Global forum on food security and nutrition

Christine Campeau, facilitator of the discussion, UNSCN

Thank you to everyone who has contributed to the conversation. It has been another week of solid input that will no doubt help to shape the breadth and depth of the Decade’s Work Programme.

Several themes are emerging strongly this week. One is the need for leadership, coordination and implementation, specifically at country level. Ending all forms of malnutrition requires bold, country-led leadership to shine a light on the pathways to coherent actions leading to results and impact. The coordination of these actions will help ensure that the final collective result is greater than the sum of the individual efforts. Through biannual reporting and course correction when necessary, the Work Programme’s strongest added value will be in its clear focus on consolidation and implementation.

The sense of urgency to act to prevent increases in overweight and obesity due to low quality diets was emphasized. Priority also needs to be given to data collection for effective evidence-based policy making, which would help us understand what people are eating and why. Concrete measures to make our food systems and our direct food environment work better for nutrition are called for. Taxation was suggested as a means to ensure that healthy diets are available on the market, but this was questioned by others. This again highlights the critical importance of better understanding both consumer behavior and the effects of market regulation. Monitoring and evaluation of interventions to ensure that they are cost-effective, sustainable and are reaching their end target is essential.

The number of commitments being expressed through this consultation shows the universality of the problem and identifies solutions moving forward. The Co-leadership team of the Sustainable Food Systems (SFS) Programme of the UN 10-Year Framework of Programmes on Sustainable Consumption and Production (10YFP) gave concrete examples of the initiatives they are undertaking to enhance international cooperation across sectors to accelerate the shift towards sustainable consumption and production. It would be a missed opportunity if not all of the existing partnerships were encouraged to take part in the Decade because everyone has a role to play. The nutrition community also needs to systematically engage in all relevant fora to ensure that nutrition is mainstreamed.

Some participants asked for a calendar of events, and on that note, allow me to remind you of the upcoming ones specifically on the Decade’s draft Work Programme. A briefing will be held on 27 February 2017 as an opportunity to informally brief the Permanent Representatives of FAO and WHO Members and seek their views on the main elements of the draft Work Programme. The FAO and WHO will then produce a revised Work Programme to discuss with their Member States during the World Health Assembly (May 2017) and the FAO Conference (June 2017). This Work Programme will remain a living document, building upon and connecting the independent initiatives of governments and their many partners and will be adapted according to needs and lessons learned.

We very much look forward to the next round of comments in the coming few days. By working together, we can make this Decade a decade of impact for nutrition.

Kind regards,

Christine Campeau

Laurence Rycken, International Dairy Federation, Belgium

The International Dairy Federation (IDF) is grateful for the opportunity to comment on the First Draft of the Work Programme of the UN Decade of Action on Nutrition, 2016-2025 (dated 27 January 2017). Since 1903, IDF is the pre-eminent source of scientific and technical expertise for all stakeholders of the dairy chain. IDF commits to help nourish the world with safe and sustainable dairy.

We congratulate the UN for drafting such an ambitious working program. As clearly addressed in the document, the solution to achieve this work program is by combined and coordinated efforts across all actors. International federations such as the IDF through the broad membership they represent can play an essential role in facilitating these partnerships. Industry can help through its expertise by knowledge sharing of social responsibility programmes, technical expertise for cost-effective product development, processing and distribution, as well as providing platforms for advocacy and education. We therefore strongly urge for that open and inclusive dialogue amongst all stakeholders.

We continue to advocate for a focus on foods and diets rather than single nutrients in any policy development and activities, other than where specific micronutrient deficiencies need to be addressed through targeted food fortification and/or supplements. Foods and diets are far more than the sum of their individual nutrients. Nutrients are not consumed in isolation and it is inaccurate to generalize about the effects of a single nutrient without considering the food matrix in which it is present. In some countries, dietary guidelines are shifting away from recommendations based on nutrients or foods in isolation and now focus primarily on healthy eating patterns. Overall, no single food or nutrient creates a healthy dietary pattern, but instead, it is the combination of nutrient-dense foods that is emphasized: “…dietary components of an eating pattern can have interactive, synergistic, and potentially cumulative relationships, such that the eating pattern may be more predictive of overall health status and disease risk than individual foods or nutrients[i]”.

Nutrition science has moved on from just focusing on nutrients in isolation – it also considers foods and dietary patterns that are associated with good health.  Nutrition policies need to take this into account[ii].  

We note that Point 21 suggests that a healthy diet is one that contains adequate macronutrients, fibre and essential micronutrients.  This is too reductionist a view as food is much more than this. 

