We discuss efforts in improving the value of nutrition research. We organised the paper in five research stages: Stage 1: research priority setting; Stage 2: research design, conduct and analysis; Stage 3: research regulation and management; Stage 4: research accessibility and Stage 5: research reporting and publishing. Along the stages of the research cycle, varied initiatives exist to improve the quality and added value of nutrition research. However, efforts are focused on single stages of the research cycle without vision of the research system as a whole. Although research on nutrition research has been limited, it has potential to improve the quality of nutrition research and develop new tools and instruments for this purpose. A comprehensive assessment of the magnitude of research waste in nutrition and consensus on priority actions is needed. The nutrition research community at large needs to have open discussions on the usefulness of these tools and lead suitable efforts to enhance nutrition research across the stages of the research cycle. Capacity building is essential and considerations of nutrition research quality are vital to be integrated in training efforts of nutrition researchers.

Knowing who eats what, understanding the various eating habits of different population groups, according to the geographical area, is critical to develop evidence-based policies for nutrition and food safety. The FAO/WHO Global Individual Food consumption data Tool (FAO/WHO GIFT) is a novel open-access online platform, hosted by FAO and supported by WHO, providing access to harmonised individual quantitative food consumption (IQFC) data, especially in low- and middle-income countries (LMIC). FAO/WHO GIFT is a growing repository, which will serve as the global FAO/WHO hub to disseminate IQFC microdata. Currently five datasets from LMIC are available for dissemination, and an additional fifty datasets will be made available by 2022. To facilitate the use of these data by policy makers, ready-to-use food-based indicators are provided for an overview of key data according to population segments and food groups. FAO/WHO GIFT also provides an inventory of existing IQFC data worldwide, which currently contains detailed information on 188 surveys conducted in seventy-two countries. In order for end-users to be able to aggregate the available data, all datasets are harmonised with the European Food Safety Authority's food classification and description system FoodEx2 (modified for global use). This harmonisation is aimed at enhancing the consistency and reliability of nutrient intake and dietary exposure assessments. FAO/WHO GIFT is developed in synergy with other global initiatives aimed at increasing the quality, availability and use of IQFC data in LMIC to enable evidence-based decision-making and policy development for better nutrition and food safety.

Despite the rich biodiversity of the African continent and the tremendous progress so far made in food production, Africa is still struggling with the problems of food insecurity, hunger and malnutrition. To combat these problems, the production and consumption of nutritious and safe foods need to be promoted. This cannot be achieved without reliable data on the quantity and quality of nutrients and other components provided through these foods. Food composition data (FCD) are compiled as food composition tables (FCT) or food composition databases (FCDB). These are subsequently used for a variety of purposes, ranging from clinical practice, research, public health/education, food industry to planning and policy, as well as nutrition monitoring and surveillance. To perform these functions effectively, the importance of reliable FCT/FCDB cannot be overemphasised. Poor quality FCT/FCDB have serious consequences on the health of the population, and provide skew evidence towards developing nutrition and health-related policies. The present paper reviews different methods to generate FCT/FCDB, their importance and use in assisting nutrition/dietetic professionals in solving Africa's nutrition problems; current status of FCT/FCDB generation, compilation and dissemination in Africa, constraint to their use by professionals and the role of FAO/INFOODS/AFROFOODS and other stakeholders towards improvement and future initiatives. The information provided will create awareness on the need for up-to-date and high-quality FCT/FCDB and facilitate the identification of data gaps and prioritisation of future efforts in FCD generation, compilation and dissemination in Africa and subsequent strategies for the alleviation of the food and nutrition problems in Africa.

Africa is experiencing a sharp rise in non-communicable diseases (NCD) related to rapid globalisation and urbanisation leading to shifts in dietary and lifestyle patterns characterised by increased energy intake and physical inactivity. However, unlike more resource-endowed regions, Africa has a double burden of disease: NCD co-exist with infectious diseases including lower respiratory tract infections, HIV/AIDS and diarrhoeal diseases. The African economy is also relatively weaker, making it difficult to cope with this burden. It is postulated that NCD will soon overtake infectious diseases as the number one cause of death in the African region. The recognition of NCD as diseases and obesity as a related risk factor is weak in Africa, compounded by stigma associated with wasting in HIV/AIDS and obesity being perceived as a sign of wealth, achievement and care. There is also a dearth of data on overweight and obesity in the region and little knowledge that infant feeding practices, such as breast-feeding, are linked to reduced risk of NCD in both children and mothers. While complex multi-sectoral approaches to address this NCD menace are needed, Africa may benefit from taking simple initial steps to address NCD risk factors including: (1) behaviour change communication to challenge perceptions on NCD; (2) promoting and protecting breast-feeding; (3) formulating policies and regulations limiting wide availability of unhealthy foods; (4) mainstream nutrition education in school curricula and (5) collection of accurate data based on indicators that can reflect the double burden of disease and malnutrition; and fostering multi-sectoral actions against NCD.

