If countries worldwide adopted the EAT-Lancet recommendations on diet, they could potentially reduce early death by 34 per cent and more than triple the reduction in greenhouse gas emissions

The national dietary guidelines (recommendations such as to eat five pieces of fruit a day) in place in countries around the world are out of step with global health and environmental targets, and reforming them to become healthier and more sustainable could prevent more deaths and cut greenhouse gas emissions.

This was one of the main findings of an analysis published in the BMJ this week.

The national dietary guidelines in Ireland were not studied as part of this analysis but researchers did find that if our nearest neighbours the UK matched their dietary guidelines to that of the EAT-Lancet recommendations they could potentially save an additional 26,000 lives.

Published in January 2019, the EAT–Lancet Commission addresses the need to feed a growing global population a healthy diet while also defining sustainable food systems that will minimise damage to our planet. The report provides interesting information on how our current eating habits impact our health and the environment and makes a number of recommendations on how, achieving a global healthy and sustainable diet will require not only examining our diets but also how food is produced.

According to the BMJ analysis, national food-based dietary guidelines (FBDGs) are government-endorsed documents that provide recommendations and advice on healthy diets and lifestyles, but most do not address the social and environmental implications of dietary choices.

So, an international research team set out to compare the health and environmental impacts of adopting global and national food-based dietary guidelines, with global targets, such as the Action Agenda on Non-Communicable Diseases and the Paris Agreement on Climate Change.

They collated and scored measurable recommendations, such as “eat five servings of fruits and vegetables a day” from 85 national guidelines in different countries along with global guidelines from the World Health Organization (WHO) and the EAT-Lancet Commission.

They then used modelling to estimate how these recommendations could reduce early death from chronic diseases, such as heart disease, type 2 diabetes and cancer, and meet environmental targets related to greenhouse gas emissions, and the use of land and freshwater resources.

They found that adoption of national guidelines was associated with an average 15 per cent reduction in early death from chronic diseases and an average 13 per cent reduction in greenhouse gas emissions from the food system, equivalent to 550 million tonnes of carbon dioxide.

However, most of the national guidelines analysed (83, 98%) were not compatible with at least one of the global health and environmental targets.

For example, about a third of the guidelines (29, 34%) were incompatible with the agenda on non-communicable diseases, and most (57 to 74, 67% to 87%) were incompatible with the Paris Climate Agreement and other environmental targets.

In comparison, adoption of the WHO recommendations was associated with similar health and environmental changes, whereas adoption of the EAT-Lancet recommendations was associated with 34 per cent greater reductions in early death and more than three times greater reductions in greenhouse gas emissions.

For example, if the UK, US, and China adopted national guidelines in line with the EAT-Lancet recommendation, this could increase the number of avoided deaths from 78,000 to 104,000 in the UK, from 480,000 to 585,000 in the USA, and from 1,149,000 to 1,802,000 in China, explained the researchers.

This study has several strengths, such as the large number of countries and rigorous assessment of guidelines.

But the researchers pointed to several limitations that may have affected the accuracy of their results, such as the often qualitative nature of many national guidelines, and say there are many potential implications for improvement in future studies.

Nevertheless, they concluded that reforming national food-based dietary guidelines, as well as WHO guidelines, “could be not only beneficial from a health perspective but also necessary for meeting global sustainability goals and staying within the environmental limits of the food system.”

In a linked editorial, researchers in Germany agreed that these findings should be interpreted with caution, saying perhaps the most important finding from this study is the uncertainty that it highlights, not least about plant-based foods.

In overall terms the EAT-Lancet Commission proposals seem superior in terms of reducing mortality from non-communicable diseases, they wrote.

However, they pointed out that adopting the EAT-Lancet recommendations globally “would not be affordable for many in low-income countries without concomitant economic growth, improved local food production and supply, and expansion of the range of lower-cost animal products, fruits, and vegetables.”

“We still have some way to go before diets can become healthier and more sustainable worldwide,” they concluded.

Commenting Irish Heart Foundation dietitian Sarah Noone, said, it was important to note that how we currently eat does not reflect the existing healthy eating guidelines and we live in a world where cheap, fast and highly processed food is easily available and often cheaper and easier to access than healthier options like fruit and vegetables.

“Dietary guidelines have historically been more focused on formulating dietary recommendations for optimal human health, as opposed to the health of our environment. Any future development of dietary guidelines needs to consider the research around which foods have the greatest environmental impact, and this needs to be balanced with the priority of our physical health. So as we go forward and dietary guidelines evolve, we need to consider what changes we can make to our diets that will improve our physical health and also be sustainable ways of eating. “

“However, as we go forward we need to take account of the nutritional requirements of specific population groups for example children, the elderly or pregnant women as well as elements such as culture, price, accessibility, adequate knowledge, food preparation skills, and local context. In other words, not one set of dietary recommendations is suitable for all,” Sarah added.

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