**1. Introduction**

#### **1.1 Status of vitamin A deficiency in the world and in Mozambique**

 Recent statistics estimate that 821 million people in the world are undernourished and the world hunger continues to rise in recent years [1]. Undernourishment and severe food insecurity are increasing in almost all regions of Africa, as well as in South America. Actually, 237 million people are undernourished in sub-Saharan Africa (SSA) [1]. The increase in hunger and food insecurity indicates that there is considerable work to be done against malnutrition and vitamin A deficiency globally.

 Vitamin A (also called retinol) is one of the fat-soluble vitamins necessary for good health. It has an important role as an antioxidant by helping to prevent free radicals from causing cellular damage and for proper function of the immune, skeletal, respiratory, reproductive, and integumentary (skin) systems and decrease the risk of certain cancers, heart attacks, and strokes [2]. It is also essential for the proper function of the retina, where it can act to prevent night blindness, as well as lower the odds of getting age-related macular degeneration [2]. As reported by Han et al. [3], vitamin A deficiency (VAD) is known to cause ocular changes, including corneal ulcers and xerophthalmia, ocular globe modifications, and loss of palpebral and pupillary reflexes.

 According to GEM [4], the recommended dietary dose (RDA) for vitamin A is 1.0 mg/day for the adult man and 0.8 mg/day for the adult woman. Vitamin A can be supplied entirely via β-carotene (6 mg of β-carotene is considered to be the equivalent of 1 mg of vitamin A [4]). The deficiency of vitamin A occurs when the chronic failure to eat sufficient amounts of vitamin A or β-carotene results in levels of blood serum vitamin A that are below a defined range [4]. Globally, Low [5] reported that 190 million preschool children and 19 million pregnant women are affected by vitamin A deficiency. In sub-Saharan Africa (SSA), more than 40% of children under five suffer from VAD.

 In Mozambique, 44% of children under the age of five are stunted, 4% are wasted, and 18% are underweight. The statistics indicate that 15% of infants are born with a low birth weight. The under-5 mortality rate has been estimated to be 138 per 1000 live births, and globally the ranking of stunting prevalence is the 19th highest out of 136 countries [6, 7]. Annually, Mozambique loses US\$116 million to vitamin and mineral deficiencies [6, 7]. As reported by Aguayo [8], an estimated 2.3 million children below the age of 5 years are vitamin A deficient. In the absence of appropriate policy and program action, VAD is the attributable cause of over 30 000 deaths annually, representing 34.8% of all-cause mortality in this age group. Historically, Mozambique was devastated by a postindependence civil war from 1977 to 1992 which destroyed infrastructures, ruined livelihoods, and severely hampered agricultural production and economic development [9]. There is a problem of physical access in rural areas, where the majority of the population lives. Contrarily, economic access to food is a major issue, especially in times of soaring food prices in urban areas. Natural shocks such as floods and drought regularly affect agricultural production [9]. The Mozambican diet is mainly composed of cassava, maize, beans, and imported wheat. There is a low supply of micronutrientrich foods. Eighty percent of the dietary energy supply is provided by cereals and starchy roots; this very poor level of dietary diversification has not improved for the last 40 years and is currently the lowest in the region.

Mozambique's population of almost 30 million people (30,804,450 current total population) remains one of the most vulnerable in the world, ranking 180 out of 188 countries in the United Nations Development Programme. Forty-four

#### *From Neglected and Underutilized Crops to Powerful Sources of Vitamin A: Three Case Studies… DOI: http://dx.doi.org/10.5772/intechopen.84829*

percent of the woman at reproductive age are anemic, and 69% of children of 6–24 months old are vitamin A deficient [10]. One-third of the population is chronically food insecure. Undernutrition in children remains at 44% while the prevalence of vitamin A and iron deficiencies at 69 and 74%, respectively. Micronutrient malnutrition, also known as hidden hunger, leads to high social and public costs, reduced work capacity, and the tragic loss of human potential. Mozambican urban dwellers are increasing at 1.5% each year, due to the migration trend from rural to urban settings. Malnutrition is affecting low-income consumers living.

