title: Strong nutrition governance is a key to addressing nutrition transition in low and middle-income countries: review of countries' nutrition policies.
abstract: Nutrition transition necessitates low and middle-income countries (LAMICs) to scale up their efforts in addressing the burdens of undernutrition and overweight/obesity. Magnitudes of undernutrition and overweight are high in LAMICs, but no study has reviewed the existence of nutrition policies to address it. No evidence is also available on the effect of nutrition policies and governance on the undernutrition and overweight/obesity patterns in such countries. We conducted a policy review to examine the presence and associations of nutrition policies and governance with the children's nutrition statuses in LAMICs.
  
  
  METHODS
  We reviewed nutrition policies, nutrition governance, and the trends of nutrition status from LAMICs. We retrieved data on the policies from the global database on the implementation of nutrition actions (GINA). We also retrieved data on the trends of nutrition status and nutrition governance from the nutrition landscape information system (NLiS), and on LAMICs from the World Bank database. We then analyzed the data both descriptively and by using a mixed effects model with random-intercept by country.
  
  
  RESULTS
  Of the 139 LAMICs reviewed, only 39.6% had policies to address both undernutrition and overweight/obesity. A higher proportion of low-income countries (LICs) had policies to address undernutrition compared to that of middle-income countries (MICs) (86.1% vs. 63.1%, p = 0.002), and a low proportion of both had policy to address overweight. Having a nutrition policy that addresses undernutrition was not associated with better nutrition status outcomes. Strong nutrition governance in LAMICS was associated with low magnitudes of stunting (beta = -4.958, p = 0.015); wasting (beta = -5.418, p = 0.003); and underweight (beta = -6.452, p = 0.001).
  
  
  CONCLUSIONS
  Despite high magnitudes of undernutrition and overweight/obesity in LAMICs, only about one third of them had nutrition policies to address such nutrition transition. Having strong nutrition governance may help to bring down the magnitudes of undernutrition in LAMICs.
authors: Bruno F
authors: BF
authors: Sunguya
authors: Ken I C
authors: KI
authors: Ong
authors: Sumi
authors: S
authors: Dhakal
authors: Linda B
authors: LB
authors: Mlunde
authors: Akira
authors: A
authors: Shibanuma
authors: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo 7-3-1, 113-0033 Hongo Bunkyo-ku, Tokyo, Japan. jyasuoka@post.harvard.edu.
authors: Junko
authors: J
authors: Yasuoka
authors: Masamine
authors: M
authors: Jimba
mesh_terms: D016208:Databases, Factual; D003906:Developing Countries; D006130:Growth Disorders / Q000453:epidemiology; D006801:Humans; D044342:Malnutrition / Q000453:epidemiology*; D018673:Nutrition Policy / Q000331:legislation & jurisprudence*; D009752:Nutritional Status; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology*; D015995:Prevalence; D013851:Thinness / Q000453:epidemiology; D019282:Wasting Syndrome / Q000453:epidemiology