Food Bytes: July 1 - July 7

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

Ever wonder why the nutrition community doesn’t play nice with each other? I do. Phil Baker at Deakin University just published an interesting, but heady, paper trying to understand nutrition action networks and what it would take to make them more effective in garnering political commitment towards ending malnutrition. Just take a look at the figure below looking at the context in which nutrition sits. Talk about complex! They argue for four things to improve political commitment to nutrition:

Complex contexts for the nutrition world

  1. Coordinating bodies that are better at advocating resources can of course, get more money and strengthen the networks in which they work.

  2. Coordinating and governance bodies need to be more inclusive and transparent in their decision making.

  3. Civil society should work to influence decision makers. Helps when transparency is in place.

  4. Finances matter and create powerful incentives for us to play in the sandbox together.

I may have gotten all this wrong, but like I said, the paper is intense, but super important to better understand why nutrition hasn’t seen massive progress like other sectors. I really do think that the grand nutrition architecture has some serious issues around coordination, cooperation, and reality checks it needs to come to grips with. Not Phil’s words, but mine…For another blog post!

Of course, the nutrition community doesn’t just struggle with political commitment. It also struggles with delivering key interventions to those populations most in need. A recent study by Stuart Gillespie and colleagues looked at 24 different nutrition interventions to see if their coverage is measured and tracked in major health surveys done at the national level. These interventions are things like vitamin A and iron supplementation, growth monitoring, and infant feeding counseling. Basically the answer is no. The coverage of these interventions are not collected and not in any standard way across countries. The paper presented a few case studies including India. The figure on the right shows the scatter of data collection of key nutrition actions (counseling, growth monitoring and food supplements) typically not included in the core national health surveys. The bars show the national coverage of data and the dots are the states of India. Another paper published in PLoS medicine looked not only at whether or not a health intervention coverage was captured in surveys, but looked at need, use, and quality of those interventions. It would be great to see these authors do a follow up looking at those three measures to assess effective coverage of nutrition indicators.

And while we are ripping on the functionality of nutritionists and their work, let’s discuss the indecisiveness of the science they dabble in. The Atlantic published a piece on why nutritional sciences is so confusing for consumers. There have been a lot of articles on this recently, and I think it started with Michael Pollan’s book In Defense of Food a decade ago. The Atlantic argue that doing the science is very hard - figuring out what people eat and the consequences of those eating patterns - is not so straight forward and as the article highlighted “inexact.” But the evidence over decades has accumulated and most nutritionists agree largely on what is considered a healthy diet and the healthful habits that people should take on. But that is sort of boring isn’t it. The article also highlights the emerging role of the microbiome. But more on that later.

There have been a few recent papers looking at the impact of interventions to improve food environments. One was a systematic review and meta-analysis on sugar‐sweetened beverage - SSB - taxes and their impact on beverage purchases and dietary intake. A suite of different taxes were examined mainly in Europe and US cities. What the researchers found was that a 10% SSB tax was associated with an average decline in beverage purchases and dietary intake of 10% in 6 jurisdictions. This tax was associated with a 2% increase in total untaxed beverage consumption (e.g. water) but this was not significant. Another study looked at the anticipated impacts of implementing a 2016 Chilean Law of Food Labeling and Advertising mandating front‐of‐package (FOP) warning label for products high in sodium, total sugars, saturated fats, and/or total energy. Researchers photographed packaged food and beverage products from six different supermarkets in Santiago, Chile before the law went into effect. They found that basically very little reformulation by industry occurred before the law went into action and <2% of products would have avoided at least one warning label with reformulation. A similar study looked at the food supply ahead of the law implementation and found similar issues.

While we are on the topic of FOPs, a really interesting study looked at how realistic would it be to mandate these types of labels in the U.S. The study found that: “Certain interpretive FOP labels which provide factual information with colors or designs to assist consumers interpret the information could similarly withstand First Amendment scrutiny, but questions remain regarding whether certain colors or shapes would qualify as controversial and not constitutional. Labels that provide no nutrient information and only an image or icon to characterize the entire product would not likely withstand First Amendment scrutiny.” Wow. Interesting. Gotta love the ol’ US of A’s constitution.

