Periodic Reporting for period 1 - ARISE-NUTRINT (Reducing nutrition-related noncommunicable diseases in adolescence and youth: interventions and policies to boost nutrition fluency and diet quality in Africa)
Reporting period: 2023-01-01 to 2024-06-30
Developing healthy nutrition behaviors in childhood may help to prevent malnutrition and chronic, long-term health issues such as obesity, cardiovascular disease, type 2 diabetes, and stroke. Undernourished adolescents can experience impaired cognitive development and school achievement, stunting, reduced economic productivity, and poor reproductive outcomes in females. Overweight or obese adolescents are more likely to experience low self-esteem, distorted body image, depression, anxiety, loneliness, discrimination, strained peer relationships, and early onset of adult chronic diseases such as type 2 diabetes, and hypertension. Adolescents in SSA are experiencing major behavioural and biological health risks and disease burdens, further underlining the need for a new public health approach to encourage healthy nutrition among children and adolescents.
Novel interventions and policies to boost adolescent health are estimated to achieve a tenfold economic return. Global initiatives, such as the United Nations’ Global Strategy for Women’s, Children’s and Adolescents’ Health have highlighted the need for innovative solutions to address adolescent prevention and healthcare needs. Yet, nearly 90% of current research evidence about adolescence and youth comes from high-income countries. Inspired by the African Union’s Year of Nutrition in 2022 and the European Union’s (EU’s) Food 2030 research and innovation policy, this project aims to empower global youth towards sustainable nutrition and healthy diets.
A school- and home-based program is an ideal strategy for adolescents given the large amount of time young people spend either in school or at home, where they could be exposed to supportive interventions such as school health policies, food and nutrition education, and physical activity. When compared to single-component nutrition interventions, integrated multicomponent interventions targeting multiple forms of malnutrition among school-age children have been shown to hold greater potential in promoting and supporting positive health behaviour changes in the long-term. However, since much of this evidence comes from high-income countries, it has limited generalizability to resource-limited settings.
The World Health Organization (WHO) has recognized that national policies aiming to reduce the consumption of ultra-processed food products is one of the “best buys” to reduce the burden of non-communicable diseases (NCDs)11,12.Today more than 50 countries have introduced taxes on sugar-sweetened beverages (SSB) to reduce SSBconsumption, which has been linked to several adverse health conditions. Only two of these countries are in sub-Saharan Africa: South Africa (introduced in 2018) and Nigeria (in 2022). Previous projects analyzed in detail thebarriers and policy landscape that is hampering the implementation process for SSB tax in SSA countries. Thisresearch revealed the need for robust data and high-quality evidence to battle against the lobby of the wealthymultinational food industry that often influences national food policies.
The impact of public policies, such as the implementation of a SSB tax, cannot be evaluated without traditional experimental methods. To maintain internal validity, quasi-experimental (QE) approaches can be used as an alternative means of assessing the impact of public policies. Beyond impact, it is also essential to understand the mechanisms behind how and why these policies work or don’t work. In this context, it is important to study perceptions of citizens and stakeholders, their awareness and acceptability for the policy, and the local context in which the policy was introduced. Assessing these dimensions requires a broad set of mixed methodological approaches including for example small-scale surveys, focus groups, and expert interviews.
This project aims to deliver a better understanding of diets and nutrition and physical activity-related risks of non-communicable diseases among adolescents in seven countries in SSA, how to optimize implementation of evidence-based interventions that promote healthy behaviours among adolescents and youth, long-term costs-and effects and impact of these interventions, and the factors that lead to the adoption, scale up, sustainment, and knowledge translation of these interventions. Given this tremendous burden noncommunicable diseases pose in the SSA, our proposed project will ultimately contribute to improving the health, economic and broader societal outcomes of all in the region. The proposed project also contributes to major targets of the Sustainable Development Goals, specifically Target 3 “Good Health and Wellbeing”, and the African Union Goals and Priority Areas of Agenda 2063 “Healthy and well-nourished citizens.” Results from the proposed project could also be transferable to other low-and middle-income country contexts struggling to tackle the growing burden of nutrition-related noncommunicable diseases among adolescence and youth.
Overall Objective:
Our overall objective is to establish a global alliance to prevent and reduce nutrition-related noncommunicable diseases (NCDs) among adolescence and youth in Africa, by boosting adolescents’ health behaviours and outcomes through nutrition literacy and fluency and by providing critical policy information and tools to scale and sustain interventions and policies to support adolescents in healthy food consumption and lives.
Specific Objectives:
Novel interventions and policies to boost adolescent health are estimated to achieve a tenfold economic return. Global initiatives, such as the United Nations’ Global Strategy for Women’s, Children’s and Adolescents’ Health have highlighted the need for innovative solutions to address adolescent prevention and healthcare needs. Yet, nearly 90% of current research evidence about adolescence and youth comes from high-income countries. Inspired by the African Union’s Year of Nutrition in 2022 and the European Union’s (EU’s) Food 2030 research and innovation policy, this project aims to empower global youth towards sustainable nutrition and healthy diets.
