by Marion Nestle

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Sep 23 2021

TODAY: The UN Food Systems Summit

The long-awaited UN Food System Summit takes place today.  The programme includes announcements from more than 85 heads of state and government.

The UN Food Systems Summit was announced by the UN Secretary-General, António Guterres, on World Food Day in October 2019 as a part of the Decade of Action for delivery on the Sustainable Development Goals (SDGs) by 2030. The aim of the Summit is to deliver progress on all 17 of the SDGs through a food systems approach, leveraging the interconnectedness of food systems to global challenges such as hunger, climate change, poverty and inequality. The Summit will take place during the UN General Assembly in New York on Thursday, September 23. More information about the 2021 UN Food Systems Summit can be found online: https://www.un.org/foodsystemssummit

Despite its focus on food systems approaches, it is highly controversial—as I explained in previous posts.

In preparation for today’s events, Lela Nargi of The Counter provides a thoughtful summary of the issues: “The UN is holding a summit on building a sustainable future for food and ag. Why are so many people upset about it?

The concerns:

  • Who is behind the Summit? [Proponents of industrial agriculture]
  • Who sets the Summit agenda? [Ditto]
  • What is excluded? [Indigenous practices, regenerative agriculture, agroecology]

While watching to see how this plays out, you can take a look at:

Also from The Guardian:

And for why the issue of agroecology is so important, see Raj Patel’s discussion in Scientific American: Agroecology Is the Solution to World Hunger

Marcia Ishii asks: Could FAO’s partnership with CropLife International have anything to do with the disappearance of agroecology from the agenda?

Aug 13 2021

Weekend reading: A call to the UN Food Systems Summit: Ultra-processed foods

I am a co-author on a paper published recently by BMJ Global Health 2021;6:e006885.  The need to reshape global food processing: a call to the United Nations Food Systems Summit.  Authors: Carlos Augusto Monteiro, Mark Lawrence, Christopher Millett, Marion Nestle, Barry M Popkin, Gyorgy Scrinis, Boyd Swinburn.

Because this paper is open access, I reproduce its text below.  The link is to the pdf.

Summary box

  • In the modern, globalised food system, useful types of industrial food processing that preserve foods, enhance their sensory properties and make their culinary preparation easier and more diverse, have been and are being replaced by food ultra-processing.

  • The main purpose of food ultra-processing is to increase profits by creating hyperpalatable and convenient food products that are grossly inferior imitations of minimally processed foods and freshly prepared dishes and meals.

  • In the last decades, obesity, type 2 diabetes and related diseases have become global epidemics, leading the health systems of many countries to or beyond breaking point.

  • Taken together, the totality of evidence summarised here shows beyond reasonable doubt that increased consumption of ultra-processed foods is a major contributor to the pandemic of obesity, type 2 diabetes and related diseases.

  • The 2021 UN Food System has a unique opportunity to urge countries to implement policy interventions required to reduce ultra-processed food production, distribution and consumption, while simultaneously making fresh or minimally processed foods more available, accessible and affordable.

Introduction

The UN Food Systems Summit is taking place later this year at a crucial time. Food systems are manifestly failing to enhance human health, social equity or environmental protection. One symptom is the pandemic of obesity and related non-communicable diseases with their vast consequences. As we show here, one of the main drivers of this pandemic is the transformation in food processing. In the modern, globalised food system, useful types of food processing that preserve foods, enhance their sensory properties and make their culinary preparation easier and more diverse, have been and are being replaced by deleterious types of processing whose main purpose is to increase profits by creating hyperpalatable and convenient products that are grossly inferior imitations of minimally processed foods and freshly prepared dishes and meals. The Summit has a unique opportunity to confront this calamitous change, and to recommend effective policies and actions to UN agencies and member states.

Processing and industry

The key issue here is the nature, purpose and extent of food processing. It is not processing as such. General criticism of food processing is too unspecific to be helpful. Most foods are processed in some way, and culinary preparations of fresh foods are usually made using processed ingredients. Some types of food processing contribute to healthful diets, but others do the opposite.1

At one extreme are minimal processes which mostly preserve or enhance whole foods, such as drying grains, pulses and nuts, grinding grains into flour and pasta, chilling or freezing fruits and vegetables, pasteurising milk and fermenting milk into yoghurt.

