Food Bytes: December 2024 Edition

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

I am here in Gotham City, writing my final blog post for 2024 in the quiet. This is one of my favorite times of the year. Not because it is Christmas and New Year’s, but more so because the whole world pauses. Less email, less bustle, less stress. The opportunity to not have to click on that Zoom link for a week or two is just pure bliss. My posts as of late have gone from reflection to angst to dread, but at this moment, dear reader, I am feeling “set” — like a voluminous beehive hairdo or a delightful buttery pound cake. I am ready to take on whatever 2025 brings, as I hope you are.

This is my last Food Bytes of 2024. I managed to publish 9 (not 12) this year. I learn a ton gathering up material for the monthly Food Bytes as it forces me to do some reading, listening, and watching to highlight the prolific content being put out in the world on food systems, climate, and nutrition. I feel incredibly fortunate to work in an area so rich and doused with science, politics, culture, and controversy. This area of chosen work would be dull without those elements all jumbled together and needing constant teasing apart. So here it goes…my last Food Bytes of 2024. Hang onto your hats, guys and gals, for a very interesting 2025…

Let’s start with obesity. There is so much coming out related to obesity prevalence and trends, as well as the new GLP-1 anti-obesity class of medications (formally known as glucagon-like peptide-1 receptor agonists). Earlier this year, the NCD Risk Factor Collaborators published a paper in the Lancet showing the obesity and undernutrition trends among adults and children. They showed that we have moved from a world paralyzed by undernutrition to a world of obesity, with some countries struggling with both forms. One in 8 people are obese - or 1 billion people suffer. Many of you know this story of the nutrition transition and the double and triple burdens of malnutrition, but the overall picture over the last 30 years is quite staggering. Check out the circular bar plots of the changes in the underweight burden (the blue bar's length shows prevalence) and obesity (pink/red bar) among women in 1990 and 2022.

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Another paper just released, again in the Lancet, showed in the United States, between 1990 and 2021, the percentage change in the prevalence of obesity in adults was 123.6% in men and 99.% in women. They forecast that by 2050 if current trends continue, the total number of adults with overweight and obesity will reach 213 million. And I am not even reporting on teen prevalence. Wowsa. Yet, JAMA just published results that found that the prevalence of BMI and obesity in the United States decreased in 2023 for the first time in over a decade. Some pontificate it is because of the GLP1 inhibitors, others because of COVID-related deaths (obesity being a heightened risk factor for morbidity and mortality associated with COVID).

The difference could be that the Lancet paper by the Global Burden of Disease 2021 US Obesity Forecasting Collaborators didn’t investigate trends beyond 2021. In contrast, the JAMA authors showed a decline in 2023 specifically. Also, we don’t know the future of the GLP-1s. Currently, they are cost-prohibitive for many living in the United States and, moreover, the world. One report estimated that if half of U.S. adults with obesity took these drugs, it could cost the healthcare system $411 billion per year. The inequities in who has access to these drugs are staggering.

These medications certainly help people lose weight, with various studies showing reductions in body weight somewhere between 10-25%, as well as other benefits for those struggling with diabetes and cardiovascular disease, to name a few. I worry that we still know so little about obesity, its drivers, and the potential ramifications of medicalizing the challenge into one silver-bullet solution. I also fear that the scale-up of these drugs gets food systems and industry “off the hook.” Why stop making ultra-processed foods and ensuring food environments are healthy for people when they can easily take these drugs? But RFK Jr is going to solve all that, right? Don’t hold your breath. I appreciated this commentary by Francesca Celletti and colleagues in JAMA on where we are at in our understanding of obesity:

“The seriousness of the crisis is now widely recognized. Yet there are many challenges that continue to hinder a successful national and global response. Perceptions and attitudes toward obesity, including the debate about whether obesity represents a risk factor or a disease, are widely divergent. Efforts to address the stigma associated with obesity have, in some cases, evolved into a narrative that obscures the importance of obesity-related morbidity and mortality. Compared with other noncommunicable diseases, there remains a lack of knowledge on the associated biological and genetic factors, and there are inconsistencies in the appreciation of the effect of obesity on other noncommunicable diseases and the overall burden of disease. There is limited evidence on long-term management interventions and their effectiveness among populations most at risk and in low-income settings in relation to issues such as access and adherence.”

Speaking of nutrition trends, the Global Burden of Disease Group published their analysis on global, regional, and national progress towards achieving the six nutrition-related Sustainable Development Goal (SDG) targets by 2030. The picture ain’t so rosy. These are their high-level results: “In 2030, we project that 94 countries will meet one of the six targets, 21 countries will meet two targets, and 89 countries will not meet any targets. We project that seven countries will meet the target for exclusive breastfeeding, 28 for child stunting, and 101 for child wasting, and no countries will meet the targets for low birthweight, child overweight, and anaemia.” Looking at current trends, the authors show that in 2021, seven countries had already met two of six targets (Georgia, Mongolia, South Korea, Peru, Rwanda, American Samoa, and Puerto Rico). What are they doing right? Case studies, anyone?

