IN ASSOCIATION WITH THE WORLDWATCH INSTITUTE

BARILLA CENTER FOR FOOD & NUTRITION

EATING PLANET 2012

NUTRITION TODAY: A CHALLENGE FOR MANKIND AND FOR THE PLANET

eating planet 2012

barilla center for food & nutrition

Barilla Center for Food & Nutrition

nutrition today: a challenge for mankind and for the planet

www.barillacfn.com info@barillacfn.com
advisory board

Barbara Buchner, Claude Fischler, John Reilly, Gabriele Riccardi, Camillo Ricordi, Umberto Veronesi
in collaboration with

Worldwatch Institute, Washington, D.C. Nourishing the Planet Editor: Danielle Nierenberg The European House Ambrosetti Editor: Luigi Rubinelli editorial production Edizioni Ambiente srl www.edizioniambiente.it Editorial Supervision: Anna Satolli Design: GrafCo3 Milan Infographics: Tati Cervetto English Translation from the Italian by: Antony Shugaar; chapter 2 by Jonathan Hine Charts, graphic elements, and tables that do not explicitly states their source should be assumed to be the creations of the authors. 2012, Barilla Center for Food & Nutrition Via Mantova 166, 43122 Parma, Italy 2012, Edizioni Ambiente Via Natale Battaglia 10, 20127 Milan, Italy tel. 02.45487277, fax 02.45487333 Printed in April 2012 by Genesi Gruppo Editoriale Citt di Castello (PG) Printed in Italy This book was printed on FSC-certified Munken Print White paper
the websites of edizioni ambiente

www.edizioniambiente.it www.nextville.it www.reteambiente.it www.verdenero.it And follow us on Facebook.com/EdizioniAmbiente

BARILLA CENTER FOR FOOD & NUTRITION

IN COLLABORATION WITH WORLDWATCH INSTITUTE

EATING PLANET 2012

NUTRITION TODAY: A CHALLENGE FOR MANKIND AND FOR THE PLANET

eating planet 2012

Barilla Center for Food & Nutrition

nutrition today: a challenge for mankind and for the planet

introduction Guido Barilla, BCFN: the Answers to Three Paradoxes preface Mario Monti, The Political Challenge of Food executive summary
XV 3 XI

1. the challenges of food

introduction Danielle Nierenberg, Worldwatch Institute: Its Possible to Work at All Scales, Small and Large food for all 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 How Rich Nations Squander Food New Techniques for the Transformation of Food Eating Better School Lunches and Nutrition Buying Local Rethinking the Green Revolution Yields and Environmental Sustainability Food Sustainability and Climate Change Integrated Animal Husbandry for Better Sustainability 10 14 15 16 17 18 18 20 21 21 22 26 28 28 30 32 32 33

food for sustainable growth

food for health

1.10 Not by Calories Alone 1.11 The Role of Vegetables 1.12 Bringing Healthy Food Everywhere 1.13 The Importance of Information 1.14 The Role of Health Structures

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food for culture

34 36 36 38 38 39 42

1.15 Relaunching Agricultural Systems 1.16 New Computer and Communications Technologies 1.17 Popularization In the Field 1.18 Incentivize Employment of the Young the three objectives of food 1.19 Increasing Awareness about the Importance of Agriculture

2. food for all

introduction Raj Patel, How to Respond to Market Excesses facts & figures access to food: present and future challenges 2.1 The Global Scope of Food Security and Access Problems 2.2 The Food Paradox: Underlying Causes 2.3 Possible Areas for Action a new emergency: dramatic instability in food prices 2.4 The BCFN Evaluation Model 2.5 Variables of the Model 2.6 Strategies for Controlling Volatility 46 50 52 53 56 62 67 67 68 75 81 82 84 86 89 91 95 95 98 102

new tools to measure and promote well-being

2.7 Gross Domestic Product Versus Indicators of Well-being 2.8 Subjective Approach Versus Objective Approach: Different Outlooks in Terms of Measuring Well-being 2.9 The BCFN Indices of Well-being and Sustainability of Well-being 2.10 Principal Results of the 2011 BCFN Index 2.11 The Different Dimensions of Sustainability interviews Paul Roberts, In Access the Key Factor Is Diversity Ellen Gustafson, Agricultural Policies Must Take into Consideration the Health and Wellbeing of Human Beings action plan

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3. food for sustainable growth

introduction Carlo Petrini, Paying Whats Fair facts & figures the double pyramid: healthy food for people, and sustainable food for the environment 3.1 3.2 3.3 3.4 3.5 The Food Pyramid as an Educational Tool Some Studies of the Mediterranean Diet The Environmental Pyramid The Double Pyramid for Growing Children The Double Pyramid over the Long Term 106 112 114 116 118 121 124 129 131 136 138 150 151 155 156 160 164 167 167 170 173

toward sustainable agriculture

3.6 Current Leading Agricultural Paradigms 3.7 The Sustainability of the Systems Used to Grow Durum Wheat: the Barilla Case the water economy and the emergency it confronts 3.8 The Availability of Water: from Abundance to Scarcity 3.9 The Right of Access to Water: Reality and Prospects 3.10 Choices and Behaviors for Sustainable Water Consumption 3.11 National Water Footprints and the Trade in Virtual Water 3.12 Water Privatization and its Implications interviews Hans R. Herren, The Challenging Transition Toward Sustainable Agriculture Tony Allan, Virtual Water Between Underconsumption and Poor Management action plan

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4. food for health

introduction Ricardo Uauy, Agriculture, Food, Nutrition and Health facts & figures food for a healthy life 4.1 A Few Key Figures: Global Trends in Chronic Diseases and their Social and Economic Impacts 4.2 Guidelines for a Healthy Way of Eating and Lifestyle 4.3 The Most Common Guidelines and Dietary Models 4.4 Recommendations food and children: educate today for a better life tomorrow 4.5 The Spread of Obesity and Overweight in Children and Adolescents and the International Economic and Social Impact 4.6 Nutrients in the Different Phases of Growth 4.7 Guidelines for Healthy Diets and Sound Lifestyles in Children and Adolescents 4.8 Recommendations longevity and welfare: the fundamental role of nutrition 4.9 Demographics, Longevity, and the Economic and Social Impacts of the Principal Diseases 4.10 Diet and Lifestyle and Their Effects on Longevity and Diseases of Aging 4.11 Inflammatory States and Caloric Restriction: Possible Interventions to Slow the Aging Processes 4.12 Recommendations interviews Marion Nestle, Companies Must Behave Responsibly Aviva Must, The Responsibility for Children Must Be Shared Alex Kalache, Lifestyles Influence the Way We Age action plan 176 180 182 184 187 191 193 193 194 196 206 207 209 213 218 222 225 227 227 231 234 238

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5. food for culture

introduction Shimon Peres, Food for Peacea Call for the Mobilization of Goodwill 242 facts & figures the cultural dimension of food 5.1 5.2 5.3 5.4 5.5 5.6 5.7 The Relationship Between Food and Culture: the Origins How Food Contributes to Communication and Conviviality Delight and Disgust: the Cultural Classification of the Edible Food: Social, Gender, and Power Roles The Symbolic Value of Foods in the Major Religious Faiths Food Prohibitions: Food and Purity Food and Culture: an Indissoluble Bond 244 246 246 248 248 250 253 254 255 255 256 261 262 264 267 268 272 273 280 282 282 284 286 289 290

5.8 The Great Culinary Traditions 5.9 Food Today: Challenges and Perspectives 5.10 Toward a New Vision of Nutrition 5.11 Guidelines for Redefining Mans Relationship with Food the mediterranean culture: the value of a lifestyle and a culinary tradition 5.12 The Salient Characteristics of the Mediterranean Diet 5.13 The Mediterranean Diet and Commensality 5.14 Mediterraneity Today: the Decline of a Model 5.15 How to Recover the Significance of Mediterraneity interviews

the great culinary traditions and the reality of food today

Joaqun Navarro-Valls, We Must Construct a Culture of Responsibility Vandana Shiva, Whoever Controls Food Controls Democracy Michael Heasman, The Consumer Culture War and the Food System: What Does This Mean for the Mediterranean Model? action plan notes

XI

introduction by

Guido Barilla *

bcfn: the answers to three paradoxes

We live in an era that is characterized by a number of global paradoxes. Three, in particular, have long attracted our attention and reinforced our belief that we are giving birth to a research center with innovative and entirely original characteristics. The first paradox has to do with the coexistence on this planet of more than a billion people who are suffering from hunger, in the face of an equivalent number of people who are suffering the consequences of excess of nutrition, consequences that take the form of grave metabolic diseases such as, for instance, diabetes. And yet, already, as of this writing, the global food system is capable of ensuring an adequate nutritional intake for all human beings now alive on the planet earth. The underlying causes for these situations are not easy to identify and solve. This however should not discourage us, but if anything, they should serve as a way of encouraging us to identify and propose new and effective solutions. The second paradox has to do with the presence on the planet of approximately three billion head of livestock. One third of the entire world production of food is destined for consumption by livestock. Moreover, the activity of raising livestock contributes substantially to the phenomena of climate change. In fact it is estimated that it is responsible for at least 50% of all agricultural emissions of greenhouse gases. Once again, these are models we should rethink. The third paradox is bound up with a further form of the improper use of resources on the planet earth: competition between biofuels and food. A growing share of farmland is being set aside for the production of fuel. By so doing, we choose to put fuel in our cars instead of giving food to human beings in need. The growing awareness of these imbalances has driven us to think about the most effective ways to communicate and to involve anyone who might be interested in exploring these topics further in a serious, independent, scientifically accurate way. From this need to inform, involve, communicate, and debate with a view to coming up with solutions, we decided to found in 2009 the Barilla Center for Food & Nutrition (BCFN), a center for providing analysis and proposals with a multidisciplinary approach that has the objective of exploring in greater depth the major issues linked to nutrition and food on a

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global scale. The BCFN is designed to pay close attention to societys emerging needs, gathering experience and qualified expertise on a worldwide level, encouraging an ongoing and open dialogue. The complexity of the phenomena explored in this context has made it necessary to adopt a methodology that goes well beyond the boundaries of the various disciplines; hence the subdivision of the themes studied here into four macro-areas: Food for All, Food for Sustainable Growth, Food for Health, and Food for Culture. The Food for All area takes on the issue of access to food and malnutrition, with the goal of thinking seriously about how best to encourage better governance of the agro-alimentary system on a global scale, with a view to making it possible to undertake a more equitable distribution of food and encourage a more favorable impact in terms of social well-being, health, and the environment. The Food for Sustainable Growth area explores the issues of the sustainability of the agro-alimentary supply chain, through a balanced use of natural resources and a steady reduction of negative impacts on the environment. The Food for Health area has undertaken a process of study of the relationships that exist between diet and health. The Food for Culture area, last of all, is meant to understand, describe, and render more significant the relationship between man and food. In its first three years of operation, the center has undertaken and produced numerous scientific publications. Guided by institutional timeframes and by the priorities present in terms of international economic and political agendas, it has reinforced, I believe, its own role as a collector and connecter between science and research, on the one hand, and political decisions and government actions on the other hand. It has moreover organized events open to the members of civil society, including the International Forum on Food & Nutrition, a major opportunity for international interactions with the leading experts in the sector, now on its third annual edition. In line with this general approach, the activities of the BCFN are guided by a multidisciplinary Advisory Board, a body composed of experts belonging to different but complementary sectors, which proposes, analyzes, and develops issues, after which it formulates concrete recommendations concerning those issues. For each area, one or more specific advisors have been identified: Barbara Buchner (an expert on energy, climate change, and the environment) and John Reilly (an economist specializing in environmental issues) for the Food for Sustainable Growth area; Mario Monti (an economist and policy maker) for the Food For All area; Umberto Veronesi (an oncologist), Gabriele Riccardi (a nutritionist), and Camillo Ricordi (an immunologist) for the Food for Health area; Claude Fischler (a sociologist) for the Food for Culture area. From the work of this group of experts, valuable ideas have emerged in recent years: with a view to understanding in what way diet and nutrition affects our

introduction

XIII

state of health, we developed the environmental and nutritional double pyramid, with the development of the BCFN index of well being, with the analysis of the Water Economy and the nutritional guidelines of the leading international medical and scientific bodies. Moreover, we have also undertaken indepth explorations concerning proper nutrition at various ages of life, with a special focus on children. This is how Eating Planet came into being, with the contributions of scientists, political leaders, Nobel laureates, and world-renowned experts, whom we would like to thank here: Tony Allan, Ellen Gustafson, Michael Haesman, Hans Herren, Alex Kalache, Mario Monti, Aviva Must, Joaqun Navarro-Valls, Marion Nestle, Danielle Nierenberg, Raj Patel, Shimon Peres, Carlo Petrini, Paul Roberts, Vandana Shiva, and Ricardo Uauy. Just three years after the creation of the BCFN, we have decided it would be useful to offer a summary of what we have developed thus far, in order to establish a landmark on our journey and begin to consider new developments. The book that we have put together struck us as the best possible way to document our passion: for man and for his daily life, but also for the work that we do, which demands that we look at more than just our corporate profitability. It demands, we believe, that we lend a hand in an attempt to create a better world. * President Barilla Center for Food & Nutrition.

XV

preface by

Mario Monti *
the political challenge of food **

Why did I feel a strong intellectual attraction for the work that the Barilla Center for Food & Nutrition has been doing over the past several years? Because I believe that the enormous problem of access to food represents a synthesis of the difficulties that those who work in the fields of market competition and global governance find themselves dealing with. We live in a context in which, more or less everywhere, decisions are being made in an emergency situation. This is what happened with the financial crisis, which was followed by immediate, or almost immediate, action, and by considerable concerted efforts toward a general coordination. After all, it is obvious that no country alone, and no region of the world, alone, could solve the problems of the financial system. An awareness of an emergency surrounds the topic of access to food, as well. At least in the case of financial issues and other macroeconomic problems, we have however observed a dangerous trend: when a problem becomes a real emergency, we tend to become frightened. As a result, we are willing to give up part of our national sovereignty because we believe that cooperation is the only way to solve the problem. The minute that the problem seems to be somewhat less urgent and sensitive, on a short term basis, we tend to go back to our old ways of doing things. First of all, I should make two observations concerning specific aspects of the topic of food and the contribution that the EU, in particular, can supply. Agriculture and food, as well as food security in its financial repercussions, are infinitely more complicated problems that are more deeply rooted in our economic system and our society, with much farther reaching and longer lasting consequences. This means that, even though the solution of the financial imbalance may be daunting to achieve, solving these problems is an infinitely longer term matter, demanding a prolonged effort, because it sinks its roots deep into the structures of society. Therefore we must guard against the risk of reversibility as soon as a solution to the problem is glimpsed. In that connection, Im optimistic about the European Union. There are 27 nations, we have decision-making bodies, institutions, and laws, as well as structures to implement those laws. Thus, the risk of reversibility, once a prob-

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lem emerges from the state of acute emergency, is less grave in the European Union. Let us take as an example the financial crisis: after all, thanks to the excellent work done by the European Parliament, together with the European Council and the European Commission, we have put togetherpretty quickly by European standardsa new system of rules guaranteed by specific authorities, on a European level, we have seen to their implementation and supervision, and now those rules will remain in place even once the emergency is over. More specifically, as far as food security is concerned, it is clear that a potential reinforcement of global governance is fundamental. Governance does not mean repression, governance does not mean blocking entrepreneurial initiatives: governance means governing the markets in general terms, and businessmen, like users and consumers, are the protagonists of the market. Therefore, what is needed, in my opinion, is not an excessively ambitious model of planning to be implemented worldwide, in a country, or in a group of countries. Quite to the contrary, I believe that the context in which it is possible to achieve the greatest return in terms of effectiveness is the capacity to establish increasingly good relationships between political tools and market reactions. There are a few proposals on the subject that I consider to be effective, beginning of course with the idea of once again assigning a central role to food in the international political and economic program. And of course it is fundamental to encourage economic development and promote the increase of agricultural productivity. A third crucial aspect is the modification of the food production and distribution chain in an attempt to manage growing price volatility and ensure the existence of safety nets. This, if you like, is where the food sector most closely resembles the financial sector. But even the conclusive point on the production chainwhich ends where the food reaches the end users, that is, the eating habits of consumersis fundamental. For various reasons that have to do with issues of sustainability, but also due to considerations of individual and family health, this is a sector that should receive much greater investmentin parallel with energy savings and respect for the environment from consumers (private citizens and industry). Allow me to make a slightly more general macropolitical observation: we might say that one of the weak points of the world economical and political models over the past twenty years has been a decline in our focus on distribution, understood as the possibility of achieving access to food. But now, all the considerations concerning equality, inequality, and distribution (that is to say, how to undertake the distribution desired) come back full-force into the domestic and global political arena. * Mario Monti (Prime Minister of Italy and also the Minister of Economy and Finance of the Italian Republic; President of the Bocconi University; Member of the

preface

XVII

Advisory Board of the Barilla Center for Food & Nutrition from February 2009 to November 2011. ** The considerations set forth in this essay were originally developed on the occasion of the workshop Can the European Union Face Up to the New Geopolitical and Economic Challenges of Access to Food? organized by the Barilla Center for Food & Nutrition at the European Parliament on June 15, 2011.

eating planet nutrition today: a challenge for mankind and for the planet

executive summary

In this section we provide a selection of the most important actions in the field of food and nutrition, to highlight the move toward more coordinated and shared activities to improve health and protect the environment that are characterized in this book.

food for all

encourage economic development in the poorest nations Hunger is a direct consequence of poverty. It is therefore necessary to identify, implement, and support concrete and sustainable development projects to define and diffuse solutions and instruments for developing nations, in the key sectors for economic growth. Agriculture, which constitutes the sector that contributes most substantially to the growth of income for the weakest sectors of the population in developing nations, is often the most important sector toward which we should channel investments and encourage the creation of adequate structures of regulations and laws and good systems of incentives. reinforcing the mechanisms of global governance The particular nature of nutritional goodswhich cannot be reduced to the mere status of commodities, as has happened in recent decades under the pressure of their growing availabilityand the failure of the mechanisms of distribution to operate properly, make it necessary to move past the paradigm of the marketplace as a system capable of self-regulation, and likewise with regard to the coordination of global policies and the reduction over time of unilateral protectionist policies. In particular, we are talking about: building a system of commercial exchanges that is transparent, responsible, and based on multilateral rules capable of guaranteeing greater access to food on a worldwide level. It is hoped in general that there will be drop in the use of trade barriers, export subsidies, and other restraints of trade;

eating planet

preventing the cultivation of crops for the production of biofuels from inter regulating excessive financial speculation on food commodities. Even though
fering with the cultivation of crops for food; the actual role that this phenomenon plays in influencing the increase in price levels of agricultural goods is still being widely debated, the one thing that we can state with a relative degree of confidence is that financial speculation in the agricultural commodities market can amplify short-term volatility; creating a multilateral system of food reserves and improving transparency in terms of volume flows and stocks. There is a close tie between variations in stock and price fluctuations of food commodities. In particular, over a sufficiently broad time horizon, it has been observed that a reduction in the stockto-use ratio of cereal grains corresponds, generally speaking, to an increase in the price levels while, in contrast, a rise in the stock-to-use ratio tends to drive down prices. encourage the use of new approaches and tools to measure and promote widespread well-being When we establish the general overall lines of economic policy there is a need to free ourselves from an excessively narrow view of well-being, restricted to its distinctive economic traits. Instead we should include the vast array of real facts that contribute to define the overall social, politic, economic, and environmental conditions in which people live. Moreover, by setting forth a future time horizon (sustainability of well-being as against current well-being) there is the opportunity of finally being able to introduce into the public debate on policy decisions the topic of the consequences of todays choices on future well-being, in a more transparent form. This is not, then, in the final analysis, not merely a matter of defining better indicators, but rather a case of increasing in real terms the quality of the public decision-making processes. manage ways of eating Government action and the approach of nutritional models designed to take into account a general profile of sustainability is destined to become a decisive variable in political economics. This aspect is taking on concrete outlines in developed nations, in an attempt to face up to a health-care emergency that is linked to the rapid spread of metabolic, cardiocirculatory, and tumoral diseases and illnesses that derive from improper ways of eating. This approach will also become crucial for the developing nations, given the impact that it will have on the global balances of production in the realm of agriculture.

executive summary

food for sustainable growth

use the double pyramid to encourage healthy nutritional behaviors and environmentally sustainable choices Following the model of the Double Pyramid means adopting a proper diet in nutritional terms, something that has positive effects on ones health and also helps to safeguard the environment. The various approaches to the Double Pyramid that are proposed, in fact, entail smaller environmental impacts in terms of the consumption of natural resources (land, water, etc.) and reduced emissions. With special reference to future generations, it is therefore necessary to undertake a process of collective responsibility that, without leaving the children themselves out entirely, focuses on parents and on the school system for the nutritional education of the young. guarantee widespread access to water and encourage better worldwide water management It is necessary to reinforce the commitment and the responsibility of the public institutions to guarantee access to drinking water and to adequate sanitation infrastructure for the most disadvantaged populations, promoting the necessary investments and removing restraints of a technical and political nature. The problems that arise in connection with water resources must be solved with integrated policies, models, and management tools. It is particularly important to spread practices, know-how, and technologies to increase water productivity (more crop per drop) and reduce wastage. encourage a balanced mix of agricultural models The global agricultural system shows a variety of aspects of fragility with which it will be necessary to deal in a positive manner through the promotion of a balanced mix of agricultural models, built in order to meet the challenge of phenomena of relative scarcity. The factors at play are numerous (quality of the soil, availability of water, adaptation to atmospheric phenomena, etc.), but certainly one of the most significant themes with a view to the future will be the issue of the availability of energy. The search for solutions based on approaches that use reduced energy consumption and elevated knowledge content will in fact become one of the decisive aspects of sustainability.

eating planet

food for health

adopt a balanced diet and an active lifestyle to prevent widespread major chronic diseases There is an unmistakable, direct, and intense link between lifestyle and health. In the context of individual choices, diet therefore plays a decisive role. In that sense, adopting a balanced diet, such as the Mediterranean diet, for instance, presents convergent factors in terms of health. A balanced diet with low content of sugars, fats, and salt and with a high content of fruit, vegetables, and cereal grains, tends to reduce to a significant degree the negative factors that cause disease and infirmities in individuals and, in some case, premature death. In brief, adopting a balanced diet and an active lifestyle, from the earliest phases of life, are factors capable of minimizing at the same time and in parallel the risks of the onset of overweight, obesity, tumors, cardiocirculatory diseases, diabetes, and metabolic syndrome, thus improving the lives of individuals. encourage good behaviors and lifestyles from childhood on for better adult health The evidence in favor of the exceptional importance of a proper approach to diet and food from the earliest age appears to be undeniable, inasmuch as there exists an elevated correlation between behavior and diet in the earliest years of life and the onset of disease in adulthood. From the studies that have been carried out it has become clear that it is indispensable to promote the further exploration of existing scientific knowledge about childhood, which is less thoroughly studied than adulthood, and encourage cooperation between the various entities and players involved (including the food industry) in properly feeding young people, in order to encourage proper food-related information and the promotion of a culture of prevention. The guarantee of good eating habits for children and adolescents seems necessarily to involve the implementation of a concerted effort, the product of the contribution of multiple subjects (school, family, pediatricians, and the food industry), which at different times of the day take care of children. maintain an adequate diet throughout your life Over the last hundred years, life expectancy at birth has practically doubled, stretching from forty-five years at the end of the nineteenth century to roughly eighty years in 2010. These results are the outcome of improved living conditions of the population, medical and scientific discoveries, and the constant improvement of medical and health technology. Despite the lengthening average life expectancy, health doesnt seem to be improving at the same rate: about 80 percent of all elderly people (older than

executive summary

sixty-five), in fact, suffers from at least one chronic illness and roughly 50 percent are afflicted with two or more chronic pathologies. In the face of a growing life expectancy and a dramatic increase in the spread of the leading chronic pathologies it is likely thatin the near futuremankind will experience for the first time in modern history an old age characterized by an average quality of life that is less than optimal, for a significantly longer time. Therefore, action must be taken, though not so much to achieve a longer lifespan, but rather to live healthier and longer, which may involve research into such particularly innovative fields as the link between inflammatory states and the onset of chronic illnesses, as well as the benefits that can be obtained through regimens of caloric restriction with optimal nutrition.

food for culture

recovering and spreading the elements of culture, taste, and enjoyment of life in order to live with close ties to ones food It is necessary to revive a number of fundamental dynamics proper to the culinary cultures that are most focused on the bond between food and the individual, such as the Mediterranean culinary culture. It is a matter of making the most of these aspects of conviviality, protecting local territorial varieties by preserving the wealth of identities, transferring the expertise and know-how linked to the preparation of foods, returning to a healthy relationship with the territory and with the context of the raw material by focusing on the excellent quality of the ingredients, recovering age-old flavors capable of being renewed into a contemporary taste, through a critical operation that makes it possible to preserve the best of the culinary tradition. educating toward a new ecology of food We must make a grand overarching deal among all the players in the world of foodincluding public institutionswho are increasingly concerned about the devastating consequences of the bad food choices being made by the citizens of the world, in order to reorient the lifestyles and ways of eating toward modes of consumption that are more sustainable in terms of health, the environment, and an intact social structure. The scale of the challenge is so great that it demands capacities to intervene that vastly outweigh the power of individual players. What is needed is a concerted effort, an alliance among the various entities that, while it preserves the distinctive character of competition in the relationships among the operators in a single sector, remains capable of implementing cooperative games aimed at the promotion of a new culinary paradigm.

table of contents
introduction
Worldwatch Institute: Its Possible to Work at All Scales, Small and Large by Danielle Nierenberg

food for all

1.1 1.2 1.3 1.4 1.5 How Rich Nations Squander Food New Techniques for the Transformation of Food Eating Better School Lunches and Nutrition Buying Local

food for sustainable growth

1.6 1.7 1.8 1.9 Rethinking the Green Revolution Yields and Environmental Sustainability Food Sustainability and Climate Change Integrated Animal Husbandry for Better Sustainability

food for health

1.10 1.11 1.12 1.13 1.14 Not by Calories Alone The Role of Vegetables Bringing Healthy Food Everywhere The Importance of Information The Role of Health Structures

food for culture

1.15 1.16 1.17 1.18 Relaunching Agricultural Systems New Computer and Communications Technologies Popularization In the Field Incentivize Employment of the Young

the three objectives of food

1.19 Increasing Awareness about the Importance of Agriculture

 1. the challenges of food

The Worldwatch Institutes Nourishing the Planet project strongly recommends the importance of developing and encouraging new strategies for satisfying the worldwide demand for food in fair and environmentally sustainable ways. In this chapter, we identify existing challenges in the food system and highlight ways to alleviate hunger and poverty while also protecting the environment.

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1. the challenges of food Worldwatch Institute: Its Possible to Work at All Scales, Small and Large
Danielle Nierenberg, Director of the Worldwatch Institutes Nourishing the Planet project

In Ahmedabad, India, a group of women farmers and food processors is changing the way Indians eat. These women belong to the Self-Employed Womens Association (SEWA), a trade union bringing together more than 1 million poor women workers. Ninety-three percent of the female workforce in India is nonunion, making these women nearly invisiblethey dont have access to credit, land or financial services, including bank accounts. But by involving women in food production SEWA is helping women better their livelihoods by becoming more self-sufficient. Fifty-four percent of SEWAs members are small and marginal farmers.1 SEWA members sort and package rice, marketing it under their own label, and at a SEWA-run farm outside the city women are growing organic rice and vegetables and producing organic compost on what was once considered unproductive and marginal land. We now earn over 15,000 rupees [US$350] per season, an amount we had never dreamed of earning in a lifetime, says Surajben Shankasbhai Rathwa, who has been a member since 2003. These women earn more income and eat better than before, and theyre providing an important community service by producing healthy, affordable, and sustainably grown food to local consumers. Most poor households cant afford high quality food, and the rice and other staples they buy are inferior productsrice grains are often broken or riddled with dirt and stones, and most food is produced with pesticides and artificial fertilizers.2 But the women in SEWA are not only interested in whats going on in their own communitytheyre also interested in what farmers thousands of miles away in sub-Saharan Africa are doing to combat climate change, conserve water, and build soils. During a meeting in early 2011 they wanted to know

boy and the bucket, togo

Les Compagnons Ruraux is an NGO based in Togo that educates farmers living in the Kpalim Cloud Forest about sustainable agriculture practices, including agroforestry and intercropping. The organization also improves local food security by training members of womens groups to grow and market organic vegetables, medicinal plants, and locally processed palm oil. By working with local residents, the organization aims to keep young adults from migrating to cities.

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what they could learn from their counterparts in an area of the world facing the same challengeserratic weather events, soil degradation, high food prices, poverty, and malnutrition. These are problems in India and Africa alike, as well as in other parts of the developing world. And while SEWAs training farms and agricultural credit services wont change the global food system on their own, they are one step toward enabling agriculture not only to feed the world but also to nourish livelihoods, environmental sustainability, and vibrant rural and urban economies.3 were at a turning point. Theres no doubt that the current food system is broken: vast amounts of food are wasted in both rich and poor countries, agriculture contributes to one-third of global greenhouse gas (GHG) emissions, foodrelated diseases are on the rise, and the environmental impacts of agriculture including deforestation, water scarcity, and GHG emissionsare increasing. 4 Over the last three decades, the Western food system has been built to promote over-consumption of a few consolidated commoditiesincluding rice, wheat, and maizeand has neglected indigenous foods that provide not only calo-

1,350 1,200 1,050 900 750 600 450 300 150 0 878 853 845 857 873 915 1,020 925 925 estimated

millions of people

825

196971

197981

199092

199597

200002

200406

2008

2009

2010

2011

figure 1.1
Hunger in the world (19692011) Source: Worldwatch Institute elaboration of data from FAO, Hunger Statistics, www.fao.org.

introduction | the challenges of food

13

ries but also essential vitamins and micronutrients and tend to be resistant to heat, drought, and disease. One result is that 1.5 billion people in the world are obese or overweight and thus at higher risk of diabetes, cardiovascular disease, and other maladies.5 But the challenges we face will not be easy to overcome. Agriculture is at a turning point. Its been roughly half a century after the Green Revolution, yet nearly 1 billion people in the world go to bed hungry each night and several billion suffer micronutrient deficiencies (figure 1.1). If we begin now, however, we can build a better strategy, vision, and road map for the global food systema system that nourishes both people and the planet by finding ways to make food production and consumption more economically, environmentally, and socially just and sustainable. The solutions are out therein market garden projects in rural Niger, at dinner tables in Italy, on rooftop gardens in Vietnam, at research institutes in Taiwan, in edible school yards in the United States, and in communities all over the worldbut they are not getting the attention and the investment they need. This needs to change.

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food for all

Famine reemerged in the Horn of Africa in 2011, reminding the world that hunger and malnourishment continue to be a cruel reality for many of the worlds poor. The famine is not the result of just one bad droughtalthough the region is experiencing the worst drought in 60 yearsor one failed policy. Its the outcome of decades of ignoring smallholder farmers and pastoralists and dismissing the impacts of climate change and environmental degradation on the region, as well as of pervasive conflict, violence, and corruption. Some 11 million people are at risk of starvation in Ethiopia, Kenya, Somalia, Djibouti, South Sudan, and Uganda.6 Nearly 4 million Somalis, more than half the population, are in need of immediate emergency aid. More than 265 million people in sub-Saharan Africa are considered malnourishedapproximately one out of every four Africans and one out of every three sub-Saharan Africans.7 The problem of hunger is not confined to Africa, however. Worldwide, more than 1 billion people are undernourisheda number that, after falling steadily throughout the 1980s and 1990s, is now creeping back up. Asia has the greatest number of hungry people: 225 million people in India, 41 million in Bangladesh. In Latin America and the Caribbean, where hunger receded dramatically throughout the 1990s, the number is 53 million.8 Food prices also continue to increase (figure 1.2). Since 2007, the UN Food and Agriculture Organizations (FAOs) Food Price Index has recorded a 70-percent jump in international food prices. World Bank data show that food prices increased 15 percent for many developing countries between October 2010 and January 2011 alone. According to the Bank, that price spike has pushed an estimated 44 million people into poverty. In sub-Saharan Africa and South Asia many farmers and consumers are earning just US$12 per day, making any increase in food prices especially painful. Instead of being able to buy nutritious beans, eggs, meat, or vegetables, many households can afford only staple crops such as rice or cassava, which fill people up but provide very few nutrients.9 According to Olivier De Schutter, the United Nations Special Rapporteur on the Right to Food, Traditional ways of looking at hunger are unhelpful because they focus on aggregates and increasing production. Governments, development agencies, NGOs, and funders have invested in increasing production and improving yields rather than on the more neglected parts of the food system that have potential to improve livelihoods, decrease malnutrition, and protect the environment. Whats needed are more investment to prevent waste from field to fork and a stronger focus on food aid and local school nutrition programs.10 Preventing the millions and millions of tons of food waste that occurs annually, for example, could be a way to help fill bellies and pocket books in both devel-

food for all | the challenges of food

15

350 300 250 price index 200 150 100 50 0

sugar cereals

meat

oils

dairy

1990

1993

1996

1999

2002

2005

2008

2011

figure 1.2
Volatility of food prices (19902011) Note: The 2011 data are the product of averaging the individual months. Source: FAO, Food Price Index, www.fao.org.

oping and developed countries. Food waste can total an astonishing 30 percent of the harvest. It is insidious, happening all along the food chaina few percent is lost on the farm, a few percent in storage, a few percent during transport, and another few percent at markets and at home.11 In poorer countries, especially those in sub-Saharan Africa and South Asia, crop storage remains woefully inadequate, wasting crops in the places that need them most. Most farmers dont have access to proper grain stores, drying equipment, fruit crates, refrigeration, or other post-harvest storage and processing technologies.12 1.1 how rich nations squander food Even countries such as the United States, Italy, France, the United Kingdom, and other wealthy nationswhich have mastered the art of preventing food losses with climate-controlled storage units and refrigeration, drying equipment, chemicals that inhibit fungi and molds, and plant breeds designed to extend shelf lifestill squander vast amounts of food. We throw away cosmetically imperfect produce, dispose of edible fish at sea, over-order stock at grocery and big box stores, and purchase too much food for home consumption. Much of it ends up in landfills instead of our stomachs. As long ago as 1974, the first World Food Conference (in Rome) called for a

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50-percent reduction in post-harvest losses over the following decade. That goal remains unachieved, and preventing waste remains a vastly underfunded dimension of the agricultural development process. Very few donors, unfortunately, are investing in helping farmers and food processors find better ways to store and manage crops post-harvest, and wealthy consumers remain uninformed about how their (over)buying habits impact the environment.13 But reducing this waste can be simple, inexpensive, and effective while improving health and nutrition. Consider, for example, food contamination by aflatoxin, a toxic fungus that can lead to liver cancer, stunting, and other health problems. Aflatoxin contamination is caused almost exclusively by consuming food that has become moldy because of poor food storage. The International Institute for Tropical Agriculture (IITA) is working with farmers to apply a non-toxic, locally occurring strain of the fungus prior to harvest. The strain developed by IITA, trademarked as Aflasafe, safely outcompetes and virtually eliminates the toxic strain, making it an effective bio-control with the potential to save farmers millions of dollars per year and protect human health at the same time.14 Another simple technology with great potential to reduce crop loss and waste is hermetic sealing: storing crops in re-sealable bags, which prevents exposure to oxygen and moisture and inhibits the growth of dangerous fungi. The bags also keep out insects and suffocate any larvae already present, and help ensure safer transport of crops from farm to market.15 In Western Africa, cowpeas (black-eyed peas) are an important staple crop, and improved storage for half the areas cowpea harvest would be worth US$255 million annually to some of the poorest people in the world. Purdue University researchers have helped farmers use inexpensive, hermetically sealed bags Purdue Improved Cowpea Storage (PICS)to prevent pests and mold from attacking harvests.16 When we open up the bag, it looks the same as the day I stored it, says Balarabe Kausani, a smallholder farmer in northern Nigeria. Because of the quality of the cowpeas, you can add 20 percent to the price. In addition to preserving an important seasonal crop year-round, the PICS bags also save farmers money on expensiveand toxicpesticides. With support from the Bill & Melinda Gates Foundation, the PICS project expected to reach 28,000 villages in Benin, Burkina Faso, Cameroon, Chad, Ghana, Mali, Niger, Nigeria, Senegal, and Togo by the end of 2011.17 1.2 new techniques for the transformation of food Finding better ways to process foods can also help prevent food waste. In Mauritania, dairy production is important for both nutrition and incomes, especially for women farmers. Unfortunately, during the rainy season herders typically dispose of around 500 liters of milk per day because they have too much milk to

food for all | the challenges of food

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sell or drink themselves. The same herders suffer extreme nutritional deficiencies in the dry season when very little food, including milk, is available.18 In 2010 Counterpart International, a global development organization that focuses on food security and governance, launched a multi-year assistance program that includes teaching women and subsistence farmers in Mauritania to turn milk into dried cheese. This value-added product can be eaten during the lean dry months, or hunger season, when villagers are most food-insecure. Dried cheese retains higher levels of protein and fat than other dried milk products, making it an important staple when very little other food is available. 19 There are many novel and income-generating ways of transforming foods so that they dont go to waste. In Bolivia, China, India, and other countries, solarpowered driers and dehydrators are helping to preserve abundant harvests of mangoes, papayas, and other fruits, providing important vitamins and nutrients to people all year long. The ulog (A-frame collapsible dryer) in Bolivia and the artisanal solar timber dryer in the Caribbean are allowing farmers to dry a number of different crops, such as tomatoes and potatoes, throughout the year. In northeast China, farmers tear the husks off maize cobs in the ripening stage so that the cobs can dry while maturing on the stalk. This method removes moisture and promotes maturity, helping to increase yields.20 Consumers are also changing their eating and buying habits to reduce waste. In the United Kingdom, the organization Love Food, Hate Waste educates citizens on food waste issues and gives simple suggestions on how to reduce personal waste. Love Food, Hate Waste is a project of the Waste and Resources Actions Programme, a nonprofit organization established in 2000 that works with businesses and individuals to improve knowledge and usage of resources and cost-efficient recycling programs. The groups work has resulted in the recycling of more than 1 billion plastic bottles a year and has helped divert 670,000 tons of food from landfills over the last decade, saving consumers over US$970 million annually. 21 1.3 eating better Besides reducing waste, another way to deliver maximum value from food produced is by improving nutrition, and there are many examples of successful programs to do this from around the world. For instance, school breakfast and lunch programs in Asia and Africa that rely on local and regional food sources are reducing child malnutrition and improving school enrollment while also boosting farmers incomes. The United Nations World Food Programme (WFP) is actively promoting such home-grown initiatives, which link local agriculture with in-country school programs. These collaborations provide steady and guaranteed income to smallholder farmers and fresh and nutritious foods to schoolchildren.22

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1.4 school lunches and nutrition Ghana began its own Home Grown School Feeding Program in 2005. By the end of 2006, the program was reaching 69,000 pupils in 200 schools across every district in the country. The program is estimated to have assisted more than 1 million children in 2010. Enrollment in schools where meals were served increased by 20.3 percent, compared to 2.8 percent where they werent available. School retention rates increased by around 10 percent for schools with the programs.23 In Thailand, where a national school lunch program is funded through the government, school lunches reach 1.8 million primary school children and 700,000 kindergartners. roughly 30 percent of all school children in the country. Thailands school food program does not mandate where individual schools get their food, but the WFP estimates that approximately 90 percent of participants purchase vegetables and meat from local producers.24 School feeding programs can be especially important in areas where theres conflict, whether its gang violence in Los Angeles or political violence in Cote dIvoire. Food from the Hood is a group of student gardeners that began in Los Angeles after the 1992 riots. The students grow kale, eggplant, and 16 varieties of heirloom tomatoes. Twenty-five percent of what they grow is given to the needy and the rest is sold for profit, half of which has been funneled into scholarships for students.25 In Cote dIvoire, the conflict that erupted after a coup detat in 2002 had a huge impact on agriculture and education in the northern part of the country. Not only did yields and incomes decrease, but many children stopped going to school because of the violence.26 The children who did attend school received meals that were often of poor nutritional quality because of inadequate funding. As a result, Mariam Ouattara, the president of Chigata Fettes et Development (Women and Development), an NGO in NGanon village, organized a womens group to start growing organic food and cook meals for the children.27 The project started with 300 students working with about the same number of women in the community to grow rice, haricot blanc (white beans), onions, tomatoes, eggplants, cabbages, radishes, and other crops. Much of this food is eaten by the children in the school canteen, while the surplus is sold to help maintain the garden and the canteen. The students and teachers know how to keep the operation going, so that even if were not there, says Ouattara, we can do the program. Their hope is that by educating children they can also change how parents cook and eat vegetables through trickle-up education. And when children eat, says Ouattara, its easier for them to become better students.28 1.5 buying local In the same way, food aid in sub-Saharan Africa is now coming from farmers in the region rather than from thousands of miles away. Much of the maize,

self employed womens association products in vadodara in gujarat, india

Goods produced by the SelfEmployed Womens Association (SEWA) in the village of Gujarats Vadodara, India. SEWA has more than one million members and helps train women farmers and food processors how to grow, package, and market organic rice, spices, and other foods. These foods are higher quality than the food typically available to poor consumers, and the women sell them under SEWAs own label.

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rice, soy, and other foods consumed locally have long come from the United States, and while they have provided much-needed calories, they have also disrupted national and local markets by lowering prices for locally grown food. Today more and more of the crops provided as food aid come from African farmers selling directly to the WFP through local procurement arrangements. In Liberia, Sierra Leone, Zambia, and several other nations in sub-Saharan Africa (as well as in Asia and Latin America), WFP is not only buying locally but helping small farmers gain the skills necessary to be part of the global market.29 In Zambia, WFP buys food directly through the Zambia Agricultural Commodity Exchange while remaining invisible, according to Felix Edwards, coordinator of the Zambia P4P Program. This way, WFP Zambia avoids distorting prices and helps create an alternative means for farmers to access markets through a network of Exchange-certified warehouses at the district level. WFP also works through its partners, including the U.S. Agency for International Developments (USAIDs) PROFIT program, to help farmers and farmer associations meet the quality standards required by the Exchange. As a result, they are preparing Zambian farmers to provide high-quality food aid not only to programs and consumers in their own country but also potentially to growing regional and international markets.30 Working with local resources and local innovations in Latin America, Africa, and Asia, farmers are finding ways to feed themselves and their communities, and even provide aid to the needy. These are exactly the types of innovations that need more research, support, and investment.

food for sustainable growth

In June 2012, policymakers, business leaders, activists, scientists, and journalists will gather in Rio de Janeiro, Brazil, for the United Nations Conference on Sustainable Development. Twenty years ago, the Rio Earth Summit was a call to action, mobilizing individuals and organizations everywhere to address the worlds most serious environmental challenges. Agriculture was blamed for many of those problems, including deforestation, water scarcity, biodiversity loss, and soil degradation. And two decades ago, organic agriculture, conservation farming, and other agro-ecological practices were considered backward and inadequate ways to feed the world. But today agriculture is emerging as a solution to the planets pressing environmental problemsand agro-ecological approaches are seen, not as nave, but as the way forward in a world of declining fossil fuel resources and increasing hunger and poverty.

food for sustainable growth | the challenges of food

21

This shift is happening in farmers fields, in parliaments and board rooms, and in research institutes worldwide. Several major research reports throughout the 2000s have painted an evolving picture of agriculture, one that shows how food production can help address climate change, unemployment, urbanization, desertification, water pollution, and other environmental challenges. 1.6 rethinking the green revolution In 2008, the International Assessment of Agricultural Science and Technology for Development (IAASTD) was released. This monumental report took more than four years to complete and brought together 400 of the worlds leading scientists, researchers, development agencies, and NGOs to outline the current state of agricultural knowledge. Their major conclusion: that business as usual approaches to feeding the world were not working. In other words, the Green Revolution technologies of the pastalthough they were effective at increasing yields in the short termhave not been as effective in addressing the real problem of malnutrition. According to Dr. Hans Herren, World Food Prize Laureate and co-chair of IAASTD, The Green Revolution ran out of steam long ago [...] We need to reinvent agriculture [...] Although the Green Revolution has promoted the production of more food, there were many factors involved; it was not only just breeding of high-yielding crops. Where it worked, there was an environment, there were roads, there was access to fertilizer, inputs, pesticides, et cetera, which helped. What we want, actually, is an agriculture that is not based on those inputs; we want an agriculture which is self-sustaining. And thats why I think we need to reinvent [the Green Revolution].31 1.7 yields and environmental sustainability According to IAASTD, Emphasis on increasing yields and productivity has in some cases had negative consequences on environmental sustainability. Nearly 2 billion hectares and 2.6 billion people have been affected by significant land degradation resulting from large-scale agricultural practices associated with the Green Revolution. Today, 70 percent of freshwater withdrawals are for agricultural irrigation, causing salinization of water supplies in developed and developing countries alike. The overuse and misuse of artificial fertilizers and pesticides have produced toxic runoffs which create coastal dead zones and reduce biodiversity.32 Although the Green Revolution is considered a success, its benefits are unevenly spread. The most striking results in decreasing poverty and increasing crop yields were seen in South Asia, while people in sub-Saharan Africa have remained poor and undernourished. Many of the poorest of the poor have

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gained little or nothing, according to the report, and at least one out of seven members of the human family still goes to bed hungry each night. Dr. Robert Watson, chief scientist for the World Bank and the director of IAASTD, said that we are putting food that appears cheap on our tables; but it is food that is not always healthy and that costs us dearly in terms of water, soil, and the biological diversity on which all our futures depend.33 Agriculture operates within complex systems and is multifunctional in its nature, according to IAASTD. Multifunctionality, says the report, is the inescapable interconnectedness of agricultures different roles and functions. The concept of multifunctionality recognizes agriculture as a multi-output activity producing not only commodities (food, feed, fibers, agrofuels, medicinal products, and ornamentals), but also non-commodity outputs such as environmental services, landscape amenities, and cultural heritages. The Green Revolution, on the other hand, tended to focus narrowly on yields and very little on biological interaction. We need a more integrated approach that links agriculture to health, to water security, to energy services, and also to education. We need a comprehensive approach to providing food security in Africa, says Judi Wakhungu, co-chair of the IAASTD committee.34 1.8 food sustainability and climate change The IAASTD report isnt the only one to come to these conclusions. According to the U.K. Foresight report, Global Food and Farming Futures, Addressing climate change and achieving sustainability in the global food system needs to be recognized as a dual imperative. Nothing less is required than a redesign of the whole food system to bring sustainability to the fore. And in 2008, the World Bank World Development Report also recognized the need for agriculture to be more environmentally sustainable in the short- and long terms. Several other major reports also point to more environmentally sustainable ways of alleviating hunger and poverty (table 1.1).35

table 1.1 the road toward agro-ecology 36

World Bank: World Development Report 2008 Agriculture for Development (2008) The 2008 World Development Report (WDR) highlights agricultures contribution to eco nomic, social, and political growth in subSaharan Africa and Asia. According to the report, agriculture can drive rural development and stimulate econo mies in developing countries. The WDR notes that GDP growth originating in the agri cultural sector is twice as effective in reducing poverty as GDP growth starting in other sectors of the economy. Agricultural development can only become a viable strategy if smallholder farmers, particularly women, are given better access to capital, new tech nologies, and land. To make this a reality, says the Bank, international governments need to make smarter and more targeted investments in rural development, and policymakers must encourage local governments to implement agricultural and environmental sus tainability measures more effectively.

woman peeling cassava in ibadan, nigeria.

In many parts of Africa, cassava provides a daily source of energy. The International Institute of Tropical agriculture (IITA) is working with cassava farmers in Nigeria to develop cassava varieties that are disease and pestresistant and high yielding. Theyre also helping farmers find ways to add value to cassava through processing the crop into gari and foofoo. The introduction of these improved varieties has already provided food for some 50 million people in Nigeria.

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International Assessment of Agricultural Knowledge, Science, and Technology for Development (IAASTD): Agriculture at a Crossroads (2009)

The IAASTD highlights past, present, and future agricultural development. It took more than four years to complete and brought together 400 of the worlds leading scientists, researchers, development agencies, and NGOs. The IAASTD focused on ways of reducing poverty and hunger, improving rural livelihoods and human health, and promoting eq uitable sustainable development through a better understanding of agricultural knowl edge, science, and technology (AKST). A major finding was that the onesizefitsall approach to agricultural development hasnt worked. Conventional agriculture hasnt recognized that agriculture and local ecosystems are dependent on one another. IAASTD recommends a greater emphasis on agroecological farming techniques, smallholder development, and more effective imple mentation of AKST at the local level. By focusing on agricultural development, significant progress can be made in eliminat ing hunger and malnutrition, fostering economic growth, and reducing poverty in some of the poorest countries in the world. This report highlights 20 successful policies, pro grams, and investments in propoor agricultural development in Africa, Asia, and Latin America, and illustrates how these accomplishments can provide both lessons and inspi ration for continued efforts in the future. Dramatic food price increases in 2008 led 110 million people into poverty and 44 million people into hunger, according to the United Nations Environment Programme (UNEP). The report analyzes the causes of these price surges and provides recommendations on how to reduce the likelihood that a similar foodprice crisis will happen in the future. To limit food price volatility in the shortterm, international leaders can create grain re serves to be used as a buffer in times of emergency and eliminate biofuel subsidies that divert edible crops to fuel production. For the mediumterm, leaders must encourage smallholders to develop diversified farms that are resilient to pests, disease, and climate change by incorporating agroforestry, livestock, and cover cropping. To combat price vol atility in the longterm, policymakers need to limit the effects of global climate change by incentivizing more energyefficient lifestyles and promoting agricultures potential as a tool to fight GHG emissions. The World Food Programme views climate change as the defining challenge of our time, and emphasizes the threat it presents towards hunger, malnutrition, and food insecurity for millions of people, particularly in Africa, the poorest areas of southern and southeast Asia, and some regions of Central America. In order to address this, the report states there is a growing consensus within the inter national humanitarian community on the need to adapt global and local food systems through investments, knowledge transfers, and innovations, focusing on improving both food access and food production. The World Food Programme stresses the importance of institutional support for these processes from the local, national, and international levels, and highlights its own role in these efforts. This report analyzes the role of the United States in fighting hunger globally and its for eign food assistance policies, with recommendations for the future. As the global community is increasingly mobilizing around hunger and malnutrition re duction, Bread for the World states that U.S. leadership can drive international action, and recommends a number of aspects in which its policies can be strengthened. In particular, the report highlights the new Feed the Future initiative, which Bread for the World claims leads the way for effective and sustainable development policy by focusing on bottomup, localled approaches. However, Feed the Future suffers the same weak nesses of other U.S. development assistancea lack of technical capacity, funding, and support from the governmentwhich the report recommends addressing by rewriting the 1961 Foreign Assistance Act and establishing the importance of poverty reduction and development in U.S. foreign policy. In the recent past decades, food price volatility, the rising world population, and food production problems have created increasing strain feeding the worlds hungry, which is being further compounded by the impacts of climate change. This report looks at the challenges of climate change and analyzes their effects on food security, including who will be most affected and what policymakers can do to facilitate successful adaptation for the future. The report summarizes its findings in four main messages: broadbased economic de velopment is central to improving living conditions; climate change offsets some of the

International Food Policy Research Institute (IFPRI): Millions Fed Proven Successes in Agricultural Development (2009) The United Nations Environment Programme: The Environmental Food Crisis (2009)

The United Nations World Food Programme: Climate Change and Hunger (2009)

Bread for the World Institute: 2011 Hunger ReportOur Common Interest: Ending Hunger and Malnutrition (Nov. 2010)

International Food Policy Research Institute (IFPRI): Food Security, Farming, and Climate Change to 2050 (2010)

food for sustainable growth | the challenges of food

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benefits of rising incomes; international trade plays an essential role in mitigating some of climate changes effects; and investing in agricultural productivity improvements properly can enhance food security and mitigate the impacts of climate change. United Nations Food and Agriculture Organization: The State of Food and Agriculture 20102011 (2011) In developing countries, women do most of the farming but typically do not have access to land rights, education, or financial services. This gender gap manifests itself as a yield gap on the farm. Female farmers are just as capable as men, but their lack of support and resources reduces their harvests by an average of 20 to 30 percent. Closing this gender gap would not only empower women and strengthen communities but it could also boost agricultural productivity and bring as many as 150 million people out of hunger. The report also notes that as women become equal shareholders in the home, they increase the food security, nutrition, education, and health of their children who will then have a better chance to become productive and engaged citizens. The FAO encourages farmers and policymakers in developing countries to reconsider the homogenous, productionintensive farming methods of the Green Revolution. One way to balance increased food production with the environment is to focus on sustainable crop production intensification, or SCPI. This save and grow approach to farming mim ics natural ecosystems, water flows and pollination cycles, but adds inputs like fertilizers and pesticides in targeted amounts when necessary. These techniques have proven suc cessful, with average yield increases of 80 percent in 57 lowincome countries. This 350page text analyzes the political, economic, and agronomic factors that have created structural poverty and hunger in the African continent. The report suggests that Africas recovery will not come from the same strategies used in Latin America and South Asias Green Revolution of the mid20th century, but rather through a grassroots Brown Revolution. This Brown Revolution focuses on agorecological food production techniques, such as soil conservation, cover cropping, legume planting, reduced tilling, and basin planting. These farming methods maintain a longterm vision of sustainability that will allow fam ily farms to prosper. To help foster this type of agricultural renaissance, advocates and international leaders need to promote diverse, regenerative systems that are inclusive, not exclusive; this means developing agriculture that is specific to its particular climate, ecosystem, and geographic context. They also need to concentrate on conservation agri culture, incorporating organic fertilizers and zerotill soil management. Leaders can also prioritize smallholder voices; over 73 percent of farmers in Africa are considered small holders, so its imperative to have their voices and concerns raised at the policy table. Finally, advocates need to get loud and busy promoting the benefits of agroecological farming and smallscale, contextspecific solutions to hunger and poverty. The United Kingdom Government Office for Science / Foresight: The Future of Food and Farming: Challenges and Choices for Global Sustainability (2011) The Foresight report was a twoyear project, involving over 400 leading experts and stakeholders from 35 countries, including the United Nations, European Union, World Bank, industry and civil society, and academia. The report identifies critical food and ag ricultural issues and possible policies and interventions for addressing those challenges. Foresight notes that balancing future demand and supply, food price volatility, reducing carbon emissions from agriculture, and protecting biodiversity, will all be major hurdles. But international leaders can work to balance food demand and supply by improving sustainable production, implementing new science and technology, and reducing food waste. To combat hunger and climate change, policymakers need to prioritize rural de velopment and poverty eradication, incentivize energy efficient lifestyles and food pro duction techniques, and help vulnerable populations adapt their food systems to chang es in climate. The Commission on Sustainable Agriculture and Climate Change is an initiative of the CGIAR Research Program on Climate Change, Agriculture and Food Security (CCAFS). The Commission is working to identify which policy changes and actions are needed to help the world achieve food security in the face of climate change. The Commission focused on bringing together existing evidence on sustainable agricul ture that contributes to food security and poverty reduction, and helps respond to climate change adaptation and mitigation. The Commission began in early 2011 and has launched its Summary for Policy Makers, with a full report to follow in 2012. Their policy recommen dations include raising the level of global investment in sustainable agriculture, targeting the most vulnerable populations, and reducing loss in the food production system.

United Nations Food and Agriculture Organization: Save and Grow (May 2011)

The Howard G. Buffett Foundation: The Hungry Continent: African Agriculture and Food Insecurity (2011)

Climate Change, Agriculture and Food Security (CCAFS), Commission on Sustainable Agriculture and Climate Change: Achieving Food Security in the Face of Climate Change (2011)

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But agro-ecology does not mean a return to old-fashioned or outdated practices. On the contrary, such approaches are highly complex, relying on the extensive knowledge of farmers and an understanding of local ecosystems. Agro-ecology mimics nature; rather than separating crops and livestock from nature, agro-ecological systems integrate farming with the environment. Agroforestry, for example, is a good illustration of how farming and ecosystems can work together. In Indonesia, Kenya, Tanzania, Zambia, Malawi, and many other countries, crops such as maize, wheat, sorghum, millet, and vegetables are being grown along Acacia, Sesbania, Gliricidia, Tephrosia, and Faidherbia trees. These fertilizer trees provide shade, improve water availability, prevent soil erosion, and add the natural fertilizer nitrogen to soils. Dr. Dennis Garrity, the former director general of the World Agroforestry Centre, calls this evergreen agriculture; integrating trees with annual and perennial crops maintains green cover on the land throughout the year. Both perennials and annual crops can be used. According to Garrity, We look at evergreen agriculture as a way of in fact assisting in reinventing agriculture for a more climate-smart farming in the future.37 This reinvention was, in fact, not dreamed up by researchers or scientists but has been a practice of farmers in places like sub-Saharan Africa for generations. Its indigenous to Africa. And the trees that make this system possible are trees that are readily available to millions more farmers in the future, says Garrity.38 Integrating trees with crops can double or even triple yields compared to crops that are grown without a canopy. Because the trees fix nitrogen from the air and deposit their biomass and leaves on the soil surface, the soils become increasingly fertile, stimulating higher crop yields, especially of cereal crops. The trees also provide a variety of ecosystem services, including sequestering carbon, preserving biodiversity, and protecting crops from harsh sunlight. Clearing land for agriculture, whether its in the Brazilian Amazon or the rainforest of Congo, destroys habitat for birds, plants, and other species. And while forests and grasslands are still rapidly declining, the number of trees on farms, according to the World Agroforestry Centre, is actually increasing. In some regions of the world, including Central America, more than 30 percent of agricultural lands enjoy tree cover.39 1.9 integrated animal husbandry for better sustainability Farmers in Japan and other parts of Asia are also finding ways to add nutrients to crops without depending on expensive artificial fertilizers or toxic pesticides, while protecting the environment at the same time. By using ducks and fish instead of pesticides for pest control in rice paddies, these farmers are providing additional protein for their families as well as increasing incomes. The ducks

food for sustainable growth | the challenges of food

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eat weeds, weed seeds, insects, and other pests, helping reduce the labor needed for weeding, and the duck droppings provide nutrients for the rice plants. In Bangladesh, the International Rice Research Institute reports that these systems have resulted in 20 percent higher crop yields. Practicing farmers have seen their net incomes rise by 80 percent.40 These systems can also work with other animals. Mixed-crop and livestock agriculture systems in communities in China, the Philippines, and Taiwan allow farmers to raise hogs, chickens, tilapia, and rice on the same farm. The manure from the pigs is used to fertilize the tilapia ponds and rice fields. This type of system generates little waste and provides diverse and stable sources of food and income for farmers.41 Agro-ecological practices also help farmers better cope with natural disasters. A 2001 study by agro-ecologist Eric Holt Gimnez compared conventional and sustainable farms on 880 plots of land with similar topography in Honduras after Hurricane Mitch in 1999, which caused millions of dollars of damage in the country. The study found the sustainable farms, or those engaged in agro-ecological or sustainable land management practices, demonstrated higher resistance and greater sustainability than conventional farms immediately after the storm.42 When Typhoon Pedring hit the Philippines in October 2011, it killed at least 90 people and caused an estimated US$250 million in damage to the countrys agricultural sector. But farmers in the Luzon region in the northern part of the country are reporting that rice grown under the system of rice intensification (SRI) has shown remarkable resilience to heavy winds and rain. SRI practices include transplanting seedlings when they are very young and growing them widely apart, adding compost from organic matter to the soil, weeding regularly, and using a minimum amount of water instead of flooding fields. This helps create deep root systems that are better able to resist drought, while also increasing yields, strengthening the plants, and enhancing their flavor. SRI increases the productivity of resources used in rice cultivation by reducing requirements for water, synthetic fertilizers, pesticides, and herbicides. 43 One reason for the resilience to storms is that rice plants grown under SRI practices are generally stronger. SRI plants, in addition to having larger panicles, more grains, and heavier grains, have larger root systems and thicker, stronger tillers (stalks). They can resist the mechanical shear power of wind and rain, explains Norman Uphoff, professor of government and international agriculture at Cornell University.44 According to Erika Styger, director of programs for the SRI International Network and Resources Center, the fact that SRI practices allow crops to be more spread out has also helped make them more resilient to storms: With less plant density, the domino effect of falling down with a strong wind cannot happen as

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easilywhich is different with the conventional high density population which also have weaker stems.45 Whether its SRI in the Philippines or agroforestry in sub-Saharan Africa, one very important thing that agro-ecological practices build is resilienceto price shocks, to droughts and flooding, and to extreme weather events. That resilience benefits not only farmers but also consumers, wildlife, the economy, and public health.

food for health

Ellen Gustafson, executive director of the 30 Project, wants to have dinner with you. Shes been bringing people together in places as diverse as San Francisco and Sioux City, Iowa, to discussaround a table of nutritious, locally grown foodvisions for a healthier food system. Gustafson started the 30 Project because she believes that hunger and obesity both spring from the same source: inadequate nutrition and poor agricultural infrastructure. Gustafson wants to make sure that over the next 30 years we create an agricultural system thats healthy, sustainable, and affordable. The dinners shes holding with corporate leaders, farmers, journalists, parents, and public health advocates all over the United States are helping start that conversation. It doesnt matter where you live or who you are, she says. You can actually create an incredible dinner in an incredible space, and have a really important, meaningful conversation at the table about what needs to happen to make sure that food is a tool for change.46 That conversation is necessary because the connections among nutrition, agriculture, and how we produce food havent always been clear. According to Meera Shekar, the lead health and nutrition specialist for the Human Development Network at the World Bank, we need to refocus our efforts on nutrition. Investments in agriculture and hunger relief, she says, have often not actually delivered in terms of nutrition, which has long been an alien concept to the agriculture and even the hunger community. Focusing on agricultural yields or caloric intake in efforts to feed people has often interfered with delivering actual vital nutrients, especially to children in utero and under age three. 47 1.10 not by calories alone Funding agencies, donors, and governments still tend to focus on calories rather than nutrients. Over the last 20 years the food output of sub-Saharan Africa and Asia has become more concentrated on raw commodities, including maize, wheat, and rice, and less on more nutritious indigenous foods, such as

Organically grown gooseberries in the village of Gujarats Vadodara, India. The SelfEmployed Womens Association (SEWA) trains women farmers how to use sustainable and organic agriculture practices to grow rice, fruits and vegetables. SEWA is a countrywide network of cooperatives, selfhelp groups, banks and training centers that help bring an end to injustice and foster the social, economic and political empowerment of women.

organic gooseberry plants in vadodara, gujarat, india

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millet, sorghum, and vegetables. And while Africans in particular get most of their calories from starchy crops, theres been very little funding for research on how to make those starchy staples palatable and nutritious. In 2002, the Consultative Group on International Agricultural Research invested US$118 million in research on cereals, but just US$15.7 million in fruit and vegetable research.48 Vegetables, unfortunately, are a luxury for many of the worlds poor. Many farmers who once grew vegetables have had to focus their attention on staple crops. But ignoring vegetables and fruits can have disastrous consequences. Vegetable production is the most sustainable and affordable way of alleviating micronutrient deficiencies among the poor. Often referred to as hidden hunger, micronutrient deficienciesincluding lack of Vitamin A, iron, and iodineafflict some 1 billion people worldwide. They lead to poor mental and physical development, blindness, and anemia, especially among children, and degrade performance in work and in school, further crippling communities already facing poverty and other health problems. 49 1.11 the role of vegetables Dr. Dyno Keatinge, the director general of AVRDCThe World Vegetable Center, a research institute that works in Asia and Africa, starkly describes the importance of vegetables in the diets of children: in Mali, Niger, the Philippines, Tanzania, and other countries, lower rates of vegetable consumption are linked to higher rates of mortality in children under five years. Increase consumption of vegetables, however, and mortality declines and the average weight of children increases (figure 1.3). Niger, for example, has about 100 grams of vegetables available per person per day, which is at the low end of a scale that reaches 800. Not surprisingly, Niger has one of the highest child malnutrition and mortality rates in the world.50 Its not just the lack of vegetables and other nutritious foods in our diets, though, that leads to illness and disease. Low- and middle-income countries often also face a double burden of under-nutrition and over-nutrition. Obesity and malnutrition are the most obvious and painful symptoms of a broken food system, and more than 2 billion people worldwide suffer from one or the other. While poor nations receive a great deal of attention for high malnutrition rates, researchers and policymakers have paid less attention to the prevalence of noncommunicable diseases (NCDs), such as cardio-vascular and respiratory diseases as well as type 2 diabetes, that result from unhealthy and inadequate diets. Sixty-three percent of global deaths are caused by noncommunicable diseases, and this rate is expected to rise.51 According to Olivier De Schutter, Our food systems create sick people and failure to act decisively on this issue kills almost 3 million adults each year.

food for health | the challenges of food

31

a
300 children <5 mortality rate (1/1,000) 250 200 150 100 50 philippines niger mali 60 50 children <5 underweight (%) 40 30 20 10 niger mali

tanzania

philippines tanzania

100

200 300 400 500 600 700 800

100

200 300 400 500 600 700 800

vegetable availability (g/person/day)

vegetable availability (g/person/day)

figure 1.3
Availability of vegetables and infant mortality Note: National vegetable availability as a factor in the health status of vulnerable groups associated with (a) preschool mortality and (b) childhood (<5 years) undernutrition. Source: FAOSTAT 2010, and WHO 2011.

