A whole system approach to childhood obesity: how a supportive environment was created in the city of Brighton and Hove, United Kingdom.

Unlabelled: Childhood obesity is a growing global challenge, and no country has yet reversed the upward trend in prevalence. The causes are multifaceted, spanning individual, societal, environmental, and political spheres. This makes finding solutions complex as traditional linear models of treatment and effect have proven only minimally successful or unfeasible at the population level.

Applying the 'Candidacy' Model to understand access to key nutrition, food & health services in LMIC contexts: a qualitative study in Odisha, India.

In order to make progress towards Sustainable Development Goal 2 - Zero Hunger - we must acquire a better understanding of what continues to hamper achieving food security, particularly in contexts where progress has been achieved, but has then faltered. This article investigates access to nutrition and food services in three of the Indian state of Odisha's traditionally poorer districts, where a large number of the state's most marginalised populations live. Semi-structured interviews were carried out in 11 villages.

Stories of change in nutrition in Burkina Faso 1992-2018: a macro-level perspective.

Looking back at the development of successful enabling environments for nutrition may inform policymakers on how to accelerate progress to end all forms of malnutrition by 2030. As under-five stunting declined substantially in Burkina Faso, from a peak at 45% in 1998/99 to 25% in 2018, we analyzed through a stories of change approach the actors, ideas, initiatives, policies and capacities which enabled wide-scale nutrition progress. We triangulated findings from policy analysis, stakeholder mapping, and national-level semi-structured interviews (n = 20).

Holding no-one back: The Nutrition Equity Framework in theory and practice.

Equity remains poorly conceptualised in current nutrition frameworks and policy approaches. We draw on existing literatures to present a novel Nutrition Equity Framework (NEF) that can be used to identify priorities for nutrition research and action. The framework illustrates how social and political processes structure the food, health and care environments most important to nutrition.

Stories of change in nutrition: lessons from a new generation of studies from Africa, Asia and Europe.

How does nutrition improve? We need to understand better what drives both positive and negative change in different contexts, and what more can be done to reduce malnutrition. Since 2015, the Stories of Change in Nutrition studies have analysed and documented experiences in many different African and Asian countries, to foster empirically-grounded experiential learning across contexts. This article provides an overview of findings from 14 studies undertaken in nine countries in South Asia, sub-Saharan Africa, and Europe between 2017 and 2021.

Changes in Nigeria's enabling environment for nutrition from 2008 to 2019 and challenges for reducing malnutrition.

Unlabelled: Key 2025 global nutrition targets are unlikely to be met at current rates of progress. Although actions necessary to reduce undernutrition are already mostly known, knowledge gaps remain about how to implement these actions in contextually appropriate ways, and at scales commensurate with the magnitude of the problem. This study describes the nutrition enabling environment in Nigeria, a country that contributes significantly to the global undernutrition burden, and identifies potential entry points for improving the enabling environment that could facilitate implementation and scale-up of essential intervention coverage.

Stories of change in nutrition in Burkina Faso 1992-2018: a micro-level perspective.

Unlabelled: Looking back at what has effectively improved nutrition may inform policy makers on how to accelerate progress to end all forms of malnutrition by 2030. As under-five stunting declined substantially in Burkina Faso, we analyzed its nutrition story at the micro-level. We conducted a regression-decomposition analysis to identify demographic and health drivers associated with change in height-for-age using longitudinal, secondary, nationally-representative data.

Understanding drivers of stunting reduction in Nigeria from 2003 to 2018: a regression analysis.

Unlabelled: Nigeria is a high burden country for stunting. Stunting reduction has been slow and characterized by unequal progress across the 36 states and federal capital territory of the country. This study aimed to assess the changes in prevalence of stunting and growth determinants from 2003 to 2018, identify factors that predicted the change in stunting, and project future stunting prevalence if these predicted determinants improve.

Historicising global nutrition: critical reflections on contested pasts and reimagined futures.

The COVID-19 pandemic has provoked a range of economic shocks, food systems shocks, public health crises and political upheavals across the globe, prompting a rethink of associated global systems. Prepandemic anticolonial movements that challenged hierarchies of race, space, gender and expert knowledge in global health took on new meaning in the context of the unequal impacts of the SARS-CoV-2 virus as it moved through different kinds of spaces and distinct political contexts. In light of these dynamics, and the desire of many current practitioners in global health to reimagine the future, the need for critical analyses of the recent past have become more urgent.

Sustainable food systems and nutrition in the 21st century: a report from the 22nd annual Harvard Nutrition Obesity Symposium.

Food systems are at the center of a brewing storm consisting of a rapidly changing climate, rising hunger and malnutrition, and significant social inequities. At the same time, there are vast opportunities to ensure that food systems produce healthy and safe food in equitable ways that promote environmental sustainability, especially if the world can come together at the UN Food Systems Summit in late 2021 and make strong and binding commitments toward food system transformation. The NIH-funded Nutrition Obesity Research Center at Harvard and the Harvard Medical School Division of Nutrition held their 22nd annual Harvard Nutrition Obesity Symposium entitled "Global Food Systems and Sustainable Nutrition in the 21st Century" in June 2021.

Stories of change in nutrition from Africa and Asia: an introduction to a special series in Food Security.

