Opinion: Concurrent issues complicate nutrition's role in healthy eating

By Guest Author

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By Carl Keen, Larry Kaagan and Kerry Tucker

There's a new and growing glut of criteria people are using to make healthful food selections. On one hand there's the traditional criteria - taste, price, convenience and nutrition. On the other is a small but growing list of consumers adding social variables to the mix - animal welfare, food security, the safety of GMOs, local and organic foods, not to mention water availability and climate change.

For some people, these social issues have joined nutritional value as decision-making criteria for what are considered healthy or not healthy foods. This can make the criteria for what constitutes healthy eating choices confusing, and at times seemingly contradictory.

For example, when comparing the nutrient content and bioavailability of agricultural crops of equal nutritional value, some would argue that if the water needed to produce the products differ, the crop requiring less water may be a “better” food choice. While on the surface such arguments may seem reasonable, it can quickly become complicated. How, for example, do we define “similar?” Is 10 percent difference in micronutrient content the same as a 10 percent difference in water use? Or perhaps even more difficult, how should one view  the “nutritional value” of two foods that have virtually identical nutrient profiles, but one  has been genetically modified to need considerably less water, or it has been modified to need less nitrogen fertilizer?

Lets Talk Food

While it may seem unlikely at the moment, our Food Foresight* panel would suggest that in the relatively near future, select, or a composite of, environmental impact factors, in all their diversity, may be listed in the same tables that provide information on the nutrient content of the food. Agriculturalists will need to find out how such a listing affects their products, and what actions might they take to improve their overall scores.

If all of this is not enough to confuse an already crowded conversation, technology is enabling nutrition research to take enormous leaps in the health make-up of individual foods and tailoring food selections to an individual's genetic profile. In the long term, tailoring food selections to the individual will do a lot to minimize confusion. It's the short term that is concerning.

Still one more phenomenon is in play: health care institutions and employers battling health costs are shifting the emphasis from treating disease to preventing it with incentives to change nutrition and physical activity habits. This has huge implications for the agri-food chain.

Put it all together and you have the makings - without clear and common messaging  - of a very information-overloaded and confused consumer.

Activists see opportunity to elevate sustainability issues

Influential consumer segments and stakeholders focused on the environment are seeing the beginnings of an opportunity emerging that could elevate environmental issues into an expanded definition of what constitutes a healthful diet for not just  people but for the planet as well.

The U.S. Dietary Guidelines Advisory Committee released its report with chapters on nutrient intake, dietary patterns and, for the first time, food sustainability.  The sustainability chapter addresses environmental links to food choices and public health concerns regarding food security - improving health while concurrently ensuring current and long-term food security. Food security is defined as all people at all times having access to sufficient, safe, nutritious food to maintain a healthy and active life.

An overarching theme of the 2015 Dietary Guidelines is that a healthy dietary pattern is one that is characterized by being high in vegetables, fruits, whole grains, low- or non-fat dairy, seafood, legumes, and nuts; moderate in alcohol (among adults); relatively low in red and processed meats; and low in sugar-sweetened foods and drinks and refined grains.

A broad coalition of health, environment and animal welfare groups applauded and embraced the panel's sustainability recommendations. Signatures on a letter of support that went to USDA and Health and Human Services (HHS) agency secretaries included Johns Hopkins Center for a Livable Future, Friends of the Earth, Healthy Food Action, Center for Biological Diversity, American Public Health Association, Yale University Prevention Research Center and Compassion in World Farming.

Research is sparse and divergent on a sustainable diet

However some meat and agricultural groups have cried foul, saying environmental additions to the report have strayed too far from the mission of the guidelines. There's also concern that the current sustainability research is sparse and divergent; that definitions of “sustainable” vary widely; and that more research needs to be done on what constitutes a “sustainable” diet that focuses on meeting nutritional requirements while lowering the environmental impact of eating patterns.

The advisory committee's report is used by USDA and HHS to update the Dietary Guidelines scheduled for later this year. It is also the foundation for the MyPlate food group recommendations and represents the government's final word on what constitutes a healthful diet. The guidelines influence billions of dollars of state and federal government funding for nutrition programs.

On a parallel front, schools and other institutional food service programs (e.g. hospitals, universities) are seeking products with sustainable attributes. For example, school feeding programs are sourcing locally grown produce when possible (e.g. farm to school (F2S)). The nature of such programs allows school districts to provide foods that align with the Dietary Guidelines for Americans of 2010, while promoting sustainable agricultural efforts.

Debate fundamental questions before changes are made

It's not that these additional values aren't important or shouldn't be considered as agriculturalists look to meet the demands of the future. However, there are some fundamental questions that should be debated before we make wholesale changes in healthy eating criteria for this country or the world. Among them:

Is it the role of nutrition experts in the U.S. (Dietary Guidelines) to continue to steer people toward optimal health and disease prevention alone? Should global food security be added to their criteria for decision-making?

Is this about science-based sustainability - balancing the needs of people, planet and profitability - or is it about what some believe to be ethically acceptable food sources?

Two even bigger questions: What is the role of U.S. agriculture in addressing world food demand, public health, sustainability, climate change and food waste, among other major issues facing society and farming?

Does U.S. agriculture feel it has an obligation to a global society to help fix these problems, or can it focus exclusively on the market-based opportunity to deliver more animal protein and fruits and vegetables to meet the demand of growing numbers of affluent populations around the world?

The intense ongoing debate as to what constitutes a “healthy diet” is an important one, and it clearly needs to be open to all stakeholders.  While nutrition science continues to bring us closer to having the tools we need to better match food, health and consumers, the debate will inevitably also take place in a context shaped by culture, values, economic interests and other factors.  Policymakers, as well as the people who grow and produce our food, need to call all these things -the science as well as the values-by their right names. 

 

About the authors: Carl Keen is professor of nutrition and internal medicine at University of California, Davis. Lawrence Kaagan heads Kaagan Research, a New York-based consultancy in consumer research and social trends. Kerry Tucker is with Nuffer, Smith Tucker, a San Diego-based strategic planning and public relations firm. All are involved with Food Foresight*, a trends intelligence collaboration between Nuffer, Smith, Tucker and the California Institute of Food and Agricultural Research at UC Davis.

 

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