Call for sustainable food systems including (medical) nutrition for hospitalised children and their families (2024)

Verbruggen SCAT, Cochius den Otter S, Bakker J, et al. Call for sustainable food systems including (medical) nutrition for hospitalised children and their families. Frontline Gastroenterology  Published Online First: 20 March 2024. doi: 10.1136/flgastro-2023-102478 (open access)

  • Key messages
    • The climate emergency is a pressing global issue that poses significant threats to human health and the environment.
    • A call to collective action from industry, legislators, and non-governmental organisations to develop standardised processes to reduce the amount of plastic in medical nutrition and associated waste.
    • To develop scalable circular economy for medical nutrition there needs to be standardisation of process and methodology, as a current lack of transparency and large-scale action hinders progress towards effecting change.
    • Research is required around behaviour change models to support the transition from animal-based to plant-based diets, including medical nutrition, for hospital patients, visitors, and staff.
    • Collective action is required for all of us, although small acts can save our planet – we need large scale action.
    • How can you get involved in advocating for your hospital to reduce the amount of medical nutrition waste?
  • Abstract
    • The climate emergency presents a profound threat to global health, adversely affecting the health and well-being of children who are projected to bear a substantial disease burden, as well as impacting children’s right to food, water, healthcare and education. The healthcare sector strives to prioritise preventative healthcare policies improving the health of individuals across the life course. However, current healthcare practices significantly contribute to greenhouse gas (GHG) emissions and waste generation, in which (medical) nutrition plays an important role.
    • Plant-based proteins offer sustainability benefits, and potential health advantages, and have a lower climate footprint, although there may also be unintended consequences of land-use change and deforestation for certain crops. However, to develop suitable plant-based alternatives to medical nutrition, it will be necessary to address regulatory obstacles as well as ensure nutritional profiles are suitable, particularly protein (amino acid) and micronutrient composition. Additionally, the development of heat-tolerant and water-efficient plant genotypes could bolster adaptation to changing climatic conditions.
    • Effective waste management, including wasted food and medical nutrition, emerges as a key strategy in mitigating the climate impact of medical nutrition. While research on food waste in healthcare settings is limited, minimising waste spillage in medical nutrition is a crucial area to explore. Healthcare professionals must acknowledge their roles in curbing the climate footprint of medical nutrition as well as recommendations for food-based approaches.
    • This review aims to investigate the sustainability of medical nutrition for paediatric care, focusing on factors contributing to GHG emissions, plant-based alternatives, waste management and plastic packaging. Such an exploration is vital for healthcare professionals to fulfil their responsibilities in addressing the climate crisis while advocating for change.
https://doi.org/10.1136/flgastro-2023-102478

Food systems-based dietary guidelines (FSBDGs, 2024)

This document is a brief introduction to the new food systems-based dietary guidelines (FSBDGs) methodology developed by FAO, which not only aims to address health and nutritional priorities but takes a food system approach to promote healthy diets, by considering socio-cultural, economic, and environmental sustainability.

Why is a food systems-based methodology necessary?

Most countries have developed dietary guidelines with a focus on improving consumers’ nutrition and overall health. Such guidelines have been mainly used for nutrition education. Only a few countries have extended their use to inform policies and interventions in other sectors, such as in public procurement and social protection.

To leverage their potential for doing more in other sectors, some countries have included sustainability considerations in new or revised dietary guidelines. However, the methodologies and approaches used by these countries differ significantly from one another and are seldom made public.

The international community has recognized the potential and need for dietary guidelines to catalyze food systems transformation towards sustainability and to influence policies beyond the scope of consumer education. However, at present, there is a lack of global guidance and tools to facilitate this.

To fill in this gap, the Food and Agriculture Organization (FAO) has developed the new food systems-based dietary guidelines (FSBDGs) methodology through a collaborative process involving multiple global, regional, and country-level experts.

Sustainability Practices in School Feeding Programs (2023 Sep)

This paper provides an overview of research on environmental considerations in school feeding programmes and a synopsis of evaluations of two school feeding programs (U.S. National School Lunch Program and Portugal) with emphasis on their environmental impacts.

The paper concludes that estimates of the environmental impacts of school feeding programs are needed to design menus and make policy recommendations, which, in turn, can reduce their environmental impacts and help students develop food preferences aligned with sustainable dietary patterns. Studies can be performed to better inform implementation of different components of new standards.

The following were strategies found to assist:
💰 Financial incentives, including local food procurement, could encourage school districts to offer beef less frequently, and provide plant-based meals on school menus.
📝 School-based curriculum that emphasizes food literacy (e.g., cooking, gardening) and marketing campaigns could ensure that menu changes are well-received by students.
🫛 Sourcing plant-based school meals seasonally and locally that use eco-friendly production practices such as organic food production and agroecology can provide environmental, economic, and social
sustainability benefits.
🧑‍🍳 Finally, introducing plant-based school meals gradually, giving careful consideration of the seasoning, naming, and aesthetics of plant-based meals, and training kitchen staff in the preparation of plant-based meals are all strategies that can be used to overcome potential implementation barriers.

