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10 Oct 2022
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4 min read
Benefits for planet health

Re-formulating processed food: a fresh approach to achieving sustainable healthy diets

Nutrient density processed food sustainable diet
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Food processing and food formulation can play a major role in achieving sustainable healthy diets for people around the world, say scientists(1).

Their research suggests it’s time to re-think the way we view processed foods. Indeed, processed foods can be tailored to contribute to sustainable living, helping to make our food healthier, safer, more affordable, more convenient – and even helping to preserve the planet.

While eating fresh unprocessed foods is essential for good health, the scientists say re-formulating processed foods to reduce unhealthy ingredients, with fortification to increase healthy nutrient content, can also help to improve diet quality and food security for all.

For example, preserving foods through processing ensures food safety and prolongs their shelf life – so we throw away less food because it has gone off and we can choose a variety of foods, including locally-grown produce even when they’re out of season.

Boosting the nutrient balance of processed foods

Re-formulating processed foods holds the key to a host of benefits. Recent advances in food technology have focused on reducing the amount of added fat, sugar and salt in processed foods.

Meanwhile, the food industry has been improving the nutrient density of processed foods with the addition of protein, fibre and micronutrients. Adding whole grains, fruit, nuts, seeds and other desirable ingredients such as fermentation products is also enhancing the quality of processed foods.

It’s a matter of taste, not just nutritional value

When it comes to our food shopping, taste, cost and convenience tend to matter more than nutrient content. Consumers aren’t so keen on an altered product that is heathier but tastes worse and costs more. So alongside the technical challenges of re-formulation food technology, scientists and the food industry need to consider preserving the sensory qualities of the product, while keeping prices down, managing their environmental footprint, and assuring product safety.

Meeting the nutritional needs of a global population

Challenges aside, re-formulation to improve the nutritional quality of processed foods can play a major part in delivering sustainable healthy diets to the global population.

For a diet to be sustainable, it should be healthy, affordable, adapted to regional and local food habits, and consistent with planetary boundaries, according to the guiding principles outlined by the UN’s Food and Agriculture Organization and the World Health Organization. (2)

Through fortification, processed foods can help to minimise disparities in access to food, provide affordable nutrient density worldwide and maintain a stable food supply that is robust enough to withstand emergencies and disasters.

By working together, public health agencies, the food industry, and consumers may improve the quality and acceptability of processed foods in the future, say the researchers.

‘…fortified processed foods provide affordable nutrient density, help minimize disparities in access to food, and ensure nutrition security for all.’ – Drewnowski A, et al. 2022

Food processing and food (re)formulation: what’s the difference?

Food processing and food (re)formulation are distinct concepts.

  • The role of food processing is to transform perishable agricultural products into foods and drinks that people consume (for example through pasteurization, fermentation, smoking process…). Food processing contributes to the stability of the food supply.
  • Food reformulation has become associated with improving the nutrient quality of processed foods and enriching fortification with nutrients, vitamins and minerals to support affordable nutrient density.

 Find out more: read the original article.

Source: (1) Drewnowski A, Detzel P, Klassen-Wigger P. Perspective: Achieving Sustainable Healthy Diets Through Formulation and Processing of Foods. Curr Dev Nutr. 2022 Apr 30;6(6):nzac089. doi: 10.1093/cdn/nzac089.
Additionnal references:
(2). FAO, WHO. Sustainable healthy diets: guiding principles. 2019.
(3). Kennedy ET, Buttriss JL, Bureau-Franz I, Klassen Wigger P, Drewnowski A. Future of food: innovating towards sustainable healthy diets. Nutr Bull. 2021;46(3):260–3.
(4). Gressier M, Sassi F, Frost G. Healthy foods and healthy diets. How government policies can steer food reformulation. Nutrients. 2020;12:1992.
(5). Reardon T, Tschirley D, Liverpool-Tasie SLO, Awokuse T, Fanzo F, Minten B, et al. The processed food revolution in African food systems and the double burden of malnutrition. Glob Food Sec. 2021;28:100466.
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03 Oct 2022
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7 min read
Benefits for planet health

Can dairy be part of sustainable diets?

dairy sustainable food sustainable healthy diet
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In many food-based dietary guidelines (FBDGs), dairy products are considered as a standalone food group, in particular because of the high calcium intake they provide in the diet [1]. However, with environmental stakes and a demand in milk and dairy products expected to rise by 2050 owe to population growth, dairy foods must respect certain dimensions in the context of their production, distribution and consumption to be deemed sustainable.

Some contextual elements

Many food products may be gathered under the “dairy” denomination. The FAO Codex Alimentarius defines a dairy product as a “product obtained by any processing of milk, which may contain food additives and other ingredients functionally necessary for the processing” [2]. Dairy products encompass hundreds of foods ranging from milk with different skimming levels, to yogurt with added probiotic strains, to the endless list of cheese options. What’s more, dairy products can be derived from a variety of animal milks [3].

To analyze if dairy products can be sustainable foods, it is necessary first to remind the four dimensions defining a sustainable healthy diet. Sustainable food products result from sustainable food production systems and part of healthy and sustainable diets, defined by four dimensions [4]:

  • with safe nutritionally-dense foods
  • culturally acceptable
  • accessible, affordable and equitable
  • must have a low impact on environment, preserve biodiversity and natural resources, and ideally be produced and consumed locally [5].

Thus, a dairy product can only be called sustainable if it respects these four pillars.

Dairy are nutrient-dense foods with health benefits

Dairy products are known as a rich source of health-promoting nutrients, notably high-quality proteins and calcium, and described as nutrient dense-products. Experts describe nutrient density as a measure of the positive nutrients brought per calorie of food.

With a composition including essential vitamins (A, B2, B3, B5, B12, …) and minerals (phosphorus, calcium, zinc…), dairy contribute to key nutrient intakes. Some dairy foods also provide emerging nutrients of interest (for instance lactoferrin, probiotics, milk-fat globule membrane) [1].

Fermented dairy products, such as yogurt or kefir, can provide health positive outcomes beyond their essential nutrient content. They have been shown to be among the most effective dietary carriers of probiotics and have been credited with protecting various aspects of gut health and overall immune function [6-9].

 “Nutrient-dense foods such as milk and dairy foods provide high-quality nutrition at all life stages and are part of healthy diets. They are a good source of under-consumed nutrients, particularly for children and older adults.”- 2021 IDF Dairy Outlook for the United Nations Summit [10]

In addition, because of their high water and ion content, milk and milk products can be good sources of hydration. In countries where sanitation problems limit access to safe drinking water, an intake of dairy products can play an essential role in ensuring good health [1].

In a whole, these nutritional properties make dairy products a dietary asset in every part of the world.

Dairy products are accessible and central to many cultures around the world

Dairy products are staple foods in many cultures around the world. The affordability of milk and dairy products enables a variety of uses and incorporation into various dietary patterns and food traditions in different countries. [10]

According to the FAO, dairy industry development is “a sustainable, equitable and powerful tool for achieving economic growth, food security and poverty reduction” [11]. Actually, dairy not only provides people with nutrient-dense foods, but also [11]:

  • provides a regular source of income for breeders as milk is produced on a daily basis
  • generates on- and off-farm employment;
  • creates opportunities for women in low- and middle-income countries. In rural communities, women often participate in milk production, especially milking and feeding. They can be involved in the whole dairy chain: collection, processing and marketing. In a household, the woman usually uses the milk money to buy necessity items (clothing and food), as well as to pay for basic health care and children’s education.

Dairy products’ environmental impact has to be improved

Considering the great global demand and a production naturally linked to the livestock (whether cows, goats or sheep), the dairy industry accounts for a significant portion of greenhouse gas emissions (GHGEs) from the whole food system [3]. According to the FAO, the global dairy sector contributes to 4% of the global GHGEs [12].

