Equity – Sustainability

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Measurement of diets that are healthy, environmentally sustainable, affordable, and equitable: A scoping review of metrics, findings, and research gaps (2023 Apr)

Citation: Webb P, Livingston Staffier K, Lee H, Howell B, Battaglia K, Bell BM, Matteson J, McKeown NM, Cash SB, Zhang FF, Decker Sparks JL and Blackstone NT (2023) Measurement of diets that are healthy, environmentally sustainable, affordable, and equitable: A scoping review of metrics, findings, and research gaps. Front. Nutr. 10:1125955. doi: 10.3389/fnut.2023.1125955

Introduction: Research on the impacts of dietary patterns on human and planetary health is a rapidly growing field. A wide range of metrics, datasets, and analytical techniques has been used to explore the role of dietary choices/constraints in driving greenhouse gas (GHG) emissions, environmental degradation, health and disease outcomes, and the affordability of food baskets. Many argue that each domain is important, but few have tackled all simultaneously in analyzing diet-outcome relationships.

Methods: This paper reviews studies published between January 2015 and December 2021 (inclusive) that examined dietary patterns in relation to at least two of the following four thematic pillars: (i) planetary health, including, climate change, environmental quality, and natural resource impacts, (ii) human health and disease, (iii) economic outcomes, including diet cost/affordability, and (iv) social outcomes, e.g., wages, working conditions, and culturally relevant diets. We systematically screened 2,425 publications by title and abstract and included data from 42 eligible publications in this review.

Results: Most dietary patterns used were statistically estimated or simulated rather than observed. A rising number of studies consider the cost/affordability of dietary scenarios in relation to optimized environmental and health outcomes. However, only six publications incorporate social sustainability outcomes, which represents an under-explored dimension of food system concerns.

Discussion: This review suggests a need for (i) transparency and clarity in datasets used and analytical methods; (ii) explicit integration of indicators and metrics linking social and economic issues to the commonly assessed diet-climate-planetary ecology relationships; (iii) inclusion of data and researchers from low- and middle-income countries; (iv) inclusion of processed food products to reflect the reality of consumer choices globally; and (v) attention to the implications of findings for policymakers. Better understanding is urgently needed on dietary impacts on all relevant human and planetary domains simultaneously.

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fnut.2023.1125955/full#supplementary-material

*Correspondence: Patrick Webb, patrick.webb@tufts.edu

Aquaculture Stewardship Council (Website)

The Aquaculture Stewardship Council (ASC) is the world’s leading certification scheme for farmed seafood – known as aquaculture – and the ASC label only appears on food from farms that have been independently assessed and certified as being environmentally and socially responsible. Aquaculture produces over half of the seafood eaten around the world and will be vital in providing healthy, affordable protein to the world’s rapidly growing population in the future. But like all food production, it has impacts and must be done responsibly.

ASC develops and manages the strictest standards in the industry. These standards include hundreds of requirements covering the potential impacts of aquaculture – including water quality, responsible sourcing of feed, disease prevention, animal welfare, the fair treatment and pay of workers, and maintaining positive relationships with neighbouring communities.

The ASC Metrics Methodology project to creates transparency and consistency into the ‘metric’ standard-setting. The ‘Baseline’ Methodology published in November 2020 was issued for a 62-day public consultation period. It is applicable to all species-specific metrics and aims to provide minimum requirements for setting and/or revising metrics within any of the ASC standards.

Click here to find a farm, supplier, or product around the globe. You’ll also be able to access ASC country / regional websites from this link as well.

The Aquaculture Stewardship Council (ASC) was launched in 2010 and we have been collecting data since the first farms achieved certification against our standards in 2012. You can visit their dashboard to see what countries are covered and how many frames and products are included. This provide an important picture of ASC’s growth, the reach of environmentally and socially responsible seafood choices, and inform market opportunities. Aggregated data are often used by stakeholders in their own research and understanding on responsible farming practices.

Click here to explore the database via the ASC dashboard.

Updated 2023 April

The importance of food systems and the environment for nutrition (2020)

Fanzo J, Bellows AL, Spiker ML, Thorne-Lyman AL, Bloem MW. The importance of food systems and the environment for nutrition. The American Journal of Clinical Nutrition. 2020;113(1):7-16.