At the other extreme are industrial processes that convert food commodities such as wheat, soy, corn, oils and sugar, into chemically or physically transformed food substances, formulated with various classes of additives into generally cheap to make, long duration substitutes to minimally processed foods and freshly prepared dishes and meals. The result is brand-named sugary, fatty and/or salty food and drink products which typically contain little or no whole food, are designed to be ready-to-consume anytime, anywhere and are highly attractive to the senses or even quasi-addictive. These products, including sweet and flavoured drinks, sweet or savoury snacks, reconstituted meat products and shelf-stable or frozen ready meals and desserts, are identified as ultra-processed foods.2

Criticisms of the food industry as a whole are also a mistake. Most of the very many millions of food farming, growing, rearing, making, distributing, selling and catering businesses throughout the world, notably in Asia, Africa and Latin America, deal solely or largely in fresh and minimally processed foods. These businesses and the foods they produce need to be encouraged, defended and supported.

By contrast, ultra-processed foods are mostly enabled, produced and sold by a small number of transnational corporations, some of whose turnovers exceed the revenues of many countries and make annual profits of US$ billions.3 These corporations use their power to formulate, mass manufacture, distribute and aggressively market their products worldwide.4

These corporations shape scientific findings by funding in-house and university-based research, so as to defend and promote ultra-processed foods.5 They also exercise political power by intensive lobbying, donations and sponsorships, and until now have dissuaded most governments from adequately regulating their products and practices.6

Time-series food sales data indicate the explosive growth in manufacturing and consumption of ultra-processed foods worldwide.7 National dietary surveys show that ultra-processed foods already make up 50% or more of total dietary energy intake8 in high-income countries, with even higher consumption among children and adolescents.9 In middle-income countries, they now represent between 15% and 30% of total energy intake8 but sales of ultra-processed foods are increasing fastest in these countries.10

The pandemic of obesity and related diseases and its link with ultra-processing

According to WHO, worldwide prevalence of obesity has nearly tripled since the mid-1970s, and now over 650 million adults are obese, and 1.9 billion adults and over 370 million children and adolescents are overweight or obese (https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight). No country has yet reversed these increases. Closely driven by the increase in obesity is a doubling of worldwide type 2 diabetes prevalence since 1980, now affecting about 420 million people (https://www.who.int/news-room/fact-sheets/detail/diabetes). Obesity, type 2 diabetes and related non-communicable diseases, including cardiovascular diseases and some common cancers, have become pandemics. Pre-COVID-19, health systems in most countries did not have the capacity to effectively treat diet-influenced diseases. Now, many health systems are at or beyond breaking point struggling with COVID-19, the severity of which is significantly higher in people with obesity and related diseases.

Evidence of the general healthfulness of dietary patterns based on fresh and minimally processed foods and culinary preparations, and their protection against all forms of malnutrition, ‘is noteworthy for its breadth, depth, diversity of methods, and consistency of findings’.11

But only in the last decade, with the advent of the NOVA food classification system that distinguishes ultra-processed foods from minimally processed or processed foods,1 has the link between changes in types of food processing and the pandemic of obesity and related diseases been revealed. Evidence here includes:

  • Three meta-analyses of findings from epidemiological studies, including large, long-duration, carefully conducted cohort studies, show dose-response associations between consumption of ultra-processed foods and obesity, abdominal obesity, type 2 diabetes, dyslipidaemias, metabolic syndrome, depression, cardio and cerebrovascular diseases and all-cause mortality.12–14

  • Analysis of national dietary or food purchase surveys in middle-income or high-income countries shows that the higher the dietary share of ultra-processed foods, the higher the obesogenic dietary nutrient profiles. These are characterised by higher energy density, free sugars, unhealthy fats and sodium, and lower protein and dietary fibre.8

  • Epidemiological and experimental studies indicate that ultra-processed foods may increase risks for obesity and related diseases in other ways beyond their nutritional composition. These include structural and physical properties that blunt satiety signalling, organoleptic characteristics associated with higher energy intake rate, neo-formed substances and migrated packaging materials that are endocrine disruptors, additives that promote pro-inflammatory microbiome, and reduced thermic effect that decreases total energy expenditures.12–14

  • A randomised controlled cross-over trial shows that consuming a high ultra-processed diet causes a highly significant increase in ad libitum calorie intake and consequent weight gain. Over a 2-week period, 20 young adults following a diet with 83% of energy from ultra-processed foods consumed approximately 500 more kcal per day than when they followed a diet with no ultra-processed foods. Participants gained 0.9 kg at the end of the 2 weeks with the ultra-processed diet and lost 0.9 kg at the end of the non ultra-processed diet, mostly of body fat.15

  • A longitudinal ecological study of 80 countries from 2002 to 2016 shows a direct association between changes in annual per capita volume sales of ultra-processed foods and corresponding changes in population adult body mass index.16

