Homelessness: The Hidden Nutrition Issue

The goal of food system transformation is to build a future where all individuals have access to healthy diets against a backdrop of current challenges such as hunger, poor diet quality, inequity and threats to nature. Charitable food donations serve as the primary food source for people who are experiencing homelessness. They suffer disproportionately high rates of diet-related chronic illness such as hypertension, hypercholesterolemia, and diabetes mellitus but are often poorly diagnosed and treated. Yet, the diets and nutrition of homeless populations receive negligible attention as a public health issue. Social institutions such as shelters and soup kitchens have the opportunities to help affect their health. Since this spring, I have begun a monthly commitment to volunteer at two non-government shelters in Washington DC where there are 6,380 people experiencing homelessness on any given day.

With a very small paid staff, The Father McKenna Center serves hot breakfast and lunch for men experiencing homelessness from Monday to Friday while relying on volunteers to providing such care. Having served hot breakfast to guests on a monthly basis there, I observe that the foods are rich in carbohydrates coupled with animal-source protein, with little addition of fruits or vegetables. It is however worth noting that they serve fresh salads for lunch.

An example of sit-down lunch served at the Father McKenna Center. Source: Father McKenna Centre

At Martha’s Table, I volunteer once a month to assist with their mobile food service, McKenna’s Wagon, that distributes meals for people experiencing homelessness directly in downtown DC. The typical package consists of hot meals (as of July 2022, it was rice and beef stroganoff), sandwiches with American cheese and ham, and bottled water. It struck me that many people then asked if we had any vegetarian alternative for the beef stroganoff. While the amazing cook at Martha’s Table would prepare vegetarian options, the quantity was usually much smaller than the typical hot meals so we could not fulfill the guests’ demand for vegetarian meals. This echoes with a 2016 study in DC through a six-month observation at Georgetown Ministry Center shelter that there were increases in consumption when healthier foods were available, in addition to verbal confirmation of interest for healthier options.

Volunteers for McKenna’s Wagon. Source: Author.

So, what can we do about it? First, we need to debunk the common belief that individuals experiencing homelessness have the tendency to desire junk foods. This is a wake-up call for us to tap the potential to impact food access, choice, and quality for homeless populations by donating healthier food products than the common high-starch, high-sugar foods. A 2015 study in ten shelters across Boston finds that two biggest obstacles for shelters to accessing healthy foods were budget and space constraints, but they could still improve food quality even within a budget constraint. Second, nutrition education programs for the cooks, food providers as well as for the guests should be considered to be included in shelters and soup kitchens. Previous research has demonstrated that such nutrition education in shelters was effective and well-received by guests.

 Such concerted efforts to improve the health among people experiencing homelessness would also spill over in other arenas of social life. In today’s difficult time where wars and global pandemics co-exist, we need to invigorate civic engagement in our own society to generate trust, reciprocity, and cooperation. This in turn will help reduce cynicism, and develop social capital that is a critical source to help tackle the issues of inequality, alienation, and crime in industrialized democracies.

Deviana W. Dewi, MA, is an International Development PhD student at the JHU School of Advanced International Studies and a GFEPP Research Assistant.

Diagnosis of Food Systems Worldwide Provides Guidance for Ensuring Healthy Diets and Environmental Sustainability

Food systems worldwide need better governance and accountability to ensure that they deliver healthy diets while safeguarding the environment and natural resources. But decision-makers often lack data about achieving these goals and even where such information does exist, tools are lacking to assess food systems’ performance. A paper published today in PLOS is the first of its kind, drawing on more than 600,000 data points, to develop a methodology for diagnosing food systems’ performance to help inform food systems governance and accountability around the globe.

“This paper presents a diagnostic methodology for 39 indicators representing food supply, food environments, nutrition outcomes, and environmental outcomes to assess performance of national food systems,” said co-author Jessica Fanzo, Bloomberg Distinguished Professor of Global Food Policy and Ethics at the Johns Hopkins Berman Institute of Bioethics. “This information can be used to generate actions and decisions on where and how to intervene in food systems to improve human and planetary health.”