Africa is currently experiencing rapid urbanisation impacting on people's food environments and dietary habits. Such changes are associated with higher prevalence of obesity coexisting with undernutrition. The present paper provides an overview of the healthiness of African urban food environments. We discuss the ways that food environments can be characterised and summarise the methods that can be used to investigate and intervene in the food environment. Data for Africa over a 50-year period (1961–2013) suggest an increasing availability of energy, animal products, fruit and vegetables, vegetable oils, sugar and sweeteners but a decrease in animal fats. There is a lack of evidence about how social, physical and macro-environments drive dietary habits in urban Africa, as most research has focused on the individual level. Examining how food consumption is embedded in everyday life, by investigating social environments is crucial to developing effective interventions. The informal food sector plays an important role in the retail food environment. Macro-level food price changes are an important factor influencing nutritional quality of African diets. The rapid expansion of food/beverages advertising in Africa threatens traditional food habits. Liberalisation of food trade is already impacting on the nutritional quality of food available. Improving African food environments represents a pressing public health concern and has the potential to prevent all forms of malnutrition. Hence, by conducting research into the role of urban social, physical and macro-environments, emerging interventions and policies are likely to positively impact on nutritional status, thereby enhancing social and economic development.

The purpose of this review is to consider the effects of the long-chain n-3 fatty acids found in marine foods, EPA and DHA, on risk for CVD, particularly fatal outcomes. It will examine both epidemiological and randomised controlled trial findings. The former studies usually examine associations between the dietary intake or the blood levels of EPA + DHA and CVD outcomes or, on occasion, total mortality. For example, our studies in the Framingham Heart Study and in the Women's Health Initiative Memory Study have demonstrated significant inverse relations between erythrocyte EPA + DHA levels (i.e. the Omega-3 Index) and total mortality. Recent data from the Cardiovascular Health Study reported the same relations between plasma phospholipid n-3 levels and overall healthy ageing. As regards randomised trials, studies in the 1990s and early 2000s were generally supportive of a cardiovascular benefit for fish oils (which contain EPA + DHA), but later trials were generally not able to duplicate these findings, at least for total CVD events. However, when restricted to effects on risk for fatal events, meta-analyses have shown consistent benefits for n-3 treatment. Taken together, the evidence is strong for a cardioprotective effect of EPA + DHA, especially when consumed in sufficient amounts to raise blood levels into healthy ranges. Establishing target EPA + DHA intakes to reduce risk for cardiovascular death is a high priority.

Health effects of fatty acids have been very controversial. Total mortality is inversely associated with the amount of total fat consumed. In contrast, trans fatty acids or SFA intake is positively related to mortality while the inverse is observed with consumption of MUFA or PUFA. Among PUFA, long-chain (LC) n-3 PUFA have many beneficial effects. Dietary intake of some types of fatty acids is specific to Africa. Energy from saturated fat does not exceed 14% and energy from n-6 PUFA does not exceed 8% of total energy intake. Dietary intake of LC n-3 PUFA is less than 100 mg/d whereas international recommendations promote 250–500 mg/d. Consumption of plant n-3 PUFA mainly α-linolenic acid (ALA) is highly variable depending on the country. Both fish and ALA availability are low in several African countries. The prevalence of diabetes and cardiovascular events remain very low in Africa, partly explained by the fact that the whole dietary pattern is globally the best of all continents. One objective of ‘fat for Africa’ could be to increase, as much as possible, the dietary intake of LC n-3 PUFA by promoting sustainable aquaculture and to maintain as much as possible traditional dietary pattern by preventing a tendency to westernisation, provided that the amount of energy and protein is sufficient to fight against wasting and stunting where it still exists.

Micronutrient deficiencies are widespread and disproportionately affect women and children in low- and middle-income countries (LMIC). Among various interventions, food fortification and supplementation with micronutrients have been proven to be cost-effective. The aim of the present paper is to review existing literature to assess risks of excessive intake in LMIC to then highlight programmatic changes required to maximise benefits of micronutrient interventions while minimising risks of adverse effects. While very few LMIC have national food consumption surveys that can inform fortification programmes, many more are implementing mandatory fortification programmes. The risks of inadequate micronutrient intakes were common, but risks of excessive intakes were also present for iodine, vitamin A, folic acid and iron. Excessive salt consumption, high concentrations of iodine in ground-water and excessive levels of iodisation were linked with excessive iodine intake. For vitamin A, overlapping interventions were the main risk for excessive intake; whereas for iron, contamination with iron from soil and screw-wares of millers and high iron concentration in drinking-water increased the risk of excessive intake, which could be further exacerbated with fortification. Before implementing micronutrient interventions, adherence to the basic principles of documenting evidence confirming that the deficiency in question exists and that fortification will correct this deficiency is needed. This can be supported with dietary intake assessments and biochemical screening that help diagnose nutrient deficiencies. Targeting micronutrient interventions, although programmatically challenging, should be considered whenever possible. Moreover, closer monitoring of appropriate fortification of foods and overlapping interventions is needed.

