Download 1 - All Party Parliamentary Food and Health Forum

ASSOCIATE PARLIAMENTARY
FOOD & HEALTH FORUM
Plant-based eating & a sustainable food policy
5-6.30pm, Tuesday 18 October, 2011
Committee Room 15, House of Commons
Minutes
Introduction
Baroness Miller of Chilthorne Domer welcomed members to the meeting and introduced the guest
speakers: Mark Driscoll, Head of the One Planet Food Programme at WWF-UK; and Dr Janice
Harland, a qualified nutritionist, author and consultant, as our guest speakers.
Mark Driscoll, Head, One Planet Food Programme, WWF-UK
Mark explained that the One Planet Food Programme was launched in 2009 and aimed at
reducing the negative environmental and social impacts of UK food production and consumption
and moving towards a more sustainable, equitable and fair food system. WWF believes plantbased eating has social, environmental and health benefits and governments should focus on this
win-win agenda: linking sustainability criteria with healthy eating advice. He stressed WWF does
not advocate a vegetarian diet, but we should eat more plants for our own health and plant
producers need to be paid a fair price for food to reflect environmental improvements. WWF works
constructively with producers and producer groups to improve production efficiency in order to
reduce impacts.
At the moment we are literally eating our way through the earth’s natural capital. Agriculture and
food production dominates two-thirds of the ice free land of the planet. According to the Millennium
Ecosystem Assessment, some 60% of these ecosystems are being degraded or are in a state of
decline, and yet our very food system depends on them. In the UK alone pollination services are
estimated to be worth in the region of over £145m to the economy; while 80 -100 commodities
globally depend on pollination services provided by insects, but the cost of our food does not
reflect the true costs of these external services.
In 2011 the UK Government’s Foresight project published Food and Farming Futures. It explores
the pressures on the global food system between now and 2050, identifying the changes needed
to ensure that a global population rising to over 9 billion can be fed sustainably and equitably.
According to the report our food system is not equal; around 1 billion people suffer from
malnutrition, a further 1 billion from hidden hunger, while about 1.5 billion people are overweight or
obese. In world of 7 billion that means 50% of people do not get enough to eat or eat too much.
According to the FAO, some 40% of the food grown is wasted.
Food is at the heart of every key environmental issue, which is why WWF has made food one of its
key priorities. The food system has a substantial impact on climate change. It is a driving force
behind habitat and biodiversity loss and a huge drain on water resources, both due to the direct
production of food and the growing of crops to feed animals.
Put simply, if everyone in the world consumed natural resources and generated greenhouse gases
at the same rate as people in the UK, we would need almost 3 planets to support us. Food
accounts for 23% humanity’s ecological footprint and a similar proportion of our contribution to
Chairman: Lord Rea
Vice-Chairmen: Baroness Miller of Chilthorne
Domer, The Countess of Mar & Roger Williams MP
Secretary: The Earl Baldwin of Bewdley
Treasurer: Baroness Gibson of Market Rasen
Associate Parliamentary Food & Health Forum
Church House, Great Smith Street
London, SW1P 3AZ
Tel: 020 7222 1265 Fax: 020 7222 1250
climate change. WWF’s own 2010 Living Planet report demonstrates that the Living Planet Index
has declined whilst globally we are consuming the resources of 1.5 planets (that is we are using
natural assets 50% faster than they can be replenished whilst creating waste).
Global food systems use about 70% of global water, much of which is non-renewable; land use
change, especially deforestation, drives habitat loss across the world from the Amazon and Borneo
to the Mediterranean; some 24% of vegetated land suffers soil degradation; we are suffering from
nitrogen and other pollution; and fisheries are over-exploited. We need to ensure food production
and consumption becomes increasingly efficient, reducing waste and changing the foods we
consume to achieve a sustainable diet.
WWF is calling for food producers, retailers, governments and others to produce key principles for
a sustainable diet. Our Livewell Report sets out a balance of food choices that would improve
health, meet climate change targets and move us towards more sustainable food consumption and
production. The aim of the report is to stimulate debate.
