Ultra-Processed Foods and Food System Sustainability: What Are the Links?

GroceryDB: Prevalence of Processed Food in Grocery Stores

The offering of grocery stores is a strong driver of consumer decisions, shaping their diet and long-term health. While highly processed food like packaged products, processed meat, and sweetened soft drinks have been increasingly associated with unhealthy diet, information on the degree of processing characterizing an item in a store is not straightforward to obtain, limiting the ability of individuals to make informed choices. Here we introduce GroceryDB, a database with over 50,000 food items sold by Walmart, Target, and Wholefoods, unveiling how big data can be harnessed to empower consumers and policymakers with systematic access to the degree of processing of the foods they select, and the potential alternatives in the surrounding food environment. The wealth of data collected on ingredient lists and nutrition facts allows a large scale analysis of ingredient patterns and degree of processing stratified by store, food category, and price range. We find that the nutritional choices of the consumers, translated as the degree of food processing, strongly depend on the food categories and grocery stores. Moreover, the data allows us to quantify the individual contribution of over 1,000 ingredients to ultra-processing. GroceryDB and the associated http://TrueFood.Tech/ website make this information accessible, guiding consumers toward less processed food choices while assisting policymakers in reforming the food supply.

Ultra-processing should be understood as a holistic issue, from food matrix, to dietary patterns, food scoring, and food systems

The ultra-processed food (UPF) concept first emerged 15 years ago, and is now studied worldwide in different contexts, for example, human health, food behavior, socio-economic, food consumption, food scoring, and food system sustainability. Briefly, UPFs are defined as containing at least one marker of ultra-processing (MUP). MUPs are (1) cosmetic additives, (2) aromas, (3) some highly processed carbohydrates, proteins, fats, and/or fiber, and (4) drastic processes directly applied to food such as extrusion cooking or puffing. The first three categories of MUPs are on the food packaging in the list of ingredients, and are extracted, then purified, from raw foods or coming from artificial syntheses, leading to a-matrix/a-cellular compounds. Therefore, the core paradigm to define MUP is extreme food matrix degradation, and for UPF, matrix artificialization. Besides, UPFs are more than just junk food, encompassing numerous industrialized foods, falsely presented as healthy, for example, animal-based food analogs, but also organic, vegan, gluten-free, micronutrient-enriched, and/or light foods. In this way, UPFs are "high-quality junk foods." Otherwise, UPF being a holistic and indivisible concept by essence, we propose in this review to analyze ultra-processing at four holistic levels corresponding to four important scientific issues: the food matrix, the dietary pattern, food system, and food scoring. We reached the main conclusion that UPFs should be first studied with a holistic and scientifically based approach, not a reductionist one. Otherwise, we take the risk of performing greenwashing and create still more new health threats at a global level.

TEMPORARY REMOVAL: Ultraprocessing and presence of additives in commercially produced complementary foods in seven Southeast Asian countries: a cross-sectional study

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Food price trends during the COVID-19 pandemic in Brazil

The present study aims to analyze the trends in food price in Brazil with emphasis on the period of the Covid-19 pandemic (from March 2020 to March 2022). Data from the Brazilian Household Budget Survey and the National System of Consumer Price Indexes were used as input to create a novel data set containing monthly prices (R$/Kg) for the foods and beverages most consumed in the country between January 2018 and March 2022. All food items were divided according to the Nova food classification system. We estimated the mean price of each food group for each year of study and the entire period. The monthly price of each group was plotted to analyze changes from January 2018 to March 2022. Fractional polynomial models were used to synthesize price changes up to 2025. Results of the present study showed that in Brazil unprocessed or minimally processed foods and processed culinary ingredients were more affordable than processed and ultra-processed foods. However, trend analyses suggested the reversal of the pricing pattern. The anticipated changes in the prices of minimally processed food relative to ultra-processed food, initially forecasted for Brazil, seem to reflect the impact of the Covid-19 pandemic on the global economy. These results are concerning as the increase in the price of healthy foods aggravates food and nutrition insecurity in Brazil. Additionally, this trend encourages the replacement of traditional meals for the consumption of unhealthy foods, increasing a health risk to the population.

Legumes and common beans in sustainable diets: nutritional quality, environmental benefits, spread and use in food preparations

In recent decades, scarcity of available resources, population growth and the widening in the consumption of processed foods and of animal origin have made the current food system unsustainable. High-income countries have shifted towards food consumption patterns which is causing an increasingly process of environmental degradation and depletion of natural resources, with the increased incidence of malnutrition due to excess (obesity and non-communicable disease) and due to chronic food deprivation. An urgent challenge is, therefore, to move towards more healthy and sustainable eating choices and reorientating food production and distribution to obtain a human and planetary health benefit. In this regard, legumes represent a less expensive source of nutrients for low-income countries, and a sustainable healthier option than animal-based proteins in developed countries. Although legumes are the basis of many traditional dishes worldwide, and in recent years they have also been used in the formulation of new food products, their consumption is still scarce. Common beans, which are among the most consumed pulses worldwide, have been the focus of many studies to boost their nutritional properties, to find strategies to facilitate cultivation under biotic/abiotic stress, to increase yield, reduce antinutrients contents and rise the micronutrient level. The versatility of beans could be the key for the increase of their consumption, as it allows to include them in a vast range of food preparations, to create new formulations and to reinvent traditional legume-based recipes with optimal nutritional healthy characteristics.

Corporate interest groups and their implications for global food governance: mapping and analysing the global corporate influence network of the transnational ultra-processed food industry

BACKGROUND

A major challenge to transforming food systems to promote human health and sustainable development is the global rise in the manufacture and consumption of ultra-processed foods (UPFs). A key driver of this dietary transition is the globalization of UPF corporations, and their organized corporate political activity (CPA) intended to counter opposition and block government regulation. UPF industry CPA and the corporate interest groups who lobby on their behalf have been well described at the national level, however, at the global level, this network has not been systematically characterized. This study aims to map, analyse, and describe this network, and discuss the implications for global food policy action on UPFs, global food governance (GFG), and food systems transformation.

METHODS

We conducted a network analysis of the declared interest group memberships of the world's leading UPF corporations, extracted from web sources, company reports, and relevant academic and grey literature. Data on the characteristics of these interest groups were further extracted for analysis, including year founded, level, type, and headquarter location.

RESULTS

We identified 268 interest groups affiliated with the UPF industry. The UPF manufacturers Nestlé (n = 171), The Coca-Cola Company (n = 147), Unilever (n = 142), PepsiCo (n = 138), and Danone (n = 113) had the greatest number of memberships, indicating strong centrality in coordinating the network. We found that this network operates at all levels, yet key actors now predominantly coordinate globally through multistakeholder channels in GFG. The most common interest group types were sustainability/corporate social responsibility/multistakeholder initiatives, followed by branding and advertising, and food manufacturing and retail. Most corporate interest groups are headquartered where they can access powerful government and GFG decision-makers, nearly one-third in Washington DC and Brussels, and the rest in capital cities of major national markets for UPFs.

CONCLUSIONS

The UPF industry, and especially its leading corporations, coordinate a global network of interest groups spanning multiple levels, jurisdictions, and governance spaces. This represents a major structural feature of global food and health governance systems, which arguably poses major challenges for actions to attenuate the harms of UPFs, and to realising of healthy and sustainable food systems.

