MIL-OSI UK: expert reaction to the EAT–Lancet Commission report on healthy diets from sustainable food systems’

Source: United Kingdom – Executive Government & Departments

Research published in the The Lancet argues that diet and food production will need to change in order to improve health and avoid damage to the planet.

Prof Alan Dangour, Professor in Food and Nutrition for Global Health at the London School of Hygiene & Tropical Medicine (LSHTM), said:

“The analysis demonstrates that shifts in our diets can have enormous beneficial effects on health and also substantially reduce our impacts on the environment.  This significant ‘win-win’ for health and the environment is not a new finding, but this analysis, which for the first time defines environmental boundaries for the food system, is the most advanced ever conducted.

“The Commission recommends a ‘healthy diet’ for all.  Populations around the world eat strikingly different diets that have been shaped among other things by tradition, culture and wealth.  The ‘healthy diet’ would require significant shifts to existing dietary habits in most countries (including the UK), such as large reductions in meat intake and substantial increases in fruit, vegetables, nuts and legumes consumption.  There is a major question about the ability of populations to shift to such dietary recommendations and their wider public acceptability.

“Many of the important policy recommendations in the Commission cut across the portfolios of traditional government departments (such as agriculture and environment, health, trade, international development in the UK) and will be challenging to implement in many countries.

“This is an important set of analyses that highlights the critical link between human health and the health of our planet.  Urgently increasing access to healthy and sustainable diets for all people, and coordinating effective policy responses across government departments, are among the key changes required if we are to safeguard human and planetary health in the coming decades.”

Prof Guy Poppy, Professor of Ecology at the University of Southampton, said:

“The global food system is complex and is failing to be good for planetary and human health. Changing the food production system and human consumption behaviour is one of the biggest challenges for society, especially as it must be quick enough to have the right effect on the environment and public health.

“This commission is an exciting development which really takes a systems approach to the intractable challenge and clearly articulates the diets which are good for the planet and your health. Developing the business systems to deliver these recommendations and the need to ‘nudge’ human consumption behaviour so dramatically will not be easy; but this ‘call to arms’ with its clear solutions is timely, comprehensively researched and deserves immediate attention.”

Dr Howard Frumkin, Head of Wellcome’s Our Planet Our Health programme, said:

“The links among diet, health and the environment are well-documented, but, until now, the challenge of attaining healthy diets from a sustainable food system has been hampered by a lack of science-based guidelines. While this report does not have all the answers, it provides governments, producers and individuals with an evidence-based starting point to work together to transform our food systems and cultures.

“We know the risks a poor diet poses to health and, in turn, the risks unsustainable agricultural practices pose to our planet.  We now have a menu of actions that can help address these challenges.”

‘Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems’ was published in The Lancet at 23.30 UK time Wednesday 16th January 2019.

Declared interests

Prof Dangour: I hold competitive research funding awards to conduct research in the area of sustainable and healthy diets.  I am currently the Specialist Advisor to the (UK government) Environmental Audit Committee inquiry on Planetary Health.

Prof Poppy is also the Chief Scientific Adviser to the Food Standards Agency

Dr Frumkin: The Wellcome Trust is a founding partner of the EAT Foundation and funded this report

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MIL-OSI UK: expert reaction to series of systematic reviews and meta-analyses about dietary fibre and the risk of non-communicable disease

Source: United Kingdom – Executive Government & Departments

Research published in The Lancet shows that relatively high intakes of dietary fibre and whole grains could be causally linked to reduced risk of non-communicable diseases. 

Prof Kevin Whelan, Professor of Dietetics, King’s College London, said:

“The study published by Reynolds and colleagues draws together all previous studies investigating fibre and human health, and importantly they include both observational studies and randomised controlled trials. The researchers were able to look at 185 observational studies which recorded what people were eating in their everyday lives and then related that to whether they go on to develop disease over time – in total for 135 million person years. The researchers also looked at the results of 58 clinical trials of fibre, whereby people were given new diets and to investigate the effect on health and the results are able to show cause and effect relationships.

“The greatest reduction in risk of disease was when dietary fibre intake was between 25-29 g per day. Dietary recommendations in the UK are that the general public should eat 30 g per day of fibre, and so this national recommendation is consistent with the findings of this latest analysis. The challenge is that many people in the UK do not eat this amount of fibre. The major sources of fibre in the UK diet are cereals (bread, pasta, rice, breakfast cereal), vegetables and fruit. People should consider ways of increasing fibre intake through changing food preparation methods (e.g. not peeling potatoes), switching to wholegrain cereals (wholegrain bread, brown pasta) and replacing sugary snacks with fruits, vegetables, nuts and seeds.

