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    • Obstacles :

      - Lobbying (with politicians) to "create doubt" around scientific questions that can call into question financial profits.

      - Scientists can offer breakthrough solutions but these are not always heard by political decision-makers if there is little money to be made behind them.

      - The (ultra) reductionist thought which is dominant and difficult to challenge because it has immense academic and financial power, while a more holistic approach to rupture is urgently needed. For example, too much focus on nutrients (nutri-centered approach) rather than on the food and its matrix for the relationship with human and environmental health.

      - Empirico-inductive and holistic science not yet sufficiently recognized while it can provide quick and effective solutions for more efficient, inclusive, resilient and sustainable agri-food systems. See for example our work on the 3V rule and the role of the food matrix in human and environmental health:

      1.    Fardet A, Rock E. Chronic diseases are first associated with the degradation and artificialization of food matrices rather than with food composition: calorie quality matters more than calorie quantity. Eur J Nutr 2022;62:2239-53.

      2.    Fardet A, Rock E. How to protect both health and food system sustainability? A holistic ‘global health’-based approach via the 3V rule proposal. Public Health Nutr 2020;23:3028-44

      3.    Fardet A, Rock E. Reductionist nutrition research has meaning only within the framework of holistic thinking. Advances in Nutrition 2018;9:655–70.

       

      Opportunities :

      - Awareness and the current environmental emergency can make political decision-makers more open and receptive to the voice of scientists.

      - Research and development of less destructuring technological processes for food: how to preserve minimally processed foods for a long time without ultra-processing them for more sustainable food systems?

      - Relocation of food processing.

    • Some comments:

      Action Area 1: Sustainable, resilient food systems for healthy diets

      • Scale up the inclusion of nutrition objectives in food and agriculture policies: increase production of context-appropriate fruits and vegetables for domestic consumption, and of legumes and pulses that contribute to healthy diets; raise production of oils in support of the elimination of industrially produced trans-fat in the food supply.

      I will add: “Increase production of oleaginous nuts and seeds, consumption of wholegrain cereals, and drastically reduced production and consumption of ultra-processed foods.”

      • Accelerate food reformulation: provide reference ranges for sodium reduction level benchmarks for processed foods.

      No reformation (reductionist approach) does not work and concern green washing of ultra-processed foods which are still more ultra-processed with reformulation. We should accelerate the development of mildly processed foods with preserved matrix (holistic approach). In addition, while nutrients are not really linked to global health and food systems, degree of processing is.

      Action Area 2: Aligned health systems providing universal coverage of essential nutrition actions

      • Scale up the integration of nutrition actions into health systems: integrate essential nutrition actions into national Universal Health Coverage (UHC) plans.

      All depends of what is meant by nutrition actions. If it is nutrient-centered nutrition actions, it will not be sufficient. Food/diet-centered nutrition actions are more appropriate.

      Action Area 3: Social protection and nutrition education

      • Scale up the implementation of nutrition-sensitive social protection policies: ensure coherence between social protection and other sector programmes such as with agricultural production, livelihood diversification and local economic development; national supplementary food bank programmes provide weekly vouchers to each user for purchase of fresh fruits and vegetables from local farmers.

      I will add: taxations on ultra-processed foods which are the most consumed by the most disadvantaged people.

      • Better leverage of schools as a platform for food and nutrition education and enabling healthy diets: set and improve nutrition standards for school meals.

      Very good point. The main point is to agree with what is a “healthy diet”, i.e., holistic and/or reductionist perspective.

      • Scale up the implementation of nutrition education interventions: implement easily understandable nutrition (front-of-pack) labelling on food products that supports consumers’ choices for healthy diets.

      Yes, but a labelling based on degree of food processing (NOVA, Siga…), not on nutrients such as compositional score which are not adapted in reality to eat healthy and sustainable. Everywhere they are applied, chronic diseases continue to progress…

      Action Area 4: Trade and investment for improved nutrition

      • Accelerate responsible and sustainable investments in nutrition: a minimum percentage of the overall national governmental yearly budget is set for nutrition interventions.

      Yes, investing in holistic prevention rather than reductionist curative treatments.

      Action Area 5: Safe and supportive environments for nutrition at all ages

      • Scale up the implementation of regulatory instruments to promote healthy diets: introduce taxation of sugar-sweetened beverages and subsidies for fruits and vegetables; implement legislation of marketing restrictions of foods and beverages high in fat, sugar and/or salt to children.

      Extending taxation on ultra-processed foods as a whole entity with growing tax as a function of the number of markers of ultra-processing linked to global human and environmental health (hidden costs).