The environmental impact of beef and ultra-processed food consumption in Brazil

OBJECTIVE

This study evaluated the independent and combined environmental impacts of the consumption of beef and ultra-processed foods in Brazil.

DESIGN

Cross-sectional study.

SETTING

Brazil.

PARTICIPANTS

We used food purchases data from a national household budget survey conducted between July 2017 and July 2018, representing all Brazilian households. Food purchases were converted into energy, carbon footprints and water footprints. Multiple linear regression models were used to assess the association between quintiles of beef and ultra-processed foods in total energy purchases and the environmental footprints, controlling for sociodemographic variables.

RESULTS

Both beef and ultra-processed foods had a significant linear association with carbon and water footprints (P < 0·01) in crude and adjusted models. In the crude upper quintile of beef purchases, carbon and water footprints were 47·7 % and 30·8 % higher, respectively, compared to the lower quintile. The upper quintile of ultra-processed food purchases showed carbon and water footprints 14·4 % and 22·8 % higher, respectively, than the lower quintile. The greatest reduction in environmental footprints would occur when both beef and ultra-processed food purchases are decreased, resulting in a 21·1 % reduction in carbon footprint and a 20·0 % reduction in water footprint.

CONCLUSIONS

Although the environmental footprints associated with beef consumption are higher, dietary patterns with lower consumption of beef and ultra-processed foods combined showed the greatest reduction in carbon and water footprints in Brazil. The high consumption of beef and ultra-processed foods is harmful to human health, as well as to the environment; thus, their reduction is beneficial to both.

Fix my food: An urgent call to action from adolescents on how they experience and want to see change in their food systems

BACKGROUND

Global food systems are failing adolescents. Poor diet quality driving malnutrition among adolescents around the world and the quality of foods eaten by adolescents not only determines their health and development, but also is the foundation of thriving communities. The present study aimed to engage adolescents across low-income, middle-income and high-income countries to determine their lived experience of food, food systems and the challenges they face within their food systems.

METHODS

The study used the Distributed Data Generation method pioneered by the Young and Resilient Research Centre, at Western Sydney University, to conduct workshops with adolescents aged 10-19 years across the globe in collaboration with UNICEF. Participatory workshops were designed to capture qualitative data on adolescents lived experiences and perspectives of their food systems, food sustainability and food security, and how improvements can be made. Thematic analysis was undertaken to analyse qualitative data. Descriptive statistics were generated for demographic data captured.

RESULTS

Six hundred and forty adolescents across 18 countries participated. Three key themes emerged, which included experiences of food, challenges to food systems and strengthening food systems. Adolescents saw potential in empowering communities to create change and contribute to food system transformation. Adolescents called for inclusion in decision-making from local food practice to large global policy development.

CONCLUSIONS

The study results demonstrated how adolescents experience their food systems and want to see sustainable change, although they also want to be a part of the change. Adolescents described that there needs to be an active choice to work with them, listen to their lived experience and across all levels of society strengthen food systems. To achieve this, adolescents need to be involved in decision-making around their food systems for a sustainable future.

Nutritional, environmental and economic impacts of ultra-processed food consumption in Australia

OBJECTIVE

To quantify the full life cycle impacts of ultra-processed foods (UPF) for key environmental, economic and nutritional indicators to identify trade-offs between UPF contribution to broad-scope sustainability.

DESIGN

Using 24-h dietary recalls along with an input-output database for the Australian economy, dietary environmental and economic impacts were quantified in this national representative cross-sectional analysis. Food items were classified into non-UPF and UPF using the NOVA system, and dietary energy contribution from non-UPF and UPF fractions in diets was estimated. Thereafter, associations between nutritional, environmental and economic impacts of non-UPF and UPF fractions of diets were examined using a multi-dimensional nutritional geometry representation.

SETTING

National Nutrition and Physical Activity Survey 2011-2012 of Australia.

PARTICIPANTS

Respondents (n 5344) aged > 18 years with 1 d of 24-h dietary recall data excluding respondents with missing values and outlier data points and under reporters.

RESULTS

Australian diets rich in UPF were associated with reduced nutritional quality, high greenhouse gas emissions, energy use, and increased employment and income associated with the food supply chains. The environmental and economic impacts associated with the UPF portion of diets become more distinct when the diets are standardised to average protein recommendation.

CONCLUSION

Increased consumption of UPF has socio-economic benefits, but this comes with adverse effects on the environment and public health. Consideration of such trade-offs is important in identifying policy and other mechanisms regarding UPF for establishing healthy and sustainable food systems.

What is the purpose of ultra-processed food? An exploratory analysis of the financialisation of ultra-processed food corporations and implications for public health

BACKGROUND

In recent decades there has been a global rise in consumption of ultra-processed foods (UPFs) to the detriment of population health and the environment. Large corporations that have focused heavily on low-cost manufacturing and extensive marketing of UPFs to maximise profits have driven this dietary transition. The same corporations claim to serve the interests of multiple 'stakeholders', and that they are contributing to sustainable development. This paper aimed to test these claims by examining the degree to which UPF corporations have become 'financialised', focusing on the extent to which they have prioritised the financial interests of their shareholders relative to other actors, as well as the role that various types of investors have played in influencing their governance. Findings were used to inform discussion on policy responses to improve the healthiness of population diets.

METHODS

We adopted an exploratory research design using multiple methods. We conducted quantitative analysis of the financial data of U.S. listed food and agricultural corporations between 1962 and 2021, share ownership data of a selection of UPF corporations, and proxy voting data of a selection of investors between 2012 and 2022. We also conducted targeted narrative reviews using structured and branching searches of academic and grey literature.

RESULTS

Since the 1980s, corporations that depend heavily on manufacturing and marketing UPFs to generate profits have been increasingly transferring money to their shareholders relative to their total revenue, and at a level considerably higher than other food and agricultural sectors. In recent years, large hedge fund managers have had a substantial influence on the governance of major UPF corporations in their pursuit of maximising short-term returns. In comparison, shareholders seeking to take steps to improve population diets have had limited influence, in part because large asset managers mostly oppose public health-related shareholder proposals.

CONCLUSIONS

The operationalisation of 'shareholder primacy' by major UPF corporations has driven inequity and undermines their claims that they are creating 'value' for diverse actors. Measures that protect population diets and food systems from the extractive forces of financialisation are likely needed as part of efforts to improve the healthiness of population diets.

Comparison of the Declared Nutrient Content of Plant-Based Meat Substitutes and Corresponding Meat Products and Sausages in Germany

Plant-based meat substitutes (PBMS) are becoming increasingly popular due to growing concerns about health, animal welfare, and environmental issues associated with animal-based foods. The aim of this study was to compare the declared energy and nutrient contents of PBMS with corresponding meat products and sausages available on the German market. Mandatory nutrition labelling data of 424 PBMS and 1026 meat products and sausages, surveyed in 2021 and 2020, respectively, as part of the German national monitoring of packaged food were used to test for differences in energy and nutrient contents. Principal component analysis (PCA) was used to describe characteristics in the energy and nutrient contents. The comparison showed that most of the PBMS subcategories had significantly lower contents of fat and saturated fat but higher contents of carbohydrate and sugar than corresponding meat subcategories. For salt, the only striking difference was that PBMS salamis had lower salt content than meat salamis. Overall, the PCA revealed protein as a main characteristic for most PBMS categories, with the protein content being equivalent to or, in most protein-based PBMS, even higher than in the corresponding meat products. The wide nutrient content ranges within subcategories, especially for salt, reveal the need and potential for reformulation.

