The need

for sustainable diets

to support optimal nutrition and health

Denis LAIRON

PhD, Research Director at INSERM

JRU 1063 INSERM-1260 INRA- Aix Marseille University, Human nutrition and health,

Faculty of medicine, Marseille, France.

No conflict of interest

Sustainable diet

DEFINITION OF SUSTAINABLE DIETS “ Sustainable Diets are those diets with low environmental impacts which contribute to food and nutrition security and to healthy life for present and future generations. Sustainable diets are protective and respectful of biodiversity and ecosystems, culturally acceptable, accessible, economically fair and affordable; nutritionally adequate, safe and healthy; while optimizing natural and human resources. “ INTERNATIONAL SCIENTIFIC SYMPOSIUM BIODIVERSITY AND SUSTAINABLE DIETS UNITED AGAINST HUNGER 3-5 NOVEMBER 2010 , FAO HEADQUARTERS, ROMA and 2012, FAO report.

Are present diets in (industrialized) countries sustainable ?

-Food production highly relies on fossil energy use, water use, eco-toxic

chemicals, is based on a minimal number of cash crops/monocultures, farmers number and incomes are decreasing

Food consumption is characterized by worldwide food insecurity (1 billion under-malnourished, 2 millions with nutrient deficiencies/ FAO), price increases/volatility, long-distance/fossil energy-based transportation, domination of multi-national/supermarket systems, animal/plant food imbalance.

Food quality and diets : - low food diversity, abandoned traditional foods; refined foods, fat/sugared foods, junk foods, contaminated foods - unbalanced diets, not fitting recommendations, especially for poors.

Are present diets in industrialized countries sustainable ?

Mostly NOT

Are present diets in developing countries sustainable ?

Essentially NOT

Are present diets in very poor countries sustainable ?

NOT at all

- Diet-related, non-communicable diseases (obesity, T2 diabetes, cardiovasc. dis., cancers) markedly increase worldwide, with dramatic trends for next decades.

To have sustainable diets is an urgent need to face increasing problems: food security, nutrition-related diseases & ecological damages

Sustainable diet

PLATFORM FOR ACTION

3. Decision-makers should give priority to and promote sustainable diet concepts in policies and programmes in the agriculture, food, environment, trade, education and health sectors. Nutrition should be given more emphasis by plant and animal breeders and research on nutrient content of food biodiversity should be encouraged.

6. Governments, UN Agencies, Civil Society, Research Organizations and the Private Sector should collaborate in the development of programme activities and policies to promote sustainable diets in order to achieve sustainable food production, processing and consumption, and to minimize environmental degradation and biodiversity loss.

Towards sustainable diet

An urgent need to face increasing problems:

food security, nutrition-related diseases and ecological damages

sustainable food consumption

sustainable food quality

-sustainable food production

Towards sustainable food production

To optimize long-run yields without compromizing ecosystems :

- Developing/improving low-imput, agricultural systems : agro-ecology, agro-forestry, organic agriculture : - already 3-14 % in European Union - present yields estimated to : 87 % of conventional ones in industrialized countries 179-213 % of conventional ones in poor countries - Increasing plant productions for humans, reducing animal productions, well-managing marine ressources

Olivier de Schutter

UN Special Raporteur on the right to food

“ Drawing on an extensive review of the literature published in the last five years, the Special Raporteur identifies agroecology as a mode of agricultural development which not only show strong conceptual connections with the rigth to food, but has proven results for fast progress in the concretization of this human right for many vulnerable groups in various countries and environments. ” UN Report, December 20, 2010 « The scalling-up of these experiences is the main challenge today. « UN Report, December 20, 2010 « Agroecology can double food production in next 10 years « UN Press release, March 8, 2011

Rice in sustainable diets

Rice is the first most important staple food for humans in the world.

