# Priorities for inclusive urban food system transformations in the Global South

Paule Moustier, Michelle Holdsworth, Dao The Anh, Pape Abdoulaye Seck,

Henk Renting, Patrick Caron, Nicolas Bricas

► To cite this version:

Paule Moustier, Michelle Holdsworth, Dao The Anh, Pape Abdoulaye Seck, Henk Renting, et al. Priorities for inclusive urban food system transformations in the Global South. Joachim von Braun; Kaosar Afsana; Louise O. Fresco; Mohamed Hag Ali Hassan. Science and innovations for food systems transformation, Springer International Publishing, pp.281-303, 2023, 978-3-031-15703-5. 10.1007/978-3-031-15703-5. hal-03923992

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Distributed under a Creative Commons Attribution 4.0 International License
Joachim von Braun

Kaosar Afsana

Louise O. Fresco

Mohamed Hag Ali Hassan *Editors*

Science and
Innovations
for Food Systems
Transformation

OPEN ACCESS

<figure><img src="image_2.png" /></figure>

Springer
Science and Innovations for Food Systems
Transformation
Joachim von Braun • Kaosar Afsana
Louise O. Fresco • Mohamed Hag Ali Hassan
Editors

Science and Innovations
for Food Systems
Transformation

<figure><img src="image_3.png" /></figure>

Springer
Editors

Joachim von Braun

Center for Development Research (ZEF)

University of Bonn

Bonn, Germany

Kaosar Afsana

James P Grant School of Public Health

BRAC University

Dhaka, Bangladesh

Louise O. Fresco

Wageningen University and Research

Wageningen, The Netherlands

Mohamed Hag Ali Hassan

The World Academy of Sciences for the
Advancement of Science in Developing
Countries (TWAS)

Trieste, Italy

This work was supported by Joachim von Braun

<figure><img src="image_4.png" /></figure>

ISBN 978-3-031-15702-8

ISBN 978-3-031-15703-5 (eBook)

https://doi.org/10.1007/978-3-031-15703-5

© The Editor(s) (if applicable) and The Author(s) 2023. This book is an open access publication.

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# Foreword

In December 2019, I received a letter from the United Nations Secretary-General requesting that I lead what he had just put together – the United Nations Secretary-General's Food System Summit 2021. My first thought at the request was that I did not need more work – I had enough on my plate. However, upon further deliberation, I could not help but consider the contradictory views on food and what it means to different people. By taking this role, I might have the opportunity to marshal a global consensus and provide the issue with momentum to generate actions for a clear way forward. I decided that I needed to attend the Summit to ensure that the issues that affect food systems from my part of the world be profiled globally, especially because, while Africa contributes 7% to global climate change, it is most exposed and its populations hit the worst due to poor resilience. I also wanted to ensure that I could bring out the engagement and voices of those most affected. Like the Secretary-General, I believe that the solutions to our challenges are already in our midst, simply needing to be profiled and harnessed for the benefit of all. Therefore, I was thrilled that, in the same letter, the Secretary-General had made it clear that the Summit was going to be anchored in science and that an independent group of the world's best scientific experts were being brought together.

The Scientific Group was thus set up as an independent group of experts under the leadership of Professor Joachim von Braun, a renowned and respected expert in science policy and a policy advisor to governments. A person with deep academic and scientific roots around the world, his work and views on zero hunger and what the world should be doing to come through on its promise by 2030 are very well known. The Vice Chairs of the Scientific Group, Profs. Kaosar Afsana from BRAC University (Bangladesh), Louise O. Fresco from Wageningen University (Netherlands) and Mohamed Hag Ali Hassan from Sudan (World Academy of Sciences), fostered scientific excellence and appropriate diversity in the Group as well.

The Scientific Group began work with a clear mandate: to draw on existing scientific research, collaborate with global science networks, advise the Summit and help the world understand food systems, specifically the status of things, what is at stake and how to go forward from where we are today. At the core of the Summit
were the 2030 Agenda and how we get back on track. The Group was charged with ensuring that the Summit was anchored in science, drawing out the challenges of our food systems, and consolidating knowledge as to how to resolve these challenges. In a nutshell, the Scientific Group was to build consensus on the critical drivers for global food systems' transformation, including the priorities we need to implement between now and 2030 to get back on track.

The Scientific Group was composed of 28 experts from across scientific networks of institutions, designed to pull in global expertise and leading scientific views and to bring in views across all groups of society, from indigenous peoples, women, producers and so many more. It was also designed to draw in all of the food systems issues influencing and impacting our world, from people to our planet to the prosperity of both all around the world – all brought together in an intelligent and digestible way. Through rigorous work, open engagement and “Science Days”, these experts engaged and consulted widely, and through meetings with other areas of the Summit. They kept abreast of key challenges that the world, societies and governments were concerned about, as informed by hundreds of dialogues, and were on top of the key emerging opportunities and possible practical game-changers through the work of Action Tracks and related peer reviews.

The UN Food Systems Summit Scientific Group dug deeply into their wide institutional networks of expertise, as per their TORS,<fnref n="1" /> to bring forth the foremost scientific evidence. They looked at the progress that has been made so far and made recommendations on science-based approaches to achieving SDGs while revealing trade-offs associated with food system transformation. Through the networks of partners from all regions of the world, the Scientific Group brought diverse viewpoints, ensuring the inclusion of a diversity of frameworks and regional voices. The Group linked science-based synthesis to ongoing initiatives under the UN system, including the Committee on World Food Security (CFS) High-Level Panel of Experts, the CGIAR, science-based institutions and many other relevant knowledge institutions, to help advance future food systems.

This volume – a critical product of the Scientific Group – does a number of things, the most important of which is building a consensus on our understanding of food systems. This is particularly important given the breadth of the area under discussion, the diversity of views and interests, the number of other sectors that are impacted and the overall complexity of the food system globally.

The volume then goes on to identify science-driven innovations and opportunities that must be pursued in an integrated manner for a successful transformation of food systems. Here, the Group dwells on the key role of science and research as a prerequisite for innovations that will accelerate the transformation of current food systems to healthier, more sustainable, equitable and resilient systems. The volume also includes a number of chapters by partners of the Group that highlight the most critical areas, information and knowledge in different sectors and the gaps in

<footnote n="1">¹The TORs can be found on the website of the Scientific Group here: https://sc-fss2021.org/about-us/tor-and-letters-un-leadership/</footnote>
knowledge that still exist. The Scientific Group recommends actions that, if implemented, have the potential to transform our food systems. The chapters in this volume further emphasize the complexity of the food systems and a clear direction for the transformation of our food systems with a number of things that can be done together. Throughout this volume, it is clear that there is no one-size-fits-all: while the concepts are similar, the translation of science into policies that inform investments is only possible if placed within the specific context of where the work will be done in a country, in different parts of the world.

I am very proud of the work captured in this volume; most of all, I am grateful that the Scientific Group contributed to what I consider the most important outcome of the Summit – the fact that we have global censuses that our food systems must transform if we are to achieve the 2030 Agenda. Second, I am proud that the Scientific Group mobilized the global science community behind the Summit, from the least heard voices and the least referred-to science that sits with indigenous peoples to the most lucrative science behind big AG. All were brought forward and the opportunities and trade-offs evaluated, ensuring that everybody feels heard, but also that the most important aspects of how we go forward are clear.

As I conclude, I want to bring out the following areas that we must keep our eyes on as we move forward from the Summit to the Hub that will coordinate Summit follow-up and the UN agencies that will help the Hub to keep the world engaged – including tracking of the Summit's commitments. These are the need to: strengthen national capacities for implementation, especially in emerging economies, develop a clear financial agenda for investments needed to address increasing hunger, but also the overall 2030 Agenda; and better coordinate and advance institutional innovations that can improve the science, such as policy interfaces to enhance implementation in countries and better global level networked science services. Lastly, there is a need to facilitate stronger synergies of food system actions with other key areas, including climate policy, Covid-19-related policies, trade policies, conflict policies and related food price inflation that will exclude even more people from accessing the right level of nutrition and, at worst, leave them with no food at all.

The work and contribution of the Scientific Group of the Summit have provided incredible direction on how we move forward from here. There will always be need for new insights, and there will always be a need to sharpen the science/policy/action interface, but, for now I am incredibly grateful that through this volume the Scientific Group gives us the steering wheel that we need to move forward towards a food systems approach that could get us back on the 2030 Agenda, on food, health and diets, environment and the prosperity of people and the planet.

The UN Secretary-General's Special Envoy for the United Nations Food Systems Summit 2021
New York, NY, USA

Agnes M. Kalibata
# The Approach of the UNFSS Scientific Group and an Overview of the Volume

## The Scientific Group's Design and Approach

In April 2020, the Deputy Secretary-General of the United Nations invited Joachim von Braun to chair the Scientific Group for the UN Food Systems Summit. The mandate was as follows: "The Scientific Group is responsible for ensuring that the Summit brings to bear the foremost scientific evidence from around the world and helps expand the base of shared knowledge about experiences, approaches, and tools for driving sustainable food systems that will inform the future. The work of the Scientific Group ensures the robustness and independence of the science underpinning dialogue of food systems policy and investment decisions. It also informs the content of the Summit, its recommended outcomes, and the asks and commitments that emerge from the Summit."<fnref n="2" /> It was new for a UN Food Summit to establish an independent Scientific Group with such a significant mandate.

The Scientific Group (ScGroup) constituted a team of 28 food systems scientists – social scientists, economists and scientists working within the natural and biological sciences, ecology and food technology – from all over the world, identified in consultation with research organizations.<fnref n="3" /> They served in their personal capacities. ScGroup members developed a series of original scientific papers, which were peer-reviewed and scrutinized by governments, civil societies and members of the general public.<fnref n="4" /> The inclusive approach of the ScGroup resulted in the earlier drafts of the chapters of this volume being widely distributed as inputs in preparation for the Summit. In addition, diverse viewpoints were sought from wide networks of partners of the ScGroup from all regions of the world.<fnref n="5" /> These research partners were selected

<footnote n="2">²See https://sc-fss2021.org/wp-content/uploads/2020/11/Terms_of_Reference_web.pdf</footnote>

<footnote n="3">³https://sc-fss2021.org/about-us/membership/</footnote>

<footnote n="4">⁴https://sc-fss2021.org/materials/scientific-group-reports-and-briefs/</footnote>

<footnote n="5">⁵The Science Reader for the UNFSS: https://sc-fss2021.org/wp-content/uploads/2021/09/ScGroup_Reader_UNFSS2021.pdf</footnote>
based on their commitment to scientific research and diversity of knowledge frame-
works and regional coverage. They included academic and research institutions,
policy think-tanks, UN agencies, academies of science, indigenous peoples' knowl-
edge communities, private-sector research and advocacy organizations.<fnref n="6" /> ScGroup
members, along with other independent experts, served as commentators and
reviewers of the contributions from the partners.

This volume compiles the findings of the ScGroup and its partners. The chapters have been further edited in the wake of the Summit. The chapters culminate the fulfillment of the ScGroup's mandate and provide science- and research-based, state-of-the-art, solution-oriented knowledge and evidence to inform the transformation of contemporary food systems in order to achieve more sustainable, equitable and resilient systems.

Volume Overview

This volume is divided into seven sections. While it is organized by key themes, the interdependence of food, health and environment systems is recognized, an interdependence vital for identifying innovations – technological, political, social and institutional – that can help to synergistically achieve multiple SDGs and end hunger by 2030.

**Part I, on Food System Concepts and Summarized Recommendations,** pre-
sents seven priorities for accelerating the transformation to healthier, more sustain-
able, equitable and resilient food systems. These are: (i) end hunger and improve
diets; (ii) de-risk food systems; (iii) protect equality and rights; (iv) boost bioscience;
(v) protect resources; (vi) sustain aquatic foods; and (vii) harness digital technology.
This section also includes a key contribution by the ScGroup concerning sharpening
food systems concepts and definitions so that these concepts are better understood
when we make calls for food system transformation.

**Part II deals with Actions on Hunger and Healthy Diets.** The section begins with a definition of a healthy diet. It was an important, but not straight-forward, task to arrive at a widely accepted definition of healthy diets in the context of a world with many diverse food systems and cultures of dietary patterns. Also, concepts of sustainable and healthy diets were elaborated and remain themes under discussion. This section also focuses on zero hunger. Approaches for ensuring access to safe and nutritious food are explored, highlighting the need for a whole-system approach in policy and research, as well as monitoring and evaluating to manage externalities. The critical importance of comprehensive modeling of the synergies and trade-offs of policy actions is demonstrated. Solutions for enabling the shift to healthy and sustainable consumption are offered, including behavior change interventions, food education, improved product design, investments in food system innovations,

<footnote n="6">⁶https://sc-fss2021.org/community/partners/</footnote>
regulatory regimes for food safety and more. Both the public and private sectors have important roles in responding to and shaping the market opportunities created by changing consumer demands. Attention is paid to the role of fruits and vegetables in healthy diets, and priorities for research and action are identified.

**Part III delves into Actions for Equity and Resilience in Food Systems.** This section discusses the various types of inequalities persistent within food systems and identifies key drivers of said inequalities. The increased inequalities at the national and also, recently, global levels are noted as major concerns for equitable food systems. Noting that the most effective way to sustainably eradicate poverty and inequality is to boost the opportunities and capacities of the poor and those living in situations of vulnerability, a wide range of actions are explored in the chapters to enhance inclusive decision-making, protect the livelihoods of those living in situations of vulnerability while creating opportunities and design policies and institutions to support equitable food system livelihoods. Opportunities for gender equality and women's empowerment are prominently discussed, as are opportunities for engagement and empowerment of youths. The future of small farms is prominently considered, and it is emphasized that food system transformation must serve small-holders and not leave them behind. Indigenous peoples' food systems received high attention from the ScGroup, and the enhanced cooperation between indigenous people's knowledge community and the scientific community is a real achievement of the UNFSS. The specific challenges faced by indigenous communities and their priorities for action are highlighted in a contribution in this section. Novel approaches to urban food systems' transformation in the emerging economies, including the role of secondary cities, are discussed. Foreign policy and security policy dimensions of food system failures are considered, because both the pathways to food insecurity from violent conflicts and those from armed conflicts to food crises have become much more prevalent in recent decades. The fundamental need to enhance food systems' resilience to vulnerabilities, shocks and stresses is addressed and different options for diversification are offered.

**Part IV focuses on Actions for Sustainable Food Production and Resource Management.** Chapters in this section explore the diversity of technological, institutional and policy innovations and actions for transforming the current “nature negative” food systems into ones that are “nature positive” in order to conserve, protect and regenerate natural resources and the natural environment, including biodiversity, through “nature positive” landscape-level interventions and agroecological practices. While important advances have been made in delineating pathways for agroecology to contribute to sustainable food systems, it is clear that much more research and dialogue is needed. The call for more research and dialogue also applies to issues of sustainable livestock production and animal-based foods. Relatedly, there is a growing understanding that food systems are not simply or only terrestrial systems and that efforts must be scaled up to embrace aquatic food systems so as to assure their sustainability and resilience as well. Climate resilience and climate mitigation were key topics that were widely accepted during the UNFSS process, and their key roles in food system transformation are addressed in various chapters. Similarly, the role of water, especially scarcity and water pollution, is tackled. It is recognized that the
integration of biodiversity into agriculture and holistic approaches to plant nutrition that consider its hidden costs are integral to improving health, eliminating hunger and reducing negative environmental impact. The reduction of food loss and waste is confronted, and it is clear that action is needed for incentives and behavior change that will cut food waste and technologies that will cut food loss.

**Part V discusses Costs, Investments, Finance and Trade Actions.** This section begins with a chapter that advances our understanding of the true cost of food – reflecting the environmental and health-related costs of food. The emerging tragedy in the efforts around food system transformation is the extraordinarily high true cost of producing and processing food, estimated at about $30 trillion, compared to the relatively low cost of overcoming hunger, estimated at about $50 billion a year. An accompanying chapter assesses the cost and affordability of a basic meal around the world. Innovative financing solutions are offered to support the investments needed for achieving the SDG2 goals and ending hunger, and it is disappointing that they did not make it into the UNFSS action agenda. Similarly, important trade issues and trade policies that can complement countries’ national policies for sustainable food systems are presented but were not taken up in the UNFSS action agenda.

**Part VI shares Regional Perspectives.** Chapters in this section show the great diversity in food systems around the world and indicate that follow-up actions for transforming food systems will need to be equally diverse. Chapters examine the opportunities for science, technologies, policies and innovations to transform food systems in Africa, Asia, Europe, Latin America and the Caribbean, as well as in large countries such as China, India and Russia. It is clear that there is much to learn, adapt and innovate from experiences within and across countries and regions, and there is an important opportunity for knowledge communities and networks to share experiences and insights in the follow-up to the UN Food Systems Summit.