Beyond Plants: The Ultra-Processing of Global Diets Is Harming the Health of People, Places, and Planet

Global food systems are a central issue for personal and planetary health in the Anthropocene. One aspect of major concern is the dramatic global spread of ultra-processed convenience foods in the last 75 years, which is linked with the rising human burden of disease and growing sustainability and environmental health challenges. However, there are also calls to radically transform global food systems, from animal to plant-derived protein sources, which may have unintended consequences. Commercial entities have moved toward this "great plant transition" with vigor. Whether motivated by profit or genuine environmental concern, this effort has facilitated the emergence of novel ultra-processed "plant-based" commercial products devoid of nutrients and fiber, and sometimes inclusive of high sugar, industrial fats, and synthetic additives. These and other ingredients combined into "plant-based" foods are often assumed to be healthy and lower in calorie content. However, the available evidence indicates that many of these products can potentially compromise health at all scales-of people, places, and planet. In this viewpoint, we summarize and reflect on the evidence and discussions presented at the Nova Network planetary health meeting on the "Future of Food", which had a particular focus on the encroachment of ultra-processed foods into the global food supply, including the plant-sourced animal protein alternatives (and the collective of ingredients therein) that are finding their way into global fast-food chains. We contend that while there has been much uncritical media attention given to the environmental impact of protein and macronutrient sources-meat vs. novel soy/pea protein burgers, etc.-the impact of the heavy industrial processing on both human and environmental health is significant but often overlooked, including effects on cognition and mental health. This calls for a more nuanced discourse that considers these complexities and refocuses priorities and value systems towards mutualistic solutions, with co-benefits for individuals, local communities, and global ecology.

Ultra-processed foods: a fit-for-purpose concept for nutrition policy activities to tackle unhealthy and unsustainable diets

Modern nutrition science began approximately 100 years ago in the context of nutrient deficiency diseases. Nutrition research and policy activities were framed mostly within a reductionist paradigm in which foods were analysed as being a collection of their constituent nutrients. Today, nutrition problems extend to all forms of malnutrition as well as environmental sustainability considerations and are associated with food and dietary pattern exposures. In 2009, researchers investigating the nutrition transition in Brazil proposed that industrial food processing was a key determinant of nutrition problems. The NOVA food classification system which is based on the nature, extent and purposes of food processing was developed to operationalise this proposition. The ultra-processed food (UPF) concept within NOVA is receiving much attention in relation to nutrition research and policy activities. This commentary describes the UPF concept as being fit-for-purpose in providing guidance to inform policy activities to tackle unhealthy and unsustainable diets. There is now a substantial body of evidence linking UPF exposure with adverse population and planetary health outcomes. The UPF concept is increasingly being used in the development of food-based dietary guidelines and nutrition policy actions. It challenges many conventional nutrition research and policy activities as well as the political economy of the industrial food system. Inevitably, there are politicised debates associated with UPF and it is apparent a disproportionate number of articles claiming the concept is controversial originate from a small number of researchers with declared associations with UPF manufacturers. Prominent examples of these claims are assessed.

Different levels of ultra-processed food and beverage consumption and associations with environmental sustainability and all-cause mortality in EPIC-NL

BACKGROUND

The adverse health effects of high ultra-processed food and drink consumption (UPFD) are well documented. However, its environmental impact remains unclear and the separate effects of ultra-processed foods (UPF) and drinks (UPD) on all-cause mortality are not previously studied.

OBJECTIVES

To assess the association between levels of UPFD, UPF and UPD consumption with diet-related environmental impacts and all-cause mortality in Dutch adults.

METHODS

Habitual diets were assessed by FFQ in 1993-1997 among 38,261 participants of the EPIC-NL cohort. The mean follow-up time was 18.2 years (SD 4.1), 4,697 deaths occurred. FFQ-items were categorized according to the NOVA classification. Associations with quartiles of UPFD, UPF, and UPD consumption and environmental impact indicators were analyzed using general linear models and with all-cause mortality by Cox proportional hazard models. The lowest UPFD, UPF, UPD consumption quartiles were used as comparator.

RESULTS

The average UPFD consumption was 181 (SD 88) g per 1000 kcal. High UPF consumption was statistically significantly inversely associated with all environmental impact indicators (_Q4vsQ1: -13.6% to -3.0%) whereas high UPD consumption was, except for land use, statistically significant positively associated with all environmental impact indicators (_Q4vsQ1: 5.9% to 1.2%). High UPFD consumption was heterogeneously associated with environmental impacts (_Q4vsQ1: 2.6% to -4.0% ). After multivariable adjustment, the highest quartiles of UPFD and UPD consumption were significantly associated with all-cause mortality (HR_Q4vsQ1 1.20, 95%CI 1.10,1.30 and HR_Q4vsQ1 1.19, 95%CI 1.09,1.29, respectively). UPF consumption of Q2 and Q3 were associated with a borderline significant lower risk of all-cause mortality (HR_Q2vsQ1 0.93, 95% CI 0.85,1.00; HR_Q3vsQ1 0.91, 95% CI 0.84,0.99), while Q4 was not statistically significant (HR_Q4vsQ1 1.05, 95% CI 0.96,1.15).

CONCLUSIONS

Reducing UPD consumption could lower environmental impact and all-cause mortality risk, however this was not shown for UPF. When categorizing foods consumption by their degree of processing trade-offs are observed for human and planetary health aspects.

Understanding the corporate political activity of the ultra - processed food industry in East Asia: a Philippines case study

BACKGROUND

Evidence is mounting that the ultra - processed food industry seeks to influence food and nutrition policies in ways that support market growth and protect against regulatory threats, often at the expense of public health. However, few studies have explored how this occurs in lower - middle income countries. We aimed to explore if and how the ultra - processed food industry seeks to influence food- and nutrition - related policy processes in the Philippines, a lower - middle income country in East Asia.

METHODS

Semi - structured key informant interviews were conducted with ten representatives from the Philippines government and non - government organisations closely involved with nutrition policy making in the Philippines. Interview schedules and data analysis were guided by the policy dystopia model, which we used to identify the instrumental and discursive strategies used by corporate actors to influence policy outcomes.

RESULTS

Informants were of the view that ultra - processed food companies in the Philippines sought to delay, prevent, water - down and circumvent implementation of globally recommended food and nutrition policies by engaging in a range of strategies. Discursive strategies included various tactics in which globally recommended policies were framed as being ineffective or highlighting potential unintended negative impacts. Instrumental strategies included: directly engaging with policymakers; promoting policies, such as industry - led codes and practices, as substitutes for mandatory regulations; presenting evidence and data that industry has generated themselves; and offering gifts and financial incentives to government individuals and agencies.

CONCLUSIONS

In the Philippines, the ultra - processed food industry engaged in overt activities designed to influence food and nutrition policy processes in their favour. A range of measures to minimise industry influence on policy processes should be introduced, to ensure that implemented food and nutrition policies align with best practice recommendations.

