healthy eating | Newcastle University Institute for Social Renewal

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:

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

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A healthy diet for sustainable development