Measuring nutritional diversity of national food supplies

Associations between national plant-based vs animal-based protein supplies and age-specific mortality in human populations

Transitions to sustainable food systems require shifts in food production and availability, particularly the replacement of animal-based protein with plant-based protein. To explore how this transition may relate to demographic patterns, we undertake an ecological analysis of global associations between age-specific mortality, total national macronutrient distributions, and protein substitution. Our dataset includes per capita daily food supply and demographic data for 101 countries from 1961-2018. After adjusting for time, population size, and economic factors, we find associations between low total protein supplies and higher mortality rates across all age groups. Early-life survivorship improves with higher animal-based protein and fat supplies, while later-life survival improves with increased plant-based protein and lower fat supplies. Here, we show that the optimal balance of protein and fat in national food supplies, which correlates with minimal mortality, varies with age, suggesting that reductions in dietary protein, especially from animal sources, may need to be managed with age-specific redistributions to balance health and environmental benefits.

Dietary species richness provides a comparable marker for better nutrition and health across contexts

Ecological diversity indices such as Hill numbers have been developed to estimate effective species numbers, yet the ability of Hill numbers to compare food biodiversity across contexts is unclear. Here we computed the between- and within-country variability of similarity-insensitive Hill numbers using dietary intake collected from prospective cohorts in nine European countries and cross-sectional studies in five low- and middle-income countries. We also assessed the relationships between more biodiverse diets, mortality rates and micronutrient adequacy. Only Hill0, better known as dietary species richness (DSR), showed strong heterogeneity between countries and individuals within countries. Higher DSR was most strongly associated with lower mortality rates in Europe as compared to Hill1, Hill2 and Hill∞, whereas relationships with micronutrient adequacy were comparable across Hill numbers in the global south. DSR can be used to assess progress towards more biodiverse diets, while also serving as a marker for the deleterious nutrition and health impacts associated with non-diverse diets.

Exploring Multidimensional and Within-Food Group Diversity for Diet Quality and Long-Term Health in High-Income Countries

Dietary diversity is a crucial component of healthy eating patterns because it ensures nutritional adequacy. Yet, concerns have been raised about the potential risks of its increase, which may reflect excessive consumption of unhealthy foods and higher obesity or cardiometabolic risk, particularly in high-income countries. However, the links between dietary diversity and different health outcomes remain inconclusive because of methodological differences in assessing dietary diversity. Numerous studies, mostly cross-sectional, have assessed dietary diversity using different indicators usually based only on the number of foods or food groups consumed. In this perspective, we emphasize that dietary diversity is a multidimensional concept encompassing the number of foods in the diet (food coverage) but also their relative proportions (food evenness) and the nutritional dissimilarity of foods consumed over time (food complementarity). Consequently, a comprehensive assessment of dietary diversity reflecting all its dimensions, both between and within-food groups, is needed to determine the optimal level of complementarity between and within-food groups required to improve health and diet quality. Moreover, given the prevailing context of abundant highly processed and energy-dense foods in high-income countries, promoting dietary diversity should prioritize nutrient-dense food groups. Until recently, within-food group diversity has received limited attention in research and public health recommendations. Still, it may play a role in improving diet quality and long-term health. This perspective aims to clarify the concept of dietary diversity and suggest research avenues that should be explored to better understand its associations with nutritional adequacy and health among adults in high-income countries.

Commercially traded fish portfolios mask household utilization of biodiversity in wild food systems

The global biodiversity that underpins wild food systems-including fisheries-is rapidly declining. Yet, we often have only a limited understanding of how households use and benefit from biodiversity in the ecosystems surrounding them. Explicating these relationships is critical to forestall and mitigate the effects of biodiversity declines on food and nutrition security. Here, we quantify how biodiversity filters from ecosystems to household harvest, consumption, and sale, and how ecological traits and household characteristics shape these relationships. We used a unique, integrated ecological (40 sites, quarterly data collection) and household survey (n = 414, every 2 mo data collection) dataset collected over 3 y in rice field fisheries surrounding Cambodia's Tonlé Sap, one of Earth's most productive and diverse freshwater systems. While ecosystem biodiversity was positively associated with household catch, consumption, and sold biodiversity, households consumed an average of 43% of the species present in the ecosystem and sold only 9%. Larger, less nutritious, and more common species were disproportionally represented in portfolios of commercially traded species, while consumed species mirrored catches. The relationship between ecosystem and consumed biodiversity was remarkably consistent across variation in household fishing effort, demographics, and distance to nearest markets. Poorer households also consumed more species, underscoring how wild food systems may most benefit the vulnerable. Our findings amplify concerns about the impacts of biodiversity loss on our global food systems and highlight that utilization of biodiversity for consumption may far exceed what is commercially traded.

Dietary factors associated with anaemia among pregnant women attending antenatal care clinics in Sekota town, Northern Ethiopia: a facility-based cross-sectional study

Background

Anaemia is a major public health problem during pregnancy, especially in developing countries such as Ethiopia. Poor diet patterns are common contributors to anaemia. This study assessed the dietary factors associated with anaemia among pregnant women attending antenatal care clinics in Sekota town, Northern Ethiopia.

Methods

A facility-based cross-sectional study was conducted from June to August 2021 among 367 pregnant women who were selected using systematic random sampling techniques. A structured questionnaire was used to collect sociodemographic, obstetric and dietary data. The nutritional status of pregnant women was assessed using a mid-upper arm circumference measuring tape, and haemoglobin levels were tested using the haematocrit centrifugation technique. The data were analysed using SPSS V.21. Bivariate and multivariate logistic regression analyses were performed to assess dietary factors associated with anaemia and p<0.05 was used to declare statistical significance.