Impact of Ultra-Processed Food Consumption on Quality of Diet among Brazilian Pregnant Women Assisted in Primary Health Care

The quality of diet and nutritional status during pregnancy are crucial to optimize maternal and fetal health. Ultra-processed foods (UPFs) are increasingly prevalent in pregnancy groups despite being nutritionally unbalanced and associated with adverse perinatal outcomes. This cross-sectional study, conducted with data from 229 pregnant women, aimed to investigate the association between UPFs consumption and dietary nutrient intake of pregnant women assisted by Primary Health Care (PHC) in Federal District (DF), Brazil. Food consumption was assessed through two non-consecutive 24-h food records and categorized by the extent of processing using the NOVA classification. Multivariate linear regression models were used to analyze the association between the quintiles of UPF consumption and the total energy and nutrients intake. Mean daily energy intake was 1741 kcal, with 22.6% derived from UPFs. Greater UPF consumption was associated with reduced intake of unprocessed and minimally processed food. The highest quintile of UPFs was positively associated with higher total energy, trans fat, and sodium intake; and inversely associated with the diet content of protein, fiber, iron, magnesium, potassium, copper, zinc, selenium, and folate. Greater UPFs intake negatively impacts the nutritional quality of the diet and impoverishes the nutrient intake of pregnant women. Reducing UPF consumption may broadly improve dietary guidelines adherence in pregnant women and promote maternal and neonatal health.

Ultra-processed foods: a fit-for-purpose concept for nutrition policy activities to tackle unhealthy and unsustainable diets

Modern nutrition science began approximately 100 years ago in the context of nutrient deficiency diseases. Nutrition research and policy activities were framed mostly within a reductionist paradigm in which foods were analysed as being a collection of their constituent nutrients. Today, nutrition problems extend to all forms of malnutrition as well as environmental sustainability considerations and are associated with food and dietary pattern exposures. In 2009, researchers investigating the nutrition transition in Brazil proposed that industrial food processing was a key determinant of nutrition problems. The NOVA food classification system which is based on the nature, extent and purposes of food processing was developed to operationalise this proposition. The ultra-processed food (UPF) concept within NOVA is receiving much attention in relation to nutrition research and policy activities. This commentary describes the UPF concept as being fit-for-purpose in providing guidance to inform policy activities to tackle unhealthy and unsustainable diets. There is now a substantial body of evidence linking UPF exposure with adverse population and planetary health outcomes. The UPF concept is increasingly being used in the development of food-based dietary guidelines and nutrition policy actions. It challenges many conventional nutrition research and policy activities as well as the political economy of the industrial food system. Inevitably, there are politicised debates associated with UPF and it is apparent a disproportionate number of articles claiming the concept is controversial originate from a small number of researchers with declared associations with UPF manufacturers. Prominent examples of these claims are assessed.

Strategies used by the soft drink industry to grow and sustain sales: a case-study of The Coca-Cola Company in East Asia

BACKGROUND

The market and non-market activities of the food and beverage industry contribute to unhealthy and unsustainable dietary patterns, increasingly in low-income and middle-income countries (LMICs). We aimed to describe how The Coca-Cola Company (TCCC), as the world market leader in the sugar-sweetened beverage sector, operationalises their activities in LMICs in East Asia, among the world's most highly populated yet under-researched countries, to illustrate the ways in which these activities may negatively influence health outcomes.

METHODS

We adopted a theoretically-guided qualitative research design and documentary analysis method. Data sources included: industry documents and web pages, marketing case studies obtained from the World Advertising Research Centre, media reports, global trade summaries and websites of industry associations. To guide data analysis, we synthesised a conceptual framework from existing commercial determinants of health literature, to describe ways in which the market and non-market activities of TCCC influence health.

RESULTS

TCCC leverages subsidiary companies and investments in international networks to expand its supply chains. The company engages in frequent political activities to minimise the implementation of nutrition policies that may impact profits. The company markets products, particularly on digital and mobile devices, often targeting children, adolescents and mothers, and undertakes public relations activities related to human rights, environmental sustainability and community and economic supports, and these public relations activities are often integrated into marketing campaigns. The identified activities of TCCC are frequently in direct contrast to efforts to improve the healthfulness of population diets in East Asia LMICs.

CONCLUSIONS

A public health analysis of the market and non-market activities of corporations active in unhealthy commodity industries needs to be broad in scope to cover the diverse set of strategies used to increase their market power and influence. Governments should consider a suite of policy options to attenuate these commercial determinants of unhealthy diets.

Environmental sustainability in national food-based dietary guidelines: a global review

Food-based dietary guidelines (FBDGs) provide country-specific guidance on what constitutes a healthy diet. With increasing evidence for the synergy between human and planetary health, FBDGs have started to consider the environmental sustainability of food choices. However, the number of countries that discuss environmental sustainability in their guidelines is unknown. The purpose of this Review was to identify countries with government-endorsed FBDGs that made explicit mention of environmental sustainability and to examine the breadth and depth of the inclusion of sustainability in FBDGs. The Food and Agriculture Organization of the UN identified 95 countries with FBDGs. We assessed 83 countries against our inclusion criteria, of which 37 mentioned environmental sustainability. Relevant content was assessed against a set of criteria based on the Food and Agriculture Organization's guiding principles for sustainable healthy diets. The depth to which environmental sustainability was discussed varied and it was often restricted to general explanations of what a sustainable diet is. Few FBDGs addressed why sustainability is important, how dietary changes can be made, or provided quantified advice for implementing sustainable diets.

Pathways to sustainable land use and food systems in Canada

Meeting global sustainability targets under the United Nations Sustainable Development Goals and the Paris Agreement requires paying attention to major land-use sectors such as forestry and agriculture. These sectors play a large role in national emissions, biodiversity conservation, and human well-being. There are numerous possible pathways to sustainability in these sectors and potential synergies and trade-offs along those pathways. This paper reports on the use of a model for Canada's land use to 2050 to assess three different pathways (one based on current trends and two with differing levels of ambition for meeting sustainability targets). This was done as part of a large international consortium, Food, Agriculture, Biodiversity, Land and Energy (FABLE), which allows for incorporating international trade in meeting both national and global sustainability targets. The results show not only the importance of increasingly stringent policies in meeting the targets, but also the role that population and consumption (e.g., diets) play in meeting the targets. Both the medium and high ambition sustainability pathways can drastically reduce greenhouse gas emissions while protecting forestland.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11625-022-01213-z.

Making Healthy, Sustainable Diets Accessible and Achievable: A New Framework for Assessing the Nutrition, Environmental, and Equity Impacts of Packaged Foods

There is a growing global consensus among food system experts that diets and how we source our foods must change. The sustainable nutrition community continues exploring the environmental impact and dietary value of foods. Packaged foods have been largely ignored within the dialogue, and if they are addressed, existing frameworks tend to label them all as "ultraprocessed" and uniformly discourage their consumption. This approach lacks the nuance needed to holistically evaluate packaged foods within recommended dietary patterns. Additionally, there is considerable diversity of opinion within the literature on these topics, especially on how best to improve nutrition security in populations most at risk of diet-related chronic disease. In support of addressing these challenges, 8 sustainability and nutrition experts were convened by Clif Bar & Company for a facilitated discussion on the urgent need to drive adoption of healthy, sustainable diets; the crucial role that certain packaged foods can play in helping make such diets achievable and accessible; and the need for actionable guidance around how to recommend and choose packaged foods that consider human, societal, and planetary health. This article summarizes the meeting discussion, which informed the development of a proposed framework based on guiding principles for defining sustainable, nutritious packaged foods across key nutrition, environmental, economic, and sociocultural well-being indicators. Although additional research is needed to substantiate specific metrics in order to operationalize the framework, it is intended to be a foundation from which to build and refine as science and measurement capabilities advance, and an important step toward broader adoption of healthy, sustainable diets.