Taken together, the totality of evidence summarised here shows beyond reasonable doubt that increased consumption of ultra-processed foods is a major contributor to the pandemic of obesity and related diseases. There is also mounting evidence of the harmful effects of the ultra-processed food industry on the planet, through its global demand for cheap ingredients that destroy forests and savannah, its displacement of sustainable farming, and its resource-intensive manufacturing and packaging.17

Policy responses

To begin with, the UN Food Systems Summit should urge international and national health and food and nutrition authorities to review their dietary guidelines to emphasise preference for fresh or minimally processed foods and avoidance of ultra-processed foods, in line with guidelines developed, for example, by the WHO/Pan American Health Organization,18 and issued in several Latino-American countries, and now also in France, Belgium, and Israel.

At the same time, national governments should be urged to use fiscal measures, marketing regulations, bold mandatory front-of-pack labelling schemes and food procurement policies, all designed to promote the production, accessibility and consumption of a rich variety of fresh or minimally processed foods, and to discourage the production, distribution and consumption of ultra-processed foods, as now done in several countries.19

Current food and nutrition policies are mostly intended to encourage food manufacturers to reformulate their products by reducing the use of salt, sugar or unhealthy fats. There is a role for strong regulations that effectively limit the levels of these components, but reformulation alone will not turn ultra-processed products into healthy foods,20 as in effect recently acknowledged in one internal document from one leading ultra-processed food corporation – “some of our categories and products will never be ‘healthy’ no matter how much we renovate” (https://www.ft.com/content/4c98d410-38b1-4be8-95b2-d029e054f492). Policies should instead stimulate the entire manufacturing industry to maintain, develop or improve processing methods that prolong the duration of whole foods, enhance their sensory properties and make their culinary preparation easier and more diverse. Ultra-processed foods should be replaced by processed foods with limited levels or absence of added salt, sugar or unhealthy fats or, preferably, by minimally processed foods.20

Conclusions

Food systems are failing. This is most clearly shown by what are now the pandemics of obesity and type 2 diabetes, of which ultra-processed food is a main contributor. The UN Food Systems Summit should urge member states to implement multiple policy interventions to reduce ultra-processed food production, distribution and consumption, while simultaneously making fresh or minimally processed foods more available, accessible and affordable.

Data availability statement

All data relevant to the study are included in the article.

Ethics statements

Acknowledgments

This paper expands a one-page submission made by the authors to the UN Food Systems Summit within Solution Cluster 2.2.1 (food environment).

References

 

Footnotes

  • Twitter @CMonteiro_USP

  • Contributors All authors contributed to the ideas presented in the manuscript. CAM wrote the manuscript. All authors contributed to redrafting and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

Jul 26 2021

The UN Food Systems Pre-Summit starts in Rome TODAY: Online Access

Thanks to Tom Forster at the New School for sending information about the programs—formal, informal, and counter.  The formal and informal events are in Rome, but available online.  Registration is essential.

For information and registration:

Formal programme: this has the schedule for the 150 sessions.    Register for them here.

Informal programme: register at the links given.

Counter Summit events: these are listed online, along with a call to action.

The Counter events are being organized by the Civil Society and Indigenous Peoples’ Mechanism for Relations with the UN Committee on World Food Security (CSM).

The CSM has produced the following resources:

Oct 13 2020

Good news #2: the Nobel Peace Prize

This year’s Nobel Peace Prize has been  awarded to the World Food Programme (WFP), “for its efforts to combat hunger, for its contribution to bettering conditions for peace in conflict-affected areas and for acting as a driving force in efforts to prevent the use of hunger as a weapon of war and conflict.”

The WFP is the United Nations agency that distributes international food aid.

Why do I think this is good news?  This prize recognizes:

  • The importance of food in maintaining a peaceful world.
  • The importance of functioning food systems during the coronavirus pandemic.
  • The value of United Nations agencies in maintaining peace and food security.

Why do I even ask this question? 

I am well aware of the inadequacies of food charity as a means to ensure nutrition, health and world peace.  All too often, international food aid:

  • Does not reach the people who most need it
  • Is siphoned off to benefit corrupt intermediaries
  • Undermines local food economies
  • Benefits donors more than recipients
  • Is used more as a political than a humanitarian tool
  • Causes more harm than good

I want to see anti-hunger policies institutionalized, not left as voluntary.

Food matters to world peace more than most people recognize.  If the prize raises recognition of the importance of food in society, it will have done good work.

