Trade-offs between addressing food security and dietary diversity

The international public health nutrition and food systems communities place considerable emphasis on addressing micronutrient malnutrition in low-income settings. This often manifests through a focus on addressing dietary diversity and ultraprocessed food consumption, and on specific dietary micronutrient deficiencies. Some scholars have questioned this, suggesting need for something broader and a greater prioritisation of hunger and food adequacy. However these discussions have largely been theoretical. We examined findings from our empirical studies in Malawi in this context. We found that severely resource-constrained households with low incomes tend to focus on alleviating hunger, not dietary diversification. Furthermore, the level of ultra-processed food consumption among our study participants was low by international standards. We are not disputing the importance of micronutrient malnutrition. However, there may be important trade-offs between addressing hunger and achievement of food adequacy aspects of food security, and addressing micronutrient nutrition. © 2023 BMJ Publishing Group. All rights reserved.