Global Expanded Nutrient Supply (GENuS) Model: A New Method for Estimating the Global Dietary Supply of Nutrients

Intake of sugar sweetened beverages among children and adolescents in 185 countries between 1990 and 2018: population based study

OBJECTIVE

To quantify global intakes of sugar sweetened beverages (SSBs) and trends over time among children and adolescents.

DESIGN

Population based study.

SETTING

Global Dietary Database.

POPULATION

Children and adolescents aged 3-19 years in 185 countries between 1990 and 2018, jointly stratified at subnational level by age, sex, parental education, and rural or urban residence.

RESULTS

In 2018, mean global SSB intake was 3.6 (standardized serving=248 g (8 oz)) servings/week (1.3 (95% uncertainly interval 1.0 to 1.9) in south Asia to 9.1 (8.3 to 10.1) in Latin America and the Caribbean). SSB intakes were higher in older versus younger children and adolescents, those resident in urban versus rural areas, and those of parents with higher versus lower education. Between 1990 and 2018, mean global SSB intakes increased by 0.68 servings/week (22.9%), with the largest increases in sub-Saharan Africa (2.17 servings/week; 106%). Of 185 countries included in the analysis, 56 (30.3%) had a mean SSB intake of ≥7 servings/week, representing 238 million children and adolescents, or 10.4% of the global population of young people.

CONCLUSION

This study found that intakes of SSBs among children and adolescents aged 3-19 years in 185 countries increased by 23% from 1990 to 2018, parallel to the rise in prevalence of obesity among this population globally. SSB intakes showed large heterogeneity among children and adolescents worldwide and by age, parental level of education, and urbanicity. This research should help to inform policies to reduce SSB intake among young people, particularly those with larger intakes across all education levels in urban and rural areas in Latin America and the Caribbean, and the growing problem of SSBs for public health in sub-Saharan Africa.

Maternal Fiber Intake and Perinatal Depression and Anxiety

(1) Background: Dietary fiber can significantly alter gut microbiota composition. The role of the gut microbiome in the Gut-Brain Axis and modulation of neuropsychiatric disease is increasingly recognized. The role of antenatal diet, particularly fiber intake, in mitigating maternal mental health disorders remains unexplored. The objective of this review is to investigate the association between maternal fiber intake and perinatal depression and anxiety (PDA). (2) Methods: A literature review of PubMed and Google Scholar was conducted using appropriate keyword/MeSH terms for pregnancy, diet, fiber, and mental health. Observational and clinical trials published between 2015 and 2021 were included and data pertaining to dietary patterns (DP), food intake, mental health, and demographic data were extracted. The top three fiber-containing food groups (FG) per study were identified using a sum rank scoring system of fiber per 100 g and fiber per serving size. The consumption of these top three fiber FGs was then ranked for each dietary pattern/group. Mental health outcomes for each study were simplified into three categories of improved, no change, and worsened. The relationship between top three fiber FGs consumed within each DP and mental health outcomes was analyzed using Spearman's correlation. (3) Results: Thirteen of fifty-two studies met the inclusion criteria. Ten (76.9%) studies assessed DPs (seven examined depression only, two examined depression and anxiety, and one examined anxiety only). Seven (53.9%) studies reported at least one significant positive relationship between mental health outcomes and DPs while three reported at least one negative outcome. Three (23.1%) studies compared intake of different food groups between depressed and non-depressed groups. In studies of DPs, the average consumption ranking of the top three fiber FGs bore a significant inverse association with mental health outcomes [r = -0.419 (95%CI: -0.672--0.078)] p = 0.015. In studies comparing the intake of different FGs between depressed and non-depressed groups, the consumption of top-ranking fiber foods was higher in the non-depressed groups, but significantly higher in four of the ten high fiber FGs. (4) Conclusions: This study reframes findings from previously published studies of maternal diet and mental health outcomes to focus on fiber intake specifically, using a fiber ranking system. A significant correlation between lower intake of fiber and poorer mental health outcomes warrants further investigation in future studies.

Evaluating Food Procurement against the EAT-Lancet Planetary Health Diet in a Sample of U.S. Universities

Aligning institutional food procurement with planetary health targets offers opportunities to improve nutrition and reduce food-related greenhouse gas (GHG) emissions. This study compared foods procured by 19 university dining programs in the U.S. in 2022 with the EAT-Lancet planetary health diet. Each university's procurement was then modeled to align with the EAT-Lancet planetary health diet, and changes to Healthy Eating Index (HEI) scores and GHG emissions were evaluated. For a subset of universities that provided cost data, changes in annual total food costs were also estimated. Universities in this study exceeded EAT-Lancet planetary health targets for beef (x- = 657% of target), pork (x- = 587%), poultry (x- = 379%), and eggs (x- = 293%). All universities failed to achieve planetary health targets for legumes and nuts (x- = 39% of the target) and vegetables (x- = 68%). Aligning food procurement with the planetary health diet would result in an estimated average 46.1% reduction in GHG emissions and a 19.7 point increase in HEI scores. Universities that provided cost data saw an average 9.7% reduction in food costs in the EAT-Lancet-aligned scenario. The procurement metrics assessed in this study can help university dining programs and other institutional food service organizations set goals and monitor progress toward planetary health targets.

Health-environment efficiency of diets shows nonlinear trends over 1990-2011

Understanding the impacts of diets on health and the environment, as well as their association with socio-economic development, is key to operationalize and monitor food systems shifts. Here we propose a health-environment efficiency indicator defined as a ratio of health benefits and four key food-related environmental impacts (greenhouse gas emissions, scarcity-weighted water withdrawal, acidifying and eutrophying emissions) to assess how diets have performed in supporting healthy lives in relation to environmental pollution and resource consumption across 195 countries from 1990 to 2011. We find that the health-environment efficiency of each environmental input follows a nonlinear path along the Socio-Demographic Index gradient representing different development levels. Health-environment efficiency first increases thanks to the elimination of child and maternal malnutrition through greater food supply, then decreases driven by additional environmental impacts from a shift to animal products, and finally shows a slow growth in some developed countries again as they shift towards healthier diets.

Adequacy and Distribution Equity of Nutrition Supplies across China

Procuring food enriched with diverse nutrients is pivotal for maintaining a robust immune system. However, the food system is now unprecedentedly globalized and faces challenges arising from climate change, pandemics, and political unrest. This study aims to illuminate the gap in exploring the adequacy and distribution equity of nutrition supplies in response to potential trade fluctuations and restrictions on agrifood within China's local agriculture endowments. Also, it seeks to identify the role of trade in contributing to these indices. Accordingly, we analyzed the distribution of nutrients in agrifood categories from production to consumption and assessed the adequacy and distribution equity of corresponding available nutrition supply from the local food provision system in terms of meeting residents' nutritional requirements, across China, and compared with those in the practical market. The local self-supply system showed that 12 out of 31 provinces have difficulty achieving an iron supply with 11% to 108% deficiencies. Except for iron, 52% (folate)-90% (vitamin B12) of agricultural output was available for diet provisioning nationwide. While food trade emerges as a crucial factor in enhancing secure and equitable nutrition supply, risks associated with micronutrient deficiencies necessitate careful consideration in current global circumstances. Our analysis explored a regional pool of nutrient information in supplements to the conventional food profile in China and could implicate better knowledge toward healthier food supplies and tailored improvements for achieving a resilient nutrition supply.

Sugar-sweetened beverage intakes among adults between 1990 and 2018 in 185 countries

Sugar-sweetened beverages (SSBs) are associated with cardiometabolic diseases and social inequities. For most nations, recent estimates and trends of intake are not available; nor variation by education or urbanicity. We investigated SSB intakes among adults between 1990 and 2018 in 185 countries, stratified subnationally by age, sex, education, and rural/urban residence, using data from the Global Dietary Database. In 2018, mean global SSB intake was 2.7 (8 oz = 248 grams) servings/week (95% UI 2.5-2.9) (range: 0.7 (0.5-1.1) in South Asia to 7.8 (7.1-8.6) in Latin America/Caribbean). Intakes were higher in male vs. female, younger vs. older, more vs. less educated, and urban vs. rural adults. Variations by education and urbanicity were largest in Sub-Saharan Africa. Between 1990 and 2018, SSB intakes increased by +0.37 (+0.29, +0.47), with the largest increase in Sub-Saharan Africa. These findings inform intervention, surveillance, and policy actions worldwide, highlighting the growing problem of SSBs for public health in Sub-Saharan Africa.

