There seems to be a huge demand for dietary guidelines if newspaper articles, the Internet or books are used as indicators but – among the huge and increasing number of diets – only the non-officials tend to be in the limelight. Official “food-based dietary guidelines” (FBDGs) actually do not make a dent in the eating behaviour of citizens.
The fact that FBDGs are not designed to quickly lose weight might explain some of the popularity difference. As science-based FBDGs aim at shaping the long-term eating patterns of citizens, almost all countries are invested in developing them. They are usually not regularly updated but only once there is sufficient new evidence that demands adaptation. Still official dietary guidelines are most of the time ignored by citizens but also policy makers. This might be about to change. Better: this ought to change as they have to be brought in line with a wider set of (public) objectives concerning the health of the population, and climate as well as environmental problems. In brief: the need to provide healthy diets to a still growing global population that respect the boundaries of the planet’s biosphere is a huge challenge given the present impact of the food system.
Why should FBDGis fix the climate, biodiversity loss and environmental degradation?
Dietary guidelines are increasingly expected to help mitigate the negative impact of diets on climate change, public health, loss of biodiversity, environmental pollution, land and water consumption – to name the most important areas. These demands are not unreasonable given that the food system is producing about 1/3 of global GHG emissions. Close to 60% of emissions are due to the huge consumption of animal products. Likewise animal keeping is the major driver in biodiversity loss and environmental pollution as well as non-communicable diet related diseases such as coronary heart diseases, stroke, cancer, respiratory diseases and type 2 diabetes. As animal keeping is occupying about 80% of agricultural land – both for feed production and pasture – the opportunity costs are huge as the land can not be renatured or reforested. Reforested or renatues land would be a huge carbon sink and bring the 1,5°C warming objective within reach again (see Sun et al., 2022, Pure – Nemecek, 2018). Presently, due to the increasing adoption of Western style diets in successfully catching-up countries, the GHG emissions together with the other unwanted side-effects of the food system are expected to grow massively until 2050 (Springmann et al, 2016).
Would adherence to the present FBDGs solve these problems? And, if not, what kind of diets should be recommended by FBDGs? And, is anybody up to the job yet?
Springmann et al. (2020a) compared the actual food intake in 85 countries with the hypothetical consumption pattern that should be observed if everybody would strictly follow the national dietary guidelines. The results underline the fact that nobody is very successful in convincing citizens to follow the official guidelines. Based on eight different categories of recommendations set by the respective countries, the most successful countries managed to achieve at most four of them. These countries tend to be in Asia rather than Europe (Spain, Greece, Turkey, Iceland, Portugal achieving 3 points) or the Americas.
Fig 1: Number of food based dietary guideline recommendations that were achieved in each country
Source: Springmann et al. (2020a)
Given that most of these guidelines were developed without reference to environmental issues, would following them really have a positive impact on the environment?
FBDGs should be beneficial for the health status of the population, right? Springman et al. (2020a) show that adherence to the national FBDGs would reduce premature mortality caused by diet-related non-communicable diseases by about 15% on average. This is as expected but food-related GHG emissions would also drop by 13%.
While this shows the potential impact of FBDGs, Springmann et al. (2020a) point out that these potential reductions are not in line with international agreements that were signed by these countries: the Paris Climate Agreement, the Aichi biodiversity targets related to land use, and the sustainable development goals related to water use and fertiliser application would be violated. Thus the FBDGs in place – even when fully adhered to – would not be sufficient to reduce GHG gas emissions, biodiversity loss and environmental degradation as well as avoidable diseases and premature death sufficiently thus violating agreements in place and signed by the countries. Clearly, there is no path to global sustainability without reforms in the food system – dietary guidelines being one building block in this process.
Fig 2: Percentage difference between recommended intake and current intake
Source: Springmann, 2020(a).
What do FBDGs want us to eat?
A clear picture emerges from the comparison of differences between the present intake and that recommended by present dietary guidelines as well as the WHO and EAT-Lancet diets: All FBDGs recommend more intake of legumes, whole grains and fruits as well as less intake of animal products. The EAT-Lancet diet recommends for example a total ban on processed meat and a reduction of red meat by 68%. Overall meat consumption should be reduced by 49%. These numbers concern the global average food intake and reductions might be higher (or lower) for the different regions.
