Inadequate consumption of micronutrient-dense foods such as vegetables and meat are an important contributing cause for anemia and deficiencies of iron and vitamin A in rural communities of Tanzania. A cross-sectional study was conducted in 2016 to examine nutritional and micronutrient status and their associations to the diet of female small-scale farmers in the sub-humid Kilosa (n = 333) and the semi-arid Chamwino (n = 333) districts, in the Morogoro and Dodoma region. An overall higher prevalence of overweight (19.7%) and obesity (7.1%) than of underweight (5.9%) was detected. Significantly more women in the two villages of Kilosa (27–40%) than in the two villages of Chamwino district (19–21%) were overweight/obese, but also more frequently had anemia (34–41% vs. 11–17%), iron deficiency (24–32% vs. 15–17%), and low serum retinol (21–24% vs. 8–9%). Overall, only a small proportion of women reached recommended daily micronutrient intakes: 27% for vitamin A, 17% for iron, 7% for zinc, and 12–38% for B-vitamins. The amount of dark green leafy vegetables (DGLV) consumed was the main determinant of vitamin A and iron intake by women in Chamwino and corresponded to higher hemoglobin, serum retinol and iron status than in the villages of the Kilosa district; in agreement, DGLV consumption also predicted iron and vitamin A intake in Kilosa district. DGLV consumed with wholemeal millet was advantageous in terms of women’s vitamin A and iron intake and status over the predominantly maize-rice-based diet lacking vegetables.

Inadequate macro- and micronutrient nutrition and its consequences, such as anaemia, iron and vitamin deficiency, and growth retardation, could particularly affect children of small-scale farmers. In the present cross-sectional study, 666 school children aged 5–10 years from villages of Chamwino and Kilosa districts were studied for associations between nutritional and micronutrient status and dietary intake. The overall prevalence of stunting, underweight, and overweight was 28.1, 14.4, and 5%, while that of anaemia and deficiency of iron (ID), vitamin A (VAD), and zinc (ZnD) was 42.9, 29.3, 24.9, and 26.4%, respectively. Dietary recalls (24h) revealed that, except of iron (74%), only small proportions of children reached the recommended daily micronutrient intakes: 4% for zinc, 19% for vitamin A, and 14–46% for B vitamins. Stunting was highly associated with wasting in both districts and with VAD in Chamwino. Anaemia was predicted by ID, VAD, and ZnD in Chamwino and by elevated infection markers, C-reactive protein (CRP) and α-1 glycoprotein (AGP), in Kilosa. Overall, elevated CRP and/or AGP increased the risk while higher serum carotenoids indicating a diet of more fruit and vegetables reduced the risk of VAD. The significantly lower prevalence of anaemia and ID in Chamwino was related to higher iron and vitamin A intake and the consumption of mainly bulrush millet with dark green leafy vegetables compared to maize or rice with legumes in Kilosa. Nutrition and hygiene education integrated with home and school garden programmes could reduce the multiple burdens of anaemia; micronutrient deficiencies and infections; and, in the long term, the prevalence of stunting.

Pigeon peas are legumes with a high nutritional value. Existing studies of pigeon peas in Tanzania mainly examine production and marketing, but little has been documented with respect to consumer preferences and the consumption of pigeon peas. This study assesses the preferences surrounding pigeon peas and their consumption as bases for the development of diversified and shelf-stable products for nutrition and income improvement. This study comprised 303 randomly selected farming households. Furthermore, 60 farmers participated in six focus group discussions in the Lindi region. A structured questionnaire and a checklist with guided questions were provided for data collection. The analysis uses SPSS (V.21), with differences between groups established using Kruskal–Wallis and Mann–Whitney tests. The associations were tested using Spearman’s ρ at p < 0.05. The mean pigeon peas consumption during the harvesting and lean seasons was 80 g/person/day and 18 g/person/day, respectively. The frequency of consumption was higher during the harvesting season (92%) than the lean (29%) season. The majority of farmers (91%) preferred to consume the local variety, with 84% of them consuming pigeon peas as stew. Five pigeon pea recipes exist in the area. The farmers identified availability, taste, source of income, and familiarity as the factors determining pigeon pea consumption and preferences. With limited recipes and other barriers limiting consumption, the creation of innovative ideas for the development of diversified and shelf-stable products fitting their consumption preferences is needed.

Despite initial progress, overall development toward zero hunger is not promising. Combating all forms of malnutrition is a complex challenge that requires complex answers from the local to global scales. To support a common understanding and to develop a joint approach that adequately addresses these challenges, an expert panel discussion was organized during the “Nutrition for Growth Summit Tokyo” on (7–8) December 2021 entitled “Multi-sectoral systems approach to holistically tackle malnutrition” upon which this article is based. We highpoint the requirement for actual access to ideas that move beyond the abstract and mostly figurative acknowledgment of the importance of bringing all actors together to combat malnutrition. Four entry points for a food-based multi-sectoral system approach to holistically tackle the burden of malnutrition were agreed upon. These entry points are not discrete, single entities but rather require integrated approaches. While we argue for an integrated approach building on all four interlinked components, it is important to note that the degree of each component's integration is context-dependent and that the examples presented as possible implementation strategies do not apply to all countries alike.

Inadequate consumption of micronutrient-dense and protein-rich foods such as vegetables, legumes and meat is an important contributing cause for anemia and deficiencies of vitamin A and iron in rural communities of Tanzania and Mozambique. A cross-sectional study was conducted to assess the nutritional status (anthropometrics and hemoglobin) and diets in particular micronutrient intake of female and male pigeon pea farmers from Lindi, Tanzania, and Gurué, the Zambézia province of Mozambique. A total of 1526 farmers (669 from Tanzania, 857 from Mozambique) were studied, of whom 16% were overweight and 35% were anemic. The highest prevalence of overweight and anemia, at 35% and 48%, was observed in Tanzanian and Mozambican women, respectively. Overall, only a small proportion of women and men reached the recommended daily dietary intake of vitamin A (10%), iron (51%) and zinc (44%). Multiple regression models revealed that dark green leafy vegetables (DGLVs) highly predicted vitamin A intake, whereas legumes in Tanzania and starchy plants in Mozambique were actually the dominant sources of vitamin A. Cereals covered over half of the iron and the zinc intake in both countries. An increased consumption of micronutrient-rich DGLVs and legumes, while reducing the high amounts of refined maize or polished rice, is suggested to counteract the high prevalence of anemia and overweight among smallholder farmers in East and South Eastern Africa.