Global Forum on Food Security and Nutrition (FSN Forum)

This member contributed to:

    • 20th June 2023

      Call for inputs on the realization of the Human Right to Adequate Food.

      Response of the European Specialist Dietetic Network (ESDN) for Public Health of the European Federation of the Associations of Dietitians (EFAD). 

      EFAD represents 35000 dietitians and 9000 students in 28 European Countries since 1978. Today, we celebrate the landmark of the 20th anniversary of the Right to Food Guidelines and welcome the opportunity to participate in this consultation. 

      In what follows we provide reflections on topics 2 -Identify any gaps, constraints and challenges encountered in realizing the right to food or in implementing the Right to Food Guidelines, and 3 -Share any lessons learned and suggest recommendations for improvement in realizing the right to adequate food, hoping they will help inform on efforts made to realize the right to adequate food at local, national, regional or global level, and provide an important stock taking opportunity for countries and their people.

      • Gaps, constraints, and challenges encountered in realizing the right to food or in implementing the Right to Food Guidelines across Europe
        • As it becomes evident in the 2019 report “Fifteen years implementing the Right to Food Guidelines Reviewing progress to achieve the 2030 Agenda”, Europe is committed to the end of hunger and malnutrition. The report describes multiple strategies and cooperation initiatives undertaken by the Commission and the countries with the aim of improving the Right to Food across the globe. Most of these, however, are actions directed to external countries to the Region, which oversees the situation of food insecurity and non-realization of the right to food across Europe. 
        • Nevertheless, the latest SOFI report reveals that nearly 8% of the European population experiences moderate or severe food insecurity. Across countries, primary studies indicate that the prevalence in the general population ranges between 5-20%, with higher rates identified in women, children, older adults, single-parent households, those with low educational attainment, and on low or unstable income and/or employment. Among food aid recipients, the prevalence of food insecurity exceeds 70%.
        • Current responses to food and nutrition insecurity mainly consist of welfare policies and food assistance programs at regional and national levels. However, these strategies often fail to address the underlying drivers of food and nutrition insecurity or ensure adequate diet quality. They also fail to recognize cultural differences in food choice.
        • This difficulty to adequately tackle food insecurity in European countries stems from the political conception of the issue, which is influenced by the notion that food insecurity is not a problem within the region. As of 2011, only Moldova, Ukraine and Belarus explicitly recognized the right to food in their constitutions(1). Others like Finland, Germany, Netherlands, or Switzerland refer to it implicitly as part of a broader set of rights.
        • Consequently, there is a lack of political instruments to guarantee sufficient food and nutrition for all European citizens. Instead, a patchwork of responses is provided, heavily relying on non-governmental, not-for-profit, and charitable sectors, which highlights a clear market failure (2). Hunger and food insecurity are two different entities, and also the right to adequate food and nutrition is different to the right to not suffer hunger (3). 
        • Strengthening research and monitoring efforts is crucial, as they can provide a better understanding of the right to food situation in different countries and serve as an objective foundation for further actions and advocacy efforts.
        • Despite limited involvement to-date, Dietitians (especially Public Health ones) are ideally positioned to provide expertise and guidance (4).

       

      • Lessons learned and recommendations for improvement in realizing the right to adequate food across Europe
        • Recommendations to improve the realization of the right to adequate food across Europe start by implementing a proper monitoring system, that allows not only to keep track of the phenomenon itself, but also structural conditions that can influence it (like poverty or healthy diets affordability) and related consequences (for example nutrient deficiencies or diet-related diseases).
        • Dietitians can play an important role to advance the realization of the right to food in at least four ways, which can contribute to make significant progress in addressing food insecurity and advancing the right to adequate food in Europe.
      • Raise Awareness: Efforts should be made to create awareness among European citizens regarding the existence, extent, and challenges people face in realizing their right to adequate food. This can involve educational campaigns, public discussions, and media engagement to highlight the issue and foster understanding and empathy.
      • Advocate for Comprehensive Data: There is a need to advocate for comprehensive and robust data collection on the determinants and prevalence of food insecurity in Europe. This data will provide a clear picture of the problem and serve as a foundation for evidence-based policy-making and targeted interventions. Researcher dietitians of public health nutrition can also contribute to data analysis with the currently available datasets (like FAO's SOFI).
      • Foster Partnerships: Collaboration with diverse stakeholders, including social assistance providers, local authorities, and non-governmental organizations (NGOs), is crucial. Taking a comprehensive, intersectoral, and integrated approach will ensure a coordinated effort to address food insecurity. By working together, these stakeholders can share resources, expertise, and best practices to develop effective solutions.
      • Engage in Policy Development: Dietitians should actively participate in the development of political instruments and interventions that promote equitable access to high-quality, safe food. Their expertise and insights can contribute to the formulation of policies that prioritize the right to food of an appropriate nutritional quality and ensure its realization for all European citizen