This review aims to explore trends of early consumption of sugar-sweetened beverages (SSB) in sub-Saharan Africa (SSA), within the context of growing child and adolescent obesity and escalating type-2 diabetes prevalence. We explore efforts to mitigate these, drawing on examples from Africa and elsewhere. SSB, including carbonated drinks and fruit juices, play a contributory role in the development of obesity and associated non-communicable diseases (NCD). SSA is an attractive market for beverage companies owing to its rapid economic growth, growing middle class and youthful populations. SSB already contribute significantly to total sugar and energy consumption in SSA where a plethora of marketing techniques targeted at younger people are utilised to ensure brand recognition and influence purchasing and brand loyalty. Coupled with a general lack of nutrition knowledge or engagement with preventative health, this can lead to frequent consumption of sugary drinks at a young age. Public health efforts in many high income and some middle-income countries address increasing prevalence of obesity and type-2 diabetes by focusing on strategies to encourage reduction in sugar consumption via health policy and public education campaigns. However, similar efforts are not as developed or forthcoming in low-income countries. Health care systems across SSA are ill-prepared to cope with epidemic proportions of NCD, particularly when contextualised with the ongoing battle with infectious diseases. We conclude that greater efforts by governments and the nutrition community to educate the public on the health effects of increased and excessive consumption of SSB are necessary to help address this issue.

Iodine is an essential trace mineral, vital for its functions in many physiological processes in the human body. Both iodine deficiency (ID) and excess are associated with adverse health effects; ID and excess iodine intake have both been identified in sub-Saharan Africa (SSA). The review aims to (1) review the iodine status among populations in SSA until October 2018, and (2) identify populations at risk of excess or inadequate iodine intakes. A systematic search of relevant articles was carried out by a seven-member research team using PubMed, Science Direct and Scopus. A total of twenty-two articles was included for data extraction. Of the articles reviewed, the majority sought to determine the prevalence of iodine status of the study populations; others measured the impact of uncontrolled and unmonitored salt iodisation on iodine excess and tested the effectiveness of water iodisation. Although iodine status varied largely in study populations, ID and excessive iodine intake often coexisted within populations. The implementation of nutrition interventions and other strategies across SSA has resulted in the reduction of goitre prevalence. Even so, goitre prevalence remains high in many populations. Improvements in access to iodised salt and awareness of its importance are needed. The emerging problem of excess iodine intakes, however, should be taken into consideration by policy makers and programme implementers. As excessive iodine intakes may have adverse health effects greater than those induced by iodine deficient diets, more population-based studies are needed to investigate iodine intakes of the different population groups.

Biofortification is an approach used to increase micronutrient content of crops through agronomic practices, conventional or modern biotechnology. Through a plethora of projects, partnerships were formed to advocate for policy changes, and increased investments in research, production and utilisation of biofortified crops. One of such projects is the Building Nutritious Food Baskets project, which has been appraised in order to draw and share successes, challenges and lessons for the improvement of similar future projects to achieve substantial impacts. The paper provides an overview of the role of biofortification in addressing nutritional challenges and highlights the efficacy of biofortified crops in improving micronutrient status. Through advocacy at the African Regional and sub-regional levels, awareness has been created on biofortification among governments, investors, development partners, farmers and consumers. This awareness has resulted in the incorporation of biofortification in some key policies, strategies and investment programmes. Key lessons learnt from regional advocacy are (1) in order to integrate biofortification in regional policies, strategies and programmes, it is important to identify champions from key and strategic regional organisations as they provide information on potential opportunities for influencing policies, (2) having a common advocacy message helps to highlight the role of biofortification in contributing to the prevention of micronutrient problems as well as evidence of impact on nutrition outcome, (3) champions need to be allocated a budget to support their advocacy work and (4) to engender adoption of biofortification, it is important to align biofortification with relevant initiatives as well as ongoing opportunities for advocacy.

Physiological and behavioural systems are tolerant of excess energy intake and responsive to energy deficits. Weight loss (WL) changes body structure, physiological function and energy balance (EB) behaviours, which resist further WL and promote subsequent weight regain. Measuring and understanding the response of EB systems to energy deficits is important for developing evidence-based behaviour change interventions for longer-term weight management. Currently, behaviour change approaches for longer-term WL show modest effect sizes. Self-regulation of EB behaviours (e.g. goal setting, action plans, self-monitoring, relapse prevention plans) and aspects of motivation are important for WL maintenance. Stress management, emotion regulation and food hedonics may also be important for relapse prevention, but the evidence is less concrete. Although much is known about the effects of WL on physiological and psychological function, little is known about the way these dynamic changes affect human EB behaviours. Key areas of future importance include (i) improved methods for detailed tracking of energy expenditure, balance and by subtraction intake, using digital technologies, (ii) how WL impacts body structure, function and subsequent EB behaviours, (iii) how behaviour change approaches can overcome physiological resistance to WL and (iv) who is likely to maintain WL or relapse. Modelling physiological and psychological moderators and mediators of EB-related behaviours is central to understanding and improving longer-term weight and health outcomes in the general population.