Results

Dietary pattern predictors such as meal frequency (adjusted OR (AOR)=0.27, 95% CI: 0.12, 0.59), meat consumption frequency (AOR=4.05, 95% CI: 2.46, 33.65), fruit and vegetable consumption frequency (AOR=2.88, 95% CI: 2.08, 26.81), Dietary Diversity Score (AOR=12.81, 95% CI: 3.93, 41.75), food aversion (AOR=0.12, 95% CI: 0.03, 0.47) and undernutrition (AOR=0.22, 95% CI: 0.07, 0.64) were significantly associated with anaemia.

Conclusion

Predictors of dietary pattern, such as meal frequency, Dietary Diversity Score, food aversion, meat consumption frequency, fruit and vegetable consumption frequency, and undernutrition were significantly associated with anaemia among pregnant women in the study area. Therefore, healthcare providers, policymakers, researchers and other stakeholders should pay special attention to maternal dietary patterns to address the identified factors. Programmes should be developed and implemented to improve optimal dietary patterns and proper nutrition during pregnancy to overcome anaemia and other pregnancy complications.

A global clustering of terrestrial food production systems

Food production is at the heart of global sustainability challenges, with unsustainable practices being a major driver of biodiversity loss, emissions and land degradation. The concept of foodscapes, defined as the characteristics of food production along biophysical and socio-economic gradients, could be a way addressing those challenges. By identifying homologues foodscapes classes possible interventions and leverage points for more sustainable agriculture could be identified. Here we provide a globally consistent approximation of the world's foodscape classes. We integrate global data on biophysical and socio-economic factors to identify a minimum set of emergent clusters and evaluate their characteristics, vulnerabilities and risks with regards to global change factors. Overall, we find food production globally to be highly concentrated in a few areas. Worryingly, we find particularly intensively cultivated or irrigated foodscape classes to be under considerable climatic and degradation risks. Our work can serve as baseline for global-scale zoning and gap analyses, while also revealing homologous areas for possible agricultural interventions.

International food trade contributes to dietary risks and mortality at global, regional and national levels

Food trade is generally perceived to increase the availability and diversity of foods available to consumers, but there is little empirical evidence on its implications for human health. Here we show that a substantial proportion of dietary risks and diet-related mortality worldwide is attributable to international food trade and that whether the contributions of food trade are positive or negative depends on the types of food traded. Using bilateral trade data for 2019 and food-specific risk-disease relationships, we estimate that imports of fruits, vegetables, legumes and nuts improved dietary risks in the importing countries and were associated with a reduction in mortality from non-communicable diseases of ~1.4 million deaths globally. By contrast, imports of red meat aggravated dietary risks in the importing countries and were associated with an increase of ~150,000 deaths. The magnitude of our findings suggests that considering impacts on dietary risks will become an important aspect of health-sensitive trade and agriculture policies, and of policy responses to disruptions in food chains.

Exploring scenarios for the food system-zoonotic risk interface

The unprecedented economic and health impacts of the COVID-19 pandemic have shown the global necessity of mitigating the underlying drivers of zoonotic spillover events, which occur at the human-wildlife and domesticated animal interface. Spillover events are associated to varying degrees with high habitat fragmentation, biodiversity loss through land use change, high livestock densities, agricultural inputs, and wildlife hunting-all facets of food systems. As such, the structure and characteristics of food systems can be considered key determinants of modern pandemic risks. This means that emerging infectious diseases should be more explicitly addressed in the discourse of food systems to mitigate the likelihood and impacts of spillover events. Here, we adopt a scenario framework to highlight the many connections among food systems, zoonotic diseases, and sustainability. We identify two overarching dimensions: the extent of land use for food production and the agricultural practices employed that shape four archetypal food systems, each with a distinct risk profile with respect to zoonotic spillovers and differing dimensions of sustainability. Prophylactic measures to curb the emergence of zoonotic diseases are therefore closely linked to diets and food policies. Future research directions should explore more closely how they impact the risk of spillover events.

Food biodiversity: Quantifying the unquantifiable in human diets

Dietary diversity is an established public health principle, and its measurement is essential for studies of diet quality and food security. However, conventional between food group scores fail to capture the nutritional variability and ecosystem services delivered by dietary richness and dissimilarity within food groups, or the relative distribution (i.e., evenness or moderation) of e.g., species or varieties across whole diets. Summarizing food biodiversity in an all-encompassing index is problematic. Therefore, various diversity indices have been proposed in ecology, yet these require methodological adaption for integration in dietary assessments. In this narrative review, we summarize the key conceptual issues underlying the measurement of food biodiversity at an edible species level, assess the ecological diversity indices previously applied to food consumption and food supply data, discuss their relative suitability, and potential amendments for use in (quantitative) dietary intake studies. Ecological diversity indices are often used without justification through the lens of nutrition. To illustrate: (i) dietary species richness fails to account for the distribution of foods across the diet or their functional traits; (ii) evenness indices, such as the Gini-Simpson index, require widely accepted relative abundance units (e.g., kcal, g, cups) and evidence-based moderation weighting factors; and (iii) functional dissimilarity indices are constructed based on an arbitrary selection of distance measures, cutoff criteria, and number of phylogenetic, nutritional, and morphological traits. Disregard for these limitations can lead to counterintuitive results and ambiguous or incorrect conclusions about the food biodiversity within diets or food systems. To ensure comparability and robustness of future research, we advocate food biodiversity indices that: (i) satisfy key axioms; (ii) can be extended to account for disparity between edible species; and (iii) are used in combination, rather than in isolation.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2022.2051163 .