**Part VII concludes by addressing Strategic Perspectives and Governance.** This section sets the stage for a broad review of the role of science, technology and innovation in transforming food systems around the world. The multidimensional concept of bioeconomy for the transformation of food systems is examined for its potentials and opportunities. Recognizing the extraordinary impacts of Covid-19, the links between global food security and “One Health” – the inter-connectedness of the health of people, animals, plants, soils, water and the environment – are discussed. It is widely acknowledged that science and policy will face challenges in regard to food system transformations at the global and national levels. Science-policy interfaces for transforming food systems emerged as a contentious topic during the UNFSS preparations – including what type of interface at what level – national or international – and whether existing interfaces are sufficient or new interfaces are needed. Another chapter details the key steps needed to transition and transform our food systems. The penultimate chapter of the section, and of this volume, reiterates the calls for exploring options for a global science-policy interface on food systems. It makes clear that the implementation of the Action Agenda of the UN Food Systems Summit and the transformation of food systems calls for enhancing countries’ local science and research capacities. The final chapter of the volume presents three key opportunities for science to transform food systems: (i) strengthen
research cooperation between scientific communities and indigenous peoples' knowledge communities, (ii) expand financing within governments to spend at least 1% of food system GDP on food system science, and (iii) establish pathways towards strong science-policy interfaces networked across national and international levels to enable evidence-based follow-ups to the action agendas established at the Summit.

The over-arching conclusion of this volume is that the global food system needs a revamp – in policies and institutions, as well as on the social, industrial and technological fronts.

## Successes of the UN Food Systems Summit and Attention to Unfinished Business

It was a bold decision by the UN leadership to unleash a multi-stakeholder process, as well as invite an independent Scientific Group to mobilize science communities around the world to advise the Summit agenda with science-based evidence. The scientific and knowledge communities welcomed this move by the UN and have become energized to address complex food system problems with a renewed commitment to identify solutions.

The ScGroup considers the UN Food Systems Summit a success, but there is also unfinished business. When benchmarking against earlier summits, five promising outcomes are highlighted: (i) *political and societal engagement* – the Summit was much more inclusive and mobilized nations and stakeholders with multiple dialogue formats – never before has the world discussed and considered food system issues with attention to nutrition, health, ecology, and much more<sup>7</sup>; (ii) *scientific engagement* – also never before has science had the opportunity to contribute in so many ways to the agenda of a food summit – open debate and action orientation mobilized many adademies of science, research organizations, academics and practitioners; (iii) *action agenda* – the UN Secretary-General's statement of action, with its systems focus, and the five action areas to help inform the transitions needed to realize the vision of the 2030 agenda are noteworthy; (iv) *national level input and implementation* were appropriately emphasized; and (v) *significant global initiatives on tackling hunger, healthy diets, anemia in women, agroecology, soil health, oceans and more* were launched.

Yet, there are some important areas that require further attention in the future: (i) *strengthening the capacities for implementation of actions at the national level*, especially in emerging economies, is essential – this is an area for stakeholders to get together and catalyze the necessary actions, and scientific bodies can assist; (ii) *developing a strong finance agenda* for the investments needed to achieve the end of hunger and other key targets is important – the financial proposals, including

<footnote n="7"><sup>7</sup>See the Food Systems Summit Dialogues https://summitdialogues.org/</footnote>
those from the ScGroup, did not find sufficient resonance, and other approaches are needed; (iii) encouraging institutional innovations and enhanced coordination for an *improved science – policy interface* at the global level that is well networked with regional and national interfaces remains critical; and (iv) facilitating strong global level actions in key areas such as *climate, Covid-19, and trade*, to accompany national level actions and implementation, is necessary, as is addressing emerging food price inflation.

This volume has been assembled to inform the way forward on the transformation of global food systems beyond the UN Food Systems Summit and to show how science can and must contribute to the transformation of food systems in order to end hunger and achieve the UN Sustainable Development Goals by 2030.

Center for Development Research (ZEF)
University of Bonn
Bonn, Germany

Joachim von Braun
Acknowledgements

We begin by expressing our appreciation to the United Nations Leadership for convening the Scientific Group for the United Nations Food Systems Summit, and thereby elevating the role of science in underpinning the dialogues, policies, and investment decisions that have emerged from the Summit. We are especially grateful to Deputy Secretary-General Amina Mohammed and to Special Envoy Agnes Kalibata and their excellent teams for their strong commitment to and continued encouragement and support for robust and independent scientific evidence and knowledge.

We warmly thank all the members of the Scientific Group for their extraordinary contributions in bringing the foremost scientific evidence from around the world. The Scientific Group constituted a team of 28 food systems scientists – social scientists, economists and scientists working within the natural and biological sciences, ecology and food technology – from all parts of the world. From July 2020 through December 2021, the Scientific Group held 14 meetings to plan, discuss and review its submissions to the Summit.<fnref n="8" /> Members of the Scientific Group developed a series of original scientific papers, as well as undertaking peer reviews of papers contributed by partners, and they participated in *Science Days* and other important events in the lead-up to the Summit and during the Summit itself.<fnref n="9" />

We gratefully acknowledge the more than 40 global research partners who delivered science- and evidence-based, policy-focused research briefs covering a wide spectrum of food systems-related thematic areas, which are collected in this volume. These research partners included academic and research institutions, the CGIAR Centers, including the International Food Policy Research Institute (IFPRI), Indigenous Peoples’ knowledge networks, policy think-tanks, UN agencies,

<footnote n="8">⁸For the list of membership of the Scientific Group, see https://sc-fss2021.org/about-us/membership/. The minutes of all meetings are public, see: https://sc-fss2021.org/materials/scientific-group-reports-and-briefs/</footnote>

<footnote n="9">⁹For the list of papers by the partners of the Scientific Group, see https://sc-fss2021.org/wp-content/uploads/2021/07/FSS_ScG_Briefs_draft_list_20-7-2021.pdf</footnote>
academies of science and private-sector research and advocacy organizations. Many of them also organized side events around *Science Days*, drawing attention to important emerging issues.<fnref n="10" />

The Scientific Group valued transparency, as well as peer review and peer culture. We thank Mahendra Dev, Zhu Jing, Per Pinstrup-Andersen, Pauline Scheelbeek and Moctar Toure for their peer reviews of the Scientific Group's own papers, and we thank the many other anonymous reviewers for their peer reviews of the partners' papers.

*Science Days*, held on July 8–9, 2021, was organized by the Scientific Group and facilitated and hosted by FAO with about 3,000 participants. Acknowledging the importance of concerns about inclusiveness, the Scientific Group has aimed at broad inclusiveness throughout, including at Science Days, to make sure all perspectives were heard. We are indebted to FAO Chief Scientist Ismahane Elouafi and her team, especially Preet Lidder and Florian Doerr for their excellent collaboration with this important event.<fnref n="11" />

Colleagues at the Center for Development Research (ZEF) at the University of Bonn provided exceptional support to the Scientific Group throughout its term, from administrative support to research support, communications support, website support and event organization support. We would like to particularly thank Heike Baumüller, Paula Rothenberger, Niklas Müller and Yesim Pacal. We thank Anja Köhler at ZEF for developing the great Scientific Group website https://sc-fss2021.org/ that served us all, and that will be maintained.

Finally, we thank Rajul Pandya-Lorch for background writing, research and communications support, and Sundus Saleemi at ZEF for splendid research support of the Scientific Group throughout the Food Systems Summit processes and for management of partnerships and supporting the editorial processes of this volume. Funding support for the team at ZEF by the German Federal Ministry for Economic Cooperation and Development is gratefully acknowledged.

Co-editors of the Volume and Former Chair
and Vice Chairs of the Scientific Group
for the UN Food Systems Summit

Joachim von Braun
Kaosar Afsana
Louise O. Fresco
Mohamed Hag Ali Hassan

<footnote n="10">¹⁰ See the authors and co-authors of these chapters at https://sc-fss2021.org/materials/fss-briefs-by-partners-of-scientific-group/ and the list of partners of the Scientific Group at https://sc-fss2021.org/community/partners/.</footnote>

<footnote n="11">¹¹ For more on Science Days, see: https://sc-fss2021.org/events/sciencedays/</footnote>
# Contents

## Part I Food System Concept and Summarized Recommendations

**Food Systems: Seven Priorities to End Hunger and Protect the Planet**
3
Joachim von Braun, Kaosar Afsana, Louise O. Fresco, and Mohamed Hag Ali Hassan

**Food System Concepts and Definitions for Science and Political Action**
11
Joachim von Braun, Kaosar Afsana, Louise O. Fresco, Mohamed Hag Ali Hassan, and Maximo Torero

## Part II Actions on Hunger and Healthy Diets

**Healthy Diet: A Definition for the United Nations Food Systems Summit 2021**
21
Lynnette M. Neufeld, Sheryl Hendriks, and Marta Hugas

**Ensuring Access to Safe and Nutritious Food for All Through the Transformation of Food Systems**
31
Sheryl Hendriks, Jean-François Soussana, Martin Cole, Andrew Kambugu, and David Zilberman

**A Shift to Healthy and Sustainable Consumption Patterns**
59
Mario Herrero, Marta Hugas, Uma Lele, Aman Wirakartakusumah, and Maximo Torero

**Fruits and Vegetables for Healthy Diets: Priorities for Food System Research and Action**
87
Jody Harris, Bart de Steenhuijsen Piters, Stepha McMullin, Babar Bajwa, Ilse de Jager, and Inge D. Brouwer
**Modeling Actions for Transforming Agrifood Systems** 105
David Laborde and Maximo Torero

## Part III Actions for Equity and Resilience in Food Systems

**Advance Equitable Livelihoods** 135
Lynnette M. Neufeld, Jikun Huang, Ousmane Badiane, Patrick Caron, and Lisa Sennerby Forsse

**A Review of Evidence on Gender Equality, Women's Empowerment, and Food Systems** 165
Jemimah Njuki, Sarah Eissler, Hazel Malapit, Ruth Meinzen-Dick, Elizabeth Bryan, and Agnes Quisumbing

**The Future of Small Farms: Innovations for Inclusive Transformation** 191
Xinshen Diao, Thomas Reardon, Adam Kennedy, Ruth S. DeFries, Jawoo Koo, Bart Minten, Hiroyuki Takeshima, and Philip Thornton

**Diversification for Enhanced Food Systems Resilience** 207
Thomas Hertel, Ismahane Elouafi, Morakot Tanticharoen, and Frank Ewert

**Addressing Food Crises in Violent Conflicts** 217
Birgit Kemmerling, Conrad Schetter, and Lars Wirkus

**In Brief: The White/Wiphala Paper on Indigenous Peoples' Food Systems** 229
Pablo Arigita Baena, Anne Brunel, Yon Fernández-de-Larrinoa, Tania Eulalia Martinez-Cruz, Charlotte Milbank, and Mikaila Way

**Marginal Areas and Indigenous People Priorities for Research and Action** 261
Sayed Azam-Ali, Hayatullah Ahmadzai, Dhrupad Choudhury, Ee Von Goh, Ebrahim Jahanshiri, Tafadzwanashe Mabhaudhi, Alessandro Meschinelli, Albert Thembinkosi Modi, Nhamo Nhamo, and Abidemi Olutayo

**Priorities for Inclusive Urban Food System Transformations in the Global South** 281
Paule Moustier, Michelle Holdsworth, Dao The Anh, Pape Abdoulaye Seck, Henk Renting, Patrick Caron, and Nicolas Bricas

**Secondary Cities as Catalysts for Nutritious Diets in Low- and Middle-Income Countries** 305
Kesso Gabrielle van Zutphen, Dominique Barjolle, Sophie van den Berg, Breda Gavin-Smith, Klaus Kraemer, Capucine Musard, Helen Prytherch, Johan Six, Simon Winter, and Kris Woltering
## Part IV Actions for Sustainable Food Production and Resource Management

**Boost Nature-Positive Production** 319
Elizabeth Hodson de Jaramillo, Urs Niggli, Kaoru Kitajima, Rattan Lal, and Claudia Sadoff

**Pathways to Advance Agroecology for a Successful Transformation to Sustainable Food Systems** 341
Urs Niggli, Martijn Sonnevelt, and Susanne Kummer

**A New Paradigm for Plant Nutrition** 361
Achim Dobermann, Tom Bruulsema, Ismail Cakmak, Bruno Gerard, Kaushik Majumdar, Michael McLaughlin, Pytrik Reidsma, Bernard Vanlauwe, Eva Wollenberg, Fusuo Zhang, and Xin Zhang

**Livestock and Sustainable Food Systems: Status, Trends, and Priority Actions** 375
Mario Herrero, Daniel Mason-D'Croz, Philip K. Thornton, Jessica Fanzo, Jonathan Rushton, Cecile Godde, Alexandra Bellows, Adrian de Groot, Jeda Palmer, Jinfeng Chang, Hannah van Zanten, Barbara Wieland, Fabrice DeClerck, Stella Nordhagen, Ty Beal, Carlos Gonzalez, and Margaret Gill

**The Vital Roles of Blue Foods in the Global Food System** 401
Jim Leape, Fiorenza Micheli, Michelle Tigchelaar, Edward H. Allison, Xavier Basurto, Abigail Bennett, Simon R. Bush, Ling Cao, Beatrice Crona, Fabrice DeClerck, Jessica Fanzo, Stefan Gelcich, Jessica A. Gephart, Christopher D. Golden, Christina C. Hicks, Avinash Kishore, J. Zachary Koehn, David C. Little, Rosamond L. Naylor, Elizabeth R. Selig, Rebecca E. Short, U. Rashid Sumaila, Shakuntala H. Thilsted, Max Troell, and Colette C. C. Wabnitz

**Food System Innovations and Digital Technologies to Foster Productivity Growth and Rural Transformation** 421
Rui Benfica, Judith Chambers, Jawoo Koo, Alejandro Nin-Pratt, José Falck-Zepeda, Gert-Jan Stads, and Channing Arndt

**Leveraging Data, Models & Farming Innovation to Prevent, Prepare for & Manage Pest Incursions: Delivering a Pest Risk Service for Low-Income Countries** 439
Bryony Taylor, Henri Edouard Zefack Tonnang, Tim Beale, William Holland, MaryLucy Oronje, Elfatih Mohamed Abdel-Rahman, David Onyango, Cambria Finegold, Jessica Zhu, Stefania Pozzi, and Sean T. Murphy
<table><tbody><tr><td><strong>Food Systems Innovation Hubs in Low- and Middle-Income Countries</strong></td><td>455</td></tr><tr><td>Kalpana Beesabathuni, Klaus Kraemer, Sufia Askari, Srijith Lingala, Madhavika Bajoria, Martin Bloem, Breda Gavin-Smith, Hamid Hamirani, Priyanka Kumari, Anne Milan, Puja Tshering, Kesso Gabrielle van Zutphen, and Kris Woltering</td><td></td></tr><tr><td><strong>A Whole Earth Approach to Nature-Positive Food: Biodiversity and Agriculture</strong></td><td>469</td></tr><tr><td>Fabrice A. J. DeClerck, Izabella Koziell, Tim Benton, Lucas A. Garibaldi, Claire Kremen, Martine Maron, Cristina Rumbaitis Del Rio, Aman Sidhu, Jonathan Wirths, Michael Clark, Chris Dickens, Natalia Estrada Carmona, Alexander K. Fremier, Sarah K. Jones, Colin K. Khoury, Rattan Lal, Michael Obersteiner, Roseline Remans, Adrien Rusch, Lisa A. Schulte, Jeremy Simmonds, Lindsay C. Stringer, Christopher Weber, and Leigh Winowiecki</td><td></td></tr><tr><td><strong>Water for Food Systems and Nutrition</strong></td><td>497</td></tr><tr><td>Claudia Ringler, Mure Agbonlahor, Kaleab Baye, Jennie Barron, Mohsin Hafeez, Jan Lundqvist, J. V. Meenakshi, Lyla Mehta, Dawit Mekonnen, Franz Rojas-Ortuste, Aliya Tankibayeva, and Stefan Uhlenbrook</td><td></td></tr><tr><td><strong>Climate Change and Food Systems</strong></td><td>511</td></tr><tr><td>Alisher Mirzabaev, Lennart Olsson, Rachel Bezner Kerr, Prajal Pradhan, Marta Guadalupe Rivera Ferre, and Hermann Lotze-Campen</td><td></td></tr><tr><td><strong>Delivering Climate Change Outcomes with Agroecology in Low- and Middle-Income Countries: Evidence and Actions Needed</strong></td><td>531</td></tr><tr><td>Sieglinde Snapp, Yodit Kebede, Eva Wollenberg, Kyle M. Dittmer, Sarah Brickman, Cecelia Egler, and Sadie Shelton</td><td></td></tr><tr><td><strong>Crop Diversity, Its Conservation and Use for Better Food Systems</strong></td><td>545</td></tr><tr><td>Stefan Schmitz, Rodrigo Barrios, Hannes Dempewolf, Luigi Guarino, Charlotte Lusty, and Janet Muir</td><td></td></tr><tr><td><strong>Safeguarding and Using Fruit and Vegetable Biodiversity</strong></td><td>553</td></tr><tr><td>Maarten van Zonneveld, Gayle M. Volk, M. Ehsan Dulloo, Roeland Kindt, Sean Mayes, Marcela Quintero, Dhrupad Choudhury, Enoch G. Achigan-Dako, and Luigi Guarino</td><td></td></tr><tr><td><strong>Reduction of Food Loss and Waste: The Challenges and Conclusions for Actions</strong></td><td>569</td></tr><tr><td>Joachim von Braun, M. Sanchéz Sorondo, and Roy Steiner</td><td></td></tr></tbody></table>
## Part V Costs, Investment, Finance, and Trade Actions

