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Focusing on “Protective Foods” to Reduce the Global Burden of Disease

Rafael Flor — Former Director, YieldWise

This is Part 2 of our April 2019 series on building a more nourishing and sustainable food system. Read Part 1 here


The EAT-Lancet report, [1] in addition to a few others that have been published recently, concludes that to sustainably nourish—not simply feed—10 billion people without overtaxing the planet’s resources by 2050, the food system would need to make five adjustments:

  1. Shift diets towards a “minimum risk” diet [2], with less meat and more vegetable and fruit consumption;
  2. Close the yield gap in sub-Saharan Africa and South Asia;
  3. Reallocate land from calorie-dense to nutrient-dense foods;
  4. Reduce food loss and waste by half; and
  5. Improve the health of our oceans [3].

These adjustments are not only important for achieving the global Sustainable Development Goals and the Paris Climate Agreement—they are also critical if we want to live longer and healthier lives.

Figure 1: EAT – Lancet Recommendations

Over the past decade, our collective efforts have expedited progress toward closing the yield gap in sub-Saharan African and South Asia and, to some degree, allowed us to start to address certain environmental sustainability issues. The Rockefeller Foundation has made substantial investments to help increase agricultural productivity in sub-Saharan Africa through the Alliance for a Green Revolution in Africa (AGRA)[4]. More recently, the Foundation led the movement toward food loss and waste reduction, through our YieldWise initiative. This investment is starting to pay off as awareness, investment, and action in this area continues to grow. Only last week, the World Bank announced the first ever Sustainable Development Bond at address SDG 12.3—halving food waste by 2030—with an initial investment of $300 million [5].

Shifting toward a minimum risk diet is the single most important intervention to improve nutrition, reduce the burden of disease, and promote environmental sustainability.

Despite these efforts, progress in human diets lags, in large part due to insufficient scientific attention and funding. Evidence collected by the Institute for Health Monitoring and Metrics (IHME) at the University of Washington is clear in connecting our diets to a higher risk of disease and disability. IHME’s analysis shows that a sub-optimal diet is responsible for more deaths than any other risks globally, including tobacco smoking [6]. In 2015, while 7 million people died from tobacco smoke, 12 million deaths could be attributed to “dietary risks” such as diets low in vegetables, nuts, and seafood, or diets high in processed meats and sugary drinks. [7] The conclusion of the analysis is clear: Shifting toward a minimum risk diet is the single most important intervention to improve nutrition, reduce the burden of disease, and promote environmental sustainability.

Figure 2: IHME Global Risk-Attributable Death

According to IHME assessment, the leading dietary risk factor for mortality are diets high in sodium, low in whole grains, low in fruit, low in nuts and seeds, low in vegetables, and low in omega-3 fatty acids, each accounting for more than 2 percent of global deaths [8]. Out of every 11 global diet-related deaths that occurred in 2017, 3 were attributable to high sodium intake, 3 were linked to low whole grain intake and 2 were linked to low fruit intake.

To reduce the risk of death associated with diets, we need to shift our diets in two critical ways. The first is to drastically reduce our intake of salt, sugar, and saturated fats. The evidence is clear on this front, and awareness has increased in recent years on this issue—resulting in attempts to curb consumption, for example through the introduction of hefty taxes for sugary drinks. The second has seen far less progress, let alone discussion or debate—to drastically increase the intake of “protective foods.” These are foods that significantly lower our risk of diseases, such as whole grains, fruits, vegetables, legumes, and nuts.

The current recommendation—as outlined by Harvard University’s Health Eating Plate model—is that half of our plate should be composed of these foods. Changing the composition of our plate would bring a better balance of nutrients in our bodies. That rebalance would require doubling production of nutrient-rich foods by 2050, and ensuring that increased production happens in a sustainable and equitable manner. Jointly, we would need to catalyze what the late former UN Secretary-General Kofi Annan once called a “uniquely evergreen revolution.”

Figure 3: Mean daily recommended consumption of food group by region. Source: IHME, 2019

 

To make a meaningful contribution toward this goal, significant obstacles need to be overcome. First, we would need to prioritize research funding for these “protective foods,” as historically there has been underinvestment [10]. These efforts would bring new, better-adapted, and more nutritious varieties into the production system. Second, smart investments in value chain infrastructure and efficiency would help to bring production costs down, making these foods more locally available and affordable while increasing their shelf life. This includes things such as in cold chain, packing and handling, processing, and advances in the use of artificial intelligence and data analytics, e-aggregation, food safety, transport, and logistics. Finally, and perhaps most importantly, we need awareness and innovation to increase the demand and desirability of these foods.

Making these adjustments would allow humanity to correct for the imbalances created by prioritizing calories over nutrients, provide a clear path out of poverty for smallholder farmers around the world, deliver better food, reduce health care costs, and allow us to eat food that brings us both health and happiness. That is the kind of food revolution our health and our planet need the most.


[1] https://eatforum.org/eat-lancet-commission/eat-lancet-commission-summary-report/

[2] A diet that encourages mostly plant-based foods while allowing meat and other animal products in moderation.

[3] https://eatforum.org/content/uploads/2019/01/EAT-Lancet_Commission_Summary_Report.pdf

[4] A joint investment of the Bill & Melinda Gates Foundation (BMGF) and Rockefeller Foundation (RF).

[5] http://www.worldbank.org/en/news/press-release/2019/03/20/world-bank-and-folksam-group-join-global-call-to-action-on-food-loss-and-waste

[6] GBD 2017 Diet Collaborators. 2019. Health effects of dietary risks in 195 countries, 1990 – 2017: a systematic analysis for the Global Burden of Disease Study 2017. Elsevier.

[7] https://www.theguardian.com/books/2019/mar/16/snack-attacks-the-toxic-truth-about-the-way-we-eat

[8] GBD 2017 Diet Collaborators. 2019. Health effects of dietary risks in 195 countries, 1990 – 2017: a systematic analysis for the Global Burden of Disease Study 2017. Elsevier.

[9] GBD 2017 Diet Collaborators. 2019. Health effects of dietary risks in 195 countries, 1990 – 2017: a systematic analysis for the Global Burden of Disease Study 2017. Elsevier.

[10] For example, in the US less than 1% of subsidies go to these crops. Second, we would need to make these foods more available, accessible and affordable.

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