The value of sustainable dietary guidance

Do we need new national guidelines that reframe the impact of food on climate and health?

A recent tweet from the Environmental Protection Agency advocating less red meat consumption was removed because of objections by the Irish Farmers’ Association that reducing red meat consumption is not in line with Government dietary guidelines.

The tweet urged consumers to “try veggie recipes” and “reduce your red meat consumption slowly: Veggie lunches, meat free Mondays, etc”. The tweet also noted that a 10th of meat is thrown out.

The suggestion raised concerns, in the midst of a climate and biodiversity crisis, as to whether national dietary guidelines should be reviewed to reflect the environmental and climate impact of food.

Food pyramid

Government recommendations on healthy eating and a balanced diet are defined within guidelines. The ‘food pyramid’ shows the different food groups and how much of each is needed for a healthy balanced diet. Food is organised onto five main shelves with advice on how much to eat from each shelf a day. The advice ranges from the bottom shelf of vegetables salads and fruit (five-to-seven servings), starchy foods (three-to-five servings), dairy (three servings), meat and alternatives (two servings) to the top shelf of fats, spreads, and oils (small amounts). This guidance varies for different ages and also gender, and there is detailed guidance on the best type of food on each shelf of the pyramid. Food and drinks high in fat, sugar, and salt are at the very top of the pyramid and should be limited to once or twice a week.

Environmental impact

There is little reference to the environmental impact of food or the impact of ultra-processed food (UPF) on health. Research on building sustainability into dietary guidelines was conducted by safefood in 2021. The research looked at what is happening in other countries, and the attitudes and behaviour of consumers. It also sought the opinions of a multidisciplinary team of experts on what a climate-friendly diet should look like as well as focus group discussions to consider potential challenges.

This comprehensive body of work found that countries that had explored integration of sustainability into healthy eating guidelines tend to focus on whole foods rather than nutrients. These countries also emphasise waste reduction and the use of seasonal or locally produced food, thereby limiting overconsumption, specifically in terms of highly processed foods.

Protective measures to limit conflicts of interest in the development of guidelines was considered essential. The impact of marketing on food environments was highlighted and guidance around vegetarian and vegan diets as well as the promotion of breastfeeding.

Evidence

A review of the evidence highlighted that key challenges include structural barriers, awareness and scepticism around the evidence of the impact of food on climate and the perceived minor role of individual behaviour in the global context of climate change. There is also poor understanding of which foods carry the heaviest environmental burden and an overestimation of the impact of ‘food miles’ over the environmental impact of specific foods such as meat, dairy, and fish.

Targeting people at an early age before strong values are formed (eg, at primary school) was identified as a useful strategy to facilitate more sustainable diets.

The cost, availability and health of food is more important to consumers than whether it is organic, locally produced or carries a high environmental impact. Almost half of all respondents were not interested in eating less animal-based foods although one-in-five said they have started to reduce their consumption of red and processed meat ‘some of the time’.

The views of an expert panel comprising health, environmental, social, political, and economic disciplines were also sought. Some of the key findings of this body include: Promoting plant-based diets as the norm rather than the exception; encouraging food literacy; addressing vested interests and counteracting industry narratives. There was some divergence of opinion on reducing the reliance on animal-based foods and the promotion of plant-based foods along with the promotion of seasonal, local, and organic diets and sustainable seafood consumption. The expert group recommended further qualitative research with a multidisciplinary expert group in these areas prior to the development of sustainable dietary guidelines.

“Such research may limit future conflicts and facilitate unified and well-supported public messaging, reducing consumer confusion, and encouraging more sustainable diets,” it stated.

Focus groups with consumers across Ireland concluded that a sustainable diet is “hard work, a lifestyle choice, more expensive, time consuming and less accessible, particularly for families”.

“Outside of the high concern for food waste and packaging, the environmental impacts of food production and consumption do not appear to influence dietary choices. This is complicated further by a general confusion concerning terminology, distrust of information, the positioning of certain foods as ‘bad’, perceived vested interest, conflicting narratives, and a legacy of changing dietary advice,” the authors of the report concluded.

The impact of food production on the environment as well as the mounting evidence of the impact of UPF on health point to the need for urgent reframing of national dietary guidelines…

International guidelines

Norway published new dietary guidelines in June following the Danish lead in adding climate to the menu. The new guidelines advocate a predominantly plant-based approach, emphasising an increased intake of vegetables, fruits, legumes, and wholegrains.

“Animal product consumption should be limited with a recommended maximum intake of 350g of meat per week,” according to the guidance.

“Likewise, the consumption of milk products, alcohol, and highly processed foods should be moderated.”

Other countries have chosen to focus dietary guidelines on the level of processing of food. Guidelines in Brazil, using the NOVA classification system, have moved away from jamming food into pyramids or child-like plates, to focusing on meals, encouraging home cooking, and scepticism of the seductive practices of ‘Big Food’. The focus is on relating to how people eat or think about how they eat. This is summed up in the Brazilian food guide’s ‘golden rule’.

“Always prefer naturally or minimally processed foods and freshly made dishes and meals to ultra-processed foods.”

Recommendations to eat mostly fresh meals instead of UPF following NOVA classification are being increasingly adopted in new official dietary guidelines issued by national governments and international health organisations.

A focus on limiting UPF has been augmented by new research published at the European Society of Cardiology in Amsterdam recently. This confirms the devastating impact of UPF on cardiovascular health, compounding previous research confirming the links between UPF and obesity, type 2 diabetes, and cancer.

The impact of food production on the environment as well as the mounting evidence of the impact of UPF on health point to the need for urgent reframing of national dietary guidelines, underpinned by the latest evidence in terms of both climate and health.

Extensive research in the Irish context has identified high levels of confusion around which foods carry a heavy environmental impact, scepticism around the evidence-base and prioritisation of cost, access, and nutrition over climate impact of food.

There is controversy among multidisciplinary experts across the fields of nutrition, health, economics, and social science, particularly in relation to reducing reliance on animal-based foods and promotion of plant-based foods.

Government consideration of emerging global evidence and multidisciplinary collaboration on sustainable dietary guidance is needed to reframe the impact of food on both health and environment at a time of climate crisis.

DR CATHERINE CONLON, Senior Medical Officer with the HSE, and former Director of Human Health and Nutrition at safefood