Diets heavily weigh into dietary outcomes, and as the SDGs stand, there is no target or monitoring of a dietary indicator, such as dietary diversity. SDGs. One of the juggernauts of our diets is how much animal source foods we should or could consume that benefit our health and the planet. A PNAS special feature delves into this quandary in what I think is quite a balanced set of papers showing all the angles and issues. We contributed a piece laying out the biological nutritional vulnerabilities stemming from high micronutrient needs per calorie among infants and young children, women of reproductive age, pregnant and lactating women, and older adults, particularly older women, and the importance of nutrient-dense foods coming from both plant and animal-source foods. Speaking of nutrient-dense foods, some colleagues from the Blue Foods Assessment published a paper in the Environmental Research Letters that assessed nutrition-sensitive climate risk to five essential micronutrients across production systems. By mid-century (2041–2060), we estimate that 75% of calcium, 30% of folate, 39% of iron, 68% of vitamin A, and 79% of vitamin B12 produced in primary food products will face frequent climate extremes globally. Nearly 50 countries are projected to face high domestic climate risk for two or more micronutrients during this period. Check out the figure below.

Speaking of the climate crisis, I have written before about tipping points, but some scientists argue the framing is distracting and confusing. Regardless, people are fatigued and confused by all the terminology: diebacks, atmospheric rivers, bomb cyclones. Grist calls it “alert fatigue”. The question is, does the fatigue translate into inaction? The scientists in that Nature paper argue that urgency and the terms and definitions to illustrate that urgency do not always translate into political commitments. And sadly, people are being left behind. Did you hear about Cyclone Chido on the French island of Mayotte? Neither did I. People are dying from climate-related extreme events, and we aren’t even able to count the dead or notice. Unless you live in a rich country… We are really on the edge here, and leaders seem to be shrugging their shoulders. Look at this year’s various COP events - climate, biodiversity, and dry lands. Were any binding and bold commitments made? Nope. And science is under ever more scrutiny and openly ignored and disregarded by some. This title says it all: Good COP, Bad COP, science struggles under a year of environmental summits. As this editorial argues in the Lancet Planetary Health, somebody has to move first. As the editors wrote: “…The absence of consensus on the world stage should not hold back individual countries from moving rapidly away from fossil fuels and benefitting from this. Keeping warming below 2°C is still possible, and actions that limit warming to almost any degree will be beneficial, but some have to do the right thing and decisively move first.”  The question is, who will be brave enough?

But we scientists keep churning. The IPBES Nexus and Transformative Change assessment summary reports have been released (my hermano, Mario Herrero, one of the lead authors says the very long reports are coming soon). First, what is IPBES? It is the Intergovernmental Platform on Biodiversity and Ecosystem Services. It is similar to the IPCC in that it sits at the interface between science and policy and is meant to spur evidence-based political action. The Nexus report argues that we need to holistically tackle biodiversity loss, water and food insecurity, health risks, and climate change because these five areas interact, cascade, and compound each other, and addressing them separately is counterproductive, redundant, and inefficient. The Transformative report focuses on the underlying causes of the biodiversity crisis, the drivers of change, and available options and argues for a “whole of society” approach. Overall, their analysis is not a chipper one. Half of the world lives in areas hit hard by food and water insecurity and biodiversity loss. Biodiversity is in massive decline. And delaying action will be catastrophic. Action in these areas could unlock trillions of dollars in economic growth and jobs. The figure below is worth a lot. It shows a wheel of interconnected challenges (different colors) and barriers (different 637 letters) to transformative change.

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We continue to push out sound data to inform policymakers across food systems. The Food Systems Countdown to 2030 Initiative will publish its 3rd annual paper in January, so stay tuned for that. Meanwhile, a few of us at the Columbia Climate School wrote a piece for IFPRI’s Impact group on food system data gaps and the future potential to measure food systems data with new big data technology.

As you may know, I am a big fan of rivers. This poem, Rest, Like a River by Leena Danawala is a fitting way to close out 2024:

I like the idea of a river yawning:

its mouth a vast open width,

just a symptom of fatigue.

I think of how it wraps its length

around itself, serpentine and sure;

how its waves rock back and forth,

a cradle on an unsteady floor.

on days like today, when the

spring fog has melted into my bones,

or when time seems to stop or slow,

I think of my spine as that river

and curl into myself like the letter “c.”

breath floating downstream,

body swaying like the currents of the sea.

Food Bytes: February 10th Edition

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

2020 is off and running and the world finds ways to fill in the gaps it makes.

There is lots of interesting stuff being published or planned for publishing in the food systems space.

There are new journals out there. Nature Food released its inaugural issue called “silos and systems” (with a corn silo on the cover) and it is really great so far. Highly recommend reading it - all open access articles to boot! While it has been around about two years, Nature Sustainability is high-quality and publishes a lot on food systems. Colleagues at Cornell are working with the Journal to come up with evidence-based innovations across food supply chains ready for scale-up. More on this project can be found here. The prestigious Cell Journal now has a sister journal called “One Earth.” While it focuses on climate and earth sciences, there are lots of food gems in each issue thus far.