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Nutrient content of white and brown rice

(/ 100 g boiled; CIQUAL-ANSES database)

Item White rice Brown rice diff (%) W vs B Energy (kcal) 136 158 86 % Protein (g) 2.5 3.5 71 % Carbohydrates 29 32 91 % Fat 0.9 1.1 82 % Calcium (mg) 8.2 20 15 % Iron 0.38 1 max 38 % Magnesium 11.4 50 23 % Zinc 0.4 max 0.6 66 % max Vitamin B1 (mg) 0.05 0.06 83 % Vitamin B2 0.01 0.O5 max 24 % min Vitamin B5 0.1 0.33 30 % Vitamin B9 5.3 12 44 % Fiber (g) 1.1 max 2.2 50 % Glycemic Index ± 64 ± 55 116 %

Rice proteins

• Protein types are different in various foodstuffs and cereals : the amino-acid composition and protein sequences differs, thus giving variable nutritional value and protein molecule 3D-spatial structure.

This is the basis of allergy to gluten, ie protein fractions found in some cereals, especially wheat. Rice does not contain such gluten proteins making rice a worthwile protein source for allergic people, especially young kids.

• depending on that, some proteins show particuler epitopes (ie small molecule portion). these species/varieties-specific epitopes trigger the immune system and generate allergic reactions.

Rice, nutrition and health (1)

Type 2 Diabetes in the USA

• examined white and brown rice consumption in relation to type 2 diabetes risk prospectively among 39,765 men and 157,463 women (HP and Nurses cohorts).

From Sun, …, and Hu, Arch Intern Med, 2011

• higher intake of white rice (≥ 5 s/wk vs <1 / mo) was associated with a higher risk (+ 17%) of type 2 diabetes. • high brown rice intake (≥ 2 servings per week vs <1 / mo) was associated with a lower risk (- 11%) of type 2 diabetes • replacing 50 g/d (cooked, 1/3 s/d) intake of white rice with brown rice was associated with a 16% lower risk of T2 diabetes.

Substitution of whole grains, including brown rice, for white rice may lower risk of type 2 diabetes..

Rice, nutrition and health (2)

Type 2 Diabetes in Japan

• Prospectively investigated the association between white rice intake and risk of type 2 diabetes among 25,666 men and 33,622 women (PHCPS cohort) in Japan over 5 years.

From Nanri, …, and Tsugane, Am J Clin Nutr, 2010

• A significant association between white rice intake and an increased risk of type 2 diabetes in women (+ 65%, higher Q vs lower) and marginally significant in men with low physical activity.

Elevated intake of white rice is associated with an increased risk of type 2 diabetes in Japanese women.

Rice, nutrition and health (3)

White rice consumption and risk of type 2 diabetes:

meta-analysis and systematic review

• Four articles were identified that included seven distinct prospective cohort analyses in Asian and Western populations (352 384 participants, 4-22 years).

From Hu, Pan and Malik, British Med J, 2012

• Comparing the highest with the lowest category of white rice intake, the risk for T2 diabetes was increased by 55% in Asian populations and by 12% in Western populations..

Higher consumption of white rice is associated with a significantly increased risk of type 2 diabetes, especially in Asian (Chinese and Japanese) populations.

• For each serving per day increment of white rice intake, the increased risk of type 2 diabetes was 11%.

Rice, nutrition and health (4)

• Based on present scientific knowledge, in a context of decreased physical activity …, Consumption of minimally refined brown rice in place of white rice should be encouraged, especially in poor populations.

• Efforts should be made to popularize the cultivation of rice cultivars with both good agronomic value and optimal nutrient content (protein, minerals, vitamins, amylose content, fibers, phyto-compounds).. Organic rice production and consumption should be encouraged for its : - better sustainability - less negative environmental and human impact - possibly improved phyto-nutrient content (lignans, phenols, etc) - lack of pesticide residues, optimal for unrefined rice.

“Should your diet be your first medicine “

Hippocrates, 400 BC

“ Positive health requires a knowledge of man’s primary constitution (today’s “genetics”) and of the powers of various foods, both those natural to them and those resulting from human skill (today’s processed food). But eating alone is not enough for health. There must also be exercise, of which the effects must likewise be known.

The combination of these two things makes regimen, when proper attention is given to the season of the year, the changes of the winds, the age of the individual and the situation of his home. “

« Bona terra, … boun toupin, … bona vida, … bona fin ! «

« Good land, … good foods, … good life, … happy end ! «

Grettings from Provence