Food Bytes: February 2024 Edition

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

As I write this, snow is floating across New York City, deeply settling me into a wintry, sedate state. Lately I have been dreaming about feeling the sun on my skin, eating juicy peaches, and wearing flip-flops…I do this every year. I yearn for crisp, cold days during the dog days of summer, but then, the blue winters come along, I long for heat, long days, and not having to spend 20 minutes layering clothes just to get out the door. That said, nothing beats homemade, hearty soups that my better half cooks up that last for several meals and doubling down on double-feature movies in the evenings. Speaking of food, let’s get to what the food world has been up to this past month – there is a lot to cover.

Scientific papers

This paper, “Health-Environment Efficiency of Diets Shows Nonlinear Trends over 1990-2011” by Pan He is getting lots of traction. They developed an indicator and applied it, as Kate Schneider (lead author of the Food Systems Countdown paper) wrote, “that builds on long-observed correlates of increasing levels of development, that is, the co-occurrence of ‘bads’ (for example, rising greenhouse gas (GHG) emissions from greater animal-source food consumption, rising risk of diet-related non-communicable disease) and the ‘goods’ (for example, the decline in child and maternal malnutrition, increased incomes and more education). With this health–environment efficiency metric, the authors sought to understand how efficiently food systems use environmental inputs to generate health outcomes.”

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They show that as countries economically grow and “develop,” they tend to see improvements in health and nutrition outcomes (reductions in undernutrition). With continued development, they see animal-source food consumption increase, with concomitant environmental degradation. This is not surprising, but it is interesting to see this indicator used to prove further the nutrition transition and how critical it is to consider planetary health with human health through our food systems. The figure to the right shows the change in dietary efficiency along with socio-economic development.

Rachel Gilbert and colleagues (including my buddy, the great Will Masters) published a fantastic paper in World Development that looked at food imports and their retail prices across 144 countries. They found that lots of food is traded worldwide, and almost half face tariffs (at a rate of 6.7%). Which foods had the highest tariffs? Vegetables, fruits, and animal-sourced foods. Where? Low- and middle-income countries, but they only account for a small portion of the cost of the diet per day. Most of the food prices consumers pay are domestic value add-ons once the foods have arrived in the country. I think I got that right…

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Although this paper came out in 2023, it is an important one by Matias Heino and colleagues. The paper shows the impacts of combined hot and dry extremes as well as cold and wet extremes on major crop commodity yields (of course…)— maize, rice, soybean, and wheat—between 1980 and 2009. They show that co-occurring extremely hot and dry events have globally consistent negative effects on the yields of all inspected crop types. Extremely cold and wet conditions reduce crop yields globally, too, although to a lesser extent, and the impacts are more uncertain and inconsistent. Check out the figure to the left.

Biodiversity is in free fall, which can impact both nature scapes and people. We know that agriculture and urbanization are two of the main drivers of biodiversity loss. This paper by Awaz Mohamed et al examined how much natural habitat is needed to ensure humans have access to the benefits of biodiversity, such as diverse food production (soil, pollination, etc.), high water quality, homeostatic climate regulation, and improved green spaces. They find that benefits significantly decline when habitat area falls below 20%–25% per km2, and 2/3 of agricultural and urban areas fall below this level globally.

Reports

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The Food Systems Economic Commission finally came out. It was a long time coming. The report assessed one specific science-based transformation pathway for food systems, which could benefit both people and the planet. This pathway is called the Food System Transformation (FST). Estimates of those benefits, measured as reductions in the unaccounted costs of food systems, amount to at least 5 trillion USD per year. When the full effects of a global food system transformation on incomes are factored in, estimates of its benefits rise to 10 trillion USD annually. See the figure to the right that shows this power of transformation.

Podcasts

I listened to two really good podcasts this past week. The first is hosted by Ambrook Research (I highly recommend receiving their weekly newsletter). It is called The Only Thing That Lasts, and in the first episode, they delve into the potential loss of U.S. farmland (spurred by the fear that Bill Gates seems to be buying it all up).

