Understanding human water turnover in times of water scarcity

This writing was originally published in Cell Metabolism in their February issue.

Water covers 70% of the planet; however, only 3% is freshwater, which the global population depends on to drink, irrigate crops, and for our sanitation and hygiene. Water is central to almost all human activity and endeavors and, most importantly, the homeostasis of our bodily functions and health. We know that access to both adequate quantity and quality of water drives optimal health. Still, when in shortage or contaminated, it can cause deleterious effects on various health outcomes, some more known than others (1).

While there is substantial research understanding the health effects of insufficient water intake, there are measurement uncertainties in how much water people consume, retain, and excrete as well as a paucity of evidence on the influence of physical, metabolic, and environmental factors on water homeostasis in the human body. A recent study by Yamada et al. published in Science provides further insight into the determinants of water turnover (WT) or the water processed and used by the body (2). The largest study of its kind, they sampled 5,604 people living across 23 countries across diverse regions of the world ranging from 8 days to 96 years old. They examined whether age, body composition, physical activity, socioeconomic status, and geographical attributes of various regions impacted WT. They did this by having subjects consume 100 ml of water, of which 5% was deuterated. This isotope tracking allowed the investigators to measure WT in a highly accurate and precise way.

Predictably, WT was highest in neonates and decreased with age, positively correlated with free mass, total energy expenditure, and physical activity, and negatively correlated with percent body fat. Interestingly, where people live, and their livelihoods matter for WT as well. WT was higher in those living in hotter and more humid places and higher altitude areas. People with traditional livelihoods, such as hunter-gatherers and subsistence farmers, had higher WT than those working outside agriculture. Furthermore, people living in countries characterized as having a low human development index (HDI)—a comprehensive composite index that measures the different dimensions of human development, including standards of living, life expectancy, and education—had higher WT than those living in countries with middle- and high HDI, even after adjusting for physiological and environmental factors.

While some of these results may not be surprising regarding age and biology, they present clear warning signs of vulnerability when considering looming global scenarios, trends, and shocks to water security, with poor populations disproportionately suffering the most severe consequences (3). The world is already grappling with water scarcity—the availability of water depends on an intimate dance between a region's water demand and water supply. As it stands, 4 billion people live with severe water scarcity at least one month a year, with nearly half of those people living in China and India. Half a billion live with severe water scarcity all year round (4). Distressing still, 784 million people worldwide lack access to safe drinking water (5). The figure below shows how these numbers break down by the four major country income groups, and climate change will likely worsen this situation.

Figure 1: Number of people (millions) without access to safe drinking water, 2020

Legend: Each bar represents the surface (drinking water directly from a river, dam, lake, pond, stream, canal, or irrigation canal), limited (drinking water from an improved source for which collection time exceeds 30 minutes for a roundtrip including queuing) and unimproved (drinking water from an unprotected dug well or unprotected spring) sources of drinking water by country income classification. Source: World Health Organization and UNICEF Joint Monitoring Programme, 2021

Climate change will have significant impacts on how much water is available as well as its quality. Already, water systems that provide freshwater to human populations are drying up and polluted from overuse and runoff, much of this coming from agriculture and other anthropogenic forces (6). Water ecosystems around the world will also continue to be strained and stressed. For example, since 1900, approximately 68% of wetlands have been lost, which are essential ecosystems that purify drinking water systems, among many other functions (7). In addition, extreme weather events related to climate change, such as changes to precipitation and severe drought, as well as the melting of glacier ice, is and will continue to impact water resources. There will also be a decline in the quality of water sources due to anthropogenic and natural factors, along with an increased demand for water due to higher temperatures and evaporation rates. As a result, water insecurity under "business as usual" climate scenarios will worsen (8).

Human demand for water worldwide has increased six-fold over the past century and continues to rise at around 1% per year due to the growing population and global economy (9). At the current consumption rate, by 2025, two-thirds of the world's population may face water shortages (10). What will be the consequences for those vulnerable populations living in countries of low HDI given their increased demand for water? Even a slight imbalance in the delicate homeostasis of WT could put these populations at disproportionate risk for various health disparities, along with constraints on access to improved water safety and quality.

We are just beginning to understand the importance of how water is cycled through the body and how to measure it. Yamada and colleagues shed further light on the factors influencing how water is used and excreted in the body. One gap they highlight is the inability to measure the influence of water coming from food on WT. For those who work in food security, it will be necessary to understand how the quality and diversity of diets contribute to and potentially further protect water homeostasis in distinct biological, sociodemographic, and geographical contexts. Understanding this relationship could spur joint policy action among communities concerned with food and water security. With climate disruption continuing to threaten the quantity and quality of food and water sources, scientific and geopolitical collaboration has never been more urgent.  

References

1.     Popkin, B.M., D’Anci, K.E., and Rosenberg, I.H. (2010). Water, hydration, and health. Nutr. Rev. 68, 439–458.

2.     Yamada, Y., Zhang, X., Henderson, M.E.T., Sagayama, H., Pontzer, H., Watanabe, D., Yoshida, T., Kimura, M., Ainslie, P.N., Andersen, L.F., et al. (2022). Variation in human water turnover associated with environmental and lifestyle factors. Science 378, 909–915.

3.     Dell’Angelo, J., Rulli, M.C., and D’Odorico, P. (2018). The global water grabbing syndrome. Ecol. Econ. 143, 276–285.

4.     Mekonnen, M.M., and Hoekstra, A.Y. (2016). Four billion people facing severe water scarcity. Sci. Adv. 2, e1500323.

5.     World Health Organization and UNICEF (2021). World Health Organization and UNICEF Joint Monitoring Programme. https://washdata.org/data/household#!/dashboard/new.

6.     van Vliet, M.T.H., Flörke, M., and Wada, Y. (2017). Quality matters for water scarcity. Nat. Geosci. 10, 800–802.

7.     Davidson, N.C. (2014). How much wetland has the world lost? Long-term and recent trends in global wetland area. Mar. Freshw. Res. 65, 934.

8.     IPCC (2022). Climate Change 2022: Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change (Cambridge University Press).