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  We suggest that the text is amended to reflect these points. 
  

Table 1 suggests establishing an action network focused on food reformulation.  The danger with this is that there is too much focus on single nutrients and too little on the overall impact of a food.   Focusing on reformulation can lead to the use of oversimplified paradigms which in turn may undermine minimally processed, naturally nutritious foods.  Nutrition policies that target the decrease or increase of the consumption of single nutrients will result in a modification of the effects of the food and even the diet itself. Food reformulation can be complex, and simply taking out a nutrient is often not feasible. Typically, the nutrient that is removed provides properties that are important for food safety and/or acceptability of a product. In products where fat is removed to produce a low fat or fat free product, carbohydrates (mostly refined) are often added to maintain an acceptable flavour or texture profile[iii]. This could be counterproductive to reducing levels of obesity and risk of non-communicable disease. As addressed in the FAO/WHO report replacing SFA largely with refined carbohydrate has no benefit on CHD and may even increase the risk of CHD and favour the development of metabolic syndrome [iv] [v].

Reformulation is also a way for highly processed unhealthy foods to be positioned as being healthy. 

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  We suggest that all action networks should take a whole of food/dietary pattern approach rather than focusing on single nutrients in isolation.
  

It is essential that before implementing any new policies or activities there should be clear evidence for a positive impact and a risk based assessment should be considered to identify any potential negative consequences.

We also note that table 1 reference sustainable livestock production. While the concept of sustainable food systems is not new, much more research is needed to establish the scientific foundation on which informed recommendations for sustainable, healthy diets can be made.

A sustainable food system must meet the nutritional needs of the human population while not depleting or degrading the natural resources upon which life depends, as indicated in this definition by the United Nations Environmental Program:

“Sustainable food systems enable the production of sufficient, nutritious food, while conserving the resources that the food system depends on and lowering its environmental impacts. Such systems are based on the idea that all activities related to food (producing, processing, transporting, storing, marketing and consuming) are interconnected and interactive.[vi]”

The concept of sustainable diets contains additional aspects of sustainability related to the human population, as described in the Food and Agriculture Organization’s definition of sustainable diets:

“Sustainable diets are those diets with low environmental impacts which contribute to food and nutrition security and to healthy life for present and future generations. Sustainable diets are protective and respectful of biodiversity and ecosystems, culturally acceptable, accessible, economically fair and affordable, nutritionally adequate, safe and healthy; while optimizing natural and human resources.[vii]”

Whether framed as sustainable food systems, sustainable healthy diets, or nutrition security, the underlying systems - agricultural, environmental, social, and economic - are connected to one another in ways that are only recently being understood and appreciated by scientists and policymakers. A coordinated, interdisciplinary approach is needed to gain vital insights on interrelated dynamic and adaptive processes within and across these systems. Dietary guidance based on an incomplete research base could lead to unintended consequences for both human health and the long-term sustainability of the food system.

Finally, we continue to support policy development that acknowledges the important and valuable role that dairy plays in balanced and varied diets. Dairy products are nutrient-dense foods that can help reduce malnutrition throughout the world, with increasing evidence that diets containing dairy help reduce the risk of obesity and NCDs.

[i] The Dietary Guidelines for Americans 2015-2020. 8th Edition https://health.gov/dietaryguidelines/2015/guidelines/

[ii] Mozaffarian D (2017) Foods, nutrients, and health: when will our policies catch up with nutrition science?  The Lancet Diabetes & Endocrinology 5, 85-8.

[iii] Sandrou DK, et al (2000). Low-fat/calorie foods: current state and perspectives. Crit Rev Food Sci Nutr. , 40(5):427-47.

[iv] Jakobsen MU, O. E. (2009). Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies. Am J Clin Nutr. ,89(5):1425-32.

[v] Fats and fatty acids in human nutrition. Proceedings of the Joint FAO/WHO Expert Consultation. November 10-14, 2008. Geneva, Switzerland. (2009). Ann Nutr Metab., 55(1-3):5-300.

[vi] UNEP. Avoiding Future Famines: Strengthening the Ecological Foundation of Food Security through

Sustainable Food Systems. United Nations Environment Programme (UNEP), Nairobi, Kenya 2012.

[vii] Burlingame B, Drnini, S. Sustainable diets and biodiversity: Directions and solutions for policy, research and action. Proceedings of the International Scientific Symposium, BIODIVERSITY AND SUSTAINABLE DIETS UNITED AGAINST HUNGER, 3 – 5 November 2010, FAO Headquarters, Rome 2012.