Food Bytes: Aug 2024 Edition

FOOD BYTES IS A (ALMOST) MONTHLY BLOG POST OF “NIBBLES” ON ALL THINGS CLIMATE, FOOD, NUTRITION SCIENCE, POLICY, AND CULTURE.

It’s been a while, well, the whole summer, since I have written a Food Bytes blog. This summer was full of guilt-free laziness, ice cream eating, and beach combing. Witness the delicious vanilla Mr. Softee cone. On those sticky, hot, humid dog days of summer in NYC when nothing seems to be going right, this will do me just fine. But ketchup-inspired ice cream? That’s a hard no for me. Oh, but there was plenty of consumption of this on those long summer nights and some earlier “draft”ernoons. Pizza always comes to mind when discussing NYC and food in the same breath. Did you know NYC has gone through 4 evolutions of pizza making? Forgeddaboudit. Call me crazy, but I am still focused on the first evolution, and I’m stickin’ to it.

We saw lots of good music over the summer including DIIV at the beautiful Brooklyn Paramount, Jessica Pratt, OFF! (with the legendary Keith Morris), and Horse Lords in central LA. I also found myself not reading many scientific articles over the summer. Why do that to oneself when days can be spent lollygagging on grassy knolls? Instead,…wait for it…I read books! What a concept. But this week, I did manage to catch up on some light reading, and here are some highlights.

The New York Times has a new series of op-eds, “What to Eat on a Burning Planet.” A real picker-upper on the title alone. David Wallace Wells started the series with an op-ed on how food supplies will change and how climate change threatens the ability to continue to generate the yields needed to feed a growing population. There are a host of other good op-eds worth the read.

The Economist, a British weekly news magazine, hasn’t always given nutrition and food much attention, but lately, they seem to have changed their tune. I am a big fan of the Economist — this idea that you don’t know who the writers are behind the stories, their bravery in calling things as they see them, and, of course, the fantastic writing. They have paid homage to food and nutrition in three great articles.

  • They call for big food to contend with ultra-processed foods. They say, "If pressure from governments ratchets up, the food industry will have to do more than tweak its recipes or roll out new product lines. Companies would have to completely overhaul their manufacturing processes.”

  • They also focused on the idea that small investments in early child nutrition can make the world smarter and that undernutrition across the world persists. This is not new to those working in international nutrition, but it is nice to see broader attention to the topic.

  • At the same time, obesity is rising and seems unstoppable. The Economist argues that drugs (like the GLP-1 class) and taxes won’t be enough. The question is, why don’t we have more solutions that work, and why has no country been able to stop this trend? Don’t say it is willpower, please….

A lot is happening in the ongoing debates of livestock and meat production and consumption — one of the most juggernaut issues in food systems. Here are some highlights:

Source: Herzon et al 2024 Nature Food

  • The Good Food Institute—a nonprofit organization that promotes plant- and cell-based alternatives to animal products, particularly meat, dairy, and eggs—released a report that argues if Americans replaced 50% of their animal consumption (meat and dairy) with plant-based foods, 47.3 million fewer acres of cropland would be needed to grow that plant protein. Let’s see how that goes down with the livestock sector.

  • According to Vox, environmental NGOs help greenwash the livestock industry’s climate impact. They use the example of the World Wildlife Fund and their relationship with McDonalds who are part of a round table on sustainable beef (with WWF accepting millions from McDonalds to assist in the roundtable collaboration. Yikes.

  • More and more studies are better articulating the impacts of red meat consumption on non-communicable disease outcomes. This meta-analysis further confirms that a higher intake of red meat and processed meat increases the risk of type 2 diabetes incidence. A microsimulation model estimated that a 30% reduction in both processed meat and unprocessed red meat intake could lead to 1,073,400 fewer occurrences of type 2 diabetes, 382,400 fewer occurrences of cardiovascular disease, 84,400 fewer occurrences of colorectal cancer, and 62,200 fewer all-cause deaths over a 10-year period among an adult US population.

  • The evidence is building…maybe leading to more statements such as this. The question is, how? These authors suggest downsizing livestock herds and for those that remain in existence, ensuring they are sustainable and present a framework (see figure above) for how sustainable livestock systems fit into a safe operating space.

  • And what we don’t talk about enough is animal and human welfare associated with our unlimited appetite for animal meats. Michael Holtz wrote an illuminating and devastating account about working in a Dodge City meatpacking plant during the COVID-19 pandemic in 2021. I also highlighted the issue of young immigrant teenagers working in dangerous conditions at slaughterhouses in a past Food Bytes post.

Food prices, cost, and affordability are hot topics these days. Kamala has made minimizing food price gouging part of her future economic plan if she were to become president-elect. Some disagree with her strategy. The FAO’s State of Food Insecurity Report released its latest data on food affordability. While the number has come down this year from 3.1 to 2.83 billion people who cannot afford a healthy diet, it is still shockingly high and inequitable across regions of the world. FAO says: “In 2022, the number of people unable to afford a healthy diet dropped below pre-pandemic levels in the group of upper-middle- and high-income countries as a whole, while the group of low-income countries had the highest levels since 2017.” But still, food prices continue to rise, pushing up the cost of a healthy diet year on year. In 2022, costs went up 11% in just one year. A group out of IFPRI suggests that the cost and affordability of healthy diets need more investigation into their accuracy and if assumptions of these metrics skew what is actually affordable. Their analysis argues that the EAT-Lancet diet is not affordable for 2.13 billion people, not the 3.02 originally reported. I am not an economist or a specialist in this topic, so I cannot agree or disagree with these findings. However, I am a scientist, and opening debates and discussions on metrics is a healthy pursuit to get to the truth. In another paper published in Nature Food, authors analyze per capita budget shares for food and an additional 12 raw food categories, including ultra-processed food and beverages, across 94 countries from the period 1990 to 2019. They found that food expenditures are not the same worldwide, and low-income food demand does not necessarily mirror high-income demand. Of course, budget allocations align with income levels, food trade and production, and culture. Check out this figure to see how much it diverges across low to high-income countries.

Source: Liang et al 2024 Nature Food

A few other Bytes: This paper on the climate-food-migration nexus by Megan Carney is a doozy but so important. Hulsen et al. published a paper on how local food environments impact children’s diets. They did this work in Malawi and found significant differences between rural and urban food environments, and that, of course, access to more variety of foods in these markets has positive impacts on children’s diets. The New York Times has highlighted a study on tipping points that may just put the fear of god in you. Die-offs! Collapses! Ghostly coral reefs! Seriously, these are scary outcomes if we do nothing about climate and the science on tipping points has momentum. Speaking of tipping points, has Italy’s marine ecosystem reached one, and the result is blue crab invasions and infestations? In the worst-case scenario, tipping points could lead to massive destruction of precious ecosystems, food insecurity for billions, and, in some cases, famines. The world has witnessed cataclysmic famines in the past. The question remains as to why Gaza and Sudan have not been declared as famine states. NPR explains. Declaring a famine is not so simple…but it doesn’t mean inaction and complacency.

And if you need some recommendations on keeping up with the latest food systems news, if you don’t read and support Civil Eats, do so. If you were a fan of The Counter and were devastated when they closed shop, have no fear. Grist has come to the rescue, and their food reporting is awesome.

And for those of you who tear up every time you hear Gillian Welch’s Time (the Revelator), she and her partner, David Rawlings, have a new album out. It may just help you laze away the last days of summer. Enjoy!

