Building climate-sensitive nutrition programmes

The food system and climate are closely interconnected. Although most research has focused on the need to adopt a plant-based diet to help mitigate climate change, there is also an urgent need to examine the effects of climate change on food systems to adapt to climate change. A systems approach can help identify the pathways through which climate influences food systems, thereby ensuring that programmes combating malnutrition take climate into account. Although little is known about how climate considerations are currently incorporated into nutrition programming, climate information services have the potential to help target the delivery of interventions for at-risk populations and reduce climate-related disruption during their implementation. To ensure climate services provide timely information relevant to nutrition programmes, it is important to fill gaps in our knowledge about the influence of climate variability on food supply chains. A proposed roadmap for developing climate-sensitive nutrition programmes recommends: (i) research aimed at achieving a better understanding of the pathways through which climate influences diet and nutrition, including any time lags; (ii) the identification of entry points for climate information into the decision-making process for nutrition programme delivery; and (iii) capacity-building and training programmes to better equip public health practitioners with the knowledge, confidence and motivation to incorporate climate resilience into nutrition programmes. With sustained investment in capacity-building, data collection and analysis, climate information services can be developed to provide the data, analyses and forecasts needed to ensure nutrition programmes target their interventions where and when they are most needed

Climate change and nutrition-associated diseases

Climate change has multiple negative effects on global public health; reduced quality and quantity of crops result in increased food and financial insecurities leading to malnutrition (undernutrition and obesity) and diet-related non-communicable diseases, such as diabetes mellitus and cardiovascular diseases. In addition, food systems substantially contribute to greenhouse gas emissions and a shift towards sustainability is required to preserve human and planetary health

The need for multisectoral food chain approaches to reduce trans fat consumption in India.

BACKGROUND: The World Health Organization (WHO) recommends virtually eliminating trans fat from the global food supply. Although several high-income countries have successfully reduced trans fat levels in foods, low- and middle-income countries such as India face additional challenges to its removal from the food supply. This study provides a systems analysis of the Indian food chain to assess intervention options for reducing trans fat intake in low-income consumers. METHODS: Data were collected at the manufacturer, retailer and consumer levels. Qualitative interviews were conducted with vanaspati manufacturers (n = 13) and local food vendors (n = 44). Laboratory analyses (n = 39) of street foods/snacks sold by the vendors were also conducted. Trans fat and snack intakes were also examined in low-income consumers in two rural villages (n = 260) and an urban slum (n = 261). RESULTS: Manufacturers of vanaspati described reducing trans fat levels as feasible but identified challenges in using healthier oils. The fat content of sampled oils from street vendors contained high levels of saturated fat (24.7-69.3 % of total fat) and trans fat (0.1-29.9 % of total fat). Households were consuming snacks high in trans fat as part of daily diets (31 % village and 84.3 % of slum households) and 4 % of rural and 13 % of urban households exceeded WHO recommendations for trans fat intakes. CONCLUSIONS: A multisectoral food chain approach to reducing trans fat is needed in India and likely in other low- and middle-income countries worldwide. This will require investment in development of competitively priced bakery shortenings and economic incentives for manufacturing foods using healthier oils. Increased production of healthier oils will also be required alongside these investments, which will become increasingly important as more and more countries begin investing in palm oil production

Unhealthy Fat in Street and Snack Foods in Low-Socioeconomic Settings in India: A Case Study of the Food Environments of Rural Villages and an Urban Slum.

OBJECTIVE: To describe the food environment in rural villages and an urban slum setting in India with reference to commercially available unbranded packaged snacks and street foods sold by vendors, and to analyze the type and quantity of fat in these foods. DESIGN: Cross-sectional. SETTING: Two low-income villages in Haryana and an urban slum in Delhi. PARTICIPANTS: Street vendors (n = 44) were surveyed and the nutritional content of snacks (n = 49) sold by vendors was analyzed. MAIN OUTCOME MEASURES: Vendors' awareness and perception of fats and oils, as well as the type of snacks sold, along with the content and quality of fat present in the snacks. ANALYSIS: Descriptive statistics of vendor survey and gas chromatography to measure fatty acid content in snacks. RESULTS: A variety of snacks were sold, including those in unlabeled transparent packages and open glass jars. Mean fat content in snacks was 28.8 g per 100-g serving in rural settings and 29.6 g per 100-g serving in urban settings. Sampled oils contained high levels of saturated fats (25% to 69% total fatty acids) and trans fats (0.1% to 30% of total fatty acids). CONCLUSIONS AND IMPLICATIONS: Interventions need to target the manufacturers of oils and fats used in freshly prepared products to improve the quality of foods available in the food environment of low-socioeconomic groups in India

The development and application of a sustainable diets framework for policy analysis: A case study of Nepal

The objectives of this study were to 1) develop a policy analysis framework for examining the components of a sustainable diet and 2) to apply its use to three relevant national polices in Nepal. We developed a policy analysis framework using existing literature and applied the framework to three Nepalese policies: Nepal’s Multisectoral Nutrition Plan (MSNP) 2013–2017, Agricultural Development Strategy (ADS) 2015–2035 and National Biodiversity Strategy and Action Plan (NBSAP) 2014–2020. Each policy was coded independently by two researchers to examine whether the different components of the sustainable diets framework were mentioned and if they had associated policy actions. We then used a health policy analysis tool to examine the overall quality of each policy. The ADS mentioned the most (89%) components of the sustainable diets framework as compared to the NBSAP (58%) and the MSNP (70%). If all three policies were fully implemented they would address all but one of the components of a sustainable diet, with the potential to deliver for health and the environment. However, there was a lack of clarity regarding how the resources to accomplish the policy objectives would be obtained as well as insufficient detail regarding the policies’ monitoring and evaluation frameworks. The sustainable diets framework developed in this study enables the identification of gaps where policies need to broaden their focus in order to incorporate a more holistic view of the food system. This will become increasingly important as climate change continues to persist and the need for more resilient food systems becomes more recognized