**The True Cost of Food: A Preliminary Assessment** 581

Sheryl Hendriks, Adrian de Groot Ruiz, Mario Herrero Acosta, Hans Baumers, Pietro Galgani, Daniel Mason-D'Croz, Cecile Godde, Katharina Waha, Dimitra Kanidou, Joachim von Braun, Mauricio Benitez, Jennifer Blanke, Patrick Caron, Jessica Fanzo, Friederike Greb, Lawrence Haddad, Anna Herforth, Danie Jordaan, William Masters, Claudia Sadoff, Jean-François Soussana, Maria Cristina Tirado, Maximo Torero, and Matthew Watkins

**The Cost and Affordability of Preparing a Basic Meal Around the World** 603

William A. Masters, Elena M. Martinez, Friederike Greb, Anna Herforth, and Sheryl L. Hendriks

**The Global Cost of Reaching a World Without Hunger: Investment Costs and Policy Action Opportunities** 625

Bezawit Beyene Chichaibelu, Maksud Bekchanov, Joachim von Braun, and Maximo Torero

**Financing SDG2 and Ending Hunger** 661

Eugenio Díaz-Bonilla

**Trade and Sustainable Food Systems** 685

Andrea Zimmermann and George Rapsomanikis

## Part VI Regional Perspectives

**Policy Options for Food System Transformation in Africa and the Role of Science, Technology and Innovation** 713

Ousmane Badiane, Sheryl L. Hendriks, Katrin Glatzel, Fadi Abdelradi, Assefa Admassie, John Asafu Adjaye, Miltone Ayieko, Endashaw Bekele, Thameur Chaibi, Mohamed Hag Ali Hassan, Mame Samba Mbaye, Fatima Ezzahra Mengoub, Douglas W. Miano, John H. Muyonga, Tolulope Olofinbiyi, Racha Ramadan, and Simbarashe Sibanda

**The Role of Science, Technology and Innovation for Transforming Food Systems in Latin America and the Caribbean** 737

Elizabeth Hodson de Jaramillo, Eduardo J. Trigo, and Rosario Campos

**The Role of Science, Technology, and Innovation for Transforming Food Systems in Asia** 751

Paul J. Moughan, Daniel A. Chamovitz, S. Ayyappan, Morakot Tanticharoen, Krishan Lal, and Yoo Hang Kim

**The Role of Science, Technology, and Innovation for Transforming Food Systems in Europe** 763

Claudia Canales and Robin Fears
Transforming Chinese Food Systems for Both Human and Planetary Health 779

Shenggen Fan, Jikun Huang, Fusuo Zhang, Wenhua Zhao, Hongyuan Song, Fengying Nie, Yu Sheng, Jinxia Wang, Jieying Bi, and Wenfeng Cong

Key Areas of the Agricultural Science Development in Russia in the Context of Global Trends and Challenges 799

Nadezhda Orlova, Evgenia Serova, Vladimir Popov, and Marina Petukhova

Food System in India. Challenges, Performance and Promise 813

Ashok Gulati, Raj Paroda, Sanjiv Puri, D. Narain, and Anil Ghanwat

Part VII Strategic Perspectives and Governance

The Role of Science, Technology and Innovation in Transforming Food Systems Globally 831

Robin Fears and Claudia Canales

The Bioeconomy and Food System Transformation 849

Eduardo Trigo, Hugo Chavarria, Carl Pray, Stuart J. Smyth, Agustin Torroba, Justus Wesseler, David Zilberman, and Juan F. Martinez

In the Age of Pandemics, Connecting Food Systems and Health: A Global One Health Approach 869

Gebbiena M. Bron, J. Joukje Siebenga, and Louise O. Fresco

How Could Science–Policy Interfaces Boost Food System Transformation? 877

Etienne Hainzelin, Patrick Caron, Frank Place, Arlène Alpha, Sandrine Dury, Ruben Echeverria, and Amanda Harding

The Transition Steps Needed to Transform Our Food Systems 893

Patrick Webb, Derek J. Flynn, Niamh M. Kelly, and Sandy M. Thomas

Engaging Science in Food System Transformation: Toward Implementation of the Action Agenda of the United Nations Food Systems Summit 909

Joachim von Braun

Science for Transformation of Food Systems: Opportunities for the UN Food Systems Summit 921

Joachim von Braun, Kaosar Afsana, Louise O. Fresco, and Mohamed Hag Ali Hassan
Part I

# Food System Concept and Summarized Recommendations
# Food Systems: Seven Priorities to End Hunger and Protect the Planet

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Joachim von Braun, Kaosar Afsana, Louise O. Fresco, and Mohamed Hag Ali Hassan

The world's food system is in disarray. One in ten people is undernourished. One in four is overweight. Almost half the world's population cannot afford a healthy diet. Food supplies are disrupted by heatwaves, floods, droughts and wars. The number of people going hungry in 2020 was 13% higher than in 2019 owing to the COVID-19 pandemic and armed conflicts. (FAO, IFAD, UNICEF, WFP and WHO 2021).

The planet suffers too. The food sector emits about 30% of the world's greenhouse gases. Expanding cropland, pastures and tree plantations drive two thirds (5.5 Million ha per year) of the loss in forests, mostly in the tropics (Pendrill et al. 2019). Poor farming practices degrade soils, pollute and deplete water supplies, and lower biodiversity.

As these interlinkages become clear, approaches to food are shifting – away from production, consumption and value chains toward safety, networks and complexity. Recent crises around global warming and COVID-19 have compounded concerns. Policymakers have taken note.

In September, the UN Secretary General will convene a Food Systems Summit. This is only the 6th UN summit on food since 1943 and the first with heads of states in the UN General Assembly. A group of leading scientists has been tasked with ensuring the science underpinning the 2021 Summit is robust, broad and independent – we write as its chair and co-chairs. While such approaches are familiar

J. von Braun (✉)

Center for Development Research (ZEF), University of Bonn, Bonn, Germany

e-mail: jvonbraun@uni-bonn.de

K. Afsana

James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh

L. O. Fresco

Wageningen University and Research, Wageningen, The Netherlands

M. H. A. Hassan

The World Academy of Sciences for the Advancement of Science in Developing Countries (TWAS), Trieste, Italy
in other areas like climate change and biodiversity, this marks the first time scientists have been explicitly brought in to multilateral discussions around food (Nature Editorial Board 2021).

The global food system needs a revamp – in policies and institutions as well as on social, business and technology fronts (OECD 2021). Science is one lens for making sure that changes are integrated and add collectively to deliver better outcomes. But it is challenging. Food spans many disciplines – not least agriculture, health, climate science, AI and digital science, political science and economics. The indirect effects of policies on climate change, biodiversity loss and adverse health effects need to be factored in to the true costs of food; these could triple <yes?] the current global value attributed to food markets (Hendriks et al. 2021). A range of voices is vital. The Scientific Group is engaging with hundreds of experts, across civil society, indigenous peoples, producer organizations, youth organizations and the private sectors.

Here we highlight key roles scientists should play to accelerate the transformation to healthier, more sustainable, equitable and resilient food systems. These seven priorities reflect the Scientific Group's evidence base, comprising more than 40 reports and briefs (see https://sc-fss2021.org/materials/fss-briefs-by-partners-of-scientific-group/).

# 1 Seven Priorities

Science-driven advances are needed in the following areas.

## 1.1 End Hunger and Improve Diets

Scientists need to identify optimal conditions and investment opportunities to make healthy and nutritious foods more available, affordable and accessible. Measures that do all three are most effective in cutting hunger and improving diets. For example, improving irrigation on small farms in Tanzania and Ethiopia has enhanced productivity, lowered prices for consumers and increased farmers' income (Passarelli et al. 2018).

Three big game changers are: enhancing research and development (R&D) in agriculture and food to increase productivity sustainably, adding income and nutrition components to social protection programs, and slashing food waste and losses. Research priorities include powering fridges and preserving plants with solar energy. Developing new forms of packaging using recycled materials, coatings of nanomaterials and even edible films, would keep foods fresh for longer and reduce losses. School feeding programs offering nutritious meals for students, plus incentives like take home rations for parents to keep children in education, have increased school participation in Mali by 10% (Aurino et al. 2019). Under Covid-19 lockdowns these programs become even more relevant, as in Addis Ababa schools.
Researchers also need to study behavioral barriers to healthy eating, such as snacking under stress. They should develop policy guidelines for educational food labels and taxes and regulations on unhealthy foods (such as sugar, trans-fats and high-fructose corn syrup). The health properties of fortified foods and cultivated meats need establishing.

## 1.2 De-risk Food Systems

The more global, dynamic and complex food systems become, the more they are open to novel risks. Scientists need to better understand, monitor, analyze and communicate such vulnerabilities. For example, droughts, biofuels expansion and financial speculation after the sudden imposition of trade barriers led to food price hikes in 2008 (Kalkuhl et al. 2016). The COVID-19 pandemic and armed conflicts have shaken food value chains across Africa this year, driving up food prices. Successful initiatives combining on the ground observations of food systems and nutrition with forecasting include FEWS NET (https://fews.net/) and the joint FAO-World Food Program Early Warning System (https://www.wfp.org/publications/fao-wfp-early-warning-analysis-acute-food-insecurity-hotspots).

Policies and economic solutions are needed. For example, novel insurance products facilitated by remote sensing and weather forecasts would provide cover for lost crops and livestock. Solar powered irrigation systems would reduce risk from drought. Smart-phone apps would provide farmers with information on local crop pests, weather risks and market opportunities; these are already used in Kenya, Senegal, India and Bangladesh (Baumüller 2017). Payment schemes are needed to encourage farmers to manage and capture carbon in soils and trees and trade it.

## 1.3 Protect Equality and Rights

Poverty and inequalities associated with gender, ethnicity and age restrict many people's access to healthy foods. Socio-economic researchers need to suggest inclusive ways to transform more than 400 million smallholder farms. They must identify pathways out of inequitable and unfair arrangements over land, credit and labor and empower the rights of women and youth. For example, if female-headed households in Southern Ethiopia had same resources as male-headed ones, their productivity in maize would increase by 40%, to match that of the latter (Gebre et al. 2021).

Protecting the land rights of smallholders, women and indigenous peoples is paramount. Technology can ensure transparency and efficiency. For example, Ghana uses Blockchain ledgers of land use and ownership rights for allocating land (Mintah et al. 2021). At the trans-national scale the Land Matrix Initiative (https://landmatrix.org/) collects and shares data on big land acquisitions and investments, covering almost 100 countries. Similar solutions are needed to protect the land rights of
Indigenous Peoples (see http://www.fao.org/publications/card/fr/c/CB4932EN/). Efforts to build local research capacity, educational programs around food and farming, as well as training and financing opportunities in rural areas are needed.

## 1.4 Boost Bioscience

Researchers need to find ways to restore soil health and improve the efficiency of cropping, breeding of crops, and re-carbonizing the biosphere. Linkages among all Earth systems must be considered together – a One Health approach.

Alternative sources of healthy protein need to be advanced, including more plant-based and insect-derived proteins, including for animal feed. Plant breeding techniques that capture nitrogen from the air, to reduce the need for fertilizers and increase nutrients, should be investigated. Genetic engineering and biotechnology should be applied to increase productivity, quality and pest and drought resistance of crops; recent examples include varieties of bananas resistant to Fusarium Wilt diseases, and pest-resistant BT eggplants. Property rights, skills and data-sharing should be addressed, to widen access to bioscience technologies.

## 1.5 Protect Resources

Tools are needed to help people manage soils, land and water sustainably. For example, hand-held digital devices and remote sensing can track concentrations of soil carbon and other nutrients. AI and drones allow farmers to spot areas that need irrigation, fertilization and pest control. Soil microbes can be harnessed to improve soil structure, ability to store carbon and yields. Researchers need to adapt and scale such technologies.

Biodiversity and genetic bases need to be protected. Seed varieties need to be preserved and their phenotype and genotype characteristics explored in the contexts of climate change and nutrition. Traditional food and forest systems, including those of Indigenous Peoples, need to be better understood and supported in national agricultural research systems. Cooperation for mutual benefit should be explored, as the Tribal Adaptation Menu in Indigenous Peoples' areas in the US has for climate adaptation https://forestadaptation.org/sites/default/files/Tribal%20Climate%20Adaptation%20Menu%2011-2020%20v2.pdf.

## 1.6 Sustain Aquatic Foods

Most of the focus on food to date has been on land-based agriculture. Seafood and seaweed have much to offer nutritionally and environmentally. Aquatic foods need to be better integrated into understanding of food systems (see https://www.nature.com/
articles/d41586-020-03303-3). Researchers should look for ways to increase nutritional diversity in aquatic foods and sequester carbon in the marine environment.

Ecological science perspectives and global cooperation and institutions are needed to bring the harvesting of oceans to sustainable levels and protect biodiversity. Science-based approaches must address the sustainability of fish feeding systems; for example, explore using insect rearing, oil-rich modified legumes and micro-algae as fish feed.

## 1.7 Harness Technology

Robots, sensors and artificial intelligence are increasingly used on farms and in food processing. For example, robots harvest crops and milk cows. Sensors can monitor the origin and quality of ingredients and products along the food processing chain to reduce losses and guarantee food safety. But most farmers and producers still don't have access. To spread the benefits, devices need to become cheaper and easier to purchase and use. Rental services should be developed, such as an Uber-like app for tractors in India. Rural electricity will be needed, and training and education programs. Again, managing property rights and sharing data are key.

## 2 First Steps

The 2021 Food Systems Summit is a great opportunity to end hunger by 2030 and set in train a sustainable food system. Previous UN food summits have delivered change. The 1943 conference led to FAO; the 1974 meeting strengthened the CGIAR and led to the founding of IFPR; the 2002 session accelerated the human right to food; and the 2009 meeting established monitoring systems to prevent food price crises.

The breadth of the 2021 agenda could be a hindrance, though, in achieving its goals. To avoid failure, delegates should focus. They should prioritize establishing a guiding framework – for transforming diverse national and local food systems, as well as global networks, with the challenges of trade, finance, climate, innovation and governance.

Debates will be fierce. Food is a contentious topic. Disagreements abound, over goals, pathways and speed of change, and the roles of science and technology, the private sector and the UN. For example, some see agroecology as the only acceptable way of farming, with minimal technology. Biotechnology and gene editing are viewed as both an opportunity and a danger. Livestock exacerbate the climate crisis. (The Scientific Group has aimed to offer a balanced view by noting the diversity of perspectives.)
## 3 Actions and Targets

Once plans are agreed, the UN Food Systems Summit will need to move to implementation. Here are our suggestions.

First, boost finance. On the research front, we propose that governments allocate at least 1% of the fraction of their nations' GDP that relates to food systems to food-related research. Many countries spend only half of that. Least-developed countries should be given aid to reach a similar level. To end hunger for the poorest, we propose a special fund be set up. This would be supported by development aid donors and bonds backed by the IMF and World Bank. Research and modeling would be required into implementation and impacts.

Second, increase scientific capacity. Use the funding above to strengthen research capacity in low and middle income countries. Expand research collaborations between the public and private sectors, among farmers, start-ups in food value chains and science communities. Sharing research infrastructure and data between the global south and north would be a good start.

Third, strengthen science-policy interfaces. In stark contrast to many other fields, agriculture, food security and nutrition do not have an international agreement or convention to consolidate actions. We call on the UNFSS and UN Member States to explore an intergovernmental treaty or framework convention on food systems, by analogy to the conventions on climate, biodiversity and desertification agreed upon in Rio in YEAR. We recommend that all science organizations and academies with food-relevant research be included in a preparatory process.

Bringing the tools of science to the table will help transform the global food system to end hunger and achieve the Sustainable Development Goals by 2030.

