WHO Europe outlines healthy and sustainable diets workstream

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The World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases have released a fact sheet on their workstreams around healthy and sustainable diets. This work is intended to guide European national policy on shifts towards more sustainable diets.

Many public health authorities and governments use WHO recommendations as a basis to guide decision making. The outlined workstreams indicate WHO’s interest in nutrient profiling, processed foods and beverages, digital marketing and sustainable food systems. Below are some details on individual workstreams:

  • Food profiling model for healthy and sustainable diets

Current food profiling tools (that score foods on nutritional and environmental factors) will be reviewed and used to develop a new standardised tool. This tool will then be used to inform the creation of sustainable food labelling.

  • Data platform for modelling healthy and sustainable dietary patterns

An open-access data platform that will allow governments to assess their national dietary intake data and model diets to meet local nutrition needs and sustainability goals.

  • Guidelines on ultra-processed plant-based foods

Investigating the nutritional composition of ultra-processed plant-based foods (such as vegan burgers) sold in retail and restaurants. This will be used to inform guidelines on ultra-processed plant-based food intake.

  • Healthy digital food environments

An online platform, called FoodDB, that compiles nutrition data from online food retailers, with the intent of making healthy online food choices easier.

These projects will have important ramifications for the treatment of sustainable nutrition by European authorities. Quantifying the nutritional composition of novel foods is essential in understanding their benefits and risks. It is to be hoped that this project will extend to consideration of the bioavailability of the nutrients in the novel foods.

The greater availability of nutritional data to researchers and policy-makers should allow for more evidence-based decisions on food policy shifts. However, the challenge of creating food profiling tools that can fully capture the nutritional and environmental aspects of different foods is clear: nutrition and environmental impacts are very broad topics, and unifying data from both of these fields in order to compare different foods directly will not be straightforward.

Moreover, there is a difference between healthy, sustainable diets and a globally sustainable food system. A diet that meets health, nutrition and sustainability goals for an individual may not be feasible for feeding the global population. For example, increasing the production of a certain food that contributes to one individual’s healthy, sustainable diet may result in less sustainable production of that food. It is essential to consider both what is healthy for individuals and what the global food system can sustainably produce for the global population.

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Feed Our Future event to bring science, government and industry together

The Riddet Institute is this week hosting an event to bring together food system stakeholders and decision makers for accessible evidence-based discussion of the key global issues and the local decisions that we need to make.

Sustainably feeding a growing population is a global problem, but also one for New Zealand to consider. Where does our reputation for high quality, premium food products fit in a hungrier world? How can kiwi innovation and ingenuity make a difference to the global future of food?

The event will explore the current conversation of sustainable food, bringing moderation and balance to what is often a debate of extremes. National and international experts in the fields of nutrition, food waste, food systems, life cycle analysis and consumer science will speak on these important issues, with open discussion from the attendees.

This dialogue will inspire our future decisions and put New Zealand at the front of the sustainable food systems debate.

Increasing the nutritional and environmental benefits of crops

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An integrated technique has been used to find the multiple benefits of introducing legumes to crop rotations in a recent Frontiers study. Not only are these promising findings for developing sustainable food systems, but also a step forward in holistic life cycle analysis measurement.

Adding legumes (beans, peas, lentils) to crop rotations has been shown to increase the nutritional value for livestock and humans while reducing environmental impacts and resource costs. In one example, introducing a legume crop into a typical rotation in Scotland reduced external nitrogen requirements by almost half, with no detriment to the crop’s human nutrient output.

The benefits of legumes range from environmental to nutritional. Unlike many other crops that require additional nitrogen to grow, legumes obtain sufficient nitrogen from the air around them without the need for additional fertilizers. This occurs through a symbiotic relationship with root bacteria that transforms nitrogen in the air to a useable form for plants. Legumes also reduce the need for fertiliser in future crops as they enrich the soil with nitrogen. In terms of human nutrition, legumes are rich in protein, fibre, folates, iron, potassium, magnesium and vitamins.

