Food Bytes: June 3 - June 30

Food Bytes is a weekly blog post of “nibbles” of information on all things food and nutrition science, policy and culture.

The month of June was filled with lots of food-related action - meetings, conferences, prizes and elections. Let me tell ya, it was hard to keep up. The question is, what is the result of all these meetings and the environmental footprint of moving all these bodies from meeting to meeting? Does it actually shift the agenda in positive directions? Are we all just talking to our friends? Is it just a way to keep us busy posting photos and videos on twitter? I wonder sometimes. I am not criticizing. I am a part of the problem. But I do think it is time to rethink what all this effort is amounting to, and for who.

The UN Food and Agriculture Organization, also known as FAO, hosted a Future of Food Symposium with some dynamo speakers, but not a lot of action coming out of it. FAO also just announced the election of their new Director General. His name is Qu Dongyu from China. He is currently the Vice Minister of Agriculture and Rural Affairs of China. Makes sense. China is a giant and is greatly shaping the world’s food system. Looking forward to seeing his vision. He has a lot of work to do…

The American Society of Nutrition @nutritionorg hosted their annual nutrition conference, right upon Johns Hopkins doorstep in Baltimore. Lots of diverse science being presented and also lots of controversy around sponsporship of events and significant presence by industry. I was only there for a day but that was about all I could take sitting in an over air-conditioned window-less conference center looking at powerpoint after powerpoint. That said, it is a great way to get caught up on the latest science. And Marie Ruel, a stellar international nutrition scientist at IFPRI, was awarded the Kellogg Prize for Lifetime Achievements in International Nutrition. Well deserved. Her talk is here. I highly recommend reading Marie’s incredible body of work. Much of it can be found here. You will see why she got the award - she accomplished so much over the last 30+ years. And she still has more to do!

The @EATforum Stockholm Food Forum, also an annual affair, took place. Glitz? Check. Grand? Check. Aspirational? Check. But what’s next? The impact of EAT is yet to be seen and it remains unclear on where they will go from here. Do they do advocacy? Policy? Science? I did the opener with Johan Rockstrom or also known as Johan Rockstar. It was fun. The video is below. One thing is clear to me, if they are advocating for a better food future for all, they need to take the show on the road.

Speaking of EAT, the EAT Lancet Commission fall-out keeps churning. Some of the authors of the Commission provide some explanation of issues raised by other scientists on the environmental targets here in a Lancet short response/commentary. Another study put the EAT-Lancet reference diet to the test among a large prospective cohort of British adults. The researchers found that the diet has beneficial associations for ischaemic heart disease and diabetes, but no association with stroke and no clear association with mortality. The media continues to churn out pieces on sustainable diets and mentioned the EAT Lancet report. Great that the work is garnering so much attention in the popular press but what now? Some highlights in the last few weeks:

• This Vox piece closely examines what our diets will look like in a hotter, drier climate. Lots of talk (literally - it is an interview style piece) on the future of food and technology.

• The Eater highlights the rise of the plant-based burgers in particular, the Impossible Burger, and how fast it went viral. Seems everything David Chang touches turns to gold.

• Stepanie Feldstein also wrote for Yes Magazine about the plant-based burgers and argues that while it won’t save the course we are on with climate, small individual actions do matter, and manifest in different ways.

• This Devex article asks about the relevancy of the EAT Lancet report to the global south. Good question. One expert from Liberia indicated that many in her country don’t even know about the report. That is not a surprise. That said, in the talks I have given on the report, I have emphasized what it does and does not mean for Africa and Asia (as well as what the report did and did not do), as a researcher who squarely works in both continents. Still a lot of work to do to ensure the global findings of the report translate in appropriate ways that ensure livelihoods and culture are considered right along with health and environmental challenges for particular, diverse country contexts.

• I had to laugh at the title of this Guardian article. “Most 'meat' in 2040 will not come from dead animals, says report.” Why does that sound scary when taken at face value?

Okay enough on that! The @WorldFoodPrize 2019 winner was announced this month. The prize will go to Simon Groot, a Dutch vegetable “seedsman” where he started the East-West Seed Company reaching over 20 million smallholder farmers. More about his life can be found here. Not sure how the World Food Prize calculates the reach. I recall last year they credited shared prize winners Haddad and Nabarro, with “reducing the world’s number of stunted children by 10 million between 2012 and 2017.” While these two giants definitely made contributions, how did they get to that number?

Two publications on India just came out that I highly recommend. The first is a book, published by the great Prabhu Pingali and colleagues on Transforming Food Systems for a Rising India. It is a part of a book series by Chris Barrett at Cornell, on Agricultural Economics and Food Policy. I will publish a book on food systems for nutrition in mid 2020. At the same time, the Global Food Security Journal just published an article on future diets in India. They show that by 2050, there will be projected increases in per capita consumption of vegetables, fruit and dairy products, and little projected change in cereal (rice and wheat) and pulse consumption. Meat consumption is projected to remain low. The question remains, what will that mean for their production and food supplies and their nutrition outcomes?