9.     Water, U.A.U.N. (2020). United Nations World Water Development Report 2020: water and climate change (United Nations Educational, Scientific and Cultural Organization).

10.   World Wildlife Fund. (2023). Water Scarcity https://www.worldwildlife.org/threats/water-scarcity#:~:text=Billions%20of%20People%20Lack%20Water&text=By%202025%2C%20two%2Dthirds%20of%20the%20world's%20population%20may%20be,and%20economic%20decline%20may%20occur.

We may not have a choice but to consume alternative proteins

Climate change is having profound impacts on the ability to grow both foods for humans and feed for livestock. Growing food and feeding livestock, in turn, exacerbates climate change. Livestock raised for beef is responsible for 6 percent of total greenhouse gas emissions largely in the form of methane. Livestock is also the number one driver of deforestation around the world, reducing the chances for large forest biomes to serve as carbon sinks.

While these stresses continue to rise if no significant action is taken to mitigate climate change, demand for meat is rising all over the world. According to the UN Food and Agriculture Organization, beef consumption has been steadily rising over the last few decades, and as people become wealthier, the more meat they consume. And people, well, like meat!

Some tech companies have come up with a solution—alternative proteins—which include lab-grown meat, plant-based meat, single-cell proteins from yeast or algae, and edible insects. The lab- and plant-based alternative innovations mimic the taste, smell, and texture of meat and could be significant disruptors, eliminating the need for people to raise or consume animals.

As of now, the products available for consumers are mainly plant-based proteins like Impossible Burger and Beyond Beef. Data suggests that these foods are tasty to most consumers and have lower environmental footprints and greenhouse gas emissions than beef. They also have benefits for those who care about animal welfare.

They are however under scrutiny about their health properties and cost. Some argue these foods are overly processed, with a lot of artificial ingredients to get them to a state of palatability. Beyond Burger has approximately 25 ingredients whereas beef has just one ingredient – muscle tissue. They are also costly. One Impossible burger in Washington DC’s Founding Farmer restaurant costs $17.50 as compared to the all-beef cheeseburger at $14.50.

The products in the R&D pipeline – such as lab-grown meats – will have to undergo significant regulation by governments and there is the issue of scale. In the film, Meat the Future, the company Upside Foods (formerly known as Memphis Meats), which is using cells taken from an animal to grow meat, is challenged in making enough products at scale to feed the world’s growing population. While these are hurdles, there are some glimpses of promise. Those that have tried these products are pleasantly surprised at how similar they taste to the real thing and issues of scale are just temporary roadblocks.

Yet, will consumers accept and embrace these foods? The backlash against genetically modified foods shows early signs of what may come as companies begin to get lab-grown meats to market. Many consumers may argue these foods are fake and may be hesitant about their food being “grown” in Petri dishes. 

The big issue is, that we may not have a choice but to eat lab-grown meats. It will be very difficult to raise livestock in a hotter world. Not only will feed and water be scarce, but hotter climates wreak havoc on the health of the animals. These projected adverse effects will put premiums on the price of meat in the grocery store.

So while the world can be picky for the time being, these new foods may become our mainstay survival foods because they may be the only option. To ensure these foods are affordable, accessible, and acceptable to consumers all over the world, and not just curious rich people, several things need to happen.

First, companies producing these foods need to ensure transparency in how these foods are produced, and their impacts across a broad range of outcomes, particularly health and nutrition. There is a need for transparency regarding their nutritional content that is easy for consumers to understand and find. Companies should take lessons from how genetically modified foods were communicated and the fears and doubts they have raised among consumers.

Second, for those products that have unhealthy ingredients with losing palatability, the companies should work hard to reformulate the products to decrease the content of sodium and unhealthy fats. They should also work to fortify these foods with adequate micronutrients.

Third, these foods should be low cost, or real meat should be more expensive, keeping with the true costs to produce beef. As the demand for these alternatives increases and more companies come on board with new products, as with any economies of scale, the price will come down.

Last, while the innovation for these new foods is tempting, there are many traditional foods such as legumes, insects, and algae that have important nutritional value, particularly protein, have low environmental footprints, and do not require raising animals. These traditional foods, while traditional, may offer low-cost, low-resources alternatives to shiny and new future foods.

The Future of Food

Growing, producing, and shipping food are big contributors to climate change. According to the UN Food and Agriculture Organization, about one-third of the global greenhouse gas emissions come from the world's food systems. Food is "an instigator of climate change and it's a victim of climate change," said Jessica Fanzo, director of the Johns Hopkins Global Food Ethics and Policy Program and author of Can Fixing Dinner Fix the Planet?, in an interview with Mike Walter of CGTN.

One of the solutions is changing individuals' diets, what Fanzo and fellow food researchers from the EAT-Lancet Commission call a "planetary health diet." The diet is high in fruits and vegetables, as well as beans, legumes, nuts, and seeds, while food from animal sources, including meat, fish, and dairy, are low. Not only is this sustainable for the planet, "it's a very plant-based diet that meets nutritional needs, decreases your risk for non-communicable diseases like cardiovascular disease and diabetes and stroke, all these long-term, chronic, quite costly diseases," Fanzo said.

Can Fixing Dinner Fix the Planet?

Two years ago, I embarked on the writing of my very first book. Coming from a field of expertise that values peer-reviewed scientific publications more than books, I did not think it was in the cards to consider authoring a book about my discipline and my experience working in that discipline. But here we are, and tomorrow, my JHU Press Wavelength series trade book, Can Fixing Dinner Fix the Planet? will be released. The pandemic helped, unfortunately. It nudged me to sit still and put pen to paper.

The book investigates the interactions among food systems, diets, human health, and the climate crisis. It draws on my experiences (along with my team and many colleagues) working and living in Africa, Asia, Europe, and the Americas. It describes how food systems must change to slow and reverse the stark trends we see with increased hunger and obesity, catastrophic climate change, and inequities. The book draws attention to the idea that the very nature of food and food systems can play a significant role in fixing these vexing challenges and bring communities together.