Relevant characteristics of food products based on alternative proteins according to European consumers

BACKGROUND

The objective of this study was to evaluate the importance attributed by consumers in Denmark (DK), Germany (DE) and Spain (ES) and across dietary lifestyles to the characteristics of different types of foods based on alternative proteins. Data were collected through a web-based survey (15 November to 16 December 2019). A total of 872 completed questionnaires from DK (n = 258), DE (n = 296) and ES (n = 318) were obtained.

RESULTS

Four segments according to frequency of animal- and plant-based food consumption were identified: (i) no animal, high plant; (ii) low animal, high plant; (iii) moderate animal and plant; and (iv) high animal, moderate plant. Across all segments, foods based on legumes/pulses as well as plant-based spreads and products that do not resemble meat in taste and texture were of interest. Segment 4 was more in favour of 'health' as an important factor in new food products, whereas segment 1 was more likely to consider 'animal friendly', 'minimally processed', 'environmentally friendly' and 'produced with minimum CO₂ emissions' as key aspects. Furthermore, familiarity was of minor importance across the segments. This could indicate an opening for new, innovative plant-based alternatives that have their own identity.

CONCLUSION

An overall interest exists towards innovative food products based on plant protein, specifically legumes/pulses, among consumers in the three countries and across different dietary lifestyles. © 2021 Society of Chemical Industry.

Consensus-building around the conceptualisation and implementation of sustainable healthy diets: a foundation for policymakers

BACKGROUND

Healthy and sustainable diets need to be adopted to reduce the negative impact of food consumption on human and planetary health. Food systems account for a third of greenhouse gas emissions. "Dietary Patterns for Health and Sustainability" is a World Health Organization (WHO) project that aims to build consensus among international food, health, and sustainability experts and policymakers on how to conceptualise healthy and sustainable diets and on the actions and policies that could be implemented in the WHO European Region to promote these diets.

METHODS

A qualitative study among European food, health, and sustainability experts and policymakers to elicit their views on multiple dimensions of food sustainability and health was carried out using a three-phase process, including semi-structured interviews, a Nominal Group Technique, and focus groups during a participatory WHO workshop held in Copenhagen. Thematic analysis was used to analyse the three data sources.

RESULTS

The workshop resulted in a shared understanding of the interconnected components of sustainable healthy eating habits. As a result of this understanding, a variety of potential solutions were identified, including actions across different policy domains, tools, strategic guidelines, needs, and pathways for sustainable healthy diets. The pathways included the need for a multi-stakeholder approach, as well as the simultaneous execution of an aligned and coherent mix of policies at the local and national levels.

CONCLUSIONS

The prioritised actions should be aimed at helping government policymakers promote sustainable healthy diets and make decisions on improving dietary patterns for citizens' health and wellbeing in line with the United Nations Sustainable Development Goals in the European Region.

Ultra-processed foods and cancer risk: from global food systems to individual exposures and mechanisms

Ultra-processed foods (UPFs) have become increasingly dominant globally, contributing to as much as 60% of total daily energy intake in some settings. Epidemiological evidence suggests this worldwide shift in food processing may partly be responsible for the global obesity epidemic and chronic disease burden. However, prospective studies examining the association between UPF consumption and cancer outcomes are limited. Available evidence suggests that UPFs may increase cancer risk via their obesogenic properties as well as through exposure to potentially carcinogenic compounds such as certain food additives and neoformed processing contaminants. We identify priority areas for future research and policy implications, including improved understanding of the potential dual harms of UPFs on the environment and cancer risk. The prevention of cancers related to the consumption of UPFs could be tackled using different strategies, including behaviour change interventions among consumers as well as bolder public health policies needed to improve food environments.

A Comparative Analysis of Plant-Based Milk Alternatives Part 1: Composition, Sensory, and Nutritional Value

Consumers are becoming increasingly interested in reducing the consumption of animal-based foods for health, sustainability, and ethical reasons. The food industry is developing products from plant-based ingredients that mimic animal-based foods’ nutritional and sensory characteristics. In this study, the focus is on plant-based milk alternatives (PBMAs). A potential problem with plant-based diets is the deficiency of important micronutrients, such as vitamin B12, B2, and calcium. Therefore, an analysis of micronutrients in PBMAs was conducted to assess their nutritional value. The second main focus was on the sensory description of the PBMAs, done by a trained panel, and instrumental assessment to characterize the sensory attributes. Almond drinks met the daily micronutrient requirements the least, while soy drinks came closest to cow’s milk in macro- and micronutrients. The experimentally determined electronic tongue and volatile compound results confirmed the sensory panel’s evaluations and could therefore be used as a method for easy and effective assessments of PBMAs. The PBMAs evaluated in this study could not completely replace cow’s milk’s nutritional and sensory properties. They are products in their own product group and must be evaluated accordingly. Given the variety of products, consumers should experiment and make their decisions regarding the substitution of cow’s milk.

Ultra-Processed Foods Elicit Higher Approach Motivation Than Unprocessed and Minimally Processed Foods

Background

Ultra-processed foods (UPF) are becoming extensively available in the food environments. UPF are industrial formulations that are designed to maximize palatability and consumption through a combination of calorie-dense ingredients and chemical additives. UPFs are also aggressively marketed, which may make them more attractive than unprocessed/minimally processed foods (UMPF). Since consumers' purchase decisions are guided by food-evoked emotions, we aimed to provide evidence that UPF visual cues trigger higher emotional responses and approach motivation than UMPF visual cues, with potential impacts on individuals' intention to consume the UPF over the UMPF.

Methods

Participants (n = 174; 144 women; mean age = 20.7 years; standard deviation = 4.35) performed two tasks. In the first task, 16 pictures of foods (8 UPF and 8 UMPF), and 74 pictures from other affective categories, were presented. After viewing each picture, the participants rated it along two basic dimensions of emotion through the Self-Assessment Manikin scale: pleasantness and arousal. In the second task, the participants viewed the same food pictures, and they rated their intention to consume the foods depicted in the pictures. Each picture was plotted in terms of its mean pleasantness and arousal ratings in a Cartesian plane, which resulted in an affective space.

Results

Pictures of UPF and UMPF were positioned in the upper arm of the boomerang-shaped affective space that represents approach motivation. Pictures containing UPF triggered higher approach motivation and intention to consume than pictures containing UMPF. We also found a stronger association between emotional responses and intention to consume UPF relative to UMPF.

Conclusion

These results shed new light on the role of ultra-processed foods evoked emotions that contribute to less healthy and sustainable food environments.

