Food and nutrition insecurity is a multi-dimensional challenge. The World Food Summit in 1996 defined food security as a situation “when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life”. At the World Summit of Food Security in 2009, this definition was reconfirmed, and the concept was extended and specified by adding that the “four pillars of food security are availability, access, utilization, and stability” and stated that “the nutritional dimension is integral to the concept”. To conceptualize the multiple dimensions of food and nutrition security, Ecker #x20B5; Breisinger (2012) have developed a framework that builds on the World Summit definition and integrates the four pillars of food security into a system approach. It links food security and nutrition, acknowledging that food security at the household (and individual) level is a necessary but not sufficient condition for adequate nutrition and that food and nutrient intake interacts with the individual health status (Figure 1).

Nutrition is an important part of food security. Nutrition of all members of a household is subject to the household's economic (and physical) access to food and to basic household assets and (public) services that affect individuals’ health conditions. A major factor of food access is household (real) income and the lack of income does not only limit the access to food of sufficient quantity and quality but also increases the vulnerability to food price shocks. Formal education and nutritional knowledge of parents, especially mothers, and gender equality in decision making on household resource allocation are also crucial factors of the nutritional status of young children in particular. Children's nutritional status is directly determined by the mother's nutritional and health status through the physiological and social mother-child relationship. Finally, a person's nutritional status is determined by their individual health status (and vice versa), influencing physiological nutrient requirements and interacting with the utilization of nutrients from food. For example, parasitic and diarrheal diseases cause nutrient losses through blood and stool, and reduce nutrient absorption, necessitating higher nutrient intake and thus more food to cover the losses, if such compensation is possible at all. At the same time, poor nutrition weakens the human immune system and therewith increases the risk of disease and illness. Thus, access to clean drinking water, hygienic sanitation, proper shelter, basic health care for disease and illness treatment and prevention including immunization, and related information and education campaigns, all determine people's nutritional status indirectly through the link with health.