Healthy Sustainable Diets: Updating the Eatwell Plate
Submission to Public Health Englandthe External Reference Group
Summary
Eating Better welcomes the invitation from Public Health England to submit our views and evidence to PHE and the External Reference Group advising on the review of the Eatwell Plate.
Eating Better urges Public Health England and the Department of Health to use the opportunity of reviewing the Eatwell Plate and associated communication messages in response to the SACN review of Carbohydrates and Healthto include within its scope an update of the Eatwell Plate in line with scientific evidence on sustainable diets.
The evidence of win-wins for health and the environment achievable via sustainable eating patterns is well established. UK guidelines do not yet reflect this evidence as they were introduced over twenty years ago and have not been updated since. It is therefore important that the Eatwell Plate and its associated communications take account of this evidence.
Integrating sustainability within Eatwell provides an opportunity for Public Health England to demonstrate its leadership in promoting system-wide change to tackle obesity and to support the principles of joined up policy across government. It will also motivate and enable a wider range of stakeholders to support PHE in the achievement of its diet and obesity objectives.
It will also enable PHE and the UK to join other countries that are already demonstrating leadership in this area. Official bodies in other countries including the Netherlands,Sweden, Nordic Countries, France and Germanyhave produced their own nutrition guidelines incorporating sustainability advice for their citizens and stakeholders. Most recently the US Dietary Guidelines Advisory Committee in its Scientific Report[1] is recommending the inclusion of environmental criteria within the 2015 US dietary guidelines.
We urge Public Health England to build on the body of work including the Livewell Plate and the peer reviewed DEFRA-coordinated work to define principles for healthy sustainable eating to implement sustainability within the Eatwell Plate.
Eating Better
Eating Better[2] is a broad alliance currently supported by forty-fivenational organisationsandpartner networksbringing together public health, environment, animal welfare, resource use, international development, research and responsible food interests and expertise.Eating Betteralso benefits from the academic advice of the Food Climate Research Network and the British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention both at the University of Oxford.
Eating Better is calling on governments, businesses and all those who can make a difference to help people move towards healthy and sustainable eating patterns based on plant-based eating with less and better meat as a healthier, fairer, greener way to eat for people and the planet.
Healthy Sustainable Diets: Updating the Eatwell Plate
Eating Better’sPolicy Briefing[3], developed in consultation with our supporting organisations and partner networks, calls on UK governments to develop policies and practices to support a transition to healthy and sustainable eating patterns.
An essential first step towards this goal, is the updating of official guidance – includingthe Eatwell Plate - to provide audiences and stakeholders,including businesses, professionals, educators and the public, with integrated advice on healthy sustainable eating patterns.
We recognise that cross-government working is vital and one department or agency alone cannot meet this objective.
DEFRA has already recognised the importance of sustainable food consumption in its Green Food Project and convened stakeholders in 2013, including the Department of Health, to define principles for healthy sustainable eating.[4] The principles include advice to:
- Eat a varied balanced diet to maintain a healthy body weight.
- Eat more plant based foods, including at least five portions of fruit and vegetables per day.
- Value your food. Ask about where it comes from and how it is produced. Don’t waste it.
- Moderate your meat consumption and enjoy more peas, beans, nuts and other sources of protein.
- Choose fish sourced from sustainable stocks. Seasonality and capture methods are important here too.
- Include milk and dairy products in your diet or seek out plant based alternatives, including those that are fortified with additional vitamins and minerals.
- Drink tap water.
- Eat fewer foods high in fat, sugar and salt.
DEFRA has supported the peer review of this work (now completed) and its forthcoming publication by the Global Food Security Programme. We urge Public Health England to build on this work and implement the guidance within the Eatwell Plate.