Children's and adolescents' rising animal-source food intakes in 1990-2018 were impacted by age, region, parental education and urbanicity

Animal-source foods (ASF) provide nutrition for children and adolescents' physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the world's child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 15-19 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes.

Multidimensional impacts from international agricultural research: Implications for research priorities

Investors in international agricultural research seek sustainable agri-food technologies that can potentially serve multiple objectives, including economic growth, food security, and sustainable use of natural resources. We employ quantitative economic models to examine the potential multi-dimensional impacts of agricultural productivity gains in the Global South. These models take into account behavior responses to agricultural technological change, i.e., how productivity changes may affect decisions on what to produce, trade, and consume. We compare potential impacts of productivity growth in different commodities and regions and assess implications along several impact dimensions, including economic and income growth, the population at risk of hunger, adequacy of protein and micronutrients in human diets, land and water use, and greenhouse gas emissions. Potential impacts vary widely by commodity group and by region. These results reveal strengths and potential tradeoffs of different R&amp;D spending allocations, and can help inform decision-making about an optimal R&amp;D portfolio that takes into account the multiple objectives of agricultural investments.

Tracing global flows of bioactive compounds from farm to fork in Nutrient Balance Sheets can help guide intervention towards healthier food supplies

Adequate supplies of healthy foods available in each country are a necessary but not sufficient condition for adequate intake by each individual. This study provides complete Nutrient Balance Sheets that account for all plant-based and animal-sourced food flows from farm production through trade to non-food uses and waste in 173 countries from 1961 to 2018. We track 36 bioactive compounds in all farm commodities recorded by the Food and Agriculture Organization of the United Nations, accounting for nutrient-specific losses in processing and cooking as well as bioavailability. We compare supply to requirements given each country's age-sex distribution and find that the adequacy of food supplies has increased but often remains below total needs, with even faster rise in energy levels and lower density of some nutrients per calorie. We use this nutrient accounting to show how gaps could be filled, either from food production and trade or from selected biofortification, fortification and supplementation scenarios for nutrients of concern such as vitamin A, iron and zinc.

Global dietary quality in 185 countries from 1990 to 2018 show wide differences by nation, age, education, and urbanicity

Evidence on what people eat globally is limited in scope and rigour, especially as it relates to children and adolescents. This impairs target setting and investment in evidence-based actions to support healthy sustainable diets. Here we quantified global, regional and national dietary patterns among children and adults, by age group, sex, education and urbanicity, across 185 countries between 1990 and 2018, on the basis of data from the Global Dietary Database project. Our primary measure was the Alternative Healthy Eating Index, a validated score of diet quality; Dietary Approaches to Stop Hypertension and Mediterranean Diet Score patterns were secondarily assessed. Dietary quality is generally modest worldwide. In 2018, the mean global Alternative Healthy Eating Index score was 40.3, ranging from 0 (least healthy) to 100 (most healthy), with regional means ranging from 30.3 in Latin America and the Caribbean to 45.7 in South Asia. Scores among children versus adults were generally similar across regions, except in Central/Eastern Europe and Central Asia, high-income countries, and the Middle East and Northern Africa, where children had lower diet quality. Globally, diet quality scores were higher among women versus men, and more versus less educated individuals. Diet quality increased modestly between 1990 and 2018 globally and in all world regions except in South Asia and Sub-Saharan Africa, where it did not improve.

Estimating the environmental impacts of 57,000 food products

Understanding and communicating the environmental impacts of food products is key to enabling transitions to environmentally sustainable food systems [El Bilali and Allahyari, Inf. Process. Agric. 5, 456-464 (2018)]. While previous analyses compared the impacts of food commodities such as fruits, wheat, and beef [Poore and Nemecek, Science 360, 987-992 (2018)], most food products contain numerous ingredients. However, because the amount of each ingredient in a product is often known only by the manufacturer, it has been difficult to assess their environmental impacts. Here, we develop an approach to overcome this limitation. It uses prior knowledge from ingredient lists to infer the composition of each ingredient, and then pairs this with environmental databases [Poore and Nemecek Science 360, 987-992 (2018); Gephart et al., Nature 597, 360-365 (2021)] to derive estimates of a food product's environmental impact across four indicators: greenhouse gas emissions, land use, water stress, and eutrophication potential. Using the approach on 57,000 products in the United Kingdom and Ireland shows food types have low (e.g., sugary beverages, fruits, breads), to intermediate (e.g., many desserts, pastries), to high environmental impacts (e.g., meat, fish, cheese). Incorporating NutriScore reveals more nutritious products are often more environmentally sustainable but there are exceptions to this trend, and foods consumers may view as substitutable can have markedly different impacts. Sensitivity analyses indicate the approach is robust to uncertainty in ingredient composition and in most cases sourcing. This approach provides a step toward enabling consumers, retailers, and policy makers to make informed decisions on the environmental impacts of food products.

An integrated assessment of environmental sustainability and nutrient availability of food consumption patterns in Latin America and the Caribbean

BACKGROUND

In Latin America and the Caribbean, historical shifts away from traditional, plant-sourced food production and consumption patterns may undermine both nutritional status and environmental sustainability. Although agricultural intensification and increasingly animal-centric dietary preferences in the region are well-documented, their influence on environmental degradation remains unknown.

OBJECTIVE

This study aimed to 1) characterize the environmental impacts of current food consumption patterns in South America, Central America, and the Caribbean and 2) identify food groups that minimize impact while maintaining adequate nutrient availability.

DESIGN

Apparent regional food consumption was derived using data from the Food and Agriculture Organization's Food Balance Sheets on per capita food availability and levels of imported vs. local food production. Region-specific life cycle assessment data on greenhouse gas emissions, land use, and freshwater consumption were leveraged to estimate total, food group-level, and nutrient-specific environmental impacts.

RESULTS

Annual overall emissions were highest in Caribbean food consumption patterns (2521.2 kg/capita), largely derived from meat (26.7%) and fruit (23.8%) production. Land use (1941.0 m2/capita) and water consumption (2060.8 m3/capita), in contrast, were highest for the South American pattern, due to high consumption of meat and dairy. Across the regions, meat constituted 7.5-12.7% of food consumption yet accounted for as much as 73.1% of greenhouse gas emissions, 56.6% of land use, and 54.2% of water consumption. In contrast, legumes and seeds, cereals, roots, and vegetables demonstrated overall low environmental impacts, particularly relative to their contributions to dietary protein, iron, and zinc availability.

CONCLUSIONS

Findings point to the capacity of plant-sourced food consumption to minimize environmental harm without necessarily jeopardizing nutrient availability in Latin America and the Caribbean. Local agriculture can contribute to food system sustainability by producing diversified plant-sourced foods, cornerstones of many traditional food customs, and mitigating the impacts of industrialized livestock operations and imported, animal-centric dietary habits.

Estimating national and subnational nutrient intake distributions of global diets

BACKGROUND

Access to high-quality dietary intake data is central to many nutrition, epidemiology, economic, environmental, and policy applications. When data on individual nutrient intakes are available, they have not been consistently disaggregated by sex and age groups, and their parameters and full distributions are often not publicly available.

OBJECTIVES

We sought to derive usual intake distributions for as many nutrients and population subgroups as possible, use these distributions to estimate nutrient intake inadequacy, compare these distributions and evaluate the implications of their shapes on the estimation of inadequacy, and make these distributions publicly available.

METHODS

We compiled dietary data sets from 31 geographically diverse countries, modeled usual intake distributions for 32 micronutrients and 21 macronutrients, and disaggregated these distributions by sex and age groups. We compared the variability and skewness of the distributions and evaluated their similarity across countries, sex, and age groups. We estimated intake inadequacy for 16 nutrients based on a harmonized set of nutrient requirements and bioavailability estimates. Last, we created an R package-nutriR-to make these distributions freely available for users to apply in their own analyses.

