Dr Swapan K. Roy is the International Senior Scientist, Chairperson BOT of Bangladesh Breastfeeding Foundation and Nutrition Foundation of Bangladesh and Professor of the Nutrition and Food Science Department, University of South Asia. He has a Ph.D. in Nutrition from University of London and has had a significant role in the diagnosis and management of acute and persistent diarrhoea in developing countries of the world. He spent time discovering and researching the impact of zinc in diarrhoea which led to the current global recommendation on zinc supplementation in acute diarrhoea that has resulted in significant impact on child survival. During the last four decades, he has worked as a distinguished scientist, philosopher and activist for the advancement of protection, promotion and support of breastfeeding, complementary feeding and maternal nutrition. 

How does your research on nutrition relate to the SDGs?

SDG 2: Zero Hunger has been addressed through nutrition intervention projects. The nutrition triangle (or pyramid), a representation of the optimal number of servings to be eaten each day from each of the basic food groups, is used to promote healthy living and in developing sustainable food production to reduce world hunger.

SDG 3: Good Health and Well-Being is a key SDG in my research on the analysis of diarrhoeal disease consequence on various grades of malnutrition leading to high risk of mortality. This work prompted the WHO to introduce a policy on nutritional management of diarrhoea. 

SDG 5: Gender Equality has been addressed by research publications on empowering women to improve the nutritional status of their family, including children, under a rural maintenance program (RMP). Improvement of maternal nutrition during pregnancy leading to safe delivery and good birth weight has also provided an empowerment and gender equality effect, which has been adopted in many countries.

SDG 6: Clean Water and Sanitation is included in healthcare that promotes water, sanitation and hygiene (WASH). Safe and sufficient WASH plays a key role in preventing numerous non-communicable diseases (NCDs) and my research has investigated the reduction of disease due to safe WASH.

Why did you decide to go into your field of research?

During my tenure at the International Center for Diarrheal Disease hospital, the burden of malnutrition leading to the death and suffering of children made me sad and prompted me to find ways to save their lives (BMJ 1983). I needed to study more in the field of nutrition area and so pursued higher education (M,SC, Diploma, Ph D, FRCP, in nutrition from UK) in the field. I contributed to all types of necessary research in this area ranging from policy to programs and individual care.

How has knowledge of global nutrition developed over the course of your career?

There have been many new concepts in nutrition introduced in the last few decades, including changes in the classification of nutritional status, altered units of measurement, and new biochemical and molecular discoveries. Research into the economic effects of malnutrition on health has also risen, as well as investigations into the steep rise of NCDs and changes in proportion of death in relation to nutrition. Reduction of undernutrition and the increase in obesity is a major change in global context, particularly in high income countries; there are major threats to good nutrition by the high production and consumption of fast foods. A positive change is that the quantity and quality of nutrition research projects and grants have been increased. However, new emerging diseases have threatened the world very recently like COVID-19, which can hinder progress on improving nutritional health and achieving the SDGs. My own personal understanding and research has also grown with the speed of the global progress.

What nutritional challenges do those from Low- and Middle-Income Countries (LMICs) in particular face?

LMICs face malnutrition in all its forms, including both undernutrition and obesity as well as micronutrient deficiencies. Many people in LMICs have a knowledge gap of the benefits of nutrient rich food and as such suffer from malnutrition; a general lack of nutritional knowledge contributes to the double burden of malnutrition in LMICs. A large proportion of the population in these areas do not have food adequate in macro- and micronutrients and so there is a high proportion of low birth weight in newborns, stunting, wasting and emaciation among children. Micronutrient deficiency is prevalent and leads to anemia, goiter, rickets, stunting, vitamin deficiency, zinc deficiency and more.Another challenge to achieving good nutrition is a higher rate of infection, some of which are endemic in some regions. The infection-malnutrition cycle continues and both malnutrition and mortality increases. Interventions to these issues such as food security, disease control and good caring practice are not in place in most LMICs and both nutrition sensitive and specific interventions are not undertaken. Environmental disasters and displacement by political unrest exacerbate existing issues and provide additional challenges. There is an urgent need to address the above issues but the policies involved may not be given priority in a national context and, even when implemented, financial constraints in many LMICs can prevent optimisation. All of these constraints can unfortunately leave these countries with very slow or stagnant progress. 

What are your hopes for progress in the future?

The simultaneous presence of opportunities and challenges has always been present and will remain in the future. The world is developing continuously, but the major benefit and share of all advanced technology, resources and benefits are centered on higher income countries. However UN agencies, especially WHO, UNICEF, UNFPA, UNESCO and FAO, have strong and favorable policies to gain equity in the health and livelihood of the general population, and their work has already improved the lives of countless individuals in LMICs. To solve inequity, we must focus on education, standard setting, commitment from governments, employment, resource allocation to poorer sections, and creating infrastructure for sustained and growing economies. I hope that ultimately all people of the world will be ensured for food security, disease control, caring practice.