Addressing Hidden Hunger in School-Aged Children and Adolescents within the Context of the Food System.

Over the past decade, public health advocates and policymakers have grappled with the increasing issue of the double burden of malnutrition. Building on the Sustainable Development Goals and the United Nations Decade of Action on Nutrition, strengthening food systems is paramount to addressing hidden hunger, otherwise known as micronutrient deficiencies, and the provision of healthy, sufficient quality and quantity, affordable, safe, and culturally acceptable food. Using the UNICEF Innocenti Framework on Food Systems for Children and Adolescents as guidance, this review identifies four evidence-based food system strategies to drive improvements in micronutrient deficiencies in low- and middle-income countries in the context of school-aged children and adolescents: agriculture, food supply chains, food environments, and social behavioral change communication. With multiple players and drivers in the picture, strong and reliable oversight from national and local governments is required, through accountability, regulation, and sustained commitment to creating policies and proper infrastructure to support healthy food consumption and limit access to unhealthy food items. Moreover, given the complexity of hidden hunger, a holistic systems approach with a "right to food" lens is required to begin addressing and improving the diets and nutrition of children and adolescents. This involves synergistic and collaborative actions from all actors within the food system, as well as interactions with systems that have the ability to deliver nutrition interventions at scale. These systems include health, water and sanitation, education, and social protection. Only through partnerships and collaboration between all drivers, determinants, and key components of the food system, including its interactions with other global systems, will we be able to appropriately address hidden hunger in school-aged children and adolescents.