The Livewell Plate provides further evidence that it is possible to include sustainability within dietary guidance[5]. This project from WWF-UK and Aberdeen University sought to define a sustainable (lower GHG) diet that is nutritionally adequate and acceptable. By adapting the Eatwell Plate to include reductions in greenhouse gas emission, Livewell offers dietary recommendations that would meet current nutritional guidance and cut GHG emissions from the UK supply chain inline with UK emission reduction targets. Livewell proposes reductions in GHG intensive foods (meat & dairy) without eliminating these and an increase in plant-based foods including vegetables and fruits. The Livewell diets have now been developed for Sweden, Spain and France.
Official bodies in other countries including the Netherlands[6],Sweden[7], Nordic Countries[8], France[9] and Germany[10]have produced their own nutrition guidelines incorporating sustainability advice for their citizens and stakeholders. The Italian Barilla Center’s‘Double Pyramid’[11], provides guidance on how to achieve diets that combine both health and environmental benefits.
Most recently the US Dietary Guidelines Advisory Committee in its Scientific Report[12] is recommending the inclusion of environmental criteria within US dietary guidelines.
Healthy eating guidelines have many functions including supporting the development, implementation and evaluation of local and national food policy and supporting professions and the public in relation to health improvement and education. Updating the Eatwell Plate for sustainability would also support PHE’s own prioritisation of sustainable food procurement at the local level.
We note that as part of its priority on obesity, PHE has committed to ‘support local authorities to deliver whole system approaches to tackle obesity, including through supporting healthier and more sustainable food procurement”.[13] Failing to include sustainability recommendations within the Eatwell Plate would be a missed opportunity to reinforce this important message to local authorities and the wider audience of stakeholders who use the Eatwell guidelines.
The evidence for healthy sustainable diets
The way we feed ourselves is unhealthy and unsustainable[14].It contributes to some 20-30% of anthropogenic greenhouse gas (GHG) emissions, is the leading cause of deforestation, land use change and biodiversity loss; accounts for 70% of all human water use and is a major source of water pollution.[15]
Strong evidence now exists of the need to shift diets towards healthy and sustainable eating patterns and there is growing agreement on the principles that underpin such healthy sustainable diets. This includes a shift to more plant-based eating with reduced levels of meat-eating among high consuming countries like the UK to help address climate change, promote public health and help feed the world more fairly and humanely.[16]
A growing body of interdisciplinary evidence demonstrates that applying environmental and sustainability factors to dietary guidelines can be accomplished because of the compatibility and degree of overlap between favourable health and environmental outcomes.[17]It is possible to devise diets that generate lower environmental impacts than the consumption average and that are broadly in line with current nutritional guidelines.[18]
An authoritative review of the evidence for sustainable dietshas recently been published in the 2015 Dietary Guidelines Advisory Committee’s Scientific Report.[19] Thisconcludes:
‘Consistent evidence indicates that, in general, a dietary pattern that is higher in plant-based foods, such as vegetables, fruits, whole grains, legumes, nuts, and seeds, and lower in animal-based foods is more health promoting and is associated with lesser environmental impact (GHG emissions and energy, land, and water use) than is the current average U.S. diet.’
The evidence the Committee drew on includes UK research.
UK research considered by the Advisory Committee include Scarborough et al.[20]This demonstrates that a diet with 50 percent reduced total meat and dairy replaced by fruit, vegetables, and cereals contributed the most to estimated reduced risk of total mortality and also had the largest potential positive environmental impact. This diet scenario increased fruit and vegetable consumption by 63 percent and decreased saturated fat and salt consumption; micronutrient intake was generally similar with the exception of a drop in vitamin B12.
Also quoted is Macdiarmid et al.[21]This research which supported the development of the Livewell Plate, demonstrates that a sustainable diet that meets dietary requirements and has lower GHG can be achieved without eliminating meat or dairy products completely, or increasing the cost to the consumer.