RESULTS

Usual intake distributions were rarely symmetric and differed widely in variability and skewness across nutrients and countries. Vitamin intake distributions were more variable and skewed and exhibited less similarity among countries than other nutrients. Inadequate intakes were high and geographically concentrated, as well as generally higher for females than males. We found that the shape of usual intake distributions strongly affects estimates of the prevalence of inadequate intakes.

CONCLUSIONS

The shape of nutrient intake distributions differs based on nutrient and subgroup and strongly influences estimates of nutrient intake inadequacy. This research represents an important contribution to the availability and application of dietary intake data for diverse subpopulations around the world.

Cereal grain mineral micronutrient and soil chemistry data from GeoNutrition surveys in Ethiopia and Malawi

The dataset comprises primary data for the concentration of 29 mineral micronutrients in cereal grains and up to 84 soil chemistry properties from GeoNutrition project surveys in Ethiopia and Malawi. The work provided insights on geospatial variation in the micronutrient concentration in staple crops, and the potential influencing soil factors. In Ethiopia, sampling was conducted in Amhara, Oromia, and Tigray regions, during the late-2017 and late-2018 harvest seasons. In Malawi, national-scale sampling was conducted during the April–June 2018 harvest season. The concentrations of micronutrients in grain were measured using inductively coupled plasma mass spectrometry (ICP-MS). Soil chemistry properties reported include soil pH; total soil nitrogen; total soil carbon (C); soil organic C; effective cation exchange capacity and exchangeable cations; a three-step sequential extraction scheme for the fractionation of sulfur and selenium; available phosphate; diethylenetriaminepentaacetic acid (DTPA)-extractable trace elements; extractable trace elements using 0.01 M Ca(NO₃)₂ and 0.01 M CaCl₂; and isotopically exchangeable Zn. These data are reported here according to FAIR data principles to enable users to further explore agriculture-nutrition linkages.

Measurement(s)	Trace Element • soil chemical properties
Technology Type(s)	Inductively-Coupled Plasma Mass Spectrometry
Factor Type(s)	Geography • Staple cereal crop
Sample Characteristic - Organism	Staple cereal food crops
Sample Characteristic - Environment	Smallholder farming
Sample Characteristic - Location	Ethiopia • Malawi

Dietary Change and Global Sustainable Development Goals

Food production for human consumption is a leading cause of environmental damage in the world and yet over two billion people suffer from malnutrition. Several studies have presented evidence that changes in dietary patterns across the world can lead to win-win outcomes for environmental and social sustainability and can complement ongoing technological and policy efforts to improve the efficiency of agricultural production. However, the existing evidence have been compiled in “silos” by a large range of researchers across several disciplines using different indicators. The aim of this quantitative review is to bring together the existing knowledge on heterogeneity of current dietary patterns across the world and how a transition toward healthy diets in different countries can aid in progress toward multiple global Sustainable Development Goals (SDGs). We first summarize the nutritional quality, economic cost, and environmental footprint of current diets of over 150 countries using multiple indicators. Next, we review which shifts in dietary patterns across different world regions can help toward achievement of SDG2 (Zero hunger), SDG3 (Good health and wellbeing), SDG 6 (Clean water and sanitation), SDG13 (Climate action), SDG14 (Life below water), and SDG15 (Life on land). Finally, we briefly discuss how to enable the shift toward sustainable dietary patterns and identify the research and data gaps that need to be filled through future efforts. Our analysis reveals that dietary change is necessary in all countries as each one has unique priorities and action items. For regions such as Sub-Saharan Africa and South Asia, increased intake of nutrient dense foods is needed to address deficiency of essential nutrients like folate, potassium, and vitamin A. For North America and Europe, shifting toward more plant-based diets would be healthier and simultaneously reduce the per capita environmental footprints. The results can be useful for policymakers in designing country-specific strategies for adoption of sustainable dietary behaviors and for food industry to ensure the supply of sustainable food items customized with regions' need.

Healthy and sustainable diets from today to 2050—The role of international trade

The connection between international trade and food systems (un)sustainability is both contentious and critical for policy work supporting progress towards achieving the twin goals of hunger alleviation and dietary health while improving the overall sustainability of development. We characterize the food system using a set of metrics based upon the EAT-Lancet commission dietary guidelines for both over- and under-consumption of different foods to assess country-level dietary health and sustainability in tandem. Using a partial equilibrium model of agricultural production and trade, we then project the functioning of the global agricultural system to 2050 and calculate the metrics for that year. For most regions we find increased overconsumption above the expert-defined healthy and sustainable diet thresholds, with more limited progress towards closing dietary health and sustainability gaps where they currently exist. Trade influences this dynamic into the future under certain socioeconomic conditions, and we find that under a “business as usual” trade environment, future agricultural import profiles continue to be misaligned with dietary health and sustainability outcomes, suggesting the potential for early intervention in trade policy as a means to positively influence food system outcomes.

Retrospective Predictions of Rice and Other Crop Production in Madagascar Using Soil Moisture and an NDVI-Based Calendar from 2010–2017

Malagasy subsistence farmers, who comprise 70% of the nearly 26 million people in Madagascar, often face food insecurity because of unreliable food production systems and adverse crop conditions. The 2020–2021 drought in Madagascar, in particular, is associated with an exceptional food crisis, yet we are unaware of peer-reviewed studies that quantitatively link variations in weather and climate to agricultural outcomes for staple crops in Madagascar. In this study, we use historical data to empirically assess the relationship between soil moisture and food production. Specifically, we focus on major staple crops that form the foundation of Malagasy food systems and nutrition, including rice, which accounts for 46% of the average Malagasy caloric intake, as well as cassava, maize, and sweet potato. Available data associated with survey-based crop statistics constrain our analysis to 2010–2017 across four clusters of Malagasy districts. Strong correlations are observed between remotely sensed soil moisture and rice production, ranging between 0.67 to 0.95 depending on the cluster and choice of crop calendar. Predictions are shown to be statistically significant at the 90% confidence level using bootstrapping techniques, as well as through an out-of-sample prediction framework. Soil moisture also shows skill in predicting cassava, maize, and sweet potato production, but only when the months most vulnerable to water stress are isolated. Additional analyses using more survey data, as well as potentially more-refined crop maps and calendars, will be useful for validating and improving soil-moisture-based predictions of yield.

The role of holistic nutritional properties of diets in the assessment of food system and dietary sustainability

Advancing sustainable diets for nutrition security and sustainable development necessitates clear nutrition metrics for measuring nutritional quality of diets. Food composition, nutrient requirements, and dietary intake are among the most common nutrition metrics used in the current assessment of sustainable diets. Broadly, most studies in the area classify animal-source foods (ASF) as having a substantially higher environmental footprint in comparison to plant-source foods (PSF). As a result, much of the current dietary advice promulgates diets containing higher proportions of PSF. However, this generalization is misleading since most of these studies do not distinguish between the gross and bioavailable nutrient fractions in mixed human diets. The bioavailability of essential nutrients including β-carotene, vitamin B-12, iron, zinc, calcium, and indispensable amino acids varies greatly across different diets. The failure to consider bioavailability in sustainability measurements undermines the complementary role that ASF play in achieving nutrition security in vulnerable populations. This article critically reviews the scientific evidence on the holistic nutritional quality of diets and identifies methodological problems that exist in the way the nutritional quality of diets is measured. Finally, we discuss the importance of developing nutrient bioavailability as a requisite nutrition metric to contextualize the environmental impacts of different diets.