Food systems include the people, places, and methods involved in producing, storing, processing and packaging, transporting, and consuming food. They can consist of either long or short supply chains and be global or local. Johns Hopkins University and The Global Alliance for Improved Nutrition (GAIN) launched a Food Systems Dashboard in 2020 to provide a single platform for food systems data relevant to diet and environmental outcomes, and to enable the use of these data by policymakers, non-governmental organizations, civil society leaders, educators, and researchers. The Dashboard draws upon more than 30 sources to provide data from over 200 indicators across 230 counties and territories, to support informed policy making and other uses.

The authors of the paper, “Diagnosing the performance of food systems to increase accountability toward healthy diets and environmental sustainability,” drew upon the Dashboard to establish parameters for likely challenges within national food systems.

“We hope this diagnosis will aid the interpretation of food systems data, so that decision-makers can see what is going relatively well as well as what is challenging in each setting and consider a range of possible actions to address challenges and maintain successes. It can be used to identify an array of possible actions to improve food security, diet, health, and environmental outcomes,” said Anna Herforth, of Harvard University, the first author of the paper who led the study.

The paper includes a global assessment and country case studies to illustrate how the diagnostics could spur decision options available to countries. For example, in Tanzania, the paper’s authors identify the challenge of child stunting and recommend policy and actions that may be appropriate to addressing it, such as investing in market infrastructure to enhance access to nutritious food and utilizing social protection platforms to enhance the purchasing power of women, especially around pregnancy.

“No single action can fix food systems, but governments, NGOs, civil society and businesses can each start to take action. We hope these diagnostics are a step towards better monitoring of food systems performance that can lead to stronger governance and accountability of food systems and their transformation,” said Stella Nordhagen, co-author of the paper, and Senior Technical Specialist at GAIN.

Jessica Fanzo named to Group Seeking Systemic Solutions for Climate Change’s Impact on Food Systems

Berman Institute faculty member Jessica Fanzo has been named to the recently launched Board for International Food and Agricultural Development (BIFAD) subcommittee on Systemic Solutions for Climate Change Adaptation and Mitigation in Agricultural, Nutrition, and Food Systems. The subcommittee will lead transdisciplinary evidence gathering to advise BIFAD with independent recommendations to improve U.S. Agency for International Development (USAID) programming and strategies.

“As a global community, we must act quickly to avoid the most severe consequence of climate changeon the world’s food supply and the health, food security, and safety of the world’s most vulnerable populations,” said Fanzo.

Dr. Fanzo is the Bloomberg Distinguished Professor of Global Food Policy and Ethics at the Berman Institute of Bioethics, the Bloomberg School of Public Health, and the Nitze School of Advanced International Studies at Johns Hopkins University. She also serves as the Director of Hopkins’ Global Food Policy and Ethics Program, and as Director of Food & Nutrition Security at the JHU Alliance for a Healthier World.

“I am honored to serve on the BIFAD Subcommittee on Systemic Solutions to Climate Change Adaptation and Mitigation. Alongside twelve other global experts, we recently began our work supporting BIFAD and USAID toward our shared goal of a resilient, prosperous, and equitable world with net-zero greenhouse gas emissions. Together, we have the important task of exploring evidence-based climate change action in programs aimed at safeguarding agricultural productivity, inclusive food systems changes, and poverty- and malnutrition-reduction objectives.”

The subcommittee is envisioned to support USAID’s role in accelerating systems change and transformative climate change adaptation and mitigation approaches in agriculture, food systems and nutrition, and in targeting climate finance to benefit smallholder farmers.  Subcommittee members bring a breadth of expertise across disciplines, diversity of views, and organizational perspectives to tackle the greatest challenge to food security.

Work Begins on Project to Incorporate Human Rights-Based Frameworks into Food Systems Policy and Planning

The Consortium for People-Centered Food Systems, led by Bloomberg Distinguished Professor Jessica Fanzo at Johns Hopkins University, has initiated the first phase of its ten-year effort to foster human rights-based approaches to food systems policy and planning. This effort seeks to strengthen the capacity of governments, peasants, and other people living in rural areas to adopt and incorporate human rights frameworks such as the UN Declaration on the Rights of Peasants and Other People Working in Rural Areas (UNDROP) into food policy and food systems action.

Adopted in 2018, UNDROP proposes that countries work with rural food system actors to create policies that promote and protect the right to adequate food, food security and food sovereignty, sustainable and equitable food systems, and others, such as the right to land, water, and seeds.