Exploring the pathways towards the mitigation of the environmental impacts of food consumption

Agriculture constitutes a quarter and more than a third of Denmark's global greenhouses gas (GHG) emissions and natural resource consumption, respectively. This paper aims to estimate the potential to lower Denmark's global food-related GHG, blue water and land footprints using the most recent version of a hybrid global multi-regional input-output (MRIO) database, EXIOBASE of the reference year, 2011. Specifically, we apply the 'what if' scenario-based MRIO approach to EXIOBASE and quantify the impact of increased livestock feed efficiency (FE), dietary changes, food loss and waste (FLW) reduction/prevention and food waste treatment scenarios on Denmark's global food-related GHG and resource footprints. We obtain modest reductions in Denmark's global food-related GHG, blue water and cropland footprint from the combination of livestock FE improvements and FLW reduction; 61 kt CO₂e, 2 Mm³ and 30 kha, respectively. In contrast, dietary change towards no/less meat and dairy diets embodies the most significant reductions potential for Denmark's total global food-related GHG, blue water, croplands and grassland footprint by up to 34% (3.63 Mt. CO₂e), 8% (90 Mm³), 23% (371 kha) and 78% (386 kha) respectively. A key policy priority should therefore be the nudging of Danish consumers towards sustainable diets. Also, this study's findings emphasise that FLW prevention remains the most effective food waste-related climate mitigation and resource efficiency strategy despite the benefits of food waste valorisation.

Does Fish Farming Improve Household Nutritional Status? Evidence from Bangladesh

In the present study, nutritional status was assessed using dietary diversity of fish and non-fish farming households in Mymensingh district of Bangladesh. It has determined the incidence of poverty in fish and non-fish farm households through a comparative analysis of family profile, food consumption, calories, and protein intake. A total of 420 farms were selected for data collection using structured questionnaires with 210 fish and 210 non-fish farm families. The study using both descriptive and functional analysis revealed that the respondent age of both farms was 45.10 years, family size was 5.70, average education was 4.64 schooling years, and average farm size was 0.514 hectares. As a result, due to the increase in household income, fish farm families improved their food consumption, calories, and protein intake in comparison with non-fish farms. On a direct calorie intake (DCI) basis, the overall absolute and hardcore poverty levels of fish farm households were 32 percent and 18 percent, respectively, while those of non-fish farm households were 22 percent and 10 percent, respectively. Therefore, the incidence of poverty was higher in non-fish farming families than in fish farming families. In principle, provision of various forms of government assistance through the Department of Fisheries (DOF) will further intensify and strengthen fish farming, which will easily bring fallow and uncultivated lands of the area under fish farming. Moreover, it is possible to inspire the younger generation through this research that will help them to become a fish farm-based entrepreneur. The main conclusion of the present study is that fish farming is more positively related to household income, family food intake, and nutritional status than any other type of farming.

Crop genetic erosion: understanding and responding to loss of crop diversity

Crop diversity underpins the productivity, resilience and adaptive capacity of agriculture. Loss of this diversity, termed crop genetic erosion, is therefore concerning. While alarms regarding evident declines in crop diversity have been raised for over a century, the magnitude, trajectory, drivers and significance of these losses remain insufficiently understood. We outline the various definitions, measurements, scales and sources of information on crop genetic erosion. We then provide a synthesis of evidence regarding changes in the diversity of traditional crop landraces on farms, modern crop cultivars in agriculture, crop wild relatives in their natural habitats and crop genetic resources held in conservation repositories. This evidence indicates that marked losses, but also maintenance and increases in diversity, have occurred in all these contexts, the extent depending on species, taxonomic and geographic scale, and region, as well as analytical approach. We discuss steps needed to further advance knowledge around the agricultural and societal significance, as well as conservation implications, of crop genetic erosion. Finally, we propose actions to mitigate, stem and reverse further losses of crop diversity.

Closing Research Investment Gaps for a Global Food Transformation

Recent calls for a global food transformation have centered on simultaneously improving human and environmental health, recognizing that food and nutrient diversity have declined over time while food systems have exacted a heavy climate and ecological toll. Grain legumes and coarse grain crops provide important human nutrition and environmental benefits, but the production and consumption of many of these crops remains relatively low compared to major commodities, such as maize, wheat, rice, and soy. Outstanding hurdles to scaling up these “minor commodity” crops include (among other things) their relatively lower yields, and lower farmer adoption, based partly on actual or perceived profitability and marketability. We hypothesize that these limitations are attributable in part to unequal funding for these crops' research and development (R&amp;D) both on a national and global scale. In the United States, we show that investment patterns for a snapshot of USDA-funded research grants from 2008 to 2019 consistently favor major commodity crops, which received 3 to 4.5 times more funding and 3 to 5 times as many grants than the minor commodity crop groups. This current USDA funding allocation poses a barrier to food system transformations. Achieving nutritious diets for planetary health requires more public agricultural investment toward minor commodity crops and increased collaboration between public health, nutrition, agriculture, and environmental sectors.

Building a Global Food Systems Typology: A New Tool for Reducing Complexity in Food Systems Analysis

Food systems have a profound impact on diets, nutrition, health, economic development, and environmental sustainability. Yet their complexity poses a persistent challenge in identifying the policy actions that are needed to improve human and planetary health outcomes. Typologies are a useful classification tool to identify similarities and differences among food systems, while reducing this analytical complexity. This study presents a new food system typology, implemented at the country level using parsimonious data that characterize food supply chains, food environments, consumer-related factors, and key outcomes, including dietary intake, nutritional status, health, and environmental impacts. Five food system types are identified: rural and traditional; informal and expanding; emerging and diversifying; modernizing and formalizing; and industrial and consolidated. Patterns across the five system types in key outcome variables align with narratives provided by the food systems and nutrition transition literature, demonstrating the usefulness of this classification method. Substantial heterogeneity nonetheless still exists within individual food system types. Therefore, the recommended use of the typology is in early stages of hypothesis generation, to identify potential risk factors or constraints in the food system that can be explored further at national and sub-national levels.