View fullsize

Future direct consumption trends in India by Alea-Carew et al 2019 GFS Journal

Much being written about the food system front these days. To start, Nicholas Kristof, Opinion Columnist for the New York Times, in all of his eloquence highlighted the obscene inequities of our food system. He wrote:

“If some distant planet sends foreign correspondents to Earth, they will be baffled that we allow almost one child in four to be stunted, even as we indulge in gold leaf cupcakes, $1,000 sundaes and half-million-dollar bottles of wine.”

Guido Schmidt Traub and colleagues from the Food and Land Use Coalition argue that there are three ways to fix the food system in Nature. I agree with their three pillared approach (see figure below) but how? and with what investment? More details please! And if you don’t even know what I am talking about when I say “food system”, Corinna Hawkes and colleagues lay it all out in a policy brief. She also has another brief on why food systems matter for policies. I really like these - and there are more to come. Marion Nestle also lays out what it would take to change the United States food system. Marion is so practical. I would love to see her do more global work. Maybe we all need a dose of her realism.

View fullsize

What it would take to change the food system. Schmidt-Traub et al 2019 nature

The SDSN Network hosted an online conference on nutrition-sensitive agriculture from 3-5 June, 2019. Nutrition-sensitive agriculture offers great potential for achieving SDG 2, as it connects agricultural development to improved nutrition outcomes. Many nutrition-sensitive agriculture interventions have been applied in recent years. This e-conference aimed to turn the evidence coming from these interventions into concrete recommendations for practitioners. Close to 1,000 people from all over the world registered for this e-conference, taking part in three live sessions and interacting via an online conference platform. We had great speakers — Matin Qiam, Harold Alderman, and Agnes Quisumbing — who highlighted the latest research. Missed it? All the powerpoints and videos can be found here.

Speaking of SDSN, they are also responsible for the SDG Index. The 2019 report just came out. Do indices really do much? Do they spur action?Guess who ranked number one in the world in moving towards achievement of the Sustainable Development Goals? Denmark followed by Sweden. What a shocker! Last? Central Africa Republic. Second worst? Chad. Triste…Looking at the OECD countries, the USA is awful. Yo Trump, I thought you were going to make America great again. Yah, right.

View fullsize

OECD Progress on the SDGs (2019)

But it ain’t just America my friends, Italy is struggling on many fronts. Just coming back from Rome, I am reminded about the scale of the rubbish there. And now it seems the trash problem is becoming a public health hazard. Such a beautiful dazzling city ruined by poor management. Oh, and tourism. Mamma mia.

Speaking of indices, Bioversity just released their Agrobiodiversity Index Report which assesses dimensions of agrobiodiversity in ten countries to measure food system sustainability and resilience. Strangely, only 10 countries are shown. Not sure why there are not more. Would be interesting to know if this will be more widespread. And if you think dedicating a day to biodiversity is important, think again. @AgroBioDiverse lays out why he dislikes the International Day for Biological Diversity. I actually completely agree with him. I have very similar sentiments with the Decade of Nutrition…

Food Bytes: May 26 - June 2

Food Bytes is a weekly blog post of “nibbles” of information on all things food and nutrition science, policy and culture.

Loved this NYT article about Africa’s millennials who are making their way back to farming. “We are making farming sexy.” Hallelujah. Welcome you “agripreneurs.” Make Africa the world’s breadbasket.

Speaking of leading newspapers, if you live in L.A., the city of angels, you will like the new Food section of the LA Times. It is more about where to eat and cook and less about politics and there is a paywall. While LA is having a renaissance on all things food creation, Gotham city is shutting many of its old school diner doors. “A luxury rental tower called the Frontier stands on the site of the old Frontier Diner in Murray Hill.” The New York we all loved died long ago…

Addicted to the joe? Here is everything you ever wanted to know about coffee and its expansion from Africa to the Americas.

Policy does matter. Did you doubt that? Bloomberg Philanthropy highlights the new Task Force on Fiscal Policy for Health – co-chaired by Mike Bloomberg and economist Larry Summers – to address the growing health and economic burden of noncommunicable diseases with fiscal policy tools that are currently underutilized by governments and their leaders. Lots o’ case studies including good stuff on sugar tax.

We know America is struggling. The Brookings Institution has published an interactive exploration of how she is doing. The Hamilton Project’s Vitality Index is a measure of a place’s economic and social wellbeing. It combines a county’s median household income, poverty rate, unemployment rate, prime-age employment rate, life expectancy, and housing vacancy rate. What does this have to do with food? Well, everything. Check it out.

View fullsize

Vitality Index of America. The bluer, the better.

The last food bytes posting highlighted the research on processed foods, and impacts on weight gain. This thoughtful NPR piece talks about how hard it is to move away from processed foods, even when Americans are cooking more. Sarah Bowen and colleagues discuss the barriers: cost, time, and culinary resources. It just ain’t that easy to cook wholesome, from scratch meals day after day. You just can’t beat convenience sometimes. As the authors say: “… inequality is baked into our food system.” And ain’t that the truth.

Our favorite Tamar Haspel over at the WashPo is keeping it real. Now she is delving deep on the plant based burgers which seem to be all the rave. There are two - The Beyond Burger (peas) and Impossible Burger (soy). She takes both to task on environmental impacts, nutrition impacts and cost. And then there is steak. Will we ever replace it or our craving for it?