In details, a recent study [1] concludes that the agricultural GHGEs come from constantly recycled carbon that is already in the atmosphere. These GHGEs contribute much less to global warming than ones from the burning of fossil fuels (where ‘new’ carbon initially buried underground is released into the atmosphere). However, within the agricultural GHGEs, there are differences. Compared to livestock (especially beef), which is considered the biggest agricultural contributor to GHGEs [4,18], dairy foods have a smaller carbon footprint. And within dairy categories, yogurt have lower carbon footprint than cheese [19].

A study led by the Commonwealth Scientific and Industrial Research Organization [13] add that a healthy balanced diet could include dairy products (such as milk and yogurt) to reach lower GHGEs compared to other less healthy options.

Yet, milk and dairy food industry remain high on the 2030 agenda of sustainable food systems mutations to achieve the Sustainable Development Goals [10].

Yogurt: a model of sustainable dairy product?

Daily consumption of yogurt is described as an effective way of meeting nutritional requirements, while combining a balanced calorie intake [14,15]. Yogurt brings through a low calory density formula numerous positive nutrients such as protein, calcium, zinc, potassium, as well as vitamins (Vit. B) and live ferments [15,16,17].

Within a balanced diet, yogurt is one of the most common and accessible products. It can be easily found in small, medium and large stores, and fermented dairy products, as well as yogurt, are already part of several traditional diets around the world: Greek yogurt, skyr, labneh and many more. Eventually, it stands amongst of the lowest cost sources of calcium and a very affordable high quality protein source [12].

For more information:

  1. Dairy matrix: it’s not just about nutrients
  2. Yogurt, a nutrient-dense food within the dairy food group
  3. Experts call for dietary guidelines to reflect the role of dairy foods in protecting us and the planet
  4. What is a sustainable diet?
References:
[1] Comerford KB, et al. Global Review of Dairy Recommendations in Food-Based Dietary Guidelines. Front Nutr. 2021 May 25;8:671999.
[2] FAO, milk and milk products
[3] Gaillac, R., & Marbach, S. (2021). The carbon footprint of meat and dairy proteins: a practical perspective to guide low carbon footprint dietary choices. Journal of Cleaner Production, 321, 128766.
[4] Food and Agriculture Organization of the United Nations; World Health Organization. (2019) Sustainable Healthy Diets, Guiding Principles.
[5] Burlingame B, Dernini S. Sustainable diets and biodiversity: Directions and solutions for policy, research and action. Food and Agriculture Organization. 2010.
[6] Nadelman, P., et al. (2018). Are dairy products containing probiotics beneficial for oral health? A systematic review and meta-analysis. Clinical oral investigations, 22(8), 2763-2785..
[7] Shiby, V. K., & Mishra, H. N. (2013). Fermented milks and milk products as functional foods—A review. Critical reviews in food science and nutrition, 53(5), 482-496.
[8] Zhai, Z., et al (2019). Synergy between probiotic Lactobacillus casei and milk to maintain barrier integrity of intestinal epithelial cells. Journal of agricultural and food chemistry, 67(7), 1955-1962.
[9] La Fata, G., Weber, P., & Mohajeri, M. H. (2018). Probiotics and the gut immune system: indirect regulation. Probiotics and antimicrobial proteins, 10(1), 11-21.
[10] International Dairy Federation. Dairy Sustainability outlook, Special edition United Nations Food systems Summit 2021. Issue n°4. July 2021.
[11] FAO, Dairy development
[12] FAO, 2010, Greenhouse Gas Emissions from the Dairy Sector: A life Cycle Assessment, p.13.
[13] Ridoutt BG, Baird D, Hendrie GA. The role of dairy foods in lower greenhouse gas emission and higher diet quality dietary patterns. Eur J Nutr. 2021 Feb;60(1):275-285.
[14] Keast DR, et al. Associations between yogurt, dairy, calcium, and vitamin D intake and obesity among U.S. children aged 8-18 years: NHANES, 2005-2008. Nutrients. 2015;7(3):1577-93.
[15] Hess J, Rao G, Slavin J. The Nutrient Density of Snacks: A Comparison of Nutrient Profiles of Popular Snack Foods Using the Nutrient-Rich Foods Index. Glob Pediatr Health. 2017 Mar 30;4:2333794X17698525.
[16] Rolls B., The Ultimate Volumetrics Diet, William Morrow, 2012.
[17] Smethers A. & Rolls B., Dietary management of obesity: cornerstones of healthy eating patterns, Med Clin N Am, 2018, 102 : 107-124
[18] van Hooijdonk T, Hettinga K, Dairy in a sustainable diet: a question of balance, Nutrition Reviews, 2015; 73 (1): 48–54
[19] Drewnowski A, Rehm CD, Martin A, et al. Energy and nutrient density of foods in relation to their carbon footprint. Am J Clin Nutr 2015;101:184–91.
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26 Sep 2022
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5 min read
Benefits for human health Children

Children’s diets in a changing world: families and schools are best-placed to guide healthy sustainable eating

children's diet nurturing sustainable diet sustainable healthy diets
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What’s the best gift you could give a child? Some would argue it’s the promise of a long and healthy life on a planet that’s also healthy and robust.

The best way to achieve this, scientists say, is for parents and schools to put kids on track for healthy eating practices from an early age to protect them from obesity and its associated risks throughout their lives (1). And the good news is that it doesn’t have to cost the Earth.

Early years offer a great chance to shape healthy sustainable eating

Dietary choices in childhood not only are sustained into adulthood but also have a long-lasting effect on future health. Children who struggle from weight issues may keep struggling into adulthood and are at risk of suffering illnesses such as diabetes and heart disease. That is why establishing healthy nutrition and lifestyles right from early childhood may be key in obesity prevention at individual and population level. It could also support sustainability in the economy and environment.

Family and school are the main childhood influencers

Parents, but also guardians and caregivers, including nurseries and day-care services, have the earliest influence in encouraging children to adopt life-long healthy eating habits. They do this through the foods they offer to the child – both in terms of quality and quantity, and in the variety of choices (2).

Children love what they know, and introducing a wide variety of foods and flavours in the first 3 years of life is the perfect time to let the child explore and get used to different tastes.

Once kids reach school age, they’re likely to eat one main meal a day there, and so school-run intervention and education programmes to optimise diets have great potential for raising children’s awareness of health and nutrition and empowering them to make informed and healthy food choices.

‘Family, school, and community are the crucial environments where educational interventions can be instituted.‘ – Mazzocchi A, et al. 2022.

Health of the planet: a major factor for menu choices

Nowadays, the planning of school meals should take into account not only meeting the nutritional needs of children according to age but also the environmental impact of its components. Scientists recommend a switch to flexitarian diets, plant-based diets with some animal sourced products, starting in early life and ensuring the diet contains all the nutrients required.

Sustainability practices that may be adopted in schools include establishing school vegetable gardens, buying local foods, and reducing food waste through recycling and composting. These measures can involve the children’s participation throughout and, with education programmes, can help them learn about the impact of their dietary choices.

It’s not just taste that matters

For a successful strategy, meals need to be more than just tasty – they must also be acceptable for the children’s cultures and religions while being affordable for the providers.

Studies show that it is possible to design nutritional diets that are both affordable and environmentally sustainable. One modelling study in Spain used combinations of 20 starters, 20 main dishes, and 7 desserts, to carry out a 20-day planning period with the aim of meeting nutrient requirements and reducing both the carbon footprint and the lunch budget. The study found that optimised school menus could shrink the carbon footprint by 13-24% and cut the costs by 10-15% while maintaining adequate nutritional content (3).

An intervention study in Sweden looked at the effects of a 4-week lunch menu that was optimised for greenhouse gas emissions, nutritional adequacy and affordability. The optimised strategy resulted in a food list that had 40% less greenhouse gas emissions and was 11% cheaper than the original menu, while meeting all the nutrient recommendations for school meals (4).

‘School meals, in line with dietary recommendations, represent a way to transmit food routines, contributing significantly to overall eating behaviours.’ – Mazzocchi A, et al. 2022.