The U.S. is not always the asshole in the room. Well, maybe we are. Let’s talk USAID. For those of you who are not familiar with them, they are the United States Agency for International Development and self describe as “the world's premier international development agency and a catalytic actor driving development results.” Okay…they are also the agency driving around in white trucks all over Africa and Asia with the cringe-worthy signage “From the American People.” Awkward. USAID has done some not so good things in international development but it has done some good things too, dammit. They have been committed to nutrition. The Official Development Assistance (ODA) numbers that are reported in the Global Nutrition Report each year demonstrate their financial commitment. They have supported many programs at a significant scale in low- and middle-income countries. Some impactful, some, not so much. I am really screwing myself over here to ensure I never get USAID money aren’t I. Anyways, they just published the history of USAID in nutrition. It is a nice story. Check it out.

Speaking of food environments and obesity, with the Chicago Council on Global Affairs, I did a one-minute video on why is obesity such an issue globally and the importance of food systems in solving, not just contributing to the issue. If your attention span lasts the whole one minute, you can find out my favorite food. It involves a food rich in zinc!

It’s not just food systems that need to improve if we want to make a dent in the obesity pandemic, it is what is inside our bodies as well. The microbiome is the next frontier for science and its role and relationship with obesity is a complex Game of Thrones TV series - it is going to take some time to dig into the history, to understand the future and who really rules us. Some researchers argue that our microbiota is associated with the propensity of being overweight. Others argue that diet is a big driver of the biome composition and species richness, maybe more so than the biological state of nutritional status - i.e. overweight and underweight. But unraveling this game requires us to be brave, yonder north of the wall, and live in peace with the Wildlings. And John Snow. Rrrrrrr.

And as always, I throw in something just to scare the hell out of any of you who are still living in la la land thinking the world is just bliss. Check out this paper. The title reads: "Global warming has increased global economic inequality.” Boom. Do I need to say more? Now you can go back to your mind-numbing regular programming.

Just so you don’t think I am a vindictive person, I leave you with Google’s Stories of Yoga. For any of you yogi gurus out there, this is everything you want and need to know about yoga, its history, its practice and its inspiration. See? I can be nice. NAMASTE!

Everybody wants to rule the world

As we approach this year’s climate summit, the Tears for Fears song “Everybody Wants to Rule the World” keeps running through my head.

Welcome to your life.

There’s no turning back.

When it comes to climate change, we are now moving on a linear path. No looking back, as painful as it is. While scientists have been warning us for decades — bordering half a century of ‘red flags’ in both evidence and advocacy — here is where we now sit. In the midst of a massive climate breakdown which will change the world as we know it.

The headlines read: Climate emergency. Climate breakdown. Climate crisis. Global heating, not global warming. It took a young girl, Greta Thunberg, to push governments — the rulers of our world — to take notice. It took an older gent, David Attenborough to scare the hell out of all of us. Fish stocks and biodiversity collapse, wildlife extinction, and with that, human extinction not being far behind.

But is anyone listening? Is there anyone out there? It seems rulers just want to keep ruling their kingdoms, playing that fiddle while Rome burns. Literally.

“All for freedom and for pleasure.

Nothing ever lasts forever.

Everybody wants to rule the world.”

Top on the list of Nero-like impersonators is Donald Trump. A buffoon, but a dangerous one. He has completely ignored the science, and refuses to cooperate with other nations by not ratifying the COP Paris agreement in which the the United States signed in 2015. By signing onto the COP, each country has in principle, agreed to reduce greenhouse gas emissions, use green energy sources and keep the world well below 1.5 degrees. This signing was an “intent.” But ratification is key. Since 2015, there are still some countries who have not legally ratified their agreement and they include Angola, Eritrea, Iran, Iraq, Kyrgyzstan, Lebanon, Libya, Oman, Russia, South Sudan, Suriname, Turkey, and Yemen. Trump is wanting to completely pull out let alone ratify. His next opportunity to do so will be in November 2020. Interesting timing yes?

