Making Healthy, Sustainable Diets Accessible and Achievable: A New Framework for Assessing the Nutrition, Environmental, and Equity Impacts of Packaged Foods.

There is a growing global consensus among food system experts that diets and how we source our foods must change. The sustainable nutrition community continues exploring the environmental impact and dietary value of foods. Packaged foods have been largely ignored within the dialogue, and if they are addressed, existing frameworks tend to label them all as "ultraprocessed" and uniformly discourage their consumption. This approach lacks the nuance needed to holistically evaluate packaged foods within recommended dietary patterns. Additionally, there is considerable diversity of opinion within the literature on these topics, especially on how best to improve nutrition security in populations most at risk of diet-related chronic disease. In support of addressing these challenges, 8 sustainability and nutrition experts were convened by Clif Bar & Company for a facilitated discussion on the urgent need to drive adoption of healthy, sustainable diets; the crucial role that certain packaged foods can play in helping make such diets achievable and accessible; and the need for actionable guidance around how to recommend and choose packaged foods that consider human, societal, and planetary health. This article summarizes the meeting discussion, which informed the development of a proposed framework based on guiding principles for defining sustainable, nutritious packaged foods across key nutrition, environmental, economic, and sociocultural well-being indicators. Although additional research is needed to substantiate specific metrics in order to operationalize the framework, it is intended to be a foundation from which to build and refine as science and measurement capabilities advance, and an important step toward broader adoption of healthy, sustainable diets.

Regional conditions shape the food-energy-land nexus of low-carbon indoor farming.

Modern greenhouses and vertical farming projects promise increased food output per unit area relative to open-field farming. However, their high energy consumption calls for a low-carbon power supply such as solar photovoltaic and wind, which adds to cost and overall land footprint. Here we use geospatial and mathematical modelling to compare open-field and two indoor farming methods for vegetable production in nine city-regions chosen globally with varying land availability, climatic conditions and population density. We find that renewable electricity supply is more costly for greenhouses per unit energy demand satisfied, which is due to the greater fluctuation in their energy demand profile. However, greenhouses have a lower energy demand per unit food output, which makes them the least land-intensive option in most of the analysed regions. Our results challenge the land-savings claims of vertical farming compared with open-field production. We also show that regionalizing vegetable supply is feasible in most regions and give recommendations based on the regional context.

Alignment of Healthy Dietary Patterns and Environmental Sustainability: A Systematic Review.

To support food security for current and future generations, there is a need to understand the relation between sustainable diets and the health of a population. In recent years, a number of studies have investigated and compared different dietary patterns to better understand which foods and eating patterns have less of an environmental impact while meeting nutritional needs and promoting health. This systematic review (SR) of population-level dietary patterns and food sustainability extends and updates the SR that was conducted by the 2015 US Dietary Guidelines Advisory Committee, an expert committee commissioned by the federal government to inform dietary guidance as it relates to the committee's original conclusions. In the original SR, 15 studies met the criteria for inclusion; since then, an additional 8 studies have been identified and included. The relations between dietary intake patterns and both health and environmental outcomes were compared across studies, with methodologies that included modeling, life cycle assessment, and land use analysis. Across studies, consistent evidence indicated that a dietary pattern higher in plant-based foods (e.g., vegetables, fruits, legumes, seeds, nuts, whole grains) and lower in animal-based foods (especially red meat), as well as lower in total energy, is both healthier and associated with a lesser impact on the environment. This dietary pattern differs from current average consumption patterns in the United States. Our updated SR confirms and strengthens the conclusions of the original US Dietary Guidelines Advisory Committee SR, which found that adherence to several well-characterized dietary patterns, including vegetarian (with variations) diets, dietary guidelines-related diets, Mediterranean-style diets, the Dietary Approaches to Stop Hypertension (DASH) diet, and other sustainable diet scenarios, promotes greater health and has a less negative impact on the environment than current average dietary intakes.

Results from the 2009 Michigan farm to school survey: participation grows from 2004.

OBJECTIVE: This study investigated changes in Michigan school food service directors' farm to school (FTS) participation levels and perspectives since a 2004 survey and factors that would facilitate FTS expansion. DESIGN: Electronic survey census of all Michigan school food service directors. SETTING: Michigan kindergarten-12th grade schools. PARTICIPANTS: Food service directors of National School Lunch programs in Michigan. VARIABLES MEASURED: Survey respondents were asked about local food purchasing behaviors, interests, motivations, concerns, and barriers. ANALYSIS: Data were analyzed through descriptive statistics. Wilcoxon signed rank tests were calculated to compare 2004 and 2009 results. RESULTS: Participation in FTS was more than 3 times higher (41.5%) than in 2004 (10.6%), and the vast majority of school districts (77.0%) had taken at least 1 step to connect students with local food. Budget and cost issues were ranked higher as barriers to FTS than in 2004, but the desire to help Michigan farms had also substantially increased. Fresh and whole produce items were generally preferred for local procurement over frozen or canned items. CONCLUSIONS AND IMPLICATIONS: Education to reverse perceived limits of procurement regulations, food safety assurances, and strategies to mitigate tight school food budgets are needed to encourage FTS expansion.