CSIS’s Take As Directed has a great podcast with Chris Murray at IHME on global diets and risk of disease. He discussed this paper that was highlighted previously on Food Bytes. “Diets account for more deaths [cardiovascular and cancers] than any other risk factor.” He argues the medical community is surprised and skeptical of this message. Interesting!

The Economist breaks down taxes on sugary drinks. Mexico was the trendsetter and now, 40 countries and seven American cities have started to tax sugary drinks. They argue that those that are not in favor of the tax argue that taxes are a “fun-killer, souring people’s pleasure” and can be regressive, because poorer people spend a bigger share of their incomes on soft drinks. But if demand is sensitive to increased prices, then a tax will change behavior, in a positive direction. Let’s see how it all plays out. The bigger question is, will taxes make a dent in the obesity pandemic. Hard to tell.

For any of you who collect and analyze child growth data (also known as anthropometry) in the field, the WHO has finally released a technical report that defines basic criteria and standards for sampling, training and standardization of anthropometrists, data collection, supervision, for data management including quality assessment and analysis, interpretation and reporting of anthropometric data. FINALLY. This is LONG overdue. Well done WHO. 

And last but not least, GAIN has started a new site called Nutrition Connect. Its purpose is to mobilize knowledge, share experiences, and stimulate dialogue on public private engagements (PPE - not be confused with PPP!) for nutrition. Links can also be found in the Food Archive’s Resources page.

Food Bytes: May 6 - May 25

Food Bytes is a weekly blog post of “nibbles” of information on all things food and nutrition science, policy and culture.

The Annual Reviews have just released a special issue on the Future of Food. Presents 20 articles on "Research & efforts to ensure a safe, nutritious, & affordable global food supply, while preserving biodiversity & minimizing environmental damage." Keen to read these by some stellar scientists!

View fullsize

Processed food is having its moment. New research shows that those who eat ultra-processed foods gain more weight than those who ate whole or minimally processed foods. Researchers at the National Institutes of Health, tested this using the randomized, controlled trial approach. Study participants on the ultra-processed diet ate an average of 508 calories more per day and ended up gaining an average of 2 pounds over a two-week period. People on the unprocessed diet ended up losing about 2 pounds on average over a two-week period. Fantastic food writer Bee Wilson has a new book entitled: The Way We Eat Now: How the Food Revolution Has Transformed Our Lives, Our Bodies, and Our World. She writes about how these processed foods, ala junk food, has taken over traditional diets everywhere in the world, and is having impacts on health, at a very alarming pace.

Another study highlighted the impacts of poor diets on health. An estimated 80,110 new cancer cases among adults 20 and older in the United States in 2015 were attributable to eating a poor diet. Other research supports this claim. The study found that decreasing dietary fat and eating more fruits and vegetables may lower a woman’s risk of dying of breast cancer. They tracked 48,835 women ages 50 to 79 without breast cancer since the 1990s.

The way we eat is changing. There is a fantastic piece by the Guardian looking at how more and more people are eating alone, and it has quite dramatic changes on the way we eat, what we eat and why we eat. Netflix is involved in this equation…

Let’s discuss individual foods. Are you obsessed with vanilla? Check this out. Like citrus? You may be disappointed after reading this. With 70% of America consuming bananas, they can’t be that bad right? Think again. Do you dig on swine? This may scare you.

Some places, as we know still are food insecure in the world. The UN FAO reports 815 million people go to bed hungry. Venezuela, sadly is not immune, and is really in a free fall. NYT is reporting that “Butchers have stopped selling meat cuts in favor of offal, fat shavings and cow hooves, the only animal protein many of their customers can afford.” Terrible times for the country. Let’s hope things turn around soon.

On the polar opposite, but strangely, very much on the same side of the coin, it always thought that urbanization is driving the obesity pandemic. A very impactful Nature study has shown that 55% of the global rise in mean body mass index since the mid-1980s—and more than 80% in low- and middle-income regions—was due to increases in body mass index in rural areas. The team of scientists argue that: “There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.”

View fullsize

The difference between rural and urban mean body mass index in women. Figure A is 1985. Figure B is 2017.

Nature is on a role. They also just published a really important paper nothing related to food, but on HIV. The researchers used a high spatial resolution across the continent to look at HIV prevalence sub-nationally. They already published a similar study examining undernutrition. They show that the epidemic is very unevenly spread. Of the 25 million HIV-positive people in sub-Saharan Africa, one third live in very small, highly concentrated pockets. The remaining two-thirds are spread out more broadly. This work will help hone in on the hotspots and where attention should be drawn to continue progress on halting the spread of HIV.

As for furthering education and building capacity, the London School of Hygiene and Tropical Medicine is starting a new Center on Climate Change & Planetary Health and the University of Washington has a new degree program on Food Systems, Nutrition and Health. Google them if you are interested in these new academic programs!

The Sustainable Development Solutions Network is hosting a 3-day webinar on Nutrition-sensitive agriculture. Sign up! We have three stellar speakers who will be talking about:

• Smallholder production and Dietary Diversity

• Market Challenges and Solutions to Nutritious Food Access

• Women’s Empowerment for Better Nutrition

And on a personal note, I was sad to hear about the passing of Kenyan writer Binyavanga Wainaina. He has some famous stories, including How to Write About Africa. But his most defining moment has been his coming out as a gay man, in a letter to his mum, raising awareness and rights of LGBTQIA throughout the continent.