This is all sad nonetheless. It would be one thing if the United States solely suffered from their silly political choices, but that is just not the case with climate (among other things). Everyone suffers from decisions of powerful rulers who just don’t give a shit.

The UN Secretary General’s remarks at the Climate Summit Preparatory Meeting said:

“It is plain to me that we have no time to lose. Sadly, it is not yet plain to all the decision makers that run our world. On the plus side, we have the Paris Agreement on climate change and a work programme agreed last year in Katowice. But we know that even if the promises of Paris are fully met, we still face at least a 3-degree temperature rise by the end of the century – a catastrophe for life as we know it. Even more worrying is that many countries are not even keeping pace with their promises under the Paris Agreement.”

The UN SG has reason to worry if one were to actually look historically at the data and trends. And the science holds up. Twenty-five years ago in 1992, the Union of Concerned Scientists comprised of 1700 independent scientists, wrote a canary in the coal mine (excuse the analogy…) piece entitled “World Scientists’ Warning to Humanity.” This group called on our global society to stop the environmental destruction being witnessed back then if we are to ensure that “vast human misery is to be avoided.” They expressed concern about past and future damage to the planet and outlined areas of concern involving ozone depletion, freshwater availability, marine life depletion, ocean dead zones, forest loss, biodiversity destruction, climate change, and continued human population growth. These scientists argued that we are fast approaching the limits of the biosphere and we may not be able to reverse the damage done.

Source: Ripple, W.J., Wolf, C., Newsome, T.M., Galetti, M., Alamgir, M., Crist, E., Mahmoud, M.I., Laurance, W.F. and 15,364 scientist signatories from 184 countries, 2017. World scientists’ warning to humanity: a second notice.  BioScience ,  67 (12), pp.1026-1028.

Source: Ripple, W.J., Wolf, C., Newsome, T.M., Galetti, M., Alamgir, M., Crist, E., Mahmoud, M.I., Laurance, W.F. and 15,364 scientist signatories from 184 countries, 2017. World scientists’ warning to humanity: a second notice. BioScience, 67(12), pp.1026-1028.

Fast forward to 2017, another group of scientists looked back at their warning and evaluated the human response since that time by exploring available time-series data across a series of environmental indicators. Since 1992, with the exception of stabilizing the stratospheric ozone layer, humanity has failed to make sufficient progress on almost all of the environmental challenges outlined in the Warning paper, and in most cases, the situation has become much worse. The figure to the left shows the different trends tracked before and after 1992 in gray and black lines, respectively. Pretty dismal and downright scary to see the the massive deforestation, declines in species, increases in dead zones, and the steep rises in greenhouse gases and temperature.

How did our world get to this state? We are in the middle of a new experiment -- a democracy free fall in which global freedom, open political systems and free societies are threatened. The world experiences ebbs and flows in the history of time, and let us hope that the decisions of rulers, the political institutions that provide the checks and balances on these rulers, and our planet survive this ebb. As the UN SG said, we have to. We are in a battle for our lives.

Food Bytes: June 3 - June 30

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

The month of June was filled with lots of food-related action - meetings, conferences, prizes and elections. Let me tell ya, it was hard to keep up. The question is, what is the result of all these meetings and the environmental footprint of moving all these bodies from meeting to meeting? Does it actually shift the agenda in positive directions? Are we all just talking to our friends? Is it just a way to keep us busy posting photos and videos on twitter? I wonder sometimes. I am not criticizing. I am a part of the problem. But I do think it is time to rethink what all this effort is amounting to, and for who.

