Is the ‘obesity crisis’ really the health crisis of the food system?: The ecological determinants of health for food system change

<p>Multilateral organizations and research institutions are increasingly calling for transformation of the industrial food system due to its negative health impacts, its contribution to climate change and the fact that the system fails to provide adequate food to more than 800 million people. A common rationale given for food system change is the so-called obesity crisis. This commentary draws from critical weight studies and ecological public health discourses to argue that it is unnecessary to connect the crises of the food system with a rise in overweight and obesity. This approach contributes to fat stigma and further marginalizes a group of people who already suffer from stigmatization. A more inclusive rationale for food system change can be found in a concept articulated by the Canadian Public Health Association termed the ‘ecological determinants of health.’ These are features of the biosphere such as water, air, food and soil systems that support life on earth and human health. The current industrial food system threatens the ecological determinants of health by contributing substantially to climate change and environmental degradation. A shift in discourse in food policy and practice to focus on the ecological health impacts of the food system is more inclusive and promotes the well-being of all. </p>

Multilateral organizations and research institutions are increasingly calling for transformation of the industrial food system due to its negative health impacts, its contribution to climate change and the fact that the system fails to provide adequate food to more than 800 million people. A foremost rationale given for food system change is the so-called obesity crisis. This commentary draws from critical weight studies and ecological public health discourses to argue that it is unnecessary to connect the crises of the food system with a rise in overweight and obesity. This approach contributes to fat stigma and further marginalizes a group of people who already suffer from stigmatization. A more inclusive rationale for food system change can be found in a concept articulated by the Canadian Public Health Association termed the ‘ecological determinants of health.’ These are features of the biosphere such as water, air, food and soil systems that support life on earth and human health. The current industrial food system threatens the ecological determinants of health by contributing substantially to climate change and environmental degradation. A shift in discourse in food policy and practice to focus on the ecological health impacts of the food system is more inclusive and promotes the well-being of all.

In “Greenhouse gases in intensive agriculture: Contributions of individual gases to the radiative forcing of the atmosphere” (Reports, 15 Sept., p. [1922][1]), G. P. Robertson, E. A. Paul, and R. R. Harwood offer an excellent long-term and systems-based analysis of the relative impacts of different cropping systems upon global warming potential (GWP). They find that no-till management has the lowest net GWP, followed by organic and low input management (each with legume cover). These three all have much lower GWP than conventional tillage (Table 2, p. 1924). In concluding, they state that “[a]griculture…plays a minor role in the GWP economy of the U.S., yet net mitigation of agricultural fluxes could offset the current annual increase in fossil fuel CO2 emissions.” This kind of basic research is of great importance in setting intelligent research and policy agendas for agriculture, and it deserves further elaboration. It is also crucial that such research and analysis be placed in the larger context of food systems. Research done in the 1960s and 1970s showed that (i) agriculture represented only about a third of the total energy used in the U.S. food system, (ii) the typical food calorie on a dinner plate required 10 calories of energy input ([1][2]), and (iii) the average food item was shipped some 1300 miles ([2][3]). Internationally, a 1993 estimate indicated that “only about 10% of the fossil fuel energy used in the world's food system is used in production” ([3][4]). We desperately need to update and improve the quality of these data and formulate an analysis of their GWP to determine where the greatest reductions are to be found. Any search for more sustainable ways to structure our food systems will require more than an energy analysis of current long-distance industrial food systems. It will be necessary to review the underlying theories of social change in conventional energy approaches ([4][5]). In addition, the many significant social, health, and environmental externalities of industrial food systems must be included ([5][6]). Global warming studies should examine not only current industrial structures and food systems, but more localized alternatives—both traditional and emerging ([6][7]). Only with such a comprehensive and systematic approach will we be able to assess the full range of the costs and benefits of more global versus more local food systems. 1. [↵][8]1. J. S. Steinhart, 2. C. E. Steinhart , Science 184, 307 (1974). [OpenUrl][9][FREE Full Text][10] 2. [↵][11]1. S. L. Brown, 2. U. F. Pilz , U.S. Agriculture: Potential Vulnerabilities (Stanford Research Institute, Menlo Park, CA, 1969). 3. [↵][12]1. G. Tansey, 2. T. Worsley , The Food System (Earthscan, London, 1995), p. 223. 4. [↵][13]1. S. Rayner, 2. E. L. Malone 1. E. Shove, 2. L. Lutzenhiser, 3. S. Guy, 4. B. Hackett, 5. H. Wilhite , “Energy and Social Systems,” in Human Choice and Climate Change, vol. 2, S. Rayner, E. L. Malone, Eds. (Batelle, Columbus, OH, 1998), pp. 291-325. 5. [↵][14]1. K. A. Dahlberg New Directions for Agriculture and Agricultural Research (Rowman & Allanheld, Totowa, NJ, 1986). 6. [↵][15]United Nations Development Program (UNDP ), Urban Agriculture: Food, Jobs, and Sustainable Cities (UNDP, New York, 1996). [1]: /lookup/doi/10.1126/science.289.5486.1922 [2]: #ref-1 [3]: #ref-2 [4]: #ref-3 [5]: #ref-4 [6]: #ref-5 [7]: #ref-6 [8]: #xref-ref-1-1 View reference 1 in text [9]: {openurl}?query=rft.jtitle%253DScience%26rft.stitle%253DScience%26rft.issn%253D0036-8075%26rft.aulast%253DSteinhart%26rft.auinit1%253DJ.%2BS.%26rft.volume%253D184%26rft.issue%253D4134%26rft.spage%253D307%26rft.epage%253D316%26rft.atitle%253DEnergy%2BUse%2Bin%2Bthe%2BU.%2BS.%2BFood%2BSystem%26rft_id%253Dinfo%253Adoi%252F10.1126%252Fscience.184.4134.307%26rft_id%253Dinfo%253Apmid%252F4816130%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [10]: /lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6MzoiUERGIjtzOjExOiJqb3VybmFsQ29kZSI7czozOiJzY2kiO3M6NToicmVzaWQiO3M6MTI6IjE4NC80MTM0LzMwNyI7czo0OiJhdG9tIjtzOjI1OiIvc2NpLzI5MC81NDk1LzEzMDAuMS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30= [11]: #xref-ref-2-1 View reference 2 in text [12]: #xref-ref-3-1 View reference 3 in text [13]: #xref-ref-4-1 View reference 4 in text [14]: #xref-ref-5-1 View reference 5 in text [15]: #xref-ref-6-1 View reference 6 in text