The other podcast is Barbecue Earth, a six-part podcast about meat as a commodity, the powerful industry behind meat, and a major reason our planet is overheating. The Carnegie Endowment for International Peace hosts it. The first focused on hogs…It will make you think twice about putting bacon on your egg cheese sandwich.

Media, Social and Otherwise

Eater has made life easier for you by guiding you where you should eat in 2024. Interestingly, neither New York nor London is mentioned. Good for them. But have no fear New Yorkers, this guy has been flaneuring around Gotham attempting to eat a meal representing every country in the world. He is almost there…

This will get some agronomists riled up. Here is a webinar hosted by the Rodale Institute (which has a certain world view of food systems) on the differences between organic versus conventional agriculture systems – and how these “stack up” from agronomics, carbon footprint, and economic perspectives. Guess what the conclusion is? :)

TV and movies

We have been watching season 4 of True Detective with Jody Foster and the awesome Kali Reis. It is filmed in a fictional town, Ennis, Alaska (although filmed in Iceland). It is assumed that we are in the far northern reaches of Alaska, where the community experiences complete darkness. It is inspired by North Slope Borough, a town on the northernmost point of Alaska, approximately 50% of which comprises indigenous populations. In the show, the water is contaminated (likely from mining operations), but of course, I always notice the diets. There are lots of highly processed, packaged foods, which makes some sense because of the remoteness. In real life, in many of these indigenous communities, their traditional diets are healthy but are disappearing. Much work has been done to understand how diets have changed in the northern territories of Canada and Siberia. In Northern Alaska, among the Inupiat, the Yup’ik, and other traditional communities, many elderly are trying to preserve their traditional diets. Still, conserving these dietary patterns is getting harder and harder for various reasons.

Art Meets Food

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Curious to know the most iconic food paintings? Check this out. The Normal Rockwell one is just downright creepy, but I always have time and space for Edward Hopper (who lived down the road from one of Columbia University’s campuses in Nyack, New York).

 The Clash has a song, “Lost in the Supermarket.” It’s a great song, and I think many of us can relate when entering these goliath spaces meant to nourish us. As Joe Strummer sang,

I'm all lost in the supermarket
I can no longer shop happily
I came in here for a special offer
A guaranteed personality

Last thoughts

Our good friend Cheryl Palm passed away this past month from a rare and devastating disease, Creutzfeldt-Jakob disease. She was a giant in the world of food systems and made massive contributions to land-use change, degradation and rehabilitation, and ecosystem processes. Here is a lovely tribute from our Earth Institute friends at Columbia University. I love this photo of her in her younger years, full of life. That is how I choose to remember her.

'Coz I'm the tax man

I get asked a lot about whether taxing soda is effective. There has been a lot published on taxing food and beverages that are deemed bad for us. So what gives? Does taxing soda have any impact on our health? This is my take on the science, but first, let this jig run through your head….

Should five percent appear too small
Be thankful I don't take it all
'Cause I'm the taxman
Yeah, I'm the taxman

I'll tax the street
(If you try to sit, sit) I'll tax your seat
(If you get too cold, cold) I'll tax the heat
(If you take a walk, walk) I'll tax your feet

TAXMAAAAAAAN!!!

Sugar-sweetened beverages (SSBs) are nonalcoholic beverages containing added caloric sweeteners. In addition to carbonated soft drinks or sodas, SSBs include energy and sports drinks, less-than-100-percent fruit or vegetable juices, ready-to-drink teas and coffees, sweetened waters, and milk-based drinks. SSBs are widely consumed worldwide, and the retail sales of these beverages have been increasing over the last decade. Their consumption has been associated with obesity, diabetes, heart disease, and other detrimental non-communicable diseases (NCDs). Because of their unhealthy nature, the World Health Organization has included a range of policy priorities, including SSB taxes, to help countries combat NCDs and improve the overall health of the global population.

Taxes on SSBs have been introduced in 118 countries, with 105 at the national level and 13 at the subnational level, covering 51% of the world’s population. Most SSB taxes are implemented using excise taxes (88%), with a handful of other countries implementing them through mechanisms such as import taxes, differential Value-Added Tax (VAT), Goods and Services Tax (GST), or regional sales tax (see the figure below). These excise taxes occur mainly as tax pass-throughs, in which the price increase of the taxed product falls on the consumer. In the U.S., for example, 70% of SSB taxes are passed onto consumers through higher-priced SSBs.