Global relationships between crop diversity and nutritional stability

Nutritional stability – a food system’s capacity to provide sufficient nutrients despite disturbance – is an important, yet challenging to measure outcome of diversified agriculture. Using 55 years of data across 184 countries, we assemble 22,000 bipartite crop-nutrient networks to quantify nutritional stability by simulating crop and nutrient loss in a country, and assess its relationship to crop diversity across regions, over time and between imports versus in country production. We find a positive, saturating relationship between crop diversity and nutritional stability across countries, but also show that over time nutritional stability remained stagnant or decreased in all regions except Asia. These results are attributable to diminishing returns on crop diversity, with recent gains in crop diversity among crops with fewer nutrients, or with nutrients already in a country’s food system. Finally, imports are positively associated with crop diversity and nutritional stability, indicating that many countries’ nutritional stability is market exposed.

Crop diversification could be important for food security. Here, using methods from network science, the authors find that a positive relationship between crop diversity and nutritional stability globally does not necessarily equate to improving nutritional stability in a given country.

Aquatic biodiversity enhances multiple nutritional benefits to humans

Humanity depends on biodiversity for health, well-being, and a stable environment. As biodiversity change accelerates, we are still discovering the full range of consequences for human health and well-being. Here, we test the hypothesis-derived from biodiversity-ecosystem functioning theory-that species richness and ecological functional diversity allow seafood diets to fulfill multiple nutritional requirements, a condition necessary for human health. We analyzed a newly synthesized dataset of 7,245 observations of nutrient and contaminant concentrations in 801 aquatic animal taxa and found that species with different ecological traits have distinct and complementary micronutrient profiles but little difference in protein content. The same complementarity mechanisms that generate positive biodiversity effects on ecosystem functioning in terrestrial ecosystems also operate in seafood assemblages, allowing more diverse diets to yield increased nutritional benefits independent of total biomass consumed. Notably, nutritional metrics that capture multiple micronutrients and fatty acids essential for human well-being depend more strongly on biodiversity than common ecological measures of function such as productivity, typically reported for grasslands and forests. Furthermore, we found that increasing species richness did not increase the amount of protein in seafood diets and also increased concentrations of toxic metal contaminants in the diet. Seafood-derived micronutrients and fatty acids are important for human health and are a pillar of global food and nutrition security. By drawing upon biodiversity-ecosystem functioning theory, we demonstrate that ecological concepts of biodiversity can deepen our understanding of nature's benefits to people and unite sustainability goals for biodiversity and human well-being.

Bambara Groundnut: An Underutilized Leguminous Crop for Global Food Security and Nutrition

Rapid population growth, climate change, intensive monoculture farming, and resource depletion are among the challenges that threaten the increasingly vulnerable global agri-food system. Heavy reliance on a few major crops is also linked to a monotonous diet, poor dietary habits, and micronutrient deficiencies, which are often associated with diet-related diseases. Diversification-of both agricultural production systems and diet-is a practical and sustainable approach to address these challenges and to improve global food and nutritional security. This strategy is aligned with the recommendations from the EAT-Lancet report, which highlighted the urgent need for increased consumption of plant-based foods to sustain population and planetary health. Bambara groundnut (Vigna subterranea (L.) Verdc.), an underutilized African legume, has the potential to contribute to improved food and nutrition security, while providing solutions for environmental sustainability and equity in food availability and affordability. This paper discusses the potential role of Bambara groundnut in diversifying agri-food systems and contributing to enhanced dietary and planetary sustainability, with emphasis on areas that span the value chain: from genetics, agroecology, nutrition, processing, and utilization, through to its socioeconomic potential. Bambara groundnut is a sustainable, low-cost source of complex carbohydrates, plant-based protein, unsaturated fatty acids, and essential minerals (magnesium, iron, zinc, and potassium), especially for those living in arid and semi-arid regions. As a legume, Bambara groundnut fixes atmospheric nitrogen to improve soil fertility. It is resilient to adverse environmental conditions and can yield on poor soil. Despite its impressive nutritional and agroecological profile, the potential of Bambara groundnut in improving the global food system is undermined by several factors, including resource limitation, knowledge gap, social stigma, and lack of policy incentives. Multiple research efforts to address these hurdles have led to a more promising outlook for Bambara groundnut; however, there is an urgent need to continue research to realize its full potential.

Urbanization and food consumption in India

The shift towards urban living is changing food demand. Past studies on India show significant urban–rural differences in food consumption. However, a scientific understanding of the underlying relationships between urbanization and food consumption is limited. This study provides the first detailed analysis of how urbanization influences both quantity and diversity of food consumption in India by harnessing the strength of multiple datasets, including consumer expenditure surveys, satellite imagery, and census data. Our statistical analysis shows three main findings. First, in contrast to existing studies, we find that much of the variation in food consumption quantity is due to income and not urbanization. After controlling for income and state-level differences, our results show that average consumption is higher in urban than rural areas for fewer than 10% of all commodities. That is, there is nearly no difference in average consumption between urban and rural residents. Second, we find the influence of urbanization as a population share on food consumption diversity to be statistically insignificant (p-value > 0.1). Instead, the results show that infrastructure, market access, percentage working women in urban areas, and norms and institutions have a statistically significant influence. Third, all covariates of food consumption diversity we tested were found to be associated with urbanization. This suggests that urbanization influences on food consumption are both indirect and multidimensional. These results show that increases in the urban population size alone do not explain changes in food consumption in India. If we are to understand how food consumption may change in the future due to urbanization, the study points to the need for a more complex and multidimensional understanding of the urbanization process that goes beyond demographic shifts.