Thanks to Jerry Hagstrom’s Hagstrom Report for most of these links

Jan 2 2019

US votes no on action on global nutrition

I was fascinated to see this FoodNavigator account of the recent United Nations’ call for action on nutrition.

The lengthy new UN resolution on “a healthier world through better nutrition” begins with pages of preliminary comments before getting to bland admonitions that member states should improve nutrition, health conditions, and living standards; address hunger and malnutrition; and promote food security, food safety, and sustainable, resilient, and diverse food systems.

The resolution encourages member states to strengthen nutrition policies that promote breastfeeding and control the marketing of breast-milk substitutes.

It also promotes physical activity. It

Calls upon Member States to develop actions to promote physical activity in the entire population and for all ages, through the provision of safe public environments and recreational spaces, the promotion of sports, physical education programmes in schools and urban planning which encourages active transport.

What got FoodNavigator’s—and my—attention, however, was its encouragement of member nations to:

develop health- and nutrition-promoting environments, including through nutrition education in schools and other education institutions, as appropriate.

Nutrition education?  That’s it on improving the nutrition environment?

Nothing about curbs on food industry marketing practices, front-of-package food labels, soda or sugar taxes, or other policies established to be effective in improving nutritional health (see, for example, the policies listed on the World Health Organization’s database, or the NOURISHING database of The World Cancer Research Fund).

The UN’s own Food and Agriculture Organization issued a report on the value of education in improving the food environment.  Its author, Corinna Hawkes, makes it clear that education is useful, but is far more effective when it thoroughly involves policies to change the food environment.

nutrition education actions are more likely to yield positive results…when actions are implemented as part of large, multi-component interventions, rather than information provision or direct education alone. It is notable that governments have been taking an increasing number of actions involving multiple components, such as combining policies on nutrition labels with education campaigns, public awareness campaigns with food product reformulation, and school food standards with educational initiatives in schools.

The resolution says none of this.  Even so, it did not pass unanimously.  The vote:

  • Yes:       157 countries
  • No:           2 (Libya and the United States)
  • Abstain:    1 (Hungary)

And why did the United States vote no?  The US mission to the UN explains its position on the grounds—and I am not making this up—that the resolution:

  • Favors abortion:  “We do not recognize abortion as a method of family planning, nor do we support abortion in our reproductive health assistance.”
  • Promotes free trade in medicines: “This could lead to misinterpretation of international trade obligations in a manner which may negatively affect countries’ abilities to incentivise new drug development and expand access to medicines.”
  • Promotes migration: “we believe [the resolution represents]…an effort by the United Nations to advance global governance at the expense of the sovereign rights of States to manage their immigration systems in accordance with their national laws and interests.”

To be clear: UN resolutions are non-binding.  The UN cannot tell member countries what to do.  All it can do is exert leadership and moral force.

When it comes to the food environment these days, we need all the moral force we can get.  We didn’t get it here.

Mar 7 2012

U.N. Special Rapporteur: Five Ways to Fix Unhealthy Diets

Olivier de Schutter, the United Nations Special Rapporteur on the Right to Food, has issued five recommendations for fixing diets and food systems:

  • Tax unhealthy products.
  • Regulate foods high in saturated fats, salt and sugar.
  • Crack down on junk food advertising.
  • Overhaul misguided agricultural subsidies that make certain ingredients cheaper than others.
  • Support local food production so that consumers have access to healthy, fresh and nutritious foods.

De Schutter explains:

One in seven people globally are undernourished, and many more suffer from the ‘hidden hunger’ of micronutrient deficiency, while 1.3 billion are overweight or obese.

Faced with this public health crisis, we continue to prescribe medical remedies: nutrition pills and early-life nutrition strategies for those lacking in calories; slimming pills, lifestyle advice and calorie counting for the overweight.

But we must tackle the systemic problems that generate poor nutrition in all its forms.

Governments, he said:

have often been indifferent to what kind of calories are on offer, at what price, to whom they are accessible, and how they are marketed…We have deferred to food companies the responsibility for ensuring that a good nutritional balance emerges.

…Heavy processing thrives in our global food system, and is a win-win for multinational agri-food companies…But for the people, it is a lose-lose…In better-off countries, the poorest population groups are most affected because foods high in fats, sugar and salt are often cheaper than healthy diets as a result of misguided subsidies whose health impacts have been wholly ignored.

Much to ponder here.  Let’s hope government health agencies listen hard and get to work.

For further information, the press release adds these links:

Sep 30 2011

Disappointing UN Declaration on chronic disease prevention

As I mentioned in a previous post, the United Nations General Assembly met this month to consider resolutions about doing something to address rising rates of “non-communicable” diseases (i.e., chronic as opposed to infectious diseases such as obesity-related coronary heart disease, type 2 diabetes, and cancers).

