This meeting report is an outcome of the WHO-UNICEF Technical Expert Advisory Group on Nutrition Monitoring (TEAM), which was supported by the Bill & Melinda Gates Foundation. The goal of the consultation was to promote increased communication, coordination and collaboration for the purpose of accelerating progress towards identifying or developing a parsimonious set of metrics for global monitoring of healthy diets for individuals over 2 years of age. Eighty-five participants took part in the consultation, representing a wide range of institutions and roles in the data value chain.

With rapidly changing diets, the burden of disease due to the consumption of unhealthy diets is a worldwide concern. Assessment and monitoring of diets across countries and population groups is critical. However, there are no harmonized metrics for tracking how the healthfulness of diets around the world is evolving. Recognizing the need for consensus and action, and to chart a way forward, FAO, UNICEF, and WHO established the Healthy Diets Monitoring Initiative (HDMI) in 2022. The joint mission of this Initiative was articulated through discussions at a technical expert meeting in Bellagio, Italy, in late 2022. This meeting report includes the discussions and conclusions made on the suitability of existing metrics for assessment and monitoring of healthy diets nationally and globally. It also includes a workplan roadmap for the HDMI for the next two years towards the development of a global guidance on healthy diets metrics.

This report scientifically assesses the validity, usefulness, and fitness-for-purpose of existing healthy diet metrics for population assessment for global and national monitoring. Existing healthy diet metrics were identified and critically assessed through a set of criteria for their use as global and national monitoring indicators. After comparative evaluation, three healthy diet metrics were identified as the most suitable for global and national monitoring. The report highlights strengths and weaknesses for the existing healthy diet indicators. Some may be suitable for simple data collection tools and short data collection time while other indicators may require complex quantitative dietary information, lengthy data collection time, and might need to confirm the validity in various contexts. Some of them may only capture a limited number of the sub-constructs of the construct of healthy diets. The report underlines main knowledge gap regarding the population groups for which the metrics could be used – whether these indicators were developed for a particular demographic and/or socioeconomic groups and their ability to be used for other population groups. The report also identifies key priority areas to further explore how these indicators could be used for more population groups and settings.

It is vital for countries to monitor their population’s diets to inform actions toward improving the health of people and the planet. The healthiness of diets must be tracked in global frameworks, such as the Sustainable Development Goals (SDGs), to help monitor how the world’s population is faring. Currently, few countries regularly assess diets and there are no dietary indicators in global monitoring frameworks. Recognizing the importance of diets for health and the lack of consensus on how to measure and monitor healthy diets at scale, FAO, UNICEF and WHO joined forces to chart a way forward via the Healthy Diets Monitoring Initiative (HDMI). The joint mission of the HDMI is to enable national and global decision-makers and stakeholders to monitor and achieve healthy diets for people and the planet. The current guidance document is focused on healthy diets for healthy people. This version of the document provides an overview of the range of purposes for measuring the healthiness of diets and offers examples of the dietary assessment methods and types of dietary intake data, surveys and metrics that are currently available to monitor healthy diets.

This paper explores the relationship between agriculture, dietary diversity, and market access in Nepal, testing the complex causal chains involved, and the nuanced connections between production diversity and dietary diversity among smallholder farmers. While diversifying farm production could enhance dietary diversity, the case of Nepal indicates a varied and context specific relationship. Market access emerges as a crucial factor, often exerting a more significant impact on smallholder farm households than production diversity. Access to markets not only influences economic viability but also contributes directly to food and nutrition security, offering a practical solution to address dietary needs. Focusing on Nepal's diverse terrain, the study analyzes the interplay of remoteness, market access, irrigation availability, and complementary inputs in shaping farmers' decisions, providing valuable insights into sustainable agricultural strategies for improved dietary outcomes in low- and middle-income countries.