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

Examining the trade-offs of palm oil production and consumption from a sustainable diets perspective: lessons learned from Myanmar

Objective: The aim of this study was to examine the trade-offs related to the production and consumption of palm oil in Myanmar from a sustainable diets perspective. Design: We used an enhanced value chain analysis approach that included semistructured interviews with key stakeholders; market analyses to assess edible oils in markets and focus groups as well as surveys with consumers to ascertain their perceptions and practices related to edible oils. Setting: Four settings in Myanmar (upper income urban; lower income urban; middle-income urban; lower income rural). Participants: Key stakeholders (n 12) from government, trade bodies and civil society organisations were included in the interviews. Women from each of the regions participated in four focus groups (n 32), and a convenience sample of male and female consumers participated in the surveys (n 362). Results: We found mistrust of the oil sector overall. Poor production practices, leading to low yields, limit the economic viability of oil palm production in Myanmar and contribute to negative environmental (e.g. deforestation) and social outcomes (e.g. land conflicts). Consumers demonstrated low preferences for palm oil as compared with traditional oils from a taste, health and transparency perspective; however, they indicated that its relative low cost led to its purchase over other oils. Conclusions: The Burmese example suggests that there may be limited benefits, and significant costs, of investing in palm oil production in regions where there are coordinating disincentives from a sustainable diets perspective. However, if oil palm cultivation is to continue, there are opportunities to improve its economic viability and environmental sustainability

The interface between consumers and their food environment in Myanmar: an exploratory mixed-methods study

Objective: To examine consumers’ perceptions of their food environments, their food consumption patterns and preferences, and to better understand the attributes of foods that are available within food environments in Myanmar. Design: An exploratory mixed-methods study using a combination of focus group discussions, market and consumer surveys. Setting: Four study settings in Myanmar were included: an upper-income township of Yangon; a lower-income township of Yangon; a middle-income township in the southern Myanmar town of Dawei; and a lower-income village in the country’s dry zone of Magway. Participants: Thirty-two women participated in the focus groups discussions, twenty market surveys were conducted and 362 consumers (both men and women) completed food consumption surveys. Results: Focus group participants indicated that the availability of a diverse range of foods had increased over time, while the quality of foods had decreased. Health was seen primarily through the lens of food safety and there was an overall lack of knowledge about which foods were more or less healthy. Consumers preferred fruits, vegetables and red meat compared with highly processed snack foods/ beverages. Although consumers reported low intakes of highly processed snack foods, Burmese street food was consumed in high quantities. The market surveys suggested that fresh, minimally processed and highly processed foods were available at all markets across the study settings. Conclusions: Consumers are exposed to a variety of foods, of varying quality, within their food environments in Myanmar. Interventions aimed at increasing consumer knowledge regarding healthy diets and improving food safety are needed

The global food environment transition based on the socio-demographic index

Food environments are a critical point for reorienting the food system towards sustainable diets, as they are directly where consumers make decisions about which foods to acquire. Using global data, we examined shifts in food environments, and the availability, affordability, convenience, and quality of foods within them, over time on the basis of socio-demographic index (SDI) country groupings. Our findings provide evidence of a food environment transition where built environments have shifted from traditional to modern retail outlets between 2005 and 2019 and the availability and affordability of nutrient-rich foods has increased alongside growing sales of ultra-processed and ready-to-eat foods. This transition has implications for the identification of policy and program levers for promoting healthy and sustainable diets and reducing malnutrition globally

A focused ethnographic study on the role of health and sustainability in food choice decisions

In the United States, typical dietary patterns are not necessarily healthy and sustainable. In order to shift diets, we need to provide support to individuals in a way that reflects what matters most to them. In this study, we aimed to identify the considerations that are most important to individuals regarding food-related decisions, and to determine how those considerations relate to specific foods, with a focus on health and environmental sus­ tainability. In a sequential mixed-methods design, we first conducted 27 semi-structured interviews with par­ ticipants in California and Nebraska. These interviews included a free-listing activity, where we used a technical construct of salience, Smith’s S Index, to identify the considerations that were most important to our participants. We followed up with 20 of those participants to complete a pile-sorting survey, where participants sorted and rated 42 food items for price, taste, health, convenience, familiarity, and environmental impact. Our findings showed that the most salient considerations cited by our participants were price, health, taste, and time. There was consensus for how participants rated the foods for price, taste, convenience, and familiarity. However, there was only weak consensus for how participants rated the foods for health impact, and no consensus for how participants rated the foods for environmental impact. There was also disagreement on how to sort new plantbased products intended to replace or substitute meat and other animal-based foods. These findings have im­ plications for how to communicate about healthy and sustainable diets. They highlight conflicting consider­ ations, disagreement in classification of new products, and limited consensus for perceived health and environmental impact of foods, which present challenges to the achievement of diets that are healthy and environmentally sustainable in the United States