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Suggested Citation:"1 Introduction." Institute of Medicine. 2014. Sustainable Diets: Food for Healthy People and a Healthy Planet: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18578.
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1

Introduction
1

One of the many benefits of the U.S. food system is a safe, nutritious, and consistent food supply. However, the same system also places significant strain on land, water, air, and other natural resources. A better understanding of the food–environment synergies and trade-offs associated with the U.S. food system would help to reduce this strain. Many experts would like to use that knowledge to develop dietary recommendations on the basis of environmental as well as nutritional considerations. But identifying and quantifying those synergies and trade-offs, let alone acting on them, is a challenge in and of itself. The difficulty stems in part from the reality that experts in the fields of nutrition, agricultural science, and natural resource use often do not regularly collaborate with each other, with the exception of some international efforts. The Institute of Medicine’s (IOM’s) Food Forum and Roundtable on Environmental Health Sciences, Research, and Medicine convened a public workshop on May 7-8, 2013, to engender dialogue between experts in nutrition and experts in agriculture and natural resource sustainability and to explore current and emerging knowledge on the food and nutrition policy implications of the increasing environmental constraints on the food system. The experts explored the relationship between human health and the environment, including the identification and quantification of the synergies and trade-offs of their

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1 The planning committee’s role was limited to planning the workshop, and the workshop summary has been prepared by the workshop rapporteur as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants, and are not necessarily endorsed or verified by the IOM, and they should not be construed as reflecting any group consensus.

Suggested Citation:"1 Introduction." Institute of Medicine. 2014. Sustainable Diets: Food for Healthy People and a Healthy Planet: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18578.
×

impact. The workshop explored the role of the food price environment and how environmental sustainability can be incorporated into dietary guidance. Finally, experts considered research priorities, policy implications, and drivers of consumer behaviors that will enable sustainable food choices. Although the focus of the meeting was on the U.S. food system, workshop participants were asked to keep in mind the global context of sustainability issues.

This workshop summary is drawn from the material that was presented and discussed at the May 2013 meeting, based on meeting transcripts and presentations. This document summarizes the statements of workshop participants and is not intended to be an exhaustive exploration of the subject matter. The reader should be aware that the materials presented here express the views and opinions of individuals participating in the workshop either as presenters, discussants, moderators, or audience members, and not the deliberations or conclusions of a formally constituted committee. The objective of the workshop was not to reach consensus on any issue or make recommendations for future action. The goal was to illuminate the issues and advance the dialogue.

Meeting Purpose

•    To explore current and emerging knowledge on the food and nutrition policy implications of the increasing environmental constraints on the U.S. food system, keeping in mind the context of global sustainability issues.

•    To engender dialogue—between stakeholders who are concerned about environmental sustainability and natural resource use and those concerned about the nutritional value of the food supply and dietary guidance policy—that will advance the discussion of dietary guidance and environmental sustainability in the United States.

ROADMAP FOR THIS REPORT

The organization of this report is parallel to the organization of the workshop (see Appendix B for the workshop agenda). This introductory chapter summarizes the major overarching themes of the workshop discussion and the keynote presentation by Kathleen Merrigan. Chapter 2 summarizes the Session 1 presentations and discussion aimed at identifying relationships between eating patterns and the environment. Chapter 3 summarizes the Session 2 presentations and discussion on quantifying synergies

Suggested Citation:"1 Introduction." Institute of Medicine. 2014. Sustainable Diets: Food for Healthy People and a Healthy Planet: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18578.
×

and trade-offs between health and the environment. Chapter 4 summarizes the Session 3 presentations and discussion on sustainable commodity sourcing and the food price environment. Chapter 5 summarizes the Session 5 presentations and discussion on options and approaches to enable sustainable food choices.

The text boxes in Chapters 1 through 5 highlight major overarching themes of the workshop as a whole (Chapter 1) and key themes of individual sessions (Chapters 2-5) were compiled by the rapporteur.

Twice during the workshop, at the end of Day One (Session 4) and again at the end of Day Two (Session 6), Lisa Eakman from the Chicago Council on Global Affairs, was invited to reflect on what she perceived as key “take-home” messages. Her remarks are summarized in Chapter 6. Also included in Chapter 6 are additional remarks by the workshop planning committee chair Erik Olson and moderator Derek Yach, as well as a summary of George Loewenstein’s presentation on consumer behavior.

Appendix A provides a list of abbreviations and acronyms used in this workshop summary. The workshop agenda is provided in Appendix B and biographical sketches for the speakers can be found in Appendix C.