Open access link to article:

https://pubmed.ncbi.nlm.nih.gov/33236086/

Relevant to:

Dietitians-Nutritionists involved in research to advance sustainability in global food systems and nutrition.

Question:

The authors identify research and information gaps needed to transition nutrition and food systems toward sustainability and put out a call from the American Journal of Clinical Nutrition (AJCN) for innovative food systems research. They also provide an overview of the rationale for the transition.

Bottom line for nutrition practice:

Climate change and environmental degradation affect human health by impacting clean air, drinkable water, food safety and exposure to pathogens, and the ability to produce and gather plant and animal-based foods. These impacts have a disproportionate effect on poor and marginalized populations, further increasing equity gaps in nutrition and health outcomes.

Environmental changes are both drivers of changes in food systems, and also impact food and agricultural outcomes; this results in a feedback loop. For example, greenhouse gas emissions from agricultural production impact climate temperatures, which in turn impact food production.

The authors maintain that nutrition professionals have a broad expertise and are well positioned to collaborate with other disciplines in order to further sustainable food system practices (e.g., reducing food loss and waste, advancing sustainable agricultural practices, and forwarding sustainability in food services and food environments).

They identify numerous gaps in knowledge – including the need for a greater understanding of the relationship between agriculture, food value chains, climate, environment, diet, nutrition, and human health, as well as how a transition can be made (e.g., what are effective public health and policy interventions to advance sustainable food systems?).

Abstract:

Global and local food system transformation is necessary in order to ensure the delivery of healthy, safe, and nutritious foods in both sustainable and equitable ways. Food systems are complex entities that affect diets, human health, and a range of other outcomes including economic growth, natural resource and environmental resiliency, and sociocultural factors.

However, food systems contribute to and are vulnerable to ongoing climate and environmental changes that threaten their sustainability. Although there has been increased focus on this topic in recent years, many gaps in our knowledge persist on the relation between environmental factors, food systems, and nutritional outcomes.

In this article, we summarize this emerging field and describe what innovative nutrition research is needed in order to bring about food policy changes in the era of climate disruption and environmental degradation.

Details of results:

The authors present the case that climate change and environmental degradation will have severe impacts on human health. They cite research suggesting that low latitude areas of the globe will have reduced crop yields as a result of climate change, whereas higher latitude areas may have increased yields in the short term. Increasing CO2 in the environment may also impact the nutrient content of foods. Lower yields, instability, decreased micronutrient content and increased costs disproportionately threaten poor households.

Further, these differences across the globe may result in a greater reliance on global rather than local food supplies, which the authors suggest will further threaten equity, food sovereignty and sustainability of food systems. Increased temperatures will also cause an escalation of crop pests and pathogens, and toxic producing algal blooms in marine systems.

The authors argue that many knowledge gaps in our understanding exist and propose a conceptual framework to further examine human health, food systems and the environment. It consists of:

environmental inputs (e.g., soil quality, temperature, ocean acidification);
food system (i.e., food supply; food environment; consumer behavior);
proximal outcomes (i.e., food safety exposures; diet; food loss and waste);
distal outcomes (nutrition and health; environment (e.g., greenhouse gas emissions)).

The framework illustrates how distal outcomes in turn influence environmental inputs in a feedback loop. Knowledge gaps are outlined in more detail under components of their conceptual framework.

i. Environmental inputs and food system processes
As well as noting gaps such as research lacking on middle of the food supply chain (versus production and consumer dietary intake), the authors stress the need to understand more about designing food environments to advance health and sustainability. For example, including ecological footprint of foods, the amount and type of packaging used, eco- and health labeling on food packages, food sourcing origins and food safety information. They also stress that more research on policies and interventions that effectively incentivize healthy and sustainable diets is required – from both the position of consumer and of food supply chain stakeholders.

ii. Proximal outcomes of the food system

Diet: The authors identify the lack of data both in what people consume, and also in methods to test the effectiveness of interventions to advance healthy and sustainable diets.
Food safety in the food system: A paucity of data is noted in relation to human health effects and exposure to chemical and biological agents, including pesticide use and plastic packaging. They also highlight the importance of understanding consumer perceptions of pesticide, chemical, and antimicrobial exposure and how this may impact decisions on food purchasing.
Food loss and waste: The authors identify the need for more accurate data on food loss and waste as well as cost effective policies and interventions to reduce it (see: of further interest, FAO Food Waste Index).

iii. Distal outcomes of food systems:

Nutrition and health outcomes: The authors cite The Global Syndemic Commission (see: of further interest) where the “syndemic”—”the consequences of undernutrition, overweight/obesity, and climate change”—are presented as interconnected (p. 12). They also note that uncertainties remain about the impacts of environmental degradation and climate change on micronutrient deficiencies.
Environmental outcomes: The impacts of food systems on environmental outcomes differ by region and method of food production. Further, research to date centers more so on high income countries, greenhouse gas emissions, and livestock and staple grain products.