NCDs will cost $30 trillion globally between now and 2030, according to research by the Chicago Council on Global Affairs. Dr. Rachel Nugent, deputy director of global health at the Council, said, The costs of dealing with NCDs are soaring in both rich and poor countries. It is obvious that the health sector alone cannot prevent all these premature deaths and chronic illnesses, and the poor of the world are the most vulnerable. 52 The International Food Policy Research Institute (IFPRI) has also recognized how the health and agricultural sectors need to combine forces in order to address malnutrition, obesity, and other food-related health problems. IFPRIs February 2011 conference in New Delhi, Leveraging Agriculture for Improving Nutrition and Health, brought scientists, researchers, NGOs, and policymakers from around the world to discuss the issue.53 At the conference, IFPRI Director General Shenggen Fan said, We are standing face to face with some serious challenges: hunger, malnutrition, and poor health are denying billions of people the opportunity for a healthy, well-nourished, and productive life. All of our effortswhether in agriculture, nutrition, or healthare inextricably linked. We are more likely to succeed in addressing the challenges if we understand these links and put them to work for peoples benefits.54

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1.12 bringing healthy food everywhere Creation of those linkages to make agriculture healthier is happening, and not just in laboratories or at conferences. It is also occurring at the grassroots level in kitchens and back yards all over the world. One successful model is The Food Trust in north Philadelphia in the United States. The Trust runs community-based nutrition and food systems programs that have helped reduce the number of obese children there by half. A more broadly based U.S. program is Food Corps, one of the newest parts of the AmeriCorps program. Food Corps is working to address the countrys childhood obesity epidemic by focusing on nutrition education, school gardens, and farm-to-school programs. Food Corps service members partner with local organizations in sites across the country, helping to support community initiatives that are in touch with local needs, while also bringing in new energy and ideas.55 Although the program is relatively youngit was established in 2009 and began operating in 2010it has already achieved much. American children on average receive only 3.4 hours of nutrition education each year, but students in schools working with Food Corps will receive at least 10 hours. Food Corps has received support from food policy activists, foundations, and national media, which may help it reach its ambitious goal of reducing childhood obesity rates to below 5 percent by 2030.56 In 2010, moreover, the White House launched the nationwide initiative Lets Move, under the leadership of First Lady Michelle Obama. 1.13 the importance of information Many consumers are simply unaware about what foods are nutritious. But researchers like Chuck Benbrook of the U.S.-based Organic Center are helping consumers make more informed food decisions. The Center recently released its Nutritional Quality Index, a new tool that helps consumers identify smart, nutrient-rich food choices. The NQI provides a comprehensive, data-driven measure of the benefits of individual foods, meals, and daily diets, and is the only profiling system that estimates overall nutritional quality based on 27 nutrients, including vitamins and minerals. It enables consumers, farmers, and researchers to know which foods deliver the biggest bang for the buck nutritionally.57 Moreover, for some time now the USDA has created and manages a database that provides a classification of all food products and gives their ingredients. Educating farmers and consumers about growing and buying more nutritious crops is important, but we also need to learn how to prepare vegetables in ways that help maintain their nutritional quality. Vegetables are often cooked so long that they lose most of their nutrients. To solve that problem, the World Veg-

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etable Center works with women farmers in sub-Saharan Africa to improve the nutritional value of cooked foods by shortening cooking times. The women learn how much better the food tastesand how much less fuel and time it takes to cook.58 1.14 the role of health structures Surprisingly, the lack of nutritious food extends into many hospitals. Even richcountry hospitals can fail on this score: at the Texas Childrens Hospital in Houston, for instance, theres a McDonalds restaurant right in the building. Hospitals in California, Ohio, Minnesota, and several other states also house fast-food restaurants.59 Health Care without Harm (HCWH), an international coalition of hospitals and health care systems, doctors, nurses, public health advocates, labor unions, environmental organizations, and religious groups, is leveraging the purchasing power of hospitals and health care systems to support food that is more nutritious and environmentally friendly. HCWH member Catholic Healthcare West, a 41-hospital system in Arizona, Nevada, and California, announced this summer a partnership with Murrays Chicken, a New York producer, to supply its hospitals with chicken raised without either antibiotics or arsenic feed additives. Neither arsenic nor antibiotics [is] necessary for growing chickens, says David Wallinga, a physician with the Institute for Agriculture and Trade Policy, whose staff co-founded HCWH and the food initiative. But that didnt stop the chicken industry from continuing the practice over the last 60 years. Having hospital systems start to make these demands of their meat suppliers has injected a healthy dose of common sense into a very industrialized food system where health is often the last thing anyone thinks about.60 In South Africa, HIV/AIDS patients at the Chris Hani Baragwanath Hospital in the Soweto township in Johannesburg are not only eating more nutritious foods but growing them as well. GardenAfrica, a U.K.-based NGO, partnered with HIV South Africa in 2006 to create a one-hectare training garden at the Baragwanath Hospital, the largest hospital in the southern hemisphere. Patients from the hospitals clinics receive training in permaculture, irrigation and water conservation, food, nutrition, and indigenous medicinal plants. The patients then cultivate and harvest the garden, bringing home nutritious vegetables, fruits, and herbs.61 Often the connection between health care and nutrition is not made, even by health professionals, says GardenAfrica co-founder Georgina McAllister. Hospitals and community clinics lend themselves to strong garden projects. They have high walls and guards to protect the plants, and hundreds of people are coming and going every day. Its also a unique opportunity to help people

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to make the connection between what they eat and their own health, creating sustainable approaches to healthcare and wellbeing.62 And at the Angkor Hospital for Children (AHC) in Siem Reap, Cambodia, families of child patients are given food to prepare in the outdoor communal kitchen, where a chef teaches cooking and nutrition. The hospital also has a garden, giving families the opportunity to learn which types of nutritious crops can be grown locally. The daily cooking classes and free seeds to take home encourage patients to start their own household gardens. AHCs outreach programs follow up with patients, checking on their gardens, teaching basic hygiene and disease prevention methods, and digging wells for communities to gain access to clean water.63 With better and more effective food, nutrition, and agricultural policiesand better communication between public health practitioners and advocates and the agriculture communitywe can look beyond simply increasing crop yields and caloric intake to building a better food system.

food for culture

In villages outside of Kampala, Uganda, something unusual is happening among rural youth. For the first time, many of them are excited about being involved in agricultureand instead of moving to the city after they finish primary school, many are choosing to stay in their communities to become involved in the food system.64 Betty Nabukalu, a 16-year-old student at Kisoga Secondary School, manages her schools garden. She explained how the project has taught the students new methods of planting vegetables. Before, she says, we used to just plant seeds, but now she and the other students know how to fertilize with manure and compost and how to save seeds after harvest. She says theyve learned not only that they can produce food but that they can also earn money from its sale.65 Kisoga School developed the program with help from Developing Innovations in School Cultivation (DISC), which is also helping to build leadership skills. Betty represents students from her school in the local Slow Food Convivium (the convivia are groups of Slow Food International members dedicated to preserving local food cultures). DISC is now part of Slow Food Internationals Thousand Gardens in Africa initiative, which hopes to start gardens in communities across the continent. Thanks to DISC, students no longer see agriculture as an option of last resort, but something that they can enjoy, is intellectually stimulating, and will provide a good income.66

cocoa pod, togo

Cocoa pod in Togo. Nearly 70 percent of the world supply of cocoa, the primary ingredient in every chocolate bar, comes from West Africa, where some 16 million people depend on the crop as their primary source of income. Unfortunately, many cocoa trees across the region face the threat of disease. To help these communities, groups like the World Cocoa Foundation are supporting programs that encourage the sustainable production of this valuable resource.

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1.15 relaunching agricultural systems Unfortunately, youth in both poor and rich countries confront serious obstacles to productive careers in agriculture. The International Labor Organization of the United Nations reports that global youth unemployment saw its largest annual increase ever recorded from 2008 to 2009, from 11.8 percent to 12.7 percent, representing an increase of 4.5 million unemployed youth worldwide. This leads to obvious economic insecurity as well as, in some cases, revolution. The recent uprisings in Egypt, Tunisia, Yemen, and elsewhere are largely driven by angry youth who are protesting high food and fuel prices, lack of jobs, and other social inequities.67 And the disconnect between young people and the global food system continues to grow. Young people, whether they live in Italy, the United States, Thailand, Guatemala, or Togo, do not grow up wanting to be farmers, and consumers all over the world have forgotten basic cooking skills because of an over-reliance on processed foods. Agricultural diversity is declining: the bulk of diets in rich countries consists of six foods, including maize, wheat, rice, and potatoes. Agriculture is looked down on as a career and often viewed as work for the poor or those who have no other options. And farmers lack access to markets, making it hard for them to earn an income from their work. The concern to find ways to advance young peoples prospects through agriculture was front and center at an event at Chicagos Field Museum in October 2011. Participants listened to World Cocoa Foundation President Bill Guyton, Kraft Foods Yaa Peprah Agyeman Amekudzi, and CARE USAs Lat LawsonLartego speak about making the cocoa industry more profitable and more environmentally sustainable by involving youth. They stressed not just improving disease control, producing organic chocolate, or preventing unfair child labor practicesalthough all these things are occurringbut making sure that the rural areas of Ghana, Indonesia, Togo, and other cocoa-growing regions are vibrant places where young people want to live and work. Amekudzi, for example, spoke about how Kraft, in conjunction with the World Cocoa Foundations Empowering Cocoa Households with Opportunities and Education Solutions (ECHOES), has reached more than 5,000 students in Ghana and Cote dIvoire. Kraft Foods subsidiary Cadburys Earthshare program is working with cocoa farmers and local university students to examine the local ecosystem and cocoa production techniques in Adjeikrom, Ghana. This has led to smarter land use, increased production, and stronger interest in farming among the next generation.68 1.16 new computer and communications technologies Another way to help youth become more excited about agriculture is by incorporating information and communication technology into farming. Already, one

food for culture | the challenges of food

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out of four Africans and one out of three Asians has access to a cell phone. A visitor to the most remote regions of Ethiopia and India will find farmers using cell phones not only to communicate with one another but also to find out about weather or markets or for making financial and banking transactions. Farmers also need better access to information about prices and markets. Information and communication technologies, such as mobile phones, are enabling farmers to obtain real-time data about market prices, which is helping them make more informed decisions about crop production. Services such as FrontlineSMS allow farmers not only to get real-time food price data but also to connect with one another and with potential consumers, increasing their market size.69 Cell phone and computer technologies are especially important for women farmers because they help erase gender barrierswomen can get the same information from a text or the Internet that male farmers are getting, which isnt always the case when information is spread from farmer to farmer or from extension agents to farmers. 70 Universities and colleges are also increasing their efforts to educate the next generation of farmers and entrepreneurs. Agricultural development programs have tended to focus on developing better production techniques while neglecting the development of the managerial skills necessary to run successful agribusinesses. EARTH University in Costa Rica, for example, is teaching farmers how to be more entrepreneurial while training students to improve yields through sustainable agricultural and integrated farming practices. EARTH believes that building sustainable businesses, including family and small farm operations, is a crucial way to eradicate poverty. 71 EARTH University also makes sure that its students interact with local farmers, helping to bridge the gap between academia and rural communities. EARTH students are exposed to the challenges faced by these communities, including the lack of inputs, education, and access to markets. Students help train local farmers to use precision agriculture techniques, reduce pesticide use, and better market their products. In 2005, EARTH launched the Open School for Farmers, enabling smallholder farmers to take courses in advanced farming techniques and business practices.72 In addition to its educational programs in Latin America, EARTH University has developed an innovative tool kit to enhance the undergraduate curricula of partnering African academic institutions through the development of entrepreneurial skills. According to Wendy Judy, EARTHs director of foundations, grant writing, and university liaison, The tool kit will enhance the capacity of universities to provide entrepreneurial leadership needed to make African agriculture economically competitive, socially responsible, and environmentally sustainable in an increasingly globalized world economy.73

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1.17 popularization in the field One obstacle farmers all over the world face is the lack of agricultural extension services. In the United States, the decline in the number of family owned and smaller farms has led to the disappearance of agricultural extension offices in many rural communities. In sub-Saharan Africa, extension agents who used to provide information to farmers about weather, new seed varieties, or irrigation technologies have been replaced by agro-dealers who sell artificial fertilizer or pesticides to farmers, often with very little education or training about how to use those inputs. But in Ghana, young and old farmers alike are benefitting from better-trained extension officers. At the Department of Agricultural Economics and Extension at Cape Coast University in southern Ghana, learning takes place not only in classrooms but also literally in fields and farms all over the country. As part of a program to improve agricultural extension services, extension officers are working with professors to find ways to improve food production in their communities. The extensionists are selected from throughout Ghana by the Ministry of Agriculture and the university and trained to better share their skills and knowledge with farmers. After attending a year of classes on campus, the students go back to their communities to apply what theyve learned in supervised enterprise projects (SEPs). According to Dr. Ernest Okorley, the department director, the SEPs give the student-professionals the opportunity to learn that particular technologies, no matter how innovative they might seem in the classroom, dont always fit the needs of communities. The SEPs also help them implement some of the communication skills theyve learned in their classes, allowing them to engage more effectively in the communities where they work. Instead of simply telling farmers to use a particular type of seed or a certain brand of pesticide or fertilizer, the extension workers are now learning how to listen to farmers and help them find innovations that best serve their particular needs. One beauty of the program, says Dr. Okorley, is the on-the-ground research and experimentation. [...] It allows the environment to teach what should be done.74 1.18 incentivize employment of the young Cooperatives can be especially beneficial for marginalized groups, including women and youth, who might not otherwise have access to markets or financial services. Smallholder farmers get multiple benefits from joining agricultural cooperatives, including boosting their bargaining power and sharing tools, machinery, transportation, and other resources. And cooperatives create jobs: worldwide, cooperatives have more than 800 million members and provide 100 million jobs, 20 percent more than multinational corporations.75

the three objectives of food | the challenges of food

39

The connections between agriculture and education are also being made in rich countries, helping young people find concrete ways to become involved in the food system. In Italy, the University of Gastronomic Sciences is finding ways to combine the passion of food connoisseurs with the science of agriculture. The university was established in 2004 by Slow Food International to help students learn ways to renew traditional farming methods and protect agricultural biodiversity, while also learning the importance of traditional foods and the connection between the farm and plate. The university conducts courses in food anthropology, food cultures, and food policy and sustainability, and students participate in study trips to examine regional food systems. As a result, these students gain a better connection to their food and the people who grow it, regardless of their future careers.76

the three objectives of food

Its clear that we need a better recipe for ensuring that agriculture contributes to health, environmental sustainability, income generation, and food security. The ingredients will vary from country to country and region to region, but there are some key components that will lead to healthier food systems everywhere. 1. Investing in agroecological food systems. Although many authoritative reports point to the need for more investment in agro-ecological solutions to alleviating hunger and poverty, very little attention is given to ensuring that farmers know about those solutions. In October 2011, philanthropist-farmer Howard Buffett called upon the agricultural development community to get loud and get busy to ensure that sustainable crop production is back on the table at the annual climate change meetings, at the 2012 United Nations Conference on Sustainable Development in Rio, and with every major agricultural donor and government in the world.77 In March 2012, the Landscapes for People, Food, and Nature (LPFN) initiative will bring together farmers, policymakers, food companies, conservation agencies, and grassroots organizations at a conference in Nairobi, Kenya, in one of several meetings to develop a long-term strategy to scale up and support agro-ecological solutions. According to Erik Nielsen of EcoAgriculture Partners, the organization facilitating the LPFN initiative, Because over two-thirds of the worlds land area is shaped by cropland, planted pastures, or other agricultural practices, it is critical to scale up such integrated systems to combat both hunger and environmental degradation.78 LPFN is documenting integrated farming landscapes around the world to strengthen policy, investment, capacity building, and research in support of sustainable land management. This sort of research can encourage policymak-

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ers to restore investment in agriculture, which has declined precipitously over the last three decades. But initiatives like Feed the Future (the U.S. food security program) and the Global Agriculture and Food Security Program could have a huge impact on malnutrition, access to markets, and farmer incomesif they were fully funded. Unfortunately, both initiatives have received very little of the billions of dollars pledged by donor countries, private businesses, and NGOs.79 2. Recognizing agricultures multiple benefits. Farmers are businesswomen and -men, educators, and stewards of the land. Finding ways to compensate farmers for these multiple roles will become increasingly important as agricultural challenges increase. Women farmers, for example, make up as much as 80 percent of the agricultural labor force in some countries, but they are often denied basic benefits such as land tenure, education, and access to banks. The Food, Agriculture and Natural Resources Policy Analysis Network is helping communities and policymakers understand womens rights and involve them in decision-makingand theyre doing it in innovative ways such as community theatre, which provides an entertaining vehicle to discuss these challenges in an open atmosphere.80 Another innovation is compensating farmers for the ecosystem services their lands provide. The Rainforest Alliance, for example, is working with more than 200 million farmers in Latin America, Asia, and Africa to ensure that the sustainably grown cocoa, coffee, bananas, and other products get a premium price from consumers in wealthy nations. These farmers produce the ingredients for countless products while helping to protect bird, wildlife, and plant species in some of the planets most fragile ecosystems. Other projects will begin paying farmers for sequestering carbon in their soils. African farmers could sequester 50 billion tons of carbon dioxideroughly a full year of global emissions from the atmosphere over the next 50 years, primarily by planting trees among crops, stewarding nearby forests, and keeping their soils planted with crops for more of the year. Roughly 75 such projects in 22 African countries are in the works, including a proposal to create an African Agricultural Carbon Facility that could incubate projects and help connect them with buyers.81 3. Cultivating better livelihoods. Building a better food system doesnt mean producing more foodthe world can already feed 9 to 11 billion people. The real culprit is poverty. More than 2 billion people live on less than US$2 per day and global unemployment is at record highs. Poor households in the developing world spend 70 percent of their income on food. The World Bank estimates that high food prices in 2010 plunged an additional 44 million people into poverty and hunger over the last year.82 Financial speculation on the price of food has played a major role in this problem. Recently, food prices have fluctuated wildly (2011 prices were nearly 20

Fish for sale at Port de Peche Fish Market in Nouakchott, Mauritania. Fish is an important source of protein for coastal communities in Africa. But overfishing, often by Chinese fishing fleets, poses a serious threat to this valuable resource: the U.N. Food and Agriculture Organizations estimates that 53 percent of fisheries are considered fully exploited. As a result, fishers have to travel increasingly farther to return home with fish to consume and sell.

the fish market of port de pche in nouakchott, mauritania

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percent higher than in 2010) as a result of investors and traders who view food as something to be indexed, leveraged, and speculated on for profit.83 A future is a financial practice which allows traders around the world to purchase a good for a fixed price. At first, this seems like an ideal scenariofarmers are guaranteed payment for their crops and food prices can be determined ahead of time, thus creating stability for farmers and consumers alike. After investing in futures, however, speculators then sell these in the marketplace, allowing traders to hedge against risk, but also causing wild fluctuations in the actual prices of the good. This flood of speculative investment has contributed to volatility in agricultural markets, with grave impacts on the livelihoods of small-scale farmers, who lack access to the most basic aspects of domestic support, including land, credit, insurance, and bargaining power in the value chain. Price volatility hurts these farmers, who need stable markets and a fair price for their yields. Clamping down on food price speculationespecially prices for maize, wheat, and rice, which are the three most heavily traded food commodities and also supply the bulk of dietary calories for 2 billion poor peoplewould be a major step forward for both farmers and the hungry. Some progress has been made in this area: the United States has already passed laws to limit speculation, and the UNs Olivier De Schutter has argued publicly for less speculation and more transparency in agricultural markets.84 In addition, farmers need access to markets where they can get a fair price. Institutions such as agricultural cooperatives can help farmers operate more efficiently and earn more money than they can as individuals. By helping farmers come together to grow, distribute, and/or sell food, cooperatives act as both business and social groups, enhancing communities economic power and as well as their social service networks.85 1.19 increasing awareness about the importance of agriculture Nations must recognize the inherent right of every human being to safe, affordable, and healthy food, and back up that right with appropriate policies. India recently approved a draft of the National Food Security Act, which aims to improve food access for the countrys poorest communities. Countries such as Ghana and Brazil have already reduced the number of people suffering from hunger through effective government action, such as national school feeding programs and increased support for agricultural extension services. 86 The projects highlighted by the Barilla Center for Food & Nutrition in this book are exciting because they are the perfect example of agriculture and food emerging as a solution to global problemsincluding reducing public health costs, making rural areas and urban communities more livable, decreasing poverty, creating jobs for youth, and even reducing climate change.

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There are many innovations that are working to ensure that everyone has access to nutritious, healthy, sustainable, and justly grown food. From SEWA in India and DISC in sub-Saharan Africa to research institutes and governments all over the world, there is a growing realization of the positive impact agriculture can have on livelihoods, nutrition, and the environment. And these are exactly the sort of innovations that should attract the support of governments, the private sector, and the international funding and donor communities.

The Nourishing the Planet project would like to thank the following people for their help with Chapter One: Bernard Pollack, the Worldwatch Communications Direc tor, provided invaluable input and advice; and Nourishing the Planet Research Fel low, Supriya Kumar, and our team of interns, including Jenna Banning, Emily Gilbert, and Joe Zaleski, helped track down information, statistics, and examples for the chapter.

table of contents
introduction
How to Respond to Market Excesses by Raj Patel

facts & figures access to food: present and future challenges

2.1 2.2 2.3 The Global Scope of Food Security and Access Problems The Food Paradox: Underlying Causes Possible Areas for Action

a new emergency: dramatic instability in food prices

2.4 2.5 2.6 The BCFN Evaluation Model Variables of the Model Strategies for Controlling Volatility

new tools to measure and promote well-being

2.7 2.8 2.9 2.10 2.11 Gross Domestic Product Versus Indicators of Well-being Subjective Approach Versus Objective Approach: Different Outlooks in Terms of Measuring Well-being The BCFN Indices of Well-being and Sustainability of Well-being Principal Results of the 2011 BCFN Index The Different Dimensions of Sustainability

interviews
In Access the Key Factor Is Diversity by Paul Roberts Agricultural Policies Must Take into Consideration the Health and Well-being of Human Beings by Ellen Gustafson

action plan

 2. food for all

Food for All explores the paradox of excess food in western nations and the challenges in gaining access to food in developing nations. We need to better understand how to ensure better governance of the agroalimentary system on a global scale. How do we find ways to have a more fair distribution of food and resources worldwide? How do we encourage better outcomes in terms of social welfare, health, and the environment?

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2. food for all How to Respond to Market Excesses

Raj Patel

Greg Page, the Chairman and CEO of the food, agriculture and financial services giant Cargill recently pointed to the central paradox in the global food system: Today, he said, we live in a time where the world is the furthest it has ever been from caloric famine [...] the number of calories that the worlds farmers are producing per inhabitant of the world are at all time record levels, he said, but raj patel is an awardwhat we do have are levels of economic famine that are winning writer, activist, and academic. He is more difficult to address.1 a visiting scholar at UC He is correct, but perhaps a little oblique. Until the recesBerkeleys Center for African Studies, an Honorary sions second downturn finally caught up with them, CarResearch Fellow at the gill and a range of other food and agriculture companies School of Development Studies at the University were surfing the waves of the international financial storm of KwaZulu-Natal and in style, posting record profits at the same time as a billion a fellow at The Institute for Food and Developpeople were undernourished. Mr Page forgot to mention ment Policy, also known that the economic famine is distributed unevenly. This as Food First. Raj is an Advisor to the United Nagulf between calories produced, increasing obesitytoday tions Special Rapporteur over 1.5 billion people are overweightand deepening on the Right to Food. He regularly writes for The hunger is a sign that our modern food system has worked Guardian, and has conto produce calories and profit, but failed to feed the world. tributed to the LA Times, NYTimes.com, The San There are five short-term reasons why were in this mess. Francisco Chronicle, The The weather has behaved unpredictably, with storms, Mail on Sunday, and The Observer. floods and droughts occurring with greater intensity and frequency than in the past. Although no one individual event can be attributed to global warming, the pattern is entirely consistent with an era of climate change which has reduced global wheat harvests by 5% over the past 30 years.2 Second, investment in biofuels has distorted the planting decisions of farmers worldwide toward crops that can be used to

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burn rather than to eatestimates attribute between 15% to 70% of 2008s global price rises to this source.3 Third, the spread of the western diet, with its emphasis on meat and empty calories means that a great deal of land is diverted toward producing feed for animals, pricing the poorest out of the grain market. Fourth, increasing financial speculation has tied the price of food to other commodities. It must be said this is controversialeconomists are embroiled in heated debate about whether speculators are to blame for the problems. Some models suggest that while the amount of speculative capital in food futures markets has increased from 12% of the Chicago wheat futures market in 1996 to 61% earlier this year, 4 higher levels of liquidity are not to blame for the increased price swings, and costs, in food markets. (See graph below.) On the other hand, traders themselves have testified that theyre playing commodities markets at the expense of consumers,5 and this wouldnt be the first time that reality has failed to live up to the models of economists. Fifth, higher oil prices have driven up production and transport costs for food. These short term phenomena sit on top of a food system that has made shocks to the food system spread quickly. With poor grain storage systems, reduced social safety nets, increasing poverty, under-investment in sustainable agricul-

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figure 2.1
Price oscillations on the food markets Source: Worthy, 2011.

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tural research, credit and extension services, and with international grain markets tightly integrated, it was inevitable that a few shocks in the worlds key grainbaskets should ripple across the planet, and push many millions more into hunger in 2008. The underlying system, and many of the shocks, continue to be with us today. Unfortunately, governments are doing little directly to address the underlying problems. In response to fires and low grain supplies, Russia announced a wheat export moratorium, which worked well for farmers there,6 but caused a panic in global wheat markets in 2010 that led to food rebellions around the world.7 China and India have joined other foreign governments in an aggressive search for overseas sources of food for their populations, particularly in Africa.8 These are ad hoc measures that leave the central tenets of the global food system largely unaddressed. Many of the more interesting policy responses to the failures of the food system are to be found at local, municipal and subnational levels, with food policy councilspopular in North America where over 200 are to be foundexperimenting with ideas for guaranteeing the right to food to local citizens.9 should we tax sugar? Some cities have attempted to address one of the other problems with the food systemthat it is largely responsible for there being over 1.5 billion people overweight. A controversial experiment involves a sugar tax, which raises prices on items high in empty calories, such as carbonated beverages. These taxes are regressive, since taxing food will always affect the poor disproportionately because they spend a greater proportion of household budgets on food than the rich. Advocates of such a tax have to answer the charge that theyre mongers of class war. As one researcher argues, obesity is the toxic consequence of economic insecurity and a failing economic environment.10 If this is true, a soda tax blames the poor for being victims of circumstance. And, certainly, if the move to tax soft drinks were an end in itself, then Id want nothing to do with it. Theres far too long a history of culture war around food, with everything from white bread to Coca-Cola conscripted into a great battle over class and identity. That said, if a soda tax can work as part of a bigger programme to rein in food companies and provide real choices to everyone across the food system, it shows promise. That a tax falls disproportionately on the poor is reason to worry, of course. But tobacco taxes are similar. What makes the difference is whether the tax is part of a bigger project to make the food industry pay for the health costs that will fall disproportionately on poor people. Ultimately, the goal is not to end soda, but poverty. This is a conversation long overdue. In the meantime, though, we continue to see experiments and ideas for change happening not at national or international levels, but at local and regional lev-

introduction | food for all

49

els. Their ideas arent the nanny state so much as responses to the wild excess of Daddy Market. For as long as food is rationed according to the ability to pay, those who are poorest will go hungry, and those merely unable to afford healthy food will continue to be profit centres for the food industry. What we see today, across the world, is a counter-movement against the status quo, asserting and experimenting with democratic control over the food system, in many cases for the first time.

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2. food for all

WoRlDFooDSYSTEm

2,550calories
Average real daily calorie requirement

2,800calories
Average daily calorie supply produced

The world food system is currently capable of producing just under 2,800 calories per person per day, while the average per capita daily calorie requirement for an individual adult is 2,550 calories.

WoRlD

53%
In developing countries, 53% of infant mortality is caused by malnutrition and undernutrition

people die every year due to malnutrition and undernutrition

36million

WORLD POPULATION: 7 BILLION PEOPLE

11billion . PEOPLE ARE

UNDERNOURISHED

men and women suffer from undernourishment

950million

facts & figures | food for all

51

GRoWTHoFVolATiliTYinFooDSTUFFSonmARKETS

+44 million +71%

OF NEW POOR PEOPLE FAO CEREAL PRICE INDEX
Between June 2010 and June 2011 the FAO Cereal Price Index increased by 71%. Over the same period, this increase helped to generate new conditions of poverty for 44 million people.

29million
DEAD EVERY YEAR
Approximately29millionpeopledieeveryyear ofdiseaseslinkedtoexcessiveconsumptionoffood

1.3 billion
PEOPLE ARE OBESE OR OVERWEIGHT
Itisestimatedthat1.3billionpeopleinthe worldareobeseorsignificantlyoverweight

1/3

WASTEDFooD
One third of the worlds food production is lost, destroyed, or wasted in the processes of preserving, transformation, distribution, or consumption

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access to food: present and future challenges

Access to food is one of the first and most fundamental of all human rights. Where food is lacking, it becomes impossible to live with dignity, and the rights to a healthy life and peaceful coexistence are undermined. The world is now experiencing a silent tragedy caused by humanitys inability to produce and distribute sufficient quantities of food. This tragedy takes an array of different forms, starvation being the first and most tragic. There is also a range of secondary impacts on human health and welfare, and they too can be devastating. They stem from the chronic or acute conditions of undernourishment and malnutrition that plague many poor and developing countries. Undernourishment and malnutrition have serious harmful effects on the human immune system. They augment susceptibility to diseases and increase the gravity and duration of the ensuing illnesses. This relationship is reinforced by a broader system of allied conditions that are typically associated with situations of inadequate nutrition, such as poor hygiene, inadequate health care, and lack of access to plentiful drinking water and basic pharmaceuticals. Moreover, poor economic and social conditions tend to exacerbate the link between malnutrition and disease, making potential workers unsuited to employment and further marginalizing the unwell in social and economic terms. In many cases, lack of basic knowledge about nutrition prevents mothers from taking adequate care of their children. However, throughout the world, the lack of food is also behind many major forms of conflict over the availability of food and natural resources: social tensions bound up with the issues of access to and control of agricultural resources mass migrations triggered by sharp deteriorations in living conditions (malnutrition and lack of water), in some cases aggravated by the effects of climate change situations of political and social instability and misgovernment and their effects on the response to the growing needs of populations pressures on international governance bound up with growing imbalances between developed countries and developing countries In general, social conflictsespecially fights over control of natural and agricultural resourcestend to undermine the potential of nations to develop socially and economically. There are significant risks that a worsening of the viability and security of agricultural and food production will lead to a noticeable increase in the amount of social conflict, already aggravated by climate change. This would occur mainly

access to food: present and future challenges | food for all

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1,050 1,000 950 900 850 800 750

1,023

915 878 853 843 787 847 833

925

71 69 19

79 19

9 19

92 0

7 9 95 19

0 20

02

05 20

07

0 20

0 20

1 20

figure 2.2
Undernourished people on earth (millions of people) Source: FAO, 2011 (the data shown for 2009 and 2010 are estimated values).

in developing areas, where food and water issues exacerbate unresolved ethnic religious and economic tensions. 2.1 the global scope of food security and access problems The seriousness of the problem of food security around the worldby which we mean the level of availability and access to food for people and populationsemerges clearly from the analysis of the data available. In 2010, the total number of undernourished people on Earth was roughly 925 million (figure 2.2). The slight decline of those numbers during 2010 is a positive development and marks a change of direction from previous years, with a drop of 98 million (9.6 percent). That development was made possible by an improved global economic situation and a decline in the prices of foodstuffs compared to the peaks in 2008. Still, the overall situation shows a serious worsening over the last 15 years at the global level. Indeed, data trends show that inadequate nutrition affects 13.4 percent of the worlds population of about 6.9 billion people.11, 12 Moreover, in the months between late 2010 and early 2011, prices for several leading food commodities began rising again, reaching and outstripping the levels recorded in 2008. This points to the real possibility of a new rise in the

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overall number of people suffering from hunger in the developing countries. Unless this situation is addressed and resolved very rapidly, it could well lead to a jump of 64 million in the total number of undernourished people.13 Over the mid- to long term, therefore, we foresee a general worsening of the overall picture, with a further deterioration in the wake of the economic downturn and the food crisis of 2008-2009. The drop from the 1996 levelthe year that world leaders expressed a commitment to reduce and finally eliminate entirely world hungeris considerable. The optimism of the time was justified by the positive results achieved in the first half of the 1990s by the aid programs undertaken by the FAO World Food Summit. The greatest number of undernourished people lives in the developing nations. According to data for 2005-2007,14 there were 835 million people living in conditions of inadequate nutrition in the developing countries; that is, in 2007 98 percent of the worlds undernourished people lived in those countries. In 2010, 16 percent of that population was suffering from hunger, more than one out of every six people. concentration in asia. A closer look at developing countries shows that Asia is the region with the highest number of undernourished people. In fact, inadequate nutrition in Asia affected 554.5 million people15 in the period from 2005 to 2007, more than twice the number for sub-Saharan Africa (201.2 million people). In Latin America, on the other hand, the figures were 47 million, while in the regions of the Middle East and North Africa the number was roughly 32.4 million. It is also worth noting that two-thirds of the worlds undernourished people are concentrated in seven countries: Bangladesh, China, the Democratic Republic of the Congo, Ethiopia, India, Indonesia, and Pakistan. More than 40 percent of those people live in China and India. As the reader can see in figures 2.3 and 2.4, radically different trends have been observed in different areasover the past 15 years. In Asia, the trend is toward a slight decline: in fact, it is estimated that the number of undernourished people dropped by 5.7 percent (approximately 33 million people) in the period from 1990 to 2007. The same thing happened in Latin America (a decline of 7.2 million of people, equal to 13.3 percent). The opposite happened, in contrast, in sub-Saharan Africa and in the regions of North Africa and the Middle East, where increases were recorded, respectively of 36.3 million (+22 percent) and 12.8 million (+65.3 percent) in the total number of undernourished people. In developed countries, in contrast, inadequate nutrition affected a limited number of people (12.3 million) in the period from 2005 to 2007. 16 The trend, moreover, showed improvement for the years from 1990 to 2007, thanks to a series of focused interventions undertaken by individual governments. For the most part, these were initiatives and measures aimed at social and economic

access to food: present and future challenges | food for all

55

600

588 532 555

578

500

498

400

300 239 200 165 187 202 201

100

54 53

51 47 53

32 32 37 20 30 Middle EastNorth Africa 2010

Asia 199092 199597

SubSaharan Africa 200002

Latin America 200507

Latin America 5.7%

Middle EastNorth Africa 4.0% Developed Nations 2.1%

SubSaharan Africa 25.8%

2010

Asia 62.5%

figure 2.3
Undernourished people in certain regions of the world (millions of people and %) Note: The Latin American region also includes the Caribbean nations. Source: FAO, 2011 (the data shown for 2010 are estimated).

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21 19.4 19.0

18 16.7 17.0

15

12 199092 199597 200002

12.3 200507 2010s

figure 2.4
Undernourished people in developed nations (millions of people) Source: FAO, 2011 (the data shown for 2010 are estimated).

assistance in the context of the various national welfare systems. It is important to point out, however, that the number of undernourished people in the developed countries increased by 54 percent in the period from 2007 to 2010, rising from a little over 12 million people to 19 million. In order to understand how the picture described here can change over the coming decades, we must analyze the development of the underlying variables and the effect of the interventions aimed at eliminating the causes of the current critical situations. 2.2 the food paradox: underlying causes Even though, technically speaking, the current capacity for the production of foodstuffs is theoretically sufficient to feed the worlds entire population, this has done nothing to prevent the persistence and spread of enormous inequalities in terms of access to food. Evidence of this is given by the coexistence on Earth of roughly a billion undernourished people, at the same time as a billion obese people. The gap of this paradox, over the course of the last two years, has only spread: more undernourished people, more obese people. structural factors. Some major structural reasons underlie the uneven distribution of access to food.

access to food: present and future challenges | food for all

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The first cause of inadequate nutrition is poverty. The crucial needs in the battle against inadequate nutrition are therefore an increase in wealth and a more equitable distribution of that wealth. It is important to keep in mind that economic growth, through agriculture, constitutes one of the best economic tools with which to approach the problem, given the fact that most of the people who lack sufficient resources for adequate access to food are small farmers living in rural zones. It is worth pointing out, in this connection, that a study done by the World Bank has shown that an increase of just one percentage point of the gross domestic product generated by the agricultural sector is twice as effective in terms of reducing poverty as an equivalent percentage of economic growth produced by other sectors.17 That means that the agricultural sector is centralto the development of strategies designed to improve the living conditions of rural populations. It is not enough, however, to invest in a simple increase of production and productivity (first and foremost through improvements in technology transfers and better management of access to water). What is also needed is a more equitable distribution of wealth through the creation of income opportunities for the poorer sector of the population. Without a process leading to a broader distribution of wealth, the agriculture of many poor and developing countries is, in fact, destined to remain at the level of pure subsistence. Similarly, it is crucially important to build up basic infrastructure and create local markets to facilitate the conditions for at least a partial market-based agriculture. Second, there is the issue of policy choices. These are complex matters; many actors interact at various levels. Here, political decisions will prove to be decisive, eitherdomestic (affecting the general and specific direction of political economy) or affecting relations between countries, especially on issues of trade. (The trade policies of the last decadecoming on the heels of the second half of the 1990s, a period of modest but continuous progress over timeseem by and large to have been spectacularly unsuccessful in improving access to food. This is not the first time that a lack of coordinated action by many countries has led to such a failure.) In light of the worlds current economic conditions and the general state of political instability, we should keep in mind the clear risk of food security being downgraded to a secondary priority. The issue of focus and priority is an important one. Developed countries must recognize that the 925 million undernourished people in the world urgently require aid. Such aid can only be provided through effective policy actions, and those actions must be planned with a view to a sustainable future. All too often, the debate narrows to the mere mechanics of food aid: while that response is laudable and fundamental in the face of emergencies, it is not enough, and it is not sustainable.

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Unfortunately, a number of emerging factors have led to growing turbulence in recent years. For example, certain rising powers eager to enhance their own prominence on the geopolitical stage have turned to the option of the land grab. Other countries have erected trade barriers in the form of tariffs and other obstacles to imports, or else they have subsidized domestic farming in an attempt to counter the instability of global markets. Then there is the seesawing trend of oil prices and, in general, the larger global challenge of energy; concomitantly there is the developing market for biofuels; it goes without saying thatfarmland planted for biofuels can no long produce crops to feed people. To summarize, increasing uncertainty on the global economic and geopolitical stage has made it harder to adopt policies of openness that might include the flexibility required to take into account the needs of the poorer countries. The problem is that governance mechanisms with respect to food security are weak and inadequate. At recent international summit meetings, however, a potential response has emerged, based on three crucial approaches: investment in food aid and in food security networks on behalf of the neediest and those at greatest risk; increased investments in agriculture and development policies; and the adoption of more balanced trade policies between developed and developing countries. short-term business factors. Alongside these structural factors other elements of equal importancerooted in specific short-term aspects of the business environment but destined to become permanent unless we are able to root out their causeshave emerged in recent years. Key among these is the increasing volatility of agricultural and food markets. Such volatility is caused by broader global phenomena, such as the volatility of the energy markets, the effects of climate change, and economic and demographic growth. We deal more extensively with this phenomenon in this chapter. What follows here is a summary to help understand the subject of access to food. As shown in various statistical sources (e.g., the FAO Food Price Index), food prices have not only increased significantly in recent years but have also been subject to greatly increasing volatility.18 The public countermeasures put in place in order to deal with the economic slowdown have highlighted the limitations of the current system of regulated markets. These limitations extend to the levels of both transparency and efficiency. Due in part to these factors, the rapid rise in agricultural prices has made it especially difficult to cushion against the effects of the slowdown. The ensuing consequences have been tragic for the most vulnerable sectors of the population in the poorest nations. This is more than just a matter of the way markets work. It is crucial to keep in mind that the factors determining agricultural prices are diverse, complex, and

chronic famines

Every year, Niger suffers a food crisis, which reaches its peak of gravity between the months of May and September. That is when NGOs like Doctors Without Borders swing into action, distributing nutritious foods. Here, like in many other countries, access to food still depends on the presence of international aid agencies.

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closely intertwined. The reasons for the resulting imbalances are to be found on both the supply and demand sides of the agricultural market. Among those factors, we should consider aspects of the world macroeconomic and demographic stage, such as population growth, the rapid economic development of countries such as China and India (with a corresponding increase in demand for food), and the first appearance on the world consumer market of populations that once couldnt afford to buy. There are also the dynamics of oil prices and the progressive changes in climate conditions. Other factors in the distortion of markets are narrower and more specific: the growing financialization of food commodities, the sharp increase in demand for agricultural products used in the production of biofuels (though biofuels are likely to become a permanent and structural factor), and the persistence protectionist policies implemented by many governments. This situation highlights the previously mentioned lack of adequate joint and multilateral interventions in the realms of political economy and social, environmental, and trade legislation designed to safeguard access to food by modifying, with structural measures if necessary, the inequalities we have encountered. In particular it underscores the failure of pure market mechanisms in the sector of food. The gains in productivity made possible in the last 30 years by technical developments and the diffusion of knowledge in the agricultural world could explain the drop in public and private investment in agriculture in the last 20 years and the simultaneous lack of political attention (except for agricultural and trade policies that were often distorting and protectionist). In real terms, the so-called Green Revolution led to steady increases in production and reductions in prices. This created the illusion that the sector no longer needed close policy direction. a misleading view of matters. Now that productivity is struggling to keep up, we are realizing how wrong and misleading that perception was. Some observers have pointed out that the demand for food today could drive greater investment by the sector, thanks to the increase in the average prices of agricultural commodities. These investments could support the launch of a new Green Revolution. However, the expected high volatility in agricultural markets involves a high level of risk, which is still blocking investment in agricultural development. In the future, a host of new global pressures will play an extraordinary role in aggravating the current food security problem. These include not only the gradual transition from oil to renewable energy sources and biofuels, but also climate change, which could seriously affect food production in the next 40 years. Demographic and economic changes in some of the emerging countries will also upset the traditional balance.

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With regard to climate change, we should remember that there are two response strategies: mitigation and adaptation. To the extent that broad and concerted actions taken to confront the phenomena of climate change are effective, agricultural strategies could succeed in the area of mitigation, mainly through adaptive adjustments. The profound structural changes occurring today require greater attention to the systematic management of natural resources. In various parts of the world, the pressure on natural resources is growing, as are concerns about their more efficient use and their preservation, as well as containing the negative effects of economic development. Often the competition to grab and exploit scarce and unequally distributed natural resources degenerates into conflict, violence, and impoverishment of the common natural asset. This competition can be exacerbated when climate change, extreme meteorological conditions, and drought alter cultivation conditions. new changes. It should also be remembered that during the first half of this century, the global demand for food, forage, and fiber will nearly double. Meanwhile, agricultural products could be increasingly grown for non-food purposes (for example, biofuels). Already forced to adapt to climate change and the need to respect natural habitats, agriculture must also compete with urban settlement for land and water resources. The desertification and degradation of arable areas represent additional challenges for the agricultural sector, which will need to produce ever more food on ever less available space. Agricultural production is already down in some areas of the planet, and the ever more difficult environmental conditions have driven some governments to find alternatives to traditional methods to ensure the necessary production levels to satisfy their food needs. The resulting phenomenon is called land grabbing, which FAO Director-General Jacques Diouf has called a form of neocolonialism. Economic and demographic pressures are also producing challenges that must not be underestimated. Projections of population growth in 40 years bring us back to the problem of identifying new ways to increase agricultural productivity. The debate concerning the need for a technical paradigm shift toward biotechnologies has been going on for some time. We should also remember that the current, significant urbanization is expected to continue. It is steadily emptying rural areas and creating a demographic explosion in the inhabited centers, mainly in the developing countries. This causes failures in agricultural production and upsets the delicate management of distribution and overall sustainability in cities. While energy sources have been the subject of broad discussion, one significant aspect seems to be underestimated: food style, both worldwide and in the

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emerging countries. In our opinion, this variable needs more research to shift the bar on productivity increases to sustain a greater demand for food under equal conditions of demographic growth. In order to identify and possibly guide the components of the demand for food in the near future, we need to define not only the demographic dynamics of increased economic well-being, but also their intersection with the consumption habits of the populations. This is the unknown in the equation, which could reveal medium- and long-term strategic alternatives. 2.3 possible areas for action To frame possible answers to the problems highlighted, we need an initial understanding of the organization of the food sector. In a very simplified form, the flow of activities in the agricultural sector can be broken down into six principal areas, in this order (figure 2.5): research and development, concerning all possible action areas (soil fertility, optimizing inputs to production, knowledge transfer, etc.); production of inputs (for example, seed and fertilizers) and access to natural resources needed for agricultural production (for example, water); agricultural activity, i.e., the cultivation, harvesting, and storage of agricultural products; this activity can have very different characteristics depending on geographic location, soil structure, the degree and type of mechanization, the use of chemical agents, the size of land parcels, etc.; the marketing of agricultural products, both to the final consumers and to a possible later phase of industrial transformation; the industrial transformation and consequent distribution of the finished product; and consumption processes. A detailed outline of the conditions needed for the proper functioning of this complex and carefully constructed system is outside the scope of this chapter. We will limit ourselves to highlighting five main areas on which, in our opinion, we need to focus attention: oversight of the entire chain, which must not be abandoned purely for market reasons, especially in the case of food production; research for places to achieve productivity gains along the different stages of the overall chain; stabilization of food markets and access to them, in order to strengthen the conditions of equity needed to attract investment, compensate producers, and increase access to food; the reduction of waste along the entire agricultural and food industry supply chain;

access to food: present and future challenges | food for all

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A Control of the Production Chain

Research and Development

Input Factors

Agricultural Activity

Trade in Agricultural Products

Industrial Transformation

Consumption

B Productivity Savings

C Stabilizing Markets

D Reduction of Wastage

E Ways of Consumption

figure 2.5
Governance of the supply chain Source: BCFN, 2011.

the direction of food style. through a communications strategy aimed at

increasing general awareness not only from a nutritional point of view, but also in cultural terms.

What are the solutions to these problems, considering the assumptions, the scope, and the complexity of the subject? For the five areas indicated, we suggest the following. reinforce worldwide governance mechanisms. There is an obvious lack of governance in the overall food system, which requires quick and precise action at various levels. Food cannot be treated simplistically as a commodity. The pressure from the greater availability of foodstuffs and the failure of distribution mechanisms make it necessary to get past the paradigm of a self-regulating market. It also means coordinating global policies and reducing unilateral protectionist policies over time. The following steps are essential: return food to a central and primary role on the international political and economic agenda. This means that the entire food chain must be structured and governed more openly with goals of accessibility, sustainability, and nutritional quality. Indeed, it seems fundamental to ensure the quantity and quality of produced and distributed food;

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to this end, we need to create common room for dialogue and analysis of

subjects related to food security. No country, institution, or business player in the industrial food chain is in a position to single-handedly meet the environmental, political, social, and economic challenges that this context poses. Rather, a multilateral approach is needed, one that involves all public and private players directly and indirectly tied to the industrial food sector, in order to eventually upgrade the average standards of the sector; economic policy actions take place one level higher, and must be aimed at supporting growth and development in the poorest countries. These actions require the active participation of the international community. Concerning this aspect, the choices are enormously important and very difficult to realize. However, they constitute one necessary prerequisite among others for an orderly functioning of the sector. facilitate economic development and increase agricultural productivity. We must identify, realize, and support real progress in sustainable development in order to define and disseminate solid, credible solutions that developing countries can implement in those sectors that are key for economic growth. In terms of productivity, in our opinion, the increase needed in the next 40 years to sustain the growth in food consumption worldwide depends on a complex pattern of variables, from the increase in the global population to the impact of climate change on agricultural yields and the composition of the future global food basket. The latter, if managed correctly, could make it possible to contain the increase in productivity needed to sustain worldwide consumption. The challenge is to innovate continuously, and to make those innovations accessible. We must look at updating agricultural and production models, achieving higher productivity, better quality, and reduced environmental impact. Therefore, scientific and technological research on these subjects, supported also by significant flows of public investment, will be decisive. Some pathways have already been outlined, including initiatives to support developing countries. These should be aimed at achieving food independence by transferring scientific and knowledge and agricultural best practices to these countries, with ad hoc programs to close the know-how gap between advanced and underdeveloped countries. Also, the maintenance and development of local systems in the production/distribution/consumption chain of agricultural goods must be facilitated, using suitable policies and incentives/disincentives. These local systems should preserve high quality production and pay attention to biosustainability. But we must also challenge those tax and trade policies that distort world food markets, particularly those harming developing countries.

price volatility

In July 2011, in the autonomous region of Ningxia Hui, China, average wholesale prices for food dropped by 7.58% from the previous month. Large quantities of fresh produce was left to rot in markets. As a result, the local government was forced to adopt price stabilization measures.

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Combined with a more rational use of the land, these measures alone can make it possible to achieve significant results. Other pathways tied to the technical paradigm (e.g., biotechnology) certainly must be explored at the same time, if we remain aware that many different aspects of using them still need to be researched and evaluated carefully. update the food production chain to manage price volatility and ensure safety nets. The industrial food sector is destined to undergo significant and growing price volatility in the near future. It must implement technical solutions to manage this new reality better. In order to be in a position to resist and prevent future food crises, three steps would seem appropriate: evaluate and select the best practices at the international, national, and local levels for creating stocks of food and raw materials, defining the costs, timelines, and roles for such a process of global insurance; define a new system of rules for the food commodities markets, capable of valuating more than just the economic role of the products traded. For example, it should provide oversight by an independent authority and impose position limits to ensure that amounts invested are not excessively speculative; coordinate trade policies at the international level, favoring market access and qualitative growth for production coming from developing countries. For a more detailed presentation of suggested actions, please see the next section, on the subject of price volatility of agricultural goods. manage food styles. In our opinion, predictive models used today suffer two serious limitations. On one hand, they downplay the difficulty of including forecast data concerning climate change, because of the objective uncertainty of possible impacts; on the other hand, estimating changes in food consumption patterns remains difficult. In fact, we know that environmental impact and natural resource consumption (land, water, feed, etc.) can differ greatly with different dietetic choices. For example, the Western diet and the Mediterranean diet differ mainly in the amounts of meat consumed. It can be shown easily that consumption patterns entailing high consumption of much meat and animal products can, over time, prejudice global food security. Any consideration of food supplies must include the future composition of the demand for food, in view of the extraordinary changes that we can foresee today. Demographic growth across a wide area of the planet is giving access to sophisticated patterns of consumption by vast strata of the populations of emerging countries. For the first time in history, government action and the molding of food patterns to take sustainability into account are becoming crucial variables of eco-

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nomic politics. This is taking firm shape in the developed countries, which face a health crisis from the spread of metabolic, cardiovascular, and tumor-related diseases caused by harmful eating habits. Over time, this will become crucial also in the developing countries, mainly because of the impact it will have on global production equilibrium in agriculture. Choosing sustainable food consumption models for the future will allow us to reduce the emphasis placed on productivity gains, which in turn create pressure on natural resources and environmental sustainability.

a new emergency: dramatic instability in food prices

The level of attention paid to the dynamics of food prices is higher than ever at this time. In fact, market prices for agricultural raw materials began increasing very rapidly in the second half of 2010. Between July 2010 and February 2011, the FAO Food Price Index increased 38 percent, surpassing the previous peak during the food crisis of 2008. In just 12 months, June 2010 through May 2011, the price of cereals alone increased 71 percent. Moreover, we see a worrisome increase in the volatility of prices, with sharp, rapid oscillations taking place even within the same trading day. This causes uncertainty and instability on the markets. In the last five years, the standard deviation, a measurement of volatility,19 has more than doubled compared to the prior 15 years (29.3 compared to 13.5). Combined with the difficult world economic crisis, high and volatile prices are a grave threat to the food security of families (particularly low-income ones) and to the development of the food industry and the economy overall (mainly, but not only, in the developing countries). 2.4 the bcfn evaluation model Faced with this situation, the BCFN carried out research aimed at identifying, studying, and clarifying the causes of the high, and sometimes extraordinary, increase in the prices of food commodities, in order to assess their effects on the food security of families (mainly low-income families, as mentioned) and on the economic and political stability of countries (particularly those in development). The BCFN evaluation model attempts to display the many elements that combine to define trends in food commodity prices. Above all it highlights the factors that can be traced to the demand side (inventory levels of product, demographic factors, economic growth of emerging countries, food choices) and to the supply side (agricultural production, scarcity of natural resources, produc-

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tion of biofuels, impact of climate change). These are called endogenous factors. Some indirect, exogenous factors that affect price levels directly or indirectly can be added to these. The evaluation model takes into account financial and exchange markets, the price of oil and energy, international trade policies, and geopolitical dynamics. The need to prepare an easily understood graphic representation required placing different factors on the demand side, on the supply side, or among the indirect factors. In reality, however, many of these factors interact in a complex way in the demand-supply relationship. Moreover, there are many interconnections among the factors themselves, shown by the dotted lines in the figure 2.6. All the elements identified and shown in the evaluation model above can also be subdivided by the type of effect they have on prices and their relative reference timeframe. That is, the increase in price volatility can be short-term or long-term; likewise, absolute price levels can increase over the middle to long term. This distinction is crucial, because the consequences and impacts of the two phenomena (absolute price level and volatility) are very different. These evaluations also show that the effects of some factors can be changed only over the middle to long term and that answers may be found as the system adapts to changed structural conditions in supply and demand. For example, the demographic and economic growth of emerging countries is creating a significant increase in the demand for food, in urbanization, in the rise in temperatures caused by climate change, and in the progressive worsening of the scarcity of natural resources. The imbalance between supply and demand is at the origin of the changes in price levels. In equilibrium, prices do not have a tendency to increase and volatility peaks are less likely. By way of example: consider a situation containing factors such as present and forecast global demographic growth, heated economic development in emerging countries, and significant investments in the production of biofuels, all in a context of low product inventories. Add a major weather disaster (drought, conflagration, or flood in key world agriculture areas). The outcome can only be a powerful shaking up of the markets. If the policy responses are protectionist, the global result will be a sudden increase in prices and greater uncertainty. In a context of extremely difficult capital markets, this is ground on which international finance gladly treads. More or less, this is what has happened in this recent turbulent phase. 2.5 variables of the model To understand in depth the reasons for price increases and their extreme volatility, we must analyze the different variables at work, their movement, and their points of interaction.

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demographics
Population growth Urbanization

exchange markets

trade policies

geopolitical dynamics

agricultural production
Productivity Technology/Innovation Loss and wastage

ways of eating
Increase in calories consumed Westernization of diet

biofuels
DEMAND

prices

SUPPLY

limited nature of natural resources

Arable soil Water

economic growth of developing nations level of inventory stock financial markets (speculation)

price of oil and energy

climate change
Rising temperatures Variations in precipitation Adverse climatic events

Contextual factors

Structural factors

Contingent factors

figure 2.6
Interpretative model of food price volatility Source: BCFN, 2011.

structural factors. These include, on one hand, demographic and economic growth, and on the other hand, insufficient supply globally and high levels of waste and losses. As a result of the increase in population and per capita income in the developing countries, the consumption of agricultural goods is constantly growing (figure 2.7). The increase in the rate of urbanization and changes in food habits are bringing about a radicaland resource-intensiveincrease in demand for foods such as meat, which directly affects the consumption of agricultural products and has a heavy impact on the consumption of resources to support animal husbandry. To try to limit this phenomenon, scientists are studying alternative ways to favor the consumption of vegetables with high protein content and to stimulate replacements for the consumption of meat. The risk of insufficient global supply arises from the increasing scarcity of natural resources, which seriously threatens the growth of agricultural productivity. The annual rate of growth in productivity from 1991 to 2010 was 0.62 percent less than that from 1961 to 1990 (figure 2.8). This is due mainly to urbanization, degradation of the land, and changes in the intended use of crops (particularly for the production of biofuels). Water is also becoming an everscarcer resource as per capita consumption increases worldwide. Water tables

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3,065

3,206

3,380

3,440

19641966

2,054

19741976

2,152

19841986 Developing nations

2,450

19971999

2,681

2,850

2015

Industrialized nations

figure 2.7
Daily per capita consumption of calories (1964estimates to 2030) Source: BCFN on FAO data, 2010.

are threatened by growing urbanization and intensive use for livestock. It takes eight to ten times as much water to produce meat as to grow grains. One of the most critical problems involves the level of waste and losses along the chain (upstream losses in developing countries; downstream in developed countries). short-term factors. There are additional, short-term factors that could either exacerbate or mitigate the effects of the structural factors by acting on the volatility and instability of prices. These include climate change-related phenomena, trade policies, oil prices, macroeconomic factors, financial speculation, and inventories. Climate change is implicated in the rising incidence of adverse weather events, and meager harvests caused by such events, (such as the drought last summer in Russia and later in Argentina or the strong rains in Canada and Australia at the beginning of this year) partially contributed to the current spike in the price of food. Recurring phenomena, such as La Nia, raged in early 2011, causing colder winters in the Northern Hemisphere, drought in the southern United States, and increased rains in Indonesia, Malaysia, and Australia.20 The international scientific community agrees that current changes in weather conditions at the global level are responsible for an intensifying of extreme weather phenomena, which have had a role in driving up the price of food over the middle to long term (figure 2.9). Decisions about international economic policy (trade policy) by individual States have always played a fundamental role in determining price levels on a global scale. During the crisis in 2008, at least 30 countries implemented restrictive export policies in an effort to safeguard internal food security, which

2,980

2,947

2030

3,500

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3,400 CAGR 19611990: + 1.84% 2,900

kilograms per hectare

2,400

CAGR 19912010: + 1.22%

1,900

1,400 2009 2003 2005 2007 1999 1969 1989 2001 1993 1963 1983 1995 1979 1997 1967 1965 1987 1985 1973 1977 1991 1975 1961 1981 1971

figure 2.8
The global yield of cereals 21 (19612010) Note: CAGR, Compound Annual Growth Rate. Source: BCFN on World Bank data, July 2011.

250
fao cereals price index, 100 = oct. 2005
Severe droughts and major wildfires have reduced forecasts for the wheat crop in Russia

Drop in harvest forecasts for Indonesian soy seeds because of excessive rain Heavy rains damage the wheat crop in Australia

200

150
Drought has damaged the hard red winter wheat harvest in the United States

Most of the hard red winter wheat zone in the U.S. suffers from light rainfall

Poor harvests in the Chinese farming regions; in India cold damages the cereal grain crops

Heavy rains and flooding destroys the corn crop in the American corn belt

100

Jun. 2010

Jul. 2010

Aug. 2010

Sep. 2010

Oct. 2010

Nov. 2010

Dec. 2010

Jan. 2011

Feb. 2011

Mar. 2011

Apr. 2011

May 2011

Jun. 2011

figure 2.9
Trend of cereal prices and principal climatic events (June 2010April 2011) Source: BCFN on USDA and FAO data, 2011.

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The government of Ukraine revokes the tariff on exports

400 350 300 250 200 150

Because of drought, Russia announces a prohibition on exports Ukraine eliminates export price supports Jordan, Libya, and Morocco increase imports to replenish their reserves

Iraq and Tunisia acquire 350KT and 100KT of wheat, greater volumes than their customary purchases

Russia announces that it is suspending its prohibition on exports

+
Turkey reduces its tariff on publicsector imports from 130% to 0%

Europe suspends tariffs on imports of fodder grain

Europe reactivates its tariffs on imports

Algeria acquires 800KT above the market price

10/2010

12/2010

11/2010

9/2010

6/2010

8/2010

4/2010

2/2010

3/2010

5/2010

7/2010

1/2010

6/2011

Monthly wheat price (Hard Red Winter) Restrictive measures imposed on international trade + Suspension of restrictive measures imposed on international trade

figure 2.10
International trade policies and grain prices (January 2010August 2011) Source: BCFN on CBT data and wire services 2010, 2011.

distorted the international market. Although duties, tariffs, or taxes on exports may provide short-term stability for internal prices, in general the effects are not positive, either internally or externally. On a global level, export restrictions can aggravate instability and cause prices to increase. These restrictions prevent achieving equilibrium between demand and supply and send uncertainty signals to the markets, which can lead to aggressive buying policies intended to protect against trends and future availability. Figure 2.10 shows major international trade policy actions (blue for impacts on exports; red on imports). There is a very tight connection between the energy sector and the food sector. Indeed, overall, the latter accounts for 10-15 percent of the energy in the industrialized countries, in the production of inorganic fertilizers, the consumption of fuel for transportation, production activities (irrigation, harvesting, animal husbandry), and in the final phases of the value-added chain (processing the harvest, freezing, and storage). Moreover, crops are increasingly going for the production of biofuels, which reduces the food supply. The two-way bond between food and energy makes the price of oil a determining factor in food production and distribution. High prices for oil will help raise the price of food by increasing production costs and the demand for biofuels (figure 2.11).

8/2011

4/2011

2/2011

3/2011

5/2011

7/2011

1/2011

food and social instability

In parts of Asia in 2011 there were sharp rises in food prices. In India unseasonal monsoon rains hit southern Asia, leading to higher prices for staple foods. This led to fears of a repeat of the food crisis in 2008 that caused instability throughout the region.

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250

$ 140 $ 120 $ 100

200

150

$ 80 $ 60 $ 40

100

50

$ 20 $0 10/2009 10/2008 10/2006 10/2004 10/2005 10/2007 10/2010 4/2004 7/2004 4/2009 1/2009 4/2006 4/2008 7/2009 1/2008 7/2006 4/2005 4/2007 7/2008 1/2006 1/2004 7/2005 7/2007 4/2010 1/2010 1/2005 1/2007 7/2010 4/2011 1/2011

FAO Food Price Index

Oil price ($ per barrel)

figure 2.11
Correlation between oil prices and food prices (January 2004April 2011) Source: BCFN on FAO and IMF data, 2011.

Macroeconomic factors such as the inflation rate, exchange rates, and interest rates are also very important in determining agricultural policy. The increase in food prices caused by the depreciation of the dollar is a unanimously recognized phenomenon. Because the United States is the principal exporter of agricultural commodities in the world and many prices are denominated in dollars, a depreciation of the American currency causes an increase in the buying power of importing countries. This translates into a significant increase in demand for imports, upsetting the balance between supply and demand internationally. Figure 2.12 shows the relationship between the cereals price index, the Euro/ dollar exchange rate, and major events in American trade policy. What of financial speculation as a short-term factor? Today, the financial derivatives markets for agricultural products offer various instruments to limit risk, such as futures, options, and swaps. These assets allow cash to flow in the markets and send powerful signals about prices, to which supply reacts in the medium term. Looking at the crisis of 2008, one wonders about the role of derivatives on the agricultural markets, and how they could influence the volatility of prices and threaten access to food. According to many observers, the flow of significant amounts of foreign money for real economic purposes

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250 200 150 100 50 0

Between March 2006 and November 2007, American grain exports rose by 46% Between July 2008 and July 2009, American grain exports dropped by 29% As a result of the recent depreciation of the dollar, American exports rose by 56%

0.85 0.8 0.75 0.7 0.65 0.6 0.55 0.5

figure 2.12
Exchange rate $/ and the Cereals/Food Price Index (March 2006June 2011) Source: BCFN on USDA, OECD, and FAO data, 2011.

(hedging operational risk) on the agricultural markets helped to aggravate the overall instability. Finally, when inventory levels are low in the absence of a cushioning mechanism, the response to a supply shock is a direct increase in price levels. For example, between 1972 and 1973, when international inventories were low, a reduction of less than 2 percent in the output of grain caused the price to double. World inventory levels are difficult to estimate, as they are recorded as annual aggregates on individual markets and therefore can only be guessed. However, figure 2.13 shows that inventory levels of rice, grain, and corn decreased worldwide between 2000 and 2011, partly because of an imbalance between production and consumption. 2.6 strategies for controlling volatility The picture that emerges from this analysis is extremely complex. It must be interpreted systematically, taking into consideration the many elements contributing to the current unbalanced situation. This lack of equilibrium translates into a powerful volatility in short-term prices and the risk of a constant increase over the middle to long term. How can we act on such a complex system, in order to guide development along a sustainable path?

