We are what we eat – analysis of the controversial planetary health diet
In a world of vegans, pegans, vegetarians, pescatarians, flexitarians and omnivores the phrase “you are what you eat” has never been more true. A generation ago people were glad to eat anything, and parents were often heard warning children to “waste not, want not”. Today we live in a world with so many options that we can define ourselves by what we choose to eat or not eat. More and more people are choosing not to eat certain foods because they think it is wrong to do so. What we eat is no longer just a question of survival and nutrition, but also a moral choice for many. Whether you chose to support Veganuary, Februdairy, neither or both, you took a moral stance on what you do or don’t choose to eat. Now that what we eat has become so much who we are, it is very difficult to have a fully objective debate and even scientific reports can be led by ideology.
A recent report by the EAT-Lancet Commission has been publicised in mainstream media such as The Guardian as providing scientific evidence that if everyone ate a plant-based diet, we would be able to sustainably feed a population of 10bn by 2050. Despite being put together by 37 well-respected scientific experts from over 20 countries, the EAT-Lancet report has come under fire from nutritionists and industry experts. Criticism includes being nutritionally deficient, misinforming the public about sustainable farming practices, being led by vegan ideology, and even having a religious and financial agenda.
Who wrote the report?
On investigation there are in fact two reports: the full report (39 pages) published in the medical journal, The Lancet; and the summary report (26 pages with lots of graphics) published on the EAT website in a format more accessible to consumers. EAT describes itself as “a global, non-profit start-up dedicated to transforming our global food system through sound science, impatient disruption and novel partnerships.” What has concerned critics is that EAT was founded by the Stordalen Foundation, Stockholm Resilience Centre and the Wellcome Trust. The Stordalen Foundation’s founder is Norwegian multi-millionaire, vegan and animal rights activist Gunhild Stordalen, while Wellcome Trust founder, Henry Wellcome, was raised as a Seventh Day Adventist (a Millennialist Christian group) that preaches vegetarianism and shuns red meat. It isn’t clear, though, how much either founder’s belief system informed the outcome of the report.
What, for me, is more alarming is the partnership EAT has with FReSH, a body of 40 major companies which, as Joanna Blythman describes them, is: “a roll call of the big names in pharmaceuticals, pesticides, GM, and ultra-processed food. They include Bayer, which now owns Monsanto and its infamous Round-Up (glyphosate) pesticide, Big Sugar (PepsiCo), Big Grain (Cargill), palm oil companies, and leading manufacturers of food additives and processing aids.” If you read the description of what FReSH is all about, it is very closely aligned with the argumentation of the EAT-Lancet report. They turn “the conventional “farm to fork” approach on its head by working from “fork to farm” which means “starting with people and focusing on their consumption habits. Then working back through the food system.” It’s hardly surprising that companies that benefit from large-scale agriculture dislike the “farm to fork” approach, which facilitates smaller-scale production. And it’s equally handy for these companies to place the onus on the consumer to change their habits while distracting from the negative impact their own businesses are having through food production.
What’s their spin on it?
Within this context there are a few striking observations about the EAT-Lancet report that are important to make:
Refined grains get off scot-free from a consumer perspective
EAT-Lancet is at least as damning of refined grains as it is of red meat when it comes to health: “refined grains are a major source of high-glycaemic carbohydrates, which have adverse metabolic effects and are associated with increased risk of metabolic abnormalities, weight gain, and cardiovascular disease.“ Yet the volume of refined grains consumed currently is not documented alongside red meat consumption in the report and, although the diet completely removes refined grains from the picture, a reduction in refined grains isn’t part of their messaging. Instead they have been discreetly replaced completely by whole grains within the diet without so much as a squeak to consumers about the importance of avoiding them. Nor have I been able to find any reports done on the environmental impact of refining grains, which is both a mechanical and chemical process. This is probably not in the interests of FReSH brands like Kelloggs.
The report shows that fertilisers have a major impact on the environment, but it doesn’t advocate an organic diet
A lot of what has driven people to switch to plant-based diets for environmental reasons centres around the methane production of ruminants like cattle and sheep but EAT-Lancet points out that while methane has 56 times the global warming potential of carbon dioxide, nitrous oxide has 280 times that potential. Since nitrous oxide “mainly arises from soil microbes in croplands and pastures and is affected by soil fertility management, such as fertiliser application”, why are they not championing organic farming practices and encouraging consumers to eat a more organic diet? The report also highlights that:
“Excessive application of nitrogen and phosphorus in food production has substantial consequences, notably in runoff into streams and rivers, driving eutrophication of freshwater and marine ecosystems and subsequent development of hypoxic (oxygen-free) conditions causing fish dieback and other environmental harm.”