The novelty of this study was in its comprehensive comparisons across ten crop sequences, 16 impact categories, lengthy timeframes and various European locations. The authors went beyond simple footprinting techniques that only consider the environment or nutrition in isolation. Instead, they considered the footprint of delivering a specific quantity of nutrition. This provides a welcome and realistic perspective on the value of the whole system, with inter-crop effects and overall efficiency of cropping sequences considered.

This work has shown that the choice of functional unit has an important influence on the apparent efficiency of different crop rotations. It also indicates a need for further research using functional units that represent the multiple nutritional attributes of crops for livestock feed. The results of this study illustrate the benefit of using whole-system thinking when designing interventions to drive sustainable food systems.

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Your health is what you eat: the role of nutrition in health

This Thought for Food from Professor and researcher in Health Economics at the University of Sao Paulo, Flavia Mori Sarti, focuses on the importance of healthy diets based on regular intake of fruit and vegetables to maintain health and prevent the onset of noncommunicable diseases (NCDs), alongside the potential impacts on health care costs.

In recent decades, advances in nutrition research have been showing the role of diet in promoting health and preventing diseases. A balanced food consumption pattern that includes diverse types of staples, fruits, vegetables, and protein sources provides the energy, macro- and micronutrients to support healthy lifestyles. The consumption of other bioactive compounds may also help prevent certain chronic NCDs such as type 2 diabetes, dyslipidemias, and cardiovascular diseases.

However, the food consumption patterns of many populations around the world have been changing away from more traditional patterns towards modern diets marked by excessive intake of industrialized foods with high content of sugar, trans-fats and salt. The nutrition transition refers to the process of substitution of foods in natura with industrialized foods in different populations. This is often accompanied by a decrease in physical activities during transport, work and leisure, and an increase in sedentary activities.

The importance of consuming fruits and vegetables

Agriculture remains one of the most important economic activities, generating employment and income for billions of individuals worldwide. There are approximately 250,000 edible plant species known; however, only around 120 species are cultivated for human consumption. In addition, 12 plants and five animal species are responsible for approximately 75% of world food. Yet, plant food sources represent the main source of energy and nutrients, and are the sole contributors to fiber intake in the human diet.

Many health authorities recommend food consumption patterns with increased consumption of fresh fruits and vegetables to ensure sufficient intake of fiber, micronutrients, trace elements and bioactive compounds, also known as phytochemicals.

Dietary guidelines referring to the daily intake of fresh fruits and vegetables seek to promote the supply of nutrients through healthy diets, optimizing body functions and maintaining an individual’s health. Considering variations in cultural habits, several countries and regions publish and update national dietary guidelines based on current nutrition knowledge adapted for their populations (for example, Australia, Brazil, European Union, India, Japan, New Zealand, and the United States).

Nutritional deficiencies, such as a lack of specific vitamins and minerals found at high concentrations in plants, may be prevented through inclusion of diverse fruits and vegetables in daily meals. There is significant evidence that the high consumption of fiber reduces cholesterol and reduces the risk of cardiovascular diseases, diabetes and certain types of cancer. In addition, research on the numerous bioactive compounds that have been identified in plant foods show their contribution to the reduction of risk of NCDs in diverse population groups.

However, not all fruits and vegetables are of equal benefit. The 5-a-day mantra, adopted by authorities in many countries to increase fruit and vegetable consumption, can give the impression that all forms of fruit and vegetables deliver equally positive health consequences. While increased fruit and vegetable consumption is linked to multiple positive health outcomes, it is important to acknowledge the varied nutritional contents of these foods.

For example, there has been much debate on whether fruit juices should count towards achieving intake targets. While fruit juices contain many important micronutrients, they are also a source of sugar while lacking fiber. In developed nations, dietary fruit and vegetable variety is poor, with starchy vegetables making a disproportionately high contribution to vegetable intakes. These foods deliver a high energy intake with low nutrient diversity compared to other vegetables, such as leafy greens. The most desirable increases in fruit and vegetable consumption would be those that deliver high concentrations of micronutrients and fiber without contributing to macronutrient excesses.