This interdisciplinary project seeks to use advocacy, build capacity, and develop accountability tools to better integrate human rights frameworks into the food systems policy context. Led by Dr. Fanzo, the project consortium includes academics, development practitioners, ethicists, and lawyers from Johns Hopkins University, RikoltoInternational Institute of Rural Reconstruction, and CIAT on behalf of the Alliance of Bioversity International and CIAT. The project is jointly funded by member organizations and the Swiss Agency for Development and Cooperation.

“Small-scale farmers produce more than 80% of the world’s food, but this diverse population suffers disproportionately from hunger, poverty, discrimination, violent conflict, and climate change. Human rights instruments like UNDROP represent a major step forward in protecting their human rights, but more work is needed to integrate them into food systems policy effectively,” says Dr. Fanzo.

Dr. Fanzo is the Bloomberg Distinguished Professor of Global Food Policy and Ethics at the Berman Institute of Bioethics, the Bloomberg School of Public Health, and the Nitze School of Advanced International Studies at Johns Hopkins University. She also serves as the Director of Hopkins’ Global Food Policy and Ethics Program, and as Director of Food & Nutrition Security at the JHU Alliance for a Healthier World.  Faculty joining Dr. Fanzo in this work from JHU include Drs. Leonard RubensteinAnne Barnhill, Swetha Manohar, and Rebecca McLaren.

Initial project activities will take place in Cambodia, Ethiopia, Honduras, and Uganda, and are funded by the Swiss Agency for Development and Cooperation. In each of these countries, project team members are partnering with Rikolto, IIRR, CIAT, and local stakeholders to assess the food systems context and identify potential areas for improvement in awareness, capacity, accountability, and policy coherence. Later phases of the project will aim to scale the approach to other countries and produce global guidance on putting people’s rights at the center of food systems. In the next few months, countries will begin by sensitizing the project in the four countries with local stakeholders and governments and will produce a paper on what it means in practical terms to integrate rights into food systems action and policy.

For media inquiries, contact: Jamie Smith, Jamie.smith@jhu.edu

Agri-food Systems Transformation: New, Ambitious Framework Proposed to Monitor Progress

Sustainable, resilient, just, and equitable food systems that support access to healthy diets for all are possible. Realizing this potential is of utmost, urgent importance if the world is to achieve the Sustainable Development Goals by 2030, the Paris Agreement, and other global goals. The UN Food Systems Summit in 2021 highlighted both the challenge and the opportunity for food systems transformation. However, at present there is no rigorous, coordinated effort to monitor all aspects of food systems and their interactions to set priorities and track progress. In a new paper, “Viewpoint: Rigorous monitoring is necessary to guide food system transformation in the countdown to the 2030 global goals,” Dr. Jessica Fanzo of the Johns Hopkins Berman Institute of Bioethics and colleagues call attention to this need for global food systems monitoring in order to inform decisions and support accountability for and good governance of the transformation process.

Under the leadership of Dr. Fanzo, Dr. Lawrence Haddad of GAIN, and Dr. Jose Rosero Moncayo of the United Nations Food and Agriculture Organization, over 50 collaborators have come together to propose a rigorous monitoring framework for food systems populated with a clear set of relevant, high quality, interpretable, and useful indicators to support evidence-based policymaking and those who hold decision-makers to account. In this initial paper, the authors have developed an overarching framework that establishes five core thematic areas in need of monitoring: (1) diets, nutrition, and health; (2) environment and climate; and (3) livelihoods, poverty, and equity; (4) governance; and (5) resilience and sustainability. Under these areas, they have established indicator domains and will go through a rigorous process over the next year to select the indicators to be monitored within each and produce a baseline assessment of global food systems.

Learn more about Professor Fanzo’s work in Food Systems Monitoring.

Exploring the Global Systems that Shape Diets and Nutrition for Nations Around the Globe

From the impacts of quinoa’s global popularity on small-scale Andean farmers, to challenges gaining public acceptance of genetically modified rice in the Philippines, to threats to human health from deforestation and cattle production in the Amazon, ensuring optimal diets and nutrition for the global population is a grand challenge fraught with many contentious issues. Food security for all depends on functional, equitable, and sustainable food systems, highly complex networks of individuals and institutions that rely on governance and policy leadership.