The UN Food and Agriculture Organization, also known as FAO, hosted a Future of Food Symposium with some dynamo speakers, but not a lot of action coming out of it. FAO also just announced the election of their new Director General. His name is Qu Dongyu from China. He is currently the Vice Minister of Agriculture and Rural Affairs of China. Makes sense. China is a giant and is greatly shaping the world’s food system. Looking forward to seeing his vision. He has a lot of work to do…

The American Society of Nutrition @nutritionorg hosted their annual nutrition conference, right upon Johns Hopkins doorstep in Baltimore. Lots of diverse science being presented and also lots of controversy around sponsporship of events and significant presence by industry. I was only there for a day but that was about all I could take sitting in an over air-conditioned window-less conference center looking at powerpoint after powerpoint. That said, it is a great way to get caught up on the latest science. And Marie Ruel, a stellar international nutrition scientist at IFPRI, was awarded the Kellogg Prize for Lifetime Achievements in International Nutrition. Well deserved. Her talk is here. I highly recommend reading Marie’s incredible body of work. Much of it can be found here. You will see why she got the award - she accomplished so much over the last 30+ years. And she still has more to do!

The @EATforum Stockholm Food Forum, also an annual affair, took place. Glitz? Check. Grand? Check. Aspirational? Check. But what’s next? The impact of EAT is yet to be seen and it remains unclear on where they will go from here. Do they do advocacy? Policy? Science? I did the opener with Johan Rockstrom or also known as Johan Rockstar. It was fun. The video is below. One thing is clear to me, if they are advocating for a better food future for all, they need to take the show on the road.

Speaking of EAT, the EAT Lancet Commission fall-out keeps churning. Some of the authors of the Commission provide some explanation of issues raised by other scientists on the environmental targets here in a Lancet short response/commentary. Another study put the EAT-Lancet reference diet to the test among a large prospective cohort of British adults. The researchers found that the diet has beneficial associations for ischaemic heart disease and diabetes, but no association with stroke and no clear association with mortality. The media continues to churn out pieces on sustainable diets and mentioned the EAT Lancet report. Great that the work is garnering so much attention in the popular press but what now? Some highlights in the last few weeks:

  • This Vox piece closely examines what our diets will look like in a hotter, drier climate. Lots of talk (literally - it is an interview style piece) on the future of food and technology.

  • The Eater highlights the rise of the plant-based burgers in particular, the Impossible Burger, and how fast it went viral. Seems everything David Chang touches turns to gold.

  • Stepanie Feldstein also wrote for Yes Magazine about the plant-based burgers and argues that while it won’t save the course we are on with climate, small individual actions do matter, and manifest in different ways.

  • This Devex article asks about the relevancy of the EAT Lancet report to the global south. Good question. One expert from Liberia indicated that many in her country don’t even know about the report. That is not a surprise. That said, in the talks I have given on the report, I have emphasized what it does and does not mean for Africa and Asia (as well as what the report did and did not do), as a researcher who squarely works in both continents. Still a lot of work to do to ensure the global findings of the report translate in appropriate ways that ensure livelihoods and culture are considered right along with health and environmental challenges for particular, diverse country contexts.

  • I had to laugh at the title of this Guardian article. “Most 'meat' in 2040 will not come from dead animals, says report.” Why does that sound scary when taken at face value?

Okay enough on that! The @WorldFoodPrize 2019 winner was announced this month. The prize will go to Simon Groot, a Dutch vegetable “seedsman” where he started the East-West Seed Company reaching over 20 million smallholder farmers. More about his life can be found here. Not sure how the World Food Prize calculates the reach. I recall last year they credited shared prize winners Haddad and Nabarro, with “reducing the world’s number of stunted children by 10 million between 2012 and 2017.” While these two giants definitely made contributions, how did they get to that number?

Two publications on India just came out that I highly recommend. The first is a book, published by the great Prabhu Pingali and colleagues on Transforming Food Systems for a Rising India. It is a part of a book series by Chris Barrett at Cornell, on Agricultural Economics and Food Policy. I will publish a book on food systems for nutrition in mid 2020. At the same time, the Global Food Security Journal just published an article on future diets in India. They show that by 2050, there will be projected increases in per capita consumption of vegetables, fruit and dairy products, and little projected change in cereal (rice and wheat) and pulse consumption. Meat consumption is projected to remain low. The question remains, what will that mean for their production and food supplies and their nutrition outcomes?