Nutrient Adequacy of Global Food Production

A major challenge for countries around the world is to provide a nutritionally adequate diet to their population with limited available resources. A comprehensive analysis that reflects the adequacy of domestic food production for meeting national nutritional needs in different countries is lacking. Here we combined national crop, livestock, aquaculture, and fishery production statistics for 191 countries obtained from UN FAO with food composition databases from USDA and accounted for food loss and waste occurring at various stages to calculate the amounts of calories and 24 essential nutrients destined for human consumption. We then compared the domestic production quantities of all nutrients with their population-level requirements estimated from age- and sex-specific intake recommendations of WHO to assess the nutrient adequacy of the national food production. Our results show inadequate production of seven out of 24 nutrients (choline, calcium, polyunsaturated fatty acids, vitamin A, vitamin E, folate, and iron) in most countries, despite the overall adequacy of the total global production. High-income countries produce adequate amounts of dietary nutrients in general, while the foods produced in low-income countries mainly comprising roots and cereal products often lack in important micronutrients such as choline, calcium, and vitamin B12. South Asian food production barely fulfills half of the required vitamin A. Our study identifies target nutrients for each country whose domestic production should be encouraged for improving nutritional adequacy through interventions such as increasing the production of foods or fortified foods that are rich in these inadequate nutrients while not undermining the local environment. This assessment can serve as an evidence base for nutrition-sensitive policies facilitating the achievement of the Sustainable Development Goals of zero hunger and good health and well-being.

Development of an Unified Food Composition Database for the European Project "Stance4Health"

The European Commission funded project Stance4Health (S4H) aims to develop a complete personalised nutrition service. In order to succeed, sources of information on nutritional composition and other characteristics of foods need to be as comprehensive as possible. Food composition tables or databases (FCT/FCDB) are the most commonly used tools for this purpose. The aim of this study is to describe the harmonisation efforts carried out to obtain the Stance4Health FCDB. A total of 10 FCT/FCDB were selected from different countries and organizations. Data were classified using FoodEx2 and INFOODS tagnames to harmonise the information. Hazard analysis and critical control points analysis was applied as the quality control method. Data were processed by spreadsheets and MySQL. S4H’s FCDB is composed of 880 elements, including nutrients and bioactive compounds. A total of 2648 unified foods were used to complete the missing values of the national FCDB used. Recipes and dishes were estimated following EuroFIR standards via linked tables. S4H’s FCDB will be part of the smartphone app developed in the framework of the Stance4Health European project, which will be used in different personalized nutrition intervention studies. S4H FCDB has great perspectives, being one of the most complete in terms of number of harmonized foods, nutrients and bioactive compounds included.

Use of the DELTA Model to Understand the Food System and Global Nutrition

BACKGROUND

Increasing attention is being directed at the environmental, social, and economic sustainability of the global food system. However, a key aspect of a sustainable food system should be its ability to deliver nutrition to the global population. Quantifying nutrient adequacy with current tools is challenging.

OBJECTIVE

To produce a computational model illustrating the nutrient adequacy of current and proposed global food systems.

METHODS

The DELTA Model was constructed using global food commodity balance sheet data, alongside demographic and nutrient requirement data from UN and European Food Safety Authority sources. It also includes nutrient bioavailability considerations for protein, the indispensable amino acids, iron, and zinc, sourced from scientific literature.

RESULTS

The DELTA Model calculates global per capita nutrient availability under conditions of equal distribution and identifies areas of nutrient deficiency for various food system scenarios. Modeling the 2018 global food system showed that it supplied insufficient calcium (64% of demographically weighted target intake) and vitamin E (69%), despite supplying sufficient macronutrients. Several future scenarios were modeled, including variations in waste; scaling up current food production for the 2030 global population; plant-based food production systems; and removing sugar crops from the global food system. Each of these scenarios fell short of meeting requirements for multiple nutrients. These results emphasize the need for a balanced approach in the design of future food systems.

CONCLUSIONS

Nutrient adequacy must be at the forefront of the sustainable food system debate. The DELTA Model was designed for both experts and nonexperts to inform this debate as to what may be possible, practical, and optimal for our food system. The model results strongly suggest that both plant and animal foods are necessary to achieve global nutrition. The model is freely available for public use so that anyone can explore current and simulated global food systems.

Aquatic foods to nourish nations

Despite contributing to healthy diets for billions of people, aquatic foods are often undervalued as a nutritional solution because their diversity is often reduced to the protein and energy value of a single food type ('seafood' or 'fish')1-4. Here we create a cohesive model that unites terrestrial foods with nearly 3,000 taxa of aquatic foods to understand the future impact of aquatic foods on human nutrition. We project two plausible futures to 2030: a baseline scenario with moderate growth in aquatic animal-source food (AASF) production, and a high-production scenario with a 15-million-tonne increased supply of AASFs over the business-as-usual scenario in 2030, driven largely by investment and innovation in aquaculture production. By comparing changes in AASF consumption between the scenarios, we elucidate geographic and demographic vulnerabilities and estimate health impacts from diet-related causes. Globally, we find that a high-production scenario will decrease AASF prices by 26% and increase their consumption, thereby reducing the consumption of red and processed meats that can lead to diet-related non-communicable diseases5,6 while also preventing approximately 166 million cases of inadequate micronutrient intake. This finding provides a broad evidentiary basis for policy makers and development stakeholders to capitalize on the potential of aquatic foods to reduce food and nutrition insecurity and tackle malnutrition in all its forms.

Global relationships between crop diversity and nutritional stability

Nutritional stability – a food system’s capacity to provide sufficient nutrients despite disturbance – is an important, yet challenging to measure outcome of diversified agriculture. Using 55 years of data across 184 countries, we assemble 22,000 bipartite crop-nutrient networks to quantify nutritional stability by simulating crop and nutrient loss in a country, and assess its relationship to crop diversity across regions, over time and between imports versus in country production. We find a positive, saturating relationship between crop diversity and nutritional stability across countries, but also show that over time nutritional stability remained stagnant or decreased in all regions except Asia. These results are attributable to diminishing returns on crop diversity, with recent gains in crop diversity among crops with fewer nutrients, or with nutrients already in a country’s food system. Finally, imports are positively associated with crop diversity and nutritional stability, indicating that many countries’ nutritional stability is market exposed.

Crop diversification could be important for food security. Here, using methods from network science, the authors find that a positive relationship between crop diversity and nutritional stability globally does not necessarily equate to improving nutritional stability in a given country.

Income, consumer preferences, and the future of livestock-derived food demand

In recent decades there has been a sustained and substantial shift in human diets across the globe towards including more livestock-derived foods. Continuing debates scrutinize how these dietary shifts affect human health, the natural environment, and livelihoods. However, amidst these debates there remain unanswered questions about how demand for livestock-derived foods may evolve over the upcoming decades for a range of scenarios for key drivers of change including human population, income, and consumer preferences. Future trends in human population and income in our scenarios were sourced from three of the shared socioeconomic pathways. We used scenario-based modeling to show that average protein demand for red meat (beef, sheep, goats, and pork), poultry, dairy milk, and eggs across the globe would increase by 14% per person and 38% in total between the year 2020 and the year 2050 if trends in income and population continue along a mid-range trajectory. The fastest per person rates of increase were 49% in South Asia and 55% in sub-Saharan Africa. We show that per person demand for red meat in high-income countries would decline by 2.8% if income elasticities of demand (a partial proxy for consumer preferences, based on the responsiveness of demand to income changes) in high-income countries decline by 100% by 2050 under a mid-range trajectory for per person income growth, compared to their current trajectory. Prices are an important driver of demand, and our results demonstrate that the result of a decline in red meat demand in high-income countries is strongly related to rising red meat prices, as projected by our scenario-based modeling. If the decline in the income elasticity of demand occurred in all countries rather than only in high-income countries, then per person red meat demand in high-income countries would actually increase in 2050 by 8.9% because the income elasticity-driven decline in global demand reduces prices, and the effect of lower prices outweighs the effect of a decline in the income elasticity of demand. Our results demonstrate the importance of interactions between income, prices, and the income elasticity of demand in projecting future demand for livestock-derived foods. We complement the existing literature on food systems and global change by providing quantitative evidence about the possible space for the future demand of livestock-derived foods, which has important implications for human health and the natural environment.

Assessing the Nutrient Adequacy in China's Food Supply from 1965 to 2018

Nutritional intake has important impacts on human health. A sufficient supply of nutrients is required to ensure high-level nutrition in a population. Assessment of nutrient supply adequacy can help to develop evidence-based policies and thereby promote public health. This study estimates the supply adequacy of nutrients in China's food system from 1965 to 2018 at the national level, aiming to reveal whether the supply of nutrients meets the demand. The results show that the nutrient supply in China's food system has experienced a sharp increase in the past five decades, and the deficiency in nutrient supply has been greatly mitigated. Although most nutrients such as potassium are already sufficiently supplied in China's current food system, some nutrients, especially calcium and zinc, still need a further enlarged supply to improve the nutrition condition of the Chinese population. Besides encouraging a healthy diet, supply-side regulation, e.g., fortification and enrichment, is also needed to improve nutrient availability. This study helps people better understand the development and current situation of nutrient adequacy in China's food supply, thereby providing information and implications for policymakers.