Yet the EAT-Lancet report concludes that “supply of nitrogen and phosphorus fertilisers to croplands is essential for maximising crop yields and will continue to be necessary for feeding a growing global population.”
Colin Tudge, Founder of the Oxford Real Farming Conference disagrees. He stated on BBC Farming Today, earlier this year, that “the world already produces about twice as much food as we really need” and we needn’t worry about feeding the world with low impact farming methods.
A report by the Grantham Centre for Sustainable Futures on the environmental impact of bread is concerned about the financial conflicts embedded within the agri-food system, “whose primary purpose is to make money not to provide sustainable global food security.” There is currently little financial incentive not to use fertiliser and it can hardly be in the interests of FReSH brands to advocate an organic diet.
The diet allows for more added sugar than red meat on a daily basis
EAT-Lancet concludes that “Because sugar has no nutritional value and adverse metabolic effects, we use a limit of 31 g/person per day of all sweeteners, or less than 5% of energy”, while for red meat it concludes: “Because data on risk of low intakes of red meat are imprecise, we have concluded that an intake of 0 g/day to about 28 g/day of red meat is desirable and have used a midpoint of 14 g/day for the reference diet.”
Not only is it unclear what the health impacts would be on a low meat diet, especially for people that can’t eat high-protein nuts, but also it isn’t clear that red meat is unhealthy if you don’t eat too much of it in combination with other unhealthy foods.
Is red meat really unhealthy?
A separate report published in Nutrition Reviews writes: “The harmful impact of animal-based products is only documented for red and processed meat at intakes higher than 50 g/d. Moreover, the higher rate of mortality and chronic disease associated with Western diets is due not only to a high content of red and processed meat but also to excessive consumption of refined cereals, fried foods, soft drinks, sweets, and energy-dense, nutrient-poor food products.”
There is also a difference between the health impact of processed versus unprocessed red meat, but no attention is paid to what is causing that difference or whether the health impact relates to the consumption of red meat itself or the preservatives used in processing them. EAT-Lancet reviews some of the evidence:
“Consumption of processed red meat (beef, pork, or lamb) was associated with increased risk of death from any cause and cardiovascular disease; unprocessed red meat was also weakly associated with cardiovascular disease mortality. Although data were scarce, consumption of white meat (poultry and fish) was not associated with increased mortality.”
“Based on evidence related to colorectal cancer, processed red meat (e.g., treated with salt or other preservatives) was determined by the International Agency for Research on Cancer review to be a group 1 carcinogen, and because data were less consistent, unprocessed red meat was classified as a group 2 carcinogen.”
Other studies, mentioned in the EAT-Lancet report, lump unprocessed red meat in with processed red meat, so there is no way of distinguishing them. I could find no conclusive evidence that unprocessed red meat was unhealthy. Interestingly one of the actually shows that unprocessed red meat carries a lower health risk as a source of protein than eggs.
Looking at red meat consumption in the context of the rest of the diet
The importance of looking at diet as a whole is highlighted by the fact that most of the red meat studies have been conducted in Europe and the USA, but the available Asian studies show that eating red meat actually relates to positive health. According to the EAT-Lancet report this “might be partly explained by the fact that Asian populations eat smaller amounts of meat than European and American populations.” Or perhaps it relates to eating more fish or proportionately more vegetables or only eating unprocessed red meat, or eating less refined grains, or generally not eating as much…
The report includes a handy graphic showing our current eating habits by region, which shows all of this to be true aside from distinguishing unprocessed meat and the quantity of refined grains consumed, which are not documented. Either way, what is shows is how much we still need to know rather than how much we definitively do know!
Is meat really as detrimental to the environment as people think?
