In the second paper in The Lancet Series on Chronic Disease and Development, experts show that in the UK everyone eating a healthy diet would deliver big health effects with minimal knock-on effects to domestic agriculture and trade. But in a middle-income country like Brazil, it's a different story. There, healthier eating (both in Brazil or the UK) could have a major impact on agriculture, trade, and, by definition, jobs. The second paper is by Professor Richard Smith, London School of Hygiene and Tropical Medicine, UK, and colleagues. The paper is the first to examine the health and economic knock-on effects of healthy eating together in this manner.
Transition to diets that are high in saturated fat and sugar has caused a global public health concern, as the pattern of food consumption is a major modifiable risk factor for chronic non-communicable diseases. For example, cardiovascular disease is the world's leading cause of death, and although the number of deaths from such disease is highest in high-income
countries, it is rapidly becoming a major health burden in middle-income countries. But unlike many risk factors for other diseases, changing dietary habits to target chronic disease can have a major impact on the wider economy of the country concerned, and other countries who produce and export diet-related products, thus causing disruption to vested interests, while also having variable impacts on health. Yet although agri-food systems are intimately associated with this transition towards western diets, agriculture and health sectors are largely disconnected in their priorities, policy, and analysis, with neither side considering the complex inter-relation between agri-trade, patterns of food consumption, health, and development.
Improvements to diets will necessitate changes in agricultural production and trade worldwide, resulting in various winners and losers between sectors of the economy, rural and urban communities, and regions and countries.
Adherence to WHO dietary recommendations in Organisation for Economic Co-operation and Development (OECD) countries would mean a substantial decrease in the consumption of vegetable oils (by 30%), dairy products (by 28%), animal fats (by 30%), meat (eg, pork by 13•5% or mutton and goat by 14•5%), and sugar (by 24%), and a substantial increase in the consumption of cereals (by 31%), fruits (by 25%), and vegetables (by 21%). The UK government has estimated that, if diets matched nutritional guidelines, 70 000 premature deaths could be prevented each year, with a saving to the health service of £20 billion every year.
The authors estimated that, to meet WHO healthy eating guidelines of no more than 10% of dietary energy as saturated fat, adults in the UK would need to reduce dietary saturated fat consumption by 22%, and adults in São Paulo by 7%. These figures equate to reductions of 7% in disability-adjusted life years and 3270 (3%) premature deaths averted in 1 year in the UK, and reductions of 3% of disability-adjusted life years and 2800 (2%) premature deaths averted in 1 year in Brazil.
But reductions similar to those required above by the UK, if translated across the EU, could have a massive impact on major meat exporters such as Brazil and China, damaging their economies and causing widespread job losses. The world economy would have to adjust to less meat and dairy produce. However, the authors point out that the jobs lost in the meat industry could be at least partly replaced by jobs elsewhere in agriculture, as other sectors such as cereal and fruit production increase to make up the calories lost from the diet through meat.
The authors say: "The benefits of such a healthy diet policy will vary between populations, not only because of population dietary intake but also because of agricultural production, trade, and economic factors... Knowledge of the effects of dietary change on both national health and wealth, and of winners and losers from policy change, are essential to secure a sustainable food policy to maximise health benefits and minimise potential risks."
They add: "Our analysis suggests that the UK would acrue substantial health benefits and associated low costs from adoption of a diet low in saturated fat from animal sources. Conversely, Brazil would experience little health benefit but far more striking economic costs from such a policy."
They conclude: "Public health policy makers need to judge whether present agriculture and trade are contributing to—or detracting from— efforts to attain dietary goals, and how agricultural policy interventions could help achieve dietary goals."
Professor Richard Smith, London School of Hygiene and Tropical Medicine, UK. T) +44 (0) 20 7927 2403 E) richard.smith@lshtm.ac.uk
For full Series paper 2, see: http://press.thelancet.com/cdd2.pdf
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