Conceptual Links between Landscape Diversity and Diet Diversity: A Roadmap for Transdisciplinary Research

Malnutrition linked to poor quality diets affects at least 2 billion people. Forests, as well as agricultural systems linked to trees, are key sources of dietary diversity in rural settings. In the present article, we develop conceptual links between diet diversity and forested landscape mosaics within the rural tropics. First, we summarize the state of knowledge regarding diets obtained from forests, trees, and agroforests. We then hypothesize how disturbed secondary forests, edge habitats, forest access, and landscape diversity can function in bolstering dietary diversity. Taken together, these ideas help us build a framework illuminating four pathways (direct, agroecological, energy, and market pathways) connecting forested landscapes to diet diversity. Finally, we offer recommendations to fill remaining knowledge gaps related to diet and forest cover monitoring. We argue that better evaluation of the role of land cover complexity will help avoid overly simplistic views of food security and, instead, uncover nutritional synergies with forest conservation and restoration.

Food Environment Typology: Advancing an Expanded Definition, Framework, and Methodological Approach for Improved Characterization of Wild, Cultivated, and Built Food Environments toward Sustainable Diets

The food environment is a critical place in the food system to implement interventions to support sustainable diets and address the global syndemic of obesity, undernutrition, and climate change, because it contains the total scope of options within which consumers make decisions about which foods to acquire and consume. In this paper, we build on existing definitions of the food environment, and provide an expanded definition that includes the parameter of sustainability properties of foods and beverages, in order to integrate linkages between food environments and sustainable diets. We further provide a graphical representation of the food environment using a socio-ecological framework. Next, we provide a typology with descriptions of the different types of food environments that consumers have access to in low-, middle-, and high-income countries including wild, cultivated, and built food environments. We characterize the availability, affordability, convenience, promotion and quality (previously termed desirability), and sustainability properties of food and beverages for each food environment type. Lastly, we identify a methodological approach with potential objective and subjective tools and metrics for measuring the different properties of various types of food environments. The definition, framework, typology, and methodological toolbox presented here are intended to facilitate scholars and practitioners to identify entry points in the food environment for implementing and evaluating interventions that support sustainable diets for enhancing human and planetary health.

Global drivers of food system (un)sustainability: A multi-country correlation analysis

At present, our ability to comprehend the dynamics of food systems and the consequences of their rapid 'transformations' is limited. In this paper, we propose to address this gap by exploring the interactions between the sustainability of food systems and a set of key drivers at the global scale. For this we compile a metric of 12 key drivers of food system from a globally-representative set of low, middle, and high-income countries and analyze the relationships between these drivers and a composite index that integrates the four key dimensions of food system sustainability, namely: food security & nutrition, environment, social, and economic dimensions. The two metrics highlight the important data gap that characterizes national systems' statistics-in particular in relation to transformation, transport, retail and distribution. Spearman correlations and Principal Component Analysis are then used to explore associations between levels of sustainability and drivers. With the exception of one economic driver (trade flows in merchandise and services), the majority of the statistically significant correlations found between food system sustainability and drivers appear to be negative. The fact that most of these negative drivers are closely related to the global demographic transition that is currently affecting the world population highlights the magnitude of the challenges ahead. This analysis is the first one that provides quantitative evidence at the global scale about correlations between the four dimensions of sustainability of our food systems and specific drivers.

Multi-dimensional characterisation of global food supply from 1961-2013

Food systems are increasingly globalized and interdependent and diets around the world are changing. Characterising national food supplies and how they have changed can inform food policies that ensure national food security, support access to healthy diets and enhance environmental sustainability. Here, we analysed data for 171 countries on availability of 18 food groups from the United Nations Food and Agriculture Organization to identify and track multi-dimensional food supply patterns from 1961 to 2013. Four predominant food group combinations were identified that explained almost 90% of cross-country variance in food supply: animal source and sugar; vegetable; starchy root and fruit; and seafood and oilcrops. South Korea, China and Taiwan experienced the largest changes in food supply over the past five decades, with animal source foods and sugar, vegetables, and seafood and oilcrops all becoming more abundant components of food supply. In contrast, in many Western countries, the supply of animal source foods and sugar declined. Meanwhile, there was remarkably little change in food supply in countries in the sub-Saharan Africa region. These changes have led to a partial global convergence in national supply of animal source foods and sugar, and a divergence in vegetables, and seafood and oilcrops. Our analysis has generated a novel characterisation of food supply that highlights the interdependence of multiple food types in national food systems. A better understanding of how these patterns have evolved and will continue to change is needed to support the delivery of healthy and sustainable food system policies.

Impacts of Reducing UK Beef Consumption Using a Revised Sustainable Diets Framework

The impact of beef consumption on sustainability is a complex and evolving area, as sustainability covers many areas from human nutrient adequacy to ecosystem stability. Three sustainability assessment frameworks have been created to help policy makers unpack the complexities of sustainable food systems and healthy sustainable dietary change. However, none of these frameworks have yet to be applied to a case study or individual policy issue. This paper uses a hybrid version of the sustainability assessment frameworks to investigate the impact of reducing beef consumption (with a concurrent increase in consumption of plant-based foods, with a focus on legumes) on sustainability at a UK level. The aim of this paper is to understand the applicability of these overarching frameworks at the scale of an individual policy. Such an assessment is important, as this application of previously high-level frameworks to individual policies makes it possible to summarise, at a glance, the various co-benefits and trade-offs associated with a given policy, which may be of particular value in terms of stakeholder decision-making. We find that many of the proposed metrics found within the sustainability assessment frameworks are difficult to implement at an individual issue level; however, overall they show that a reduction in beef consumption and an increase in consumption of general plant-based foods, with a focus around legumes production, would be expected to be strongly beneficial in five of the eight overarching measures which were assessed.