Perspective: Soy-based Meat and Dairy Alternatives, Despite Classification as Ultra-processed Foods, Deliver High-quality Nutrition on Par with Unprocessed or Minimally Processed Animal-based Counterparts

In many non-Asian countries, soy is consumed via soy-based meat and dairy alternatives, in addition to the traditional Asian soyfoods, such as tofu and miso. Meat alternatives are typically made using concentrated sources of soy protein, such as soy protein isolate (SPI) and soy protein concentrate (SPC). Therefore, these products are classified as ultra-processed foods (UPFs; group 4) according to NOVA, an increasingly widely used food-classification system that classifies all foods into 1 of 4 groups according to the processing they undergo. Furthermore, most soymilks, even those made from whole soybeans, are also classified as UPFs because of the addition of sugars and emulsifiers. Increasingly, recommendations are being made to restrict the consumption of UPFs because their intake is associated with a variety of adverse health outcomes. Critics of UPFs argue these foods are unhealthful for a wide assortment of reasons. Explanations for the proposed adverse effects of UPFs include their high energy density, high glycemic index (GI), hyper-palatability, and low satiety potential. Claims have also been made that UPFs are not sustainably produced. However, this perspective argues that none of the criticisms of UPFs apply to soy-based meat and dairy alternatives when compared with their animal-based counterparts, beef and cow milk, which are classified as unprocessed or minimally processed foods (group 1). Classifying soy-based meat and dairy alternatives as UPFs may hinder their public acceptance, which could detrimentally affect personal and planetary health. In conclusion, the NOVA classification system is simplistic and does not adequately evaluate the nutritional attributes of meat and dairy alternatives based on soy.

The influence mechanism and spatial effect of carbon emission intensity in the agricultural sustainable supply: evidence from china's grain production

Agricultural carbon mitigation is critical for China to encourage the sustainable development of agriculture and achieve the carbon peak by 2030 and carbon neutrality by 2060. By exploring the impact mechanism of the carbon emission intensity (CEI) of grain production, we can effectively promote the low-carbon transformation of agricultural production and ensure the sustainable development of the food supply. This article analyzes the temporal and spatial evolution of the total carbon emission (TCE) and CEI of staple crops and adopts a dynamic spatial model to explore the influence mechanism and spatial spillover effects of the CEI of grain production based on evidence from China's major grain-producing provinces from 2002 to 2018. The results indicate that the TCEs of rice, wheat, and maize fluctuate upward and that the CEI in most producing areas decreases with low-low agglomeration (or high-high agglomeration). Among the influencing factors, technology is the main factor reducing CEI. Technical efficiency, urbanization, industrial structure, agricultural agglomeration, and agricultural trade openness can be transmitted to neighboring areas through spatial spillover mechanisms. The spatial spillover mechanisms are resource flow, technology spillover, and policy learning, producing the demonstration effect and siphon effect. Based on our findings, agricultural technology innovation and popularization, urbanization, optimization of the agricultural structure, financial payments, and factor flow among regions should be improved to encourage the low carbon transformation of grain production.

Meat-Reduced Dietary Practices and Efforts in 5 Countries: Analysis of Cross-Sectional Surveys in 2018 and 2019

BACKGROUND

Diets that reduce reliance on animal-source foods are recommended in some contexts.

OBJECTIVES

This study aimed to compare proportions of respondents who reported following meat-reduced dietary practices (i.e., vegetarian, vegan, or pescatarian diets) and/or making efforts to reduce animal-source foods, and to examine sociodemographic correlates across 5 countries.

METHODS

Online surveys were conducted in November and December 2018 and 2019 with 41,607 adults from Australia (n = 7926), Canada (n = 8031), Mexico (n = 8110), the United Kingdom (n = 9129), and the United States (n = 8411) as part of the International Food Policy Study. Respondents were asked whether they would describe themselves as vegetarian, vegan, or pescatarian, and whether they had made efforts to consume less red meat, less of all meats, or less dairy in the past year. Logistic regressions examined differences in the likelihood of each behavior between countries and sociodemographic subgroups.

RESULTS

Approximately 1 in 10 respondents reported following a vegetarian, vegan, or pescatarian diet, ranging from 8.6% (Canada) to 11.7% (UK). In the past 12 months, the proportions of respondents who reported efforts to consume less red meat ranged from 34.5% (Australia) to 44.4% (Mexico), less of all meats ranged from 27.9% (US) to 35.2% (Mexico), and to consume less dairy ranged from 20.6% (UK) to 41.3% (Mexico). Respondents were more likely to report efforts to consume less animal-source products in 2019 compared to 2018 in most countries. Sociodemographic patterns varied by country; in general, women, those with higher education levels, and those in minority ethnic groups were more likely to report following meat-reduced dietary practices or efforts to consume fewer animal-source products.

CONCLUSIONS

Nearly half of respondents reported following a meat-reduced diet or efforts to reduce animal-source products, with differences between countries and population subgroups. Population-level approaches and policies that support meat reduction may further reduce consumption of animal-source products.

Evaluation of foods, drinks and diets in the Netherlands according to the degree of processing for nutritional quality, environmental impact and food costs

OBJECTIVE

This study investigates nutritional quality, environmental impact and costs of foods and drinks and their consumption in daily diets according to the degree of processing across the Dutch population.

DESIGN

The NOVA classification was used to classify the degree of processing (ultra-processed foods (UPF) and ultra-processed drinks (UPD)). Food consumption data were derived from the Dutch National Food Consumption Survey 2012-2016. Indicators assessed were nutritional quality (saturated fatty acids (SFA), sodium, mono and disaccharides (sugar), fibre and protein), environmental impact (greenhouse gas (GHG) emissions and blue water use) and food costs.

SETTING

The Netherlands.

PARTICIPANTS

Four thousand three hundred thirteen Dutch participants aged 1 to 79 years.

RESULTS

Per 100 g, UPF were more energy-dense and less healthy than unprocessed or minimally processed foods (MPF); UPF were associated with higher GHG emissions and lower blue water use, and were cheaper. The energy and sugar content of UPD were similar to those of unprocessed or minimally processed drinks (MPD); associated with similar GHG emissions but blue water use was less, and they were also more expensive. In the average Dutch diet, per 2000 kcal, ultra-processed foods and drinks (UPFD) covered 29% (456 g UPF and 437 g UPD) of daily consumption and 61% of energy intake. UPFD consumption was higher among children than adults, especially for UPD. UPFD consumption determined 45% of GHG emissions, 23% of blue water use and 39% of expenses for daily food consumption. UPFD consumption contributed 54% to 72% to daily sodium, sugar and SFA intake.

CONCLUSIONS

Compared with unprocessed or minimally processed foods and drinks, UPF and UPD were found to be less healthy considering their high energy, SFA, sugar and sodium content. However, UPF were associated higher GHG emissions and with less blue water use and food costs. Therefore daily blue water use and food costs might increase if UPF are replaced by those unprocessed or minimally processed. As nutritional quality, environmental impacts and food costs relate differently to the NOVA classification, the classification is not directly applicable to identify win-win-wins of nutritional quality, environmental impact and costs of diets.

Classification of African Native Plant Foods Based on Their Processing Levels

With increasing advocacy for plant food consumption, the sub-Saharan Africa landscape is home to diverse plant-based food commodities. The need to leverage the advantages of unprocessed/minimally processed foods (PFs) over ultra-processed foods (UPFs) is a system that requires exploitation. Most of the crops produced in the continent are either classified as traditionally or moderately PFs. However, the rise in industrialization and formalization of markets is impacting and marginalizing traditional food processing (FP). Current FP classification frameworks are briefly discussed. The level of processing of cereals, grains, fruits, vegetables, roots, and tuber crops in the continent requires intervention from nutritionists, food scientists, and scientific and governmental bodies to gain a holistic view and tackle the issue of food insecurity in Africa. This study reviews the levels of processing of African foods, challenges, and future directions.