Childhood obesity: a growing global concern

Childhood overweight and obesity are a growing public health crisis worldwide (5):

  • By 2020, globally 39 million children under 5 years of age were overweight or obese. On top of that, the COVID-19 pandemic has led to economic, food, education and health systems disruptions that are likely to have added to the problems of malnutrition (under and over) globally. Consumption of comfort food (high in fat, sugar and salt) increased during the pandemic and the more sedentary lifestyle may have contributed to the rise in obesity.
  • Healthy dietary patterns established by the age of 3 years tend to be maintained throughout childhood. These early years are particularly important because during adolescence, other factors may influence dietary choices, such as food marketing, peer pressure and body image perception. Adopting a healthy diet from childhood and maintaining it into adolescence are key to a healthy dietary pattern in adulthood, supporting health throughout life
Find out more: read the original article.
Source: (1) Mazzocchi A, De Cosmi V, Milani GP, Agostoni C. Health and sustainable nutritional choices from childhood: dietary pattern and social models. Ann Nutr Metab. 2022;78 Suppl 2:21-27. 
Additional references:
(2).Haines J, Haycraft E. et al., Nurturing Children’s healthy eating: Position statement, Appetite, 2019, S0195-6663(18)31341-2
(3).Ribal J, Fenollosa ML, García-Segovia P, et al. Designing healthy, climate friendly and affordable school lunches. Int J Life Cycle Assess. 2016;21(5):631–45.
(4). Eustachio Colombo P, Patterson E, Lindroos AK, et al. Sustainable and acceptable school meals through optimization analysis: an intervention study. Nutr J. 2020 Jun 24;19(1):61.
(5). WHO. Obesity and overweight. 2021 (accessed August 2022).
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12 Sep 2022
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8 min read
Benefits for planet health

What are sustainable food systems?

food system sustainable diet
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Feeding tomorrow’s world with ever-growing population has already become a global challenge. According to the UN nations’ predictions, we will be 9.5 billion in 2050 [1]. According to the FAO, global agri-food systems produced 11 billion ton of food in 2021, but yet, about 10% of the world population still suffer from hunger and malnutrition [2,3]. Thus, adopting a policy of transition to a more sustainable food production system means building resilient agri-food systems.

What is a food system?

A food system is a complex entity. Taken as a whole, food systems encompass primary production but also food supply chains ending with distribution to retail outlets or consumers [2]. A food system represents all the elements, activities and actors involved in production, processing, preparation, distribution, and eventually consumption of food [3]. It also includes all the inputs needed and the outputs generated at each link of the chain.

The actors in the food system are very diverse:

  • primary producers who provide inputs
  • post-harvest, storage, food processing and transportation services
  • distributors, wholesalers and retailers of food products
  • and finally, households and individuals, as final consumers.

A food system also includes more abstract but equally essential dimensions: food choices and cultures. The values, beliefs and social norms around food, carried by consumers around the world, play an important role in shaping what people eat and what they demand from food, and therefore directs the functioning of the food system [4].

The current global food systems are not sustainable

Many institutions agree to say that our current food production system is unsustainable and must be reoriented towards resilient, quality production that preserves the resources of the planet. Food production accounts for 30% of global greenhouse gas (GHG) emissions, 70% of water use and a huge loss of marine and continental biodiversity [2].

“Global food production threatens climate stability and ecosystem resilience. […] A radical transformation of the global food system is urgently needed. Without action, the world risks failing to meet the UN Sustainable Development Goals and the Paris Agreement.” – Prof. Johan Rockström, for the Summary Report of the EAT-Lancet Commission, 2019

Our global food system is indeed focused on quantity and productivity, but not enough on quality. Thus, the latter need to be repositioned “from feeding people to nourishing people well” [4]. Feeding the world’s growing population, expected to count nearly 10 billion people in 2050, will require widespread changes in the way we produce our food, especially in the face of mounting pressure from climate change. Yet, these mutations in food production must also encompass the aim of reaching global nutritional and health needs for the population. 

Sustainability in food production: a story of resiliency

A transition towards more sustainable food systems underpin an essential environmental dimension. Water and soil resources are extremely strained by agriculture and livestock production, which are sources of GHG emissions all around the globe. A sustainable food system is based on the four dimensions that define sustainability in the FAO and WHO reports [2,3,5]:

  • provide safe and nutritionally-dense foods that are included in a balanced healthy diet, in order to lessen the malnutrition burden worldwide
  • be culturally acceptable by the populations
  • be inclusive and ethical
  • have a low impact on environment and preserve biodiversity and natural resources, ideally produced and consumed locally [5].

In a report published in 2019 [6], EAT-Lancet considers some key aspects we need to aim to change our food system into an eco-friendly production:

  • use no more land than it does currently
  • safeguard existing biodiversity
  • reduce water use and manage water responsibly
  • substantially reduce nitrogen and phosphorus pollution (coming from fertilizer use)
  • produce zero carbon dioxide emissions
  • cause no further increase in methane and nitrous oxide emissions.

While the environmental aspect seems to be among the most urgent, becoming more resilient and sustainable involves being able to deal with crises and challenges at many scales, like conflicts or humanitarian crisis. Thus, sustainable food systems must be able to cope with risks and uncertainty, such as the onset of the COVID-19 Coronavirus outbreak in 2020. FAO focuses its agenda on these resilience objectives, which it defines as “the capacity over time, in the face of any disruption, to sustainably ensure availability of and access to sufficient, safe and nutritious food for all, and sustain the livelihoods of agrifood systems’ actors”.

Hence, key actions led by government and public policies to change the food system would be associated with addressing the malnutrition burden [2,3]. A sustainable food production must indeed provide individuals with nutrients they need to protect and improve their health to avoid the onset of diseases. To be successful over the long term, sustainable diets need to be adapted to local food habits and cultures, and should also be a source of pleasure, warmth, and sharing.

Foster short circuit production systems and reduce food waste and loss

Relying on local production for staple foods may be one of the best solutions to ensure food security. Food chains have indeed become longer over the last decades, always moving the final consumer further away from the initial producer [4]. The journey of food from the farm to the table consumes energy. This energy consumption is not limited to agricultural production, but is related to transportation, processing, packaging, distribution, retailing, and preparation… All of these elements of the food system produce greenhouse gases that contribute to climate change. Thus, switching to local and seasonal consumption is a first step to consuming more sustainably.

On the other hand, nearly one-third of food produced in the world currently goes to waste. In the European Union countries, this represents an average of 173kg of wasted food per capita and year [7]. Food waste is a widespread phenomenon, occurring at many levels in the food chain production [8]:

  • During harvesting
  • In the processing of the agri-food industry
  • Retailers, wholesalers and supermarkets
  • Consumers (mainly households) and food service providers (restaurants, collective catering)

To achieve more sustainable food production and distribution, EAT-Lancet recommends at least halving food losses – this will require major changes in food storage, transport, processing and packaging (especially in low-income countries), as well as informing consumers, food retailers and restaurant owners on how to reduce their food waste (especially in higher-income countries) [6].

Healthy and sustainable consumption is achieved by adopting sustainable diets

The development of sustainable food production systems is part of a global trend towards healthier and more sustainable diets. Among these, flexitarian diets but also diversified territorial diets (TDDs) allow to integrate this more sustainable diet.

The TDDs, specific to a region, include mainly seasonal and locally sourced foods and present a flexitarian model that combines a high proportion of plant-based foods, low amounts of meat but moderate intake of poultry, fish, eggs and dairy products [9].

Scientists are currently exploring the options, developing regenerative agriculture models in order to preserve and renew resources while providing reliable and safe access to healthy foods for all. The global aim is to pave the way to make informed decisions about guiding agriculture and food industries for a sustainable future.