3/2006 5/2006 7/2006 9/2006 11/2006 1/2007 3/2007 5/2007 7/2007 9/2007 11/2007 1/2008 3/2008 5/2008 7/2008 9/2008 11/2008 1/2009 3/2009 5/2009 7/2009 9/2009 11/2009 1/2010 3/2010 5/2010 7/2010 9/2010 11/2010 1/2011 3/2011 5/2011 Food Price Index Cereal Price Index $/e

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2.36% 2.44%

0.75%

0.93% Rice

0.95%

1.03% Wheat 0.7% Corn

3.4%

3.5%

CAGR production

CAGR consumption

CAGR Stock

figure 2.13
Rate of average annual variation of production, consumption, and stock levels of rice, grain, and corn (World, 20002011) Note: CAGR, Compound Annual Growth Rate. Source: BCFN on Food and Agricultural Policy Research Institute (FAPRI) data, 2011.

In terms of possible leverage, it will be fundamental to sort the factors examined according to the concrete possibility of being able to affect them, either to reduce volatility or to stabilize prices at levels that are compatible with global food security objectives and development of the industrial agricultural sector. It is essential to consider the timeline for taking this action. In our opinion, there are seven principal areas for action: agricultural production. Stimulate the overall growth of agriculture, by defin ing optimal production models and agricultural patterns for various geographic con texts. The challenge will be to promote innovation, guiding the sector to update production models and agricultural patterns for greater productivity, higher quality, and less environmental impact. Scientific and technical research on these subjects, supported by significant amounts of public investment, will be decisive. For a more detailed description of our approach to an agricultural system and a food industry that would be better suited to the challenges of the future, we refer the reader both to the section Facilitate economic development and increase agricultural productivity, as well asfor a more general treatment to the chapter Food for Sustainable Growth, where there is a detailed analysis of the requirements for sustainability of the agro-industrial system.

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natural resource scarcity. Come to grips with the scarcity of natural resources for agricultural production. The limits of available natural resources, especially water and arable land, represent a very important barrier to the growth of global agricultural production capacity. In response, action is needed to reduce the use of water in cultivation. Water usage in agriculture accounts for 70 percent of worldwide water use, and there is considerable room for improvement, both by reducing waste and by using technologies that make water usage more productive (more crop per drop). We also need to adopt advanced techniques for collecting rainwater to be used for irrigation. Disseminating technology and tools for managing agricultural irrigation for maximum efficiency does not always translate into costly investments in technology, but often simply means spreading awareness and know-how. Concerning production processes, incentives are needed to promote investment in available technology that can save water used in production processes. climate change. Act to reduce, delay, and mitigate the effects of climate change. According to the most reputable studies, without radical intervention climate change is very likely to reduce future global agricultural productivity. Moreover, climate change could disproportionately affect particular geographic areas and their ability to ensure adequate production levels, mainly because of the increase in temperature and greater difficulty gaining access to water resources, with the most severe impacts possibly occuring in equatorial areas, the Mediterranean, Australia, etc. An additional threat is that climate change intensifies adverse weather (drought, floods, heat waves, heavy downpours), which can cause significant crop losses. Incentives are needed for various actions to reduce the impact of climate change, including managing cropland and pasture better, increasing carbon reserves in the soil, restoring cultivated peat soils and degraded land, improving production techniques for growing rice and raising livestock, managing fertilizer use to reduce methane (CH4) emissions, improving techniques for applying nitrogen-based fertilizers to reduce emissions of nitrogen dioxide (NO2), and improving energy efficiency. It is also necessary to support actions to adapt to climate change in order to sustain agriculture production, including the diversification of crops. trade policies. Reduce barriers to imports, subsidies to exports, and various forms of trade restriction. Trade barriers and subsidies distort the dynamics between demand and supply on the international food commodities market. Between 2008 and 2010, in response to predictions of reduced harvests and higher international prices, some important agricultural exporting countries introduced export taxes to increase domestic supply and limit the internal effect

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of the worldwide increase in food prices. Recently, these dynamics have been repeating themselves and are causing another rapid price increase. One of the major challenges facing the international community today is the need to build a transparent, responsible system of international trade based on multilateral rules that can guarantee greater access to food at the global level. In general, one would hope for a reduction in the use of import barriers, export subsidies, and other trade restrictions. In particular, it appears necessary to eliminate export restrictions and reduce subsidies with an eye to creating equitable conditions on the international market, thus increasing its efficiency. It would also be helpful toreduce the use of mechanisms to support internal demand, because these create distortions especially when employed by the more developed countries. Finally, it is critical to significantly improve market transparency while maintaining appropriate systems to protect developing countries, in order to improve those countries efficiency and competitiveness and reinforce their integration into international markets. inventory levels. Create a multilateral system for food reserves and improve the transparency of flows and inventories. In recent years, different factors have made it necessary to draw on inventories accumulated over the years to satisfy the growing demand for food (growing more rapidly than supplies) and to stabilize domestic prices. Analyses conducted during this research study show a strong connection between changes in inventories and the price trends for food commodities. In particular, we noted that, over a sufficiently long time span, a reduction in the stock-to-use ratio of cereals tends to correspond to an increase in the price level; on the other hand, with an increase in the stock-to-use ratio, the price tends to go down. Various measures could mitigate this effect. For example, building a multilateral, regional, and cross-border food reserve would increase the elasticity of the world food supply. This would require facilitating the coordination of storage policies at the international level. Improving market transparency, in terms of sharing information concerning demand, supply, inventories, and importexport dynamics, would help dampen the recent volatility of food prices. Establishing a supranational authority to control the balance between demand and supply would also ensure the presence of an information system capable of collecting reliable data and offering operators more accurate analyses and statistical databases. It would be particularly important to collect data about the levels of reserves and disseminate estimates about the size of demand and supply, by providing harvest forecasts to support national government decision-making. the production of biofuels. Avoid competition between biofuel produc tion and food in growing crops. At the international level, the price of food cor-

food safety

The outbreak of E. coli from contaminated produce in northern Germany in 2011 had serious repercussions on developing countries. The outbreak led to the destruction of tons of foodstuffs, even though they tested negative for the pathogen.

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relates strongly to the price of oil. Increases in the price of oil make biofuels more attractive and increases the demand for them internationally. Because most first-generation biofuels are produced with the same inputs used for food and livestock (cereals, sugarcane, vegetable oil, etc.), this creates competition between the energy sector and the food sector for the use of agricultural raw materials. Thus, changes in the price of oil and biofuel subsidy policies cause strong volatility and price increases on food markets. One helpful response would be for governments (particularly in Europe and the United States) to significantly reduce support for production and consumption of first-generation biofuels. These products use food crops as raw materials and thus compete directly with food products and livestock for these raw materials. If the incentives are not removed, governments should develop emergency plans to restraun policies (at least in the short term) that stimulate the production and consumption of biofuels when world markets are under pressure and food supplies are reduced. At the same time, second-generation biofuels should be supported, beginning with crops that do not compete with food for the use of land. Incentives should be provided for research into new technologies to produce biofuels to respond to the growing worldwide demand for energy and to reduce its impact on agricultural raw materials markets. In addition to limiting subsidies, it is also important to facilitate the opening of international markets, so that biofuels can be produced where conditions are economically advantageous. financial markets. Regulate financial speculation in food commodities. Futures markets are an integral part of the food commodities market, performing two important functions: transferring price risk and helping to determine the price itself. However, the recent global financial crisis has led non-commercial investors (index funds, which hold long positions, and hedge funds, which operate aggressively over the short term) to increase their investments in agricultural commodity derivatives in order to diversify their portfolios. The increase in the share of contracts held by non-commercial investors may have brought about speculation of the sort typical of stock markets. How significant a role this speculation may be playing in the increase in the prices of agricultural assets is still widely debated. We can state with relative certainty, however, that financial speculation in the agricultural commodities markets could have aggravated short-term volatility. Without demonizing the work of the financial intermediaries or interfering with their legitimate activity, we can suggest some actions that could be taken to facilitate greater transparency, order, and equilibrium on the markets. On one hand, to enable regulators to identify possible anomalies in financial

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trends and to prevent possible excessive speculative behavior, the flow of information and the transparency of over-the-counter operations could be improved. This could be done by monitoring the activity of all operators (through a transaction/positions reporting system and by requiring operator registration) and possibly by imposing caps on their activity. For example, mechanisms could be introduced to distinguish between sector operators and non-commercial operators, so that limits could be placed on speculative operators to prevent excessive betting on the movement of prices, leaving the real market free to operate. On the other hand, it also appears desirable to introduce rules22 to define the perimeter of action for financial intermediaries on the agricultural commodities market, in order to progressively harmonize trades on these markets. As the United Nations Special Rapporteur on the Right to Food, Olivier De Schutter, underscored at the G-20 Summit of Agriculture Ministers in Paris in June 2011, the United States has had legislation concerning financial derivatives for about one year and the G-20 could encourage other economic powers to move in the same direction. We wanted to paint as broad a picture as possible because we believe that there are no shortcuts or half-measures capable of effectively solving the problems on the table today. In other words, it will be impossible to obtain significant results without acting on the system. We need balanced action that touches all, or most, of the various critical points, removing the causes of the systems current fragility.

new tools to measure and promote well-being

In recent decades there has been a growing sense of a gap between improvements in key macroeconomic variables and how well off people perceive themselves to be. In particular, economic growth does not seem to be capable by itself of ensuring higher levels of overall well-being. The recent dramatic economic crisis has led many countries to focus their energies on the problem of trying to re-launch interrupted growth. But it is becoming ever more important to define the conditions under which economic growth can be considered sustainable. For the fact is that there is often a strong disconnect between growth and well-being. This happens partly because there are costs associated with growth that are difficult to quantify but which nevertheless have a significant impact on peoples lives, such as excessive exploitation of environmental resources, or the wide range of negative effects of economic activity, such as industrial water pollution or mercury emissions from coal-fired power plants. Perhaps even more important, the disconnect arises because con-

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ventional economic indicators that measure growth by their nature obscure fundamentally important social and environmental aspects of well-being. The emergence of a greater awareness in this area has recently nourished a lively debate on the efficacy of the principal indicators that governments have used to make major economic and political choices. The gross domestic product (GDP) is the principal focus of this debate. 2.7 gross domestic product versus indicators of well-being GDP is a quantitative measure of macroeconomic activity.23 It reflects the volume of economic activity of a country (except for activity carried out on the black market and not captured in the formal accounts). GDP growth is traditionally taken to approximate the ability of an economic system to generate wealth and therefore the level of economic well-being of its citizens. However, over time the indicator has become a key index of overall social and economic development, assuming a role for which it was not designed. It needs to be supplemented by other measurements of a wide range of phenomena that influence living conditions, such as social inclusion, inequality, and the state of the environment. This was stated publicly as far back as 1968, when Robert Kennedy, in a famous speech at the University of Kansas, said: We will find neither national purpose nor personal satisfaction in a mere continuation of economic progress, in an endless amassing of worldly goods. We cannot measure national spirit by the Dow Jones Average, nor national achievement by the Gross National Product. For the Gross National Product includes air pollution and advertising for cigarettes, and ambulances to clear our highway carnage. It counts special locks for our doors and the jails for the people who break them. It counts [...] and the television programs which glorify violence in order to sell toys to our children. It grows with the production of napalm and missiles and nuclear warheads and research on spreading bubonic plague [sic] and armored cars for the police to fight the riots in our cities, which will only grow when the slums are rebuilt over their ashes [sic]. Yet the Gross National Product does not allow for the health of our children, the quality of their education, or the joy of their play. It does not include the beauty of our poetry or the strength of our marriages, the intelligence of our public debate or the integrity of our public officials. It does not count the justice in our courts or the equity of our relationships [sic]. It measures neither our wit nor our courage, neither our wisdom nor our learning, neither our compassion nor our devotion to our country. It measures everything, in short, except that which makes life worthwhile. And it can tell us everything about America except why we are proud that we are Americans. Back in 1934, the inventor of the GDP, economist Simon Kuznets, 24 testified before the Congress of the United States that well-being and the GDP are two

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different things: The well-being of a nation [...] cannot be easily deduced from an index of national income. how to measure well-being. The purpose here is not to criticize an instrument that has shown its reliability over time, albeit with well-known limitations. The point is that it is simply not possible to characterize well-being in one dimension. Well-being touches on economic, social, environmental, and political factors, personal elements, and health issues, as well as the lifestyles of individuals and societies. Therefore, even a detailed list of the factors that could affect any single dimension of individual well-being, no matter how sophisticated, would be incomplete. However, it is worthwhile to consider as many factors as possible, to construct summary indicators that possess great statistical and methodological rigor. Along this line, many multidimensional descriptive indicators have been developed25 with the intent of measuring well-being and quality of life for a particular nation, region, city, or territory. This type of measurement combines several indicators focusing on crucial aspects that directly or indirectly influence quality of life, including education and training, employment, environment, energy, health, human rights, disposable income, infrastructure, public and private safety, and recreational and cultural activities. An important milestone in developing alternatives to GDP was reached in 2008 when French President Nicolas Sarkozy ordered the Commission for the Measurement of Economic Results and Social Progress26 to research alternatives. Nobel-Prize winners Joseph Stiglitz and Amartya Sen co-chaired the group of about 30 internationally renowned economists; Frenchman Jean-Paul Fitoussi coordinated their work.27 The work of the Sen-Stiglitz-Fitoussi Commission, as the group became known, was published in September 2009 and has become required reading for those working on new indicators of well-being.28 The process begun in France continued in other countries (the earliest were Germany, the United Kingdom, the United States, Australia, Ireland, Mexico, Switzerland, and the Netherlands). For example, in Great Britain, Prime Minister David Cameron charged the National Statistical Institute with identifying new measurements for support the evaluation of economic policies. In Italy, the two institutions traditionally charged with measuring economic data in the country, ISTAT (National Statistics Institute) and CNEL (National Council on Economy and Labor), which reports to Parliament on economic subjects, recently established a Working Group to Measure Progress in Italian Society that consists of representatives of social and public agencies. In a preliminary phase of their work, the chairs of CNEL and ISTAT met with representatives of the Barilla Center for Food & Nutrition to learn about their experience and the results they achieved in developing a multidimensional indicator focused on nutrition and lifestyle.

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social well-being according to the sen-stiglitz-fitoussi commission

The Sen-Stiglitz-Fitoussi Commission* did not identify a new summary indicator, but did prepare a series of recommendations to capture social well-being in its many dimensions: Material well-being should be evaluated at the level of the family unit, taking into consideration income and consumption, rather than production. More emphasis should be placed on income distribution, consumption, and wealth; an increase in average income does not mean that everyone got a raise. Data collection and statistics need to be developed for non-market activities, because well-being also depends on activities that do not trigger market trades, such as direct services between parties (for example, healthcare and senior care provided within the family). Measuring the multidimensionality of well-being needs to be considered. Well-being is shaped not only by economic conditions, but also by education, health, the level of democracy, social networks, environment, and security. Attention must be paid to environmental sustainability, in order to measure growth net of the destruction of resources and the risks of climate change. Measurement of government-provided services should be based not on their cost, as occurs with the GDP, but on their impact on the well-being of constituents. Concerning the non-material dimension of well-being, we should remember the importance of free time and the need to measure social relationships, political inclusion, and the security or vulnerability of individuals. Finally, in general both objective and subjective measurements should be considered. 29 It is important to include sustainability indices for well-being, as environmental problems may increasingly undermine well-being over time.
* Professor Joseph E. Stiglitz, Chair, Columbia University; Professor Amartya Sen, Chair Adviser, Harvard University; Professor Jean-Paul Fitoussi, Coordinator of the Commission, IEP, Report by the Commission on the Measurement of Economic Performance and Social Progress.

2.8 subjective approach versus objective approach: different outlooks in terms of measuring well-being In order to put the phenomenon of well-being into contextin terms of a methodological approach for its measurementwe should first and foremost define the standpoint for the investigation. We should choose, in fact, to adopt the individual as a point of referenceaccording to what is ultimately a funda-

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mental problem, linked to the points of view of the choice, measurement, and evaluation of the various factors that contribute to any definition of individual well-being. There exist, in fact, when the outlook is that of the individual person, as many objective factors as there are subjective factors of well-being. On the one hand the approach is that of the measurement of the factual elements of a persons existence, gathered and evaluated in an objective manner because they are thus unbound from any partial and personal evaluation. On the other hand, the logic is that of the evaluation that individuals give of their own lives, of the interpretation of the objective phenomena that each person formulates subjectively. With the first option (objective measurement) we give up the possibility of directly consulting the perceptions of individual persons, through forms of opinion surveys, thus limiting the investigation to a certain number of objectively measured indices. For instance, we might decide that good-health life expectancy in a country constitutes, on average, a factor capable of having a positive effect on the lives of all the people who live in that country, without exceptions. According to the second approach (subjective measurement), the level of wellbeing becomes the subject of an evaluation expressed by each individual contacted, with all the challenges and difficulties that ensue when one is attempting to carry out comparisons over time and space, since the evaluation of wellbeing depends upon perceptual and emotional factors. There are different ways of filling the gap between objective measurements and subjective perceptions. One possibility is that of requesting that individuals provide an evaluation of the latter elements. In other words, it is necessary to build indicators that include both objective parameters and personal evaluations. This makes the measurement of individual well-being more complete and in closer alignment to the real evaluation of quality of life of individuals. An approach of this kind was utilized recently by the OECD29 which issued three indicators for the measurement of subjective well-being relative to the number of positive experiences/sensations enjoyed over the course of the previous year, the number of negative experiences/sensations suffered over the course of the previous year, and the number of people who stated that they experienced an elevated level of well-being in their lives. It is evident that the use of these variables introduces elements of subjectivity into the measurement of well-being, making it all the more complex to make comparisons between different individuals and countries. The alternative is to remain within the context of objective measurements, expanding the spectrum of phenomena that are considered co-determinant with well-being, in order to attempt to approach in an asymptotic manner a measurement of well-being that is as close as possible to the real value. This second approach too is not entirely devoid of critical elements. In the first

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place, the techniques of statistical measurementhowever broad the array of indicators utilized may beare linked, from a methodological point of view, to broad simplifications and a necessary set of conventions. In the second place, these are based on a trade off. A limited number of variables observed and estimated, in fact, possess an intrinsic value of focusing and limiting the potential distortions due to the multiple accounting of an end effect on the phenomenon under investigation. On the other hand, the choice of a limited number of variables pays the price of an elevated level of approximation in terms of the description of reality, generating the riskall the greater the more one approaches phenomena in which the individual is at the center of interestof a failure to consider a set of elements that can together play a decisive role. We should take into account, when we discuss the various options, that today the national statistical systems of the various nations are not yet structured in such a manner as to collect all the necessary information to effectuate adequate measurements and that, in the current state of the art in the field, every decision brings with it an elevated and necessary level of approximation. 2.9 the bcfn indices of well-being and sustainability of well-being The Barilla Center for Food & Nutrition has tried to contribute to the subject of well-being as it relates to our principal area of research and analysis: careful consideration of nutrition and its impact on the quality of life. We have avoided definitions that emphasized one element or one particular aspect at the expense of others, in order to take into account the greatest number of factors that have an impact on well-being. We have also considered it fundamental to pay special attention to the impact of nutrition and lifestyles on the well-being of individuals in social groups. It is obvious that food and nutrition directly or indirectly affect well-being. Consider first the effect that food choices have on the health of children and adults, both negatively (direct causes or risk factors for serious disease), and positively (protection against certain diseases). However, the impact that food and nutrition have on the environment around us is also significant, because they are responsible for consuming and degrading natural resources (from greenhouse gas emissions to soil depletion and water pollution). Also, there are aspects of food that closely involve the social sphere and interpersonal relationships (conviviality, socializing, time spent preparing food, meals, etc.). the two indices. the outcome of our work is two multidimensional summary indices for the quantitative measurement of national well-being: the BCFN Index of Current Well-being, to measure the present well-being of individuals (what people feel and live today, an inventory of well-being); and the BCFN

food waste

More than 30 percent of all food is wasted before it ever reaches peoples stomachs. But initiatives to educate the public are growing. In Great Britain, where 6.7 metric tons of food are discarded every year, London has led the way with the Feeding the 5,000 initiative. The program feeds people with food that would have otherwise been wasted.

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Index of Well-being Sustainability, to measure the dynamics and future trends of the current level of well-being (the sustainability of well-being). While it is undoubtedly important to measure well-being today, at the same time we must evaluate its future trajectory. For example, it is possible to achieve very high levels of well-being in the short term, by consuming environmental resources in excess, thus compromising the well-being of future generations. Only an integrated reading of both indicators allows us to understand wellbeing in depth. To bring maximum consistency and scientific quality to the methodology, the starting point was the work of Stiglitz, Sen, and Fitoussi noted above, which suggested analyzing a wide range of different variables (for example, income, health, education, strength of social networks, democracy, etc.) in order to evaluate multiple aspects and dimensions of well-being at the same time. For an international comparison, 10 benchmark nations were chosen: three European countries from the Mediterranean: Italy, Spain, and Greece; two Continental European countries: France and Germany; two Scandinavian countries: Denmark and Sweden; the United Kingdom; the United States; Japan. The performance of each nation was measured in seven dimensions (psychophysical and behavioral well-being, subjective well-being, material well-being, environmental well-being, educational well-being, social well-being, and political well-being) using both the BCFN Index of Current Well-being and the BCFN Index of Well-being Sustainability, through specific key performance indicators (KPI). Each KPI measures one or more contexts for the methodology being used, for each of the reference nations. In some cases, it was not possible to measure a phenomenon precisely, because of lack of available data or the nature of the phenomenon itself. For these, proxies were used to obtain a reliable measurement. Consistent with the assumptions, a very high relative weight was assigned to lifestyles and personal relationships, in the conviction that these were at least as important as economic factors in defining the state of wellbeing of individuals. Assigning a relative weight to each KPI, to each dimension of well-being, and to each of the three sub-indices (figure 2.14) made it possible to use a simple weighted average to calculate partial indicators for each of the seven dimensions of well-being, the three sub-indices under consideration, and the two final summary indicators mentioned above, (which aggregate the results of the three sub-indices). The three sub-indicesthe lifestyle sub-index, the wealth

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bcfn index of well-being

35% lifestyle
sub-index

35% wealth and

environmental sub-index

30% social and

interpersonal sub-index

psychophysical and behavioral well-being

(health)

25%

(income, investments, and property)

material well-being

20%

(education and culture)

educational well-being

10%

(perception of individuals in relation to their own lives)

subjective well-being

10%

environmental well-being
(quality of the environment)

15%

(welfare, family, society, and institutions)

social well-being

10%

political well-being
(democracy and individual freedom)

10%

figure 2.14
The BCFN Index of actual wellbeing and its components Source: BCFN, 2011.

and environmental sub-index, and the social and interpersonal sub-indexare compiled from 27 performance indicators that measure the seven identified dimensions of well-being. 2.10 principal results of the 2011 bcfn index The BCFN Index of Current Well-being is a multidimensional measurement of individual well-being from a static point of view, that is, the Index represents a snapshot of the well-being of a population at a specific instant. Using a simple weighted average to aggregate the scores of the 10 countries yields a classification in accordance with the BCFN Index of Current Wellbeing, shown in figure 2.15. Of the 10 countries compared with the BCFN Index of Current Well-being on seven dimensions of well-being, Denmark led with 7.5 points, followed

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point scale from 1 to 10 6.3 5.0 5.5 5.7 5.7

7.0

7.5

4.5 3.8

4.9

greece

spain

italy

usa

germany

france

japan

great britain

sweden

denmark

figure 2.15
Ranking of the BCFN Index of actual wellbeing Source: BCFN, 2011.

closely by Sweden with 7.0 points. The United Kingdom came in third with 6.3 points. The next three countries received similar scores, namely (in order), Japan (5.7 points), France (5.7 points), and Germany (5.5 points). Italy (5.0) and the United States (4.9) were in sixth and seventh place, respectively. Spain (4.5) and Greece (3.8) brought up the rear. Table 2.1 shows the detailed list of the 27 performance indicators used, grouped into the dimensions to which they belong.30 The BCFN Index of Well-being Sustainability represents a multi-dimensional measurement of the future sustainability of the well-being of individuals, from a dynamic point of view. It is also an aggregate index, consisting of 25 performance indicators to measure the seven dimensions of well-being in three sub-indices: the lifestyle sub-index, the wealth and environmental sub-index, and the social and interpersonal sub-index. Using a simple weighted average to aggregate the scores of the 10 countries into the three sub-indices, we obtain the BCFN Index of Well-being Sustainability, shown in figure 2.16. By this index, Sweden led with 7.66 points, followed closely by Denmark with 7.57 points. Then came France and Germany with similar scores a little over 6.10 points. Italy was in next-to-last place with 5.09 points, although the difference between third and fourth place was only one point. Last was Greece with 3.29 points, significantly behind the others.

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point scale from 1 to 10

7.6

7.7

5.8 5.1 5.5 5.5 5.6

6.1

6.2

3.3

greece

italy

spain

usa

japan

great britain

france

germany

denmark

sweden

figure 2.16
Ranking of the BCFN Index of sustainable wellbeing Source: BCFN, 2011.

Table 2.2 shows the detailed list of the 25 performance indicators used, grouped into the dimensions to which they belong. We have placed among objective indicators those measurements of change over time that feature significant predictive capability. Thus, changes in education encountered today affect the overall value of the human capital of tomorrow, just as the reducing the incidence of various diseases has a positive effect on the expectancy of a healthy life. Similarly, current levels of economic investment condition the future competitiveness of the economy. For the subjective indicators, we have used existing measurements designed to gather assessments of future scenarios. 2.11 the different dimensions of sustainability The importance of this work is not so much to pinpoint the relative position of each country in a final classification (which discounts each countrys historical, social, and economic history and circumstances) as the existence of more or less equilibrium between the different dimensions of sustainability of well-being for each country and the possibility to identify specific areas for improvement in the different contexts, in order to increase the overall well-being of people. If the saying is true that you get what you measure, then only by developing more precise instruments for measurement can we design policies to maximize the overall well-being of a society. For this, however, we need to make a leap

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in quality, letting go of a narrow view of well-being reduced to its economic features, to include the broad range of real factors that combine to define the social, political, economic, and environmental conditions in which people live. Moreover, by introducing a future time horizon (current vs. sustainable wellbeing), we can call attention to the consequences of present choices on future well-being in public policy debates with more transparency. In the end, it is not just a matter of defining better indicators. What is at stake is the ability to increase noticeably the quality of public decision-making.

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table 2.1. performance indicators used in compiling the bcfn index of current well-being
psychophysical and behavioral well-being 1 life expectancy in good health 2 average time spent on meals 3 obese and overweight population (adult) 4 death rate from suicides 5 consumption of antidepressants and mood stabilizers subjective well-being 6 oecd positive experience index 7 oecd negative experience index 8 people reporting high evaluation of their life as a whole (present time) material well-being 9 disposable income 10 net family assets environmental well-being 11 pm10 levels (particulates) 12 urban waste 13 intensity of freight and passenger traffic on the street educational well-being 14 pisa (programme for international student assessment) score* 15 average annual number of college graduates 16 foreign students enrolled in the university system 17 number of newspapers sold 18 unemployment rate among graduates social well-being 19 number of hours dedicated to the care of children 20 inactivity rate among young people 21 unemployment rate 22 annual vacation days 23 diffusion of broadband internet connections 24 interpersonal trust index 25 national institution index political well-being 26 the economist intelligence unit s index of democracy 27 corruption perception index 50% 50% 25% 25% 10% 15% 15% 5% 5% 25% 35% 15% 10% 15% 40% 20% 40% 70% 30% 25% 25% 50% relative weight 30% 10% 20% 30% 10%

* The Program for International Student Assessment is an international survey sponsored by the OECD designed to evaluate every three years the level of education of adolescents in the leading industrialized nations. Source: BCFN, 2011.

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table 2.2 performance indicators used in compiling the bcfn index of well-being sustainability
psychophysical and behavioral well-being 1 variation in mortality from cardiovascular pathologies 2 variation in mortality from tumors 3 variation in mortality from diabetes 4 population ages 11 to 15 obese and overweight 5 percentage of smokers 6 consumption of alcohol 7 physical activity 8 spending on the consumption of fruit and vegetables 9 daily average individual consumption of calories subjective well-being 10 people reporting high evaluation of their life as a whole (future time) material well-being 11 variation of disposable income 12 per capita gross level of investment environmental well-being 13 adjusted net saving 14 contribution of renewable sources to energy supply 15 water footprint 16 total emissions (co2 /nox/sox) educational well-being 17 variation of enrollment in the tertiary educational system 18 rate of participation in ongoing education and training activities social well-being 19 persons at risk of poverty 20 rate of dependency among the elderly 21 variation from the national institution index 22 inequality in income distribution 23 differential between the rate of youthful unemployment and the overall unemployment rate political well-being 24 variation from the economist intelligence unit s index of democracy 25 variation from the corruption perceptions index 50% 50% 25% 25% 10% 20% 20% 60% 40% 30% 25% 25% 20% 40% 60% 100% relative weight 15% 15% 15% 10% 15% 5% 10% 10% 5%

Source: BCFN, 2011.

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interview in access the key factor is diversity

Paul Roberts
What are the main reasons the global food system, on a global perspective, is not working properly? What are the key reasons for the unbalances we observe?

I would point to several factors that are destabilizing the global food system. Most obvious are the risks associated with the key agricultural inputs, such as energy, fertilizers, and waterrisks that are only likely to grow as the system strives to feed a population of 10 billion by mid-century. Right now, the biggest input risks relate to energy. Keep in mind that our global food system was designed when oil cost less than $30 a barrelaround a quarter of the current pricewhich encouraged a business model in which low-cost production, not distance, was the dominating factor. But with oil trading at around $110, this system is now under extraordinary strain, with producers and manufactures, unable to easily shrink their market scale, struggling, not always successfully, to reduce costs without compromising quality or safety. Of course, researchers are working hard to find alternatives for oil. Unfortunately, the most successful current alternativebiofuelsmay simply be adding pressure to prices. And, of course, transportation isnt the only high-energy part of food production. Farming, processing, and packaging are all very energy intensive. And, of course, after the risk of energy there is the risk of water. In many areas, soaring crop yields have only been possible through rapid growth in irrigation, a practice that has gradually depleted some regional water sources to dangerous levels in both developing and advanced economies. According to a report by the National Academy of Sciences, roughly one sixth of Chinas population is now being fed with irrigation that cannot be sustained. And we cannot forget the largest inputclimate. Already, the effects of global warming are wreaking havoc in sub-Saharan Africa, where repeated draughts have pushed many millions of citizens into chronic food insecurity. But Africa isnt the only climate victim. The United States, Europe, and Asia are expected to face dramatic changes in rainfall, temperature, and frequency of extreme weather events, such as severe drought and storms, which will significantly reduce crop yields. Add to this the risks as tropical pests migrate into temperate zones in Europe and North America, and climate change could seriously hamper global food output even as population is rising.

Paul Roberts is an American journalist and writer, the author of two nonfiction books: The End of Oil (2004) and The End of Food (2008). He writes about politics and energy issues, and regularly appears on national and international television and radio broadcasts. He is a contributor to the Los Angeles Times, the Washington Post, the Guardian, and Rolling Stone.

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In particular, do you think that the modern and industrialized agricultural approach to food, as a collection of interrelated mutually dependent parts, can effec tively contribute to fighting hunger and malnutrition in the least developed and developing countries? If not, why? This is a very important question. The industrialization of agriculture was instrumental in allowing us to dramatically raise output and lower prices in the last century, and the developing world has unquestionably benefited from these advances. But too often, the developing world benefited as a recipient, not as a participant. Many developing countries lack the capital, infrastructure, and political stability to take part in large-scale industrial production, and are thus cannot compete with the developed world on price. As a result, these countries have failed to develop vital domestic food systems and must import a large share of their food, which only further drains their treasuries of the capital needed for economic developmenta vicious cycle. If we want the industrial model to work in the least developed and developing countries, we need to re-design that model, in terms of scale and technology requirements, to fit the realities on the ground. Personally, I am optimistic that such a re-design is possible. But I also know it will require a lot of new thinking and strong political will, both within the developing world and elsewhere. What kind of agricultural models should be promoted and subsidized, and what should the role of R&D in agrifood systems be in order to make them more sus tainable? The key point here is diversity: as weve seen in the developing world, we need to be promoting a whole spectrum of agricultural models. Consider the question of scale. Today, there are basically just two sizes in food productionthe very large-scale model, which can be quite low cost, but also has many external costs, such as pollution and high-energy and water use; and the very small-scale, which can be better suited to high-quality, or specialty products, or authentic foods, but is often inefficient and costly. What is missing, and what we need to support, is a middle-groundthat is, a mid-size model that can produce food sustainably but also affordably, and which may be better suited to less developed economies. The need for diversity goes beyond scale. We need models for polyculture that is, farms which grow not just one or two crops, but four or five or ten crops, all deployed in ways that help restore soil fertility or control pests naturally, with less need for synthetic inputs. Of course, we need low-capital, lowtech models of agriculture, which are appropriate for Africa and other parts of the developing world. But I think we also need a new model of agricultural

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production for another undeveloped part of the worldurban areas. Today, Urban horticulture is hugely popular in the media, but in reality, it is still practiced mainly in the margins, as a specialty or a novelty. We need models that can bring urban horticulture to the urban mainstream, into schools and resthomes and hospitals, municipal buildings and grocery story rooftops, but also backyards and parksin other words, a human-scale model for human-scale food production. So, as you can see, the future role for R&D is large indeed. Beyond developing these new models of agriculture, we will new elements for those models. Among these are: food crops that require far less water or fertilizers; more efficient irrigation systems; and a more sustainable model for aquaculture (in part because conventional livestock production consumes so much acreage and energy.) And we must find ways to affordably produce food, and especially fresh produce, which are less vulnerable to food-borne pathogens. In my opinion, R&D is the most critical piece of the future agriculture puzzle. Yet, paradoxically, it is the piece most at risk, because spending on agricultural R&D has been decliningpart of a larger trend in all sectors, and one that must be reversed if were going to solve the food challenge of the next forty years. From a market perspective, considering the high level of volatility of the last few years, how do you see the future of access to food? Volatility is quite worrying. As weve seen, prices for food, and for the energy necessary for food production, are now hugely unstable, with major repercussions for producers and consumers alike. In the developing world, food price spikes can be lethal. But even among well-off producers, volatility makes it impossible to correctly anticipate demand or plan production, resulting in over - or under -supply. Volatility also makes investors wary about putting capitalanother key inputinto farms or, importantly, into research, which will have devastating long-term effects. Of course, the causes of volatility are still debated. In one theory, high demand in emerging economies, especially Asia, coupled with biofuels production, has tightened world food markets, making them more prone to price swings and, thus, more attractive to speculators, whose bets can then exacerbates price trends. No doubt there are other factors, and one hesitates to blame a single culprit. But this very complexity undermines a hope for a simple solution, such as a ban on short-selling. I dont agree, as some suggest, that we must simply learn to live with higher volatility, and all the uncertainty that comes with it. But I do think volatility will pose one of the greatest challenges.

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interview agricultural policies must take into consideration the health and well-being of human beings

Ellen Gustafson
We know there is enough food in the world to feed everyone. You have often raised this point. What, then, are the causes of the paradox that has a billion people starving while a billion people are suffering the consequences of diseases linked to an excess of food?

Ellen Gustafson is a young entrepreneur, very well known in her native country (the United States), where she is fighting for a sustainable worldwide nutritional system. She is the founder and executive director of The 30 Project and a cofounder of FEED Projects, LLC, a company that creates good products with the ambition feeding the world.

The fundamental problem continuing to cause both hunger and obesity is that it is difficult, almost everywhere in the world to access nutritious foods. In the developed world, food is abundant, but the most abundant is usually the least nutritious and most calorie dense. In the developing world, where agriculture and markets are failing, you can often still access soft drinks or packaged processed foods, but not the diversity of healthy foods that are needed for good nutrition. Looking back at changes in the global food system, seismic shifts began around 1980 concurrent with consolidation in food and agribusiness. As farms in the developed world consolidated and focused on a few, highly subsidized commodities, food companies pushed for new ways to make food cheaply from those crops. Products like soft drinks, package snacks, and fast food, ballooned with a population that came to assume that cheap, ever-present food was a new right and represented progress. Since 1980 these strong consolidated forces have over-produced corn, soy and wheat, poured those crops into the Western food-stream as highly processed foods and into the developing world in the form of food aid (which dramatically increased at the expense of agricultural aid from 1980 through the mid2000s). Now that we are re-engaging with agricultural development, much of it is led by agribusiness with the goal of opening new markets to its fertilizers, pesticides and commodity seeds. Unfortunately, what we all need is more fruits and vegetables, whole grains and healthy proteins for good nutrition. Until those foods are focus of agricultural systems all around the world, both sides of the malnutrition coin hunger and obesityare likely to persist. In particular, you invite us to view the paradox as a problem relative to the management of a single global system. What does it mean to deal with the para dox in this perspective? What functional implications does it involve?

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The reality of the globalized economy is that we have created supply and demand systems that circumnavigate the eartheven for our breakfast, lunch and dinner. In the US, we import around 60 percent of our fruits and vegetables and we are the largest producer and exporter of corn (most of which is used to feed animals and to make processed foods, drinks, and fuel). We have created food economies and commodities markets that deeply link together many corners of the global system from pricing to agricultural inputs to our actual diets. Today, you can get western foods, like soft drinks, packaged sugary carbohydrates, and fried fast foods almost anywhere (even in the poorest communities) due to an unbelievable logistics network. But, it is much harder, almost anywhere in the world, even in the wealthy west, to find the fruits, vegetables, and whole grains that we should be eating. The paradox of one billion hungry and one billion overweight in the world is that the same structural problems within this global foodsystem that have lead to obesity (over-production of corn, soy and wheat leading to a preponderance of cheap foods produced from those same three ingredients) have also lead to continued hunger (over-production of corn, soy, and wheat dumped as food aid, price fluctuations in commodity markets hurting urban consumers and small farmers, and agricultural development focused on market commodities in lieu of nutrition). Food and agriculture businesses often view the whole world as a single market but the development and policy communities have consistently segmented their work in siloes of agricultural development, health, nutrition, and economic development. The implications to the worlds consumers of a food system that is not rooted in health and nutrition are obvious, but we should also be considering the implications of our current food systemon economic development, environmental health, and water issues in both the West and developing world. Specifically, what choices of agricultural policy do you think western countries should make, and what agricultural models should be promoted in the different geographical contexts? The first step for smart agricultural policy is for western countries to assess the damage that the current agricultural system is doing. We have to take very seriously the effects of agricultures negative externalities on human health, environmental health (especially water and soil) and the economy. Cheap food has driven farmers from land and become an aggravator of our immigration and unemployment issues, as farm and food factory jobs are done by migrant, undocumented, and mostly underpaid workers. Over-pro-

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duction of a few commodity crops has also wreaked havoc on our diet, as what we grow is what we eat. Considering these externalities, agricultural policies should be primarily focused on improved health and nutrition outcomes along with maintaining healthy soil and water, promoting innovation, fair jobs and fair trade. Although most countries will require or desire imported food, there are some realistic pricing factors that should work to promote local and regional purchases and, with it, economic development. Agriculture policy should be focused toward promoting more universal availability of the most nutritious foods, helping farmers weather natures shifts and protecting our vital environmental resources, since without good farmers, water and soil, we cant grow anything. Policies based on these principles are universal and will be as essential for the developed world as for the developing world. You have launched a number of important projects to deal with the parallel prob lems of hunger and obesity. What are the main features and the results of these projects? What do you think can be the contribution of civilian society in sup porting and urging their governments to resolve these serious problems? And what about the role of the agrifood industry? The focus of my work with the 30 Project so far has been to gather the activists, farmers, policy-makers, food companies and chefs from a particular city together, with the purpose of talking about long-term shifts in the food system. I noticed in my work on global hunger, that the main stakeholders who are fighting hunger often work at odds with the main stakeholders who are fighting obesity through sustainable food systems. We need to change the conversation to focus on the system problems affecting both hunger and obesity, not just the outcomes themselves. When people engaged in the food system sit down to talk about what their goals for the food system in 30 years are, they agree: we need better access to healthy foods, more reasonable agriculture policies that protect all farmers as well as eaters, and to re-educate people about food and nutrition. There is still a huge opportunity to engage the public in food system change, and the 30 Project will be launching the ChangeDinner campaign with that goal. If we work to change our food systems through consumer shifts, especially in the west, along with policy changes, we can push to shift what is grown and how. If people view their table as an advocacy platform, food purchases and mealtime become great tools for social change. Companies have a huge opportunity to change food systems, as consumers are demanding better food. The USDA My Plate says half of our plates

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should be fruits and vegetables and 70% of consumers say their shopping decisions are affected by how food is grown and raised (according to a U.S. Farmers and Ranchers Alliance Poll). Entrepreneurs are cropping up to fulfill the demands of healthier, better-raised foods, so established food businesses should work to improve their practices and meet consumer demands or be eaten.

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action plan
facilitate the economic development of the poorest countries
Hunger is a direct consequence of poverty. To alleviate poverty, we need to develop and maintain clear and reliable pathways for sustainable development and to define and disseminate solutions and tools for developing countries in the key sectors of economic growth. Agriculture is the sector that makes the greatest contribution to income growth among the weakest populations in developing countries. It is often the most important sector and the one toward which investment should be targeted to help build regulatory frameworks and good incentive systems.

reinforce worldwide governance mechanisms

The special nature of food (which cannot be reduced to a commodity despite its abundance in recent decades) and the failure of distribution mechanisms make it necessary to get past the paradigm of a self-regulating market. Global policies must be coordinated and unilateral protectionist policies must be reduced over time. This requires at least four actions: building a transparent, responsible trading system based on multilateral rules that can assure greater access to food worldwide. In general, one would hope for a reduction in the use of import barriers, export subsidies, and other trade restrictions; avoiding competition between biofuels and food in growing crops; regulating financial speculation on food commodities. Despite the ongoing debate about the role speculation may play in the increase in agricultural prices, we can state with relative certainty that such speculation could have amplified short-term volatility; creating a multilateral system for food reserves and improving the transparency of flows and inventories. There is a strong connection between changes in inventories and the price trends for food commodities. In particular, over a sufficiently long time span, a reduction in the stock-to-use ratio of cereals tends to correspond to an increase in prices, while prices tend to decline with increases in the stock-to-use ratio.

facilitate new approaches and tools for measuring and promoting well-being
Policy must reflect the fact that well-being encompasses far more than one simple economic dimension and depends on the status of many economic, social, political, and environmental factors that influence peoples lives. Policy

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must also acknowledge that present choices can have profound consequences for future well-being. The creation of the BCFN dual indices is a small step in that direction. In the end, however, better indicators are not enough; they are simply one means to improve the quality of public decision making.

manage food consumption styles

Government action and efforts to guide nutritional patterns according to the demands of sustainability are becoming crucial variables in economic policy. This is taking firm shape in some developed countries, which are facing a health crisis from the spread of metabolic, cardiovascular, and tumor-related diseases caused by harmful eating habits. This initiative will also become crucial in developing countries, mainly because of the impact it will have on global production equilibrium in agriculture.

table of contents
introduction
Paying Whats Fair by Carlo Petrini

facts & figures the double pyramid: healthy food for people, and sustainable food for the environment
3.1 3.2 3.3 3.4 3.5 The Food Pyramid as an Educational Tool Some Studies of the Mediterranean Diet The Environmental Pyramid The Double Pyramid for Growing Children The Double Pyramid over the Long Term

toward sustainable agriculture

3.6 3.7 Current Leading Agricultural Paradigms The Sustainability of the Systems Used to Grow Durum Wheat: the Barilla Case

the water economy and the emergency it confronts

3.8 3.9 3.10 3.11 3.12 The Availability of Water: from Abundance to Scarcity The Right of Access to Water: Reality and Prospects Choices and Behaviors for Sustainable Water Consumption National Water Footprints and the Trade in Virtual Water Water Privatization and its Implications

interviews
The Challenging Transition Toward Sustainable Agriculture by Hans R. Herren Virtual Water Between Underconsumption and Poor Management by Tony Allan

action plan

 3. food for sustainable growth

Food for Sustainable Growth explores the challenges involved in making agriculture more sustainable, beginning with personal and collective lifestyle changes that help safeguard the environment and natural resources. The objective is to improve both human survival and the survival of the planet.

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3. food for sustainable growth Paying Whats Fair

Carlo Petrini

Sustainability is a concept bound up with an age-old idea: time. Its a concept that tells us just how long something can last. Its a fine word, and sustainability has a fine etymology: it originates with reference to one of the pedals of a piano, known in English as the sustain pedal. That pedal is pressed when the piano player wishes to prolong a note, to make it endure. In fact, its significant that the carlo petrini is the presiFrench term is durabilit, capacity to endure. dent of the international association, Slow Food. The clear understanding that the things we plan to do In the 1980s, he founded (personal and private actions as well as public or business Arcigola, which in 1989 became the international projects) must be able to last over time and on a number of association, Slow Food. different levels (social, economic, and environmental) is one Out of his ideas sprang the first University of Gastroof the crucial factors in the future of all human pursuits. nomic Sciences and Terra Today sustainability is a very widely used term; were all Madre (Mother Earth), a network of more than thinking a little more about the future. Many of us think 2,000 food communities about it constantly, because the very idea of sustainability that brings together farmers and producers of food contains a germ of the understanding that the future doesnt from around the world. really belong to us, any more than natural resources do. The future and natural resources are both shared patrimonies, and our generation has the duty of preserving them for the generations still to come. We have certain responsibilities toward those generations. And that is yet another factor: the idea of responsibility toward those who are not yet among us. We have a responsibility to those who will one day come into this world with the same rights that we enjoy: the rights to enjoy flavors, climates, panoramas, health, and quality of life. But thats not all. We also know that if we wish to protect everything we enjoy ourselves and hope to pass on to future generations, then a single level of action will not suffice. What we need are certain high-level strategic approaches on the part of the governments of the world, along with international treaties and national laws. Along with those factors, it is crucial to be able to rely upon daily acts, indi-

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vidual choices, and the yes-and-no decisions that each of us can make, reordering the priorities of our everyday lives and business. This means that we must put emphasis not only on saving time and making money, or vice versa, making time and saving money. Instead, we should consider the time we spend choosing the food we will eat as time invested in the care of our health and the state of the environment at large. We must also consider the money we spend on that food as an indicator of our involvement in a profession, the profession of farming. Farmers should be repaid for the many services that they perform for society and for the Earth, not just for the products that they put on the market. This money pays for certain values, not just for the price of a product. In the general context of sustainability, food is a crucial factor. In terms of sustainability and food, the private level, where the actions of individuals take place, is certainly the forum for the most active and conscious decision making. In contrast, the level of politics remains particularly vague and distracted; in many cases, it is even genuinely ignorant. Agriculture is frequently thought of by politicians as a stand-alone sector, a mere producer of goods, of commodities. To politicians, those commodities have only one metric of value, which is the prices they fetch, or else the prices that are influenced by various corrective supports and regulations imposed from above. (Even worse, those prices can be influenced by financial speculations.) All too often, we think of agriculture as a productive sector devoid of the other values that actually do accrue to it. And those factors, as it happens (and this is no accident), are profoundly bound up with the very idea of sustainability. For instance, consider the care of soil and farmland. That care involves a number of skills and bodies of knowledge: how to keep soil alive by the very act of farming, the care taken of a vital biodiversity that can be seen at a glance by observing the plants (whether or not they are cultivated) and the animals (wild or bred), a care that is also concealed in the countless array of microorganisms, the micro-life that makes farmlands fertile and productive, that keeps them rich and abundant for the future, that makes them last. Unfortunately intensive monocultures that are planted and harvested for many years without interruption permanently undermine both farmland and biodiversity. The failure to properly rotate crops and the misuse of fertilizers and pesticides only make matters worse. Often these practices are justified by saying that they are necessary if we wish to increase production. But production for the mere sake of production is not a sustainable activity and, as we shall see, its not even necessary. Equally unnecessary and unsustainable is the unbridled spread of concrete over the landscape, which cannot be compatible with the conservation of increasingly endangered natural and agricultural systems. A landscape that is covered with cement can never become fertile again. It is lost forever, and we can never hope to restore it for the use of future generations.

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Fertile soil and biodiversity, moreover, are prerequisites for abundant and healthful food supplies. Those supplies should be characterized by diversity in accordance with the climates and the crops, thus ensuring that they are sustainable foods. The heroic determination shown by some in the defense of small local agricultural economies, especially those at risk of complete extinction, is much more than a mere exercise in weak-minded nostalgia or the epicurean activity of people who like to consume rare, high-quality foods. Actually that defense is a sustainable action that is valid for all kinds of food production. It is a defense of biodiversity, of communities that are perfectly in harmony with the environment, and all the various factors that go along with that. By this, we are referring to the diversity of flavors and therefore of cultures: further guarantees of sustainability for the future progress of human life on this planet of ours. Because if theres no diversity theres no identity; if theres no exchange, theres no reciprocal enrichment; if serial standardization triumphs, then we become poor and defenseless, hesitant in the face of the future, with no confidence in our own durability. These are only some of the leading values that we ought to pay forboth as individual citizens when we do our grocery shopping, and as a society, a collective, when we levy taxes. And we should value good agriculture that respects the natural setting in which it operates. It should be done through serious and carefully monitored parameters. It should further mean including multifunctionality in our evaluation of the work done by farms. This should go well beyond lip service: it should take the form of actual strict regulations. And heres why: multifunctionalityall these valuesalmost always translates into a more beautiful landscape, panoramas which positive anthropization (the transformation or adaptation of the environment to meet the needs of humans, or by human activity) has rendered even more pleasant and charming. Places where it is unmistakable that someone is taking care of them. Care for a territory is just one more prerequisite of sustainability, and it is a product of the love that we feel for the things among which we live, the things that we use, the things that we transform with respect and which can therefore be perpetuated. Such care and all the other values are almost automatically translated into beauty but also into goodness. They result in the capacity to take the greatest possible benefit from a product, building upon its basic characteristics through agricultural techniques and techniques of transformation, and making its unique and distinctive flavor known far and wide. Beauty and goodness are therefore integral parts of the concept of sustainability. It is time for us to be done, once and for all, with the idea that ethics and aesthetics are two separate fields, two distinct ideas, two incompatible philosophies of life. Ethics and aesthetics, in the context of sustainability, are so complementary that they ultimately become the same thing, a single lighthouse, a guiding beacon.

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Out of this thinking we can draw up a list of commandments: dont pollute, dont overuse chemicals, dont do harm in the name of mere profit to our resources, to the land, and to farmers. Dont destroy fertile farmland. Defend biodiversity. Stimulate local economies, traditional crops and products, and small-to-medium-sized farming operations in challenging, isolated, or underfed areas. Establish stronger and closer ties between city-dwellers and farmers and agriculture. Encourage young people to go back to the land. These, then, are a few of the commandments that should be observed in the name of sustainability, a few actions that can be carried out on its behalf at all the levels mentioned above. Actions that, moreover, go hand-in-hand with the beautiful and the good, in a world that actually produces too much food (the total quantity of food produced on Earth is more than enough to feed all the inhabitants of this planet) but wastes nearly as much as it produces. After all, official figures on food waste are absolutely intolerable, not to mention how offensive they are in light of the billion or so people who struggle every day with outright starvation and malnutrition. Here are a few more commandments: produce a little less food, produce better quality food, distribute intelligently, rooting production and consumption as far as possible in the various different territories, acting first and foremost at the local level. To come back to individual city dwellers, the fact that beauty and goodness are at the same time consequences and prerequisites of sustainability can only encourage us to change our routines, beginning with our food choices and our everyday grocery shopping. Very soon, we will discoverif we havent alreadythat eating can be as pleasurable and healthful an activity as it is a sustainable one. Moreover, we can do our part easily without making great sacrifices. Indeed, doing our part can add small but significant portions of happiness to our lives. We can do so by learning to pay whats fair: the right price, taken together with values. Eating is an agricultural act, wrote the farmer-poet Wendell Berry. We can add to that thought that eating is an ecological act, an act that affects the landscape, an act of profound respect for the diversity of cultures, and a political act. It must also become a sustainable act, because eating is the act that is most directly and intimately linked with everything that surrounds us. Those links are both evident and hidden because they remain impenetrable at the current level of scientific understanding. But the food we eat is surely bound up with the vast and complex system that is the planet in which we live, the biosphere. In other words, the planet is our home, but we are not just its tenants. We are an integral part of it, because we are part of that system. For too long now we have pretended that we are somehow an extraneous entity on that planet. We are guests housed here, and everything on the planet is at our disposal, until

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we run out of itwhich has been our reason for failing to act in a sustainable manner. But to do so, to harm our Earth and act so as to keep it from lasting, also harms us humans. And so even the selfish considerations that have always characterized us as a species demand that we change so many of our choices, beginning precisely with those choices that really have become insignificant for many of usfar too many of usjust because they are everyday decisions. Among them is the decision of what to eat each day. But that is actually a decision that has the power to change the world.

agrarian landscapes: tokyo

The production of food crops in industrial plants is an increasingly concrete prospect in Japan, where the aging of the farming population is taking on critical aspects: with an average age of 65, with only 5% under 40. Production under controlled conditions furthermore makes it possible to stabilize product quantity and quality.

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3. food for sustainable growth

9 bILLIOn
+
2012

In 2050, the population of Earth will be 9 billion, compared to 7 billion today

+ bILLIOn

THIRSTY PEOPLE ON EARTH

In 2025, 3 billion people will lack adequate drinking water

30%

2050

IMPACT OF AGRICULTURAL ACTIVITY

33% OF 80% PRODUCTION WATER CONSUMPTION

- 8/20% ARAbLE LAnD
By the year 2050 the amount of arable land will diminish due to climate change and the geography of agricultural production will be radically modified

GREENHOUSE GASES

Farming is responsible for 33% of the global production of greenhouse gases and 80% of water is used to produce food.

- 45% OF GREEn LUnGS

Roughly 43% of all tropical and subtropical forests and 45% of all temperate forests have been converted into farmland

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LIVESTOCK bREEDInG

FOR 1/3 FARMLANDANIMAL FEED 26% USE OF LAND THE PRODUCTION OF FOR PASTURAGE
Livestock are the main users of agricultural land: roughly 26% of land is used for pasture or grazing, while a third of all farmland is cultivated for the production of animal feed.

5,400 LITERS

2,600 LITERS

1,500 LITERS

RESOURCES In DAnGER OF EXHAUSTIOn

32% of the fishing areas have been over fished, impoverished, or exhausted entirely

32% FISHInG

COnSUMPTIOn OF VIRTUAL WATER

The consumption of virtual water with a diet rich in meat is close to 5,400 liters, while a diet composed of cereals, fruit, vegetables, and fish uses somewhere between 1,500 and 2,600 liters

-THE EMISSIONS 30% OF

1%
2012

3.8%
2030

OF CO2 IN AGRICULTURE
The use of climate friendly farming practices can reduce CO2 emissions generated by farming by 30%

USE OF bIOFUELS
Currently 1% of all farmland is used for biofuels. By 2030, between 2.5% and 3.8% of all farmland will be used for biofuels

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the double pyramid: healthy food for people, and sustainable food for the environment
Its impossible to get a grip on the topic of development unless we put into the foreground all the pieces that make up the vast system that transports food from farms to tables. The reason is simple: it is from this agro-alimentary sector that many of the problemsand a great many of the solutionsof sustainability first arise. Further, the sustainability of the agro-alimentary chain of production depends not only on the commitment of the farmers, the producers, and the distributors, but alsoand perhaps even more soon the behaviors of individuals and families, who have such a powerful effect on the entire market with the daily choices and decisions they make. But there is a key difference between the food sector and other sectors. In transportation, for instance, your having a car interferes a little bit with my enjoyment of my own car, and millions of other carsand the traffic jams and congestion they createcan make owning a car almost pointless. In other words, the collective advantage is frequently at odds with individual advantages. But in the food sector, asking people to be more responsible in no way diminishes their well-being. Quite the opposite, in fact: it is fair to say that the reduction of ones nutritional environmental footprintwhich benefits everyonenot only incurs no additional costs, it actually benefits ones own health as well. In fact, the BCFN has analyzed the data available concerning the ecological footprint of certain foods and has discovered unexpected and interesting environmental qualities of those products that nutritionists tell us we ought to eat more of. It has been shown that if you adopt as a regular menu the choices that appear on the classic food pyramid (which places at the top the foods that should be consumed less frequently and at the base the foods that it is healthiest to eat in abundance), not only do you respect your own health, but also the health of the planet we inhabit. In 2010 the BCFN created and published the Double Food and Environmental Pyramid, a communications tool for linking the nutritional aspects and the environmental impacts of food. In 2011, on the basis of further analysis, the Double Pyramid was updated and redesigned in the version shown in Figure 3.1. In the food pyramid on the left, the level of each food category suggests the proper frequency of consumption. While it is crucial to ensure the greatest possible variety in ones diet, the foods closest to the top of the pyramid should be eaten least frequently, and the foods at the base of the pyramid should be part of every meal. The food/nutritional section of the Double Pyramid was built with an eye to the model of the Mediterranean diet, which is the traditional approach to food adopted in such Mediterranean basin countries as Italy,

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environmental pyramid
low
Sweets Red Meat Cheeses Eggs White Meat Fish Cookies Milk Yogurt

high
Red meat Cheese Fish

su mp ti

on

ge

Bread, Pasta, Rice, Potatoes, Legumes Fruit Vegetables

su g

high

low

food pyramid
figure 3.1
The model of the food and environment double pyramid Source: BCFN, 2011.

Spain, Portugal, Greece, and southern France. The Mediterranean diet stands out for its completeness and its remarkable nutritional balance. It has been recognized by a number of nutritional scientists as one of the finest diets available, hands down, when it comes to physical health and the prevention of chronic diseases, especially cardiovascular diseases. The new portion of the Double Pyramid is the environmental pyramid, shown on the right in figure 3.1. It was built by reclassifying the same foods that appear in the nutritional pyramid in terms of their impact on the environment: those closest to the base have the greatest environmental impact, and those closest to the top are most eco-sustainable. This pairing of the two pyramids shows that the sequence of foods is roughly the same, though inverted; this correlation, in fact, becomes unmistakable if you turn the environmental pyramid upside-down. The double pyramid makes it easy to see that the foods recommended for greatest consumption are, generally speaking, also the foods that result in the smallest and most limited environmental impact. Conversely, the foods that are recommended for the most restricted consumption are also the foods that have the greatest environmental impact. This brings together, in a single food model, two different but equally significant objectives: personal health and safeguarding the environment.

en

Fruit Potatoes Vegetables

v ir

Oil

on me n

dc

ste

tal

Bread, Pasta Milk, Rice, Cookies

im pa c

Oil Poultry

on

Legumes, Sweets Yogurt, Eggs

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3.1 the food pyramid as an educational tool In recent years, there has been a striking increase in the number of people who can freely choose what, and how much, they eat. These people, however, are at great risk of developing imbalanced diets because they lack an adequate food culture or widespread nutritional guidelines that are clearly understood and easy to apply. One unmistakable indicator of this fact is the recent galloping spread of pathologies caused by excessive consumption of the wrong kinds of food (as well as a concomitant decline in physical activity among all age groups). The American physiologist Ancel Keys, who published the best-seller Eat Well and Stay Well in 1958, was one of the first to explain to a worldwide audience why people were longer-lived in certain regions. The secret of longevity lies in the balanced consumption of all natural foods, with an emphasis, in terms of frequency and quantity, on fruit, vegetable, and grain products. At the same time, it is important to reduce the consumption of foods rich in saturated fats, meats, and sweets. In particular, Keys discovered that it was due to this diet (which he dubbed the Mediterranean diet) that rates of death from heart disease in the countries of southern Europe and North Africa were much lower than the rates found in English-speaking and other northern countries, where the diet tended to be rich in saturated fat. Unfortunately, since then the Mediterranean diet, in Italy and elsewhere, has been challenged by competition from global food models (first and foremost, American fast food). We hope to help reverse this sad trend with the Double Pyramid, which has two strengths: it is an excellent synthesis of the principal knowledge developed by medicine and by food studies, and it is a powerful educational tool for changing patterns of consumption, thanks to its simple and intuitive graphic nature. the base of the pyramid. Lets take a more detailed look at the food pyramid. The general pattern is obvious: at the base we find plant-based foods, typical of the dietary habits of the Mediterranean region, that are rich in nutrients (vitamins, mineral salts, water) and protective compounds (fibers and plantbased bioactive compounds). As we move upward, we find foods with progressively greater energy density (very much present in the American diet), which ought to be consumed in smaller quantities. The first level contains fruits and vegetables, which are foods with limited caloric content that provide the body with water, carbohydrates, vitamins, minerals, and fiber. Protein and fat content is very low. The carbohydrates found in fruit and vegetables consist for the most part of simple sugars, which can be easily utilized by the body, and small amounts of starch. Plant-based foods are also the chief source of fiber, which helps regulate intestinal function and makes us feel full, which contributes to lower consumption of high-energy foods. Continuing upward, we find pasta, rice, potatoes, bread, and legumes. Pasta

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is rich in starch, with a substantial protein content and a negligible lipid ratio. Rice, like all cereal grains, has high starch content, low protein content, and even lower fat content. Rice also contains small quantities of minerals and B vitamins. Potatoes have very low fat and protein content, while they are rich in starch and carbohydrates. They are also a very significant source of potassium, phosphorus, and calcium. Bread is a staple, because it contains the necessary level of carbohydrates to provide the human body with the ideal fuel. Last of all, legumes are the highest-protein plant-based foods known (proteins of excellent quality) and also contain lots of fiber. Legume proteins are rich in essential amino acids and are easily digested. Legumes are also an excellent source of B vitamins (especially B1, niacin, and B12) and such minerals as iron and zinc. They are a good alternative to meat. One level farther up we find extra-virgin olive oil, which is composed of triglycerides (rich in monounsaturated fatty acids), essential fatty acids, vitamin E, polyphenols, and phytosterols. Just beyond that we come to milk and yogurt. Milk is almost 90 percent water, with trace contents of high-quality proteins, mostly easily digested short-chain saturated fats (many of which are also rich in animal fats that encourage the rise of plasma cholesterol levels and should therefore be consumed in moderation) and sugars (chiefly lactose, which is made up of galactose and glucose). The vitamins found in the largest quantities in milk are A, B1, B2, B12, and pantothenic acid. Milk is also the chief source of calcium in the human diet. Yogurt, like milk, is a food with high nutritional value. It may be more easily digested than milk by people who suffer from lactose intolerance. the second part of the pyramid. At the next higher level, we find a vast assortment of diverse products, such as cheeses, white meats, fish, eggs, and cookies. Cheeses contain proteins and fats, but practically no carbohydrates at all. Cheeses also contain significant amounts of calcium in a form that is well absorbed into the bloodstream. B vitamins are present in small quantities and there is a good quantity of vitamin A. Then come fish and eggs; fish contain proteins with an elevated metabolic value and variable quantities of fats up to 10 percent of the weight of the food. Fish fats contain polyunsaturated fatty acids, which belong to the category of essential fatty acids; the family of the omega-3 fatty acids, in particular, is considered to be beneficial in the prevention of cardio-circulatory diseases. Eggs contain proteins with such a high metabolic value that for years the protein composition of eggs was the benchmark used to evaluate the proteins of other foods. Cookies are composed of a wide variety of ingredients with different nutrient and energy content. In general terms, there is a significant content of simple sugars, while the fat content is quite variable, on average between 9 percent and 25 percent.

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The consumption of meat, especially lean meat, is important because it helps to provide high quality proteins, which are crucial to childrens growth and to the formation of muscles. About half of the proteins in meat consist of amino acids that are essential to the human organism. We also find B vitamins (in particular, B12), selenium, copper, and zinc. Fat content is variable. It can range from virtually zero to almost 30 percent, depending on the kind of meat. The fats are mainly saturated and monounsaturated, with a small proportion of polyunsaturated fats. White meats are therefore recommended and the consumption of red meat should be reduced. This is evident in the many versions of the food pyramid developed by national and international institutes that place red meat at the very top of the pyramid, along with sweets (which are rich in fats and simple sugars) and should be consumed in moderation. 3.2 some studies of the mediterranean diet From an analysis of the many reference studies, we can see that one protective factor against many of the most common chronic diseasesespecially cardiovascular diseases and tumors, but also Parkinsons and Alzheimers diseasesis the adoption of a way of eating based on the Mediterranean nutritional model, which is the same model employed by the BCFN for the construction of the food pyramid. That diet is characterized by high consumption of vegetables, legumes, fresh and dried fruit, olive oil, and cereal grains (which in the past were largely unrefined); moderate consumption of fish and dairy products (especially cheese and yogurt) and wine; and limited consumption of red meat, white meat, and animal fats. The consumption patterns typical of the Mediterranean diet in fact appear to be consistent with the nutritional guidelines set forth by the most respected international scientific societies and institutions working on the most common pathologies of our time (in particular, cardiovascular diseases, cancer, and diabetes). The nutritional value of the Mediterranean diet was scientifically proven by the well-known Seven Countries Study conducted by Ancel Keys. In that study, the diets adopted by various populations were compared to determine their benefits and critical points. The study demonstrated associations between types of diet and the risk of developing chronic diseases. It also showed that elevated levels of saturated fatty acids in the diet and of cholesterol in the bloodstream are factors capable of explaining the difference in rates of mortality and predicting future rates of coronary disease in the populations studied. From Keyss study to the present day, extensive research has analyzed the links between ways of eating and the rise of chronic diseases. Beginning in the mid1990s, a series of studies has also shown a strong correlation between diet

new places of knowledge

Community gardens and vegetable patches are becoming, especially in big cities, increasingly common, and not only for food production, but also as means for teaching about food and food production. Popular with families and used by schools, they offer a chance to experience, in the field, where food comes from, for people who live in major urban areas.