That banks the river for which it's named

Rivers are special. These ribbon-like bodies of water cut through topography, shaping and shifting the landscape around them.

rivers begin where they end
if 1 considers rain + jet stream winds
look deeper into grainy sands
the sublimation from the wind-swept lands ever reach sea — Jordan, Sound Furies

My partner and I have always been drawn to rivers and try to live or be near them. We currently reside quite close to the great Hudson River (~500 km long), where we can amble through Riverside Park and enjoy the views. We are so obsessed with rivers that we made a double album as the Sound Furies dedicated to rivers, entitled “Tributaries.” One of my favorite songs from the album is Columbia.

We are not alone in our obsession with all things river. There are many songs inspired by rivers in the archives of rock-n-roll. Al Green just wanted someone to take him to the river. Jimmy Cliff had many rivers to cross. Joni Mitchell longed to have a river to skate away on. Sam Cooke was born by a river. Tina fearlessly rolled on a river (thanks for the original CCR). I could go on and on, but I think you get the point. Rivers mean something to many of us.

It is not just music. There are a plethora of movies about rivers. African Queen, A River Runs Through It, and one of the best movies ever made which spends most of its time on the river, Apocalypse Now. In the movie, the French woman living on the plantation says to Willard (played by Martin Sheen), “Do you know why you can never step into the same river twice?” Willard answers, “Yeah, 'cause it's always moving.” The best scene, though, is the conversation between Willard, who has come to assassinate the unhinged Colonel Kurtz (played by Brando). They converse about the Ohio river and a gardenia plantation.

What was up with all those movies in the 90s about dead bodies being found along river banks — Short Cuts, Stand By Me, A River’s Edge, and of course, David Lynch’s Twin Peaks? We Gen Xers were so demented.

Supposedly, there are 165 major rivers around the world, but no one really knows the real number. The five longest rivers in the world are the Nile, which starts in Uganda and moves north (odd, right?) to Egypt, the Amazon-Ucayali-Apurimac in South America, the Mississippi-Missouri-Red Rock in the U.S., the Yangtze in China, and the Yenisey-Baikal-Selenga in northern Asia. The Nile is the longest, topping out at 6,650 km. The Danube in Europe flows through 10 countries. The Congo River is the deepest. Rivers serve all sorts of purposes. They provide water, food, habitats, transportation, and recreation, to name just a few purposes. Rivers are really important for food. Fish and other aquatic creatures that live in rivers are consumed. Food is traded on and transported by rivers. Food is grown in or around river banks. Water from rivers irrigates crops.

We wrote a paper on the dynamism and multifaceted nature of rivers as food environments (i.e., the place within food systems where people obtain their food) and their role in securing food security, including improved diets and overall health. In the figure below, we showed the elements of multidimensional riverine food environments.

The paper nicely describes why river ecosystems are so critical. “Rivers can be described as nutrient highways across the earth’s surface, transporting sediment and water, sequestering carbon from the atmosphere, and connecting and storing immense biodiversity through aquatic life. The flow and transportation of sediment create environments for cultivation (e.g. rice farming), with river deltas being one of the world’s most agriculturally productive areas. Rivers support approximately 1/3 of all global food production, and an estimated 70% of freshwater from rivers is used for agriculture.”

There are so many challenges with rivers. The first issue is environmental: climate change, environmental degradation, and pollution are vastly changing these waterscapes - altering their composition and flow. The second issue is overfishing and overallocation, meaning the building of dams for electricity, are altering the riverine ecosystems and marine life and creating water shortages and river connectivity, respectively. As for rivers that cut across multiple countries, who governs these waters and decides who can build dams and where? We see those challenges in large rivers such as the Mekong — where China is building dams upstream impacting many Cambodian and Vietnamese living downstream. We also see this with the Nile, in which Ethiopia is building damns to electrify the nation, which could have massive impacts on irrigation systems for Egyptian agriculture. The third issue is that while rivers transport and contain food, they also bring other things, like diseases and unhealthy foods deep into river communities. This New York Times article discusses how the Amazong brought the COVID-19 pandemic into the far reaches of the Amazon forest.

The spread of covid in just a few months during the pandemic along the Amazon waterways. Source: NYT

“The Amazon River is South America’s essential life source, a glittering superhighway that cuts through the continent. It is the central artery in a vast network of tributaries that sustains some 30 million people across eight countries, moving supplies, people and industry deep into forested regions often untouched by road. But once again, in a painful echo of history, it is also bringing disease.”

The Amazon also carries highly processed foods. According to this article, multinational companies like Nestle had river barges that delivered junk foods to isolated communities in the Amazon basin.

There is also the issue of rivers flooding, damaging infrastructure and harming humans and animals in their way. And now, we are experiencing rivers above us — atomospheric rivers corridors of concentrated water vapor in the atmosphere that wreak havoc. What the hell?!

World WildLife Fund’s solutions for sustainable rivers

I can’t recommend enough the documentary “A River’s Last Chance,” about the Eel River. It delves into the history of how this river has been managed, or lack thereof. The Eel River is in Northern California and has been vulnerable to overfishing of its salmon, logging, floods, droughts, and dams. While the wild salmon population is trying to recover, new cash crops—weed and wine — threaten the salmon once more. It is quite a story of a river struggling to survive.

World Wildlife Fund has a fantastic initiative, Rivers of Food, in which they propose a four-pronged solution towards a more sustainable future for rivers and food security.

Let’s hope rivers can be saved as they provide a vital lifeline for nature, animals, and humans. They are also just so romantic and atmospheric. We used to dwell right near the Tiber when we lived in Rome. It was so magical. The way the early morning light hit the surface of the water, the banks, and the bridges. During the late summer months of the year, the starlings would circle around the Tiber, before settling in for the night in the treetops along the river banks. In Paolo Sorrentino’s La Grande Belleza, the early morning light on the Tiber is captured so beautifully below.

Food Bytes: October 2023 Edition

FOOD BYTES IS A (ALMOST) MONTHLY BLOG POST OF “NIBBLES” ON ALL THINGS CLIMATE, FOOD, NUTRITION SCIENCE, POLICY, AND CULTURE.

 

It is hard to find the time to read, let alone write about what you read. One of the things about reading scientific literature is that you have to weed through many journals’ tables of contents to find the nibbles and nuggets that are worth your time. Sometimes, you get lucky and find some gems; other times, you don’t get further than the abstract. Regardless, if you don’t have LinkedIn or X, spoon-feeding your biased and “like-minded lemur” content, the never-ending search for quality papers is laborious and time-consuming.

Enter documentaries and podcasts. I find myself more and more listening to them to get a synthesis of a topic or a deep dive into an issue or scientific discovery. There is no shortage of food podcasts, but most focus on cooking and gourmandery. But a few goodies discuss the politics of food and the history of food. I try to add them to the Resource section of The Food Archive. I found this particular episode of the podcast, “What You’re Eating,” fantastic on the confusion of egg labels. The host lays out the issues and clarifies where your eggs come from and how to understand the labels on those confusing cartons better.