Food books abound—cookbooks by celebrity chefs (thanks Anthony Bourdain!), history of food and cuisines, and self-help diet books. My book does not delve into these areas much. Instead, it delves deep into politics and shows that if we take a “business as usual” path of how food systems have, are, and will operate, there will be significant negative consequences on human and planetary health. It provides examples of what can be done by the various actors like government and food and agriculture industries to promote healthy, sustainable, and equitable diets, sustain the earth’s biodiversity, and protect the environment and all species living on the planet. And last, it raises readers’ food and environmental literacy and empowers readers to take immediate and long-term changes by helping them make informed decisions when they walk into restaurants, grocery stores, farmers' markets, and their kitchens.

The book changed the way I communicate my work. It is not easy to write about a complex topic like food systems and ensure that it inspires eaters, global experts in governments, and those working in and shaping food systems to make better decisions. I tried my best to bring to life some of my experiences working in different countries—from very poor to prosperous—and the experiences of those I have worked with and shared time with in deeply rural and urban pockets of the planet. It provides a nuanced story that takes you away from computer and desk research to farmer’s fields, families’ kitchens, and United Nations’ working forums.

I hope the book shows readers how our everyday diets are the products of massive, interconnected, and highly complex food systems that extend from the seedlings in a farmer’s field to the global distribution and marketing networks that deliver food to our plates. These systems have direct and substantial impacts on poverty, the planet’s natural resources, the nutrition of individuals and populations, the composition of the atmosphere, and social equity. They also are incredibly vulnerable to the climatic changes that we have already seen and that will accelerate in the future.

It is easy to see the beginnings of things, and harder to see the ends.

At least, that is what Joan Didion wrote in “Goodbye to All That.” She was referring to herself when she moved to New York City and unexpectedly stayed for a good long while. Maybe too long.

I have been thinking a lot about what she wrote, feeling the palpability of those words as we mark our 30th day in self-isolation amidst a global COVID-19 pandemic, without a clue to where we are within it. The end is indeed abstruse. Are we at the beginning of it? Are we in the middle? Or nearing the end? It is harder to see, know, or predict when this will all resolve, and no Jim Morrison, the end is not always near.

We saw COVID coming for a while now. We had early lessons of historical pandemics in which many of us mortal souls perished. The Plague (killing 200+ million), the Spanish Flu (killing 50+ million), and HIV/AIDS (killing 25+ million and still going on). The visual below shows the impact of these pandemics killing 25 to 35% of the total global population. We have also been warned over the last two decades that more and more zoonotic diseases — i.e. animal to human transmitted diseases — are coming and creeping into our food supply. Think avian and swine flu, SARS, and MERS.

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Then there are other infectious diseases that are downright scary, but seem to be contained to certain regional epidemics. Think Ebola and Zika. These have never quite made the jump to be classified as a “pandemic” which is classified as a disease impacting every country in the world, yet.. Then there are the insidious, neglected and tropical diseases like river blindness, Leishmaniasis, and Guinea worm that impact people living in the poorest areas of the world. And Dengue and malaria continue to wreak their widespread havoc. The warnings were and are persistently there.

The beginning of COVID-19 was surreal, yet predictable to witness, much like watching the beginnings of Steven Soderberg’s movie Contagion (a virus that spread from China to the rest of the world via air travel, killing 25% of the global population, which stemmed from a bat to pig to human food system zoonotic transmission). Noticing events unfold mid-to-late December in China, as it quickly made its way through some Asian countries, and then slammed into Italy, were obvious signs that this virus moves fast and stealthy, and does not discriminate. And it was coming for everyone, leaving no one behind. Observing the way governments responded to tampering down the virus has been mixed, with the U.S. being way too slow to move and react, and with a “president” who not only doesn’t understand the science but doesn’t care to learn and listen to the experts (like the great Tony Fauci) who surround him reluctantly. Now, the country is reeling from the highest number of cases and deaths in the world.

We also had knowledge and evidence of how such a pandemic would unfold and how the food system is particularly vulnerable to being the source and breeder of these zoonotic type diseases. Now one might wonder if COVID-19 is truly a zoonotic disease. Its origins are being debated in the scientific literature. While there are some thoughts that the virus originated from a wet market in Wuhan, scientists are still unclear about its origin. Did it come from animal and if so, which one(s)? Did it really come from a seafood market or from food at all? There are many early assumptions that it came from snakes or pangolins. The science is leaning towards snakes not being the source. Viruses have a hell of a time jumping from warm-blooded to cold-blooded back to warm-blooded. And it is thought overall that COVID-19, like SARS, is a mammalian virus. There was one article in late January 2020 in the Journal of Medical Virology that though some of the genetic code of the COVID can be found in two snake varieties, but that has been discredited.

There is an interesting article in Nature that is trying to determine its origins. The starting point is the genome: 80% of the COVID-19 genome is shared with SARS and 96% with bat coronaviruses. They hypothesize that the origin of COVID-19 is either natural selection in an animal host before zoonotic transfer (bat to pig or bat to pangolin) OR (ii) natural selection in humans following zoonotic transfer (so human to human, i.e. SARS to COVID).

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I am going to write more about zoonotic (also known as zoonoses) diseases for a new blog series myself and some stellar colleagues are curating on COVID-19 and nutrition. Still, for now, it is of the utmost importance for the global community to prevent these food-borne zoonotic diseases in the future. Scaling up a “One Health” approach is one way to prevent future pandemics.

Humans co-exist with animals - as companions for our overall wellbeing, as producers of food, and as a source of livelihoods. This interface between animals and humans and their shared environments can be a source of disease too. Those who work on One Health work at this interface to prevent zoonotic diseases from spreading by considering animal, human, and environmental connections.

But here we are, with each day running into another, wondering if tomorrow will be different or more of the same. For now, we are stuck in this endless cycle of a beginning. But maybe this is a new beginning - one of a new reality, a new way to see the world and our place in it, and a new appreciation of what we have and a profound sadness and empathy for those who have less or have suffered loss, in every shape and form. The question is, when the end is near, or even better yet, comes and COVID-19 is in the rearview mirror, what will we be as a human society then? Hopefully, one that is better informed, ready, and resilient for the next one.

Food bytes: March 21st edition

Food Bytes is a weekly blog post of “nibbles” of information on all things food and nutrition science, policy and culture.

