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Global progress in social and economic development is occurring, although slowly, in the most needy parts of the nonindustrialized world, where nutritional deficiencies, including micronutrients, remain significant public health problems. Until empowering benefits accrue from development spin-offs, policy guidance for purposeful public health actions can help reduce the unconscionable toll on health and quality of life from micronutrient malnutrition and can interrupt its intergenerational debilitating effects on national development. Narrowly focused control programs including homestead production, plant breeding, fortification, and supplementation are in effect, but in general, they have not been holistically planned and integrated into overall development programs. Such integration is needed to ensure sustainability into the next century. A new paradigm is needed, including a new way of thinking by nutrition scientists and program implementers that includes partnerships with the poor in all aspects of program planning and implementation. [ABSTRACT FROM AUTHOR]

To reduce the increased burden of diet-related disease and promote human potential through food and nutrition globally, harmonization of efforts is urgently needed. This article examines the concept of food-based dietary guidelines (FBDGs) and discusses the possibilities and challenges of harmonizing the process of developing and implementing dietary guidelines. The authors argue that while the development of FBDGs has contributed to the understanding of the role of nutrients and foods in achieving optimal health, the impact of these guidelines on human health has been limited. Science or evidence must be used in FBDG development; nevertheless, there are limitations in current nutrition science. FBDGs should address the health consequences of dietary insufficiency, excess, or imbalance with a broader perspective, considering the totality of the effects of a given dietary pattern, rather than focusing on single nutrients alone. Moreover, the food selection guideline should be seen as complementary to a strategic, comprehensive, and culturally appropriate dietary and health promoting intervention, and not only as a tool for providing nutrition policy and information. Technically, a single unified global set of FBDGs may be desirable and even achievable. This concept, however, presents novel challenges on how to address cultural diversity and the complex social, economic, and political interactions between humans and the food supply, not to mention the complexity of its communication and implementation. Therefore, global harmonized efforts in support of strategic dietary interventions, together with strong global scientific support and facilitation for the development and communication of FBDGs at national or regional levels, are proposed to implement FBDGs for healthier populations.

Lack of effective implementation mechanisms is identified as a major obstacle in the prevention and control of iron-deficiency anemia. This paper discusses experiences gained from implementing iron-folic acid supplementation in the Philippines, Vietnam, and Cambodia. The understanding of contextual elements is proposed as a foundation for planning interventions. Moreover, it is suggested that a social marketing framework should provide a way of thinking about how to influence related behaviors. The application of a social marketing framework applied using a "5 P's" approach: public relations and collaboration, product, price, place, and promotion, is described, as well as enabling factors (possibilities) and inhibiting factors (challenges) of this approach. Although a program to improve iron nutrition among women of reproductive age may not be simple to implement, it is essential to enhancing health, human development, and economic advancement in developing countries.

Community-based social marketing and mobilization increased knowledge and participation in preventive weekly iron-folic acid supplementation among women of reproductive age in Vietnam. Rates of buying and taking the weekly supplement containing 60 mg elemental iron and 3.5 mg folic acid among non-pregnant women of reproductive age was between 55% and 92%. Free distribution to pregnant women of the weekly supplement containing 120 mg iron and 3.5 mg folic acid covered almost all pregnant women during the project. In developing countries where community women's groups and health networks are strong, preventive supplementation can be successfully promoted to encourage active participation in the prevention and control of iron-deficiency anemia.

Thailand is a Southeast Asian country in rapid transition. It is considered to be food self-sufficient and an important food exporter in the world market. Quantitative data reveal that overall, the population of Thailand consumed a sufficient amount of most macronutrients and micronutrients, except for calcium. Nevertheless, there exist considerable problems of under- and overnutrition, due to unbalanced development in the past 40 y. Programs to increase animal source food intake in Thailand can be categorized into three main types: 1) programs to increase production; 2) programs to increase accessibility; and 3) programs to increase consumption. Overall production of fish, egg, chicken and pork has been adequate; and only beef and milk products need to be imported. To improve access for the poor, the National Poverty Alleviation Plan has been implemented since 1981. In terms of consumption, the Royal Thai government has promoted overall nutritious diets, but does not have national programs to promote animal source foods specifically, except for milk. Programs to increase milk, fish and micronutrient consumption are highlighted. Also, some lessons learned and suggestions for future programs and research are discussed.

Though nutrition communities are still far from understanding how to bring science to bear in formulating effective policies and programs, the contributions of nutrition science have provided recommendations leading to ways and means to improve nutrition in developing countries. To transfer these recommendations into successful implementation, effective nutrition communication has played an important role in the development. Nevertheless, its success has been limited due to several factors including the fact that there is likely only a small proportion of professionals who consistently aim to use theory as a tool to guide action. This paper highlights the importance of using theoretical frameworks to guide the design and implementation. Based on Thailand's experience, social cognitive theory and social marketing are suggested for further applications in developing country context. It is proposed that the role of researchers/practitioners should be formed to facilitate nutrition implementation. Issues relating to the creation of supportive structures and environments i.e. quality personnel, capacity building, proper status and reasonable budgets, are also identified.

What is lacking in nutrition information, education and communication (IEC) work today is accurate knowledge about the processes which bring about beneficial nutritional behavior changes. In this paper, Nutri-action Analysis is proposed as a mechanism for nutrition planners to gain this knowledge and seek ways to improve the effectiveness of nutrition IEC interventions. It suggests that a more holistic and dynamic approach is necessary to conceptualize nutrition IEC and increase its effectiveness in bringing about changes in behaviors which lead to nutritional status improvement. Nutri-Action Analysis, as a research strategy, is illustrated by a three-stage procedure: (i) pre-action, (ii) action, and (iii) post-action. This process leads investigators to begin conducting a macro-analysis of nutrition IEC in general and within their specific contexts in order to understand the system and identify the best approach to be adopted for a nutrition IEC intervention in their particular context. What is discovered should then be tested in a community-based operational research study using both quantitative and qualitative data so that it is possible to subsequently conduct a synthesis focusing on process determinants.