A Rapid Review of Territorialized Food Systems and Their Impacts on Human Health,Food Security,and the Environment

The global food system is facing multiple problems, including rising food insecurity, degrading environments, and an increased incidence of diet-related chronic diseases. International organizations are thus calling for a transition toward territorialized food systems to alleviate some of these challenges. Yet, limited evidence supporting the benefits of territorialized food systems is available. Our objective was to summarize the current body of literature on territorialized food systems and their impacts on human health, food security, and the environment using a rapid review methodology. Articles were retrieved from three databases and analyzed using keywords and inclusion criteria corresponding to territorialized food systems, environment, human health, and food security. Six relevant publications were identified. While this limited evidence suggests that territorialized food systems may have positive effects on all three dimensions, data are not consistent across publications. For example, territorialized food systems may contribute to improved diet quality, provide agroecosystem services, and contribute to food security. However, food produced within these food systems may have a higher carbon footprint and be less available than industrially produced food. This rapid review also highlights the siloed nature of the current research on territorialized food systems and emphasizes the need for more holistic and interdisciplinary research.     

Implementing micronutrient fortification programs as a potential practical contribution to achieving sustainable diets

Due to sustainability concerns related to current diets and environmental challenges, it is crucial to have sound policies to protect human and planetary health. It is proposed that sustainable diets will improve public health and food security and decrease the food system's effect on the environment. Micronutrient deficiencies are a well-known major public health concern. One-third to half of the world's population suffers from nutrient deficiencies, which have a negative impact on society in terms of unrealised potential and lost economic productivity. Large-scale fortification with different micronutrients has been found to be a useful strategy to improve public health. As a cost-effective strategy to improve micronutrient deficiency, this review explores the role of micronutrient fortification programmes in ensuring the nutritional quality (and affordability) of diets that are adjusted to help ensure environmental sustainability in the face of climate change, for example by replacing some animal-sourced foods with nutrient-dense, plant-sourced foods fortified with the micronutrients commonly supplied by animal-sourced foods. Additionally, micronutrient fortification considers food preferences based on the dimensions of a culturally sustainable diet. Thus, we conclude that investing in micronutrient fortification could play a significant role in preventing and controlling micronutrient deficiencies, improving diets and being environmentally, culturally and economically sustainable.     

‘It’s Hard to Make Good Choices and It Costs More’: Adolescents’ Perception of the External School Food Environment

Research on the impact of school and community food environments on adolescent food choice is heavily reliant on objective rather than subjective measures of food outlets around schools and homes. Gaining the perspective of adolescents and how they perceive and use food environments is needed. The aim of this study was to explore adolescent’s perception and use of the food environment surrounding their schools. Purposive sampling was used to recruit schools. Mapping exercises and discussion groups were facilitated with 95 adolescents from six schools. Thematic analysis showed that adolescents are not loyal to particular shops but are attracted to outlets with price discounts, those with ‘deli’ counters and sweets. Cost, convenience and choice are key factors influencing preference for food outlets and foods. Quality, variety and health were important factors for adolescents but these features, especially affordable healthy food, were hard to find. Social factors such as spending time with friends is also an important feature of food environments that deserves further attention. Adolescents’ perceptions of their food environment provide insights into features that can be manipulated to enable healthy choices.     

Current Facts About the Animal Food Products Safety Situation in Nigeria

The production, handling, sales, and consumption of poor quality animal food products are serious public health problems in Nigeria traceable to the underdeveloped status of livestock producers, marketers, meat processors, quality regulating agencies, and consumers. Operational research and published information about the quality status, consequence of contaminated animal food products on human health, the economics, and socio-cultural factors inhibiting change in the country are scanty and fragmented. The present report establishes some aspects of the quality status of animal food products as well as the need to investigate the socio-cultural facts and statistics about the status of animal food products production, handling, and consumption and their impact on human health in the country. It further highlights the major research issues that need to be addressed in order to generate relevant information for intervention and containment of the problem and its health risks.     

Current Facts About the Animal Food Products Safety Situation in Nigeria

The production, handling, sales, and consumption of poor quality animal food products are serious public health problems in Nigeria traceable to the underdeveloped status of livestock producers, marketers, meat processors, quality regulating agencies, and consumers. Operational research and published information about the quality status, consequence of contaminated animal food products on human health, the economics, and socio-cultural factors inhibiting change in the country are scanty and fragmented. The present report establishes some aspects of the quality status of animal food products as well as the need to investigate the socio-cultural facts and statistics about the status of animal food products production, handling, and consumption and their impact on human health in the country. It further highlights the major research issues that need to be addressed in order to generate relevant information for intervention and containment of the problem and its health risks.     