      As last remark, we present the argument that in the slightly shifting the title of the RtFG to “Right to culturally appropriate, sustainable and healthy food choices for everyone” would contribute to spread the notion that it is not only food that needs to be guaranteed, but food that protects health, culture and environment. 

      The European Specialist Dietetic Network (ESDN) for Public Health of the European Federation of the Associations of Dietitians (EFAD) reasserts the relevance of the Right to Food Guidelines and wants to express its willingness and availability to be further involved in this activity. EFAD has a wide reach to the dietetic organizations of WHO Europe Region and could be a more active actor with FAO on this matter.

      References

      1. Constitutional and Legal Protection of the Right to Food around the World. (2011). FAO. Available at: http://www.oda-alc.org/documentos/1340937409.pdf
      2. Greiss J, Schoneville H, Adomavičienė A, Baltutė R, Bernat A, Cantillon B, et al. Food aid in Europe in times of the COVID-19 crisis An international survey project. Working paper 22/05. [Internet]. Antwerp; 2022 Sep [cited 2022 Oct 6]. Available from: https://www.uantwerpen.be/en/research-groups/csb/
      3. UN. International Covenant on Economic, Social and Cultural Rights. Geneva: UN; 1966.
      4. Holben DH, Marshall MB. Position of the Academy of Nutrition and Dietetics: Food Insecurity in the United States. J Acad Nutr Diet. 2017;117(12):1991–2002.
      See the attachments:

    • Dear Drafting Team,

      The European Federation of the Associations of Dietitians (EFAD)1 specialist Public Health group recognizes the huge amount of work of the  HLPE FSN team for the draft Report on Reducing inequalities for Food Security and Nutrition (FSN) and welcome the opportunity to participate in this consultation. 

      We offer the following comments and suggestions, which we hope will contribute to an even stronger version of the report.

