Public health nutrition and sustainability

Health and Sustainability: Scientists are looking at new methods to assess both the health and the sustainability of protein production, rather than assessing those aspects independently. Seafood, along with a more plant-based diet, should fare well in this new approach.

A central challenge for the 21st century entails feeding a huge and growing number of people in ways that are healthy and equitable yet maintain the global environment upon which humanity depends. Indeed, global food and nutrition security are linked to most of the United Nations Sustainable Development Goals (SDGs) as articulated in the 2030 Agenda for Sustainable Development (adopted by the Member States of the United Nations in 2015).[i] Realization of these SDGs will require profound changes to the global food system. Similarly, a transformation of the food system will be required to meet the overarching climate goal of the Paris Agreement.[ii]

It is currently quite unclear as to how this will come about, particularly given the complex dynamics of the global food system. This has led to the formation of the EAT-Lancet Commission, “an independent, international consortium of research institutions, philanthropic foundations, non-government organisations, and companies”.[iii] Highlighting the unchartered waters that humanity is now entering, the Commission “… will, for the first time, scientifically assess whether a global transformation to a food system delivering healthy diets from sustainable food systems to a growing world population is possible”.

Since the beginning of the 1980s, overnutrition and obesity have transformed from relatively minor public health issues in the most affluent societies to what is now considered to be a staggering global challenge.[i] [ii] [iii] In 2013 some two billion people were deemed overweight (i.e., with a body-mass index (BMI) of 25 or over), of which about one-third, some 671 million people, considered obese.[iv] The impacts of this on human health are considerable, causing an estimated 3.4 million deaths in 2010.[v]

At the same time approximately 795 million people are chronically undernourished – some 216 million less than recorded in 1991 – and an estimated 2 billion people suffer from micronutrient deficiencies.[vi] [vii]

Further, and barring large-scale lifestyle changes and drug intervention, a global pandemic of hyperglycemia and diabetes mellitus has been forecast, in line with rising national incomes and urbanization and increasing adoption of western diets.[viii]

[i]   Finucane, M.M. et al. 2011. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet 377(9765): 557-567.

[ii]   International Food Policy Research Institute. 2016. Global Nutrition Report 2016: From Promise to Impact: Ending Malnutrition by 2030. Washington, DC.

[iii]   Ng, M. et al. 2014. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 384(9945):766-781.

[iv]   ibid.

[v] Lim, S.S. et al. 2012. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380(9859): 2224-2260.

[vi] FAO, IFAD and WFP. 2015. The State of Food Insecurity in the World 2015. Meeting the 2015 international hunger targets: taking stock of uneven progress. FAO, Rome.

[vii] International Food Policy Research Institute, op cit.

[viii] Danaei, G. et al. 2013. The global cardiovascular risk transition: associations of four metabolic risk factors with national income, urbanization, and Western diet in 1980 and 2008.

The idea that food and nutrition are causally connected to both human health and environmental integrity, resilience and productivity is not recent. For example, it was cogently addressed by chemist Ellen Swallow Richards at MIT beginning in the 1890s[i] and by the American nutritionist Henry Clapp Sherman who, as early as 1919, advocated the purchase of locally-grown produce to reduce energy costs and the use of grains to feed people rather than livestock, among many other recommendations.[ii]

It was not until 1986, however, that the term ‘sustainable diet’ – i.e., linking nutrition and human health with the sustainability of food production – was first introduced.[iii] Yet 30 years later it is still unclear what a sustainable diet actually constitutes.[iv] The Food and Agricultural Organisation (FAO) and Bioversity International have proposed a working definition, which, though necessarily vague, incorporates a number of critical elements:

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.[v]

Numerous definitions of sustainability and sustainable development have been formulated over the past four decades and, more recently, for ‘sustainable seafood’. The difficulties in adequately doing so, particularly for the latter, have been recently reviewed by fisheries scientist Ray Hilborn and colleagues,[vi] and underscore many of the challenges faced in developing operational definitions of diets that are sustainable.

[i]   Merchant, C. 2007. American Environmental History: An Introduction. Columbia University Press, New York.

[ii]   Sherman, H. 1919. Permanent gains from the food conservation movement. Columbia University Quarterly 21(1): 1-14.

[iii]   Gussow, J.D. and Clancy, K.L. 1986. Dietary guidelines for sustainability. Journal of Nutrition Education 18(1): 1-5.

[iv]   Lang, T. et al. 2009. Food Policy: Integrating Health, Environment and Society. OxfordUniversity Press, Oxford, United Kingdom.

[v]   Burlingame, B. et al. (Eds.). 2012. 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. FAO and Bioversity International, Rome.

[vi] Hilborn, R. et al. 2015. When is a fishery sustainable? Canadian Journal of Fisheries and Aquatic Sciences 72(9): 1433-1441.