**Acknowledgment** This chapter was originally published as an article in Nature, 597, 28–30, (2021).

## References

Aurino E et al (2019) School feeding or general food distribution? Quasi-experimental evidence on the educational impacts of emergency food assistance during conflict in Mali. J Dev Stud 55 (sup1):7–28. https://doi.org/10.1080/00220388.2019.1687874

Baumüller H (2017) Towards smart farming? Mobile technology trends and their potential for developing country agriculture. In: Skouby KE, Williams I, Gyamfi A (eds) Handbook for ICT in developing countries: 5G perspectives. River Publishers, Delft, pp 191–201. ISBN: 978-87-93379-91-6

FAO, IFAD, UNICEF, WFP and WHO (2021) The state of food security and nutrition in the world 2021. FAO, Rome. http://www.fao.org/3/cb4474en/online/cb4474en.html
Gebre GG et al (2021) Gender differences in agricultural productivity: evidence from maize farm households in southern Ethiopia. GeoJournal 86:843–864. https://doi.org/10.1007/s10708-019-10098-y

Hendriks S et al (2021) The true cost and true price of food. A paper from the Scientific Group of the UN Food Systems Summit, June 2021. https://sc-fss2021.org/wp-content/uploads/2021/06/UNFSS_true_cost_of_food.pdf

Kalkuhl M et al (2016) Food price volatility and its implications for food security and policy. Springer, Cham. http://link.springer.com/book/10.1007%2F978-3-319-28201-5

Mintah K et al (2021) Blockchain on stool land acquisition: lessons from Ghana for strengthening land tenure security other than titling. Land Use Policy 109. https://doi.org/10.1016/j.landusepol.2021.105635

Nature Editorial Board (2021) Does the fight against hunger need its own IPCC? Nature 595:332. https://doi.org/10.1038/d41586-021-01904-0

OECD (2021) Making better policies for food systems. OECD Publishing, Paris. https://doi.org/10.1787/ddfba4de-en

Passarelli S et al (2018) Evaluating the pathways from small-scale irrigation to dietary diversity: evidence from Ethiopia and Tanzania. Food Secur 10:981–997. https://doi.org/10.1007/s12571-018-0812-5

Pendrill F et al (2019) Environ Res Lett 14:055003

**Open Access** This chapter is licensed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

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Joachim von Braun, Kaosar Afsana, Louise O. Fresco, Mohamed Hag Ali Hassan, and Maximo Torero

For fruitful deliberations and concerted action at the science-political interface the very concept of food systems and drivers of change need to be clearly understood and employed by all

# 1 Introduction

Food systems exist at different scales: global, regional, national and local. Local food systems around the world are very diverse and location-specific. They share some key features, but any attempt to change them should reflect their uniqueness embedded in traditions, cultures, economic structures, and ecologies of locations. Change in food systems comes about through external and internal drivers as well as through feedback mechanisms between these drivers. External drivers are for instance from climate or health systems, internal drivers are for instance from

J. von Braun (✉)

Center for Development Research (ZEF), University of Bonn, Bonn, Germany
e-mail: jvonbraun@uni-bonn.de

K. Afsana

James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh

L. O. Fresco

Wageningen University and Research, Wageningen, The Netherlands

M. H. A. Hassan

The World Academy of Sciences for the Advancement of Science in Developing Countries
(TWAS), Trieste, Italy

M. Torero

Food and Agriculture Organization of the United Nations (FAO), Rome, Italy
productivity gains as a consequence of innovations or from changes in consumer behavior.

The way in which changes in food systems impact sustainability in its diverse social, economic, and ecological dimensions is critical. With the Sustainable Development Goals (SDGs) there is an accelerating momentum worldwide, to adopt systems approaches to bring consumption and production patterns together to achieve sustainable development through an integrated approach to food systems (United Nations 2020).

## 2 Defining and Conceptualizing Food Systems

A practical definition of food systems should meet two essential criteria:

* it should be suitable for the purpose at hand, which is to support the global and national collective efforts to bring about positive change in food systems, by accelerating progress on meeting the 2030 Agenda and the SDGs in particular end hunger, improve diets and protect ecologies; and

* it should be sufficiently precise to define the domains for policy and programmatic priorities, and it should be sufficiently general to not exclude any aspects of the economic, social, and ecological dimensions of sustainability.

The significance of criterion (1) is that the definition should guide not only scientific inquiry, but also actions of all types, toward a common purpose, i.e. food systems change and in the long run even food systems transformation (von Braun et al. 2020). The point of criterion (2) is to avoid the intellectual hubris that accompanies many efforts of characterizing and graphically depicting food systems' complexities in great detail. Efforts to map food systems visually may help scientists as well as decision makers to identify key interactions and the mechanisms, both natural and social, which regulate those interactions. Yet, food systems' maps that try to be fully comprehensive tend to collapse under the density and complexity of the interactions to be described and analyzed. At the other extreme, food systems' maps and models that focus too narrowly on a reduced set of phenomena gain apparent explanatory power at the price of realism, adequacy or the exclusion of important economic, social or bio-physical environmental forces. There is no clearly defined pathway out of this dilemma. Much depends on the relevant policy question as well as on the context and scale of the food systems under consideration.

Food systems embrace the entire range of actors and their interlinked value-adding activities involved in the production, aggregation, processing, distribution, consumption, and disposal (loss or waste) of food products, that originate from agriculture (incl. livestock), forestry, fisheries, and food industries, and the broader economic, societal, and physical environments, in which they are embedded (FAO 2018). The range of actors importantly includes science, technology, data, and innovation actors (Herrero et al. 2020).
*Sustainable food systems* are those that contribute to food security and nutrition for all in such a way that the economic, social, cultural, and ecological bases to generate food security and nutrition for future generations are safeguarded (Global Panel on Agriculture and Food Systems for Nutrition 2020). It should be noted that desirable food systems are necessary but not sufficient to assure good nutrition – even the best food system cannot assure good nutrition in a situation of poor hygiene, unclean drinking water, poor child care, and widespread infectious diseases. Moreover, the availability of plentiful and healthy food does not guarantee adequate consumption patterns or prevent excess body weight.

The concept of *food systems transformation* has been linked to the aspirations of the 2030 Agenda and refers to the objective of pursuing fundamental change of food systems, for instance, to aim for climate neutrality and achieving the SDGs. *Transformation* is a never-ending process in food systems. *Transition* is the movement from one state to another. And *evolution* is the process of change. These are not interchangeable terminologies. Most food systems need all three.

Conceptualizing food systems entails defining systems boundaries and systems building blocks and linkages among them, while simultaneously being connected to neighboring systems such as health, ecological, economy and governance, and the science and innovation systems (see Fig. 1). Food systems are in a continuous state of change and adaptation. For the Food Systems Summit this means to identify actions which enhance positive side-effects of or to remediate or mitigate negative side-effects of policies. The elimination of net-negative externalities of food systems in terms of ecology and health costs would guide toward recognizing the true costs and price of food. A sustainable circular bio-economy concept as an overarching systems frame, in which food systems are embedded, could be considered in the solution-finding process.

<figure><img src="image_8.png" /><figcaption>**Fig. 1** The food system in the context of other systems (positive systems concept). (Source: designed by authors, adapted from InterAcademy Partnership (2018) and von Braun (2017))</figcaption></figure>
## 3 An Action-Oriented Concept of Food Systems

Systems can be conceptualized from a *positive* or from a *normative* perspective. The *positive concept* attempts to design systems' structures and functions as they occur in the current real world and identify points of entry for desirable systems' change. The *normative concept* postulates a set of objectives and aims to shape the systems to serve the stated objectives. Both concepts aggregate and simplify real world structures and processes. Neither of these approaches escape the yardsticks of scientific evidence. For theoretical clarity of underlying value judgments, however, the two approaches need to be distinguished. As the Food Systems Summit is based on clearly stated objectives already defined in the SDGs, a *normative* approach is justified. Yet, normative approaches need to be put to the test by positive approaches in order not to steer into a dead end of unrealistic wishful thinking. Thus, normative and positive approaches are complementary. To build upon existing efforts, we suggest a concept of food systems that may help to frame action-oriented agenda setting, such as the one reflected in the five Action Tracks for the Food Systems Summit in support of the SDGs. These Action Tracks are described as:

1. Ensuring Access to Safe and Nutritious Food for All (enabling all people to be well-nourished and healthy);

2. Shifting to Sustainable Consumption Patterns (promoting and creating demand for healthy and sustainable diets, reducing waste);

3. Boosting Nature-Positive Production at Sufficient Scale (acting on climate change, reducing emissions and increasing carbon capture, regenerating and protecting critical ecosystems and reducing food loss and energy usage, without undermining health or nutritious diets);

4. Advancing Equitable Livelihoods and Value Distribution (raising incomes, distributing risk, expanding inclusion, creating jobs); and

5. Building Resilience to Vulnerabilities, Shocks and Stresses (ensuring the continued functionality of healthy and sustainable food systems).

The five *Action Tracks* capture various key opportunities and challenges of food systems and relate to one or more food systems components, but *they do not define a food systems concept* as such. Therefore, the pursuit of the Action Tracks needs to be conscious of an overarching food systems concept. Pursuing each Action Track in isolation from the others would lead to inefficient solution proposals that neglect system-wide effects. We thus offer a perspective that attempts to position the five Action Tracks in a food systems framework (Fig. 2): We expect food security and nutrition, livelihood improvements, and production with environmental sustainability; we want resilience to shocks (i.e. low variability, and a quick recovery from negative shocks); and we know that consumption patterns are a powerful lever for change. “Ensuring Access to Safe and Nutritious Food for All (enabling all people to be well-nourished and healthy)” is supported by the other four Action Tracks, yet there is also feedback from improved nutrition to the other four Action Tracks.
<figure><img src="image_9.png" /><figcaption>**Fig. 2** Action Tracks in a Food System (a normative systems perspective). (Source: Designed by authors)</figcaption></figure>

The Action Tracks need to consider functional relationships among them in systemic ways.

The systems perspective must not overlook some key cross-cutting issues and themes, which need due attention, for example, Covid-19 has highlighted the intertwining of food and health systems. Science and new and emerging technologies and innovations, including gene editing, digitization, Internet of Things, and Artificial Intelligence, are critical for improving productivity, efficiency, equity, and sustainability of food systems. The role of women and gender are important determinants for productive, healthy and sustainable food systems, and are fundamental for equity. Trade, market structures and dynamics of food industries require policy attention (OECD 2021). And there is a tendency to think of food systems as terrestrial systems only, but it will be vital to broaden the understanding of food systems to include their links to water cycles, oceans and fisheries.

# 4 Concluding Remarks

The discourse on food systems must not abstract from the issue of culture and values, making it seem as if it is merely a technical question. This especially - but not only - applies to the greatly diverse indigenous food systems, and the culture and knowledge embedded in them.

The Food Systems Summit needs to facilitate action to overcome systems failures that contribute to the hunger, malnutrition, and obesity problems; to the ecological problems of deforestation, green-house gas emissions, biodiversity losses and species extinctions; to the problems of poor livelihoods in farming communities especially of women and youth; and to the fundamental issues of food system related violations of rights - human right to food, broadly defined. The Summit needs to
come up with visions for food systems transformations in their respective contexts. While a strong sense of urgency is called for due to the big food systems malfunctioning, the time horizon of the food systems transformations needs to reach far beyond 2030, given demographic change, climate change, technological change and people – nature linkages in the Anthropocene.

If food systems shall deliver on the stated objectives (i.e. the SDGs), the Food Systems Summit needs to be open to new thinking, to new concepts, and to establishing new institutional and organizational arrangements. Addressing symptoms of systems failures will not be sufficient. Investing in science is essential to innovate, develop, and implement game-changing propositions that fit the respective food systems contexts. Science and policy have a lot to gain from cooperation through a strong and effective science – policy interface to help guide the follow up to the Summit (InterAcademy Partnership 2018).

**Acknowledgements** We gratefully acknowledge the peer review of a background paper on which this comment is based by these reviewers:

Per Pinstrup-Andersen, Professor (em) of Food, Nutrition and Public Policy at Cornell University and Adjunct Professor, Copenhagen University.

Pauline Scheelbeek, Assistant Professor in Nutritional & Environmental Epidemiology, London School of Hygiene & Tropical Medicine.

Mahendra Dev, Professor, Director and Vice Chancellor, Indira Gandhi Institute of Development Research, India.

Zhu Jing, Cheung Kong Chair Professor and Dean of College of Economics and Management, Nanjing Agricultural University (NAU), China.

Dr. Moctar Toure, Vice President of The World Academy of Sciences (TWAS) for the advancement of science in developing countries, representing the Africa Region.

The text was originally published in Nature Food, 2, 748–750 (2021).

## References

* FAO (2018). http://www.fao.org/3/ca2079en/CA2079EN.pdf

* Global Panel on Agriculture and Food Systems for Nutrition (2020). https://www.glopan.org/foresight2/

* Herrero M et al (2020) Nat Food 1:266

* InterAcademy Partnership (2018) Trieste and Washington, DC. https://www.interacademies.org/sites/default/files/publication/iap_fnsa_global_web_complete_28nov.pdf

* OECD (Organization for Economic Co-operation and Development) (2021) Paris. https://www.oecd.org/food-systems/

* United Nations (2020) Sustainable development goals, New York. https://sdgs.un.org/goals

* von Braun J, Chichaibelu BB, Cullen MT, Laborde D, Smaller C (2020) Berlin. https://www.zef.de/fileadmin/downloads/SDG2_policybrief.pdf
**Open Access** This chapter is licensed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

The images or other third party material in this chapter are included in the chapter's Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the chapter's Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

<figure><img src="image_10.png" /></figure>
Part II

**Actions on Hunger and Healthy Diets**
# Healthy Diet: A Definition for the United Nations Food Systems Summit 2021

<figure><img src="image_11.png" /></figure>

Check for
updates

Lynnette M. Neufeld, Sheryl Hendriks, and Marta Hugas

## 1 Definition

*A healthy diet is health-promoting and disease-preventing. It provides adequacy, without excess, of nutrients and health-promoting substances from nutritious foods and avoids the consumption of health-harming substances.<fnref n="1" />*

## 2 Approaches to Translating a Healthy Diet into Specific Food-Based Recommendations

Moving beyond the available broad definitions so as to operationalize what constitutes a healthy diet has been a source of debate within the nutrition community for decades. Innumerable definitions exist, with many similarities and several

<footnote n="1">¹The hyper-linked sections seek to provide further clarifications in relation to terminology and concepts. Specifically, it is important to distinguish between *diets* (combinations of food consumed by individuals or populations over time) and individual foods, which have characteristics that make them more or less nutritious. Annex 1 below provides a definition of nutritious foods, and related evidence, gaps, and controversies. In Annex 2, we similarly highlight such issues in relation to food safety and the identification and management of health-harming substances in foods.</footnote>

<footnote>L. M. Neufeld (✉)
International Union of Nutrition Scientists (IUNS), Knowledge Leadership, Global Alliance for Improved Nutrition (GAIN), Ottawa, Canada
e-mail: lynnetten@gmail.com</footnote>

<footnote>S. Hendriks
Department of Agricultural Economics, Extension and Rural Development, University of Pretoria, Pretoria, South Africa</footnote>

<footnote>M. Hugas
European Food Safety Authority (EFSA), Madrid, Spain</footnote>
contradictions emerging over time (Cena and Calder 2020). In part, the contradictions arise from diversity in the underlying health issues that the diets were intended to address. Approaches to operationalizing the broad definitions and a move toward specific food-based recommendations have typically used one of three approaches: i) observing existing dietary patterns associated with a lower prevalence of specific diseases; ii) perspective approaches based on evidence related to one or several outcomes; and iii) indicative approaches providing evidence-based guidance to be adapted to a specific context. Several examples of each and their related strengths and weaknesses are discussed below.

1. Some research about healthy diets has observed dietary patterns in populations for which certain diseases, usually non-communicable diseases (NCDs), appear less prevalent. Dietary patterns in these population groups are studied, then tested in other contexts for their potential to promote health or prevent disease. One well-known example is the Mediterranean diet (Mocciaro et al. 2017), which has been the topic of much research (Cena and Calder 2020). There are several limitations to using such dietary patterns as the basis for recommendations, most importantly, because they do not consider all potential health outcomes. These examples do not account for local availability and the affordability of food types or the cultural traditions and acceptability of foods. Another approach has been to model optimal dietary patterns for a specific food group based on consumption and mortality data (Afshin et al. 2019). However, several challenges remain, including the lack of dietary data from many populations and sub-groups.

2. A second approach has been to quantify the specific dietary intake patterns associated with multiple outcomes, both human and environmental or planetary health. This dual outcome approach is not new. Principles for guiding a “sustainable, healthy diet” based primarily on eating local and minimizing processed food were published as early as 1986 (Dye Gussow and Clancy 1986). From the start, these principles have received considerable criticism from the nutrition, agriculture, and food sectors (Dye 1999). The recent *EAT-Lancet Commission on Healthy Diets from Sustainable Food Systems* (Willett et al. 2019) provided recommendations for the consumption of specific quantities of foods or groups of foods that promote human health and can be produced within planetary boundary considerations. As with earlier efforts, the EAT-Lancet Commission diet has received criticism on several fronts, including the lack of consideration of food affordability (Hirvonen et al. 2020). However, the Commission calls for research to adapt the diet to local contexts. Future studies may provide evidence of the potential to do so.