KEYNOTE PRESENTATION2

Kathleen Merrigan, former Deputy Secretary of Agriculture, U.S. Department of Agriculture (USDA), was the keynote speaker for the event. Merrigan identified local and regional agriculture as a place where the nutrition and sustainable agriculture agendas converge and where the two “silo” communities could be brought together in a way that builds a powerful coalition for change. In Merrigan’s opinion, USDA has done a great job translating the dietary guidelines into a more usable form, with the MyPlate graphic sending a single leading message: half a plate of fruits and vegetables. “It’s simple. We get it,” Merrigan said. “The challenge is, how do we get there?” The U.S. population is not nearly at half a plate of fruits and vegetables, a finding that cuts across all socioeconomic classes.

One route may be through domestic agriculture. A growing percentage of fruits and vegetables consumed in the United States are imported. Even when bananas, which account for about 50 percent of fruit imports yearly, are removed from the data, the percent of consumed fruits that are imported jumped from 12 percent in 1990 to 25 percent in 2008 (USDA, 2012a). More recent data show that the percentage is even higher today. Likewise, with vegetables, including frozen vegetables, the percent of consumed vegetables that are imported jumped from 8 percent in 1990 to 15

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2 This section summarizes the keynote address by Kathleen A. Merrigan, Ph.D., former Deputy Secretary of the U.S. Department of Agriculture, Washington, DC.

Suggested Citation:"1 Introduction." Institute of Medicine. 2014. Sustainable Diets: Food for Healthy People and a Healthy Planet: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18578.
×

Major Overarching Themes of Workshop Discussiona

•    Diet impacts the environment. A couple of workshop participants described how different diets have different environmental impacts with respect to greenhouse gas (GHG) emissions and the use and contamination of air, water, and other natural resources.

•    Although there are several tools available for quantifying the environmental impacts of the U.S. diet, workshop participants expressed caution that results not be over-interpreted. Several participants considered the newness of some of the methodologies being used; the unreliability of some data sources; the inappropriate use of global averages to evaluate regional situations; and the importance of not mistaking the relative end results of life-cycle assessment for absolute answers.

•    Much of the discussion of the environmental impacts of diet focused on meat, with many workshop participants agreeing that meat has a significantly greater environmental impact than other food groups. Some participants provided quantitative estimates of GHG emissions and other environmental outcomes associated with meat consumption and how those outcomes would change if Americans were to eat less meat. The estimates triggered several questions and comments from audience members and, in some cases, disagreement.

•    Although most of the workshop discussion revolved around the environmental impacts of food and diet choices, the trade-offs are two-way. The environment also impacts diet. A couple of workshop participants considered the loss of agricultural biodiversity and its impact on micronutrient availability.

percent in 2008 (USDA, 2012b). Merrigan argued that many of the fruits and vegetables being imported could be grown domestically, especially given that many imported fruits and vegetables are imported in the middle of their U.S. growing seasons. “That seems crazy to me,” Merrigan said, “when we’ve got rural communities struggling and farmers and ranchers not making their payments in the smaller and midsize operations. It seems there’s a really glorious opportunity there to build a food system that provides economic opportunity to them.”

Moreover, American agriculture is undergoing a transition, Merrigan opined, with the average age of farmers and ranchers nearing 60 (Bureau of Labor Statistics, 2013). A new generation of individuals is entering agriculture not by seeking capital to purchase a 5,000-acre commodity-producing farm, as earlier generations did, but rather by seeking high-value crops that can be grown on small acreage. Local agriculture is the most likely stepping stone for most new farmers and ranchers.

Suggested Citation:"1 Introduction." Institute of Medicine. 2014. Sustainable Diets: Food for Healthy People and a Healthy Planet: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18578.
×

•    Drawing on lessons learned from the European Union, the U.S. Department of Agriculture, the United Nations, and elsewhere, many workshop speakers considered a multitude of potential policy, research, and other approaches and options for reducing the impact of the U.S. diet on the environment. Much of the policy discussion focused on the U.S. dietary guidelines, with several participants calling for future guidelines to be based on environmental as well as nutritional considerations. There were several calls put forth for the public sector in the United States to become more concerned and engaged in diet sustainability policy and research.

•    The challenge of addressing sustainable diets is complex. Many workshop participants touched on the wide range of issues relevant to understanding and managing health and environmental synergies and trade-offs associated with the U.S. food system, including social justice challenges (e.g., access to food, exposure to environmental impacts), consumer behavior at the point of purchase, and the significant environmental cost of food waste.

•    What is a “sustainable diet”? No single definition of “sustainable diet” was provided or developed for use during this workshop, with some concern expressed that the term was being used in different ways by different people. There was one call for a broadening of the notion beyond what most people think of when they think of something as being sustainable and another call for a working definition of “sustainable diet” for use in developing new U.S. dietary guidelines.

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a There are issues related to the fields of nutrition/diet and environmental sustainability that were not covered or fully explored at the meeting due to limited time and scope of the workshop and limited perspectives of the participants in the workshop.

