Evidence-based nutrition interventions included in the WHO e-Library of Evidence for Nutrition Actions (eLENA) that may contribute to the achievement of the WHO global nutrition and diet-related NCD targets Global nutrition targets 2025

Global NCD targets for 2025 (diet-related)

40% reduction in the number of children under-5 who are stunted

(4) A 30% relative reduction in mean population intake of salt/ sodium intake

50% reduction of anaemia in women of reproductive age

(6) A 25% relative reduction in the prevalence of raised blood pressure or contain the prevalence of raised blood pressure, according to national circumstances

30% reduction in low birth weight

(7) Halt the rise in diabetes and obesity

No increase in childhood overweight Increase the rate of exclusive breastfeeding in the first 6 months up to at least 50% Reduce and maintain childhood wasting to less than 5%

eLENA interventions1,2

Global nutrition targets 1

2

3

4

5

Global NCD targets 6

4

6

Fortification Biofortification of staple crops Fortification of rice Fortification of wheat and maize flours Multiple micronutrient powders for home fortification of foods consumed by children 6–23 months of age Multiple micronutrient powders for home fortification of foods consumed by pregnant women (NR) Vitamin A fortification of staple foods

1 2

Interventions in bold are interventions for which there are WHO recommendations. WHO does not currently have recommendations for the interventions which are not in bold. NR indicates that WHO recommends against the intervention.

7

Low birth weight Breastfeeding of low-birth-weight infants Cup-feeding for low-birth-weight infants unable to fully breastfeed Demand feeding for low-birth-weight infants Donor human milk for low-birth-weight infants Feeding of very-low-birth-weight infants Kangaroo mother care to reduce morbidity and mortality and improve growth in low-birth-weight infants Micronutrient supplementation in low-birth-weight and very-low-birth-weight infants Mother’s milk for low-birth-weight infants Standard formula for low-birth-weight infants following hospital discharge Maternal, infant and young child nutrition Breastfeeding Early initiation of breastfeeding Exclusive breastfeeding Continued breastfeeding Breastfeeding education for increased breastfeeding duration Implementation of the Baby-friendly Hospital Initiative Regulation of marketing breast-milk substitutes Appropriate complementary feeding Assessment for nutrition-related disorders in women during pregnancy Balanced energy and protein supplementation during pregnancy High-protein supplementation during pregnancy (NR) Restricting caffeine intake during pregnancy Long chain polyunsaturated fatty acid supplementation during pregnancy Nutrition counselling during pregnancy Optimal timing of cord clamping for the prevention of iron deficiency anaemia in infants Micronutrients

Calcium supplementation during pregnancy for the prevention of pre-eclampsia Iodine supplementation in pregnant and lactating women Iodization of salt for the prevention and control of iodine deficiency disorders Iron and/or folic acid Daily iron and folic acid supplementation in adult women and adolescent girls Daily iron and folic acid supplementation during pregnancy Daily iron and folic acid supplementation during pregnancy in malaria-endemic areas Intermittent iron and folic acid supplementation in menstruating women Intermittent iron and folic acid supplementation in menstruating women in malaria-endemic areas Intermittent iron and folic acid supplementation in non-anaemic pregnant women Intermittent iron and folic acid supplementation in non-anaemic pregnant women in malaria-endemic areas Daily iron supplementation in children 6-23 months of age Daily iron supplementation in children 6-23 months of age in malaria endemic areas Daily iron supplementation in children 24-59 months of age Daily iron supplementation in children 24-59 months of age in malaria endemic areas Daily iron supplementation in children 5-12 years of age Daily iron supplementation in children 5-12 months of age in malaria endemic areas Intermittent iron supplementation in preschool and school-age children Intermittent iron supplementation in preschool and school-age children in malaria-endemic regions Iron or iron/folic acid supplementation to prevent anaemia in postpartum women Periconceptional folic acid supplementation to prevent neural tube defects Vitamin A supplementation in children with respiratory infections Vitamin A supplementation in HIV-infected adults Vitamin A supplementation in HIV-infected women during pregnancy (NR) Vitamin A supplementation in HIV-infected infants and children 6–59 months of age Vitamin A supplementation in infants 1–5 months of age (NR) Vitamin A supplementation in infants and children 6–59 months of age

