Achieving optimal nutrition - the critical role of food systems and diets
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Conference given by Jessica Fanzo at University Paris-Saclay / AgroParisTech on 11 January 2018 as part of Master CLUES (week on Natural resources, food security and poverty alleviation)
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Achieving optimal nutrition - the critical role of food systems and diets
- 1. Achieving Optimal Nutrition: The Critical Role of Food Systems & Diets Jessica Fanzo, PhD Bloomberg Distinguished Associate Professor of Global Food & Agriculture Policy & Ethics Director of the Global Food Policy & Ethics Program
- 2. For Our Discussion • Map the components of a food system, food environments and their drivers . • Describe the major global challenges and trade- offs of ensuring food security and healthy diets and their health, environment, economic and sociocultural consequences. • Describe the exogenous drivers to the food system that will inhibit success if action is not taken. • Understand the prevailing evidence in improving diets and nutrition.
- 3. Part 1: Food Systems and Environments
- 4. Food systems for diets and nutrition HLPE 2017 Food Systems and Nutrition Report
- 5. Barriers & opportunities for healthier eating Mozafarrian 2016 Circulation; Afshin et al 2015
- 6. Part 2: Transitioning Diets 1. Too much 2. Poor quality 3. Not affordable 4. Not sustainable
- 7. 1. Too Much Ranganathan, J. et al. 2016. “Shifting Diets for a Sustainable Food Future.”Working Paper, Installment 11 of Creating a Sustainable Food Future.Washington, DC:World Resources Institute. Accessible at http://www.worldresourcesreport.org;Theresa M Marteau et al. BMJ 2015;351:bmj.h5863
- 8. 2. Poor Quality Micha et al 2015 BMJ; Harvard, Neel 2012; Global Panel on Agriculture and Food Systems for Nutrition. 2016. Food systems and diets: Facing the challenges of the 21st century. London, UK Global sugar supply per calories/person/per day in 2008
- 9. Global Dietary Database, 2017
- 10. Some improvements over time, some not Global Panel on Agriculture and Food Systems for Nutrition. 2016. Food systems and diets: Facing the challenges of the 21st century. London, UK Dietary intake data from the Global Dietary Database (Tufts) comparing 1990 to 2013
- 11. Consumption of sugar sweetened beverages Popkins and Hawkes Lancet Diabetes 2016
- 12. Global Dietary Database; Global Panel on Agriculture and Food Systems for Nutrition. 2016. Food systems and diets: Facing the challenges of the 21st century. London, UK. Per capita sales volumes of non-alcoholic beverage types 2000-2015
- 13. Processed, packaged foods Baker and Friel Globalization and Health (2016) 12:80 Distribution share (%) of processed foods through modern grocery retail channels, 1999–2013 Sales of ultra-processed food products and oils & fats, in selected Asian markets, 2000–2013 with projections to 2017
- 14. Global dietary patterns among men and women in 187 countries in 2010 Imamura et al Lancet Glob Health 2015; 3: e132–42
- 15. 3. Not Affordable Hallegatte, Stephane, Mook Bangalore, Laura Bonzanigo,Marianne Fay, Tamaro Kane, Ulf Narloch, Julie Rozenberg, David Treguer, and Adrien Vogt-Schilb. 2016. Shock Waves: Managing the Impacts of Climate Change on Poverty. Climate Change and Development Series. Washington, DC: World Bank; Semba, R. D. (2012). The historical evolution of thought regarding multiple micronutrient nutrition. The Journal of nutrition, 142(1), 143S-156S
- 16. 0.0 2.0 4.0 6.0 8.0 10.0 12.0 USA Singapore United Kingdom Switzerland Canada Ireland Australia Austria Germany Denmark % Share of Consumer Expenditures on Food Countries in which consumers spend less than 15% of income on food expenditures 0 10 20 30 40 50 60 Turkmenistan Azerbaijan Guatemala Pakistan Philippines Algeria Kazakhstan Cameroon Kenya Nigeria % Share of Consumer Expenditures on Food Countries in which consumers spend more than 30% of income on food expenditures Economic access to food
- 17. Global Dietary Database; Global Panel on Agriculture and Food Systems for Nutrition. 2016. Food systems and diets: Facing the challenges of the 21st century. London, UK. % of monetary value of food consumed from different sources: Ethiopia 2004/2005, Uganda 2009/2010, Tanzania 2010/2011, Mozambique 2008/2009, Malawi 2001/2011, South Africa 2010