While the authors maintain that nutrition professionals are well positioned to address healthy and sustainable food systems, they also suggest that more data is required.

Further, they stress that different geographical, political, and societal contexts will greatly impact how the issues are addressed by stakeholders within various countries including professionals and governments.

Finally, this article is a call by the American Journal of Clinical Nutrition (AJCN) for cross-disciplinary, innovative food systems research that will inform action at various geographical levels across the globe.

Of additional interest:

The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report (2019) https://www.thelancet.com/commissions/global-syndemic

FAO Food Waste Index (2021): https://www.unep.org/resources/report/unep-food-waste-index-report-2021

Editor’s comment:

n/a

Conflict of interest/ Funding:

The authors reported no funding received for this study.

Corresponding author:

jfanzo1@jhu.edu

Nordic food systems for improved health and sustainability: Baseline assessment to inform transformation (2019)

According to the report “Nordic food systems for improved health and sustainability: Baseline assessment to inform transformation (2019)”, there are sufficient data on Nordic food systems to understand the crucial action areas and to begin taking immediate steps towards food systems transformations. A transformation implies a journey into aspects partly unknown and untested. The report highlights the complementarity of scientific assessment and normative dialogue on this journey.

Dietitians and Nutritionists (D-Ns) are key to this! From the report:

Food system actors would benefit from building a common understanding of desired pathways towards transformation, which should be informed by the best available evidence. This can be achieved through sustained, cross-sectoral (e.g. policy, business, research, civil society, producer, consumer) stakeholder dialogues. It is particularly important to include stakeholders who are often marginalized in these types of collaborative decision-making processes.

There will be challenges to initiating these changes, such as adopting a ‘whole food system’ approach; addressing trade-offs among food system goals; and confronting prevailing forces and lock-ins. Yet these challenges should not be an excuse for inaction.

Key messages

Food systems should be a critical lever of change in the Nordics to reach global health and environmental sustainability commitments.
The gap between current and desired food systems is substantial enough to require transformative change.
An integrated food systems approach aligning agricultural, production, trade, manufacturing, retailing and consumption priorities must be taken.
There is enough evidence on necessary food system changes to begin action in setting current food systems on a trajectory towards healthy and sustainable development.
Sustained, multi-sectoral forums are needed to steer Nordic food system transformation.

Next steps

Begin immediate action to transform Nordic food systems
Initiate a multi-stakeholder scenario development process to define a common vision for Nordic food systems
Develop strategies to handle the trade-offs of change
Evaluate Nordic food systems in the global context

Acknowledgement: This page is an extracted from the introduction to the report.

Guide to a healthy and low-cost diet for families with children (2020)(Spanish)

The ICDA SFS Toolkit Regional Contact for Spain, Júlia Muñoz (@juliamunoz_dn in our COP), collaborated with her colleagues (Dr, RD Elena Carrillo, RD Marta Anguera, and Dr Irene Cussó) in the development of this document to help citizens follow a healthier and more sustainable diet at the minimum cost. This guideline is based on the results of a previous European-lead research carried out at Blanquerna School of Health Sciences Ramon Llull University to promote a healthy and economical diet for different types of families. They then worked with the Barcelona City Council to publish two documents:

1) Guide to a healthy and low-cost diet for families with children. The guide can serve municipal professionals and other social agents or entities to support families in situations of social vulnerability in the field of food. The ultimate goal is to have a useful tool that families and entities can use to quickly manage the fundamental right to adequate food with a small budget.