Types of SSB taxes being implemented around the world

In a systematic review and meta-analysis of 62 empirical studies of SSB taxes across 45 countries, the majority of SSB taxes were implemented as a tax pass-through. While the impacts were heterogeneous across the countries, the demand for SSBs was sensitive to tax-induced price increases, with a mean reduction in sales of SSBs by 15%. The sales resulted in no substitution towards healthier, untaxed beverages (e.g., bottled water). Another review argued that SSB taxes provide no substantive changes to dietary or purchasing behavior due to the lack of substitution towards healthier alternatives. Another study found that while SSB taxes modestly reduced the purchases of some taxed beverages in the taxing jurisdiction, consumers respond to the taxes by increasing cross-border shopping, in which they go outside the taxing jurisdiction and buy those same taxed beverages at a lower cost. However, taxes may spur downstream effects on other industry responses and policies, including reformulating products to reduce sugar consumption in those beverages, as was seen with the graduated sugar tax implemented in the UK.

Of the tax policies around the world, 73% are implemented in low- and middle-income countries (LMICs), with the highest in South Asia. However, LMICs face many challenges in implementing SSB taxes, including a lack of political will and resources, weak national capacity to implement policies, large informal food sectors, and substantial influence of the food and drink industry on policy development.

The question remains whether SSB taxes can result in healthier dietary patterns and reduce the health implications accompanying excess consumption of these products – particularly NCDs. Most of the evidence — particularly from  Nakhimovsky et al., 2016; Niebylski et al., 2015; Teng et al., 2019; and Thow et al., 2014 — suggests that SSB taxes have impacted the purchases of taxed products to varying degrees, but not necessarily long-term and impactful behavior change towards healthier diets and improvements in health. One potential reason may be that the SSB taxes translate to only a 5 to 22-kilocalorie reduction per capita daily. This is insufficient to have a meaningful impact on disease outcomes. Some researchers suggest that one way to deal with this is to raise the current tax rates from the current approximate 5% to 20%. This would also be aligned with the WHO’s recommendation for at least a 20% tax on SSBs. Several countries, such as Qatar and Saudi Arabia, have substantive (50-100%) excise taxes on SSBs, which are more in line with the taxation rates of tobacco.

The question is whether other foods, particularly red meat, should be taxed due to their significant implications on the environment and contributions to climate change. While consuming red meat in high amounts can contribute to NCDs, red meat is also a source of important nutrients. If a tax on red meat makes them prohibitively expensive for those who already struggle to afford these foods, it could put these nutrient-dense foods even further out of reach for the world’s poor. Thus, a “carbon tax” on red meat might be appropriate in wealthy countries with strong social protective measures and in countries with disproportionately high levels of red meat consumption.

Barriers to a just, sustainable dietary transition

As world leaders meet to discuss grand global challenges, like climate change, over champagne cocktails this week here in NY, my friend and colleague, Chris Barrett and company asked to write about what I think are the main barriers or challenges to a just, sustainable dietary transition. Hmmmm. Where to even start?

The overarching major challenge is the inequities in the ability of many people to access (physically, economically, and socially) what is considered healthy, safe, and sustainable diets. Ironically, many of these same people are the food producers for the world. Accessing these diets and adapting will only get more complex if we stay on a business-as-usual course in the context of climate mitigation and adapting to climate-related extreme weather events.

There are many reasons for this lack of access that could cut across inefficiencies across food supply and environments and demands for specific kinds of food that put the world on a dangerous course. However, there are a few barriers that I would like to highlight. This summary focuses on food systems. However, many systems and sectors are responsible for meeting this goal, such as health, economics, education, and urban/rural development.

The first challenge is unrealistic goal and recommendation setting. Goals such as the Sustainable Development Goals provide a universal road map for how we want the world to be in seven years. Still, not every goal is relevant, meaningful, or a priority for every country. Recommendations for food system transformation are often made as generalities, not articulating who is responsible, for what, and by when. They also do not indicate how these recommendations can be translated into action ‘on the ground’ in the context of established interests and constrained budgets.