Risk assessment to underpin food regulatory decisions: an example of public health nutritional epidemiology

The approach used by food regulation agencies to examine the literature and forecast the impact of possible food regulations has many similar features to the approach used in nutritional epidemiological research. We outline the Risk Analysis Framework described by FAO/WHO, in which there is formal progression from identification of the nutrient or food chemical of interest, through to describing its effect on health and then assessing whether there is a risk to the population based on dietary exposure estimates. We then discuss some important considerations for the dietary modeling component of the Framework, including several methodological issues that also exist in research nutritional epidemiology. Finally, we give several case studies that illustrate how the different methodological components are used together to inform decisions about how to manage the regulatory problem.     

Responding to food,environment and health challenges by changing meat consumption behaviours in consumers

Current meat consumption levels impact environment and health, highlighting a need to reduce meat consumption and increase that of plant‐based alternative proteins. There appears to be a lack of awareness amongst consumers as to how meat consumption affects health and climate change, which is likely to undermine intention to change. Of those who intend to change, many do not translate that intention to reduce meat consumption into behaviour change. Consumers appear open to the notion of reducing meat consumption but lack the knowledge, motivation or capability to make such changes. For many, meat eating is a traditional social practice, re‐enforced by economics, ecological, technological and institutional factors, including media and marketing. Many food choices are not logical reasoned actions but subconscious, automatic, rapid decisions, relying on heuristic processing and heavily influenced by contextual cues. Promising targets for changing individual consumption patterns could focus on closing the awareness‐intention and intention‐behaviour gaps. Modifying contextual determinants of food choice, highlighting personally relevant internal motivators related to individual requirements, and aligning such messages with positive re‐enforcement about animal welfare and environment would close the awareness‐intention gap. A framework of reference for a healthy, sustainable diet, improvements in the range, sensory attributes, convenience and ease of use of meat substitutes, reduction in the meat portion components of ready meals (by substitution with other foods), reformulation of processed products to include a greater proportion of non‐meat proteins, economic incentives and emphasis on the benefits to environment and animal welfare could reduce the intention‐behaviour gap. Better alignment of environmental and health messages would concentrate public health messages and effort to create a market environment that facilitates sustainable food choices to produce moderate population level wide‐scale changes in plant protein consumption, with significant impact on health and environmental outcomes.     

A Menu for Health: Changes to New York City School Food, 2001 to 2011(*)

BACKGROUND: The high prevalence of obesity puts children at risk for chronic diseases, increases health care costs, and threatens to reduce life expectancy. As part of the response to this epidemic, the New York City (NYC) Department of Education (DOE)-the nation's largest school district-has worked to improve the appeal and nutritional quality of school food. This article highlights some of the structural and policy changes that have improved the school food environment over the past decade, with the aim to share lessons learned and provide recommendations and resources for other districts interested in making similar modifications. METHODS: This article details changes DOE has implemented over 10 years, including revised nutrition standards for school meals and competitive foods; new school food department staffing; food reformulations, substitutions, and additions; and transitions to healthier beverages. RESULTS: NYC's revised nutrition standards and hiring of expert staff increased availability of fruits and vegetables, whole grains, and low-fat dairy and decreased sugary beverages, and foods high in saturated fats and added sugars-the major contributors to discretionary calorie intake. DOE also introduced healthier beverages: switching from high-calorie, high-fat whole milk to low-fat milk and increasing access to water. CONCLUSIONS: NYC has successfully improved the quality of its school food environment and shown that healthier food service is possible, even under budgetary constraints. Several broad factors facilitated these efforts: fostering community partnerships and inter-agency collaboration, implementing policies and initiatives that target multiple sectors for greater impact, and working to make incremental improvements each year.     