Unhealthy Dieting During the COVID-19 Pandemic: An Opinion Regarding the Harmful Effects on Brain Health

Since 2020, the world has been suffering from a pandemic that has affected thousands of people regardless of socio-economic conditions, forcing the population to adopt different strategies to prevent and control the advance of the disease, one of which is social distancing. Even though social distancing is a safe strategy to reduce the spread of COVID-19, it is also the cause of a rising sedentary behavior. This behavior develops an excess of fat tissue that leads to metabolic and inflammatory disruption related to chronic diseases and mental health disorders, such as anxiety, depression, and sleep issues. Furthermore, the adoption of dietary patterns involving the consumption of ultra-processed foods, higher in fats and sugars, and the reduction of fresh and healthy foods may play a role in the progress of the disease. In this perspective, we will discuss how an unhealthy diet can affect brain function and, consequently, be a risk factor for mental health diseases.

The nutrition transition, food retail transformations, and policy responses to overnutrition in the East Asia region: A descriptive review

BACKGROUND

The East Asia region is facing an increasing burden of overweight, obesity and related noncommunicable diseases, resulting from an ongoing nutrition transition. This study aimed to document the growing burden of overweight and obesity, and the accompanying dietary shifts, in the East Asia region and describe the policy responses to this.

METHODS

We present noncommunicable disease risk factor collaboration data on trends in the burden of malnutrition, and Euromonitor International data on trends in dietary purchases, in the East Asia region. We searched the NOURISHING and GINA databases to identify food and nutrition policies implemented in these countries.

RESULTS

There is an ongoing nutrition transition in the East Asia region, notably in upper-middle and lower-middle income countries. The prevalence of overweight, obesity, and accompanying health conditions, purchases of ultra-processed foods and beverages, and purchasing from supermarkets, fast-food and takeaway outlets, and other convenience retailers, are increasing. The policy response to this nutrition transition is limited, with the majority of policies implemented in higher-income countries.

CONCLUSIONS

East Asian countries are facing a growing burden of malnutrition, due in part to the dietary shifts occurring here. An ecological approach to policy intervention is needed to drive transformative food systems change.

Dietitians Australia position statement on healthy and sustainable diets

It is the position of Dietitians Australia that to promote human and planetary health, a food system transformation is needed that enables the population to adopt healthy and sustainable diet-related practices. A healthy and sustainable diet must (i) be nutritionally adequate, healthy and safe, (ii) have low environmental impact and be protective of natural resources and biodiversity, (iii) be culturally acceptable and (iv) be accessible, economically fair and affordable. Dietitians Australia acknowledges that it is critical to prioritise Indigenous knowledges in consultation, policy-making and implementation processes to achieve these recommendations. In facilitating the uptake of healthy and sustainable diets, dietitians are contributing to the transformation of our current food system that is urgently required to nourish present and future generations within planetary boundaries. In developing this position statement, opportunities for future research have been identified including those to advance the professions' capacity to improve environmental sustainability outcomes across all areas of practice. To achieve a population-level shift towards this diet, Dietitians Australia recommends: (i) the development of a National Food and Nutrition Strategy which honours Indigenous knowledges on food systems, (ii) the integration of sustainability principles in Australia's dietary guidelines, (iii) the reorientation of our food environment to prioritise access to healthy and sustainable foods, and (iv) investment in capacity building activities to equip the current and future nutrition and dietetics workforce.

The nutrition transition to a stage of high obesity and noncommunicable disease prevalence dominated by ultra-processed foods is not inevitable

The Nutrition Transition model is presented with the nature and pace of change in key stages varying by location and subpopulations. At present, all high-income and many low- and middle-income countries are in a stage of the transition where nutrition-related noncommunicable diseases including obesity, type 2 diabetes, and hypertension are dominating adult morbidity and mortality and are very high or growing rapidly in prevalence. Some countries still have key subpopulations facing hunger and undernutrition defined by stunting or extreme thinness among adults. We call these double burden of malnutrition countries. All low- and middle-income countries face rapid growth in consumption of ultra-processed food and beverages, but it is not inevitable that these countries will reach the same high levels of consumption seen in high-income countries, with all the negative impacts of this diet on health. With great political and civil society commitment to adoption of policies shown in other countries to have improved dietary choices and social norms around foods, we can arrest and even reverse the rapid shift to diets dominated by a stage of high ultra-processed food intake and increasing prevalence of nutrition-related noncommunicable diseases.

[What is ultra-processed food and how is it related to diet-related diseases?]

Ultra-processed food is part of a modern lifestyle and accounts for about 46 % of daily energy intake in Germany. Cross-sectional and cohort studies indicate associations between consumption of ultra-processed food and a range of non-communicable diseases (obesity, diabetes, cancer, cardiovascular disease, and depression). As underlying mechanisms, a high energy density, altered food matrix, an unbalanced nutritional composition, high glycemic index, adverse additives, processing- and packaging contaminants are discussed. In order to understand the role of these potential mechanisms and to provide a scientifically based and risk-associated definition of ultra-processed food it is important to conduct appropriate intervention studies and to improve dietary assessment of processed food in prospective cohort studies.

Transition to a Sustainable Circular Plastics Economy in The Netherlands: Discourse and Policy Analysis

The circular economy (CE) has become a key sustainability discourse in the last decade. The Netherlands seeks to become fully circular by 2050 and the EU has set ambitious circularity targets in its CE Action Plan of 2015. The plastics sector, in particular, has gained a lot of attention as it is a priority area of both the EU and Dutch CE policies. However, there has been little research on the different and often contested discourses, governance processes and policy mechanisms guiding the transition to a circular economy and society. This paper aims to fill these gaps by asking what circular discourses and policies are being promoted in the Netherlands and what sustainability implications and recommendations can be drawn from it. It does so through a mix of media analysis, policy analysis, semi-structured interviews, and surveys using Q-methodology. Results indicate a dominance of technocentric imaginaries, and a general lack of discussion on holistic, and transformative visions, which integrate the full social, political, and ecological implication of a circular future. To address those challenges, this research brings key policy insights and recommendations which can help both academics and practitioners better understand and implement the transition towards a sustainable circular plastics economy.

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.

Sustainable Food Support during an Ultra-Endurance and Mindfulness Event: A Case Study in Spain

The present industrial food-production system is not suitably ecological for the environment. Mindful nutrition in sport is a relevant emergent sub-discipline that could help reduce environmental degradation. This case study describes a sustainable support diet during an ultra-endurance running (UR) event called the "Indoor Everest Challenge". This UR challenge involved attaining the altitude of Mount Everest (8849 m) in a simulated way, in less than 24 h, without using ultra-processed food and without wasting plastics. During this challenge, a male athlete (34 years, weight: 78 kg, and height: 173 cm) wore a SenseWear Armband® (BodyMedia Inc., Pittsburg, PA, USA) accelerometer on his right arm to estimate energy expenditure. To supply his nutritional requirements, the athlete consumed only specially prepared homemade and organic food. All consumption was weighed and recorded in real-time; we determined nutrients using two databases: a food composition software, Dial Alce Ingenieria® (Madrid, Spain), to measure energy and macro- and micro-nutrients, and Phenol Explorer Database® (INRA Institut National de Recherche pour l'Alimentation, Paris, France) precisely to determine polyphenolic content. Most energy intake (up to 96%) came from plant foods. We found that subject consumed 15.8 g/kg-1/d-1 or 1242 g of carbohydrates (CHO), (2.4 g/kg-1/d-1) or 190 g of proteins (P), and 10,692 mL of fluid. The total energy intake (7580 kcal) showed a distribution of 65% CHO, 10% P, and 25% lipids (L). Furthermore, this sustainable diet lead to a high antioxidant intake, specifically vitamin C (1079 mg), vitamin E (57 mg), and total polyphenols (1910 mg). This sustainable approach was suitable for meeting energy, CHO, and P recommendations for UR. Physical and mental training (mindfulness) were integrated from the specific preliminary phase to the day of the challenge. The athlete completed this challenge in 18 h with a low environmental impact. This sports event had an educational component, as it awakened curiosity towards food sustainability.

