Partial substitutions of animal with plant protein foods in Canadian diets have synergies and trade-offs among nutrition, health and climate outcomes (2024 Feb)

Auclair, O., Eustachio Colombo, P., Milner, J. et al. Partial substitutions of animal with plant protein foods in Canadian diets have synergies and trade-offs among nutrition, health and climate outcomes. Nat Food (2024). https://doi.org/10.1038/s43016-024-00925-y

The study was published in Nature Food in February 2024 and was conducted by researchers at McGill University and the London School of Hygiene & Tropical Medicine. It analyzed the impacts of partially replacing red and processed meat or dairy with plant protein foods in Canadian diets on nutrition, health and climate outcomes.

Key findings include:

  • Replacing 50% of red and processed meat with plant proteins could reduce diet-related greenhouse gas emissions by 25% and increase life expectancy by up to 8.7 months
  • Replacing 50% of dairy with plant proteins had smaller benefits, reducing emissions by only 5% and increasing life expectancy by 7.6 months
  • Replacing dairy increased calcium inadequacy by up to 14%

Abstract

Dietary guidelines emphasize the consumption of plant protein foods, but the implications of replacing animal with plant sources on a combination of diet sustainability dimensions are unknown.

Using a combination of data from a national nutrition survey, greenhouse gas emissions from dataFIELD and relative risks from the Global Burden of Disease Study 2017, we assess the impact of partially substituting red and processed meat or dairy with plant protein foods in Canadian self-selected diets on nutrition, health and climate outcomes.

The study provides evidence that partially substituting animal with plant proteins, especially red meat, can have synergistic benefits for human and planetary health in Canada.

The substitutions induced minor changes to the percentage of the population below requirements for nutrients of concern, but increased calcium inadequacy by up to 14% when dairy was replaced. Replacing red and processed meat or dairy increased life expectancy by up to 8.7 months or 7.6 months, respectively. Diet-related greenhouse gas emissions decreased by up to 25% for red and processed meat and by up to 5% for dairy replacements.

Co-benefits of partially substituting red and processed meat with plant protein foods among nutrition, health and climate outcomes are relevant for reshaping consumer food choices in addressing human and planetary health.

German Nutrition Society (DGE): DGE position statement on a more sustainable diet (2021)

Renner B, Arens-Azevêdo U, Watzl B, Richter M, Virmani K, Linseisen. J for the German Nutrition Society (DGE): DGE position statement on a more sustainable diet. Ernahrungs Umschau 2021; 68(7): 144–54. DOI: 10.4455/eu.2021.030

Summary

Our understanding of the term sustainability has evolved considerably over the last 50 years and is now a key element of social action. An essential part of sustainable development is a more sustainable diet. In this position paper, the German Nutrition Society states that advocating for and promoting a more sustainable diet is an integral part of its activities. Health is a key goal of a more sustainable diet since health, quality of life, and well-being are affected by what people eat and drink. The goal dimensions of environment, animal welfare, and social aspects are explicitly added to the goal dimension of health (in their various definitions).

The food environment is also immensely important for nutritional behaviour. The DGE relies on statements from the report of the Scientific Advisory Board on Agricultural Policy, Food and Consumer Health Protection at the Federal Ministry of Food and Agriculture (WBAE) to present a comprehensive form of the various aspects of a more sustainable diet. The position paper ensures a common basis for developing an understanding of a more sustainable diet, and enables the different fields of nutritional science to pursue a differentiated development from their specific perspectives. This paper should provide the DGE with an orientation and a commitment for its work in the future.

Sustainable diets and risk of overweight and obesity: A systematic review and meta-analysis (2024)

Citation: Reger C, Leitzmann MF, Rohrmann S, Kühn T, Sedlmeier AM, Jochem C. Sustainable diets and risk of overweight and obesity: A systematic review and meta-analysis. Obesity Reviews. 2024;1‐11. doi:10.1111/obr.13707

Summary

Sustainable diets are gaining interest as a possible approach to tackle climate change and the global extent of obesity. Yet, the association between sustainable diets and adiposity remains unclear.

We performed a systematic review and meta-analysis, calculating summary relative risks and 95% confidence intervals (CI). We pooled maximally adjusted risk estimates, assessed heterogeneity and publication bias, calculated the E-value, and evaluated the risk of bias across the included studies.

A total of eight studies were eligible for analysis. Comparing the highest versus the lowest levels of adherence to sustainable diets, the pooled effect estimate was 0.69 (95% CI = 0.62–0.76) for overweight and 0.61 (95% CI = 0.47–0.78) for obesity.

These results suggest that sustainable diets may decrease the risk of overweight/ obesity and therefore could serve as enablers for improving both public and planetary health. An agreed-upon clear definition of sustainable diets would enhance the comparability of future studies in this area.