Future direct consumption trends in India by Alea-Carew et al 2019 GFS Journal

Much being written about the food system front these days. To start, Nicholas Kristof, Opinion Columnist for the New York Times, in all of his eloquence highlighted the obscene inequities of our food system. He wrote:

“If some distant planet sends foreign correspondents to Earth, they will be baffled that we allow almost one child in four to be stunted, even as we indulge in gold leaf cupcakes, $1,000 sundaes and half-million-dollar bottles of wine.”

Guido Schmidt Traub and colleagues from the Food and Land Use Coalition argue that there are three ways to fix the food system in Nature. I agree with their three pillared approach (see figure below) but how? and with what investment? More details please! And if you don’t even know what I am talking about when I say “food system”, Corinna Hawkes and colleagues lay it all out in a policy brief. She also has another brief on why food systems matter for policies. I really like these - and there are more to come. Marion Nestle also lays out what it would take to change the United States food system. Marion is so practical. I would love to see her do more global work. Maybe we all need a dose of her realism.

What it would take to change the food system. Schmidt-Traub et al 2019 nature

The SDSN Network hosted an online conference on nutrition-sensitive agriculture from 3-5 June, 2019. Nutrition-sensitive agriculture offers great potential for achieving SDG 2, as it connects agricultural development to improved nutrition outcomes. Many nutrition-sensitive agriculture interventions have been applied in recent years. This e-conference aimed to turn the evidence coming from these interventions into concrete recommendations for practitioners. Close to 1,000 people from all over the world registered for this e-conference, taking part in three live sessions and interacting via an online conference platform. We had great speakers — Matin Qiam, Harold Alderman, and Agnes Quisumbing — who highlighted the latest research. Missed it? All the powerpoints and videos can be found here.

Speaking of SDSN, they are also responsible for the SDG Index. The 2019 report just came out. Do indices really do much? Do they spur action?Guess who ranked number one in the world in moving towards achievement of the Sustainable Development Goals? Denmark followed by Sweden. What a shocker! Last? Central Africa Republic. Second worst? Chad. Triste…Looking at the OECD countries, the USA is awful. Yo Trump, I thought you were going to make America great again. Yah, right.

OECD Progress on the SDGs (2019)

But it ain’t just America my friends, Italy is struggling on many fronts. Just coming back from Rome, I am reminded about the scale of the rubbish there. And now it seems the trash problem is becoming a public health hazard. Such a beautiful dazzling city ruined by poor management. Oh, and tourism. Mamma mia.

Speaking of indices, Bioversity just released their Agrobiodiversity Index Report which assesses dimensions of agrobiodiversity in ten countries to measure food system sustainability and resilience. Strangely, only 10 countries are shown. Not sure why there are not more. Would be interesting to know if this will be more widespread. And if you think dedicating a day to biodiversity is important, think again. @AgroBioDiverse lays out why he dislikes the International Day for Biological Diversity. I actually completely agree with him. I have very similar sentiments with the Decade of Nutrition…

"EAT"ing my banoffee pie

I had the pleasure of launching the EAT Lancet Commission report in beautiful Cork Ireland at the University of Cork College, hosted by Nick Chisholm at the Center for Global Development. It was a really great event attended by a diverse set of individuals including those from the livestock sector and dairy farmers, advocates, students, professors and researchers.

I presented the overall findings from the EAT Lancet Commission report but I also gave two additional perspectives. The first was my personal view on what I thought the EAT Lancet did not cover adequately or ignored, but should not have. The second was the Ireland perspective - what does the EAT Lancet mean for the future of Ireland’s food system? My slides are here.

On what I thought the EAT Lancet did not adequately do. It did not:

1. Address the confused space of sustainable diets and the epidemiology and science to support it. This was the most contentious aspect of the report and continues to be questioned. I don’t think the report cleared up the debate of what are considered sustainable diets and may have made things more contentious and perplexing.