To go further:

References:
[1] United Nations. Population Division, World Population Prospects 2019, Graphs / Profiles. [Online]
[2] FAO. 2021. In Brief to The State of Food and Agriculture 2021. Making agrifood systems more resilient to shocks and stresses. Rome, FAO.  
[3] Willett W, Rockström J, Loken B, et al. Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems. Lancet. 2019;393(10170):447-492.
[4] Einarsson, Rasmus et al. “Healthy diets and sustainable food systems.” Lancet (London, England) vol. 394,10194 (2019): 215.
[5] Burlingame B, Dernini S. Sustainable diets and biodiversity: Directions and solutions for policy, research and action. Food and Agriculture Organization. 2010.
[6] Willett W, Rockström J, Loken B, et al. EAT-Lancet Commission Summary report: Food in the anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems. Lancet. 2019;393(10170):447-492
[7] Scherhaufer S, Moates G, Hartikainen H, Waldron K, Obersteiner G.O., Environmental impacts of food waste in Europe, Waste Management (2018); 77: 98-113.
[8] Papargyropoulou E, Lozano R, Steinberger J. K, Wright N, bin Ujang Z; The food waste hierarchy as a framework for the management of food surplus and food waste; Journal of Cleaner Production, (2014); 76:106-115,
[9] Luis A Moreno, Rosan Meyer, Sharon M Donovan, Olivier Goulet, Jess Haines, Frans J Kok, Pieter van’t Veer, Perspective: Striking a Balance between Planetary and Human Health—Is There a Path Forward?, Advances in Nutrition, 2021; nmab139
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05 Sep 2022
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5 min read
Children Fermentation benefits

Probiotic yogurts may be designed to target children’s specific health issues

children fermented dairy probiotics teenagers toddlers yogurt
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The future could see the supermarket shelves stacked with ‘designer’ yogurts and probiotic fermented milk made specifically to address different childhood health issues.

And if you’re a mum or dad, you may find yourself choosing a different yogurt according to how old your child is, scientists believe.

The authors of a review of research on children’s yogurt consumption believe that intriguing possibilities may lie ahead in the use of yogurt in our daily diet to support our health and well-being, starting in childhood (1).

Yogurt is an everyday food that’s easy to get hold of and generally affordable – and most kids like it. It’s also a nutrient-dense food, packed with macro and micro-nutrients. As part of a balanced diet, it’s a great food for helping kids to reach their recommended nutrient intakes such as that of calcium. Even better, it’s a perfect vehicle for delivering potential health-promoting probiotics, say the authors.

‘Encouraging yogurt consumption, as a healthy snack or dessert may be beneficial to achieving recommended nutrients intake and healthier dietary patterns among children and adolescents.’ 

Probiotics in yogurt may vary in their health effects

Yogurt is made by fermentation of milk by two starter bacterial cultures, Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus. These live bacteria have probiotic properties, meaning they confer health benefits when consumed in sufficient amounts. Many yogurt products also contain other strains of bacteria that are added to give additional potential health benefits.

Adding specific types of probiotic bacteria to standard yogurt cultures may have different health benefits according to the strain of bacteria that has been added, the authors believe. For example, yogurt’s effects on childhood infectious diseases, gastrointestinal diseases and atopic-related disorders have been attributed to the specific probiotic strain used.

Childhood is a window of susceptibility for illness in later life

Yogurt consumption may play a role in preventing both childhood infections and long term diseases such as diabetes and heart disease, say the authors. That’s because during childhood there’s a ‘window of susceptibility’ when the risk of developing these long-term diseases may be influenced by diet. For example, children’s weight and metabolic profile strongly influence their risk of cardiovascular disease (CVD) later in life. Consuming yogurt during childhood is associated with reduced chances of obesity and CVD, although the cause of this association isn’t yet understood, say the authors.

From infancy to teenage years and on, health benefits of yogurt may differ

To find out more about the possible health effects of yogurt consumption in different age groups, they reviewed the published research carried out over the past 25 years in children up to the age of 18 years.

They found that regularly eating yogurt is associated with several health benefits for children.

Infants and toddlers

Research suggests that specific probiotic yogurt or fermented milk may be associated with:

  • Reduced diarrhoea when supplemented with additional probiotics such as Lactobacillus (Lb) casei which may modulate the immune system (2)
  • Reduced risk of common infectious diseases and urinary tract infections in pre-school children given a prebiotic dairy drink containing Lb casei or Lb rhamnosus
  • Reduce risk of atopic disease during infants’ complementary feeding stage and early childhood (3).

Childhood and adolescence

Regular yogurt consumption may be associated with:

  • A better diet quality, eating more healthy food such as fruits and vegetables, with more dietary fibre and less total fat compared with children who don’t eat yogurt
  • Reduced rate of severe diarrhoea when the yogurt is supplemented with probiotics
  • Reduced risk of obesity when eaten by school-aged children and adolescents (4).

‘Non-invasive manipulation of gut microbiota composition by yogurt and probiotics consumption during infancy could offer an interesting approach to prevent childhood obesity’ 

How does yogurt achieve its health benefits?

Research suggests that yogurt probably exerts its health benefits by modifying the gut microbiota – the community of microbes that live in our gut – which in turn may have an impact on our immune responses. Exactly how this happens in children has not been fully explored, but the authors believe that it may be possible to modulate the gut microbiota using different strains of yogurt probiotics, and so achieve specific health benefits.

More research is needed to find out the differing effects of specific strains and how they interact with children’s immune systems to achieve different health outcomes.

According to the research team, led by Prof. Sculati, Once we know the health effects of specific strains, it would make sense to add certain probiotic strains to standard yogurt to help promote kids’ health.

[Increasing yogurt consumption] ‘is a desirable goal in the paediatric age: it results in better nutritional habits that, in turn, potentially impact obesity and cardiometabolic outcomes.’ 

Find out more: read the original article.

Source: (1) Fiore G, Di Profio E, Sculati M.et al. Health effects of yogurt consumption during paediatric age: a narrative review. Int J Food Sci Nutr. 2022.
Additional references:
(2) Cazorla SI, Maldonado-Galdeano C, Weill R, De Paula J, Perdig_on GDV. 2018. Oral administration of probiotics increases paneth cells and intestinal antimicrobial activity. Front Microbiol. 9:736.
(3) Donovan SM, Rao G. 2019. Health benefits of yogurt among infants and toddlers aged 4 to 24 months: a systematic review. Nutr Rev. 77(7):478–486.
(4) Hobbs DA, Givens DI, Lovegrove JA. 2019. Yogurt consumption is associated with higher nutrient intake, diet quality and favourable metabolic profile in children: a cross-sectional analysis using data from years 1-4 of the National diet and Nutrition Survey, UK. Eur J Nutr. 58(1):409–422.
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29 Aug 2022
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5 min read
Fermentation benefits

Why we should eat more fermented foods

Fermented food Fermented milk food system sustainable diet
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The age-old process of food fermentation may hold the key to solving two of the biggest challenges facing us in our modern world, scientists say.

Not only could adopting fermentation help combat the ill-effects of our unhealthy ‘western’ diet, but it could also reduce the damage done to the environment through our food production and processing. The scientists call for a revival and promotion of food fermentation technology to help reduce these two 21st century problems for health and sustainability (1).

The challenges of today’s food systems

Today’s food systems (including diets, agriculture and food processing industries) face two major challenges, say the authors:

  • Difficulties to provide good options for health-promoting diets. That’s largely why we’re seeing a leap in the number of people around the world with obesity, type 2 diabetes, cardiovascular disease, and neurodegenerative diseases.
  • Keeping the practices within environmental limits to mitigate climate change and ensure overall ecological sustainability while ensuring productivity and profits.

They may also generate nutrient-rich waste that is under-used, the authors point out.

What is food fermentation and how can it help?

Food fermentation is the process of creating a food or changing the properties of a food using microbes. It has been used throughout human history – evidence suggests as far back as 10,000 years – to preserve foods or enhance their taste, and the health benefits, for example of certain fermented dairy foods, have long been recognised. Typical fermented foods are cheese, yogurt, wines, soy sauce, and kimchi.

