Advancing research

Sight and Life contributes to growing new evidence for nutrition interventions, and supports thought leadership – discussion and debate on key nutrition issues amongst stakeholders. A key focus is to actively explore innovative implementation platforms, and support leadership development.

Ghana GIZ-DSM: partnering and co-funding Affordable Nutritious Food For Women

Sight and Life recognizes that nutrition during a child’s first 1,000 days depends, to a greater extent, on the nutrition status of the mother. We are partnering and co-funding an Affordable Nutritious Food For Women project in Ghana together with the German Development Agency (GIZ), within the greater German Food Partnership program.  

Sight and Life’s main role is to provide technical expertise on formative assessment, in order to select the appropriate food product, recipe, and product formulation to both meet nutritional needs and ensure its acceptability amongst Ghanaian women. The project will also support the development of a business case for small- and medium-size enterprises, and provide support for a broader social marketing campaign to increase nutrition awareness within the target group. It is hoped that, if successful, this approach could provide a blueprint for best practice for private sector engagement when developing affordable and nutritious foods in other developing countries.

Micronutrient powders (MNPs): developing applications for home fortification

Sight and Life is actively involved with partners in developing packaging innovations and applications around multiple micronutrient powders (MNPs), which provide an easy-to-use, practical solution towards improving the vitamin and mineral status of targeted individuals.

In conjunction with the United Nations World Food Programme, Sight and Life has developed single multiple MNP sachets which can be used for home fortification to ensure that the micronutrient needs of infants and young children, who are often the most vulnerable when it comes to micronutrient deficiencies, are met without making any changes to their traditional diet.

At Sight and Life, we continue to advance research in the field of MNPs in collaboration with the Swiss Federal Institute for Technology, Save the Children, and the London School of Hygiene and Tropical Medicine. This includes the development of new formulations, which address specific needs in the context of diseases such as malaria and diarrhea, and the investigation of new delivery platforms in order to scale up MNP interventions.

Sight and Life, together with Scientists Without Borders and The Sackler Institute for Nutrition Science, initiated » an open innovation competition to promote innovations for more sustainable and environmentally friendly packaging for MNPs. This illustrates our care for both the nutritional sufficiency of the sachet contents, and the impact the packaging has on the environment.

Macheo Children’s centre, Kenya: empowering and protecting vulnerable children

Sight and Life supported the initiation of the Macheo Children’s Centre school feeding program (» www.macheo.org) at Mugomo-ini Primary School Kenya in 2011. More recently, working in conjunction with John’s Hopkins University, Sight and Life funded a project to develop an evaluation tool for the program.  

Macheo Children’s Centre helps empower and protect vulnerable children and their communities to provide them with a brighter future. The Children’s Home provides over 50 vulnerable children with a stable home environment and support. The School Program for over 12,000 children provides primary school children in 21 public schools with daily meals, counseling, psycho-social support, and an improved infrastructure aiming to remove financial barriers to education for adolescent girls most at risk of dropping out of secondary school.

It is essential to have the tools to evaluate this and other similar programs, so that interventions have the maximum impact on health and well-being.  The Sight and Life and John Hopkins University project involved a food insecurity and anthropometric survey of over 500 caregiver-child pairs from schools working with the Macheo primary school program, providing insights into the current food insecurity and nutrition situation and facilitating the development of future evaluation tools. Working together with Macheo, Sight and Life intends both processes, tools, and knowledge to be more broadly applied to longer-term Macheo activities.

Anne-Catherine Frey:

“With our new focus on a multiple micronutrient approach, Sight and Life’s activities now include in-home fortification programs. These provide micronutrient powders (MNPs) packed individually in single-dose sachets that can be added to meals after food preparation – at home, or at school, and so benefit the most vulnerable with improved nutrition.”

Implementation Research: generating thought leadership and supporting advocacy

Sight and Life and the nutrition community are increasingly aware that nutrition’s new frontier is implementation science. As many countries look to scale up proven nutrition interventions, the challenge today is how best to deliver them within existing health systems or large-scale programs, where delivery relies on staff motivation, training, work-load, cost, eating habits, and the food environment of the target population.

Sight and Life is working with a number of partners on increasing this discussion, and generating thought leadership on implementation for scaling up effective and efficient approaches. This is being supported by an advocacy campaign to spark dialogue around implementation science. This is critical if we are to show that nutrition interventions can and do make a real difference when scaled-up, and is to ensure on-going commitments from all stakeholders to nutrition programs.