As much as we want to pretend all is normal, it is clearly not. We are in the middle of a global pandemic, with a massive amount of uncertainty, fear, and in some places, complacency. We will be posting another blog entry on the COVID crisis but for now, we will highlight, just a few emerging articles on the growing concern of food insecurity and the food supply, along with our regular updates on all things happening in the food space.

On COVID, we have never been in a situation like this before with talk of it reshaping the global order or social collapse or cohesion. So to predict how markets will continue to react to the future and the health of the global food supply is uncertain. Anyone who postulates how it will go is misleading us. Yes, of course, we can look in real-time on how households and communities are handling the crisis, and we can look to the past, on how other pandemics like the Spanish Flu, impacted food security and supplies. However, times are different. Food supplies are globalized. The population in 1918 was 1.6 billion. We are now at 7.5 billion.

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Locusts in east africa (copyright: BBC News)

Rob Vos at IFPRI argues there is no major concern for food insecurity, yet. They came to this conclusion by looking at food prices of staple crops. Huh. As the Brookings Institution rightly pointed out, low-income seniors are already feeling the impacts. In the U.S., with roughly 15% of households being food insecure, some are concerned about their ability to feed themselves in the coming months. A WaPo article quoted: “If coronavirus doesn’t get us, starvation will.” Then there is Africa. Food insecurity and stark hunger could worsen in an already fragile context. East Africa is also reeling from an invasion of locusts which don’t help the already burgeoning food insecurity in the region. This video is pretty insane if you want to see the locust infestation.

The EAT-Lancet Commission report follow ons just keep coming. Did you know that the report has already been cited 790 times since its publication in January 2019? Insane! A few interesting articles are emerging that again test the validity of the Commission’s findings.

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The water footprint (blue and green water) of different nut types (shelled) as well as some other food products for comparison, in litre/kg and litre per g of protein. (Vanham et al 2020)

• One article published by the LIvestock Innovation Lab at the University of Florida shows the importance of animal source foods and explains that raising livestock and eating animal source foods can be compatible with sustainable development.

• Another article questioned the recommendation in the report to increase nut consumption. The article dissects the water intensity issues in producing trees and ground nuts especially in India, China, Pakistan, the Middle East, Mediterranean, and the U.S. Check out cashews in the figure!!

• A publication in the Journal of Nutrition argued that the mortality reduction effect of the EAT-Lancet proposed diet in the USA is no greater than the impact of energy consumption changes that would prevent under-weight, over-weight, and obesity alone, calling into question its findings. Authors are funded by the National Cattlemen's Beef Association…

• Pedro Sanchez, one of the world’s experts on tropical soils and a World Food Prize winner wrote a piece about the land needed to grow the Lancet-EAT diet was oversimplified. He provided some alternative calculations. He argues that current total world food production is estimated at 9.30 billion metric tons of crops and animal-sourced foods, with crops grown in 1.27 billion hectares of land. Implementation of the EAT-Lancet diet for 10 billion people by 2050 would require a lot less, 5.39 billion metric tons of food in 1.10 billion hectares of cropland, assuming no increase in crop yields.

Pedro’s paper was part of a special issue in Food Policy in the Food Policy journal initiated by Editor in Chief Chris Barrett. The issue is about the evolution of the Consultative Group on International Agricultural Research (CGIAR), and the international agricultural research centers (IARCs) that comprise the CGIAR System. Over the past two decades, the CGIAR has undergone a series of reforms with the latest reform being termed “One CGIAR”.  Maybe they should take a lesson from the UN and find out how the One UN worked out…The special issue is out and is meant to “help inform a research strategy for the new One CGIAR.”

Robotics, AI, nano. Will these technologies transform the food system, and eliminate the “human” element from agriculture work? Yet to be seen. This article in the Economist discusses agricultural robots. And they have names: Tom, Dick, and Harry.

In the world of nutrition, meat will remain a controversial topic that is heating up. Nutrition is always accused of having serious conflicts of interest - who pays for the research? Who is biased? Who is paid off? JAMA and Scientific American highlights the controversy with meat-funded research and plant-funded research - and the “bullying” by both sides. Katz responds here. The livestock industry responds here. This debate has left consumers confused, and lacking any trust in science. A few other tidbits on meat. This NYT opinion piece by Alicia Wittmeyer argues that to stop eating meat, can alienate us from our traditions. Meanwhile, the EU is considering a tax on meat.

Speaking of diets, with 2.1 billion overweight and obese adults, and half of the U.S. facing obesity, we need some new strategies. Intermittent fasting seems to be all the rage these days as the best way to lose weight and keep it off. A review in JAMA highlights the evidence, and NYT provided some guidance. We tried it. It is not so hard. Just eat between the hours of noon and 8 pm. Thereafter, no calories should be consumed in solid or liquid forms.

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Changes in purchases of high-in beverages, by education level of household head (Tallie Smith et al 2020)

Diet quality matters too. Bee Wilson, an amazing writer of food and its history, wrote a long piece in the Guardian on the contributions of ultra-processed foods on the global obesity crisis. These foods are cheap, attractive and convenient, and we eat them every day. But they are also riddled with sugar, salt, and unhealthy fats. This article is worth the read. Some countries are worried. Take Chile. They instituted a Food Labelling and Advertising which put warning labels on the front of food packages if the food was high in sugar, high in salt or high in fat. Sugary drinks, unhealthy snacks, and packaged foods must carry the front-of-pack labels. These foods are also regulated. These foods cannot be marketed or sold in schools or on TV. Has it worked? Yup. Sales of these foods are down 23%. In college-educated consumers, as you can see in the figure, purchases were done 29%!

2019: The year of food and nutrition reports!

2019 was an interesting year in the food and nutrition space.

The Lancet had food on its mind this year with THREE Commissions/Series:

• Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems

• The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report

• The Double Burden of Malnutrition

The EAT-Lancet Commission made the biggest “footprint” and spurred much debate and controversy, and pissed some people off. Good. That is exactly what it was meant to do. This along with the Syndemic made the Altmetrics top 100 papers of 2019. Cool.