Inequities in meat consumption

Inequities in meat consumption

2. Tackle the inequities in food systems. The report did not at all go into how people experience difficulties in accessing healthy foods and the inequities in which they bring. It is easy to say eat less meat, but it really depends on where you are in the world, who you are, how contexts and situations can be more or less vulnerable, and what you can afford and access.

3. Take on the entirety of food systems. The EAT Lancet Commission just covered food production and consumption — the head and the tail of the food system — but we know there is this whole middle piece that drives health, sustainable and economies: food supply chains, food environments and drivers of food system transition. The EAT fell short in covering the full scope of food systems but if we did, the report would be 500 pages, not the current 50, in which still, no one read…

4. Focus on who will feed us and their livelihoods. The report did not at all go into the impacts of this type of diet and earth system change on food producers and their livelihoods, ways of life, and traditions. Nor did it go into women producers, small and medium sized producers or rural development/impacts.

5. Examine the actors, especially, consumers and behavior change. The diet really looked at supply side changes and not much on how consumers can take on such a diet, how behavior change is needed and what nudges should be put into place.

6. Consider the local social determinants, and the trade-offs. The report was lofty, ambitious and global. But local nuance, decision making and context is needed, and the report just didn’t have the bandwidth to take on local to global perspectives.

On Ireland. It was fascinating to launch the report in Ireland for a few reasons. I took the train from Dublin to Cork and the landscape was riddled with black and white cows and green rolling hills. I knew the launch could be tough…Was I entering a snake pit?

Bountiful beef cows!

Bountiful beef cows!

First, the cattle and dairy industry is strong here. And for good reason. The agriculture sector contributes significantly to the GDP of the country. The Irish beef sector currently accounts for over 30% of the value of Irish agricultural output at producer prices. Number of cattle heads here. The beef output of Irish farming provides the key input to the Irish meat processing industry. In 2014 the Irish meat processing employed over 13,000 people. Irish agriculture is dominated by family-owned farms.  There are almost 140,000 farms, with an average land holding of 32.5 hectares.  Pasture-based farm enterprises dominate, and as a result, Irish output is dominated by dairy and livestock, especially beef.  Dairy and beef account for two-thirds of gross agricultural output and similar proportions of agri-food exports. Ireland is currently one of the world’s fastest-growing dairy producers and exporters.

Second, the impacts on climate change should not be taken lightly. They have seen a 25% and 9% increase in dairy and cattle head numbers. As a result, their agriculture sector contributes 33% of GHGe in Ireland. Methane is 64% of that. Nitrous oxide from N fertilizer application and excretion of manure is 31%. Energy contributes less - 20% and transport 19% of GHGe. GHGe have been increasing 3.5% every year since 2015 in Ireland. Ireland can play a lead role in fulfilling the “sustainable intensification” goal but so far, they are falling short on the climate agenda. Irish farmers are aware of the need to produce more from less and are addressing their carbon footprint. There is a lot more to do. A Teagasc blueprint on how to make Irish farming carbon neutral is a roadmap, but stakeholders have not signed up to the necessary timelines which will cause them to be fined 600 million for not adhering to the targets set out during the Paris COP agreement. 

The insanely delicious banoffee pie

The insanely delicious banoffee pie

Third, we know that the traditional Irish diet is not sustainable. Some of the top risk factors of death and disease in Ireland are related to diet. And have you ever had banoffee pie? Enough said.

While I was there, there were a lot of the questions about the “hangover” of the report. More of the questions asked by media were about the political backlash of the report findings, why WHO pulled their consensus of the report, and what it means for Ireland’s livestock industry. I found myself defending a report that while I feel fully responsible for what it says, I too find not helpful when we get into the nitty gritties, the realities and the nuance needed to make such transformational changes.

I have never been in something so high profile that I have had to defend but don’t have complete ownership over its content. I am glad to take the fall on things that I believe in or that I have been solely responsible for. But this is a different beast.