Key Notes extracted from the paper:

  • Of the 798 potential studies, after exclusion, 8 studies were eligible (four cohort and four cross-sectional studies) and were included in the systematic review and meta-analysis. Those studies yielded a total of 438,020 participants at baseline and ultimately 170,923 participants in the analytic sample. Six studies originated from Europe, one from North America, and one from South America.
  • Studies were considered eligible for inclusion if they (1) were observational studies, including cohort, case–control, or cross-sectional studies; (2) were carried out in generally healthy participants; (3) defined sustainable diets as exposure in a reasonable and reproducible way using a sustainability measure and considered BMI-defined overweight/obesity as the primary outcome; (4) provided a relative risk (RR) or odds ratio (OR) and 95% confidence intervals (CI) for the highest versus the lowest levels of sustainable diet/organic food consumption; (5) were published before November 23, 2023; and (6) were written in English language.
  • They use the definition by Willett et al. of sustainable diets being diets that promote health and well-being while reducing the environmental impact of food production and consumption. Besides mostly plant-based diets such as the Planetary Health Diet (PHD), organic food consumption meets several of the dimensions that characterize sustainable diets. Sustainable diets aim to ensure adequate nutrition of people worldwide while maintaining planetary boundaries and are thereby positively contributing to planetary health.
  • Sustainability itself lacks a universally agreed-upon definition. Therefore, every study included utilized a different method to classify sustainable diet, and organic agriculture was assumed to be sustainable, potentially resulting in high between-study heterogeneity. Although organic food consumption seems to be associated with more sustainable diets, the higher monetary costs of organic food is not in line with the Food and Agriculture Organization definition of sustainable diets. Furthermore, the sustainability of organic food can vary depending on factors such as location, crop type, and farming methods. Water and arable land requirements might even be higher than conventional farming methods.
  • To evaluate sustainability, studies used various indices or scores. The PHD Index assesses adherence to a reference diet proposed by the EAT-Lancet Commission. The Sustainability Diet Index is a score with a maximum of 20 points summed up using four subindices encompassing environmental, nutritional, economic, and sociocultural aspects. Kesse-Guyot et al. utilized an Organic Score ranging between 0 and 32 points across 18 food groups, and Andersen et al. used an overall organic food score ranging from 6 to 24 points.

Manifesto for One Health in Europe (2023)

From the Manifesto:

The Coalition of Health Professionals for Regenerative Agriculture is a growing movement of health professionals and a multidisciplinary set of people and organisations connecting the dots between soil health and human health. This manifesto aims to give voice to a European Regenerative Healthcare movement and incentivise actions across the food, agriculture, and healthcare systems. This piece aims to align the voices of different stakeholders to achieve One Health in Europe.

The One Health concept highlights that the health and well-being of humans are inseparably linked to the health of other ecosystem components such as soil, plants, and animals. As health professionals, we recognise our unique role in mitigating the climate, food, and health crisis by promoting One Health.

Regenerative Healthcare is one of the practical solutions of One Health, where soil health connects to human health. The cycle starts with the farmer, who grows nutrient-dense food through agroecological practices. The food is then provided to hospitals and other public institutions as a tool to treat and prevent disease.

This chain demands that health professionals and all the different stakeholders involved have a holistic understanding of agriculture, nutrition, food systems, and also prevention-based measures to tackle human and environmental health crises. Training healthcare providers in regenerative healthcare promote soil, plant, animal, and human health, and it can scale regenerative agriculture and agroecology.

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

Recipe for a Livable Planet: Achieving Net Zero Emissions in the Agrifood System (2024)

Sutton, William R.; Lotsch, Alexander; Prasann, Ashesh. 2024. Recipe for a Livable Planet: Achieving Net Zero Emissions in the Agrifood System. © Washington, DC: World Bank. http://hdl.handle.net/10986/41468  License: CC BY 3.0 IGO.

Abstract

The global agrifood system has been largely overlooked in the fight against climate change. Yet, greenhouse gas emissions from the agrifood system are so big that they alone could cause the world to miss the goal of keeping global average temperatures from rising above 1.5 centigrade compared to preindustrial levels. Greenhouse gas emissions from agrifood must be cut to net zero by 2050 to achieve this goal.

Recipe for a Livable Planet: Achieving Net Zero Emissions in the Agrifood System offers the first comprehensive global strategic framework to mitigate the agrifood system’s contributions to climate change, detailing affordable and readily available measures that can cut nearly a third of the world’s planet heating emissions while ensuring global food security.

These actions, which are urgently needed, offer three additional benefits: improving food supply reliability, strengthening the global food system’s resilience to climate change, and safeguarding vulnerable populations.

This practical guide outlines global actions and specific steps that countries at all income levels can take starting now, focusing on six key areas: investments, incentives, information, innovation, institutions, and inclusion.

Calling for collaboration among governments, businesses, citizens, and international organizations, it maps a pathway to making agrifood a significant contributor to addressing climate change and healing the planet.