The reality is that the environmental impact of agriculture is much more complex than the often-cited production of methane by livestock. To start with, not all livestock is the same. Pigs and chickens produce a much lower volume of methane and only through manure. If managed efficiently, this methane can be recaptured through carbon offset strategies. While, cattle has other environmental advantages as the Sustainable Food Trust points out:
“The failure to make a stronger recommendation in relation to reducing poultry meat consumption is misguided. We recognise that meat consumption overall needs to be reduced, but poultry are in direct competition with humans for grain. Although intensive cattle in some countries are fed on grain, ruminants in many countries predominantly eat grass and arable by-products which humans cannot digest. In relation to the environment, our analysis is that for net greenhouse gas emissions, soil degradation, biodiversity, diffuse agrochemical pollution and human health, reductions need to be made in meat that is largely fed on grain, not meat that is predominantly fed on grass.”
The National Farmers Union adds that: “65% of UK farmland is highly suitable for grass production over other crops, so the UK is well placed to produce food from sustainable livestock grazing systems. Grassland is a very good store of carbon, helping to mitigate the effects of climate change.”
This is an asset that EAT-Lancet also recognises and adds that: “grazing lands occupy about 23% of land surface and are important for biodiversity conservation.” A separate study suggests that moderate-to-low stocking of pastureland and semi-grassland is recommended to help recovery plans for rare butterflies, based on the success of many European farms.
The impact of crop farming on biodiversity
When it comes to loss of biodiversity, the impact of croplands is not insignificant. According to EAT-Lancet: “Between 2000 and 2014, Brazil lost on average 2·7 million ha/year of forest, the Democratic Republic of Congo lost 0·57 million ha/year with a 2·5 factor increase since 2011, and Indonesia lost 1·3 million ha/year, with 40% occurring in primary forest. This land-system change is a major contributor to biodiversity loss and greenhouse-gas emissions and undermines other Earth system processes.”
Investigation into the causes of deforestation in each of these three key-contributing countries shows that the only country where deforestation has been largely driven by meat production is Brazil and even there soy production is another major driver. In the Democratic Republic of Congo environmentalists fear an increase in deforestation for palm oil, rubber and sugar. Finally, in Indonesia, the main agricultural culprit seems also to be palm oil. Both palm oil and sugar are represented by FReSH companies.
Cropland also consumes considerably more freshwater than pastureland. 70% of all global water withdrawals are used for irrigation and according to one study the amount of pastureland irrigated in the USA was 10 times less than the amount of cropland.
Generating calories from our land resources
If you consider that the human race has a required energy intake (kcal) to survive and has access to a finite amount of land resources, it would make sense to look at kcal/area required for production. The EAT-Lancet report gives their diet a set calorific content, but chooses to assess environmental effects of different food stuffs on a per serving basis that favours vegetables, which are typically low in calories:
“Environmental effects of foods can be measured with various units, including per kcal, per g protein, or per serving, depending on the nutritional contribution of each food. Using a universal indicator to measure environmental effect can be misleading for some foods. For example, vegetables contain few calories per serving and thus using kcal to measure their environmental effect would indicate that some vegetables have high environmental footprints whereas, from a per serving basis, their environmental effects are low. Given this ambiguity, environmental effects are shown per serving.”
One critic asks: “How many heads of cauliflower would we have to grow to equal the nutrient value of a pound of beef?” More relevant, given the EAT-Lancet suggestion of substituting animal protein with protein from nuts and legumes, is the question: how many nuts would we have to grow to replace animal protein? Clearly this is a challenge and one which EAT-Lancet has addressed by suggesting genetically modifying nuts to improve the yield, thereby also reducing their biodiversity and resilience:
“By food group, the reductions in cropland use for feed crops was, to a large extent, compensated by large increases in cropland use for legumes and nuts which are relatively low-yielding. Redirecting investments towards higher-yielding varieties of those crops could be an effective strategy for reducing cropland use in the context of changes towards healthier diets which contain larger amounts of legumes and nuts.”
And then there’s the question of where would these nuts be grown? Would they be able to be grown on the same land as currently used for animal feed or would we have to convert more natural land to agriculture? And in areas like Wales, which is largely unsuitable for crop production as Abi Reader, a member of the NFU’s national dairy board, pointed out on a recent Farming Today programme, how far would arable produce have to travel to replace the local inhabitants’ protein intake from meat and dairy? It could well be more environmentally friendly to eat locally-produced, grass-fed meat and dairy than substituting that protein with intensively farmed soy beans from Brazil.