Diet-health nexus for reduction of health care costs

Although there is substantial evidence on the protective effects of healthy diets, the consumption of diverse fruits and vegetables in daily diets is usually lower than recommendations in many countries.

The World Health Organization recommendation regarding consumption of fruits and vegetables is to include at least 400 grams per capita per day in the diet. However, according to data from the Food and Agriculture Organization (FAO), only 101 out of 174 countries had sufficient food supply to achieve this recommendation in 2018. Accounting for food waste (approximately 15% to 30% of food supply, depending on the country), the proportion of countries that fulfill the WHO recommendation reduces to approximately 60 out of 174 countries.

On the other hand, 169 out of 174 countries had a food energy supply greater than 2,000 calories per capita per day. Even accounting for food waste, approximately 120 countries still provide excess daily calories for adult individuals with sedentary lifestyles.

Therefore, modern lifestyles lead to a higher prevalence of obesity and related morbidities in many countries. The recent Global Burden of Disease Study 2019 indicated the greatest recorded increase in populations’ exposure to obesity and diabetes was between 1990 and 2019, among other risk factors for early mortality linked with modifiable behaviors. Simultaneously, the low diversity in food consumption patterns provide low intakes of micronutrients and bioactive compounds, characterizing the double burden of diseases, marked by coexistence of undernutrition and obesity related to NCD.

In Brazil, direct costs due to outpatient and inpatient care for treatment of 14 overweight- and obesity-related diseases has been estimated to total US$ 2.1 billion per year between 2008 and 2010. Other estimates pointed to expenditures of approximately 3.45 billion reais (US$ 908 million), attributable to outpatient, inpatient and medication for treatment of hypertension, diabetes and obesity on the national health system in 2018.

A systematic review of literature showed estimates of substantial direct health care costs of obesity and related diseases in 17 studies from developed countries and 6 studies from developing countries. They found that the medical costs associated with obesity and its knock-on effects had been increasing across both the developed and developing world. A previous review indicated that obesity was responsible for approximately 0.7% to 2.8% national health care expenditures in developed and developing countries worldwide. Additionally, individuals diagnosed with obesity usually presented costs 30% higher in comparison with healthy weight individuals due to occurrence of obesity-related NCD.

Conclusion

The reversion of negative nutrition transition trends worldwide depends on changes at individual, social, and policy level: these include gradual modifications of dietary patterns towards greater inclusion of nutrient-dense fruits and vegetables; increased physical activity levels, particularly during transportation and leisure; regulation of food marketing directed at children; adoption of nutrition education strategies; and health promotion actions within primary health care.

The cost-effectiveness of numerous strategies targeting obesity among children, adolescents and adults was assessed through economic evaluation studies in Australia, showing higher effectiveness of actions focusing on lifestyle changes among younger individuals, especially tackling consumption of industrialized foods and beverages, promoting physical activity and encouraging regular consumption of nutritious foods. Primary health care strategies addressing healthy lifestyles through family-based visits and surgical interventions showed reasonable cost-effectiveness.

Besides reducing costs in national health systems, incremental changes in diet associated with adjustments in physical activity level may prevent the onset of diverse NCD and reduce early mortality in different population groups worldwide, thus prolonging healthy life years and maintaining quality of life of individuals. In sum, following dietary guidelines will be a win-win situation for individuals and governments.

The Thought for Food was written by Flavia Mori Sarti, professor and researcher in Health Economics from the University of Sao Paulo, Brazil.

Glossary

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Finding harmony between plant-based and meat-eater diets

A recent survey commissioned by Finnish plant-based brand “Beanit” was carried out to explore the dispute on various diets, and the barriers this creates in behaviour change. It highlights the contrasting opinions of consumers, with vegetarians and meat-eaters alike feeling judged on their food choices.