2) A booklet on Healthy and economic food for families with children. This is a practical booklet for all citizens, mainly aimed at families with children and adolescents from 18 months to 18 years old, especially in situations of economic difficulties, which provides them with guidance and recommendations to prepare healthy and economic daily meals. The guide provides a shopping list for different types of families, seasonal menus, and an estimated cost for one person. The sample menus were prepared based on recommendations of the Spanish Society of Community Nutrition and the Public Health Agency of Catalonia.

Júlia explains that the recommendations include practices for food sustainability such as the use of leftovers to create new recipes or select seasonal foods. Given the current situation of increasing food insecurity due to the rise of food prices, and acknowledging that when people suffer from stress they tend to eat convenient and non-healthy foods (which have a high environmental impact apart from impairing health), it is important to identify these types of resources to keep promoting sustainable diets in a practical way.

EFAD Position Paper: Sustainable Dietary Patterns (2021)

An interdisciplinary approach is needed to successfully integrate more sustainable healthy diets into a complex system of food production and supply. To achieve that goal, European dietetic associations and the European dietitian workforce are committed and willing to promote healthier and more sustainable dietary patterns through affordable diets that are diversified, nutritious, less resource-intensive, and produce minimal waste.

EFAD also asks European countries to review their national food-based dietary guidelines to include sustainability aspects as a connecting force for the health and the environment and calls upon policymakers, civil society, food industry, farmers, and consumers to support actions and policies which facilitate transitions towards a healthier and greener Europe.
The time is now and the European dietitians are ready.

The position Paper was developed as part of the Sustainable Dietary Patterns Program of EFAD Learning supported by an unrestricted educational grant from Danone and Nestle. it was adopted by an EFAD General Meeting October 2021. It was developed an EFAD working group: Manuel Moñino, Andreja Misir, Katerina Belogianni, Klaus Nigl, Ada Rocha, Angela Garcia Gonzalez, Katarzyna Janiszewska. EFAD Position Paper on Sustainable Dietary Patterns was originally published in Komp Nutr Diet 2021;1:118–119 DOI: 10.1159/000519851.

EFAD is the umbrella organisation for the National Dietetic Associations across Europe. Their primary goal is to improve nutritional health and promote sustainable diets in Europe by advocating the leadership role for dietitians in collaboration with members and stakeholders. All with the aim of improving the health and lives of European citizens.

Native Food Supply Chains Report by First Peoples Worldwide (2022 Nov)

From 2021-2022, via direct engagement with over 85 Native food producers and entrepreneurs, First Peoples Worldwide collected qualitative and quantitative information from Native farmers, ranchers, harvesters, fishers, chefs, and practitioners to examine the current state of Native food supply chains and to collate recommendations towards strengthening and expanding these chains from Native perspectives. In addition to nearly 40 recommendations, overarching themes are:

Native food businesses are creating food systems that care for both Native and non-Native people, guided by Indigenous values and self-determination.
Systemic racism and inequitable access to capital continue to have profound and far reaching impacts on Native food systems, from lack of infrastructure to limited personnel bandwidth.
Many of the barriers limiting the current supply of Native-produced foods can be addressed through creating sustained and equitable access to capital.
At the broadest level, Native food producers are creating immense social value through their work, guided by Indigenous values that see the interconnections between Native food systems and individual, social, and environmental wellbeing.

Sustainable healthy diets – Guiding principles (2019)

Acknowledging the existence of diverging views on the concepts of sustainable diets and healthy diets, countries have requested guidance from the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) on what constitutes sustainable healthy diets. The two organisations jointly held an international expert consultation on Sustainable and Healthy Diets from 1 to 3 July 2019 at FAO headquarters in Rome, Italy, to address these issues.

The Consultation agreed on guiding principles for what constitutes “Sustainable Healthy Diets”. This comes at a time when the debate around the sustainability of diets is high on the agenda of governments, international organisations, civil society organisations, the private sector and academia.

These guiding principles take a holistic approach to diets; they consider international nutrition recommendations; the environmental cost of food production and consumption; and the adaptability to local social, cultural and economic contexts. At the Consultation the experts agreed on the term “Sustainable Healthy Diets” which encompasses the two dimensions – sustainability and healthiness of diets. Countries should decide on the trade-offs according to their situations and goals.

These guiding principles emphasize the role of food consumption and diets in contributing to the achievement of the SDGs at country level, especially Goals 1 (No Poverty), 2 (Zero Hunger), 3 (Good Health and Well-Being), 4 (Quality Education), 5 (Gender Equality) and 12 (Responsible Consumption and Production) and 13 (Climate Action).