Together with Cornell University and Helen Keller International, we are developing an implementation conceptual framework paper, and are establishing the International Society for Implementation Science in Nutrition (ISISN). The aim of ISISN is to bring together scientists and program implementers to support a systematic approach to implementing efficacious nutrition interventions at scale in countries, and to guide developments in this field.

iCheck: From challenge to solution - developing and validating a tool to assess vitamin A status

Sight and Life has long recognized that the lack of simple, field-ready tools to analyze micronutrient concentration in both blood and food has been a significant challenge, requiring an innovative solution. Sight and Life has been part of the collaboration to develop the iCheck tool, an effective and efficient means of measuring vitamin A in biological and food samples.  

We therefore worked with BioAnalyt, Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM), and the Swiss Tropical and Public Health Institute to develop and validate an easy-to-use handheld tool for assessing vitamin A status, known as the ‘iCheck’. This resulted in a breakthrough. Today, iCheck delivers reliable results, empowering those who have the need to make decisions autonomously. iChecks are currently used in over 60 countries by researchers, monitoring authorities and quality control managers. Its usage ensures food safety and quality, and will thus save and improve peoples’ lives.  

Noel W. Solomons, Scientific Director, CeSSIAM Guatemala City:

 “Guatemala is one of the countries with obligatory fortification of granulated table sugar with vitamin A. We have been able to verify that the readings the iCHECK FLUORO gives for sugar vitamin A concentrations conforms to level mandated by the national norm.”

The Complementary Food Supplement Project: advancing knowledge of nutritional components

Sight and Life is not only about micronutrients. We also advance knowledge around other nutritional components which contribute to achieving optimal nutrition and health, especially for the most vulnerable.

Sight and Life is engaged with other partners in a study being undertaken in South Africa by North West University to investigate the effects of two fortified complementary food supplements on growth in young children.

The first product is a fortified fat-based paste, which provides essential fatty acids, decosahexaenoic acid (DHA), and arachidonic acid (ARA). The second is a fortified fat-based paste, which provides essential fatty acids from vegetable oil alone.

The study’s objective is to determine the two products’ impact on addressing malnutrition, and improving psychomotor development in young children. The ultimate aim is to support the development of solutions, beyond the provision of micronutrients alone, which comprehensively address malnutrition in young children. 

Phytase: increasing iron and zinc absorption

Sight and Life believes in innovation to address some of the world’s most pressing nutrition challenges. Despite many interventions, iron and zinc deficiency remain major public health problems in many parts of the world. An exciting development supported by Sight and Life is the enzyme phytase and the potential role of the enzyme in increasing the bioavailability of the micronutrients.

Infants, young children, and women of reproductive age are particularly vulnerable to iron and zinc deficiency, due to their high requirements. Despite the fact that Iron and zinc are found in significant amounts in the plant-based diets typically consumed in developing countries, their bioavailability is low due to the high levels of absorption inhibitors, such as phytate, in these same diets. These absorption inhibitors make it a challenge to meet specific individual dietary needs, particularly for vulnerable groups.

Sight and Life recognized the potential of the enzyme phytase to increase mineral bioavailability, and in collaboration with the Swiss Federal Research Institute initiated research to prove the concept. It has subsequently been demonstrated that adding phytase to foods at the time of consumption increases iron and zinc status in humans. Thus, when phytase is added to multiple micronutrient powders (MNPs) to overcome the anti-nutritive effects of phytic acid, it has the potential to further improve micronutrient status in diets containing a significant amount of phytic acid.  A number of peer-reviewed publications give more detailed information on this research. Today, the enzyme is available to the market.

 

Risk-benefit models: assessing fortification projects’ health impacts and consequences

Sight and Life has been involved with supplementation and fortification initiatives to eradicate vitamin A deficiency for many years. Countries face major challenges when developing and implementing food fortification strategies. These include how to set effective and safe vitamin A fortification levels, and how to choose the most suitable food vehicle for fortification. Risk-benefit analysis offers important answers to the most commonly-asked questions.

Countries which explore or implement food fortification projects which include vitamin A often ask why they should prioritize fortification in terms of health and economic impact. They are also increasingly concerned about excessive vitamin A consumption. A method that assesses the anticipated health impact of vitamin A fortification can be used to justify both mandatory and voluntary vitamin A fortification, and allows for an evidence-based approach to policy decision making.  

Sight and Life and its partners (the Ministry of Health, Kenya; the University of Ulster, UK; the Micronutrient Initiative; the National Institute for Public Health, The Netherlands; and DSM) are using risk-benefit and cost-benefit models to develop a comprehensive case study in Kenya. This project aims to deliver a tested approach, which will enable countries to assess the health and economic consequences of vitamin A fortification, and thus prioritize and optimize fortification strategies and investments in food fortification.