FOOD BYTES: WEEKLY NIBBLES FROM APR 22 - May 5

Food Bytes is a weekly blog post of “nibbles” of information on all things food and nutrition science, policy and culture.

We saw a lot of really great stuff being written in the diet space this week by mainstream media. First, Thomson Reuters Foundation, and particularly Thin Lei Win published a great piece entitled, and get ready for it, “Death by Diet.” Gothic meets food. Love it. But seriously. The article and accompanying pieces highlight the fact that our diets are now so unhealthy, they are causing illness, disability and death. I really liked this figure below from the report showing what we should be eating and what we are actually producing.

View fullsize

View fullsize

Second, the NYTimes hit it big and right this week with a Food and Climate series. One article highlighted what we should eat for health and the environment and answer lots of pesky questions that we have about diets and what is considered more sustainable or not. Got a question about the impact of different milk products on different environmental indicators? They show you the path. Grass or grain fed beef? They have you covered. Check it out and take the quizzes. Clearly, diets are “hot” (no pun intended) at the moment.

The Economist had an interesting piece on global meat consumption and the transitions in demand. While some high-income countries are moving away from meat consumption, other countries are and will continue to see an increase in the demand for pork and beef. Countries like China, and continents like Africa will continue to demand meat as incomes rise, and imports make their move to these parts of the world. The impacts on undernutrition can be profound - with animal source foods filling important nutrient gaps. However, the environmental effects cannot be underestimated. So what do we do? Trade-offs are inevitable. As the article states, the consequences “will be global.”

Speaking of diets, many women in the world do not get enough iron, resulting in anemia which has serious health ramifications. This past week, I participated in a webinar hosted by the WHO and The Accelerated Reduction Effort on Anaemia (AREA) Community of Practice. I talked about how double duty actions can be done to address anemia and obesity or undernutrition in women. Marion Roche focused on adolescent anemia and gave an excellent overview. My slides are here.

View fullsize

Antimicrobial resistance, is getting more attention these days. The UN just came out with a report and the NYT highlighted it in scary detail. The report argues that overuse of antimicrobial drugs in humans, animals and plants is fueling resistant pathogens that could kill 10 million people annually by 2050. Yikes. Food system actors, beware.

I did a fun podcast with my former student Khris at UNC Chapel Hill. The podcast is called “We All Gotta Eat .” We talked about food but more largely development, youth movement sand just being a bit more punk rock if you really want transformational change.

"EAT"ing my banoffee pie

I had the pleasure of launching the EAT Lancet Commission report in beautiful Cork Ireland at the University of Cork College, hosted by Nick Chisholm at the Center for Global Development. It was a really great event attended by a diverse set of individuals including those from the livestock sector and dairy farmers, advocates, students, professors and researchers.

I presented the overall findings from the EAT Lancet Commission report but I also gave two additional perspectives. The first was my personal view on what I thought the EAT Lancet did not cover adequately or ignored, but should not have. The second was the Ireland perspective - what does the EAT Lancet mean for the future of Ireland’s food system? My slides are here.

On what I thought the EAT Lancet did not adequately do. It did not:

1. Address the confused space of sustainable diets and the epidemiology and science to support it. This was the most contentious aspect of the report and continues to be questioned. I don’t think the report cleared up the debate of what are considered sustainable diets and may have made things more contentious and perplexing.

Inequities in meat consumption

2. Tackle the inequities in food systems. The report did not at all go into how people experience difficulties in accessing healthy foods and the inequities in which they bring. It is easy to say eat less meat, but it really depends on where you are in the world, who you are, how contexts and situations can be more or less vulnerable, and what you can afford and access.

3. Take on the entirety of food systems. The EAT Lancet Commission just covered food production and consumption — the head and the tail of the food system — but we know there is this whole middle piece that drives health, sustainable and economies: food supply chains, food environments and drivers of food system transition. The EAT fell short in covering the full scope of food systems but if we did, the report would be 500 pages, not the current 50, in which still, no one read…

4. Focus on who will feed us and their livelihoods. The report did not at all go into the impacts of this type of diet and earth system change on food producers and their livelihoods, ways of life, and traditions. Nor did it go into women producers, small and medium sized producers or rural development/impacts.

5. Examine the actors, especially, consumers and behavior change. The diet really looked at supply side changes and not much on how consumers can take on such a diet, how behavior change is needed and what nudges should be put into place.

6. Consider the local social determinants, and the trade-offs. The report was lofty, ambitious and global. But local nuance, decision making and context is needed, and the report just didn’t have the bandwidth to take on local to global perspectives.

On Ireland. It was fascinating to launch the report in Ireland for a few reasons. I took the train from Dublin to Cork and the landscape was riddled with black and white cows and green rolling hills. I knew the launch could be tough…Was I entering a snake pit?

Bountiful beef cows!