In Global Food Systems, Diets, and Nutrition: Linking Science, Economics, and Policy, a new textbook published this month by Palgrave Macmillan, authors Jessica Fanzo and Claire Davis of Johns Hopkins University explain how interconnected food systems and policies affect diets and nutrition in high-, middle-, and low-income countries. In tandem with food policy, food systems determine the availability, affordability, and nutritional quality of the food supply, which influences the diets that people are willing and able to consume.

“Global food systems touch on every aspect of society in both positive and negative ways. The challenges facing food systems are critical ones that demand urgent attention. As Covid-19 and climate change are showing, our food systems are fragile and inequitable. The book tackles why that is, and what can be done about it,” said Fanzo, the Bloomberg Distinguished Professor of Global Food Policy and Ethics at Johns Hopkins. “This book is a comprehensive evaluation of how food systems and policy intersect around the world to affect diets and nutrition. By taking a global perspective on food systems and policy, it fills a gap among existing academic textbooks”

Readers will become familiar with both domestic and international food policy processes and actors and be able to critically analyze and debate how policy and science affect diet and nutrition outcomes.

Part I provides an introduction to the key concepts of food systems and food policy. Part II explores the causes and consequences of global malnutrition, assesses the current state of global dietary patterns, and analyzes how various drivers affect food systems, diets, and nutrition. Part III covers the global policy landscape and its influence on diets and nutrition, including policies affecting the food supply chain, food environments, and consumer behavior. Part IV focuses on new challenges to achieve healthy diets for nutrition, addressing the accessibility of diets, sustainable diets amidst the threat of climate change, and new technologies shaping diets and nutrition.

“Our hope is that this book will help educate the next generation of policymakers, researchers, and public health practitioners and improve their understanding of global food policy processes and actors,” said Davis, a science writer for the Global Food Ethics and Policy Program at the Berman Institute of Bioethics.

Case studies examine experiences from Brazil, South Sudan, Malawi, Ethiopia, Mexico, Chile, India, Denmark, Pacific Island countries, United States, and many other countries from around the world. Additional features include chapter introductions and illustrative figures.

“While students enrolled in public health nutrition and policy courses are our intended audience, many chapters may also interest lay readers who want a deeper dive into food systems and policy,” said Davis.

Jessica Fanzo is the Bloomberg Distinguished Professor of Global Food Policy and Ethics at the Berman Institute of Bioethics, the Bloomberg School of Public Health, and the Nitze School of Advanced International Studies at Johns Hopkins University. She also serves as the Director of Hopkins’ Global Food Policy and Ethics Program, and as Director of Food & Nutrition Security at the JHU Alliance for a Healthier World. From 2017 to 2019, Jessica served as the Co-Chair of the Global Nutrition Report and the UN High Level Panel of Experts on Food Systems and Nutrition. Claire Davis is a Science Writer for the Global Food Ethics and Policy Program. Her work focuses on the relationship between food and diets, human health, and environmental sustainability.

Prof. Fanzo Awarded $3.8 Million to Apply Human Rights-Based Approach to Food Systems

The Berman Institute of Bioethics’ Jessica Fanzo, Bloomberg Distinguished Professor of Global Food & Agricultural Policy and Ethics at Johns Hopkins University, has received a $3.8 million grant to apply a human rights-based approach to food systems. The Swiss Agency for Development and Cooperation will contribute half of the grant funding, with the remainder funded jointly by the multidisciplinary project consortium’s member organizations. The consortium includes Johns Hopkins University, CIAT on behalf of the Alliance of Bioversity International and CIAT, The International Institute of Rural Reconstruction, and Rikolto. The award supports the first phase of a ten-year project to strengthen the capacity of governments, peasants, and other people living in rural areas to adopt and incorporate human rights frameworks such as the UN Declaration on the Rights of Peasants and other People Working in Rural Areas (UNDROP) into food policy and food systems action.

The project, “People-centered Food Systems: Fostering Human Rights-based Approaches,” aims to characterize constraints globally and within countries for peasants and other rural dwellers to claim their rights to food security, adapt to and mitigate against climate change, and preserve the agrobiodiversity fundamental to their livelihoods. Led by Dr. Fanzo, the multidisciplinary project consortium includes academics, development practitioners, ethicists, and lawyers from its member organizations.

