Cultivating Sustainable, Resilient, and Healthy Food and Water Systems: A Nutrition-Focused Framework for Action

Spiker ML, Knoblock-Hahn A, Brown K, Giddens J, Hege AS, Sauer K, et al. Cultivating Sustainable, Resilient, and Healthy Food and Water Systems: A Nutrition-Focused Framework for Action. Journal of the Academy of Nutrition and Dietetics. 2020 2020/06/01/;120(6):1057-67

Relevant to:

Dietitians-nutritionists interested in a systems approach to integrating sustainability into their work.


This article describes a framework for action describing how Registered Dietitian Nutritionists (RDNs) and Nutrition and Dietetics Technicians, Registered (NDTRs) can integrate work on sustainable food systems into their profession – individually, as a profession, and in collaboration with other sectors.

The framework for action was created through a process of a roundtable meeting of 24 experts including credentialed nutrition and dietetics practitioners and external stakeholders. The meeting was held in November 2018 by the Academy of Nutrition and Dietetics Foundation as part of the Future of Food initiative (funded through an educational grant from the National Dairy Council). A preliminary framework was developed and iteratively revised by roundtable participants and other key stakeholders following the meeting.

Bottom line for nutrition practice:

The framework is intended to provide a map for the profession to advance sustainable food systems using a systems approach. It draws on skills of the profession, arguing that advancing sustainable food systems requires unique skills that nutrition and dietetics practitioners can offer, while acknowledging that additional professional development is needed. The authors also state that fulfilling a sustainability vision cannot be realized by the profession alone, noting that collaboration with other sectors is required.

The framework for action has two main segments, which are illustrated in a matrix (see Figure 3 within article). The horizontal row outlines five “entry points” for RDNs and NDTRs. These include: 1. Shape and deliver dietary guidance; 2. Improve food and nutrition security and water security; 3. Align food production and nutrition; 4. Optimize supply chains and food environments; 5. Reduce waste. The vertical access includes four cross-cutting areas (roles): 1. Education and training; 2. Research; 3. Practice; 4. Policy (organizational and public). Examples of implications for each of the 5 entry points are listed for each of the 4 cross-cutting areas/ roles. Examples are not meant to be exhaustive, but to spark discussion.

To further describe the matrix, in the case of the entry point “reduce waste”, ideas under each of the 4 cross cutting areas are given. For example, under “education and training”, students and practitioners may want to increase their knowledge of the waste management hierarchy. Under “research”, the relationship between the rescue of surplus food to food and nutrition security is listed as a potential research question. Under “practice”, identifying ways to prevent waste of food in congregate settings is noted. Under “policy”, the example of policies to prevent waste such as standardized food labeling to reduce consumer confusion is given.

The authors suggest that an individual practitioner isn’t intended to develop expertise in all of the entry points. They also note that the framework can be scaled to address issues at individual, community, institutional, population and global levels (the latter is delineated as many food systems issues cross geopolitical borders).


Abstract not provided (n/a)

Details of results:

In addition to providing specific examples within the framework, the authors provide general descriptions of how RDNs and NDTRs can be involved in each of the entry points. A brief synopsis is provided below.

1. Shape and deliver dietary guidance
RDNs and NDTRs are involved with the development of dietary guidance at population, institutional and individual levels. The authors suggest that they can increase competence and leadership in this area by bringing expertise to multisectoral research collaborations; using the best available evidence when providing sustainability-related dietary guidance; and communicating clear, evidence-based messaging with professionals and the public through a diversity of communication platforms.

2. Improved food and nutrition security and water security
RDNs and NDTRs can lead, collaborate on, and evaluate policies and programs to address underlying structural factors impacting vulnerable populations such as low-income households, disadvantaged groups and communities impacted by, or susceptible to environmental injustices. Due to the complex interrelationships between these issues, this work requires a systems approach. RDNs and NDTRs can also connect individuals to existing services.

3. Align food production and nutrition
The authors suggest that RDNs and NDTRs bring a critical perspective to efforts that ensure that our food supply advances nutritional, environmental, economic and societal goals. They therefore need to be represented in multisectoral collaboration such as research studies and policy advisory councils.

4. Optimize supply chains and food environments

As RDNs and NDTRs work in upstream settings where food is processed, packaged, distributed, and downstream settings where food made available, they hold the potential for a broad scope of influence. In upstream settings, for example, they can improve food sourcing to benefit both nutrition and sustainability. In downstream settings, they can modify the built environment to influence individual behaviour.

5. Reduce waste

RDNs and NDTRs can prevent and reduce waste of food, water, and other resources (e.g., packaging) across the food system. The authors argue that RDNs and NDTRs are uniquely positioned to lead efforts in this area, as food waste is central to issues of the profession, including food safety, consumption and individual and organizational behavior.

A list of key Academy of Nutrition and Dietetics publications related to sustainable food and water systems is provided within the text, as well as a figure outlining examples of possible collaborators for each entry point.

Of additional interest:

The authors point to curricula on sustainable, resilient, and healthy food and water systems and on food insecurity and food banking, which can be found on the American Academy of Nutrition and Dietetics Foundation website:

Editor’s comment:


Free access link to article:

Conflict of interest/ Funding:

The roundtable and associated travel costs were funded through an educational grant to the Academy of Nutrition and Dietetics Foundation from the National Dairy Council.

External relevant links:


Tags (for administration): 
Role: administration; community; dietetic educator; food service; nutrition care; public health; research
Activity: education; personal knowledge development; policy development; programming
Geographic region: Americas
Topics: food waste; water

Corresponding author: (Dr. Alison Steiber)

Transparency | Diversity | Dynamism | Evidence-based |

AdministrationCommunityDietetic EducatorFoodserviceNutrition carePublic HealthResearch
EducationPersonal Knowledge DevelopmentPolicy ChangeProgramming