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van Dooren C, Loken B, Lang T, Meltzer HM, Halevy S, Neven L, Rubens K, Seves-Santman M, Trolle E. The planet on our plates: approaches to incorporate environmental sustainability within food-based dietary guidelines. Front Nutr 2024; 11:1223814. [PMID: 39036493 PMCID: PMC11259098 DOI: 10.3389/fnut.2024.1223814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 06/24/2024] [Indexed: 07/23/2024] Open
Abstract
For many decades, food-based dietary guidelines (FBDGs) were only health-oriented. This changed post-2009 when gradually, an increasing number of countries began to include environmental sustainability considerations in their guidelines. International organisations such as the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) have stated that governments should include environmental sustainability in future FBDGs. However, methodologies on how this should be done are lacking. Therefore, through workshops and discussions with experts, we analysed a selection of methodologies and classified them into six groups: (1) health first; (2) additional advice; (3) demonstrating synergies; (4) modelling impact; (5) combining strategies; (6) systems first. We then assessed how innovative each approach was and their potential for transformative impact. Of the 6 approaches investigated, only approaches 5 and 6 could be considered as disruptive innovations and leading to major changes. Adding environmental sustainability into FBDGs is a policy innovation and has become a debate between old and new multi-criteria guidelines for eating. With the addition of environmental sustainability in FBDGS, a new or emerging set of multi-criteria guidelines for judging food are being proposed that challenges past norms and governance. Today, there is growing scientific consensus that diets that are good for human health are also good for the environment. There is also a growing recognition that food system change is inevitable and desirable. We see this as a positive opportunity to collaborate on FBDGs that are more appropriate for the 21st century and ambitious enough to meet the environmental challenges at hand.
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Affiliation(s)
- Corné van Dooren
- WWF-NL, Zeist, Netherlands
- Wageningen University and Research, Wageningen, Netherlands
| | - Brent Loken
- WWF Global Science, Washington, DC, United States
| | - Tim Lang
- Centre for Food Policy, City University of London, London, United Kingdom
| | | | | | - Loes Neven
- Flanders Institute for Healthy Living (Gezond Leven vzw), Brussels, Belgium
| | - Kristof Rubens
- Department of Environment and Spatial Development (Flemish Government), Brussels, Belgium
| | | | - Ellen Trolle
- National Food Institute, Technical University of Denmark (DTU), Kongens Lyngby, Denmark
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van Dooren C. Planet-based diets: improving environmental sustainability of healthy diets. Proc Nutr Soc 2023:1-7. [PMID: 37827993 DOI: 10.1017/s0029665123003737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
The focus of nutritionists is on improvement of the health impact of current diets. Therefore, it is important to ask the question whether healthy diets are more sustainable. This review provides an overview on the research on synergies between health and sustainability. Synergies are found from shifts from animal-based to plant-based diets, from ultra-processed foods to fresh and whole foods and from reduction of food waste. The importance of looking at sustainability of the present diets has led to steps made in Europe to incorporate sustainability into food-based dietary guidelines. Examples from UK, Nordics, Belgium and the Netherlands are given. World Wildlife Fund has summarised the insides in a future-proof diet: the planet-based diet within planetary boundaries.
