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Abstract
This paper reviews current knowledge and experience with food-based
approaches to reduce vitamin A and iron deficiencies. It presents a review of recently
published literature, highlights some of the lessons learned, and identifies knowledge
gaps and research priorities. The main strategies reviewed are food-based interventions
that aim at (1) increasing the production, availability and access to vitamin A and iron-rich
foods through the promotion of home production; (2) increasing the intake of
vitamin A and iron-rich foods through nutrition education, communication, social
marketing and behavior change programs to improve dietary quality among vulnerable
groups; and (3) increasing the bioavailability of vitamin A and iron in the diet either
through home processing techniques or food-to-food fortification strategies. Plant
breeding strategies are also discussed because of their potential to increase the content of
vitamin A and iron in the diet as well as their bioavailability. The review highlights two
contrasting facts. On the one hand, it is clear that the technologies and strategies reviewed
have the potential to address many of the concerns about both the intake and the
bioavailability of vitamin A and iron among impoverished populations. On the other
hand, enormous information gaps still exist in relation to both the efficacy and the
effectiveness of most of the strategies reviewed, even for approaches as popular as home
gardening. Significant progress has been achieved in the past 10 years in the design and
implementation of food-based approaches, particularly with respect to the new generation
of projects integrating production and nutrition education and behavior change strategies.
Yet, little has been done to evaluate their efficacy, effectiveness, feasibility, sustainability
and their impact on the diets and nutritional status of at-risk populations. The same
question as that posed in previous reviews decades ago remains at the end of the present
review: what really can be achieved with food-based interventions to control vitamin A
and iron deficiency? Food based approaches could be an essential part of the long-term
global strategy to alleviate micronutrient deficiencies but their real potential is still to be explored.