Management of moderate wasting (MW) is an important component of country-level strategies to address wasting, given high caseloads and susceptibility to illness and death. However, many countries experience challenges in providing targeted supplementary feeding programmes with specially formulated foods involved in managing MW. Some implementing agencies have developed a community-based programme using locally available foods (LF) for MW management known as Tom Brown. This study assessed the costs and cost-efficiency of three Tom Brown programmes (two with an 8-week supplementation duration, one with a 10-week duration).

We assessed institutional costs and selected estimates of societal costs to households and community volunteers.

Northeast Nigeria

Programme staff

Total cost per child ranged from $155 to $184 per 8-week programme and $493 per 10-week programme. Monthly LF supplementation cost per child ranged from $5 to $21. Unit costs were influenced by implementation duration and variations in programme features including storage and transportation models, the inclusion of voucher transfers and volunteer cadre models. Opportunity costs to beneficiaries and volunteers in preparing recipes were substantial. Cash/voucher components, when used, represented a cost driver for institutional and societal costs.

An updated WHO guideline emphasises the role of LF for supplementing MW children who lack other risk factors. Given that specially formulated foods are not necessary for all MW children to recover, programme approaches using LF are important options for managing MW. This study from Nigeria provides the first cost estimates for using LF to manage MW. Future research is needed on the effectiveness and cost-effectiveness of these approaches.

Traditional diets are culturally accepted and adapted to local environments, but globalisation has shifted towards unhealthy, unsustainable eating habits. This study aims to assess the literature on the effects of traditional, place-based diets on health and sustainability and examines the suitability of common tools used to evaluate them.

A systematic search was conducted using the PRISMA 2020 guidelines across seven databases (CINAHL, Cochrane Library, MEDLINE, Scopus, Web of Science, PubMed and Google Scholar), and the protocol was registered with PROSPERO (CRD42023445750). The inclusion criteria were traditional place-based diets, studies examining the nutritional, health benefits and sustainability impacts of traditional food consumption, published in English, with no date restriction.

Eleven studies from Spain, Romania, Portugal, Mexico, Chile, Japan, Uganda and India met the criteria. Assessment tools included carbon footprints (via LCA), nitrogen footprints, NRF9.3, Nutri-Score and EAT-Lancet; some incorporated qualitative methods. Mediterranean, Atlantic and Japanese diets aligned well with health and sustainability, whereas meat-heavy or nutrient-deficient patterns raised concerns. Most studies relied on standardised tools and secondary datasets, with limited use of region-specific environmental data or qualitative insights. Only one intervention study was identified.

Traditional diets show promise as culturally appropriate models for sustainable and healthy eating. Current tools designed around standardised, reductionist frameworks often fail to capture the complexity of traditional food systems, including local practices, preparation methods and cultural meaning. To better assess traditional diets, future research should develop regionally adapted indicators and integrate quantitative measures with qualitative insights from local communities.