3. Finally, the World Health Organization (WHO) has identified a series of guiding principles for healthy diets that seek to address all forms of malnutrition and related health issues. Unlike the approaches above, this indicative approach is designed to permit the contextualization of recommendations to individual characteristics, cultural contexts, local foods and dietary customs (WHO 2020). Building on such evidence, *food-based dietary guidelines* (FBDG) are intended to guide the development and revision of national food and agricultural policies.
FBDGs have been developed by over 100 countries (FAO 2020). The content of FBDG may vary by country or region, but generally includes a set of recommendations for foods, food groups, and dietary patterns that minimize the risk of deficiencies, promote health, and prevent disease in specific contexts.

## 3 Conclusion

This chapter defines a healthy diet for the Food Systems Summit, placing human health promotion and disease prevention at the center. In doing so, it draws attention to food safety. Without the assurance of safety, diets cannot nourish, and will instead cause illness.

However, to inform policy and programmatic action, this definition must be translated into specific food-based recommendations. In doing so, the sustainability of food systems, food affordability, and cultural and other preferences must be considered. There will always be tensions between the indicative or guiding principles and approaches that propose more quantified recommendations. The former leaves much room for interpretation, while the latter tends to underestimate the complexities of extrapolating prescribed diets to varying age, sex, life stage, culture, food availability, or affordability, among other considerations. The Food and Agriculture Organization (FAO) and WHO have now set out a series of guiding principles for achieving contextually appropriate sustainable, affordable, healthy diets (Food and Agriculture Organization of the United Nations, World Health Organization 2019; HLPE 2017) that are aligned with the guiding principles for healthy diets (#3 above) and form the basis for such actions.

We hope that this overview can help to align terminology and concepts used in the Food Systems Summit concerning healthy diets, and we encourage readers to read Annex 1 and 2 below for further information.

## Annexes

### Annex 1: Defining Nutritious Foods

#### The Distinction Between Diets and Foods

Over any particular period of time, an individual will eat many *foods* and combinations of foods. Diets are the combination of foods consumed over time, through which we achieve adequacy without excess of all nutrients (including energy). Foods that make up a healthy diet should be safe (see Annex 2) and nutritious. In this section, we will explore the concept of nutritious food, along with related evidence, gaps and controversies.
A nutritious food is “one that provides beneficial nutrients (e.g., protein, vitamins, minerals, essential amino acids, essential fatty acids, dietary fibre) and minimizes potentially harmful elements (e.g., anti-nutrients, quantities of sodium, saturated fats, sugars)” (GAIN, (2017) drawing on definitions published by Drewnowski (2005) and Katz et al. (2011)). While conceptually simple, there is no straightforward, universally accepted approach to classifying individual foods as more or less nutritious. Similarly, some context specificity is required in the categorization of individual foods as nutritious. The same food, for example, whole fat milk, may provide much-needed energy and other nutrients to one population group (e.g., underweight three-year-old children), but be less “healthy” for another due to high energy (calories) and fat content (e.g., obese adults).

“Nutrient profiling,” or the rating of foods based on their nutrient density (i.e., nutrient content per 100 g or per 100 kcal of energy or per serving), has evolved substantially in recent years as an approach to classifying individual foods as more or less nutritious (Drewnowski and Fulgoni III 2020). Such scores now provide the basis for several regulatory and health-promoting efforts, including front of pack labeling and health claims (Croker et al. 2020). Recent efforts have also proposed more complete profiling approaches that, in addition to nutrient density, take into consideration the food groups of ingredients (e.g., fruit or vegetable content) and further develop the content of ingredients (e.g., types of fat) that should be limited (Drewnowski and Fulgoni III 2020). To date, nutrient profiling has been used predominantly for packaged foods in many high-income and several middle-income countries. Considerable limitations remain for extending its utility to unpackaged foods and in contexts in which a large portion of food is not commercially produced.

## Several Evidence Gaps and Controversies That Influence Our Ability to Characterize Health Diets and Nutritious Foods

While much progress has been made in the characterization of healthy diets and the classification of individual foods as nutritious parts of said healthy diets, several gaps in evidence and controversies remain.

* *Imperfect characterization of population nutrient requirements to avoid deficiency and promote health:* Reference values for the nutrient intakes of humans have been established, focusing on the avoidance of deficiency and excess. Nutrient requirements vary by age, sex, and life stage (e.g., pregnancy), and among individuals such that no single nutrient requirement value can be defined, even within age/sex groups. *Estimated average requirements* are therefore developed and converted *into recommended daily nutrient intake* levels that will, at the population level, ensure that the requirements of 95% of the population are met (FAO, WHO 2002). *Upper tolerable limits* are set at the minimum level above which potentially harmful effects may be observed and are essential for understanding health risks and avoiding excess. FAO (2021) and many national governments have published nutrient requirements. However, several limitations
exist, including diverse methodological approaches to setting estimated require-
ments and the extrapolation of requirements from one age group to another,
among others. Some experts are now calling for additional research to estimate
requirements using a consistent approach (Yaktine et al. 2020).

In addition to the focus on the positive (and negative) effects of individual
nutrients, much research has focused on the potential health effects – both
positive and negative – of specific foods, food groups or dietary patterns (Cena
and Calder 2020). This is critically important, as it advances our understanding of
the link between diet and health, as well we the importance of food, which
contains many more bioactive components than just the commonly-known nutri-
ents. Evidence of the health-promoting qualities of bioactive components in many
food groups (e.g., fruits and vegetables, nuts and seeds, fermented dairy) and the
health-harming effects of excessive quantities of some nutrients or dietary com-
ponents (e.g., trans fat, salt, sugar) forms the basis of the guidelines proposed by
FAO (Burlingame 2012), WHO (2020), and the High-Level Panel of Experts
(FAO 2020). While the basic tenets of these guidelines are unlikely to change,
evidence continues to evolve for all dietary components and, to some extent, is
constrained by the imperfect estimates of nutrient requirements and tolerable
upper limits discussed above. Some have also called for greater transparency
and better management of commercial interests in researching the associations
between food products and health outcomes (Lesser et al. 2007). Emerging
evidence suggests that, eventually, dietary recommendations may be personalized
to optimize human health outcomes based on individual characteristics (Fenech
et al. 2011; Precision Nutrition 2020), but science is still far from achieving
this goal.

* *Imperfect knowledge of the nutrient and “anti-nutrient” content of food:* Our ability to fully characterize dietary patterns of populations and individuals (where data permit) is highly dependent on the quality of the food composition tables, i.e., databases containing the amounts of nutrients in foods per specific portion sizes. Unfortunately, there are many issues with food composition tables, including a lack of data or out-of-date information for many countries and world regions, particularly for less common foods (e.g., edible insects) and substances that influence nutrient absorption (e.g., tannins, phytate), as well as a similar dearth of good and/or up-of-date information on nutrients added (or lost) as a result of processing, including food fortification or plant breeding (biofortification), poor or unclear analytical approaches and the lack of consideration for nutrient bioavailability, among others (Micha et al. 2018). Fortunately, this issue is well recognized, and substantial advances have been made through the efforts of the INFOODS project of FAO (2020).

* *Lack of consensus and standardized definitions related to food processing and health implications:* A growing body of evidence suggests that highly-processed foods (or ultra-processed foods) are health-harming for humans (Hall et al. 2019). Recent studies have also highlighted the impact of such foods on the environment (Seferidi et al. 2020), an issue that was even raised in the early discussions on sustainable diets (Dye Gussow and Clancy 1986; Dye 1999). Recent studies have
primarily used the NOVA classification of ultra-processed foods (Monteiro et al. 2019; Monteiro et al. 2018). However, at present, there is no single accepted definition that clearly lays out the specific aspects of food processing that may be health-harming (Gibney 2018; Gibney et al. 2017). The implications of highly-processed foods, particularly those high in sugar, trans fat or salt, are not under debate. Urgent consensus is needed on how to classify such foods, define food processing categories and operationalize the implications for the private sector.

# Annex 2: Avoiding the Consumption of Health-Harming Substances

## Bringing Safety to the Definition of Healthy Diets

Food safety refers to “all those hazards, whether chronic or acute, that may make food injurious to the health of the consumer” (FAO 2003). Food safety issues can arise from food contamination with biological hazards, pathogens, or chemicals (natural or processed contaminants, residues of pesticides or veterinary medicine, etc.) during the production, processing, storage (including, but not limited to a lack of adequate cold storage), transport and distribution of food, as well as in the household. Standards and controls are in place to protect consumers from unsafe foods (HLPE 2017). In addition to the disease burden, food-borne disease in low- and middle-income countries (LMICs) is also a concern because of a broad range of economic costs and their impacts on market access (Unnevehr and Ronchi 2014).

Current knowledge suggests that biological hazards and antimicrobial resistance may present a higher disease burden than chemical hazards. However, there is still uncertainty due to difficulty in measuring and attributing long-term and chronic effects. Chronic effects due to chemicals (natural or processed contaminants, pesticide residues, etc.) are more challenging to trace and their actual impact on disease burden more difficult to quantify. The study by the Foodborne Disease Burden Epidemiology Reference Group of the World Health Organization (FERG/WHO)<fnref n="2" /> estimated that the global burden of food-borne diseases was comparable to that of HIV/AIDS, malaria and tuberculosis, with LMICs bearing 98% of this burden. The FERG/WHO report (WHO 2015) quantified the burden of disease from the most critical food-borne toxins (aflatoxin, cassava cyanide and dioxins). Some work has also been done to estimate the burden of illness due to four food-borne metals (arsenic, cadmium, lead, methylmercury), which is estimated to be substantial (Gibb et al. 2019). As with nutrition, our evidence related to food safety and health continues to evolve. For example, the clinical outcome of exposure to food-borne pathogens may be modulated by the human gut microbiome (Josephs-Spaulding et al. 2016).

Despite the heavy burden of disease among LMICs, the systems and practices for monitoring food-borne hazards and risks, food safety system performance and related disease outcomes are predominantly utilized in high-income countries

<footnote n="2">²WHO 2015.</footnote>
(HICs). While there are many promising approaches to managing food safety in LMICs, few have demonstrated a sustainable impact at scale. It is also essential to distinguish between food safety and food quality: food safety ensures that food is fit for human consumption and not harmful to human health, and most often falls under the competence of veterinary, health or agricultural inspectors, while food quality is a market category that is usually the responsibility of food or market inspectors (Independent Evaluation Group (IEG) 2014).

Several Evidence Gaps and Controversies That Influence the Ability to Assess and Ensure the Safety of Foods as Part of a Healthy Diet

* *Food safety has complex interactions with other societal concerns.* Safety must be built into foods, and this puts responsibility for food safety all along the value chain, including on producers, processors, transporters, retailers, and consumers. If food chain actors lack the requisite knowledge, resources, and skills, then safety cannot be assured. Some food safety perceptions and knowledge may be shared generationally and may not be scientifically grounded. In many LMICs, food is often purchased from traditional markets close to the point of production and undergoes limited transformation (Jaffee et al. 2019). Several traditional ways of processing food can be highly effective at reducing risk, but food-borne illness may still be linked to poor hygiene conditions, close contact with animals, and limited access to clean water from the market through to the household. Informal market drivers and incentives for safe food are often weak, although adverse food safety events can leave the sellers vulnerable to reputational harm. As such, food safety has implications for livelihoods. Likewise, food-borne diseases can have important consequences for women's resilience. Women predominate in traditional food processing and sales and are usually responsible for food preparation at home.

* *The preferred method for improving food safety and quality is preventive, and many, although not all, potential food hazards can be controlled along the food chain.* Engaging the food industry at all levels to understand their role in preventing food contamination through the application of good practices, i.e., good agricultural practices (GAP), good manufacturing practices (GMP), good hygienic practices (GHP), and the Hazard Analysis Critical Control Point system (HACCP), is challenging. The HACCP principles have been formalized by the Codex Committee on Food Hygiene and provide a systematic structure that actors within the food industry, both large and small, can use to identify and control food-borne hazards. Governments should recognize the application of a HACCP approach by the food industry as a fundamental tool for improving the safety of food (FAO 2003). However, the level of safety that these food safety systems are expected to deliver has seldom been defined in quantitative terms.
In addition to HACCP, the Codex Alimentarius Commission (CAC) sets standards for addressing the safety and nutritional quality of foods for most segments
of the food chain so as to protect consumer health and fair practices. The CAC establishes standards for maximum levels of food additives, limits for contaminants and toxins, and residue limits for pesticides and veterinary drugs.

* *Some countries, especially LMICs, have not adopted modern food safety control systems, even though there is a significant burden of food-related illness.*<fnref n="3" /> Many countries lack effective public health surveillance systems, so the burden of food-borne disease and broader economic ramifications are not well understood. Food safety capacity may be concentrated either geographically, for example, in the capital city, or for niche markets intended for export. Building on these analyses, the World Bank recommends that governments consider how to make “smart” food safety investments, such as investing in foundational knowledge, human resources and infrastructure, including those that address basic environmental health issues, like access to clean water, improved sanitation and reduced environmental contamination in the soil, water and air (FAO 2003).

Food safety priorities for countries include addressing risks from farm to table, transitioning from reactive to proactive approaches to food safety, and adopting a risk analysis approach to ensure prioritized decision-making. The building of food safety capacity will assist governments in economic development by improving the health of their citizens and opening countries to more food export markets and tourism (Jaffee et al. 2019).

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# Ensuring Access to Safe and Nutritious Food for All Through the Transformation of Food Systems

<figure><img src="image_12.png" /></figure>

Check for
updates

Sheryl Hendriks, Jean-François Soussana, Martin Cole, Andrew Kambugu, and David Zilberman

## 1 Introduction

Action Track 1 of the Food Systems Summit offers an opportunity to bring together the crucial elements of food safety, nutrition, poverty and inequalities in the framework of food systems within the context of climate and environmental change to ensure that all people have access to a safe and nutritious diet. These elements are embedded in fundamental human rights, including the right to food, the rights to safe water and sanitation (essential for safe food), and the right to be free from discrimination.

Food systems provide a framework for advancing access to safe and nutritious food for all (including all crops, fish, forest foods and livestock). Food systems encompass all of the elements and activities that relate to the production, processing, distribution, preparation and consumption of food, as well as the output of these

S. Hendriks (✉)

Department of Agricultural Economics, Extension and Rural Development,
University of Pretoria, Pretoria, South Africa

e-mail: sheryl.hendriks@up.ac.za

J.-F. Soussana

INRAE (National Research Institute for Agriculture, Food and Environment), Paris, France

M. Cole

School of Agriculture, Food and Wine, University of Adelaide, Adelaide, Australia

A. Kambugu

Infectious Disease Institute, Makerere University, Kampala, Uganda

D. Zilberman

Agricultural and Resource Economics Department, University of California at Berkeley,
Berkeley, CA, USA
<figure><img src="image_13.png" /><figcaption>**Fig. 1** Action Tracks of the UN food systems summit in a normative systems perspective. (Von Braun et al. 2021)</figcaption></figure>

activities, including socio-economic and environmental outcomes (HLPE 2020). Ensuring access to safe and nutritious food for all underlies the other Summit Action Tracks (Fig. 1).

## 2 What Is a Safe and Nutritious Diet?

A safe and nutritious diet is a healthy diet that “is human health-promoting and disease-preventing. It provides adequacy (without an excess of nutrients) and health-promoting substances from nutritious foods and avoids the consumption of health-harming substances” (Neufeld et al. 2021). A nutritious food “provides beneficial nutrients (e.g., protein, vitamins, minerals, essential amino acids, essential fatty acids, dietary fibre) and minimises potentially harmful elements (e.g. anti-nutrients, quantities of sodium, saturated fats, sugars)” (Neufeld et al. 2021, drawing on GAIN (2017), Drewnowski (2005) and Katz et al. (2011)). Safe food promotes health and is free of foodborne diseases caused by microorganisms, including bacteria, virus, prionics, parasites and chemicals, as well as foodborne zoonoses transferred from animals to humans and other associated risks in the food chain (WHO 2013).

Malnutrition includes undernourishment, micronutrient deficiencies and overweight (including obesity). Malnutrition increases susceptibility to foodborne diseases, creating a vicious cycle for health, reducing productivity and compromising
development. The COVID-19 pandemic is expected to increase the risk of all forms of malnutrition (Headey et al. 2020).

