Food Bytes: Aug 2024 Edition

August 24, 2024

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:

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.

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!

How much does it cost to eat a decent meal?

July 28, 2019

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

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

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

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

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

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

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

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

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

Energy-dense foods composed of refined grains, added sugars, or fats are cheaper per calorie than are the recommended nutrient-dense foods.
Lower-quality diets, with a higher content of added sugars and fats, were generally less expensive on a per-calorie basis.
Cheaper and more energy-dense diets, often devoid of vegetables and fruit, tend to be selected across different countries by lower-income groups.

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

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

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

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

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

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

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

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

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

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