Are agri-business companies hiding their own responsibilities behind that of the consumer?
From EAT-Lancet’s own analysis, improved production practices and reducing food waste had at least as much environmental impact as changing diets, yet the diet was the focus of their message, conveniently placing responsibility on consumer choice over agri-business.
While there is a lot of truth to the EAT-Lancet report, what is served up to consumers in the summary report has a certain spin on it and if further simplified by the popular press could be wholly misleading. Even the full report, which more clearly recognises the uncertainties of the evidence, reaches overzealous conclusions. If consumers are to be responsible for consuming a sustainable diet, they should at least be armed with complete information and the knowledge of how to practically implement it.
How would consumers put the recommended diet into practice?
It is likely that consumers, who are already making active diet choices based on environmental and health concerns, will be the most likely to adopt the diet. Unfortunately, these are not the consumers most likely to be in need of eating more vegetables and less meat. Obesity levels are closely connected with income levels, knowledge and skills. Yet understanding, interpreting and actioning the EAT-Lancet diet requires a high level of education. Let’s consider what would happen if we followed the recommended diet.
Their recommendations are based on averages (age, weight, physical activity) that wouldn’t apply to a large number of people and could even encourage overeating in consumers that haven’t understood the basis of the recommendations. To cater for current levels of obesity, the report actually assumes a higher BMI than the optimum, increasing overall calorific content from 2,100 kcal/day to 2,500 kcal/day. This over-estimation is probably helpful when planning agricultural resources, but not helpful when defining a diet for a global population. Critically, there is no guidance provided on how to adapt the recommendations to individual people, like people with high or low metabolisms, or people with nut allergies, or people with a very high level of physical activity, or people at different stages of development. The full EAT-Lancet report details one specific example:
“Adolescent girls are at risk of iron deficiency because of rapid growth combined with menstrual losses. Menstrual losses have sometimes been a rationale for increased consumption of red meat, but multivitamin or multimineral preparation provide an alternative that is less expensive and without adverse consequences of high red meat intake.”
By publicising the summary report without this specific guidance, we risk malnourishing a whole generation of adolescent girls. And do we really want to encourage supplementing diets with highly processed multivitamins? Have we studied the environmental impact of producing enough of these to replace meat intake in adolescent girls?
Eating is much more than just stocking up on calories and nutrients as needed. People enjoy eating. And it’s important that they do. With so little time on our hands, it would seem a shame to waste our precious leisure time by eating healthy meals we don’t enjoy. There’s even evidence to suggest that enjoying your meal affects your nutrient absorption and encourages a strong metabolism. If we were all eating by the gram as outlined by the EAT-Lancet diet, our stress levels would go up (with an impact on our overall health) and our enjoyment of food would go down. Then there’s the issue of food waste. I have yet to see red meat packaged in 14g quantities or even 98g for a full week before it goes off. And do people know how to cook it in such small quantities?
Rather than pushing people into changing their diets through a sense of duty towards the environment, which generates feelings of guilt and stress around food, couldn’t we attract people to more healthy, sustainable meals, by showing them how to cook tasty recipes quickly and economically? Cooking education in schools, especially in low-income areas, could have a much greater beneficial effect on health and the environment, than advocating an over-generalised plant-based diet.
The EAT-Lancet report is valuable in many ways. It shows us where our knowledge gaps are; it encourages an important global discussion; and it consolidates much of the current research done on food production and consumption.
However, its focus on the consumer diet and connection with FReSH has shifted responsibility from food producers to consumers in a way that hides a lot of detail around the major environmental impact of fertilisers for crops and the effect of intensive arable farming, as well as genetically modifying crops for higher yields on biodiversity.
A plant-based diet is an oversimplified solution that ignores the differences between processed and unprocessed meats, low-impact versus intensive farming and organic compared to non-organic food. It has the potential to dangerously mislead consumers nutritionally and completely ignores the benefit of getting consumers to reduce their food waste (7.14bn tonnes/year in the UK alone) over changing their diet.
Eating is a major part of culture. Not just what, but also how we eat is very much who we are. Food production is a highly complex system and the truth is never obvious. People need to be wary of over-simplistic conclusions and avoid defining other people’s diet choices. It would be better to encourage people to change their diets by educating them on tasty alternatives, rather than guilt-tripping them into making dietary choices that may be misguided.