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Bekele TH, van Rooijen M, Gerdessen JC, Brouwer ID, Feskens EJM, Trijsburg L, Alemayehu D, de Vries JHM. Developing feasible healthy diets for Ethiopian women of reproductive age: a linear goal programming approach. Public Health Nutr 2023; 26:2096-2107. [PMID: 37448219 PMCID: PMC10564607 DOI: 10.1017/s1368980023001374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 05/08/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE To develop a healthy diet for Ethiopian women closely resembling their current diet and taking fasting periods into account while tracking the cost difference. DESIGN Linear goal programming models were built for three scenarios (non-fasting, continuous fasting and intermittent fasting). Each model minimised a function of deviations from nutrient reference values for eleven nutrients (protein, Ca, Fe, Zn, folate, and the vitamins A, B1, B2, B3, B6, and B12). The energy intake in optimised diets could only deviate 5 % from the current diet. SETTINGS Five regions are included in the urban and rural areas of Ethiopia. PARTICIPANTS Two non-consecutive 24-h dietary recalls (24HDR) were collected from 494 Ethiopian women of reproductive age from November to December 2019. RESULTS Women's mean energy intake was well above 2000 kcal across all socio-demographic subgroups. Compared to the current diet, the estimated intake of several food groups was considerably higher in the optimised modelled diets, that is, milk and dairy foods (396 v. 30 g/d), nuts and seeds (20 v. 1 g/d) and fruits (200 v. 7 g/d). Except for Ca and vitamin B12 intake in the continuous fasting diet, the proposed diets provide an adequate intake of the targeted micronutrients. The proposed diets had a maximum cost of 120 Ethiopian birrs ($3·5) per d, twice the current diet's cost. CONCLUSION The modelled diets may be feasible for women of reproductive age as they are close to their current diets and fulfil their energy and nutrient demands. However, the costs may be a barrier to implementation.
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Affiliation(s)
- Tesfaye Hailu Bekele
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Maike van Rooijen
- Group Operations Research and Logistics, Wageningen University and Research, Wageningen, The Netherlands
| | - Johanna C Gerdessen
- Group Operations Research and Logistics, Wageningen University and Research, Wageningen, The Netherlands
| | - Inge D Brouwer
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Edith JM Feskens
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Laura Trijsburg
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | | | - Jeanne HM de Vries
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
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Verly E, Machado ÍE, Meireles AL, Nilson EAF. Avoidable diet-related deaths and cost-of-illness with culturally optimized modifications in diet: The case of Brazil. PLoS One 2023; 18:e0288471. [PMID: 37432939 DOI: 10.1371/journal.pone.0288471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 06/27/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Dietary risk factors have an important impact on premature deaths and disabilities due to non-communicable diseases. In this study, we perform diet optimization to design different dietary scenarios taking into account food prices and preferences and evaluate the number of deaths that would be prevented as well as the economic burden and costs from the health system that would be saved in Brazil. METHODS We used dietary intake and food prices data from the nationwide Household Budget Survey (HBS) and the National Dietary Survey (NDS) 2017-2018. Linear programming models were performed to design five scenarios which different sets of key diet modifications at the least deviation from the baseline consumption. Comparative risk assessment models were used to estimate the health impacts of optimized dietary changes on mortality and the economic impacts on morbidity (hospitalizations) and premature deaths. RESULTS The optimized diets were, on average, more expensive than the baseline diets, varying from Int$ (international dollar) 0.02/day to 0.52/day/adult. The number of deaths prevented or postponed varied from 12,750 (10,178-15,225) to 57,341 (48,573-66,298) according to the different scenarios. The diet modifications would save from 50 to 219 million in hospitalizations and from 239 to 804 million yearly in productivity losses with the reduction of premature deaths. CONCLUSION A substantial number of deaths and costs due to hospitalization and productivity losses would be avoidable even with small changes in diets. However, even the cheapest intervention might be prohibitive for deprived families, yet subsidies and social policies could contribute to improving diets.