- 18. 4. Not Sustainable Ranganathan, J. et al. 2016. “Shifting Diets for a Sustainable Food Future.” Working Paper, Installment 11 of Creating a Sustainable Food Future. Washington, DC: World Resources Institute. Accessible at http://www.worldresourcesreport.org Ruminants contribute ~50% of GHGe from ag producAnimal based protein consumption is rising in many countries
- 19. Part 3: The Implications of Our “Choices” • Health Consequences • Environmental Consequences • Social Inequity Consequences
- 20. 1. Health Consequences • 815 million undernourished (hungry) • 155 million children under five stunted, or chronically undernourished • 52 million children under five wasted, or acutely undernourished • 2.1 billion adults overweight or obese (Of that, 603.7 million adults & 107.7 million children are obese) • 41 million children under five overweight • 2 billion people with some type of micronutrient deficiency Global Nutrition Report, 2016; IHME GDB Group Lancet 2017; Joint Child Malnutrition Estimates 2017 GBD 2013 Risk Factors Collaborators; Lancet 2015; Global Panel on Agriculture and Food Systems for Nutrition. 2016. Food systems and diets: Facing the challenges of the 21st century. London, UK
- 21. Joint Malnutrition Estimates 2017 Stunting Burden
- 22. Joint Malnutrition Estimates 2017 Wasting Burden
- 23. Famines are back Global Nutrition Report 2017
- 24. Joint Malnutrition Estimates 2017 Childhood Overweight Burden
- 25. Adult Obesity NCD Risk Factor Collaboration, 2017. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128· 9 million children, adolescents, and adults. The Lancet.
- 26. Number of countries facing burdens of malnutrition Global Nutrition Report, 2017
- 27. 2. Environmental Consequences Ranganathan, J. et al. 2016. “Shifting Diets for a Sustainable Food Future.” Working Paper, Installment 11 of Creating a Sustainable Food Future. Washington, DC: World Resources Institute. Accessible at http://www.worldresourcesreport.org; Downs, S. M., & Fanzo, J. (2015). Is a cardio-protective diet sustainable? A review of the synergies and tensions between foods that promote the health of the heart and the planet. Current nutrition reports, 4(4), 313. 0 5000 10000 15000 20000 25000 30000 fruit dried fruit vegetables potatoes bread pasta rice fish milk cheese yogurt olive oil nuts beef poultry pork cookies sweets alcoholic beverages Fruits Vegetabl esWholeGrains Fish and shell fish Dairy products Veg etab le oils Nut sMeat Sweets and bakery foods Alco holi c bev erag es FoodstoEncourageFoodstoDiscourage Carbon footprint (grams of C02/ litre or kg of food) Water footprint (litre of water/litre or kg of food) Water footprint Carbon footprint Cardio-protective diet’s on water and carbon footprintsAnimal-based foods are more resource intensive than plant-based foods
- 28. 3. Social Inequity Consequences • The NEED VS ACCESS: In the high- and middle- income countries and among urban populations in all income countries, meat consumption is rising (exceptions). Whereas, in many low-income countries, populations cannot access or afford animal source foods and these are of critical importance to growth, development and wellbeing. • CONSEQUENCES of DECISIONS: Those most vulnerable and in low income countries will suffer the most from high-income country decisions regarding the environment, natural resource depletion and climate change. UNICEF Global databases 2016, based on MICS, DHS and other national surveys.
- 29. Part 4: Drivers of Food System Changes 1. Poverty 2. Population growth & urbanization 3. Natural resource degradation 4. Climate change 5. Geopolitics & conflicts
- 30. 1. Poverty remains an issue • While some regions of the world have been successful in terms of reducing poverty, gains have not been even. • Prosperity has spread to the cities much faster than the countryside. • Vulnerable groups, such as minorities and women, are still more likely to be poor despite reductions in national poverty rates. • Some areas in otherwise prosperous countries retain stubbornly high levels of poverty.