The first issue the Livewell Report considers is the main constituents of the current UK diet. We
found that compared with the UK Government’s own nutritional guidelines (the “eatwell plate”) our
diet is too high in saturated fat, sugar and salt and too low in fibre. A move towards more plantbased foods is needed; we need to increase the amount of fibre, fruit and vegetables we eat. The
report estimates that the GHG emissions from the current UK diet amount to 7.14 kgCO2e/adult/
day, which is similar to previous estimates, and a large part of this is due to the high emissions
from non-dairy sources of protein (see slide 10).
The methodology used in the report, which was commissioned from the Rowett Institute, of
Nutrition and Health at the University of Aberdeen, put practical limits on food choices to develop a
realistic “acceptability” outcome. For example, it ensures that the Livewell diet includes enough
milk to have on breakfast cereals, which together with bread is a major source of fibre in the UK
diet. The Livewell Report includes a sample 7 day menu and shopping list to demonstrate that
Livewell could be combined with a recognisable and acceptable diet. It does not remove meat
from the diet - far from it. The Livewell diet should not be seen as definitive; a sustainable diet is
about more than just GHG emissions; it should include other environmental criteria and could
involve different combinations of foods, but the diet was developed to stimulate debate.
The Livewell conclusions are that the current UK diet is neither healthy nor sustainable in terms of
GHG emissions. Eating a healthy diet is affordable and compatible with reducing GHG emissions,
but it requires eating a different balance of food to the current UK diet. WWF hopes the Livewell
Report will be a starting point for understanding ways of achieving healthy, sustainable diets.
WWF is now calling on the Government to support the development of “sustainable diets” by
defining key principles and linking sustainability criteria into healthy eating advice, whilst
highlighting them as a national policy objective. It wants the Government to define the key
principles of sustainable diets involving producers, supermarkets, Government and other relevant
stakeholders; and to develop a more integrated food strategy which tackles some of the challenges
highlighted by Foresight. We need a more integrated food strategy.
Dr Janice Harland, nutritionist and author
Janice explained she had been asked to speak about whether plant-based eating could meet all
our nutritional needs and, if so, whether Government advice on healthy eating should encourage
more plant-based eating. Her comments would be based on a few chapters in a new book, The
Plant-based Plan - Reference guide for plant-based nutrition, and she thanked her co-author,
Lynne Garton, for all her help with the research for this book and the Alpro Foundation for funding
it.
To review the evidence on plant-based eating, Lynne and Janice conducted a Medline search
looking for all references to “plant-based”. They found this is a relatively modern term, so
supplemented the search with other related terms, such as vegetarian and “Mediterranean Diet”.
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They drew on systematic reviews and observational data and found a total of over 900 references.
They sought to extract all the information from the appropriate references and to summarise it in
the book.
A plant-based diet is based on fruit and vegetables; nuts and seeds; pulses including soya and
wholegrains; but the book is not suggesting that people should exclude meat completely, just that it
should be a smaller part of our diets. There is a spectrum of plant-based eating (see slide 7) from
vegans to plant-based meat eaters and people do not share the same criteria for common
descriptions so, for example, some vegans eat dairy products and some pescetarians eat small
amounts of meat.
The current UK diet fails to meet the targets for saturated fat, fibre, fruit and vegetables set in
national guidelines. The UK does not have a target for wholegrains, but the USA does and we are
eating less than a third of the amount of wholegrains recommended in the USA.
The Oxford arm of the EPIC study is very useful because it compares meat eaters with vegans,
vegetarians and fish eaters. It shows that anyone not eating meat tends to eat fewer calories, less
fat and less saturated fat, but more polyunsaturated fatty acids (PUFAs) and more fibre - nonstarch polysaccharides (PSG) - than meat eaters (see slide 9).