I am also serving as the Editor in Chief of the Global Food Security Journal. We publish:

1. Strategic views of experts from a wide range of disciplinary perspectives on prospects for ensuring food security, food systems, and nutrition, based on the best available science, in a clear and readable form for a wide audience, bridging the gap between biological, social and environmental sciences.

2. Reviews, opinions, and debates that synthesize, extend and critique research approaches and findings from the rapidly growing body of original publications on global food security and food systems.

I am also serving as an Associate Editor of Food Systems and the Environment for the American Journal of Clinical Nutrition. We published our 10-year vision. In that, we highlight that the Journal will be soliciting cutting-edge papers that disentangle research that spans food system activities and actors, environmental change, and health and nutrition outcomes, taking into account the rapid socioeconomic, political, and societal transitions in the 21st century. The research space is complex and requires a convergence of new disciplines to understand the benefits and trade-offs of evidence so vital to improving diets and nutrition. We are looking for agriculture, food value chains, climate, environment, and diet themes to come together to answer the many evidence gaps that impact nutrition and human health.

The Lancet series on the double burden came out in late 2019 basically showing that there is a significant increase in low- and middle-income countries struggling with both undernutrition and overweight and obesity. The second and third papers on the etiology and actions to address the double burden stand out.

There is some controversy brewing in the nutrition world. But what else is new? JAMA published a pretty scathing article about conflicts of interest stemming from the series of articles that meat is actually not detrimental, or at least, neutral for health. JAMA argues that another group of scientists basically bullied the journal into retracting the articles, which did not happen. The JAMA called it “information terrorism.” What a mess.

A few of us from GAIN and Johns Hopkins University presented the Global Food Systems Dashboard at IFPRI last week. Check out the video and highlights here. The Dashboard brings together extant data from public and private sources to help decision-makers diagnose their food systems and identify all their levers of change and the ones that need to be pulled first.  Follow updates and announcements of the official launch on Twitter.

Food Bytes: Weekly Nibbles from Mar 25 - Apr 4

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

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

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

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

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Timeline of the nutrition science field

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

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

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

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

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

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

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

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

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

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

Food Bytes: Weekly Nibbles from Jan 21 - 27

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

Environmental effects per serving of food produced

The EAT Lancet Commission report entitled: “Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems” came out this week. It was both praised and demonized but regardless, it made a big splash across many media outlets. I was part of the Commission and I must say, I felt pretty worn out with interviews and podcasts after the first week of its release. So what is the report? It was made up of 37 scientists that came together to do three things: The first was to quantitively describes a universal healthy reference diet that would provide major health benefits, and also increase the likelihood of attainment of the Sustainable Development Goals. The second was to define six scientific boundaries for food systems that would ensure a safe operating space within six Earth systems, towards sustaining a healthy planet. The third outlined five strategies needed for the “Great Food Transformation.” Establishing targets has its benefits but it also breeds controversy. I will write in some detail on the politics of the report at a later date, but for now, the link above has all the deets including a podcast I did with Professor Tim Lang.

On the same week as the EAT Lancet, a paper was quietly published in the New England Journal of Medicine by Andy Haines urging for a renewed focus on climate and health. The authors argue that “climate change is expected to alter…climate-sensitive health outcomes and to affect the functioning of public health and health care systems.” One could argue, we know this, but the fact that it was in a clinical medical journal shows the breadth of how climate change will impact all facets and medical professionals need to be thinking about how this will impact their patient populations, particularly the more vulnerable.

What wasn’t discussed much in the EAT Lancet were “food environments.” These are the places where consumers make a decision about what to buy, order or have delivered. Food environments are markets or cafeterias, or restaurants or food trucks. They look different everywhere. My colleague, Shauna Downs and I published an article in Public Health Nutrition looking at consumers’ perceptions of their food environments and their food consumption patterns and preferences in urban and rural Myanmar. The study shows that the availability of diverse foods had increased over time, while the quality of foods had decreased. Most consumers greatest concern about the foods available was the safety. Consumers preferred fruits, vegetables and red meat compared with highly processed snack foods/beverages. Although consumers reported low intakes of highly processed snack foods, Burmese street food was consumed in high quantities.

One food environment that could improve is the office. A study done by the CDC shows that nearly a quarter of respondents ate food obtained directly at their office. And the foods they ate were not necessarily healthy. Think the leftover pizza, the corporate snack bar, the candy in the jar, the cake for someone’s birthday. The study found that what they officemates ate during work hours was “high in empty calories, sodium, and refined grains, and low in whole grains and fruit.” Shocker? Not really but I do think work places need to stop making it so hard for their colleagues to eat healthy.

Enough with the studies! How about a podcast? A great one has just been started by our friends at NPR. It is called Life Kit and they “help you cut through all the nutrition noise” and provide guidance on how to eat healthy. And there is indeed a lot of noise out there. I listened to three of their podcasts - only about 20 minutes long - and they had some stellar nutrition experts including Dary Mozaffarrian who is the Dean of Tufts Friedman School and Doctors David Katz and David Ludwig. They are great, and I think provide sound advice on nutrition and what to eat. Listen to them on your way to work or even better, while exercising!

And speaking of eating healthy, here is an old video of Andy Warhol, eating a hamburger. Took him about 4 minutes.