The Global Burden of Disease finally published a solo paper on diets as a risk factor. That too made the Altmetrics top 100 list.

A slew of other reports on food, planet, and people came out this year. See the image below which doesn’t capture everything. They all pretty much say the same thing: We need to transform our food system if we want to save ourselves and the planet that we live on. We cannot disentangle the two. We depend on each other. It won’t be easy. The stakes are high and so are the challenges (like urban and population pressure). It will take significant, synergistic political will and investment. We are running out of time. That is the gist.

The Global Nutrition Report and Scaling Up Nutrition (SUN) movement churned on to keep the momentum, largely in the undernutrition space, moving.

We saw some neglected areas get more attention this year. Fish, plant-based burgers, older children and adolescents. The Nobel Prize went to two stellar development economists whose research has informed our thinking on poverty, and how we can reduce it. But of course, with a dose of caution.

The Committee on Food Security is in the process of crafting the Voluntary Guidelines on Food Systems and Nutrition. Regional consultations took place all year, and a draft is now out for review. If you are interested in providing written feedback on Draft One, you can do so by sending comments to cfs@fao.org by February 5, 2020. You can find all the info here.

This was the year of reports. Let’s make 2020 the year of action. We have a lot of evidence of what to do and how to do it. Many of us have written about it in ways in an attempt to get the attention of politicians. Now, we need to take what is written on paper and translate that into changes that matter for people. We need to vote for policymakers that care about these issues at the local level. Let’s push to make food, climate, and health a part of their campaigns, and give them the opportunity to take ownership of the issues.

We also need to think about politics outside our hometowns. We have seen some major shifts in the global political machinery of how we relate to each other and our willingness to participate as global citizens. Some of the heavy hitters, such as the U.S., will continue on its downward spiral into irrelevance, with the UK following close behind. But until they completely make themselves obsolete, their decisions, unfortunately, matter for the world, as we witnessed with the shoulder-shrugging at the COP 25 negotiations in Spain. Another year, lost.

But I am a cautious optimist. Well…let’s not push our luck here. Maybe more of a realist. We have the Tokyo 2020 moment to increase investments for nutrition (which are currently dismal). We will be half-way through the UN Decade of Action on Nutrition and 1/3 through the Sustainable Development Goals (not sure what this means, but hey). Derek Byerlee and I wrote about how far we have come and what achieving SDG2 means for the world. We have the Committee on Food Security hopefully approving the Voluntary Guidelines mentioned above. And we always have COP 26, to stir up a miracle to save the planet. These global moments are important, but not enough.

This is what I plan to do in 2020:

1. I am going to take a look in my own backyard to make changes (and maybe stop flying around the world, thinking I am saving it).

2. I will vote with my fork and the dire importance of the 2020 election in the U.S. cannot be understated.

3. I will work more with people and less with paper – i.e. stop being involved in all these goddamn reports (that few read…).

Food Bytes: October 6th edition

Food Bytes is a weekly blog post of “nibbles” of information on all things food and nutrition science, policy and culture.

Fall has arrived and with it, some interesting controversies in the food space.

Let’s start with sustainable diets. The New Yorker has a great read about the Impossible burger saving climate change. But according to the International Livestock Research Institute, “alt proteins” are not an answer for poorer countries. As Romeo Void sang, “never, say never.” Jonathan Safran Foer was a meat eater and went cold vegan. And he has another book about it.

Who is not going to save us all from climate change? Brazil. There is a lot of attention to the Brazilian Amazon forest fires. Here is a really good video summarizing the current situation of the Brazilian Amazon forest fires, much of it due to beef. Speaking of beef, there was a lot of controversy over a recent publication that it is okay for people to not limit their red meat consumption, following a slew of reports on its harmful impacts on health and the environment. NYT has been covering the controversy and now most recently, backlash with conflicts of interest. It turns out some were funded by the beef cattlemen association and ILSI, quoting NY Times here a “shadowy industry shaping food policy around the world.”

Paul Ferraro of Johns Hopkins has an article about how climate change solutions remain so elusive, particularly on the way we disseminate evidence. He argues: “We've always assumed the evidence must matter, but in reality we have almost a complete absence of evidence about the value of evidence…But then when it comes to building capacity, disseminating that information, we don't apply a scientific lens anymore. We just do it. We have no idea how to effectively use the science and the evidence we generate to move human behavior.” Tru dat.

Maybe fish will save us all. A fantastic article in Nature on the importance of global fisheries in solving micronutrients. My favorite? Shellfish, particularly, clams. Did you know spaghetti vongole was from Naples? Certo!

The World Bank has summarized the current controversy of childhood stunting being equated to a measure of cognitive development. And on the other end of the spectrum of child growth, a new report estimates that the number of obese children globally is predicted to reach 250 million by 2030, up from 150 million now. Wow. Scary stuff. We often things of these child outcomes — stunting, wasting and overweight — as separate, but we should really stop doing that. This article calls for a unified approach. While I agree, it seems these days we are on a divided battlefield in nutrition and food, with no agreement on much of anything in sight. But, I am a pessimist!

Food Bytes: Aug 26 - Aug 31

Food Bytes is a weekly blog post of “nibbles” of information on all things food and nutrition science, policy and culture.

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Have you ever wondered which cuisine the world craves? Turns out, Italy. Yeah, no shit Sherlock. Italy is the largest exporter of their cuisine followed by Japan, Turkey and Mexico — Órale! Who is the largest importer, meaning, their food just sucks? You guessed it Sherlock. America. F!@#%* yah! China and Brazil don’t seem so keen on their local cuisine either. They follow the U.S. on importing other country cuisines. Funny. Brazil’s food based dietary guideline boasts harnessing its local cuisine. We guess people just don’t read those pesky guidelines…

Dari Mozaffarian and Dan Glickman wrote a timely op-ed piece in the New York Times that diets are now the number one risk factor killing Americans, costing the U.S. health care system billions each year. They provide a range of solutions and signify that governments and food and beverage industries need to be held accountable. While unhealthy diets continue to kill so many, politicians completely ignore the issue. As America moves towards what will be a contentious, decisive election year, they suggest that “every candidate should have a food platform, and every [presidential] debate should explore these positions.” Not sure this rhetoric will be high on the Trump “make American great again, for real this time” re-election campaign because the “Potus” just ain’t really that into food. Unless you consider consuming fast food a gourmand type diet.