The World Health Report 2000 has generated considerable media attention, controversy in some countries, and debate in academic journals. This volume brings together in one place the substance of many of these key debates and reports, methodological advances, and new empiricism reflecting the evolution of the WHO approach since the year 2000. Specifically, the volume presents many differing regional and technical perspectives on key issues, major new methodological developments, and a quantum increase in the empirical basis for cross-country performance assessment. It also gives the full report of the Scientific Peer Review Group's exhaustive assessment of these new approaches.

Hunger, malnutrition, poor health, and deficient food systems are widespread in Sub-Saharan Africa. While much is known about African food systems and about African health and nutrition, our understanding of the interaction between food systems and health and nutrition is deficient. Moreover, the potential health gains from changes in the food system are frequently overlooked in policy design and implementation.The authors of The African Food System and its Interactions with Human Health and Nutrition examine how public policy and research aimed at the food system and its interaction with human health and nutrition can improve the well-being of Africans and help achieve the United Nations Millennium Development Goals (MDGs). Several of the MDGs focus on health-related challenges: hunger alleviation; maternal, infant, and child mortality; the control of HIV/AIDS, tuberculosis, and malaria; and the provision of safe water and improved sanitation. These challenges are intensified by problems of low agricultural and food system productivity, gender inequity, lack of basic infrastructure, and environmental degradation, all of which have direct and indirect detrimental effects on health, nutrition, and the food system.Reflecting the complexity and multidisciplinary nature of these problems and their solutions, this book features contributions by world-renowned experts in economics, agriculture, health, nutrition, food science, and demography. Contributors: Harold Alderman, World Bank; Christopher B. Barrett, Cornell University; Kathryn J. Boor, Cornell University; Laura K. Cramer, Cornell University; Stuart Gillespie, International Food Policy Research Institute; Anna Herforth, Cornell University; Dorothy Nakimbugwe, Makerere University; Rebecca Nelson, Cornell University, Onesmo K. ole-MoiYoi, Kenyatta University and Kenya Agricultural Research Institute; Per Pinstrup-Andersen, Cornell University and the University of Copenhagen; Marie T. Ruel, International Food Policy Research Institute; David E. Sahn, Cornell University; Barbara Boyle Torrey, Population Reference Bureau; E. Fuller Torrey, Stanley Medical Research Institute; Joachim von Braun, University of Bonn; Speciosa Wandira, Concave International; Derrill D. Watson, Cornell University

Updates for many countries have made it possible to estimate hunger in the world with greater accuracy this year. In particular, newly accessible data enabled the revision of the entire series of undernourishment estimates for China back to 2000, resulting in a substantial downward shift of the series of the number of undernourished in the world. Nevertheless, the revision confirms the trend reported in past editions: the number of people affected by hunger globally has been slowly on the rise since 2014. The report also shows that the burden of malnutrition in all its forms continues to be a challenge. There has been some progress for child stunting, low birthweight and exclusive breastfeeding, but at a pace that is still too slow. Childhood overweight is not improving and adult obesity is on the rise in all regions. The report complements the usual assessment of food security and nutrition with projections of what the world may look like in 2030, if trends of the last decade continue. Projections show that the world is not on track to achieve Zero Hunger by 2030 and, despite some progress, most indicators are also not on track to meet global nutrition targets. The food security and nutritional status of the most vulnerable population groups is likely to deteriorate further due to the health and socio economic impacts of the COVID-19 pandemic. The report puts a spotlight on diet quality as a critical link between food security and nutrition. Meeting SDG 2 targets will only be possible if people have enough food to eat and if what they are eating is nutritious and affordable. The report also introduces new analysis of the cost and affordability of healthy diets around the world, by region and in different development contexts. It presents valuations of the health and climate-change costs associated with current food consumption patterns, as well as the potential cost savings if food consumption patterns were to shift towards healthy diets that include sustainability considerations. The report then concludes with a discussion of the policies and strategies to transform food systems to ensure affordable healthy diets, as part of the required efforts to end both hunger and all forms of malnutrition.