a female].

h.       During the geriatric period of every male & female.

Note:

These will be very easy to adopt whenever required, if the real awareness was created among the people [pupil] in the school period itself.

B. To generate the awareness to enable the people to cultivate the possible food crops and medicinal plants with available source.

Types of cultivation:

1.      Pot cultivation:

2.      Tub cultivation:

3.      Hanging cultivation:

4.      Housing garden- cultivati:

5.      Concrete cultivation:

6.      Waste land cultivation:

7.      Uncultivable land cultivation:

8.      Agro forestry:

9.      Compost pit on backyard to supply organic manure to the house hold crops:

10.  Ground cultivation of fodder crops in a village as cattle feed as common field to have food to the cattle in homes:

11.  Border trees as a fencing for every small field to get natural green manure:

12.  Provide adequate land for gardening in every school to teach about the cultivation of possible vegetables, greens and medicinal plants to the students.

To promote the utilization of land:

1.       Land allocation to be made by the government to their citizen on free of cost with bindings;

2.       Land allocation to be made by the government to their citizen on nominal cost with bindings;

3.       Land allocation to be made by the government to their citizen on lease basis to cultivate and to pay a share in benefit to the government;

4.       Land allocation to be made by the government to their citizen on cost according to the market value, by facilitating to enable them to pay in easy installments to cultivate by their own.

5.       Unutilized land from the land lords may be purchased by the government. Then the same may be allocated to their citizen on cost according to the market value, by facilitating to enable them to pay in easy installments to cultivate by their own

Every government should concentrate on the cultivation of irrigated crops and rain fed crops. On poor water source area, the government may promote the cultivation by implementing the drip irrigation system and the sprinkler irrigation system.

Moreover, every government should concentrate on the farming’s such as fish farming, poultry farming, cattle farming, buffalo farming, goat farming, camel farming and sheep farming to enable the people to have access to nutritionally adequate and safe foods.

WATER SOURCES

1.      Rain water savings:

Government should arrange to collect the rain water from everywhere and infuse into the earth without any wastage. Collect the rain water through small canals and store into small pools wherever and whenever possible.

2.      Percolation tanks

Government should construct small and large percolation tanks by collecting the waste water wherever and whenever possible.

3.      Wells and bore wells

Every home should have a small or large well depends upon the potentiality of water wealth.

4.      Ponds and lakes

Government should arrange to collect the rain water from everywhere from heavy water flow area while raining and collect into the ponds and lakes without any wastage.

5.      Rivers and Dams

Government should construct small and large dams across the rivers wherever possible to have enough water.

Priceless suggestion:

Everyone can see variation in all..,such as, in nationality, in age, in educational qualification, in wealth status, in health status, in mother tongue, in profession, in colour, in personality and so on.

But no variation in what? If we spent few seconds, we can realize the valuable fact! Only in time! 24 hours in every day to everybody! Everyone can able to buy several clocks! But no one can able to buy even a single second!

Don’t waste the time! No need to spend the time!! Please try to utilize & encash the time!!!

If anything lost from us, there are many possibilities to collect back them with required efforts. But, if the time, even a single moment is lost … how can? who can? when can? where can?

I hope that these efforts will be useful to the entire mankind!

Thank you very much.

With respectful regards

DR.I.ABDUL RAHIM