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  • Let food be thy medicine: linking local food and health systems to address the full spectrum of malnutrition in low-income and middle-income countries

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Commentary
Let food be thy medicine: linking local food and health systems to address the full spectrum of malnutrition in low-income and middle-income countries
  1. Lindsay M Jaacks,
  2. Alexandra L Bellows
  1. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
  1. Correspondence to Dr Lindsay M Jaacks; jaacks{at}hsph.harvard.edu

https://doi.org/10.1136/bmjgh-2017-000564

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    Summary box

    • Advancing universal health coverage and improving health system quality are among the most important issues faced by those engaged in global health today.

    • The critical role played by a healthy food system in disease prevention and treatment is overlooked in discussions of health system reform, especially in low-income and middle-income countries.

    • Forming strong links between local food and health systems may be an important point of intervention for addressing both ends of the malnutrition spectrum.

    • In this commentary, we highlight the potential for healthcare institutions to improve access to and adoption of healthy diets beyond providing nutrition counselling in order to address the full spectrum of malnutrition in low-income and middle-income countries.

    Hippocrates (fifth century BCE), the father of medicine and namesake of the Oath many medical students swear by to this day, was among the first to recognise the centrality of diet in disease prevention and treatment. In that Oath, the statement, ‘I will apply dietetic measures for the benefit of the sick according to my ability and judgement’, comes before statements about drugs and surgery. Unfortunately, the importance of diet and nutrition in medicine is lost in most discussions of health system reform today, especially in low-income and middle-income countries (LMICs). Moreover, few food system researchers and policymakers consider the myriad opportunities for improving health through forging partnerships between local food, agriculture and health systems.

    In this commentary, we highlight the potential for healthcare institutions to improve access to and adoption of healthy diets beyond providing nutrition counselling in order to address the full spectrum of malnutrition in LMICs (figure 1) and provide examples of how this framework could be implemented in LMICs. We adopt the United Nations’ definitions of a food system as ‘all activities related to the production, distribution and consumption of food’, and of a …

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