What must be done to improve global diets and reduce the burden of non-communicable diseases? And who will do it? I asked Rocco Renaldi, Secretary General of the International Food and Beverage Alliance (IFBA), about how the food and drink industry is performing on the global stage. He has penned his thoughts below.
Few will remember WHO Technical Report 916 on Diet, Nutrition and the Prevention of Chronic Diseases. The obscure title belies the significance of this report in setting the course for the global debate on nutrition and health since its publication in 2003. The output of a joint WHO/FAO Expert Consultation, TR 916 was the first comprehensive global institutional analysis of the shift in diets that is a consequence of economic development, and of the relation between these dietary shifts and the rapidly rising global epidemic of noncommunicable diseases (NCDs).
Much has changed since 2003. TR 916 generated a strong industry reaction and public controversy, first and foremost in relation to the guideline that free sugars should not make up for more than 10 per cent of daily energy intake. While there is still a lively debate about the evidence underpinning different dietary recommendations today, the question is less about what the exact dietary recommendation should be, and much more about what needs to be done and who needs to do what to improve diets and reduce the burden of NCDs.
The question is less about what the exact dietary recommendation should be, and much more about what needs to be done and who needs to do what
The International Food and Beverage Alliance (IFBA), comprising twelve of the leading global companies in the sector, was an early adopter of the point of view that, regardless of whether the correct dietary recommendation is 5, 10 or 20 per cent, each player in the system needs to play a part – and that collaboration among all players would be necessary to achieve progress. It is on this basis that in 2008 IFBA made a set of global voluntary commitments, on:
- Improving the nutrition of products, through progressive reduction of saturated fat, sugar and salt, while increasing beneficial ingredients, as well as working on portion sizes.
- Implementing a common responsible marketing policy globally, with particular attention to children.
- Providing clear, transparent nutrition information to consumers on product labels, including on front of pack, as well as online and at point-of-sale.
- Supporting healthy lifestyle programs at the workplace and in communities.
These commitments, evolved and enhanced several times since, are today shared by many other companies and industry groups and are the subject matter of a wide range of public-private initiatives worldwide. They also reflect the mandate to the private sector set out in the most salient global policy framework, the 2018 UN Political Declaration on NCDs.
Have these actions made a difference? Yes: thousands of products have been reformulated to remove industrial trans fats, reduce salt and sugar, include more wholegrain and fiber, etc.; product innovation for nutrition has accelerated; the trend in portion sizes is downwards; marketing has changed for the better; front-of-pack nutrition labeling has spread.
Thousands of products have been reformulated to remove industrial trans fats, reduce salt and sugar and include more wholegrain and fiber
Is this enough? Clearly not: the Global Nutrition Report 2020 shows unequivocally that most countries are failing to meet nutrition and health targets, that malnutrition in all its forms remains a major global challenge, and that, globally, we are not winning the fight against NCDs. So, what must we do?
Firstly, we must persevere in our efforts. Reformulation and portion size control, for instance, are some of the most cost-effective interventions that we can make. And, importantly, nutritional improvement is not just something to do out of responsibility. It is, alongside authenticity and transparency, what consumers increasingly demand. This has become a significant part of the competitive playing field, so that shying away from it likely means losing market share longer term.
Nutritional improvement is not just something to do out of responsibility. It is, alongside authenticity and transparency, what consumers increasingly demand
Secondly, we must seize the opportunity of the current political momentum behind the food systems transformation agenda. Diet is a product of the food system. Improving a product is beneficial in absolute terms, but it will only have a relative impact, and will not, by itself, improve diets. And reformulation has its limits. To improve diets, we cannot but take on the task of tackling the complex web of interrelated factors that determine it – economic, social and cultural. The food systems transformation agenda offers the opportunity to look at the problem through a systemic lens, without which we cannot disentangle the factors that cause the problem, and without which, therefore, we cannot develop a coherent, holistic policy response. It is in the interest of the food industry to be a constructive part of this debate, as the outcomes will impact it in manifold ways. And it is in the interest of policymakers and society at large to include the food industry, for without it there will be a major knowledge gap and the risk of misguided measures will be high. Encouragingly, the UN has signaled that the private sector will be strongly involved in the 2021 UN Food Systems Summit. Industry had better show up with an intelligent vision.
It is in the interest of policymakers and society at large to include the food industry, for without it there will be a major knowledge gap
Thirdly, industry must be braver in asking for government leadership. We know that, when it comes down to implementation, concrete multi-stakeholder cooperation is fundamental to shaping solutions that work – particularly when the objective is to impact something as complex as diets. This is because of a basic truism: you cannot push a chain. And to pull it, you need all hands on deck, pulling in the same direction. Who chooses which direction to pull in? That should be the subject of multi-stakeholder dialogue. But both the direction and the strongest pull are ultimately going to be given by government. Leadership is also the ability to ask others to lead.
The need for a whole-of-society approach is hardly novel. TR 916 already recognised that “all sectors in the food chain, from farm to table, will need to be involved if the food system is to respond to the challenges posed by the need for changes in diets to cope with the burgeoning epidemic of noncommunicable diseases”. Farm to table has become Farm to Fork; and the debate on nutrition is increasingly morphing into a broader food systems debate. But the fundamental challenge is unchanged: to translate the rhetoric of an inclusive, multi-stakeholder approach into a reality that delivers results. With its ambitious new Farm to Fork Strategy the EU has a chance to do so. It will need the full involvement of the food industry to demonstrate that it can be done.