 VAD is a public health problem in more than half of all countries, especially in Africa and Southeast Asia, hitting hardest young children and pregnant women in low-income countries. According to the World Health Organization [11], an estimated 250 million preschool children are vitamin A deficient, and it is likely that in VAD areas a substantial proportion of pregnant women is vitamin A deficient. According to the same source, 250,000 to 500,000 vitamin A-deficient children become blind every year, half of them dying within 12 months of losing their sight. VAD is the major cause of preventable blindness in children and increases the risk of disease and death from severe infections. VAD also causes night blindness in pregnant woman and may increase the risk of maternal mortality. Supplying adequate vitamin A in high-risk areas can significantly reduce mortality and is crucial for maternal and child survival. The absence of this vitamin causes a high risk of disease and death.

According to the WHO [11], an intensified action to end and eradicate worldwide the VAD and ensure universal access to healthier and more sustainable diets for all people wherever they live is the main goals of the United Nations Decade of Action on Nutrition 2016–2025. All countries are claimed to undertake activities and nutrition actions to reduce malnutrition. Such actions will require large commitment from all institutions and communities. Such commitment implies that new interventions must be created, sustained, and strengthened over time. One of the solutions is the promotion of orphan crops in the diet of small farmer agriculture. The main goals of the chapter are to discuss the use of orphan or underutilized crops (arrowroot, cassava, and cowpea) as potential sources of vitamin A with key examples of Mozambican situation.

## **1.2 Global population growth: challenges in food production versus climate changes**

The world population is projected to reach 9.9 billion by 2050, representing up to 2.3 billion or 29% from an estimated 7.6 billion people now, according to projections by the Population Reference Bureau (PRB) included in the 2018 World Population Data Sheet [12]. The PRB projects that Africa's populations will more than double to 2.6 billion by 2050 and account for 58% of the global population increase by that date. Particularly, the Mozambican population will increase to 36.9 million by 2050 (**Table 1**). The number of people in Asia, America, and Oceania is projected to increase about 717 million to 5.3 billion, from 1 billion now to 1.2 billion, and from 41 million to 64 million, respectively, while in Europe will decline from 746 million to 730 million.

 The Global Agricultural Productivity report [13] points out that in India, national production will only meet 59% of the country's food demand in 2030. In East Asia, only 67% of food demand up to 2030 will be supported within the region. In sub-Saharan Africa, projections indicate that only 15% of food demand will be reached by 2030, which would require significant imports or food assistance or the opening of new areas for development, which may not be suitable for sustainable production [13]. The need for increased production is facing important constraints.


*\*\*Current population (2018 world data sheet) and predicted growth by 2050 with focus in Africa and Mozambique Special attention is also given for sub-Saharan Africa (SSA) region and Mozambique country.* 

#### **Table 1.**

*Current population (mid-2018) and the predicted growth by 2050 in the world and for each region in particular.* 

Among them are the depletion and reduction in the productivity growth rates of the main crops, the dependence of phosphorus derived from rock, a nonrenewable resource, and climate change [14].

 On the other hand, the increase in production alone is not enough to achieve economic, environmental, and socially sustainable food systems. Food and agricultural systems are vulnerable to a variety of risks, including extreme weather events and climate change, market volatility, and political instability. Climate change affects the availability, access, use, and stability of food supply, as well as work, capital, and the choice of crops intended for food production [15, 16]. Studies show that the average global yields of rice, maize, and wheat are projected to decrease between 3 and 10% by a heating degree above historical levels [17]. Climate change poses a major challenge to food security, which is very vulnerable to changes in climate patterns [18]. Food production in developing countries is negatively affected by climate change, especially in countries that are already vulnerable to climate effects (drought or floods) and that have low yields and high indices of hunger and poverty. Vulnerable populations are the most affected by climate change, and threats to these groups can interfere with their food, nutrition, access to water, and income, exacerbating conflicts [19].

There is a need for new approaches to ensure food and nutrition security. These should be sustainable, resilient, and practical solutions. Given this context, biodiversity, especially neglected crops, is essential to addressing the impacts of climate change [20]. They are nutrient-rich crops that demonstrate the potential for adaptation and production in several continents, reinforcing the importance of diversity in the face of climate change and which must be the priority in future research [21]. In addition, small farmers need support to improve agricultural production, diversifying crops such as the use of neglected or underutilized species. This chapter reinforces and calls attention for the use of neglected crops to face climate changes and as potential sources of vitamin A while combating malnutrition and vitamin A deficiency.

