Milk-and-Dairy-Products-in-Human-Nutrition-FAO

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Chapter 7 – Milk and dairy programmes affecting nutrition 279 figure 7.1 (continued) c. Fortified milk programmes Fortified milk programmes Availability of micronutrient-dense milk products Demand for fortified milk products Food quality improves Production of fortified milk products Morbidities (diarrhea, ARI) Economic development Nutrition improves (body composition, micronutrient status) Inappropriate targeting (cost or marketing) Overdose on micronutrients Nutrition worsens or shows no improvement (stunting, poor health) d. Milk powder and blended food programmes Recovery from severe malnutrition Milk powder and blended food programmes Availability of nutrient dense products containing milk Child consumption of quality foods in HH Health maintained or improved Nutrition improves (anthropometry, body composition, micronutrient status) Demand for milk Local dairy production Economic development Source: Iannotti, Muehlhoff and McMahon, 2013 include increased labour demands on childcare providers, diversion of milk for sale and exposure to zoonoses. Previous reviews have explored these pathways in the broader categories of agricultural production (Berti, Krasevec and FitzGerald, 2004; World Bank, 2007) and livestock development (Tangka, Jabbar and Shapiro, 2000; Leroy and Frongillo, 2007; Randolph et al., 2007). World Bank (2007) identified five pathways from agriculture to nutrition: subsistence-oriented production for household’s own consumption; incomeoriented production for sale in markets; reduction in real food prices associated with increased agricultural production; empowerment of women as agents instrumental to household food security and health outcomes; and an indirect relationship
280 Milk and dairy products in human nutrition between increasing agricultural productivity and nutrition outcomes through the agriculture sector’s contribution to national income and macroeconomic growth. The report finds that most information about agricultural programming pertains to changes in food availability and access, and very little to direct nutrition outcomes. It concludes that in order to successfully influence nutrition, agricultural programmes should more broadly address women’s empowerment, behavioural change and health, and incorporate specific, targeted nutrition and health interventions. Berti, Krasevec and FitzGerald (2004) also found that interventions with explicit nutrition objectives and those including investments in human capital inputs (nutrition education and gender) were more likely to show positive nutrition outcomes. Tangka, Jabbar and Shapiro (2000), Leroy and Frongillo (2007) and Randolph et al. (2007) also found that livestock interventions improve production and income, but such programmes often do not have evaluations capable of demonstrating impact on dietary intakes or nutritional status. Positive impacts on “intermediate” outcomes (production, income and dietary intake) do indicate the potential for improving nutrition through increasing livestock production and highlight the need for better-designed evaluations and cost-benefit analyses (Leroy and Frongillo, 2007). Tangka, Jabbar and Shapiro (2000) cite several observational studies that link ownership of milk-producing livestock to improved child nutrition outcomes. These reviews did not conduct meta-analyses of original study data, and did not assign comparative quality ratings, as was done in the present review. Eleven dairy production and agriculture programmes were included in this review, seven from sub-Saharan Africa and four from Asia. Six of the programmes were not included in the five previous reviews described above: Ayalew, Gebriel and Kassa (1999), Ayele and Peacock (2003), Hop (2003), Cunningham (2009), Iannotti, Cunningham and Ruel (2009) and Sadler and Catley (2009). The typical programme model involved only production strategies such as improved animal feeding (e.g. zero-grazing) or the introduction of cross-breeds. Some programmes introduced a gender component either through targeting women for dairy production inputs or use of female extension workers. Others incorporated more explicitly nutrition-related strategies in the dairy production inputs, including behaviour change communication, promotion of milk consumption and, in the case of Viet Nam, policy-level links between agriculture and nutrition goals. Finally, some programmes applied a more comprehensive, multidisciplinary approach combining agriculture, health and nutrition interventions. 7.3.1 Africa In the Kilifi District of Kenya, a national dairy development project (DDP) initiated in 1980 and supported by the Netherlands Government aimed at improving dairy management practices primarily through the introduction of “zero-grazing” or keeping cattle permanently in stables (Hoorweg, Leegwater and Veerman, 2000). A study was conducted to assess whether households participating in the DDP since before 1985 (group 1; n=30) or dairy customers of DDP farmers (group 2; n=24) showed higher levels of milk consumption and improved anthropometry of young children (6–59 mo) compared with a control group of rural households (group 3; n=90). Using a 24-hour dietary intake recall, the study showed that milk consumption was higher in DDP farmer and customer groups than in control households and that height-for-
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MILK dairy products in and human nu
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cover photo credits front: © EADD/
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iv 2.7 Emerging issues and challeng
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vi 5.2 Dairy components 209 5.2.1 M
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viii 9.2 Key trends and emerging is
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x 2.5 Per capita energy intake from
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xii Preface Billions of people arou
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xiv The publication serves a variet
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xvi (Research Assistant Professor,
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xviii Permissions granted by extern
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xx FPCM fat and protein-corrected m
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xxii Contributors Anthony Bennett j
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xxiv from the National University o
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xxvi Award 2010 along with colleagu
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2 Milk and dairy products in human
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11 Chapter 2 Milk availability: Cur
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Chapter 2 - Milk availability: Curr
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Table 2.5 Volume and share of milk
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41 Chapter 3 Milk and dairy product
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Chapter 3 - Milk and dairy product
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Table 3.1 Proximate composition of
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Table 3.2 (continued) Vitamins Ribo
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Table 3.4 Mineral composition in mi
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Table 3.6 (continued) Riboflavin Vi
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103 Chapter 4 Milk and dairy produc
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Chapter 4 - Milk and dairy products
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Table 4.1 Nutrient content of full
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Table 4.2 Contents of selected nutr
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Table 4.4 Summary of recent review
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Annex Table 4.7 Milk and dairy prod
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Table 4.7 (continued) Region and co
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207 Chapter 5 Dairy components, pro
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330 Milk and dairy products in huma
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