The EAT-Lancet Commission on healthy diets
This ground-breaking scientific EAT-Lancet Commission publication brought together 19 Commissioners and 18 coauthors (including leading nutrition academic Professors Walt Willett and food policy exper Tim Lang) from 16 counties in various fields of human health, agriculture, political sciences, and environmental sustainability to develop global scientific targets based on the best evidence available for healthy diets and sustainable food production. These global targets define a safe operating space for food systems that allow the assessment of diets and food production practices against the UN Sustainable Development Goals (SDGs) and the Paris Agreement on climate change. Until now, clear scientific targets for the global food system did not exist.
Food in the Anthropocene (our current geological epoch dominated by humanity as the major change agent) represents one of the greatest health and environmental challenges of the 21st century. Diets inextricably link human health and environmental sustainability.
The report quantitatively describes a universal healthy reference diet (2500kcal/10,500kJ) per day consisting mostly of vegetables, fruits, wholegrains, legumes, nuts and unsaturated oils, low to moderate amounts of seafood and poultry and little if any red meat, processed meat, added sugar, refined grains and starchy vegetables. They focussed on healthy individuals aged over 2 years. The authors state they have a high level of confidence that the reference diet will meet nutritional requirements and reduce non-communicable diseases and overall mortality. They do point out that the diet is designed to meet nutritional requirements of healthy people over 2 years (energy intake depending on age, body size and energy requirements) and note that there are also special considerations for adolescent women, and pregnant and breastfeeding women, who often have different nutritional requirements. They also say vitamin B12 may be inadequate and supplements or fortified foods may be required.
Healthy reference diet, with possible ranges, for an intake of 2500 kcal/day
For sugar and other (nutritive)sweeteners, the authors cite adverse outcomes from high intakes as well as the World Health Organisation (WHO) and American Heart Association recommended limits of 10% and 5% energy, respectively. The healthy reference diet contains 31g a day of added sugars and other sweeteners. This equates to 4.7% of total energy, based on a 2500kcal diet.
The authors propose that this framework is universal for all food cultures and production systems in the world, with a high potential of local adaptation and scalability.
The Commission concludes that global food systems can provide win-win diets to everyone by 2050 and beyond. However, achieving this goal will require rapid adoption of numerous changes and unprecedented global collaboration and commitment: nothing less than a Great Food Transformation.
This report has attracted a lot of media commentary and much of it has been critical. Some have questioned the scientific rigour of the report and identified errors in the referencing despite a peer review process. The animal food sector, perhaps predictably, have been loudest in their criticism. They are squarely in the path of a plant-based Great Food Transformation. Some nutritionists too have questioned the impact of such a high fibre and phytate content on iron and zinc status with such low meat intakes. Some go so far as to say the diet is nutritionally deficient in vitamin B12 (acknowledged in the report), as well as retinol, potassium, calcium and haem-iron (especially for women) and omega-3. Proponents of high protein, low-carb diets have also come out fighting, including some health professionals who believe the (“high-carb”) diet is unsuitable for people with diabetes and pre-diabetes. To be fair, the report states it is not designed for people needing medical nutrition therapy but rather describes a population approach.
Perhaps more fundamentally, criticism may be based on the hesitance of affluent countries to relinquish global resources in order to more equitably share them among the world’s people (as per the UN Sustainable Development Goals) or accept any sacrifices in diet or lifestyle to address environmental sustainability. This report is a hypothetical assessment of what could be achieved within such global equality and commitment to sustainable food systems.
The EAT Lancet Commission’s framework for feeding the world in a healthy and sustainable way invites countries around the world to incorporate its principles into national policy. Australia does not have a national nutrition policy, but the Dietary Guidelines are due for review.
You can read more about the EAT-Lancet Commission on Food, Planet, Health here, including a blog on how the diet can be translated into a daily menu.