Two food documentaries worth the watch are Poisoned and How to Live to 100, Wherever You Are in the World. Let’s take Poisoned first, about how “unsafe” the U.S. food supply is, although often touted as being one of the most secure. The documentary starts with the contaminated burgers from Jack in the Box, which killed and sickened a slew of people. After lawsuits and regulations, getting sick from E. coli-contaminated hamburger meat is hard now. It shows that it works once governments can set their mind to something and put in strict and enforced regulations. Enter vegetables. After watching the show, I am not sure I will ever eat romaine lettuce again…much of it is grown right next to concentrated animal feed operations (where beef is raised in the U.S.). The manure runs off into waterways,  and the water from those said waterways irrigates the nearby lettuce crops. And then bingo! You’ve got severe contamination issues. It is worth watching to understand how food is produced in this country, how it is regulated, and how you can be safer with food in your kitchen.

How to Live to 100 is hosted by Dan Buettner, who wrote Secrets of the Blue Zones. He has been studying why, in some places, people live such long lives – sometimes beyond 100 years. He travels to Okinawa, Japan; Ikaria, Greece; Sardinia, Italy; Nicoya, Costa Rica; and Loma Linda, California — where more people live significantly longer than average. He summarizes some of their secrets to longevity into four basic mantras. Keep in mind these populations all get to their winter years in different, contextualized ways, and it is never that straightforward why someone lives a long life and others die too early. Dan argues these four lifestyle changes help:

  • Make movement a habit

  • Have a positive outlook

  • Eat wisely

  • Find and connect with your tribe

There are a lot of valuable lessons in this documentary (sans Dan showing himself riding his bike for 1/3 of the docuseries. Why do documentarians always have to show themselves so much? I digress…). One lesson is that no matter how long you live, you can live your best life and one of high quality. A lot of that centers around food. And wine. Yay!

The NY Times Magazine had two fantastic articles last week. David Wallace-Wells wrote a piece on the financial responsibility for climate change and how difficult it is to figure out the historical tally of damage. The price of historical emissions and removing carbon would cost $250 trillion. The U.S. alone has accrued a climate debt of $2 trillion. By 2100, $100 trillion. This shows how daunting it will be to turn around the damage we have done and will continue to do without serious action on climate change.

Another NY Times Magazine article focuses on young migrant kids from Central America who work night shifts in slaughterhouses – a dangerous, low-paying job – with very little compensation or legal status. They are often too tired when they get to school after working long, laborious hours all night, and often, they get maimed, injured, or exposed to terrible toxins that stay with them for a lifetime. It is a tragic story but so important to read to understand why younger kids and teens are trekking up to the U.S., what they face along the way and when they get here, and the fine line to ensuring their freedom. While it seems we have come a long way from the days of The Jungle, written in 1906 by Upton Sinclair of the Chicago slaughterhouses, this article makes you pause. Your heart will break for Marcos Cux.

And for some self-promotion, my team and colleagues published a few papers in the last six months that may be of interest to Food Archive readers:

  • Challenges and opportunities for increasing the effectiveness of food reformulation and fortification to improve dietary and nutrition outcomes: This article is about how reformulation and fortification face numerous technical and political hurdles for food manufacturers and will not solve the issues of increased consumption of ultra-processed foods. You can’t make junk food healthier at the end of the day…

  • Harnessing the connectivity of climate change, food systems, and diets: Taking action to improve human and planetary health: This paper presents how climate change is connected to food systems and how dietary trends and foods consumed worldwide impact human health, climate change, and environmental degradation. It also highlights how specific food policies and actions related to dietary transitions can contribute to climate adaptation and mitigation responses and, at the same time, improve human and planetary health. While there is significant urgency in acting, it is also critical to move beyond the political inertia and bridge the separatism of food systems and climate change agendas currently existing among governments and private sector actors. The window is closing and closing fast.

  • A global view of aquaculture policy: This article shows that government policies have strongly influenced the geographic distribution of aquaculture growth, as well as the types of species, technology, management practices, and infrastructure adopted in different locations. Six countries/regions are highlighted – The EU, Bangladesh, Zambia, Chile, China, USA, and Norway. These case studies shed light on aquaculture policies aimed at economic development, aquaculture disease management, siting, environmental performance, and trade protection. 

  • Riverine food environments and food security: a case study of the Mekong River, Cambodia: Rivers are critical, but often overlooked, parts of food systems. They have multiple functions supporting the surrounding communities' food security, nutrition, health, and livelihoods. However, given current unsustainable food system practices, damming, and climate change, most of the world’s largest rivers are increasingly susceptible to environmental degradation, with negative implications for the communities that rely on them. Rivers are dynamic and multifaceted food environments (i.e., the place within food systems where people obtain their food) and their role in securing food security, including improved diets and overall health.

Grocery Delivery Services: A Mixed Bag

This is a cross-posted blog from the Berman Institute of Bioethics’s Global Food Policy and Ethics (GFEPP) blog. It was written by Leslie Engel, MPH, a Science Writer Consultant for the GFEPP.

Americans have more ways than ever to shop for the ingredients needed for their meals. This was not always the case. Prior to the first self-service grocery store opening over a century ago, shoppers had to rely on clerks to retrieve and package items for them. Since then—aside from the invention of scanners and self-checkout—the grocery shopping experience has remained largely unchanged. It’s an industry ripe for disruption, and tech companies have seized upon this.

Rowan Freeman, Unsplash License

Enter grocery delivery services. These companies make lofty promises—to eliminate the hassle of grocery shopping, meal planning, preparation, and even the act of cooking itself—while also being good for you and the environment. And more Americans than ever are now using them.

I worked as a recipe manager for a leading grocery delivery startup whose mission is to make healthy eating easy by using artificial intelligence (AI) technology to predict customer food preferences. As a professionally trained chef with a background in public health, I was fascinated with the ability of such services to seamlessly deliver top-quality, nourishing, and sustainable products and recipes to customers, potentially as another avenue to improve health and wellbeing through home cooking. However, as I developed yet another recipe involving ground beef, I began to question how healthy this industry really is, both for ourselves and for our food system.

Convenience, for a price
Convenience, safety, and accessibility are the main appeal of these delivery services. This was especially evident during the COVID-19 pandemic, when many consumers turned to delivery to avoid in-person shopping. In theory, this means that more people will have better access to food, especially those with health, mobility, or other constraints. However, convenience comes at a price, and grocery delivery services pass this cost onto consumers in the form of markups, service, and delivery fees. Additionally, increased food costs due to inflation likely render this convenience financially out of reach for those most in need.

Reduction in greenhouse gas emissions?
There’s some evidence that grocery delivery could be more environmentally friendly than hopping into the car because it reduces greenhouse gas emissions. A study in Washington State demonstrated that it may be more efficient for a fully stocked truck to deliver to multiple households in the same neighborhood rather than individuals driving to the store themselves. But this is a best case scenario. The biggest emissions reductions would require households to cluster their orders together and forgo specific delivery times, thus reducing the convenience factor and the main selling point of such services.

Tim Mossholder, Unsplash License

Reliance on California’s Central Valley
Twenty-five percent of our nation’s food is produced in the Central Valley of California. The area is so integral to business that the company I worked for hired someone specifically from the region to oversee produce sourcing. But its agricultural future is in peril: water is scarcer than ever, severe droughts related to climate change have diminished groundwater stores and decimated crops, and intensive farming practices exacerbate the problem.

Crop failures or shortages were a huge sourcing and supply chain headache with trickle down effects. Customers often complained about receiving an inferior product, or one not as uniform as what they were accustomed to. Receiving a last minute vegetable “swap” presented a whole new set of customer challenges: I don’t like the cauliflower that replaced my broccoli! And how am I supposed to cook this?

