A win-win for health and environment

The EAT-Lancet Commission calls for a great food transformation that could save 11 million lives a year and mitigate climate change. Though that would require new institutions such as an IPCC for our food system.

The report “Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems” got a lot of media attention in connection with its publication on 16 January 2019. Most of it focused on the radical dietary changes proposed in the study.

Reduce your intake of red meat to one serving a week, fill half the plate with fruit and vegetables and the rest with beans, nuts and whole grains. That in short is what you need to do to embrace the EAT-Lancet reference diet. For the detailed version see table 1.

The point of departure in designing this diet was health. The authors have scrutinised scientific reports to find evidence of the effects of different foods categories on disease and nutrition. The intake of red meat and in particular processed meat has been associated with cardiovascular diseases, diabetes and certain types of cancer. High consumption of nuts and legumes have on the other hand been found to reduce the risk of some diseases and overall mortality. Since vegetable oil is found to be more healthy than dairy fats, butter has simply been excluded from the diet. The intake of starchy tubers, such as potatoes and cassava, is also reduced to a low level because of their relatively low nutrient content and high glycaemic load that could be a precursor to diabetes.

Few people eat according to the reference diet today. The consumption of animal-based foods in affluent populations exceeds the recommendations by far. In sub-Saharan Africa and South Asia, where meat intake is low, the share of starch-rich food in the diet is higher than the recommendations. The Middle East is the only region where vegetable consumption is close to being in line with the recommendations.

However, if everyone followed their recommendations it is estimated that around 11 million deaths per year could be avoided. Or a mind-blowing reduction in global mortality by a fifth.

The authors then show how this diet, if adopted by a global population of 10 billion in 2050, could be compatible with five aspects of sustainability: climate change, fresh water use, nitrogen and phosphorus flows, biodiversity loss and land-system change.

Concerning climate change, the authors are pessimistic about achieving any greater reductions in methane and nitrous oxide by 2050 since they arise through biological processes in animals and in the soil. However, they see two other vital areas for action. The first is to eliminate the use of fossil fuels along the whole the food chain. This includes fossil-free transportation, storage and processing. The second and more challenging condition is that total emissions from land-use change caused by food production must be zero.

If these two conditions are met the food system would be responsible for 5 Gt of carbon dioxide equivalents a year by 2050. This is nearly half of the allowable global emissions from all sources by then, if we are to achieve a 66 per cent probability of maintaining less than 2°C of global warming. This is significantly higher than the current situation, where the food system accounts for around a quarter of total global greenhouse gas emissions.

Halting the overall expansion of agricultural land is also required to keep species extinction at an acceptable level and safeguard essential terrestrial and marine biomes. It is however noted that in some regions more farmland will be needed to feed a growing population. New land that is devoted to crop production must then be concentrated in areas with low biodiversity that are already affected by human activities, such as already cleared forest, plantations, pastures and rangelands.

Another solution to reduce the demand on land is to increase productivity, particularly in regions with low productivity, a process known in the agronomic literature as closing yield gaps. According to the authors this could be done by shifting nitrogen and phosphorus fertilisers from some regions with over-use to other regions where chemical fertilisers are hardly used at all.  

Attaining the sustainable development goal of halving global food waste is also a key to reducing the environmental impact of agriculture. In poor countries, food is often wasted before it reaches consumers. Crops are left in the field because of a lack of storage facilities, or absence of market access. Investments in infrastructure and education in areas such as post-harvest handling could be solutions.

In more affluent countries, more food is wasted at the consumer stage. The authors suggest public information campaigns to promote improved planning of purchases, understanding of best-before and use-by labels, storage practices, assessment of portions needed, food preparation techniques, and knowledge of how to use leftovers.

In the final part of the report they note that the combined challenges of changing diets, improving food production and halving food waste “will require rapid adoption of numerous changes and unprecedented global collaboration and commitment: nothing less than a Great Food Transformation.” They also state that “this transformation will not happen unless there is widespread, multi-sector, multi-level action to change”.

They look to the efforts at the end of World War II to improve the global food system. At this time international institutions such as WHO, the Food and Agriculture Organization and the World Bank were founded to tackle the current food and agricultural challenges. They also recognise that previous examples of global system change and action, like tackling HIV/AIDS and limiting tobacco, have required profound international cooperation based on science.

The authors present a list of possible institutions that could encourage and facilitate the Great Food Transformation (table 2). A body similar to the Intergovernmental Panel on Climate Change (IPCC), could provide the world with continuously refined scientific targets for health and a sustainable food system, and help to narrow the gap between scientific evidence and policy making. They also call for a new convention on sustainable food systems that could provide a global framework.

Finally, they stress the importance of embarking on this transition now and not later: “data are sufficient and strong enough to warrant action, and delay will increase the likelihood of serious, even disastrous, consequences”.

Kajsa Pira

The report Food in the Anthropocene: the EAT-Lancet Commission on healthy diets from sustainable food systems can be found here: https://www.thelancet.com/commissions/EAT

Table 1: Healthy reference diet, with possible ranges, for an intake of 2500 kcal/day.


Table 2: Potential new evidence-based institutions which could champion and monitor the Great Food Transformation.

  Purpose Tasks 1  Tasks 2
Intergovernmental Panel on Climate Change-type mechanism for healthy diets from sustainable food systems To be a consortium of scientists which collates and updates data for the UN  Provide regular sources of impartial state-of-the-art summaries, which combine data across disciplines Review policy options for the UN system
UN Framework Convention on Sustainable Food Systems To provide a framework for healthy diets from sustainable food systems with functions akin to those of the Framework Conventions on Climate Change and on Tobacco Produce guidelines and protocols that set targets and enable monitoring Host a Food Meeting of the Parties akin to the Convention of the Parties process
International Working Party on Sustainable Dietary Guidelines To produce evidence-based guidelines to add sustainability criteria to existing food-based and nutrient-based dietary guidelines Provide science-based advice for a wide range of bodies Set healthy and sustainable dietary guidelines to meet the food-related Sustainable Development Goals
A Standing Panel of Experts on healthy diets from sustainable food systems To be a subcommittee or standing advisory body to an existing body such as the UN Standing Committee on Nutrition or UN Codex Alimentarius Commission  Produce expert reviews of problem issues for the parent body Advise national governments on healthy diets from sustainable food systems standards
Roadmaps to healthy diets from sustainable food systems To generate one-off sector plans for public or private sectors or both Industry-specific and sector-specific plans to contribute to healthy diets from sustainable food systems Develop plans with phased processes of change to meet specific targets
Global Food Systems Report To author an authoritative annual report, ideally under the auspices of a UN or Bretton Woods body, jointly with others Produce an annual overview report of the world food system Conduct special reviews attached to the report
Global Food Systems Observatory  Consortium of scientists providing high-quality evidence on interventions, modelled on the Cochrane Collaboration and Health/Obesity Observatories Create a global working network of universities and scientists to refine evidence-based policy Monitor regional and national performance in line with agreed targets and criteria

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