Vitamin A supplementation in neonates (NR) Vitamin A supplementation in postpartum women (NR) Vitamin A supplementation during pregnancy (NR) Vitamin B6 supplementation during pregnancy (NR) Vitamin D supplementation during pregnancy (NR) Vitamin D supplementation during pregnancy for the prevention of pre-eclampsia (NR) Vitamin D supplementation in children with respiratory infections Vitamin D supplementation in infants Vitamin E supplementation for the prevention of morbidity and mortality in preterm infants Vitamin E and C supplementation during pregnancy (NR) Zinc supplementation and growth in children Zinc supplementation during pregnancy (NR) Zinc supplementation in children with respiratory infections Zinc supplementation in the management of diarrhoea Multiple micronutrient supplementation during pregnancy (NR) Nutritional care of individuals with communicable diseases Management of moderate undernutrition in individuals with active tuberculosis Management of severe acute malnutrition in individuals with active tuberculosis Micronutrient supplementation in individuals with active tuberculosis Nutrition assessment and counselling in individuals with active tuberculosis Infant feeding for the prevention of mother-to-child transmission of HIV Macronutrient supplementation for people living with HIV/AIDS Multiple micronutrient supplementation for HIV-infected women during pregnancy Nutrition counselling for adolescents and adults with HIV/AIDS Nutritional care for HIV-infected children Nutritional care of children and adults with Ebola virus disease in treatment centres Nutrition-sensitive interventions

Conditional cash transfer programmes and nutritional status Deworming during pregnancy Deworming in children Intermittent preventative treatment to reduce the risk of malaria during pregnancy Insecticide-treated nets to reduce the risk of malaria in pregnant women Water, sanitation and hygiene interventions to prevent diarrhoea Obesity and diet-related NCDs Exclusive breastfeeding to reduce the risk of childhood overweight and obesity Increasing fruit and vegetable consumption to reduce the risk of noncommunicable diseases Increasing potassium intake to control blood pressure in children Increasing potassium intake to reduce blood pressure and risk of cardiovascular diseases in adults Limiting portion sizes to reduce the risk of childhood overweight and obesity Reducing consumption of sugar-sweetened beverages to reduce the risk of childhood overweight/obesity Reducing consumption of sugar-sweetened beverages to reduce the risk of unhealthy weight gain in adults Reducing sodium intake to control blood pressure in children Reducing sodium intake to reduce blood pressure and risk of cardiovascular diseases in adults Reducing the impact of marketing of foods and non-alcoholic beverages on children Undernutrition Supplementary foods for the management of moderate acute malnutrition in children Management of severe acute malnutrition (SAM) Fluid management in severely malnourished children under 5 years of age with shock Fluid management in severely malnourished children under 5 years of age without shock Identification of SAM in children 6–59 months of age Identification of SAM in infants under 6 months of age Identification of SAM requiring inpatient care in children 6–59 months of age Management of HIV-infected children under 5 years of age with SAM Management of infants under six months of age with SAM

Management of SAM in children 6–59 months of age with oedema Micronutrient intake in children with SAM Transition feeding of children 6–59 months of age with SAM Therapeutic feeding of children 6–59 months of age with SAM and acute or persistent diarrhoea Treatment of hypoglycaemia in children with SAM Treatment of hypothermia in children with SAM Use of antibiotics in the outpatient management of children 6-59 months of age with SAM Vitamin A supplementation in children 6–59 months of age with SAM Supplementary feeding in community settings for promoting child growth

Methodology With few exceptions, links noted between interventions and global nutrition or NCD targets are based on published evidence resulting from systematic reviews of the literature. Individual studies were not assessed unless they were included in such a published review. Coloured icons indicate that there is evidence of a direct link between the intervention of interest and target(s); i.e. systematic reviews are available assessing the effect of the intervention on an outcome directly relevant to the targets (e.g. prevalence of stunting, rate of breastfeeding, etc.). Gray icons indicate that there is evidence of an indirect link between the intervention of interest and target(s). Where indirect links have been noted, systematic reviews linking the intervention directly to one or more targets are not currently available; i.e. the studies included in the review(s) do not assess the effect of the intervention on the outcomes that are directly relevant to the targets. For example, systematic reviews directly linking breastfeeding to stunting are not currently available. However, systematic reviews linking breastfeeding to a reduction in diarrhoea are available, as are reviews linking diarrhoea to increases in stunting. Therefore, interventions that increase breastfeeding rates may indirectly reduce stunting. Additionally, indirect links may be noted when the only available outcome data is for an indicator used to assess outcomes relevant to the targets. For example, body mass index (BMI) is an indicator for overweight and obesity and an intervention that reduces BMI may contribute to decreasing rates of overweight and/or obesity. Therefore, an indirect link would be noted between interventions for which systematic review(s) report BMI as an outcome, and the global overweight and obesity targets.