This article appeared in a member-only newsletter of the Vegetarian Nutrition Dietetics Practice Group of the Academy of Nutrition and Dietetics and is shared with permission. The author, Christine McCullum-Gomez, PhD, RDN, is a food and nutrition consultant based in Bogotá, Colombia. She has a PhD in Nutritional Sciences from Cornell University with minors in Program Evaluation and Public Policy. Her research and work experience lie in food security and sustainable food systems. Dr. McCullum-Gomez is a Column Editor and serves on the Editorial Board for the Journal of Hunger & Environmental Nutrition. She is also Chair-Elect of the Global Member Interest Group (GMIG) of the Academy of Nutrition and Dietetics.

Blue Foods as Medicine Curricula (2023 Oct)

Blue Foods as Medicine is a FREE, interactive, four-module online curriculum for health and nutrition professionals and students. The modules are 1: Blue Foods Foundation, 2: Sea Vegetables, 3: Bivalves, Clams, Oysters, Mussels; and 4: Integrating into Your Practice.

The modules are self-paced and evidence-based focused on actionable ways to implement concepts across a variety of settings. There are culturally diverse recipes & resources such as shopping guides, messaging tips, case studies, plus content and programming ideas.

The curriculum widens the food as medicine lens to include sustainability considerations and an array of aquatic foods. The content is open access and shareable, thoughtfully designed to advance your learning journey and drive positive community change.

Funded by Builders Initiative and created by Food for Climate League and Food + Planet.

For more on Blue Foods, see the #ICDAsfsToolkit Hot Topic Resource Cluster: Blue Foods.

Red-Listed Seafood (2023 Aug)

At a Glance

  • Madalyn Higgins, RD, the Dietitian and Sustainability Manager at Acadia Dining Services (provided by Chartwell’s Canada) worked with the students in NUTR 4913 Sustainable Food Systems and Dietary Patterns to address this target, providing them with a meaningful experiential learning opportunity. The students were all studying to become nutrition or health professionals, at least half of them intended on a career in dietetics.
The efforts of the students focused on three areas:
  • Understanding and communicating key messages about sustainable seafood.  Students put together a comprehensive review of existing research surrounding the topic and created communications tools to be displayed in the dining hall to inform staff and students about the negative effects of Red-Listed seafood and what steps they can take to minimize these effects.
  • Identifying Red-Listed seafood on the menu. Students investigated seafood sources to determine if they are on the Red List. This meant speaking with food system actors such as distributors and fisheries and comparing information to Ocean Wise resources.
  • Exploring strategies for more sustainable menu alternatives. Students proposed potential replacements using comparable items and looked for distributors.
  • The students presented their work to the dining hall’s Chef, Dietitian and Sustainability Manager, Director of Operations and Marketing Manager.
  • These efforts aimed to promote environmentally responsible dining practices at Acadia University while raising awareness about the importance of sustainable seafood sourcing.

Background:

Buying seafood that is Red-Listed has been recognized worldwide as a significant problem, as it is linked to major concerns for our fisheries and the health of the planet such as low fish stock numbers, destabilization of the ecosystem-wide food chain, and Irresponsible fishing practices that contribute to the destruction of our oceans.

With the growing population and growing appetite for fish and seafood in developed nations, billions of people around the world rely on fish and seafood as an essential source of protein and a means of income. Researchers have gathered that this seafood should not be made commercially available and alternative options need to be considered.

Organizations such as Seafood Watch, categorize red-listed seafood through different ranking systems tailored for various types of fishing such as fisheries and aquaculture, and score them based on their sustainability criteria.

The sum of the scores allow the seafood to fall into Green (good choice), Yellow (good alternative), or Red (avoid) categories. Other organizations such as Ocean-Wise and Aquaculture Stewardship Council also assess sustainability based on Seafood Watch’s sustainability scoring system  and convert the scores from three-fold to a binary system of Green and Red. Learn more…


Lessons Learnt:

  • Through research, students gathered that the problem is that there is a lot of complexity and lack of transparency surrounding the global seafood supply chain and what seafood is sustainable to eat.
  • There is a need to improve transparency regarding sustainable seafood and ability to access this information. The group learned about the importance of understanding these tools to identify relevant information about sustainable seafood options.
  • It is everyone’s responsibility to ensure sustainable seafood consumption. Policies should be put in place to regulate how seafood is being labeled sustainable.
  • While not easy, it is possible to identify unsustainable seafood sources and replace them with more sustainable sources.
  • Sustainably sourced seafood, such as recirculating aquaculture is not perfect but can create seafood options. These options can be much more expensive, and we rely on food and nutrition professionals to get creative in the kitchen to use them more sparingly.
  • The seafood that the students helped remove included the red-listed atlantic salmon and white shrimp that was being served in the Acadia dining hall.  Students gathered sustainable options to be presented as recommendations to replace these red-listed menu items. The better choices included the Ocean Wise-approved farmed Whiteleg shrimp and the Ocean Wise-approved farmed Giant Tiger shrimp. 