- 31. 2. By 2050, 9.8 and urbanized United Nations, Department of Economic and Social Affairs, Population Division (2017). World Population Prospects: The 2017 Revision, Key Findings and Advance Tables. Working Paper No. ESA/P/WP/248.
- 32. Receding Famine Rural, subsistence, smallholder farming Diets high in grains, tubers, low in animal source foods, seasonal access to local fruits & vegetables High labor intensity jobs on farms, mines Cook food at home with less fuel efficiency High stunting, micronutrient deficiencies and communicable diseases, shorter life expectancy Transitioning Economies Peri-urban, urban, service-based economy More processed & packaged foods, street food, vegetable oils and sugar Increased sedentary-type work, increase public transport and cars Eat prepared foods away from home, cook less Increased obesity, non- communicable diseases, longer life expectancy but more disability Modern Systems Mainly urban or connected, small town living More dietary diversity and variety, access to animal source foods, fruits and vegetables Greenspace, bike pathways, purposeful physical activity Eat away from home, food deliveries High obesity and non- communicable disease burden, but better health care, thus higher life expectancy With urbanization, comes the nutrition transition Popkin and Drewnowski 1993
- 33. Many micro-food environments among nutrition transitions HLPE 2017 Report Nutrition and Food Systems
- 34. 3. Depletion of Natural Resources in the Food Supply Khoury et al 2014 PNAS
- 35. Myers et al 2017 Public Health Reviews; Myers et al Lancet 2015 4. Climate Change, Everything Change
- 36. Number (in millions) of undernourished children under age 5 years in 2000 and 2050 from extended results of the IMPACT model published in the Global Food Policy Report February 2017 Climate Change, Everything Change No. of undernourished children under age 5, in millions 2050 Additional no. of children undernourished because of climate change 2010-2050 Region 2010, base climate Without climate change With climate change Sub-Saharan Africa 40.9 37.0 39.3 2.4 South Asia 77.1 50.4 51.9 1.4 East Asia/Pacific 21.9 7.8 8.2 0.4 Latin America & Caribbean 4.3 1.5 1.8 0.3 Middle East/North Africa 4.0 1.7 1.9 0.2 Europe and FSU 1.8 1.5 1.6 0.1 WORLD 150.0 99.9 104.8 4.8
- 37. Climate Change Impacts on Future Food Prices
- 38. 5. Food Geopolitics: Food Crises & Social Unrest Andrew Holland Arab Spring and World Food Prices: http://www.americansecurityproject.org/climate-security-report; Hendrix C (2016) When Hunger Strikes: How Food Security Abroad Matters for National Security at Home. The Chicago Council on Global Affairs, Chicago USA.
- 39. Conflict, Hunger and Undernutrition Hendrix C (2016) When Hunger Strikes: How Food Security Abroad Matters for National Security at Home. The Chicago Council on Global Affairs, Chicago USA.
- 40. Arid Land Stress and Conflict Copyright: Brent Stirton
- 41. Part 5: Ten Ideas Towards Solutions
- 42. Sustainable Diets Those diets with low environmental impacts which contribute to food and nutrition security and to healthy life for present and future generations. Sustainable diets are protective and respectful of biodiversity and ecosystems, culturally acceptable, accessible, economically fair and affordable; nutritionally adequate, safe and healthy; while optimizing natural and human resources. Johnston, Fanzo and Cogill 2014 Adv Nut FAO 2012. Sustainable Diets and Biodiversity: Directions and Solutions for Policy, Research and Action
- 43. 1. Global Goal Setting Matters
- 44. In 2017, yet again, the world is off course to meet nutrition targets – and, therefore, SDG 2.2 Number of countries categorised by assessment category for global targets on nutrition No data / insufficient trend data to make assessment no progress or worsening / off course Some progress On course 4 4 4 4 7 150 146 136 142 163 181 189 189 137 16 16 21 9 49 7 7 24 26 8 20 31 29 18 Diabetes, women Diabetes, men Obesity, women Obesity, men Anaemia EBF Overweight Wasting Stunting
- 45. Integrate Nutrition into the SDGs 1 2 3 4 5 Making connections Improving nutrition will be a catalyst for achieving goals throughout the SDGs… ...and tackling underlying causes of malnutrition through the SDGs will help to end malnutrition. Global Nutrition Report 2017
- 46. SUSTAINABLE FOOD PRODUCTION 1 Agricultural yields will decrease as temperatures rise by more than 3°C. More carbon dioxide will mean less protein, iron, zinc and other micronutrient content in major crops consumed by much of the world. More sustainable diets could make a significant difference to climate change, biodiversity and our waters. Food production uses 70% of the world’s freshwater supply, agriculture produces 20% of all greenhouse gas emissions, and livestock uses 70% of agricultural land.