Some research by the MRC Human Nutrition Research Unit (see slide 10) shows that wholegrain
consumers, representative of higher fibre consumers, eat more fruit and vegetables and less
saturated fat. It also shows that there are fewer people in this group failing to meet national targets
for certain important micronutrients, including iron, calcium, zinc, riboflavin and vitamin A.
If we look at a plant-based diet against key nutritional and dietary recommendations (see slide 11)
we can see that it does meet all the UK recommendations for intake of fat, saturated fat, fibre, fruit
and vegetables as well as the USA recommendation for wholegrains.
If we look at where saturated fat in our diet comes from, we can see that it is largely – over 50% derived from meat and meat products and milk and milk products (see slide 13).
The three major health issues facing the UK and European populations are cardiovascular disease
(CVD), obesity and diabetes.
A plant-based diet is associated with a reduction in overall cholesterol level of 8-10% and a
reduction in LDL cholesterol level of 9-15% (see slides 15 & 16). For example, a long-term
"portfolio-diet" study conducted by Professor Jenkins (see slide 16) shows a diet rich in soya
protein, viscous fibres, tree nuts and plant sterols is associated with a 13% reduction in LDL
cholesterol levels. Typically the observational studies show a reduction of about 20% in CHD if
they involve people who are vegans, vegetarians or eating a Mediterranean diet. It is a trend in the
right direction and the overall evidence from clinical studies, portfolio diet studies and observational
studies supports the conclusion that plant-based eating tends to promote heart health.
With respect to overweight and obesity, a recent large meta-analysis shows that adults and
children have a lower body weight if they are on a vegetarian diet. It also indicates that
vegetarians tend to put on less weight over time (see slide 17). More epidemiological evidence
from four studies (see slide 18) shows that vegetarians gain less weight over time. A WHO report
has identified the key causes of obesity as reduced physical activity and increased consumption of
energy-dense foods high in saturated fats and sugars. It found that plant-based eating is
associated with lower body weight and less weight gain over time; and that plant-based foods and
eating patterns are typically low in saturated fat and high in unsaturated fats and fibre, which is
important for control of body weight. It suggests that specific components found intrinsically in
plant foods may work together to help with appetite regulation and promoting satiety, but more
research is needed before definitive conclusions can be drawn about this. WHO guidelines
recommend increasing fruit and vegetable consumption and focussing on whole grain foods to
manage weight.
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Diabetes is linked to obesity and heart disease and often associated with them. Most of the
evidence Janice and Lynne found in this area was based on observational data. A systematic
review of 12 cohort studies (see slide 20) found that the risk of developing diabetes was 17%
higher when comparing high and low meat intake. For each 120g increase in red meat intake the
risk of developing diabetes was 20% higher
Some people are concerned that a plant-based diet will not provide enough calcium to sustain
healthy bones. There are two meta-analyses that considered the evidence in this area (see slide
21). The most recent cites evidence from 9 observational studies. It found that overall bone
density at lumbar spine was 2% lower in lacto-ovovegetarians than omnivores; 4% lower in
vegetarians and 6% lower in vegans; although the bone marrow density at femoral neck was
similar in vegetarians and omnivores. The authors concluded that these differences were not
clinically significant and Dr Lanham-New, who reviewed this analysis, confirmed that vegetarianism
is not a serious risk factor for osteoporotic fracture. Dr Lanham-New also pointed out that the
analysis made no adjustment for body weight which was a significant design weakness.
There is evidence to show that plant-based eating supports bone growth throughout life provided a
wide variety of plant foods is eaten. Some plant-based foods, such as soya, may contain phytochemicals that can support bone density, but more research in this area is needed. Meanwhile it
may be sensible, where possible, to choose plant foods fortified with calcium.
Various international bodies, including the WHO, WRCF and the American Dietetic Association
have recommended plant-based eating (see slide 23). One report1 concluded that “the totality of
evidence documenting a beneficial impact of plant-based dietary patterns on CVD risk is
remarkable and worthy of recommendation.”