First, the cattle and dairy industry is strong here. And for good reason. The agriculture sector contributes significantly to the GDP of the country. The Irish beef sector currently accounts for over 30% of the value of Irish agricultural output at producer prices. Number of cattle heads here. The beef output of Irish farming provides the key input to the Irish meat processing industry. In 2014 the Irish meat processing employed over 13,000 people. Irish agriculture is dominated by family-owned farms.  There are almost 140,000 farms, with an average land holding of 32.5 hectares.  Pasture-based farm enterprises dominate, and as a result, Irish output is dominated by dairy and livestock, especially beef.  Dairy and beef account for two-thirds of gross agricultural output and similar proportions of agri-food exports. Ireland is currently one of the world’s fastest-growing dairy producers and exporters.

Second, the impacts on climate change should not be taken lightly. They have seen a 25% and 9% increase in dairy and cattle head numbers. As a result, their agriculture sector contributes 33% of GHGe in Ireland. Methane is 64% of that. Nitrous oxide from N fertilizer application and excretion of manure is 31%. Energy contributes less - 20% and transport 19% of GHGe. GHGe have been increasing 3.5% every year since 2015 in Ireland. Ireland can play a lead role in fulfilling the “sustainable intensification” goal but so far, they are falling short on the climate agenda. Irish farmers are aware of the need to produce more from less and are addressing their carbon footprint. There is a lot more to do. A Teagasc blueprint on how to make Irish farming carbon neutral is a roadmap, but stakeholders have not signed up to the necessary timelines which will cause them to be fined 600 million for not adhering to the targets set out during the Paris COP agreement. 

The insanely delicious banoffee pie

Third, we know that the traditional Irish diet is not sustainable. Some of the top risk factors of death and disease in Ireland are related to diet. And have you ever had banoffee pie? Enough said.

While I was there, there were a lot of the questions about the “hangover” of the report. More of the questions asked by media were about the political backlash of the report findings, why WHO pulled their consensus of the report, and what it means for Ireland’s livestock industry. I found myself defending a report that while I feel fully responsible for what it says, I too find not helpful when we get into the nitty gritties, the realities and the nuance needed to make such transformational changes.

I have never been in something so high profile that I have had to defend but don’t have complete ownership over its content. I am glad to take the fall on things that I believe in or that I have been solely responsible for. But this is a different beast.

Why Hunger Amidst Plenty?

I had the pleasure of doing a keynote talk at the “Ending Global Hunger Conference” at the Center for Global Food Security of Purdue University . My talk was entitled “Why Hunger Amidst Plenty?” My slides are here.

The punchline of the talk was this: We are living in a complex world made up of multiple burdens of malnutrition. While the obstacles to address the burden are daunting for citizens, there are tools to solve it. We just need political will, global cooperation, and immediate action.

The malnutrition burden is massive. But the story is mixed - there is the good, the bad, and the ugly. Let’s start with the good. Stunting is coming down - in some places quite fast - like Ethiopia, Bangladesh and Nepal. Also, the risk of dying from a famine has become much, much smaller than at any time in history. Then there is the bad. For the third year in a row, there has been a rise in world hunger. The absolute number of undernourished people has increased to nearly 821 million in 2017, from around 804 million in 2016. These are levels from almost a decade ago. Further, “hidden” hunger remains significant but is shrouded in mystery. We don’t know the state of micronutrient deficiencies, particularly among the nutritionally vulnerable populations, such as children under five years of age, women and adolescent girls. And now the ugly. Overweight and obesity is rising everywhere and among every stage of life. No country has stopped the trends we are witnessing.

The question remains why?

• Why do we still have hunger & undernutrition?

• Why are we not seeing improvements? And in some cases reversals of progress?

• How did we get to this place of paradox: hunger & obesity?

• What can we do about it?

I argue that hunger is still rampant because of poverty, conflict change, conflict, poor infrastructure, unstable markets, food loss and waste, and periods of seasonal hunger in rural places.

But how did we get to this place of paradox? That is complex but in a nutshell, our lives and lifestyles are transforming as are our diets and food systems. Many in the world are now consuming sub-optimal diets, exercising less and hence are more sedentary, and these contribute to the risk of disease and death. At the same time, healthy diets are not accessible to all.

As a result, many people are now affected by both food insecurity and obesity at the same time.  Food-insecure populations, really no matter where they live, are subject to the same, but unique influences in trying to consume a healthful diet:

• Limited resources and lack of access to healthy, affordable foods

• Cycles of food deprivation and overeating

• High levels of stress, anxiety and depression

• Limited access to health care

• Fewer opportunities for physical activity

• Greater exposure to marketing of obesity-promoting products

The question remains, what to do? There is no one simple measure that can successfully shift the burden at the national or global scale. Rather, a constellation of different approaches and strategies, operating across scales and supply chains, and targeted at different people and organizations will be required. I argue for 10 actions:

1. Care. We need governments, industry and citizens to care about their diets and their nutrition, climate change and food systems.

2. Push for countries to develop a food systems policy. No country has implemented a full range of updated, comprehensive, and evidence informed strategies to encourage a healthier and more equitable food system.

3. Consider the situation a “Syndemic” and take on triple duty actions.

4. Consider options for keeping the food system within environmental limits. Dietary, technological change on farms, and reductions in food loss and waste are critical to reduce environmental impacts of our food system on the planet.