- 47. SYSTEMS INFRASTRUCTURE 2 Infrastructure like roads, sanitation and electricity is needed to deliver food, water and energy more equitably. This includes cities: the world’s urban population will reach 66% by 2050, yet deprived areas are underserved, while infrastructure has made it easier to deliver foods that increase the risk of obesity. Improved nutrition supports ‘grey matter infrastructure’: healthy people with the knowledge, ability and energy to drive economic development and build the future. Good nutrition gives people more labour and mental capacity, offering a $16 return for every $1 invested.
- 48. HEALTH SYSTEMS 3 A well-functioning health system is vital to deliver preventative interventions at scale, to prevent and treat undernutrition, particularly in young children and mothers, and to tackle diet- related NCDs and obesity. Undernutrition leads to 45% of all under-5 deaths. Improved nutrition reduces sickness and lowers death rates, and so reduces the burden on health systems.
- 49. EQUITY AND INCLUSION 4 Education is associated with improved nutritional outcomes. Mothers who have had quality secondary school education are likely to have significantly better nourished children. Nutrition is linked to GDP growth: a 10% rise in income translates into a 7.4% fall in wasting. Well-nourished children are 33% more likely to escape poverty, and each added centimetre of adult height correlates to an almost 5% increase in wage rates. Improved nutrition means better outcomes in education, employment and female empowerment, as well as reduced poverty and inequality.
- 50. 5 The proportion of undernourished people living in countries in conflict and protracted crisis is almost three times higher than that in other developing countries. Malnutrition will not end without peace and stability. Investing in food security and the fair distribution of natural resources is critical for both nutrition resilience and reduced fragility. PEACE AND STABILITY
- 51. 2. Align National Dietary and Food Policies US and Swedish food-based dietary recommendations in weight compared with global supply averages for 2009 Wiggins and Keats 2013 ODI Dietary Shifts Report
- 52. Shauna M. Downs, Alex Payne, Jessica Fanzo (2017) The development and application of a sustainable diets framework for policy analysis: A case study of Nepal. Food Policy, Volume 70, 2017, 40–49. http://dx.doi.org/10.1016/j.foodpol.2017.05.005 Case Study: Nepal MSNP = Multi-Sectoral Nutrition Plan NBSAP = National Biodiversity Strategy and Action Plan ADS = Agriculture Development Strategy
- 53. 3. Take on double or triply duty actions WHO 2017
- 54. 4. Improve food systems for better diets and nutrition
- 55. 5. Maximize Entry Points, Minimize Exit Points for Nutrition Fanzo, J. C., Downs, S., Marshall, Q. E., de Pee, S., & Bloem, M. W. (2017). Value Chain Focus on Food and Nutrition Security. In Nutrition and Health in a Developing World (pp. 753-770). Springer International Publishing.
- 56. Support Small and Medium Holder Farmers Herrero, M., Thornton, P. K., Power, B., Bogard, J. R., Remans, R., Fritz, S., ... & Watson, R. A. (2017). Farming and the geography of nutrient production for human use: a transdisciplinary analysis. The Lancet Planetary Health, 1(1), e33-e42.