The second challenge is data gaps. High-quality analytical methods and tools to collate, curate, and analyze data across food systems; integration of data sets across disciplines; and new empirical research to solve the grand challenge of sustainable development (Fanzo et al., 2020). These data gaps bring about difficulties in navigating unintended consequences or trade-offs. While there are many gaps across food systems science, I focus on diets here.

We remain unclear on what people consume, why, and their barriers to accessing healthy, sustainable diets. Global dietary intake data that are nationally and subnationally representative remain sparse. Most countries do not consistently and systematically collect individual dietary intake data, and the existing data are often based on models relying on household expenditure and consumption survey data, food balance sheet data, or data from subpopulation nutrition surveys. Although these modeled estimates may give us a sense of dietary intake and patterns of consumption, they are an uncertain substitute for robust, representative individual dietary intake data reflecting recent consumption patterns at a national level, particularly in low- and middle-income contexts. Collecting robust longitudinal dietary data would allow researchers and policymakers to understand better how diets change over time and why.

The third challenge is the politics across food systems governance. As one example, the United Nations Food Systems Summit (UNFSS) and its stock take in July 2023 is not without uncertainties and controversies, with rumblings of it all being grandiose political wonk talk. With summits, there are always questions about impact. Will all stakeholders be included? Will the needs of the vulnerable and marginalized be prioritized? Will there be a sense of urgency to scale up investment? Will there be any accountability mechanism to track commitments and hold those to account who fall behind? If this is the mechanism for food systems change and for governments to engage, these questions are critical to understand and act on.

While addressing effective governance is a sticky issue, more and more, we as researchers must engage in this space if we are to see evidence come to bear in policy- and decision-making.

Building Stronger Food Systems in the Face of Global Shocks

I recently wrote a report for the Farm Journal Foundation on the current global food system crisis and the U.S.'s role in supporting small-scale producers by ramping up agricultural development assistance. A summary is below, and the full report can be found here.

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Over the past few years, the world has faced a series of unprecedented shocks that have pushed farmers and our global food system to the breaking point. The COVID-19 pandemic, international and regional conflicts, including the war between Russia and Ukraine, and extreme weather events caused by climate change have come together to create a true “polycrisis” – significantly impacting food, fertilizer, feed, fuel, and finance available to farmers. These challenges have been extremely difficult in their own right, but worst still, they have left humanity vulnerable to any future “black swan” moments that could have severe and far-reaching consequences for global food supplies.

Recent shocks have led to high food prices and worsening hunger and malnutrition around the world. This polycrisis has disproportionately negatively impacted small-scale producers and people living in low-income, food-deficit countries who spend most of their incomes on food. Smallholders generally have low levels of agricultural productivity, high exposure to climate change and other threats, scarce assets, and poor access to information, technology, markets, and services – increasing their vulnerability to shocks.

Because Russia and Ukraine are major crop producers and fertilizer suppliers, a key input to help smallholder farmers increase their crop yields, the war between the two countries has significantly impacted global food and nutrition security. Trade bottlenecks, initially caused by the COVID-19 pandemic but compounded by the Russia-Ukraine war, have further exacerbated the crisis. Structural challenges to food systems in developing countries, including farmers’ lack of access to markets and finance, poor storage and transportation infrastructure, which contribute to food loss and waste, and persistent disempowerment of women in agriculture, mean that countless farmers and food producers were already teetering on the edge of survival; additional burdens stemming from the polycrisis have pushed many into disaster. Consumers around the world have also faced enormous pressure, as disrupted agricultural supplies have led to rising food prices and lower availability and affordability of nutritious foods. New research has shown that even modest increases in the prices of staple foods leads rapidly to negative nutrition impacts from deteriorating diet quality as low-income families shift away from more nutritious and expensive foods, including vegetables, fish, and eggs, in order to afford the increased costs of rice, wheat, maize, or other dietary staples.

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A global map of the number of people with acute food insecurity, mid-2022

Through its whole-of-government Feed the Future initiative, the U.S. has an important role in enabling farmers and food systems in developing countries to withstand shocks better. Supporting global food and nutrition security is in America’s best interest both from an economic and national security standpoint. Studies show that U.S. investment in international agricultural development, research, and innovation benefits both developing countries and U.S. producers and consumers, far exceeding its costs.