5. Don’t forget about who will continue to feed the world. As Ruth DeFries eloquently wrote: “Now we are transforming from farmers to urbanites. Our newest experiment-to feed massive numbers of people from the work of a few-is just beginning. The outcome is yet to be seen.” Who will feed us when the average age of the world’s farmer is 60?

6. Invest in small and medium holder farmers. Smallholder farmers have more diversified landscapes, making important contributions to the overall dietary diversity for the world’s population. 53-81% of micronutrients in the food supply are produced by small and medium farms. These farms make up 84% of all farms and 33% of the land areas globally and are more predominant in Asia and sub-Saharan Africa.

7. Maximize net increases of nutrition along value chains. Identify points in the chain that can be “leveraged for change.” Leverage points can cause nutrients to be lost or exit the value chain as well as enhance the nutritional value of select nutrient-rich foods.

8. Engage and empower women in on- and off-farm opportunities. Women need social capital including information and access to new technologies and farming practices and tapping into social networks that may assist in times of hardship. Women need access to credit with greater ability to invest in infrastructure and to smooth consumption or production shocks. And last, we need to improve their human human capital and agency - give them opportunities for education, and increase their ability to get health and nutrition services.

9. Help consumers navigate this complex web. Give them the information and knowledge the make healthy choices. Make them affordable, accessible and culturally appropriate. But consumers are super, duper confused…

10. Dig deeper. We must address the underlying social determinants that impact malnutrition. Every country is impacted by poverty but its determinants may be different, or the same…

Food Bytes: Weekly Nibbles from Mar 25 - Apr 4

Food Bytes is a weekly blog post of “nibbles” of information on all things food and nutrition science, policy and culture.

This week’s food bytes focuses on the complications of understanding what is a healthy diet because there seems to be much havoc and confusion in the space. The more havoc, the more people want to dissect the havoc or relish in it. And we seemed to be inundated these last two weeks with diet news.

Tamar Haspel is a fantastic food columnist for the Washington Post. There was a lot of twittering and conversation, which she does not shy away from, about her recent article entitled “Here’s what the government’s dietary guidelines should really say.” She hauls the science of nutrition over the coals leaving no one left standing. In her article, she presents two main criticisms. Her first issue is the flawed nature of nutritional sciences. Errors abound in the way diet data is collected, the way observational studies assess impacts of those diets on outcomes, and the ways in which confounding factors are taken into account. Her second issue is the conflicts of interest in nutritional science. She highlights not just perverse industry-funded research, but also, the nutrition experts’ often ideological world views, or “fanatical opinions that abound in nutrition” which shape interpretations of the data in misleading ways. These two issues, the imperfect science and the conflicts of interest, interact and influence each other.

Following her merciless critique, Haspel concludes that “In the two decades I’ve been writing about nutrition, my confidence in what we know about food and health has eroded.” She is not alone. Many people are very confused about what is healthy and what is not. What will kill you and what will keep you alive. What is sustainable, and what will ruin the planet. She is left feeling certain about three simple things: (1) eat a wide variety of foods with their nutrients intact; (2) keep your weight down; and (3) get some exercise. Sounds about right.

View fullsize

Timeline of the nutrition science field

Do former New York Times writer Mark Bittman and Yale Professor David Katz agree with these sentiments? Largely yes. They argue, “eating well remains difficult not because it’s complicated but because the choices are hard even when they’re clear.” But they have answers. Lots of them. They thought of every question imaginable about diets and health and tried to answer them. Many of the answers are a bit “take my word for it,” but I give them the benefit of the doubt. Although some could wonder why we trust Bittman over credible scientists, but I digress. They argue that future conversations are no longer needed. Yeah, if it were only that easy boys…

Katz also delves deep into why we are eating as if we know less about food than ever before. He argues that humans have been bamboozled by prominent ideologues in the field of nutrition who have built careers defending just one point of view. Similar sentiments to what Haspel highlighted. He argues:

“Where humans practice any reasonable variant on the theme of wholesome foods, mostly plants, in a balanced, time-honored assembly; wherever they eat mostly vegetables, fruits, whole grains, beans, lentils, nuts and seeds, and drink mostly water, they tend to live long, prosper with vitality, and go late and gentle into that good night.  It is not the job of “science” to tear down this established foundation: It is the job of science to build upon it.”

I think what Katz is getting at is that the science of nutrition has come a long way, and there is lot of agreement about the science, but we need to build further on that evidence base. At least, I hope that is what he means. Well-respected Dariush Mozaffarian (Dean and Jean Mayer Professor at the Tufts Friedman School of Nutrition Science and Policy) and colleagues have shown a timeline of the nutrition field and how far the science has come. In the final piece of their timeline - the future - they argue, “Public health future nutrition policy must unite modern scientific advances on dietary priorities with creative new approaches for trusted public communication and modern evidence on effective systems level behavior change.” Trusted public communication. Sounds quite similar to what is being argued by Katz and Haspel. The question is, how do we ensure the science and the way it is communicated by scientists, media and journalists, is trustworthy?

View fullsize

Global Burden of Disease Lancet study: impact of diets on mortality

But the chug and churn of nutritional sciences continues amidst the havoc. Here are three studies published these past two weeks that show the impact of diets on health, at three different levels: at the dietary pattern/whole diet level, the food group level and the individual nutrient level.

