GLOBAL: Food and nutrition jargon buster

Follow @{0}NAIROBI, 12 September 2011 (IRIN) - The humanitarian spheres of food and nutrition are rich in specialized terminology. This glossary defines most of the more common terms employed.
* The text in blue links to related IRIN reports.

Acute malnutrition: A sudden, drastic reduction in nutritional intake. Affects some 55 million children around the world. See GAM, MAM, SAM. Cf chronic malnutrition.

BMI - Body mass index: The number reached when weight (in kg) is divided by the square of height (in metres). Used in assessments of malnutrition.

BNSP - Basic nutrition services package: Measures to treat and prevent malnutrition as well as to promote optimal nutrition behaviours and practices, including acute malnutrition management, micronutrient support, immunization and deworming.

BSFP - Blanket supplementary feeding programme: See SFP

CDR - Crude death rate: Deaths per 10,000 people per day in a given area over a specified period. A rate above two contributes to a declaration of famine. (Note the non-standard use in the humanitarian context. In demographics, CDR is generally defined as deaths per year per 1,000 people.).

Chronic malnutrition: A long-term deprivation of required nutrients. Can cause stunting.

Complementary feeding: For very young children, complementary feeding starts at six months as breast-milk is no longer adequate for a child's nutritional needs. For populations dependent on food aid, additional food items are often added to make the diet more nutritious and in particular to ensure adequate micronutrients.

Complications: Symptoms associated with acute malnutrition that require specialized in-patient treatment. These include swelling (Oedema), fever, lower respiratory tract infection, severe dehydration, anaemia, lack of alertness and lack of appetite for the products used for out-patient treatment.

CSI - Coping strategies index: A numerical indicator of household food security based on a questionnaire about what people do in the absence of sufficient food or money to buy such food. CSI is used to predict food crises, identify specific areas of greatest need, assess the impact of food aid programmes in emergencies and to outline long-term trends.

CSB - Corn-soya blend: A partially pre-cooked fortified food to supplement protein used in SFPs and MCH consisting of maize, soya beans, sugar, vitamins and minerals, consumed as porridge.
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CSB+: A variant of CSB for children aged two years and over. Also known as Super Cereal.

CSB++: A variant of CSB made of de-hulled soya beans, sugar, dried skim milk, refined soya bean oil, vitamins and minerals. Also known as Super Cereal Plus. Used as a complement to breast-feeding for children aged between six and 24 months.

CTC - Community-based therapeutic care: Management of acute malnutrition in the home rather than in TFCs with an added community focus, often involving referral by or follow-up from community health workers.

Famine: The most serious of the food security phases of the IPC, which describes Famine/Humanitarian Catastrophe as: “Extreme social upheaval with complete lack of food access and/or other basic needs where mass starvation, death, and displacement are evident.”

Famine is declared when GAM exceeds 30 percent AND CDR exceeds two AND at least 20 percent of a population receives less than 2,100 calories per day.

In the current food crisis in the Horn of Africa, six areas of Somalia are affected by famine, but no areas in other countries in the region fall into this phase at the time of writing (early September 2011).
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Food Security: Two straightforward words with, when combined, about 200 definitions and 450 indicators, and that was in 1999*. Recent decades have seen definitions evolve from a purely supply-side focus (how much food is there?) to incorporate demand-side factors (what can people afford?). In 2002 the UN Food and Agriculture Organisation defined food security as a “situation that exists when all people, at all times, have physical, social, and economic access to sufficient, safe, and nutritious food that meets dietary needs and food preferences for an active and healthy life”. Food security is often broken down into three components: availability (in an area), access (by a household) and utilization/consumption (by individuals). The stability over time of these components is also a key factor.
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GAM - Global acute malnutrition: The total rate of acute malnutrition in a given population, this is assessed in children aged between six and 59 months by determining the proportion whose HFW, MUAC, etc measurements deviate by standardized degrees (see Z-scores) from the median or other benchmarks. See MAM, SAM.