Another op-ed piece in the New York Times by Catherine Kling urges that producers who cause “nutrient pollution,” in the form of nitrogen and phosphorus coming from agriculture fertilizer and manure run-off, should be required to pay for the cleanup. She suggests that state government regulations should be enforced to ensure that farmers reduce nutrient pollution. Wonder how livestock ranchers feel about that? Gee, take a guess.

IFAD and Bioversity just put out a great guideline on supporting nutrition-sensitive neglected and underutilized species (NUS) and wild edibles (check out Figure 2 particularly). The guideline is led by the great Stefano Padulosi at Bioversity who has some deep experience working on NUS value chains in many parts of the world. He is also the “Rocket Man.” What are NUS you ask? Here is how they define it in the guideline:

Many are the synonyms which have been used since the mid-1980s to refer to NUS, including minor, under-used, under-exploited, under-developed, orphan, promising, lost, alternative, traditional, niche crops, crops of the future, future smart food. In reality, all these terms are often context-specific and loaded with heavy cultural meanings and not easily understood in the same way by everybody. The term “Neglected and Underutilized Species” might not be the ideal expression and may not be appealing to people.

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There is so much focus these days on diet and the food system footprints on climate change. It is seriously having its moment. But in the back of our mind’s eye, we hark back to an article published in 2017 in Environmental Research Letters, that indicated that largest impact an individual can make to reduce their greenhouse gas footprint is to have one less child. Check out this graphic to the right. Powerful. This action is followed by living car free. Diet is further down the list of impacts. Food for thought…

Interestingly, they didn’t model reducing food waste by individuals. The World Resources Institute (WRI) has just released a global action agenda on reducing food loss and waste by 2030. It is a really practical guide to setting targets, honing in on who should take action and what scalable interventions are available. Everything WRI puts out is pretty stellar and this is another data rich, practical guide to tackle one of the most important issues of the food system.

What if all Americans ate less meat? Not necessarily eliminating meat completely, but just much less? By the way, American are already slowly and steadily decreasing their beef consumption since the 1980s. In the Nature journal Scientific Reports, scientists tested this idea. By replacing 25% meat with plant alternatives dominated (strangely) by soy, green pepper, squash, buckwheat, and asparagus, Americans can eliminate pastureland use while saving 35–50% of their diet related needs for cropland and 330 million metric tons of greenhouse gas emissions each year, but increase their diet related irrigation needs by 15%.

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These advertisements on the left for PETA Vegan guides are all over DC (note the elephant in the background just to remind you that yes, DC is the capitol of the U.S. and the district lives and breathes politics. You can’t get away from it. It will smother, suffocate and slowly destroy you). Where were we? Oh yeah. We picked up the guide and thumbed through it. Some of the recipes didn’t look so tantalizing, and much of what was recommended wasn’t all that healthy. There were lots of photos of faux meat mimicking fried chicken fingers, hotdogs, and meatballs doused in sticky sauce, as well as lots of cakes. Is it possible to promote sustainable, healthy, and animal cruelty free vegan diets for those who choose to go that route PETA? That can’t be too hard can it? While it was an A for effort, maybe version 2 of the guide will feature more healthy foods and less overly processed, junk food.

In other news, with Uber Eats and other gig economy food deliveries on the rise, so is the toll on the drivers delivering food. They are risking their lives in places like South Africa. Tragic. And just to deliver the ultimate convenience to our dinner table.

Venezuela. Talk about a free fall into despair and chaos. Because of the turmoil, food security and the deeper issues of consistent insecurity have taken a big hit. Venezuelans lost an average of twenty-four pounds in body weight. Nine out of ten live in poverty. Roughly one in ten have left the country.

A paper just published in the Lancet hits right at the heart of the trade war between the U.S. and China. The authors feel that it is time to reshape trade policies towards those that favor sustainable food and nutrition systems. They argue there are three starting points for public health actors to take up this agenda.

1. Recognize the fundamental and front-line nature of trade policy as both a barrier and potential catalyst for health.

2. Engage more effectively and with the right stakeholders to push for policy space within trade and investment agreements.

3. Reach beyond trade to promote a development discourse that makes explicit the nutrition imperative — nutrition is crucial to achieving most of the Sustainable Development Goals.

The Food Archive holds a special place in its heart for special focus issues that scientific journals put out. That is, when journals hone in on a hot topic and publish a complementary set of articles on the topic to show different facets and perspectives on the topic.

Here are some recent highlights:

• Tomorrow’s Earth by Science Magazine

• Climate Crisis and Health by New England Journal of Medicine

• Food Security and Violent Conflict by World Development

• Health in Humanitarian Crises by Lancet

• Food for Thought by British Medical Journal

In the last food bytes post, the hard to watch unfold Brazilian Amazon fires were highlighted. This piece highlights that forest fires are happening all over the world, many in biodiverse hotspots, making climate change all that much worse. Very sad not only for forests but for those who live among and depend on them. The map on the right shows fires over the last year. Look at southwest Africa and Southern Africa. Look at Madagascar (think lemurs…) and Southeast Asia. Wah!!

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One place prone to massive forest fires (the 2018 fires were the most devastating in the state’s history) is California but every day it finds a way to rub its beauty in our face. Geez, okay Cali, you win.

Speaking of California, and to keep the whole Woodstock vibe going, let’s just end with a little Joni Mitchell, because she sings about omelets and stews and well, because this has to be one of the best albums ever recorded. Click below to hear her beautiful song, California.

California, Joni.

Oh the rogue, the red red rogue
He cooked good omelets and stews
And I might have stayed on with him there
But my heart cried out for you, California
Oh California, I'm coming home
Oh make me feel good rock'n roll band
I'm your biggest fan
California, I'm coming home

— Joni Mitchell

Food Bytes: July 21 - Aug 25

Food Bytes is a weekly blog post of “nibbles” of information on all things food and nutrition science, policy and culture.