- 57. Food & Nutrient Loss and Waste, and its ties to safety
- 58. 6. Consider Climate-Smart, Nutrition-Smart Solutions Fanzo et al 2017 IFPRI
- 59. 7. Improve the food environment • Improve the built environment for healthier eating – food swamps, food deserts • Incentivize retailers and sellers of food through tax breaks • Reformulate foods – remove trans fats, reduce sugar and salt • Phase out advertising and promotion of unhealthy foods to children and adolescents • Limit the sale and serving of unhealthy foods in schools or near schools • Promote healthy eating by introducing new foods to young taste buds thru school meals • Information warning, certifications and safety standards on foods
- 60. Eliminate Food Deserts and Swamps PRODUCTION & VALUE CHAIN CONSUMPTIONFOOD ENVIRONMENT IMMANA Food Environment Working Group, 2017
- 61. Bring food to low-income areas “Mo Gro” in Native American Neighborhoods of USA Southwest “Arrabars” in African American Neighborhoods of Baltimore Milk “Tarakwo Dairies” In urban slums of Kenya
- 63. Food/ beverage taxes Nutrient-focused taxes Subsidies Effect on consumption Strongest evidence for SSB taxes – reduce consumption by same percentage as tax rate. Subsidies increase healthy food intake. Strongest evidence for fruit and vegetable subsidies. Reduce consumption of target but may increase consumption of non-target nutrients; may apply to core foods; better if paired with subsidy. Effects on body weight/disease outcomes Substitution will affect total calorie intake. Most effective to target sugar sweetened beverages. Limited evidence for disease outcomes. Disease outcome affected by substitution – nutrient profile taxes less likely to have unintended effects than single nutrient-based taxes. Subsidies may also increase total calorie intake and body weight. Very likely to reduce dietary NCD risk factors. May be most effective for low- income populations; may have greater effect on those who consume most. Mixed socioeconomic status effects for population subsidies, may benefit wealthy. Targeted low-income subsidies effective. May be more likely to have regressive effects as more likely to apply to core foods. Differential effects Taxes and subsidies
- 64. Realize that Taxes are not a Panacea but One Tool Fable et al 2016 AJPH; Stern et al JN 2016; Cochero et al 2017 Health Affairs
- 66. Food Advertising is a major problem…
- 67. A Solution: Front of the Pack Labels in Chile • The labels are one part of a three-pronged approach set in motion by a law passed in 2012. (1) front of the pack black-labeled food (2) Black-labeled food cannot be advertised to children under 14 or include toys (3) Black-labeled food cannot be sold in or near schools. • It is not the government's intention to regulate the content of food, but to "change the environment" by informing consumers of the fat, sodium calories and sugar in foods.
- 68. 8. Creating Demand for Healthier Foods • KNOWLEDGE: Provide information, awareness, incentives for consumers to choose healthier choices – labels, dietary guidelines, and nutrition education. • MASS MEDIA CAMPAIGNS: These can be provocative and influential. Media themselves are also very influential. • NUDGING: Positive reinforcement and indirect suggestions to encourage better choices. • CHANGE THE DEMAND! Arno and Thomas 2016 BMJ
- 69. Certifications and safety qualifications
- 70. Mass media campaigns Intakes of fruits increased from 1.5 to 1.7 servings/day and vegetables from 2.6 to 3.1 servings/day 9.3% reduction in using salt at table 1.5 million New Yorkers who saw the ad campaign said they consequently scaled back on soda
- 71. Consider Nudges & Choice Architecture • Nudging includes positive reinforcement and indirect suggestions to encourage better choices. • Nudging does not include direct instruction, legislation, or enforcement. • Nudging alters people’s behavior in a predictable Arno and Thomas 2016 BMJ SR showing nudge interventions on average cause a 15.3% increase in healthier consumption decisions
- 72. 9. Consider the Future of Sustainable Alternatives “Eat Food. Not too much. Mostly Plants.” Michael Pollan
- 73. 10. Empower Women as the Nutrition Caretakers IFPRI 2012. Women’s Empowerment in Agriculture Index. International Food Policy Research Institute, Washington DC.
- 74. Conclusion
- 75. Future Sustainable Diets: I Leave You With 5 Questions 1. Is it even possible to have both human and planetary health and if yes, what are the trade-offs we are willing to live with? And how to we account for and measure those trade-offs? 2. How can create more social equity and justice across the food system and who should be responsible for ensuring that? 3. Who owns the food system and if no one owns it, how do we hold anyone accountable? How do we deal with power dynamics? 4. Where can we better align policies, policy decision making and funding to have double and triple duty effects? 5. How do we model the unknown/less certain drivers/shocks of food system change and their impact on diets?