Key findings of the study were that 64% of the surveyed population found public discussion around diets polarising, with 44% wanting to increase vegetarian foods in their diets. It is known that there is a gap between consumer intent and action, and this survey highlights the effect public scrutiny can have. Consumer discomfort between information and action can lead to a defensive or confrontational approach. This type of conversation is counterproductive in the transition to a reduced impact lifestyle. It fosters an environment of extremity between two groups.

The survey suggests a flexitarian diet offers the largest opportunity for Beanit’s plant-based market. The company takes the perspective that small changes made by large populations produce better results than a small group cutting out a certain behaviour entirely.

Although Beanit’s value in this may be to urge consumers to adopt a plant-based diet to increase sales, they addressed the results through a campaign named “Meat Saturday”. This encourages consumers to eat meat once a week on Saturdays. It looks to facilitate inclusivity between the labelled meat-eater and plant-based groups, offering the idea of mutual acceptability between diets.

The takeaway from the survey is relevant to any disruptive industry or product claiming to be a sustainable option. A positive, objective and inclusive narrative must be encouraged to facilitate progress towards sustainable behaviour change.

Glossary

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DELTA Model version 1.3 launched

The coloured bar shows the global average availability of each nutrient. The error bars show the range in availability in different parts of the world (10th and 90th population percentiles based on country level averages). While there are only a couple of nutrients where global availability is below target, the level of variation results in many more nutrients of concern at a country level.

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The latest version of the DELTA Model is now available online. It features new insights into national and regional nutrient availability, as well as nutrient trade.

It’s common to talk about food trade between countries or regions, but less common to think about the movement of individual food nutrients around the world. For example, New Zealanders are probably very aware of our country’s exports of animal-sourced foods (like dairy and red meat), but likely haven’t thought about what this means in terms of the calcium or iron included in these exports.

DELTA 1.3 presents the domestic production of 29 food nutrients, the export and import dynamics of these nutrients, and how this measures up to meeting per capita per day nutrient targets for a country. It also presents how this availability differs in different parts of the world, showing the user the inequalities in access to different nutrients. The results are adjusted for waste, non-food uses and bioavailability in the same way as the rest of the DELTA calculations.

Another change is to the splash page first displayed to the user. This now features an outline of the global nutrition challenge that the world is facing, as well as a description of how the DELTA Model was designed to contribute to our understanding of this complex challenge. Further additions and changes can be found in the release notes.

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Could this be the end to ‘dairy-free’ or ‘creamy’ plant-based food in the EU?

The Dairy Ban or ‘Amendment 171’, saw a narrow majority vote by the European Parliament in October 2020, preventing imitation of dairy products by non-dairy products.

This result saw a rally of 21 campaign groups, climate activists such as Greta Thunberg, and large dairy-alternative food producers such as Oatly protest the amendment. A petition against Amendment 171 created by ProVeg has received over 400,000 signatures. Further discussion on the amendment between Council, the Commission and the EU Parliament will continue this year.

Currently dairy terms in the EU are protected by law to ensure integrity of dairy products and to reduce misleading claims by non-dairy products. “Imitation or evocation” of existing dairy products is banned, including terms such as “almond milk” or “vegan cheese”. Amendment 171 furthers this to censor all use of dairy-related language, packaging and imaging in the marketing of plant-based foods. This would see dairy-alternative food producers banned from using terms such as “yoghurt-style”, “creamy”, or packaging that resembles the traditional milk carton and yoghurt pot shapes.

A recent study published in the Journal of Animal and Environmental Law found no difference in consumer perception of products coming from animals, or not, when branding incorporates wording traditionally associated with animal products, e.g. “milk”. Furthermore, omitting these words can lead to confusion from the consumer on taste and use of the product. However, a nutritional aspect was not included in the study, which could provide interesting results in the consumers perception of the product’s nutritional benefit.

Whether the dairy industry secures exclusive rights to the use of dairy-related language or not, this discussion comes down to the consumer. At the heart of both arguments is the push for consumer awareness. Further awareness will allow consumers to make informed decisions on the products they are purchasing and the impact these have on the environment and their health. All of which feeds into the sustainability of us as individuals, communities and globally.