Janice and Lynne believe that with plant-based eating there is an improved likelihood of achieving
nutritional targets and this does not require people to give up meat completely, but to put plant
foods first. A conservative approach would be to reshape the eatwell plate so that plant-based
foods make up two-thirds of the plate and animal foods make up one-third. A more ambitious
approach would be to aim for an 80:20 split. A plant-based diet is achievable and 20-25% more
affordable.
Questions
Jenny Wilson said she is a vegetarian and finds that fruit is very expensive. She asked if the diets
being recommended included processed foods, which are cheaper but have a greater
environmental impact. Janice Harland said that their research indicated that the typical cost per
day of a diet which includes meat is £3.96, but when meat and meat products are replaced by plant
foods the cost is £3.49. They did include processed foods and they did not purchase organic
products because they were trying to demonstrate that a plant-based diet could simply include a
slightly different combination of conventional foods. The vast majority of wholegrains we consume
are derived from bread and breakfast cereals, both of which are processed foods. Mark Driscoll
said the WWF research had also found a small reduction in cost for a plant-based diet based on
convention, not organic, products. WWF may encourage people to eat more seasonal temperate
fruit and vegetables, but if the UK strives for self-sufficiency in food it will affect developing
countries that depend on food exports and local food products do not always have the lowest
carbon or environmental footprint.
Alex Jackson of Sustain said he fully supports a plant-based diet approach and believes the
public sector in the UK should buy less meat for environmental and health reasons. He suggested
many health organisations avoid this issue when it should be tackled head on and he asked the
speakers if they would support a more direct approach. Mark Driscoll agreed that the
environmental movement should recommend people, particularly in the developed world, eat more
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The Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans 2010
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plants. Yes, it means reducing meat consumption and the meat we do eat is ‘better and that
producers are rewarded in terms of environmental improvements by being paid a fair price at the
farm gate. In some parts of Europe the debate is quite polarised between producers and the
environmental movement. We need to understand some of the barriers and challenges confronted
by producers so we do not export environmental costs overseas. The issues are quite complex.
Some producers would like to make environmental improvements but are constrained by upper
limits on price imposed by retailers; and the role of the new Groceries Code Adjudicator will be
very important in the future. WWF also wants to promote positive messages and encouraging
people to eat more plant foods is positive. Mark agreed that public procurement can be a powerful
tool in securing change. Janice Harland agreed that it is important to promote positive messages
because consumers respond better to them. Traditionally in the UK we have talked about “meat
and two veg”. She would like people to think about meat as an accessory to plant-based food.
This approach builds on Government encouragement to eat 5-a-Day and might lead to future
quantitative recommendations for other plant foods.
Professor Tom Sanders of King’s College London said he has some concerns about the more
extreme plant-based diets, especially about the risk of inadequate B12 intake. His research on the
EPIC survey found that about 20% of vegans presented with nutritional deficiencies. Calcium
deficiency is another risk and calcium deficiency is an important factor associated with various
diseases, including cancers, as well as bone density. Vegetarians are not normally anaemic but
he and his colleagues observed that vegans are smaller in stature. Being tall as an adult is an
advantage for cardiovascular health, though it may be a risk factor for some cancers. He also
observed that in England we do have a lot of rain and grass and that does favour ruminants;
chicken and pigs are possibly less sustainable. He suggested that if you look at the sustainability
agenda of individual countries it does not necessarily match health recommendations. Janice
Harland agreed with Professor Sanders and emphasised that she is not recommending an
extreme or vegan diet, just that people reduce the amount of meat in their diet.
Louise Maxwell Symington of the British Dietetic Association asked the speakers if they thought
we should now have more tangible guidelines for the size and frequency of portions. Mark
Driscoll said that WWF had published the Livewell Plate to stimulate the debate and encourage
the Government to publish recommendations for our health and global health. WWF only looked at
GHG emissions and there are other criteria that should be taken into account such as water
scarcity. WWF believes the Government should integrate broader climate change criteria with its
healthy eating guidelines. Mark acknowledged that countries differ in their dietary advice, but it is
encouraging that other countries, including many in Europe, are looking at these issues.