The end result was often wasted food, as evidenced in the customer comments I analyzed. Food wasted at the household level is especially egregious because it squanders all the resources that went into growing, processing, packaging, and shipping it. In the U.S., between 73 and 152 metric tons of food is wasted somewhere along the supply chain annually. About half of that waste is happening at the household or food service level. And worldwide, food waste contributes 8% of human-generated greenhouse gas emissions, making it a significant contributor to climate change.

Technology
When customers rated a product or recipe, it became a data point used to further refine the AI, which then “decides” what product or recipe will go into their next delivery. You’ve no doubt seen the effectiveness of this technology in eerily relevant pop-up ads. Similar to how AI learns which ads you are most likely to click on, it can also learn which foods you’re going to enjoy or not. Like that hamburger? You shall receive more ground beef! It becomes a feedback loop designed to retain customers and increase profits, but not necessarily improve your health or the environment.

Looking Ahead
I still believe that grocery delivery services and the technology that drives them are the way of the future and can be a positive force within the food system. AI can potentially be used to improve diets, not just increase profits; researchers have harnessed this technology to help people grappling with obesity and diabetes to eat better.

To improve access for everyone, the U.S. government should make it easier for grocery delivery companies to accept Supplemental Nutrition Assistance Program (SNAP).The USDA is currently piloting a program that enables SNAP recipients to purchase groceries online from select retailers. Incentives should also exist for companies to waive delivery and service fees for SNAP recipients.

In addition, produce should be sourced regionally when possible. Shorter transit distances from farm to fridge mean less greenhouse gas emissions and fresher, more nutritious produce with a longer shelf life that’s less likely to be tossed. Fresh Direct offers a selection of local produce and more services should follow suit. The increased demand could help boost struggling regional agriculture and decrease demand on the imperiled Central Valley. Finally, the biggest thing missing from this new grocery shopping experience are people. AI may be “filling” your cart, but humans still harvest, process, pack and deliver everything we eat for low wages in unsafe working conditions. The pandemic has revealed that the meatpacking industry will go to great lengths–at the expense of humans–to maintain production and profits. Most recently, dozens of children were found to be illegally working as sanitation workers in meatpacking plants. By further alienating ourselves from where our food comes from, we’re less likely to see the value in the people behind the scenes making sure your fridge is full.

Leslie Engel, MPH, is a Science Writer Consultant for the Global Food Ethics and Policy Program.

19 days of COVID cuisine: Cooking to combat cabin fever

My better-half, who does all the cooking in this casa and serves as the main hunter-gatherer-forager for all things food, wrote a post on his 5cense blog, but gave me the permits to post it here too. He goes into our food life in the times of COVID and how he gets by with a recent diagnosis of Ménières disease. He tries hard to practice what I preach in my professional life, ensuring we eat as sustainably as possible, and have zero food waste. Right now, these principles are harder for everyone, with the strained global food supply trying to keep up as the economy slows. For those already suffering from food insecurity and uncertain employment, the struggles are immense and we can’t even begin to comprehend the sacrifices and hardship. We feel so incredibly lucky to be able to put food on the table every night and are trying to support our local food system and community as best we can.

Please go and support your local farmers and CSAs (see who we support below), restaurants and food banks. They need us more than ever.

Virtual Sourcing
Don't know how y'all get your food, but this is problema #1 these days, 'specially for car-less folks like us that are used to the Italian way of doing things—buying fresh stuff every day for what you're gonna eat that night. By the time we went to the market a few weeks ago, most everything had been hoarded (btw, the TP shortage phenomena has an EZ answer—a Tushy bidet attachment... toilet paper is a filthy habit anyway). We have a Trader Joe's a block away, but seems to be a cesspool for Corona right now (+ no, not the beer). And when u go on Fresh Direct the time slots are always taken... so what u gotta do is wake up (or stay up til) 12:01am when they release time slots for the next day + then be patient thru 15 minutes of tumbling hourglasses or spinning wheels as everyone in the country is also refreshing their browsers over + over like you are. On the 2nd or 3rd night we got lucky + scored a rez for a week later.

Fresh Direct lets u modify your cart up until the night before your delivery so just put whatever in there to book a slot and then keep adding as u wait a week for your time to come up... of course lately they are out of most everything + even if u do manage to get some stuff in your cart, by the time they deliver ⅓ of your items are missing + the recommended replacements are ridiculous like in loo of raisins they suggest maraschino cherries, or low-sodium Goya black beans instead of the regular (which we've probably eaten more of then any other food item in el mundo (we brought cases of 'em to Rome, along w/ 5 or so kilos of Maseca)... spose u can just add your own salt + here's a tip: squeeze a lime into the can so u don't waste all them juices + gook stuck to the side of the can. And sure, u can boil your own, but we're lazy + DiY beans give us gas (tho pressure cookers help) + they were out of the dried ones too.

Whole Foods on the other hand has the opposite approach—u can reserve only 2 days in advance for delivery, but they release slots throughout the day, so if u keep ⌘-R'ing the screen u might score a delivery w/in a few hours. They don't let u update your cart tho + their bait + switch tactics are more extreme... yesterday we went to buy butter, Jasmine rice + paper towels but ended up w/ a few bottles of cava, organic blueberries + Engine-2 Rip's (only cereal we can find w/o added sugar or oils), but none of what we originally ordered (they don't tell u until after checkout that they are out of these things), tho guess we did score a few bags of Peet's Major Dickason's (no other coffee will do for us).

Daily Bread for a Fortnight
If ever we was gonna write a cookbook, it wouldn't be about singular recipes but the flow from 1 day to the next... about efficiency, variety, conservation of resources, adaptability + yes, 1-pot meals cuz we're fundamentally lazy. Rule #1 would be don't follow recipes. Just get creative w/ what u got, analyze the contents of your fridge in the order of when it will go bad + then figure out what u can concoct so nothing gets wasted... can't remember when the last time something in our fridge went bad. Most every meal ends up being a unique dish, tho there are a few general patterns that repeat. Rarely does a week go by that we don't have tacos, so we start w/ a batch of salsa. Choice of peppers might vary (+ sometimes we opt for green tomatillos) but usually, it's habaneros, cilantro, white onion, lime + roasted Roma tomatoes (5 makes enough to exactly fill our container)... the only problem is that there was no cilantro (a problem we are well used to, living in Italy where they regard cilantro as worse than old man b.o.) so we did the unspeakable + used basil + parsley. When we ordered habaneros from Fresh Direct last week we thought we were getting 6, but ends up we got 6 bags... so really like 40-50 habaneros. No problema, we roasted all of 'em w/ our stovetop roaster (w/ fan on high!) + then added a bit of olive oil + lime (to make it pasty) + put it in the freezer so whenever we need roasted habanero (which is always) we can just nuke it for 10 seconds then take a spoonful. While we were mucking up our food processor (Breville... highly recommended) figured we may as well whip up the jerk + pesto sauces (read on). Ideally, this prep day should coincide w/ the day u get your goods, which this time around conveniently fell on April 1.