Recent reports draw attention to the affordability of a healthy diet (FAO et al. 2020; Masters et al. 2018). The pandemic has exposed long-standing inequalities in our food and health systems that affect access to safe and nutritious food, as well as income that enables this access (Laborde et al. 2020). Shocks (including health shocks such as COVID-19 that increase the need for a nutritious diet) make healthy diets less accessible and affordable.

While the definitions of an adequate diet and safe food are established and widely accepted, there is debate in the literature about what constitutes a sustainable diet. Each proposed diet has trade-offs in terms of affordability, climate and environmental impacts. These trade-offs are discussed in the sections that follow.

## 3 We Are Not on Track to Meet International Targets for Ensuring Safe and Nutritious Food for All By 2030

Despite some progress in reducing the rate of extreme poverty, with only 10 years to go to 2030, the world is not on track to meet nutrition-related targets. Table 1 presents a summary of the international targets related to ensuring safe and nutritious food for all. While the proportion of the population that is undernourished, stunting, of low birth weight and displaying anaemia among women of reproductive age has declined, the reductions are not sufficient to meet the global targets. The experience of food insecurity (FIES, a survey that comprises eight questions regarding people's access to adequate food) as measured by FAO et al. (2020) has increased somewhat. Moreover, the numbers of overweight children and adults is rising.

No country is exempt from the scourge of malnutrition. Undernutrition coexists with overweight, obesity and other diet-related non-communicable diseases (NCDs), even in poor countries. UNICEF et al. (2020) report that 37% of overweight children reside in low and middle-income countries. Likewise, fragile and extremely fragile countries are disproportionally burdened by high levels of all three forms of malnutrition compared to less-fragile countries (GNR 2020).

While some progress has been made in certain countries and in some regions, the 2020 Global Nutrition report shows that no country is 'on course' to meet all of WHO's global nutrition targets (GNR 2020). Although the health and behavioural actions required to reduce all forms of malnutrition are well documented (Lancet report, various WHO guidelines), as are the benefits (Hoddinott, etc.), progress has been far too slow. Inequalities in society and the food system make affordable and healthy diFets inaccessible to the most vulnerable populations. There is an urgent need to transform food systems so as to deliver on nutrition outcomes. Unless nutrition-specific (direct) and nutrition-sensitive (indirect) interventions are implemented at scale and in a sustainable way (see Box 1) with complementary services (such as the regular deworming of children), the impact will be suboptimal (Ruel et al. 2018). In addition, urgent action is necessary to minimise the impact of the COVID-19 pandemic on children's nutrition (Headey et al. 2020).
<table><caption>**Table 1** Taking stock</caption><thead><tr><th></th><th>Element</th><th>International target/s</th><th>Baseline year</th><th>Baseline estimate</th><th>Latest assessment year</th><th>Latest global estimates (with population estimates where available)</th><th>Change to date (global)</th></tr></thead><tbody><tr><td rowspan="3">Nutrition</td><td>Hunger (Proportion of the population that is undernourished, PoU)<sup>a</sup></td><td>SDG2: By 2030, end hunger and ensure access for all people, in particular, the poor and people in vulnerable situations, including infants, to safe, nutritious and sufficient food year-round</td><td>2004–2006</td><td>12.5% (FAO et al. 2020)</td><td>2017–2019</td><td>PoU = 8.8% (690 Million) (FAO et al. 2020)</td><td>Down 3.7%</td></tr><tr><td>Prevalence of food insecurity (Food Insecurity Experience Scale, FIES) measured as the number of people living in households where at least one adult has been found to be food insecure (FAO et al. 2020)<sup>abc</sup></td><td></td><td>2014–2016</td><td>Severe – 8.1%<br>Moderate – 22.7% (FAO et al. 2020)</td><td>2017–2019</td><td>Moderate FIES = 25%, or two billion, including 9% with severe food insecurity (FAO et al. 2020)</td><td>Severe: up 0.9%<br>Moderate: up 2.3%</td></tr><tr><td>Wasting (being underweight for one's height)<sup>d,f</sup></td><td>WHO target: Reduce and maintain childhood wasting at less than 5% by 2025 and less than 3% by 2030 (WHO and UNICEF 2017)</td><td>2012</td><td>8%</td><td>2019</td><td>6.9% (moderate and severe), or 47 million children (UNICEF et al. 2020)</td><td>Down 1.1%</td></tr></tbody></table>
<table><tr><td>Stunting (being short for one's age)<sup>d.e.f</sup></td><td>WHO target: 40% reduction in the number of children under 5 years of age who are stunted by 2025 and 50% by 2030 from 2016 (WHO and UNICEF 2017)</td><td>2012</td><td>24.6% (UNICEF et al. 2020)</td><td>2019</td><td>21.3% (moderate and severe), or 149 million children under 5 years of age (UNICEF et al. 2020)</td><td>Down 3.3%</td></tr><tr><td>Overweight children (children &lt;5 years with a Body Mass Index (BMI) over 30 – calculated as weight/height<sup>2</sup><sup>d.e.f</sup>)</td><td>WHO 2025 target: No increase in child overweight (WHO and UNICEF 2017)</td><td>2012</td><td>4.9%</td><td>2019</td><td>5.3%, or 38.3 million under 5 years of age are overweight (FAO et al. 2020)</td><td>Up 0.7%</td></tr><tr><td>Obesity (Adults with a BMI over 30)</td><td>WHO 2025 target: Halt the rise in levels (WHO and UNICEF 2017)</td><td>2012</td><td>11.8%</td><td>2016</td><td>13.1%, or 677.6 million obese adults (GNR 2020)</td><td>Up 1.3%</td></tr><tr><td>Low birthweight (less than 2500 g)<sup>f</sup></td><td>WHO 2025/2030 target: 30% reduction in low birth weight (WHO and UNICEF 2017)</td><td>2012</td><td>15%</td><td>2015</td><td>14.6% (FAO et al. 2020)</td><td>Down 0.4%</td></tr><tr><td>Anaemia (iron deficiency)</td><td>WHO 2025/2030 target: 50% reduction of anaemia (iron deficiency) in women of reproductive age (WHO and UNICEF 2017)</td><td>2012</td><td>30.3%</td><td>2016</td><td>2016 32.8% (FAO et al. 2020)</td><td>Up 1.5%</td></tr></table>

(continued)
<table><caption>Table 1 (continued)</caption><thead><tr><th></th><th>Element</th><th>International target/s</th><th>Baseline year</th><th>Baseline estimate</th><th>Latest assessment year</th><th>Latest global estimates (with population estimates where available)</th><th>Change to date (global)</th></tr></thead><tbody><tr><td>Food safety</td><td>Foodborne disease burden</td><td>None established</td><td>2010</td><td>Unsafe food caused 600 million cases of foodborne diseases and 420,000 deaths, equivalent to 33 million years of healthy lives lost, WHO Foodborne Disease Burden Epidemiology Reference Group (FERG 2007–2015)</td><td>Not applicable (N/A)</td><td>N/A – only baseline available</td><td>Unknown – only data for 2010 published</td></tr><tr><td>Poverty and inequality</td><td>Poverty</td><td>SDG1: By 2030, eradicate extreme poverty for all people everywhere, currently measured as people living on less than $1.90 a day (World Bank 2018)</td><td>2015</td><td>10%, or 734 million (World Bank 2018)</td><td>2019</td><td>8.2% (UN 2021)</td><td>Down 1.8%</td></tr></tbody></table>
<table><thead><tr><th></th><th>Affordability</th><th>None</th><th>2019</th><th>% of population that cannot afford an energy-sufficient diet = 4.6% (FAO et al. 2020)</th><th>-</th><th>N/A - only baseline available</th><th>Unknown - this is a new indicator, without historical data</th></tr></thead><tbody><tr><td></td><td></td><td></td><td></td><td>% of population that cannot afford a nutrient-adequate diet = 23.3% (FAO et al. 2020)</td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td>% of population that cannot afford a healthy diet = 38.3% or three billion (FAO et al. 2020)</td><td></td><td></td><td></td></tr></tbody></table>

<sup>a</sup>Regional estimates were included when more than 50% of the population was covered. To reduce the margin of error, estimates are presented as 3-year averages (FAO et al. 2020)

<sup>b</sup>FAO estimates of the number of people living in households where at least one adult has been found to be food insecure (FAO et al. 2020)

<sup>c</sup>Country-level results are presented only for those countries for which estimates are based on official national data or as provisional estimates, based on FAO data collected through the GallupR World Poll, for countries whose relevant national authorities expressed no objection to their publication (FAO et al. 2020)

<sup>d</sup>For regional estimates, values correspond to the model predicted estimate for 2019. For countries, the latest data available from 2014 to 2019 are used (FAO et al. 2020)

<sup>e</sup>For regional estimates, values correspond to the model predicted estimate for 2012. For countries, the latest data available from 2005 to 2012 are used (FAO et al. 2020)

<sup>f</sup>Wasting, stunting and overweight under 5 years of age and low birthweight regional aggregates exclude Japan (FAO et al. 2020)
Box 1: Sustainable Food Systems

"Sustainable food systems are: productive and prosperous (to ensure the availability of sufficient food); equitable and inclusive (to ensure access for all people to food and to livelihoods within that system); empowering and respectful (to ensure agency for all people and groups, including those who are most vulnerable and marginalized to make choices and exercise voice in shaping that system); resilient (to ensure stability in the face of shocks and crises); regenerative (to ensure sustainability in all its dimensions); and healthy and nutritious (to ensure nutrient uptake and utilization)" (HLPE 2020).

WFP has predicted that the number of people facing acute food insecurity in low and middle-income countries will nearly double to 265 million by the end of 2020 (WFP 2020). Children are disproportionately affected, with likely intergenerational consequences for child growth and development. The pandemic's impact could have life-long implications for education, chronic disease risks and overall human capital formation (Martorell 2017).

Approximately 600 million people fall ill through the consumption of contaminated food each year, with considerable differences among sub-regions; with the highest burden observed in Africa (WHO 2020). More than 420,000 die every year, equating to the loss of 33 million Disability-Adjusted Life Years (WHO 2015a). Foodborne diseases disproportionately affect children, accounting for 40% of the foodborne disease burden. The consumption of unsafe foods costs low- and middle-income countries at least US$ 110 billion in lost productivity and medical expenses annually (Jaffee et al. 2019). With a large proportion of emerging human infectious diseases originating from animal sources (zoonotic diseases), there is also an increasing need to consider both animal and human health as a 'One Health' issue.

Devleesschauwer et al. (2018) report that food safety is a marginalised policy objective, especially in developing countries. The scale of foodborne outbreaks has become more extensive and has affected more countries since 2004 (INFOSAN 2019), representing a constant threat to public health and an impediment to socio-economic development. However, updated data is not available regarding progress on reducing the incidence of foodborne diseases, presenting a major obstacle to adequately addressing food safety concerns (Devleesschauwer et al. 2018).

A recent innovation is the assessment of the adequacy, affordability and access to healthy diets included in the 2020 State of Food Security and Nutrition in the World (SOFI) report (see affordability, Table 1). If continually updated, this indicator could become a comprehensive proxy for monitoring progress on ensuring safe, nutritious food for all.
# 4 Interconnected Food System Drivers That Affect the Access to Safe and Nutritious Food for All

Several interconnected socio-economic and biophysical food system drivers affect access to safe and nutritious food. Nutrition is both a health and food system concern. While some drivers of food systems are global (e.g., trade liberalisation, climate change), others are regional, national and sub-national (e.g., conflicts). At the same time, many are differentiated across geographies (e.g., poverty, demography, technologies, land degradation). Below, we provide a brief overview of the main drivers, depicted in Fig. 2. At the centre of the diagram is the food system, spurred by socio-economic, supply chain and climate change and land-use drivers (depicted by the segmented circle). The drivers and the food system are influenced by globalisation and the global COVID-19 pandemic. In certain contexts, the drivers and the food system are also affected by conflict and fragility.

## 4.1 Socio-Economic Drivers

There is a vast array of socio-economic drivers that increase global food demand, including population growth (Gerten et al. 2020), the westernisation of diets, increased food waste and overweight (including obesity) (Hasegawa et al. 2018), increased demand for animal-sourced foods in diets leading to increased demand of feed from arable crops (Mottet et al. 2017), and rapid urbanisation (van Vliet et al. 2017). These trends could cause a doubling of food demand by 2050 and will require

<figure><img src="image_14.png" /><figcaption>Fig. 2 Food system context and drivers related to Action Track 1</figcaption></figure>
a mean global increase of crop yields by over 30% from 2015 for a range of scenarios without climate change (FAO 2018), a value lower than those in previous projections that assumed rapid economic growth (Alexandratos and Bruinsma 2012).

**Globalisation** Lockdowns caused by the COVID-19 pandemic of zoonotic origin have disrupted the production, transportation, and sale of nutritious, fresh and affordable foods, forcing millions of families to rely on nutrient-poor alternatives (Fore et al. 2020). International food trade can increase the diversity of diets and has established a global standard food supply, which is relatively species-rich regarding measured crops at the national level, but species-poor globally (Khoury et al. 2014). Globalised food trade can also contribute to unsustainable water use (Rosa et al. 2019) and land degradation (IPCC 2019). The availability of cheap, high-energy, fatty and sugary foods, the high price of nutritious fresh foods and the demand for more ‘westernised’ and often obesogenic foods increase the incidence of nutrition-related NCDs (Chaudhary et al. 2018). Nevertheless, globalised supply chains support the wide distribution of food, reducing shortages in import-dependent regions (Janssens et al. 2020), improving seasonal availability and often reducing food loss through technological advances in processing, packaging and storage (Zilberman et al. 2019).

**Demography and Urbanisation** Although population growth has slowed globally, the population in the 47 least developed countries (mostly in Africa and Asia) is projected to double between 2019 and 2050. By 2030, the number of youths in Africa will have increased by 42% from 2015. Nevertheless, in 2018, for the first time in history, the proportion of older persons (above 65) outnumbered that of children under five, a trend that is predicted to continue (UNDESA 2019). A growing proportion of older people will put a strain on the health system and change nutritional needs and dietary preferences. Aging is accompanied by multiple physiological changes that affect diets and nutrition. This may include a lower sense of taste and/or smell; reduced appetite; poor oral health and dental problems; lower gastric acid secretion that may affect the absorption of minerals and vitamins; and loss of vision and hearing and reduced mobility that may limit mobility and affect elderly people's ability to shop for food and prepare meals (WHO 2015b). Moreover, by 2050, 68% of the global population could be urban, shifting the proportion of producers to consumers, changing consumption patterns (demand), driving land take and putting extra pressure on soil resources (Barthel et al. 2019; van Vliet et al. 2017).

**Poverty and Inequality** Poverty traps millions in poor nutrition, depriving them of their potential. The prevalence of both undernutrition and overweight adults is directly linked with relative food prices (Headey and Alderman 2019). Healthy diets cost roughly 60% and 400% more than nutrient-adequate and energy-sufficient diets, respectively (FAO et al. 2020). More than 1.5 billion people cannot afford a nutrient-adequate diet and over three billion cannot afford even the cheapest of
healthy diets (FAO 2011). Food system disruptions caused by COVID-19 measures have aggravated this situation (Headey et al. 2020). The out-of-pocket costs on health care spent by the poorest billion due to NCDs and injuries may be high, accounting for 60–70% of the public health care costs in low-income and lower-middle-income countries (Zuccala and Horton 2020). In total, it has been estimated by the World Bank that under- and malnourishment costs 3% of global GDP, and overweight and obesity another 2% (Jaffee et al. 2019).

Women play a key role in multiple components of food systems and in decisions over food choices. Nonetheless, inequalities and barriers related to access to farming opportunities and services such as extension, credit, digital platforms for knowledge and market access constrain their participation relative to men (Quisumbing et al. 2011). Inequalities and barriers also affect the nutrition and health of minorities and off-farm and food system workers (including migrants and undocumented workers), which is a barrier to food system and societal transformation (CFS 2020).

**Conflict and Fragility** Conflict can be both a cause and an outcome of food insecurity. Increased competition for natural resources leads to conflict and political fragility, exacerbated by the failure of traditional conflict resolution mechanisms to adapt to the new governance system of communities (FAO, IFAD, UNICEF, WFP, WHO 2017). Government and political institutions (municipalities, legal systems and political party structures) have not adapted to the social fabric they presently govern, constraining development and also affecting development and the delivery of humanitarian aid.

While widespread famine has largely been eradicated, the nature of food crises has changed in recent times. The Food Security Information Network (FSIN 2020) reports that, in 2019, about 135 million people were affected by crisis levels of acute food insecurity, reflecting an increase of 11 million people from the previous year (FSIN 2020). While these crises are largely driven by conflict and economic downturns, they have a severe effect on the ability of people to access food. The provision of food transfers in emergency situations may alter the food preferences of communities, leading to changes in production and consumption post-conflict.