In plants and dairy products, the microbes that dominate during spontaneous fermentation tend to be lactic acid bacteria (LAB). These produce bacteriocins – biological peptides that inhibit the growth of contaminating bacteria, and so preserve the food.

Fermented foods have unique health-giving properties

During fermentation, the microbes produce a wide range of metabolites that can help keep us to stay in good health. These include vitamins not found in the original food. Fermentation makes the nutrients in the food more bioavailable, retaining nutrients that otherwise may be lost during cooking.

Fermentation also enriches our gut microbiota, the trillions of microorganisms that shelter in our gut where they play a key role in maintaining human health and well-being by modulating our immune system, helping to fight infections and to protect against cancer, the authors say.

The microbes in fermented food may compete with harmful bacteria in the gut. Research also shows that fermented food boosts diversity in this microbial community, important for good health (2).

Fermentation of plants enhances the bioavailability of phytochemicals – a group of chemicals that have antioxidant, anti-inflammatory and anti-cancer activities and have been linked to various health benefits.

Fermented dairy foods have several health benefits

Research suggests that eating fermented dairy products such as yogurt and cheese has specific health benefits:

  • During fermentation, LAB breaks down the milk proteins, casein and whey, into bioactive peptides. As well as being antioxidants, these peptides help communication between the gut and the brain (3).
  • Fermented dairy are rich in a trans fatty acid that is known to help protect against obesity and to keep blood vessels healthy.
  • Vitamin B such as niacin and riboflavin, are made by various other bacteria during dairy fermentation. In cheese, vitamin K2 is associated with a reduced risk of cardiovascular disease.
  • Thanks to lactic acid produced by the LAB, many people with lactose intolerance can eat fermented dairy products without ill effect.

How do we get better value from food waste?

Waste from food processing includes rinds, seeds, pulp, wheat bran from making flour, hops, whey, and from meat processing, blood, manure, hair, feathers fat and bones.

Some of this waste ends up in landfill sites or incinerators, say the authors. But much of it could be recycled or re-used through composting of agricultural waste, fermentation for biomass production, making fertilisers, animal feed, making bio-fuels, cosmetics, and even as substrates for antibiotic production (4).

Fermentation of waste from agriculture and food processing could also generate value-added healthy foods and sustainable food sources, say the scientists.

To help grow the market for foods made this way, the scientists appeal to us all to consider the harmful environmental impact of our current food production practices and take responsibility for reducing this impact.

In the meantime, further research is needed to help develop the technology of fermentation to make our food sources more sustainable.

‘… promoting the consumption of fermented plants and dairy products can help attenuate the adverse health effects of consuming refined carbohydrates and prevent age and lifestyle-related disorders.’ – Rastogi YR, et al, 2022.

Find out more: read the original article.

Source: (1) Rastogi YR, Thakur R, Thakur P, et al.  Food fermentation – Significance to public health and sustainability challenges of modern diet and food systems. Int J Food Microbiol. 2022. PMID: 35397315 Review..
Additional references :
2.Wastyk, H.C., Fragiadakis, G.K., Perelman, D., Dahan, D., Merrill, B.D., Feiqiao, B.Y., Topf, M., Gonzalez, C.G., Van Treuren, W., Han, S., Robinson, J.L., 2021. Gut-microbiota-targeted diets modulate human immune status. Cell 184 (16), 4137–4153.
3. Ano, Y., Ayabe, T., Kutsukake, T., Ohya, R., Takaichi, Y., Uchida, S., Yamada, K., Uchida, K., Takashima, A., Nakayama, H., 2018. Novel lactopeptides in fermented dairy products improve memory function and cognitive decline. Neurobiol. Aging 72, 23–31.
4. Girotto, F., Alibardi, L., Cossu, R., 2015. Food waste generation and industrial uses: a review. Waste Manag. 45, 32–4
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15 Aug 2022
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8 min read
Q&A

Plant-based or animal-based proteins: differences?

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Over the past 20 years, Western societies have noticed a growing interest in plant-based diets such as vegetarianism or even veganism. Similarly, the number of new scientific publications that address this topic underscores the growing interest in plant-based diets (1). These diets are characterized by a food pattern without meat or fish for vegetarianism, and a food pattern that exclude any animal products (meat, fish but also milk, eggs, butter, honey…) for veganism.

What is a protein? Why do our body need it?

Proteins are active biomolecules found throughout the human body, with several metabolic and structural biologic roles (enzymes, hormones…). They are long 3D folded “chains” made of amino acids, the “building blocks” of protein. Of the 20 main amino acids used by the body, 9 are considered “essential” (EAA) – as the human body can’t synthetize on its own – and must be obtained from the diet (2,3).

The quality of a protein relates on the part of essential and non-essential amino acids it contains. Hence, high quality proteins contain all 9 EAA in the proportions that cells need for protein synthesis (2, 3, 4).

The quality of a protein relates also on its digestibility. A score can determine the digestibility of dietary proteins: the digestible indispensable amino acid score (DIAAS). This score is expressed by numerical values below or above 100. A DIAAS score above 100 means that the digestibility of the protein considered is very high: it is then a good complementary protein to those with inferior qualities. Generally, proteins of animal origin have higher DIAAS scores than proteins of vegetable origin: 40 for wheat and almonds, 59 for rice, 83 for chickpeas while chicken breast scores 108, eggs score 113 and whole milk 114 (4).

How much protein is required in a healthy food pattern?

According to the European Food Safety Agency (EFSA) (5), the dietary protein recommendation for a healthy adult is 0.83 g/day per kg of body weight. For a 70kg adult, this results in 58g of protein intake per day. However, it is a general recommendation and may vary depending on the weight, age, health status and physical activity (6).

Ensuring an adequate daily protein intake is a key nutritional issue when adopting a plant-based diet. Although the word “protein” often brings to mind meat products and fish, many plant products are rich in protein and considered plant-based proteins.

What are the high-protein plant foods?

There are many sources of plant proteins, among which (7):

  • Tofu: It is a white and soft paste, resulting from the curdling of soy milk. It is very popular in East and Southeast Asia. 100 grams of tofu approximately contain 8g of protein (6).
  • Legumes and pulses: Lentils, many varieties of dried beans, chickpeas provide high levels of protein without the high fat content that is usually associated with protein-rich foods and particularly meat products (7,8).
  • Nuts and seeds: Nuts such as walnuts, hazelnuts, peanuts, cashews, almonds, and pistachios actually have relatively high total protein content (between 14g and 26g of protein per 100g (6)). Among high-protein seeds, you can find hemp seeds, flax seeds, pumpkin seeds and chia seeds. Nuts and seeds contain protein, and yet, they need to be consumed moderately due to their high fat content and high energy density (6).
  • Whole grains: wild or brown rice, buckwheat, bulgur, millet, oatmeal, quinoa, whole grain barley and whole wheat are examples of a whole grain. The latter refers to a whole grain seed, and consists of three components: the bran (outer layer rich in fibers (12-17%)), the germ (inner part, high in nutrients) and the endosperm (central part of the kernel, rich in starch (80 to 85%)). For a food product to be classified as a “whole grain”, its components must be present in the same relative proportions (bran, germ and endosperm) as they are in the intact grain (9).

Plant-based and animal-based proteins differ in some quality features

Proteins can be found in both animal and plant sources. Nonetheless, plant-based proteins may differ from animal one in terms of amino acid composition, digestibility and bioavailability (4,10).

Animal proteins are considered as high-quality proteins, because they generally contain the nine EAA. On the other hand, most plant-based proteins will contain the 20 amino acids but will provide only a very small amount of some EAA, so called then ‘liming amino acids’ (4, 11). Therefore, it is crucial to diversify the plant sources of protein to overcome the problem of limiting amino acids (4).

Moreover, anti-nutritional factors present in some vegetables (tannins, trypsin inhibitors, phytates…) can limit protein digestibility and absorption, thus resulting in a reduction in their overall efficiency of use (6, 7,12).