What Else? Other Relevant Examples

  • Recirculating aquaculture is Ocean Wise approved by fisheries worldwide and is often used for Atlantic salmon farming. Learn more…
  • Through the Aquaculture Stewardship Council, you can search ASC-certified seafood using a simple drop-down search. Learn more…
  • Organizations such as the Marine Conservation Society create resources to help educate students about ocean sustainability. Learn more…
  • Nourish Canada has developed a Sustainable Menu Guide that can guide menus for organizations such as University campuses. The menu guide simplifies efforts o create sustainable menus that reduce environmental impact while offering healthy, affordable, acceptable, and fair food to clients.  While not specific to sustainable seafood, it is more broadly helpful with practical examples.

Food for Thought
How do we ensure that we have aquatic resources for the future, especially with the growing demand?
What kind of tools are effective or needed to empower and educate consumers to make sustainable choices?
What supports do food service providers need to serve sustainable seafood choices?

Contact Information
Madalyn Higgins, Madalyn.Higgins@compass-canada.com

Thank you to Naomi Kereliuk for facilitating this case study!

Aquatic Foods Toolkit (2023)

A World of Aquatic Foods Resources: Open-access resources designed to empower chefs, foodservice, consumer packaged goods entrepreneurs, healthcare professionals, and other aquatic food advocates in promoting bivalves and sea vegetables.

🌐 You’ll get: Free, open-access toolkits, packed with evidence-based resources, eater insights, tested messaging, nutritional guidance, and inspiring recipes. Access to an interactive Aquatic Foods Ecosystem Map, so you can connect with others creating impact through sea vegetables and bivalves.

Aquatic foods—foods derived from aquatic animals, plants, or algae—have long been enjoyed traditionally by many cultures through the centuries. They have been highlighted in recent landmark reports for their ability to help build a healthy, diversified, equitable, and sustainable food future. Few topics today at the intersection of food, cuisine, health, and sustainability are more exciting than the vast potential of foods from the sea.

For this project, Food for Climate League joined forces with Food + Planet (F+P) and set out to develop narratives that can equip foodservice, CPG, retail, and nutrition professionals to market and promote sustainable aquatic foods successfully. With funding from Builders Initiative, they developed evidence-based health and wellness messaging and narratives for sustainable and nutritious aquatic foods, namely bivalves and sea vegetables.

🪸 The research outlined in the toolkits is a mix of qualitative and quantitative work conducted in 2022 to understand the aquatic foods landscape, including current and potential focus points and narratives around sustainable aquatic foods.

Strategies for reducing meat consumption within college and university settings: A systematic review and meta-analysis (2023 March)

Citation: Chang KB, Wooden A, Rosman L, Altema-Johnson D and Ramsing R (2023) Strategies for reducing meat consumption within college and university settings: A systematic review and meta-analysis. Front. Sustain. Food Syst. 7:1103060. doi: 10.3389/fsufs.2023.1103060 (open access)

  • Introduction: Despite the considerable public and planetary health benefits associated with reducing the amount of meat consumed in high-income countries, there is a limited empirical understanding of how these voluntary changes in food choice can be effectively facilitated across different settings. While prior reviews have given us broad insights into the varying capacities of behavior change strategies to promote meaningful reductions in meat consumption, none have compared how they perform relative to each other within a uniform dining context.
  • Methods: To address this gap in the literature, we synthesized the available research on university-implemented meat reduction interventions and examined the variations in the success rates and effect estimates associated with each of the three approaches identified in our systematic review.
  • Results: From our analyses of the 31 studies that met our criteria for inclusion (n = 31), we found that most were successful in reducing the amount of meat consumed within university settings. Moreover, independent of the number of individual strategies being used, multimodal interventions were found to be more reliable and effective in facilitating these changes in food choice than interventions targeting the choice architecture of the retail environment or conscious decision-making processes alone.
  • Discussion: In addition to demonstrating the overall value of behavior change initiatives in advancing more sustainable dining practices on college and university campuses, this study lends further insights into the merits and mechanics underlying strategically integrated approaches to dietary change. Further investigations exploring the persistence and generalizability of these effects and intervention design principles are needed.

3.4.1. Success rate variations

Figure 4. Grouped bar graph comparing the proportion of interventions associated with significant reductions in meat consumption across each investigated approach. Relative to other approaches, multimodal interventions were more likely to lead to significant reductions in the amount of meat consumed within university settings (p = 0.029). No increases in meat consumption were reported.

