Supporting Healthy and Sustainable Diets: How Do We Get There?

The global food system is a primary driver of environmental degradation and biodiversity loss. It accounts for one-third of anthropogenic greenhouse gas (GHG) emissions, and for the single greatest use of land (40%) and freshwater (70%). At the same time, the food system is also failing to deliver nutritious diets. No less than 815 million people continue to suffer from hunger and 2 billion from micronutrient deficiencies, while 1.9 billion adults are overweight, of whom 600 million are obese.

Absent radical changes in dietary trends, the dearth of spare arable land may mean intensified production is needed to meet the growth in demand in regions such as sub-Saharan Africa, where significant yield gaps remain. Improvements in technical efficiency have brought significant productivity gains. The United States, for example, produces 60 per cent more milk today than in the 1940s, with around 80 per cent fewer cows. However, agricultural production today is over reliant on inputs – from land and freshwater to phosphorus- and nitrogen-based fertilizers, pesticides and antibiotics, as well as fossil energy. Worse still, half of the world’s land surface area will need to remain uncultivated to maintain critical levels of biodiversity. This implies no further expansion of agricultural land (i.e. no net loss in terms of land use). It also means avoiding land-use change, especially deforestation.

Incremental change – through efficiency gains, regulating the use of harmful substances and practices, and better transparency and traceability – will not suffice. Achieving multiple objectives will likely require new generations of interventions and solutions. For example, disruptive technologies could help to realize ambitious estimates for carbon-sequestration potential in soils, with suggestions that up to eight times the existing carbon storage is possible. New technologies can also accelerate the decarbonization of food supply chains (through using renewable energy in crop, livestock and fertilizer production). Given the varied capacity in different geographies to provide micronutrients within planetary boundaries, other options may also be needed, such as increased trade of synthetic B12 to supplement naturally produced micronutrients.

The political economy of the current global food system, however, stands in the way of transformative policies and innovative interventions. Market power is highly concentrated. The agricultural sector is also core to national income generation in many countries. Even with the scientific rationale for reducing meat consumption, strong resistance from livestock-producing states will likely ensue, not least because the sector accounts for some 50 per cent of total agriculture-related national income. Incumbents in the private sector will also continue to challenge measures aimed at tackling childhood obesity amidst mounting health costs.

Ill-conceived farm and fisheries subsidies, together with biofuel mandates and food self-sufficiency targets, continue to prop up unsustainable production around the world. They encourage systemic wastage and inefficiencies, and they worsen environmental degradation. They have also driven greater concentration of agricultural production. Absent robust regulation and governance – whether on supply-chain transparency and traceability, land rights, labour conditions, marketing ethics, or environmental and social impacts – the pervasion of artificially cheap, nutritionally poor and environmentally unsustainable food products remains (including processed foods high in fats and sugar.)

Against this backdrop, the public-health costs of diet-related disease will likely skyrocket, not only in high-income countries but also in middle- and low-income ones. This means that lower-income populations will remain disproportionately vulnerable to nutrient deficiency and malnutrition, despite increased food availability. Meanwhile, the contributions of unhealthy and unbalanced diets to rising public-health costs are rarely acknowledged by governments.

Experts and advocates are yet to converge around a shared vision for future food systems, with persistent ideological divisions among those calling for urgent and radical change. For example, the relative merit of grain-fed and grass-fed beef remains contentious, while some argue that the distinction is irrelevant as sustainable food futures would require minimal, if any, beef in future diets. Some experts question the universality of the need for dietary change. Some suggest it is a matter of protecting and maintaining traditional diets in developing economies, which are often rich in plant-based foods and relatively diverse compared with encroaching influences of the ‘Western’ diet. Others point to the lack of nutritional diversity across the developing world as a contributor to childhood wasting and stunting.

Safeguarding the planetary boundaries is a non-negotiable priority if we are to secure healthy diets. A recent analysis shows that four out of nine boundaries – climate, deforestation, biodiversity loss and nitrogen and phosphorus use – have been transgressed. The imminent challenge is to develop tailored roadmaps that have traction among policymakers and business leaders, that are palatable for consumers, and that act on the multiple and incontrovertible imperatives for wholescale transformation to emerge from the EAT-Lancet Commission.

Governments need to step up their support for innovative solutions to drive delivery of these goals. Technologies and new supply models are already catalysing rapid changes along food supply chains, and many more are in the pipeline. Innovators within the food sector and beyond are beginning to explore a more diverse array of tools to decouple food production from land use and to set dietary trends on a healthier and more sustainable trajectory.

An improved evidence base can help inform the design of effective policies that address both sustainability and public health challenges. Few policies to date attempt to improve both; fewer still have been evaluated on the basis of achieving the co-benefits. In 2014, the best available evidence was used in Brazil during the revision of the National Dietary Guidelines. Where scientific evidence was lacking, consensus established among the diverse range of stakeholders involved in the yearlong consultation process was deemed sufficient for the guidelines. This experience also points to the need to address the public as well as the expert community in communicating core messages around sustainable, healthy diets.

Effective outreach requires speaking to the priorities and constraints of each given audience as well as aligning incentives for change and disruption. Whoever the messenger, the vision for a future food system must be grounded in politically and economically astute analysis of the challenges inherent in food-system change and of practicable solutions. Narratives of global stewardship and equitable development should be accompanied by ones of economic growth and job creation.

Securing proactive and collaborative engagement from stakeholders is also key to kick-starting pilot projects and generating practical knowledge for implementation. Suppliers and retailers have tremendous influence over our food choices, shaping the ‘choice architecture’ in shops and restaurants alike. In addition to financial resources and marketing capacity, the food industry also has an ever increasing amount of data on purchasing behaviours and opportunities to test, monitor, evaluate and quantify the impact of a given product or approach. Several food retailers have offered their retail space as testing grounds to pilot interventions to help shift consumption habits.

Governments could play a more proactive role in ‘upskilling’ the agricultural and food processing workforce, whether through financial support, investment in accelerators or training programmes. Farmers in low-income countries face major economic and practical constraints in accessing the skills and resources required to adopt new production methods. Such ‘upskilling’ will be equally necessary in developed countries as sustainable energy management, GHG monitoring, precision agriculture techniques and blockchain-ready traceability standards are increasingly incorporated into the basic responsibilities of food sector stakeholders.

Experts engaged in conversations around healthy and sustainable diets should call for high-level action in the public domain. Commitments to food-system transformation are unlikely to develop organically from existing institutions and structures. This is in part due to environmental sustainability, food security and public health often remaining separate competencies among international and national institutions. With momentum building through continued evidence gathering and civil-society pressure, a catalyst is needed to elevate this issue to the highest echelons of government, business and the investment community. Concerted efforts and a coherent policy push from those leading and supporting the initiatives discussed here should be an early priority to effect the change desired.