GFD - General food distribution: The free distribution of a mixed basket of food, usually including gains, pulses and vegetable oil, to a particular population that lacks access to normal food sources because of a crisis. GFD is designed to meet immediate food needs and protect livelihoods.

HDDS – Household dietary diversity score: A measure of the range of food groups (cereals, vegetables, meat, fish, etc) consumed in a household in a given period. Twelve groups are used in the evaluation and the HDDS ranges from 0 to 12.

Photo: Jaspreet Kindra/IRIN

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HEA - Household economy approach: A framework for analyzing how people obtain food, non-food goods and services, and how they might respond to changes in their external environment, such as a drought or a rise in food prices.

HFA - Height for age: A measurement taken in assessments of malnutrition in children aged between six and 59 months.

HHS – Household hunger scale: A tool to measure household food deprivation, used to improve targeting of interventions and evaluate food security policies. A simple questionnaire produces one of three scores: Little to no household hunger; moderate household hunger; and severe household hunger.

HINI - High impact nutrition interventions: A comprehensive package of nutrition interventions including improved practices, micronutrient supplementation and management of malnutrition, which have proven impact on mortality and morbidity.

IPC - Integrated Food Security Phase Classification : A scale developed by UN agencies and NGOs using existing data (mortality rates, GAM, access to food and water, security, etc) to place geographical areas into categories ranging from “Generally food secure” to “Famine”, with the aim of harmonizing humanitarian analysis of and responses to crises, and ensuring the most efficient allocation of resources. IPC has been adopted in Burundi, Côte d’Ivoire, Kenya, Somalia, North Sudan, South Sudan and Uganda.

IMAM - Integrated management of acute malnutrition: A strategy aimed at integrating the prevention and treatment of MAM and SAM into routine health services.

IYCF - Infant and young child feeding: Nutritional strategies designed to reduce child mortality and malnutrition by promoting optimal breast-feeding, complementary feeding, hygiene and childcare-related practices as well as related maternal nutrition and health.

Kwashiorkor – A condition caused by SAM characterized by bilateral pitting oedema. Increased water retention means that such severely malnourished children may not display weight loss. Kwashiorkor can cause tight, shiny skin and discolour the hair.

Livelihood: How people make ends meet. Usually applied to vulnerable rural populations, especially pastoralist communities. Programmes that support livelihoods are designed to increase communities’ ability to survive (economic, weather, etc) shocks.

Livelihood assets: Factors that contribute to livelihood. These include natural resources, skills and technology, health, education, access to credit and social networks.

MAM – Moderate acute malnutrition: Also known as moderate wasting. Indicated when WFH is less than 80 percent of the median, or between minus two and minus three Z-scores from the median WFH of the standard reference population.
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Malnutrition: A condition resulting from inadequate food intake, sub-optimal care practices and diseases, resulting in increased vulnerability to disease and death, as well as mental and physical growth retardation. See GAM, SAM, MAM.

Marasmus: Severe wasting. Defined by WFH under 70 percent of (or more than three Z-scores under)  the median WFH for the standard reference population, and/or MUAC less than 115mm in children under five. A symptom of SAM, marasmus often produces a wizened appearance.

MCHN - Maternal and child health and nutrition: An interdisciplinary approach to the factors that influence the health and healthcare of women and children. Sometimes referred to as MCH

MUAC - Middle upper arm circumference: A measurement taken in the assessment of malnutrition which provides a good indicator of mortality risk.
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Nutrition: Strictly speaking, the provision of the various food substances required to maintain life. In the broader context of humanitarian interventions, good nutrition is the result of adequate food security, health and care. It encompasses a diet of sufficient quantity and – particularly in the case of children – variety, as well as the availability of clean water and decent sanitation and hygiene. Health is a component of nutrition because sickness can suppress appetite and reduce the absorption and retention of key micronutrients. Nutrition responses prioritize the most vulnerable people in a population: infants, children, pregnant women and breastfeeding mothers because it is very young children whom malnutrition adversely affects most severely and long-lastingly.
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Oedema: Swelling due to accumulation of water in body tissues, most commonly in the feet and legs. If a depression caused by applying a finger to a swollen area persists for some time the oedema is described as “pitting”, and “bilateral” when two feet or legs are affected.