Over two-thirds of the included interventions were associated with significant reductions in meat consumption (67.7%). The remaining interventions yielded no differences in behavior (32.3%), with none of the included studies reporting any increases in meat consumption resulting from negative reactance or rebound effects.

Between the three investigated approaches, multimodal interventions were significantly more likely to be associated with reductions in meat consumption than those targeting conscious decision-making processes or the choice architecture of the retail environment alone (p = 0.029) (see Figure 4). There was no difference in the rate of success across interventions targeting the choice architecture of the retail environment and conscious decision-making process.

Interventions using at least two strategies concurrently were also more likely to be associated with reductions in meat consumption than interventions using a single strategy in isolation (p = 0.024), though both sets of interventions significantly reduced the amount of meat consumed within university settings on at least half of the evaluated occasions. Interventions that used promotional messaging strategies, in particular, were successful 57.1% of the time when used in isolation and 76.0% of the time when used in combination with other strategies (p = 0.029).

When comparing the performance between multimodal interventions and unimodal interventions leveraging two or more strategies, multimodal interventions were associated with a higher rate of success (100%, compared to 50.0%) and a greater overall effect on food choice (OR = 2.88 [1.95, 4.64]), compared to (OR = 2.13 [1.64, 3.05]).

There were no significant differences in the success rates associated with interventions conducted in Europe and North America (p = 0.28).

*Correspondence: Kenjin B. Chang, kbc45@cornell.edu

SEAFOOD TOMORROW (2021)

cover of the book
Wilson, Annette M., Reuver, Marieke, Santos, Marta, & Marques, António. (2021). SEAFOODTOMORROW Key Achievements Booklet – Nutritious, safe and sustainable seafood for the future. Zenodo. https://doi.org/10.5281/zenodo.4696236

SEAFOOD TOMORROW was a €7m European Union Horizon 2020-funded project that ran from 2017-2021 that aimed to develop innovative sustainable solutions for improving the safety and dietary properties of seafood in Europe.

Addressing the challenge to meet the growing market need for safe and sustainable seafood, the project generated new knowledge to develop commercial solutions for improving the socio-economic and environmental sustainability of the European seafood production and processing industry.

This interactive booklet summarises the key achievements of the SEAFOOD TOMORROW project: Nutritious, safe and sustainable seafood for consumers of tomorrow.

This booklet is for all seafood stakeholders, including industry representatives, policy- and decision-makers, and seafood consumers.

They present the Eco-Innovative Solutions and Key Exploitable Results generated by the SEAFOOD TOMORROW team, including their potential or realised impact, a summary of dissemination and exploitation activities carried out, and the next steps needed to ensure maximum uptake and legacy of the SEAFOOD TOMORROW outcomes.

Marine Conservation Society & Good Fish Guide (website)

Marine Conservation Society (MSC) is fighting for a cleaner, better protected, healthier ocean: one we can all enjoy.

For a cleaner ocean, MSC campaigns to stop pollution entering our oceans, and volunteer beach cleans remove and record the litter on the UK coastline. Using science, MSC tracks the health of our waters, influences business practice, and calls for better environmental regulations.

For a better-protected ocean MSC secures space where species and habitats can recover. MSC is campaigning for a minimum of 30% of UK waters being effectively managed by 2030 to protect wildlife and ecosystems. Only seas full of life can absorb carbon and help tackle climate change.

For a healthier ocean MSC promotes sustainable fishing and seafood to minimise harm. MSC support businesses to catch, produce and source seafood sustainably and incorporate conservation into their work. The MSC Good Fish Guide highlights the most and least sustainable fish, so people can make better seafood-buying choices.

MSC makes sure ratings are as up-to-date as possible, aiming to review them all at least once every three years. Many are updated annually. Any significant changes, like new laws or new scientific evidence, may trigger an update. For transparency and credibility, MSC researches and drafts a set of ratings updates, and puts them out to consultation. Scientists, fishermen, and businesses review proposed updates and provide extra information. In between consultations and launches, MSC is working on the next set of ratings updates, so always looking out for important changes and incorporating the latest available information. MSC follows two separate processes, one for farmed seafood and one for wild-caught, allowing us to address key issues for each area.

FishChoice Calculator (Website)

Click to go to FishChoice, your personal fish calculator

This is a personal fish consumption calculator. Seafood has been recognised as a high-quality, healthy and safe food type and is one of the most important food commodities consumed worldwide. However, seafood, like other types of food, can also be a source of harmful environmental contaminants with potential to impact on human health.

FISHCHOICE is part of the H2020 project SEAFOODTOMORROW, aimed at assessing food safety issues related to priority contaminants present in seafood as a result of environmental contamination and evaluating their impact on public health.