Key Recommendations

Agricultural research and development (R&D) can help developing countries address their own unique challenges and shore up local food systems to withstand shocks better. Unfortunately, there have been significant decreases in inflation-adjusted U.S. and multilateral investment in food systems R&D to countries and universities in recent years, and important institutions, including CGIAR have seen fluctuations in research funding.

The U.S. government is uniquely positioned to lead investments in international agricultural research by virtue of its unparalleled capacity from the federal, university, private sectors and to generate benefits that would simultaneously help smallholder farm families around the world and American farmers and ranchers. The U.S. can strengthen its portfolio by providing additional resources to initiatives such as CGIAR, U.S. Feed the Future Innovation Labs, and the Foundation for Food and Agriculture Research (FFAR), and by partnering with institutions with long histories of designing and delivering research for development overseas, such as the International Fund for Agricultural Development (IFAD). Within this context, the U.S. should consider targeting additional research funding toward the following areas to increase impact:

1. Climate change adaptation and mitigation: The impact of climate change on agriculture is expected to intensify in coming years, and more investments are needed to improve smallholder resilience, productivity, and incomes. Areas that need increased research investment include drought-resistant crop varieties, better on-farm water management and improved irrigation, more precise fertilizer application, and additives to cattle feed to improve feed efficiency and/or reduce enteric methane emissions.

2. Soil health and nutrient management: More research is needed into solutions that can reduce global dependence on Russian fertilizer. The U.S. should consider investing in R&D and partnering with the private sector to develop and scale up green fertilizer, biofertilizers, fertilizer alternatives, and innovations that boost fertilizer efficiency and nutrient uptake.

3. Crop diversity and nutrition: Low productivity, high production risks, and insufficient diversification towards producing more nutritious foods are critical drivers of the elevated cost of healthy diets, especially in low-income countries. More research should focus on developing sustainable and scalable production methods for various crops, including fruits, vegetables, legumes, nuts, improved forages for climate-smart animal nutrition, and where appropriate, biofortification and fortification of crops and food. In addition, more research is needed to improve the affordability of animal-source foods, such as fish, eggs, and dairy, that would enhance both nutrition and livelihoods.

4. Access to markets and finance, especially for women: Research could focus on how to address barriers to smallholders’ access to credit and market information, ways to develop new market linkages, innovative financing models, and partnerships with development banks to expand lending to farmers, and how to improve farmer organizations’ capacity to negotiate with buyers.

5. Supply chain infrastructure: Inadequate food storage, poor road infrastructure, limited food preservation capacity, and the lack of physical access to food markets, especially for perishable foods, lead to significant food losses and inefficiencies along supply chains in many developing countries. Innovations focused on the infrastructure needs of small-scale producers and strategies developed to address those needs could help attract additional investment on-farm and across the entire food system.

6. Local capacity building: Giving voice and agency to local producers allows for their participation and leadership in R&D funding and prioritization decisions. Without their engagement from the start, adoption of technologies and other R&D tools produced could be futile. It is also critical to ensure that R&D investments do not cause unintended negative consequences, burdens, or harms, particularly for women who already face significant hurdles.

Can Fixing Dinner Fix the Planet?

Two years ago, I embarked on the writing of my very first book. Coming from a field of expertise that values peer-reviewed scientific publications more than books, I did not think it was in the cards to consider authoring a book about my discipline and my experience working in that discipline. But here we are, and tomorrow, my JHU Press Wavelength series trade book, Can Fixing Dinner Fix the Planet? will be released. The pandemic helped, unfortunately. It nudged me to sit still and put pen to paper.

The book investigates the interactions among food systems, diets, human health, and the climate crisis. It draws on my experiences (along with my team and many colleagues) working and living in Africa, Asia, Europe, and the Americas. It describes how food systems must change to slow and reverse the stark trends we see with increased hunger and obesity, catastrophic climate change, and inequities. The book draws attention to the idea that the very nature of food and food systems can play a significant role in fixing these vexing challenges and bring communities together.