April 1: Vongole—this is another dish in high rotation, if not weekly then every fortnight, being that clams are our bedder-½'s favorite food (she's got a tattoo as proof) + low on the food chain, low carbon footprint (unless u get them from New Zealand... which we must admit, them cockles are tasty). Our custom is to make this for whenever she comes back from a trip, which used to be often, but seeing as no one is traveling these days we make 'em just because. Ain't much to do w/ vongole (or linguine 'Congolese' as our iPhone calls it)... soak the clams 1st thing in cold salted water (our seafood monger in Rome used to tell us how much salt per liter but we forget) in the sink + apologize to them 1 x 1 for the trauma they endured being scooped from the sand + shipped thru whatever supply chain to your home (hopefully your seafood monger knows better not to seal the bag so they can breathe). Rub each 1 down + if they are slightly ajar they should clench close when u massage them otherwise they ain't no good. If u squeeze 'em a bit u can sorta tell.

If we had a baguette we would of made garlic bread to "fare la scarpetta con le vongole" (mop up the clam juices w/ the bottom of your shoe) but apparently everyone's hoarding baguettes (which at least makes more sense then guns + TP) so instead we just took regular sliced (whole grain sourdough) bread + smeared crushed garlic + olive oil (butter is also out of stock, so we're rationing the little that we have) + put it in the oven. Then put the water on to boil.

In another pot (a janky non-teflon 1 cuz it might get scratched up by the clams) put some chopped garlic, olive oil + white wine... we like to put sum sorta cherry tomatoes (ideally those nippled piennoli from the slopes of Mt Vesuvius) but alas, out of stock, so instead we chopped up some red peppers (sweet minis). At the same time u put the pasta in (linguini or spaghetti for vongole... nothing else will do) put the poor little clams in the pot w/ the lid on. Make sure to under-cook pasta, we just drain against the side of the sink to not have to wash a strainer then add lots of fresh chopped parsley, red pepper flakes, ground pepper, salt + a squeeze of lemon, then dump the clams (cook long enough for them to all open) + juices on top + hold onto the pot u used to steam the clams cuz u can use that for the discarded shells. We didn't take a photo of the vongole cuz we didn't know then we'd write this post + we're more into eating our food then taking pictures of it. We also had a salad (use them greens while their fresh) w/ avocado + red onion. We've been trying not to drink during the week, but hard to have vongole senza vino bianco.

April 2: Gnocchi Pesto—fresh basil should also be made into pesto as soon as possible... it doesn't mean u have to eat it that day, but at least make it. As we mentioned, we also made the salsa + jerk sauce at the same time to save on cleaning. Often humus gets worked into this routine, but not this time. Pesto is e-z p-z.. throw basil, pine nuts, garlic, olive oil + pecorino romano in the food processor + voilà. Most recipes probly call for parmigiano but our time in Rome has biased our buds. Sometimes we squeeze a squirt of lemon into the mix. ½ of the pesto we'll put in a jar (top off w/ a layer of olive oil so it stays green + unoxidized).

We chose gnocchi cuz we had pasta the night before + also cuz the last time we went to Trader Giotto's they were out of all the pastas except gnocchi. While the gnocchi were boiling (if u have gnocchi w/ tomato sauce u can cook them right in the sauce + save a pot) we sautéed a bit of shrimp + mustard greens (often we'll throw chick peas in for protein, but the shrimp suffice this time) then add the gnocchi + mix in the pesto last, after the heat is off. Again, w/ a salad + unfortunately sliced bread instead of a baguette to mop up the oily remnants. Pesto is hard to eat w/o vino rosso, but we can't drink red wine this time of year w/ our allergies + we ain't sposed to be drinking anyway during the week. We usually also have sparkling water but SodaStream is taking forever refilling our cannisters... so it's tap water straight up, w/ a squeeze of lemon (April is the month they chlorinate the water in DC (gotta keep them pipes clean living in the swamp) which smells gross but u can't really taste it). Again, we didn't take photos of the final product, tho here's the pesto sauce we haven't used yet, along w/ the salsa we haven't tapped into either.

April 3: Jerk Chicken—we haven't been talking much about what we eat the rest of the day.... if we have leftovers from the night before we skip breakfast + eat those for lunch. Or we eat a late breakfast + skip lunch, or just snack on whatever throughout the day. Lately we've been into smoothies + while we haven't resorted yet to frozen berries, we got some for the day when we can't get 'em fresh.

'Jerk' is 1 of those vague words that to us means whatever u find laying around, but usually entails roasted habaneros (which we already mentioned we have a frozen stash of) + green onions... those are the only 2 real requirements, + oh, spose allspice is must-have to be jerk. If we have pickles on hand (which we do) we'll pour some of the briney water into the mix, or capers w/ some of the juices they're soaking in,... soy sauce, ponzu, whatever salad dressing u might have, lime, vinegar, salt, pepper, spices, etc. Baste the chicken in this concoction overnight (we did all this the day before). Then all u got to do is fire up the grill + throw 'em on.

Actually, shuck the corn + put those on 1st cuz they take longer. Then put the meatier breasts + legs before the wings + smaller pieces... tho we couldn't get a whole chicken, all we could get was 2 legs + a package of wings (if we wanted organic, free range). We don't do chicken that often btw, maybe once a month. It's the only animal we eat that doesn't live in the ocean. We justify it cuz it's low on the food chain + comparatively resource-efficient, but fact is it's delicious. Roasted corn doesn't need anything, perhaps just a squeeze of lime. And again, a salad, while the greens last. Washed down w/ Pilsner Urquel. We got tired of waiting for SodaStream so canceled our order + put on a bandanna + braved the hardware store to exchange our cannisters. After dinner mixed sum gin into our limey soda water (it was Friday night after all)... nursing our Japanese gin to stretch it for as long as we can.

April 4: Tacos—we've eaten tacos probably more than any other dish in our lifetime, at least once if not twice a week. We had a bit of leftover chicken so grilled it up w/ sum mushrooms, green onions + a few types of peppers (dare we use the word fajitas?). We actually scored some tortillas (albeit small "street" style ones) otherwise we would of made our own. And whipped up a batch of guacamole... + the salsa, sour cream, jack cheese (sadly they were out jalapeño jack) + a bottle of pilsner.

April 5: Risotto—take the bones you've been collecting from the chicken, along w/ whatever else (we keep a pot in our fridge for scraps), the tips of onions, celery, etc. + add water to boil. The longer they simmer the better. This week we made risotto w/ the broth, but the last time we made vegetable bean soup + the time before that pozole.

While the broth simmers start chopping up stuff for the risotto... this time we put garlic, eggplant, shitake mushrooms, a few frozen shrimps, mustard greens (add last) + green chilies. Fortunately we have 10 kg of frozen roasted Hatch chilies we got last September... we still have about 5 kg left. Roast the garlic + briefly toast the risotto then start adding stuff. We just put the strainer right on top + pour the broth straight in. Set the risotto simmering, stirring often. Once the stuff in the strainer has cooled (spraying a bit of cold water thru helps) we like to get in there + wring all those juices out, squeezing the remnants to a pulp. Broth-making should correspond w/ the day before garbage day so these remnants don't stink up your kitchen or attract vermin. When it's near to done grate some pecorino in. We served it on a bed of arugula since we had some to use up.

April 6: black bean tostadas/tacos—we had a few leftover broken tortillas that we put in the oven to make tostadas + since we don't have any more tortillas we made our own from Maseca... again, plenty used to doing this since they don't have tortillas in Rome or Nairobi (not corn ones anyway). We still have salsa from a few days ago + grated some cheese + diced up some peppers, green onions, arugula, cilantro, sour cream, etc...