Glossary

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Plight of the bumblebee

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Research in Global Change Biology has shown that cultivated land dependent on pollinators has increased by 137% over the last 50 years. Simultaneously, monoculture cropping has also increased, leaving pollinators challenged for diverse food sources at all times of the year.

Concerns over the decreasing population of many insect pollinators, particularly bees, are broadly heard. While many agricultural crops provide a food source for these insects, their seasonality means that they cannot be their sole food source. Expansion of monoculture agriculture leads to a decreasing diversity of available food sources for pollinators.

The article looks at global and regional trends, finding substantial differences in the degree of dependence on pollinators around the world. Generally, the greatest dependence on pollinators for successful cropping was in developing nations.

The article recommends the use of marginal land for pollinator-friendly plants and farmland heterogeneity, as conserving pollinator populations is essential to ongoing agricultural productivity.

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Trading in soil carbon stocks

Soil carbon has become a hot topic, with carbon sequestration in soil a possible method for reducing atmospheric CO2. But this isn’t an easy task, and there’s a lot more to soil carbon than just sequestration. Here, we provide an overview of soil carbon flows and what they mean in the context of the global food system.

The term soil carbon refers to carbon stocks, in various forms, present in the world’s soil. Soil carbon can be organic (e.g. living or decomposing organisms, humus) or inorganic (e.g. carbon-containing minerals such as calcite).

The amount of carbon in the world’s soils is estimated in the region of 2500 gigatons, more than three times that present in the atmosphere and more than four times that in all living organisms. Organic matter in the soil, including soil carbon, is vital to good soil health, improving water and nutrient retention, maintaining soil structure and as nutrient sources for plant and microbial life.

Soil carbon content can be understood as the balance between carbon inputs and carbon losses. A major contributor to soil carbon inputs is photosynthesis. Plants capture atmospheric CO2, which is transferred below the soil surface via the roots. As well as contributing to the structure of the plant, some carbon is passed to rhizobial microorganisms, the microbial populations that live in close association with plant roots. As root structures and microbial populations in the soil grow, so too does the bound soil carbon.

Carbon can also be added to the soil through decomposing plant and animal material. The process of decomposition involves microbial respiration, which releases CO2 into the atmosphere, but some of the carbon in the decomposing material remains in the soil. The net balance between carbon inputs and losses to the atmosphere determine whether the soil carbon concentration increases or decreases.

However, further complexity is added to the system by other, abiotic factors. Soil composition, temperature, water content and erosion all influence soil carbon cycling. Naturally, this means that soil carbon stocks vary enormously between different parts of the world, from less than 1 tonne of carbon per hectare in desert environments to several hundred tonnes in tropical forests. Even within local regions, soil type can result in significant differences in soil carbon concentrations. This variation makes quantifying soil carbon challenging.

Agriculture directly influences soil carbon stocks. Clearing of land for agriculture, and tillage and cropping are generally considered to reduce soil carbon concentrations. However, this is not always the case: in certain systems, conversion of forest to grassland results in increased soil carbon concentrations, but it is uncertain how permanent this change is.

A number of activities exist that can increase carbon sequestration in the soil, or decrease the rate of carbon loss incurred by agriculture. Reducing tillage and soil erosion minimises carbon loss to the atmosphere or to waterways, while organic fertiliser application can add to the carbon input on agricultural land. The use of cover crops, which prevent leaving the soil bare between cropping cycles, can also help to maintain or even increase soil organic carbon.

The benefits of such practices are both local and global. Increased soil carbon benefits soil health, increasing crop yields in some systems. The benefits to soil structure of high soil carbon also allow for better retention of micronutrients, such as iron and zinc. This can result in higher concentrations of these mineral in crops, and thus in our own nutrition.

However, there are challenges in increasing agricultural soil carbon stocks in many areas. It is far easier to add to soil carbon in areas where the current concentration is low than in areas with relatively high existing stocks, which may be close to saturation with carbon. Moreover, it is easier for agricultural interventions to increase carbon concentrations in the upper layers of soil than the deeper layers.