The question is, assuming that American dietary patterns are changing for the better (i.e., that Americans are eating more fruits and vegetables), how can the need for healthy food be met with domestic production? Merrigan described the intersection of healthy food and domestic production as the “‘Venn diagram for the crowd here today” (see Figure 1-1).

USDA Efforts to Meet the Need for Healthy Food with Domestic Production

USDA has initiated several programs within that Venn diagram. First are Electronic Benefit Transfer (EBT) programs at farmers’ markets; many farmers want EBT availability so that they can accept Supplemental Nutrition Assistance Program; Special Supplemental Nutrition Program for Women, Infants, and Children; and senior market coupon benefits. A number of foundations have been advocating for EBT at farmers’ markets as

Suggested Citation:"1 Introduction." Institute of Medicine. 2014. Sustainable Diets: Food for Healthy People and a Healthy Planet: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18578.
×

img

FIGURE 1-1 The intersection of healthy food and domestic food production as the focus of some efforts of the U.S. Department of Agriculture.

a way to simultaneously address food access issues and farmer economic viability issues. Merrigan described the efforts as “successful,” with both farmers’ markets and nutrition benefit redemptions skyrocketing. “And I think we’ve only scratched the surface,” she said.

Second are USDA-invested mobile markets. There has been a lot of recent discussion about food deserts, that is, areas of low access to food. In many rural parts of the country, there are not enough people to sustain a grocery store that is open 24 hours per day or 7 days per week, or even one that is open 5 days per week. Food deserts exist in both rural and urban areas. In many inner cities, people are buying food at corner stores and sometimes liquor stores, paying more money for less healthful foods. USDA has been investing in mobile markets to make sure that people are getting access to the food they need. Merrigan mentioned a mobile market in Chicago3: an old bus that was retrofitted to provide food, especially fresh produce, to inner-city communities. The question is, how can the concept be expanded out to make sure that everyone is getting access to the food they need?

Commercial kitchens are a third USDA-funded effort aimed at using domestic production to meet healthy eating needs. Farmers are using commercial kitchens for value-added food production, while communities are using them for cooking classes and demonstrations, canning, and other activities. USDA commercial kitchens are bringing people into the kitchen in exciting ways, in Merrigan’s opinion. She mentioned Michael Pollan’s compelling argument for families cooking together and gathering around

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3 See http://www.freshmoves.org (accessed December 6, 2013).

Suggested Citation:"1 Introduction." Institute of Medicine. 2014. Sustainable Diets: Food for Healthy People and a Healthy Planet: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18578.
×

the dinner table and observed that commercial kitchens could play a role (Pollan, 2012).

A fourth USDA effort of relevance is the Farm to School program. Children who are engaged in garden-based learning are more science literate and more environmentally aware, according to Merrigan. More importantly, they are willing to try and consume different types of fruits and vegetables. Much of the USDA’s focus has been on elementary school, while some has been on high school. Now, efforts need to be directed at the preschool level, where eating habits initially form. In Merrigan’s opinion, there are many opportunities at that level for small and midsize regional farmers who are seeking institutional outlets.

A fifth opportunity, still largely on the drawing board, would be to combine USDA’s food bank and food hub investments. USDA funds both food banks, including food bank delivery trucks, and food hubs. A food hub is a central place where small farmers bring their products to be aggregated or lightly processed for further distribution to institutional buyers. Merrigan suggested that the food bank delivery trucks could also be used to pick up food from the food hub farmers, en route, and deliver that food to a food hub. This would allow transportation to be shared, as well as cold storage and other services. Merrigan suspects that strengthening the links between food banks and food hubs would result in a sizeable increase in farm donations to food banks. She said, “That’s the kind of innovation I think we need when we’re talking about the Venn diagram and bringing these communities together.”

Finally, Merrigan observed plentiful opportunity in Supplemental Nutrition Assistance Program Education (SNAP-Ed). She acknowledged that some policy makers are advocating for the elimination or reformation of SNAP-Ed. However, she views the program as an opportunity to “work harder and better in that Venn diagram.”

Affordable, Accessible Healthy Eating

When asked by a member of the audience what specifically could or should be done with SNAP-Ed, Merrigan replied that figuring out how to get SNAP-Ed dollars to work harder is the task of the workshop participants. She cautioned that the “elephant in the room” is the notion that sustainable agriculture equals more expensive food, and she recalled hearing many federal government leaders saying that if people were to eat more healthfully by eating more fruits and vegetables, for example—it would be a “budget buster” for the federal government. However, studies from the USDA Economic Research Service and elsewhere have demonstrated that many fruits and vegetables, especially seasonal fruits and vegetables, are in fact quite inexpensive (Bishop and Wootan, 2013; Stewart et al., 2011). In

Suggested Citation:"1 Introduction." Institute of Medicine. 2014. Sustainable Diets: Food for Healthy People and a Healthy Planet: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18578.
×

Merrigan’s opinion, that kind of thinking—that a more sustainable food system would price poor people out of the food they need—has hurt reform efforts for decades.