      • Scale up the implementation of national dietary guidelines: include in national dietary guidelines for children, adults and elderly biodiversity and sustainability considerations.

      Also food degree of processing, the missing link.

      Action Area 6: Strengthened governance and accountability for nutrition

      • Enhance political commitment through political dialogue and advocacy at national and sub-national levels: establish and strengthen coordination mechanism through a multistakeholder consultation process for the uptake of the CFS Voluntary Guidelines on Food Systems and Nutrition.

      Yes, but the question of lobbies should be addressed. Lobbying may be virtuous or deleterious, depending on public or private interests. To discuss.

    • The agri-food system supporting the globalization and massive consumtpion of ultra-processed foods is no more sustainable for small farmers, animal well-being, environment, socio-economics, culinary traditions and human health. The producers are incited to produce massive cheap food ingredients under pressure of multinational and mass retailing for ultra-processed foods. Therefore, the food value chain should be rethink with more emphasis on producers, and developing more minimal food processing by private sector to supply foods respecting food accessibility, safety, nutritional and environmental securities. Food transformation should be relocalized and fragmented to adapt more to what can be produced locally in respect of sustainability.

    • Private sector (i.e., mainly multinationals) must face four securities: food security (food availability for everyone worlwide), food safety, nutrition/health and environment. With the globalization of ultra-processed foods, food security and food safety have been almost fully met, but to the detriment of human health and environment. The challenge relative to SGD for private sector would be to meet all four dimensions at the same time:. For this, developping minimal processing? And to both fragment and relocate food transformation to avoid long distance (allowed by ultra-processing). Food systems are 34% GHGE (Crippa, M., Solazzo, E., Guizzardi, D., Monforti-Ferrario, F., Tubiello, F.N., Leip, A., (2021). Food systems are responsible for a third of global anthropogenic GHG emissions. Nature Food 2(3), 198-209.). The largest contribution came from agriculture and land use/land-use change activities (71%), with the remaining were from supply chain activities: retail, transport, consumption, fuel production, waste management, industrial processes and packaging. This means 10% of GHGE by "retail, transport, consumption, fuel production, waste management, industrial processes and packaging", but we should not forget that all is linked and that probably the 24% by agricultural productions is dependent on the way that we process foods. Notably, ultra-processed foods drive intensive agriculture and breeding (see attached file). An important issue would be to measure impact of private sector on GHGE when coming back to less processed foods, and private sector fragmentation and relocalization, and how it will impact in return food agricultural production.

    • I am senior researcher at INRAE Clermont-Ferrand in preventive and sustainable diets:

      In the 2020 report (FAO, The State of Food Security and Nutrition in the World 2020.) the degree of food processing as a lever for improved food system sustainability did not appear very much. I proposed that in the the 2021 report the links between between ultra-processed foods and food systems (see attached paper) may be more emphasized. This is an emerging dimension which was lacking in previous studies, probably explaining sometimes contradictory results. In addition, to take into account this dimension, we elaborated in our lab the 3V's rule (see attached paper) that describes three dimensions that govern the diet-global health relationship. If ever one dimension were to be missing the global health would no longer work. This generic rule may serve as a simple and holistic tool to orientate food system towards more sustainability. 

      Thank you for considering our propositions and works. Best regards and congrats for the 2020 report.

      Anthony FARDET

    • In a recent paper we elbaorated the three golden rules for protecting human health, animal biodiversity and welfare, and envrionment in all their dimensions:

      Fardet A E Rock, Reductionist nutrition research has meaning only within the framework of holistic thinking. Advances in Nutrition 2018;9:655–670.

      In details:

      • Rule 1: “Végétal” for Plant: consuming at least 85% calories from plantbased foods, limiting animal-based foods to 2-3 servings a day;
      • Rule 2: “Vrai” for Real: consuming at least 85% from real foods, limiting ultraprocessed foods to 1-2 servings/day;
      • Rule 3: “Varié” for Varied: varying real foods within cereals, legumes, vegetables, nuts, fruits, meats, fish, eggs and dairy.

      Then, when possible, eat organic, local and seasonal.

      This dietary pattern is closed to flexitarian diet, and in agreement with recommendations from FAO, EAT-Lancet commission, and French Agrimonde-Terra reports. It can be declined locally for each world region according to agricultural context. Within these rules, limiting animal-based and ultra-processed foods is a strong lever for human health, animal welfare and preservation of environment. Eat varied allows stimulating biodiversity. Notably, the production, transformation, and distribution of ultra-processed foods is particularly deleterious to the all planet.

      tending towards the 3Vs golden rules should allow respecting both health, animal biodiversity and welfare, environment, small farmers, socioeconomics, and culinary traditions.