A school- and home-based program is an ideal strategy for adolescents given the large amount of time young people spend either in school or at home, where they could be exposed to supportive interventions such as school health policies, food and nutrition education, and physical activity. When compared to single-component nutrition interventions, integrated multicomponent interventions targeting multiple forms of malnutrition among school-age children have been shown to hold greater potential in promoting and supporting positive health behaviour changes in the long-term. However, since much of this evidence comes from high-income countries, it has limited generalizability to resource-limited settings.
The World Health Organization (WHO) has recognized that national policies aiming to reduce the consumption of ultra-processed food products is one of the “best buys” to reduce the burden of non-communicable diseases (NCDs)11,12.Today more than 50 countries have introduced taxes on sugar-sweetened beverages (SSB) to reduce SSBconsumption, which has been linked to several adverse health conditions. Only two of these countries are in sub-Saharan Africa: South Africa (introduced in 2018) and Nigeria (in 2022). Previous projects analyzed in detail thebarriers and policy landscape that is hampering the implementation process for SSB tax in SSA countries. Thisresearch revealed the need for robust data and high-quality evidence to battle against the lobby of the wealthymultinational food industry that often influences national food policies.
The impact of public policies, such as the implementation of a SSB tax, cannot be evaluated without traditional experimental methods. To maintain internal validity, quasi-experimental (QE) approaches can be used as an alternative means of assessing the impact of public policies. Beyond impact, it is also essential to understand the mechanisms behind how and why these policies work or don’t work. In this context, it is important to study perceptions of citizens and stakeholders, their awareness and acceptability for the policy, and the local context in which the policy was introduced. Assessing these dimensions requires a broad set of mixed methodological approaches including for example small-scale surveys, focus groups, and expert interviews.
This project aims to deliver a better understanding of diets and nutrition and physical activity-related risks of non-communicable diseases among adolescents in seven countries in SSA, how to optimize implementation of evidence-based interventions that promote healthy behaviours among adolescents and youth, long-term costs-and effects and impact of these interventions, and the factors that lead to the adoption, scale up, sustainment, and knowledge translation of these interventions. Given this tremendous burden noncommunicable diseases pose in the SSA, our proposed project will ultimately contribute to improving the health, economic and broader societal outcomes of all in the region. The proposed project also contributes to major targets of the Sustainable Development Goals, specifically Target 3 “Good Health and Wellbeing”, and the African Union Goals and Priority Areas of Agenda 2063 “Healthy and well-nourished citizens.” Results from the proposed project could also be transferable to other low-and middle-income country contexts struggling to tackle the growing burden of nutrition-related noncommunicable diseases among adolescence and youth.
Overall Objective:
Our overall objective is to establish a global alliance to prevent and reduce nutrition-related noncommunicable diseases (NCDs) among adolescence and youth in Africa, by boosting adolescents’ health behaviours and outcomes through nutrition literacy and fluency and by providing critical policy information and tools to scale and sustain interventions and policies to support adolescents in healthy food consumption and lives.
Specific Objectives:
WP1: - The quantitative questionnaire was developed, reviewed, tested and then digitalized for all partners to test and conduct fieldwork. The qualitative tools were also developed, reviewed and tested for cultural appropriateness at each partner site. By Month 18, five partners had begun quantitative data collection, and three countries had begun the qualitative.
WP2: Scoping reviews of previous literature and nutrition policy documents informed part of this objective. Additionally, design thinking workshops have taken place including participants from all partner sites, along with stakeholders and adolescents to understand the knowledge, attitudes, practices and expectation of adolescents; and co-create the concept of nutrition fluency for the region.
WP5: A costing and data collection template to collect all necessary data to perform the costing study and cost-effectiveness analysis of the ANFI intervention and sugar tax policies has been developed.
WP7: The members of the ATTAYH convened physically for their inaugural meeting and officially launched in Addis Ababa Ethiopia from 24th-26th June 2024.
WP8: A high-quality hosting platform for both quantitative and qualitative data has been configured and is hosted centrally by one of our African Partners AAPH. Each partner site has been given access to their own account for data management.
WP9: Structures for effective management, communication and monitoring of project implementation have been enacted and are continuously executed.
WP2: Scoping reviews of previous literature and nutrition policy documents informed part of this objective. Additionally, design thinking workshops have taken place including participants from all partner sites, along with stakeholders and adolescents to understand the knowledge, attitudes, practices and expectation of adolescents; and co-create the concept of nutrition fluency for the region.
WP5: A costing and data collection template to collect all necessary data to perform the costing study and cost-effectiveness analysis of the ANFI intervention and sugar tax policies has been developed.
WP7: The members of the ATTAYH convened physically for their inaugural meeting and officially launched in Addis Ababa Ethiopia from 24th-26th June 2024.
WP8: A high-quality hosting platform for both quantitative and qualitative data has been configured and is hosted centrally by one of our African Partners AAPH. Each partner site has been given access to their own account for data management.
WP9: Structures for effective management, communication and monitoring of project implementation have been enacted and are continuously executed.
The results are not ready yet, as the data set is yet to be analyzed.