Another member of the audience commented on a recent study in South Africa, where a 25 percent discount on healthy foods led to a fairly large shift in diet over the course of 2 years (An et al., 2013). The study involved approximately 350,000 individuals. Although the price change led to increased consumption of fruits and vegetables and a decline in meat and fried food consumption, it did not have much impact on obesity. According to the audience member, one reason for the lack of impact on obesity was that portion size issues were not included in the messaging. The results of the study raise questions about how food quality and quantity can both be improved simultaneously.

Merrigan responded that empowering women should be part of the agenda, given that in many countries women are the ones who guide their families’ eating choices. She emphasized early education, noting that dietary patterns are set early, and mentioned FoodCorps,4 an offshoot of AmeriCorps. FoodCorps service members encourage school children to make healthful eating choices through efforts such as cheering kids on at the lunch line. Although Merrigan was unsure how such a program would be scaled up at either the domestic or global level, she said, “against all the onslaught of convenience and processed food, healthy food—good eating—needs a cheerleader.”

Keynote speaker Kathleen Merrigan identified local and regional agriculture as a place where the siloed nutrition and sustainable agriculture communities could come together to build a powerful coalition for change. U.S. farmers would fare better, and Americans would have greater access to healthy foods.

REFERENCES

An, R., D. Patel, D. Segal, and R. Sturm. 2013. Eating better for less: A national discount program for healthy food purchases in South Africa. American Journal of Health Behavior 37(1):56-61.

Bishop, K., and M. G. Wootan. 2013. Healthy bargains. Fruits and vegetables are nutritious and economical. Washington, DC: Center for Science in the Public Interest.

Bureau of Labor Statistics. 2013. Labor force statistics from the Current Population Survey. http://www.bls.gov/cps/occupation_age.htm (accessed September 26, 2013).

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4 See https://foodcorps.org (accessed December 6, 2013).

Suggested Citation:"1 Introduction." Institute of Medicine. 2014. Sustainable Diets: Food for Healthy People and a Healthy Planet: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18578.
×

Pollan, M. 2012. Cooked: A natural history of transformation. New York: Penguin Press.

Stewart, H., J. Hyman, J. C. Buzby, E. Frazao, and A. Carlson. 2011. How much do fruits and vegetables cost? Economic Information Bulletin No. EIB-71. Washington, DC: U.S. Department of Agriculture, Economic Research Service.

USDA (U.S. Department of Agriculture). 2012a. Fruit and tree nuts. Trade. http://www.ers.usda.gov/topics/crops/fruit-tree-nuts/trade.aspx#.Ui8Lu9LkuSo (accessed September 10, 2013).

USDA. 2012b. Vegetables and pulses. Trade. http://www.ers.usda.gov/topics/crops/vegetables-pulses/trade.aspx#.Ui8OA9LkuSo (accessed September 10, 2013).

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Suggested Citation:"1 Introduction." Institute of Medicine. 2014. Sustainable Diets: Food for Healthy People and a Healthy Planet: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18578.
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Suggested Citation:"1 Introduction." Institute of Medicine. 2014. Sustainable Diets: Food for Healthy People and a Healthy Planet: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18578.
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One of the many benefits of the U.S. food system is a safe, nutritious, and consistent food supply. However, the same system also places significant strain on land, water, air, and other natural resources. A better understanding of the food-environment synergies and trade-offs associated with the U.S. food system would help to reduce this strain. Many experts would like to use that knowledge to develop dietary recommendations on the basis of environmental as well as nutritional considerations. But identifying and quantifying those synergies and trade-offs, let alone acting on them, is a challenge in and of itself. The difficulty stems in part from the reality that experts in the fields of nutrition, agricultural science, and natural resource use often do not regularly collaborate with each other, with the exception of some international efforts.

Sustainable Diets is the summary of a workshop convened by The Institute of Medicine's Food Forum and Roundtable on Environmental Health Sciences, Research, and Medicine in May 2013 to engender dialogue between experts in nutrition and experts in agriculture and natural resource sustainability and to explore current and emerging knowledge on the food and nutrition policy implications of the increasing environmental constraints on the food system. Experts explored the relationship between human health and the environment, including the identification and quantification of the synergies and trade-offs of their impact. This report explores the role of the food price environment and how environmental sustainability can be incorporated into dietary guidance and considers research priorities, policy implications, and drivers of consumer behaviors that will enable sustainable food choices.

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