A healthy diet for sustainable development

Posted on 16 June, 2015 by Fiona

The United Nations proposed Sustainable Development Goals include ending hunger, improved nutrition and sustainable agriculture (Goal 2), healthy lives and well-being (Goal 3) and sustainable consumption and production patterns (Goal 12). To achieve these goals we need to move towards a diet that is adequate, healthy and sustainable for all, argues Dr Wendy Wrieden from the Newcastle University’s Institute of Health and Society. Part of a blog series from Newcastle University Societal Challenge Theme Institutes giving recommendations for targets and indicators of the UN Sustainable Development Goals.

Many public health organisations emphasise a healthy balanced diet consisting of at least two-thirds fruit, vegetables and whole grain cereal products, with smaller amounts of meat, fish and dairy. This model has also been adopted to create a more sustainable dietary pattern (see for example the New Nordic Diet [1], and the Double Pyramid and the Dietary Guidelines for the Brazilian population. It is well established that consumption of meat and animal products use proportionally more resources than plant foods in both land and energy and generate more greenhouse gases [2]. Therefore to realise the sustainable development goals that address diet, plant-based diets should be emphasised as a healthier more sustainable option.

Lessons from the UK on diet and sustainability

A move towards a more plant-based diet (i.e. fruit and vegetables, wholegrain cereal products with minimal processing) would be good for population health and the environment. A plant-based diet is likely to be lower in calories [1] which should alleviate the obesity epidemic as well as prevent chronic diseases such as cancer. Researchers in Scotland have shown that the ‘Livewell Diet’ can be achieved which meets the recommendations for health (as displayed for example in the eatwell plate and the UK Dietary Reference Values [3] ) and results in reducing greenhouse gas emissions by 25%. Eatwell plate diet

The Livewell Diet is characterised by five main sustainable diet principles: waste less food, eat less processed food, eat more plants, eat less meat and buy food that meets a credible certified standard. However, convincing consumers of the need to change their diet is not easy and our work on the Scottish Diet [4] using UK food purchase survey data, with adjustment for waste showed that there has been little change in the diet over the period 2000-2012.

Make access to fruit and veg-based diets a priority

While eating fruits and vegetables is the basis of a healthy, sustainable diet, the daily average fruit and vegetable consumption has shown no change since 2000 i.e still less than 2.5 portions per day (5 a day recommended). There were similar findings for fibre intake which remained low and only equated to around two-thirds of the recommended daily allowance. Red and processed meat consumption did reduce slightly, but processed meat was around two-thirds of total meat consumption thus adding to energy costs due to processing.

What was apparent from this study is that there are clear socioeconomic differences as those who consume large amounts of meat and sugar, and less fibre, fruit and vegetables tend to be more from deprived groups. However, even for the least deprived fifth of the population the goals for fruit and vegetables, fibre and free sugars were not being met. Using the UK as an example, to meet target 2.1 creating access to diets mainly based on fruit, vegetables and fibre is necessary for ending hunger by 2030 and for 2.2 in ending malnutrition.

Is a healthy diet more sustainable?

We should not assume that a healthy diet will always be more environmentally sustainable. The general public have different ideas as to what constitutes a healthy diet such as the current trend for low carbohydrate which could reduce the plant contribution to the diet even more. Plant-based diets tend to be higher in carbohydrates and lower in proteins [5]. The environmental impact of diet to date has been restricted to considering the greenhouse gas (GHG) reductions up to the time the food reaches the regional distribution centre (RDG), often termed pre-RDG GHG.

This does not take into account the post RDC GHG of aspects such as refrigeration and transport of fruit and vegetables and the waste generated (25% of avoidable household waste compared with 6% for meat and fish). Broader environmental issues need to be considered such as land use change, use of water resources, seasonality of food production, pollutants and biodiversity [6], not to mention the actual cost of the diet to the consumer. In addition there is evidence that organically produced food is not necessarily “environmentally superior”- this appears to be the case for poultry, eggs and milk [1] [7] [8] and is of particular relevance to target 12.2 in achieving “…sustainable management and efficient use of natural resources”.

There are plans for these aspects to be incorporated into further work at Newcastle University in the coming years building on the current Life Cycle Analysis work carried out on eggs, poultry and pork in the School of Agriculture Food and Rural Development [7] [9] and expertise in dietary assessment and survey methodology in the Human Nutrition Research Centre [9] .

Reduce dependence on animal-based diets

We need to define healthy and sustainable diets that are culturally and financially acceptable across the globe, especially in meeting targets 12.2-12.5 in reducing food, energy and chemical wastes at all levels of the food production chain. Most of the diets designed to date are for developed nations but what about the developing nations aspiring to a more Western diet and increasing the demand for animal products. There are no targets for reducing dependence on animal-based diets which is interconnected with achieving less energy intensive and low-carbon economies.