Farm-to-school programs: perspectives of school food service professionals.

OBJECTIVE: This qualitative study used a case study approach to explore the potential of farm-to-school programs to simultaneously improve children's diets and provide farmers with viable market opportunities. DESIGN: Semistructured interviews were the primary data collection strategy. SETTING: Seven farm-to-school programs in the Upper Midwest and Northeast regions of the United States. PARTICIPANTS: Seven school food service professionals, 7 farmers, and 4 food distributors recruited from 7 farm-to-school programs. PHENOMENON OF INTEREST: Interviews probed why farmers, school food service professionals, and food distributors participate in farm-to-school programs and how they characterize the opportunities and challenges to local school food procurement. ANALYSIS: Data were analyzed using thematic coding and data displays. RESULTS: School food service professionals described 3 motivators for buying locally grown food for their cafeterias: (1) "The students like it," (2) "The price is right," and (3) "We're helping our local farmer." Students' preference for locally grown food was related to food quality, influence of school staff, and relationships with farmers. Buying food directly from farmers and wholesalers was associated with lower prices and flexible specifications, and the "local feel." CONCLUSIONS AND IMPLICATIONS: Understanding school food service professionals' motivations for buying locally grown food is critical to the sustainability of farm-to-school programs.

Food Systems and Public Health: Linkages to Achieve Healthier Diets and Healthier Communities.

The Airlie Conference on "Food Systems and Public Health: Linkages to Achieve Healthier Diets and Healthier Communities" was convened to discuss how we as a nation can shift toward promoting healthy, sustainably produced foods that are aligned with national dietary and health priorities; the most strategic changes in policy, governance and practices that can help this shift occur; and identify knowledge gaps and policy-relevant research needs. This special theme issue presents papers emanating from the conference, and policy-relevant research and action recommendations from the small group breakout sessions.

Principles for Framing a Healthy Food System.

Wicked problems are most simply defined as ones that are impossible to solve. In other words, the range of complex interacting influences and effects; the influence of human values in all their range; and the constantly changing conditions in which the problem exists guarantee that what we strive to do is improve the situation rather than solve the wicked problem. This does not mean that we cannot move a long way toward resolving the problem but simply that there is no clean endpoint. This commentary outlines principles that could be used in moving us toward a healthy food system within the framework of it presenting as a wicked problem.

Research and Action Priorities for Linking Public Health, Food Systems, and Sustainable Agriculture: Recommendations from the Airlie Conference.

One hundred leading researchers, practitioners, and advocates in public health, health care, nutrition, obesity, economics, sustainable agriculture, and food systems met at the Airlie Conference Center in April 2009 to discuss creating linkages among food systems, public health, and sustainable agriculture in order to achieve healthier diets, healthier communities, and a healthier planet. Participants convened in small groups to explore and discuss research that is needed to create a health-based and sustainable food system. The discussion and key recommendations from the small breakout sessions are presented.

Results from the 2004 Michigan Farm-to-School Survey.

The purpose of this study was to investigate Michigan school food service directors' interest in, and opportunities and barriers to, implementing a farm-to-school program. Farm-to-school may be a timely and innovative approach to improving the school food environment and helping food service directors meet their nutrition goals for school meals. Health and agriculture advocates have recognized the importance of farm-to-school in addressing health issues and creating opportunities for farmers and rural communities. Research subjects were 664 food service directors representing school districts across Michigan. Respondents (n = 383) reported a high degree of interest in sourcing food from local producers (73% reported being very interested or interested). Interest was significantly augmented (83%) when respondents were asked to assume that these foods were available through current vendors. Interest was independent of free/reduced lunch participation rate or school district location (rural, suburban, urban location). Food service directors expressed diverse motivations for their interest in farm-to-school, including supporting the local economy and community; accessing fresher, higher-quality food; and potentially increasing students' fruit and vegetable consumption. The most frequently reported barriers and concerns included cost, federal and state procurement regulations, reliable supply, seasonality of fruits and vegetables, and food safety. Michigan school food service directors appear ready to make linkages with local agriculture. However, there is need to address the concerns and barriers through education; inclusion of community partners, such as current vendors; funding; and state and federal policies that support local purchasing.

Community food security: background and future directions.

Nutrition educators research, teach, and conduct outreach within the field of community food security (CFS), yet no clear consensus exists concerning what the field encompasses. Nutrition education needs to be integrated into the CFS movement for the fundamental reason that optimal health, well-being, and sustainability are at the core of both nutrition education and CFS. Establishing commonalities at the intersection of academic research, public policy development, and distinctive nongovernmental organizations expands opportunities for professional participation. Entry points for nutrition educators' participation are provided, including efforts dedicated to education, research, policy, programs and projects, and human rights.