The EAT-Lancet diet was specifically developed by a group of eminent scientists to provide healthy food for a still growing world population while respecting the boundary of the biosphere, i.e. being sustainable over the long term. This diet is the only one among those analysed by Springman et al. (2020b) which accomplishes both environmental as well as health targets. The in depth analysis of the impact of different variants of the EAT-Lancet diet on health, climate and environmental goals shows that the flexitarian version that still allowed for about 15kg of meat – mostly chicken – per year just about met the set goals. The vegan diet had the best outcomes overall and a particularly positive climate impact: only 24% of the GHG allowance to stay within international agreements would be emitted.
What follows?
The research by Springmann et al. (2020b) clearly shows that most FBDGs – including those of the WHO – neither adhere to already signed international agreements nor produce optimal health outcomes nor keep the food system within planetary boundaries. There is a common driver behind the impact of the food system on climate, biodiversity loss, environmental pollution and health issues: the huge consumption of animal-based products and animals. Based on the analysis of the Lancet Commission – a group of eminent experts in the field of climate change, diets and health – about 80% of the potential to reduce negative externalities of food systems can be realised by a reduction of the intake of animal products. Another 10% could be removed if production methods in agriculture would be changed. Only 5% – and this is somewhat surprising – if food waste would be reduced.
Previous studies have already indicated that there is a need to adjust what is being on the plate globally. Given the evidence, one would expect that policy makers around the globe have been busy in adopting the food system in their sphere of influence. Existing evidence suggests that governments are rather slow in updating their FBDGs. Klapp et al. (2022) analysed 95 dietary guidelines with regard to the provision of evidence on plant-based and vegetarian diets, plant-based alternatives to milk, dairy products or meat. Of the reviewed guidelines only 36 (37.9%) mentioned plant-based meat alternatives, 35 (36.8%) mentioned plant-based alternatives to milk, and 12 (12.6%) mentioned plant-based alternatives to dairy products. The large majority of FBDGs was classified as “uninformed” about alternatives to animal products. Also, the authors criticised the missing granularity of many guidelines. Out of 100 countries, 47 have a purely animal-based meat food group, giving meat a special status by implying that it should be an essential part of a healthy diet. Four countries (France, Italy, Germany, Switzerland) opposed a vegan diet while most countries were in “the uninformed” group, i.e. they did not have a position on vegetarian/vegan diets.
Klapp et al. (2022) used the references to plant-based alternatives to meat, milk and dairy products for developing the “Balanced Food Choice Index ” which is a ranking of countries based on the inclusion of up to date dietary recommendations in their guidelines. The Netherlands were on top of the ranking, followed by Australia and Switzerland. While there are 3 EU countries among the top ten (Sweden (9.), Belgium (Flanders, (10)), the 3 lowest ranking EU countries occupy rank 89 (Slovakia), 76 (Austria) and 61 (France). As the ranking of EU countries spans across the whole spectrum, the potential for learning and progress is significant in Europe. The huge heterogeneity, and also some examples given by the authors, are an indicator that policy makers might be out of sync with their constituents (see e.g. Veganz, 2020, Agroberichten Buitenland, 2020,) and scientific research thus not delivering evidence-based recommendations.
Some Implications
There is obviously a huge discrepancy between official guidelines and the food intake of citizens directly questioning the authority of national policy makers in this domain. Is it that the efforts to enforce FGDBs are negligible or is it simply impossible to be heard among the ”noise” produced by the food industry and media or are FBDGs often so outdated that they are hardly relevant anymore?
There is, of course, no straightforward answer to these questions but various layers on which eating behaviour could be influenced:
It is the task of the public sector to actually address the challenges created by the present structures in the food system and dietary habits. The way forward are system innovations rather than punctual interventions that bring the food sector onto a sustainable path. Ideally this change process is guided by a strategy and implemented in a participatory way.
While many citizens are already adopting eating habits that are healthy, climate friendly and non pollutant, many are not aware of the problems and challenges caused by the food system and are largely guided by inherited, traditional and cultural norms/experiences as well as influenced by communications of the food industry. FBDGs are the basis for educating citizens – both young and older – thus laying the foundation for biosphere-friendly and healthy eating. Of course, they have to be easily understood and applied and – equally important – up to date and up to the job. None of this holds for most guidelines as was clearly demonstrated by the research of Springmann et al. (2020) and Klapp et al. (2022). Many guidelines are so outdated that most citizens may have a better understanding of diets which are beneficial for both climate and health than the recommendations themselves. The climate dimension is clearly missing in many guidelines.