Inequalities in dietary intake occur within countries and health and social inequalities are a contributing factor as well as an outcome. The problem will not be solved by health and agricultural scientists alone, but requires combining expertise from a range of relevant disciplines. We need to also understand the causes of poor dietary intake and work with social scientists to address the economic and cultural reasons for inequalities that will ultimately allow us to achieve Goal 3 to ensure healthy lives and promote well-being for everyone.

[1] SAXE, H. (2014) The New Nordic Diet is an effective tool in environmental protection: it reduces the associated socioeconomic cost of diets. Am J Clin Nutr, 99, 1117-25

[2] MILLWARD, D. J. & GARNETT, T. 2010. Plenary Lecture 3: Food and the planet: nutritional dilemmas of greenhouse gas emission reductions through reduced intakes of meat and dairy foods. Proc Nutr Soc, 69, 103-18

[3] Department of Health (1991), Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Report of the Panel on Dietary Reference Values of the Committee on Medical Aspects of Food Policy (COMA) Department of Health report on Health and Social Subjects 41. London: HMSO

[4] Wrieden, W.L., Armstrong, J., Sherriff A, Anderson, A.S., Barton K.L. 2013., Slow pace of dietary change in Scotland: 2001-9. British Journal of Nutrition, vol 109,pp.1892-1902

[5] TURNER-McGRIEVY et al (2015). Randomization to plant-based dietary approaches leads to larger short-term improvements in Dietary Inflammatory Index scores and macronutrient intake compared with diets that contain meat ^☆http://www.sciencedirect.com/science/article/pii/S027153171400267X#

[6] MACDIARMID, J. et al. 2012. Sustainable diets for the future: Can we contribute to reducing greenhouse gas emissions by eating a healthy diet? Am J Clin Nutr, 96, 632-9.

[7] LEINONEN , I.,WILLIAMS, A.G , J. WISEMAN, J.,GUY , J. & I. KYRIAZAKIS. I. 2012a.Predicting the environmental impacts of chicken systems in the United Kingdom through a life cycle assessment: Egg production systems. Poult. Sci. Vol. 91:pp26-40:

[8] LEINONEN, I., WILLIAMS, A.G. AND KYRIAZAKIS, I. 2014. The effects of welfare-enhancing system changes on the environmental impacts of broiler and egg production. Poultry Science. 93, 256-266.

[9] FOSTER, E & ADAMSON, A. (2014) Challenges involved in measuring intake in early life: focus on methods. Proc.Nut.Soc, 73 (2), 201-9

Newcastle University Societal Challenge Theme Institutes:

To end urban hunger, focus on low-income housing and settlements in cities

Posted on 22 May, 2015 by Fiona

Millions of adults who live in low-income urban areas regularly fall short of the calorie requirement recommended for a healthy life. The relationship between low income housing and food security needs to be targeted by the UN Sustainable Development Goals (SDGs) in order to achieve Goal 2: ‘to end hunger, achieve food security and improved nutrition, and promote sustainable agriculture’. Dr Suzanne Speak (GURU, School of Architecture, Planning and Landscape) contributes to the Newcastle University Societal Challenge Theme Institute blog series by showing how the UN SDGs could end urban hunger.

Food security for the urban poor

In its 2013 report on the State of World Food Security, the UN Food and Agriculture Organisation estimated that one in eight people in the world were suffering from chronic hunger and undernourishment in 2011-13. While the crises of acute famine or drought afflicting small farmers and rural dwellers are well reported to the international community, the ongoing, daily undernourishment of many low-income people in urban areas is less well understood or prioritised.

The focus on food security has, until recently, been overwhelmingly on rural problems and on issues of food availability at a global and national scale. The UN Sustainable Development Goals do little to address this rural focus. Despite SDG 2 aiming to ‘end hunger, achieve food security and improved nutrition and promote sustainable agriculture’, there remains no explicit reference to urban hunger. Yet many millions of urban adults regularly fall short of the 2,100 kilocalories recommended for a healthy, active life. Urban food insecurity has been significantly overlooked, especially by some of the professionals who could influence it most. Food security remains invisible to urban planners and managers in comparison to other problems such as unemployment, overcrowding and decaying infrastructure [1].

Urbanisation has brought with it the urbanisation of poverty and now, many low-income urban populations are equally at risk of poverty and food insecurity. Indeed, the UN itself acknowledges the food security and malnutrition issues associated with this urbanisation of poverty [2]. There are many reasons for this urban food stress. While it is difficult for urban policymakers to intervene to address all of them, here are three points around housing and settlement policy which can help drive urban food strategies.