1. The Global Burden of Disease project out of the University of Washington just published a Lancet paper on the impact of suboptimal diet on noncommunicable disease mortality and morbidity (Full discloser: The Food Archive archiver is an author on this paper). The estimates (and modeled data) show that 11 million deaths and 255 million disability adjusted life years (DALYs) were attributable to dietary risk factors. High intake of sodium (3 million deaths and 70 million DALYs), low intake of whole grains (3 million deaths and 83 million DALYs), and low intake of fruits (2 million deaths and 65 million DALYs) were the leading dietary risk factors for deaths and DALYs globally and in many countries.  

2. Sabrina Schlesinger and authors published a systematic review looking at the impact of food groups on risk of overweight, obesity and weight gain. They found that increased consumption of whole-grains, fruits, nuts, legumes and fish consumption had a negative association with overweight and obesity. Positive associations were found for refined grains, red meat, and and sugar sweetened beverages and overweight, obesity and weight gain. 

3. And last, a Nature paper examined the impact of carbohydrate, a macronutrient, quality on health. They argue that the quality of carbohydrate-rich foods (high in fiber and whole grains) rather than quantity has the strongest effect on decreased mortality and reduced incidence of cardiovascular diseases, type 2 diabetes mellitus and colorectal cancer.

Still confused? Everyone is sort of saying the same thing that Michael Pollan said so simply a decade ago, now a mantra for many: Eat food, mostly plants and not too much.

Soda, Celebrities and Sell Outs

I wrote this piece two years ago on my urwhatueat blog, but I feel it needed to be updated and resurfaced.  So here it is.

A few years ago, Mark Bittman wrote: “Why Do Stars Think It’s O.K. to Sell Soda?” This was in response to Beyonce’s TV ad selling Pepsi to the masses. I couldn’t agree more. It is maddening actually. With the current culture being so obsessed with all-things celebrity, you would think that actors, musicians, and athletes would use that position, an enormously powerful one, to make positive change in the world. I was really surprised and disappointed to see one of my favorite actors, Steve Carell (with Cardi B and others), doing a Pepsi commercial during the 2019 Super Bowl yelling that Pepsi is “okay!” But is it Steve?

One out of every 4 people are overweight or obese globally – approximately 2.1 billion people. This “globesity” pandemic touches everyone including young children and teenagers. Obesity has more than doubled in children and quadrupled in adolescents in the past 30 years and now more than one third of children and adolescents were overweight or obese.

So what does obesity have to do with soda? Well…the evidence is pretty cut and dry at this point. Some would argue, and are often “paid” to do so, that soda doesn’t make a dent as a contributor to our waistlines but that is just hogwash. Much of the deleterious effects are due to the high content of sugar in these products. One single 12-ounce can of soda contains three-quarters of the daily added sugar the World Health Organization deems as safe. We know three things about soda and other sugar-sweetened beverages (SSBs such as soda, energy, sports drinks, sweetened teas):

1. Serving sizes have increased: Before the 1950s, standard soft-drink bottles were 6.5 ounces. Now, 20-ounce to 42 ounce bottles are the norm.

2. People everywhere are drinking more soda: In one decade, calories from sugary beverages increased by 60% in children ages 6 to 11, and sugary drinks (soda, energy, sports drinks) are the top calorie source in teens’ diets.

3. Soda does contribute to obesity and diabetes: Frank Hu at Harvard outlined the studies that make the case. Recent meta-analyses show that higher intake of SSBs among children was associated with 55% higher risk of being overweight or obese; A meta-analysis showed that one to two servings per day of SSB intake was associated with a 26% greater risk of developing type 2 diabetes compared with occasional intake (less than one serving per month); Two large randomized control trials showed that reducing consumption of SSBs significantly decreases weight gain and adiposity in children and adolescents.

Convinced yet? Unfortunately, some of the top-selling artists and athletes are clearly not convinced or just don’t care. Instead, they have sold their souls to the soda companies. Not that some scientists are any better. This whole fiasco of soda companies funding science and pushing the product in emerging economies is just beyond me. With all the commoditization of everything on the planet, isn’t there anything that remains pure and of sound truth? Science should remain untouched, un-monetized: an “immuno-priveleged” place where you just don’t tamper with evidence. Marion Nestle, professor at NYU, has written a whole book on the poltics of soda aptly entitled “Soda Politics” highlighting the perverse tactics used by soda industries to fund and push their products on the public. But I digress…

Selling products with saccharin-sweet pop music is so ubiquitous in our culture that you can even take quizzes on which celebrity sold Coke or Pepsi. Not sure the point of that but indeed a good time waster.

The 1980s saw pop music come to life (and further exploited) through our TV, not just our record players (cassette tapes in those days) thanks in large part to MTV. Commercials or mini videos followed. As an 80s teenager, the first massive star I remember selling soda was Michael Jackson and he took a pretty decent pop song, Billy Jean, and changed its lyrics from “Billy Jean is not my lover” to “You’re the Pepsi generation.” Swell. But it all didn’t work out so well for Mike. Remember the hair catching fire incident not to mention other controversies…Next up. Madonna aka self-proclaimed #rebelheart. Dancing in lingerie in front of burning, Catholic crosses and kissing a black Jesus proved to be a bit too racy for Pepsi in which her ad was banned. Mamma mia.