Malnutrition in all its forms continues to be a massive global challenge, and the past decade has seen a growing political attention to addressing malnutrition in different contexts. What has been largely missing so far, and is in growing demand from countries, is tangible, practical and rigorous insights and lessons (from other countries or contexts) on how to translate this burgeoning political momentum into effective policies and programme implementation strategies - and ultimately impact on the ground. This new climate of learning from experience and evidence led to the launch in 2015 of the Stories of Change initiative.

The Basic Determinants of Malnutrition: Resources, Structures, Ideas and Power.

Background: While child undernutrition is improving overall, different population groups are experiencing different outcomes. What sets some groups apart is their experience of the 'basic determinants' of malnutrition, that underpin the 'immediate' and 'underlying' determinants, and that have been much less studied, defined and understood.

Methods: We undertook a qualitative narrative review based in two sets of ideas: nutrition's basic determinants as laid out in the original United Nations Children's Fund (UNICEF) framework, and critical concepts emerging from development studies.

Factors influencing the performance of community health workers: A qualitative study of Anganwadi Workers from Bihar, India.

Globally, there remain significant knowledge and evidence gaps around how to support Community Health Worker (CHW) programmes to achieve high coverage and quality of interventions. India's Integrated Child Development Services scheme employs the largest CHW cadre in the world-Anganwadi Workers (AWWs). However, factors influencing the performance of these workers remain under researched.

Conflict of Interest in Nutrition: Where's the Power? Comment on "Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool".

Actual or perceived conflict of interests (COIs) among public and private actors in the field of nutrition must be managed. Ralston et al expose sharply contrasting views on the new World Health Organization (WHO) COI management tool, highlighting the contested nature of global debates. Both the WHO COI tool and the Ralston et al paper are largely quiet on aspects of power among different actors, however, which we argue is integral to these conflicts.

Integrating nutrition and physical activity promotion: A scoping review.

Background: This paper investigates actions that combine nutrition and physical activity which hold potential for 'double duty action' to tackle multiple forms of malnutrition simultaneously. Expanding on previous research on single component actions, we assessed the state of the literature to map integrated interventions across the life course to analyse potential double duty effects, and identify knowledge gaps and needs for future design, implementation, evaluation and research for effective double duty action.

Methods: A scoping review of peer-reviewed and grey literature was conducted to explore the pathways that extend from combined physical activity and nutrition promotion interventions, with potential synergistic effects on outcomes other than obesity.

Understanding the nourishment of bodies at the centre of food and health systems - systemic, bodily and new materialist perspectives on nutritional inequity.

That nutritional inequalities continue to proliferate at a global level requires new insight from all disciplines, given their formation at the intersection of broader inequities in food, health and other systems. This paper argues that critical social scientific perspectives are needed to supplement public health and food focused approaches, which, while helpful, tend to reduce research and intervention to remedial action on malnourished bodies or on food production. A number of alternative perspectives draw on work on both bodies and on systems which are reviewed here.

The challenges of institutionalizing community-level social accountability mechanisms for health and nutrition: a qualitative study in Odisha, India.

Background: India has been at the forefront of innovations around social accountability mechanisms in improving the delivery of public services, including health and nutrition. Yet little is known about how such initiatives are faring now that they are incorporated formally into government programmes and implemented at scale. This brings greater impetus to understand their effectiveness.

Evidence to Action: Highlights From Transform Nutrition Research (2012-2017).

Background: The Transform Nutrition ( Transform) research consortium (2012-2017), led by the International Food Policy Research Institute, sought to generate evidence to inform and inspire action to address undernutrition in 4 high-burden countries (India, Bangladesh, Kenya, and Ethiopia) and globally.

Objective: Within the context of the literature, this synthesis article brings together core findings of Transform, highlighting priorities for future research.

Methods: This article uses a narrative approach to synthesize diverse study findings that collectively address Transform's three primary research questions: (1) How can nutrition-specific interventions be appropriately designed, implemented, scaled, and sustained in different settings?; (2) How can the nutritional impact of social protection and agriculture be improved?; and (3) How can enabling environments be promoted so as to use existing political and economic resources more effectively?

Results: Highlights of Transform include (1) improved understanding of the relative effectiveness of different combinations of nutrition-specific interventions and the ways in which they can be scaled for maximal impact; (2) evidence that shows that social protection and agriculture need to be explicitly linked to nutrition in order to contribute to stunting reduction; (3) identification of key components of "enabling environments" for nutrition and how they can be cultivated/sustained; (4) research that examines ways in which leaders emerge and operate to change the political and policy landscape in different settings; and (5) "stories of change" that provide in-depth contextual knowledge of how transformative change has been driven in countries that have made inroads in reducing malnutrition.

The politics of reducing malnutrition: building commitment and accelerating progress.

In the past 5 years, political discourse about the challenge of undernutrition has increased substantially at national and international levels and has led to stated commitments from many national governments, international organisations, and donors. The Scaling Up Nutrition movement has both driven, and been driven by, this developing momentum. Harmonisation has increased among stakeholders, with regard to their understanding of the main causes of malnutrition and to the various options for addressing it.

The future of the global food system.

Although food prices in major world markets are at or near a historical low, there is increasing concern about food security-the ability of the world to provide healthy and environmentally sustainable diets for all its peoples. This article is an introduction to a collection of reviews whose authors were asked to explore the major drivers affecting the food system between now and 2050. A first set of papers explores the main factors affecting the demand for food (population growth, changes in consumption patterns, the effects on the food system of urbanization and the importance of understanding income distributions) with a second examining trends in future food supply (crops, livestock, fisheries and aquaculture, and 'wild food').