Increase secure livelihoods

Urban dwellers pay up to 30% more for their food than rural households [3]. However, livelihoods are unstable, being more dependent on waged income from precarious informal employment. Much of the informal-sector activity takes place outdoors (construction, street vending, or rickshaw drawing), making the rainy season an especially difficult period. Seasonal variations need to be taken into consideration when designing urban interventions. Urban households may need to remit funds back to the rural family, putting further stress on income and budgets.

The UN SDGs can help to address the problem of urban food insecurity through focused work on urban poverty. However, poverty is not the only issue affecting urban food security. We need to recognise the synergy between food security and several of the goals, especially Goal 11 on cities and human settlements, and Goals 6 and 7 on water, sanitation and energy.

Promote sustainable urban agriculture and improve access to land

As the homes of the poor are usually small they have less storage to set food aside for harder times. Urban agriculture could play a significant role in managing fluctuations in food availability and support women who are unable to work outside the home. Indeed target 5a urges ‘reforms to give women equal rights to economic resources, as well as access to ownership and control over land ….’ Urban land is as vital for women’s livelihoods as is rural land. However, authorities seldom recognise this. Many urban migrants, men and women, tend to have good agricultural skills but there is less land available. However, encouraging urban agriculture for low income households would support SDG 12 to “Ensure sustainable consumption and production patterns”.

City authorities can do much to support both food security and gender equality by enabling the urban poor to have access to land for livelihood and agricultural purposes, and reconsidering their attitudes towards urban agriculture. This cannot be achieved easily, given the spiralling cost of urban land in many cities of the south. Nevertheless, urban planning policy can, and in some countries does, manage to regulate in such a way that undeveloped urban land can be temporarily put to more productive use. This requires municipal planning authorities to have strong vision and commitment to addressing urban hunger. It also requires strong governance and improved capacity within municipalities to develop and enforce regulation, such as land banking, which pushes up the cost of land and removes it from productive use.

Ensure easy access to food markets and adequate conditions for cooking

The absence of markets and the small size of low-income housing, which has limited kitchen facilities, means an over reliance on street vendors and processed ‘snack’ foods for daily calorie intake. Street foods are often more expensive, and less nutritious, than home-prepared foods. Urban household budgets also compete with other resources such as water, devoting a significantly higher share of their limited household budget to drinking water than rural households.

SDG 6 aims to “ensure healthy lives and promote well-being for all at all ages”. However, food safety can be more problematic in urban settlements, where inadequate space and services for food production and storage have implications for both individual and public health. The lack of basic water, sanitation, drainage and solid-waste disposal services makes it impossible for the poor to prevent contamination of water and food.

Reliance on street foods further exposes urban residents to higher levels of food contamination and low nutritional intake. In this respect, two SDGs are particularly relevant — SDG 6 to ‘ensure availability and sustainable management of water and sanitation for all’ may be critical in improving food safety. Targets 6.1 – 6.5 are especially relevant to enabling low-income urban people to avoid food borne disease and lead healthier lives in general. In this respect they will be more productive for the city and better able to improve their own livelihoods.

Even if food can be purchased and stored effectively, much cooking is done on open fires or kerosene stoves, both of which produce toxic fumes in small, badly ventilated houses. In this respect SDG 7 can help in its determination to “Ensure access to affordable, reliable, sustainable and modern energy for all”.

SDG 11 recognises the importance of making cities and human settlements inclusive, safe, resilient and sustainable. However, this cannot be achieved until the availability of, access to and use of food in low income settlements is recognised as a specific and urgent issue, and addressed by urban professionals not simply those engaged in agriculture.

Summary of action points for reaching SDGs on hunger:

The UN SDGs can help address urban food insecurity by targeting urban poverty, but it is not the only issue affecting food security which includes human settlements, water, sanitation and energy.
Rather than be seen as inappropriate in urban planning by city managers, low-income households should be encouraged to take up urban agriculture to alleviate hunger in cities.
Create food markets, sharing networks and urban agriculture projects to decrease reliance on street food which is often more expensive, less nutritious and more likely to be contaminated than home-prepared meals.

These are only some examples of actions that could be taken to address food security for the urban poor. However, the importance of markets and income-earning opportunities cannot be over-emphasised as it is sustainable livelihoods that will enable people to ensure their food security for present and future generations. Urban planners and similar practitioners could play a key role in achieving food security, improving food nutrition and promoting sustainable agriculture together by focusing on the plights of low-income urban areas.

[1] Maxwell, D. (1999). The political economy of urban food security in Sub-Saharan Africa.World Development, 27(11), 1939-1953.