      • We find that the proposed framework is an effective conceptual device to guide the conversation and action surrounding inequalities and food insecurity, especially when combined with the food systems framework (p.26). The framework and the report adequately discuss the implication of adopting the six-dimension definition of FSN. We agree with the view that addressing inequalities in FSN requires a drastic transformation of the food systems and the whole status quo upon which they exist. While global tendencies, especially market-driven (as the report highlights when discussing the commercial determinants of health and food - p. 66), exist, we celebrate that the report recognizes context-specific realities of and solutions to FSN. 
      • In this regard, and while realising the ‘universal development’ approach (Longhurst, 2017) that guides this report, we would like to suggest to also include data about high-income regions, like Europe, in some of the featured tables and figures. Just like the report recognises, inequalities and FSN are also present in those countries, but, when it comes to FSN data, their relevance may end up being blurred by the magnitude of the data in other regions. For instance, epidemiological surveys performed in European countries show that poor iron status affects 10±30% of menstruating women and iron deficiency anaemia, which in the case of adolescents, might increase up to 48%. Likewise, research on healthy diet affordability found that, in 2019, for 16 out of 24 countries at least 10% of the population in (sub)urban areas would be confronted with income-related food insecurity. After the COVID-19 pandemic and the inflation crisis these figures are likely to have grown. Displaying such data along the text and in key elements of the report such as table 2.1. can contribute to appreciating the existence and scope of FSN in high-income countries and regions like Europe. Rising awareness is the first step toward taking action towards the issue in the region.
      • We would like to identify three aspects that we find underrepresented in the report. The first one is food literacy. Various definitions of food literacy exist. Vidgen and Gallegos (2014) define it as 'the scaffolding that empowers individuals, households, communities or nations to protect diet quality through change and strengthen dietary resilience over time. It is composed of a collection of inter-related knowledge, skills and behaviours required to plan, manage, select, prepare and eat food to meet needs and determine intake'. Cullen et al (2015) conceptualize food literacy as the interconnection of two spheres: community food security and individual food skills, which lead to a comprehensive understanding of the food system within a society and culture which culminate in food choices that impact health and wellbeing. Several works describe the relation between food literacy and food insecurity. In this regard, while we recognize the structural factors as major drivers of FSN, and while running from individualistic approaches, we do believe that empowering individuals, families and communities about their relation to food can leverage some of the inequities that lead to FSN. Moreover, increased food literacy is directly related to enhancing the autonomy dimension of FSN.
      • The second point is the recognition of how the way in which FSN is tackled can create further health inequalities. Food aid is the main mechanism to face FSN in high-income countries, but without proper political involvement and regulation it often ends up acting as a bandaid for hunger instead of an ensurement of the possibility to have adequate nutrition. Dealing with inequalities in FSN cannot be separated from the promotion of diet quality.
      • Thirdly, we are delighted that the authors identified the aggressive marketing of infant formulae as an issue, and wondered if there could be an extension of the 'life-course' approach and some mention of the fact that the elderly are also a group at risk. 
      • Last, may we draw your attention to the following work on measuring food and nutrition insecurity, which complements the existing reference by Barrett (2010) and can allow to identify further ways of operationalizing and monitoring the elements of the conceptual framework
      1. Castetbon K. Measuring food insecurity. In: Biesalski H., Drewnowski A., Dwyer J., Strain J., Weber P., Eggersdorfer M., editors. Sustainable Nutrition in a Changing World. Springer; Cham, Switzerland: 2017. 
      2. Anderson S., editor. Core indicators of nutritional state for difficult-to-sample populations. J. Nutr. 1990;120:1559–1600. doi: 10.1093/jn/120.suppl_11.1555. 
      3. Carrillo-Álvarez E, Salinas-Roca B, Costa-Tutusaus L, Milà-Villarroel R, Shankar Krishnan N. The measurement of food insecurity in high-income countries: A scoping review. Int J Environ Res Public Health. 2021;18(18):9829. 
      4. Beacom E., Furey S., Hollywood L., Humphreys P. Investigating food insecurity measurement globally to inform practice locally: A rapid evidence review. Crit. Rev. Food Sci. Nutr. 2020 doi: 10.1080/10408398.2020.1798347.

      The European Federation of the Associations of Dietitians (EFAD) specialist Public Health group reasserts the recognition to the drafting team and wants to express its willingness and availability to be further involved in this activity.

      1 Elena Carrillo (Spain), Amanda Avery, (United Kingdom), Teresa Rodrigues (Portugal), Zeynep Begüm Kalyoncu (Turkey) Zoi Toumpakari (United Kingdom), Bernadette Kiss-Toth (Hungary) and Manuel Moñino (Spain). http://www.efad.org/en-us/specialists-networks/public-health/

      References

      1. Hercberg S, Preziosi P, Galan P. Iron deficiency in Europe. Public Health Nutr. 2001;4(2B):537–45. 
      2. Penne T, Goedemé T. Can low-income households afford a healthy diet? Insufficient income as a driver of food insecurity in Europe. Food Policy [Internet]. 2020;99(101978):101978. Available from: https://www.sciencedirect.com/science/article/pii/S0306919220301822
      3. Vidgen HA, Gallegos D. Defining food literacy and its components. Appetite.2014:9;76:50–9. 
      4. Cullen T, Hatch J, Martin W, Higgins JW, Sheppard R. Food literacy: Definition and framework for action. Can J Diet Pract Res [Internet]. 2015;76(3):140–5. 
      5. Michou M, Panagiotakos DB, Lionis C, Costarelli V. Socioeconomic inequalities in relation to health and nutrition literacy in Greece. Int J Food Sci Nutr [Internet]. 2019;70(8):1007–13. 
      6. Begley A, Paynter E, Butcher LM, Dhaliwal SS. Examining the association between food literacy and food insecurity. Nutrients [Internet]. 2019 [cited 2023 Jan 3];11(2):445. 
      See the attachments: