It is easy to see the beginnings of things, and harder to see the ends.

At least, that is what Joan Didion wrote in “Goodbye to All That.” She was referring to herself when she moved to New York City and unexpectedly stayed for a good long while. Maybe too long.

I have been thinking a lot about what she wrote, feeling the palpability of those words as we mark our 30th day in self-isolation amidst a global COVID-19 pandemic, without a clue to where we are within it. The end is indeed abstruse. Are we at the beginning of it? Are we in the middle? Or nearing the end? It is harder to see, know, or predict when this will all resolve, and no Jim Morrison, the end is not always near.

We saw COVID coming for a while now. We had early lessons of historical pandemics in which many of us mortal souls perished. The Plague (killing 200+ million), the Spanish Flu (killing 50+ million), and HIV/AIDS (killing 25+ million and still going on). The visual below shows the impact of these pandemics killing 25 to 35% of the total global population. We have also been warned over the last two decades that more and more zoonotic diseases — i.e. animal to human transmitted diseases — are coming and creeping into our food supply. Think avian and swine flu, SARS, and MERS.

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Then there are other infectious diseases that are downright scary, but seem to be contained to certain regional epidemics. Think Ebola and Zika. These have never quite made the jump to be classified as a “pandemic” which is classified as a disease impacting every country in the world, yet.. Then there are the insidious, neglected and tropical diseases like river blindness, Leishmaniasis, and Guinea worm that impact people living in the poorest areas of the world. And Dengue and malaria continue to wreak their widespread havoc. The warnings were and are persistently there.

The beginning of COVID-19 was surreal, yet predictable to witness, much like watching the beginnings of Steven Soderberg’s movie Contagion (a virus that spread from China to the rest of the world via air travel, killing 25% of the global population, which stemmed from a bat to pig to human food system zoonotic transmission). Noticing events unfold mid-to-late December in China, as it quickly made its way through some Asian countries, and then slammed into Italy, were obvious signs that this virus moves fast and stealthy, and does not discriminate. And it was coming for everyone, leaving no one behind. Observing the way governments responded to tampering down the virus has been mixed, with the U.S. being way too slow to move and react, and with a “president” who not only doesn’t understand the science but doesn’t care to learn and listen to the experts (like the great Tony Fauci) who surround him reluctantly. Now, the country is reeling from the highest number of cases and deaths in the world.

We also had knowledge and evidence of how such a pandemic would unfold and how the food system is particularly vulnerable to being the source and breeder of these zoonotic type diseases. Now one might wonder if COVID-19 is truly a zoonotic disease. Its origins are being debated in the scientific literature. While there are some thoughts that the virus originated from a wet market in Wuhan, scientists are still unclear about its origin. Did it come from animal and if so, which one(s)? Did it really come from a seafood market or from food at all? There are many early assumptions that it came from snakes or pangolins. The science is leaning towards snakes not being the source. Viruses have a hell of a time jumping from warm-blooded to cold-blooded back to warm-blooded. And it is thought overall that COVID-19, like SARS, is a mammalian virus. There was one article in late January 2020 in the Journal of Medical Virology that though some of the genetic code of the COVID can be found in two snake varieties, but that has been discredited.

There is an interesting article in Nature that is trying to determine its origins. The starting point is the genome: 80% of the COVID-19 genome is shared with SARS and 96% with bat coronaviruses. They hypothesize that the origin of COVID-19 is either natural selection in an animal host before zoonotic transfer (bat to pig or bat to pangolin) OR (ii) natural selection in humans following zoonotic transfer (so human to human, i.e. SARS to COVID).

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I am going to write more about zoonotic (also known as zoonoses) diseases for a new blog series myself and some stellar colleagues are curating on COVID-19 and nutrition. Still, for now, it is of the utmost importance for the global community to prevent these food-borne zoonotic diseases in the future. Scaling up a “One Health” approach is one way to prevent future pandemics.

Humans co-exist with animals - as companions for our overall wellbeing, as producers of food, and as a source of livelihoods. This interface between animals and humans and their shared environments can be a source of disease too. Those who work on One Health work at this interface to prevent zoonotic diseases from spreading by considering animal, human, and environmental connections.

But here we are, with each day running into another, wondering if tomorrow will be different or more of the same. For now, we are stuck in this endless cycle of a beginning. But maybe this is a new beginning - one of a new reality, a new way to see the world and our place in it, and a new appreciation of what we have and a profound sadness and empathy for those who have less or have suffered loss, in every shape and form. The question is, when the end is near, or even better yet, comes and COVID-19 is in the rearview mirror, what will we be as a human society then? Hopefully, one that is better informed, ready, and resilient for the next one.

Food bytes: March 21st edition

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

As much as we want to pretend all is normal, it is clearly not. We are in the middle of a global pandemic, with a massive amount of uncertainty, fear, and in some places, complacency. We will be posting another blog entry on the COVID crisis but for now, we will highlight, just a few emerging articles on the growing concern of food insecurity and the food supply, along with our regular updates on all things happening in the food space.

On COVID, we have never been in a situation like this before with talk of it reshaping the global order or social collapse or cohesion. So to predict how markets will continue to react to the future and the health of the global food supply is uncertain. Anyone who postulates how it will go is misleading us. Yes, of course, we can look in real-time on how households and communities are handling the crisis, and we can look to the past, on how other pandemics like the Spanish Flu, impacted food security and supplies. However, times are different. Food supplies are globalized. The population in 1918 was 1.6 billion. We are now at 7.5 billion.

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Locusts in east africa (copyright: BBC News)

Rob Vos at IFPRI argues there is no major concern for food insecurity, yet. They came to this conclusion by looking at food prices of staple crops. Huh. As the Brookings Institution rightly pointed out, low-income seniors are already feeling the impacts. In the U.S., with roughly 15% of households being food insecure, some are concerned about their ability to feed themselves in the coming months. A WaPo article quoted: “If coronavirus doesn’t get us, starvation will.” Then there is Africa. Food insecurity and stark hunger could worsen in an already fragile context. East Africa is also reeling from an invasion of locusts which don’t help the already burgeoning food insecurity in the region. This video is pretty insane if you want to see the locust infestation.

The EAT-Lancet Commission report follow ons just keep coming. Did you know that the report has already been cited 790 times since its publication in January 2019? Insane! A few interesting articles are emerging that again test the validity of the Commission’s findings.

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The water footprint (blue and green water) of different nut types (shelled) as well as some other food products for comparison, in litre/kg and litre per g of protein. (Vanham et al 2020)

• One article published by the LIvestock Innovation Lab at the University of Florida shows the importance of animal source foods and explains that raising livestock and eating animal source foods can be compatible with sustainable development.

• Another article questioned the recommendation in the report to increase nut consumption. The article dissects the water intensity issues in producing trees and ground nuts especially in India, China, Pakistan, the Middle East, Mediterranean, and the U.S. Check out cashews in the figure!!

• A publication in the Journal of Nutrition argued that the mortality reduction effect of the EAT-Lancet proposed diet in the USA is no greater than the impact of energy consumption changes that would prevent under-weight, over-weight, and obesity alone, calling into question its findings. Authors are funded by the National Cattlemen's Beef Association…

• Pedro Sanchez, one of the world’s experts on tropical soils and a World Food Prize winner wrote a piece about the land needed to grow the Lancet-EAT diet was oversimplified. He provided some alternative calculations. He argues that current total world food production is estimated at 9.30 billion metric tons of crops and animal-sourced foods, with crops grown in 1.27 billion hectares of land. Implementation of the EAT-Lancet diet for 10 billion people by 2050 would require a lot less, 5.39 billion metric tons of food in 1.10 billion hectares of cropland, assuming no increase in crop yields.

Pedro’s paper was part of a special issue in Food Policy in the Food Policy journal initiated by Editor in Chief Chris Barrett. The issue is about the evolution of the Consultative Group on International Agricultural Research (CGIAR), and the international agricultural research centers (IARCs) that comprise the CGIAR System. Over the past two decades, the CGIAR has undergone a series of reforms with the latest reform being termed “One CGIAR”.  Maybe they should take a lesson from the UN and find out how the One UN worked out…The special issue is out and is meant to “help inform a research strategy for the new One CGIAR.”

Robotics, AI, nano. Will these technologies transform the food system, and eliminate the “human” element from agriculture work? Yet to be seen. This article in the Economist discusses agricultural robots. And they have names: Tom, Dick, and Harry.

In the world of nutrition, meat will remain a controversial topic that is heating up. Nutrition is always accused of having serious conflicts of interest - who pays for the research? Who is biased? Who is paid off? JAMA and Scientific American highlights the controversy with meat-funded research and plant-funded research - and the “bullying” by both sides. Katz responds here. The livestock industry responds here. This debate has left consumers confused, and lacking any trust in science. A few other tidbits on meat. This NYT opinion piece by Alicia Wittmeyer argues that to stop eating meat, can alienate us from our traditions. Meanwhile, the EU is considering a tax on meat.

Speaking of diets, with 2.1 billion overweight and obese adults, and half of the U.S. facing obesity, we need some new strategies. Intermittent fasting seems to be all the rage these days as the best way to lose weight and keep it off. A review in JAMA highlights the evidence, and NYT provided some guidance. We tried it. It is not so hard. Just eat between the hours of noon and 8 pm. Thereafter, no calories should be consumed in solid or liquid forms.

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Changes in purchases of high-in beverages, by education level of household head (Tallie Smith et al 2020)

Diet quality matters too. Bee Wilson, an amazing writer of food and its history, wrote a long piece in the Guardian on the contributions of ultra-processed foods on the global obesity crisis. These foods are cheap, attractive and convenient, and we eat them every day. But they are also riddled with sugar, salt, and unhealthy fats. This article is worth the read. Some countries are worried. Take Chile. They instituted a Food Labelling and Advertising which put warning labels on the front of food packages if the food was high in sugar, high in salt or high in fat. Sugary drinks, unhealthy snacks, and packaged foods must carry the front-of-pack labels. These foods are also regulated. These foods cannot be marketed or sold in schools or on TV. Has it worked? Yup. Sales of these foods are down 23%. In college-educated consumers, as you can see in the figure, purchases were done 29%!

2019: The year of food and nutrition reports!

2019 was an interesting year in the food and nutrition space.

The Lancet had food on its mind this year with THREE Commissions/Series:

• Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems

• The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report

• The Double Burden of Malnutrition

The EAT-Lancet Commission made the biggest “footprint” and spurred much debate and controversy, and pissed some people off. Good. That is exactly what it was meant to do. This along with the Syndemic made the Altmetrics top 100 papers of 2019. Cool.

The Global Burden of Disease finally published a solo paper on diets as a risk factor. That too made the Altmetrics top 100 list.

A slew of other reports on food, planet, and people came out this year. See the image below which doesn’t capture everything. They all pretty much say the same thing: We need to transform our food system if we want to save ourselves and the planet that we live on. We cannot disentangle the two. We depend on each other. It won’t be easy. The stakes are high and so are the challenges (like urban and population pressure). It will take significant, synergistic political will and investment. We are running out of time. That is the gist.

The Global Nutrition Report and Scaling Up Nutrition (SUN) movement churned on to keep the momentum, largely in the undernutrition space, moving.

We saw some neglected areas get more attention this year. Fish, plant-based burgers, older children and adolescents. The Nobel Prize went to two stellar development economists whose research has informed our thinking on poverty, and how we can reduce it. But of course, with a dose of caution.

The Committee on Food Security is in the process of crafting the Voluntary Guidelines on Food Systems and Nutrition. Regional consultations took place all year, and a draft is now out for review. If you are interested in providing written feedback on Draft One, you can do so by sending comments to cfs@fao.org by February 5, 2020. You can find all the info here.

This was the year of reports. Let’s make 2020 the year of action. We have a lot of evidence of what to do and how to do it. Many of us have written about it in ways in an attempt to get the attention of politicians. Now, we need to take what is written on paper and translate that into changes that matter for people. We need to vote for policymakers that care about these issues at the local level. Let’s push to make food, climate, and health a part of their campaigns, and give them the opportunity to take ownership of the issues.

We also need to think about politics outside our hometowns. We have seen some major shifts in the global political machinery of how we relate to each other and our willingness to participate as global citizens. Some of the heavy hitters, such as the U.S., will continue on its downward spiral into irrelevance, with the UK following close behind. But until they completely make themselves obsolete, their decisions, unfortunately, matter for the world, as we witnessed with the shoulder-shrugging at the COP 25 negotiations in Spain. Another year, lost.

But I am a cautious optimist. Well…let’s not push our luck here. Maybe more of a realist. We have the Tokyo 2020 moment to increase investments for nutrition (which are currently dismal). We will be half-way through the UN Decade of Action on Nutrition and 1/3 through the Sustainable Development Goals (not sure what this means, but hey). Derek Byerlee and I wrote about how far we have come and what achieving SDG2 means for the world. We have the Committee on Food Security hopefully approving the Voluntary Guidelines mentioned above. And we always have COP 26, to stir up a miracle to save the planet. These global moments are important, but not enough.

This is what I plan to do in 2020:

1. I am going to take a look in my own backyard to make changes (and maybe stop flying around the world, thinking I am saving it).

2. I will vote with my fork and the dire importance of the 2020 election in the U.S. cannot be understated.

3. I will work more with people and less with paper – i.e. stop being involved in all these goddamn reports (that few read…).

Food Bytes: October 6th edition

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

Fall has arrived and with it, some interesting controversies in the food space.

Let’s start with sustainable diets. The New Yorker has a great read about the Impossible burger saving climate change. But according to the International Livestock Research Institute, “alt proteins” are not an answer for poorer countries. As Romeo Void sang, “never, say never.” Jonathan Safran Foer was a meat eater and went cold vegan. And he has another book about it.

Who is not going to save us all from climate change? Brazil. There is a lot of attention to the Brazilian Amazon forest fires. Here is a really good video summarizing the current situation of the Brazilian Amazon forest fires, much of it due to beef. Speaking of beef, there was a lot of controversy over a recent publication that it is okay for people to not limit their red meat consumption, following a slew of reports on its harmful impacts on health and the environment. NYT has been covering the controversy and now most recently, backlash with conflicts of interest. It turns out some were funded by the beef cattlemen association and ILSI, quoting NY Times here a “shadowy industry shaping food policy around the world.”

Paul Ferraro of Johns Hopkins has an article about how climate change solutions remain so elusive, particularly on the way we disseminate evidence. He argues: “We've always assumed the evidence must matter, but in reality we have almost a complete absence of evidence about the value of evidence…But then when it comes to building capacity, disseminating that information, we don't apply a scientific lens anymore. We just do it. We have no idea how to effectively use the science and the evidence we generate to move human behavior.” Tru dat.

Maybe fish will save us all. A fantastic article in Nature on the importance of global fisheries in solving micronutrients. My favorite? Shellfish, particularly, clams. Did you know spaghetti vongole was from Naples? Certo!

The World Bank has summarized the current controversy of childhood stunting being equated to a measure of cognitive development. And on the other end of the spectrum of child growth, a new report estimates that the number of obese children globally is predicted to reach 250 million by 2030, up from 150 million now. Wow. Scary stuff. We often things of these child outcomes — stunting, wasting and overweight — as separate, but we should really stop doing that. This article calls for a unified approach. While I agree, it seems these days we are on a divided battlefield in nutrition and food, with no agreement on much of anything in sight. But, I am a pessimist!

Food Bytes: Aug 26 - Aug 31

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

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Have you ever wondered which cuisine the world craves? Turns out, Italy. Yeah, no shit Sherlock. Italy is the largest exporter of their cuisine followed by Japan, Turkey and Mexico — Órale! Who is the largest importer, meaning, their food just sucks? You guessed it Sherlock. America. F!@#%* yah! China and Brazil don’t seem so keen on their local cuisine either. They follow the U.S. on importing other country cuisines. Funny. Brazil’s food based dietary guideline boasts harnessing its local cuisine. We guess people just don’t read those pesky guidelines…

Dari Mozaffarian and Dan Glickman wrote a timely op-ed piece in the New York Times that diets are now the number one risk factor killing Americans, costing the U.S. health care system billions each year. They provide a range of solutions and signify that governments and food and beverage industries need to be held accountable. While unhealthy diets continue to kill so many, politicians completely ignore the issue. As America moves towards what will be a contentious, decisive election year, they suggest that “every candidate should have a food platform, and every [presidential] debate should explore these positions.” Not sure this rhetoric will be high on the Trump “make American great again, for real this time” re-election campaign because the “Potus” just ain’t really that into food. Unless you consider consuming fast food a gourmand type diet.

Another op-ed piece in the New York Times by Catherine Kling urges that producers who cause “nutrient pollution,” in the form of nitrogen and phosphorus coming from agriculture fertilizer and manure run-off, should be required to pay for the cleanup. She suggests that state government regulations should be enforced to ensure that farmers reduce nutrient pollution. Wonder how livestock ranchers feel about that? Gee, take a guess.

IFAD and Bioversity just put out a great guideline on supporting nutrition-sensitive neglected and underutilized species (NUS) and wild edibles (check out Figure 2 particularly). The guideline is led by the great Stefano Padulosi at Bioversity who has some deep experience working on NUS value chains in many parts of the world. He is also the “Rocket Man.” What are NUS you ask? Here is how they define it in the guideline:

Many are the synonyms which have been used since the mid-1980s to refer to NUS, including minor, under-used, under-exploited, under-developed, orphan, promising, lost, alternative, traditional, niche crops, crops of the future, future smart food. In reality, all these terms are often context-specific and loaded with heavy cultural meanings and not easily understood in the same way by everybody. The term “Neglected and Underutilized Species” might not be the ideal expression and may not be appealing to people.

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There is so much focus these days on diet and the food system footprints on climate change. It is seriously having its moment. But in the back of our mind’s eye, we hark back to an article published in 2017 in Environmental Research Letters, that indicated that largest impact an individual can make to reduce their greenhouse gas footprint is to have one less child. Check out this graphic to the right. Powerful. This action is followed by living car free. Diet is further down the list of impacts. Food for thought…

Interestingly, they didn’t model reducing food waste by individuals. The World Resources Institute (WRI) has just released a global action agenda on reducing food loss and waste by 2030. It is a really practical guide to setting targets, honing in on who should take action and what scalable interventions are available. Everything WRI puts out is pretty stellar and this is another data rich, practical guide to tackle one of the most important issues of the food system.

What if all Americans ate less meat? Not necessarily eliminating meat completely, but just much less? By the way, American are already slowly and steadily decreasing their beef consumption since the 1980s. In the Nature journal Scientific Reports, scientists tested this idea. By replacing 25% meat with plant alternatives dominated (strangely) by soy, green pepper, squash, buckwheat, and asparagus, Americans can eliminate pastureland use while saving 35–50% of their diet related needs for cropland and 330 million metric tons of greenhouse gas emissions each year, but increase their diet related irrigation needs by 15%.

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These advertisements on the left for PETA Vegan guides are all over DC (note the elephant in the background just to remind you that yes, DC is the capitol of the U.S. and the district lives and breathes politics. You can’t get away from it. It will smother, suffocate and slowly destroy you). Where were we? Oh yeah. We picked up the guide and thumbed through it. Some of the recipes didn’t look so tantalizing, and much of what was recommended wasn’t all that healthy. There were lots of photos of faux meat mimicking fried chicken fingers, hotdogs, and meatballs doused in sticky sauce, as well as lots of cakes. Is it possible to promote sustainable, healthy, and animal cruelty free vegan diets for those who choose to go that route PETA? That can’t be too hard can it? While it was an A for effort, maybe version 2 of the guide will feature more healthy foods and less overly processed, junk food.

In other news, with Uber Eats and other gig economy food deliveries on the rise, so is the toll on the drivers delivering food. They are risking their lives in places like South Africa. Tragic. And just to deliver the ultimate convenience to our dinner table.

Venezuela. Talk about a free fall into despair and chaos. Because of the turmoil, food security and the deeper issues of consistent insecurity have taken a big hit. Venezuelans lost an average of twenty-four pounds in body weight. Nine out of ten live in poverty. Roughly one in ten have left the country.

A paper just published in the Lancet hits right at the heart of the trade war between the U.S. and China. The authors feel that it is time to reshape trade policies towards those that favor sustainable food and nutrition systems. They argue there are three starting points for public health actors to take up this agenda.

1. Recognize the fundamental and front-line nature of trade policy as both a barrier and potential catalyst for health.

2. Engage more effectively and with the right stakeholders to push for policy space within trade and investment agreements.

3. Reach beyond trade to promote a development discourse that makes explicit the nutrition imperative — nutrition is crucial to achieving most of the Sustainable Development Goals.

The Food Archive holds a special place in its heart for special focus issues that scientific journals put out. That is, when journals hone in on a hot topic and publish a complementary set of articles on the topic to show different facets and perspectives on the topic.

Here are some recent highlights:

• Tomorrow’s Earth by Science Magazine

• Climate Crisis and Health by New England Journal of Medicine

• Food Security and Violent Conflict by World Development

• Health in Humanitarian Crises by Lancet

• Food for Thought by British Medical Journal

In the last food bytes post, the hard to watch unfold Brazilian Amazon fires were highlighted. This piece highlights that forest fires are happening all over the world, many in biodiverse hotspots, making climate change all that much worse. Very sad not only for forests but for those who live among and depend on them. The map on the right shows fires over the last year. Look at southwest Africa and Southern Africa. Look at Madagascar (think lemurs…) and Southeast Asia. Wah!!

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One place prone to massive forest fires (the 2018 fires were the most devastating in the state’s history) is California but every day it finds a way to rub its beauty in our face. Geez, okay Cali, you win.

Speaking of California, and to keep the whole Woodstock vibe going, let’s just end with a little Joni Mitchell, because she sings about omelets and stews and well, because this has to be one of the best albums ever recorded. Click below to hear her beautiful song, California.

California, Joni.

Oh the rogue, the red red rogue
He cooked good omelets and stews
And I might have stayed on with him there
But my heart cried out for you, California
Oh California, I'm coming home
Oh make me feel good rock'n roll band
I'm your biggest fan
California, I'm coming home

— Joni Mitchell

Food Bytes: July 21 - Aug 25

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

Took a bit longer to get up the next Food Bytes entry due to summer holidays. So here it goes.

Summer is going out with a roar. The Inter-Panel on Climate Change (IPCC) produced their outstanding report on climate change, desertification, land degradation, sustainable land management, food security, and greenhouse gas fluxes in terrestrial ecosystems. Lots of media coverage followed. Diet recommendations were made (reducing beef, taking on a more flexitarian diet etc). If we want to live in this changed climate, we need to adapt. The saber-toothed tiger had a less flexitarian diet and we know what happened to them…

Speaking of adapting, scientists found a “stature gene” among Central African hunter gatherers, also known as pygmies. This short gene gave them an advantage in Africa’s hot, humid rainforests. I was really hoping this gene hopped across the Atlantic to Italians, or even more so, short Italian American women living in DC to help explain my enduring squat-ness, but alas, no such luck. While on the topic of luck, according to the Union of Concerned Scientists, you should also stay away from cereal that has corn as the main ingredient if you want to have an environmentally friendly diet. So better forget about your Froot Loops and Trix and reach instead for your Lucky Charms.

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Farmgate value of global vegetable production by income groups of countries, average 2012–2013, current US dollars (Source: Schreinemachers et al 2019 GFS Journal)

Let’s continue with the climate onslaught shall we? This article talks about the beginning of the end of the livestock industry. But is that really so? Don’t underestimate the chicken man. And do you know how much of a carbon footprint you consume with your diet? BBC provides a calculator - do the math and you will quickly be blanketed in a quilt of guilt. It ain’t just beef that you gotta worry about…

Sam Myers of Harvard published a great piece in the WaPo on how increased CO2 in the atmosphere will “zap” nutrients from key crops. He argues that 175 million people could become zinc-deficient, 122 million would not be able to get protein, and 0.5 billion would have iron-deficiency-related disease. So now we need to worry not only about getting enough food to feed 10 billion, but the quality of those foods in fulfilling our nutrient needs. And the declines in nutritional quality are happening in real time. A study examining 43 “garden” crops in the U.S. found declines of 6 nutrients - protein, calcium, iron, phosphorous, riboflavin and vitamin C - since 1950. The food supply already can’t keep up. Mario Herrero and colleagues found that our current food supply does not produce enough fruits and vegetables, and in the course of the next 30 years, that supply will worsen. If everyone were to follow the WHO recommendation of 400 g/person/day of fruits and vegetables, 1.9 billion people would not have the access to these foods – the food supply just cannot keep up.

But a recent article in the Global Food Security Journal argues that vegetables hold a lot of economic power. Yeah sure. That is, if we can produce them. And then people want to eat them. They suggest that governments will need to increase their investment in farm productivity including improved varieties, alternatives to chemical pesticides, and the use of protected cultivation. There is also a need for better post-harvest storage of veggies, food safety and market opportunities. To tap the nutritional power of vegetables, consumers need to know how vegetables contribute to health, be able to afford them, or be able to grow them themselves. God speed to those New Yorkers living in 300 square feet of space with no windows and definitely, no outdoor space.

The recent paper by Eker and colleagues, published in Nature Sustainability, adds to the sustainable diet literature and evidence base, examining how consumer diet shifts can contribute to mitigation of climate change. Utilizing scenario assessments, the authors model the impacts of different compositional and behavioral dietary shifts among the global population on environmental footprints. Compositional dietary shifts included average meat consumption, flexitarian (more plant-based), vegetarian, and vegan dietary patterns. As other studies have shown, changes in diet composition towards more plant-based diets, have implications on the environment. However, more significant shifts, by a large swatch of the world’s population, towards vegetarianism would need to occur to see impacts on greenhouse gases and other environmental measures (such as land use). The paper is unique in that it models the behavioral dietary shifts among consumers and their impacts. The authors found that younger populations (ages 15-45) respond to social norm behaviors, that is, as the world moves towards more vegetarian type diets, the change towards those diets is more rapid.

They argue that the values a society holds among peer groups can outweigh the influence of scientific facts. This was evident in that behavior shifts in response to health or climate risks were not as significant as motivators of behavior change. Secondary education attainment (a predominant proportion of the world’s population) and self efficacy and identity among women were also important motivators of dietary behavioral change. This study argues that for us, as individuals to make an impact on the environment through our diets, significant shifts need to be made by a large segment of the world’s population. These shifts require a movement towards a vegetarian type diet to reap both environmental and health benefits. Much of this change would happen through peer influence (think social media), through women’s agency, and through those with a secondary school education. The change, would need to happen on a grand, transformative level as called for by the EAT-Lancet Commission report in early January 2019.

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Fires in the Brazilian Amazon. Source: NYTIMES

Foreign Policy well articulates the findings from the EAT Lancet and the IPCC report here and argue that the global food crisis is here. Now. Live. I also was on the Bloomberg Daybreak America’s show to discuss the impacts of the food system and diets on climate change. Check out the show here (segment starts at 1:22:50). Scientists have been forecasting their warnings for 40 years - they were right and no one listened. Maybe people (and governments) will start paying more attention and take some serious action. The NOAA show that July 2019 was the hottest month on record since they started recording temperatures. Speaking of heat, the Brazilian amazon fires are getting lots of attention right now. The NY Times shows a time scale of problem. It should be noted that these human induced fires are mainly done to prepare agriculture lands. And they occur every year, around the same time in the Amazon. The article makes three points on why these fires are different. (1) There were 35 percent more fires so far this year than in the average of the last eight years. (2) There has been a rise in deforestation in recent years, after a long period of decline. (3) While a large majority of the fires were on land that had already been cleared of forests many others are burning with particular intensity that are “deforestation fires.”

While we are discussing trees, it seems a banana fungus, known as “Fusarium wilt tropical race 4 (TR4)” has been devastating plantations in Asia and now the Americas. It is supposedly impossible to eradicate and can live in soil for 30 years. The economic upheaval cannot be overstated. Speaking of loss, a study out of Santa Clara University found that one-third of edible produce (like tomatoes, sweet corn, artichokes, watermelon, cabbage, strawberries and kale) remains unharvested in the fields. Reasons? Field/harvest stability, weather, pests and plant diseases, labor availability, market prices, and buyer specifications for how produce should look and feel like.

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By the time we got to Woodstock…

I just can’t keep up with all the latest food trends. Did you know McDonalds has jumped on the podcast bandwagon? Yeehaw. Virtual restaurants are on the rise, meaning that they are digital-only establishments that don’t need a dining room or waiters. They rely on people ordering their food from apps. But kickin it back to ol’ school, this article gives ode to the Waffle House, started in 1955 in Avondale Estates Georgia. You just can’t replicate that with an app. Oh, how I reminisce of those bygone days. Can you believe Woodstock happened 50 years ago? I just bought this book: Hippie Food: How Back-to-the-Landers, Longhairs, and Revolutionaries Changed the Way We Eat by Jonathan Kauffman. Bring on the tempeh. Seems all things hippie are back in style. Keep an eye out for a blog dedicated to 1968-1969 and how it influenced our food ways.

Delving further back into history, the New York Times has an excellent piece on the “barbaric history of sugar” that fueled slavery in the United States. By the mid-19th century, the U.S. had 125,000 slaves working on sugar plantations! Fast forward to today, we are now trying to figure out how to reduce, remove or tax this “white gold” in the food supply. Forty countries and 7 cities have a sugar tax. The Economist highlights a study showing how to optimize sugar taxes without regressive effects. They suggest that: “In the real world, if taxes in one place get too high shoppers will arbitrage the rules by traveling to buy soft drinks elsewhere. Taking this into account they reckon that the optimal rate for cities is 0.5 cents, although a more efficient system would be a state or national tax to control America’s sugar rush.”

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Impact of climate change on crops, water and income in Timor-Leste. Source: Bonis-Profumo et al 2019.

Here is just a few cool papers, reports and books that came out in the last few weeks:

• Association Between Plant-Based Dietary Patterns and Risk of Type 2 Diabetes: A Systematic Review and Meta-analysis. There is a strong inverse dose response association between plant-based diets and risk of type 2 diabetes This association was strengthened when healthy plant-based foods, such as fruits, vegetables, whole grains, legumes, and nuts.

• Soft condensed matter physics of foods and macronutrients. This article discusses the importance of physics in understanding the texture, taste, and composition of foods. It is an atom-colliding article of food science and matter physics. Get your genius on.

• Ravaged landscapes and climate vulnerability: The challenge in achieving food security and nutrition in post-conflict Timor-Leste. This article focuses on the fascinating Timor-Leste - an agrarian society that won independence in 2002 and is struggling to achieve food security and reduce undernutrition as the country modernizes. The economy depends on fossil fuel revenues and oil reserves are dwindling. A review of climate, agricultural, and nutrition data reveals high weather vulnerability, low agricultural productivity, and slow dietary and nutritional progress. But solutions exist. Agricultural sector actions can make important contributions to poverty reduction, food security, dietary diversity, micronutrient sufficiency, and overall nutrition. Agriculture can be made to be more nutrition- and gender-sensitive with a focus on mixed farming systems, biodiversity, climate-smart practices, and access to inputs, training, and technologies for farmers to enable sustainable and healthy rural livelihoods. Ultimately, productivity levels must improve to support the availability of sufficient and nutritious foods.

• Gene-environment interplay: what do our genes say about dietary choices? Those of us who work in public health often forget about epigenetics and the way our genes play out in our diets and health status. The authors say: “Diet is not just dictated by guidelines and individual choices, but also by availability and accessibility. Therefore, future studies that investigate the relationship of gene expression and a healthy diet in individuals exposed to a similar environmental milieu—for example, in accessibility, inducements, and the socioeconomic construct—are needed to understand the gene–environment interplay at the community level. These results can leverage genetic expression analyses to provide early biological footprints of an unhealthy diet environment, in order to facilitate the investigation of social factors that influence prevalences and outcomes of disease processes, such as food deserts and food swamps.”

• Trends and Correlates of Overweight among Pre-School Age Children, Adolescent Girls, and Adult Women in South Asia: An Analysis of Data from Twelve National Surveys in Six Countries over Twenty Years. The researchers found that overweight children had significantly higher odds of having an overweight mother and were more likely to come from wealthier households, live in urban areas, and have more education.

• Modernization of African Food Retailing and (Un)healthy Food Consumption. In Zambia, two-thirds of the households use modern and traditional retailers simultaneously, but richer households are more likely than poorer ones to use supermarkets and hypermarkets. Use of modern retailers is positively associated with higher consumption of ultra-processed foods, after also controlling for income and other socioeconomic factors. However, the use of traditional stores and kiosks is also positively associated with the consumption of ultra-processed foods, suggesting that modern retailers are not the only drivers of dietary transitions. Interesting!

• The SDG of zero hunger 75 years on: Turning full circle on agriculture and nutrition. In this paper, Derek Byerlee and I look back to the pioneering 1943 UN Conference on Food and Agriculture in Hot Springs, Virginia where the first international commitment to ending hunger was made. Despite these good intentions, however, the agricultural and nutrition communities largely went their separate ways for the next 50 years. Following through on the conference’s balanced approach of “more and better food” would have resulted in better nutrition for all. Today, the SDGs have once again put nutrition and agriculture together at center stage. Despite some important gaps in knowledge, financing, and implementation capacity, we are finally in a better position to shape food systems in a way that ends hunger and all forms of malnutrition.

• Technical Brief: Economic Evaluations of Multi-sectoral Actions for Health and Nutrition. This is a fantastic brief by the AHN Academy. This is a fantastic brief by the AHN Academy to “created to advance knowledge and scientific understanding among the global research community of economic evaluation methods and metrics related to costs and benefits of agriculture, food and livelihood strategies for nutrition and health.” They examine different types of economic evaluations and move towards standardizing a set of metrics to economically assess nutrition.

• The Political Economy of Food. Jody Harris and colleagues at IDS just published this IDS Bulletin that examines the issues of power across food systems. It looks at the various active players, relationships, activities, and institutions that play a major role in shaping food systems and power inequities. This was a much needed publication and I plan to use it in my class on food policy.

How much does it cost to eat a decent meal?

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The incredible Alex Honnold, also a vegan… Copyright: The great Jimmy Chin for National Geographic

The answer to that question turns out to be a lot for some people. There are have been some recent projects and papers as a result aimed at trying to understand whether or not people can afford the kind of diets recommended in national food-based dietary guidelines, the EAT Lancet, and other publications. Many have pontificated that these healthy, higher quality diets — promoted in such guidelines and Commissions made up elitist scientists — are unaffordable for most of the world. Some argue the recommendations are just downright dangerous (beef industry responding to the EAT Lancet) or unfair. GAIN argued that meat is important for child growth, and athletes. I don’t think they meant it is an absolute essential for athletes, as Alex Honnold is a vegan and that dude climbed El Capitan with nothing but sheer muscle strength, stamina and maybe an insanely lack of feeling of fear. If you have not seen the documentary Free Solo, I highly recommend it. What a human feat, and with no meat! Yes, I wax poetic.

This debate is not new, and there has been a lot of science articulated the cost. And there are more papers to come. But a few new papers are looking beyond just a specific country, a specific national dietary database or a specific population, and looking at the costs of foods and diets around the world from low- to high-income countries, whether they fulfill nutritional needs, and if not, what disease outcomes are they associated with.

IFPRI’s Derek Headey and Harold Alderman, two pretty stellar researchers in nutrition, published a fantastic piece in the Journal of Nutrition. They tested relative caloric prices (RCPs) for different food categories across 176 countries. One will have to read the methods in some detail to understand how they come up with this calculation but one key piece is how they calculate the RCP. They measure the ratio of the price of 1 calorie of a given food (the edible portion) to the price of 1 calorie of a representative basket of starchy staple food in each country. As the authors articulated: an RCP of 5 for eggs implies that it is 5 times as expensive to obtain a calorie from eggs as it is to obtain a calorie from starchy staples. Easy yes?

While the authors find that there is a lot of variety in the food prices nationally, in high-income countries, most non-cereal foods were relatively cheap, including sugar- and fat-rich foods. In contrast, in low-income countries, healthy foods were expensive, especially most animal-sourced foods and fortified infant cereals. Oils/fats were notably very cheap in all regions as were unprocessed red meat, which was moderately cheap in all regions. As the authors wrote in a recent blog:

“As countries develop, their food systems get better at providing healthier foods cheaply, but they also get better at providing unhealthier foods cheaply. Hence the problem in less developed countries is that poor people also live in poor food systems: Nutrient-dense foods like eggs, milk, fruits and vegetables can be very expensive in these countries, making it much harder to diversify away from nutrient-sparse staple foods like rice, corn and bread. The problem in more developed countries is rather different: Unhealthy calories have simply become a very affordable option. In the U.S., for example, calories from soft drinks are just 1.9 times as expensive as staple food calories and require no preparation time.”

The authors then looked at the association of these prices with nutrition outcomes, controlling for confounders like education, urbanization and income. Higher milk and fortified infant product prices were positively associated with childhood stunting. They also found that little children consume less of these important foods when expensive. An increase in soft drink prices was associated with a reduction on overweight prevalence.

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Headey and Alderman show the association of milk prices with childhood stunting. Copyright: IFPRI

A few years ago Adam Drewnowski and Nicole Darmon published a study, using very different methodology and from French databases, showing that foods of lower nutritional value and lower-quality diets generally cost less per calorie and tended to be selected by groups of lower socioeconomic status. A number of nutrient-dense foods were available at low cost but were not always palatable or culturally acceptable to the low-income consumer. Acceptable healthier diets were uniformly associated with higher costs. They argue three things:

1. Energy-dense foods composed of refined grains, added sugars, or fats are cheaper per calorie than are the recommended nutrient-dense foods.

2. Lower-quality diets, with a higher content of added sugars and fats, were generally less expensive on a per-calorie basis.

3. Cheaper and more energy-dense diets, often devoid of vegetables and fruit, tend to be selected across different countries by lower-income groups.

Another paper coming out in the Lancet by IFPRI (including Headey) and Tufts colleagues including the great Will Masters, examined retail prices of foods and identified the most affordable foods to meet EAT-Lancet targets. They compared the total cost per day of these foods to each country's gross national income to see if the MOST affordable EAT-Lancet diet exceeded household incomes.

Here is what they found: Examining 744 items across 159 countries, revealing that the most affordable EAT-Lancet diets cost a global average of $2.89 per day ($2.44 per day for low-income countries and $2.77 for high-income countries). The largest share was the diet cost was fruits and vegetables (31.2%), followed by legumes and nuts (18.7%), meat, eggs and fish (15.2%) and dairy (13.2%). While this is a pretty cheap diet in high-income countries, it is not affordable for 1.56 billion of the poorest households in the world where this diet would cost households 70% of their daily income (national averages)! Where is this diet unaffordable? Mostly in sub-Saharan Africa and South Asia.

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On the left side is the cost of the EAT-Lancet diet by country income levels and major regions. On the right side, is the cost of the EAT-Lancet diet as a percentage of Gross National Income per capita. Copyright: Lancet.

They also concluded that the EAT-Lancet diet would cost 64% more than achieving minimally adequate levels of essential nutrients and is currently unaffordable in low-income countries, because “it requires larger quantities of higher-cost food groups such as dairy, eggs, meat, fish, fruits and vegetables than the near-subsistence diets that are currently consumed by very low-income people.” The authors argue that:

“Our findings indicate that a widespread global shift to the EAT-Lancet diet recommendation is feasible only through some combination of higher earnings, more favorable market prices and nutrition assistance for low-income people, in addition to changes in local and global food systems that drive food choice among more affluent populations. Meeting EAT-Lancet targets in low-income areas will require higher farm productivity and improved access to markets, plus greater non-farm earnings and social safety nets, allowing people to shift consumption away from starchy staples and increase their intake of more nutritious but currently unaffordable animal-sourced and vegetal foods.”

Sam Bloch tested out the EAT-Lancet diet in early 2019 and wrote up a great piece in the New Food Economy (love this site). He found it hard to follow and it was more expensive. And he is probably a high-income consumer (living in New York City) and his wife is a chef!

A group at World Food Programme is doing a “Fill the Nutrient Gap” (FNG), which aims to “support identification of strategies to increase availability, access, and choice of nutritious foods, to ultimately improve nutrient intake.” This approach looks at the nutrient intake of different target groups, and then uses linear programming to look at the barriers to nutrient intake including the availability, cost and affordability of nutritious diets for households and target groups with higher nutritional needs. They then model potential interventions to improve them. I have heard they have done at least 25 countries. So they are taking it further as compared to these other studies. They are not only looking at the cost of diets, but why they are expensive and what households can do about it.

In last year’s Global Nutrition Report, we showed some preliminary data on the range of non-affordability of a nutritious diet across areas in different countries. The data shows a range of non-affordability depending on the region in each country – for example, across different regions of El Salvador, 9% to 44% of households cannot afford a nutritious diet, whereas the range is much greater in Lao People’s Democratic Republic (17% to 95%).

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The range of “non-affordability” of the typical diet in select countries. Copyright: GNR 2018

There are others working on the cost of a diet. Marco Springmann will also test out the cost of the EAT-Lancet diet, as an EAT-Lancet Commissioner. I think his study will look more at the cost of dietary patterns - vegetarian, pescetarian, omnivorous etc. So keep your eye out on that publication!

Food Bytes: July 8 - July 20

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

Food environments seem to be on the tip of the tongue for everyone these days. Food environments are the “collective physical, economic, policy and sociocultural surroundings, opportunities and conditions that influence people’s food choices and nutritional status.” Or to put it more simply, it is the place where consumers go to buy or order food - a market, a restaurant, a cafeteria.

The UN Standing Committee on Nutrition, also known as UNSCN, has just published a collection of papers on the food environment. It splits up the food environment into two entry points - the food supply shaping these environments and the consumer demand side - and what it would take to make change, also known as the enabling environment. The publication is chock-full of case studies from all over the world. I like the ones on Mexico, the private sector last mile, the flathead reservation, cash transfers, and the digital influence.

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Food Environment Framework showing supply and demand. Source: Marshall et al 2019 UNSCN report

In South Africa’s Soweto hood, women struggle to be healthy. Food environments are pretty dismal (fries, fries and more fries), and exercising outside can be dangerous. It is not just about supply and demand of healthy foods, which the UNSCN publication focused on, but the whole built environment, the way women are treated in our society and urban safety. At the same time, its seems many South Africans are taking food security into their own hands. One study found that 2.2 million households have recently constructed food gardens at their homes in order to avert food insecurity.

While we are on the lovely UN, the UN Committee on Food Security is rolling out a series of regional consultations on what is known as the Voluntary Guidelines on Food Systems and Nutrition. This stems from the High Level Panel of Experts on Nutrition and Food Systems report which called for these guidelines to be developed by governments collectively and collaboratively. These voluntary guidelines are meant to create a global norm of reference in the governance of food systems and nutrition/diets. The guidelines outline principles and practices that governments can refer to when making laws and administering food systems. These guidelines should be seen as an internationally negotiated soft law or a set of guidelines in which all governments have reached a common ground. So, they can be important, and quite powerful. Anyone can comment on the zero draft - far from its final - here. The regional consultations started in Africa, Ethiopia. Then, Asia, Bangkok. Then Central and South America, Panama, North Africa, Egypt, Europe, Budapest and last but not least, North America. I had the pleasure of being at the Ethiopia meeting and it was quite fantastic to have so many African countries in one room talking about African food systems. Amazing stuff.

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Source and Copyright: Johnny Miller, NYT 2019

Speaking of Africa, the diversity of cuisines and culture is what makes the continent so amazing. Take Nigeria. Reading Yewande Komolafe’s recipes made me want to jump on a plane to Lagos and eat my way through it.

But it is not always a rosy picture for Africa. The continent is still struggling with food insecurity, while at the same time, obesity is creeping up, up and up. The FAO State of Food Insecurity (SOFI) 2019 report just came out, two months early. It was reasoned that it came out to line up with the High Level Political Forum. Yeah sure. I think it was timed to be released right before the Director General, José Graziano da Silva stepped down to celebrate his 8 years as the leader of FAO. However, the report is nothing to celebrate. I digress…The major findings of the SOFI were the following:

• More than a quarter of the world’s population now struggles to eat safe, nutritious and sufficient food.

• Hunger is on the rise in most of Africa, in parts of the Middle East and in Latin America and the Caribbean. The situation is most alarming in Africa, where since 2015 undernourishment has steadily increased in almost all subregions. In Asia, undernourishment has been decreasing in most regions, reaching 11.4 percent in 2017. In Latin America and the Caribbean, rates of undernourishment have increased in recent years, largely as a consequence of the situation in South America.

• Economic shocks are contributing to prolonging and worsening the severity of food crises caused primarily by conflict and climate shocks.

• No region is exempt from the rising trends of overweight and “obesity rates are higher in those countries where moderate food insecurity is also higher.”

We see this in the United States too. I just wrote a piece for Bloomberg Opinion (I didn’t choose the photo.) showing that food insecure adults in the U.S. are 32% more likely than others to be obese — especially if they are women. Poverty and unemployment have driven the dual rise in food insecurity and obesity since the 1960s, especially in rural America. But many city dwellers subsisting with inadequate social services and support structures are also susceptible. Every time I write a piece in Bloomberg Opinion, I always get lots of interesting email comments. For this piece, most commenters feel that if you are fat, it is your fault. If healthy foods are available, affordable and easy to access, “these people” will always make the wrong choice. My reaction? WOW. It is so hard to eat healthy in our perverse food environments. Blaming and shaming is not going to make things better. But it seems, consumers are catching on in the U.S. - diet quality is improving.

But what does the latest evidence suggest for those who are overweight and want to lose weight? I will soon dedicate a longer blog to this issue because the literature is confusing. Is it a keto diet? Is it intermittent fasting? Is it low-carb? Is it putting a teaspoon of oil in your coffee every morning? New evidence suggests that cutting 300 calories per day, from any food, can lead to substantial weight loss in adults (7.5 kilos over two years) compared to the control group. Tamar Haspel of the Washington Post, argues that eating ultra-processed foods comes down to increased calorie consumption. We consume more of those foods, and they are calorically dense. She wrote:

“In a nutshell: The root of obesity is palatability and calorie density, combined with ubiquity and convenience. Satiety hormones and other metabolic machinations have much less to do with it. We’re responding to cues from without, not from within. One new study doesn’t prove it, of course, but it’s the hypothesis that best fits the preponderance of the evidence.”

I really appreciate this article that “Being Fat is Not a Moral Failure.” Damn straight. This Scientific American article argues “Individual behavior change is ineffective in the face of social and structural barriers that constrain individual choice. These barriers are uniquely relevant among racial and ethnic minorities and impoverished adults who are more likely to be obese.”

A bunch of scientific papers and media articles came out this week on diets, nutrition, and food systems. Here are some highlights.

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Kathmandu food stall - healthy and unhealthy foods. Source and Copyright: Jess Fanzo

• “Ultra-processed” foods or what I call, junk food, are in the news again. This article outlines four dangers with food reformulation - redesigning an existing processed food product with the objective of making it healthier. This article argues that reformulation just tinkers around the edges, and isn’t really fixing the root problems of the food system, and what the authors say is food and beverage industries.

• Case in point? Nearly 10,000 cases of heart disease and stroke and 1,500 cases of cancer could have been avoided in England if the government had not switched to a voluntary deal (as opposed to mandatory) with the food industry to cut salt in food. England is doing so much good stuff in the food space right now, but man, there are potential setbacks with Brexit and political shifts. This BMJ post by Annie Purdie and colleagues is concerned about Boris Johnson’s recent decision to look at “sin taxes” and creating a nanny state. The authors argue that the public health community needs to “move beyond debating the cost-effectiveness of interventions, and engage with the underlying political nature of the issue.” We need to pay more attention to the language (sin, nanny, liberties etc) used to highlight the problem and the proposed solutions like taxes on soda and regulating the levels of salt and sugar in foods. As Bob Marley sang, “don’t let ‘em fool ya.”

• There is more and more coming out that nutritional sciences is “broken.” In this article, they use the “eggs are again bad for you” study that came out in JAMA. Waah. Is it? I disagree! Of course, when we focus on specific foods and nutrients, the data is not clear, but dietary patterns show basically the same thing. Give it a rest dudes.

• While these researchers argue that more evidence is needed, they did find that snack foods and sugar‐sweetened beverages are providing a substantial proportion of energy intakes (ranges from 13 to 38%!) among children below 2 years of age in Latin American and South‐east Asian low and middle income countries.

• A study in the capitol of Nepal, Kathmandu, showed just that consumption of unhealthy snack foods and beverages contributed 47% of total energy intake among the wealthiest consumers, compared with 5% among the poorest. This pattern of junk food consumption among young children was associated with inadequate micronutrient intakes. The reason that mom’s give these foods to their children? Convenience - they are easy to prepare and easy to feed. Makes sense. Looks like even among very poor countries, we are seeing the nutrition transition play out in real time. Ever try making dal bhat from scratch? Not easy and incredibly time consuming…

• I love that the Lancet is calling on oral health researchers to review the evidence and conflicts of interest of the impacts of what we eat on our dental health and the caries that come with sugar consumption. The lead scientist argues, and this goes back to the infant studies: “A particular concern is the high levels of sugar in processed commercial baby foods and drinks which encourage babies and toddlers to develop a preference for sweetness in early life. We need tighter regulation and legislation to restrict the marketing and promotion of sugary foods and drinks if we are to tackle the root causes of oral conditions.”

• New microbiome research shows that a specialized food made up of chickpeas, soy, peanuts, bananas and a blend of oils and micronutrients substantially boost microbiome health in severely malnourished children. Yummy.

• Do cookbooks need nutrition labels? Great question but sort of takes the fun out of cookbooks no?

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Some things have improved for food security and nutrition. Source: Byerlee and Fanzo, 2019 GFS Journal

Derek Byerlee and I wrote a piece looking back 75 years on commitment to hunger when the first international commitment to ending hunger was made at the UN Conference on Food and Agriculture, at Hot Springs, Virginia, USA in 1943. That conference set the goal of ‘freedom from want of food, suitable and adequate for the health and strength of all peoples’ that should be achieved ‘in all lands within the shortest possible time’ (US Department of State, 1943). It is sobering and shameful that 75 years after this clarion call, as well as the dozens of similar global declarations since 1943 for ending hunger, some 800 million persons are estimated to be undernourished and over 2 billion adults and children suffer from other forms of malnutrition be it obesity or micronutrient deficiencies. We remind readers of the significance of the Hot Springs conference and briefly trace the long road that has led us back to the original vision of ending hunger that recognized the several dimensions of nutrition, from undernourishment to micronutrient deficiencies. While there has been progress, this reflection over 75 years helps appreciate the fact that today for the first time, the links of agriculture, health and nutrition outlined in 1943 are again at center stage in the global hunger challenge as embraced in SDG2. Accordingly, SDG2 offers a better foundation for accelerating progress in reducing malnutrition in its several dimensions, although we recognize major gaps in knowledge, financing, and implementation capacity for realizing SDG2 targets.

Someone else is realizing the importance of agriculture. It seems Bill Gates has woken up to the fact that the CGIAR exists. His article is titled “You’ve probably never heard of CGIAR, but they are essential to feeding our future.” Hate to spoil it Billie Boy, but we have heard of the CGIAR…and I don’t confuse it with the word “cigar,” cigarillos, ciggies, or ziggie stardust.

Country ratios of fruit and vegetable availability to WHO age-specific recommendations. Source: Mason-D’Croz et al 2019

On the environmental and climate change front, lots going on. The World Resources Institute released a mother of a report - 564 pages - on Creating A Sustainable Food Future. You may have seen the abbreviated version released 6 months ago. But this one goes into great detail a 22-item “menu” which is divided into five “courses” that together could close the food, land and greenhouse gas gaps: (1) reduce growth in demand for food and agricultural products; (2) increase food production without expanding agricultural land; (3) protect and restore natural ecosystems; (4) increase fish supply (through improved wild fisheries management and aquaculture); and (5) reduce GHG emissions from agricultural production. Richard Waite and Janet Ranganathan are seriously my heroes in creating these action oriented solutions. Well done.

Following on the heals of that report, two Lancet Planetary Health papers came out. One paper shows that even under optimistic socioeconomic scenarios future supply of fruits and vegetables, central components of a healthy diet, will be insufficient to achieve recommended levels in many countries. Consequently, systematic public policy targeting the constraints to producing and consuming fruits and vegetables will be needed. The second paper shows climate change and increased atmospheric CO2 will impact the availability of protein, zinc and iron availability. The many countries that currently have high levels of nutrient deficiency would continue to be disproportionately affected.

This expose by the Guardian shows that Brazil’s huge beef sector, and the appetite for beef, continues to threaten health of world’s largest rainforest, the Amazon. This is just downright sad.

And while those of us in nutrition don’t really get to the larger social determinants of food insecurity and malnutrition, it is important to do so. This article in NPR’s Goats and Soda delve into the practice of trading sex for fish in Lake Chilwa in Malawi. This is driven by poverty and food insecurity and the impacts are catastrophic in this southern African country - HIV, violence and stigma - for these women.

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?

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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.

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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.

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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…

"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.