Given that most FBDGs are not up to date and are ignoring the impacts on the biosphere, the quickest way forward is to build on the EAT-Lancet guidelines which are evidence based and meet all relevant criteria. Flexitarian, pescetarian, vegetarian and vegan variants are available. The task at hand is to “localise” them by somehow “translating” global guidelines into locally understood dietary guidelines/recommendations.
FBDGs are to be taken seriously by the public sector as well and resources must be allocated to actually achieve the targets. If this is not done – which seems to be the status quo – then this exercise is meaningless. If taken seriously, the public sector has channels to directly implement them. One is communal feeding in schools, hospitals, retiree homes, the military, etc. where updated DBFGs can be applied immediately (see Mayrhofer et al., 2022).
Dietary changes may be faced by all forms of resistance if they are not elaborated in a participatory way. There are examples in various countries where top down changes in the offering of canteens (e.g. one vegetarian day per week) has led to massive resistance. The way forward are participatory processes that give a say to all stakeholders in the change process. This helps to find solutions for more plant based offerings that improve health and reduce the impact on the biosphere.
The framing of the food system change process is hugely important. Many discussions focus on food you have to do without rather than on the discovery of new equally tasty or tastier food. Helping citizens to explore the large food cosmos might be one of the most important and rewarding tasks in this process. When successful, the so far neglected options might be the better options overall.
The outcome of such an inclusive, properly framed process might be totally different than expected. The Swedish mission-oriented process to change school food is a nice example for this. The video illustrates how Vinnova went about changing school food by involving everybody in the process, not least pupils. They went on an organised discovery process screening alternatives to the food actually offered in school canteens. Obviously, there is a lot of “new” food to discover that helps to translate FBDGs which might be marked by some as “totally frugal” into both tasty/ier and better alternatives for health and the environment. The change process creates win/win situations in areas that are heavily disputed in other environments. Fact-based, inclusive, participatory and hands-on approaches work in developing alternatives to traditional offering and are a vital tool in making change happen. Fortunately, there is a handbook on the mission-oriented (Hill et al., 2022) approach cultivated by Vinnova which is also highly recommended for those that are about to venture into changing “the system”.
References
Hill, D., et al., Designing missions – Mission-oriented innovation in Sweden— A practice guide by Vinnova, Vinnova, 2022, https://www.vinnova.se/en/publikationer/mission-oriented-innovation—a-handbook-from-vinnova/
Klapp, A.-L., Feil, N., Risius, A., A Global Analysis of National Dietary Guidelines on Plant-Based Diets and Substitutions for Animal-Based Foods, __Current Developments in Nutrition__, Volume 6, Issue 11, November 2022, nzac144, https://doi.org/10.1093/cdn/nzac144
Mayerhofer, P., Sinabell, F., (WIFO), Garaus, C., Hanz, K., Jäger, H., Kunesch, C., Schottroff (BOKU), F., Leo, H., (cbased), Food-Standort Wien, Innovationen in der Wertschöpfungskette für Lebensmittel in der Metropolregion, Studie im Auftrag der MA23, Wien, 2022, https://cbased.com/wp-content/uploads/2022/10/Vienna-Food-System-Action-Lines-English.pdf
Poore, T. Nemecek, Reducing food’s environmental impacts through producers and consumers, Science, 01 Jun. 2018, Vol. 360, Issue 6392, https://science.sciencemag.org/content/360/6392/
Springmann M, Spajic L, Clark M A, Poore J, Herforth A, Webb P et al., 2020a, The healthiness and sustainability of national and global food based dietary guidelines: modelling study, BMJ 2020; 370 :m2322 doi:10.1136/bmj.m2322
Springmann M, Spajic L, Clark M A, Poore J, Herforth A, Webb P., Rayner, M., Scarborough, P., 2020b, The healthiness and sustainability of national and global food-based dietary guidelines: modelling study, Supplementary information, BMJ 2020; 370 :m2322 doi:10.1136/bmj.m2322
Springmann, M.. Charles, H., Godfray, J., Rayner, M., Scarborough, P., Analysis and valuation of the health and climate change co-benefits of dietary change, PNAS, 2016, https://www.pnas.org/content/pnas/early/2016/03/16/1523119113.full.pdf
The Lancet Commission, Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems, 2019, https://www.thelancet.com/action/showPdf?pii=S0140-6736%2818%2931788-4
Sun, Z., Scherer, L., Tukker, A., Spawn-Lee, S. A., Bruckner, M., Gibbs, H. K, Behrens, P., Dietary change in high-income nations alone can lead to substantial double climate dividend, Nature Food, volume 3,, 2022.