Food books abound—cookbooks by celebrity chefs (thanks Anthony Bourdain!), history of food and cuisines, and self-help diet books. My book does not delve into these areas much. Instead, it delves deep into politics and shows that if we take a “business as usual” path of how food systems have, are, and will operate, there will be significant negative consequences on human and planetary health. It provides examples of what can be done by the various actors like government and food and agriculture industries to promote healthy, sustainable, and equitable diets, sustain the earth’s biodiversity, and protect the environment and all species living on the planet. And last, it raises readers’ food and environmental literacy and empowers readers to take immediate and long-term changes by helping them make informed decisions when they walk into restaurants, grocery stores, farmers' markets, and their kitchens.

The book changed the way I communicate my work. It is not easy to write about a complex topic like food systems and ensure that it inspires eaters, global experts in governments, and those working in and shaping food systems to make better decisions. I tried my best to bring to life some of my experiences working in different countries—from very poor to prosperous—and the experiences of those I have worked with and shared time with in deeply rural and urban pockets of the planet. It provides a nuanced story that takes you away from computer and desk research to farmer’s fields, families’ kitchens, and United Nations’ working forums.

I hope the book shows readers how our everyday diets are the products of massive, interconnected, and highly complex food systems that extend from the seedlings in a farmer’s field to the global distribution and marketing networks that deliver food to our plates. These systems have direct and substantial impacts on poverty, the planet’s natural resources, the nutrition of individuals and populations, the composition of the atmosphere, and social equity. They also are incredibly vulnerable to the climatic changes that we have already seen and that will accelerate in the future.

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.

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?

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:

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…

Nutrition and Agriculture Research: Some Thoughts

I recently was asked to provide some commentary at the International Food Policy Research Institute (IFPRI) at the ARENA-II (Advancing Research on Nutrition and Agriculture) project policy seminar. I thought I would post my speaking notes on what I think is a really fascinating set of research findings stemming from the project. The seminar presented new research on food markets and nutrition including cross-country studies of the costs of nutritious foods and nutritious diets as a whole, and case studies of fish, dairy, and poultry products. The event can be watched here.

ARENA is trying to understand markets in low-income contexts. Markets play a key role in delivering food and nutrition, even for poor and remote rural households. But nutrient-rich foods, especially animal-sourced foods, are very expensive in poor countries, suggesting that markets for perishable but nutritious foods are not functioning well. Both scientific research and real-world programs have largely focused on farm-level interventions to diversify household production and consumption, not recognizing the important role of market purchases.

The major findings coming out of ARENA:

1. Nutritious foods are typically very expensive sources of calories in low income countries, although there are exceptions.

2. Consumption patterns are strongly associated with prices - price variations explains a LOT of the gap between low and high consumers.

3. Indirect evidence that non-price factors (also implicit price factors) matter a lot: e.g. refrigeration and water quality.

4. No single solution for improving affordability or increasing consumption:

• Eggs: domestic productivity is key, often improving feed sectors (maize, soybean, fishmeal).

• Dairy: production in some countries, but trade in others. Markets work incredibly badly in rural areas.

• Fish: cheap and nutritious but under-appreciated by consumers.

• Domestic and international value chains very important, but also important to think about industrial policy: e.g. How do we create a viable modern dairy industry that delivers affordable safe milk to both rural and urban consumers?

My talking points:

Diets are significant risk factors of morbidity, disability and mortality

The Global Burden of Disease based out of the University of Washington in Seattle has recently assessed the burden of malnutrition in all its forms for the Syndemic commission report in the Lancet. Globally and in the lower income countries, malnutrition in all its forms (shown as the contributions of undernutrition, high. body-mass index, and dietary risks) contributes as much disease burden as high blood pressure, tobacco, high fasting blood glucose and water, sanitation and hygiene combined. For countries with a low Socio-demographic Index, undernutrition incurs a much higher burden both in absolute terms and relative to the other leading contributors. The recognition that undernutrition and obesity are both due to poor diet quality and a low variety of healthy foods is a more helpful perspective to resolve nutrition problems collectively.