- 76. Do we have the right to eat wrongly? If we take a social justice approach in that all people share a common humanity and therefore have a right to equitable treatment, support for their human rights, and a fair allocation of community resources…. Don’t we have a social contract to ensure that everyone has a fair share of nutritional benefits from our food system?
Editor's Notes
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- Global and regional mean fruit (A) intake (g/d) in 2010 for adults ≥20 years of age in 2010
- Data comes from Tufts University Global Dietary Database, a comprehensive compilation of information on food and nutrient consumption levels in countries worldwide. This is a large, collaborative, ongoing global project to collect, validate, and disseminate data on dietary intakes of major foods and nutrients for children and adults by age, sex, pregnancy/nursing status, rural vs. urban residence, and level of education. This figure represents 1198 surveys from 193 countries and territories. Corresponding Member Data refers to those surveys contributed to the current Global Dietary Database by nutrition researchers around the world.
- Fruit consumption tends to increase from lower to higher income regions while vegetable consumption declines. Consumption of seafood omega-3 fatty acids, present in fatty fish, is over 70% higher in South-East Asia compared to other regions. This is in contrast to dairy intake where consumption exceeds 200 g/day in Europe, compared to <40 g/day in South-East Asia. In general, the consumption of the foods and diet components in Panel A (the ‘healthy’ items) has grown in all regions over the past decade and only about 5% show declines in a few areas. However, there are some important differences across food types. Fruit consumption is increasing in all regions, while vegetable consumption is increasing in only four out of seven regions. Intake of wholegrains is rising substantially only in South-East Asia, while consumption of seafood omega-3 fatty acids is declining in three out of seven regions. The changes in consumption patterns for the foods and diet components in Panel B (the so-called ‘unhealthy’ items) are mixed. The picture for trans fats is encouraging, with declines in all regions. Red meat consumption has declined everywhere except in East Asia where it has risen by nearly 40%. The consumption of processed meat has risen in all regions while sugar-sweetened beverage consumption has risen in more than half of the regions, with the largest increase in North America during the period. Changes in salt/sodium consumption have been minimal in all regions. Red meat consumption is similar in East Asia, Latin America, North America and the EU-15. Trans fat intake is highest in South Asia. Notably, the relative consumption of sugar-sweetened beverages exceeds 400 g/day in Latin America, followed closely by North America in contrast to East Asia, where intakes are ten-fold lower (~40 g/day).
- As compared to North America, SSA sales of sugar sweetened beverages is low and sports/energy drinks hardly register. Interestingly, bottled water sales have gone up a lot comparing 2000 to 2015 in SSA and are comparable to North america sales.
- Using self-reported diet surveys from 187 countries that are home to 89% of the world’s adult population, researchers led by Fumiaki Imamura from the University of Cambridge analyzed the intake of healthy foods such as fruit, vegetables, legumes, whole grains, and fish, as well as foods containing fiber and omega-3s. They also looked at the consumption of unhealthy foods such as sugary drinks, saturated fats, sodium, and processed meats. Taken all together, Sub-Saharan Africa, particularly West Africa, ranked better than wealthier regions in North America and Europe, probably because of a diet comprised of lean meats, vegetables, legumes and staple starches, with less processed foods than countries that fared worse. There’s one important caveat. The study examines only nutrition—the quality of diet—and does not speak to the quantity of food consumed. It assumes that all adults surveyed are consuming 2,000 calories a day.
- Data from 6 African countries. Rural places still consume a lot of the food that they grow themselves although in wealthier households in rural places, there is shift towards purchasing of food, and with that, highly processed foods. Urban tells a different story. Most food is purchased not grown and as africans get wealthier, they consume more highly processed foods in urban centers.