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figure 3.2
The graphic representation of food advice issued by the USDA Source: USDA, 2011.

and longevity. For instance, that a study appearing in the PubMed scientific database, over a three-month time span, found some 70 scientific publications focusing on the Mediterranean diet. Those publications presented the findings of clinical or epidemiological studies showing that following the Mediterranean diet resulted in measurable benefits in a broad array of areas of human health, including metabolic conditions, cardiovascular diseases, neurological or psychiatric diseases (for instance, Alzheimers disease), respiratory diseases or allergies, sexual disturbances (both female and male; for instance, erectile dysfunction), as well as a number of oncological (cancer-related) pathologies. A recent broad-based European study by EPIC (European Prospective Investigation into Cancer and Nutrition), which evaluated 485,044 adult subjects over a period of about nine years, showed that strict adherence to the Mediterranean diet was associated with a significant reduction (-33 percent) of the risk of developing a gastric carcinoma. Last of all, it is worth noting that research shows that the Mediterranean diet has a positive impact at all ages, from the prenatal period into advanced old age. from the pyramid to the dinner plate. A major international effort is under way to make the arguments of the food pyramid and the Mediterranean diet increasingly accessible to ordinary people. One example is what the United States

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121

Department of Agriculture is doing in America with the USDA food plate, a different visual translation of the contents of the Food Pyramid (figure 3.2). However a healthy diet is depicted, it is clear that a large share of the most respected scientific research on the relationship between diet and chronic diseases shows, beyond any reasonable doubt, that the Mediterranean dietary model must be taken as a point of reference for proper nutrition and that healthy lifestyles should be associated with that diet. Figure 3.3 shows the guidelines for the prevention of cardiovascular diseases, diabetes, and tumors. 3.3 the environmental pyramid The food pyramid based on the Mediterranean diet is clearly among the healthiest dietary approaches available. But what about its impacts on the health of the environment? The BCFN Environmental Pyramid is an effort to illustrate those impacts. It was constructed from research tracing the environmental effects of various food types using the life-cycle assessment (LCA) method. LCA analysis follows a product or service throughout its entire life in order to evaluate the energy and environmental loads imposed by its production. LCA begins with the initial cultivation or extraction of raw materials, and follows them through processing, fabrication, assembly, transport, distribution, use, reuse, recycling, and final disposal. The LCA approach offers the most objective and complete evaluation possible of the system (figure 3.4).

healthy diet and lifestyle

30 minutes of physical activity every day 1 Avoid conditions of overweight and obesity 2 Avoid the excessive consumption of alcohol Prefer complex carbohydrates and increase the consumption of unrefined cereal grains 3 Dont smoke 7 Increase the consumption of legumes 8 4

5 Adopt a balanced diet Increase the consumption of fruit and vegetables 9

Consume 23 portions of fish every week Restrict the consumption of meat and poultry to 34 portions a week

Prefer plantbased condiments

10

11 Restrict the consumption of foods with high fat content Restrict the consumption of foods and beverages with high sugar content 15

Restrict the consumption of fried foods

12

13 Restrict the added consumption of salt

14

16 Avoid the daily use of food supplements

figure 3.3
Scheme of medical guidelines Source: BCFN, 2009.

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1. Cultivation 2. Transformation

5. Cooking

3. Packing

4. Transportation

figure 3.4
The LCA method of analysis is regulated by the international standards ISO 14040 and 14044 Source: BCFN, 2011.

20,000 8,000 4,000

2,000

Beef Cheese Butter Eggs Pork Fish Rice Poultry Oil Dried Fruit Pasta Breakfast Cereal Sweets Cookies Legumes Margarine Milk Yogurt 1,000 Bread Fruit Vegetables Potatoes

3,850 3,000 2,300 2,200 2,000 1,900 1,600 1,400 1,300 1,100 900 670 665 600 0 2,000 4,000 6,000

4,640 4,250 3,900 3,600

8,600

9,500

26,000

3,200

legend
average value + cooking cooking max

min

8,000

25,000

45,000

figure 3.5
Carbon footprint of foods (gCO2 eq per kg or liter of food) Source: BCFN, 2011.

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environmental indicators. A close look at the chains of food production reveals that the chief environmental loads are represented by three factors: the emission of greenhouse gases (which help drive climate change), the utilization of water resources, and the capacity to regenerate the territorial resources that are utilized in producing food. To measure greenhouse gases, BCFN used the carbon footprint, measured in equivalent CO2 mass (figure 3.5). A foods water footprint (or virtual water content) accounts for the consumption and means of use of water resources. It is measured in volume (liters) of water (figure 3.6). Finally, the ecological footprint of a food measures the quantity of biologically productive land (or sea) necessary to supply resources and absorb the emissions associated with a system of production. It is measured in global square meters or hectares (figure 3.7). It important to note that the impacts considered in the BCFN environmental pyramid are not the only ones generated by the food production sector. They are, however, the most significant impacts. In the interests of brevity and clarity, BCFN chose to construc the environmental pyramid using only the ecological footprint. We include the descriptions of the carbon and water footprints to make it clear that a truly complete accounting of the environmental impacts of food would require using multiple lenses.

10,000

Beef Dried Fruit Oil Cheese

15,500 8,560 5,555 5,000 5,000 4,800 3,900 3,400 3,300 3,160 3,140 1,775 1,300 1,000 1,000 930 920 900 240 0 2,000 4,000 6,000 8,000 / 15,000 min max 1,360

5,000 4,000

Butter Pork Poultry Rice Eggs Legumes Sweets Pasta Cookies Bread Milk Yogurt Fruit Potatoes Vegetables

2,000

legend
average value

1,000

Breakfast Cereal

figure 3.6
Water footprint of foods (liters of water per liter or kg of food) Source: BCFN, 2011.

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100

Beef Cheese Butter Fish Margarine Oil Pork Poultry Legumes Sweets Yogurt Eggs Pasta
15 15

93 71 40

109 86

50

66 28

25

19 16

25

18

16

15

Milk Cookies Breakfast Cereal Rice Bread Fruit Potatoes Vegetables

15

13 13

13

legend
average value + cooking cooking max.

7 4

12

min.

3 20 30 40 50 60 70 80 90 100 110 / 160

10

figure 3.7
The ecological footprint of foods (global square meter per kg or liter of food) Source: BCFN, 2011.

the influence of food choices. Figure 3.8 gives an idea of the degree to which individual food choices can affect the ecological footprint by comparing two different daily menus. Both menus are balanced in nutritional terms, both for caloric content and nutrients (proteins, fats, and carbohydrates). In the first menu, however, the proteins are from plants (vegetarian menu), while in the second menu the proteins are for the most part of animal origin (meat menu). The meat menu has a threefold greater environmental impact than the vegetarian menu. Imagine how great a reduction of environmental impact an individual could bring about by merely modifying his or her eating habits! Lets take a sample weeks diet, and imagine three different dietary regimens, with varying frequencies of a vegetarian menu as opposed to a meat menu. If we limit the consumption of animal proteins to just twice a week, as recommended by nutritionists, it is possible to save as much as a total of 20 square meters a day. 3.4 the double pyramid for growing children The generic Double Pyramid is aimed primarily at adults, so we also explored the concept of the Double Pyramid for growing children and adolescents.

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2,030 2,095
Breakfast

vegetarian menu
total kcal g CO2 eq

14% 30% 56%

Midmorning snack 1 Portion lowfat yogurt 1 Fruit Lunch

Protein

Fats

Carbohydrates

1 Portion of fruit (200 g) 4 Zwieback toasts

1 Portion of pasta with fennel 1 Portion of squash and leek quiche

195 g CO2 eq

210 g CO2 eq

555 g CO2 eq

Snack 1 Portion of lowfat yogurt 1 Packet of unsalted crackers 145 g CO2 eq

Dinner 1 Portion of vegetables: steamed green beans (200 g) and potatoes (400 g) with grated cheese (40 g) 990 g CO2 eq

2,140 6,455
Breakfast

meat menu

total kcal g CO2 eq

Protein

15% 25%
Midmorning snack 1 Portion of fruit (200 g) 135 g CO2 eq

Fats

Carbohydrates

60%
Lunch

1 Cup of lowfat milk 4 Cookies 250 g CO2 eq

1 Portion of cheese pizza, mixed green salad 1,720 g CO2 eq

Snack 1 Portion of lowfat yogurt

Dinner 1 Portion of vegetable soup/pasta with peas 1 Grilled beef steak (150 g) 1 Slice of bread 4,210 g CO2 eq

140 g CO2 eq

figure 3.8
How the ecological footprint varies as a function of food choices Source: BCFN, 2011.

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Breakfast 20% Dinner 30%

Midmorning snack 5%

Afternoon snack 10%

Lunch 35%

figure 3.9
The recommended breakdown of daily caloric intake for children and adolescents Source: BCFN, 2011.

There are three critical factors that should be avoided during adolescence to lower the risk of chronic disease during adulthood: developing bad eating habits, consuming alcohol and tobacco, or gaining excessive weight; adopting a sedentary lifestyle, such as spending ones free time watching TV, playing videogames, or in front of the computer instead of engaging in physical activity; neglecting prevention or ignoring risk factors, such as by failing to monitoring the adolescents weight or scheduling checkups with a pediatrician. In combination these three factors can rapidly produce obesity, insulin resistance, dyslipidaemia, and arterial hypertension. They can also generate longterm effects, such as an acceleration of the processes that lead to diabetes and to cardiovascular diseases in adulthood. poor nutrition and chronic diseases. But even considering diet alone, it has been clearly shown that there is a strong link between poor nutrition, excessive body weight, and increased risk of contracting chronic diseases. While the public is fairly well aware of this correlation in the case of adults, the crucial importance of diet in the prevention of many diseases in children and young people is less widely understood. Figures 3.9 and 3.10 illustrate the daily allocation of calories and the makeup of an optimal weekly diet, based on nutritionists and pediatricians understanding of the nutrients needed for proper development in various phases of growth.

making farms and forests coexist

Teaching how to make farm crops and forest harvests coexist is the objective of the World Agroforestry Centre (ICRAF), which works in Kenya to spread land management models designed to ensure better living conditions for the poorest farmers. Agroforestry methods improve soil and water availability, while at the same time, increasing the variety of food, fuel, and fodder provided by farms.

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Consumption of cereal grains (bread, pasta, and rice), especially whole grains

Consumption of fruit and vegetables

Consumption of milk and dairy products

EVERY DAY Consumption of meat

EVERY DAY Consumption of fish

EVERY DAY Consumption of cheese

2/3 TIMES A WEEK Consumption of eggs

AT LEAST THREE TIMES A WEEK Consumption of legumes

TWICE A WEEK

ONE EVERY TWO WEEKS

AT LEAST TWICE A WEEK

figure 3.10
The optimal weekly breakdown of food intake for children and adolescents Source: BCFN, 2011.

A proper diet will contain a lot of day-to-day variety: a mixture of foods that includes plant-based foodstuffs (fruit, vegetables, legumes, cereal grains, seeds, etc.) and animal-based foods (meat, cheese, dairy products, ham, etc.). Despite these recommendations, numerous international studies show that poor eating habits are widespread among children aged 6 to 10 and that those habits tend to undermine proper growth and predispose them to weight gain. Only 1 percent of all children consume portions and varieties of food that are nutritionally optimal. The same studies also show that the daily caloric intake observed for most school-aged children is not only greater than their needs, but is also prin-

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cipally oriented toward the consumption of fats and sugars, instead of fruits and vegetables. This is especially true of children with a tendency toward obesity. Based on the information weve described in these pages, the BCFN has constructed a nutritional pyramid that is used in the development of the Double Pyramid applicable to children (particularly from the age of two) and adolescents (figure 3.11). (The needs of youth are comparable in terms of frequency of consumption to those of adults). As with adults, the diet for children and adolescents ought to be based prevalently on plants, and in particular the various cereal grains, especially whole and unrefined grains, as well as fruits and vegetables. These are very important because of their fiber content and the presence of nutrients that protect against disease. Moving up the pyramid, we find milk and dairy products (preferably in low-fat versions), as well as meats and fish, until we finally come to products with higher fat and sugar content. For these products, a relatively low frequency of consumption is recommended. The need for unsaturated fats should be met with fish and dried fruit, preferably utilizing plant oils as a condiment. Table 3.1 summarizes the BCFNs exploration of the research on the nutritional needs of growing children in a set of broad guidelines for achieving a diet and lifestyle suited to the proper and healthy development of children and adolescents. 3.5 the double pyramid over the long term The symbolic power of the Double Pyramid grows if it is viewed in a long-term context. The very concept of sustainability contains the fundamental value of durabilitythe capacity of any system, natural or social, to preserve itself intact and vital over the long term. And it is precisely in those terms that the

table 3.1 summary of the macro-guidelines for healthy growth

Adopt a healthy balanced diet that alternates all the chief food groups on a daily basis, supplying all the nutrients and micronutri ents (calcium, iron, vitamins, etc.) that an adolescent needs. Avoid excessive introduction of calories by not eating highly caloric foods, or foods with elevated concentrations of fats. Break down the nutrients during the day so as to assure the presence of a proper equilibrium between the intake of animal and plant proteins, which should have a 1:1 ratio, simple and complex sugars (through the consumption of fewer sweets, more bread, potatoes, pasta, or rice), animal and plant fats (by using less lard and butter and more olive oil). Reduce to a minimum the extra intake of salt in order to reduce the risk factors for developing hypertension, especially as an adult. Distribute the intake of food to five moments throughout the day: breakfast, morning snack, lunch, afternoon snack, and dinner. Avoid consuming food outside of the five moments just listed. Engage in physical activity for at least an hour every day, including both sports and play. Reduce as much as possible ones sedentary life, in particular time spent in front of a video screen (television and computer).

Source: BCFN, 2011.

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environmental pyramid
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Red meat Cheese Fish

su g

Fruit and vegetables Cereal Grains (50% unrefined), Bread, Pasta, Rice

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food pyramid
figure 3.11
The double pyramid for growing children and adolescents Source: BCFN, 2011.

model of the Double Pyramid suggests that we evaluate all our dietary choices and behaviorsincluding those that may seem unimportant in the short term but which can loom much larger if measured over time. In this context, applying the Double Pyramid to future generations, beginning with children, leads to certain implications that ought to be further explored and popularized among families and educators. On the one hand, increasingly widespread ways of eating are leading to a gradual decline in the health of younger people (in particular, via the spread of overweight and obesity) and a corresponding reduction of their life expectancy. That development runs counter to a well-established trend of growing life expectancies. On the other hand, the excessive use of certain foods (generally speaking, the same foods that ought to consumed less frequently) is causing a substantial impact on the environment and on natural resources that might well further reduce the quality of life and the overall welfare of the coming generations. The adoption of a proper dietary model thus has both direct and indirect effects on the future of our children. That makes it indispensable to create a collective sense of responsibility. Such a campaign should focus on parents and the educational system, and secondarily on the children themselves; parents and school systems must commit to collaborating more intensely to the nutritional education of future generations.

en

Milk and Dairy Products Yogurt

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su mp ti

Legumes Sweets Yogurt Eggs Bread Milk and Dairy Products Pasta Rice Cereal Grains (50% unrefined)

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Fats/ Oils White meat

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toward sustainable agriculture

The field of sustainable agriculture has reached a point at which the debate is focused increasingly on agro-alimentary biotechnologies. In that context, BCFN has developed its own vision of agricultural sustainability and has used it as a reference point in examining the critical issues and opportunities in various forms of agricultural innovation. In this section we will evaluate the chief characteristics of agricultural production paradigms with respect to their sustainability. Agriculture is a complex activity and its sustainability depends on many factors. In addition to the agro-alimentary production system in the narrowest sense (the actual productive chain), we must consider energy issues (the production and use of energy and, in particular, of fossil fuels), soil quality (soil loss and soil depletion), and the availability and use of water resources. There is also the population variable (now and in the future) and the growing significance of migration (especially in the most critical socioeconomic contexts) as well as the impact of the various agricultural models on food security and human health (epidemics, undernutrition, malnutrition). And of course any evaluation of the worlds agricultural systems must address two additional underlying themes: dietary habits (current and future, Western and otherwise) and the consequences of climate change (increase of average temperatures, changes in precipitation, extreme weather phenomena, etc.). These variables, in their reciprocal influence and interaction, work together to describe the complex reality of world agriculture (figure 3.12). Given the possibility of energy shocks that could undermine one or more of that realitys constituent factors, it is urgent that new forms of equilibrium be found in order to make the structure sustainable over the long term. Sustainable agriculture can be defined, briefly, as food production that makes the best use of natures goods and services while not damaging these assets. 1 As the UN Food and Agriculture Organization (FAO) reminds us, it: conserves land, water, plant and genetic resources, is environmentally non-degrading, technologically appropriate, economically viable and socially acceptable.2 The various models of sustainable agriculture share certain traits in their interactions with the ecosystem: they seek to protect the soil against erosion; optimize the consumption and use of water; minimize the application of plant protection products (such as herbicides, fungicides, and pesticides), synthetic fertilizers, and fossil fuel-based energy; and encourage biodiversity (which reinforces the resiliency of ecosystems and their ability to self-regulate). These measures ensure both that farmers and producers receive adequate income and that the land is protected and safeguarded. Interest in such practices has risen chiefly

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for two reasons: the spreading awareness of the damage conventional agriculture inflicts on the environment, and growing concern about the potential scarcity of key resources, especially petroleum. In the past 50 years farming has developed rapidlythough not at the same pace in all regions of the worldtoward the adoption of technologies capable of increasing the productivity of individual farmers and toward a general modernization of production techniques. In certain areas, beginning in the 1960s and 1970s, four new innovations appeared: high-yield plant varieties (HYVs), the practice of monoculture, the spread of mechanized farming, and the adoption of agrochemistry (the massive use of pesticides, herbicides, fungicides, and synthetic fertilizers developed through the use of nitrogen, phosphorus, and potassium). These led to a striking rise in the volumes of production per working farmer, especially of wheat, corn, and rice.

land loss & flooding energy sector

Land Loss

food production
Life Sustaining Calories per Capita

Biofuels Production Petroleum Use for Fertilizer

o
Habitat Conversion

o s

health catastrophes
Famines

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s r

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Fertilizer Demand

s o s b
Acres in Agriculture

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Calories per Capita

Human Human Population Human s Deaths Births Population Density

Soil Capacity Soil Nutrient Productioin

Soil Nutrient Consumption

Plant Calories Plant Plant Consumption Production Droughts

o
Plant Calories for Human Use

human population

Migration

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s
Irrigation

Variation in Rainfall Pattern

Plant Calories for Meat Production

s
Exposure to a Higher Standard of Living

s
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Global Temperature

s s
Pursuit of 1 st World Food Mix Meat Calories Meat Consumption

migration

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s global warming

Meat Production

figure 3.12
The model developed by the IAASTD for representing the complex system of agriculture Source: IAASTD, 2011.

single room

With regard to environmental impact, factory farming represents the most critical sector of the entire food system. In addition, animals are often raised in crowded and unsanitary conditions, leading to the overuse of antibiotics. But an organic pig farm can provide a different vision of meat production. These farms have series of smaller enclosures for pigs, allowing animals to have access to the outdoors.

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This model, emerging from the combination of intensive monoculture, agrochemistry, and mechanization, allows farmers to take advantage of potential economies of scale throughout the entire production chain. It has made possible a lengthy period of rising productivity and low prices for foodstuffs. However, as the 2009 report from the International Assessment of Agricultural Knowledge, Science, and Technology for Development (IAASTD) (Agricul ture at a Crossroads) firmly reminds us (the report was the work of 400 world experts over four years), this increase in productivity was won at the cost of the intensive and often irreversible exploitation of natural resources: soil erosion, water contamination, pollution of drainage basins, deforestation, and loss of biodiversity. Moreover, in the last decade the trend of growth in agricultural productivity has dropped sharply, ushering in a period of stagnating yields. The develop-

food, agriculture, and the scarcity of natural resources*

The incessant drive to exploit farmland and increase yields, especially since the mid-twentieth century, has led to an array of alarming trends: The grave depletion of arable farmland. Forty percent of world farmland is depleted or poor. The gradual reduction of the expanse of large forested areas. Roughly 43 percent of all tropical and subtropical forests and 45 percent of temperate forests have been converted into farmland; this includes the conversion of some 13 million hectares (32 million acres) of wetland forests in southeast Asia, largely for the production of palm oil. The poor and exploitative management of farmland and forests. This accounts for some 30 percent of global emissions of greenhouse gases. The intense exploitation of fishing areas. Thirty-twopercent of those areas have been overfished, depleted, or exhausted, and 52 percent fully exploited. The use of approximately 70 percent of all available water resources. The use of 80 percent of all available phosphorus, with deposits rapidly running out in the three leading producing countries. Heavy dependency on fossil fuels as an input (for instance, in the production of fertilizers, in irrigation, and in mechanization), with the risks of peak oil pricing leading to price surges and of climate change.
* FAO/OECD, Expert Meeting on Greening the Economy with Agriculture, Paris, 5-7 September 2011.

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11 10 9 8 7 6 5 4 3 CAGR 6475 3.0% CAGR 7586 2.0% CAGR 8698 1.5%

CAGR 9809 1.6%

1995

2005

Annual yield per hectare (metric tons per hectare)

Trend (simple moving fiveyear average)

CAGR = Compound Annual Growth Rate

figure 3.13
The trend of corn yield per hectareUSA (metric tons per hectare, 19612009) Note: Yield per hectare has been calculated as the relationship between the level of production and the area harvested, for every single year considered; the trend was identified by using a moving fiveyear average. Source: Elaboration of data from United States Department of Agriculture Database, 2011.

ment that marked the first 30 years since the introduction of the intensive monoculture paradigm has progressively lost momentum (figure 3.13). The critique of the intensive monoculture approach, meanwhile, has led to experimentation with approaches that are more considerate of overall sustainability. But despite some promising results from the emerging new models, a clear way forward has not yet materialized, at least not one that is capable of delivering high-volume production, high-quality product, and environmental, economic, and social sustainability. That is why the debate over the process of radically rethinking the prevalent models and approaches is nowadays more wide open and vibrant than ever before. The first task is to identify the underlying prerequisites of the potential agricultural models in light of the demand for sustainability.

2009

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a future to be built. For instance, a central issue will continue to be the control and elimination of diseases and infestations of crops. This is because it is important to ensure sufficient yields, stability of production, and food security. It will also become increasingly crucial to identify techniques that allow us to confront the challenges of the changes under way (and expected only to increase) in two key factors: availability of water and quality of soil. Another open and important issue is agricultural productivity. While it is true that the widely acknowledged problems of access to food are chiefly due to poor distribution than to any real insufficiency of world agricultural production, it is equally evident that in some areas of the planet agricultural yields are still much lower than the levels achieved even in the distant past in economically more advanced countries. In large areas of the world, in fact, agriculture is dominated by pure subsistence farming. In these areas, characterized by poverty of both means and knowledge, the chief objective is simply to raise enough food to feed the farmers nuclear family. The proper application of agricultural techniques (including some very basic ones) to improve yields remains, rightly, the focus of interest in agriculture, especially when we look to those parts of the world that are still developing and need a significant improvement in average living conditions. 3.6 current leading agricultural paradigms The various alternative approaches to agriculture can be classified in a variety of different ways. Among these, of particular interest in terms of sustainability is the approach proposed by the FAO, in which the numerous systems of agricultural production are broken down into three main categories:3 HEI (high external input) systems, IEI (intermediate external input) systems, and LEI (low external input). What is crucial in this approach is the reference to the intensity of resources consumed (figure 3.14). HEI systems are characterized by a sharp commercial orientation, by the use of plant varieties with high yields in terms of productivity, by intense mechanization (which corresponds to a low level of manpower), and by heavy dependency on synthetic fertilizers and plant protection products. These are production models designed to maximize output in conditions of optimal efficiency through attainable economies of scale. Systems based on the use of genetically modified organisms (GMOs) are emblematic of this approach. At the opposite extreme of the spectrum we find LEI systems. Here the focus is on the use of traditional plant varieties, the use of techniques involving considerable labor and knowledge, and the limited use of chemical products. Most agricultural models are IEI systems and fall somewhere in between. IEI models call for the use of plant varieties modified by traditional techniques of crossbreeding and hybridization, the quest for a sustainable balance between

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mechanization and labor, the use of high knowledge-content techniques, and the use of fertilizers and chemical products. The sustainability of the various paradigms obviously differs. HEI systems, in particular, seem capable of ensuring better cultivation yields in terms of product per surface area, but they do so by means of higher consumption of resources. That is why they are also the most fragile systems under future scenarios of potential scarcity. LEI systems, on the other hand, are usually forced to pay for their lesser impact on resources with reduced cultivation yields.

natural management resource options

low-external input intermediate-external input
Aquaculture and capture fisheries Forestry systems Conservation agriculture, IPM, Precision farming systems

high-external input

nature

Organic agriculture Multitrophic marine systems

Grassland and forage crops

GMObased systems High external input livestock systems High external input cropping systems

Biodynamic agriculture
Agroforestry systems

Mountain systems UPA

SRI (Polydome systems ) Mixed ricefish systems

Permaculture

Traditional & perennial polycultures

Mixed crop livestock systems

perennial / integrated more resilient & efficient

Less energy to maintain, low GHG emissions High diversity, connectedness, coherence

annuals less resilient & efficient

More energy to maintain, high GHG emissions Low diversity, connectedness, coherence

figure 3.14
The three main agricultural models according to the FAO Note: IPM (Integrated Pest Management), SRI (System of Rice Intensification), UPA (Urban and Periurban Agriculture). Source: FAO/OECD, Food availability and natural resource use in a green economy context, 2011.

man-made

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Clearly, this is an extremely simplified depiction of reality. Still, it can help us to formulate a number of broad observations in response to these critical questions: How do the various models (HEI, LEI, IEI) measure up to the challenges of the future? How will those same paradigms evolve? To what extent will they be capable of taking on and sustaining a world of increasingly scarce resources? 3.7 the sustainability of the systems used to grow durum wheat: the barilla case In keeping with the ideas discussed here, Barilla decided to carry out a number of experiments to test the possibilities for improving its own agricultural supply chain. This section summarizes the most significant results of this work. In various studies it has been shown that the agricultural phase (actual work in the fields) is one of the most decisive in terms of the environmental impact of the production chain of pasta. Barilla therefore underwrote a study to analyze and compare different agricultural models for the cultivation of durum wheat. The ultimate objective was to identify sustainable agricultural systems that could subsequently be tested in the various national territories of production, and thus both increase the quality and the quantity of cereal grain produced. Our methodology focused on four regions: the Lombard and Venetian plains, the Emilia-Romagna region, central Italy (Tuscany, Marches, and Umbria), and southern Italy (Puglia, Basilicata, and Sicily). For all of these macro-areas, standard rotation practices were identified that were representative of the rotations of durum wheat in Italy (figure 3.15). Agronomic and economic studies were bolstered by the environmental evaluations done using life cycle assessment 4 and summarized in terms of water footprint5 and ecological footprint.6 The study made it clear that, in many cases, Italian farmers can reduce the emission of CO2 (by as much as 40 to 50 percent, or the equivalent of 300 kilograms of CO2 per metric ton of durum wheat) and the other environmental impacts of their agricultural practices without compromising the quality of their productsin fact, while improving both quality and profitability. Figure 3.16 (A, B, C) shows a number of findings of the study concerning the carbon footprint,7 the gross revenue generated,8 and the efficiency in terms of the utilization of nitrogen.9 The study revealed that the adoption of the traditional proper crop rotations drastically reduces the environmental impact and offers higher earnings for the farmer, i.e., it is more sustainable in both environmental and economic terms. The study also made clear that the characteristics of a plant species, in this case, durum wheat, are intimately tied to the agricultural setting where it is cultivated. When that setting varies, not only do all the parameters of its sustainability alter substantially, but so do the final quality and quantity of the material produced.

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lombard-venetian plain Cultivation of Corn Industrial corn soy durum wheat durum wheat corn rapeseed corn corn

emilia-romagna Cultivation of Cereal Grains Industrial Cultivation of Vegetables corn soy tomatoes durum wheat durum wheat durum wheat sorghum corn corn common wheat common wheat common wheat

central italy Cultivation of Cereal Grains Protein Pasturage Industrial durum wheat garden peas alfalfa sunflower durum wheat durum wheat alfalfa durum wheat sorghum garden peas alfalfa rapeseed durum wheat durum wheat durum wheat durum wheat

southern italy and islands Cultivation of Cereal Grains Pasturage Protein Industrial durum wheat pasturage chickpeas tomatoes durum wheat durum wheat durum wheat durum wheat durum wheat pasturage chickpeas durum wheat durum wheat durum wheat durum wheat durum wheat

figure 3.15
Crop rotations studied in the four macroareas of Italy Source: Sostenibilit dei sistemi colturali con frumento duro, Filiera Grano Duro News, 2011.

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carbon footprint (t co2 /t kernel)

{ cereal crop /rotations * = 0.31 t CO2 eq/t } Cultivation of Cereal Grains ** Pasturage Industrial Protein Cultivation of Cereal Grains ** Industrial Industrial Vegetable Crops Industrial Cultivation of Corn ** Cultivation of Cereal Grains ** Pasturage Industrial Vegetable Crops Protein 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8

gross revenue ( / t)
{ cereal crop /rotations * = + 100 } Cultivation of Cereal Grains ** Pasturage

Industrial Protein Cultivation of Cereal Grains ** Industrial Industrial Vegetable Crops Industrial Cultivation of Corn ** Cultivation of Cereal Grains ** Pasturage Industrial Protein 0 20 40 60 80 100 120

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efficiency use of nitrogen (kg kernel of hard red winter wheat/kg nitrogen)
{ cereal crop /rotations * = 100% } Cultivation of Cereal Grains ** Pasturage Industrial Protein

Central Italy EmiliaRomagna LombardVenetian Plain Southern Italy and Islands * Difference between the average of values recorded in the rotations and the values recorded in the cereal crop system. ** Standard crop rotations normally adopted in each area.

c
Cultivation of Cereal Grains **

Industrial Industrial Vegetable Crops Industrial Cultivation of Corn ** Cultivation of Cereal Grains ** Pasturage Industrial Vegetable Crops Protein 0 10 20 30 40 50 60 70

figure 3.16
Effect of farming sistems on carbon footprint a , on gross revenue b , on efficiency of nitrogen use c Source: Sostenibilit dei sistemi colturali con frumento duro, Filiera Grano Duro News, 2011.

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the six strategic points of agriculture

1. sustainable agriculture is based on wider and more intensive adoption of already well-known principles. Current scientific and practical knowledge has coalesced around several major principles which, adapted to diverse situations as appropriate, are the underlying foundation of a truly sustainable agriculture. The crucial steps are: 10 Adopt crop rotation as a systematic practice. Grow a broader array of plant species through the systematic (and oncecommon) practice of crop rotation on the same land in order to achieve the proper distribution of trees, underbrush, shrubs, pasturage, and crops, thereby improving the resilience of the system. Minimize mechanized operations on the land, in order to preserve intact the soils structure and organic materials. Improve and maintain a protective organic cover over the soil surface, especially by making short-term use between crops of ground cover or organic residue from the harvest, in order to protect the surface of the farmland and conserve water and nutritive substances. Encourage the biological activity of the farmland and practice the integrated management of parasites and weeds. These techniques involve the use of high-yield plant varieties that are resistant to biotic and abiotic stress factors and with good nutritional qualities, the optimized use of organic and inorganic fertilizers, the integrated management of parasites and diseases through appropriate practices11 (based on biodiversity, the selection and the use of low-environmental-impact pesticides) and, when necessary, the efficient management of water resources. Practiced this way, they allow farmers, with equal macro reference models (HEI, LEI, or IEI), to obtain better performance in terms of sustainability. In section 3.7 we offer a brief summary of the experimentation conducted by Barilla that reinstituted these sound guidelines among certain agricultural vendors that supply the company with raw materials. The results, as of this writing, are very promising. 2. agricultural knowledge appears to be restricted. Science has brought to agriculture a great expanse of new knowledge concerning the characteristics of the natural environment and the physiology of plant species. This merges with practical experience accumulated over centuries of

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farming to yield a vast patrimony of knowledge that is of extraordinary valuebut which is currently being utilized only in part. In some cases this is due to the lack of effective means to transfer know-how. In other cases, there is a wide belief that available technologies at least in part render superfluous an in-depth understanding of natural dynamics. In other words, whatever the model adopted (HEI, LEI, or IEI), the biggest problem confronting agriculture today is the need to reinforce its foundations in terms of human capital, bridging the gap between the knowledge that is available and individual system-wide expertise. Overcoming this hurdle will require significant investment to spur development that trends toward greater levels of sustainability. 3. use the proper agricultural model for the context with the objective of reducing the level of external inputs. Having established these prerequisites, as far as we are concerned there are no inherently good or bad agricultural paradigms. There are certainly HEI models that we believe will ultimately prove to be unsustainable in practice, and there are LEI models that will be impossible to implement in certain contexts. Still, alongside those extremes, there is a broad array of possibilities, IEIs adjacent to LEIs, that can be managed on a practical basis in the light of the previously mentioned needs for sustainability. The choice of the model depends on the context. In places where higheconomic-yield HEI systems are solidly rooted (for example, in the United States, Brazil, and Argentina), it makes no sense to propose or advocate extreme shifts in direction. In those cases, it will be necessary to consider the models limits in terms of sustainability and introduce the necessary course corrections, such as considering a portfolio of managed agricultural models. In much the same way, the obligatory path forward for Europe is that of practicing increasingly sophisticated IEI/LEI models. In other words, what matters is the general trend line: the shift toward increasingly sustainable IEI paradigms and the balancing among models within macroregions. A different approach is required with developing countries. Where there is still a complete lack of agricultural models that are sustainable in economic and social terms, we should not fall for the illusion that we can simply import paradigms from outside. Instead, we should adapt and revise models that prove to be appropriate to the specific characteristics of the local situation.

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4. biodiversity can and should be used as a tool for effective risk management. As noted in the previous point, a pragmatic and open-minded approach to the choice among agricultural paradigms allows policies that maximize the overall resiliency of the agricultural systems in question. Sound management of biodiversity and the use of different models, all equally optimized for sustainability, enhances the capability to respond to adverse events and to attain specific system objectives, when alternatives (maximum quality vs. high volume, for instance). 5. invest in technology to make agriculture more adaptable to change. According to the approach that we are suggesting, technology too takes on a different connotation from the one that these days seems to be all too prevalent. Nowadays, in fact, when people talk about technology in agriculture, they are frequently talking only about productivity and yield. The belief is that these can only be increased by improving individual strains and varieties. But what is even more important is the capacity to adapt, which takes the form of an integrated and coordinated management of a broad array of tools and approaches: plant varieties that are resistant to stress, the use of advanced irrigation systems, a scientific approach to fertilization, etc. 6. address the exogenous factors of sustainability in agriculture: food waste and biofuels. A substantial portion of the problems afflicting the agricultural and agro-alimentary system have nothing to do with the choice of models or their optimization. The most important issue of this kind is food waste, which exists in truly unsettling proportions and represents one of the chief challenges for future agricultural sustainability (figures 3.17 and 3.18). In addition to food waste and loss, another issue is central to decisions about the allocation of financial and physical resources in the agricultural sector: the production of biofuels, which competes directly with the use of raw materials in the food and feed sectors. The production of biofuels especially raises the demand for wheat, corn, sugar, and oilseeds. From 2008 to 2010, bioethanol was produced mainly from raw cereal grains (55 percent) and cane sugar (35 percent), while biodiesel production relied mainly (90 percent) on vegetable oils.12 The extensive use of corn for the production of ethanol in the United States has had significant worldwide repercussions. It represents a third of world production and two-thirds of total exported volumes. In 2010 the U.S. used

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The per capita quantity of food lost or wasted in different regions of the planet (kg/year) Source: FAO, Global food losses and food waste, 2011.

an estimated 38.4 percent of its total corn production to make ethanol. Between 2004 and 2007, volumes of corn used in food and food products increased at an annual rate of 1.5 percent, while the share of the total corn crop used in the production of ethanol increased by 36 percent. The same dynamic seems to be at play in the production of biodiesel: in Europe, a total of 8.6 million metric tons of vegetable oils, roughly 3 percent of world production, was used in the production of biodiesel fuel. The industrial use of vegetable oils grew by 15 percent annually from 2004 to 2008, a much greater rate than the growth rate for production of vegetable oils as foodstuffs (4.2 percent).

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figure 3.18
Share of cereal production lost or wasted along the productionconsumption supply chain, in different regions of the planet (% of initial production) Source: FAO, Global food losses and food waste, 2011.

While growing shares of several agricultural crops are being sucked into the biofuels sector, the problem of alternative energy production cannot merely be limited to the quantity of a crop that is used in the production of fuel. That issue must be expanded as well to include the quantity of farmland that can be destined or reconverted to production for the biofuels industry. With waste and biofuels alike, inadequate management of the problem and questionable energy policy decisions combine to produce massive pressure on the agricultural system to make up for shortcomings that are none of its responsibility.

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In order to consolidate these results, a series of recommendations for the sustainable cultivation of durum wheat was developed and a similar course of study was begun for other cereal grains (soft wheat and rye segale and in other geographic areas (France, Germany, Greece, Turkey, Sweden and Canada). A second part of the study analyzed the results that could be achieved through already-sustainable crop rotations by improving the efficiency of the most common and relevant agricultural practices, i.e., the way the land is tilled, nitrogenbased fertilization, sowing, and the protection of plants. The theoretical results have shown that the transfer of knowledge to farmers and the use of modern decision-making tools can lead to further reductions of the carbon footprint at the same time as an increase in profitability. The study has shown that it is possible to evaluate in concrete terms the sustainability of a crop or an agricultural system through a multidisciplinary analysis, combining various indicators of an environmental, agricultural, and economic nature. simulating agricultural models and their effects on food production. In an effort to assess the performance of current agricultural models and to come up with alternatives for the future, BCFN (in collaboration with the Millennium Institute) has constructed a simulation model to study the impact of variations in current agricultural practices on the quantity of food available worldwide. The findings of this model underlie many of the observations described above. Our objective was to understand how substantial external shocks, summarized here by a very significant increase in the price of oil, can impact the world agricultural system, while taking into account a diverse array of scenarios of the development of the shock, expressed in terms of the agricultural models adopted. We ran simulations involving two principal models: an LEI (low external input) model characterized by low energy use and high labor input,13 and an HEI (high external input) model, which assumes higher consumption of energy and use of inorganic fertilizers.14 These two models differ primarily in terms of their varying characteristics of sustainability over time. Considering a time span of 80 years (1970-2050) and evaluating the impact on the per-capita quantity of food calories (calories) produced annually, it becomes possible to form hypotheses about what the appropriate choices of production policy should be. Before going any farther, we want to stress a key point. According to the simulations we conducted, the quantity of food produced every year is enough to feed the worlds population. And it will continue to be sufficient, since the current rate of increase in farming productivity is in line with the current and projected rates of demographic growth estimated by the FAO and the Organiza-

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tion for Economic Cooperation and Development.15 As we have already said, a significant proportion of the problems that now challenge the agro-alimentary system hinge on issues of distribution, decisions about ultimate use, and wastage of the food produced. We ran a variety of simulations, beginning with three different scenarios that assumed abundant availability of energy: a Business-as-Usual (BAU) case, in which practices using high levels of external input account for 60 percent of global cultivated area in 2050; a Strong-HEI-Growth case, in which practices using high external inputs spread at an accelerating pace and cover 90 percent of global cultivated area in 2050; and a Stopped-HEI-Growth case in which there is minimal diffusion of HEI models and their share of cultivated land is maintained at 45 percent in 2050. We also ran a simulation of the effects of an oil price shock between 2025 and 2030 (the Very High Energy Price case). In this case oil prices rise rapidly, reaching a price in 2030 of US$200 per barrel and then US$280 dollars per barrel in 2050. As a result, prices of inorganic fertilizers rise substantially and their use declines. The only crops for which they are affordable are those with high added value; they account for only 50 percent of the global cultivated area. In this case as well, the effects have been estimated on the number of annual per-capita calories for each of the three basic scenarioes (BAU, HEI, LEI). Assuming the constant availability of energy over our 80-year period, the highest-yield production scenarioin terms of a sustainable approachis Strong HEI Growth, followed by the BAU scenario, and last of all, the Stopped HEI Growth scenario. In a hypersimplified worldin which energy is the most important factor of production, we can assume there will be no energy shocks, and we exclude all the other elements that help determine sustainabilitya pro-HEI policy would result in the production of a quantity of calories much higher than the level needed. It is worth noting that the Stopped HEI Growth scenario also seems capable of supplying more calories than needed. This suggests that there is no real problem in terms of total availability of calories. The model does not take into account inequalities between the various geographic areas, which is the real problem. The idea of constant availability of energy over time, however, is unrealistic. Fossil fuel sources are constantly dwindling and renewable energy is not yet a viable alternative. It is therefore reasonable to imagine that at a certain point there will be a shock in global energy supply that will put the worlds highenergy-consumption systems, such as the HEI models, very much to the test. These models would become economically unsustainable and not very profitable. Moreover, there would be serious problems with the transition to models that would be more efficient in terms of energy use. The costs of the change in production would take the form of a lower available output and the amount of time

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required to acquire the necessary know-how for the transition. Figure 3.19 shows the estimated effects of an energy shock in the year 2050 on global output. The results of the simulation show that, in the case of reductions of available energy from 2025 on, an approach with low external inputs would lead to a Worse-Before-Better (WBB) result, i.e., a drop in productivity over the short term with a return to higher yield levels over the mid to long term. If there is no reduction in the quantity of energy available, the results are sharply influenced by the share of cereal grains destined for animal feed and biofuels. In any case, a modification of these hypotheses would not change the outcome in qualitative terms, leaving unchanged the rankings of the scenarios in terms of yields and calories produced. In case of an energy crisis, the results will be strongly dependent on how long agricultural systems will take to shift from an HEI approach to an LEI one. If that period proves to be short, the results of a strong HEI growth energy shock and a BAU energy shock should be less negative. As these results suggest, the world agricultural system is clearly fragile. We

3,500 kcal/person/day 3,250 3,000 2,750 2,500 2,250 2,000 2000 2005 2030 2040 2020 2050 1990 1980 1995 1970 2010 2015 2035 2045 1975 1985 2025

min. FAO The HEI is fragile and does not withstand energy shocks

Data BAUEnergy Shock

Stopped HEI GrowthEnergy Shock Strong HEI GrowthEnergy Shock

The average calorie requirement (cal/person/day) from men and women from the ages of 18 to 60 recommended by the FAO

figure 3.19
Agricultural production for human nutrition (daily cal per capita) and the simulation of energy shocks Source:BCFN su data FAO, 2011.

agrarian landscapes: california

On a farm in Valley Center, returning veterans from Afghanistan and Iraq are learning organic farming techniques. An initiative designed to not only help returning veterans fit back into society, but also to help deal with the issue of an aging population in the farming sector.

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should take a positive approach to this fragility through the encouragement of a balanced mix of agricultural models designed to face the challenge of shortages. Of course, reality is far more complex than the intentionally simplistic representation of our simulation model. There are a great number of factors at play aside from energy inputs: soil quality, availability of water, adaptation to atmospheric phenomena, etc. The result presented here, however, is by no means insignificant. In fact, it illustrates one of the most important topics of future development. The search for solutions based on approaches involving low energy consumption and high knowledge content (according to the balancing calculus described above) will become one of the decisive aspects of sustainability.

the water economy and the emergency it confronts

The water economy is the science that studies the way in which water resources, which are limited by nature, must be managed in order satisfy the growing needs of man without creating social inequalities and unsustainable environmental impacts. That water is precious is something we realize only when it begins to run short. Until now, water scarcity might have appeared to be restricted to less fortunate countries, but matters might quickly change because quality waterfresh, unpolluted waterconstitutes only a minimal percentage of our water reserves. And we are constantly using increasing quantities of it, both because the world population is rising and because the growing prosperity of many countries leads people to consume (and waste) more and more water. That consumption should be considered not only in real terms (that is, by calculating the quantities used for personal care, for cooking, and for cleaning house), but also in the virtual terms of the water footprint (all the water that has been used throughout the life cycle) of any product or service we consume. As we noted earlier, one of the best ways to reduce ones virtual water footprint is to change to a diet rich in fruit, vegetables, and cereal grains, while limiting the quantity of animal proteins. If demand grows and resources dwindlein part because of both pollution and climate changethen clearly the economic value of water will grow and the inequitable gap between those who have plenty of water and those who do not will provoke new frictions and conflicts. We know full well the nature of the interests and the dire litigious tensions that revolve around the control of petroleum deposits. Conflicts over water might well be far more serious. After all, in the end one can survive without oil. What is therefore necessary is a concerted effort to adopt a more rational use of water, especially in agriculture (which represents the most water-thirsty sector

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par excellence) and on a personal level (for instance, with water-saving diets). We also need to formulate a new set of regulations that really will ensure the right to water while defining the boundaries of privatization. While privatization may entail certain advantages in terms of greater efficiency in the management of water sources, it must be closely controlled to avoid unfair price increases and limited accessibility for the more vulnerable members of the population at large. 3.8 the availability of water: from abundance to scarcity To understand the current scenario in terms of water resources, we must consider the availability of water and its various uses, present and future, in agriculture, industry, and in our homes. That means, in turn, taking into account the global factors that will affect water consumption (demographic increase, rising prosperity of the population with a resulting modification of lifestyles and eating habits, urbanization and expansion of economic activities, and the production of biofuels) and the reduction of the available water reserves (climate change and pollution in particular) (figure 3.20). how much water do we have? Overall, our planet possesses some 1.4 billion cubic kilometers of water. It is estimated, however, that less than 45,000 cubic kilometers of water (0.003 percent of the total) are theoretically usable and only 9,000 to 14,000 cubic kilometers of water (approximately 0.001 percent of the total) is actually available for use by human beings, because it is of adequate quality and is accessible at an acceptable cost. Freshwater resources are also distributed very unequally among the regions of the globe: 64.4 percent of all world water resources are found in just 13 countries. A growing number of countries, on the other hand, find themselves gravely short of water, with annual per capita availability of less than 1,000 cubic meters. how we use water: farming, industry, and families. The agriculture sector accounts for 70 percent of global freshwater consumption, while 22 percent goes to industry and the remaining 8 percent to domestic uses. The share allocated to agriculture is even greater in countries with a low to medium incomes (in some developing countries it reaches 95 percent), while in developed countries the share given to industry is by far predominant (59 percent). Where the domestic use of water is concerned, more than one out of every six people on Earth does not have access to the minimum quantities defined by the UN (2050 liters of freshwater daily per capita) as necessary to meet primary needs linked to food and hygiene. the scarsity of water, now and in the future. Demand for water is already quite high and, absent serious action, will only grow in the future and

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lead to a progressive scarcity, especially in certain areas of the planet. From an environmental point of view, water is considered to be scarce when more than 75 percent of the fluvial and subterranean water resources are drawn upon for use in agriculture, in industry, and for domestic use. In such cases the exploitation is coming close to (or may have even exceeded) the limit of sustainability. The scenario foreseen for 2025 in terms of the scarcity of water appears starkly worse than the current scenario. Areas using a large share of available resources (greater than 20 percent) will increase substantially, expanding to the entire territory of the United States, continental Europe, and southern Asia, and worsening significantly in terms of percentage values in ample areas of Africa and the Indian peninsula. why demand for water is increasing. Among the factors that will influence the growth of world demand for water, an especially significant role will be played by population dynamics and the growing rate of urbanization. Estimates indicate that global population will rise to more than 8 billion people

Today

Tomorrow

Climate Change Pollution

Causes of increasing water demand Demographic growth Increasing prosperity and wellbeing Socioeconomic development

Processes of urbanization

Changes in dietary habits

Biofuels

figure 3.20
The current and future scenario of water resources Source: BCFN, 2011.

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in 2030 and reach 9 billion in 2050. The current population already uses 54 percent of freshwater resources in rivers, lakes, and accessible water tables. With the growth of population, it is estimated that by 2025 rising demand will require increases in water supplies of 50 percent in developing countries and 18 percent in developed countries (figure 3.21).

1995

2025

above 40 percent

from 40 percent to 20 percent

from 20 percent to 10 percent

below 10 percent

figure 3.21
Amount of water used compared with available resources. Two scenarios compared: 1995 and 2025 Source: WBCSD, Business in the World of Water. WBCSD Water Scenarios 2025, 2006.

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Meanwhile, the process of urbanization is accelerating sharply. In 2007, for the first time in history, the worlds urban population outstripped its rural population, with clear and direct consequences in terms of infrastructure for access to water. The investments needed to ensure distribution of water to the growing number of city dwellers are rising, as are those for the corresponding treatment and purification of waste water from domestic and industrial use. The increase in world population and the rising purchasing power of people in developing countries go hand-in-hand with the changes in eating habits and the rise in calories consumed. In the past 20 years meat consumption in China, for example, has more than doubled; by 2030 it will double again. This leads to a rise in water resources utilized because the production of meat, milk, sugar, and vegetable oils typically requires the use of a greater quantity of water than does the production of cereal grains. Economic development is also a key driver of the future rise in demand for water. Improvements in economic and living conditions in developing countries, as well as the general expansion of economic activities (ranging from industrial production to the service industry and tourism), exert growing pressures on available water resources and on natural ecosystems. Above all, the rising global demand for energy puts massive pressure on water resources. In particular, the production of biofuels has increased exponentially in recent years (ethanol production has tripled between 2000 and the present day), principally because of the volatility of oil prices and the support of national and international environmental policies. Biofuels are subverting the equilibrium of the water system and the biodiversity of several countries because of their heavy use of water (and fertilizers) for growing feedstock corn, sugar cane, and other crops. why water availability is declining. Among the chief causes of reduced water availability is pollution, which threatens water quality. In particular, economic development and access to market economies by large numbers of people who had long been excluded from mass consumption are generating serious problems, especially in terms of waste management. Certain statistics throw a harsh light on the scale of the problem: it is estimated that every day 2 million metric tons of waste generated by human activity are dumped into watercourses. The food sector accounts for 40 percent of organic pollutants in water supplies in developed countries and 54 percent in developing countries. In developing countries, 70 percent of industrial waste is dumped into rivers and streams without any purifying treatment whatever, which results in the pollution of a substantial part of available freshwater resources. Another major factor that will affect the future availability of water resources is climate change. By now there is a broad consensus about the effects of climate change on water and its availability: a sharp decline in the area of the Earths

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surface and oceans that is covered with ice, a substantial increase in average sea level, a gradual shift toward the poles of non-tropical storms (with resulting significant effects on winds, precipitation, and temperatures), as well as a significant increase in the frequency of extreme weather phenomena, such as intense precipitation or strong heat waves. The future that looms before us therefore appears especially challenging. It demands immediate choices that must be both wise and courageous, and capable of altering current trends. There is no mistaking the necessity for indepth reflection that is directed toward identifying a truly sustainable model of growth that can ensure access to food for a growing world population in the face of increasingly scarce water resources. 3.9 the right of access to water: reality and prospects The right to waterrecognized for the first time in history, and only recently, as a fundamental and essential human right through a UN resolution dated 29 July 2010takes the concrete form of the right of each individual, without discrimination, to enjoy physical and economic access to an adequate and secure supply of water. Making drinking water accessible in sufficient quantity and quality to meet the primary needs of every person was Target 10 of the Millennium Development Goals (MDG), which aimed to halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation. Yet in 2008, roughly 884 million people lacked access to sufficient water resources of adequate quality, 84 percent of them in rural areas. In that same year, 2.6 billion lacked access to adequate basic sanitation. Studies done by the World Health Organization and UNICEF on the progress so far in providing access to drinking water (Target 10) clearly show that we are only partway to the goal. If we extrapolate from current trends, in 2015 the percentage of the population with access to water in their own homes will surpass the stated goal of 90 percent, reducing to 672 million the number of people who still do not have running water where they live. But it will not be possible to attain the goal of halving the number of people without access to basic sanitation, because the result is projected to be 13 percentage points below the stated goal. In fact, it is estimated that in 2015 some 2.7 billion people will not have access to basic sanitation facilities. The actions designed to improve water supply and basic sanitation in a community cannot be adopted in isolation. They must be framed within the context of an overall cross-sector development strategy that takes into account infrastructure, education, and governance. In fact, to attain effective and sustainable operation of structures over time demands periodic maintenance activities, as well as the training and creation of an adequate professional staff. Moreover, the distribution of information about how to collect and store water resources

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in homes is a critical factor in preserving the taste and smell of fresh water and in preventing the creation of potential environments for disease-bearing parasites. To achieve the goals set by the United Nations will demand the coordinated involvement of all actors, both on a local scale and internationally, whether they are public agencies or private organizations. 3.10 choices and behaviors for sustainable water consumption As we discussed earlier, the water footprint of a commodity, a good, or a serviceor in other words its virtual water contentconsists of the volume of fresh water consumed to produce it throughout all the phases of its life cycle. The term virtual refers to the fact that most of this water is not contained physically in the product, but has to do with the direct and indirect consumption necessary for its production. A comparison of the water footprint (expressed in cubic meters per metric ton) of certain agricultural products in a number of countries around the world reveals substantial differences, both when you compare different products with one another, and when you take into consideration the place of production. In particular, livestock and dairy products (meat, eggs, milk, and derivatives) present a greater water footprint than cultivated products, because livestock consumes a significant quantity of cultivated products as food, in some cases for many years before being transformed into food products. Moreover, the water footprint of a single product can vary considerably from one place to another, depending on such factors as climate, the agricultural techniques employed, the yield of crops, etc. Figure 3.22 shows the quantities of virtual water linked to certain kinds of easily identified mass market products and finished industrial products. The water footprint of some of them may appear surprising. Our consumption habits and our behavior, especially our food-related behavior, have a powerful effect on our consumption of water resources. Individuals directly consumes a range of two to five liters of drinking water every daybut their virtual daily consumption of water linked to food ranges from roughly 1,500 to 2,600 liters (in the case of vegetarian diet) to about 4,000 to 5,400 liters in the case of meat-rich diet. As we described in section 3.1, the Barilla Center for Food & Nutrition has developed the Double Pyramid to describe both the principles of a sound diet and the impacts that diet has on the environment. In the environmental pyramid on the right, the foods with the greatest environmental impact are at the top and the foods with the lowest impact are at the bottom. Figure 3.23 shows the food pyramid adjoining the environmental pyramid of water, in which the different food categories are arranged in hierarchical order, depending on their environmental impact in terms of the water footprint.

landscapes at risk: italy

In the fall of 2011, the effects of climate change became dramatically evident in one of the best knownand most fragileagrarian settings: the Cinque Terre, in Liguria. On land already vulnerable to hydrogeological imbalance, heavy rains plummeted crops. And, in the Mediterranean basin, phenomena of this kind are usually accompanied by desertification.

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An A4 sheet of paper (80 g/m2)

A tomato (70 g)

A potato (100 g)

10

13

25

A slice of bread (30 g)

An orange (100 g)

An apple (100 g)

40

50

70

An egg (40 g)

A bag of potato chips (200 g)

A slice of pie (80 g)

135

185

250

Cheese (100 g)

Chocolate (50 g)

A Tshirt (250 g)

500

860

2,000

A hamburger (150 g)

A pair of leather shoes

2,400

8,000

figure 3.22
Average global water footprint of certain commonly used product typologies Source: BCFN, 2011.

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low
Sweets Red meat 10 k 5k 4k 2k 1,5 k 1k 0,5 k 0

Olive oil Bread, Pasta Rice, Potatoes, Legumes Fruits Vegetables

high

re c

om me n

de

Milk, Yogurt

dc

on

su p

Cheese, Fish, Eggs

ti o

Cookies, White meat

15,500 Meat 9,065 Walnuts and hazelnuts 6,795 Sunflower seed oil 5,000 Cheese 4,900 Olive oil 4,800 Pork 4,055 Legumes 3,900 Poultry 3,400 Rice 3,300 Eggs 3,140 Sweets 1,800 Cookies 1,693 Pasta 1,645 Cereals 1,500 Sugar legend 1,300 Bread 1,000 Milk 1,000 Yogurt average value 970 Fruits 900 Potatoes Vegetables: 325

1k

2k

3k

4k

5k

6k

15 k 20 k

food pyramid
figure 3.23
Water footprint of the food pyramid (liters of water per kg or liter of food) Source: BCFN, 2011.

There can be no doubt that most of the foods recommended for relatively higher consumption are also those that present a smaller water footprint. And vice versa: most of the foods recommended for low consumption are those that also impose a larger water footprint. By analyzing the water footprint of the most widespread and commonly consumed beverages, it is possible to build another pyramid, which shows the water consumption required in order to produce each of those beverages (figure 3.24). Eating habits, therefore, entail substantial environmental fallout as well as nutritional effects. To illustrate the differences we have drawn up two daily menus, both balanced in nutritional terms, and then we have calculated their impacts in terms of water consumption (figure 3.25). The first daily menu calls for a diet that is rich in plant-based proteins and with few animal fats; the second is based on the consumption (actually rather limited consumption), of red meat. If we compare the water footprints of the two menus, it is clear that including dairy and livestock products such as milk and meat, however minimal, results in approximately three times the consumption of water resources. This is simply because of the considerable quantities of agricultural products fed to the livestock in order to bring them to market as food. A menu heavy on animal-based food products is decidedly less sustainable as a result. It is clear that individual eating habits, especially multiplied across whole societies, can have a very substantial impact on the availability of water resources. If everyone on the planet were to adopt the average, high meat-consumption

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150

140 125 Milk 120 Wine 106 Orange juice 43 38 Beer 34 Espresso 15 Tea
0.3/0.7 (bottle) Water 0.3 (tap)

Americanstyle coffee

100 50

Carbonate beverage

25

legend
average value min max

0
0

20

40

60

80

100

140

figure 3.24
Water footprint of beverages (liters of water per glass Source: BCFN, 2011. , 125 ml, or cup , 30 ml, of beverage)

dietary regimen of the Western nations, the amount of water used in food production would soar by an estimated 75 percent. Given the strain water supplies are already under, this would clearly be unsustainable. 3.11 national water footprints and the trade in virtual water Weve seen how water footprints can be calculated for each product or activity. They can also be calculated for each well-defined group of consumers (an individual, a family, the inhabitants of a city, an entire nation) or producers (private companies, public organizations, economic sectors). The global water footprint, for instance, amounts to 7,452 trillion cubic meters of fresh water a year, or 1,243 cubic meters per person per yeartwice the annual outflow of the Mississippi River. In absolute terms, the country that consumes the largest volume of water is India (987 billion cubic meters per year), followed by China (883) and the United States (696). In terms of per capita consumption, however, the citizens of the United States top the list with an average water footprint of 2,483 cubic meters per person per year, followed by the Italians (2,232), and the Thais (2,223) (figure 3.26).

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2,030 1,530
Breakfast

vegetarian menu
total kcal

liters of water consumption

14% 30% 56%

Snack 1 container of lowfat yogurt 1 piece of fruit 185 LITERS Lunch

Proteins

Fats

Carbohydrates

1 portion of fruit (200 g) 4 pieces of zwieback toast

1 portion of Caserecce Sicilian with wild fennel 1 portion of squash and leek casserole 300 LITERS

152 LITERS

Snack 1 container of lowfat yogurt 1 packet of unsalted crackers 115 LITERS

Dinner 1 portion of vegetables: green beans (200 g) and potatoes (400 g) with flakes of parmesan cheese (40 g) 780 LITERS

2,140 4,300
Breakfast

meat menu

total kcal liters of water consumption

Proteins

15% 25% 60%

Snack 1 piece of fruit (200 g) 120 LITERS Dinner 1 portion of Barilla Risoni soup and peas 1 grilled steak (150 g) 1 slice of Pan Bauletto sliced bread 2,550 LITERS Lunch

Fats

Carbohydrates

1 cup of lowfat milk 4 Tarallucci biscuits 183 LITERS Snack 1 container of lowfat yogurt

1 portion of Margherita pizza Mixed raw vegetables 1,325 LITERS

125 LITERS

figure 3.25
Virtual water consumption and eating habits: two menus compared Source: BCFN, 2011.

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The differences between countries depend on several factors, including volume of consumption (generally correlated to the wealth of the country), the model of consumption (especially where eating habits are concerned, as noted above, as well as the utilization of industrial goods), the climate (which especially affects the level of precipitation, plant transpiration, and the quantity of water necessary for farming), and the agricultural practices adopted (especially how efficiently water is used). Today agricultural products are traded all over the world. That trade pays no attention whatsoever to the water component included in the exchange. Yet virtual water trading goes on in huge volumes as crops requiring large amounts of water to cultivate are shipped far and wideand not always with sensible results. Of the top 10 wheat exporters, for example, three are seriously short of water, while of the top 10 wheat importers, three are blessed with an overabundance of

United States Italy Thailand Nigeria Russia Mexico Brazil Indonesia Pakistan Japan India China 0 500 1,000 1,500 Industrial products 2,000 2,500 3,000 Average world water footprint

Home consumption of water

Agricultural products

figure 3.26
Contribution of the leading consumers to the global water footprint (m3 per capita/year) Source: BCFN, 2011.

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Eastern Europe

18

Former Soviet Union

13

North America

Western Europe

108

152

Central and Southern Asia

Central America

North Africa

45

150

South America

Central Africa

Middle East

Southeast Asia

107

16

47

30

Southern Africa

Oceania

70

figure 3.27
Virtual water flows between countries linked to trade in agricultural products (net virtual water importersGm3 /year) Source: Hoekstra and Chapagain, Water Neutral: Reducing and Offsetting the Impacts of Water Footprints.

it. The level of interdependence among countries in the virtual exchange of water resources is, however, critical and is also destined to grow in the future, given the ongoing deregulation of international trade. Figure 3.27 gives some sense of the patterns and volumes of the global trade in virtual water embodied in agricultural products; net importers are shaded in red and next exporters in green. The globalization of the use of water seems to entail both opportunities and risks. One of the chief opportunities lies in the fact that virtual water can be considered as an alternative water source, allowing local water resources to be preserved when high water footprint products are imported instead of directly produced. Moreover, because of the option of trade, it is possible to achieve a net savings in the volume of water consumed when a product is marketed by a country with high water productivity for that product, to a country with low water productivity. The greatest risks, on the other hand, lie in the possibility of excessive dependence on other nations water, and in the possibility of water colonialism. In this process, importing nations benefit from the products made using lots of water while leaving the exporting nations, which made the products using their own water resources, to suffer the problems of overconsumption. Water colonialism can be seen as a form of domination of poor countries by rich ones even if no physical occupation takes place.

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Water as a strategic objective is increasingly at the root of conflicts within and between countries, triggered by competition among the various uses of water (domestic, industrial, or agricultural) within a single country, or else by the use of a body of water that extends over borders. The potential for increasing conflict of this sort is reflected in the fact that water basins shared by multiple countries cover almost half the worlds surface and link 145 nations. 3.12 water privatization and its implications The expression water privatization can refer to three different contexts. The first is the context of the rights of private property for water resources, allowing the free purchase and sale of water. This context can be found in some parts of the United States and in some developing countries but is quite foreign to the European experience, where water is firmly in the hands of the collective. The European institutional system has in fact always been based not on the regulation of the use of water as a commonly owned resource which cannot be sold. The user, therefore, does not buy the water, but rather acquires the right to use it. The second context is the involvement of the private sector in the management of water services. Any of three different business models may apply: lifelong territorial monopoly, privatized and regulated, as applied in the United Kingdom; this model in effect transfers ownership of the entire infrastructure and control of the water to the private operators; public ownership with temporary awarding to private operators through bid competitions, which is what happens in France; public ownership and operation, as in Italy and Germany, with the acquisition from the market of the resources necessary in order to provide the service. The third context is the involvement of the private sector in financing infrastructure and services, when the traditional means of public finance are no longer sufficient to do so in a timely and satisfactory manner. The privatization of water brings with it risks and benefits. Among the chief potential benefits is the presumed greater efficiency of the private sector in optimizing the management of water distribution, controlling costs, and reducing user costs and pricing. Entrusting these contracts to private operations also makes it possible to share the costs of infrastructure maintenance in exchange for profits. Among the risks are price hikes, which can be substantial at times, and the failure of private operators to meet their obligations to contribute to the development of the water system, especially where poorer neighborhoods are concerned. Given these risks, if water is a good that belongs to everyone then only an effective system of democratic control can adequately guarantee against the waste and abuses deriving from ineffective management of water resources, whether public or privatized.