      We think this a simple lever to improve food system sustainability.

    • Here are definitions of processed and ultra-processed foods by NOVA: Monteiro, C., et al., The star shines bright. World Nutrition, 2016. 7(1-3): p. 28-38.

      Ultra-processed foods:

      « These are industrial formulations typically with five or more and usually many ingredients. Such ingredients often include those also used in processed foods, such as sugar, oils, fats, salt, anti-oxidants, stabilizers, and preservatives. Ingredients only found in ultra-processed products include substances not commonly used in culinary preparations, and additives whose purpose is to imitate sensory qualities of un/minimally-processed foods or of culinary preparations of these foods, or to disguise undesirable sensory qualities of the final product. Raw/minimally-processed foods are a small proportion of or are even absent from ultra-processed products. »

      « Substances only found in ultra-processed products include some directly extracted from foods, such as casein, lactose, whey, and gluten, and some derived from further processing of food constituents, such as hydrogenated or interesterified oils, hydrolyzed proteins, soy protein isolate, maltodextrin, invert sugar and high fructose corn syrup. Classes of additive only found in ultra-processed products include dyes and other colors, color stabilizers, flavors, flavor enhancers, non-sugar sweeteners, and processing aids such as carbonating, firming, bulking and anti-bulking, de-foaming, anti-caking and glazing agents, emulsifiers, sequestrates and humectants. Several industrial processes with no domestic equivalents are used in the manufacture of ultra-processed products, such as extrusion and moulding, and pre-processing for frying. The main purpose of industrial ultra-processing is to create products that are ready to eat, to drink or to heat, liable to replace both unprocessed or minimally processed foods that are naturally ready to consume, such as fruits and nuts, milk and water, and freshly prepared drinks, dishes, desserts and meals. Common attributes of ultra-processed products are hyper-palatability, sophisticated and attractive packaging, multi-media and other aggressive marketing to children and adolescents, health claims, high profitability, and branding and ownership by transnational corporations. »

       

      Processed foods:

      « These are relatively simple products made by adding sugar, oil, salt or other culinary ingredients to raw or minimally-processed foods. Most processed foods have two or three ingredients. Processes include various preservation or cooking methods, and, in the case of breads and cheese, non-alcoholic fermentation. The main purpose of the manufacture of processed foods is to increase the durability of raw or minimally-processed foods, or to modify or enhance their sensory qualities. Typical examples of processed foods are canned or bottled vegetables, fruits and legumes; salted or sugared nuts and seeds; salted, cured, or smoked meats; canned fish; fruits in syrup; simple breads and cheeses. Processed foods may contain additives used to preserve their original properties or to resist microbial contamination. Examples are fruits in syrup with added anti-oxidants, and dried salted meats with added preservatives».

    • My research project is the characterization of the food degree of processing in relation with health potential. In this perspective I am notably working on ultra-processed foods. A food is defined as ultra-processed if it contains at least one ultra-processed ingredient (excessive fractionation of its original matrix/cracking) or a cosmetic additive (coloring, texturizer, taste enhancer, sweetener, ...) or additive considered at risk for health or if it has underwent a very industrial drastic process (e.g., extrusion-cooking, puffing...). Such foods, when massively consumed worldwide, are associated with degradation of food systems as a whole and are not sustainable. They are notably associated with increased risks of chronic diseases, animal suffering, environment degradation (pollution, deforestation, climatic changes...), degradation of social life (food often eaten by isolated individuals), culinary traditions (hyperstandardized foods replacing local ones) and small farmers or peasants (because they are cheaper than local foods). Therefore, we defined the three golden rule for preservations of all these dimensions of sustainability : Végétal, Vrai, Varié (if possible organic, local and seasonal). In English : Plant, Real (food), Varied. These rules are holistic allowing meeting all human nutrient needs and preserving human health, animal well-being and environment. In addition they are scientific because all protective diets worldwide are rich in plant-based, minimally-processed and varied foods. In detail these rules recommand not to exceed daily 15% calories from animal products and ultra-processed foods. For details see : Fardet, A. and E. Rock, Reductionist nutrition research has meaning only within the framework of holistic thinking. Advances in Nutrition, 2018. 9(6): p. 655–670. Therefore we think we have a powerpuf lever to activate locally and for a global change.