However, it is possible to obtain quality protein from plants and there are many options for including them in the diet. It is essential to combine and vary the different plant protein sources throughout the day (6). For instance, whole grain rice is limited in lysine and thiamine but rich in methionine. Accompanying it with beans (limited in methionine, but rich in lysine and thiamine) in a vegetarian chili creates a complementarity of amino acids to meet EAA needs (4).

Plant-based protein intake is associated to positive health outcomes 

After a two years cohort study, experts associated positively high animal-protein intake with cardiovascular morbidity, whereas high plant-based protein consumption was inversely correlated with all-cause of mortality, including cardiovascular diseases and type 2 diabetes (13). According to the authors, substituting animal-based protein, particularly from processed red meat, with plant-based protein may have a significant health benefit (13).

Indeed, in other prospective studies (6,7,14), scientists link health benefits with the plant-based nutrient content, including mono- and poly-unsaturated fatty acids, n-3 fatty acids, dietary fiber, antioxidant vitamins, minerals, proteins and phytochemicals.

Plant-based proteins are more eco-friendly

Adapting one’s diet for a more plant-based intake while respecting protein needs can also be rooted in ecological values. Evidence shows that meat consumption is one of the reasons for the increase of the individual carbon footprint. It is linked to the important greenhouse gas emissions produced by meat production (7). Furthermore, the production of legumes as a source of plant protein for non-meat eaters improves the biodiversity and general well-being of the soil in which they are grown by allowing increased biological nitrogen fixation (7).

Diversity is key

Thus, in the context of an omnivorous diet, it may be better to focus on eating a varied diet rich in both nutrient-dense plant-based proteins and lean animal-based proteins, rather than focusing on consuming one or the other. In order to promote a sustainable healthy diet, it is necessary to pay more attention to meat consumption, and to replace these animal proteins with various sources of vegetable proteins is a good way to ensure one’s health and that of the planet, while covering daily nutritional needs.

Adopting a flexitarian diet constitutes one of the solutions to initiate a deliberate reduction of animal products consumption by replacing them with high-quality plant-based proteins. As a sustainable alternative to classical western diets, flexitarianism is an interesting compromise for a more balanced, nutritive and sustainable diet, without the needs of a constant medical follow-up.

References:
(1) Medawar, E., Huhn, S., Villringer, A. et al. The effects of plant-based diets on the body and the brain: a systematic review. Transl Psychiatry 9, 226 (2019).
(2) Tome D. Criteria and markers for protein quality assessment – a review. Br J Nutr. 2012; 108 Suppl. 2: S222-9.
(3) Boye J, Wijesinha-Bettoni R, Burlingame B. Protein quality evaluation twenty years after the introduction of the protein digestibility corrected amino acid score method. Br J Nutr. 2012; 108 Suppl. 2: S183-211
(4) EUFIC. What are proteins and what is their function in the body [Online]. Last Update: 16 December 2019.
(5) EFSA. European Food Safety Authority, Scientific Opinion on Dietary Reference Values for protein. EFSA Journal 2012; 10(2):2557.
(6) EUFIC. Plant-based protein: all you need to know to get enough of it [Online].
(7) Rylee T Ahnen, Satya S Jonnalagadda, Joanne L Slavin, Role of plant protein in nutrition, wellness, and health, Nutrition Reviews, Volume 77, Issue 11, November 2019, Pages 735–747
(8) FAO. What are pulses? 2016 International year of pulses, nutritious seeds for a sustainable future
(9) EUFIC. Whole grain (Q&A), What is a whole grain?
(10) Millward, D. The nutritional value of plant-based diets in relation to human amino acid and protein requirements. Proceedings of the Nutrition Society, 58(2), 1999. 249-260.
(11) Mariotti, F. Plant protein, animal protein, and protein quality. In Vegetarian and plant-based diets in health and disease prevention (pp. 621-642). 2017. Academic Press.
(12) Herreman L, Nommensen P, Pennings B, Laus MC. Comprehensive overview of the quality of plant- And animal-sourced proteins based on the digestible indispensable amino acid score. Food Sci Nutr. 2020;8(10):5379-5391. Published 2020 Aug 25.
(13) Song M, Fung TT, Hu FB, et al. Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality [published correction appears in JAMA Intern Med. 2016 Nov 1;176(11):1728]. JAMA Intern Med. 2016;176(10):1453-1463.
(14) Hu FB. Plant-based foods and prevention of cardiovascular disease: an overview. Am J Clin Nutr. 2003;78(3 Suppl):544S-551S
(15) Joan Sabaté, Sam Soret, Sustainability of plant-based diets: back to the future, The American Journal of Clinical Nutrition, Volume 100, Issue suppl_1, July 2014, Pages 476S–482S
(16) David Pimentel, Marcia Pimentel, Sustainability of meat-based and plant-based diets and the environment, The American Journal of Clinical Nutrition, Volume 78, Issue 3, September 2003, Pages 660S–663S
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25 Jul 2022
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5 min read
Benefits for planet health

Enjoy the benefits of the Mediterranean Diet – anywhere in the world

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Get ready for the new buzz word set to crash into our vocabulary. Planeterranean: it’s not so hard to pronounce once you’ve practised it a few times, but what does it mean? Well, it’s a type of diet that’s like the Mediterranean Diet (MD) but not necessarily anywhere near the Mediterranea.

The term has been coined by a UNESCO expert group that has taken on the challenge of finding out how to extend the health and environmental benefits of the MD to reach people across the world(1).

The expert group believes that wherever you live in the world, you can enjoy the nutritional and health benefits provided by the MD but from foods grown locally to you.

Most current diet habits can be improved.

Today, many people living in urban areas present a poor diet quality and variety, with most of energy intake coming from foods with high glycaemic index (i.e., white rice and potatoes), sugar-rich and fatty ultra-processed foods (i.e., ready-to-eat foods, sugary drinks, chips, etc.). These eating habits, are known for their unfavourable effects on health, leading to obesity and other long-term diseases.

How does the Mediterranean Diet help?

A varied, plant-rich diet on the other hand, is known to be kind both to our health and to our planet (2). The MD is one such diet; highly nutritional, it comprises olive oil as a source of unsaturated fats, and nuts, legumes, vegetables, whole grain, fruit, a moderate amount of fish, as well as dairy, meat, and red wine.

A large body of evidence points to a host of health benefits of the MD thanks to its nutritional profile, including a reduced prevalence of cardiovascular disease and cancer. It’s a sustainable diet model because it uses foods that are locally-produced, limiting the impact on environmental resources and biodiversity while being part of the local culture (3,4).

How can the benefits of MD be extended globally?

The challenge is now on to transfer the benefits of the MD to non-Mediterranean countries.

That’s why the UNESCO Chair on Health Education and Sustainable Development has been tasked with finding out whether it’s possible to promote worldwide a healthy and sustainable dietary model based on nutritional properties of MD but using foods available locally. The new ‘Planeterranean’ dietary model would be consistent with the Sustainable Development Goals set by United Nations.

And the good news is that throughout the world, there are indeed specific fruits, vegetables, legumes, wholegrain, and sources of unsaturated fats, that offer similar nutritional benefits to those of the MD, says the UNESCO group.

So wherever you live in the world, you should be able to choose your diet that shares similar health benefits to those of the MD.

The authors point to some examples that stand out, for some regions or countries in different continents:

  • Latin America: avocado, papaya, green bananas, and açaí berries are all good sources of monounsaturated fatty acids and micronutrients. Quinoa, rich in proteins, provides essential amino acids and is low in fat.
  • Central Africa: cereals may be good for short-chain fatty acids.
  • North America: canola oil and pecan nuts contain monounsaturated fatty acids and phytosterols, and can reduce harmful cholesterol.
  • Asia: Sesame seeds and soy contain bioactive compounds and antioxidants, good for reducing hypertension, oxidative stress, insulin resistance, and inflammatory markers.
  • Australia: Macadamia nut, Davidson’s plum, native pepper berry, finger lime, and bush tomato, rich in flavonoids, vitamins, and minerals, have antioxidant and anti-inflammatory properties.
  • In some countries, seaweeds, wakame and spiruline contain complex polysaccharides, minerals, proteins, and vitamins, with anti-cancer, antiviral, antioxidant, and anti-diabetic properties.