“Small-scale farmers produce more than 80% of the world’s food, but this diverse population suffers disproportionately from hunger, poverty, discrimination, violent conflict, and climate change. Human rights instruments like UNDROP represent a major step forward in protecting their human rights, but more work is needed to integrate them into food systems policy effectively,” says Dr. Fanzo.

Dr. Fanzo is the Bloomberg Distinguished Professor of Global Food Policy and Ethics at the Berman Institute of Bioethics, the Bloomberg School of Public Health, and the Nitze School of Advanced International Studies at Johns Hopkins University. She also serves as the Director of Hopkins’ Global Food Policy and Ethics Program, and as Director of Food & Nutrition Security at the JHU Alliance for a Healthier World.  With twenty years of research and program experience working in the field in sub-Saharan Africa, South and East Asia, and the United States, her area of expertise focuses on the impact of transitioning food systems on healthy, environmentally sustainable and equitable diets, and more broadly on the livelihoods of people living in resource-constrained places. Faculty joining Dr. Fanzo in this work from JHU include Drs. Leonard Rubenstein, Anne Barnhill, Swetha Manohar, Rebecca McLaren, and staff Science Writer Claire Davis.

The project team seeks to use advocacy, build capacity, and develop accountability tools to better integrate human rights frameworks within food system policy and action. Initial project activities will take place in Cambodia, Ethiopia, Honduras, and Uganda with the intention of scaling up the approach to other countries in later phases and producing global guidance on this issue.

Other members of the project consortium include CIAT on behalf of the Alliance of Bioversity International and CIAT, The International Institute of Rural Reconstruction, and Rikolto.  CIAT on behalf of the Alliance of Bioversity International and CIAT is an international research for development organization that is part of the Consultative Group on International Agricultural Research, the largest international network on agricultural public research to service the global South. The International Institute of Rural Reconstruction is an international not-for-profit organization aimed at enabling communities, and those who work with them, to develop innovative yet practical solutions to poverty through a community-led development approach, and to share widely these lessons to encourage replication. Rikolto is an experienced market system & inclusive business facilitator, using innovative approaches in co-creation with a sector-wide range of partners to find more sustainable ways of accessing, distributing, and producing nutritious food, so no one is left behind.

Nataly Pinto, Director of Sustainable Food Systems at Rikolto, says, “Rikolto charts a clear and unifying path toward sustainable food systems by focusing on interventions like these to reshape the roles of multiple food system actors from the global to the local level. We are excited to be part of this joint effort together with JHU, CIAT on behalf of the Alliance of Bioversity International and CIAT, and the International Institute of Rural Reconstruction, supported by the Swiss Agency for Development and Cooperation to enable a human rights-based approach to food systems. Access to sufficient and healthy food is a right…not a privilege.”

Bug Appetit: Why Eating Cicadas is Good for the Environment

Trillions of cicadas are poised to get their buzz on across much of the United States, with the once-every-17-year emergence of Brood X. Hope you’re hungry!

One person’s infestation is another’s free eco-friendly lunch, according to Johns Hopkins University sustainable food expert Jessica Fanzo, author of the forthcoming Can Fixing Dinner Fix the Planet?

Fanzo, who plans to collect and eat cicadas herself as soon as they hit her own backyard, can explain how the insects have as much protein as red or other factory-farmed meat, but without the harsh environmental effects, including greenhouse gases and biodiversity loss.

She can also discuss how insects are already an established source of protein around the world, including in Mexico, where people eat crickets; in Thailand, where people enjoy water bugs; and in Africa where people regularly eat locusts and crickets.

Fanzo, Bloomberg Distinguished Professor of Global Food Policy and Ethics at the Berman Institute, who has sampled most of the insect dishes of other cultures, believes the shrimp-tasting cicadas of the United States should certainly rank among them, although the North American palate might not be ready.

“There is the yuck factor but people who are looking for alternative sources of animal protein shouldn’t rule out cicadas” she says. “They’re a great natural source of protein and other nutrients, there’s going to be a lot of it in a very short period of time so, it’s a great opportunity to give them a try.

“Once you get over the look of them, they’re quite tasty.”

In Can Fixing Dinner Fix the Planet? Fanzo explores the interactions among food systems, diets, human health, and the climate crisis. Drawing upon her decades of hands-on research projects in Africa, Asia, Europe, and the Americas, Fanzo describes how food systems must evolve to promote healthy, sustainable, and equitable diets.