April 7: Penne Pesto w/ shrimp, mushrooms, peppers on a bed of arugula (using rest of pesto sauce made a few days ago).

April 8: Veggie-burgers /w fries + babaga-humus—scraping the bottom of the fridge so dipped into the freezer to dig out some Engine-2 Pinto-Habanero Burgers that we've been meaning to try since we like their cereals so much (all simple plant-based ingredients w/ no added oils or sugars). Grilled up some onions, mushrooms + peppers to put on the patties + also a slice of NY sharp cheddar cheese. Roasted some potatoes in the oven (w/paprika, rosemary, garlic, salt + o'bay). While we had the oven on, roasted an eggplant + mixed it w/ some humus (why not... humus + babaganoush have basically the same ingredients): chick peas, tahini, olive oil, lemon, fresh parsley, habanero paste, sesame seeds + the roasted eggplant). Celery + pickles. Washed down w/ a bottle of Cava since our bedder-½ got promoted to full professor (she was already tenured + endowed, but technically "assistant" prof before) so we were celebrating. The verdict on Engine-2 Pinto-Habanero "burgers"? Consistency was weird, soft + mushy + falling apart, but w/ all the fixings + mayo + mustard it's all tasty.

Oh yah, the cookies... those are the professor's doing. We don't bake... at least not baking that necessitates following a recipe.

Eating + drinking w/ Ménières
Didn't sleep so well + woke up w/ our head pounding/spinning, maybe on account of the cava + cookies. Last year we were diagnosed w/ Ménières disease + our doctor said no salt, alcohol, caffeine + basically every food item listed here that we love. But life's too short! Would rather be dizzy + lose hearing in 1 ear than eat unsalted beans. Especially since there's been no conclusive studies demonstrating that this even helps, it's all just anecdotal speculation. A few months ago we started to keep a food journal to see if we could identify any triggers, but barometric pressure, allergies + lack of sleep seem to have more of an influence than diet... tho salt, sugar + alcohol certainly doesn't help + eating a lot in 1 meal after fasting all day doesn't bode well for us either. In particular we've noticed we don't do so well w/ wine (especially red, but even whites now). We're okay w/ beer (as long as it's low alcohol %... not these crazy high-octane IPAs they make nowadays), in fact we sleep + feel even better if we have 1 or 2 beers. Really it's about moderation in everything, keeping fluid levels at an even keel, don't eat a bunch of salt 1 day + then no salt the next + don't binge on anything all at once, but eat consistently throughout the day. Our Ménières is probably acting up cuz it's allergy season (this time last year we were really hating life). Yesterday we went for a run (only cuz it rained all night) + when we got back our legs felt + looked like we got bit by 100s of mosquitoes all at once, in addition to sneezing attacks + itchy bloodshot eyes. So avoiding the outside world is something we should be doing anyway for the next month, regardless of COVID.

April 9: Shrimp Tacos w/ Guacamole—Re-up day... got our Fresh Direct delivery this morning... this as we learn that the Trader José's near our house closed cuz an employee got COVID, so now we'll be even harder pressed to get food in our hood. We made shrimp tacos cuz 2 of the avocados we're really soft so figured we may as well make guacamole + the shrimp weren't frozen so best to 'em sooner rather than later. Made another batch of fresh salsa for the week.

April 10: Mushroom Gorgonzola Stroganoff—we have no clue how a proper stroganoff is made, this is based more on the Hungarian Mushroom soup recipe we remember from Moosewood (back when we was a hippie child in the '80s we admit to using that cookbook). Sauté some mushrooms (a mix of cremini + the regular ones) + onions + garlic in white wine, olive oil + butter. We couldn't get sour cream so used Greek yogurt. Spice w/ salt + pepper + most importantly paprika + fresh parsley. Oh yah, and this time we sprinkled some crumbled gorgonzola in which gave it a nice zest.

April 11: Linguini Vongole—1 of the professor's students was going to Whole Foods w/ a car today + asked us if we wanted anything (spose this is the 2020 version of giving the teacher an apple) so we gave her a list of things including vongole, so repeated day 1's clam-fest only this time w/ linguini + we had little kumatos to throw in. Not only was this student kind enough to do our shopping but she souprized us w/ other goodies we didn't ask for such as burrata, so included that in our meal.

We were going to do a whole fortnight of food getting us thru lock-down, but seems the cycle is starting to repeat + we have friends in Naples asking to swap recipes, so we'll go ahead + post now... u get the idea, it's not about knocking your socks off w/ 1 meal, but sustaining yourself thru the week, month + also eating to sustain the planet. W/ the nearby Trader Joe's closed cuz of COVID it's getting harder to shop (supposedly the queue at the nearby Whole Food's is 2 blocks long). We're losing sleep staying or waking up at midnight to get a delivery rez on Fresh Direct only to find out they are all booked in advance + seems all food delivery services are overwhelmed. On the other hand, there is tons of food going to waste cuz the chain is severed from farmers that normally supply restaurants + business besides supermarkets, or the mom + pop specialty farms that supply farm-to-fork restaurants. We signed up for a local CSA (Earth N Eats) so we are getting a bunch of fresh stuff on Friday. There's also lots of otherwise thumb-twiddling restaurants getting involved in distributing (uncooked) food (at least in DC). So we're set for at least a few weeks, here's what our fridge looks like at the moment:

Next Week's Menu
As mentioned, we don't follow recipes or plan meals in advance (+ or even grocery lists) but we have a vague notion in the back of our head that gets inspired day off based on the status of food in our fridge in the order it will go bad (not a drop or leaf of any food item above will go to waste). But here's some other e-z to make meals that usually find their way into the mix:

  • Pozole—while the authentic version is complicated (+ involves pig feet) we have our own version that can be made in minutes. Ideally u do this w/ broth u made, but in a pinch u can use 1 of them boxes (+ veggie broth if you don't do chicken). Grill up onions + garlic, add roasted Hatch green chilies (we have them frozen, but u can get them canned, tho they're not nearly as good/spicy), oregano, a can of hominy, black beans + voilà. Mexicans garnish w/ cabbage, onions (white), pork, radish, lime + chili sauce... we modify this sometimes w/ whatever leafy green, green onions, grated cheese + chicken, if we have it.

  • Quiche—quiche is another great way to use things up, just grill up whatever u have on hand, add 4 eggs (2 per pie) + grated cheese... basically an omelet in a pie crust. We only make pie crusts if we have to (like in Italy where u can't buy them frozen) but what a pain in the ass when u can just buy 'em frozen. If u don't have a pie crust, u can always make breakfast for dinner... we often do a Mexican version of this w/ huevos rancheros + black beans + home fries.

  • Pizza—same thing we said about pie crusts applies to pizza dough... much easier to get frozen + thaw + roll it out out day of. U also need to an oven that can crank up to 450° if not 500°+ ... ours never seems to get hot enough to get a crispy crust (+ we never forked over the dough for a proper pizza stone but use a metal 1), but maybe also cuz we load it up w/ veggies (usually lots of mushrooms) + cheese, to try to make a meal of it. We also often pile arugula on to turn it in to a sort of pizza salad. Otherwise, if we want a proper pizza we leave that to the professionals (same could be said about sushi).