- The University of Washington is leading the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD Study 2010), which will produce new estimates measuring the impact of hundreds of diseases, injuries, and risk factors in 21 regions around the world over two decades. This work is carried out in conjunction with 800 researchers around the world with the objective of ensuring that the global health community is able to base its research and policies on complete, valid, and reliable information. The results of the study are expected to be released in early 2012. http://www.healthdata.org/gbd
- Are we attempting to achieve quality diets at the expense of sustainability? How should our global population consume foods that meet both our nutrition requirements but that fit within our planetary boundaries? “12 to 24 billion pounds of whole landed fish are needed to meet U.S. population needs for recommended dietary intakes of fish and shellfish, but only 8.851 billion pounds are available.” IOM, 2014: Sustainable Diets: Food for Healthy People and a Healthy Planet: Workshop Summary Multivariate ordination of crop commodity composition in contribution to calories in national food supplies in 1961, 1985, and 2009. Red points represent the multivariate commodity composition of each country in 1961, blue points in 1985, and black points in 2009. Circles represent 95% CIs around the centroid in each year. Between 1961 and 2009, the area contained within these 95% CIs decreased by 68.8%, representing the decline in country-to-country variation of commodity composition (i.e., homogenization) over time. Since the 1900s, 75% of plant genetic diversity has been lost 30% of livestock breeds are at risk of extinction Of the 250,000 to 300,000 known edible plant species, only 150 to 200 are used by humans And of those, 75% of the world’s food is generated from only 12 plants and five animal species Rice, maize and wheat contribute nearly 60% of energy obtained by humans from plants
- In the high- and middle-income countries and among urban populations in all income countries, meat and dairy consumption is rising (exceptions). Whereas, in many low-income countries, populations cannot access or afford animal source foods and these are of critical importance to growth, development and wellbeing. Quality varies all over the world and is it fair to promote healthier meats that are largely inaccessible to most of the world? Those most vulnerable and in low income countries will suffer the most from high-income country decisions regarding the environment, natural resource depletion and climate change.
- .
- Food Value chain (FVC) approaches can provide useful frameworks to examine the food system and the potential to achieve improved nutritional outcomes by leveraging market-based systems. However, understanding the links between value chains, the overall business environment in which they operate, and nutrition among targeted populations is complex, as the figure on the previous slide indicates. In the recent Lancet series on child and maternal nutrition, value chains were highlighted as a potential way to leverage agriculture to improve nutrition, particularly with regards to traditional value chains for micronutrient rich foods (Ruel et al., 2013). In order for the agricultural sector to play a more effective role in terms of improving access, acceptability, and quality of diets and more nutrient rich foods, there needs to be a greater focus on what happens to foods being produced all the way to their consumption (Hawkes and Ruel, 2011). One of the main uses of value chain analysis is to help identify points in the chain that can be “leveraged for change” (Hawkes 2009). 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. It is also important to understand potential entry points as indicated above. The figure shows ways in which more nutrition can enter or exit a chain system and the potential for innovation to address some of these drains.
- Introduce topic of transitioning food systems Describe how topic came up in the HLPE when discussing the nutrition transition
- intakes of fruits (from 1.5 to 1.7 servings/day; P<0.05) and vegetables (from 2.6 to 3.1 servings/day; P<0.001) among adults [25]. Salt reduction in UK: 9.3% reduction in using salt at table “Would you drink 12 teaspoons of sugar? Sugar is sweet, diabetes is not.” Billboard supporting a soda tax in Mexico. An online evaluation of the campaign conducted during the fall of 2011 found that nearly half of the estimated 1.5 million New Yorkers who have seen the “Pouring on the Pounds” ad campaign said they consequently scaled back on soda consumption. A survey conducted in January 2012 with a representative sample of New Yorkers found that 40% of all respondents surveyed said that they recalled the ads. This is a statistically significant increase of 14% from 2011, when 35% of respondents that that they recalled the campaign.
- To Rawls, social justice is about assuring the protection of equal access to liberties, rights, and opportunities, as well as taking care of the least advantaged members of society. Thus, whether something is just or unjust depends on whether it promotes or hinders equality of access to civil liberties, human rights, opportunities for healthy and fulfilling lives, as well as whether it allocates a fair share of benefits to the least advantaged members of society. Rawls' conception of social justice is developed around the idea of a social contract, whereby people freely enter into an agreement to follow certain rules for the betterment of everyone, without considering the implications of these rules for their own selfish gain. Rawls posits that rational, free people will agree to play by the rules under fair conditions and that this agreement is necessary to assure social justice because public support is critical to the acceptance of the rules of the game (Rawls, 2003: 27-28). These rules or principles "specify the basic rights and duties to be assigned by the main political and social institutions, and they regulate the division of benefits arising from social cooperation and allot the burdens necessary to sustain it" (Rawls, 2003: 7).