[2] United Nations Standing Committee on Nutrition August 2013 available at: http://www.unscn.org/files/Statements/August_31-_UNSCN_World_Urban_Forum_6-_Statement_final_3108_finalfinal.pdf

[3] World Food Programme. Annual Session. Rome 20-23 May 2002 Report on Agenda Item 5 Policy Issues (http://www.wfp.org/eb)

Newcastle University Societal Challenge Theme Institutes:

The Whole Grain Truth

Posted on 1 May, 2015 by Fiona

Professor Chris Seal is a Professor of Food and Human Nutrition, and Kay Mann is a postgraduate student, within the Human Nutrition Research Centre at Newcastle University. They are calling for the next government to introduce clear guidelines on the amount of whole grain we should be consuming.

The evidence: Whole grains are good for us

Current literature suggests that those eating three or more servings of whole grain, compared with those that eat none or only small amounts, have a 20-30% reduction in their risk of developing cardio-vascular disease and type 2 diabetes. Higher whole grain intake has also been linked to lower body weight, BMI and cholesterol levels. Other research suggests that eating whole grains can make you feel fuller for longer and that you do not need to eat as much of a wholegrain food compared with a refined version to feel full.

The problem: The picture in the UK

Our new research on over 3000 UK adults and children who took part in the National Diet and Nutrition Survey (NDNS) between 2008 and 2012 shows that over 80% of us are not eating enough whole grains. Amazingly, almost one in five people don’t eat any whole grains at all!

One reason for this may be that in the UK there aren’t any specific recommendations on the amount of whole grain we should eat each day, other than the NHS Eatwell Plate advice to “choose wholegrain varieties whenever you can”. Countries such as the US, Canada, Australia and Denmark give much more specific daily recommendations. These range from a minimum of 3 servings (or 48g) per day in the US to between 60g and 90g per day for women and men in Denmark.

Three servings (around 48g) is equivalent to:

3 slices of wholemeal bread
A bowl of porridge or wholegrain breakfast cereal and a slice of wholemeal toast
A portion of whole grain rice/pasta/quinoa or other whole grains

UK public advice about whole grains was first introduced back in 2007, when it was recommended to look out for ‘whole’ on food labels and to ‘choose brown varieties where possible’. We analysed whole grain intake from the NDNS back then and it seems little has changed in consumer habits since.

The amount of whole grain we eat in the UK is still very low – an average of around 20g a day for adults– compared with Denmark where the average daily intake is around 55g. In the UK, we tend to eat a lot of white bread, rice, pasta and cereals and lots of processed foods, all of which have no – or very little – whole grain in them and also tend to be higher in fat and sugar.

In Denmark, since the introduction of a whole grain campaign backed by the government and food producers, whole grain intake has risen by 72 per cent. We’d like to see a similar commitment here in the UK with a government-backed daily intake recommendation which can be used to develop successful public health campaigns.

So what are whole grains and what do they do?

Whole grains are defined as the ‘intact, ground, cracked or flaked kernel after the removal of the inedible parts such as the hull and husk’. This means that the three component parts of a grain – the outer bran, the germ and endosperm – remain in the final food product. Combined, these contain important nutrients such as fibre, vitamins and minerals and phytochemicals. When grains are refined to make white flour, many of these valuable nutrients are lost, and only a few are return with mandatory fortification.

Whole grains include; whole wheat (wholemeal), whole/rolled oats, brown rice, wholegrain rye, whole barley, whole corn/maize, whole millet and quinoa. The key is to look for the word ‘whole’ on an ingredients list and also for the ingredient to be high up on the list. These ingredients can be found in foods such as wholemeal bread, wholegrain breakfast cereals, porridge, wholegrain pasta and rice.

There are a small number of people that suffer from a gluten intolerance, which means that they have to avoid eating grains that contain high levels of gluten such as wheat, barley and rye. It is still possible for them to get their whole grains. Whole grain oats do not contain gluten but can sometimes be contaminated with wheat during harvesting and processing, others such as amaranth, buckwheat, brown rice and quinoa are also gluten free.

How whole grains have their effects is not clear. Certainly a key factor is better digestive health, but we also see lowered blood cholesterol, reduction in inflammation, lower body weight and lower weight gain in people who eat more whole grains.

The solution

We advocate:

the introduction of specific guidelines to promote whole grain intake in the UK
an emphasis on how easy it is to introduce more whole grains into diet – no major lifestyle change is needed
small tweaks to diet such as replacing white rice and pasta for brown, eating porridge or a wholegrain cereal for breakfast instead of a refined grain breakfast cereal, or swapping white bread for whole meal bread

Newcastle University Institute for Social Renewal

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A healthy diet for sustainable development

To end urban hunger, focus on low-income housing and settlements in cities