A growing body of literature explores the connection between the retail environment and diet in North America. Scholars have coined the term ‘food swamp’ to describe neighbourhoods that are dominated by retail food outlets selling processed foods. As a metaphor, food swamp evokes the unhealthiness of the food found there, speaking to notions of disease that have been associated with the swamp for centuries. However, considering the discourse of the retail environment from a posthumanist perspective and applying the ecological determinants of health, the term food swamp is unable to offer insight into the problems underlying the industrial food system’s failure to connect with its ecological base and promote population health. Rather than being a threat to health, swamps – also known as forested wetlands – are natural features that perform ecological functions upon which human health is fundamentally dependent. The article argues that avoiding the use of the term ‘food swamp’ can lead to a better understanding of food-related public health crises associated with the global industrial food system, thereby altering the discourse. It proposes a swampy notion of food systems and health and takes an ecosystem approach, considering nonhuman nature and the ecological determinants of health. This means evaluating the health of the food by examining it from its agricultural beginnings, to the processing, production and consumption stages as well as looking at its waste. The article suggests that such an ecosystem approach could shift focus from consumer behaviour and the retail environment to much-needed transformative solutions.

The idea of food as commons or commodity in academia. A systematic review of English scholarly texts

S.1 Main research questionThis study aims to examine how biodiversity narratives are integrated and represented within food system transformation literature. It seeks to identify gaps, variations, and opportunities to foster more coherent and inclusive integration of biodiversity, ultimately uncovering strategic insights. To achieve this, the study addresses the following research questions:1. How are key narratives constructed within food system transformation literature?2. How is biodiversity conceptualised, positioned, and utilised within these narratives?3. What assumptions, biases, and blind spots do the narratives contain?4. What commonalities and divergences exist among the selected narratives?S.2 Message(s)• The study examines seven key narratives: food sovereignty, agroecology, One Health, more-than-human, multifunctional landscapes, market-based frameworks, and regenerative food systems, revealing both varying levels of overlap and divergence. All identify the current ‘industrial food system’ as fundamentally flawed, but propose different understandings of why it is flawed and what appropriate responses would be.• Biodiversity is rarely a central theme in food system narratives; it is usually framed indirectly as biodiversity loss or as an instrumental environmental factor. Its complexity is insufficiently explored, often subsumed under the broader sustainability agenda without deeper engagement with values, dependencies, risks, and opportunities.• Most narratives adopt an anthropocentric perspective, except for More-Than-Human, and they differ across key dialectics such as top-down versus bottom-up, radical versus reformist, and techno-optimism versus techno-pessimism.• Common blind spots and biases exist across narratives, including limited attention to strategies for phasing out existing harmful practices or engaging with dominant actors in the current ‘flawed’ food system. There is also a tendency to frame biodiversity primarily in instrumental terms, overlooking its intrinsic and relational values.• Engagement with stakeholders reveals the subtle role of emotions and discomfort in narrative dialogue. Personal values often align with narratives other than the professional narratives.• Narratives can be leveraged based on pragmatic, strategic or moral principles. • Working with narratives can make hidden values, opposing worldviews, and blind spots visible and encourage self-reflection. By recognising the context and diversity of narratives, they can transform from invisible barriers to bridges for connection, learning, and inclusive dialogue.• Dialogue sessions generated findings, and they reflected: raising individual awareness of diverse narratives, raising awareness between personal and professional lenses, raising awareness about the power dynamics between dominant and marginalised perspectives, and simultaneously fostering collective awareness in a more open, exploratory exchange space.The combination of individual reflection and collective dialogue creates a unique and mutually reinforcing effect.S.3 MethodologyThe study followed three phases—Exploration, In-depth Review, and Validation—to identify and compare key narratives on biodiversity and food systems. Seven narratives were selected based on a mapping exercise with PBL and NFP and ranked as most valuable for illustrating diverse storylines on biodiversity and food system transformation in the literature, and analysed for how they position biodiversity, their assumptions, biases, blind spots, and visions of transformation (Exploration). Forty-two peer-reviewed articles (six per narrative) published since 2020 were reviewed for problems, solutions, actors, values, worldviews, blind spots, assumptions, and biases, using a four-part framework covering narrative components, biodiversity positioning, context, and dialectical propositions (In-depth Review). Findings were further discussed in three stakeholder dialogues and compared across dialectical propositions (Validation).