#### **1.3 Neglected crops: basic concept and nutritional potential**

 Staple foods are facing major challenges and will continue in the near future due to climate changes. In this regard, diversification of crops including neglected crops is important if the world needs to achieve the goal of food security. Neglected

#### *From Neglected and Underutilized Crops to Powerful Sources of Vitamin A: Three Case Studies… DOI: http://dx.doi.org/10.5772/intechopen.84829*

crops are crop species traditionally used with local communities with great potential to contribute with food security and vitamin A deficiency issues [22].

 According to the Food and Agriculture Organization (FAO) [23], neglected, underutilized, or orphan crops (NUCs) are plant species which for social, agronomic, or biological reasons have lost their importance over the 500 years. The original function of some neglected crops or their potential uses have been marginalized along the time; others have practically been forgotten. They constitute plant species which played a fundamental role in the agriculture and food supply of indigenous peoples and local communities. Their neglect was in many cases the result of the deliberate suppression of self-sufficient ways of life which characterized traditional cultures [23].

Currently, agriculture needs to explore nonconventional pathways such as underutilized crops (NUCs) as possible future crops. This is premised on reports that NUCs are adapted to a range of agroecologies and may be nutrient dense and offer better prospects in marginal production areas. Neglected crops are drought and heat stress tolerant, resistant to pests and diseases, and adapted to semiarid and arid environments and could be useful in diversifying diets and addressing micronutrient deficiencies in poor rural communities [24, 25].

 Neglected crops are integral part of local culture, are present in traditional food preparations, and are the focus of current trends to revive culinary traditions; they have comparative advantages over staple crops because they have been selected to stressful conditions and can be cultivated using low input and biological techniques. These crops are generally ignored by policymakers and excluded from research and development agendas, and if we need to survive future climate changes and food production challenge, special efforts must be needed to improve their cultivation, management techniques, and harvesting and post-harvesting processes, and we need to better research the nutritional status and create secure policies and legal frameworks to regulate their use [22]. Neglected crops are represented by ecotypes or landraces which require some genetic improvement. Due to dependence of modern crops and industrialization, unfortunately, neglected crops are suffering rapid erosion of traditional knowledge [24]. These crops are represented in ex situ gene banks, but efforts are needed to rescue and conserve the genetic diversity of these underutilized species. Without better characterization and evaluation of these species, they will remain poorly understood [25]. A combination of ex situ with in situ (on-farm) conservation efforts must be implemented [24]. Another approach to promote the use of neglected crops is conservation through use. Neglected crops are also characterized by having fragile seed supply systems, and efforts need to be made to provide planting material to farmers in order to make the cultivation of underutilized species more feasible and sustainable over time [25].

 Nowadays, only four main crops, i.e., maize, potato, rice, and wheat, supply more than 60% of the human's energy intake. The projected increase in the world's population has driven up the need for food and increased food demand [26]. It has become clear that the lack of diversity due to concentrating on fewer crops can have negative consequences for the human diet, which may cause malnutrition and diet-related diseases [26]. Since neglected crops are also rich in nutrients and health-promoting compounds with preventive effects against malnutrition and some chronic diseases and can survive in marginal or stressful conditions, they have a great potential in improving nutrition in local communities [26]. Diversifying the food chain by including these neglected species could be an effective tool to improve overall human nutrition and health [26].

In Africa and Mozambique to address vitamin A deficiency and malnutrition, focus must be concentrated not only on staple foods but also on diet-relevant neglected crops [27]. Currently, sub-Saharan Africa accounts for 9% of the global

 population and is characterized by high prevalence of food and nutrition insecurity, which is partly due to a lack of crop diversification [27]. Apart from playing an important role in the African diet, neglected crops can also contribute to the local economy and are part of traditional medicine as leaves of certain crops are used both as a food and a medical source. Most of the plants used grow indigenously in the wild or are cultivated on a very small scale [27]. Hence, production, as well as availability, is limited [27].