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Affiliation(s)
- Eliseu Verly
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Ísis Eloah Machado
- Medicine School, Federal University of Ouro Preto, Ouro Preto, MG, Brazil
| | | | - Eduardo A F Nilson
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, SP, Brazil
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Comi M, Becot F, Bendixsen C. Automation, Climate Change, and the Future of Farm Work: Cross-Disciplinary Lessons for Studying Dynamic Changes in Agricultural Health and Safety. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4778. [PMID: 36981685 PMCID: PMC10049460 DOI: 10.3390/ijerph20064778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
In this review, we first assess the state of agricultural health and safety research as it pertains to the dynamic challenges facing automating agriculture on a warming planet. Then, we turn to social science fields such as rural sociology, science and technology studies, and environmental studies to leverage relevant insights on the introduction of new technologies, environmental risks, and associated workplace hazards. Increased rates of automation in agriculture alongside new risks associated with climate change create the need for anticipatory governance and adaptive research to study novel mechanisms of worker health and safety. The use of the PRISMA framework led to the 137 articles for our review. We identify three themes in the literature on agricultural health and safety: (1) adoption outcomes, (2) discrete cases of health risks, and (3) an emphasis on care and wellbeing in literature on dairy automation Our review led to the identification of research gaps, noting that current research (a) tends to examine these forces separately, instead of together, (b) has not made robust examination of these forces as socially embedded, and (c) has hesitated to examine the broad, transferable themes for how these forces work across industries. In response to these gaps, we suggest that attention to outside disciplines may provide agricultural health and safety research with a toolset to examine needed inquiry into the multiplicity of experiences of rural stakeholders, the industry specific problems arising from automation and climate change, and the socially embedded aspects of agricultural work in the future.
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Masino T, Colombo PE, Reis K, Tetens I, Parlesak A. Climate-friendly, health-promoting, and culturally acceptable diets for German adult omnivores, pescatarians, vegetarians, and vegans - a linear programming approach. Nutrition 2023; 109:111977. [PMID: 36801703 DOI: 10.1016/j.nut.2023.111977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 01/14/2023] [Accepted: 01/15/2023] [Indexed: 01/22/2023]
Abstract
OBJECTIVES A frequently suggested approach to reduce greenhouse gas emissions (GHGEs) caused by food production is to reduce the intake of animal products, which can create nutritional deficiencies. This study aimed to identify culturally acceptable nutritional solutions for German adults that are both climate friendly and health promoting. METHODS Linear programming was applied to optimize the food supply for omnivores, pescatarians, vegetarians, and vegans considering nutritional adequacy, health promotion, GHGEs, affordability, and cultural acceptability by approaching German national food consumption. RESULTS Implementing dietary reference values and omitting meat (products) reduced the GHGEs by ≤52%. The vegan diet was alone in staying below the Intergovernmental Panel on Climate Change (IPCC) threshold of 1.6 kg carbon dioxide equivalents per person per day. The optimized omnivorous diet constrained to meet this goal maintained ≥50% of each baseline food and, on average, deviated from baseline by 36% for women and 64% for men. Butter, milk, meat products, and cheese were reduced by half for both sexes, whereas bread, bakery goods, milk, and meat were reduced mainly for men. The intake of vegetables, cereals, pulses, mushrooms, and fish increased by between 63% and 260% for the omnivores, compared with baseline. Besides the vegan dietary pattern, all optimized diets cost less than the baseline diet. CONCLUSIONS A linear programming approach for optimizing the German habitual diet to be healthy, affordable, and meet the IPCC GHGE threshold was possible for several dietary patterns and appears to be a feasible way forward toward including climate goals into food-based dietary guidelines.
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Affiliation(s)
- Talia Masino
- Global Nutrition and Health, University College Copenhagen, Copenhagen, Denmark; Department of Nutrition, Exercise and Sports, Copenhagen, Denmark
| | - Patricia Eustachio Colombo
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Kia Reis
- Global Nutrition and Health, University College Copenhagen, Copenhagen, Denmark; Department of Nutrition, Exercise and Sports, Copenhagen, Denmark
| | - Inge Tetens
- Department of Nutrition, Exercise and Sports, Copenhagen, Denmark
| | - Alexandr Parlesak
- Department of Nutrition, Exercise and Sports, Copenhagen, Denmark; Baden-Württemberg Cooperative State University (DHBW), Heilbronn, Germany.