  • Cevicherashi—while we don't usually make sushi ourselves, we often do a Mexican/Peruvian hybrid that we already documented here. Or a Polynesian take on this is poisson cru (basically the same thing but w/ coconut milk).

  • TJ's Thai Lime + Chili Amondless Larb—it's easy to fall prey to the Asian stir-fry, face it, we all have + it's never the same as when u go to a good Thai or Chinese restaurant. Maybe 1 reason is that it usually requires liberal doses of fish sauce which stinks your house up to high hell. But the classic stir-fry is always a good way to use up those fresh veggies + Jasmine rice is a nice change from pasta. One secret we have (being that we consume mass quantities of those Trader Joe's Thai + Lime Almonds) is we re-use all those leftover spices (lemongrass, kaffir, etc.) once we've eaten the almonds + yes, u sorta have to plug your nose + use fish sauce, that's the dirty secret to Thai cooking. When we 1st got turned on to Thai food in the '80s in San Jose, we got the cook from our favorite restaurant drunk so she'd reveal her secrets + evidently cooking w/ vodka is also key. If we don't use shrimp, our stir-fry dishes often end up a bit larby, w/ lime, scallions, cilantro + ground chicken or turkey or crumbled tofu, tempeh or we've even tried this w/ beyond burger.

  • Casarecce Carciofi—we got some artichokes coming friday in our CSA so we'll likely make a variation of this, hopefully they'll have the stems on them cuz them's good eating. Basically we follow the recipe for carciofi ala Romana (steam w/ garlic, mint + lemon) + rather than waste those juices the artichokes were simmering in, we take the artichokes out, mash up the stems (hopefully they're soft enough) + garlic + then maybe add mushrooms or whatever else + put the pasta in there + add pecorino Romano to stretch your artichokes into a meal.

  • Anything Goes Mulligatawny—googling now this doesn't resemble the mulligatawny recipes we see on Inurnet, but it's usually what we call our goulashy vegetable soups. The inspiration goes back to 2 decades ago when we used to stand in line at the Soup Nazi in Hell's kitchen (before he sold out + franchised + had to drop the "Nazi") + it was pretty much just like in Seinfeld (except u stood in line outside, rain or shine), u had to know the drill or get scolded. And it was well-worth it. My favorite was his mulligatawny, which seemed more Persian than Indian. And we'll use a dollop of sour cream or yogurt instead of coconut milk (as we think did the Soup Nazi). Regular players in our mulligatawny include: lentils or chick peas and/or whatever beans, celery, carrots, squash or pumpkin, onions, potatoes or faro, etc. but really this all hinges on your broth. We might spice it w/ a bit of curry powder or rosemary + tarragon + usually there's habaneros involved or some other chilies.

Bon appétit! And wash those hands.

 

The COVID-19 Crisis and Food Systems: Addressing threats, creating opportunities

Lawrence Haddad, Jess Fanzo, Steve Godfrey, Corinna Hawkes, Saul Morris, and Lynnette Neufeld

With the spread of COVID-19, we find ourselves plunged into a global health crisis. By most accounts, we are only at the early stages of the pandemic so it is going to reshape economy, society, and politics, probably permanently.

Pre-COVID-19 crisis, many families the world over already spent a lot of time and energy thinking about getting access to food. During the crisis, the most vulnerable face the rapid loss of their income - spent mainly on food - and this is an immediate threat that should be prioritized. For many others, simple access to shops has also become very worrying and needs swift attention. Even the wealthy are increasingly thinking about food access at this time.

But are governments, businesses and civil society thinking enough about food access and the wider food system?

How will the crisis shape the food system if we do nothing? And what can we do in the context of the crisis to get the food system in better shape to improve the consumption of nutritious foods for all, especially the most vulnerable?

We desperately need to focus on the operation of food systems at the moment because we know that the quality and quantity of the food we eat is the number one risk factor in the prevention of general mortality and morbidity. If we forget the food system right now, the COVID-19 health crisis will unwittingly use the food system as a catapult to have an even bigger impact on the global burden of disease. If we think and act to change the food system right now, we can reposition it to be more effective at delivering affordable nutritious food during the crisis, and perhaps even after the crisis.

What are the probable effects of COVID-19 (and the efforts to control it) on the food system which shapes our access to nutritious food?

It is difficult to say for sure, but in this table we share some thoughts on the potential impacts throughout the food system of COVID-19 (and the response to it), and some ways of mitigating the impacts. We do this for high- and low-income contexts, which may well exist within the same countries. Many of our suggested actions are responses to immediate needs, but many would have positive impacts well after the crisis is under control.

What are the main threats? We are of course worried about food prices, especially for more nutritious foods, which are already more expensive than staples and unaffordable for many people, especially those on low incomes who already spend much of their money on food. More food staples will be consumed as a result of price hikes, but likely also more, unhealthy, highly processed foods that are cheaper, have longer shelf lives and may provide comfort in tough times. In addition, increased food price volatility (due in part to hoarding and cross border impediments) generates uncertainty and makes it more difficult for food system actors to take all manner of decisions.

We are also deeply worried about negative income shocks on the most vulnerable, through the loss of livelihoods as the demand for certain services collapses and certain production systems are disrupted due to affected workers. Farming, in particular, seems very vulnerable given the older age profile of farmers and the mortality pattern of COVID-19 as well as the sector’s common reliance on mobile workforces. This vulnerability, if realized, will mean less food produced and weaker non-farm rural livelihoods and higher food prices for all, wherever we live. Physical distancing will have an impact on the costs of moving food around, within countries and across borders leading to more food loss and emptier markets. Lapses in food safety, which potentially started all this in a wet food market in Wuhan, will likely exacerbate if no action is taken. 

What are the probable effects of COVID-19 (and the efforts to control it) on the food system which shapes our access to nutritious food?

But there are opportunities. Healthier foods build immune systems throughout life but especially among vulnerable ages, including early life and the elderly, and so there is a window of opportunity to make the case for safe nutritious food. Diabetes and other non-communicable diseases are risk factors for COVID19 mortality and additional attention should be given to preventing the former because of the latter. 

We expect to see food safety move strongly up the policy priority list because of the origins of COVID-19. Social protection programs should be more linked to promoting the consumption and production of nutritious food, not just preventing food insecurity. We expect the prevention of food loss, especially fresh food, during storage and transport to gain a greater profile. The aging of farming capacity will be treated more seriously, with efforts increasing to make farming more profitable and appealing to younger generations.

We can see opportunities for reshaping public sector messaging, not only about hygiene but about nutritious food consumption and preparation. Will there be new opportunities to disrupt food transport by using shared economy models capitalizing on any underutilized haulage capacity to lower costs? Will we see more financing facilities for investing in nutritious food production, processing, storage, distribution and retailing? Will civil society become more organized and active about the provenance of food and about the behavior of businesses and governments in ensuring the provision of affordable food? 

Social protection programs should be more linked to promoting the consumption and production of nutritious food, not just preventing food insecurity. © Unsplash

Social protection programs should be more linked to promoting the consumption and production of nutritious food, not just preventing food insecurity. © Unsplash

Finally, will we see greater collaboration between government and the private sector during the crisis spill over into a reshaped narrative post-crisis about how the two sectors - public and private - can work better together to improve access for all to safe nutritious foods?