Took a bit longer to get up the next Food Bytes entry due to summer holidays. So here it goes.

Summer is going out with a roar. The Inter-Panel on Climate Change (IPCC) produced their outstanding report on climate change, desertification, land degradation, sustainable land management, food security, and greenhouse gas fluxes in terrestrial ecosystems. Lots of media coverage followed. Diet recommendations were made (reducing beef, taking on a more flexitarian diet etc). If we want to live in this changed climate, we need to adapt. The saber-toothed tiger had a less flexitarian diet and we know what happened to them…

Speaking of adapting, scientists found a “stature gene” among Central African hunter gatherers, also known as pygmies. This short gene gave them an advantage in Africa’s hot, humid rainforests. I was really hoping this gene hopped across the Atlantic to Italians, or even more so, short Italian American women living in DC to help explain my enduring squat-ness, but alas, no such luck. While on the topic of luck, according to the Union of Concerned Scientists, you should also stay away from cereal that has corn as the main ingredient if you want to have an environmentally friendly diet. So better forget about your Froot Loops and Trix and reach instead for your Lucky Charms.

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Farmgate value of global vegetable production by income groups of countries, average 2012–2013, current US dollars (Source: Schreinemachers et al 2019 GFS Journal)

Let’s continue with the climate onslaught shall we? This article talks about the beginning of the end of the livestock industry. But is that really so? Don’t underestimate the chicken man. And do you know how much of a carbon footprint you consume with your diet? BBC provides a calculator - do the math and you will quickly be blanketed in a quilt of guilt. It ain’t just beef that you gotta worry about…

Sam Myers of Harvard published a great piece in the WaPo on how increased CO2 in the atmosphere will “zap” nutrients from key crops. He argues that 175 million people could become zinc-deficient, 122 million would not be able to get protein, and 0.5 billion would have iron-deficiency-related disease. So now we need to worry not only about getting enough food to feed 10 billion, but the quality of those foods in fulfilling our nutrient needs. And the declines in nutritional quality are happening in real time. A study examining 43 “garden” crops in the U.S. found declines of 6 nutrients - protein, calcium, iron, phosphorous, riboflavin and vitamin C - since 1950. The food supply already can’t keep up. Mario Herrero and colleagues found that our current food supply does not produce enough fruits and vegetables, and in the course of the next 30 years, that supply will worsen. If everyone were to follow the WHO recommendation of 400 g/person/day of fruits and vegetables, 1.9 billion people would not have the access to these foods – the food supply just cannot keep up.

But a recent article in the Global Food Security Journal argues that vegetables hold a lot of economic power. Yeah sure. That is, if we can produce them. And then people want to eat them. They suggest that governments will need to increase their investment in farm productivity including improved varieties, alternatives to chemical pesticides, and the use of protected cultivation. There is also a need for better post-harvest storage of veggies, food safety and market opportunities. To tap the nutritional power of vegetables, consumers need to know how vegetables contribute to health, be able to afford them, or be able to grow them themselves. God speed to those New Yorkers living in 300 square feet of space with no windows and definitely, no outdoor space.

The recent paper by Eker and colleagues, published in Nature Sustainability, adds to the sustainable diet literature and evidence base, examining how consumer diet shifts can contribute to mitigation of climate change. Utilizing scenario assessments, the authors model the impacts of different compositional and behavioral dietary shifts among the global population on environmental footprints. Compositional dietary shifts included average meat consumption, flexitarian (more plant-based), vegetarian, and vegan dietary patterns. As other studies have shown, changes in diet composition towards more plant-based diets, have implications on the environment. However, more significant shifts, by a large swatch of the world’s population, towards vegetarianism would need to occur to see impacts on greenhouse gases and other environmental measures (such as land use). The paper is unique in that it models the behavioral dietary shifts among consumers and their impacts. The authors found that younger populations (ages 15-45) respond to social norm behaviors, that is, as the world moves towards more vegetarian type diets, the change towards those diets is more rapid.

They argue that the values a society holds among peer groups can outweigh the influence of scientific facts. This was evident in that behavior shifts in response to health or climate risks were not as significant as motivators of behavior change. Secondary education attainment (a predominant proportion of the world’s population) and self efficacy and identity among women were also important motivators of dietary behavioral change. This study argues that for us, as individuals to make an impact on the environment through our diets, significant shifts need to be made by a large segment of the world’s population. These shifts require a movement towards a vegetarian type diet to reap both environmental and health benefits. Much of this change would happen through peer influence (think social media), through women’s agency, and through those with a secondary school education. The change, would need to happen on a grand, transformative level as called for by the EAT-Lancet Commission report in early January 2019.

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Fires in the Brazilian Amazon. Source: NYTIMES

Foreign Policy well articulates the findings from the EAT Lancet and the IPCC report here and argue that the global food crisis is here. Now. Live. I also was on the Bloomberg Daybreak America’s show to discuss the impacts of the food system and diets on climate change. Check out the show here (segment starts at 1:22:50). Scientists have been forecasting their warnings for 40 years - they were right and no one listened. Maybe people (and governments) will start paying more attention and take some serious action. The NOAA show that July 2019 was the hottest month on record since they started recording temperatures. Speaking of heat, the Brazilian amazon fires are getting lots of attention right now. The NY Times shows a time scale of problem. It should be noted that these human induced fires are mainly done to prepare agriculture lands. And they occur every year, around the same time in the Amazon. The article makes three points on why these fires are different. (1) There were 35 percent more fires so far this year than in the average of the last eight years. (2) There has been a rise in deforestation in recent years, after a long period of decline. (3) While a large majority of the fires were on land that had already been cleared of forests many others are burning with particular intensity that are “deforestation fires.”

While we are discussing trees, it seems a banana fungus, known as “Fusarium wilt tropical race 4 (TR4)” has been devastating plantations in Asia and now the Americas. It is supposedly impossible to eradicate and can live in soil for 30 years. The economic upheaval cannot be overstated. Speaking of loss, a study out of Santa Clara University found that one-third of edible produce (like tomatoes, sweet corn, artichokes, watermelon, cabbage, strawberries and kale) remains unharvested in the fields. Reasons? Field/harvest stability, weather, pests and plant diseases, labor availability, market prices, and buyer specifications for how produce should look and feel like.