International health agencies and the health agencies of many countries now recommend regular seafood consumption as a way to both optimize health and reduce chronic disease. Yet capture fishery production has generally plateaued since the late 1980s and seafood demand has only been met by the massive growth in aquaculture over the past few decades. In fact, 2014 marked the first time that aquaculture’s contribution to seafood provision overtook that of capture fisheries.[i]

There is concern, however, that the ever-growing demand for seafood along with its associated environmental and social impacts, and current biophysical limits, especially for fatty fish, are incompatible with governmental health recommendations and dietary guidelines.[ii] [iii] [iv] Or, in other words, and within an emerging context of public dietary advice that incorporates environmental and social criteria, an important question arises: Should people eat more seafood?[v]

One can clearly make a compelling case that people should eat more seafood if facing food insecurity and micronutrient deficiency, assuming that option is or made available.[vi] [vii] [viii] [ix] The answer may not be so clear in the case of, for example, the U.S., whose citizens consume about one-third of the recommended amount of seafood as stipulated by the 2015-20 Dietary Guidelines for Americans.[x] Nonetheless, achieving dietary sustainability may well require radical change in how societies define ‘progress’ and in consumer expectations over rights to specific foods.[xi]

There is little doubt of the importance of the capture fishery and aquaculture sectors in meeting many of the goals outlined in the 2030 Agenda for Sustainable Development.[xii] [xiii] This, in itself, according to the FAO, will be “immensely challenging”,[xiv] particularly since declining numbers of marine fish may be adding to rates of malnutrition in developing countries.[xv] Overall, the seafood sector looks to be increasingly forced to respond to international climate and human development and food security agreements while having to address diverse, contradictory and rapidly changing sustainability criteria which are likely to progressively include, for example, working conditions and worker rights, human rights, gender equality, societal well-being, and equity and other social justice issues. [xvi] [xvii] [xviii] [xix] [xx] [xxi] [xxii] [xxiii] [xxiv] [xxv]

[i] FAO. 2016. The State of World Fisheries and Aquaculture 2016. Contributing to food security and nutrition for all. FAO, Rome.

[ii] Jenkins, D.J.A. et al. 2009. Are dietary recommendations for the use of fish oils sustainable? Canadian Medical Association Journal 180(6): 633-637.

[iii] Lang, T. and Barling, D. 2013. Nutrition and sustainability: an emerging food policy discourse.Proceedings of the Nutrition Society 72(1): 1-12.

[iv] Thurstan, R.H. and Roberts, C.M. 2014. The past and future of fish consumption: Can supplies meet healthy eating recommendations? Marine Pollution Bulletin 89(1-2): 5-11.

[v] ibid.

[vi] Belton, B. and Thilsted, S.H. 2014. Fisheries in transition: Food and nutrition security implications for the global South. Global Food Security 3(1): 59-66.

[vii] Belhabib,D. et al. 2015. Feeding the poor: Contribution of West African fisheries to employment and food security. Ocean and Coastal Management 111: 72-81.

[viii] Béné, C. et al. 2015. Feeding 9 billion by 2050 – Putting fish back on the menu. Food Security 7(2):261-274.

[ix] Béné, C. et al. 2016. Contribution of fisheries and aquaculture to food security and poverty reduction: assessing the current evidence. World Development 79: 177-196.

[x] Kantor, L. 2016. Americans’ seafood consumption below recommendations. Amber Waves (October).

[xi] Lang, T. and Barling, D., op cit.

[xii] United Nations, op cit.

[xiii] Thilsted, S.H. et al. 2016. Sustaining healthy diets: The role of capture fisheries and aquaculture for improving nutrition in the post-2015 era. Food Policy 61: 126-131.

[xiv] FAO, 2016, op cit.

[xv] Golden, C.D. et al. 2016. Fall in fish catch threatens human health. Nature 534(7607): 317-320.

[xvi] Bush, S.R. et al. 2013. Certify sustainable aquaculture? Science 341(6150): 1067-1068.

[xvii] Little, D.C. et al. 2016. Aquaculture: a rapidly growing and significant source of sustainable food? Status, transitions and potential. Proceedings of the Nutrition Society 75(3): 274-286.

[xviii] Haugen, A.S. et al. 2017. Weaknesses in the ethical framework of aquaculture related standards.Marine Policy 75: 11-18.

[xix] Hall, S.J. et al. 2013. Innovations in capture fisheries are an imperative for nutrition security in the developing world. Proceedings of the National Academy of Sciences 110(21): 8393-8398.

[xx] Hilborn, R. et al., op cit.

[xxi] McClenachan, L. et al. 2016. Fair trade fish: consumer support for broader seafood sustainability. Fish and Fisheries 17(3): 825-838.

[xxii] Jennings, S. et al. 2016. Aquatic food security: insights into challenges and solutions from an analysis of interactions between fisheries, aquaculture, food safety, human health, fish and human welfare, economy and environment. Fish and Fisheries 17(4): 893-938.

[xxiii] Sumaila, U.R. et al. 2016. Fishing for the future: An overview of challenges and opportunities. Marine Policy 69: 173-180.

[xxiv] Sampson, G.S. et al. 2015. Secure sustainable seafood from developing countries. Science 348(6234):504-506.

[xxv] Marschke, M. and Vandergeest, P. 2016. Slavery scandals: Unpacking labour challenges and policy responses within the off-shore fisheries sector. Marine Policy 68: 39-46.

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