Source apportionment of micronutrients in the diets of Kilimanjaro,Tanzania and Counties of Western Kenya

Soil, water and food supply composition data have been combined to primarily estimate micronutrient intakes and subsequent risk of deficiencies in each of the regions studied by generating new data to supplement and update existing food balance sheets. These data capture environmental influences, such as soil chemistry and the drinking water sources to provide spatially resolved crop and drinking water composition data, where combined information is currently limited, to better inform intervention strategies to target micronutrient deficiencies. Approximately 1500 crop samples were analysed, representing 86 food items across 50 sites in Tanzania in 2013 and >230 sites in Western Kenya between 2014 and 2018. Samples were analysed by ICP-MS for 58 elements, with this paper focussing on calcium (Ca), copper (Cu), iron (Fe), magnesium (Mg), selenium (Se), iodine (I), zinc (Zn) and molybdenum (Mo). In general, micronutrient supply from food groups was higher from Kilimanjaro,Tanzania than Counties in Western Kenya, albeit from a smaller sample. For both countries leafy vegetable and vegetable food groups consistently contained higher median micronutrient concentrations compared to other plant based food groups. Overall, calculated deficiency rates were <1% for Cu and Mo and close to or >90% for Ca, Zn and I in both countries. For Mg, a slightly lower risk of deficiency was calculated for Tanzania at 0 to 1% across simplified soil classifications and for female/males, compared to 3 to 20% for Kenya. A significant difference was observed for Se, where a 3 to 28% risk of deficiency was calculated for Tanzania compared to 93 to 100% in Kenya. Overall, 11 soil predictor variables, including pH and organic matter accounted for a small proportion of the variance in the elemental concentration of food. Tanzanian drinking water presented several opportunities for delivering greater than 10% of the estimated average requirement (EAR) for micronutrients. For example, 1 to 56% of the EAR for I and up to 10% for Se or 37% for Zn could be contributed via drinking water.

Development and validation of an individual sustainable diet index in the NutriNet-Santé study cohort

In the current context of unsustainable food systems, we aimed to develop and validate an index, the sustainable diet index (SDI), assessing the sustainability of dietary patterns, including multidimensional individual indicators of sustainability. Based on the FAO's definition of sustainable diets, the SDI includes seven indicators categorised into four standardised sub-indexes, respectively, environmental, nutritional, economic and sociocultural. The index (range: 4-20) was obtained by summing the sub-indexes. We computed the SDI for 29 388 participants in the NutriNet-Santé cohort study, estimated its validity and identified potential socio-demographic or lifestyle differences across the SDI quintile. In our sample, the SDI (mean=12·10/20; 95 % CI 12·07, 12·13) was highly correlated to all the sub-indexes that exerted substantial influence on the participants' ranking. The environmental and economical sub-indexes were the most and less correlated with the SDI (Pearson R 2 0·66 and 0·52, respectively). Dietary patterns of participants with a high SDI (considered as more sustainable) were concordant with the already published sustainable diets. Participants with high SDI scores were more often women (24 %), post-secondary graduates (22 %) and vegetarians or vegans (7 %), without obesity (16 %). Finally, the SDI could be a useful tool to easily assess the sustainability-related changes in dietary patterns, estimate the association with long-term health outcomes and help guide future public health policies.

The Minimum Dietary Diversity for Women of Reproductive Age (MDD-W) Indicator Is Related to Household Food Insecurity and Farm Production Diversity: Evidence from Rural Mali

BACKGROUND

The popularity of nutrition-sensitive interventions calls for high-quality monitoring and evaluation tools. In this context, the Minimum Dietary Diversity for Women of Reproductive Age (MDD-W), validated as a proxy of micronutrient adequacy, does fill a gap. However, because it is a newly endorsed indicator, information on its linkages with other dimensions of food and nutrition security is still scarce.

OBJECTIVE

The objective of this study was to investigate whether the MDD-W is related to household food insecurity and farm production diversity.

METHODS

A cross-sectional survey on a representative sample of 5046 women of reproductive age was conducted in the region of Kayes, Mali, in 2013. Dietary diversity was assessed through qualitative 24-h recall, and MDD-W was computed. MDD-W equaled 1 if the women consumed at least 5 different food groups and 0 otherwise. Food insecurity was measured using the Household Food Insecurity Access Scale and the Household Hunger Scale (HHS), and a farm production diversity score (FPDS) was calculated based on a count of food crops/livestock groups produced. Logistic regressions were used to assess the relation between MDD-W and the indicators of household food security.

RESULTS

Only 27% of women reached the MDD-W. These women consumed animal source foods and/or vitamin A-rich vegetables and fruits more frequently than did other women. Women from extremely food insecure households (moderate to severe hunger according to the HHS) were less likely to reach the MDD-W (OR: 0.70; 95% CI: 0.50, 0.97). One more group in the FPDS increased the odds of attaining the MDD-W (OR: 1.12; 95% CI: 1.06, 1.18).

CONCLUSION

In the rural region of Kayes, Mali, women's dietary diversity, as measured by the MDD-W, was associated with household-level food security indicators. This study was registered at ISRCTN.org as ISRCTN08435964.