Perhaps the greatest driver of recent interest in soil carbon is for its potential in sequestering atmospheric carbon emissions from human activity. Atmospheric carbon, in the form of CO2, is well known as a greenhouse gas. Thus, the possibility of using soil as a carbon sink is gaining momentum.

The potential of this possibility has recently been demonstrated in Australia. Australia has an existing Carbon Farming Initiative that provides the legislation for obtaining carbon credits by demonstrating increases in soil carbon on owned land. Recently, an Australian cattle farm sold carbon credits to Microsoft to the value of $500,000, obtained entirely from soil carbon sequestration from the management of the farm’s grazing land.

Schemes like the Carbon Farming Initiative have the potential to spread. However, in order to quantify changes in soil carbon stocks, it is essential to measure changes in soil carbon over time. This can be done by taking soil samples from a number of representative sites and quantifying the carbon present. These measurements can then be repeated to establish changes in soil carbon concentration over time. However, the wide variation in soil carbon even within a small area makes generalisation of carbon concentrations difficult. Currently, work is underway to benchmark New Zealand soil carbon concentrations, with a view to tracking changes in the future. This work will have to contend with the difficulties of varied concentrations, but may ultimately lead to some form of soil carbon credit system in New Zealand.

Study of soil carbon is benefiting from the interest sparked by the need to reduce atmospheric carbon concentrations. However, its importance to the global food system reaches beyond carbon sequestration. Healthy soils play a role in reducing the environmental impacts of agriculture by retaining nutrients and structure, and enabling optimum crop yield and nutrient content. In the future, the drive for carbon sequestration may also influence land management and provide another source of income for food producers.

Glossary

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Dietary Guidelines for Americans 2020 – 2025 published

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The USDA has released their latest dietary guidelines document, with a new emphasis on the importance of considering different life stages when designing guidelines.

A new set of dietary guidelines are designed for the US population every five years, based on the recommendations of a scientific advisory committee who review the latest nutrition and health research, ensuring up-to-date advice.

In this document, specific dietary recommendations for infants and toddlers appear, where before this advice was absent. These recommendations cover breastfeeding and infant formula use, as well as complementary foods. Strong emphasis is placed on food variety for toddlers, as well as on the importance of iron and zinc intake.

The guidelines recommend that Americans should eat more whole fruits, vegetables, and whole grains, while limiting added sugars and saturated fat to less than 10% of daily calories each. While this largely chimes with the advisory committee’s scientific report, they had suggested that only 6% of daily calories be from added sugar, due to the negative health outcomes of high dietary sugar intake. The committee were also cautious on the contentious subject of saturated fat, not recommending any change to the current guidelines and mentioning that replacement of these fats with carbohydrates is not advised.

Nutrient density and dietary patterns were pulled out as important terms in the report. Nutrient dense foods are recommended throughout, and listed as vegetables, fruits, whole grains, seafood, eggs, beans, peas, lentils, unsalted nuts and seeds, fat-free and low-fat dairy products, and lean meats and poultry. However, the recommendations put emphasis on dietary patterns rather than on individual foods or food groups to enable adaptations that fit cultural, personal and individual needs and preferences. The three food patterns of the guidelines are the Healthy U.S-Style Pattern, the Healthy Vegetarian Pattern and the Healthy Mediterranean-Style Pattern. All three patterns provide most of their energy from plant-based sources, provide protein and fat from nutrient rich sources and limit intakes of added sugars, solid fats and sodium.

This is consistent with the results of the DELTA Model which illustrates that most of our energy should come from nutrient rich foods to ensure all nutrient requirements are met. Nutrient poor foods such as sugar should be minimised, and it is essential to consider the different needs of different demographic groups.

Interestingly, the guidelines make no mention of the environmental sustainability of different foods or diets. Several countries already make this inclusion, with this number likely to increase, but it will be at least 2025 before any such recommendations appear in the US dietary guidelines.

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Glossary

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