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the potential areas of intervention needed to take on the challenge of the water economy
Its clear that this sobering litany of challenges surrounding the worlds water resources needs focused and ongoing attention. Among the objectives of the Barilla Center for Food & Nutrition is to increase that attention and awareness, with a focus on the most critical aspects of water use. We have also provided a series of recommendations on how best to deal with the various emerging challenges of the water economy. In our view, there are eight priority areas for intervention: 1. the policies, models, and tools that can be used to encourage a genuine integrated management of water. 2. the practices, know-how, and technology for increasing the productivity of water (more crop per drop) and reducing waste. The existing correlation, nowadays very strong, between economic development, demographic growth, and corresponding increases in the levels of water consumption, must be broken. 3. the water footprint as an objective indicator, simple and easy to communicate. The water footprint is an invaluable tool for assessing the environmental impacts of individuals, companies (of production and distribution, within each sector), and countries. 4. ways of eating and consumption requiring a lower water content. We must begin shifting individual behavior and models of consumption toward lifestyles that entail more careful use of water. 5. the efficient localization of crops and virtual water trading. Major efficiencies in global water consumption could be achieved by rethinking the localization of cultivations requiring high water quantity in countries where water is abundant and trade them in the countries where water is scarce. 6. support for institutions commitment to their responsibilities for ensuring access to water. Disadvantaged populations rely heavily on existing institutions to ensure access to drinking water and sanitary infrastructures, to promote the necessary investments, and to remove technical and political obstacles. 7. the economic exploitation of water resources and the internalization of the cost of water in the price. A key measure here is to reframe economic

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thinking about water markets through the development of economic models that allow the precise valuation of water in various uses. 8. an effective democratic control on the water resource management either the water is privatized or public. Privatization must be considered from the point of view of its effects on individuals and communities, and private companies must be required to operate ethically. A strong and effective democratic control systems must be built in order to protect users from the risks that derive from inefficient management and services of water, whether it is public or privatized.

in the global scenario of water, there is both good news and bad news

Theres plenty of water on earth, but not always where its needed. Water is free in nature, but the infrastructures needed to distribute it are

extremely costly. In many areas of the planet, water is easily accessible at reasonable costs, but people take it for granted that it will always be available. Nature constantly recycles and purifies the water of rivers and lakes, but humanity is polluting water faster than nature can recycle it. Theres a great amount of underground water, but mankind is using it faster than nature can replace it. About 5.7 billion people have access to clean water, but 800 million dont. Four billion people have basic sanitation, but 2.5 billion dont. Millions of people are trying to escape from their condition of poverty, while the richer people on Earth use more water than necessary. The pace of industrialization is rising, even though industry needs more fresh water. Industry is becoming more and more efficient in the way it uses water, even though many companies still use water in an unsustainable and inefficient way. There is a growing awareness of the water problem, but translating that awareness into action is a slow process. The challenge of the water economy begins now: to win that match will take the collaboration of each and every one of us.

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interview the challenging transition toward sustainable agriculture

Hans R. Herren
What are the key challenges for agriculture sustainability now and in the future? What are the problems with the current situation? The main challenges agriculture and the food system in general are facing are: How to eliminate the persistent nexus of hunger and poverty? How to deal with the nutrition and health issue? How to reduce inequities and cater for rural livelihoods? The main problems agriculture is facing today are in the realm of adaptation to climate change; producing sufficient, diverse and quality food, feed and fiber at affordable prices while being remunerative for the producers and compatible with sustainable agricultural practices; the increasing competition from the bio fuel sector; the increase of fossil energy prices and in the medium and long term also its scarcity. Are there some agricultural production models which could help in achieving a higher level of sustainability? How is it possible to effectively manage the transition towards more sus tainable production paradigms?

Farmers and scientists have devised a number of agricultural practices over the years that are in line with the requirements of a sustainable and multifunctional agriculture, as requested in the IAASTD report Agriculture at a Crossroads. These go by different names, ranging from organic, bio dynamic, agroecological, low or zero tillage to conservation agriculture, with different levels of compliance to the sustainability and multifunctional goals. The closest models to the set goals are agroecology, and organic /bio dynamic agriculture, although even in these cases, more work is needed to meet social, environmental and economic sustainability. In principle, there is a need to develop and build into these and new systems more resilience and regenerative potential, given that the present system still uses too much water and external, often non renewable inputs. The transition from these unsatisfactory systems requires a new approach to

Hans R. Herren is a worldrenowned scientist, and since May 2005 he has been the president of the Millennium Institute. He was the director general of the International Center of Insect Physiology and Ecology in Nairobi (ICIPE), as well as one of the directors of the International Institute of Tropical Agriculture (IITA) in Benin. Today he is a board member of many organizations; he was codirector of the International Assessment of Agricultural Knowledge, Science, and Technology for Development (IAASTD); president of Biovision, a Swiss foundation with a worldwide goal of alleviating poverty and improving life for poor people while still preserving the pool of precious natural resources that support life. He has won many prizes for his research.

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research and extension, which is participatory, localized and includes the stakeholder beyond production, such as consumers / users, providers of inputs and also the transformation and retail sectors. This is necessary, as production systems are shaped in part at least, by these sectors that are beyond the farm gate and research lab sectors. There is also a need to recognize that agriculture and food are the responsibility of Governments and that these areas need major funding from the public sector, rather than to be delegated to the private sector alone. The latter still has a large role to play past the farm gate in particular, along the value chain from the farmer to the consumer. The transition will be further help and supported by introducing true pricing of the products, i.e., include the production and transformation, as well as the indirect health costs externalities into the retail price, removing all perverse subsidies and replacing them with payments for ecosystem services and rewards for sustainable practices. Managing this transition will need political will and vision beyond what is presently experienced, at all levels of governance, from global to local, new institutions to support and manage the paradigm change as well as a change in consumer / user behavior. It will also require a new systemic and holistic approach to analyzing the agriculture and food system, to identify the key leverage point and synergies to achieve the multifunctional agriculture goals while minimizing the negative feed backs. New national agricultural policies will need to cater for the internal need of food, feed and fiber production, as well as for the enabling conditions, that are just as important, as rural infrastructure, access to markets and both capital and insurances. What kind of technology innovation and agricultural practices are required to meet the goals of sustainability in agriculture? What should be done to improve and pro mote agricultural best practices all over the world and further foster innovation? The main areas of knowledge, science and technology needed to transition agriculture towards the sustainable systems required to address the above mentioned challenges are rooted in the soil, so to speak! The world is facing many challenges, in particular the fact that in the developing countries the soils have been largely mined of their nutrients, while in the developed countries, we have mostly over-fertilized, the consequence of each practice are degraded, eroded and low fertility soils, devoid of the needed soil biota to assure sustainable fertility levels that allow quality and quantity production under the new stresses of climate change. Soil fertility restoration is therefore the number one concern, to which we need to add improved and more diverse cropping systems, with more different crops in the rotation, the inclusion of animals on farm and new methods for pest and disease management that take advantage of the gifts of nature in the form of natural control mechanisms, either already built into

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plants through evolution or through system management practices, that go from field to landscape scale. It has been demonstrated in the UNEP Green Economy Report Agriculture chapter (2011), that by implementing the basic tenets of sustainable agriculture as suggested in the IAASTD report, all key sustainability goals can be achieved, with investments that are below todays subsidy levels. The main factor being that agriculture needs to be green by design, rather than by making few changes at the margins (green washing), as suggested by most vested interest groups from the input agribusiness. Investments need also to be made in enabling conditions, such as rural infrastructure, institutions and along the value chain to assure markets for agricultural products, provide quality jobs in and around agriculture to keep the younger population in the rural areas By making serious changes from agricultural sciences to political choices, agriculture and food systems can be made sustainable and able to deliver on the multifunctional goals, for the present and future food, feed and fiber needs of a growing and more demanding population and also for the long haul.

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interview virtual water between underconsumption and poor management

Tony Allan
You introduced the concept of virtual water many years ago: the products we use and the foods we eat on a daily basis are produced consuming large quantities of water. How can we promote greater awareness of the impact of the use of water on the environment and encourage the diffu sion and the adoption of sustainable behaviour among citi zens and enterprises?

Only with great difficulty. We humans beings dont understand the true value of water, and we are at a point in our relationships with natures vast but limited water resources where we simply cannot afford to stay ignorant. Already, our over-consumption and mismanagement of water has had a very serious impact on our water environments and the essential services they provide. Our ignorance is immense. Most of us dont have the slightest idea about the sheer volumes of water involved in our daily lives. To make a cup of coffee, it takes 140 litres. Thats the true amount of water used in growing, producing, packaging and shipping the beans you use to make your morning coffee. A lunchtime hamburger take 2,400 litres and that favourite pair of jeans a whopping 11,000 litres. In fact, all the goods we buyfrom food to clothing to computershave a water cost in the form virtual water: the powerful new concept that reveals the hidden factors of our real global water consumption. At the start of the twentieth century, with a global population of one billion, this ignorance simply did not matter. The ratio of water to people was so massive that it was as if our water supply was infinite. But it is not. And now, with a global population pushing seven billion, water scarcity is not just a possibility. It is already a reality for many. Unfortunately society has evolved not to value water. We are addicted to over-consuming water, and we dont know it. Are the main economic players conscious of the problems and challenges involved in water management? Neo-liberal markets that operate in the food supply chain are almost totally blind to the costs of delivering water. This is especially true on the farms of the world, where most of the water needed by society is used and man-

Tony Allan is one of the worlds leading international experts on water. For his revolutionary virtual water concept, he was awarded the Stockholm Water Prize in 2008. His latest book (Virtual Water) is a textbook in the subject and one of the most original pieces of thinking in the field in recent years.

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aged: farmers are the de facto water managers of the world. They manage the big water, the invisible 80-90 per cent of all water used in the global economy, employed for the production of food. Of the eight nations states I examined in my latest book,16 seven have seen significant improvements in their returns to water in farming. We have indeed uncovered a golden rule: the development and diversification of economies is always associated with massive increases in the productivity of water, and these increases are delivered by farmers using big water. That is, the big volumes of water integral to food production. Sadly, the converse is also true. Developing economies, that falter or face nearly insurmountable problems in combining their land, water and capital see little or no improvement in their water productivity. These markets are regulated by water blind accounting rules held in place by armies of accountants and lawyers that populate powerful bodies such as the Federal Accounting Standards Board [in New York] and others world-wide. As well as the big four global auditorsPwC, E&Y, KPMG and Deloitte and countless other accountants and lawyers in the transnational agribusinesses and traders and other private sector firms. In the near future, the increase in the demand for water and the reduction in water supplies will make water more valuable and, consequently, increase eco nomic interests in it. Is it possible that the value (and the price) of goods and ser vices will be affected by the amount of water required to produce them? Getting the accounting rules establishment to adopt green economics and green audit principles will be a long elemental struggle. The food supply value chain is massively distorted by public policies that introduce financial pressures that have and will overwhelm attempts to get water valued to reflect its costs of delivery and to internalise the environmental impacts of its use. Of course, it is possible to reflect the costs and impacts in the use of water for domestic, municipal and industrial uses. But these uses only account for 10% of the water needed by society. The big volumes of water are in our food. Just as with the right to food, the right to water will require new laws on both local and international levels in order to prevent the interests of a select few from prevailing. How can we guarantee water for everyone? Do you see the risk of water wars in the coming years around the globe? Nations do not go to war over water. They trade food. International trade is much cheaper and low risk compared to armed conflict. Food prices have been falling for 200 years and prices will be low again once the current price spikes are over. Although probably not as cheap as in the past when wheat

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and other staples were on the world market at half costas a consequence of the subsidies in the US and the EU. Sustainably intensifying the use of scarce water resources and using them in ways that are socially and environmentally just in these distorted conditions will challenge this generation and a number of future generations.

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action plan
encourage nutritional behaviors and choices that are in keeping with the model of the double pyramid
Following the model of the double pyramid means adopting a balanced diet both in nutritional terms and in terms of environmental impact. The model of the double pyramid (food and environment) in fact shows that with sustainable diets the two objectives can be easily attained. We should consider that healthier foods also imply lesser environmental impacts in terms of the consumption of natural resources (soil, water, etc.) and reduced emissions. With particular reference to future generations, it therefore becomes necessary to undertake a process of collective awareness of responsibility which, while it should not exclude the children themselves, ought to focus on parents and the school system in order to encourage more responsible approaches to consumption.

encourage sustainable agriculture that takes into account local needs and considerations
The global agricultural system reveals a number of aspects of fragility, in part due to the current and future effects of climate change. In the awareness that there cannot be a single model of production that is capable of ensuring sustainability in different agricultural context, the only possible solution is that of a differentiated approach, one that takes into account the actual availability of resources and different socioeconomic and geographic settings. In this context, aside from the classic factors at play (soil quality, water availability, adaptation to atmospheric phenomena, etc.), we should also take into account other significant variables such as the local availability of energy and human expertise.

ensure water access, and manage it in a sustainable manner on a global level

It is important to reinforce the commitment and responsibility of public institutions to ensure access to drinking water and adequate sanitation infrastructures to everyone. In that context, it is necessary to encourage investments that make it possible to remove technical and political obstacles. More in general, the issues of water resources must be dealt with through models and instruments of integrated management that take into account the value of virtual water (included in all products on the market) and of water productivity in agriculture (more crop per drop), in part with a view to the reduction of waste. But it is also a good idea for the water footprint to be commonly used in order to assign a value to the production of goods and services, in order to better orient individuals to modify their behaviors and models of consumption in directions that entail a more careful and responsible use of water.

table of contents
introduction
Agriculture, Food, Nutrition and Health by Ricardo Uauy

facts & figures

4.1 4.2 4.3 4.4

food for a healthy life

A Few Key Figures: Global Trends in Chronic Diseases and their Social and Economic Impacts Guidelines for a Healthy Way of Eating and Lifestyle The Most Common Guidelines and Dietary Models Recommendations

food and children: educate today for a better life tomorrow

4.5 4.6 4.7 4.8 The Spread of Obesity and Overweight in Children and Adolescents and the International Economic and Social Impact Nutrients in the Different Phases of Growth Guidelines for Healthy Diets and Sound Lifestyles in Children and Adolescents Recommendations

longevity and welfare: the fundamental role of nutrition

4.9 4.10 4.11 4.12 Demographics, Longevity, and the Economic and Social Impacts of the Principal Diseases Diet and Lifestyle and Their Effects on Longevity and Diseases of Aging Inflammatory States and Caloric Restriction: Possible Interventions to Slow the Aging Processes Recommendations

interviews
Companies Must Behave Responsibly by Marion Nestle The Responsibility for Children Must Be Shared by Aviva Must Lifestyles Influence the Way We Age by Alex Kalache

action plan

 4. food for health

Food for Health explores the relationship between food and better health. It analyzes the recommendations made by the most well respected scientific institutions around the world in the fields of nutrition and health. The chapter offers a set of concrete proposals designed to facilitate the adoption of healthier lifestyles.

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4. food for health

Agriculture, Food, Nutrition and Health
Ricardo Uauy

sor of Public Health Nutrition the Institute of Nutrition and Food Technology (INTA), Chile and at the London School of Hygiene and Tropical Medicine. Since 2008 he has been a member of the WHO/FAO expert committee on Fats and Fatty Acids in Human Nutrition, and since 2007 he has been a member of the WHO/FAO expert committee on Scientific Update on CHO 06 and on Trans Fats. He is also a member of many other scientific committees including: expert consultation on Prevention and Control of Childhood Obesity and the WHO expert panel for Scientific Update on Carbohydrates in Human Health/ Disease, the Reference Group for Global Strategy Diet Nutrition and the Prevention of NCDs (non-communicable diseases), and FAO/WHO Expert Consultation on Energy Requirements in Rome.

ricardo uauy is Profes-

There is no good health without good nutrition, and good nutrition depends on agriculture. Yet international and national agencies for agriculture and health interact little and often have different and sometimes contradictory agendas. Ministries of agriculture as well as nternational food and agriculture agencies aim for increases in food and feed production, while health ministries and the World Health Organization focus on the need for healthier food and controlling the pandemic of nutrition related chronic diseases. Yet health and nutrition objectives can only be met if both food and health needs are addressed with a common agenda. A healthy diet provides sufficient energy to maintain a balance between consumption and expenditure. Based on these goals, a healthy diet is one that is high in whole grain cereals, vegetables, fruits, and legumes (supplying the necessary energy, fiber, micronutrients, and protein), while limiting the amounts of saturated and trans fats, added sugars, and salt. A healthy diet is diversified, because consuming a variety of foods across and within different food groups is the best way to secure the intake of all essential nutrients. Because dietary patterns and foods differ across the world, recommended food groups should be established according to the prevailing agricultural practices and cultural context, utilizing the local foods available that contribute in meeting nutritional needs. Dietary diversity may be difficult to achieve under conditions of poverty,

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where diets are based on single energy-rich foods (wheat, corn, rice, or potatoes) with little consumption of animal products, fruits, or vegetables. In urban areas, increased consumption of packaged foods, even among the poor, may aggravate inadequate micronutrient intake. A healthy life is conditioned not only by the food we eat but also by how much energy we spend, since we evolved under conditions of limited energy and food supply. We are equipped with a set of highly effective systems that allow us to get virtually all the energy available in our foods, and if we eat beyond our expenditure we are very efficient in storing all forms of food energy as fat tissue. This allowed us to survive food shortages and even famine conditions. Our genes over the past several millennia were selected based on this model, thus the difficulty of preventing obesity. In summary, the quality of the diet has been recognized from the earliest of times to play a key role as a determinant of health and wellbeing of human populations. The evolution of humans has been shaped by the nutritional quality of our diets. Homo sapiens is virtually identical to most primates in terms of its genetic make up., What made us different was the diet of early hominids; from being almost strict vegetarians we diversified our diets, and animal foods and fats then provided not only increased energy density but essential fatty acids

food based dietary guidelines

In any diet, we recommend the consumption of: Fruits and vegetables. Whole grains and fiber (intact plant foods not added fiber). Tree nuts. Fish, algae and other marine foods. Healthy vegetable oils (olive, soy, rapeseed). Low saturated fat dairy and milk products. We recommend moderating the consumption of: Processed foods (high in sugar, trans fats and sodium). Processed meats. Sugar-sweetened beverages. Industrial partially hydrogenated fats (trans fats). Refined carbohydrates and free sugars. Added sodium and salty foods. Added sugars and sugary drinks.

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and micronutrients to form a progressively larger brain and a more complex nervous system. More than hunter-gatherers, we evolved as scavengers. Now, traditional diets in most developing and transitional countries are being replaced by high-fat, high-carbohydrate, energy-dense diets with a substantial fat and sugar content. This increases palatability but also leads us into obesity and related chronic diseases. The solution to hunger and malnutrition is not achieved by providing energy in sufficient or excessive amounts; it should also be adequate in micronutrient content and in the quality of the macronutrients supplied (fats, carbohydrates and proteins). Good health requires good nutrition, and good nutrition depends on healthy foods and sustainable agricultural practices.

food education: the schools

Schools can play a fundamental role in teaching good eating habits. The initiatives that encourage healthier diets among children and students are becoming more widespread, and they often involve very influential testimonials, such as the First Lady of the United States, Michelle Obama.

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4. food for health

RISE IN DEATHS CAUSED BY CARDIOVASCULAR DISEASE

17.5 mILLION
2007

2005

2015

Equivalent to 30% of all deaths worldwide. Of these deaths, 7.6 million are due to heart disease and 5.7 million to strokes

20 mILLION
2030

This figure confirms heart disease as the leading cause of death worldwide

GROWTH OF DEATHS DUE TO CANCERS

7.9 mILLION 9 mILLION 11.4 mILLION

In 2007, there were 7.9 million deaths worldwide that can be attributed to cancers. According to future estimates, this figure will rise to 9 million in 2015 and to 11.4 million in 2030.

2015

+ mILLION

7 YEAR DIABETICS/PER
Every year there are more than 7 million new cases of diabetes worldwide: one every 5 seconds. In 2007, the worldwide rate of diabetes was roughly 6% among people aged 20 to 79, equivalent to approximately 246 million people, with roughly a 27% increase over 2003 (194 million diabetics)

194 mILLION
+
INCREASE

estimate 2003

27%

246 mILLION
estimate 2007

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LIFE EXPECTANCY AND CHRONIC DISEASES

80%

of those over 65 are suffering from at least one chronic disease

50%

of those over 65 suffering from two or more chronic diseases

In the last hundred years, life expectancy at birth in western nations has almost doubled, rising from 45 years at the end of the nineteenth century to roughly 80 years in 2010. Despite this, the percentage of people over 65 suffering from two or more chronic diseases is very high.

12.5 mILLION OBESE CHILDREN

25%

17%
CALORIC INTAKE & AGING
There is a significant link between food and problems in the aging process. The molecular, metabolic, and hormonal alterations caused by an excessive and chronic caloric intake, and by a defective nutritional model and lifestyle, play a central role in the aging process

In the United States, 17% of all children between the ages of 2 and 9 and one third of all adolescents are either overweight or obese

148 mILLION UNDERWEIGHT CHILDREN

OF THE POPULATION IS UNDERNOURISHED
That is how many underweight children under the age of 5 there are in the world, and they live, for the most part, in developing nations; they account for 25% of the entire world population of undernourished people

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food for a healthy life

Diet plays an increasingly crucial role in any attempt to enjoy a balanced lifestyle. Food, in fact, plays an essential part in the prevention of a number of pathologies, including chronic diseases. These conditions have risen continuously and to a significant degree in recent decades within populations all over the world. The interpretative model adopted by the Barilla Center for Food & Nutrition begins with this key fact and goes on to analyze in detail the importance of various factors correlated with diet to human health. We analyzed the trends, worldwide and in Italy alone, in the chief chronic non-transmissible diseases (cardiovascular diseases, diabetes/metabolic syndrome, tumors). These are the three disease groups whose onset appears to be most clearly tied to diet and to overweight and obesity, an increasingly real critical factor in the overall picture of world health. The next step was to analyze the role played by different dietary and behavioral choices in preventing the most significant chronic diseases. Then we reviewed the principal findings in the international scientific literature on the relationship between diet and cardiovascular diseases, diabetic diseases, and cancers. We looked closely at the linkages between the ingestion of a broad array of macro- and micronutrients and the likelihood of the onset of these diseases. At this point it was necessary to translate the complex and deeply technical scientific findings into more user-friendly dietary and behavioral guidelines. We did this by reviewing the guidelines offered by the most respected international scientific societies on good nutrition, diet and lifestyles for the prevention of chronic diseases. Finally, we wrote a summary of the guidelines, noting where they agreed and overlapped. The end result was a document that distills the best current understanding of diets role in preventing chronic diseases and promoting general good health. (Beyond their medical benefits, we have also tried to quantify the benefits of adopting sound diets in economic and financial terms.) Building on this analysis, BCFN has developed a set of practical recommendations intended to encourage the spread of beneficial ways of eating. While doing this work BCFN has made a few general observations. First, over the last 50 years we have seen a growing awareness of the greater efficacy and efficiency of prevention as opposed to acting only when patients have already become sick. We say greater efficacy because prevention makes it possible to attain better results overall, in part because prevention works to the benefit ofit of a broader share of the population than does medical treatment. We also say greater efficiency because prevention costs less. It is this second factor

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that ensures that prevention will be one of the chief strategic approaches in the effort to ensure the sustainability of health systems burdened by constantly rising levels of investment and operating costs, as seems to be the case in every nation in the Western world. At the same time, however, prevention is clearly also fundamental in emerging and developing countries, where we have seen a general movetoward the westernization of diet and lifestyles, with corresponding increases in the dietary disorders and diseases linked to them. In these areas its necessary to act before the bad habits can develop into deep-rooted practices, if we have learned anything from the experience of the last few decades in Western countries. For all these reasons, the gradual shift weve seen over the last few decades, from treating diseases to preventing them, is welcome. Still, not enough has been done yet, especially in the face of the dramatic change in world dietary habits. BCFN is convinced that prevention is an essential and not fully explored area for the future of medicine and nutritional science. Prevention appears to be fundamental to ensuring that the younger generations do not find themselves saddled with inferior conditions of health and welfare (perhaps even radically inferior) compared with those enjoyed by preceding generations. So it is fortunate that the awareness of the links among diet, lifestyle, and health are growing. The first studies establishing those links between behavioral choices and the onset of diseases began to appear in the 1950s. Investigations followed into the nature of the underlying social, environmental, and cultural factors. One of the most important of those factors, not surprisingly, is simply information about diet and health. By itself, however, information about diet is not enough. The problem is bigger than that. Everywhere we see a way of life emerging that involves an increase in the average quantity of calories ingested, the emergence of nutritionally unbalanced dietary models, significant reductions in time spent in physical activity, and the loss of value attributed to food as a central social and cultural element of everyday life. To prevent these trends from spreading their devastation, what is required is the rediscovery and renewed appreciation of an idea of food and lifestyle centered on quality: a reduction of the quantity of food that we consume and a greater focus on the quality of that food, but also on the quality of the way we live and the quality of the relationship between man and food. We must rediscover and appreciate the social and cultural importance of the act of eating. What we need, then, is an overall paradigm shift that focuses on the person and his or her behaviors, not just on their narrow dietary choices. This shift will affect not just individuals, but also medical institutions, public agencies, and the private businesses in the agro- alimentary sector. The first and perhaps the most important task will be to correct the dietary

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habits and ways of life among children, from pre-school age all the way up to adolescence. This phase of life is absolutely crucial to all subsequent development. The dietary habits and behaviors adopted during the first few years of life are decisive influences on ones health during childhood and adolescence and health and quality of life in later years. However, individuals cannot by themselves change trends that have been influenced, encouraged, or not adequately disincentivized by many other forces shaping public health, including government, doctors, the mass media, and private companies and corporations. To succeed, any effort to improve the current scenario must fully and synergistically engage all the key actors in the agroalimentary world. This collaboration is not just important, but fundamental, in mounting a successful prevention effort. And we must act quickly; the rapidity and depth of the trends make time a crucial element in all and every corrective intervention. All the data are revealing a rapid decline in average health conditions, both current and predicted, even in areas (such as Italy) normally considered the homelands of sound diets and healthy lifestyles. Unless the dietary and lifestyle trends that have emerged with such striking speed over the last few decades on a worldwide level are reversed, future generations will be inexorably condemned to live less well than the generations that preceded them. In fact, in the modern history of humanity there has never been such a marked shift in the quality of life and the average conditions of health as the one thatto judge from the data at handwe can fairly expect to see beginning in the coming 10-30 years. Unless we begin, and immediately, to modify the lifestyles and dietary habits of the current generations, starting with young people, what will we be capable of doing once all the medical and health consequences of those habits have done their damage? BCFN has come to the firm beliefthrough the work that it has carried out in these years, through the analysis, the observations, the discussions with the leading international experts on the issues of diet and healththat there is no more time to waste. 4.1 a few key figures: global trends in chronic diseases and their social and economic impacts Today the principal chronic diseases (cardiovascular diseases, diabetes, and tumors), represent the chief risk factor for human health, as well as an enormous socioeconomic burden on society as a whole. These diseases cause some 35 million deaths every year60 percent of all worldwide deaths and 80 percent of deaths in low- and medium-income nations. The most important studies reveal that roughly 80 percent of all cases linked to these diseases could be prevented by eliminating such risk factors as

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the consumption of tobacco, unhealthy diets, physical inactivity, and the excessive consumption of alcohol. On the other hand, without adequate prevention, their impact on global health could increase by 17 percent in the next 10 years. Over the last decade, in nearly all the countries on earth, there has been an exponential increase in obesity. This trend has been so marked that it led the European Association for the Study of Diabetes (EASD) to proclaim the prevention and treatment of obesity the most important public health problem throughout the world. Currently, more than 65 percent of all Americans are obese or overweight, and we are seeing this phenomenon spread to the younger sectors of the population. The gravity of overweight and obesity among young people is documented, to cite once again a shocking American statistic, by the tripling of cases of overweight young people from 1970 to the present day. According to a recent study by the Trust for Americas Health and the Robert Wood Johnson Foundation, nearly a third of all American children and adolescents have been found to be either overweight or obese.1 Overweight and obesity are now fully recognized as diseases. Aside from their importance to health, they also have significant economic effects. In the United States, for example, the World Health Organization (WHO)2 estimates that the direct cost of obesity accounted for roughly 7 percent of all health-related costs in 1995, that is, some US$70 billion. the impact of cardiovascular diseases. Similarly, the increase in cardiovascular diseases is strongly linked to poor diet. The World Health Organization has noted that in 2005 there were roughly 17.5 million deaths due to cardiovascular diseases worldwide, equal to 30 percent of all deaths. Of those deaths, 7.6 million were due to heart disease and 5.7 million were caused by strokes. Its been estimated that, by 2015, the number of deaths caused by cardiovascular diseases worldwide will grow to 20 million every year. This makes cardiovascular disease the number one killer on Earth. In the United States it is estimated that 80 million people are affected by one or more cardiovascular disease in any given year, and more than 860,000 die of those diseases. Throughout Europe, on the other hand, cardiovascular diseases are responsible for 4.3 million deaths every year (2 million within the European Union).3 Coronary diseases are responsible for the greatest number of fatalities (1.9 million deaths in all Europe and over 741,000 in the member nations of the European Union). If we assign a cash value to these data, some truly astonishing numbers emerge. The most recent estimates of the total cost of cardiovascular diseases in the United States indicate an impact of US$473.3 billion in 2009. This value includes both direct health costs (hospital treatment and care, pharmaceuti-

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cals, home assistance, etc.), and the indirect costs calculated as a loss of working productivity caused by the sickness or premature death of the patients. In Europe, the total economic impact of cardiovascular diseases for 2006 was estimated at roughly 192 billion, which corresponds to a total average per capita cost of 391. In Italy, the total costs of cardiovascular diseases have been estimated at roughly 21.8 billion per year. 4 Of these costs, 63 percent (13.8 billion) have to do with the direct costs charged to the health system, which include the costs of hospital treatment and care and the cost of pharmaceuticals. Another 37 percent of the total economic impact of cardiovascular diseases is due to the indirect costs related to the loss of productivity of the working-age patients due to sickness and death and the other informal costs for the care of patients,5 for a total of roughly 8 billion annually. The spread of cardiovascular diseases entails serious economic and social repercussions, not only in the developed countries, but also in developing nations such as China. According to recent WHO estimates,6 the cumulative cost over 10 years of cardiac diseases, strokes, and diabetes in China will be equivalent to US$558 billion. the impact of diabetes. With reference to diabetes (another disease strongly influenced by diet), among people aged 20 to 79 the worldwide incidence of the disease was around 6.0 percent in 2007, or about 246 million people. Thats an increase of roughly 27 percent over 2003 (when it was estimated that 194 million people suffered from this disease). Every year, worldwide, there are more than 7 million new cases of diabetesa new case every 5 seconds. Estimates for 2025 indicate a substantial increase in the rate, which will rise to 7.1 percent of world population (380 million people), an increase of 54.5 percent over 2007. The prevalence of diabetes will grow both in industrialized countries and in developing countries. In China, for example, it is estimated that there were approximately 39.8 million people with diabetes in 2007, equal to 4.3 percent of the population; in 2025 this number is expected to to rise to a little under 60 million (5.6 percent of the population), a 50-percent increase. An even more worrisome growth trend is expected in India, where the current number of cases of 40.8 million (6.2 percent of the population) is expected to rise to 69.8 million (7.6 percent of the population) by 2025. As in the case of cardiovascular diseases, the costs incurred in the treatment and care of diabetes are very high. According to the estimates of the International Diabetes Federation, those costs reached a global level in 2007 of about US$232 billion, with a projected rise to US$300 billion in 2025. A study by the American Diabetes Association7 estimated the cost of diabetes

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in the United States in 2007 to be US$174 billion, including US$116 billion for direct medical expenses and US$58 billion calculated as the loss of productivity of the patients and the family members involved in their care. American diabetic patients on average bear costs of over US$11,400 annually, of which US$6,650 is attributable directly to diabetes. Another study done of European diabetics8 estimates that, just for the direct health costs of the disease (hospitalization, clinical treatment, pharmaceuticals, etc.), an annual average cost of 2,834 per patient was incurred. Most of those costs (55 percent) was due to hospitalization for acute and chronic complications. cancers. Cancers are also tied to poor diet and nutrition. According to WHO data, in 2007 there were 7.9 million deaths worldwide that could be blamed on tumors; of them, about 75 percent occurred in low- to medium-income countries. Estimates point to a worldwide rise in deaths caused by tumors, to a level of 9 million in 2015 and 11.4 million in 2030. A clear majority of these deaths will occur place in low- to medium-income countries. In the United States, according to the estimates of the U.S. National Institutes of Health, the economic impact of cancers rose to more than US$228 billionin 2008, including both health costs and productivity losses. As for Europe (EU25), in 2002 cancer caused a loss of human life equivalent to nearly 10 million years, roughly 16.7 percent of the total years of health lost by all European citizens to disease. In a similar context, direct medical costs alone for cancer in Europe have been estimated, by the European Society for Medical Oncology, at 56.6 billion. The scope of the socioeconomic impact that can be traced to cardiovascular diseases, diabetes, and tumors is such that it demands an in-depth analysis of the role played by the different dietary and behavioral choices (physical activity first and foremost) in the onset of the leading chronic diseases. 4.2 guidelines for a healthy way of eating and lifestyle The World Health Organization defines health as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity,9 while a healthy lifestyle is a way of life directed toward the reduction of the risk of diseases and premature death. 10 Not all diseases can be prevented (for instance, heart attacks and cancer), but in many cases conscientious prevention can put off or reduce the risk of onset. Diet, therefore, is a fundamental component in creating a healthy lifestyle. But what kind of diet and lifestyle? Analyzing the guidelines for preventing chronic diseases from the World Health Organization and the worlds most

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risk factors and lifestyle

The WHO has published an in-depth study of the vast array of negative factors that cause the premature deaths of millions of people. The study, conducted worldwide, shows that among the top 10 health risks on Earth, seven are linked to lifestyle and diet: 1. Low weight and malnutrition (diet). 2. Unprotected sexual relations. 3. Arterial hypertension (diet and lifestyle). 4. Smoking tobacco (lifestyle). 5. Alcohol (lifestyle). 6. Non-potable water and hygienic shortcomings. 7. Hypercholesterolemia (diet and lifestyle). 8. Smoke produced by indoor fires. 9. Iron deficiencies (diet). 10. Obesity (diet and lifestyle).

respected international scientific societies11 leads us to the following key actions (figure 4.1): 1. Engage in regular physical activity, for 30 to 60 minutes a day, either moderate (for instance, walking, or bicycling) or high intensity (for instance, running, swimming, or team sports), most days of the week. 2. Avoid overweight and obesity, over both the short and long term (and make sure not to regain any excess weight you might have lost). 3. Avoid the excessive consumption of alcohol (no more than one glass for women and two glasses for men a day). 4. Dont smoke. 5. Adopt a balanced diet, characterized by careful control of the total caloric intake and by a proper composition of the various macro- and micro-nutrients. 6. Increase (up to about 400grams/day) the consumption of fruit and vegetables, focusing especially on those that are rich in food fibers, i.e., consume four to five portions of fruit and vegetables a day, which is easy to do through the elimination of snacking. 7. Choose sources of complex carbohydrates (cereal grains and legumes) and increase the consumption of unrefined cereal grains (for example, bread, pasta, breadsticks made with whole wheat flour). 8. Increase the consumption of legumes. 9. Eat two to three portions of fish a week.

teaching children to cook

In addition to proposing healthier and more balanced menus in school cafeterias, schools can involve children in food preparation through simple and entertaining activities. In this photo, children are making pizza at a food education workshop at a school in Madrid.

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guidelines for cardiovascular prevention

Fats: 1530% of total calories 30 minutes of physical activity every day Saturated fats < 10% and trans fats < 1% Less than 140 g of meat a day 45 portions of fruit and vegetables daily 45 portions of legumes a week 12 portions of fish every week Avoid conditions of overweight and obesity Encourage the consumption of unrefined cereal grains Dont smoke Consumption of alcohol not recommended Salt: 45 g/day and no dietary supplements

guidelines for prevention of diabetes

Fats: < 30% of total calories 150 minutes of physical activity every week Saturated fats < 10% and trans fats < 1% Proteins: 1020% of total calories 5 portions of fruit and vegetables daily 4 portions of legumes a week 23 portions of fish every week Avoid conditions of overweight and obesity Encourage the consumption of unrefined cereal grains Maintain a normal BMI Consumption of alcohol not recommended Salt: 6 g/day and no dietary supplements

guidelines for prevention of tumors

Limit consumption of fats 4560 minutes of physical activity every day Dont smoke Limit consumption of red meat and salami 5 portions of fruit and vegetables daily Eat legumes regularly Prefer fish to red meat Avoid conditions of overweight and obesity Encourage the consumption of unrefined cereal grains Maintain a normal BMI No more than one glass of alcohol per day Moderate salt intake

convergence of the guidelines barilla center for food & nutrition

healthy diet and lifestyle

1 5
30 minutes of physical activity every day Adopt a balanced diet Consume 23 portions of fish every week Restrict the consumption of meat and poultry to 34 portions a week

2 6

Avoid conditions of overweight and obesity Increase the consumption of fruit and vegetables Prefer plantbased condiments Restrict the added consumption of salt

3 7

Avoid the excessive consumption of alcohol Prefer complex carbohydrates and increase the consumption of unrefined cereal grains Restrict the consumption of foods with high fat content Restrict the consumption of foods and beverages with high sugar content

4 8

Dont smoke Increase the consumption of legumes Restrict the consumption of fried foods Avoid the daily use of food supplements

9 13

10 14

11 15

12 16

figure 4.1
The methodology followed for the convergence of guidelines for healthy diet and lifestyle Source: BCFN, 2009.

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10. Choose plant-based condiments (vegetable oils) over condiments with high contents of animal fat (butter, lard). 11. Reduce the consumption of foods with high fat content (for example, hot dogs, sauces, creams, cheese products, sausages), and increase the consumption of low-fat products (such as low-fat yogurt and skim or low-fat milk). 12. Reduce the consumption of fried foods. 13. Reduce the consumption of meat and poultry to three to four portions a week. 14. Limit the additional use of salt, above and beyond the levels naturally contained in foods (dont use more than 5-6 grams of added salt, roughly a teaspoonful). 15. Reduce the consumption of foods and drinks with high concentrations of sugars (for example, pastries and sugary drinks). 16. Avoid the daily use of dietary supplements. 4.3 the most common guidelines and dietary models Science does not identify a single hypothetical perfect diet, capable of ensuring the greatest possible benefits in terms of health and prevention of diseases. And for good reason: every region and country on Earth has its own native agriculture, dietary traditions, and customs, making any attempt to spread an ideal meta-diet both arrogant and pointless. To ensure that a diet can improve peoples state of health, actions and strategies should promote the rediscovery of regional diets and their most healthful nutritional components, which should be fully considered in light of the most recent scientific knowledge. BCFN, through a deliberate effort at simplification, has found it possible to single out three great dietary traditions in the world, each is characterized by its own distinctive traits: the Mediterranean model, the North American model, and the Asian model (which contains a number of important traditions and cultures, ranging from the Japanese to the Vietnamese and Chinese diets). different dietary models. The Mediterranean dietary model, prevalent in the countries of the Mediterranean region(in particular Italy, Spain, Portugal, Greece, and France), stands out for its nutritional equilibrium. Its first four componentsfruit, vegetables, products derived from cereal grains (in particular, unrefined cereal grains), milk and dairy productspresent a breakdown that is both balanced in terms of quantities ingested (from 200 to 260 grams a day of each food group) and in terms of daily consumption (the sum of the first four components amounts to more than 40 percent of daily consumption). If closely adhered to, the Mediterranean model is one of the most effective in terms of welfare and prevention of diseases. The North American (i.e., U.S. and Canada) dietary model has long been at

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the center of attention of the scientific world. That diet has triggered concern over the exponential increase in obesity and metabolic diseases in the United States. This seems to be the result of an excessive consumption of food (about 2,600 grams as against the roughly 2,000 grams daily of the Mediterranean model and the Japanese model) and an unbalanced nutritional composition that tends toward overconsumption of red meat and sweets; respectively 11.7 percent and 7.1 percent of total daily consumption.12 This diet, basically, is largely rich in proteins and sugars, which are not adequately counterbalanced by a high level of fruit and vegetables. These characteristics ensure that the North American diet falls notably far from recommended guidelines and should be to some extent revised and supplemented. The Japanese dietary model 13 taken as an example of the dietary style prevalent in eastern Asiafavors the consumption of cereal grains, equal to no less than 24 percent of the total daily intake, and fish. Fish consumption averages 107 grams daily, much higher than the 45 grams of the Mediterranean diet and the 18 grams of the North American diet. This diet is very similar to the Mediterranean diet in both components and preparation (a relatively modest use of frying as a way of cooking food). This diet includes an abundance of mineral salts, omega-3 fatty acids, phosphorus, and polyunsaturated fats, largely derived from fish. All of this shows that very different dietary models can coexist side-by-side, capable of adheringin different measures and waysto the principles sanctioned by medical science. The nutritional value of the Mediterranean diet, in particular, was scientifically demonstrated by the well-known Seven Countries Study 14 directed by Ancil Keys. That study compared the diets of the populations of seven different countries to test those diets benefits. The indicated that the best dietary regime was that of the inhabitants of Nicotera, in Calabria, who followed a Mediterranean dietary style. The populations of Nicotera, Montegiorgio (Marche), and Campania had very low blood cholesterol levels and a minimal percentage of coronary diseases. Their diet was based on olive oil, bread and pasta, garlic, red onions, aromatic herbs, vegetables, and very little meat. diet and chronic diseases. In general, diets close to the Mediterranean diet help protect against the most widespread chronic diseases. A number of studies15 have shown that sticking to the Mediterranean diet produces significant reductions in overall mortality, especially from deaths caused by cardiovascular diseases and tumors. The Mediterranean diet appears capable of reducing the risk of heart attack by 72 percent, but is protective against all causes of mortality, including Parkinsons disease and Alzheimers disease.16 Similar results are also found in recent studies17 conducted for 10 years on a sample of more than 380,000 Americans.

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4.4 recommendations In conclusion, two principal findings have emerged from BCFNs analysis up to this point. The scientific community is convinced that the linkage between lifestyle and health is direct and quite intense. In the context of individual choices, diet plays a decisive role. Moreoverand this result is even more interesting than the first onecomparing the various guidelines issued by the most respected international scientific bodies reveals general agreement on this simple fact: there are lifestyles and ways of eating that are capable of reducing, simultaneously and in parallel, the risks of the onset of overweight, obesity, tumors, cardiocirculatory disease, diabetes, and metabolic syndrome. This is an important finding. It lays the foundations upon which it is possible to send citizens and consumers clear, unequivocal, and detailed messages concerning the preferable lifestyles and dietary choices. The fact that it was possible to reach these conclusions by means of simultaneous studies in three different fields (cancers, diseases of the cardiocirculatory system, dysfunctions of the metabolism), shows once again how profitable it can be to examine on a systemic level knowledge that has been codified in contiguous but separate areas. The BCFN intends, therefore, as its very reason for existence, to work to generate new knowledge through efforts to assemble evidence, observations, and analyses that are already in part familiar, but which are rarely considered on an integrated and comprehensive basis.

food and children: educate today for a better life tomorrow

After devoting an entire year (2009) to the analysis of the overall relationship between diet and health, the BCFN concentrated its efforts in 2010 on an investigation of the link between nutrition and healthy growth in the various phases of a childs life, from the pre-school age to adolescence. As noted above, in Western countries, a high number of adult deaths are linked to excessive consumption of food and poor dietary and life habits. In many cases, those habits date back to a very young age. Childhood obesity, for example, is a serious risk factor for obesity in adulthood. On a more general level, lifestyles and behaviors that are acquired during an impressionable agesuch as dietary preferences, the composition of ones diet, the distribution of meals through the day, portions, the way of consuming foods, the tendency to an active or sedentary lifestylecan be important factors in creating an overall dietary behavior that

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is either adequate or inadequate in adulthood as well, as a result of a memory effect bound up with the habits acquired. It therefore appears to be fundamental to focus attentionbeginning in early childhoodon the adoption of healthy daily dietary habits and proper lifestyles. Although some of the factors leading to overweight and obesity are genetic in origin and therefore resistant to therapeutic or preventive intervention, others can respond to preventive actions aimed at modifying diets and lifestyle habits. But these interventions, if they are to be as effective and lasting as possible, must begin in the earliest phases of life. As the pediatrician Claudio Maffeis pointed out at the Second International Forum on Food and Nutrition, The earliest years of life are a very important window in terms of the development of the organism. [...] Eating right during the developing years is important because it not only ensures that the child will grow and develop properly, but it also guarantees a defense against diseases, metabolic and otherwise, that we might encounter in later phases. 4.5 the spread of obesity and overweight in children and adolescents and the international economic and social impact All Western countries are experiencing an exponential growth of the phenomenon of childhood obesity and overweight. According to data gathered by the International Obesity Task Force,18 there are 155 million obese or overweight school-age children, or 1 in 10. Of them, 30-45 million are classified as obese, which means 2-3 percent of children between the ages of 5 and 17. Even though it is not an isolated case, the United States certainly exemplifies the trend of spreading obesity and overweight among the younger sections of the population (as well as among adults19). Twenty-five percent of American children are overweight and 11 percent are obese. These fractions seem to be confirmed by a more recent study done by the Trust for Americas Health and the Robert Wood Johnson Foundation, which states that nearly a third of all American children and adolescents are either overweight or obese. According to the National Institutes of Health, moreover, alongside the 16 percent of children between ages 6 and 19 that are currently overweight, we should keep our eye on a further 15 percent who appear to be at considerable risk of becoming overweight. The rapid spread of this phenomenon has been affecting not only the United States, but all the leading advanced nations over the last 20 years. In Europe too the problem of childhood obesity is increasingly widespread: every year in member countries of the European Union approximately 400,000 children are considered overweight and more than 85,000 are considered obese.20 As for juvenile obesity alone, nowadays its prevalence in Europe has been shown to be 10 times greater than it was in the 1970s.21 In Italy this issue has taken on growing importance, as a result of the rise of the

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numbers of adolescents and children who are overweight or obese. In Italy, out of every 100 children in third grade, almost 24 are overweight (23.6 percent) and more than 12 are obese (12.3 percent). Overall, it is estimated that more than 1.2 million children between the ages of 6 and 11 have problems of obesity or overweight: more than a third of all children. The statistics on physical activity are anything but comforting: only one child out of ten obtains enough physical activity for their age and one out of four engaged in no physical activity on the day before the survey. Half the children, moreover, have television sets in their bedrooms. Finally, the perception of the problem by the parents, seems to be inversely proportional to the statistical frequency of the excess weight. Four mothers of overweight children out of ten do not believe that their children are overweight for their height. As the reader can easily imagine, the impact of overweight and obesity in childhood and adolescence is extremely significant, both for government health-care budgets and in terms of effects on the physical and cognitive development of children and adolescents. The European Association for the Study of Diabetes (EASD) recognizes that the prevention and treatment of obesity is the most important public health problem throughout the world. While the health consequences of childhood obesity and overweight appear to be well documented in the literature, as of this writing the economic impacts on social and health systems have only been quantified by a small number of studies. Particularly interesting are the findings of one recent research project22 conducted on young Americans between the ages of 6 and 19, which revealed that the subjects who are considered obese generated higher health costs compared with normal-weight children: US$94 more for doctors visits, US$114 more for drug prescriptions, and US$12 more for emergency services. If we extrapolate these data to the entire nation, obesity and overweight

bad eating habits in children

Often, children are obese or overweight because of dietary habits that both fail to support healthy growth and predispose those children to weight gain. In particular, it appears that: 11 percent of children dont eat breakfast; 28 percent eat an inadequate breakfast; 82 percent eat too abundant a mid-morning snack; and 23 percent of parents state that their children do not consume fruit or vegetables on a daily basis.

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among young people appear to cause incremental costs to the American health system of US$14.1 billion dollars a year just for those three categories. 4.6 nutrients in the different phases of growth Growth is a continual process that begins at the moment of conception and ends with the attainment of sexual maturity. Body growth is accompanied by neurological and psychological development. This long journey can be subdivided into three time periods distinguished by the particular anatomical and physiological modifications that take place in the child: childhood, adolescence, and youth. Specific dietary needs are associated with each phase, as are the intakes of nutrients and lifestyles to be recommended for healthy development. The earliest phase, childhood, can itself be subdivided into early childhood, which runs from birth to the first two years and includes the so-called periods of newborn (the first month of life), suckling, and weaning (first teeth); second childhood or the age of play: this includes the period running from the third to the fifth year of age, and third childhood, also called school age, which includes the period from 6 to 11 years of age. The second phase is adolescence (or puberty), and includes the period between the ages of 11 and 18 in the male, and between 11 and 16 in the female. Youth, finally, ranges from age 18 to 25 for males and from age 16 to 20 for females. In this latter phase, the nutritional and lifestyle indications are roughly the same as for adults. childhood. During the period of early childhoodwhich is characterized by very rapid growthit appears particularly necessary to ensure that a child is supplied with an adequate quantity of energy. The macronutrients contained in the foods that are capable of providing that energy are fats, carbohydrates, and proteins. A measure of how important the ingestion of energy is in the early years is the fact that, for every gram of macronutrients ingested and per unit of body weight, the quantity of proteins ingested by a young child is almost the same as an adult, but the carbohydrates ingested are almost twice as much and the quantity of fats is almost four times greater. Energy is necessary for maintaining respiration, circulation, and renal and cerebral function in conditions of rest (basal metabolism). Beyond that, energy is consumed in digestion, metabolism, and warehousing nutrients (thermogenesis), during the deposit of new tissues (growth), and in physical activity. In the first year of life, the demand for energy for growth is considerable compared to the total but it rapidly decreases, from 35 percent in the first month to 5 percent at the end of the first year. After the first year and until the ages of 9 or 10, 50-60 percent of the energy spent daily by the child is due to basal metabo-

education on the farm

In many of the most advanced economies, farms are changing their identities. In addition to producing crops, farms are now creating awareness among consumers about the benefits of local, organic, and sustainable food. Promoting direct knowledge about farming can encourage more conscious consumption among consumers.

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lism, 30-40 percent to physical activity, 5-8 percent to thermogenesis, and only 2 percent to growth. The WHO23 points out the fact that there is substantial similarity among the various recommendations concerning the quantity of energy necessary for preschool-age children. And so there is an overall range of values that can be considered reliable, derived from the product of the estimated quantity of energy necessary per kilogram of body weight and the average weight of children at different ages (table 4.1). The chart shows average values, which can also vary considerably in terms of weight characteristics, the body makeup, and the average level of physical activity of the individual boy or girl. When the intake of energy is to be lower than the required minimum, problems may arise, some of them quite serious, in the childs growth and ability to perform normal physical activities, especially pre-school-age children. Prolonged periods of inadequate energy intake can lead to full-blown malnutrition and/or a state of reduced protein reserves, in which tissue-deposited proteins are used for the generation of energy. In contrast, excessive inputs of energy encourage the deposit of excess fat. Therefore, in view of the rise of obesity among children and adolescents, the WHO recommends limiting the excessive ingestion of fats and sugars from the earliest ages. the principal macronutrients. As noted earlier, the principal macronutrients necessary for the proper ingestion of energy for pre-school-age and school-age children are proteins, fats, and carbohydrates. Proteins constitute an essential component of all human cells and for that reason an adequate protein intake has proven to be fundamental, especially for school-age and pre-schoolage children. Their bodies are undergoing a phase of growth that demands the presence of the amino acids necessary for the generation of tissues, especially

table 4.1. the optimal average quantitative amount of energy to be ingested in ones diet (kcal/daily) 24
age of the child italy 13 years 46 years 710 years 7681,094 1,4171,667 1,7922,034 countries / organizations who 9061,088 1,2041,398 1,5001,916 usa 8061,377 1,4531,613 1,6941,957

Source: Societ italiana di nutrizione umana, 1996; FAO, 2006.

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organs and muscles. Optimal sources of high-quality proteins include animal liver, meat, fish, cheese, milk, eggs, and certain plant-based products, such as soy products, green beans, and legumes. The products derived from wheat are also a source of proteins, while most plants and fruit contain limited quantities. The second energy-vital macronutrient is fats. Fats ingested in food supply both energy and essential fatty acids. In particular, long-chain polyunsaturated fatty acids have specific and important physiological functions. Structural fats are an essential part of the cell membranes, the neural tissue, and the cellular architecture as a whole, while deposited fats (especially in the adipose tissue), serve as a long-term energy bank. The ingestion of fats with food promotes optimal absorption of the fat-soluble vitamins A,D,E, and K. The WHO suggests that, during the transition from weaning to the pre-school age (around age 2), some 30-40 percent of total energy input should derive from fats. The Nemours Foundation25 emphasizes that fats and cholesterol play an important role in a childs growth, especially in relation to cerebral development, and they should not be reduced below certain given limits: for very young children (2-3 years), calories deriving from fats ought to account for 30-35 percent of total caloric intake, while from age 4 on fats should account for 25-35 percent of the total. Carbohydrates are the third and the most important (in quantitative terms) energy source of the human organism. The carbohydrates in foodonce they have been transformed into monosaccharides (glucose)provide energy to all the tissues in the human body, especially to the brain and to the red corpuscles that only use glucose as a fuel for cellular activity. The carbohydrates that are not absorbed into the small intestine are transformed inside the colon into lactic acid and into short-chain fatty acids. These metabolites, along with a number of oligosaccharides, also serve the function of encouraging the acquisition and maintenance of an adequate level of tropism of the intestinal mucosa, in part through the prebiotic effect exerted on intestinal microbial flora. the categories of carbohydrates. There are three main types of carbohydrates in food: sugars, starches, and fibers. Sugars are a primary source of energy, but they provide no other important nutrition. In part to establish a proper long-term dietary regimen, the WHO believes that it is a mistake for the diet of school-age and pre-school-age children to be excessively rich in sugary foods and beverages. Numerous governments and organizations recommend that the daily intake of added sugars not rise above 10 percent of the overall energy intake. In the case of a pre-schoool-age child, this translates into a daily average of no more than 25 grams of sugar. If added sugars contribute more than 30 percent of total energy intake, the result is higher risk of significant

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health problems for children, especially significant increases in the levels of glucose, insulin, and blood lipids.26 The WHO also suggests that a diet too rich in starchesprincipally found in products derived from cereal grains, and in potatoes and ricecan be unsuitable, especially at an early age, even though starches are easily digested and absorbed. Higher intake of starches is, on other hand, generally recommended as the child reachesschool age, even though we should not overlook the fact that studies on the effect of diets rich in starches on pre-school-age and schoolage children are still relatively few in number. The third main category of carbohydrates is represented by fiber, which has been shown to have numerous positive effects on a childs health from the the earliest years. Fiber appears to have a beneficial effect on the speed of intestinal transit (they make the alvus more regular), the characteristics of intestinal absorption (they slow the pace of the absorption of nutrients, in particular cholesterol and glucose), and the risk of becoming overweight (they help to make the diet less energy-dense and increase satiety). In fact, foods with high fiber content are characterized by low energy density, reduce the post-prandial glycemic response, and do an excellent job of satisfying hunger, thus limiting the overall ingestion of food and benefiting the digestive process. Fruits and vegetables are strongly recommended for the diet of pre-school-age children and are, if anything, even more strongly recommended for school-age children. Fruits and vegetables, in fact, are rich in fiber, but they also contain high quantities of important micronutrients, especially those valuable during the phases of rapid growth. Fruits and vegetables, moreover, seem to have an advantage with respect to other fiber-rich foods recommended for the diets of children (such as whole cereal grains and legumes) because, unlike those food groups, they do not contain elements that can reduce the absorption of the zinc and iron ingested with the food. the role of vitamins and minerals. Alongside the principal macronutrients, vitamins and minerals are essential elements of a sound diet for schoolage and pre-school-age children. An adequate intake of vitamin A is necessary for the proper development of sight, in order to ensure the integrity of the epithelial tissues, and for the development and differentiation of tissues. It also plays a central role in the development of the immune system and is involved in the development of taste and hearing. The chief sources of vitamin A are liver, cheese products, eggs, fish, margarine, and certain fruits and vegetables (for example, carrots and yellow-to-orange fruit). The B vitamins also play a fundamental role in childrens growth, health, and development. B vitamins are found prevalently in whole cereal grains, legumes, peanuts, meat, leafy green vegetables, eggs, milk, and fish.

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Vitamin C is fundamental in the optimal functioning of the immune system and for the synthesis of collagen. It also plays a significant support role in the process of iron absorption (especially from plant sources). Vitamin C is present mainly in fruits and vegetables, in particular in spinach, tomatoes, potatoes, broccoli, berries, and citrus fruit. Vitamin D is essential in metabolizing calcium (by stimulating its intestinal absorption), in muscle function, in the proliferation and maturation of cells, and in the proper functioning of the immune system. The principal dietary sources of vitamin D are fatty fishes (sardines, salmon, tuna, and herrings), fish oils (especially cod liver oil), margarine, cheese products, eggs, liver, and beef. Alongside macronutrients and vitamins, minerals are essential elements in the diet of school-age and pre-school-age children. These include iron (both hemoglobinic, which is present in meat and fish, and non-hemoglobinic, which is present in cereal grains, legumes, beans, vegetables, and fruits), calcium (milk and milk products, peanuts, and fish), magnesium (roasted peanuts, dried fruit, raw spinach, and some varieties of green vegetables), phosphorus (milk, cheese, shrimp, salmon, sardines, herrings, and in green-leaf vegetables), sodium (sausages, bread, ham, sauces, pickled foods, and in added salt), and zinc (red meat, liver, fish, milk and dairy products, wheat, and rice). adolescence. Adolescence is a period distinguished by intense metabolic activity.27 In this period, in fact, there is a sharp rise in the rate of growth, in both males and females. Body growth is also accompanied by rapid psychological and behavioral development that leads the boy or girl to experience a progressively more intense need for independence and autonomy; this has a significant effect on his or her dietary behavior. During adolescence the daily consumption of food should be sufficiently rich to satisfy the increased demand from the growth processes. At the same time, however, nutrition must meet the need to safeguard against the metabolic and degenerative diseases that are characteristic of adulthood: hypertension, diabetes, atherosclerosis (hardening of the arteries), and tumors. Nutrition and the issues bound up with the adoption of a proper diet and lifestyle take on a fundamental importance in adolescence. In this age during which ones psychic and physical development is being completed, the foundation of proper diet and nutrition is laid, ideally to serve over time as a preventive factor against many diseases of later life. Although the nutritional needs of adolescents is of great interest, only a few research projects have analyzed them. Often, in fact, the available data derive from extrapolations of studies done on childhood and adulthood. In the absence of in-depth and sufficiently broad studies (both in terms of number of subjects and the time span) on the energy requirements of adoles-

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cents, it is difficult to establish the requirement for individuals who present rapid swings in growth rates from one year to the next and differ notably from one to the next and between genders. Table 4.2 shows the intervals of energy requirements in adolescents. The ranges are sharply influenced by such factors as weight, body makeup, and level of physical activity. The energy requirement, in most cases, is efficiently satisfied through the finely calibrated and automatic regulation of the appetite by the hypothalamus. The appetite encourages the ingestion of food that satisfies the need for both energy and various nutrients. The system generally works well to ensure the ingestion of sufficient quantities of energy to satisfy metabolic needs. In contrast, the regulation of the ingestion of nutrients may prove to be less than optimal, which may result in shortages of given elements. The nutritional requirements of adolescents are influenced first of all by physical growth. Peak growth generally occurs between the ages of 11 and 15 for girls and 13 and 16 for boys. Requirements of energy and nutrients are variable from day to day, even for the same individual. The most common nutrient deficiencies at this age are iron and calcium deficiencies. Anemia due to a lack of iron is one of the most widespread and common diseases associated with inadequate diet.28 Adolescents can come down with anemia as a result of the sharp increase in the tissue demand for iron, in particular in the muscular and erythrocytic mass, which involves a significant increase in the iron requirement needed to produce hemoglobin (a protein that serves to transport oxygen) and myoglobin (a globular protein contained in muscles). The increase in lean body mass,29 especially of muscles, is more significant in male adolescents than their female counterparts. During pre-adolescence, lean body mass is roughly equivalent in the two sexes, but when adolescence begins males accumulate more lean body mass for every additional kilogram of body weight acquired during growth, which means that they have a final value of lean body mass almost twice that of females.

table 4.2. the energy requirements during adolescence for males and females
age energy requirements (kcal/daily) 11/12 years 13/14 years 15/16 years 17/22 years males 1,9932,343 2,2772,794 2,3932,976 2,5153,215 females 1,7392,048 1,8642,297 1,8982,338 1,9422,411

Source: Developed by BCFN on data from the Societ italiana di nutrizione umana, Associazione italiana di dietetica e nutrizione clinica, 2011.

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Another factor that helps to increase the iron requirement is the appearance of the menstrual cycle in girls. Blood (and thus iron) loss due to menstruation requires supplementation of this fundamental trace element. Iron supplements must therefore be taken on those specific days. Because of this higher need for iron in adolescents, they should increase their consumption of iron-rich foods30 such as lean meats and fish, legumes, dark green vegetables, walnuts, and cereal grains enriched with iron. Once menstruation begins, girls need to ingest a good 50 percent more iron than boys do. This means a daily requirement of about 18 milligrams as against the 12 milligrams daily requirement for boys. The iron contained in foods of animal origin, also known as iron eme, is absorbed more easily than iron from non-animal sources (also known as noneme iron). Therefore, adolescents who eat a vegetarian diet are more at risk of iron shortages. The ingestion of foods that are rich in vitamin C, such as citrus fruits, encourages the absorption of iron from plant sources. Calcium also performs an essential function in adolescents experiencing rapid growth, inasmuch as it forms part of the makeup of bones and teeth. The human skeleton contains some 99 percent of the total body reserves of calcium and the increase in the skeletons size and weight reaches its highest point during adolescence. In fact, approximately 45 percent of the skeletal mass of an adult is formed during adolescence, even though the growth of the skeleton continues almost until the age of 30, and a calcium shortage during this period can damage an individuals proper growth. The greatest need for calcium comes in what is called the first adolescence, between the ages of 10 and 14 in girls and 12 and 15 in boys. In this period the average daily retention of calcium is approximately 200 milligrams in females and 300 milligrams in males. Because only about 30 percent of calcium ingested is actually absorbed, it is fundamental that an adolescents diet provide an adequate intake of calcium in order to attain the greatest possible bone density. Only during the period of adolescence can the youth deposit the maximum possible quantity of calcium in growing bone tissue in order to attain the so-called peak bone mass, that is, the greatest possible level of calcification. Although the maximum quantity of calcium that can be deposited in the bones is determined genetically, peak bone mass can never be attained if the individual fails to ingest an adequate quantity of calcium. This makes it clear just how important intake of calcium-rich foods is for boys and especially for girls, who will be more exposed to the risk of osteoporosis with the onset of menopause later on. A number of studies31 confirm that attaining peak bone mass in adolescence is crucial to reducing the risk of osteoporosis in later years. On the other hand, it is very common for adolescents to have diets that are lacking in a number of nutrients, because of fads or because they want to lose

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weight quickly and to an excessive degree. Osteoporosis represents one of the most serious and potentially irreversible consequences of anorexia nervosa and of the rapid and excessive weight losses experienced by adolescent girls, who often therefore fail to reach peak bone mass. For adolescents of both genders the daily consumption of 1,200 milligrams of calcium per day is recommended. The principal dietary source of calcium is dairy and cheese products. Aged cheeses contain greater concentrations of calcium because they have been subjected to a process that leads to water loss. Consuming various portions of such dairy products as milk, yogurt, mozzarella, and cheese makes it easy to reach the recommended level of calcium. Overweight and obesity in adolescents constitute a serious nutritional problem that is very likely to persist in adulthood; obesity in adolescence is associated with metabolic diseases in adulthood and to higher mortality rates. Addressing this problem requires not only a sound diet but also a focus on physical movement. Motor activity helps to burn calories, release tension and stress, and improve moods and psychological welfare. Regular physical activity and sports bring notable benefits to the cardiovascular and skeletal systems as well as to the metabolism. Regular motor activity encourages the maintenance of adequate body weight and an optimal body makeup; it also makes adolescents stronger and accustoms them to adopting a lifestyle that will sustain healthier lives in the years to come. Conversely, the lack of physical activity among adolescents plays an important role in the development, progression, and persistence of a number of diseases such as obesity. Studies undertaken in Europe and in the U.S. have shown that most adolescents are physically inactive or else adopt a lifestyle that does not call for adequate physical activity; they are, in other words, sedentary. Physical inactivity is not merely one of the leading causes of overweight and obesity in adolescents, but also of the later development of such chronic diseases as heart disease, diabetes, hypertension, constipation and intestinal diverticulosis, osteoporosis, and certain forms of cancer. Sports and motor activities such as swimming, calisthenics, gymnastics, etc., or else just bicycling, skating, ball sports, dance, and weightlifting with an instructors supervision, for about 60 minutes a day, from three to five times a week, can help to increase bone mass and density. Adequate physical condition also correlates positively with the improvement of the bodys elasticity, equilibrium, agility, and coordination, and the reinforcement of the bones. On the basis of current recommendations,32 adolescents should be physically active for at least 60 minutes a day, which includes both athletic physical activity and play. Aside from engaging in adequate physical activity, adolescents must eat properly for health and growth. To be specific, eating properly means considering the quantity and quality of food ingested and the distribution of food con-

advice for mothers

Medical staff at a hospital in Uganda provide information and suggestions about the nutritional properties of food to a group of mothers. This is invaluable information to people whose responsibility it is to grow and prepare food for their families.