The largest numbers of acutely food-insecure people are in Africa, where extreme weather events in the continent's Horn and its southern region have led to widespread hunger. In many parts of the world, armed conflicts, intercommunal violence and other localised tensions create insecurity (FSIN 2020). Adverse climate events and stresses compound violence, displacement and disrupted agriculture and trade. Often, those affected by crises flee to neighbouring countries, putting additional stress on the international humanitarian response system and on the food systems of the host countries. Women and girls are disproportionately affected by crises. Populations in crisis are disproportionally vulnerable to the impact of the COVID-19 pandemic and have little capacity to cope with the health and socio-economic aspects of the shock (FSIN 2020). WFP predicts that the number of people in LMICs facing acute food insecurity will nearly double to 265 million by the end of 2020
(WFP 2020). Moreover, fragile and extremely fragile countries are disproportionally burdened by high levels of malnutrition compared to non-fragile countries (GNR 2020).

## 4.2 Supply Chain Failures and Under-Utilised Technologies Affecting the Supply of Food

The focus of food supply has shifted over the past few decades from 'feeding the world' to 'nourishing the world', but technological advancements still lag behind, and many supply-side factors and failures affect the ability of the food system to sustainably (see Box 1) ensure access to safe and nutritious food for all. In many developing countries (especially in Africa), supply chain failures and the under-utilisation of technology are major constraints on the ability of the transformation of food systems to achieve this access. More than half of the calories consumed by humans are provided by three major cereal crops (rice, maize, and wheat) with a high-calorie output, and current research investments are positively correlated with the energy output of crops, with a number of crop species (e.g., sweet potato, potato, wheat, broad bean, and lentil) remaining under-researched relative to their contribution to healthy human nutrition (Manners and van Etten 2018). Orphan crops that are usually well adapted to low-input agricultural conditions have received little attention from researchers (Tadele 2019). There is a growing recognition that the development of perennial versions of important grain crops and grasses could expand options for ensuring food and ecosystem security (Glover et al. 2020). Viable high biomass perennial grain crops could be further developed in agroecosystems that regenerate soils and capture other important ecosystem functions (Crews and Cattani 2018). In the same way, this lack of research applies to some fruit and vegetable crops and local livestock breeds, especially for small ruminants, as well as fish.

Closing yield gaps on underperforming lands and increasing cropping efficiency would have considerable potential to meet an increasing food demand (Foley et al. 2011). One main reason why yield gaps exist is that farmers do not have sufficient economic incentives to adopt yield-enhancing seeds or cropping techniques, including mechanisation, precision and digital agriculture. Moreover, a lack of access to extension services, to formal credit and cooperative membership, often limits technology adoption, which is associated with positive household welfare effects (Wossen et al. 2017). While efficiency and substitution are steps towards sustainable intensification, system redesign may be essential for agro-ecological intensification through, e.g., integrated pest management, conservation agriculture, integrated crop and biodiversity, pasture and forage, trees, irrigation management and small or patch systems (Pretty et al. 2018).

Currently, 25–30% of total food produced is lost or wasted (IPCC 2019), equating to about one-quarter of land, water, and fertiliser used for crop production (Shafiee-Jood and Cai 2016). Food losses and food waste occur throughout the food chain.
They constrain food system sustainability due to their adverse effects on food security, natural resources, environment, climate and human health (e.g., toxic emissions from incineration) (Xue et al. 2017).

Plant biotechnologies are mostly used for fibre and animal feed, less often for food, because of regulatory constraints and intellectual property rights barriers (Barrows et al. 2014). New and innovative technologies such as biotechnologies, precision agriculture and digital agriculture, alternative protein sources, underutilised food sources and the use of biomass for bioenergy and green chemicals need to be harnessed to improve food systems (reviewed below). However, such advances can also drive negative food system changes. For example, biofuel production based on grains from food crops can drive up staple food prices and increase competition for land, exacerbating inequalities.

## 4.3 Climate Change, Land-Use Change and Natural Resource Degradation

Climate change, including increases in the frequency and intensity of extremes, has adversely impacted food security, affecting the yields of some crops (e.g., maize and wheat) and the pastoral systems in low latitude regions (IPCC 2019). Climate change may aggravate food system problems in countries with delicate food security balances and relatively high levels of vulnerability to climate change due to the large-scale use of scarce resources (water, land, etc.) for feed and food production for exports, particularly in the case of mono cropping. Diets and cropping patterns may change as climate factors constrain the production of traditionally grown crops.

With increasing warming, the frequency, intensity and duration of heatwaves, droughts and extreme rainfall events are projected to increase in most world regions, increasingly threatening the stability of food supplies (IPCC 2019). For example, Gaupp et al. (2020) found an estimated 86% probability of losses across the world's maize breadbaskets with warming of 4 °C, compared to 7% probability for 2 °C warming under business-as-usual conditions and without considering crop adaptation to climate change. Likewise, in a business-as-usual scenario, Alae-Carew et al.'s (2020) review of predicted changes in environmental exposures has reported likely reductions in yields of non-staple vegetables and legumes. Where adaptation possibilities are limited, this may substantially change their global availability, affordability and consumption in the mid- to long term (Alae-Carew et al. 2020; Scheelbeek et al. 2018). The nutritional quality of crops may also be affected by rising atmospheric CO₂ levels through reduced proteins and micronutrient contents (IPCC 2019). Labour productivity is also likely to reduce with increasing temperatures (Watts et al. 2021).

The global food system (from farm inputs to consumers) emits about 30% of global anthropogenic greenhouse gases (GHG), contributes to 80% of tropical deforestation and is a main driver of land degradation and desertification, water
scarcity and biodiversity decline (IPCC 2019). About one-quarter of the Earth's ice-free land area is subject to human-induced degradation and about 500 million people live within areas undergoing desertification (IPCC 2019). By 2050, land degradation and climate change could lead to a reduction of global crop yields by about 10%, with strong negative impacts in India, China and sub-Saharan Africa resulting in the displacement of up to 700 million people (Cherlet et al. 2018). Around two billion people live within watersheds exposed to water scarcity, a number that could double by 2050 (Gosling and Arnell 2016). Future agricultural productivity in the tropics is also at risk from a deforestation-induced increase in mean temperature and the associated heat extremes, as well as from a decline in rainfall (Lawrence and Vandecar 2015). Over half of the tropical forests worldwide have been destroyed since the 1960s, affecting the lives of one billion poor people whose livelihoods depend on forests and set to equal a mass extinction event should tropical deforestation continue unabated (Alroy 2017).

# 5 Transforming Food Systems Is Key to Safe and Nutritious Food for All

Business-as-usual is not an option with the future of food and nutrition security in jeopardy. Changing the path of our future will demand a structural transformation (transitioning from low productivity and labour-intensive economic activities to higher productivity, sustainable and skill-intensive activities) of food systems. This will require changes in the allocation of resources, and research attention to factors beyond production will be necessary in order to transition to more sustainable patterns of production and consumption (CFS 2020). More concerted effort is needed to coordinate activities, monitor progress more closely and extract greater accountability from all players across the food system. Priority should be given to the establishment of functional problem-solving institutions that address the core challenges facing each of the various components of the global food systems.

A global social compact (an implicit agreement among the members of a society to cooperate for social benefits) is needed to manage the demand and consumption drivers and harness science, technology and innovation for the purpose of improving the sustainable production of enough food to ensure access to affordable, safe and nutritious foods for all (Fig. 3). The sections below identify some of the levers for change.

## 5.1 Coordination, Monitoring and Accountability

The ambition of the CFS is to be “the most inclusive international and intergovern- mental platform for all stakeholders to work together in a coordinated way to ensure food security and nutrition for all” (CFS 2021). Moreover, UN agencies and their
<figure><img src="image_15.png" /><figcaption>**Fig. 3** Food system transformations and solutions related to Action Track 1</figcaption></figure>

partners have converged through various mechanisms for food security coordination (e.g., FSIN, the Global Network Against Food Crises, expanding the SOFI collaborators, the CFS Global Strategic Framework, etc.). Strengthening global governance and accountability regarding safe and nutritious food for all and sustainable food systems is key to meeting the challenges ahead and will require the cross-sectoral integration of policies. Nonetheless, agriculture, development and trade policies that affect access to food, as well as other dimensions of food systems, are often dealt with in separate for a (De Schutter 2013). Therefore, improved coordination, monitoring and accountability across the food system and among all stakeholders is necessary, including knowledge-sharing, capacity-building, better measurement, updated data, better modelling for foresight, scenarios and case studies and access to documented success stories. Food systems bring together elements from various sectors of society: agriculture, consumer affairs, food processing, health, trade, water and sanitation, women's and child welfare, etc., challenging the sectoral organisation found in most countries.

If we are to transform food systems to ensure safe and nutritious food for all from a model of sustainability, a concerted effort is needed to develop a global compact – a non-binding agreement to encourage the transformation of food systems – and appropriate accountability of all stakeholders to monitor agreed-upon transformation targets. Integrated, science-based policies (health and nutrition, food and agriculture, climate and environment) would allow for reinforcing accountability at both national and international scales.

*Advances in information technology and data science* play an important role in enabling the rapid assessment of situations, monitoring and decision-making and adaptive learning. An integrated global food system model is needed, as existing models (see Valin et al. 2014; Khanna and Zilberman 2012) do not have consistent global coverage and are not designed to assess the impacts of all of the elements of
food systems. Strengthening national policy scenarios and foresight is also necessary (Schmidt-Traub et al. 2019). Moreover, improved indicators of food systems (see FAO et al. 2020) are required (see Sukhdev 2018; Chaudhary et al. 2018, for examples) that could provide more holistic measures capturing the four elements addressed by Action Track 1, namely, safety, nutrition, inequality and sustainability.

*Rigorous global monitoring systems* require global collaboration, updated information, and investment with significant returns. The monitoring of underlying systemic risks (perhaps using artificial intelligence or machine learning), as well as food system indicators, is essential to identify threats/pressure at an earlier stage. A task force charged with global monitoring and data collection opportunities about agri-food systems could provide a clearinghouse for the multiple (often duplicated) data held by UN agencies and public and private organisations. While some effort has been made to coordinate international actions to address crises, access to food requires targeted interventions for the most vulnerable. Two-way real-time and artificial intelligence applications for collecting information of systemic risks and food systems and disseminating information to various stakeholders and beneficiaries are needed in last-mile and crises situations and in regions disproportionately affected by the COVID-19 pandemic food system disruptions. This could include driving supply-side demand through food banks, social grants, subsidised meals, vouchers and other food assistance (including through e-commerce systems) (WFP 2017).

## 5.2 Influencing Food Demand and Dietary Changes

There are several ways to reduce demand on the global food system in both the short and long term and make nutritious foods more available and affordable (see Herrero et al. 2021). Some of these may be achieved by accelerating demographic transitions, increasing incomes, reducing food losses and waste and changing diets.

*Household food waste* is proliferating in emerging economies and is likely to increase without deliberate efforts to curb it (Barrera and Hertel 2020). Halving food losses and waste is a target of SDG 12 that could help feed more people, benefit climate and the environment and conserve water (Kummu et al. 2012; Searchinger et al. 2018; IPCC 2019). This requires changes along supply chains (agricultural production, food processing, distribution/retail, restaurant food service, institutional food service, and households) through improved logistics and processing technologies, economic incentives, regulatory approaches and education campaigns (Barrera and Hertel 2020). The amount of food waste/loss varies greatly from region to region, and therefore context-specific interventions are crucial (Hodson et al. 2021).

Private investment is needed to develop food processing, refrigeration, storage, warehousing, and retail markets to reduce food waste. Vertical integration of food chains can shorten said chains to the benefit of smallholder farmers, while trade can expand market opportunities. Compared to a business-as-usual scenario, a combined
scenario targeting undernourishment while also reducing over-consumption and food waste would reduce food demand by 9% in 2050 (Hasegawa et al. 2018).

Because of the strong associations between female education, fertility and infant mortality, alternative education scenarios alone (assuming similar education-specific fertility and mortality levels) lead to a difference of more than one billion people in the world population sizes projected for 2050 (Lutz and Samir 2011; Samir and Lutz 2017), and could therefore reduce the rise in food demand.

Balanced diets, featuring plant-based foods, such as those based on coarse grains, legumes, fruits and vegetables, nuts and seeds, complemented by animal-sourced food produced in resilient, sustainable and low-GHG emission systems present major opportunities for the adaptation and mitigation of climate change while generating significant co-benefits in terms of human health (Springmann et al. 2018; IPCC 2019; Jarmul et al. 2020). ‘Healthy sustainable diets’ can be defined by optimisation procedures (Donati et al. 2016). However, most diets have trade-offs among nutritional values, affordability and environmental issues (Headey and Alderman 2019).

Populations with a high prevalence of undernutrition and micronutrient deficiencies (Fanzo 2019) benefit from increasing the consumption of animal-sourced products due to the bioavailability of key micro-nutrients (Perignon et al. 2017). Many highly nutritious foods may simply be unaffordable to poorer populations and displaced by cheap, nutrient-poor foods. Moreover, a balance is necessary between meeting the demand for diversified, nutritious and affordable food and minimising the time and energy needed to prepare meals.

Policies can create incentives for change. Urgent public policy action is needed to create incentives for creating healthy, sustainable food systems and delivering safe, nutritious and affordable foods for all. Policy options could be used to manage food demand, shift consumption patterns, reduce the environmental footprint of food systems and ensure equity across the food system. A wide range of well-established and relatively inexpensive policy options and interventions are available for improving nutrition at the individual level (Bukhman et al. 2020; Hawkes et al. 2019; Bhutta et al. 2008). Policies that enable healthy food environments (such as sugar taxes, educational food labelling, salt reduction, the prohibition of trans-fats and a reduction in the use of high-fructose corn syrup) are core to improving food environments and limiting the burden of NCDs. Increasing the diversity of food sources in public procurement, health insurance, financial incentives and awareness-raising campaigns can potentially influence food demand, reduce healthcare costs, contribute to reducing GHG emissions and enhance adaptive capacity.

Increased income can drive food demand, especially in terms of diversification away from staple crops to more diverse and nutrient-dense foods (diary, fruit, meat, nuts and vegetables). Likewise, income from social protection programmes can drive changes in dietary composition and quality (Alderman 2016). The evidence reviewed in this paper indicates that subsidies on fortified foods can have positive nutritional effects, and in-kind transfers may limit food deficits during periods of currency or price volatility. The affordability of healthy diets can be improved with the distribution of biofortified food in government schemes, cash transfers and
nutrition programmes. However, price subsidies and in-kind assistance have com-
plex interactions in regard to markets and purchasing decisions, with both negative
implications and benefits (Alderman 2016).

5.3 Shifting to More Sustainable Consumption
and Production Within Planetary Boundaries

Nutrition outcomes in developing countries are affected by agriculture in
several ways: as a source of food for household consumption and of income, through
the role of food prices and agricultural policies, through the role of women's
employment in agriculture for nutrition, child care and child feeding and their own
nutritional and health status (Gillespie and van den Bold 2017).

There are more than 570 million farms worldwide, most of which are small and family-operated. Between 1960 and the turn of the century, the average farm size decreased in most lower- to middle-income countries, whereas it increased in most high-income countries (Lowder et al. 2016). The diversity of agricultural production diminishes as farm size increases (Herrero et al. 2017). Hence, as farm size increases, the production of diverse nutrients and viable, multifunctional, sustainable landscapes requires efforts to maintain production diversity, which may lead to increased dietary diversity (Pellegrini and Tasciotti 2014). Targeted policies that focus on the farmer may incentivise positive changes in landscapes, production diversity and dietary diversity.

In turn, diversification in the food system (e.g., implementation of agro-
ecological production systems, broad-based genetic resources, combined with bal-
anced diets) can enhance adaptation to increased climate variability under climate
change (IPCC 2019). Diversified agro-ecological systems can play a role in meeting
health and nutrition goals while also reducing environment-related health risks
caused by conventional agriculture through water and air pollution, and more
specifically, by pesticides, antibiotics and inorganic fertilisers (Frison and Clément
2020). Compared to conventional agriculture, organic agriculture generally has a
positive effect on a range of environmental factors, including above and below-
ground biodiversity, soil carbon stocks and soil quality and conservation, but it has
weaknesses in terms of lower productivity and reduced yield stability (Knapp and
van der Heijden 2018).