With each decade, the hits and the soda sales just escalated. Britney Spears, Beyonce, One Direction for both Pepsi and Coke (isn't that a conflict of interest?), Selena Gomez (sipping the slurpy stuff from a Coke bottle with a straw got over 7 million likes!) and Taylor Swift, to name a few. But Taylor is okay because she promotes diet soda. Taylor – don’t you know about the implications of diet soda on the profile of the microbiome? Sigh…

Biggie in da Bronx

CSPI, a DC nutrition watchdog, published a list of celebrities, what they promote, and twitter feeds like Pittbull’s elegant tweets of poetry: “Hanging out at Club23 with Dr. Pepper.”  Nas and Drake for Sprite – Obey your thirst. In the ridiculous video, showing lots of young African American men drinking soda, Drake actually credits Sprite with his success. Maybe he should give himself more credit instead of belittling his talent to something so nutritionally deficient. Even the dead cannot RIP. I saw the below ad in the Bronx. Who gave Sprite permission to use Biggie’s image? His estate? Is that even legal?

Kendall Jenner, one of the Kardashians, did a Pepsi ad last year, that infuriated the #blacklivesmatter (BLM) movement. At the end of the commercial, Kendall walks to the front of the protest line, and hands a police officer a Pepsi. There is an exchange of peace, love and understanding. The crowd cheers on Kendall, who has saved the day, ending any resentment and policy brutality. Indeed art imitates life with this ad taking inspiration from a photo of a specific black woman, Leisha Evans, bravely standing up to riot gear adorned police at a BLM protest in Baton Rouge.  Live bolder, live louder, live for now. "Pepsi was trying to project a global message of unity, peace and understanding. Clearly, we missed the mark and apologize." Um…yah.

What makes this so infuriating is that they are targeting young, African Americans. But African Americans are not untouched by the obesity epidemic and often, suffer significantly more than other races due to poor access to healthy foods, poverty and inequity. Some stats in case you don't believe me:

• African American adults are nearly 1.5 times as likely to be obese compared with White adults.

• 47.8% of African Americans are obese compared with 32.6% of Whites

• More than 75% of African Americans are overweight or obese compared with 67.2% of Whites

• 35.1% of African American children ages 2 to 19 were overweight, compared with 28.5% percent of White children

#BlackLivesMatter – indeed they do. And if we continue to push junk food and soda on populations, racial health inequities will continue to persist.

On one hand, I understand the pull of profit. Celebrities make bank with these commercials. We could equally criticize all the sports players who promote equally unhealthy sugar sweetened beverages (Gatorade etc) and movie stars promoting fine Japanese whiskey (for a relaxing time, make it Santori time), but picking on pop stars is fun. And they earn so much money already. One Direction, a British pop boy band, was the highest grossing band in 2017 due to touring, which of course is always sponsored by somebody. Do they need to sell Toyota, Coke, and everything else that comes along, to sell their songs and get teenagers to come to their concerts?

I am not judging them. Well, maybe I am. I bet they are all great human beings and many have promoted important causes. One Direction is pushing Action 1 which is getting the young generation to take action and raise their voices to what future they want in the post 2015 development agenda. Commendable. Taylor Swift in her own right is empowering young women #GirlPower! The millennial generation, which Taylor and others are 'labeled' as, is impressive. I know. I teach them every day. What bothers me is the selling of their songs – their “art” – to sell soda. Why? They should really start thinking about their fans. If they want them to continue buying their records, going to their movies, and going to their shows, they should want their pre-pubescent and adolescent fans to be healthy. Especially our girls who are particularly vulnerable to obesity, with life-long repercussions.

We know celebrities care about their own health. They gotta look good with 25million+ Twitter and Instagram followers watching their every move. Most popstars are on special diets, have brutal trainers, do yoga and soul cycle. They probably don’t drink soda or for that matter, consume any sugar. Because well, that is what their personal nutritionist advised them to do…And advice given by "nutritionists to the stars" is ALWAYS of sound scientific evidence (Think Beyonce + Cleanse).

One could argue that there are efforts underway to counter these ads - companies are reformulating sodas to get the sugar content down or using alternative sweeteners, and national and municipal governments are taxing soda at the point of sale. Is this enough? I will write on these topics in some detail at a later date.

And maybe it is all just a bit unethical to be pushing soda on children? Marketing junk food and soda to children is generally considered pretty immoral in some circles, and wreaks of the same tactics used by tobacco to get kids to smoke. Check out this Coke 2018 ad called The Wonder of Us that promotes “the diversity of youth” and “there is a different coke for all of us.” Rafael Acevedo, the group director for Diet Coke in North America said “Millennials are now thirstier than ever for adventures and new experiences, and we want to be right by their side. We're making the brand more relatable and more authentic.”

Maybe celebrities need to be held accountable to what they are selling and to who?Young popstars should take a page from the songbook of Neil Young. Or at least watch "This Notes for You" and his rip on the commercialism of rock and roll.

 Ain't singin' for Pepsi


Ain't singin' for Coke


I don't sing for nobody


Makes me look like a joke


This note's for you.

Well sung Neil Young.