Recommendations for Integrating Evidence-Based, Sustainable Diet Information into Nutrition Education

The adoption of more sustainable diets (SD) has the capacity to meet the needs of individuals without compromising future generations' abilities to do the same. Nutrition educators are ideal candidates for delivering SD education to consumers, yet evidence-based recommendations for the profession have not been crafted. The results of a thorough, narrative review of the literature performed in 2021 suggest there are five well-supported recommendations nutrition educators should consider incorporating in their work. They are (1) shift towards a plant-based diet, (2) mitigate food waste, (3) limit consumption of ultra-processed foods (UPF), (4) engage in local food systems, and (5) choose sustainable seafood. Each recommendation is discussed below in detail, to provide nutrition educators with a nuanced scope of the issue, after which suggestions for the inclusion of these recommendations, using an example of the authors' experiences from the US Expanded Food and Nutrition Education Program (EFNEP), are provided.

A Multidisciplinary Perspective of Ultra-Processed Foods and Associated Food Processing Technologies: A View of the Sustainable Road Ahead

Ultra-processed foods (UPFs) are negatively perceived by part of the scientific community, the public, and policymakers alike, to the extent they are sometimes referred to as not "real food". Many observational surveys have linked consumption of UPFs to adverse health outcomes. This narrative synthesis and scientific reappraisal of available evidence aims to: (i) critically evaluate UPF-related scientific literature on diet and disease and identify possible research gaps or biases in the interpretation of data; (ii) emphasize the innovative potential of various processing technologies that can lead to modifications of the food matrix with beneficial health effects; (iii) highlight the possible links between processing, sustainability and circular economy through the valorisation of by-products; and (iv) delineate the conceptual parameters of new paradigms in food evaluation and classification systems. Although greater consumption of UPFs has been associated with obesity, unfavorable cardiometabolic risk factor profiles, and increased risk for non-communicable diseases, whether specific food processing techniques leading to ultra-processed formulations are responsible for the observed links between UPFs and various health outcomes remains elusive and far from being understood. Evolving technologies can be used in the context of sustainable valorisation of food processing by-products to create novel, low-cost UPFs with improved nutritional value and health potential. New paradigms of food evaluation and assessment should be funded and developed on several novel pillars-enginomics, signalling, and precision nutrition-taking advantage of available digital technologies and artificial intelligence. Research is needed to generate required scientific knowledge to either expand the current or create new food evaluation and classification systems, incorporating processing aspects that may have a significant impact on health and wellness, together with factors related to the personalization of foods and diets, while not neglecting recycling and sustainability aspects. The complexity and the predicted immense size of these tasks calls for open innovation mentality and a new mindset promoting multidisciplinary collaborations and partnerships between academia and industry.

Greenhouse gas emissions, water footprint, and ecological footprint of food purchases according to their degree of processing in Brazilian metropolitan areas: a time-series study from 1987 to 2018

BACKGROUND

The consumption of ultra-processed foods has increased worldwide and has been related to the occurrence of obesity and other non-communicable diseases. However, little is known about the environmental effects of ultra-processed foods. We aimed to assess the temporal trends in greenhouse gas emissions (GHGE), water footprint, and ecological footprint of food purchases in Brazilian metropolitan areas, and how these are affected by the amount of food processing.

METHODS

In this time-series study, we used data from five Brazilian Household Budget Surveys (1987-88, 1995-96, 2002-03, 2008-09, 2017-18) to calculate GHGE, water footprint, and ecological footprint per 1000 kcal of food and beverages purchased. Food items were classified into NOVA food groups: unprocessed or minimally processed foods (G1); processed culinary ingredients (G2); processed foods (G3); and ultra-processed foods (G4). We calculated the proportion each NOVA food group contributes to daily kcal per person. Linear regression was performed to evaluate trends of the environmental impacts across the years.

FINDINGS

Between 1987-88 and 2017-18, diet-related GHGE increased by 21% (from 1538·6 g CO₂ equivalent [CO₂e] per 1000 kcal [95% CI 1473·3-1604·0] to 1866·0 g CO₂e per 1000 kcal [1788·0-1944·0]; p_trend<0·0001), diet-related water footprint increased by 22% (from 1447·2 L/1000 kcal [95% CI 1400·7-1493·8] to 1769·1 L/1000 kcal [1714·5-1823·7]; p_trend<0·0001), and diet-related ecological footprint increased by 17% (from 9·69 m²/1000 kcal [95% CI 9·33-10·05] to 11·36 m²/1000 kcal [10·91-11·81]; p_trend<0·0001). We found that the change in the environmental indicators over time varied between NOVA food groups. We did not find evidence of a change in the environmental indicators for G1 foods over time. GHGE from G2 foods decreased by 18% (p_trend<0·0001), whereas GHGE from G4 foods increased by 245% (p_trend<0·0001). The water footprint from G2 foods decreased by 17% (p_trend<0·0001) whereas the water footprint from G4 foods increased by 233% (p_trend<0·0001). The ecological footprint from G2 foods decreased by 13% (p_trend<0·0001), whereas the ecological footprint from G3 foods increased by 49% (p_trend<0·0001) and from G4 foods increased by 183% (p_trend<0·0001). We found no significant change in contribution by any other NOVA food groups to any of the three environmental indicators over the study period.

INTERPRETATION

The environmental effects of the Brazilian diet have increased over the past three decades along with increased effects from ultra-processed foods. This means that dietary patterns in Brazil are becoming potentially more harmful to human and planetary health. Therefore, a shift in the current trend would be needed to enhance sustainable healthy food systems.

FUNDING

Science and Technologies Facilities Council-Global Challenges Research Fund.

The food system and climate change: are plant-based diets becoming unhealthy and less environmentally sustainable?

A plant-based diet, which can include small amounts of meat, is the foundation for healthy sustainable diets, which will have co-benefits for health, climate and the environment. Studies show that some of the barriers to making this dietary change and reducing meat consumption are perceptions that plant-based diets are inconvenient, it takes too much time and skills to prepare meals and ingredients are expensive. The food environment is changing and the industry is responding with the exponential increase in the market of highly processed, convenient and cheap plant-based foods. This overcomes some of the barriers, but there is concern about whether they are healthy and environmentally sustainable. Plant-based foods have a halo effect around health and the environment, but many being produced are ultra-processed foods that are high in energy, fat, sugar and salt and have a higher environmental impact than minimally processed plant-based foods. The trend towards eating more highly processed plant-based convenience foods is a concern with regard to both public health and the targets set to reduce greenhouse gas (GHG) emissions. The 'modern day' plant-based diet emerging is very different to a more traditional one comprising pulses, vegetables and wholegrain. Studies show that those who are younger and have been a vegetarian for a shorter duration are eating significantly more ultra-processed plant-based foods. While there is a place for convenient, desirable and affordable plant-based food to encourage dietary change, care should be taken that this does not subconsciously set a path which may ultimately be neither healthy nor sustainable.