Short-Term Implications of Climate Shocks on Wheat-Based Nutrient Flows: A Global "Nutrition at Risk" Analysis through a Stochastic CGE Model

Food security analyses of international trade largely overlook the importance of substantial heterogeneity and complexity of nutrient content in food products. This paper quantifies the extent to which wheat-based nutrient supplies, including energy, protein, iron, zinc, and magnesium, are exposed to the risks of realistic productivity and trade shocks. By employing a static and stochastic world trade computable general equilibrium (CGE) model, we find that productivity shocks may result in losses in households’ nutrient consumption of up to 18% for protein, 33.1% for zinc, and 37.4% for magnesium. Significant losses are observed in countries mostly in the Middle East, North Africa, and Central Asia. Since the main centers of wheat exports have recently been shifting to former Soviet Union countries, we also simulated the nutritional risks of export restrictions imposed by the Russian Federation, Ukraine, and Kazakhstan, which have resorted to this policy instrument in recent years. We find that partial export restrictions increase the probability of nutrient shocks by five times or more in most countries that we studied. Increased nutrient deficiencies have a range of public health implications in the affected countries, which could be mitigated and/or avoided by adjusting production and trade policies and by targeting high nutritional risk groups, such as women and children. Since the potential implications of supply shocks are diffused across countries through international trade, the stricter regulation of export restrictions to enhance the predictably and reliability of global food supplies is also needed.

The Contribution of Thai Fisheries to Sustainable Seafood Consumption: National Trends and Future Projections

Sustainably feeding a growing human population is one of the greatest food system challenges of the 21st century. Seafood plays a vital role in supporting human wellbeing, by providing bioavailable and nutrient-dense animal-source food. In Thailand, seafood demand is increasing, and wild capture fishery yields have plateaued, due to oceanic ecosystem degradation and fishery stock exploitation. In this study, we investigated the supply trend of fishery products and subsequent seafood-derived nutrient availability over the last decade. In addition, we explored the possibility of predicting seafood availability and consumption levels, including adherence to Thailand’s national food guide and global dietary recommendations for sustainable seafood consumption. Our findings indicate that, at national-level, fishery products supplied between 19% and 35% of the Thai populations recommended dietary protein intake, 4–6% of calcium, 6–11% of iron, and 2–4% of zinc from 1995 to 2015. Nevertheless, our research also reports that if Thailand’s wild-caught seafood production were to decrease by 13%, as is highly likely, by 2030, the country might face a per capita supply deficit of fish and shellfish to meet healthy and sustainable dietary recommendations (28–30 g/day), let alone the current Thai average intake (32 g/day). Although a 1% per year increase in aquaculture production might bridge this supply gap, policymakers and relevant fishery stakeholders must consider the long-term environmental impacts of such an approach in Thailand.

Global dietary convergence from 1970 to 2010, despite inequality in agriculture, leaves undernutrition concentrated in a few countries

Humans globally have similar nutritional needs but face large differences in natural resource endowments and local food production. This study quantifies food system inequality across countries based on natural resource inputs, food/nutrient outputs, and nutrition/health outcomes, from 1970 to 2010. Animal source foods and overweight/obesity show rapid convergence while availability of selected micronutrients demonstrate slower convergence. However, all variables are more equally distributed than national income per capita, whose Gini coefficient declined from 0·71 to 0·65. Inequalities in total and animal-source dietary energy declined from 0·16 to 0·10 and 0·55 to 0·36, respectively. There was convergence in overweight/obesity prevalence from 0·39 to 0·27, while undernutrition and stunting became increasingly concentrated in a few high-burden countries. Characterizing cross-country inequalities in agricultural resources, foods, nutrients, and health can help identify critical opportunities for agriculture and food policies, as well as prioritize research objectives and funding allocation for the coming decade.

Investigating the risks of removing wild meat from global food systems

The COVID-19 pandemic has brought humanity’s strained relationship with nature into sharp focus, with calls for cessation of wild meat trade and consumption, to protect public health and biodiversity.^1,2 However, the importance of wild meat for human nutrition, and its tele-couplings to other food production systems, mean that the complete removal of wild meat from diets and markets would represent a shock to global food systems.3, 4, 5, 6 The negative consequences of this shock deserve consideration in policy responses to COVID-19. We demonstrate that the sudden policy-induced loss of wild meat from food systems could have negative consequences for people and nature. Loss of wild meat from diets could lead to food insecurity, due to reduced protein and nutrition, and/or drive land-use change to replace lost nutrients with animal agriculture, which could increase biodiversity loss and emerging infectious disease risk. We estimate the magnitude of these consequences for 83 countries, and qualitatively explore how prohibitions might play out in 10 case study places. Results indicate that risks are greatest for food-insecure developing nations, where feasible, sustainable, and socially desirable wild meat alternatives are limited. Some developed nations would also face shocks, and while high-capacity food systems could more easily adapt, certain places and people would be disproportionately impacted. We urge decision-makers to consider potential unintended consequences of policy-induced shocks amidst COVID-19; and take holistic approach to wildlife trade interventions, which acknowledge the interconnectivity of global food systems and nature, and include safeguards for vulnerable people.

Global environmental and nutritional assessment of national food supply patterns: Insights from a data envelopment analysis approach

The global food system inextricably connects human health and environmental integrity. It holds the transformative capability to significantly reduce levels of environmental degradation, caused by current food production practices, and alleviate the 'triple burden' of malnutrition, existing due to food consumption patterns. System-wide transitions are therefore paramount to tackling environmental and nutritional challenges that are exacerbated by a rapidly growing population. This work presents a novel application of Data Envelopment Analysis (DEA) to study the sustainability of food supply patterns around the world and appraise the potential to lower environmental pressure without compromising the supply of calories and nutritional quality. By relating environmental impacts to caloric availability and nutritional adequacy, DEA computes a relative performance score for 139 countries and identifies only 18 countries with per capita food supplies that are 'efficient' in transforming five environmental inputs (land use, greenhouse gas emissions, acidification potential, eutrophication potential and freshwater withdrawals) into calories and nutrition. The widespread extent of 'inefficiency' stresses that the significant opportunity and need to reduce environmental impacts from food is truly global and extensive. Results of this analysis also provide quantitative information on the varying degrees of potential to improve the ways in which each nation's population is fed and therefore offers country-specific insight for decision-makers into the integration of environmental and nutritional outcomes for sustainable development.

The Potential Contribution of Fortified Maize Flour, Oil, Rice, Salt, and Wheat Flour to Estimated Average Requirements and Tolerable Upper Intake Levels for 15 Nutrients in 153 Countries

Food fortification is designed to improve the nutritional profile of diets. The purpose of this research was to estimate the potential nutrient contribution of fortified maize flour, oil, rice, salt, and wheat flour in 153 countries, using the national intake (or availability) of the food and the nutrient levels required for fortification. This was done under two scenarios—maximum, where 100% of the food is assumed to be industrially processed and fortified, and realistic, where the maximum value is adjusted based on the percent of the food that is industrially processed and fortified. Under the maximum scenario, the median Estimated Average Requirements (EARs) met ranged from 22–75% for 14 nutrients (vitamins A, B1, B2, B3, B6, B12, D, E, folic acid and calcium, fluoride, iron, selenium and zinc), and 338% for iodine. In the realistic scenario, the median EARs met were 181% for iodine and <35% for the other nutrients. In both scenarios, the median Tolerable Upper Intake Levels (ULs) met were <55% for all nutrients. Under the realistic scenario, no country exceeded 100% of the UL for any nutrient. Current fortification practices of the five foods of interest have the global potential to contribute up to 15 nutrients to the diets of people, with minimal risk of exceeding ULs.