“Importantly this research was able to investigate not only the effect of the total amount of fibre, but also the quality of the fibre. For example, wholegrain fibres were shown to have significant health effects whereas the evidence that low glycaemic index diets were effective were less convincing.”

Dr Ian Johnson, Nutrition Researcher and Emeritus Fellow, Quadram Institute Bioscience, said:

“This very comprehensive systematic review of published evidence on the relationship between the quality of dietary carbohydrates and human health confirms that diets rich in fibre provide real protection against a range of diseases including Type II diabetes, coronary heart disease and bowel cancer. The sheer volume of evidence, together with the consistency of findings from both observational studies and randomised controlled trials shows that we can now be very confident that a high consumption of fibre from all sources, and particularly from whole-grain cereals, provide significant protection against the common diseases of later life that now place considerable strains on the NHS.

“The greatest reductions in risk were seen at levels of intake of between 25g and 29g of fibre per day, a finding which is consistent with the current dietary recommendation from the UK government that adults should consume 30g of fibre per day, from a variety of foods including wholegrain cereals, fruits and vegetables.  It is a concern that the fibre consumption in the UK is on average, currently much less than this. It is also worrying that otherwise healthy consumers who try to follow popular diets low in carbohydrate will find it very difficult to achieve a healthy level of fibre intake.”

Prof. Naveed Sattar, Professor of Metabolic Medicine, University of Glasgow, said:

“I think this is an important paper which highlights better than before the potential value to health of higher dietary fibre intake. However, as with the vast majority of nutritional data, most of the evidence comes from observational studies and one has to be cautious about conclusions reached given the unavoidable biases they contain. That noted, this paper importantly also includes risk factor data from trials and the reductions in weight and other known causal risk factors such as blood pressure, cholesterol, etc seen with higher fibre (whole grain) diets, although modest do support the overall findings linking more fibre in the diet to less heart disease, diabetes, cancers, and potentially longer life. So I tend to believe the overall findings are directionally true and so concur with the authors conclusions when they write “recommendations to increase dietary fibre intake and to replace refined grains with whole grains is expected to benefit human health.”

Prof. Nita Forouhi, MRC Epidemiology Unit, University of Cambridge

“We need to take serious note of this study, based on a robust analysis and complementary findings from both observational and randomised trial evidence. This study effectively re-endorses that the UK Government advice to consume 30g fibre per day is pretty spot on. The onus is on individuals themselves, as well as public agencies, to make it happen, as average fibre intakes remain woefully low at a population level in the UK.

“This research did not study total carbohydrate intakes specifically, but its findings do imply that, though increasingly popular in the community at large, any dietary regimes that recommend very low-carbohydrate diets should consider the opportunity cost of missing out on fibre from whole grains. This research confirms that fibre and whole grain intakes are clearly important for longer term health.

“Ultimately this research provides a solid foundation that when it comes to carbohydrates, the quality matters very much, over and above the debate on quantity. Whole grain foods are typically high in fibre, and this research provides further evidence to highlight their importance and support a shift in our diets from processed and refined foods in the food supply chain towards more fibre-rich whole grain foods.”

*‘Carbohydrate quality and human health: a series of systematic reviews and meta-analyses’ by Reynolds et al. will be published in The Lancet at 23.30 UK time on Thursday 10 January 2019, which is also when the embargo will lift. 

All our previous output on this subject can be seen at this weblink: http://www.sciencemediacentre.org/tag/diet-nutrition/

Declared interests

Prof Kevin Whelan: “I have received research funding from government agencies such as the Medical Research Council, National Institute of Health Research, charities such as Helmsley Trust, Kenneth Rainin Foundation and Crohn’s and colitis UKL and industry bodies including the Californian Dried Plum Board, Almond Board of California, International Nut and Dried Fruit Council, Nestle and Danone.”

Dr Ian Johnson: “Until 2015 Ian Johnson was an external expert member of the SACN working group on Carbohydrates and Health.”

Prof. Naveed Sattar: “COI None.”  

Prof. Nita Forouhi: “I am a member of the Joint SACN/NHS-England/Diabetes-UK Working Group on ‘lower carbohydrate diets compared to current government advice for adults with type 2 diabetes’. Views expressed are my own, not the Group’s.”

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