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Breakfast 20% Dinner 30%

Midmorning snack 5%

Afternoon snack 10%

Lunch 35%

figure 4.2
Breakdown of caloric intake during the day Source: BCFN on Societ italiana di nutrizione umana data, 2011.

sumed over the course of the day. Caloric intake should be broken down as shown in figure 4.2. Variety is also a good idea; it means a mixed diet that includes plant-based foods (fruit, vegetables, legumes, cereal grains, seeds, etc.) and foods produced by and from animals (meat, cheese, dairy products, prosciutto, etc.), as well as alternating foods over the course of the week. Dietary behaviors focused on a single diet and the repeated and frequent consumption of lunches and dinners away from home significantly increase the risk of overweight and obesity in adolescents.33 4.7 guidelines for healthy diets and sound lifestyles in children and adolescents Given the importance of diet during adolescence, especially for the prevention of the chief chronic diseases, governments and international organizations that are involved in health issues have formulated guidelines to establish a balanced diet in the various stages of life, with a specific focus on adolescence.34 In general, nutritional science indicates that children should eat five times a day. As we have noted, good nutrition is not enough; regular physical activity (especially if practiced outdoors in the fresh air) is one of the factors considered fundamental to the health of children and adolescents. It also can help reduce risks linked to common chronic diseases in later ages, up to and including adulthood.

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4.8 recommendations Two key findings emerge from these observations and analyses. First, we can document at all levels a growing awareness of the importance of adopting proper dietary approaches in the earliest years of a persons life (up to adolescence) in order to ensure conditions of good health in adulthood as well. Second, awareness is spreading within both the scientific community and throughout society of the importance of disease prevention and of the fundamental role dietary habits and lifestyles play in preventiong obesity and chronic diseases. Prevention is also emerging as one of main lines of future action to ensure the financial sustainability of healthcare systems. However, most of the studies done to date have focused on adults; problems of methodology, economics, and organization have made it difficult to study children and adolescents in sufficient detail. Nevertheless, and although the general picture we present here is based to some degree on fragmentary evidence, the findings undeniably reveal the extreme importance of a sound approach to diet from the youngest age. Above all else, ensuring that children and adolescents eat properly seems to require a concerted effort, the result of the coordination of a variety of actors (school, family, doctors, pediatricians, etc.) who provide care to children at different times of the day. The family and the school appear to be the principal focuses of effective education about proper diet aimed both at young people andin the futureat the adults of tomorrow. It is in the family that a child learns to eat and internalizes dietary behaviors. On the other hand, the schoolby virtue of its growing importance in shaping diets and the potential

the weekly menu for children

During a given week, a sound diet might mean eating various foods at these intervals: cereal grains (bread and pasta): every day; fruits and vegetables: every day; milk and dairy products: every day; meat: two or three times a week; fish: at least three times a week; cheese: twice a week; eggs: once or twice a week; legumes: at least twice a week.

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lifestyle for adolescents

The guidelines that should be followed in order to provide proper diet and lifestyle to foster the healthy development of an adolescent are the following: Adopt a healthy and balanced diet. Alternating every day among all the principal food groups will provide all the nutrients and micronutrients (calcium, iron, vitamins, etc.) that adolescents need. Avoid the excessive calories from consuming highly caloric foods or foods with elevated concentrations of fat. Distribute daily nutrients evenly to ensure a good equilibrium between the intake of animal and plant proteins (a ratio that should be 1:1), simple and complex sugars (through the ingestion of less sweets and more bread, potatoes, pasta, or rice), and animal and plant fats (utilizing less lard and butter and more olive oil). Minimize the additional intake of salt in order to reduce the risk factors for the development of hypertension, especially in adulthood. Distribute meals over five periods during the day: eat at breakfast, midmorning snack, lunch, afternoon snack, and dinner. Avoid eating at other times. Engage in physical activity for at least an hour every day, including both athletic activity and play. Stay active, and especially reduce time spent in front of video screens (televisions and computers).

knowledge and information

We consider it more necessary than ever to: encourage the further exploration of scientific knowledge; encourage cooperation among the various entities involved in feeding young people; properly structure the various interventions in accordance with the most broadly accepted international best practices; and encourage the diffusion of proper dietary information and promote a culture of prevention.

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involvement of the families themselvescan and should play a truly active role in encouraging balanced ways of eating, by inviting families to understand the most appropriate dietary choices and to become allies in a joint and concerted program of intervention. Finally, physicians are also key actors in establishing dietary and lifestyle virtuous cycles. In particular, it is clearly fundamental that family doctors and pediatricians more fully become first-access gatekeepers to topics having to do with proper nutrition and adequate physical activity for all the members of the nuclear family, in the various phases of their lives from children through old ages.

longevity and welfare: the fundamental role of nutrition

In 2025, according to United Nations estimates, the world will have more than 8 billion inhabitants, principally as a result of the general increase in average life expectancy. In the last hundred years, life expectancy at birth has almost

(gr ow )

Fa m

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Diet and the childs lifestyle

Ped

( e ncourage )

i a tr i c i a n s

figure 4.3
The various actors in food education Source: BCFN, 2010.

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doubled, stretching out from 45 years at the end of the nineteenth century to approximately 80 years in 2010. The percentage of elderly people (over age 65) has also increased to an astonishing extent, for example rising in Italy from 4 percent in 1900 to 20.6 percent in 2010. In 2050, in Italy, people over 65 are expected represent 34 percent of the population: one out of every three people will be elderly. The same trend can be seen all over the world. In the period from 1950 to 2010, the worlds elderly population grew at an average annual rate of 13 percent, a trend that shows no sign of slowing: it is estimated that in 2050 the over-65 population will amount to 1.9 billion people. These demographic changes are very worrisome and could cause a general crisis in the healthcare systems of many countries, both industrialized and developing. Approximately 80 percent of all elderly people suffer from at least one chronic disease and approximately 50 percent are affected by two or more (such as cardiovascular and cerebrovascular diseases, tumors, diabetes mellitus, arterial hypertension, and chronic pulmonary diseases).35 Those numbers are destined to rise because of the epidemic of obesity and diabetes that is currently under way, even among the younger members of the population. Overweight and obesity (in particular abdominal obesity) are associated with an increase in the risk of developing cardiovascular diseases and tumoral conditions. Those diseases are responsible for about 70 percent of all deaths in many industrialized and developing countries. In light of these demographic changes, the epidemic of obesity, and the deterioration of lifestyles (sedentary lifestyle, hypercaloric diets, cigarette smoking), it becomes fundamental to design and implement interventions that are aimed at the prevention of the chronic diseases associated with aging and to work for improvements in the quality of life, that is, a reduction of the gap between the duration of ones life (lifespan) and the duration of ones health (healthspan). It is more necessary than ever before to identify and adopt lifestyles that promote healthy and successful aging, and that ensure that individuals can remain physically and mentally healthy, happy, active, strong, independent, and socially useful for the longest possible time, ideally for their entire lives. Unless corrective interventions are carried out in the lives of millions, the fact that those lives are growing longer might no longer imply that they are also improving in quality. We might find ourselves facing an old age characterized by a sharply reduced quality of life for a significantly longer time. We must confront squarely the problem of aging and the diseases associated with aging by implementing a preventive and integrated approach. The strategy of combating each disease only when it comes to a doctors attention is conceptually faulty and fails to offer an adequate response to the challenge of the reduction of the gap between lifespan and healthspan.

water, food, health

Kibera, Nairobi is a slum or informal settlement with more than one million inhabitants. This school, run by a local NGO, provides a daily lunch and water for drinking and washing, a resource that is as scarce as it is precious.

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Aging is caused by the progressive accumulation over time of damage to the bodys DNA, its cells, and all its organs, due to a defect in the mechanisms assigned to repair the damage. The accumulated array of damages causes a progressive decline of many physiological functions and the vital structures of the organism. Recent studies have shown that lifestyle (nutrition, physical activity, exposure to cigarette smoke, toxic and radioactive substances, and pollutants) can have major influences on the aging process. For instance, a hypercaloric diet, rich in saturated fats and poor in nutrients (vitamins, mineral salts, etc.), and a sedentary lifestyle accelerate aging as well as encourage the onset of obesity, diabetes mellitus, arterial hypertension, cardiovascular diseases, and tumoral conditions. On the other hand, countless scientific findings have shown how a moderately hypocaloric diet (low in calories) that is rich in nutrients is capable of slowing the aging processes and preventing most of the chronic diseases associated with aging. Although we cannot prevent or reverse natural aging, we can still act decisively to affect environmental (or secondary) aging and influence the processes tied to intrinsic (or primary) aging. It is possible to slow the natural aging processes and, especially, intervene preventively on the onset of the chronic diseases associated with those processes (obesity, diabetes, metabolic syndrome, cancer, cardiovascular diseases, hypertension, and inflammatory processes). Food and lifestyle have a critical role to play in preventing the onset of those diseases, mitigating their effects and encouraging a qualitatively better form of longevity. For example, numerous studies36 designed to measure the impact of behavior on increased risks of mortality have made it clear that the adoption of a healthy lifestylein terms of dietary regimen, alcohol consumption, smoking, and physical activityhelps prevent mortality by extending average life expectancy by 5 to 14 years per individual. In this chapter, we have analyzed the general relationship between diet and health, paying particular attention to those diseases that by now represent full-blown contemporary epidemics (obesity, cardiovascular diseases, diabetes, and tumoral diseases). We have also explored the links between good nutrition and healthy growth in the various phases of childs lives. Now we will complete this in-depth study by examining the relationship between diet and a healthy longevity. As mentioned, it is no longer sufficient these days to hope to live longer without also living well during the second part of your life, the years of ones maturity. Quality of life is a crucial factor that no one wishes to do without, either as individuals or as a society. It is a crucial foundation for the truly sustainable progress of nations.

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4.9 demographics, longevity, and the economic and social impacts of the principal diseases As a result of global economic growth, a general improvement in living conditions, and scientific progress, average worldwide life expectancy37 has increased steadily since the turn of the century; in 2010 it was 70.14 years for women and 65.71 years for men (figure 4.4). Life expectancies are rising even in countries that still lag in terms of economic and social development. In Bangladesh, for example, mens life expectancy in 2020 will rise to 71 years, which is only three years less than mens life expectancy in Europe, even though Bangladesh is a country with only partial suffrage, inadequate healthcare structures, and major challenges in terms of obtaining basic pharmaceuticals. World values are driven by the Western high-to-medium averages and by the high rates of growth in average life expectancy found in developing economies. Figure 4.5 shows the 10 nations in the Organization for Economic Cooperation and Development (OECD) with the highest life expectancies. The United States, alone among all developed countries, is beginning to witness a decline in life expectancy at birth in some states. A recent study38 has shown that in states such as Mississippi, Arkansas, Kentucky, Tennessee, Oklahoma, Alabama, and Louisiana, life expectancies are progressively falling, especially among women, who are showing the highest rates of obesity and smoking. In Mississippi in particular, the state with the highest rate of obesity, life expectancy is just 67 years for men and 74 years for women, numbers that are much lower than in the countries shown above. As was mentioned earlier in this chapter, the global elderly population (over 65) is growing continuously and will reach an estimated 1.9 billion in 2050. This means an increase in economic inactivity and dependency on the younger members of the population. Europe has the highest rate of dependency on Earth. Estimates tell us that that rate will rise until it reaches 48 percent in 2050. Worldwide, the UN predicts that the rate of elderly dependency will grow from the current 11.5 percent to 25.4 percent in 2050. Chronic diseases are already the leading cause of death in the world, but it is expected that between 2005 and 2015 deaths from such diseases will grow by 17 percent. Figure 4.6 shows the effects on healthcare costs of living longer lives but not in good health. The chart shows the increase in the share of GDP spent on healthcare on average in the OECD nations and certain representative countries. In the United States, 17.4 percent of GDP (approximately US$2.5 trillion) was invested in healthcare in 2009 compared with 5 percent in 1960. In Italy, too, there has been growth in healthcare spending, albeit more modestly, with a shift from approximately 6 percent of GDP per year in the 1960s to the current level of

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10 percent (approximately 180 billion). In China and India, major increases in healthcare spending are also predicted. A great deal of this spending, of course, goes for the treatment and care of those suffering from the chronic diseases we have discussed in this book, diseases that result from, or are worsened by, unhealthy diets and lifestyles. In general, perhaps 80 percent of all cases of chronic disease could be prevented, by eliminat-

19501955 19551960 19601965 19651970 19701975 19751980 19801985 19851990 19901995 19952000 20002005 20052010 20102015 20152020 20202025 20252030 0 10 20 30 40

48.66 46.67 51.01 48.52 53.10 49.35 57.83 55.05 60.42 56.59 62.64 58.70 59.85 64.33 65.76 66.63 67.47 68.65 70.14 71.59 72.75 73.79 74.79 80

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figure 4.4
World life expectancies, comparison between the male and the female Source: BCFN on UN (World Population Prospect) data, 2010. population (19502030)

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ing such risk factors as smoking tobacco, unhealthy dietary models and customs (diets), physical inactivity, and the excessive consumption of alcohol. Older people are also more likely to be stricken by neurodegenerative conditions (dementia) and osteoporosis as they age. Dementia affects between 1 and 5 percent of the population over 65, with the prevalence doubling every four years, finally rising to a rate of about 30 percent at the age of 80. (Recent statistics have shown a rising incidence of dementia in individuals over 65, tobetween 2 percent and 10 percent.) By dementia we mean a condition of chronic and progressive failure of the cerebral functions that lead to a decline of a persons cognitive faculties. According to the Global Burden of Diseases Study, dementia results in people living 11.9 percent of their years on Earth in a condition of chronic disability and to lose 1.1 percent of their total years of life. Certain risk factors predispose people to both dementia and cardiovascular diseases. Patients with high levels of cardiovascular risk (hypertension, diabetes, high levels of cholesterol, and smoking) are often predisposed to contract neurodegenerative diseases as well (figure 4.7). The estimated worldwide cost of dementia in 2010 was US$604 billion; 70 per86 Italy cent of those costs are incurred in West80 ern Europe and in North America.39 85 Japan 80 These costs represent approximately 1 85 percent of world GDP and significant Spain 80 shares of GDP in all nations: 0.24 percent 85 Switzerland in low-income nations, 0.35 percent in 79 low- to medium-income nations, 0.50 per85 France 78 cent in medium- to high-income nations, 83 and 1.24 percent in high-income nations. Korea 80 In England the social cost of dementia 84 Australia (17 billion) is greater than the cost of 78 strokes, cardiac diseases, and cancer. 84 Finland 78 While only 38 percent of the people who 84 suffer from dementia live in high-income Austria 77 nations, 72 percent of the costs are 84 Canada incurred in those very same countries. 77 For the poorest countries a fundamental 72 74 76 78 80 82 84 86 88 part of patient care is provided outside the healthcare system by the families figure 4.5 because of an absence of structured and accessible healthcare services. Life expectancy in 10 OECD countries, comparison between the male Currently in Italy it is estimated that 2 population (2010) and the female million people suffer from dementia, of Source: BCFN on OECD data, 2010.

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whom roughly 63 percent are older than 80. The costs are high, both for the healthcare and social welfare systems and for the patients and their families. If we multiply the number of Italians suffering from dementia by the annual average cost per patient we come up with an estimate of the total annual cost

4%

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5% 6% 5%

OECD United States Great Britain

7% 7% 7%

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5% 5%

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figure 4.6
Share of GDP spent on total health care costs (19602009) Source: BCFN on OECD data, 2009.

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of dementia in Italy: approximately 50 billion (10 billion for direct costs and 40 billon for indirect costs). Osteoporosis is a pathology characterized by the decline in bone mass and the deterioration of the microarchitecture of the bones. Osteoporosis is increasing worldwide and the World Health Organization has identified it as a health priority. The incidence of osteoporotic fractures is expected to increase from one every 8.1 minutes in 2001 to one every 3.7 minutes in 2021. 40 Osteoporosis affects an estimated 150 million people around the world, 75 million of them in Europe, Japan, and the United States. Most of them have a 15 percent probability of suffering wrist, femur, or vertebral fracturesvery close to the likelihood of suffering coronary problems. In Europe one out of every three women and one one out of every five men older than 50 have suffered an osteoporotic fracture at least once. In the United States perhaps 10 million people suffer from osteoporosis, and an additional 34 million have such low bone mass that they are at risk of developing osteoporosis. In Italy, too, osteoporosis is one of the most common chronic diseases associated with aging, afflicting 7 percent, putting it third after hypertension (16 percent) and arthrosis and arthritis (17.3 percent). There are marked differences

3059 6064 6569 7074 7579 8084 8589 9094 > 95

0% 0% 0% 2% 3% 5% 4% 5% 7% 12 % 14 % 18 % 23 % 32 % 32 % 32 % 0% 5% 10% 15% 20% 25% 30% 35%

Women Men

1%

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figure 4.7
Prevalence of Alzheimers by age group (2009) Source: BCFN on EURODEM study, 2011.

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by gender, however: in Italy the disease afflicts 3.9 million women and 840,000 men.41 Among women, 15 percent between 50 and 59 are affected, compared with more than 30 percent in the 60-69 age range and 45 percent of the 70-79 age range. The economic burden of osteoporosis is comparable to that of the leading chronic diseases, but in women older than 45 osteoporosis is the cause of a greater number of hospital admittances than other diseases, including diabetes, heart attacks, and breast cancer. The number of osteoporotic fractures is expected to rise with the aging of the European population, with costs rising from 31.7 billion in 2000 to approximately 76.7 billion in 2050. 4.10 diet and lifestyle and their effects on longevity and diseases of aging As we have said, with life expectancies and the rate of principal chronic diseases both rising, it is likely that humankind will soon experience, for the first time in modern history, a prolonged old age marked by the risk of fragility, disability and suboptimal health. Thats why it is more necessary than ever to identify lifestyles and diets that can extend the disease-free period of life at the same time that they prolong life itself. Below is a summary of whats currently known about the relationship between longevity and certain diseases (diabetes, tumors, obesity, neurodegenerative diseases, and osteoporosis) and the role played by diet and lifestyle. diabetes. The nutritional approach is univerally recognized as a fundamental tool in preventing and treating Type 2 diabetes and its complications. In particular, diet is important in preventing the accumulation of excess abdominal fat, which is linked to Type 2 diabetes. 42 Numerous studies have shown that abdominal fat is perhaps even more strongly correlated with Type 2 diabetes than a high body mass index, since it is also strongly correlated to insulin resistance, a central feature of diabetes. Because overweight and obesity are both linked to the development of insulin resistance and the onset of diabetes, programs designed to alter lifestyles in the direction of weight reduction and higher physical activity appear to be help reduce the likelihood of contracting Type 2 diabetes. A 5-7 percent reduction of body weight, combined with two-and-a-half hours of regular physical activity every week and a dietary strategy that reduces the intake of fats and calories, may reduce the risk of Type 2 diabetes by as much as 60 percent. cancers. Tumors and tumoral diseases are caused by many factors but harmful lifestyles and diets certainly increase their likelihood. One of the most important non-dietary factors is smoking tobacco, a practice that increases roughly thirty-fold an individuals risk of contracting pulmonary tumors.

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Smoking accounts for 80 percent of all cases in developed countries and pulmonary tumors are the most common type of tumor worldwide. Tobacco smoke is also one of the principal risk factors for oral, laryngeal, and esophageal tumors. Smoking, therefore, is clearly linked to lower life expectancy. Diet also affects the incidence of tumoral diseases. Some studies have estimated poor diet may account for 30 percent of the incidence of tumoral diseases, second only to tobacco smoke. The International Agency for Research on Cancer has indicated that overweight and physical inactivity account for somewhere between 20 percent and 35 percent of breast, colon, kidney, and esophageal tumors. Both longstanding and temporary obesity and overweight can increase the risk of various tumors, in particular colorectal tumors. Excessive Alcohol consumption is the principal dietary risk factor for oral, laryngeal, and esophageal tumors. If we add tobacco to alcohol consumption, we explain the origin of more than 75 percent of all tumoral diseases in the mouth. cardiovascular diseases. Cardiovascular diseases are also increasingly characteristic of aging populations. Although their causes include a diverse array of environmental factors, they too depend to a great degree on dietary habits, lifestyle, and behavior: smoking, alcohol abuse, sedentary lifestyle, etc. Conversely, many studies43 confirm that the right dietary behaviors and personal habits can help reduce the risk of cardiovascular disease, especially at an advanced age. Recommended measures include daily consumption of fruits and vegetables, the ingestion of eicosapentaenoic acid and docosahexaenoic acid (contained principally in fish), appropriate amounts of n-6 fatty acids and potassium, adequate physical activity, and low alcohol consumption. On the other hand, the available research cautions against consumption of high quantities of saturated fatty acids, high concentrations of sodium in the blood, persistent overweight, and excessive consumption of alcohol. All the studies agree that, although cardiovascular diseases occur more often in middle- or old age, the risk factors that cause them are largely linked to behaviors learned in childhood and youth and perpetuated into adulthood. neurodegenerative diseases. Dementia and neurodegenerative diseases such as Alzheimers and Parkinsons are primary disturbances that tend to arise and worsen with aging. It is now clear that the damage is the product of an interaction between a genetic predisposition and environmental factors. Among those factors are lifestyle, diet, infectious agents, and environmental toxins. The relationship between lack of nutrients and dementia has long been clear. A study44 of protective factors in the serum of patients suffering from either Alzheimers-linked or vascular dementia showed significant drops in the levels

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of vitamins E and C, carotenoids, zinc, and albumin, reflecting a possible link between poor diet and the disease. As for Parkinsons disease, it has been found 45 that a suite of nutrients (vitamin E, beta-carotene, vitamin C, and flavonoids) that are natural chemical compounds very commonly found in numerous varieties of fruit (citrus fruit, apples, apricots, etc.), vegetables (cabbages, broccoli, spinach, tomatoes, fennel, onions, etc.), and some beverages (red wine, tea, fruit juices), can protect against the onset of the disease in a small sample of participants.46 There is evidence47 that dementia is associated with an insufficiency of magnesium (contained in cereal grains, walnuts, almonds, peanuts, buckwheat, cocoa, wheat germ, lentils, green vegetables, meats, and starchy foods). A shortage could be caused either by low dietetic intake of the mineral or a limited physiological ability to absorb or maintain it. There are factors moreover that establish a linkage between forms of dementia like Alzheimers and other forms of vascular dementia. Hypercholesterolaemia, already known to be a risk factor for atherosclerotic diseases, can in fact be a joint causative factor in the development of dementia of the Alzheimers type. Studies on cholesterol levels and on the relationship between saturated and polyunsaturated fatty acids in the diet48 suggest that neurodegenerative disease involves the metabolism of fats. It is certainly clear that a high consumption of saturated fats and cholesterol increases the risk of cardiovascular diseases, which can be associated with dementia. Diets with high fish content are linked with lower incidence of dementia in general and of Alzheimers disease in particular. A 2004 study explored the role played by fruits and vegetables in Alzheimers disease and concluded that elderly women who ate plants rich in folates and antioxidants such ascarotenoids and vitamin C (e.g., green-leaf vegetables and cruciferous vegetables such as cabbages, broccoli, cress, turnips, and radishes), showed a lower level of cognitive decline than women who had low intake of these vegetables.49 Finally, restricting the ingestion of calories50 may help prevent such neurodegenerative diseases as Alzheimers. For instance, some populations in China and Japan ingesting only 1,600-2,000 calories a day show a lower incidence of Alzheimers disease compared with the inhabitants of the United States or western Europe, who generally consume about 2,000 calories a day.51 In summary, even though the studies on the relationship between diet and neurodegenerative diseases point to fairly vague direct links between diet and neurodegenerative processes, it is worthwhile pointing out that dietetic habits can certainly contribute to the definition of an individuals risk profile. osteoporosis. Good nutrition, in terms of a balanced diet and adequate caloric intake, is essential for normal growth and for the development of all the

eating in the global slum

Growing urbanization can lead to extreme poverty and the marginalization of the poor. In 2008, the urban population exceeded the population of people in rural areas for the first time in history. In cities, health and nutritional education programs can limit the damage caused by poor living conditions.

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tissues, including bone tissue. It appears, in fact, that one of the keys to preventing osteoporosis in old age is laying down an ample foundation of bone mass during the developmental phases of youth to protect against the inevitable loss of mass later. Vitamin D is among the nutrients critical to bone mass formation. Recent studies52 have shown that the daily ingestion of vitamin D with calcium reduces the risk of fractures by up to 8 percent. However, lack of vitamin D is very common in the older population, both because of reduced intake and in part because of diminished intestinal absorption, a diminished cutaneous synthesis, and reduced conversion to the more active form of the vitamin. Foods with the highest content of this vitamin are liver, fish oils (especially cod liver oil), fatty fishes such as salmon and sardines, milk and milk derivatives (especially butter), and eggs. Calcium deficiencies cannot be exclusively blamed for osteoporosis53 but are implicated in it. Adequate calcium intake is fundamental to the prevention of osteoporosiswhich makes all the more alarming the fact that, in all age groups, the typical daily dose of calcium ingested is actually far lower than the recommended level. The risk factors we have discussed repeatedly here also contribute to the loss of calcium: excessive consumption of animal proteins, sodium chloride, and alcohol; tobacco smoke; and of course being overweight. In conclusion, the studies conducted to date have found a moderate but significant link between diet and the prevention of osteoporosis. There is agreement that prevention must begin at an early age, when the ingestion of calcium through diet is absorbed and is able to contribute effectively to the consolidation of bone density. And in adulthood and during old age, retarding osteoporosis must rely upon proper dietcharacterized by reduced sodium, increased consumption of fruits and vegetables, ingestion of at least 400-500 milligrams of calcium daily, and the elimination of alcoholas well as a healthy lifestyle marked by moderate physical activity, stable body weight, and the elimination of smoking. 4.11 inflammatory states and caloric restriction: possible interventions to slow the aging processes Two new areas of research have emerged in recent yearsinto the role of inflammation in aging and the possible benefits against aging offered by caloric restrictionthat could lead to new understanding of the possibilities of living better and longer. inflammatory states and longevity. Aging is caused by the progressive accumulation of damage to the DNA, the cells, and the organs of the human body due to the failure of the mechanisms responsible for repairing that dam-

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age. The cumulative effect of this damage is a decline of many physiological functions and the vital structures of the organism itself. The potential longevity of any individual is closely tied to the proper functioning of the cells that protect against damage and repair it when it occurs. These cells can exhaust their capacity to replicateand therefore their reparative potentialearlier or later in the course of life, depending on a number of factors. This failure to replicate and thus replace the worn-out reparative cells leads to the progressive onslaught of inflammatory and degenerative phenomena such as arteriosclerosis. Some degenerative chronic diseases can stem from a progressive incapacity to deal with conditions of continual inflammation and the progressive failure to repair the damage. Other diseases and health conditions, such as diabetes and obesity, produce an inflammatory state in the blood and tissues that can intensify the repair processes and lead to their early exhaustion. This too can translate into a shortening of life expectancy. Recent scientific research has studied the link between chronic disease and the state of low-level, non-painful silent inflammation generated by the adoption of unhealthy dietary models. Those studies make clear that the dietary model adopted can either benefit or impair the bodys inflammatory responses. Longterm silent inflammation accelerates consumption of the bodys repair capacity and thus the onset of chronic diseases, reducing longevity and quality of life. In this context, the telomeres (the terminal region of the chromosomes), which serve the function of preventing the loss of information during the phase in which chromosomes are duplicated in the wake of cellular reproductiona phase that takes place during the reparative processesare reduced in length until they are no longer able to carry out their protective function toward the chromosomes. Cells, therefore, are no longer able to reproduce correctly, and they therefore age and die. In other words, the process takes place in the following manner: every time that a cell is duplicated, it loses a sequence of telomeres. When the cell runs out of telomere sequences, it dies. Certain studies that have been done on telomeres show that there is a relation between the length of the telomeres and the onset of chronic diseases. Moreover, in a more direct link, it seems to emerge from some studies that cellular inflammation (even silent inflammation, that is to say, inflammation caused by diet) is one of the interpretative bases for the origin of a diverse array of chronic diseases. While it is known, and has been known for many years, that injuries or microbial attacks were the cause of inflammatory responses on the part of the organism, in the past few years studies have emerged that also indicate that dietary models can have a positive or negative influence on these inflammatory responses. In summary, increasing attention to telomeres on the part of the mass reader-

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ship can be detected in recent years, that is, since researchers first began associating them with the aging process. In general terms, the studies that have been carried out on telomeres demonstrate that there is a relationship between the length of the telomeres and the onset of chronic diseases, which are in turn linked to lifestyle and diet. In a more direct linkage, it seems to emerge from some studies that dietary models too can have positive or negative influences on the organisms inflammatory responses. The level of inflammation deriving from the adoption of improper diet would appear to be low level, that is, below the threshold of pain, and therefore not perceptible. Silent cellular inflammation, then, becomes one of the interpretative bases for the origin of a diverse array of chronic diseases, inasmuch as these levels of inflammation, triggered by the kind of dietary model adopted, require repair actions by the organism, and those actions involve telomeres in a primary role. As we stated above, the greater the frequency and intensity with which the telomeres are summoned to make repairs, and the greater the speed with which they are shortened to the point of running out entirely. The diet adopted by individuals in a population becomes a determinant factor in the care and treatment of inflammatory states produced by conditions of obesity,54 diabetes, and the presence of cardiovascular diseases. caloric restriction and longevity. The second area of research has to do with the effects on the bodys physiology and biochemistry of reducing intake of calories while maintaining intake of the necessary nutrients. These studies have found that caloric restriction can help prolong life in conditions of optimal health. In fact, caloric restriction (without malnutrition) has proven to be a powerful intervention for slowing the aging process and increasing life span in many species.55 Hundreds of studies on experimental animals have shown that caloric restriction prevents or slows the onset of most of the chronic diseases associated with aging and prolongs the average and maximum life span by as much as 50 percent.56 For instance, caloric restriction drastically reduces (up to a maximum of 60 percent) the risk of developing cancers, which are the leading cause of death in rodents.57 Moreover, as shown by studies done by Shimokawa et al. (1993),58 approximately 28 percent of rodents on a regimen of caloric restriction die a natural death at an advanced age without any significant anatomopathological lesions, while only 6 percent of the rodents who ate as much as they wanted died without any pathology. These data suggest that, in mammals, aging is not inevitably associated with the onset of chronic diseases, and that it is possible to live a long life without getting sick. Many studies are currently under way in an attempt to understand the metabolic and molecular mechanisms that underlie this phenomenon.

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The mechanisms underlying the anti-aging effect of caloric restriction are complex and not entirely clear. In general terms, during caloric reduction the organism slows the aging processes and focuses on the systems assigned to repair damage. Nature, in a sense, places itself on a stand-by and protection footing if it perceives the absence of nutrition. Does it work in humans? A recent study of our genetic near-relatives, chimpanzees, has shown that a 30-percent reduction of caloric intake over 20 years in chimpanzees is capable of reducing mortality from cancer and cardiovascular diseases by 50 percent. These particular chimpanzees were also completely protected against obesity and diabetes. And the researchers saw a significant slowing in the atrophy of certain areas of the study chimpanzees brains. It is not yet known whether such a diet can slow aging in humans as well. But studies conducted on a group of volunteers who allowed themselves to be subjected to a regimen of caloric restriction with optimal nutrition for a period of roughly eight years (consuming at least 100 percent of the recommended levels for every nutrient) showed significant reductions of the leading factors of cardiovascular risk, inflammation, high arterial blood pressure, insulinemia, glycemia, carotid artery intima and media thickness, and certain hormones and growth factors. (However, it is necessary to emphasize that excessive caloric restriction could also involve risks of serious health damage, such as osteoporosis, sarcopenia, immune deficiency, anemia, reduction of body temperature and sensitivity to cold, libido reduction, infertility, and amenorrhoea.) For the time being, research on the inflammation.diet linkage and on caloric restriction is not conclusive. There are important differences between studies done on cells and on animals, and studies done on human beings, and it is premature to extend the results of the former to the latter. This research, for now, remains at the current threshold of scientific medicine. 4.12 recommendations This in-depth exploration of food and longevity captures current scientific knowledge about the linkage between proper diet and life expectancy in good health conditions. The objective is not just to live longer, but rather to live better, longer. The first piece of important information to emerge from the project is the fact that aging processes affect each of us, once we emerge from the age of growth, paradoxically from the day of our birth. Inside our bodies, the processes of cell regeneration are constantly active. The fact that mechanisms of cell repair are maintained in good functioning condition throughout our entire lifespan has a great deal to do with our overall life expectancy and quality of life.

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In turn, it has become increasingly clear that those mechanisms are heavily influenced by diet and lifestyle. Diet has an influence on the multiple processes that underlie aging and the processes of cellular inflammation, as well as on the prevention of the diseases mentioned above, which are a crucial factor in the acceleration of the aging process. So if we were looking for a slogan to capture this wisdom, it might be Eat well today to live better today. But thats not all; we should also add Eat well today to live better and longer tomorrow too.

points on diet and nutrition and longevity

encourage the further exploration of available scientific knowledge on

the relationship between diet and health. This includes the mechanisms of aging and cell repair; the relationships between genes and nutrients and diseases; the topic of caloric restriction; and further studies on those dietary models that are already providing us with significant findings in the prevention of chronic diseases and prolonging healthy lives. encourage the spread of proper information and dietary education in order to promote the adoption of adequate dietary habits and lifestyles. Governments, scientific societies, the medical industry, and private companies must make an intense effort to communicate effectively. There are lifestyles that constitute a form of insurance for an adulthood and advanced old age in good health conditions: it is necessary that people be able to access an adequate level of information on the subject. structure social and health care policies and interventions so as to promote the spread of healthy dietary behaviors, with a view to the best international practices in the field. It is necessary to findwith the coordinated contributions of all the subjects involved, according to a systematic logicnew approaches for the transmission of the scientific knowledge available in the field of diet and health, in order to allow that knowledge to be translated into concrete interventions capable of having a real impact on the behaviors of individuals.

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interview companies must behave responsibly

Marion Nestle
Recent authoritative studies have clearly shown the impor tance of prevention within health policies. Despite this, topics linked to prevention tend to remain on the theoretical plane more than on the practical one, and dont seem to be able to reach us in our daily life. How can we overcome these prob lems? And what are the most adequate prevention policies and best practices in this area?

It is no trouble to think of many examples of prevention policies that are highly effective in public life. These aim to prevent illness or harm in one of two ways: changing the environment or changing personal behavior. The classic, prototypical public health measureturning off the Broad Street pump to prevent the spread of cholerawas an environmental change. It did not depend on personal behavior. Water chlorination, and fluoridation to prevent tooth decay are other such measures. But Im guessing that you are more interested in policies that change personal behavior. Laws that require automobile drivers and riders to wear seat belts and cyclists to wear helmets are obvious examples. To these must be added anti-smoking policies that raise taxes, put warning labels on cigarette packages, and forbid smoking in schools, offices, buses, and airplanes have made it so expensive or inconvenient to smoke that many people have stopped. And many countries have food safety laws, some more effective than others. But in all of these cases, it took aggressive action on the part of government to implement such policies. That brings us to food and obesity. Foods are not cigarettes, and policies to change the food environment or personal eating behavior are necessarily more complicated. With cigarette smoking, its just one product. The message is simple: stop. And the ultimate goal of anti-smoking advocates is to put cigarette companies out of business. But people have to eat. The message has to be eat less or eat this instead of that. And nobody wants to put the food industry out of business. We just want companies to behave better, make healthier products, and stop marketing junk food as healthy or targeting children. Therefore, regulating the food environment or personal choice presents different kinds of challenges. The big one is how to influence what people eat and how much they eat. This is a new area of regulation and in the United States

Marion Nestle is one of the most respected nutritionists in the world. She is a writer and a university professor, she specializes in the issues of food policy and dietary choices. She is the author of Food Politics (2002), Safe Food (2003), and What to Eat (2003). Food Politics received many awards. She is the Paulette Goddard Professor in the Department of Nutrition, Food Studies, and Public Health (the department she chaired from 1988-2003) and Professor of Sociology at New York University. She is also a visiting professor at the Division of Nutritional Sciences at Cornell University.

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we are now experimenting with such measures as calorie labeling, soda taxes, and incentive programs for choosing more fruits and vegetables. Large food portions are a major influence on calorie intake (larger portions have more calories!) and much attention is now focused on ways to encourage restaurants to reduce serving sizes. Government agencies are exploring ways to regulate food advertising directed at children and front-of-package logos that indicate nutritional quality. I wish they would also improve regulation of health claims on food labels. Measures like these are strongly opposed by the food industry and it has been difficult for regulatory agencies to make much progress. And we do not yet know whether these kinds of actions will help reverse obesity. Given rising rates of obesity, especially among children, environmental interventions seem well worth trying. The patrimony of scientific knowledge regarding nutrition is already very extensive and continues to grow. Nonetheless, the concrete possibility does exist to make a note worthy improvement in our level of understanding of the dynamics between food and health. Among the following subjects of study / frontiers of knowledge, which in your opinion are the most significant in the foodhealth equation, also in the future? Education, as any student of health education will tell you, is only the first step in helping to improve behavior. Environmental interventions tend to be far more effective, as they do not depend on personal choice. But if we do try to make education be effective, it must begin in early childhood. In the United States, much of todays food movement focuses on reforming school meals. These, over the years, came more and more to resemble fast food. The goals of the movement are to introduce healthier food into school meals. The more forward-thinking programs are making efforts to source the food locally, cook it well, and introduce children to a wide range of food tastes and flavors. Some schools have introduced gardens to teach children to plant, grow, harvest, prepare, and eat food, as a means of teaching them where food comes from. Early evidence from such experiments suggests that children exposed to these kinds of programs do indeed eat better and exhibit greater interest in a variety of foods, just as expected. For both adults and children, education programs must counter the effects of food marketing. Food companies spend billions of dollars a year to encourage sales of their products, much of it on television but increasingly on electronic media. People of every age are exposed to food advertisements all day long, so much so that food marketing has become part of the daily environment and is not consciously noticed. Food marketing is not supposed to be noticed. As an advertising executive once explained to me, marketing is supposed to slip below the radar of critical thinking. If so, the objective of nutrition education

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clearly must be to teach critical thinking about food marketing in all its dimensions: advertisements, product placements in supermarkets, vending machines in schools, candy at the checkout counters of business supply and clothing stores, and cafes in bookstores. Noticing how food is marketed is the first step to learning how to resist it. What is currently known about nutrition is already sufficient to create a massive, pervasive and scientifically unassailable communication campaign on a global scale that could lead to saving a very high number of human lives and improve the quality of life on our planet. What actions do you think should be undertaken to improve communication processes and encourage people to adopt lifestyles and dietary behavior in line with available scientific knowledge? Communication? I dont see that as fixing the problem. Environmental changes are much more likely to be effective, because education is aimed at changing personal behavior which is too hard for most people to do. What you really want is to change the food environment to make it easier for people to make healthier food choices. With that said, the basic message for preventing obesity is quite simple: eat less (and move more, of course), but also eat better. I like to add one more precept: get political. We know that communication alone is not going to make much of a difference unless its messages come with substantial changes to the food environment. Telling people not to smoke cigarettes did nothing to change smoking patterns. Getting people to stop smoking required policies that made cigarettes expensive, difficult to use, and socially unacceptable. If people throughout the world are to eat less and eat better, we have to help create a food environment that supports healthier food choices. Given that obesity is now a global problem, messages and policy changes will have to be tailored to the particular food culture of each country, but the basic eat less message is essential. But before getting to that message, it is essential to ensure that everyone in the population has enough food to support life, growth, and health. This requires serious attention to inequalities in income and the widening gap between the incomes of rich and poor. Income inequality underlies most health problems. But lets get back to eat less as essential for preventing obesity. Eating less, alas, is very bad for business. Eat better also confronts a food industry determined to sell highly profitable processed foods and drinks, regardless of their effects on health. That is why worldwide efforts to prevent obesity must focus on regulation of food marketing, especially to children. Governments should do all they can to discourage frequent consumption of snack foods and sugared drinks. They should ensure that every child is fed adequately and healthfully

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in school. They should establish agricultural policies that encourage production and consumption of vegetables and other plant foods and variety in food intake, but discourage consumption of highly processed food products. Improving food environments to promote health will benefit individuals and populations and will help reduce the financial and societal burdens of obesityrelated chronic diseases on governments that can ill afford them.

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interview the responsibility for children must be shared

Aviva Must
Guaranteeing correct eating habits for children and adolescents would seem necessarily to involve a joint effort with the con tribution of a number of players (school, family, pediatricians, sports groups, etc.) involved in caring for children at differ ent times of the day. For different reasons, family and school would appear to be the main players in an effective effort of teaching correct eating habits, alongside the pediatricians. What actions are necessary to promote cooperation among the various players involved in different ways in child nutrition?

Aviva Must is a professor of Public Health and Community Medicine at Tufts University School of Medicine, where she is also the department chair. She is also the director of the Clinical and Communit y Research Core at the Boston Obesity Nutrition Research Center. Her chief area of research has to do with the epidemiology of obesity, with a special focus on the effects of obesity in critical periods of life, such as adolescence and pregnancy.

I certainly agree that instilling healthful eating habits in children and adolescents is a shared responsibility. In addition to these important players, one must also consider the impact of culture, community values, and regional or national policies. With respect to family, school personnel, and health care providers, those who are closest to the child, coordination throughout the different settings children find themselves in is essential. Parents are definitely key given that they determine what food comes into the home, family rules around what, when, and where food may be eaten, and how treats are handled. It is useful to think about child feeding as a shared responsibility, with parents responsible for serving food that is healthy and appetizing and children responsible for how much of it is eaten. Parents, especially before adolescence, often arrange for and provide the necessary equipment for children to participate in organized sports. For younger children, opportunities for free play are in the domain of family life. Schools are important reinforcing environments and school policies can directly influence child food intake. Children may eat breakfast, lunch, and a snack at school, so that as much as half the childs intake may occur in the school setting. When schools prepare and serve food to students, high-quality nutritious balanced meals and snacks should be the only kind of meals and snacks served. In the policy arena, some schools have banned vending machines on school premises and limit the kinds of foods that are sold la carte in the cafeteria. Schools should consider policies that ban use of any product names, logos, or spokes-characters on any curricula or other educational materials. In the US, schools no longer teach cooking skills as part of secondary school curricula although it would take a lot to bring it back, it deserves serious consideration: the lack of cooking skills represents a important impediment to healthful eat-

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ing at home, where increasingly youth prepare their own meals. Physical activity during the school day, in class or at recess may represent as much as half of the physical activity the child engages in daily. High-quality physical education instruction should emphasize development of skills for a lifetime and insures that all students participate, regardless of their sports prowess. In afterschool settings, considerations with respect to food served and physical activity are important as well. The pediatrician serves an important role as a trusted source of health-related information to parents. From the first well-baby visits, the pediatrician plays a central role in teaching mothers how to feed their child. By asking questions about what complementary foods are being fed, what liquids are put into the babys bottle, and whether the toddler is permitted to walk around carrying the bottle the pediatrician learns about parental behaviors on which to counsel. As the child grows older, as part of preventive care, healthcare providers should ask about eating habits, whether the family eat meals together, physical activity patterns, screen time (time spent viewing television, playing video games, and working on the computer). Health care providers can encourage healthy family behaviors, such as eating meals together, turning the television off at mealtimes, and not allowing a television in a childs bedroom. Healthcare providers also should adhere to weight screening guidelines, which in the US call for annual screening of weight using BMI (weight in kilograms/height in meters squared). In view of the increasing number of obese and overweight children from the earliest years of life, and the potential consequences of serious health problems persisting in adults (increased risk of chronic diseases), what actions can be or have been put in the field successfully to promote the spread of correct eating habits and lifestyles from the earliest years? The rise in numbers of obese and overweight children has occurred across all of the stages of childhood, starting in infancy. Children are born with higher weights, partially due to women entering their childbearing years at higher weights. So, one promising area for intervention is women before they become pregnant. During the early years of life some data suggest that children who are breast-fed are more open to a variety of food flavors and less likely to be overweight later in childhood. Although this latter association is not fully established, it may reflect the mother child feeding relationship where the breastfed infant controls intake more than the bottle-fed infant. In childcare settings, policies around food served, use of the television, and opportunities for physical activity should be established. Once established, there must be a mechanism to ensure that policies are being followed. In the home setting, guidelines develop-

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ment and their wide promulgation would help inform parents of young children about their role in ensuring healthful eating for the very young. In the US, the Dietary Guidelines are developed for individuals over the age of 2 guidelines for children younger than two, especially restriction of sugar-sweetened beverages, would represent a beneficial first step. Policies around limits for screen time and for physical activity for the very young would also be welcome. In recent years we have become more and more aware that the agrifood industry has a role that is both possible and necessary in contributing actively to the develop ment of products and offers coherent with the information we have about correct dietary habits and lifestyles for children and adolescents. What actions can be iden tified and coordinated, in your opinion, with the food industries to promote healthy dietary habits and lifestyles from the earliest years of life? I agree with the premise that the agrifood industry has a major role to play and one that is both possible and necessary. Unfortunately, there are economic disincentives to many of the best ideas. One would like to see the industry make a business commitment to healthelevating the manufacture of healthful products to be a key criterion for their activities. Foods could be reformulated to be less energy dense, more nutrient-dense and of more appropriate portion size. For example, the soft drink industry might reduce the amount of sweetener in all sugar-sweetened beverages. The consumer would quickly adjust to less sweetness, just as they adjusted to greater sweetness. In terms of food processing, the addition of key nutrients to otherwise unhealthy foods is a trend that may fail to deliver expected benefits as consumers no longer can distinguish between healthy and unhealthy foods in the context of an everincreasing number of choices and variations. The marketing of low nutrient dense foods to children is an industry practice that runs counter to health and should be restricted.

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interview lifestyles influence the way we age

Alex Kalache
In industrialized countries, starting from the beginning of the 20th century, average life expectancy has increased sharply thanks to the constant improvement in medical care and important scientific discoveries. Nonetheless, contemporane ous with this, diseases such as diabetes, cardiovascular disease and cancer have continued to emerge, and over the last decade overweight and obesity have exploded. This caused a significant increase in medical costs, while a general change in lifestyles goes ahead. But, considering the different concepts of lifespan & health span, are we sure that living longer is living better?

Alexandre Kalache is one of the leading world experts on issues linked to aging, with special reference to the care and treatment of the elderly and the epidemiology of aging. He was the director of the Department of Ageing and Life-Course at the World Health Organization (WHO) from 2004 to 2008. In 2002 he established the Active Ageing Policy Framework, and introduced the Global Network of Age-Friendly Cities. He is president of the International Longevity Centre (Brazil), the director of the International Centre for Policies on Ageing in Rio de Janeiro, a senior advisor to the President on Global Ageing at the New York Academy of Medicine, and a consultant to the municipal and state governments in Rio de Janeiro and Sa Paulo, as well as for Brazils federal government in Brasilia.

We are indeed facing the serious risk of turning the greatest achievement of the 20th centuryan increase of more than 30 years in life expectancy at birth worldwide, even more than that for most of the developed worldinto a major problem of the 21st century. It does not make sense. Policies and interventions to ensure good health and quality of life as individuals age are urgently required. Important gains of recent decades are already clearly under threat. To illustrate this point I refer to a paper by the Canadian researcher PC Michaud and collaborators from both sides of the Atlantic, published in the prestigious Journal of Social Sciences and Medicine last July. This paper shows that in the 1970s the USA led the world in terms of life expectancy at birth yet four decades later LEB in the USA lags behind European countries of comparable socio-economic development. Americans are now living 18 months less than their European counterparts despite the fact that the US spends more than twice as much on health-care as a percentage of GNP. The paper is based on a sophisticated study which concludes that the difference between USA and Europe would disappear if prevalence of obesity in the US would be the same as in Europe. The authors emphasize that inneficiency in the American health care system is not a factor. Americans are not dying earlier because their health system fails them but because of their prevailing life-style. The study also suggests that policies to reverse unhealthy behaviour are particularly critical among middle aged individuals, when they are around 50 years old. Although the earlier an individual is when healthy life styles are adopted, the better, middle age is the threshold to yield major health gains.

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While living longer does not necessarily mean living better, it seems that American are not only living shorter lifes but also worse lifes. Obesity is both taking years from their lives but also negatively impacting their quality of life. Diseases associated with obesitysuch as diabetes, osteomuscular problems, cardiovascular disorders and some forms of cancernot only lead to premature death but also to many years of suffering through morbidity and disability. In addition, they substantially add to health care costs, taking away billions of dollars from the public sector which could be otherwise used in interventions and policies (such as education, environmental, recreational) that would be translated into better quality of life for the population as a whole. Modernday theories indicate there could be a common source to the various non communicable diseases: gradual cell inflammation that then manifests itself in actual pathologies. Numerous studies currently underway demonstrate that an approach which reduces caloric intake constitutes a powerful weapon in reducing inflammation, thus slowing aging in individuals. How to reduce inflammation with the adoption of a balanced diet and healthy lifestyles? While we do not yet fully understand the process of biological ageing there is no doubt that life styles affect it in important ways. Over the last few decades study after study confirm the importance of our behaviour in relation to ageassociated diseases. Control of four modifiable risk factors for non-communicable disease would lead to a huge decrease in their morbidity and mortality: sedentary life-styles; tobacco smoking; unhealthy diets and excessive consumption of alcohol. Gradual cell inflammation seems to be at the core of the pathogenic mechanism. The problem is how to implement sustainable policies. Although studies using animal models suggest substantial life extension through reduction in the amount of calories ingested, they are still to be confirmed in humans. Similar results might extend human life span to 150 years or more. However, available evidence in these studies suggest that the calorie reductions might have to be at levels that would not be easily accepted by a large majority of the population. The very fact that obesity has become such a major public health problem throughout the world shows that humans are inclined to eat more than they needand to burn less calories than they should, in the absence of major intervention to invert recent trends. Take for instance what is already happenning in developing countries as varied as Brazil, Mexico, Jamaica, India and the Phillippines. As soon as socio-economic levels reach a certain threshold this is followed by a spree of over-consuption of food in parallel to the adoption of sedentary life-styles. Most recently available data for Brazil for example, shows that virtually half of the adult population is now overweight, some 15% of them obese. Equivalent figures in the 1970s

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and 1980s were at a fraction of these; showing how fast negative trends are achieved. Changes in life-style that are more acceptable to the population at large should be pursued with more vigour. This would require a combination of marketing researchto ascertain what are the healthy behavioural preferences of the population as well as how to encourage themwith fiscal and legal policies that would sustain effective policies. For instance, research to find out which health food is more easily accepted by the population (marketing campaigns through the media) at affordable prices (fiscal policies decreasing taxes for fruits and vegetables) while creating barriers to discourage unhealthy items (legal policies, for instance, prohibiting trans-saturated fats or the provision of sugary drinks at school meals). Today, it is no longer enough to merely aim at living longer without also living well: quality of life is an indispensable factor that no one wants to give up. Pre vention from the earliest years of life and change in lifestyle as adults (by which is intended eating habits and physical activity) has become an approach that can no longer be put off. What are your suggestions, from a nutritional point of view, for healthy aging? The World Health Organization defines Active Ageing as the process of optimizing the opportunities for health, participation and security in order to enhance quality of life as individuals age. This implies a life course approach: the earlier one starts to invest on ones own health, the higher the health capital for life. Health is the central pillar (to which lifelong learning should be added) through which to guarantee participation, the second of the pillars of the Active Ageing concept. Finally, security: a system that should be there in place to ensure that those who do not age in good health will receive the adequate protection and care so that they continue to have some quality of life however low is their residual level of functional capacity (independence). From the nutritional point of viewand coherent with the active ageing approachhealthy diets should be encouraged as early as possible, and made sustainable throughout the life course. This is easier said than done; the emergence of fast and sugary food, the easy availability of cheap, high calory/low nutrient food as well as overly-aggressive marketing strategies conspire to cause children to acquire unhealthy diets early in life. In addition, in some cultures cooking styles are not healthy to begin withfor instance, a white diet based on refined carbohydrates, refined sugar, high in fat (fried food), salt and, often, alcohol. Compare that with the Mediterranean diet (high intakes of olive oil, unrefined cereals, fruits and vegetables; moderate intake of dairy products; moderate to high intake of fish; low consuption of meat and; moderate intake

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of wine) or the Okinawan diet (low calories and fat; high consumption of green and yellow vegetables; high consumption of soya beans and other legumes; small to moderate consumption of fish; little meat; virtually no eggs or diary products). Inevitably, some cultures predispose one to good dietary decisions while others induce one to a bad start. Policies and interventions aimed at promoting and sustaining healthy diets should be followed from as early as possible in lifebut not neglected later in middle age or dismissed in older age with the wrong assertion that it is too late. In this respect, studies recently conduct by Professor Ng Tze Pin, from Singapore, have shown that the importance of health eating for healthy brainsnot only through high intakes of fruits and vegetables, fibers, low fat, etcbut also demonstrating that there are other food ingedients that may well protect individuals from senile dementia later in life such as green tea (polyphenols) or yellow curries (basic ingredients, tumeric and cumin) possess strong anti-oxidant and anti-inflamatory properties)

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action plan
adopt a balanced diet and an active lifestyle
There exists an evident, direct, and intense linkage between lifestyles and health and, in the context of individual choices, diet and nutrition play a decisive role. Specifically, the adoption of a balanced diet, such as the Mediterranean diet with a low content of sugars, fats, salt, and a high content of fruits, vegetables, and cereal grainssignificantly reduces the negative factors that cause diseases, states of infirmity in individuals and, in some cases, premature death. In brief, the adoption of a balanced diet and an active lifestyle, from the earliest phases of our lives, can help minimize, at the same time and in parallel, the risks of overweight, obesity, tumors, cardiocirculatory diseases, diabetes, and metabolic syndrome.

encourage good behaviors and lifestyles from childhood on for better adult health
The findings in favor of the exceptional importance of a proper dietary regimen from the earliest age appear to be undeniable. There is clearly a high correlation between poor behaviors and diet in the early years of life and the onset of diseases in adulthood. It is clear that we must encourage the further exploration of scientific knowledge concerning childhood, which has been less thoroughly studied than adulthood. We must also encourage cooperation among the various subjects involved (including the food industry) in shaping the diets of young people, with a view to channeling proper dietary information and the promotion of a culture of prevention. Ensuring sound ways of eating in children and adolescents will require a concerted group effort by the numerous actors (school, family, physicians, pediatricians, and the dietary industry) who take care of children at different points throughout the day.

maintain an adequate diet throughout your life

Over the last hundred years life expectancy at birth has almost doubled, rising from 45 years at the end of the nineteenth century to about 80 years in 2010. These results are the product of improvements in living conditions, medical and scientific discoveries, and continuous advances in medical and healthcare technologies. Despite the prolonged average life span, health does not seem to be improving at the same rate: about 80 percent of elderly people (over age 65) suffer

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from at least one chronic disease and about 50 percent suffer from two or more chronic diseases. In the face of a steady increase of life expectancy and the dramatic rise in the spread of the leading chronic diseases, it is probable that humanity will soon experience, for the first time in modern history, a widespread old age characterized by a sub-optimal average quality of life, for a significantly longer period of time. Therefore, what is needed is not so much to find a way of living longer but actions to live better, longer. This may mean studying fields that are particularly innovative, such as the link between states of inflammation and the onset of chronic diseases, as well as the benefits that can be obtained through regimes of caloric restriction with optimal nutrition.

table of contents
introduction
Food for Peacea Call for the Mobilization of Goodwill by Shimon Peres

facts & figures the cultural dimension of food

5.1 5.2 5.3 5.4 5.5 5.6 5.7 The Relationship Between Food and Culture: the Origins How Food Contributes to Communication and Conviviality Delight and Disgust: the Cultural Classification of the Edible Food: Social, Gender, and Power Roles The Symbolic Value of Foods in the Major Religious Faiths Food Prohibitions: Food and Purity Food and Culture: an Indissoluble Bond

the great culinary traditions and the reality of food today

5.8 5.9 5.10 5.11 The Great Culinary Traditions Food Today: Challenges and Perspectives Toward a New Vision of Nutrition Guidelines for Redefining Mans Relationship with Food

the mediterranean culture: the value of a lifestyle and a culinary tradition

5.12 5.13 5.14 5.15 The Salient Characteristics of the Mediterranean Diet The Mediterranean Diet and Commensality Mediterraneity Today: the Decline of a Model How to Recover the Significance of Mediterraneity

interviews
We Must Construct a Culture of Responsibility by Joaqun Navarro-Valls Whoever Controls Food Controls Democracy by Vandana Shiva The Consumer Culture War and the Food System: What Does This Mean for the Mediterranean Model? by Michael Heasman

action plan

 5. food for culture

Food for Culture explores the relationship between man and food, focusing on the importance of recovering its cultural value in the world we now live in. We highlight the great food traditions, including the Mediterranean diet, and their evolution. Particular attention is given to behaviors linked to food and the need to rediscover aspects of conviviality around eating.

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5. food for culture

Food for Peacea Call for the Mobilization of Goodwill

Shimon Peres, President of the State of Israel

In todays changing world, food for peace has become a crucial and burning issue that needs to be urgently addressed. I cannot help but be reminded of John F. Kennedys words which encapsulate the very essence of the role of food in our global society: Food is strength and food is peace and food is freedom and food is helping people around the world whose goodshimon peres has been will and friendship we want. the President of Israel Generations ago the source of livelihood and food supply since June 2007. Politician, thinker and Zionist was land, and therefore the main concern was territory activist, Shimon Peres has enclosed by borders and based on an economy that was held major positions of national. Today, science and technology have replaced land responsibility within the state of Israel as statesas our source of livelihood and food supply, overcoming man, public administrator poverty and pointing to a tomorrow of hope and prosperand parliamentarian. He was prime minister from ity. Like a new and fresh wind they are blowing away bor1984 to 1986 and from ders, breaking down barriers, erasing distances, their influ1995 to 1996. Because ence is global, like todays economy. of his long-term commitment to the peace Science enabled us to have a longer life expectancy process, and in particuand reduce child-mortality, which has led to a populalar thanks to the start of the Oslo Accords, he was tion growth that presented new issues that call for new awarded the Nobel Peace answers. With the growing population, food consumption Prize in 1994 together with Israeli prime minisincreases, and in the global era, expectations also grow, ter Yitzhak Rabin and Yasand finding the right answers to meet the surging demand ser Arafat. for food is of the essence. But the answers are few. Water is declining, desertification is spreading and people are becoming bitter. In other words, it is easier to produce children than to produce food for them. It is easier to promise dreams than to realize them. The Middle East lives in a state of tension. It has been subject to conflict and

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war. Today it needs a hopeful tomorrow. It needs peace. It needs prosperity and well-being for its people. It needs food for its children. And for this, goodwill and volunteers with this in mind have to be mobilized to work together towards a common goal. There is no limit to human potential. Israel, a minuscule country with practically no natural resources, has proven this point. With little land, meager water supplies, and without a drop of oil, we had no choice but to give up the cultivation of land and replace it with the cultivation of hi-tech. Israels agriculture is based more on technology than on land and water. As a result, we have increased our yearly crops by twenty using little water. With the power of innovation, countries can overcome deserts. So we look upon science as a provider of food and existence. Decreasing waterconsumption, augmenting clean energy, developing plants that require little water, and recycling water for home consumption and agricultural use that boosts food supply, is all a matter of experience which we would be glad to share with everyone, because in our view, poverty is more dangerous than anything else. Only 23% of the surface of the globe is being cultivated agriculturally, and we can improve on this. Matching the potential of water and land with the potential of science is a promise for the future. And my greatest hope is that we shall succeed in combining both these elements to meet the need for food, placing it as a priority above borders, above nationalities, above prejudice. By placing food above politics, we can attain a better quality of life. Let us plant the seeds of innovation into the soil of human potential and we shall feed the children of the Middle East, and of the world, with hopes and dreams.*

* Quoted from the addresses of the President of the State of Israel, His Excellency Shimon Peres, at the Barilla Center for Food & Nutrition Forum in December 2009 and the Villa dEste Conference in September 2011.

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5. food for culture

CHOOSE FOODS CONSCIOUSLY

Humans have remarkable capacities for recognizing and memorizing, and these skills help people to avoid poisons and to find the most nutritious foods. Aside from their senses and memories, individuals based their food choices on culture and traditions that preserve the flavor and experience of countless tasters who went before them.

GREATER FAIRNESS IN THE WORLD THE OMNIVORES DILEMMA

Culture codifies the rules of a wise diet with a complex series of taboos, rituals, recipes, regulations, and traditions. All of this allows human beings to avoid being faced on a daily basis with the omnivores dilemma

Fairer food means that we have a responsibility for our weaker neighbors, that wet value food as a means of peaceful coexistence among peoples, and that we find ways to establish socio-economic equilibriums through the phases of production

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REDISCOVERING THE PLEASURE OF FOOD

The great challenge of our time is to redevelop a deeper, richer, more meaningful relationship with food, where the relationship with the things we eat is restored to the dimension of esthetics, taste, and conviviality.

THE IMPORTANCE OF CULINARY TRADITIONS FIGHTING OBESITY AND FOODBASED PATHOLOGIES

Eating has become a banal experience, leading to the epidemic of obesity and diseases linked to obesity Currently, we are witnessing the progressive abandonment of the gastronomical traditions of the past, as well as the loss of knowledge about cooking and the makeup of food

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the cultural dimension of food

Ever since the earliest times humans, like every other species on the planet, have interacted with nature on the basis of one dominant imperative: survival. For eons, that imperative required protection from harsh climatic environments and the ability to turn to ones own advantage the perpetual contest to eat, but not be eaten. Roaming the landscape in search of food, early humans sought survival through two principal practices: hunting and the collection of any and all possible edible objects. Continually exposed to the danger of becoming food themselves, our ancestors developed increasingly sophisticated abilities to manipulate nature, long before the adoption of agriculture some 15,000 years ago. We are all familiar with that process. As early as the Paleolithic era humans had discovered and begun to use fire. In the same period, they also devised a growing number of tools and weapons first in stone, later in metalto hunt, fish, defend themselves, and create shelters. Whether were talking about picking a piece of fruit or killing prey for food, the human relationship with the environment that surrounds us has always been transformative. Our capacity to manipulate nature passed a crucial milestone with the discovery of fire. Used for heat, light, protection, signaling, and drying (food and clothing), fire gave rise to progressive cultural developments of enormous importance, especially in the realm of diet and nutrition. In the words of Claude LviStrauss,1 cooking food with fire is the invention that made humans human. Before we learned about cooking, food, especially meat, was eaten raw, rotten, and even putrefying. The use of fire was a decisive turning point. Cooking then symbolically marks a transition between nature and culture, and also between nature and society, given the fact that, while the raw is natural in origin, the cooked implies a transition that is at once cultural and social. From this transition onward, food becomes a point of departure for the extraordinary social and cultural developments that followed. National cuisines, as the psychologist Paul Rozin puts it,2 embody the dietary wisdom of populations and their respective cultures. It is not far-fetched to argue that the history of mans relationship with food has been an extraordinary social and cultural saga of a quest for meaning. What was perhaps the most problematic aspect of life (the hunt for food) was transformed from a critical challenge into an opportunity. 5.1 the relationship between food and culture: the origins Physically ill-equipped in comparison with other animals, hunter-gatherer humans were endowed with considerable brainpower and an exploratory curiosity to match.

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In some populations of hunter-gatherers, the diet was actually largely based on game and the consumption of meat. This is also true among the modern populations of hunter-gatherers in the arctic and subarctic regions, where there is not much else to eat. But many modern scholars believe that by far most of the hunter-gatherers of the past lived primarily on foods derived from plants, or else, in areas near seas and rivers, on fish and shellfish. Some populations were almost exclusively vegetarian. Over the course of the Paleolithic Homo erectus was replaced by Homo sapiens, and brain size rose from about 400 cubic centimeters almost to the current size of 1,400 cubic centimeters. A large brain demands an extraordinary quantity of nutrients. Nonetheless, the American anthropologist Eugene Anderson3 questions the theory that this specific factor explains the inclination to hunt and eat meat, given human beings pitiful lack of fangs and claws and the doubtful efficiency of primitive hunting equipment. His explanation of the link between brain development and diet is different: In my view, the only credible theory of human dietary evolution is that the early hominids just became better and better at omnivory. They got better at finding meat, both by scavenging and by hunting, but also at finding roots, seeds, shoots, eggs, and anything else edible. [] The only way an animal with a huge, demanding brain can survive is by using the brain to figure out how to draw on a wide range of good food to get the most nutrition with the least effort. Humankinds first cultural elaborations were therefore by and large focused on the challenge of how to find food and accommodate an omnivorous propensity that was decidedly out of the ordinary. Michael Pollan4 fully subscribes to this theory in his bestselling book The Omnivores Dilemma. Other animals, Pollan notes, pursue the opposite strategy and consume a very selective diet, and correspondingly possess much smaller brains. The koala is an extreme case. In fact, this notoriously small-brained animal eats only eucalyptus leaves. Humans, in contrast, must devote enormous mental energy to refining the cognitive and sensory knowledge needed to distinguish which foodsamong the many availableare safe to eat. That effort is an essential part of humanitys cultural processes. In short, we think about foodand write about it, make art and music about it, and study it scientificallya great deal. It is part of who we are. As noted earlier, cooking is deeply embedded in human culture, so its no surprise that humans have developed our notions of cooking extensively. The culinary triangle, for instance, distinguishes among three different categories of cooked food: the roasted, the boiled, and the smoked. In all societies, roasting was the first form of cooking, the one closest to the natural order. The most ancient uses of fire for cooking simply exposed food directly to the flames; food was held on sticks and simply scorched or burned.