This publication on Sustainable Healthy Diets – Guiding principles (2019) aims to support the efforts of countries as they work to transform food systems to deliver on sustainable healthy diets.

Farm to Fork strategy for a fair, healthy and environmentally-friendly food system (EU, 2020)

The Farm to Fork Strategy is part of the European Green Deal aiming to make food systems fair, healthy and environmentally-friendly. Food systems cannot be resilient to crises such as the COVID-19 pandemic if they are not sustainable. We need to redesign our food systems which today account for nearly one-third of global GHG emissions, consume large amounts of natural resources, result in biodiversity loss and negative health impacts (due to both under- and over-nutrition) and do not allow fair economic returns and livelihoods for all actors, in particular for primary producers. Putting our food systems on a sustainable path also brings new opportunities for operators in the food value chain. New technologies and scientific discoveries, combined with increasing public awareness and demand for sustainable food, will benefit all stakeholders.

The Farm to Fork Strategy aims to accelerate our transition to a sustainable food system that should:

have a neutral or positive environmental impact
help to mitigate climate change and adapt to its impacts
reverse the loss of biodiversity
ensure food security, nutrition and public health, making sure that everyone has access to sufficient, safe, nutritious, sustainable food
preserve affordability of food while generating fairer economic returns, fostering competitiveness of the EU supply sector and promoting fair trade

Impacto ecológico de la alimentación en España (2022)

Presentamos la nueva edición (31) de Cuadernos de las Cooperativas de Consumidores con un monográfico sobre el «Impacto ecológico de la alimentación en España». Nuestros hábitos de alimentación y el sistema actual de producción y consumo de alimentos tienen un indudable impacto en la salud del planeta, de manera que las decisiones de compra y consumo deberían ser tomadas con la mayor información posible.

Como sociedad, es necesario avanzar hacia modelos más sostenibles y todos los eslabones de la cadena alimentaria deben contribuir a mitigar el impacto ambiental de nuestras prácticas y actividades. Analizado en términos de oportunidad, el camino hacia la sostenibilidad se presenta como un buen momento para transformar nuestro sistema alimentario.

En este trabajo se aborda, desde el punto de vista del sector de la alimentación, cómo nuestros comportamientos y decisiones de consumo generan considerables impactos ambientales y qué se necesita para minimizar los efectos de nuestros hábitos cotidianos con respecto a los alimentos. Esta publicación forma parte del Proyecto “Impacto ecológico de la alimentación”, subvencionado por Ministerio de Consumo, y cuenta con el apoyo y colaboración del Ministerio de Agricultura, Pesca y Alimentación.

Hemos conseguido reunir las reflexiones de responsables en la materia y reconocidos especialistas, incluyendo los aspectos normativos y nutricionales, dando voz al sector de la producción y la distribución comercial. Cada artículo se aproxima al problema con un punto de vista diferente, configurando un completo trabajo de lectura recomendada.

Las personas consumidoras quieren reducir su huella ecológica y ya apuestan por las empresas que se comprometen y actúan para reducir tanto sus emisiones como los impactos ambientales. Pero cada día es más patente la gran distancia que existe entre la intención y la acción. A esto se añade el aumento del coste de la vida, que impide tomar decisiones de forma responsable con el planeta. En esta situación, el precio se ha convertido en una barrera para el comportamiento sostenible, por lo que debemos tener en consideración a aquellos colectivos de personas vulnerables para que no se queden fuera en estos momentos y avancen igualmente en el camino hacia la reducción del impacto ambiental de los hábitos de compra y consumo de alimentos.

En la apuesta por la sostenibilidad, compartida de forma unánime por todos los sectores, hay muchas lagunas y la persona consumidora, como último eslabón de la cadena, reclama más información y un compromiso real y contrastable del sector de la alimentación con el medio ambiente, para que se ofrezcan productos que nos permita seguir unos patrones de alimentación más saludables, a la vez que sostenibles.

Con este Monográfico también queremos hacer, en nombre de las cooperativas de consumo un llamamiento al compromiso sincero con la sostenibilidad, impulsando innovaciones y nuevas oportunidades empresariales, que permitan avanzar hacia un sistema alimentario más sostenible y respetuoso con el planeta y las personas.