Global Dietary Database 2017: data availability and gaps on 54 major foods, beverages and nutrients among 5.6 million children and adults from 1220 surveys worldwide

BACKGROUND

We aimed to systematically identify, standardise and disseminate individual-level dietary intake surveys from up to 207 countries for 54 foods, beverages and nutrients, including subnational intakes by age, sex, education and urban/rural residence, from 1980 to 2015.

METHODS

Between 2008-2011 and 2014-2020, the Global Dietary Database (GDD) project systematically searched for surveys assessing individual-level intake worldwide. We prioritised nationally or subnationally representative surveys using 24-hour recalls, Food-Frequency Questionnaires or short standardised questionnaires. Data were retrieved from websites or corresponding members as individual-level food group microdata or aggregate stratum-level data. Standardisation included quality assessment; data cleaning; categorising of foods and nutrients and their units; aggregation by demographic strata and energy adjustment.

RESULTS

We standardised and incorporated 1220 surveys into the final GDD 2017 database, together represented 188 countries and 99.0% of the world's population in 2015. 72.1% were nationally, 17.0% subnationally, and 10.9% community-level representative. 41.2% used Food-Frequency Questionnaires; 23.4%, 24-hour recalls; 15.8%, Demographic Health Survey questionnaires; 13.1%, biomarkers and 6.4%, household surveys. 73.9% of surveys included data on children; 52.2%, by urban and rural residence; and 30.2%, by education. Most surveys were in high-income countries, followed by sub-Saharan Africa and Asia. Most commonly ascertained foods were fruits (N=803 surveys), non-starchy vegetables (N=787) and sugar-sweetened beverages (N=440); and nutrients, sodium (N=343), energy (N=256), calcium (N=224) and fibre (N=200). Least available data were on iodine, vitamin A, plant protein, selenium, added sugar and animal protein.

CONCLUSIONS

This systematic search, retrieval and standardised effort provides the most comprehensive empirical evidence on dietary intakes across and within countries worldwide.

Food and nutrition security under global trade: a relation-driven agent-based global trade model

This paper addresses the highly relevant and timely issues of global trade and food security by developing an empirically grounded, relation-driven agent-based global trade model. Contrary to most price-driven trade models in the literature, the relation-driven agent-based global trade model focuses on the role of relational factors such as trust, familiarity, trade history and conflicts in countries' trade behaviour. Moreover, the global trade model is linked to a comprehensive nutrition formula to investigate the impact of trade on food and nutrition security, including macro and micronutrients. Preliminary results show that global trade improves the food and nutrition security of countries in Africa, Asia and Latin America. Trade also promotes a healthier and more balanced diet, as countries have access to an increased variety of food. The effect of trade in enhancing nutrition security, with an adequate supply of macro and micronutrients, is universal across nutrients and countries. As researchers call for a holistic and multifactorial approach to food security and climate change (Hammond and Dubé 2012 Proc. Natl Acad. Sci. USA 109, 12 356-12 363. (doi:10.1073/pnas.0913003109)), the paper is one of the first to develop an integrated framework that consists of socio-economic, geopolitical, nutrition, environmental and agri-food systems to tackle these global challenges. Given the ongoing events of Brexit, the US-China trade war and the global COVID-19 pandemic, the paper will provide valuable insights on the role of trade in improving the food and nutrition security across countries.

Global associations between macronutrient supply and age-specific mortality

Animal experiments have demonstrated that energy intake and the balance of macronutrients determine life span and patterns of age-specific mortality (ASM). Similar effects have also been detected in epidemiological studies in humans. Using global supply data and 1,879 life tables from 103 countries, we test for these effects at a macrolevel: between the nutrient supplies of nations and their patterns of ASM. We find that macronutrient supplies are strong predictors of ASM even after correction for time and economic factors. Globally, signatures of undernutrition are evident in the effects of low supply on life expectancy at birth and high mortality across ages, even as recently as 2016. However, in wealthy countries, the effects of overnutrition are prominent, where high supplies particularly from fats and carbohydrates are predicted to lead to high levels of mortality. Energy supplied at around 3,500 kcal/cap/d minimized mortality across ages. However, we show that the macronutrient composition of energy supply that minimizes mortality varies with age. In early life, 40 to 45% energy from each of fat and carbohydrate and 16% from protein minimizes mortality. In later life, replacing fat with carbohydrates to around 65% of total energy and reducing protein to 11% is associated with the lowest level of mortality. These results, particularly those regarding fats, accord both with experimental data from animals and within-country epidemiological studies on the association between macronutrient intake and risk of age-related chronic diseases.

Reorientation of aquaculture production systems can reduce environmental impacts and improve nutrition security in Bangladesh

Aquatic foods are a critical source of human nutrition in many developing countries. As a result, declines in wild-caught fish landings threaten nutritionally vulnerable populations. Aquaculture presents an opportunity to meet local demand, but it also places pressure on natural resource inputs and causes a range of environmental impacts. Here, we examine whether current aquaculture systems in Bangladesh can be reoriented to address prevailing nutritional deficiencies while minimizing these environmental impacts. Current fish farming practices, even when optimized, cannot fully supply the same essential micronutrient densities of zinc, iron and calcium as wild-caught fish. However, when the proportion of highly nutrient-dense small indigenous fish species (SIS) was increased to at least 30% of the total output in any of the 14 aquaculture production systems analysed, these systems were able to meet or surpass the nutrient densities of average wild-capture fisheries. Extensive aquaculture systems that co-produce fish and rice had the lowest environmental burdens in six out of seven metrics examined when the composition of all aquaculture systems was modified to include 50% SIS. Nutrition-sensitive aquaculture that provides greater human health benefits and minimizes environmental impacts is a key societal challenge that requires targeted interventions and supportive policies.

Spatial prediction of the concentration of selenium (Se) in grain across part of Amhara Region, Ethiopia

Grain and soil were sampled across a large part of Amhara, Ethiopia in a study motivated by prior evidence of selenium (Se) deficiency in the Region's population. The grain samples (teff, Eragrostis tef, and wheat, Triticum aestivum) were analysed for concentration of Se and the soils were analysed for various properties, including Se concentration measured in different extractants. Predictive models for concentration of Se in the respective grains were developed, and the predicted values, along with observed concentrations in the two grains were represented by a multivariate linear mixed model in which selected covariates, derived from remote sensor observations and a digital elevation model, were included as fixed effects. In all modelling steps the selection of predictors was done using false discovery rate control, to avoid over-fitting, and using an α-investment procedure to maximize the statistical power to detect significant relationships by ordering the tests in a sequence based on scientific understanding of the underlying processes likely to control Se concentration in grain. Cross-validation indicated that uncertainties in the empirical best linear unbiased predictions of the Se concentration in both grains were well-characterized by the prediction error variances obtained from the model. The predictions were displayed as maps, and their uncertainty was characterized by computing the probability that the true concentration of Se in grain would be such that a standard serving would not provide the recommended daily allowance of Se. The spatial variation of grain Se was substantial, concentrations in wheat and teff differed but showed the same broad spatial pattern. Such information could be used to target effective interventions to address Se deficiency, and the general procedure used for mapping could be applied to other micronutrients and crops in similar settings.

Projected declines in global DHA availability for human consumption as a result of global warming

Docosahexaenoic acid (DHA) is an essential, omega-3, long-chain polyunsaturated fatty acid that is a key component of cell membranes and plays a vital role in vertebrate brain function. The capacity to synthesize DHA is limited in mammals, despite its critical role in neurological development and health. For humans, DHA is most commonly obtained by eating fish. Global warming is predicted to reduce the de novo synthesis of DHA by algae, at the base of aquatic food chains, and which is expected to reduce DHA transferred to fish. We estimated the global quantity of DHA (total and per capita) currently available from commercial (wild caught and aquaculture) and recreational fisheries. The potential decrease in the amount of DHA available from fish for human consumption was modeled using the predicted effect of established global warming scenarios on algal DHA production and ensuing transfer to fish. We conclude that an increase in water temperature could result, depending on the climate scenario and location, in a ~ 10 to 58% loss of globally available DHA by 2100, potentially limiting the availability of this critical nutrient to humans. Inland waters show the greatest potential for climate-warming-induced decreases in DHA available for human consumption. The projected decrease in DHA availability as a result of global warming would disproportionately affect vulnerable populations (e.g., fetuses, infants), especially in inland Africa (due to low reported per capita DHA availability). We estimated, in the worst-case scenario, that DHA availability could decline to levels where 96% of the global population may not have access to sufficient DHA.