This is the first of a series of blogs that we will put out in the coming months. We have asked Nutrition Connect to set up a COVID-19 and food systems site and we would like to encourage our partners, colleagues, friends, and fellow travelers to post blogs, opinion pieces and research reports and papers that are relevant to this topic on the site, with full organizational recognition and lots of cross-posting. 

The COVID-19 health crisis is here. Let’s work together to stop it turning into a food crisis and further exacerbating disease burdens.

Governments, communities, and businesses around the world are showing astonishing energy and innovation to cope with COVID-19. The short-term priority is to stabilize food systems and keep trade open – all people working in food systems from the farmer to the check-out supermarket agent are critical to keep the food system moving. But it is in times of great crisis that fundamental reforms are born. The United Nations, the World Bank, the International Monetary Fund and the advance of the welfare state were developed in the darkest days of the Second World War.

So let’s stand by our neighbors, critical workers, and communities today. Let’s also work to reshape our food systems for tomorrow - to deal with the new COVID-19 crisis as well as the much bigger diet-related health crisis; one that has been with us for decades. 

Download the mitigation and adaptation table here.

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.

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.

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.

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?

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

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: July 1 - July 7

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

Ever wonder why the nutrition community doesn’t play nice with each other? I do. Phil Baker at Deakin University just published an interesting, but heady, paper trying to understand nutrition action networks and what it would take to make them more effective in garnering political commitment towards ending malnutrition. Just take a look at the figure below looking at the context in which nutrition sits. Talk about complex! They argue for four things to improve political commitment to nutrition:

Complex contexts for the nutrition world

  1. Coordinating bodies that are better at advocating resources can of course, get more money and strengthen the networks in which they work.

  2. Coordinating and governance bodies need to be more inclusive and transparent in their decision making.

  3. Civil society should work to influence decision makers. Helps when transparency is in place.

  4. Finances matter and create powerful incentives for us to play in the sandbox together.

I may have gotten all this wrong, but like I said, the paper is intense, but super important to better understand why nutrition hasn’t seen massive progress like other sectors. I really do think that the grand nutrition architecture has some serious issues around coordination, cooperation, and reality checks it needs to come to grips with. Not Phil’s words, but mine…For another blog post!

Of course, the nutrition community doesn’t just struggle with political commitment. It also struggles with delivering key interventions to those populations most in need. A recent study by Stuart Gillespie and colleagues looked at 24 different nutrition interventions to see if their coverage is measured and tracked in major health surveys done at the national level. These interventions are things like vitamin A and iron supplementation, growth monitoring, and infant feeding counseling. Basically the answer is no. The coverage of these interventions are not collected and not in any standard way across countries. The paper presented a few case studies including India. The figure on the right shows the scatter of data collection of key nutrition actions (counseling, growth monitoring and food supplements) typically not included in the core national health surveys. The bars show the national coverage of data and the dots are the states of India. Another paper published in PLoS medicine looked not only at whether or not a health intervention coverage was captured in surveys, but looked at need, use, and quality of those interventions. It would be great to see these authors do a follow up looking at those three measures to assess effective coverage of nutrition indicators.

And while we are ripping on the functionality of nutritionists and their work, let’s discuss the indecisiveness of the science they dabble in. The Atlantic published a piece on why nutritional sciences is so confusing for consumers. There have been a lot of articles on this recently, and I think it started with Michael Pollan’s book In Defense of Food a decade ago. The Atlantic argue that doing the science is very hard - figuring out what people eat and the consequences of those eating patterns - is not so straight forward and as the article highlighted “inexact.” But the evidence over decades has accumulated and most nutritionists agree largely on what is considered a healthy diet and the healthful habits that people should take on. But that is sort of boring isn’t it. The article also highlights the emerging role of the microbiome. But more on that later.

There have been a few recent papers looking at the impact of interventions to improve food environments. One was a systematic review and meta-analysis on sugar‐sweetened beverage - SSB - taxes and their impact on beverage purchases and dietary intake. A suite of different taxes were examined mainly in Europe and US cities. What the researchers found was that a 10% SSB tax was associated with an average decline in beverage purchases and dietary intake of 10% in 6 jurisdictions. This tax was associated with a 2% increase in total untaxed beverage consumption (e.g. water) but this was not significant. Another study looked at the anticipated impacts of implementing a 2016 Chilean Law of Food Labeling and Advertising mandating front‐of‐package (FOP) warning label for products high in sodium, total sugars, saturated fats, and/or total energy. Researchers photographed packaged food and beverage products from six different supermarkets in Santiago, Chile before the law went into effect. They found that basically very little reformulation by industry occurred before the law went into action and <2% of products would have avoided at least one warning label with reformulation. A similar study looked at the food supply ahead of the law implementation and found similar issues.

While we are on the topic of FOPs, a really interesting study looked at how realistic would it be to mandate these types of labels in the U.S. The study found that: “Certain interpretive FOP labels which provide factual information with colors or designs to assist consumers interpret the information could similarly withstand First Amendment scrutiny, but questions remain regarding whether certain colors or shapes would qualify as controversial and not constitutional. Labels that provide no nutrient information and only an image or icon to characterize the entire product would not likely withstand First Amendment scrutiny.” Wow. Interesting. Gotta love the ol’ US of A’s constitution.

The U.S. is not always the asshole in the room. Well, maybe we are. Let’s talk USAID. For those of you who are not familiar with them, they are the United States Agency for International Development and self describe as “the world's premier international development agency and a catalytic actor driving development results.” Okay…they are also the agency driving around in white trucks all over Africa and Asia with the cringe-worthy signage “From the American People.” Awkward. USAID has done some not so good things in international development but it has done some good things too, dammit. They have been committed to nutrition. The Official Development Assistance (ODA) numbers that are reported in the Global Nutrition Report each year demonstrate their financial commitment. They have supported many programs at a significant scale in low- and middle-income countries. Some impactful, some, not so much. I am really screwing myself over here to ensure I never get USAID money aren’t I. Anyways, they just published the history of USAID in nutrition. It is a nice story. Check it out.

Speaking of food environments and obesity, with the Chicago Council on Global Affairs, I did a one-minute video on why is obesity such an issue globally and the importance of food systems in solving, not just contributing to the issue. If your attention span lasts the whole one minute, you can find out my favorite food. It involves a food rich in zinc!

It’s not just food systems that need to improve if we want to make a dent in the obesity pandemic, it is what is inside our bodies as well. The microbiome is the next frontier for science and its role and relationship with obesity is a complex Game of Thrones TV series - it is going to take some time to dig into the history, to understand the future and who really rules us. Some researchers argue that our microbiota is associated with the propensity of being overweight. Others argue that diet is a big driver of the biome composition and species richness, maybe more so than the biological state of nutritional status - i.e. overweight and underweight. But unraveling this game requires us to be brave, yonder north of the wall, and live in peace with the Wildlings. And John Snow. Rrrrrrr.

And as always, I throw in something just to scare the hell out of any of you who are still living in la la land thinking the world is just bliss. Check out this paper. The title reads: "Global warming has increased global economic inequality.” Boom. Do I need to say more? Now you can go back to your mind-numbing regular programming.

Just so you don’t think I am a vindictive person, I leave you with Google’s Stories of Yoga. For any of you yogi gurus out there, this is everything you want and need to know about yoga, its history, its practice and its inspiration. See? I can be nice. NAMASTE!

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.

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.

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.

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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?

Screen Shot 2019-04-13 at 2.53.16 PM.png

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:

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  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…