Professor David Jenkins of Toronto University commended the Forum’s discussion of these
issues, but expressed scepticism about whether many people would be willing to eat much less
meat and adopt a plant-based diet. He is also aware of data that suggests that too much food
fortification may have adverse effects. He congratulated the speakers, nonetheless on the route
they set out for health and environmental reasons. Professor Tom Sanders suggested that if
people do move to a plant-based diet they may need to eat more fortified foods and many people
on plant-based diets do not like eating fortified foods. Mark Driscoll said WWF does not have
nutritional expertise, which is why they worked with the Rowett Institute on the Livewell Plate, but
he thought there may be a role for food reformulation. The danger is consumers may feel “short
changed” if they find there is less meat in the meat products they buy.
Patricia Mucavele of the School Food Trust referred to the Trust’s work on standards for school
food and children’s diets. She said they had succeeded in reducing the amount of salt in school
food and increasing the amount of fibre, but ensuring children have adequate iron intakes is still a
challenge. She pointed out that bread is a huge contributor to the amount of salt in children’s diets,
so it is necessary to balance foods carefully and ensure children eat other sources of fibre, such as
wholewheat pasta, as well. She suggested that most children are not interested in healthy eating
messages but they are interested in sustainability, so it would be helpful if sustainability messages
were used to encourage children to eat a healthier diet. She thought school children would respond
better to messages about sustainability than an exhortation to eat more plant foods.
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Dr Jenny Lisle of the Royal Colleges of Physicians Faculty of Public Health suggested it may be
time for a public health campaign on changing diets. The Forum’s Behaviour Change conference
had illustrated how difficult it can be to achieve successful change using only “nudges” and she
asked what the speakers would suggest. Janice Harland suggested that practical advice about
making small changes would be most helpful, for example, encouraging parents to use more
vegetables and less meat in dishes such as Shepherds Pie and encouraging them to try vegetable
rather than meat sauces on pasta. Similarly using a variety of vegetables to bulk out meals is
more attractive than always relying on potatoes and lentils. Janice suggested it helps people to
have specific examples and they should be encouraged to plan their food shopping so they include
more plant foods. She agreed with Mark that there is an opportunity for food producers to use
more plant foods in their food products. Lynne Garton said that during her research she had
looked at evidence on behaviour change. Two Australian studies had looked at the barriers to
persuading people to eat more plant foods. It found cost and a lack of information were two
important issues, but people were also concerned that they would lack protein and about the side
effects of eating too much fibre. We need to understand the obstacles to change and address
them if we want to change behaviour. The studies found that over 60% of participants were
interested to learn more about a plant-based diet it if did not involve giving up meat completely.
Mark Driscoll said that governments and civil society could do more to bring about behaviour
change. Nudge is a slow means of bringing about change and given the environmental costs and
obesity crisis we have now, more financial incentives and disincentives may be needed. A huge
amount of effort has gone into the 5-a-Day campaign but it has not achieved that target,
particularly among low income families. If we look at decision-making on food choices it depends
on cost, then quality, then health. We could use financial incentives at the producer level, as well
as with consumers. Denmark has imposed a “fat tax” and we should be exploring a range of fiscal
incentives, rewarding environmental improvements whilst penalising those that do not step up to
the mark in terms of sustainability
Conclusion
Baroness Miller thanked the guest speakers for their presentations and announced the date of the
next FHF meeting, which will take place on Tuesday 15 November when we will be discussing
children’s food, focussing on growing and cooking food in schools to encourage healthy eating.
Our speakers will be Joe Harvey of the Food for Life Partnership, Sara Jayne Stanes of the
Academy of Culinary Arts and Dr Michael Nelson of the School Food Trust.
CLC, October 2011
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