Sustainable land management can bridge yield gaps and avoid deforestation
while providing climate change adaptation and mitigation and land degradation
co-benefits in croplands and pastures (Smith et al. 2020). This can be achieved
through increased organic carbon in soil (Soussana et al. 2019), agroforestry, erosion
and fire control, improved irrigation water and fertiliser management, and heat- and
drought-tolerant plants (Smith et al. 2020). For livestock, sustainable options include
better grazing land management, improved manure management, higher-quality
feed, and use of breeds and genetic improvement (Herrero et al. 2016). Under
stringent global climate change mitigation policy, risks to food security would be increased (Hasegawa et al. 2018) through competition among those seeking land use for, respectively, food production, bioenergy and afforestation, be it driven by local or foreign investment in land (Cotula et al. 2014). Nevertheless, increasing and valuing soil carbon sequestration on agricultural land would allow for the reduction of these negative impacts by approximately two-thirds (Frank et al. 2017). The large-scale deployment of bioenergy options such as afforestation, energy crops, carbon capture and storage has adverse effects on food security, but small scale projects with best practices may deliver co-benefits (Smith et al. 2020).

Increased demand for fish and seafood has threatened fisheries and the sustainability of ocean resources. Limited attention has been given to fish as a key element in food security and nutrition (HLPE 2014). The aquaculture industry has emerged and increasingly fills the seafood supply gap to meet growing demand. Overfishing and relatively high waste (often due to catching under-sized fish) pose environmental and biodiversity challenges, threatening the long-term sustainability of fishery resources (HLPE 2014). Additional challenges in production facilities such as marine feed supply, antibiotic use and waste recycling need to be overcome to further develop aquaculture (Belton et al. 2020). The impacts of activities such as oil drilling, energy installations, coastal development and the construction of ports and other coastal infrastructures, dams and water flow management (especially for inland fisheries) affect aquatic productivity. The impact of these activities on the habitats that sustain resources (e.g., erosion and pollution) and the livelihoods of fishing communities – such as the denial of access to fishing grounds or displacement from coastal settlements – need to be carefully balanced with the growing demand for resources (HLPE 2014).

Ensuring that food prices reflect real costs, including major externalities caused by climate change, land and water resource degradation and biodiversity loss, is necessary in order to address artificial price distortions, reduce food waste, internalise the costs of externalities (including the public health impacts) and, at the same time, ensure decent incomes and wages for farmers and food system workers. However, a true calculation of food costs would, on average, increase food prices. Food assistance policies that do not distort market and labour incentives can meet emergency food needs and improve access to food. Trade can help to improve food availability, diversify diets and smooth price volatility (MacDonald et al. 2015).

## 5.4 Harnessing Science and Innovation and Managing Risks

Structural transformation to a more sustainable food system can bring about efficient and more rapid productivity growth through investment in research and development over the long term (Fuglie et al. 2020). Science should increasingly inform solutions and generate knowledge that is actionable for transforming food systems and achieving safe and nutritious food for all (Arnott et al. 2020). Since policy agendas
are largely set at national and local scales, the translation of global-scale scientific assessments into actionable knowledge at national and local scales is needed.

New and emerging technologies appropriate for health, climate change adaptation and mitigation, and disaster preparedness could be game-changers for overcoming challenges and building system resilience. Nonetheless, their development should be guided by an assessment of their socio-economic, ethical and environmental impacts. Evidence-based assessment is needed of the risks and benefits associated with new technologies. Research is also needed to understand the diffusion modes of traditional knowledge and social innovations for supporting the conservation of common goods in more participatory, collaborative, inclusive and equitable ways.

Advances in science and technology such as genome editing (Khatodia et al. 2016), precision agriculture and digital agriculture (Basso and Antle 2020), agro-ecology (Caquet et al. 2020), vertical farming, alternative protein sources (e.g., algae, insects), active packaging and blockchain technologies (Kamilaris et al. 2019), artificial intelligence and big data analysis (Wolfert et al. 2017) and whole-genome sequencing in food safety (Deng et al. 2016) have the potential to meet a number of food system challenges. However, adapting these technologies to local conditions, making them accessible to farmers and retaining much of the gain among consumers and rural communities is challenging, especially for developing economies, smallholder farmers and small businesses. Therefore, investments in science-based, participatory processes for mapping out realistic and equitable options are needed (Basso and Antle 2020).

The importance of agriculture in producing non-food products (biofuels, chemicals, biomaterials) and in supporting ecosystem services is increasingly recognised within the context of the bioeconomy, which targets an increased reliance on renewable resources to address climate change (Zilberman 2014). A circular bioeconomy envisions developments in industrial biotechnologies to generate co-products, by-products and waste recycling, thereby generating an overall increased input efficiency of agricultural systems that produce bio-based products in diversified agro-ecological landscapes (Therond et al. 2017; Maina et al. 2017).

Global and regional data-sharing systems (including machine learning) based on the FAIR (findable, accessible, interoperable and reusable data) principles (Mons et al. 2017) can advance food system knowledge and enhance the accountability of all stakeholders within food systems. The use of open-source platforms for data- and code-sharing should be encouraged to stimulate global learning.

Table 1 shows the fragmented nature of data related to this Action Track, with global reports focussing on single elements. National nutrition assessments are costly and infrequently conducted, constraining the monitoring of progress and the impact of interventions at scale. Even where the indicators have been included in the SDG indicator set, current data on foodborne diseases, some malnutrition indicators (such as wasting), poverty and inequality data are not updated or are missing comparative baselines. Very few sex-disaggregated indicators are available, constraining analysis and the tracking of progress towards gender equality. The upcoming *Countdown on Food System Transformation* mechanism may support the effort to bring together various indicators in a systematic framework for monitoring and evaluation.
Increasingly, risk assessment tools will be needed to drive food safety policy and standards and optimise surveillance, detection and early warning systems of zoonotic diseases for both the formal and informal sectors (Di Marco et al. 2020) and crop diseases (Mohanty et al. 2016). Modernising our food safety and biosecurity risk management systems is an integral part of the food system transformation required to meet food and nutrition security needs. This will require a science- and risk-based approach for production of safe food within a food systems approach.

# 6 Concluding Messages

Action to address safety, malnutrition, poverty and inequality, as well as climate and environmental issues, through food system transformation will undoubtedly bring large health, social, economic, ecological and development co-benefits and savings for public expenditure while supporting several interrelated SDGs. A range of priority actions to speed up progress towards international targets and scale up the solutions proposed in Sect. 5 can be taken in the short-term, based on existing knowledge, while supporting longer, more sustainable responses with significant co-benefits. Future actions will have to be iterative, coherent, adaptive and flexible to maximise co-benefits and minimise trade-offs. Many recommended policy changes and interventions have win-win potential for food security, health and the environment. However, other choices will have adverse or unintended impacts on the interconnected drivers affecting food systems and their outcomes.

Adopting a whole-system approach in policy, research and monitoring and evaluation is crucial for managing trade-off and externalities from farm-level to national scales and across multiple sectors and agencies. Ultimately, context matters, and comprehensive national action plans are crucial for setting out actions suited to the particular economic, agricultural, social and dietary preferences of the particular nation. Careful consideration of the trade-offs and co-benefits of any actions will be necessary at different levels (sub-national, national, regional and global). Likewise, there may be 'winners' and 'losers' in each action adopted to transform to more sustainable food systems. The losses and gains will vary depending on the context, but could include a loss of income and livelihoods across the food system, such as would happen with a reduction in the production and consumption of animal-sourced foods or the implementation of seasonal banning of fishing to allow for the regeneration of marine resources. Such shifts could lead to the marginalisation and stigmatisation of people in the food system who have not yet been considered as vulnerable or marginalised.

Including all stakeholders in discussions, policy-making and evaluation processes is essential for the inclusive transformation of food systems at all levels. Strengthening collaboration among research, the private sector and policy-makers is pivotal in creating food environments and guiding consumers' choices in practical and implementable ways. The elaboration and implantation of the National Food
Systems Plans will be essential instruments for bringing the relevant public sectors and diverse stakeholders together.

Adaptive learning and new knowledge must be shared globally in order to accelerate our capacities to meet existing and future challenges. Substantial public, private and international investment is necessary to foster progress towards the targets and recover from the setbacks of the COVID-19 pandemic. Improved international cooperation and coordination of the food system is necessary, including the establishment of a thorough monitoring, evaluation and early warning system with comprehensive indicators, transparency and commitments from all stakeholders. For example, bringing all of the indicators in Table 1 into one annual food system monitoring report would facilitate cooperation among UN agencies. Creating a food system compass could be based on bottom-up pathways developed at the national scale to reach food systems targets supporting an ensemble of global-scale and integrative food system models. Establishing such a system will require capacity development for comprehensive foresight, scenario and predictive modeling to better understand uncertainties, trade-offs and impacts of various change pathways. More research is needed to identify the most adequate, affordable, healthy and sustainable diets across different contexts. More frequently collected nutrition and poverty data are necessary to provide more data points for monitoring change and progress. Innovative indicators such as the affordability of adequate, nutritious and healthy diets are vital for bringing the three elements of safety, nutrition and inequality together.

The costs of acting and not acting on the key drivers of diet and food system change and the impact of these changes and shifts are required for effective decision-making. For example, the cost of nutrition interventions is relatively low per unit compared to the long-term losses in human potential and incomes for poorer people. The cost of NCDs to the health system is significantly higher per unit than that of scalable interventions. Rapid reductions in anthropogenic GHG emissions across all sectors can reduce the negative impacts of climate change on food systems in the long term (similar to land and water restoration).

Research and technology advances are essential for solving critical constraints and offering many opportunities to improve productivity and food safety and reduce food losses and waste, as well as GHG emissions. Capacity-building, property rights, technology development, transfer and deployment and enabling financial mechanisms across the food system can support livelihoods and increase incomes. Greater cooperation regarding trade could overcome constraints and barriers.

Safe and nutritious food for all requires a transformation of food systems, changing both supply and demand of food in differentiated ways across world regions: bridging yield gaps and improving livestock feed conversion, largely through agro-ecological practices and agroforestry, deploying soil carbon sequestration and agricultural greenhouse gas abatement at scale, reducing food loss and waste, as well as addressing over-nourishment and changing the diets of wealthy populations. Global food system sustainability also requires halting the expansion of agriculture into fragile ecosystems while restoring degraded forests, fisheries, rangelands, peatlands and wetlands.
**Acknowledgements** Helpful comments on an earlier draft by five external peer reviewers and by colleagues in the Scientific Group are gratefully acknowledged.

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<figure><img src="image_16.png" /></figure>
# A Shift to Healthy and Sustainable Consumption Patterns

<figure><img src="image_17.png" /></figure>

Check for
updates

Mario Herrero, Marta Hugas, Uma Lele, Aman Wirakartakusumah, and Maximo Torero

## 1 Introduction

There is global convergence on the need to transform food systems so that they deliver nourishment and health for humanity while contributing to reducing the environmental pressures on our ecosystems. Transforming food systems involves five action tracks: AT1) access to safe and nutritious food, AT2) sustainable consumption, AT3) nature-positive production, AT4) equitable livelihood, and AT5) resilience to shocks and stress. As discussed in Action Track 1, we are not on track to meet international targets related to healthy diets. Currently, 690 million people are chronically malnourished, and two billion individuals suffer micronutrient deficiencies. Over-consumption, notably of unhealthy dietary items, is rising rapidly. Two billion people are overweight or obese, with many suffering chronic diseases driven by poor dietary health (Development Initiatives, 2020; Global Panel on Agriculture and Food Systems for Nutrition 2020). Food, which enjoys the most proximate relationship to our physical health, is failing us. Globally, poor-quality diets are

M. Herrero (✉)

Department of Global Development and Cornell Atkinson Center for Sustainability,
Cornell University, Ithaca, NY, USA

e-mail: mh2258@cornell.edu

M. Hugas

European Food Safety Authority (EFSA), Madrid, Spain

U. Lele

International Association of Agricultural Economists (IAAE), Delhi, India

A. Wirakartakusumah

Department of Food Science and Technology and SEASTAR Center, Bogor Agricultural University (IPB), International Union of Food Science and Technology, Jakarta, Indonesia

M. Torero

Food and Agriculture Organization of the United Nations (FAO), Lima, Peru
linked to 11 million deaths per year (Afshin et al. 2019; Global Panel on Agriculture and Food Systems for Nutrition 2020).

As discussed in Action Track 1, we are failing the planet by enabling the food system to be the single largest driver of multiple environmental pressures. Food production accounts for 80% of land conversion and biodiversity loss, including the collapse of major marine fisheries and freshwater ecosystems (Campbell et al. 2017; IPCC 2019) and high levels of contamination of freshwater and marine ecosystems (Mateo-Sagasta et al. 2017); it is responsible for 70% of freshwater withdrawals (Campbell et al. 2017), with major river systems such as the Colorado River in the USA no longer reaching their deltas; and it contributes approximately 30% of global greenhouse gas emissions (IPCC 2019). Action Track 2 recognises that current food usage patterns, often characterised by high levels of food loss and waste, significant prevalence of the consumption of energy-rich diets, and the production of natural resource-intensive foods, need to be transformed in order to protect both people and the planet. At the same time, context is very important. The challenges and opportunities associated with a nutrient transition will vary for different contexts and countries and will need to be evaluated and solved with an array of different solutions appropriate to their local conditions, culture and values. Awareness-raising, regulatory and behaviour change interventions in food environments, food education, strengthened urban-rural linkages, reformulation, improved product design, packaging and portion sizing, investments in food system innovations, public-private partnerships, public procurement, and separate collection that enables the reutilisation of food waste can all contribute to this transition. Local and national policy-makers and private sector actors of all sizes have a key role in both responding to and shaping the market opportunities created by changing consumer demands.

## 2 Building the Evidence for Healthy Diets

A healthy diet is health-promoting and disease-preventing. It provides adequacy, without excess, of nutrients and health-promoting substances from nutritious foods and avoids the consumption of health-harming substances (**Healthy diet: A definition for the United Nations Food Systems Summit 2021**). It must supply adequate calories for energy balance and include a wide variety of high-quality and safe foods across a diversity of food groups to provide the various macronutrients, micronutrients and other food components needed to lead an active, healthy and enjoyable life.

Consumer demand, availability, affordability and accessibility are important drivers of dietary patterns. It is essential that these four aspects are considered simultaneously when pursuing dietary shifts (Global Panel on Agriculture and Food Systems for Nutrition 2020). There is great diversity in the food and culinary traditions that, together, can form healthy diets, which vary widely across countries and cultures according to traditions, preferences and local food supplies. Food-based dietary guidelines translate these common principles into nationally or regionally
relevant recommendations that consider these differences, as well as context-specific
diet-related health challenges. National food-based dietary guidelines provide
context-specific advice and principles on healthy diets and lifestyles, which are
rooted in sound evidence and respond to a country's public health and nutrition
priorities, food production and consumption patterns, socio-cultural influences, food
composition data, and accessibility, among other factors. <fnref n="1" /> Most food-based dietary
guidelines recommend consuming a wide variety of food groups and diverse foods
within food groups, plentiful fruits and vegetables, the inclusion of starchy staples,
animal-source foods and legumes, and the limiting of excessive fat, salt and sugars
(Herforth et al. 2019; Springmann et al. 2020). However, there can be wide variation
in inclusion of and recommendations for other foods. Only 17% of food-based
dietary guidelines make specific recommendations about quantities of meat/egg/
poultry/animal-sourced food to consume (20% make specific recommendations
about fish), and only three countries (Finland, Sweden and Greece) make specific
quantitative recommendations to limit red meat (Herforth et al. 2019). Only around
one-quarter of food-based dietary guidelines recommend limiting consumption of
ultra-processed foods, yet this is emerging as one of the most significant dietary
challenges around the world.

Adherence with national food-based dietary guidelines and recommendations around the world is low. However, accurate data on actual consumption and its determinants is limiting, particularly for low- and low-middle-income countries (Lele et al. 2021). Recent estimates of consumption found that the foods available did not meet a single recommendation laid out in national food-based dietary guidelines in 28% of countries, and the vast majority of countries (88%) met no more than two out of twelve dietary recommendations (Springmann et al. 2020). Dietary intake surveys show vast regional and national differences in consumption of the major food groups (Afshin et al. 2019). No regions globally have an average intake of fruits, whole grains, or nuts and seeds in line with recommendations, and only central Asia meets the recommendations for vegetables. In contrast, the global average intake (and several regional averages) of red meat, processed meat and sugar-sweetened beverages exceeds recommended limits. Australasia and Latin America had the highest levels of red meat consumption, with high-income North America, high-income Asia Pacific and western Europe consuming the highest amount of processed meat (Afshin et al. 2019). In general, consumption of nutritious foods has been increasing over time, albeit, likewise, the consumption of foods high in fat, sugar, and salt, in a trend that is particularly evident as country incomes rise (Imamura et al. 2015). Of particular concern is the growing importance of highly processed foods and sugar-sweetened beverages in diets across the world. Sales of highly processed foods and sugar-sweetened beverages are about ten-fold higher in high-income compared to lower middle-income countries. However, sales growth is evident across all regions, the fastest occurring in middle-income countries (Baker et al. 2020).

<footnote n="1">¹http://www.fao.org/nutrition/education/food-dietary-guidelines/home/en/</footnote>