Based on the foods available in each part of the world, it should be possible to develop ‘nutritional pyramids’ that offer the same health benefits and low environmental impact as the MD, says the UNESCO Chair on Health Education and Sustainable Development.

Ultimately, the UNESCO group hopes that the Planeterranean model will help every country to develop healthier dietary patterns among the population, based on traditional and local foods.

‘…in every place of the world, it is possible to identify specific fruits, vegetables, legumes, wholegrain, and sources of unsaturated fats which present nutritional contents and characteristics similar to those provided by typical foods of MD, likely to have also similar health benefits for populations living far from the Mediterranean area.’ – Colao A. et al, 2022.

The UNESCO Chair on Health Education and Sustainable Development is looking for possible contributors to its Planeterranean research programme, coming from all parts of the world. The programme will be launched trough a dedicated UNESCO Chair platform under the name of ‘Planeterranean’

Find out more: read the original article.
Source: (1) Colao A, Vetrani C, Muscogiuri G, et al. “Planeterranean” Diet: extending worldwide the health benefits of Mediterranean Diet based on nutritional properties of locally available foods. J Transl Med. 2022 May 17;20(1):232.
Additional publications:
(2). Moreno LA, Meyer R, Donovan D, et al. Perspective: Striking a Balance between Planetary and Human Health: Is There a Path Forward? Adv Nutr2021 Nov 27;13(2):355-375. doi: 10.1093/advances/nmab139.
(3) Trichopoulou A, Martínez-González MA, Tong TY, Forouhi NG, Khandelwal S, Prabhakaran D, Mozaffarian D, de Lorgeril M. Definitions and potential health benefits of the Mediterranean diet: views from experts around the world. BMC Med. 2014;12:112.
(4) Estruch R, Ros E, Salas-Salvado J, Covas M-I, Corella D, Arós F, Gómez-Gracia E, Ruiz-Gutiérrez V, Fiol M, Lapetra J, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368:1279–90.
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11 Jul 2022
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6 min read
Expert interviews Nutri-dense food

The food matrix in dietetic practice, by Lauren Twigge

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During the latest online congress ASN Nutrition live 2022, we asked Lauren Twigge to follow and share with us the latest data on food matrix. Based on the conference “Next level health solutions: the magic of the matrix”, she accepted to answer some questions.

When did you first hear about the notion of the food matrix? Did it change your view on the links between nutrition and health?

I was introduced to the idea of the food matrix while attending my master’s degree. At the time the concept was quite new, and not yet popularized, but the idea made great sense: you consume foods, not nutrients, which implies you should have a food-level understanding of nutrition. Following traditional training as a nutrition expert, I got educated on the interactions that occur between nutrients, focused on individual nutrients needs: the so-called reductionist approach. But as of 2017-2019, It evolved to focus on a balanced diet as a whole to cover all nutrients needs and optimize their efficiency but taking into account the entire ‘content on the plate’.

Finally, I had the opportunity to further explore the notion of “food matrix” in 2019, at the National Dairy Council, where we could begin to talk about the importance of food as a whole. Dairy makes a great case for the food matrix, as it is both easy to narrow down dairy products to a ‘single nutrient’ approach and better characterize the benefits of dairy foods when taking into consideration the whole food and its specifics: milk, cheese, or yogurt, because they have different matrices, have different identified benefits.

The food matrix concept has changed the way I think about food! Clearly it leads to a ‘add rather than remove’ approach to dieting, which is the best way to personalize nutrition recommendations.

Food matrix is quite an expert’s concept: how do you take the notion of food matrix into account when counseling your patients? Do you let them know about it? If yes, is it a convincing element for them?

I always counsel using the ‘on the plate’ method: grains, dairy, protein, veggies… with all food groups on it. Explaining that there is more to food than nutrients is a ground rule of nutrition! This makes perfect sense with the food matrix. Over the last few months, I have started using the phrase so people get more familiar with it and deliver it with bite size pieces, for instance, by explaining that calcium and vitamin D collaborate to make each other better.

The key is to pass on to patients the reflex of thinking on a food level. This can be done by educating on reading food labels, understanding macronutrients… leading to two complementary visions of their nutrition:

  • one where they know where calories come from
  • another where they compensate and build the balance there needs to be between carbs and proteins

During the ASN session, what is the new element you heard about the dairy matrix? Do you think the notion of food matrix fits particularly well with dairy foods?

I do really love the concept of ‘food matrix’, which offers a powerful illustration of how dairy products make a great contribution to health, and help reduce risks of certain diseases…

I’ve found out a lot from a nutrient perspective and also from non-nutrient components, such as the method of cooking, pH, temperature, whether the food comes in a liquid, gel or solid form, and the overall approach of the food complexity.

We did a recent poll with our twitter community, which mainly gathers nutrition experts. Some reported they were not familiar with the food matrix concept. Where would you advise them to start?

I have found that including this concept allowed me as a nutrition expert to significantly reinforce the personalization of my counseling for each patient. During the ASN session, this was particularly well explained with the example of the common medical advice to remove saturated fats in order to prevent cardiovascular diseases. A lot of evidence based on the study of the dairy matrix now shows that not only these saturated fats do not represent a difficulty, thanks to the food and nutrient structures of certain dairy products, but consuming them actually brings many beneficial effects.

Understanding the food matrix is working on better personalization of nutrition instead of using umbrella recommendations.

The USDA and other such public institutions have lots of references and formal definitions about the food matrix. I would start by visiting government pages and their definitions. I personally learned a lot with dairy councils, where the food matrix, applied to dairy, is one of the most studied cases.

“We need to stop reducing foods down to nutrients” (video)

In her Reel that she published on Instagram, Lauren Twigge, aka Nutrition.at.its.roots, shares with her community the key takeaways from the ASN 2022 session about the dairy matrix. One point of focus: ‘We need to stop reducing our foods down to single nutrients’!

Lauren Twigge, RDN, LDLauren Twigge is a Dallas based registered and licensed Dietitian with a Master’s degree in Clinical Nutrition and a bachelor’s degree in Animal Science. Along with running her own nutrition company and working with private clients, Lauren works as social media dietitian, recipe developer, blogger, and brand ambassador. Lauren was born and raised in a family of farmers located in central California and is an outspoken supporter of the agricultural industry. Growing up on a dairy and being raised around farming her whole life has given Lauren a unique perspective on where our food comes from and her passion is to work at the crux of agriculture and human nutrition to fight misinformation and give consumers back their food confidence. Lauren is on Instagram @nutrition.at.its.roots and educates on a variety of health topics including the truth about the agricultural industry, education on where our food comes, and discussing the role that various agricultural products, like milk, can play in a healthy diet!

Instagram page: https://www.instagram.com/nutrition.at.its.roots/

Website: https://www.laurentwiggenutrition.com

Blog: https://www.laurentwiggenutrition.com/blog 

Tik Tok: https://www.tiktok.com/@nutrition.at.its.roots 

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04 Jul 2022
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7 min read
Benefits for planet health

What are the Mediterranean diet benefits?

local diets Mediterranean Diet sustainable healthy diet
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The Mediterranean Diet (MD) is worldwide known for its benefits and was added in 2010 to the UNESCO list of intangible cultural heritage of humanity. Not only is this diet recognized for its nutritional properties and density, but it also “encompasses a set of skills, knowledge, practices and traditions from landscape to table, including crops, harvesting, fishing, conservation, processing, preparation and, in particular, food consumption” [1].

An historical territorial diet, based on local and cultural food

The MD has indeed a strong historical and regional dimension. It is rooted in the Mediterranean area, which was during centuries a point of passage of numerous civilizations: Greeks, Romans, Cretans, Italians… The MD was first described by Ancel Keys in the 1980s [2], as a low-saturated fat diet.