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By the time we got to Woodstock…

I just can’t keep up with all the latest food trends. Did you know McDonalds has jumped on the podcast bandwagon? Yeehaw. Virtual restaurants are on the rise, meaning that they are digital-only establishments that don’t need a dining room or waiters. They rely on people ordering their food from apps. But kickin it back to ol’ school, this article gives ode to the Waffle House, started in 1955 in Avondale Estates Georgia. You just can’t replicate that with an app. Oh, how I reminisce of those bygone days. Can you believe Woodstock happened 50 years ago? I just bought this book: Hippie Food: How Back-to-the-Landers, Longhairs, and Revolutionaries Changed the Way We Eat by Jonathan Kauffman. Bring on the tempeh. Seems all things hippie are back in style. Keep an eye out for a blog dedicated to 1968-1969 and how it influenced our food ways.

Delving further back into history, the New York Times has an excellent piece on the “barbaric history of sugar” that fueled slavery in the United States. By the mid-19th century, the U.S. had 125,000 slaves working on sugar plantations! Fast forward to today, we are now trying to figure out how to reduce, remove or tax this “white gold” in the food supply. Forty countries and 7 cities have a sugar tax. The Economist highlights a study showing how to optimize sugar taxes without regressive effects. They suggest that: “In the real world, if taxes in one place get too high shoppers will arbitrage the rules by traveling to buy soft drinks elsewhere. Taking this into account they reckon that the optimal rate for cities is 0.5 cents, although a more efficient system would be a state or national tax to control America’s sugar rush.”

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Impact of climate change on crops, water and income in Timor-Leste. Source: Bonis-Profumo et al 2019.

Here is just a few cool papers, reports and books that came out in the last few weeks:

• Association Between Plant-Based Dietary Patterns and Risk of Type 2 Diabetes: A Systematic Review and Meta-analysis. There is a strong inverse dose response association between plant-based diets and risk of type 2 diabetes This association was strengthened when healthy plant-based foods, such as fruits, vegetables, whole grains, legumes, and nuts.

• Soft condensed matter physics of foods and macronutrients. This article discusses the importance of physics in understanding the texture, taste, and composition of foods. It is an atom-colliding article of food science and matter physics. Get your genius on.

• Ravaged landscapes and climate vulnerability: The challenge in achieving food security and nutrition in post-conflict Timor-Leste. This article focuses on the fascinating Timor-Leste - an agrarian society that won independence in 2002 and is struggling to achieve food security and reduce undernutrition as the country modernizes. The economy depends on fossil fuel revenues and oil reserves are dwindling. A review of climate, agricultural, and nutrition data reveals high weather vulnerability, low agricultural productivity, and slow dietary and nutritional progress. But solutions exist. Agricultural sector actions can make important contributions to poverty reduction, food security, dietary diversity, micronutrient sufficiency, and overall nutrition. Agriculture can be made to be more nutrition- and gender-sensitive with a focus on mixed farming systems, biodiversity, climate-smart practices, and access to inputs, training, and technologies for farmers to enable sustainable and healthy rural livelihoods. Ultimately, productivity levels must improve to support the availability of sufficient and nutritious foods.

• Gene-environment interplay: what do our genes say about dietary choices? Those of us who work in public health often forget about epigenetics and the way our genes play out in our diets and health status. The authors say: “Diet is not just dictated by guidelines and individual choices, but also by availability and accessibility. Therefore, future studies that investigate the relationship of gene expression and a healthy diet in individuals exposed to a similar environmental milieu—for example, in accessibility, inducements, and the socioeconomic construct—are needed to understand the gene–environment interplay at the community level. These results can leverage genetic expression analyses to provide early biological footprints of an unhealthy diet environment, in order to facilitate the investigation of social factors that influence prevalences and outcomes of disease processes, such as food deserts and food swamps.”

• Trends and Correlates of Overweight among Pre-School Age Children, Adolescent Girls, and Adult Women in South Asia: An Analysis of Data from Twelve National Surveys in Six Countries over Twenty Years. The researchers found that overweight children had significantly higher odds of having an overweight mother and were more likely to come from wealthier households, live in urban areas, and have more education.

• Modernization of African Food Retailing and (Un)healthy Food Consumption. In Zambia, two-thirds of the households use modern and traditional retailers simultaneously, but richer households are more likely than poorer ones to use supermarkets and hypermarkets. Use of modern retailers is positively associated with higher consumption of ultra-processed foods, after also controlling for income and other socioeconomic factors. However, the use of traditional stores and kiosks is also positively associated with the consumption of ultra-processed foods, suggesting that modern retailers are not the only drivers of dietary transitions. Interesting!

• The SDG of zero hunger 75 years on: Turning full circle on agriculture and nutrition. In this paper, Derek Byerlee and I look back to the pioneering 1943 UN Conference on Food and Agriculture in Hot Springs, Virginia where the first international commitment to ending hunger was made. Despite these good intentions, however, the agricultural and nutrition communities largely went their separate ways for the next 50 years. Following through on the conference’s balanced approach of “more and better food” would have resulted in better nutrition for all. Today, the SDGs have once again put nutrition and agriculture together at center stage. Despite some important gaps in knowledge, financing, and implementation capacity, we are finally in a better position to shape food systems in a way that ends hunger and all forms of malnutrition.

• Technical Brief: Economic Evaluations of Multi-sectoral Actions for Health and Nutrition. This is a fantastic brief by the AHN Academy. This is a fantastic brief by the AHN Academy to “created to advance knowledge and scientific understanding among the global research community of economic evaluation methods and metrics related to costs and benefits of agriculture, food and livelihood strategies for nutrition and health.” They examine different types of economic evaluations and move towards standardizing a set of metrics to economically assess nutrition.

• The Political Economy of Food. Jody Harris and colleagues at IDS just published this IDS Bulletin that examines the issues of power across food systems. It looks at the various active players, relationships, activities, and institutions that play a major role in shaping food systems and power inequities. This was a much needed publication and I plan to use it in my class on food policy.