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Smoking food and boiling are distinguished from roasting by the inventive use of two different elements of mediation in cooking: air and smoke in one case, and water (plus a receptacle) in the other case. The use of cooking utensils, necessary for boiling, is certainly evidence of cultural evolution, but the same is true of the ability to smoke food in such a way as to extend its ability to withstand deterioration far longer than with any other method of cooking. So even the simple act of cooking, probably discovered by accident, succumbs to the human drive for cultural elaboration. 5.2 how food contributes to communication and conviviality Food took on a very important role in the development of the earliest forms of human communication. As the human brain grew, so did social groups begin to expand, from the 20 or so members typical of Homo erectus groups to the roughly 50 to 150 members common during the period of Homo sapiens. The extent of the territory occupied by the group also expanded. In a larger territory the discovery of a food source had to be communicated in greater detail, in order to explain exactly where it was located and how many members of the group it could feed. This was undoubtedly one of the ways in which language developed. Language probably also evolved in part due to the need to alleviate tensions bound up with the division of foods. At the origins of what we now call conviviality were the primitive practices of sharing food around a fire by groups of human beings who sat face to face, smiling, laughingand eventually talking. These practices are not found among other species, not only because of the fear of fire, but also because in the animal kingdom direct eye contact, opening the mouth, and showing teeth are typically hostile gestures. Moreover, as noted by Lvi-Strauss, if we add to this the idea of placing food in the middle of a group of individuals, with different parents and children, there is a clear recipe for conflict and violence. So the ability to communicate must have played a considerable role, and been in turn rewarded, in those rituals of sharing through which our ancestors managed to reverse signals of danger and transform them into the very essence of that conviviality that characterizes human social relations. The contemporary table and the habit of mixing food and conversation in convivial circumstances of all kinds therefore derives from an experience with ancient roots very distant in time, an experience that allowed the human species to overcome natural instinctive tensions and climb a number of steps up the ladder of cultural and social development. 5.3 delight and disgust: the cultural classification of the edible The growing mastery of language and the higher brainpower of Homo sapiens do not imply that establishing what to eat was ever an easy choice.

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Humans and other omnivores, unlike animals that follow a very selective diet, constantly confront the question of whether a certain edible substance would be beneficial or harmful. For humans, the problem is acute. For, as Michael Pollan says, Indeed, there is probably not a nutrient source on Earth that is not eaten by some human somewherebugs, worms, dirt, fungi, lichens, seaweed, rotten fish; the roots, shoots, stems, bark, buds, flowers, seeds, and fruits of plants; every imaginable part of every imaginable animal. This capacity for nutritional and dietary adaptation greatly assisted the evolution of the species, but it also put humankind in constant difficulties in distinguishing the foods that were advisable to eat. As Pollan observes, The omnivores dilemma is replayed every time we decide whether or not to ingest a wild mushroom, but it also figures in our less primordial encounters with the putatively edible: when were deliberating the nutritional claims on the boxes in the cereal aisle; when were settling on a weight-loss regimen (low fat or low carb?); or deciding whether to sample McDonalds newly reformulated chicken nugget; or weighing the costs and benefits of buying the organic strawberries over the conventional ones; or choosing to observe (or flout) kosher or halal rules; or determining whether or not it is ethically defensible to eat meat. The concept of the omnivores dilemma is already present in the writings of Jean Jacques-Rousseau and Brillat-Savarin,5 but it was officially singled out and identified as such by Paul Rozin, an American psychologist working at the University of Pennsylvania. In 1976 Rozin wrote an article titled The Selection of Foods by Rats, Humans, and Other Animals, in which he compared the existential condition of omnivores, such as rats and human beings, with that of animals tethered to specialized diets. The latter animals are untroubled by doubts about what to eat, inasmuch as their dietary preferences are written in their genes. These animals waste no thought or emotion on deciding what to eat and what not to eat. For these animals, the natural and instinctive mechanism functions perfectly because the digestive system is only capable of obtaining all that the organism needs from a few foods. Omnivores, on the other hand, have to devote time and study in an attempt to understand which of the countless foods offered by nature can be safely eaten. In our case, the ability to do this has allowed humans to colonize all of the Earths habitats, by adapting to and exploiting the different types of food available. When an omnivore encounters something new and potentially edible, he finds himself dealing with two clashing feelings: neophobia, that is, the fear of eating an unknown substance; and neophilia, that is, the desire to experience new flavors. These sentiments are completely unknown to animals with specialized diets. Humans are endowed with extraordinary abilities to distinguish and remember that help us to avoid poisons and toxins and to seek out the most nutritious foods. In this process, we are aided by our sense of taste, which spon-

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taneously leads us to prefer the sweet, a signal of a wealth of energy-packed carbohydrates, and makes us avoid the bitter, which is characteristic of many poisonous alkaloids synthesized by plants. Likewise, disgust flags potentially dangerous foods, such as stale or rotten food. Humans have another advantage as omnivores too. Aside from using our senses and memory in choosing foods, we can rely on the culture and traditions that preserve the cumulative knowledge and experience of countless tasters before us. The culture codifies the rules of wise nutrition with a complex series of taboos, rituals, recipes, rules, and traditions. All this allows human beings to avoid having to deal each time with the omnivores dilemma. While humans as a species are ready to gobble down almost anything that comes to hand, it should be said that the various human societies tend to restrict considerably the notion of what constitutes food. Between delight and disgust there seems to be a fairly thin line, and that boundary is almost always defined in cultural terms. As Rozin made clear, disgust (a term of general meaning but etymologically derived from the nutritional and dietary concept of taste, as in gusto and gustatory) is the fear of ingesting substances that might prove harmful. Some things have the power to disgust individuals belonging to all human societies. But specific societies express rather idiosyncratic forms of disgust, which often have no underlying reasons other than the cultural development of customs and habits. Even in Western societies, depending on the geographic region and the social group, foods such as snails, frogs, and animal organs can be either hailed as delicious or considered repellent. What we ingestor rejectsays a great deal more than a simple dietary preference. Every culture tends to have its own way of dividing the world into that which can be eaten and that which cannot. That subdivision often includes many elements of a symbolic nature which, beginning with the physical body, guide a certain perception of the social body, and vice versa. As we shall see below, the crucial meanings of these processes of classification primarily speak to the notion of purity. 5.4 food: social, gender, and power roles Access to food and nutritionwhat might be called the nutritional order and hierarchyis governed by power. The hierarchy of rank establishes the rules governing access to food, even among other animal species. Even though lionesses do the hunting themselves, they do not touch the prey until the lion has finished eating. Among human beings, the control of food was historically one of the principal sources of power. In the Middle Ages, the banquets of aristocratic families contrasted with endemic starvation among the peasantry, and in

the importance of markets

The wooden ceilings of the Mercat de Santa Caterina in Barcelona, Spain. Markets tend to be one of the sites where people interact in urban areas. In addition to selling produce and prepared foods, markets also attract tourists and visitors since they are the perfect place to watch the local culture and economy.

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various parts of Europe those who were caught poaching in the royal reserves or the preserves of local lords were put to death. Countless battles and wars have been waged between farmers and stockbreeders in many regions of the world, and what was at stake was always getting the upper hand over a certain way of producing food. On the African continent these conflicts are still under way. Food can be a signifier of power in terms of social prestige as well. But it is interesting to observe that the cultural perception of such forms of prestige is fairly complex, and in some cases contradictory. The categories of Lvi-Strausss culinary triangle allow us to understand this aspect very clearly. In his analysis, boiled food constitutes a more evolved form and therefore communicates more refined values than roasted food. But this relationship in terms of prestige and power can be overturned as well, because boiled food frequently tends to be associated with a more intimate, family-oriented style of cooking (dishes such as stews or boiled meats), foods that were generally cooked by women. Roasted foods, on the other hand, could be presented in public celebrations, often in the open air and with great ostentation, which tended to be associated with the world of males. A very significant example of the latter form is the barbecue, especially in the United States. Our understanding of these issues has been updated and expanded by socioanthropological studies that examine the relationship between food and gender. There can be no doubt that food practices give rise to countless varieties of hierarchy, and that in many societies this traditionally tends to place women in a subordinate position. For instance, the anthropologist Anne Allison emphasizes that Japanese mothers, in their meticulous and dutiful preparation of the bento (the lunch-box for their pre-school-age children), tended to reproduce an ideology of their own role that was deeply reductionistic and strongly influenced by state institutions. At the same time, the sociologist Marjorie DeVault points out that the female practices of providing food for the family, however gratifying they might be for those who perform them, are subtly but pervasively implicated in unequal relationships of subordination, which thus reinforces the naturalness sensed in their deference to the needs of men and undermines any progress toward forms of food culture under the aegis of reciprocity. Of course, especially in the more prosperous Western societies, the role of women can also be viewed in a more positive light. The comparative specialization of women in the purchase and preparation of food can in many cases represent an area of strength in their relationship with men. Also playing a part in that context are increasingly articulated factors of market knowledge, nutritional expertise, purchasing autonomy, and self-expression. According to some, women can take pleasure from their condition of chosen preparers of homecooked food, the pleasure of an activity that is no less intelligent and imagina-

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tive than other activities that are customarily considered to have superior standing, such as music. 5.5 the symbolic value of foods in the major religious faiths As Eugene Anderson points out, with reference to mile Durkheim,6 a great many rituals, ceremonies, and religious celebrations inevitably include the relationship with food. The symbolic value of foods in the major religions is impossible to overestimate. In Judaism a substantial number of the 613 mitz vot (commandments or precepts) that guide the life of an observant Jew have to do with the dietary sphere and originate within important passages of the Old Testament. Jewish tradition tends to perceive in the act of nourishment a significance that educates people to make a constant series of choices and verifications, defining the relationship of humans with nature and partaking profoundly of sacredness. There is no comparable set of rules about food in Christianity. In particular, there is no general distinction between foods that are permitted and foods that are prohibited. Nonetheless, peoples relationship with food remains a part of the dimension of the relationship with God. The symbolic role of the wine and the host in the sacrament of Eucharist (Holy Communion), which is based on the words uttered by Jesus during the Last Supper, represents for Christians the means of communion of souls and a form of ongoing memory of the passion of Christ. Even though the relationship with food in Christianity is a relatively free one, some prescriptions require the faithful to restrict their consumption of meat and to engage in periods of abstinence and fasting, especially during the liturgical period of Lent. The third great monotheistic religion, Islam, rejects both the narrow strictures of Judaism and the dietary freedom of Christianity, and tends instead to preach an attitude of moderation in the consumption of food. However, the halal dietary tradition, which is followed by about 70 percent of all Muslims on Earth, also dictates some rules about what can be eaten and what cannot. The chief limitations (less stringent than those in Judaism) also have to do with meat. Moreover, unlike Judaism and Christianity, Islam famously forbids the consumption of alcoholic beverages. The importance of dietary practices as defined by religious strictures is emphasized by the fast of Ramadan, designed to educate Muslims in the practices of patience, modesty, and spirituality. Certain other religions are characterized in dietetic terms by the almost absolute prohibition against eating meat, at least among the most devout followers. Anderson points out that meat is seen as involving the killing of animals, a violent and anti-spiritual thing. The religions based in IndiaHinduism, Buddhism, and Jainismshare this commitment to what is called in Sanskrit

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ahimsa, nonviolence. Jainism, in particular, assumes that every living thing, however microscopic, possesses a soul, and that the soul is potentially divine. It therefore rejects the eating of meat as well as all useless forms of violence, such as the violence practiced by modern factory-farming of animal products. What stands out, in all these cases, is the narrow connection between food and destiny, food and final significance. Even within those extraordinary processes of cultural elaboration that are the religions, food plays a role of enormous importance, given its ability to be a catalyzer of meanings and symbolisms. In most religions, food is also an important factor in social aggregation, an element that serves the functionamong othersof establishing who is a member of the congregation of the faithful and who is not. Anderson also explains this point very effectively: Typically, aggregation and differentiation are stronger and more emotionally intense in religion than in other human activities (though political ideology and ethnicity have sometimes taken pride of place in the last century or so). Food is almost always a marker. The sharers eat together at ritual meals. 5.6 food prohibitions: food and purity Religious rules include, as we have mentioned, a number of prohibitions concerning food. Of course, certain foods tend to be considered inedible for reasons that may be purely cultural, and which have no specific foundation in the realm of religion. These prohibitionsand at the same time, the rules about the foods that were allowedhave been interpreted on the basis of various orders of explanations, ranging from disgust toward certain species to hygienic reasons, from symbolic motivations (for instance, strictures against eating birds of prey out of a rejection of the violence intrinsic to those animals), to educational considerations (teaching man that not all goods need to be enjoyed directly and thoughtlessly). British anthropologist Diane Mary Douglas7 traces many rituals that are intended to define the relationship between the individual body and the social body back to the idea of purity. This analysis broadly applies to food, which is a symbolic element of particular significance since it is a piece of reality that we literally incorporate. In her vision, the idea of contamination, and the fears that derive from it, are strongly present both in the primitive world and in contemporary societies. A great many rituals are therefore designed to ensure an attempt to approach some ideal of purity through practices of separation, demarcation, and punishment. The clearest example is that of the Hindu caste system, in which the lower castes (which are by definition impure, or at any rate assigned to a lower rank of purity than the higher castes), habitually participate in the production of food in various roles, for instance, as farmers. For that reason, in

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the higher castes, food must be cooked by the family or by someone else who belongs to the same level of caste, in an act of symbolic demarcation. 5.7 food and culture: an indissoluble bond It would certainly be possible to write entire volumes on the relationship between food and nutrition (and in fact, many books have been). What we have chosen to discuss in this brief introduction to the topic is the close, intimate nature of the link between food and culture. The very act of feeding oneself, to the extent that it entails rationality, tradition, memory, symbols, and values, is a cultural thing. It is so innate to human beings to establish a relationship with foods that it is the point of departure for remarkable developments, with repercussions in social and individual terms of extreme significance. This is evident when this relationship is balanced. It becomes even more so when it loses all semblance of equilibrium.

the great culinary traditions and the reality of food today

We showed in the previous section that there is a deep-seated link between food and culture. Food has a marked effect on peoples lives and ways of eating reflect and are conditioned by individual lifestyles and the nature of relationships between people. The interaction of these variables has given rise over time, in some cases, to unique and specific dietary approaches and gastronomical traditions. Keeping in mind that every tradition is the inevitably provisional product of a series of innovations and the changes that they have induced in the cultures that accepted those innovations, there are three great culinary traditions that we will attempt to describe in very abbreviated form in the following pages: Mediterranean cuisine, Asian cuisine, and Anglo-Saxon cuisine. Rather than working back to the origins or exploring the history of these three different approaches to nutrition, we will focus on trying to chart their trajectories, in view of current opportunities and challenges. 5.8 the great culinary traditions mediterranean cuisine. Beginning in the Neolithic Age, the Mare Nostrum, or Mediterranean Sea, was the destination of countless migrations. The new arrivals settled in existing communities in search of better living conditions:

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more fertile soil for those who came from Asian or African deserts, a milder climate for those coming from Scandinavia or Germany. During the eleventh and twelfth centuries C.E., contacts between Muslim and Christian communities based on the Iberian peninsula grew into intense commercial exchanges, during which a significant number of new food products were traded and introduced into the respective gastronomical cultures. At first, during the high Middle Ages, the ancient Roman traditionwhich, on the model of Greek culture, identified bread, wine, and oil as the products symbolizing the tradition of a farming and agricultural civilization, as well as the chosen symbols of the new faithencountered the culture of the Germanic peoples. Those peoples lived in close symbiosis with the forest, from which they drew most of their nutritional resources, through hunting, herding, and harvesting. Thereafter, the new food civilization that emerged from the marriage and fusion of the nutritional models of the Roman and Christian civilization and its Germanic counterpart measured itself against the tradition of the Arab world, which had developed, along the southern shores of the Mediterranean Sea, its own specific nutritional culture. It was precisely the Muslims who gave rise to a significant process of agricultural renewal in which irrigated fields played a fundamental role. The new agriculture introduced unfamiliar plant species or varieties that had only been utilized by the more prosperous social classes because of their elevated prices. Among the products introduced into Mediterranean cuisine that originally came from the Islamic world, we should mention sugar cane, rice, citrus fruit, the eggplant, spinach, and spices. Moreover, the use of rose water, orange water, lemon water, almond water, and pomegranate water was introduced as well. Islamic culture, then, played a role in the change and the transformation of the cultural unity of the Mediterranean, as Rome had so forcefully constructed it, providing a decisive contribution to the new gastronomic model that was taking shape. Another chapter of great historic impact was the discovery and the conquest of America by the Europeans. This discovery also resulted in a to-and-fro of food products: the potato, the tomato, corn, the pepper, and the chili pepper, as well as a number of varieties of beans. The tomato, initially treated as no more than an exotic curiosity and an ornamental fruit, was not thought of as edible until a relatively late datethe first red vegetable to enrich our pantry of edible plantsbut it has now become a symbol of Mediterranean cuisine and, in particular, of Italian cuisine. While the central role of vegetables is one of the most distinctive characteristics of the Mediterranean tradition, it is also important to remember the role played by cereal grains as the foundation of the poor mans cuisine and as a tool of

food and urban space

In many cities, the market square is the true center of urban and social life. In Marrakech, Morocco, the Jamaa el Fna is the square around which the historic city has grown. It still preserves its roll as a meeting place. A market by day, at night it becomes a giant openair restaurant.

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day-to-day survival, given their capacity to fill stomachs and help assuage the hunger pangs of the less well-to-do classes. This vast geo-culinary movement, which benefited from nutritional inputs that were originally typical of the Far East and Africa, as well, emphasizes the fact that the Mediterranean basin has long served as a crucible and melting pot of civilizations, beliefs, and lifestyles. Crossbreeding is one of the causes of its cultural diversity and peculiarity. The food model that we now call the Mediterranean diet, then, is not only a way of nourishing oneself, but also the expression of an entire cultural system, based on healthfulness, the quality of the foodstuffs, their distinctive territorial characteristicsand conviviality and a love of food. Despite the changes in dietary customs and lifestyles that have taken place since the second half of the twentieth century, the Mediterranean diet continues to be a point of reference, and not only in the Mediterranean region but also in regions throughout the world, given its distinctive nutritional characteristics. The Mediterranean diet also represents a very important resource in terms of sustainable development for all the countries that overlook the Mediterranean basin, because of the economic and cultural importance that food has in the entire region and for its capacity to inspire a sense of continuity and identity for the local populations. asian cuisine. Asian cuisineChinese or Japanese, Thai or Vietnameseis rich in flavors that are unexpected for the Western nations. They are the product of a historic and cultural tradition comparable in importance with the tradition that sprang up around the Mediterranean basin. Here we shall focus on the great Chinese tradition and its distinctive features, as they are representative of a broader approach. Rooted in a vast rural world, Chinese cuisine boasts an extraordinary variety of ingredients and excellent dietetic qualities. In China, for millennia, health has represented the focus of all nutritional behavior. In daily life, in fact, cuisine forces people to respect the dietetic rules that have been acquired as the foundation of traditional medicine. In order to understand the Chinese culinary tradition, therefore, it is indispensable to place it in the broader context of a body of knowledge that defines the relationship between nutrition and health. This attention to diet, to the nutritional characteristics of the foods and the nutrients that were being attentively studied by physicians and by Taoists, is emblematic of the concept of food that is central to the Chinese tradition, and has been for thousands of years. The Chinese, in fact, identified proper and harmonious nutrition as one of the principal ways to improve health and seek longevity. In this connection, we should mention another important factor of the Chinese tradition: the central role played by food in festivities and the symbolic value of

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certain dishes. For birthdays and at New Years, for instance, noodles are eaten, because their thin and elongated shape symbolizes longevity. According to the philosophy of Tao, the world is a continual process of becom ing whose propulsive force derives from the dynamic opposition of yin and yang (female and male, darkness and light, cold and heat). These are far from being merely theoretical principles; they are viewed as concrete categories of life which also permeate the realm of diet. Foodstuffs are therefore divided into four categories, according to their yin and yang nature: cold and cool foods are yin, warm and temperate foods are yang. Cooking and cuisine, therefore, must take care to respect the equilibrium and harmony of these categories of ingredients. In Chinese cuisine there is also a particular technical rationality that can be found in the methods of cooking and in the cutting of the raw materials. The cooking is designed to attain harmony of the flavors: cooking in fact is meant to achieve the ideal consummation of the substance through fire, as LviStrauss put it.8 Cutting the foods very thin before cooking, which is so characteristic of this cuisine, is also the chief criterion of differentiation from other cuisines. The practice can easily be traced back thousands of years and is quite understandable if we consider the use of chopsticks that is associated with it. In comparison with the Mediterranean tradition, which was more accustomed to the consumption of wine, in China tea was the characteristic beverage of tradition. Tea was so important that it was listed among the seven products that were indispensable to life, along with fuel, oil, rice, salt, soy sauce, and vinegar. The Chinese were the first to cultivate tea, and the production and consumption of tea were widespread throughout the territory as far back as the time of the Tang dynasty (A.D. 618-907). In China, nutrition is a social concern of enormous importance. In fact, we find in Chinese gastronomic culture (and more generally in Asian gastronomic culture) parallel traits to the conviviality typical of the Mediterranean tradition. A taste for that is translated into the taste for the consumption of food together with other people, a simultaneous vehicle for pleasure and relationships. The Chinese and Mediterranean cuisines in fact share important values with respect to the importance attributed to food, to the care and the creativity employed in its preparation, and the attention to taste and the social dimension of eating. anglo-saxon cuisine. Anglo-Saxon cuisine, and in particular North American cooking, develops out of a logic, an approach, and social contexts that are very different from the ones described above. Were referring to the absence of a sufficiently long history to permit the deep rooting of widespread cultural practices and values; a tendency toward hyper-mobility that prevents attachment to any given territory; the objective absence of typical products that characterize a culinary style; and lifestyles and ways of consumption based on individual-

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ism, pragmatism, and speed. All of these factors seem to have prevented North America (and Great Britain9) from developing an original gastronomic culture of quality comparable to the Mediterranean and Chinese cuisines. If we are to attempt to characterize the Anglo-Saxon culinary tradition, we cannot ignore the fact that as early as the beginning of the 1960s in America, and subsequently in England and Europe as well, women in every social class began to work. Women moreover began to work outside of the home: this significantly changed the female model prevalent until then, which had been that of a woman primarily devoted to caring for home and children. The preparation of food lost its connotation as an everyday obligation and therefore became a moment of pure socializing, bound up primarily with the sphere of recreation. Prepared foods tended to become the norm, while over time the consumption of meals eaten outside of the house increased, often in the form of fast food. In brief, it is possible to see that the deep social changes experienced in the United States many decades ahead of the other Western countries, along with the absence of a strong nutritional tradition, together helped to orient the American and Anglo-Saxon city dweller toward speed of consumption and choice, and to a resulting disinterest in the characteristics of the product, as well as in terms of the quality of the social interaction that accompanies the consumption of food. This is perhaps the most evident case of how the absence of a patrimony of knowledge and shared, common choicesa nutritional culturewinds up unloading upon the individual, who then lacks basic tools of information and culture, the capacity of choosing and selecting foods, often with very negative results. Moreover, despite the fact the United States is a land of transition and settlement for people of all nations and civilizations, there has not been, except on the margins, a process of creative cross-fertilization capable of leading to the birth of original approaches. To the contrary, in fact, there has been a general leveling toward a diffuse mediocrity. As we conclude this introductory overview, it should be pointed out that the process of exchange between cultural traditionsthe so-called crossover traditionsis generally growing to an exponential degree. In the past, changes in nutritional culture were for the most part the result of migration. Today, globalization, along with a growing mobility between countries, the desire to discover characteristic traits of other civilizations in a generalized process of drawing closer to others, and the strategies of industrial expansion pursued by multinationals, have modified the picture, with a variety of outcomes. While on the one hand it is certainly a positive development to see the choice of food as a channel of knowledge that makes it possible to appreciate and get closer

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to novel experiences, that often lead creative contamination, it is quite worrisome to envision a setting in which the responses to the social changes now under way (changes in the role played by women, less and less free time, etc.) seem to emulate those productivist solutions of the pastpresuming that the purpose of economic activity, indeed of human society, is sheer production that proved to be so misguided and dangerous. 5.9 food today: challenges and perspectives The current relationship between food and culture is particularly challenging. The equilibrium attained by the great culinary traditions, that happy balance among pleasure, well-being, health, and conviviality, appears to be increasingly precarious. Lifestyles change, the capacity to transfer gastronomical knowledge and skills declines, a growing demand for functionality intervenes, health concerns emerge, and suddenly Michael Pollans omnivores dilemma becomes relevant again. Although humanitys age-old dietary history has introduced fairly strictly codified forms of the best nutritional practices from the various dietary traditions, today this body of nutritional information and knowledge seems to be vanishing from many places. The combination of excessive quantities and varieties of foods in the supermarkets, associated with the lack of adequate contexts of analysis and interpretation caused by a progressive loss of dietary identity, is increasingly disorienting individuals and taking them backwards in time, to the moment of initial choices. The most natural of all human activitiesnourishing oneself, deciding what to eathas become an undertaking that requires aid from nutritionists, food scientists, and doctors. Such a radical change in eating habits is an unmistakable sign of a diffuse nutritional disorder. Nothing of the sort could ever have happened in a society that possessed solid traditions concerning food and eating. the omnivores dilemma. As Pollan writes, When you can eat just about anything nature has to offer, deciding what you should eat will inevitably stir anxiety, especially when some of the potential foods on offer are liable to sicken or kill you. This is the modern face of the omnivores dilemma. What historically referred to a natural condition of humanity becomes, ironically, its almost complete opposite: an emblem of uncertainty generated by the prevalence of general conditions of unnaturalness. Bewildered by the excess of supply and information, and incapable of thoroughly understanding industrial processes, the makeup of food, or the health consequences of what he ingests, the omnivore struggles to make decisions and choices.

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No doubt in reaction to this trend, an increasing demand for authenticity is arising, linked to the rediscovery of sustainability in all its embodiments (environment, health, social relations) and which points a finger at the food industry, asking it to take on new responsibilities. This is a turning point. We are now seeing the possibility of rethinking our relationship with food in terms of a new overall vision. The emerging traits of this new approach could beaccording to Baumans analysis10 situated at the intersection between the pleasure of the sensory experience and the demand for a situational comfort that makes it possible to savor in full the flavor of the food. The aspect of speed, which has become a characteristic element of our time, will significantly influence our relationship with foodand in different terms than the ones that we already know (nowadays it is an expression of a stark poverty of cultural contents). This introduces other significant dimensions: from the need to simplify the procedures for the preparation of food (in order to save time, which is in such short supply today, and to make up for the loss of food culture), to the notion of universal portability, understood as the ease of application of the desired way of eating within an increasingly frenetic society in constant movement. The domain of ritual is a powerful aspect of the relationship with food. The recovery of food rituals can confer a dimension of reassuring meaning that will help to render more immediate the experience of eating. We must try to reinterpret our relationship with food so as to reconcile the social dynamics of our times with a healthy and positive approach to nutrition and food. To put it in a slogan, there are three imperatives today: restore direct contact with the cultural dimension of food, redefine its pleasure, and spread its flavor. 5.10 toward a new vision of nutrition There are a number of different factors, as we have noted above, that will influence the future of food in the coming decades: first and foremost is the demand for greater naturalness and the need for a rebalancing of ways of eating toward a healthier and more sustainable dietetic approach. But the great challenge of our time is probably that of reclaiming for ourselves a deeper, richer, more satisfying relationship with food, in which the rapport with the food fully embraces the dimensions of aesthetics, taste, and pleasure. From this point of view, the temporal dimension appears decisive: we must find a way to ensure that time once again stretches out and opens up for this new approach to the eating experience. Likewise, of equal importance is the recovery of conviviality, a quality that in many ways lies at the foundation of the very possibility of a gratifying experience.

excess supply

It is probably more difficult to list the foods that are currently eaten than it is to list the foods that humans dont eat. Are current levels of meat consumption a problem for the environment and health? We can reduce the impact of meat production by beginning to eat insects, for example, already a widespread habit in many countries. According to the UN Food and Agriculture Organization, around the world some 1,400 species of insects are eaten by humans.

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Even as we do our best to recover traits that were typical of the ritual aspects of tradition, modern reality demands that we move toward a pattern of food consumption that complies with new paradigms of behavior. Post-modern society is the society of disenchantment, of the loss of the magic of the symbolic exchange, of the disruption and distortion of the space and time of lifestyle. Globalization itself makes the presence of otherness a looming fact, depriving people of the human dimensions of tangibility, resemblance, durability, connection, and depth. The risk is that a desperate need to find interaction and relationships with other people and the growing fear and inability to do so will tend to render fragile and ephemeral any sense of community and all temporary and fragmentary emotions. In short, the society of the future will be a society of multiplicity and uncertainty: an older, more feminine society, economically more polarized, multiethnic, far more urbanized, based on total mobility and fragmented, pressured lifestyles, with serious environmental concerns. Speed of life and loss of conventional spatial dimension will determine the way we live. Lifestyles will become fluid, influenced by changing situations and shifting moods, and identities based on age, gender, and culture will become multiple and undergo continuous change. What role will food play in this emerging world? The basis of all consumption will increasingly tend to be the realm of the imagination. It will not be the products themselves that will encourage choices, but rather their code of significance. In order to induce consumption and remain in consumers preferences, products will need to integrate their functional and emotional aspects with symbolic elements, responding to and interpreting the need for roots, localization, duration, anxiety relief, and a reassuring physical and mental boundary. Food preparation will need to be simplified (which will save time, now at such a premium, and help make up for the general loss of culinary culture and the guidance it passes on). And food will require universal portability, understood as the ease with which a desired way of eating can be applied even within a society that is constantly moving at an increasingly frenetic pace. Finally, the recovery of food rituals will confer a dimension of meaning and reassurance that will help to make more immediate the experience of eating. In summary, the future will see an attempted constructive reinterpretation of our relationship with food, in an attempt to reconcile the social dynamics of our time with a healthy and positive approach to nutrition. 5.11 guidelines for redefining mans relationship with food The consumption of food is, by its very nature, a cultural experience specific to humans. The link between food practices and culture is a strong bond that

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extends back throughout all human history. The progressive dying out of this important aspect of human culture seems to be the result of a process of alienation that, as we have shown, generates anxiety and uncertainty. Our era thus represents the most opportune moment to requalify, in positive terms, the cultural value of the relationship between humans and food. The social importance and the urgency of a vast operation of rethinking that relationship makes it impossible to put it off any longer. It is necessary if we hope to respond, at the root, to the needs and the aspirations of people everywhere. Food culture is the most effective lever for redefining the relationship between man and food. It is only by beginning from a nutritional culture that is more focused on the values of naturalness and sustainability that we might tackle the challenge of the great food emergencies of this century, ranging from those linked to food access, to the prevention of a broad array of pathologies and a more general respect for the environment. Culture has long been a multiplier of results, thanks to its innate capacity to activate and orient the energies of individuals into collective action. Limiting ourselves to technical solutions to the emerging issues, and overlooking the spread of a cultural dimension and the role of knowledge and understanding, means planning only short-term interventions and renouncing the possibility of having any real effect on the deeper causes of the current challenges.

redirecting the future of food

make the best possible use of the bountiful reservoir of conviviality.

The times we live in are impoverished in terms of relationships. The proliferation of opportunities for contact (through new technologies, among other things) often correlates with superficiality in human relations. Food, on the other hand, is still a vehicle for opportunities for interaction and relations. It is necessary to recover this natural inclination intrinsic to food and restore to a more appropriate social dimension the moments in which it is consumed. protect forms of local territorial variety and work to expand them. Food is an expression of the identity of a community and a territory. It thereby preserves a quality of unique individuality that makes it, on the one hand, an opportunity to rediscover ones own cultural roots and, at the same time, an opportunity to establish relations with other traditions. For this to happen, however, it is necessary to preserve the wealth of food and cuisine identities, without giving up the taste for contaminations and cross-fertilizations, thus reinforcing the emotional capital linked to roots, distinctive traits, and territorial localization while capitalizing on their universally human aspects.

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transfer knowledge and know-how. These are extraordinary deposits of cultural wealth. The preparation of food is by its nature an artisanal experience; the consumer is summoned to contribute by joining into forms of co-production with the people who make foodstuffs available. Such participation demands major skills and expertise, which must be preserved and handed down over time. restore healthy relationships with territory and the context of the raw material, with a view to the excellence of the ingredients. In the case of nutrition, the relationship between the physical and material quality of the food and the quality of the cultural experience is very strong. Poorquality food does not produce culture. It is therefore necessary to work carefully on the excellence of the ingredients, establishing a direct and respectful link with the soils and lands where the raw materials are created. recover the value of food as a fertile link between generations. The table at which breakfast and the evening meal are served seems to remain, in many families, one of the few privileged places where they share the experience of their lives, a place for cultivating mutual bonds of affection. This should be recovered as a means of constructing (and reconstructing) a social fabric that modern life is steadily weakening. recover the ancient flavors that can be renewed in the context of contemporary taste. We should strive to preserve the best of gastronomic traditions by reinterpreting them creatively. This, in all fields, is the principal mechanism for the transmitting culture across generations. finally, spread the culture of taste and enjoyment of life through authentic food. If we can revitalize the magic and the astonishment of food in its rituals and its carefree pleasuresas an existential and cultural fuelwe can restore people, their feelings and human relations to the center of the human experience. Future luxury and health will consist to a very great degree in the art of living and conceiving of food in a cultural context.

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the mediterranean culture: the value of a lifestyle and a culinary tradition

There is a strong cultural bond that has united and continues to unite the diverse peoples of the Mediterranean basin. The Mediterranean Sea has long been a special theater of encounters between diverse cultures continually exchanging material goods, ideas, and values. This created a geographic and cultural context made up of significant differences but also of numerous points of convergence. One of these is the attitude toward food: the Mediterranean peoples share a view of reality that identifies food as one of the essential components of their identity. It is not a matter of the sameness of the products consumed; to the contrary, they are rather diversified. It is instead the approach to food that is unique; an approach that attributes a central role in peoples lives to food and the moments of conviviality linked to food. This is, in other words, a combination of foods and types of relationships with food that is the basis of a durable cultural identity. Together with other factors (but no less a degree than the other factors), this identity helps to constitute the foundation of a rich and articulated system of sociability. As Claude Fischler, the French sociologist, recently pointed out, the Mediterranean approach to foodthe so-called Mediterranean diet, understood here in the broader sense as an overall lifestyle and foodwayhowever now displays an unexpected degree of fragility. It is unexpected because in the past it was the Mediterranean diet more than any other that had proved capable of successfully assimilating elements of extraordinary novelty (think of the various New World foods, first and foremost the tomato) without losing its distinctive personalityindeed, being enriched by them. Secure in a clear and strong identity, the Mediterranean diet assimilated elements of innovation in a complementary manner, encouraging an even more complete structuring of the way of eating. Today, however, within the same Mediterranean countries the lifestyles and foodways of recent history tend to be lost very easily, giving way to nutritional habits, foodways, and approaches to eating that come from other traditions. Those traditions are often much less rich in terms of nutritional content as well as elements of sociability and significance. This seems to be happening to a much greater degree within regions that, more than others, once represented the select territories of the Mediterranean identity. What seems to be blocked is a strong mechanism for transmitting tradition. This exposes the people of the Mediterranean to the risk of losing a trove of knowledge and nutritional behaviors that are unrivalled on Earth.

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But before exploring ways to address this challenge, first let us attempt to clarify what we mean when we talk about the Mediterranean diet. 5.12 the salient characteristics of the mediterranean diet As discussed above, there are three principal culinary traditions in the world, each of them characterized by specific traits: the Mediterranean model, the North American model, and the Asian model (which contains a number of very important traditions and cultures, from the Japanese and the Vietnamese traditions to Chinese cuisine). We can describe the Mediterranean diet as the nutritional model inspired by the traditional dietary models of the European countries of the Mediterranean basin, in particular, Italy, Greece, southern France, Spain, and Portugal. This diet has spread widely outside of the borders of these countries and has been broadly adopted in South America (Argentina and Uruguay, in particular) and in certain areas of the United States of America and Canada. Many scientific studies have concluded that the Mediterranean diet is one of the best diets for promoting physical well-being and preventing chronic diseases, in particular cardiovascular diseases. the first intuition of the mediterranean diet. The concept of the Mediterranean diet was first developed in 1939 by Lorenzo Piroddi, a physician and nutritionist, who intuited the linkage between nutrition and diabetes, bulimia and obesity.11 Later, in the 1950s, Ancel Keys,12 a doctor and scientist at the University of Minnesotas Department of Food Science and Nutrition, who later wrote the bestselling book Eat Well and Stay Well, the Mediterra nean Way, spent time in Italy and noted a fact that at the time struck him as distinctly odd: the less well-to-do people (the so-called poor) of the small villages of southern Italy ate a diet mainly of bread, onions, and tomatoesyet appeared to be much healthier than city-dwellers in New York, and even than their own relatives who had emigrated to the United States in previous years. In later studies, Keys observed a very low incidence of coronary disease among the inhabitants of the Cilento and the island of Crete and theorized that this situation was a result of the diet adopted in those areas. These early observations led to the renowned Seven Countries Study,13 based on a comparison of the diets of over 12,000 people, ranging in age from 40 to 59, in Finland, Japan, Greece, Italy, the Netherlands, the United States, and the former Yugoslavia. From the findings of the Seven Countries Study, numerous associations were discovered between the kind of diet consumed and the risk of onset of chronic diseases.14 As seen in the findings, levels of saturated fatty acids and cholesterol

mediterranean constants

The balance in the makeup of the Mediterranean diet is represented in this traditional Turkish breakfast: tomatoes, olives, fresh cheese, cucumbers, bread, honey, and yogurt. Certain of these foods represent genuine pillars in the eating habits that are customary along the shores of the entire Mediterranean basin and in various combinations they characterize many moments of the daily relationship with food.

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in the blood largely explain the differences in mortality rates of the populations analyzed, as well as predicting the future their rates of coronary disease.15 Mortality due to heart attack is still lower among the Mediterranean populations than in countries, like Finland, where diets are rich in saturated fats (butter, lard, milk and milk products, and red meats). The final results of the Seven Countries Study indicated that the best dietary regimen was that followed by the inhabitants of Nicotera, in Calabria, and that they had adopted a Mediterranean way of eating. The population of Nicotera, Montegiorgio (Marche), and the inhabitants of the Campania region presented very low levels of blood cholesterol and a minimal percentage of coronary disease. These rates were due to a dietary regimen based on olive oil, bread and pasta, garlic, red onions, aromatic herbs, vegetables, and not much meat.16 more recent studies. From the first Seven Countries Study to today, a great many other research projects have analyzed the characteristics and the associations between ways of eating and onset of chronic diseases.17 Since the middle of the 1990s, moreover, a line of studies has been investigating the association between diet and longevity.18 What this work reveals is that the adoption of a Mediterranean diet, or one similar to it, helps protect against the most widespread chronic diseases, allowing people to live better and longer. As we indicated above, the Mediterranean dietary model calls for a high consumption of vegetables, fruits, legumes, nuts, olive oil, and cereal grains (which in the past were mainly unrefined); moderate consumption of fish and dairy products (especially cheese and yogurt) and wine; and low consumption of red meat, white meat, and saturated fatty acids.19 The model is largely based upon an apparent paradox: The peoples that adopt the Mediterranean diet consume relatively high quantities of fats (levels similar to those consumed by people in the United States), but they have lower rates of cardiovascular disease than do other populations in North America. The explanation is that the large quantity of olive oil used in Mediterranean cuisine substitutes for animal fats, at least in part. In fact, olive oil seems to help to maintain lower levels of cholesterols. Aside from olive oil, cereal grains occupy a special place in the Mediterranean diet. Unlike what is commonly thought, cereal grains are not limited to bread and pasta; they also include barley, spelt, oats, rice, and corn. Unrefined cereal grains take on special prominence in the Mediterranean diet. These are different from refined cereal grains, which undergo the removal of the outside part of the kernel. This impoverishes the food in terms of its use as an alimentary fiber and other important components, such as minerals, vitamins, and anti-oxidants. The food customs that have spread over recent years have gradually excluded

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legumes from diets. In the Mediterranean diet, on the other hand, their presence is fundamental. Legumes contain slow-absorption carbohydrates (low glycemic index) and substantial amounts of proteins mineral salts, certain vitamins, and food fiber. The Mediterranean diets stress on fruits and vegetables is now well accepted in the international scientific community; the standard recommendation is to consume at least five portions of fruits and vegetables every day. These foods contain essential vitamins (such as vitamin C) and contribute to a sense of fullness without adding many calories. This is mainly due to the presence of high quantities of fiber and water, which increase the volume of the food but not its caloric content. what to consume, in order to live better. The Mediterranean diet requires not only consuming fresh fruit on a daily basis (though in limited quantity) but also dried fruit. Dried fruit contains very little water, rather low levels of proteins, limited sugar, and a substantial portion of fats. Given the last characteristic, only moderate consumption is advisable. With dried fruit, however, there is a substantial intake of vitamin E, mineral salts and essential fatty acids such as omega-6, for instance. Generally speaking, the Mediterranean diet tends to recommend more extensive consumption of fish than of meat. On a cultural basis, to say nothing of the nutritional aspect, fish could not help but be a major presence on Mediterranean dining tables, precisely because the marine environment that did so much to shape and determine the history of Mediterranean countries lay right on their doorstep. Fish has excellent quantities of protein, essential fatty acids, and some mineral salts. With reference to meat, on the other hand, the Mediterranean diet tends to prefer white meat (chicken, turkey, rabbit) to red meat. Rich in proteins, vitamins, and mineral salts, the lipidic components (fats) depend strongly on the animal the meat comes from, as well as the part of the animal consumed. Last of all, it is believed that the moderate consumption of red wine during meals (equivalent to two glasses a day for men and one glass for women, in healthy individuals of normal weight) is another protective factor, because of the antioxidants contained in alcoholic beverages.20 In that connection, according to a study done by the American Heart Association, the Mediterranean diet lowers the rate of mortality from coronary disease by 50 percent. Studies of the Mediterranean diet not only point to its effects in reducing chronic diseases, they also show protective effects on the brain; people who adhere to it are less likely to suffer premature cognitive decline. The Mediterranean diet, moreover, apparently reduces the likelihood of developing Alzheimers disease in people who are already showing signs of cognitive difficulties.

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5.13 the mediterranean diet and commensality When we think about the Mediterranean diet, we are not referring only to its composition, but also and especially to the lifestyle associated with it. A key feature of that lifestylein fact, of human evolutionis commensality.21 In the literal sense, this word means to eat at the same table (from the medieval Latin, commensalis, from condividere + mensa, or table). In the broader sense it conveys the idea of habitually sharing food, in some cases implying the dependence of one or more of the commensals, or messmates, on another. Commensality is not specifically Mediterranean. But in several of the cultures that developed around the Mediterranean basin it acquired a greater degree of institutionalization and political significance, which in turn contributed to crucial further developments. Historians have shown that, in the wake of the sacrificial banquet, public meals in fact became an essential factor in the development of Athenian democracy. And in the monotheistic religions that grew in the Mediterranean world, the formal meal and its rules acquired a high degree of ritualization and symbolic significance (for instance, the Sabbath meal of the Jews and the commemoration of the Last Supper performed by Christians in the Eucharist, or communion). toward individual and medical consumption. Recent comparative research projects have shown that inside the Western world there are surprising differences between countries with relatively similar levels of development as far as the models concerning the act of eating and the relationship with food in general. For instance, in the United States, and to a certain extent in Great Britain, eating has become an increasingly individualized and medicalized act. It is considered a form of private consumption. In Italy or in France, in contrast, the act of eating rotates to a greater degree around the appointed hours of the meals and commensality, with an essentially social (public) dimension. Until very recent times, medical nutrition did not adequately take into account the social and cultural dimension of food and eating. A great many of the efforts to improve the general level of nutrition are based on the implicit presumption that simply giving information about nutritious substances, calories, and physical exercise to individuals should be enough to optimize their behavior. However, thinking of food and eating in terms of nutritious substances and choices of personal responsibility does not seem to be sufficiently helpful. On the other hand, some of the nations that preserve traditions of commensality seem to have better diet and nutrition in terms of obesity and correlated health problems. In fact, commensality ought to be considered a fundamental concept and become the subject of research in the field of diet and nutrition. The Mediterranean cultures that eat best are those that seem to devote the greatest attention to the foods as opposed to the nutritious substances; to their

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origin, not just their makeup; to the total quality, not just the nutritious value and health; to the social occasions in which the foods are consumed, not just the maintenance of the body, responsibility, and personal choices; and to the sacral importance of food, not just its quotidian aspects. And vice versa: obesity, diabetes, and correlated pathologies are most common not in the areas where food and eating are considered important daily social occasions, but rather in those areas where food is pervasive, cheap, of also of poor quality, always available for consumption, thoughtlessly or indifferently, at any timein short, where food is commodified, trivialized, stripped of all meaning, and deprived, so to speak, of its sacrality. The great German sociologist Max Weber wrote about the disenchantment (Entzauberung) of the world associated with advent of modernity: where food has become disenchanted, we ought to turn to the quality and the world of Mediterraneity in order that it might help us to re-enchant it. 5.14 mediterraneity today: the decline of a model From the 1950s to the present day, that is, since Keyss first study, we have witnessed all over the Mediterranean region, Italy included, a gradual abandonment of the Mediterranean approach to food in favor of less-healthy ways of eating. The results of the studies by Flaminio Fidanza (one of the pioneers in food and nutrition research, who thoroughly investigated the state of affairs in Italy beginning in the Sixties)22 have shown that the index of Mediterranean adequacy in two Italian cities that have been symbolic in this context has dropped drastically: in Nicotera that index was 7.2 in 1960 but dropped to 2.2 in 1991. In Montegiorgio, where the index had been 5.6 in 1965, it fell to 3.9 in 1991. The abandonment of the Mediterranean diet appears to be unmistakable in the larger Italian cities, as well.23 A study presented in July 2009 by the Italian Association for Dietetics and Clinical Nutrition (Associazione italiana di dietetica e nutrizione clinica) and by the Nutritional Observatory of Grana Padano (Osservatorio nutrizionale Grana Padano) confirms the trend: in Italy in general, the index of Mediterranean adequacy has dropped to 1.44. A recent study done on Spanish and Italian diets24 noted that the younger generations have seemed to be gradually but steadily abandoning the Mediterranean diet in favor of new eating trends characterized by foods with high fat content. Overweight and obesity in Italy and Spain seem to correlate with the abandonment of the Mediterranean diet, as well as with a reduction in physical activity. In recent years European society, and specifically Italian society, have changed from a number of points of view. Every day in Italy about 105 million meals are consumed, of which 76 percent are eaten at home and 24 percent are eaten

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Late morning meal Lunch on the run Normal lunch Makeup lunch

1% 1% 3% 3% 1%

Total At home Away from home 11 % 46 % 46 % 48 %

2% 1% 1% 0% 2% 1% 1% 2%

5%

Aperitif

Dinner on the run Normal dinner

44 % 27 % 1% 1% 3% 1% 1% 1%

49 %

Late dinner

Dinner late at night

figure 5.1
Breakdown of the 105 million meals consumed daily in Italy by mode of consumption Note: Data expressed in %. Base: 99,000 meals analyzed; 105 million meals daily. Source: BCFN on Nielsen-Barilla data, 2009.

away from home.25 On an aggregate level lunches (53 percent) outnumber dinners (47 percent) while 71 percent of the meals are consumed with ones family, 16 percent with friends and colleagues, and 16 percent are eaten alone. Sixtyseven percent of the 25.5 million meals consumed daily away from home are lunches, and only in 30 percent of all cases are those lunches eaten between one and two oclock in the afternoon (figure 5.1). Observing the breakdown by method of the meals eaten every day in Italy (aside from the prevalence of the normal lunches and dinners) we see, among the meals consumed away from home, that 11 percent are lunch on the run and 5 percent are the catch-up lunch. Lunches eaten in less than 10 minutes account for 9 percent of the total number of lunches eaten away from home.

eating on the street

Street food has become the object of new appreciation for its flavor, diversity, and link with local cultures. But eating street food is also one of the most universal ways of experiencing a place.

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Less than 10 minutes From 10 to 20 minutes From 20 to 30 minutes From 30 minutes to 1 hour From 1 to 2 hours More than 2 hours

5% 4%

Total 9% 29 % 30 % 39 % 28 % 22 % 22 % 22 % At home Away from home

26 %

42 %

4% 2% 1% 0%

10 %

4%

figure 5.2
Distribution of preparation time for meals at home and away from home Note: Data expressed in %. Base: 80 million meals at home daily. Source: BCFN on Nielsen-Barilla data, 2009.

Moreover, 14 percent of the meals eaten away from home were eaten standing up, while 15 percent of those meals were eaten sitting down, but not at a table. As for the meals eaten away from home, they are predominantly primi piatti, or pasta or soup dishes (41 percent) and main entrees (42 percent), with one million primi piatti consumed away from home every day (for the most part in bars and cafeterias). The composition of the meals eaten at home, on the other hand, shows a greater degree of variety, as can be seen in figure 5.2. The picture drawn by these data seems to be fairly clear: the pace of Italian life is accelerating and the way of eating is progressively following this trend. The result is that the time and the quality of the space devoted to nutrition over the course of the day is more and more squeezed in among the other daily commitments of individuals who increasingly find themselves obliged to sacrifice the quality of their own nutrition. The distinctive features and traits of Mediterraneity, especially the tendency to assign meaning and significance to eating that rise above the merely nutritional or functional aspects, represent a cultural patrimony that still endures in Italian society despite the pressure to which individual lifestyles are subject. But it is

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increasingly difficult to reconcile Mediterraneity with a reality that makes its practice more and more challenging. The statistics shown have to do with Italy, but they correspond to the figures for Europe as well. In fact, if we broaden our view to include sociopolitical context of the entire European Unionwhich, although it only partly shares the larger cultural tradition mentioned here, is undergoing social changes parallel to those seen in Italywe observe the same tendency toward a fluidity and a social movement that are structurally modifying the customs established over time. While, on the one hand, it tends to affirm itself over time, and this is the most worrisome datum, the same productivist paradigm that is now sweeping other areas of Earth (this is demonstrated, among other things, by the growing number of people afflicted with diseases directly linked to overweight and all obesity26), on the other hand it is clear that certain values typical of Mediterraneity have by now permeated the entire continent. What appears most significant, however, is the emergence of a meaningful fracture between ideal dietary choices and actual everyday practice. While awareness of the importance of good nutrition to overall well-being is rising, actually practicing those values is becoming increasingly difficult. the challenges of adopting a balanced diet. A survey undertaken by Eurobarometer for the European Commission in 2006 of the nutritional habits of the citizens residing in the twenty-five European countries27 revealed that the majority of European citizens believe that eating in a healthy way means adopting a balanced diet made up of a variety of foods. Specifically, 59 percent of European citizens believe that a diet composed of a wide variety of foods and including significant consumption of fruit and vegetables meets the needs of healthy nutrition. Some European citizens (about one out of four) are also aware that excessive consumption of fats and sugars is not healthy and should therefore be avoided (figure 5.3). Well aware of the importance of the makeup of diet, the vast majority of European citizens (83 percent of the total) say they are conscious of the crucial significance of what they eat for their own physical well-being. However, despite the fact that most European citizens say they follow a healthy diet, the number of people who have difficulty eating in a healthy manner is pretty high in countries such as Hungary (54 percent), Slovakia (52 percent), and Poland (49 percent). On the other hand, people report it seems fairly easy to adopt a healthy diet in countries such as the Netherlands (79 percent), Sweden (77 percent), and Malta (77 percent). Italy is below the European average, with 57 percent of respondents who believe that it is easy to eat in a healthy manner as against the 66 percent of the EU25 average. The lifestyle of European citizens seems to be the chief obstacle to their eating

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Eat a variety of different foods/balanced diet Eat more fruit and vegetables Avoid/do not eat too much fatty food Avoid/do not eat too much sugary food Eat more fish Do not eat too many calories Avoid/do not eat too much salt Eat less meat Avoid/do not eat food containing additives Eat organic food Eat more bread, rice, pasta and other carbohydrates Eat less bread, rice, pasta and other carbohydrates Eat more meat Eat less fruit and vegetables Eat less fish Other DK 8% 8% 7% 3% 2% 1% 11 % 2% 28 % 25 % 22 % 19 % 16 % 13 % 45 %

59 % 58 %

figure 5.3
What does it mean to follow a healthy diet? Source: The European House-Ambrosetti on Eurobarometro data, 2006.

in a healthy and nutritious manner. According to the survey, two principal factors hinder that possibility: the excessive amount of time required for the selection and preparation of a meal (31 percent of respondents), and the inability to supervise the foods consumed because they were purchased or prepared by someone else (27 percent). A third significant reason expressed is the idea that healthy food isnt particularly tasty (23 percent). Twelve percent also report a lack of information concerning what constitutes a healthy diet and 15 percent complain about the confusing and contradictory information accompanying foodstuffs. In conclusion, the Eurobarometer survey seems to indicate an increasingly widespread awareness of the importance of diet and nutrition in terms of a healthy, full life. But it also confirms the difficulty of translating that awareness into concrete forms of behavior. What is lacking is a means of cultural mediation that makes it possible to translate in a natural way what is already known and acknowledged by scien-

street food and extreme climates

Bangkok, Thailand, November 2011: with water kneehigh, a food stand continues selling to customers. More than two months of incessant rain did not stop clients or vendors.

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tific nutrition about sound dietary practices into proper behavior. (Just consider, in this connection, the Food Pyramiduniversally known for the past 30 years, but never so seldom applied in the world as it is today.) What emerges from these observations is a clear indication of the challenge facing us. The battle for good nutrition depends upon and can only be won on the field of behavior, even before it is fought in the realm of the choice of foods. It will be decided on the good practices that will make it possible to attribute a value and a meaning to food. We are not suggesting that food become an obsession or a tedious task but, quite to the contrary, a path toward the rediscovery of oneself and others, within the context of time devoted to caring for oneself as a person. This original theme has always constituted the heart of the Mediterranean approach to diet and nutrition. 5.15 how to recover the significance of mediterraneity Aside from the loss of nutritional value, what seems to be progressively vanishing in many countries is a balanced relationship with food. The objective, then, should be to make the time we spend eating less predictable and banal, and therefore more immediate and intense, more beautiful, and more attractive attractive because it will become the vehicle of a conviviality, a measured use of time, of an aesthetic taste that we sometimes have a hard time expressing in a daily life that is punctuated by frenetic rhythms, anxiety, and superficiality. If this belief is well-foundedthat culture is the primary tool in the attempt to win back a portion of daily reality from merely economic and productive concernsthen the problem arises of how to redirect concrete termsthe future of nutrition. What should the most significant dimensions of this movement be? The topic is complex and deserves to be explored at much great length than we have here. We shall therefore limit ourselves to suggesting two ideas that, in our opinion, are decisive. The first has to do with the capacity of the agro-alimentary industry to put itself at the service of some fundamental dynamics of Mediterraneity (explored in greater depth in the insert Redirecting the Future of Food): make the best possible use of the rich and diverse resource of conviviality, in this era of ours that is so impoverished in terms of relationships; protect local territorial variety by preserving the wealth of identities (while still encouraging cross-fertilizations), thus reinforcing the emotional capital invested in roots, distinctive qualities, and territorial localization, while at the same time emphasizing the aspects that are humanly universal; transfer the knowledge and know-how linked to the preparation of foods; they are extraordinary deposits of cultural wealth;

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food materials that go into a cuisine, aiming at the excellence of the ingredients, establishing a direct and respectful link with the context in which the raw materials develop; restore the value of food as a medium for a fertile relationship between the generations, in the simplicity and clarity of its benefits, to promote the construction (and reconstruction) of a social fabric that is steadily weakening under the pressure of modernity; recover the flavors of bygone times to preserve the best of gastronomic traditions and seek to renew and reinterpret them creatively in the context of contemporary tastes; last of all, spread the culture of taste and the enjoyment of life through authentic food. Revitalizing the magic and astonishment of food in its rituals and its carefree pleasureas the fuel of life and cultureallows a renewed centrality to the role played by people and their feelings. The second significant element is bound up with the method of activating the process of change. It is necessary, to this end, to forge a great pact among all the actors of the world of nutrition and food, including the public institutions nowadays increasingly concerned about the devastating consequences of the improper dietary choices being carried out by their citizensin order to reorient lifestyles and ways of eating toward modes of consumption that are more sustainable in terms of health, the environment, and an intact social structure. The scale of the challengeto educate the populace to a new dietary ecologyis so great that it demands an ability to intervene that is well beyond the power of the individual actors. A concerted effort will be required, an alliance, which while it preserves the typical character of competition in the relationships between the various players in a single sector, makes it possible to undertake cooperative games intended to promote a new dietary paradigmin the hope that one day in the not too distant future it may become dominant. An exquisitely Mediterranean nutritional paradigm.

return to a healthy relationship with the territory and the context of the raw

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interview we must construct a culture of responsibility

Joaqun NavarroValls
There are problems on a worldwide level that never seem to find resolution: we are referring to world hunger and, in more general terms, the development of the poorer nations. What are the priorities for undertaking a sustainable develop ment that will include all countries, and not only the more advanced countries?

To find the solution to a problem, the first thing is to state the problem itself correctly. A badly formulated problem will never find a solution. The problem of sustainability is one that we created ourselvesthe developed nationsnot the developing nations. We can decide to solve a problem that we do not want to take on ourselves by dumping upon developing nations the responsibility for that problem and the corresponding measures. I say this because it is very easy for us in the west to criticize, for example, the partial deforestation of certain zones of the Amazon. Ive been in Africa many times and Ive visited nearly every African country (North-Saharan and SubSaharan). Every time I go there with the mentality of sustainable development, but it is wrong to think that it has to begin in those countries: it is we who need to change our habits. This strikes me as the first aspect: it is necessary to state the problem in truly global terms. Not a globalization that excludes us, but a globalization that instead begins to include us, in terms of responsibility as well. Which are the chief actors who can undertake development in this direction: the local governments, the international institutions, the NGOs, the universities, the research centers? Who should be the first to move? From my point of view, any decision that can affect the habits of human beings must be based not on national or supranational considerations, but on something called a sense of responsibility. Naturally, a sense of responsibility is always individual, but it can be created and fostered with aid that is political, geopolitical, and global in nature. Until we realize that the problems of mankind in general must be solved with the sense of responsibility of people themselves and we stop handing it off to others, we will never solve this kind of problem.

Joaqun Navarro-Valls h as been president of the Telecom Italia Foundation since January 2009 and has been president of the Advisory Board Biomedical University of Rome since January 2007. Since 1996 he has been a visiting professor at the school of Social Institutional Communication at the Pontifical University of the Holy Cross, Rome. From 1984 to 2006 he was Director of the Holy See Press Office (or Vatican Press Office).

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The solution to global problems always demands a multidisciplinary approach, therefore an approach that takes into account economic, social, cultural, and also environmental problems. Can politicians and institutions manage to adopt this type of approach? From my point of view, in this problem and in others like it, the only way forward is through education. To educate a person, a geographic area, humanity in general: its always the same thing. In order to acquaint a person with a situation, there must be someone who is doing the teaching, who knows that situation and who can explain it in a process of educational development. Now, from that point of view, it strikes me that we havent done enough; Im talking about the developed western world in relation to the developing nations. Perhaps we have not done enough because we are not placed face to face with the responsibility that I was talking about earlier. This however is a form of education that must begin with us. Many habits in the developed western world must change, and in fact in many places they already are changing; the only thing is that they are not changing as the result of any free decisions, but rather as an anguished necessity because things cant keep going on as they are. This is the crux of the matter. However, to reiterate the question, it strikes me that the only way forward is education, I see no other solution. As an opinion leader, and on the basis of your experience and your own observa tions, what do you expect from the coming years? Building the future is never a simple thing, imagining it is impossible. I can say what I hope, more than formulating any prophecy for tomorrow. I hope that the process of taking on individual responsibility, and therefore collective responsibility, continues to grow. If we lose our sense of personal responsibility (individual responsibility, social responsibility, collective responsibility, etc.) then it will be difficult to produce a better future. If we forget this, if the prevailing interest is selfish in nature, then selfishness breeds chaos. Only responsibility can lead us out of chaos.

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interview whoever controls food controls democracy

Vandana Shiva
The one billion people starving and the two billion people sick, and the planet sickwater disappearing, biodiversity disappearing, the climate damagedsoil losing fertilityare all interconnected. And they are interconnected in a model of farming that forgets the nutrition of the soil, it forgets the nutrition of people and puts at the center profits from extraction. That means small farmers cant feed themselves because they are now part of the new dispossessed. Or if they are farming theyre indebted and they are selling what they grow. So of the one billion people who are hungry, 500 million are producers of food. And a system that forgets that food is about nourishment then produces non-food. And non-food becomes junk food and junk food creates all kinds of diseases. Thats also the same system that is able to exploit water because it doesnt have to bear the cost. They can push species to extinction. They can put 40% of the greenhouse gases into the atmosphere that gives us climate change. So profits lead to destroying food, destroying the Earth, destroying our farmers, destroying our health. Obsession with profits.

Vandana Shiva is the founder of Navdanya, a movement for the conservation of biodiversity and to protect the rights of farmers. She is the founder and director of the Research Foundation for Science, Technology and Natural Resource Policy, whose mission is to solve the most serious social and economic problems in collaboration with local communities and social movements. She has also served as an adviser to the Indian government and for foreign governments, as well as for such NGOs as the International Forum on Globalization, Womens Environment and Development Organization, and Third World Network.

Given this, what approach should developing countries take towards agriculture, to prevent the problem getting worse? Well, I think the most important point is that so-called developing countries are called developing because we werent industrialized in the first industrial revolution. And the large majority of people in our countries, even China and India, are small farmers. Africa for sure, Latin America, for sure. And we need to treat our small farmers as our social capital, because small farms produce more. If we start imitating the large scale industrial corporate farming of the West, we will not only destroy our farmers, we will destroy our food security. The second thing we need to do because developing countries happen to lie in the part of the world that has higher bio-diversity, we need to recognize that natures capital of bio-diversity is real capital. Not financial loans from banks that are going to take away your land down the line. Not technologies that are already failing us like genetic engineering. We need to have respect for the land, for our farmers,

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and for the knowledge that has been older and more time-tested in agriculture. That is what the IAASTD report has pointed out. The International Assessment of Agricultural Knowledge, Science and Technology for Development. That neither the Green Revolution, nor genetic engineering are food security solutions. Ecological farming very often linked and growing out of indigenous knowledge systems is the place to increase your production while conserving your resources. Do you think that in this process women have a specific role? Women have a specific role for two reasons. First, when we talk about the long history of agriculture which did not starve people, which did not create obesity, which did not give us diabetes epidemics, that long history was an agriculture and food in which women had the knowledge and control. So we need to turn to women to say how do we feed people with nourishment? Thats why in Navdanya we run a Grandmothers university, so that we learn once again how to give respect to food. The second thing is that the agriculture that is creating all these problems for a billion hungry people, 2 billion obese, is an agriculture that has its roots in war. It came out of war. Agri-chemicals came out of war. And it has its roots in what I call the patriarchal mindset of man as dominator. Man as a violent conqueror of the Earth and people. That model has become too heavy for the food system. We need the non-violence, the diversity, the multifunctionality that women bring to agriculture. You once said that whoever controls our food system will control our democracy as well. What do you mean, can you explain better? Well, at one level it is what Kissinger said when he talked about food as a weapon. He said when you control weapons, you control governments and armies. When you control the food you control people. In todays context, food is being controlled through control of seeds. Monsanto has emerged as the single biggest player on the seed front. And sadly the US government which has made itself extremely impoverished by outsourcing all its production, is now only collecting royalties from patented seed, taking away the democracy of the third world farmer to have their own seed, taking away the democracy of people worldwide to choose the food they grow and to know whats in the food. Food democracy in our times means having seed sovereignty and seed freedom. Therefore no patents on seed. Having the ability to grow your own food, therefore the defense of the small farm and therefore stopping the perverse subsidies of 400 billion dollars that give industrial farming an unfair benefit to prosper. And third, it means being much more aware of what youre eating and how it is grown. That means democracy begins with food.

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the consumer culture war and the food system: what does this mean for the mediterranean model?

