Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
Department of Anthropology, Northwestern University, Evanston, IL, USA.
J Nutr. 2021 Jul 1;151(7):2010-2021. doi: 10.1093/jn/nxab052.
There are urgent calls for the transformation of agriculture and food systems to address human and planetary health issues. Nutrition-sensitive agriculture and agroecology promise interconnected solutions to these challenges, but evidence of their impact has been limited.
In a cluster-randomized trial (NCT02761876), we examined whether a nutrition-sensitive agroecology intervention in rural Tanzania could improve children's dietary diversity. Secondary outcomes were food insecurity and child anthropometry. We also posited that such an intervention would improve sustainable agricultural practices (e.g., agrobiodiversity, intercropping), women's empowerment (e.g., participation in decision making, time use), and women's well-being (e.g., dietary diversity, depression).
Food-insecure smallholder farmers with children aged <1 y from 20 villages in Singida, Tanzania, were invited to participate. Villages were paired and publicly randomized; control villages received the intervention after 2 y. One man and 1 woman "mentor farmer" were elected from each intervention village to lead their peers in agroecological learning on topics including legume intensification, nutrition, and women's empowerment. Impact was estimated using longitudinal difference-in-differences fixed-effects regression analyses.
A total of 591 households (intervention: n = 296; control: n = 295) were enrolled; 90.0% were retained to study end. After 2 growing seasons, the intervention improved children's dietary diversity score by 0.57 food groups (out of 7; P < 0.01), and the percentage of children achieving minimum dietary diversity (≥4 food groups) increased by 9.9 percentage points during the postharvest season. The intervention significantly reduced household food insecurity but had no significant impact on child anthropometry. The intervention also improved a range of sustainable agriculture, women's empowerment, and women's well-being outcomes.
The magnitude of the intervention's impacts was similar to or larger than that of other nutrition-sensitive interventions that provided more substantial inputs but were not agroecologically focused. These data suggest the untapped potential for nutrition-sensitive agroecological approaches to achieve human health while promoting sustainable agricultural practices.
为了解决人类和地球健康问题，迫切需要对农业和粮食系统进行改革。营养敏感型农业和农业生态系统有望为这些挑战提供相互关联的解决方案，但它们的影响证据有限。
在一项整群随机试验（NCT02761876）中，我们研究了坦桑尼亚农村地区的营养敏感型农业生态干预措施是否能改善儿童的饮食多样性。次要结果是粮食不安全和儿童人体测量。我们还假设这种干预措施将改善可持续农业实践（例如，生物多样性、间作）、妇女赋权（例如，参与决策、时间利用）和妇女福祉（例如，饮食多样性、抑郁）。
邀请来自坦桑尼亚辛吉达 20 个村庄、有 1 岁以下儿童的粮食不安全小农户参加。村庄配对并公开随机分组；对照组在 2 年后接受干预。每个干预村庄选举 1 名男性和 1 名女性“导师农民”，带领他们的同行学习豆类强化、营养和妇女赋权等主题的农业生态知识。使用纵向差异-差异固定效应回归分析估计影响。
共纳入 591 户家庭（干预组：n=296；对照组：n=295）；90.0%的家庭保留到研究结束。经过 2 个生长季后，干预措施使儿童饮食多样性评分增加了 0.57 个食物组（共 7 个；P<0.01），收获季后达到最低饮食多样性（≥4 个食物组）的儿童比例增加了 9.9 个百分点。干预措施显著降低了家庭粮食不安全程度，但对儿童人体测量没有显著影响。干预措施还改善了一系列可持续农业、妇女赋权和妇女福祉的结果。
该干预措施的影响程度与提供更多投入但非农业生态重点的其他营养敏感型干预措施相似或更大。这些数据表明，营养敏感型农业生态方法在促进可持续农业实践的同时实现人类健康的潜力尚未得到充分利用。