Multi-dimensional characterisation of global food supply from 1961-2013

Food systems are increasingly globalized and interdependent and diets around the world are changing. Characterising national food supplies and how they have changed can inform food policies that ensure national food security, support access to healthy diets and enhance environmental sustainability. Here, we analysed data for 171 countries on availability of 18 food groups from the United Nations Food and Agriculture Organization to identify and track multi-dimensional food supply patterns from 1961 to 2013. Four predominant food group combinations were identified that explained almost 90% of cross-country variance in food supply: animal source and sugar; vegetable; starchy root and fruit; and seafood and oilcrops. South Korea, China and Taiwan experienced the largest changes in food supply over the past five decades, with animal source foods and sugar, vegetables, and seafood and oilcrops all becoming more abundant components of food supply. In contrast, in many Western countries, the supply of animal source foods and sugar declined. Meanwhile, there was remarkably little change in food supply in countries in the sub-Saharan Africa region. These changes have led to a partial global convergence in national supply of animal source foods and sugar, and a divergence in vegetables, and seafood and oilcrops. Our analysis has generated a novel characterisation of food supply that highlights the interdependence of multiple food types in national food systems. A better understanding of how these patterns have evolved and will continue to change is needed to support the delivery of healthy and sustainable food system policies.

The global effect of extreme weather events on nutrient supply: a superposed epoch analysis

BACKGROUND

To date, the effects of extreme weather events on nutrient supply within the population have not been quantified. In this study, we investigated micronutrient, macronutrient, and fibre supply changes during 175 extreme weather events within 87 countries in the year that a major extreme weather event occurred, with a targeted focus on low-income settings.

METHODS

We collected data from the International Disasters Database and the Global Expanded Nutrient Supply model for the period 1961-2010, and applied superposed epoch analysis to calculate the percentage change in nutrient supply during the year of an extreme weather event relative to its historical context. We composited globally and by subgroup (EU, landlocked developing countries, least developed countries, low-income food deficit countries, and net food-importing developing countries). Lastly, we reported nutrient supply changes in terms of recommended dietary allowance for children aged 1-3 years.

FINDINGS

Globally, all micronutrient supplies had a modest negative percentage change during the year of an extreme weather event; of these effects, those that reached an α=0·05 significance level included calcium, folate, thiamin, vitamin B6, and vitamin C, with nutrient supply changes ranging from -0·40 to -1·73% of the average supply. The effect of an extreme weather event was especially magnified among landlocked developing countries and low-income food deficit countries, with significant nutrient supply changes ranging from -1·61 to -7·57% of the average supply. Furthermore, the observed nutrient supply deficits in landlocked developing countries constituted a large percentage (ranging from 1·95 to 39·19%) of what a healthy child's sufficient average dietary intake should be.

INTERPRETATION

The global effects of extreme weather events on nutrient supply found in this study are modest in isolation; however, in the context of nutrient needs for healthy child development in low-income settings, the effects observed are substantial.

FUNDING

Australian-American Fulbright Commission.

Country-Specific Sustainable Diets Using Optimization Algorithm

Current diets of most nations either do not meet the nutrition recommendations or transgress environmental planetary boundaries or both. Transitioning toward sustainable diets that are nutritionally adequate and low in environmental impact is key in achieving the United Nations' Sustainable Development Goals. However, designing region-specific sustainable diets that are culturally acceptable is a formidable challenge. Recent studies have suggested that optimization algorithms offer a potential solution to the above challenge, but the evidence is mostly based on case studies from high-income nations using widely varying constraints and algorithms. Here, we employ nonlinear optimization modeling with a consistent study design to identify diets for 152 countries that meet four cultural acceptability constraints, five food-related per capita environmental planetary boundaries (carbon emissions, water, land, nitrogen, and phosphorus use), and the daily recommended levels for 29 nutrients. The results show that a considerable departure from current dietary behavior is required for all countries. The required changes in intake amounts of 221 food items are highly country-specific but in general point toward a need to reduce the intake of meat, dairy, rice, and sugar and an increase in fruits, vegetables, pulses, nuts, and other grains. The constraints for fiber, vitamin B12, vitamin E, and saturated fats and the planetary boundaries for carbon emissions and nitrogen application were the most difficult to meet, suggesting the need to pay special attention to them. The analysis demonstrates that nonlinear optimization is a powerful tool to design diets achieving multiple objectives.

Combining the effects of increased atmospheric carbon dioxide on protein, iron, and zinc availability and projected climate change on global diets: a modelling study

BACKGROUND

Increasing atmospheric concentrations of carbon dioxide (CO2) affect global nutrition via effects on agricultural productivity and nutrient content of food crops. We combined these effects with economic projections to estimate net changes in nutrient availability between 2010 and 2050.

METHODS

In this modelling study, we used the International Model for Policy Analysis of Agricultural Commodities and Trade to project per capita availability of protein, iron, and zinc in 2050. We used estimated changes in productivity of individual agricultural commodities to model effects on production, trade, prices, and consumption under moderate and high greenhouse gas emission scenarios. Two independent sources of data, which used different methodologies to determine the effect of increased atmospheric CO2 on different key crops, were combined with the modelled food supply results to estimate future nutrient availability.

FINDINGS

Although technological change, market responses, and the effects of CO2 fertilisation on yield are projected to increase global availability of dietary protein, iron, and zinc, these increases are moderated by negative effects of climate change affecting productivity and carbon penalties on nutrient content. The carbon nutrient penalty results in decreases in the global availability of dietary protein of 4·1%, iron of 2·8%, and zinc of 2·5% as calculated using one dataset, and decreases in global availability of dietary protein of 2·9%, iron of 3·9%, and zinc of 3·4% using the other dataset. The combined effects of projected increases in atmospheric CO2 (ie, carbon nutrient penalty, CO2 fertilisation, and climate effects on productivity) will decrease growth in the global availability of nutrients by 19·5% for protein, 14·4% for iron, and 14·6% for zinc relative to expected technology and market gains by 2050. The many countries that currently have high levels of nutrient deficiency would continue to be disproportionately affected.

INTERPRETATION

This approach is an improvement in estimating future global food security by simultaneously projecting climate change effects on crop productivity and changes in nutrient content under increased concentrations of CO2, which accounts for a much larger effect on nutrient availability than CO2 fertilisation. Regardless of the scenario used to project future consumption patterns, the net effect of increasing concentrations of atmospheric CO2 will slow progress in decreasing global nutrient deficiencies.

FUNDING

US Environmental Protection Agency, Consultative Group on International Agricultural Research (CIGAR) Research Program on Policies, Institutions and Markets (PIM), and the CGIAR Research Program on Climate Change and Food Security (CCAFS).

Global Health Implications of Nutrient Changes in Rice Under High Atmospheric Carbon Dioxide

A growing literature has documented that rising concentrations of carbon dioxide in the atmosphere threaten to reduce the iron, zinc, and protein content of staple food crops including rice, wheat, barley, legumes, maize, and potatoes, potentially creating or worsening global nutritional deficiencies for over a billion people worldwide. A recent study extended these previous nutrient analyses to include B vitamins and showed that, in rice alone, the average loss of major B vitamins (thiamin, riboflavin, and folate) was shown to be 17-30% when grown under higher CO2. Here, we employ the EAR cut-point method, using estimates of national-level nutrient supplies and requirements, to estimate how B vitamin dietary adequacy may be affected by the CO2-induced loss of nutrients from rice only. Furthermore, we use the global burden of disease comparative risk assessment framework to quantify one small portion of the health burden related to rising deficiency: a higher likelihood of neural tube defects for folate-deficient mothers. We find that, as a result of this effect alone, risk of folate deficiency could rise by 1.5 percentage points (95% confidence interval: 0.6-2.6), corresponding to 132 million (57-239 million) people. Risk of thiamin deficiency could rise by 0.7 points (0.3-1.1) or 67 million people (30-110 million), and riboflavin deficiency by 0.4 points (0.2-0.6) or 40 million people (22-59 million). Because elevated CO2 concentrations are likely to reduce B vitamins in other crops beyond rice, our findings likely represent an underestimate of the impact of anthropogenic CO2 emissions on sufficiency of B vitamin intake.