OTP - Out-patient therapeutic programme: Treatment of uncomplicated cases of SAM using specialized products. See RUTF

Plumpy’Nut : Peanut paste RUTF for severely malnourished children.
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Plumpy’Sup: Peanut paste RUSF for moderately malnourished children.

Photo: Ann Weru/IRIN

Weight-for-height is a key factor in assessing malnutrition

Protective ration: Food sometimes given to immediate relatives of malnourished TSFP recipients to reduce the chance of the specialized food being shared among family members.

RUSF – Ready-to-use supplementary food: Specialized foods fortified with micronutrients for the management of MAM . Produced in the form of pastes, compressed bars and biscuits, RUSFs are designed to deliver a wide range of required nutrients in a relatively small quantity of food.

RUTF - Ready-to-use therapeutic food: Specialized, ready-to-use foods for management of SAM. A range of products is available and in use, some of them peanut-based pastes. See Plumpy’Nut, Plumpy’Sup

SAM - Severe acute malnutrition: A sub-category of GAM in which patients’ WFH is less than 70 percent of the median or whose MUAC is less than 110mm or who present oedema. Such measurements are generally taken from children aged six months to five years. SAM increases susceptibility to disease and mortality risk. SAM above 5 percent in a given area’s population is generally considered “very critical”, although the rate of increase in SAM is also a key factor in planning interventions.

SC - Stabilization centre: Specialized medical facility for the treatment of acute malnutrition with complications.

SFP - Supplementary feeding programme: The provision of specialized food to ensure beneficiaries receive the requried number of daily kilocalories and key micronutrients to recover from moderate malnutrition (MAM), or to prevent them reaching that state. A targeted programme (TSFP) is geared towards children and pregnant/lactating women who have been diagnosed as moderately malnourished  and often uses RUSF or CSB++ and vegetable oil. A blanket programme (BSFP) is more preventative and used when GAM rates are very high or among populations where there is a high nutritional risk, such as patients with TB or HIV/AIDS. It is provided to all members of a demographic group, such as children under five, pregnant or lactating women, the sick and elderly.

SSR – Food self-sufficiency ratio: The magnitude of food production in relation to domestic utilization. Defined as: production divided by production-plus-imports-minus-exports times by 100. SSR is used for specific commodities and groups of commodities. The higher the ratio the greater the self-sufficiency.

Stunting: Being too short for one’s age. A synonym for, and major effect of or adaptation to chronic (as opposed to acute) malnutrition, which can impede both physical and cognitive development. Stunting can also be caused by repeated acute infections.

Therapeutic feeding: The provision of medical care and all required nutrients to severely malnourished children. It is the service provided under various headings such as TFC, TFP, OTP, CTC etc.

TFC -Therapeutic feeding centre: see above

TFP – Therapeutic feeding programme: see above

U5DR – Under-five crude death rate: CDR among children under five.

Wasting: Being dangerously thin in relation to height.

Wet feeding: The supply of cooked or ready-to-eat meals, used in extreme situations when cooking beans, pulses and grain, etc, in the home is impractical for sanitary or security reasons or when populations are on the move.

WFH – Weight for height: An indicator of acute malnutrition/weight-loss. Also used to evaluate responses to food crises.

Z-score: A statistical term used to define the gap between an individual measurement (of, for example WFH) and the median among a reference population. Also called a standard deviation, a Z-score is a sort of standardized yardstick that can be applied to different data sets.

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*Hoddinott, J. 1999. Operationalizing household security and development strategies. An introduction. Technical guideline No 1, International Food Policy Research Institute, Washington, D.C., USA

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