Association between sustainable dietary patterns and body weight, overweight, and obesity risk in the NutriNet-Santé prospective cohort (2020)

Seconda L, Egnell M, Julia C, et al. Association between sustainable dietary patterns and body weight, overweight, and obesity risk in the NutriNet-Santé prospective cohort. Am J Clin Nutr. 2020; 112(1): 138-149. doi: 10.1093/ajcn/nqz259

From the abstract: Improving the sustainability of current food systems may prevent future public health, environmental, and social concerns. Our objective was to investigate the associations between sustainable dietary patterns, assessed using the Sustainable Diet Index (SDI), and the risk of obesity, overweight, and weight gain in French adults, with a prospective design. The findings support a potential protective role for more sustainable diets to prevent the risk of weight gain, overweight, and obesity.

The construction of this index was based on the FAO definition of food sustainability. The SDI includes 7 indicators categorized into 4 subindexes: environmental, nutritional, economic, and sociocultural.

  1. land occupation, 
  2. greenhouse gas emissions, 
  3. primary energy consumption (grouped together in pReCiPe), 
  4. difference between energy need and intake in absolute terms, 
  5. probability of adequate nutrient intake (PANDiet), 
  6. contribution of organic food to diet, 
  7. proportion of income devoted to diet, place of food purchase, and ready-made product

Food diversity: its relation to children’s health and consequent economic burden (2024)

Hasanah, A., Kharisma, B., Remi, S. S., et al. (2024) Food diversity: its relation to children’s health and consequent economic burden. BMC Public Health. doi:10.1186/s12889-024-18530-w (open access)

This study investigates the impact of low food diversity on the health status of children using the Dietary Diversity Score (DDS) and Dietary Serving Score (DSS) in a sub-district with the highest percentage of poor households in Indonesia. The economic burden of low food diversity was observed by analysing the cost of illness in the children with low food diversity. They conclude that the effect of inadequate dietary diversity on children’s health is potentially high and contributes to the economic burden on households and the government.

One of their recommendations is to utilize or enhance the agroecological practices referring to a study that shows that some practices such as crop diversification, agroforestry, mixed crop and livestock systems, and improving soil quality are estimated to have positive outcomes on dietary diversity. As agriculture is one of a key sectors in Indonesia, this approach can potentially benefit the agriculture sector and improve dietary diversity (quality and quantity) and health outcomes. Future studies can further explore this approach within the Indonesian context.

Communicating about healthy & sustainable eating to consumers with low socioeconomic status: Evidence-based recommendations (2024)

Consumers with low socioeconomic status (SES) face unique challenges that limit their uptake of healthy & sustainable eating (e.g., reduced affordability, accessibility, and availability of healthy & sustainable foods). The reduced exposure to, seeking of, and trust in health information that has been observed in consumers with low SES further reinforce these challenges.

This toolkit presents evidence-based recommendations on how to tailor your communication to consumers with low SES to empower them to shift towards healthier & more sustainable diets. The recommendations were developed based on a combination of qualitative and quantitative research findings.

Focus groups with social supermarket beneficiaries and professionals of the Caritas Trieste charitable foundation in Italy provided insights into the barriers and communication preferences of consumers with low SES with regard to healthy & sustainable eating. Based on these insights, tailored communication material (i.e., infographics) was developed and tested in a larger pool of consumers with low SES via an online survey.

This toolkit of recommendations is particularly relevant for science communicators, researchers, health professionals, journalists, NGOs, and policymakers who work with communities with low SES.

Can agroecology improve food security and nutrition? A review (2021)

Bezner Kerr, R., Madsen, S., Stüber, M., Liebert, J., Mazibuko, H., Funnel, K., … & Wezel, A. (2021). Can agroecology improve food security and nutrition? A review. Global Food Security, 29, 100540. (paid access)

Highlights

  • 56 agroecology studies had evidence for food security & nutrition (FSN) outcomes.
  • 78% of studies showed positive FSN outcomes from agroecological practices.
  • Key agroecological practices are crop diversity, organic soil amendments, and agroforestry.
  • Farmer networks and attention to social equity dimensions were important.
  • Increased complexity of agroecological system more positively associated with FSN.

Abstract

Agroecology increasingly has gained scientific and policy recognition as having potential to address environmental and social issues within food production, but concerns have been raised about its implications for food security and nutrition, particularly in low-income countries.

This review paper examines recent evidence (1998–2019) for whether agroecological practices can improve human food security and nutrition. A total of 11,771 articles were screened by abstract and title, 275 articles included for full review, with 56 articles (55 cases) selected.

A majority of studies (78%) found evidence of positive outcomes in the use of agroecological practices on food security and nutrition of households in low and middle-income countries. Agroecological practices included crop diversification, intercropping, agroforestry, integrating crop and livestock, and soil management measures.

More complex agroecological systems, that included multiple components (e.g., crop diversification, mixed crop-livestock systems and farmer-to-farmer networks) were more likely to have positive food security and nutrition outcomes.