Seasonal trends of nutrient intake in rainforest communities of north-eastern Madagascar

OBJECTIVE

We collected dietary records over the course of nine months to comprehensively characterize the consumption patterns of Malagasy people living in remote rainforest areas of north-eastern Madagascar.

DESIGN

The present study was a prospective longitudinal cohort study to estimate dietary diversity and nutrient intake for a suite of macronutrients, micronutrients and vitamins for 152 randomly selected households in two communities.

SETTING

Madagascar, with over 25 million people living in an area the size of France, faces a multitude of nutritional challenges. Micronutrient-poor staples, especially rice, roots and tubers, comprise nearly 80 % of the Malagasy diet by weight. The remaining dietary components (including wild foods and animal-source foods) are critical for nutrition. We focus our study in north-eastern Madagascar, characterized by access to rainforest, rice paddies and local agriculture.

PARTICIPANTS

We enrolled men, women and children of both sexes and all ages in a randomized sample of households in two communities.

RESULTS

Although the Household Dietary Diversity Score and Food Consumption Score reflect high dietary diversity, the Minimum Dietary Diversity-Women indicator suggests poor micronutrient adequacy. The food intake data confirm a mixed nutritional picture. We found that the median individual consumed less than 50 % of his/her age/sex-specific Estimated Average Requirement (EAR) for vitamins A, B12, D and E, and Ca, and less than 100 % of his/her EAR for energy, riboflavin, folate and Na.

CONCLUSIONS

Malnutrition in remote communities of north-eastern Madagascar is pervasive and multidimensional, indicating an urgent need for comprehensive public health and development interventions focused on providing nutritional security.

Healthy Diets and Reduced Land Pressure: Towards a Double Gain for Future Food Systems in Nigeria

Nigeria is one of the most dynamic economies in Africa. Strong GDP and population growth coupled with urbanization trends place tremendous pressures on natural resources and the food systems that are dependent on them. Understanding the impact of these “mega trends” is important to identify key leverage points for navigating towards improved nutrition and food security in Nigeria. This paper contributes to the Foresight Project of the Food Systems for Healthier Diets which aims to analyse how the food system in Nigeria is expected to transform in the next decades, and to identify the leverage points for making sure that the transformation contributes to balanced consumer diets. For the food systems foresight, a well-established global economy-wide model, MAGNET, is applied that enables to capture the interlinkages among different food industry players in one consistent framework. By linking MAGNET to the GENUS nutritional database, it is further possible to relate the developments occurring on a macro-level with detailed macro and micronutrient consumption. Model projections suggest that a process of intensification of agriculture in combination with land substitution appears critical for the evolution of food and nutrition security, and for shifts towards healthy diets for the population. Intensification results in greater diversity of the production systems, which in turn cascades into positive effects on the diversity in the food supply and better food security outcomes.

Health and nutritional aspects of sustainable diet strategies and their association with environmental impacts: a global modelling analysis with country-level detail

BACKGROUND

Sustainable diets are intended to address the increasing health and environmental concerns related to food production and consumption. Although many candidates for sustainable diets have emerged, a consistent and joint environmental and health analysis of these diets has not been done at a regional level. Using an integrated health and environmental modelling framework for more than 150 countries, we examined three different approaches to sustainable diets motivated by environmental, food security, and public health objectives.

METHODS

In this global modelling analysis, we combined analyses of nutrient levels, diet-related and weight-related chronic disease mortality, and environmental impacts for more than 150 countries in three sets of diet scenarios. The first set, based on environmental objectives, replaced 25-100% of animal-source foods with plant-based foods. The second set, based on food security objectives, reduced levels of underweight, overweight, and obesity by 25-100%. The third set, based on public health objectives, consisted of four energy-balanced dietary patterns: flexitarian, pescatarian, vegetarian, and vegan. In the nutrient analysis, we calculated nutrient intake and changes in adequacy based on international recommendations and a global dataset of nutrient content and supply. In the health analysis, we estimated changes in mortality using a comparative risk assessment with nine diet and weight-related risk factors. In the environmental analysis, we combined country-specific and food group-specific footprints for greenhouse gas emissions, cropland use, freshwater use, nitrogen application, and phosphorus application to analyse the relationship between the health and environmental impacts of dietary change.

FINDINGS

Following environmental objectives by replacing animal-source foods with plant-based ones was particularly effective in high-income countries for improving nutrient levels, lowering premature mortality (reduction of up to 12% [95% CI 10-13] with complete replacement), and reducing some environmental impacts, in particular greenhouse gas emissions (reductions of up to 84%). However, it also increased freshwater use (increases of up to 16%) and had little effectiveness in countries with low or moderate consumption of animal-source foods. Following food-security objectives by reducing underweight and overweight led to similar reductions in premature mortality (reduction of up to 10% [95% CI 9-11]), and moderately improved nutrient levels. However, it led to only small reductions in environmental impacts at the global level (all impacts changed by <15%), with reduced impacts in high-income and middle-income countries, and increased resource use in low-income countries. Following public health objectives by adopting energy-balanced, low-meat dietary patterns that are in line with available evidence on healthy eating led to an adequate nutrient supply for most nutrients, and large reductions in premature mortality (reduction of 19% [95% CI 18-20] for the flexitarian diet to 22% [18-24] for the vegan diet). It also markedly reduced environmental impacts globally (reducing greenhouse gas emissions by 54-87%, nitrogen application by 23-25%, phosphorus application by 18-21%, cropland use by 8-11%, and freshwater use by 2-11%) and in most regions, except for some environmental domains (cropland use, freshwater use, and phosphorus application) in low-income countries.

INTERPRETATION

Approaches for sustainable diets are context specific and can result in concurrent reductions in environmental and health impacts globally and in most regions, particularly in high-income and middle-income countries, but they can also increase resource use in low-income countries when diets diversify. A public health strategy focused on improving energy balance and dietary changes towards predominantly plant-based diets that are in line with evidence on healthy eating is a suitable approach for sustainable diets. Updating national dietary guidelines to reflect the latest evidence on healthy eating can by itself be important for improving health and reducing environmental impacts and can complement broader and more explicit criteria of sustainability.

FUNDING

Wellcome Trust, EAT, CGIAR, and British Heart Foundation.

Human augmentation of ecosystems: objectives for food production and science by 2045

Current food production systems require fundamental reformation in the face of population growth, climate change, and degradation of health and the environment. Over the course of human history, every agricultural system that has emerged has featured some sort of trade-off between productivity and environmental load. These trade-offs are causing the planet to exceed the boundaries of its biogeochemical cycles and are triggering an unprecedented extinction rate of wild species, thus pushing global ecosystems to the brink of collapse. In this era, characterized as it is by human activity that can profoundly influence climate and the environment (i.e., the Anthropocene epoch), tipping points can be either negative or positive. While a negative tipping point can produce sudden, rapid, and irreversible deterioration of social and environmental systems, a positive tipping point can produce improved health and sustainable social-ecological systems. The key to promoting positive global tipping points is a thorough understanding of human activity and life history on an evolutionary scale, along with the comprehensive integration of science and technology to produce intelligent policies and practices of food production, particularly in the developing world (See Supplementary Material 1 summary for policymakers). Simply increasing the efficiency and scale of monoculture-intensive agriculture is unlikely to drive social-ecological change in a positive and sustainable direction. A new solution to the health-diet-environment trilemma must be developed to achieve a net positive impact on biodiversity through the anthropogenic augmentation of ecosystems based on the ecological foundation of genetic, metabolic, and ecosystem health. This paper discusses the fundamental requirements for sustainable food production on the molecular, physiological, and ecological scales, including evolutionary and geological insights, in an attempt to identify the global conditions needed for the primary food production to ensure we survive this century. Particular emphasis is placed on how to make extensive use of this planet's genetic resources without irretrievably losing them.