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Vieux F, Rémond D, Peyraud JL, Darmon N. Approximately Half of Total Protein Intake by Adults Must be Animal-Based to Meet Nonprotein, Nutrient-Based Recommendations, With Variations Due to Age and Sex. J Nutr 2022; 152:2514-2525. [PMID: 36774117 PMCID: PMC9644177 DOI: 10.1093/jn/nxac150] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/13/2022] [Accepted: 07/01/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Shifting towards a more plant-based diet, as promoted in Western countries, will reduce the animal protein contribution to total proteins. Such a reduction may not only impair protein adequacy, but also the adequacy in other nutrients. OBJECTIVES We determined, for different adult subpopulations, the minimum total protein levels and the minimum animal protein contributions to total proteins that are compatible with the fulfillment of all nonprotein nutrient-based recommendations. METHODS Mean nutritional contents and mean diet costs were estimated using a French, cross-sectional, representative survey for 5 French subpopulations: 1) women < 50 y; 2) women 50-64 y; 3) women ≥ 65 y; 4) men < 65 y; and 5) men ≥ 65 y. For each subpopulation, linear programming optimization was used to assess the minimum protein level (model set #1) and the minimum animal protein contribution to total proteins (model set #2) that are compatible with the fulfillment of all nutrient-based recommendations (except proteins, for which levels were analyzed as outputs). Total diet costs were not allowed to increase. Eating habits were considered in model set #2 only. RESULTS The minimum amount of protein that was theoretically compatible with the fulfillment of nutrient-based recommendations (model set #1) was below the minimum recommended protein intake for all subpopulations except women < 50 y. In model set #2, for women and men ≥ 65 y, decreasing animal protein contributions to total proteins below 55% and 60%, respectively, led to protein levels below recommended levels. For the other subpopulations (women < 50 y, women 50-64 y, and men < 65 y), the lowest animal protein contributions to total proteins compatible with a nutritionally adequate diet (including protein adequacy) were 55%, 50%, and 45%, respectively. CONCLUSIONS This study provides factual information about the animal protein contributions to total proteins compatible with meeting all nutrient-based recommendations at no additional cost, and shows that they vary between 45% and 60% depending on the group of adults considered.
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Affiliation(s)
| | - Didier Rémond
- Université Clermont Auvergne, INRAE UNH, Clermont-Ferrand, France
| | | | - Nicole Darmon
- MoISA, University of Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
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Faber M, de Villiers A. Field-testing of food-based dietary guidelines. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2021. [DOI: 10.1080/16070658.2021.2004690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Mieke Faber
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Anniza de Villiers
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South Africa
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Additional costs of lactose-reduced diets: lactose-free dairy product substitutes are a cost-effective alternative for people with lactose intolerance. Public Health Nutr 2021; 24:4043-4053. [PMID: 34180787 DOI: 10.1017/s1368980021002779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE People with lactose intolerance have to limit their consumption of lactose-containing dairy products which are a main source of Ca. In particular, for low-income people it is of interest which alternative diet form rich in Ca leads to the lowest additional costs. This study aims to calculate the additional costs of lactose-reduced diets and to show which of different options represent the most cost-effective alternative within a lactose-reduced diet. DESIGN Using linear programming, food baskets with different lactose contents were calculated and were compared to a basic model, reflecting a normal diet without a limitation of lactose. By comparing the costs and the composition of the food baskets, recommendations for a lactose-reduced diet were derived. SETTING Germany. PARTICIPANTS A consumer panel dataset representative for Germany is used for the calculations. Information on prices and nutrients is derived from the 9429 adult households without children, and information on consumed food quantities from the 3046 single households. RESULTS The minimum additional food costs depend on the severity of lactose intolerance and range from 0·2 % to 6·1 % per month. It was found that the greatest adjustments due to lactose reduction could be observed within the dairy product group. In this group, with a rising lactose limit, normal milk was increasingly replaced by lactose-free milk. CONCLUSION It was shown that a lactose-reduced diet is generally associated with higher food costs. When suffering from lactose intolerance, switching to lactose-free milk seems to be the most cost-effective way to cover nutrient requirements.
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