The potential of diversified agroecological systems to deliver healthy outcomes: Making the link between agriculture, food systems & health

Shaping future food system leaders

The ecological determinants of health make explicit the ways in which human health and well-being depend on the biosphere and its systems. Water, oxygen, and food are listed along with soil systems, water systems, material for shelter, energy, the ozone layer and a stable climate. Research in the sciences is uncovering the critical role that the earth microbiome, including the human microbiome, plays in human health. The relationship between commensal microbiota and the systems of the human body, as well as the ways in which these systems are interdependent with other ecosystems such as food systems, invites revisiting the ecological determinants of health. In this commentary, I argue that microbiota, including the human microbiome, should be considered ecological determinants of health. Such a characterization would recognize the importance of the microbiome to human health. It would also frame this as a public health issue and raise questions about health equity, including who benefits from the knowledge produced through biomedical research.

The National Consultation Workshop on Food and Agriculture System Transformation in Nepal was held in Kathmandu, Nepal on May 18–19, 2023. The consultation was organized by International Food Policy Research Institute (IFPRI) and Institute for Integrated Development Studies (IIDS) with support from the United States Agency for International Development, Nepal (USAID/Nepal). This consultation was a part of generating insights / evidence for the United States Government’s (USG) Global Food Security Strategy-Refresh (GFSS-R) process. The US Government’s Global Food Security Strategy (GFSS) is an integrated whole-of-government approach that aims to end global hunger, poverty, and malnutrition through Feed the Future (FtF) initiatives. Several innovations in food and agriculture sectors have been successfully implemented in Nepal, being one of the oldest and most successful Feed the Future countries. However, more remains to be done to ensure food security in the nation. Farmers are still reliant on subsistence farming, leading to low agricultural productivity in the country. Rapid feminization in agriculture, owing to high outmigration and impact of climate change and natural disasters, has further burdened the poor, women, and marginalized groups in achieving food security. Additionally, the COVID-19 pandemic has had a significant negative impact on the country’s economy, thwarting the achievement of Sustainable Development Goals (SDGs). This National Consultation Workshop was designed with an objective to inform the GFSS-R 2022– 2026, with emphasis on i) equity and inclusion, ii) an ambitious approach to climate change, iii) countering the long-term impacts of COVID-19, iv) employing system thinking and working across food systems, and v) integration of conflict management, peace-building, and social cohesion. The Whole System in the Room (WSR) approach was applied to facilitate the workshop with 116 participants representing government, non-government organizations (NGOs), private sectors, and farmers from the federal, provincial, and local levels. Discussions during the consultation workshop were mostly centered on the proposed five themes: (i) Risk and Resilience Capacity, (ii) Food Systems Innovations, (iii) Markets and Trade, (iv) Food Systems Outputs and Outcomes, and (v) Food System Governance and Control. Additional sub-themes were identified to capture the status of each of the themes, and to address their gaps and constraints along with recommendations required to transform the food and agriculture system of Nepal. The participants have proposed specific prioritized recommendations from the list that was generated from the consultation. The summary of these prioritized recommendations for all five themes is given below.

Food systems are a complex web of actors and activities involved from farm to fork on aspects of food production, processing, distribution, preparation, consumption and ultimately the management of food...

The Value-Based Narrative of Food as a Commons. A Content Analysis of Academic Papers with Historical Insights

Dietitians as change agents for promoting healthy and sustainable food systems

Q&A with Gunhild Stordalen: Feeding the world and protecting the planet with healthy and sustainable diets

The current global food system is inadequate to meet the needs of the current world population without compromising future well-being. For example, current intensified production systems lead to undernutrition in some regions coupled with epidemics of obesity in others while compromising their underlying ecological foundations, such as creating areas of ocean hypoxia. Such common observations challenge the research community to ask new types of basic questions and apply novel analytical frameworks for analyzing them. Elaboration of an integrated applied research agenda is imperative to addressing these global food system challenges. We propose that core competencies of a new analytical framework lie at the intersection of four domains: 1) the ecology of agroecosystems; 2) equity in global and local food systems; 3) cultural dimensions of food and agriculture; and 4) human health. This intersection constitutes a new analytical framework for transitions toward global food system sustainability.