Food bytes: March 21st edition

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

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

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

Locusts in east africa (copyright: BBC News)

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

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

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

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

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

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

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

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

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

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

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

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

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

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.