Regional and global shifts in crop diversity through the Anthropocene

The Anthropocene epoch is partly defined by anthropogenic spread of crops beyond their centres of origin. At global scales, evidence indicates that species-level taxonomic diversity of crops being cultivated on large-scale agricultural lands has increased linearly over the past 50 years. Yet environmental and socio-economic differences support expectations that temporal changes in crop diversity vary across regions. Ecological theory also suggests that changes in crop taxonomic diversity may not necessarily reflect changes in the evolutionary diversity of crops. We used data from the Food and Agricultural Organization (FAO) of the United Nations to assess changes in crop taxonomic- and phylogenetic diversity across 22 subcontinental-scale regions from 1961–2014. We document certain broad consistencies across nearly all regions: i) little change in crop diversity from 1961 through to the late 1970s; followed by ii) a 10-year period of sharp diversification through the early 1980s; followed by iii) a “levelling-off” of crop diversification beginning in the early 1990s. However, the specific onset and duration of these distinct periods differs significantly across regions and are unrelated to agricultural expansion, indicating that unique policy or environmental conditions influence the crops being grown within a given region. Additionally, while the 1970s and 1980s are defined by region-scale increases in crop diversity this period marks the increasing dominance of a small number of crop species and lineages; a trend resulting in detectable increases in the similarity of crops being grown across regions. Broad similarities in the species-level taxonomic and phylogenetic diversity of crops being grown across regions, primarily at large industrial scales captured by FAO data, represent a unique feature of the Anthropocene epoch. Yet nuanced asymmetries in regional-scale trends suggest that environmental and socio-economic factors play a key role in shaping observed macro-ecological changes in the plant diversity on agricultural lands.

Buchanania obovata: An Australian Indigenous food for diet diversification

AIM

Buchanania obovata Engl., the Green Plum, is a small green fruit eaten by Australian Indigenous peoples of the Northern Territory and Western Australia that has had limited study and has potential as a source of food for diet diversification. The flesh and seed of the fruit are eaten and the plant is used as bush medicine.

METHODS

Physical characteristics of the fruit were measured. The flesh and seed freeze dried powders were measured separately for proximates, mineral/trace elements and heavy metals, and folate analysis. Vitamin C was analysed in the flesh.

RESULTS

The flesh is high in protein (12.8 g/100 g dry weight (DW)) and both flesh and seed are high in dietary fibre (55.1 and 87.7 g/100 g DW, respectively). The flesh is high in potassium (2274.7 mg/100 g DW), and is a good source of magnesium (570.5 mg/100 g DW), calcium (426.0 mg/100 g DW) and phosphorous (216.8 mg/100 g DW), whereas the seed is high in iron (8.15 mg/100 g DW). The flesh contains folate at 752.4 μg/100 g DW and the seed contains 109.5 μg/100 g DW as pteroylmonoglutamic acid equivalents.

CONCLUSIONS

The flesh and seed have good nutritional properties and the results support the use of the Green Plum for diet diversification and nutrition in Indigenous and non-Indigenous populations in Australia.

The role of farming and rural development as central to our diets

Farming and rural development are central to the diversity of global food systems and diets, both significant factors in determining the nutrition and health outcomes of the world's population. Diets are not static and indeed are changing due to globalization, urbanization and demographic shifts. In addition, multiple burdens of malnutrition (both undernutrition and overweight and obesity) are not improving fast enough and in some cases, reversing for the worse. Unhealthy diets are major contributors to these burdens. Rural people and particularly smallholder farmers, are critical in delivering the key nutrients in the global food supply that make up our diets for human health. However, rural populations in some parts of the world are often poor, and suffer burdens of malnutrition on both ends of the spectrum - undernourished or overweight. They are also faced with significant challenges, often due to poor investment towards rural development. Challenges include natural resource declines, climate change risk, women disempowerment, conflict, and urbanization; which wreak havoc on these populations. If actions are not taken and their livelihoods are not prioritized, it will be a challenge to achieve sustainable development in these rural places that are so essential for future food systems.

Understanding dietary and staple food transitions in China from multiple scales

China is facing both non-communicable diseases (NCDs) and micronutrient deficiency, which have been largely related to transitions within Chinese diets, for example, the overconsumption of vegetable oils and animal-source products and decreasing consumption of coarse staple foods. In this study, we use three metrics-dietary diversity score (DDS), staple diversity score (SDS) and the proportion of coarse staple consumption (PoCS)- to investigate overall dietary transitions as well as trends in staple food consumption for nine provinces in China from 1997 to 2009. We also investigated how household characteristics, community urbanicity, and provincial conditions have affected household diets and the relationship between overall diet and staple diet across socio-economic gradients. Overall dietary diversity (DDS) showed consistent growth across all the provinces and subpopulations and was strongly associated with a household's socio-economic status. However, staple indicators (SDS and PoCS) showed notable difference both geographically and socio-economically. The relationship between overall dietary indicator (DDS) and staple indicators (SDS, PoCS) across SES gradients revealed that education is a more important influence than income in ensuring dietary balance and nutritional quality. Our findings show that programs aimed at promoting dietary balance and healthy staple diets must account for differences between provinces in terms of agronomic, nutritional, social, and economic conditions. By identifying the socio-economic characteristics and locations of the most nutritionally vulnerable populations, this study also points toward the need for policies that incorporate nutritional considerations into grain production systems and provide a strategy for enhancing China's national food security.

Multi-indicator sustainability assessment of global food systems

Food systems are at the heart of at least 12 of the 17 Sustainable Development Goals (SDGs). The wide scope of the SDGs call for holistic approaches that integrate previously “siloed” food sustainability assessments. Here we present a first global-scale analysis quantifying the status of national food system performance of 156 countries, employing 25 sustainability indicators across 7 domains as follows: nutrition, environment, food affordability and availability, sociocultural well-being, resilience, food safety, and waste. The results show that different countries have widely varying patterns of performance with unique priorities for improvement. High-income nations score well on most indicators, but poorly on environmental, food waste, and health-sensitive nutrient-intake indicators. Transitioning from animal foods toward plant-based foods would improve indicator scores for most countries. Our nation-specific quantitative results can help policy-makers to set improvement targets on specific areas and adopt new practices, while keeping track of the other aspects of sustainability.