It was traditionally characterized by a high intake of fresh and local vegetables, legumes, fruits and nuts, and unrefined cereals, a moderately high intake of fresh fish, a low intake of dairy, meat and poultry, and a moderate intake of alcohol, essentially wine during meals, if it was accepted by religion.

The MD was considered at first because it was known to be efficient in coronary diseases prevention, by lowering the total cholesterol level in the plasma. Nonetheless, several studies have proven that this diet benefits were eventually attributable to what it involves: a high olive oil intake [3-6].

A dense, varied and healthy food pattern with several health benefits

Numerous studies and clinical trials have been conducted over the past four decades to understand the health consequences of adhering to the MD. In 2017, a meta-analysis [7] showed that the MD reduced the risk of cardiovascular diseases incidence by 45%, compared to a classic Western diet.

Today, there is no doubt about the benefits of this diet in preventing forms of malnutrition (obesity, type 2 diabetes mellitus [8]), but it is also recognized to be favorable in the prevention of cancer [8-11], neuro-degenerative diseases [8] and in promoting longevity [12, 13].

“Adherence to the MD has been associated with a significant reduction in total mortality, mortality from cardiovascular disease (CVD) and cancer, and with cancer-risk lowering potential.” – Hachem et al, 2020.

In short, with the MD being low in saturated fats, animal proteins, high in antioxidants and fibers, it has been proven that this diet is associated with several positive health outcomes whether it is disease prevention or forms of malnutrition.

Nowadays, the interest of MD goes beyond nutrition and culture. With a preoccupying increase of malnutrition in all its forms (obesity, nutrients deficiencies, undernutrition…), deeply transitioning towards more sustainable healthy diets and environmental-friendly dietary habits seems mandatory. Studies suggest that Territorial Diversified Diets (TDD), including the MD, could enable shifts and changes commensurate with the challenge we are currently facing [14].

The Mediterranean diet is a territorial diversified diet

Territorial Diversified Diets (TDD) are region-specific diets that primarily includes seasonal, locally-sourced foods and have a flexitarian pattern. Flexitarianism indeed combines large amounts of plant-sourced foods, low levels of meat but moderate volume of poultry, fish, eggs and dairy [15].

TDDs are considered healthy sustainable diets, relying on four dimensions [16]:

  • involve safe nutritionally-dense foods in a healthy and varied pattern
  • be culturally acceptable
  • be accessible, affordable and equitable
  • have a low environmental impact and preserve biodiversity as well as natural resources

A recent review [15] suggests that the TDD, among which are the Mediterranean and New Nordic diets for example, can meet the energy and nutritional needs without the need for dietary supplementation or professional advice.

‘In reviewing the criteria for sustainable healthy diets, we show that flexitarian and territorial diversified diets may offer the optimal balance between human and planetary health without the need for support from healthcare professionals.’ – Moreno et al, 2021

The environmental stakes of territorial diversified diets 

When it comes to environmental sustainability, the TDDs and more specifically the MD are of a great relevance in order to address environmental pressure, by being culturally and economically deeply anchored in populations habits around the Mediterranean area, easy to adopt and accessible. By consuming locally grown food and raised cattle, MD adepts value short circuits that avoid exportations and polluting food transport, while promoting local economy.

For comparison, following a daily Northern American diet has a daily ecological footprint of 5.4 kg of CO2 released into the atmosphere, while a person who follows the MD equals to 2.2 kg of CO2 emitted daily in average [17].

Thus, when it is adopted locally, a Mediterranean food pattern would enable a reduction of greenhouse gases emissions (GHGE), land use and energy and freshwater consumption. According to a study in Spain, adherence to the MD could lower GHGEs by 72% [18].

Thus, the MD has many advantages both in terms of nutrition and sustainability of our food.

Nevertheless, it is important to note that such a diet has its place only in the Mediterranean basin, where it legitimately exploits local resources for a diet adapted to the local populations, without excessive importation of products and a reasonable local consumption.

This model, when adapted to the territory under study, has variations specific to the resources of the region and the socio-economic factors of the local populations.  For example, the NDD reflects the MD in the Nordic countries. Therefore, more research and involvement in studying new territorial diets has its role to play in the transition to healthy and sustainable diets.

For more information:

References:
[1] UNESCO . Convention for the safeguarding of the intangible cultural heritage, 9th Session. Published online 2014
[2] Trichopoulou, A., Corella, D., Martínez-González, M.A., Soriguer, F., & Ordovás, J.M. (2006). The Mediterranean Diet and Cardiovascular Epidemiology. Nutrition Reviews, 64, 13-19..
[3] Martinez-Gonzalez Ma, Sanchez-Villegas A. The emerging role of mediterranean diets in cardiovascular epidemiology: monounsaturated fats, olive oil, red wine or the whole pattern? Eur J Epidemiol. 2004;19(1):9 –13
[4] Sacks FM, Willett W. Chewing the fat: how much and what kind? N Engl J Med. 1991;324:121–123. 4.
[5] Willett WC. Diet and health: what should we eat? Science. 1994;264:532–537. 5.
[6] Willett WC, Sacks F, Trichopoulou A, et al. Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr. 1995;61(suppl):1402s– 1406s.
[7] Grosso G, Marventano S, Yang J, et al. A comprehensive meta-analysis on evidence of Mediterranean diet and cardiovascular disease: are individual components equal? Crit Rev Food Sci Nutr. 2017;57(15):3218-3232.
[8] Lăcătuşu, CM, Grigorescu, ED, Floria, M, Onofriescu, A, Mihai, BM. The Mediterranean diet: from an environment-driven food culture to an emerging medical prescription. Int J Environ Res Public Health. 2019;16(6):942.
[9] Giacosa, Attilio et al. “Cancer prevention in Europe: the Mediterranean diet as a protective choice.” European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) vol. 22,1 (2013): 90-5.
[10] Tavani A, La Vecchia C. Fruit and vegetable consumption and cancer risk in a mediterranean population. Am J Clin Nutr. 1995;61:1374s–1377s.
[11] Trichopoulou A, Lagiou P, Kuper H, Trichopoulos D. Cancer and Mediterranean dietary traditions. Cancer Epidemiol Biomarkers Prev. 2000;9:869 – 873
[12] Trichopoulou A, Kouris-Blazos A, Walhqvist Ml, et al. Diet and overall survival in elderly people. BMJ. 1995;311:1457–1460.
[13] Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med. 2003;348: 2599 –2608.
[14] Hachem, F., Vanham, D., & Moreno, L. A. (2020). Territorial and Sustainable Healthy Diets. Food and Nutrition Bulletin, 41(2_suppl), 87S-103S.
[15] Luis A Moreno, Rosan Meyer, Sharon M Donovan, Olivier Goulet, Jess Haines, Frans J Kok, Pieter van’t Veer, Perspective: Striking a Balance between Planetary and Human Health—Is There a Path Forward?, Advances in Nutrition, 2021; nmab139
[16] Food and Agriculture Organization of the United Nations; World Health Organization. (2019) Sustainable Healthy Diets, Guiding Principles.
[17] LACIRIGNOLA, Cosimo et CAPONE, Roberto. Mediterranean diet: territorial identity and food safety. New Medit: Mediterranean Journal of Economics, Agriculture and Environment= Revue Méditerranéenne dʹEconomie Agriculture et Environment, 2009, vol. 8, no 4, p. 2.
[18] Sáez-Almendros, S., Obrador, B., Bach-Faig, A. et al. Environmental footprints of Mediterranean versus Western dietary patterns: beyond the health benefits of the Mediterranean diet. Environ Health 12, 118 (2013).
Related Posts
Milk matrix matters: why dairy deserves a place in plant-based diets From plate to planet: the challenge of building sustainable diets Gut health: the prebiotic power of lactose Focus on the bioactive peptides in dairy and yogurt
See More
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Practical sheets
Experts Interviews
Key Publications
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