Our knowledge of diets is still a black box

Understanding what people are eating is important to shape food system and nutrition policies, including dietary guidelines. However, determining what people are eating, remains somewhat of a black box. We don’t know key questions such as, what are people actually eating? Where do they get their food from and how much do they pay, or are willing to pay for food? What influences their dietary choices? Does health or even the environment factor into their decision making? Data on diets and their sourcing and costs are developing with better use of metrics and surveys that feed into larger databases. We are learning more and more with each passing year. We still have significant gaps in low-income settings on many of these questions.

Diets are inequitable

We are really living in a time of haves and have nots. Globally, there is a significant debate going on about the impacts of animal source foods (mainly large ruminants) on climate change, the environment and on human health. Clearly, this debate sits with high-income countries and those countries which produce and consume vast quantities of meat that do not align with the sustainable development goals. However, we know that the production and consumption practices of some, will impact the many living in low-income countries who do not have the resources to adapt and change rapidly and are limited in their options. The inequities are staggering - the rural, the poor, the geographically isolated struggle to get enough animal source foods that are important, particularly for young children who are growing and developing and need nutrient-rich foods high in iron, zinc, protein, D, B12 etc. The ARENA study advances are understanding of the challenges that rural populations face in getting access to these critical foods – eggs, dairy and fish, rich in important nutrients and other health promoting properties – through both informal and formal markets. While the evidence is growing on the impacts of on-farm production to dietary diversity of households, we know rural peoples, smallholder farming families and day labor workers are net buyers of food and they need market that work.

 My questions

I know the ARENA is meant to of course shed and shine a light but it is also meant to set out a research and policy agenda. Here are some of my questions that I was left wondering about for future research:

• Infrastructure is so important. Not just roads but technology and innovation along supply chains. What would be the role of the private sector or PPPs to accelerate action and get over the barriers to access?

• We cannot think about commodities as stand alone. They interact (the ARENA shows how important feed sectors (maize, soybean, fishmeal) are critical for the growth of animal source foods). How do we grapple this with land use changes?

• The enabling environment is key. What should policies focus on? Subsidies? Trade?

• Changing food environments or markets. How shall we measure changes and rapid shifts that we are seeing in many rural places, with the encroachment and influence of urban hubs? I would be keen to see how processed, packaged foods are changing the diets and market landscape in rural places.

• Many consumers all over the world are driven by the same issues - price, convenience, taste. Other factors matter too like reliability and safety. How do we get consumers to care more about nutrition or is that completely unrealistic? What are the trade-offs?

• Eggs: Can these rural areas shift from scavenging systems to intensive systems? How realistic is that? How much does that cost? Is there infrastructure and investment to do this? There is new evidence showing eggs increase cholesterol and heart disease risk - once again, eggs are deemed to not be god for us. Should we be worried about future burdens if we are promoting these foods to children to improve nutrition?

• Dairy: Lactose intolerance. The expression of lactase which digests lactose from milk in humans is generally lost after weaning, but selected mutations influencing the promoter of the lactase gene have spread into the human populations. This is considered a classical example of gene-culture co-evolution, and several studies suggested that the lactase gene has been under strong directional evolutionary selective pressure in the past 5000 to 10,000 years. These data indicate that a combination of socio-economic, ethnic and evolutionary factors converged to shape the genetic structure of lactase persistence in East African populations. A Lancet systematic review study in 2017 showed that lactose malabsorption is widespread in most of the world, with wide variation between different regions and an overall frequency of around two-thirds of the world's population. 63% (54–72) in sub-Saharan Africa. Lactose malabsorption was also widespread in Africa. including northern Africa (53–84%) and sub-Saharan Africa (77–100%), with the exception of Niger (13%), Kenya (39%), Sudan (55%), and Tanzania (45%) - pastoralist populations. I am keen to learn more about this?

• Fish: What would be the strategies to improve the status of fish among consumers as they get wealthier? What role does aquaculture play in these areas and ensuring feed is affordable and more sustainable? What about alternative feeds?

• Are there gender links to any of these commodities as they become commercialized and how does that change household intake of these foods?

• How do we ensure these rural places thrive? Someone needs to feed this growing urban population. Who will it be and how if rural places struggle to feed themselves?