Meat consumption
A reduction in the consumption of meat has been demonstrating as likely to have the most significant and immediate impact on making diets more sustainable.[22]UK per capita meat consumption is average for the EU it is high in global terms – approximately twice the world average.[23]
High levels of meat consumption - particularly of red and processed meat - are detrimental to public health. UK Department of Healthadvice[24]is to consume no more than 70g/day of red and processed meat.Other scientific bodies go further in their advice. The World Cancer Research Fund (WCRF), which carries out a major global study of cancer and diet every ten years, recommends that we should eat mostly foods of plant origin and limit intake of red meat and avoid processed meat.[25]
Current average intakes of red meat for men exceed government health recommendations, with young men (16-24) being the highest consumers of red meat. Four in 10 men and one in 10 women eat more than 90g of red and processed meat a day[26]. In 2012 it was calculated that six out of ten men and one in four women consume more red and processed meat than government health guidelines recommend[27].
Reducing meat consumption in high meat consuming countries, such as the UK, will help reduceheart disease, obesity and cancer.[28]It has been calculatedthat eating meat no more than three times a week would prevent 45,000 early deaths a year in the UK and save the NHS 1.2bn a year.[29]
Eating meat that is more extensively farmed may also have health benefits. Pasture-reared beef has been found to contain less fat and has a higher proportion of omega-3 fatty acids compared with intensively reared beef.[30]There are therefore health grounds, as well as environmental and animal welfare reasons, when consuming meat, dairy products and eggs to choose the highest possible welfare options. A ‘less and better’ approach to consumption of these products means that such choices need not cost more.
Conclusion
This submission demonstrates the substantive body of evidence that now exists on the co-benefits for public health and the environment of a transition to healthy and sustainable eating patterns in the UK. It also highlights practical ways in which it is possible to update the Eatwell Plate to integrate sustainability.
We urge Public Health England to progress the work already undertaken in the UK, including work led by DEFRA and to update the Eatwell Plate and associated messaging in line with scientific evidence on sustainable diets.
Eating Better, April 2015
Contact: Sue Dibb, Coordinator, Eating Better
Email:
1
[1]
[2]
[3]
[4]Sustainable Food Consumption Report, Follow-Up to the Green Food Project July 2013
[5]
[6]
[7]
[8]Norden (2014).Nordic Nutrition Recommendations 2012, Nordic Council of Ministers, Copenhagen
[9]
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[13]
[14]The Government Office for Science, The Future of Food and Farming: Challenges and Choices for Global Sustainability, 2011,
[15]T Garnett, What Is a Sustainable Healthy Diet? Food Climate Research Network, 2014,
[16] See for example
UN Food and Agriculture Organization (FAO), Sustainable Diets and Biodiversity - Directions and Solutions for Policy, Research and Action, 2014,
[17]Scientific Report of the 2015 Dietary Guidance Advisory Committee: Advisory Report to the Secretary of Health and Human Services and the Secretary of Agriculture, February 2015
[18]T Garnett, What Is a Sustainable Healthy Diet? Food Climate Research Network, 2014,
[19]
[20]Scarborough P, Allender S, Clarke D, Wickramasinghe K, Rayner M. Modelling the 2028 health impact of environmentally sustainable dietary scenarios in the UK. Eur J Clin 2029 Nutr. 2012;66(6):710-5. PMID: 22491494. 2030
[21]Macdiarmid JI, Kyle J, Horgan GW, Loe J, Fyfe C, Johnstone A, et al. Sustainable diets 2006 for the future: Can we contribute to reducing greenhouse gas emissions by eating a 2007 healthy diet? Am J Clin Nutr. 2012;96(3):632-9. PMID: 22854399. 2008
[22]Garnett, T. (2013). Food sustainability: Problems, perspectives and solutions. Proceedings of the Nutrition Society, 72(1), 29-39.
[23]FAOSTAT, 2013. FAOSTAT.
[24]
[25]World Cancer Research Fund / American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington DC: AICR, 2007
[26]Red meat and the risk of bowel cancer, NHS Choices
[27]S. Westland and H. Crawley, Healthy and Sustainable Diets in the Early Years, First Steps Nutrition Trust, 2012,
[28]McMichael A J, et al, 2007, The Lancet 370:1253-1263
[29]
[30]Compassion in World Farming (2012) Nutritional benefits of high welfare animal products.