The development of sustainable food systems requires an understanding of potential trade-off between various objectives. Here, Chaudhary et al. examine how different nations score on food system performance across several domains, including environment, nutrition, and sociocultural wellbeing.

Home-grown school feeding: promoting local production systems diversification through nutrition sensitive agriculture

The consumption of some non-staple crops such as legumes and dark, green leafy vegetables can address common deficiencies in key nutrients such as vitamin A and iron; however, limited markets and supply chain development impede their production and accessibility to consumers. This study investigates the pathways to promote agricultural production and dietary diversity for a local market intervention called Home-Grown School Feeding (HGSF). School feeding menus from 24 districts across 10 regions in Ghana during the 2014–15 school year were analysed in terms of food groups and several individual foods. The menus were then compared with food groups produced by households during the past year or consumed in the past seven days using data collected from a household survey. Greater inter-food group diversity in the menus was associated with higher production levels for tubers and dark, leafy green vegetables in the South and cereals in the North. A correspondence between the frequency in which a food group appeared in a menu and the share of households who consumed foods from the food group was also noted. Key issues, such as optimizing supply chains, enabling farm linkages and supporting diverse nutrient rich food groups, that underlie the success of Home-Grown School Feeding and other agricultural policies with similar goals of promoting production and dietary diversity are highlighted through commodity specific examples. The findings of this study may help strengthen operational linkages between agriculture production and nutrition for HGSF and other similar interventions.

What drives diversification of national food supplies? A cross-country analysis

Little previous research has explored what drives the diversification of national food supplies (DFS) across countries and regions. We construct and analyse a cross-country dataset linking a simple DFS indicator - the share of calories supplied by nonstaple foods - with structural transformation and agroecological indicators. Panel econometric models show that several indicators of structural transformation (economic growth, urbanization and demographic change) are strong predictors of diversification within countries, yet time-invariant agroecological factors are also significantly associated with diversification, which appears to explain why some countries have exceptionally low or high DFS relative to their level of economic development. We discuss the implications of these findings for food and nutrition strategies.

Critical review of the emerging research evidence on agricultural biodiversity, diet diversity, and nutritional status in low- and middle-income countries

The declining diversity of agricultural production and food supplies worldwide may have important implications for global diets. The primary objective of this review is to assess the nature and magnitude of the associations of agricultural biodiversity with diet quality and anthropometric outcomes in low- and middle-income countries. A comprehensive review of 5 databases using a priori exclusion criteria and application of a systematic, qualitative analysis to the findings of identified studies revealed that agricultural biodiversity has a small but consistent association with more diverse household- and individual-level diets, although the magnitude of this association varies with the extent of existing diversification of farms. Greater on-farm crop species richness is also associated with small, positive increments in young child linear stature. Agricultural diversification may contribute to diversified diets through both subsistence- and income-generating pathways and may be an important strategy for improving diets and nutrition outcomes in low- and middle-income countries. Six research priorities for future studies of the influence of agricultural biodiversity on nutrition outcomes are identified based on gaps in the research literature.

Contribution of Nutrient Diversity and Food Perceptions to Food and Nutrition Security Among Smallholder Farming Households in Western Kenya: A Case Study

BACKGROUND

Sub-Saharan Africa is the only region in the world where hunger is prevalent in over one-third of the population, with smallholder farming households, producers of over 80% of Africa's food, facing both calorie and micronutrient deficiencies. With agricultural systems serving as the main source of all nutrients, little is known about the extent to which agricultural diversity in different seasons can meet macro- and micronutrient needs in rural Africa.

OBJECTIVE

Linkages between nutrient diversity and food species were investigated.

METHODS

A case study was conducted in Western Kenya to assess the seasonal nutrient diversity, seasonal nutrient accessibility levels, and food perceptions in 30 smallholder farms, 7 markets, and among 97 focus group discussion participants, respectively. All present food plant and animal species were inventoried and assigned to 1 of the 7 major Food and Agriculture Organization-defined food groups. Based on 2 macronutrients and 5 micronutrients, dendrogram-based nutrient functional diversity metrics were calculated.

RESULTS

On-farm and market food species offered all 7 macro- and micronutrients under investigation, regardless of seasonal variation in species numbers. Although there were varying seasonal nutrient accessibility levels in markets, farms were especially effective in readily availing 4 of the 7 nutrients. However, the main food shortage months coincided only with maize shortage, but a diversity of local foods, deemed to be of low cultural and culinary preferences, were available.

CONCLUSIONS

Nutrition education on the importance of a diversity of local foods in meeting dietary needs, thus stimulating the demand side, can contribute to achieving year-round household food security.

The Trans-Pacific Partnership: Should We "Fear the Fear"? Comment on "The Trans-Pacific Partnership: Is It Everything We Feared for Health?"

RLabonté et al entitle their paper in this issue of the International Journal of Health Policy and Management "The Trans-Pacific Partnership: Is It Everything We Feared for Health?" Tantalisingly, they do not directly answer the question they pose, and in this commentary, we suggest that it is the wrong question; we should not 'fear' the Trans-Pacific Partnership (TPP) at all, rather we should ask how we are to respond. The public health community is right to be concerned with the potential implications of trade and investment agreements (TIAs) for health, particularly with shifts from multilateral to regional/bilateral agreements including provisions with greater risk to public health. But it is critical to understand also the potential health benefits, and especially the mitigating policy and governance mechanisms to respond to adverse TIA implications. Given entrenched and divergent sectoral worldviews and perspectives between trade and health communities on these issues, achieving the requisite understanding will also likely require characterisation of these perspectives and identification of areas of common understanding and agreed solutions.