Michael Heasman
The traditional Mediterranean model to eating could be a potential roadmap towards a different diet and food system, not least through creating a model for constructing Michael Heasman is a a sustainable dietthat is, one that enables an ecologiprofessor of food policy in cally integrated food system from production through to the bachelors degree program in Global Nutrition consumption. But the current food system is rooted in the and Health at the Metroindustrial food model and its resulting consumer food culpolitan University College di Copenhagen and he is a ture. This food system continues to shape and influence Visiting Research Fellow food consumption patterns and hence consumer food culat the Centre for Food Policy, City University, tures.28 The impact of the Mediterranean model has to London. He specializes be situated within this broader context which sees todays in food and health, the global food industry and food culture war framed as a conflict within the future of food policies. He has writfood consumerism itself. ten more than 90 publications or presentations, The on-going industrial food system dynamic is driven including: Food Wars: The by consumerismthat is, creating the desire to purGlobal Battle for Mouths, Minds and Markets (2004, chase goods and services in even greater amounts and the with Professor Tim Lang), mechanisms to activate this. In this respect the industrial The Functional Foods Revolution: Healthy People, production model and its accompanying, hugely sophisHealthy Profits? (2001) ticated, consumer marketing industries, are designed to and Consumption in the Age of Affluence: The push this consumption agenda forward, so that this model World of Food (1996). appears to be the only option available.29 But the consumer culture food war is not simply between the mainstream and alternatives. Within the mainstream a struggle is also underway to shape consumer culture towards particular interests. So food processors work to sell their branded product dreams, foodservice operators lure consumers to their food offerings through strategies that owe more to the entertainment industries than food a trend termed eatertainment in the United Statesand the supermarkets try to outdo both. A late entry into this food cultural melee are farmers who are attempting to inject their imagery into this consumer cultural mix with an appeal to the natural. Increasingly all of these players attempt to convince consumers of their sustainability and environmental credentials. The Mediterranean model is competing with all these consumer and societal influences. While food consumer culture is important it is rarely mentioned in nutrition and food policy documents.30 Instead much modern food and nutrition policy (and business language) is all about framing consumers through a market-led consumer choice lensin this sense choice defines consumer culture. So an important task is for societies to reclaim their narratives relevant to their food

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cultures. For example, the Mediterranean model might be regarded as both under threat and, at the same time, as posing a threat to the industrial food system. It is a diet, as is well known,31 established on plant-based foods with little meat and dairyalmost the opposite to the modernizing trends in global food markets which are seeing increasing promotion of meat and dairy product consumption. But in other ways the modern global consumer culture offers possibilities for the Mediterranean model. In a globalizing world, cuisines have opened up or created new consumer markets and introduced new eating possibilities for people that were unheard of for earlier generations. In this manner the modern globalizing food system relies as much on breaking down and reinventing food cultures as it does on breaking down the chemical and nutrient components of foodstuffs and ingredients and reassembling them into branded consumer food products with new marketing stories about their naturalness and healthiness and provenance. And the Mediterranean diet itself has not been immune from this process. In some instances the Mediterranean diet has itself become medicalised stripped of its cultural heritage, gastronomy, and ecological framingand instead been turned into a package of nutrients which in the right combinations will prevent individual heart attacks and other diet-related ill-health. Food traditions and heritage need careful nurturing to remain authentic in the brutally competitive consumer culture war around food, diet, our bodies and health. As importantly the Mediterranean consumer culture itself has started to succumb to globalizing and industrializing dietary tendencies. As a result the diet of Mediterranean countries today relies more on both sugars and saturated fat and childhood obesity rates are now higher in some Mediterranean countries than compared to northern Europe. Consumers in European Mediterranean countries have also moved away from traditional Mediterranean diets and foodstuffs in recent decades.32 Some of these societal and cultural trends can be identified through following the olive oil food system in recent years. In a study of the olive oil systems between 1972-2003 by Armin Scheidel and Fridolin Krausmann33 they demonstrate how olive oil developed from a niche product that could hardly be found in food stores outside of the producing regions towards an integrated component in the diets of industrial countries. While global olive oil production is still concentrated in the Mediterranean region just three countries are dominant: Greece, Italy and Spain. Until relatively recently olive oil markets were predominantly for local consumption. But promotional campaigns for the healthy Mediterranean diet especially from the 1980s onwards and devised and promoted by production interests, saw increased demand in non-traditional marketssuch as northern European countrieswith a more than 10 food increase. But Scheidel and Krausmann also document some of the consequences of

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these production-consumption changes. First, is the impact on local and traditional Mediterranean olive groves. Many of these were abandoned and modern, intensive, mono-cultural production plantations were set up which rely upon irrigation systems, agro-chemicals and mechanization. This has enabled much higher productivity and modernization of industrial processes, but has also meant major structural changes in land use. This intensification has been especially pronounced in Andalusia, Spain. As Scheidel and Krausmann write: While traditionally rain fed olive trees were grown mainly on marginal soils, industrial olive groves expanded primarily into agricultural land with high quality soils. The growth in olive oil consumption has therefore had profound ecological impacts leading to a structural transformation of Mediterranean landscapes. The case of olive oil also serves as a lesson in how it is often difficult for consumers in a globalized food system to connect to the environmental consequences of their consumption patterns. The Mediterranean diet when set in the context of the industrial food consumer culture war raises many questions about its implementation as a potential new model for a healthier and sustainable diet. From such a perspective we have to ask (and provide answers if we are serious) about what would be the impact of its large-scale adaptation on agricultural practices, food economies, consumption patterns, in addition to public health and nutrition. As noted from the olive oil case study, some of the downstream production implications may be unexpected and not necessarily desirable over the longer-term and the consumption impact in relation to public health objectives might be minimal. This then raises the question of how to internationalize the Mediterranean model in a culturally appropriate way, for local food systems and global consumers. In the food policy world there has been a reluctance to confront the true scope of consumer cultureall too often consumer culture is reduced to choice, and even choice is limited to macro-issues such as price and convenience, whereas consumer choice itself embraces a much more complex set of demands and aspirations.34 Increasingly, in food, both health and ecological principles together are key consumer concerns and a repositioning of an authentic Mediterranean diet seems well placed to reconnect with these concerns and aspirations.

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action plan
culture, taste, and joy of living bound up with food
We need to bring back to life a number of fundamental dynamics typical of the gastronomic cultures that are most keenly aware of the link between food and person, such as the Mediterranean gastronomic culture. Whats involved is the revitalization of the aspects of conviviality, the protection of local territorial variety by preserving the wealth of identities, the transfer of knowledge and know-how tied up in the preparation of foods, the return to a healthy relationship with the territory and with the context of the raw material by focusing on the excellence of the ingredients, and the recovery of traditional flavors capable of being renewed in the context of contemporary tastes, through a critical operation that allows us to preserve the best of the gastronomic tradition.

teach a new ecology of food

We must establish a grand overriding pact among all the actors of the world of food, including the public institutionsnow increasingly worried about the devastating consequences of the mistaken nutritional choices being made by their own citizensto redirect the lifestyles and ways of eating toward forms of consumption that are more sustainable in terms of health, the environment, and an intact social structure. The scale of the challenge is such that it demands a capacity for intervention that rises above the power of the individual operators. What is needed is a concerted effort, an alliance among diverse subjects, such that, while still preserving the distinctive characteristic of competition in the relationship among players in a single sector, it becomes capable of implementing cooperative games aimed at the promotion of a new nutritional and dietary paradigms.

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notes

1. the challenges of food Self Employed Womens Association (SEWA), About Us, at http://www.sewa.org/About_ Us.asp, viewed 1 November 2011; Danielle Nierenbergs visit to SEWA Farm, Ahmedabad, India, February 2011. Surajben Shankasbhai Rathwa, in interview with Janeen Madan, Women farmers key to end food insecurity, Worldwatch Institute: Nourishing the Planet, 6 August 2011, at http:// blogs.worldwatch.org/nourishingtheplanet/women-farmers-key-to-end-food-insecurity/; SEWA Manager in School, at http://www.sewamanagernischool.org/index.htm, viewed 1 November 2011; Danielle Nierenbergs visit to SEWA Farm, Ahmedabad, India, February 2011.
3 2 1

World Bank, Reduced Emissions and Enhanced Adaptation in Agricultural Landscapes, Agricultural and Rural Development Notes (Washington, D.C.: World Bank, 2009), p. 1, at http://w w w.google.com/url?sa=t&rct=j&q=agriculture%2030%20percent%20ghg&so urce=web&cd=10&ved=0CHEQFjAJ&url=http%3A%2F%2Fsiteresources.worldbank. org%2FINTARD%2FResources%2FWB_ARD_ClimateChange_v3.pdf&ei=XRKwTp6WH Mn50gGx7ZHlAQ&usg=AFQjCNFEYJTDnmqiGtZbeuRmbK_3Wo9pDg&cad=rja.
5

SEWA members, Ahmedabad, India, interview with author, February 2011.

UN Food and Agriculture Organization, The State of Food Insecurity in the World, (Rome: 2010) p. 8; UN Food and Agriculture Organization, Obesity and Overweight, Fact Sheet No. 311, (at http://www.who.int/mediacentre/factsheets/fs311/en/, March 2011, viewed 1 November 2011. Alan Taylor, Famine in East Africa, In Focus, The Atlantic, 27 July 2011, at http://www. theatlantic.com/infocus/2011/07/famine-in-east-africa/100115/; Ngor Arol Garang, South Sudan Warns Food Crisis Developing into Famine, Sudan Tribune, 6 October, 2011, http:// www.sudantribune.com/South-Sudan-warns-food-crisis,40342.

Jeffrey Delaurentis at UN Security Council Meeting, In Somalia Seeds of Hope and Progress Have Begun to Sprout, but They Need to be Carefully and Generously Nurtured, United Nations, New York, 14 September 2011; UN Food and Agriculture Organization, 925 Million in Chronic Hunger Worldwide, press release (Rome: 14 September 2010).

UN Food and Agriculture Organization (FAO), Food Security Statistics, online database, at http://www.fao.org/economic/ess/ess-fs/en/, accessed 11 October, 2011; FAO, op. cit. note 3; FAO, Global Hunger Declining, but Still Unacceptably High, at http://www.fao.org/ docrep/012/al390e/al390e00.pdf, September 2010. FAO, Food Price Index, at http://www.fao.org/worldfoodsituation/wfs-home/foodpricesindex/en/, updated 6 October, 2011; World Bank, Food Price Watch, at http://www.worldbank.org/foodcrisis/food_price_watch_report_feb2011.html, February 2011; World Bank, Data Bank: Poverty Headcount Ratio at Rural Poverty Line, online database, at http://data. worldbank.org/indicator/SI.POV.RUHC, accessed 11 October 2011.

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10

11 UN Food and Agriculture Organization, Cutting Food Waste to Feed the World, UNFAO Media Centre, 11 May 2011, at http://www.fao.org/news/story/en/item/74192/icode/ 12

Olivier De Schutter, The Eleventh Annual Edward and Nancy Dodge Lecture, 27 September 2011, Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health.

Tristram Stuart, Post-Harvest Losses: A Neglected Field, State of the World 2011, Worldwatch Institute (New York: W.W. Norton and Company, 2011), p. 100; Julian Parfitt and Mark Barthel, Global Food Waste Reduction: Priorities for a World inTtransi tion, review commissioned as part of the U.K. Governments Foresight Project on Global Food and Farming Futures (London: Government Office for Science, January 2011), p. 13, at http://www.google.com/url?sa=t&rct=j&q=world%20food%20conference%2C%20 1974%2C%20rome%2C%20waste%20reduction&source=web&cd=17&ved=0CEwQ FjAGOAo&url=http%3A%2F%2Fw w w.bis.gov.uk%2Fassets%2Fbispartners%2Ffor esight%2Fdocs%2Ffood-and-farming%2Fscience%2F11-588-sr56-global-food-wastereduction-priorities&ei=4BmwTpOsEqnL0QGxnpCu AQ&usg=A FQ jCNGzf1AttbULqvMvz8IktGQ2ZQW9g&cad=rja.
13

International Institute of Tropical Agriculture (IITA), IITA, Partners Launch initiative to Tackle Killer Aflatoxin in African Crops, press release, 4 April 2011, at http:// www.iita.org/home-news-asset?p_p_id=101_INSTANCE_1nBS&p_p_lifecycle=0&p_p_ state=normal&p_p_mode=view&p_p_col_id=column-2&p_p_col_pos=1&p_p_col_ count=4&_101_INSTANCE _1nBS_struts_action=%2Fasset_publisher%2Fview_content&_101_INSTANCE_1nBS_urlTitle=iita-partners-launch-initiative-to-tackle-killer-aflatoxin-in-african-crops&_101_INSTANCE_1nBS_type=content&redirect=%2Fhome; IITA, Making African Food Crops Safer, 9 April 2010, at http://annualreport.iita.org/?p=478; IITA, Investing in aflasafe, 13 April 2011, at http://r4dreview.org/2011/04/investing-inaflasafe%E2%84%A2/. Phillippe Villers, Improving Food Security by Reducing Post Harvest Losses, presentation at a workshop at the World Bank, Washington, D.C., 20 September 2011; Jess LowenbergDeboer, Purdue Improved Crop Storage (PICS): Hermetic Storage for Grain, presentation at a workshop at the World Bank, Washington, D.C., 20 September 2011; Danielle Nierenberg, Innovation of the Week: Investing in Better Food Storage in Africa, Worldwatch Institute: Nourishing the Planet, 21 January 2010, at http://blogs.worldwatch.org/nourishingtheplanet/ innovation-of-the-week-investing-in-better-food-storage-in-africa-africa-agriculture-conservation-farmers-food-security-hunger-innovation-of-the-week-state-of-the-world-2011-storagewaste-purdue-unive/.
16 17 15

14

Julian Parfitt and Mark Barthel, op. cit. note 12; Julian Parfitt et al. Food waste within food supply chains: quantification and potential for change to 2050 (U.K.: The Royal Society, September 2010), at http://rstb.royalsocietypublishing.org/content/365/1554/3065.full.

Storage of cowpeas from Purdue University, Gates Foundation Funds Purdue Effort to Protect Food, Enhance African Economy, press release; Seattle, Washington, 6 July 2007. Bill & Melinda Gates Foundation, Profiles of Progress: Cowpea Storage Project, at http:// www.gatesfoundation.org/agriculturaldevelopment/Pages/cowpea-storage-project-profiles-ofprogress.aspx; Purdue University International Programs in Agriculture, Purdue Improved Cowpea Storage, at http://www.ag.purdue.edu/ipia/pics/Pages/Home.aspx, viewed 1 November 2011.

18 Moustapha Gaye, Resident Representative, CounterPart International, Mauritania, interview with author, September 2010; Lauren Lewis, Program Coordinator, CounterPart Interna-

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tional, Mauritania, interview with author, September 2010; Counterpart International, Storing Protein through Dried Cheese, Counterpart.is: The Staff Blog of Counterpart International, 12 August 2010, at http://www.counterpart.org/blog/storing-protein-through-dried-cheese.
19

Counterpart International, Storing Protein through Dried Cheese, Counterpart.is: The Staff Blog of Counterpart International, 12 August 2010, at http://www.counterpart.org/blog/ storing-protein-through-dried-cheese.

David E. Whitfield V, Solar Dryer Systems and the Internet:Important Resources to Improve Food Preparation, International Conference on Solar Cooking. Kimberly, South Africa, November 2000, http://solarcooking.org/drying/Whitfield-drying1.htm#_edn12; T.A. Lawand. Potential of Solar Agricultural Dryers in Developing Areas, Technology for Solar Energy Utilization, 1977; Wang Hanbin, Overview of Grain Drying in China, Research and Development Issues in Grain Postharvest Problems in Asia, Group for Assistance on Systems Relating to Grain after Harvest.
21 Waste and Resources Action Programme (WRAP), at http://www.wrap.org.uk/wrap_corporate/about_wrap/resource_efficiency.html#.

20

Francisco Espejo, Carmen Burbano, and Elena Galliano, HomeGrown School Feeding: A Framework to Link School Feeding with Local Agricultural Production (Rome: World Food Programme, 2011), at http://documents.wfp.org/stellent/groups/public/documents/newsroom/ wfp204291.pdf, viewed 11 October 2011
23

22

United Nations World Food Program, WFP Buys Rice from Ghanian Farmers for School Meals, 9 April 2010, at http://www.wfp.org/stories/wfp-buying-rice-ghanaian-farmers-schoolmeals, viewed 11 October 2011

United Nations World Food Programme, Thailand: Desk Review of the School Feeding Programmes, July 2007, 2007, pp. 17-18, at http://home.wfp.org/stellent/groups/public/documents/newsroom/wfp207425.pdf, viewed 11 October, 2011.
25

24

Corporation for Educational Radio and Television, Food from the Hood, viewed 1 November 2011, at http://www.certnyc.org/ffth.html.

Agricultural Science & Technology Indicators (ASTI), Cte dIvoire, International Food Policy Research Institute, 2010, at http://www.asti.cgiar.org/cote-divoire; Joseph Sany, Education and Conflict in Cte dIvoire, United States Institute of Peace, April 2010, at http://www. google.com/url?sa=t&rct=j&q=cote%20d%27ivoire%202002%20educational%20and%20 agricultural%20impact&source=web&cd=10&ved=0CGYQFjAJ&url=http%3A%2F%2F www.usip.org%2Ffiles%2Fresources%2FSR235Sany_final_lowres-1.pdf&ei=5T2wTvPFO4fo 0QHh4eG1AQ&usg=AFQjCNG2sSnj8Q JSh4Qgmlyq5nvRneYrXw&cad=rja.
27

26

Mariam Outarra, Abidjan, Ivory Coast, interview with author, May 2010; Danielle Nierenberg, Bringing High-Quality Food Aid Closer to Home, Worldwatch Institute: Nourishing the Planet, at http://blogs.worldwatch.org/nourishingtheplanet/bringing-high-quality-foodaid-closer-to-home-africa-farmers-agriculture-united-nations-world-food-programme-wfp-unpurchase-for-progress-p4p-bill-melinda-gates-foundation-zambia-agricultural-commodi/, 29 March, 2010.

Mariam Outarra, Abidjan, Ivory Coast, interview with author, May 2010; Danielle Nierenberg, In the Classroom, Trickle Up Education to Improve Diets and Livelihoods for the Whole Community, Worldwatch Institute: Nourishing the Planet, at http://blogs.worldwatch. org/nourishingtheplanet/in-the-classroom-trickle-up-education-to-improve-diets-and-livelihoods-for-the-whole-community/, 18 October 2010; Slow Food International.

28

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29

30

Ken Davies and Nicole Menage, Connecting Farmers to Markets: Insights from the Purchase to Progress Initiative, Revolution: From Food Aid to Food AssistanceThematic Areas, World Food Program, pp. 125-138, 21 September 2010, at http://www.wfp.org/aid-professionals/blog/three-waves-innovation-food-assistance. Danielle Nierenberg, Bringing High-Quality Food Aid Closer to Home, Worldwatch Institute: Nourishing the Planet, at http://blogs.worldwatch.org/nourishingtheplanet/bringinghigh-quality-food-aid-closer-to-home-africa-farmers-agriculture-united-nations-world-foodprogramme-wfp-un-purchase-for-progress-p4p-bill-melinda-gates-foundation-zambia-agricultural-commodi/, 29 March 2010; Felix Edwards, Coordinator and Head of Local Food Procurement, UN World Food Programme Purchase for Progress (P4P), Zambia, interview with author, March 2010.

31

32 33

International Assessment of Agricultural Knowledge, Science, and Technology for Development, Agriculture at a CrossroadsGlobal Summary for Decision Makers, (2008), at http://www.agassessment.org/reports/IAASTD/EN/Agriculture%20at%20a%20Crossroads_ Global%20Summary%20for%20Decision%20Makers%20%28English%29.pdf; FoodForThoughtTV, Hans Herren InterviewPart 19, YouTube, 15 October 2009, at http://www. youtube.com/watch?v=seiVWF3-Frs. IAASTD, op.cit. note 31, p. 5. IAASTD, op. cit. note 31, p. 5; IAASTD, op.cit. note 31, p. 606.

34

35 Foresight: The Future of Food and Farming (2011) Executive Summary, (London: The Government Office for Science, 2011) p.12; Department for Business Innovations & Skills, Foresight, Global Food and Farming Futures Briefing Note, at http://www.bis.gov.uk/foresight/our-work/projects/published-projects/global-food-and-farming-futures/other-resources/ briefing-note, viewed on 19 October 2011; The World Bank, World Development Report 2008Agriculture for Development, (Washington, D.C.: 2007), at http://econ.worldbank. org/WBSITE/EXTERNAL/EXTDEC/EXTRESEARCH/EXTWDRS/EXTWDR2008/0 ,,menuPK:2795178~pagePK:64167702~piPK:64167676~theSitePK:2795143,00.html; David Spielman and Rajul Pandya-Lorch, Millions Fed: Proven Successes in Agricultural Develop ment (Washington, D.C.: International Food Policy Research Institute, 2009); The United Nations Environment Programme, The Environmental Food Crisis, 2009, at http://www. unep.org/pdf/FoodCrisis_lores.pdf; Martin Parry, Alex Evans, Mark Rosegrant, and Tim Wheeler, Climate Change and Hunger, (Rome: UN World Food Programme, 2009); Bread for the World Institute, 2011 Hunger Report: Our Common Interest Ending Hunger and Malnu trition, (Washington, D.C.: Bread for the World Institute, 2010); Gerald Nelson et al., Food Security, Farming, and Climate Change to 2050 (Washington, D.C.: International Food Policy Research Institute, 2010); United Nations Food and Agriculture Organization, The State of Food and Agriculture 2010-2011, 2011, at http://www.fao.org/docrep/013/i2050e/i2050e00. htm; United Nations Food and Agriculture Organization, Save and Grow: A Policy Makers Guide to the Sustainable Intensification of Smallholder Crop Production, May 2011, at http:// www.fao.org/ag/save-and-grow/; The Howard G. Buffett Foundation, The Hungry Continent: African Agriculture and Food Insecurity, 2011, at http://www.thehowardgbuffettfoundation.org/about-hgbf/advocacy. 36

IAASTD, op. cit. note 31, p. 5; FoodForThoughtTV, Judy Wakhungu InterviewPart 4, YouTube, 15 October 2009, at http://www.youtube.com/watch?v=wF7C0n8-0_o&featur e=related.

Table XX from the following: The World Bank, World Development Report 2008Agri-

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culture for Development, (Washington, DC: 2007), at http://econ.worldbank.org/WBSITE/ EXTERNAL/EXTDEC/EXTRESEARCH/EXTWDRS/EXTWDR2008/0,,menuPK:27951 78~pagePK:64167702~piPK:64167676~theSitePK:2795143,00.html; International Assessment of Agricultural Knowledge, Science and Technology for Development, Agriculture at a Crossroads, (2009), at http://www.agassessment.org/; Foresight, The Future of Food and Farming: Challenges and Choices for Global Sustainability, Final Project Report, (London: The Government Office for Science, 2011), at http:// www.bis.gov.uk/assets/bispartners/foresight/docs/food-and-farming/11-546-future-of-foodand-farming-report.pdf; David Spielman and Rajul Pandya-Lorch, Millions Fed: Proven Suc cesses in Agricultural Development (Washington D.C.: International Food Policy Research Institute, 2009); The United Nations Environment Programme, The Environmental Food Crisis, 2009, at http://www.unep.org/pdf/FoodCrisis_lores.pdf; Martin Parry, Alex Evans, Mark Rosegrant and Tim Wheeler, Climate Change and Hunger, (Rome: UN World Food Programme, 2009); Bread for the World Institute, 2011 Hunger Report: Our Common Inter est Ending Hunger and Malnutrition, (Washington D.C.: Bread for the World Institute, 2010); Gerald Nelson et al., Food Security, Farming, and Climate Change to 2050, (Washington D.C.: International Food Policy Research Institute, 2010); United Nations Food and Agriculture Organization, The State of Food and Agriculture 2010-2011, 2011, at http://www.fao.org/ docrep/013/i2050e/i2050e00.htm; United Nations Food and Agriculture Organization, Save and Grow: A policy makers guide to the sustainable intensification of smallholder crop production, May 2011, at http://www.fao.org/ag/save-and-grow/; The Howard G. Buffett Foundation, The Hungry Continent: African Agriculture and Food Insecurity, 2011, at http:// www.thehowardgbuffettfoundation.org/about-hgbf/advocacy; Government Office for Science, The Future of Food and Farming: Challenges and choices for global sustainability, (London: The Government Office for Science, 2011);); Climate Change, Agriculture and Food Security (CCAFS), Achieving Food Security in the Face of Climate Change, 2011, at http://ccafs. cgiar.org/commission.
37 World Agroforestry Center, at http://www.worldagroforestrycentre.org, viewed 14 October 2011; Dennis Garrity, An Evergreen Revolution for Africa, in Linda Starke (ed.), State of the World 2011: Innovations that Nourish the Planet (New York: W.W. Norton & Company, 2011), pp. 97-98; The World Agroforestry Center, Dennis Garrity on Evergreen Agriculture, 2011, at http://www.youtube.com/watch?v=pT29wqcAClA, viewed 8 November 2011.

The World Agroforestry Center, Dennis Garrity on Evergreen Agriculture, 2011, at http://www.youtube.com/watch?v=pT29wqcAClA. The World Agroforestry Center, op. cit. note 37; Yvonne Otieno, Putting Trees on Farms Fundamental to Future Agricultural Development, press release, (World Agroforestry Centre: Nairobi, Kenya, 10 February 2011, at http://www.worldagroforestrycentre.org/newsroom/ press-releases/putting-trees-farms-fundamental-future-agricultural-development.
40 39

38

Danielle Nierenberg, Happier Meals, in Happier Meals: Rethinking the Global Meat Indus try, Worldwatch Paper 171, September 2005, pp.54-55.
42

41

Olivier De Schutter, Agroecology and the Right to Food, report presented at the 16th Session of the United Nations Human Rights council [A/HRC/16/49], Office of the UN Special Rapporteur on the Right to Food, March 2011; P. Van Mele et al., Integrated Rice-duck: A New Farming System for Bangladesh, in Innovations in Rural Extension: Case Studies from Bangladesh, Oxfordshire, U.K./Cambridge, U.S.A., CABI Publishing, 2005.

Eric Holt-Gimnez, Measuring Farmers Agroecological Resistance after Hurricane Mitch

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in Nicaragua: A Case Study in Participatory, Sustainable Land Management Impact Monitoring, Agriculture, Ecosystems and Environment, 93 (2002), pp. 87105. National Disaster Risk Reduction and Management Council (NDRRMC), Sitrep No. 22 re Effects of Typhoon Pedring (NESAT), NDRRMC Update, pp. 1-2, 7 October 2011, at http://reliefweb.int/sites/reliefweb.int/files/resources/Full_Report_2598.pdf; Marvyn N. Benaning, SRI-grown Rice Resists Typhoon, Manila Bulletin, 8 October 2011.
44 45 43

Norman Uphoff, professor of government and international agriculture at Cornell University, email to author, October 2011. Erika Styger, director of programs for the SRI International Network and Resources Center, email to author, October 2011.

46

Meera Shekar, Scaling Up Nutrition: A Framework for Action, 5th Friedman School Symposium on Nutrition Security, Tufts University, Boston, Massachusetts, 5 November 2010; Meera Shekar, State of the World 2011 Symposium Panel Discussion, Carnegie Endowment, Washington, D.C., 12 January 2011. K. Weinberger and T.A. Lumpkin, Horticulture for Poverty AlleviationThe Unfunded Rev olution, Working Paper No. 15 (Shanhua, Taiwan: AVRDCThe World Vegetable Center, 1995); Abdou Tenkouano, The Nutritional and Economic Potential of Vegetables, in State of the World 2011 (New York: W.W. Norton & Company Inc., 2011) pp. 27-35.
49 Danielle Nierenberg, Breeding Vegetables with Farmers in Mind, Worldwatch Institute: Nourishing the Planet, posted 3 December 2010, at http://blogs.worldwatch.org/nourishingtheplanet/breeding-vegetables-with-farmers-in-mind-advisory-group-africa-agriculture-breedingclimate-change-drought-farmers-fertilizer-food-security-nutrition-poverty-seeds-state-of-theworld-2011-world-vegeta/; Monika Blssner and Mercedes de Onis, Malnutrition: Quantifying the Health Impact at National and Local Levels, World Health Organization (WHO Environmental Burden of Disease Series, No. 12, 2005) at http://whqlibdoc.who.int/publications/2005/9241591870.pdf. 50 48

47

Ellen Gustafson, founder and executive director of the 30 Project, interviewed in 30 Project SAN FRANCISCO Dinner, The 30 Project, YouTube, 1 August 2011, at http://www.youtube.com/user/The30project#p/a/u/0/cQHhxFei9uA.

World Health Organization, Global Status Report on Noncommunicable Dis eases 2010, (Italy: World Health Organization, 2011), p. 9, at http://www.google.com/ url?sa=t&rct=j&q=sixty%20three%20percent%20of%20global%20deaths%20are%20 caused%20by%20non-communicable%20diseases&source=web&cd=3&sqi=2&ved=0CCsQFjAC&url=http%3A%2F%2Fwww.who.int%2Fnmh%2Fpublications%2Fncd_report_full_ en.pdf&ei=VnugTuONE-Pk0QGrgKmdBQ&usg=AFQjCNHwURf26uL75MM4Z7OBfRBn lPsTbw&cad=rja; Rachel Nugent, Bringing Agriculture to the Table, The Chicago Council on Global Affairs, 2011, at http://www.thechicagocouncil.org/UserFiles/File/GlobalAgDevelopment/Report/Bringing_Agriculture_To_The_Table.pdf.
52

51

Dyno Keatinge, speaking at State of the World launch event, Taipei, Taiwan, 16 August 2011; Save the Children, Child Hunger Crisis in Niger, posted September 2010, at http:// www.savethechildren.org/site/c.8rKLIXMGIpI4E/b.6235815/k.BC34/Child_Hunger_Crisis_ in_Niger.htm; Dyno Keatinge, et al., AVRDCThe World Vegetable Center, Food Security, forthcoming (2012).

Olivier De Schutter, UN Special Rapporteur on the Right to Food, UN Food Expert: Chance to Crack Down on Bad Diets Must Not be Missed, press release, UN Office of the High Commissioner for Human Rights (UN OHCR), 16 September 2011, at http://www.

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ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=11382&LangID=E; Rachel Nugent, Bringing Agriculture to the Table, The Chicago Council on Global Affairs, 2011, at http://www.thechicagocouncil.org/UserFiles/File/GlobalAgDevelopment/Report/Bringing_ Agriculture_To_The_Table.pdf.
53

Leveraging Agriculture for Improving Nutrition and Health, International Conference, New Delhi, India, 10-12 February 2011.

Shenggen Fan, Welcome Remarks, at the International Food Policy Research Institute Conference on Leveraging Agriculture for Improving Nutrition & Health, New Delhi, India, 10 February 2011.
55 Oran Hesterman, Fair Food (New York: Public Affairs, 2011), p. 51; The Food Trust, at http://www.thefoodtrust.org/, viewed 8 November 2011; The Food Corps, at http://www.foodcorps.orgs, viewed 8 November 2011.

54

Mark Bittman, Food Corps Food Soldiers, in Their Own Words, New York Times, 25 August 2011, at http://bittman.blogs.nytimes.com/2011/08/25/foodcorps-service-membersspeak/; Jane Black, Food Corps Steps in to Help Schools Do What They Couldnt Otherwise Afford, Washington Post, 4 October 2011, at http://www.washingtonpost.com/lifestyle/food/ foodcorps-steps-in-to-help-schools-do-what-they-couldnt-otherwise-afford/2011/09/26/gIQAs2UJLL_story.html; Food Corps, at http://foodcorps.org.
57

56

The Organic Center, The Path to Improved Health, two-page summary, at http://www. organic-center.org/reportfiles/NQI2-pagerFINAL11-1[1].pdf (Boulder, Colorado: September 2011).

58

Danielle Nierenberg, Cultivating Food Security in Africa, Worldwatch Institute: Nourishing the Planet, posted 20 February 2010, at http://blogs.worldwatch.org/nourishingtheplanet/cultivating-food-security-in-africa-kansas-city-star-hunger-africa-food-security-nutrition-avrdc-world-vegetable-center-asian-vegetable-research-and-development-center-farmersagriculture-africa-biodi/; The World Vegetable CenterAVRDC, at http://www.avrdc.org/, viewed 8 November 2011.

59 Hannah B. Sahud, Helen J. Binns, William L. Meadow, and Robert R. Tanz, Marketing Fast Food: Impact of Fast Food Restaurants in Childrens Hospitals, Pediatrics, vol. 118, no. 6, 1 December 2006, pp. 22902297, at http://pediatrics.aappublications.org/content/118/6/2290.

Health Care Without Harm, at http://www.noharm.org/, viewed 8 November 2011; PR Newswire, HCWH Applauds Premier Healthcare Alliance for Contract that Provides Healthier, More Sustainable Chicken to Health Care Members, 6 September 2011, at http:// www.prnewswire.com/news-releases/hcwh-applauds-premier-healthcare-alliance-for-contractthat-provides-healthier-more-sustainable-chicken-to-health-care-members-129317053.html; David Wallinga, Senior Advisor in Science, Food, and Health, Institute for Agriculture and Trade Policy (IATP), email to author, 20 October 2011.
61

60

Molly Theobold, Innovation of the Week: Healing Hunger, Worldwatch Institute: Nourishing the Planet, posted 13 January 2011, at http://blogs.worldwatch.org/nourishingtheplanet/ innovation-of-the-week-healing-hunger/; Chris Hani Baragwanath Hospital, Chris Hani Baragwanath Hospital, South Africa, at http://www.chrishanibaragwanathhospital.co.za/, viewed 8 November 2011. George McAllister, GardenAfrica co-founder and Programmes Director, quoted in Molly Theobold, Innovation of the Week: Healing Hunger, Worldwatch Institute: Nourishing the

62

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Planet, posted 13 January 2011, at http://blogs.worldwatch.org/nourishingtheplanet/innovation-of-the-week-healing-hunger/.

63

Michael Wansbrough, A Morning at the Angkor Hospital for Children, Canadian Journal of Emergency Medicine, vol. 9, no. 5 (2007), pp. 374-377, at http://www.cjem-online.ca/v9/n5/ p374; Native Source, Angkor Hospital for ChildrenSiem Reap, Cambodia, at http://www. nativesource.com/Angkor_Hospital_for_Children.html.

Edward Mukiibi, Project Coordinator, Developing Innovations in School Cultivation (DISC), Uganda, interview with author, November 2009; Danielle Nierenberg, How to Keep Kids Down on the Farm, Worldwatch Institute: Nourishing the Planet, posted 9 December 2010, at http://blogs.worldwatch.org/nourishingtheplanet/how-to-keep-kids%E2%80%9Ddown-on-the-farm%E2%80%9D-africa-agriculture-climate-change-droughteducation-farmers-farmers-group-food-security-hunger-income-uganda-developing-innovations-in-school-cultiv/.
65 Betty Nabukalu, student, Developing Innovations in School Cultivation (DISC), Uganda, interview with author, November 2009; Danielle Nierenberg, How to Keep Kids Down on the Farm, Worldwatch Institute: Nourishing the Planet, posted 9 December 2010, at http:// blogs.worldwatch.org/nourishingtheplanet/how-to-keep-kids-%E2%80%9Ddown-on-thefarm%E2%80%9D-africa-agriculture-climate-change-drought-education-farmers-farmersgroup-food-security-hunger-income-uganda-developing-innovations-in-school-cultiv/. 66

64

Danielle Nierenberg, How to Keep Kids Down on the Farm, Worldwatch Institute: Nourishing the Planet, posted 9 December 2010, at http://blogs.worldwatch.org/nourishingtheplanet/how-to-keep-kids-%E2%80%9Ddown-on-the-farm%E2%80%9D-africa-agricultureclimate-change-drought-education-farmers-farmers-group-food-security-hunger-incomeuganda-developing-innovations-in-school-cultiv/; Slow Food International, A Thousand Gardens in Africa, at http://www.slowfood.com/terramadreday/pagine/eng/pagina2.lasso?-id_ pg=113, viewed 8 November 2011. International Labour Organization (ILO), Global Employment Trends for youth: 2011 Update, (Geneva, International Labour Office, October 2011), at http://www.ilo.org/wcmsp5/ groups/public/---ed_emp/---emp_elm/---trends/documents/publication/wcms_165455.pdf.

67

68 PRNewswire via COMTEX, World Cocoa Foundation, USAID and IDH Launch the African Cocoa Initiative, press release (Washington, D.C.: 18 October 2011); World Cocoa Foundation (WCF), Success Story: Family Support Scholarships - Parents Entrepreneurship for Childrens Education at www.worldcocoafoundation.org/what-we-do/success-stories/ ECHOES_succes-story1.asp, viewed 1 November 2011; Cadbury, Case Study: Earthshare, at collaboration.cadbury.com/SiteCollectionDocuments/Earthshare.pdf, viewed 1 November 2011; Nurturing the Next Generation of Cocoa Farmers, event at the Field Museum, Chicago, IL, 4 October 2011.

Frontline SMS, About the Project, at http://www.frontlinesms.com/abouttheproject/ about-the-project/, viewed 5 November 2011.
70 71

69

International Telecommunication Union, ICT Data and Statistics (IDS), at http://www. itu.int/ITU-D/ict/statistics/ict/index.html.

EARTH University Foundation, Entrepreneurial Program, 2007, at http://www.earthusa.org/Page5352.aspx.

72

EARTH University Foundation, Community Development Program, 2007, at http:// www.earth-usa.org/Page5353.aspx.

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EARTH University, EARTH University Selected as Semi-finalist of the Buckminster Fuller Challenge, (EARTH University Foundation, Atlanta, 23 March 2011), at http://www. earth-usa.org/UserDyn/EarthUniversity/earth_buckminsterfullerchallenge_final.pdf

73

74 Danielle Nierenberg, Learning to Listen to Farmers, Worldwatch Institute: Nourishing the Planet, at http://blogs.worldwatch.org/nourishingtheplanet/learning-to-listen-to-farmersfarmers-agriculture-department-of-agricultural-economics-and-extension-ghana-africa-technology-women-education-extension-innovation-nourishing-the-planet-state-of-the-wor/, 28 June 2011; Ernest Laryea Okorley, University of Cape Coast, School of Agriculture, Ghana, interview with author, June 2010. 75

University of Gastronomic Science, About: History and Mission, at http://www.unisg. it/pagine/eng/about/history_and_mission.lasso, viewed on 25 September 2011; (University of Gastronomic Sciences, Master in Food Culture and Communications: Courses athttp:// www.unisg.it/pagine/eng/programs/master_in_food_culture_and_communications/courses. lasso and University of Gastronomic Sciences, Master in Food Culture and Communications: Study Trips, at http://www.unisg.it/pagine/eng/programs/master_in_food_culture_and_communications/study_trips.lasso)
77

76

Ibid.

EcoAgriculture Partners, EcoAgriculture Partners Launches New Landscapes for People, Food, and Nature, an International Initiative for Dialogue, Learning and Action, press release, (26 October 2011); Erik Nielson, Senior Manager, Knowledge Sharing and Policy Advocacy, EcoAgriculture Partners, e-mail to author, 26 October 2011.
79

78

Howard G. Buffett Foundation report, executive summary, at http://www.thehowardgbuffettfoundation.org/.

80 Food, Agriculture, and Natural Resources Policy Analysis Network (FANRPAN), About FANRPAN, at http://www.fanrpan.org/about/, viewed 4 November 2011. 81

Feed the Future (FTF), at http://www.feedthefuture.gov/, viewed 4 November 2011; The Global Agriculture & Food Security Program (GAFSP), at http://www.gafspfund.org/gafsp/, viewed 4 November 2011.

Sara J. Scherr and Sajal Sthapit, Mitigating Climate Change through Food and Land Use, Worldwatch Report 179 (Washington, D.C.: Worldwatch Institute, 2009), p. 5; World Agroforestry Centre, Creating an Evergreen Agriculture in Africa for Food Security and Environment Resilience (Nairobi: 2009), p. 23.

82 $2 per day from The World Bank, World Development Indicators 2010, pp. 91-92; World Bank, Data Bank: Poverty Headcount Ratio at Rural Poverty Line, online database, at http:// data.worldbank.org/indicator/SI.POV.RUHC, accessed 11 October 2011; World Bank, Food Price Watch, at http://www.worldbank.org/foodcrisis/food_price_watch_report_feb2011. html, February 2011. 83

Olivier De Schutter, Food Commodities Speculation and Food Price Crisis: Regulation to Reduce the Risks of Price Volatility, briefing note (September 2010), at http://www.materialien.org/agrar/20102309_un.pdf.
85

84

Hazel Healy, The Food Rush, New Internationalist Magazine, Issue 447, October 2011, at http://www.newint.org/features/2011/11/01/food-speculation-commodities-trading/.

United Nations, United Nations Launches Year-Long Celebration of Vital Role of Cooperatives in Sustainable Development (New York: 31 October 2011), at http://www.un.org/ News/Press/docs/2011/dev2919.doc.htm.

food for all | notes

299

NAC Draft Food Bill: PDS Gets Legal Backing & Eminent Panel, Indian Express, 7 June 2011, at http://www.indianexpress.com/news/nac-draft-food-bill-pds-gets-legal-backing-&-eminent-panel/800250/1; The World Food Prize, The 2011 World Food Prize Laureates, at http:// www.worldfoodprize.org/index.cfm?nodeID=33367&audienceID=1, viewed 4 November 2011. 2. food for all
1 2 3

86

www.bbc.co.uk/news/business-15077909.

Lobell, David B., Wolfram Schlenker, Justin Costa-Roberts, Climate Trends and Global Crop Production Since 1980, Science, 2011.

Bush, George W., Press Conference by The President. Rose Garden, White House, Washington DC, 29 april, 2008.
4 5 6 7

Worthy, Murray, Broken markets: How financial market regulation can help prevent another global food crisis, London: World Development Movement 2011. Masters, Michael M., Testimony of Michael W. Masters, Washington DC, 5 august 2009. Lex, Russia Wheat Ban Worked, Financial Times, 31 may 2011.

Holt-Gimnez, Eric, Raj Patel, Food Rebellions! Crisis and the hunger for justice, Oxford: Fahamu, 2009.
8

World Bank, Rising Global Interest in Farmland: Can it Yield Sustainable and Equitable Ben efits?, Washington D.C.: World Bank 2010.

Winne, Mark, Closing the food gap: resetting the table in the land of plenty, Boston, Mass.: Beacon; Enfield: Publishers Group UK [distributor] 2009.

Drewnowski, A., Obesity, diets, and social inequalities, Nutrition reviews, 67 Suppl 1:S36-9, 2009.
U.S. Census Bureau, International Data Base, update of 22 March 2011. This agency estimated that the world population as of 22 March 2011 was 6,907,373,920. That datum was calculated by using the world population figure as of 31 December 2010, to achieve consistency with FAO estimates for 2010 on the number of undernourished people in the world. It is important to underscore that the estimate is burdened by statistical gaps because of the lack of updated and homogenous data on malnutrition in the world. The data shown in the figure above related to the last two years, based on FAO estimates using the Food Security Model of the United States Department of Agriculture (USDA).
13 14 15 16 17 18 12 11

10

FAO, The State of Food Insecurity in the World, 2010. FAO, Statistics Division, March 2011. FAO, Statistics Division, March 2011. FAO, Statistics Division, March 2011. World Bank, World Development Report 2008 Agriculture Center Development, October 2007.

For an explanation of volatility, please see the section entitled A New Emergency: the Dramatic Instability in Food Prices.

19 The standard deviation, or typical displacement, or average quadratic displacement is an index of dispersion in experimental measurements. It measures the amount of variability of one group of data or one causal variable. Standard deviation measures the dispersal of data around an expected

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value, and it has the same unit of measurement as the observed values, unlike variance, the unit of measurement of which is the square of the unit of the reference values.
20

This weather phenomenon in the Central Pacific Ocean recurs between December and January, every five years on average, with a variable periodicity of three to seven years. It causes flooding, drought, and other disturbances, which differ each time. Developing countries that depend heavily on agriculture and fishing, especially those on the Pacific Rim, are the most seriously hit. The yield of cereals, in kilograms per hectare, includes: wheat, rice, corn, barley, oats, rye, millet, sorghum, buckwheat, and mixed cereals.

21

Currently, some European operators on the physical market and some derivatives on commodities are not subject to oversight or regulation, because they benefit from exceptions (or loopholes) in the MIFID (Markets in Financial Instruments Directive) and the MAD (Market Abuse Directive).
23

22

The GDP is the market value of all goods and services produced in a country over a particular period of time, usually one year. When converted to a population GDP (GDP per capita), it allows comparisons across space and time between different countries, regions, or other units. Generally, it is the first indicator used to diagnose an economic or social situation and to compare different contexts. As a growth rate, it is the principal indicator for assessing the performance of a country or region over time. American economist, Nobel Prize for economics. At the international level, the following may be cited:

24 25

The Measure of Economic Welfare (MEW) by William Nordhaus and James Tobin The Genuine Progress Indicator (GPI) by the Redefining Progress Institute The Index of Economic Well-being (IEWB) by the Centre for the Study of Living Standards The Index of Social Health (ISH) by Fordham University The Index of Living Standards (ILS) by the Fraser Institute The Human Development Index (HDI) by the United Nations Development Program The Quality of Life Index (QOL) by Ed Diener of the University of Illinois The Index of Social Progress (ISP) by Richard Estes of the University of Pennsylvania The BC Stats Index of Regional Indicators The Oregon Benchmarks by the Oregon Progress Board
The WWF has also launched a Beyond GDP track working with the European Parliament, the European Commission, the OECD, and the Club of Rome (www.beyond-gdp.eu). In Italy the Enrico Mattei Foundation has published its 15th edition of the FEEM index (www. feemsi.org), based on an aggregation of variables that consider the social and environmental sustainability of development; the quality of life index of the newspaper Il Sole 24 Ore; the quality of life study by the magazine Italia Oggi; the Legambiente Urban Ecosystem report, drawn up in collaboration with Ambiente Italia and Il Sole 24 Ore.
26 27

The Italian representative was Enrico Giovannini, president of ISTAT.

Professor of Economics and Chair of the Institut dEtudes Politiques de Paris and Chair of the Observatoire Franais des Conjonctures Economiques. Professor Fitoussi was a member of the Advisory Board of the Barilla Center for Food & Nutrition, the scientific authority for the construction of the BCFN Index of Well-being.
28

Report by the Commission on the Measurement of Economic Performance and Social Progress, 14 September 2009.

food for sustainable growth | notes

301

29 30

OECD, Factbook 2010, People reporting various positive and negative experiences.

BCFN, La misurazione del benessere delle persone: il BCFN Index (2010) e La misurazione del benessere delle persone: il BCFN Index (2011). 3. food for sustainable growth Food production that makes the best use of natures goods and services while not damaging these assets (Pretty, 2005).
2 3 1

FAO, 2008.

FAO/OECD Expert Meeting on Greening the Economy with Agriculture, Paris, 5-7 September 2011. Previously, see also Global Agro-Ecological Zone Assessment input levels, IIASA and FAO (2010). The LCA method is an objective method of evaluation and quantification of the energy and environmental loads and the potential impacts associated with a product/process/activity throughout its entire life cycle, from the acquisition of the raw materials until the end of its life (from cradle to grave). The importance of this technique is due to its innovative approach, which involves an evaluation of all the phases of a productive process, as correlated and dependent. The water footprint represents the water consumption tied to the production of goods and services. Roughly 85 percent of the human water footprint is linked to agricultural (and animal) production, 10 percent to industrial production, and 5 percent to domestic consumption.

The ecological footprint measures the biologically productive area of sea and land that is necessary to regenerate the resources consumed by a human population as well as to absorb the corresponding waste products. The carbon footprint expresses the total amount of GHG (greenhouse gases) that represent those substances present in the atmosphere, both natural and anthropic in nature, that are transparent to the solar radiation reaching the earth but which are able to contain, to a substantial extent, the infrared radiation emitted by the earths surface, by the atmosphere, and by the clouds. This represents the difference between the GMP (gross marketable production, updated to the prices of March 2011) and the cost of production of the crops.

9 This represents the quantity of grain corn produced in the harvest per unit of nitrogen distributed in the tillage of durum wheat. 10 11

Save and growA policymakers guide to the sustainable intensification of smallholder crop production, FAO, 2011. IPM = Integrated Pest Management. OECD-FAO, Agricultural Outlook 2011-2020.

12 13

The LEI (low external input) model of agricultural production utilizes roughly 35 percent more work per hectare of land farmed than an HEI (high external input) model. LEI agriculture utilizes roughly 50 percent less energy per hectare than an HEI model.
14

The difference in yield between HEI and LEI is a topic that is still being extensively discussed. Even though numerous studies indicate that HEI generally has relatively better yields (Badgley et al., 2007, Stanhill, 1990), the yield of each type of model of production depends on the economic, social, and environmental context in which it is applied. For the purposes

302

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of this study, let us introduce the hypothesis that the density of nitrogen in the soil, in a low external input (LEI) regimen of agriculture, is some 30 percent lower than a high external input (HEI) regimen of agriculture. Therefore, the yield per hectare in an LEI model is lower. This difference tends to decline over the long term thanks to a general improvement in the knowledge needed for an efficient application of the LEI model. For more information, see the FAO/OECD study: Food Availability and natural resource use in a green economy context.
16 15

Tony Allan, Virtual Water, I.B. Tauris, 2011.

4. food for health

1

Trust for Americas Health and Robert Wood Johnson Foundation: F as in Fat: How Obesity Policies Are Failing in America, July 2009.

WHO Technical Report Series 916, Diet, Nutrition and the Prevention of Chronic Diseases, Report of a Joint FAO/WHO Expert Consultation, World Health Organization, Geneva, 2003. British Heart Foundation, European Cardiovascular Disease Statistics 2008; Health Promotion Research Group, Department of Public Health, University of Oxford; Health Economics Research Centre, Department of Public Health, University of Oxford, 2009. British Heart Foundation, European Cardiovascular Disease Statistics 2008; Health Promotion Research Group, Department of Public Health, University of Oxford; Health Economics Research Centre, Department of Public Health, University of Oxford, 2009.
5 4 3

For the most part, these are the hours of assistance received by patients suffering from coronary or cerebrovascular diseases by unpaid persons. World Health Organization, Cardiovascular Diseases, Fact sheet n. 317, February 2007. American Diabetes Association, Economic Costs of Diabetes in the U.S. in 2007, Diabetes Care, Volume 31, Number 3, March 2008. Health & the EU Lisbon AgendaHigh Returns on Health Investment, May 2006. World Health Organization, Healthy Living, 1999. World Health Organization, Healthy Living, 1999.

6 7

8 9 10 11

We considered: for cardiovascular diseases, the American Heart Association, the European Society of Cardiology, and the Societ italiana di cardiologia; for diabetes, the European Association for the Study of Diabetes, the American Diabetes Association, and the Societ italiana di diabetologia; for tumors, the International Agency for Research on Cancer, the American Cancer Association, and the Federation of European Cancer Societies.
12 13 14

Agriculture Fact Book, Profiling Food Consumption in America, 2002. The Japan Dietetic Association, National Nutrition Survey, 2001.

Keys A., Aravanis C., Blackburn H., Buzina R., Djordjevic B.S., Dontas A.S., Fidanza F., Karvonen M.J., Kimura N., Menotti A., Mohacek I., Nedeljkovic S., Puddu V., Punsar S., Taylor H.L., Van Buchem F.S.P.: Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease, 1980 Harvard University Press, Cambridge, MA and London, 1-381; Toshima H., Koga Y., and Blackburn H.: Lessons for Science from the Seven Countries Study, 1995 Springer Verlag, Tokyo.
15 Trichopoulou A., Costacou T., Bamia C., Trichopoulos D., Adherence to a Mediterranean Diet and Survival in a Greek Population, New England Journal of Medicine, Volume 348, n. 26, 2003.

food for health | notes

303

De Lorgeril M., Salen P., Martin J.L., Monjaud I., Delaye J., Mamelle N., Mediterranean Diet, Traditional Risk Factors, and the Rate of Cardiovascular Complications after Myocardial Infarction: Final Report of the Lyon Diet Heart Study, Circulation, 1999.
17

16

Mitrou P.N., Kipnis V., Thiebaut A., Reedy J., Subar A.F., Wirfalt E., Flood A., Mouw T., Hollenbeck A.R., Letizmann M., Schatzkin A.: Mediterranean Dietary Pattern and Prediction of All Cause Mortality in a U.S. Population: Results from the NIHAARP Diet and Health Study, Archives of Internal Medicine, 2007. IASOInternational Association for the Study of Obesity; IOFTInternational Obesity Task Force.

18

19

More than 65 percent of all Americans are either obese or overweight and approximately 31 percent of the adult population (that is to say, more than 61 million people) appear to fall under the criteria identified to define conditions of obesity (an individual is defined as obese if he or she has a body-mass index, or BMI, of more than 30). The National Institutes of Health believe, moreover, that 4.7 percent of the American adult population falls under the criteria for what is called extreme obesity (with a BMI of over 40). Libro Bianco della Commissione Europea sullAlimentazione, 2007. World Health Organization, 2008.

20 21 22 23

Trasande L., Chatterjee S., The Impact of Obesity on Health Service Utilization and Costs on Childhood, Obesity, September 2009. OMS Regional Office for Europe and UNICEF, Feeding and Nutrition of Infants and Young Children, OMS Regional Publications, European Series, n. 87, 2000 (updated reprint 2003).
24

The values that are reported in the charts and tables presented in this subchapter make reference to the following documents: Societ Italiana di Nutrizione Umana, L.A.R.N., 1996 revision; FAO Nutrition and Consumer Protection Division, Nutritional requirements reports; Food and Nutrition Board (Institute of Medicine of the National Academies), Dietary Reference Intakes, 2006 The Nemours Foundation Center for Childrens Health Media is an initiative accredited by the U.S. Department of Agriculture, U.S. National Institutes of Health, and the U.S. National Library of Medicine.

25

26 Department of Health, United Kingdom, Dietary Sugars and Human Disease, London, H.M. Stationery Office, 1989 (Report on Health and Social Subjects, n. 37).

In particular, the prevalent part is anabolism or biosynthesis, that is, the part of the processes of synthesis of the more complex organic molecules out of simpler molecules of nutritious substances. In other words, during adolescence, complex molecules are produced from the of simpler molecules that are useful to the cell. These processes demand energy, and specifically anabolism is responsible for the formation of the cellular components and the bodys tissues, and thus, for the growth of the individual.
28 American Academy of Pediatrics, Committee on Nutrition, Iron Fortification of Infant Formulas, Pediatrics, 1999. 29 30

27

Lean body mass represents what is left of the organism after stripping of its deposited fat.

Wardley, B. L.; Puntis, J. W. L.; Taitz, L. S., Handbook of Child Nutrition, 2nd Edition. Oxford University Press, Oxford, 1997; James, J., Iron Deficiency in Toddlers, Maternal and Child Health, 1991; Walter, T., Dallman, P.R., Pizarro, F., Velozo, L., Pena, G., Bartholmey, S.J., Hertrampf, E., Olivares, M., Letelier, A., Arredondo, M., Effectiveness of Iron-Fortified Infant Cereal in the Prevention of Iron Deficiency Anaemia, Pediatrics, 91(5):976-982, 1993.

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31

Weaver, C. M., The Growing Years and Prevention of Osteoporosis in Later Life, Proceedings of the Nutrition Society, 59:303-306, 2000. United States Department of Agriculture, Center for Nutrition Policy and Promotion, 2006.

32 33

Sarah E. Barlow, Expert Committee Recommendations Regarding the Prevention, Assessment, and treatment of Child and Adolescent Overweight and Obesity: Summary Report, Pediatrics, 2007.
34 35 36

OMS, Food and Nutrition Board, Societ italiana di nutrizione umana. National Vital Statistics Reports, Volume 56 (10), 2008.

For an in-depth study of the topic, consideramong othersthe following studies: Osler M., Schroll M., Diet and Mortality in a Cohort of Elderly People in a North European Community, Int J Epidemiol, 1997; 26:155-9; Zubair K., Bennett K. et al., Life-Years Gained from Population Risk Factor Changes and Modern Cardiology Treatments in Ireland, European Journal of Public Health, 2006; Hamer M., McNaughton S.A., Bates C.J., Mishra G.D., Dietary Patterns, Assessed from a Weighed Food Record, and Survival Among Elderly Participants from the United Kingdom, University College London, 2010; Cai H., Zheng W., Xiang Y.B., Xu W.H., Yang G., Li H., Shu X.O., Dietary Patterns and Their Correlates Among MiddleAged and Elderly Chinese men: A Report from the Shanghai Mens Health Study, Vanderbilt University, Nashville, 2007; Spencer C.A., et al., A Simple Lifestyle Score Predicts Survival in Healthy Elderly Men, Elsevier 2005.
37 38 39 40 41 42

The average number of years that a human being can hope to live. Population Health Metrics, 2011. World Alzheimer Report, 2010. World Health Organization, Prevention and Management of Osteoporosis, 2003. ISTAT, Annuario statistico italiano 2010.

For an in-depth study of the topic, we refer the reader to section 4.2 of this document, concerning the topic Caloric Restriction and Longevity.

43 World Health Organization, North Karelia Project; National Public Health Institute, The North Karelia ProjectPioneering Work to Improve National Public Health, 2002.

Jeandel C., Nicolas M.B., Dubois F., Nabet-Belleville F., Penin F., Cuny G. Lipid Peroxidation and Free Radical Scavengers in Alzheimers Disease, Gerontology, 35:257-282, 1989.
45

44

De Rich M.C., Breteler M.M., den Breeijen J.H., Launer L.J., Grobbee D.E., van der Meche F.G., Hofman A. Dietary Antioxidants and Parkinsons Disease: The Rotterdam Study, Arch Neu rol, 54:762-765, 1997. De Rijk M., et al. Dietary Antioxidants and Parkinsons Disease, The Rotterdam Study, Archives of Neurology, 1997.

46 47

Glick J.L., Dementias: the Role of Magnesium Deficiency and an Hypothesis Concerning the Pathogenesis of Alzheimers Disease, Medical Hypotheses, 31:211-225, 1990.

48

Kalmijn S., Launer L.J., Ott A., Witteman J.C., Hofman A., Breteler N.M., Dietary fat intake and the risk of incident dementia, Rotterdam Study, Ann Neurol, 42:776-782, 1997. The 9th International Conference on Alzheimers Disease and Related Disorders in Philadelphia, July 17-22, 2004. Jae Kang, Fruit and Vegetable Consumption and Cognitive Decline in Women. For an in-depth study of the topic, we refer the reader to section 5.2 of this position paper, concerning the subject of Caloric Restriction and Longevity. Mattson M.P., Will Caloric Restriction and Folate Protect against AD and PD?, Neurology, 2003.

49

50 51

food for culture | notes

305

52

Abrahamsen B., Patient Level Pooled Analysis of 68,500 Patients from Seven Major Vitamin D Fracture Trials in the US and Europe, Department of Internal Medicine and Endocrinology, Copenhagen University Hospital Gentofte, 2010. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board, Institute of Medicine, Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride, Washington, DC, National Academy Press, 1999. Sears B., Ricordi C., Anti-Inflammatory Nutrition as a Pharmacological Approach to Treat Obesity, Journal of Obesity, 2011. Fontana L. et al., Extending Healthy LifespanFrom Yeast to Humans, Science, 2010. In this connection, see also: Fontana L., Obesit viscerale, restrizione calorica ed aging, G Gerontol, 2006; 54:131-133; Weindruch R., Sohal R.S. Caloric Intake and Aging, N Engl J Med, 1997;337:986-94; Masoro E.J., Overview of Caloric Restriction and Aging, Mech Ageing Dev, 2005;126:913-22. Albanes D., Cancer Research, 1987.

53

54 55

56

57 58

Shimokawa I., Higami Y., Hubbard G.B., McMahan C.A., Masoro E.J., Yu B.P.: Diet and the Suitability of the Male Fischer 344 Rat as a Model for Aging Research, J Gerontol Biol Sci, 48: B27-32, 1993.

5. food for culture Claude Lvi-Strauss (Brussels, 28 November 1908Paris, 30 October 2009 was a French anthropologist, psychologist, and philosopher. Among his contributions to scientific psychology was the application of the method of structuralist investigation to anthropological studies.
2 3 1

Psychologist at the University of Pennsylvania.

Anderson E., Everyone Eats: Understanding Food and Culture, New York University Press, New York, 2005

Michael Pollan is a writer, journalist, activist, and professor of journalism at the University of California, Berkeley Graduate School of Journalism. Brillat-Savarin A., The Physiology of Taste, or Transcendental Gastronomy. The book was originally published in French in 1826.
6 mile Durkheim (pinal, 15 April 1858Paris, 15 November 1917) was a French sociologist, anthropologist, and historian of religion. 7 5

Douglas D.M., Isherwood B., The World of Goods: Towards an Anthropology of Consumption, 1979. Lvi-Strauss.

8 9

The influence that North American culture has exercised over the United Kingdom in the twentieth century makes it possible now to group the two countries together in this context. Numerous authors refer to the entire Anglo-Saxon world when they speak about the Western diet.
10

Zygmunt Bauman (Pozna, 19 November 1925) is a Polish sociologist and philosopher of Polish-Jewish origin.

11 Piroddi L., Cucina Mediterranea. Ingredienti, principi dietetici e ricette al sapore di sole, Mondadori, Milan, 1993.

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Ancel Benjamin Keys (1904-2004) an American doctor and physiologist was known as one of the first proponents of the benefits of the Mediterranean diet as a way of combatting many pathologies common in the west, in particular cardiovascular diseases.
13 Keys A., Aravanis C., Blackburn H., Buzina R., Djordjevic B.S., Dontas A.S., Fidanza F., Karvonen M.J., Kimura N., Menotti A., Mohacek I., Nedeljkovic S., Puddu V., Punsar S., Taylor H.L., Van Buchem F.S.P, Seven Countries: A Multivariate Analysis of Death and Coro nary Heart Disease, 1980. Harvard University Press, Cambridge, MA and London, 1-381; Toshima H., Koga Y., and Blackburn H., Lessons for Science from the Seven Countries Study, 1995, Springer Verlag, Tokyo.

12

Keys A., Aravanis C., Blackburn H.W., Van Buchem F.S.P., Buzina R., Djordjevic B.S., Dontas A.S., Fidanza F., Karvonen M.J., Kimura N., Lekos D., Monti M., Puddu V., Taylor H.L., Epidemiological Studies Related to Coronary Heart Disease: Characteristics of Men Aged 40-59 in Seven Countries, Acta medica scandinavica, 1967 (Supplement to vol. 460) 1-392.
15

14

Keys A., Coronary Heart Disease in Seven Countries, Circulation, 1970 (Suppl to vol. 41) 1-211. Kromhout D., Menotti A., The Seven Countries Study: A Scientific Adventure in Cardio vascular Disease Epidemiology, 1994 Brouwer, Utrecht.

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This section is based on ideas and concepts developed principally by Claude Fischler, a French sociologist and a member of the scientific advisory board of the BCF&N.

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Lang T., Heasman M. (2004), Food Wars: the Global Battles for Mouths, Minds and Markets, London, Earthscan.

Fitzpatrick I. et al., Understanding food culture in Scotland, Edinburgh: NHS Health Scotland, 2010. Nestle M., Mediterranean diets: historical and research overview, American Journal of Clinical Nutrition, 61(Suppl), pp. 1313S-1320S, 1995.

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Drewnowski A., Eichelsdoerfer P., The Mediterranean diet: does it have to cost more?, Public Health Nutrition, 12 (9A), pp. 1621-1628, 2009; Da Silva R. et al., Worldwide variation of adherence to the Mediterranean diet, in 1961-1965 and 2000-2003, Public Health Nutrition, 12 (9A), pp. 1676-1684, 2009. Scheidel A., Krausmann F., Diet, trade and land use: a socio-ecological analysis of the transformation of the olive oil system, Land Use Policy, 28, pp. 47-56, 2011.

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EATING PLANET
NUTRITION TODAY: A CHALLENGE FOR MANKIND AND FOR THE PLANET
Can we produce food for all the inhabitants of Earth and distribute it fairly? Is it possible to make the food system more sustainable to help protect the environment and save resources? What are ways to provide better nutrition that help people maintain good health over the long term? Within the great culinary traditions, is it possible to rediscover the ingredients for healthy, fair, and convivial eating? The paradoxes of the global food system, the cultural value of food, production and consumption trends, and the effects of food production and consumption on health and the environment are some of the major themes of Eating Planet 2012, the first global report on food and nutrition by the Barilla Center for Food & Nutrition, in collaboration with the Worldwatch Institute. Analysis of these issues and discussions about potential solutions are enriched by the contributions of prestigious experts: Tony Allan, Ellen Gustafson, Michael Heasman, Hans Herren, Alex Kalache, Mario Monti, Aviva Must, Joaqun Navarro-Valls, Marion Nestle, Raj Patel, Shimon Peres, Carlo Petrini, Paul Roberts, Vandana Shiva, Ricardo Uauy.