The Declaration adopted by the Assembly disappointed a consortium of 140 non-profit public health advocacy groups who issued a statement noting the conflicts of interest that occur when international agencies “partner” with companies that make products that contribute to an increase in disease risks.”

The consortium suggested actions that they hoped the U.N. would recommend, such as:

  • Realign food policies for food and agricultural subsidies with sound nutrition science
  • Mandate easy-to-understand front-of-pack nutrition labeling
  • Ban the promotion of breast-milk substitutes and high-fat, -sugar and -salt foods to children and young people
  • Prohibit advertising and brand sponsorship for alcohol beverages
  • Increase taxes on alcohol beverages
  • Expand nutritious school meal programs

The group also said that the U.N. should still work on:

  • Developing tools to navigate the trade law barriers to health policy innovation,
  •  Establishing disease-reduction targets and policy implementation schedules
  • Instituting mechanisms to keep commercially self-interested parties at arms-length and public-interest groups constructively involved

Food companies and trade associations are actively involved in lobbying the U.N. not to do any of these things.  This consortium has much work to do.


 

 

Sep 19 2011

United Nations to consider the effects of food marketing on chronic disease

In what Bloomberg News terms an “epidemic battle,” food companies are doing everything they can to prevent the United Nations from issuing a statement that says anything about how food marketing promotes obesity and related chronic diseases.

The U.N. General Assembly meets in New York on September 19 and 20 to develop a global response to the obesity-related increase in non-communicable, chronic diseases (cancer, cardiovascular disease, respiratory disease, type 2 diabetes) now experienced by both rich and poor countries throughout the world.

As the Bloomberg account explains,

Company officials join political leaders and health groups to come up with a plan to reverse the rising tide of non- communicable diseases….On the table are proposals to fight obesity, cut tobacco and alcohol use and expand access to lifesaving drugs in an effort to tackle unhealthy diets and lifestyles that drive three of every five deaths worldwide. At stake for the makers of snacks, drinks, cigarettes and drugs is a market with combined sales of more than $2 trillion worldwide last year.

Commenting on the collaboration of food companies in this effort:

“It’s kind of like letting Dracula advise on blood bank security,” said Jorge Alday, associate director of policy with World Lung Foundation, which lobbies for tobacco control.

The lobbying, to understate the matter, is intense.  On one side are food corporations with a heavy financial stake in selling products in developing countries.  Derek Yach, for example, a senior executive of PepsiCo, argues in the British Medical Journal that it’s too simplistic to recommend nutritional changes to reduce chronic disease risk.  [Of course it is, but surely cutting down on fast food, junk food, and sodas ought to be a good first step?]

On the other side are public health advocates concerned about conflicts of interest in the World Health Organization.  So is the United Nations’ special rapporteur for  the right to food, Olivier De Schutter.  Mr. De Schutter writes that the “chance to crack down on bad diets must not be missed.”

On the basis of several investigative visits to developing countries,  De Schutter calls for “the adoption of a host of initiatives, such as taxing unhealthy products and regulating harmful food marketing practices…Voluntary guidelines are not enough. World leaders must not bow to industry pressure.”

If we are serious about tackling the rise of cancer and heart disease, we need to make ambitious, binding commitments to tackle one of the root causes – the food that we eat.

The World Health Organization’s (WHO) 2004 Global Strategy on Diet, Physical Activity and Health must be translated into concrete action: it is unacceptable that when lives are at stake, we go no further than soft, promotional measures that ultimately rely on consumer choice, without addressing the supply side of the food chain.

It is crucial for world leaders to counter food industry efforts to sell unbalanced processed products and ready-to-serve meals too rich in trans fats and saturated fats, salt and sugars. Food advertising is proven to have a strong impact on children, and must be strictly regulated in order to avoid the development of bad eating habits early in life.

A comprehensive strategy on combating bad diets should also address the farm policies which make some types of food more available than others…Currently, agricultural policies encourage the production of grains, rich in carbohydrates but relatively poor in micronutrients, at the expense of the production of fruits and vegetables.

We need to question how subsidies are targeted and improve access to markets for the most nutritious foods.…The public health consequences are dramatic, and they affect disproportionately those with the lowest incomes.

In 2004, the U.N. caved in to pressures from food companies and weakened its guidelines and recommendations.  The health situation is worse now and affects people in developing as well as industrialized countries.  Let’s hope the General Assembly puts health above politics this time.