Food Involvement,Food Choices,and Bioactive Compounds Consumption Correlation during COVID-19 Pandemic: How Food Engagement Influences Consumers’ Food Habits

The containment measures due to the COVID-19 pandemic affected food-related activities, influencing dietary behavior, food habits, and dietary choices. This study aimed to compare the relationship between food involvement and dietary choices before and during the pandemic, investigating the role played by food in dietary habits. Responses given by 2773 Italian consumers to an online survey were studied through the Food Involvement Scale (FIS) and correlated to eating habits. FIS scores were then used to explain the importance given to food in circumstances related to well-being, health, and protection against COVID-19 and used to study the relationship between FIS and bioactive compound knowledge, use, and efficacy against COVID-19. The consumers more involved in food issues recognized the importance of food in circumstances related to well-being, health, and protection against COVID-19 and improved their diet during the pandemic. Moreover, consumers who gave more importance to food also revealed higher attention to the use of healthy substances, such as bioactive compounds, considering them effective against COVID-19. These results showed that food experiencing and involvement could be important elements to promote healthy dietary habits that are essential to maintain physical and mental health during emergency periods such as the COVID-19 pandemic.     

Reconsidering the retail foodscape from a posthumanist and ecological determinants of health perspective: wading out of the food swamp

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.     

Don't forget the bigger picture: the impact of societal issues on a community-based TB programme, Swaziland

PURPOSE: The purpose of this paper is to explore the wider societal issues that can impact on the success of a TB programme. DESIGN/METHODOLOGY/APPROACH: The paper is a qualitative study of the experiences of people involved in a community-based DOTS programme in Lubombo, Swaziland, involving patients, DOT treatment supporters, clinic nurses and other key informants. FINDINGS: The paper finds that study participants spontaneously raised two main societal issues, which had major impact on the success of the TB programme: health beliefs and poverty. It is seen that health beliefs can have a major impact on treatment-seeking behaviour and outcomes of TB treatment. Problems related to poverty were of two main types: insufficient funds to attend for review, and lack of food whilst on TB treatment. ORIGINALITY/VALUE: This paper discusses why these issues, although strictly outside the remit of the health services, are important factors to consider when implementing TB programmes. It suggests further research that may help break the link between TB and poverty (particularly relating to food insecurity) and recommends considering local health beliefs when dealing with individuals and the community. Neither the impact of health beliefs nor the impact of poverty are new ideas, yet these issues tend to be forgotten by quantitative researchers who perhaps understandably focus on issues that may be perceived as being easier to measure. This paper serves to remind one of their importance and to illustrate the value of qualitative research in highlighting them and ensuring that issues that are important to participants are not neglected.     

The role of functional foods, nutraceuticals, and food supplements in intestinal health

New eating habits, actual trends in production and consumption have a health, environmental and social impact. The European Union is fighting diseases characteristic of a modern age, such as obesity, osteoporosis, cancer, diabetes, allergies and dental problems. Developed countries are also faced with problems relating to aging populations, high energy foods, and unbalanced diets. The potential of nutraceuticals/functional foods/food supplements in mitigating health problems, especially in the gastrointestinal (GI) tract, is discussed. Certain members of gut microflora (e.g., probiotic/protective strains) play a role in the host health due to its involvement in nutritional, immunologic and physiological functions. The potential mechanisms by which nutraceuticals/functional foods/food supplements may alter a host's health are also highlighted in this paper. The establishment of novel functional cell models of the GI and analytical tools that allow tests in controlled experiments are highly desired for gut research.     

Food insecurity in people living with obesity: Improving sustainable and healthier food choices in the retail food environment—the FIO Food project

At both UK and global level, dietary consumption patterns need to change to address environmental, health and inequality challenges. Despite considerable policy interventions, the prevalence of overweight and obesity in the United Kingdom has continued to rise with obesity now a leading cause of mortality and morbidity. Obesity prevalence is greater among those on lower incomes and the current UK food system, including government policy, does not effectively address this. Current behavioural approaches, without the support of structural changes in the system, may even widen the inequalities gap. Hence, using behavioural insights from those living with obesity and food insecurity, the project will explore potential avenues that can be applied in the food system to promote healthier choices in the food retail environment. The National Food Strategy report recommends that the UK food system should ensure “safe, healthy, affordable food; regardless of where people live or how much they earn”. However, the association between food insecurity and the development of obesity is not well understood in relation to purchasing behaviours in the UK retail food environment, nor is the potential effectiveness of interventions that seek to prevent and reduce the impact of diet-induced health harms. The FIO Food (Food insecurity in people living with obesity – improving sustainable and healthier food choices in the retail food environment) project provides a novel and multi-disciplinary collaborative approach with co-development at the heart to address these challenges. Using four interlinked work packages, the FIO Food project will combine our knowledge of large-scale population data with an understanding of lived experiences of food shopping for people living with obesity and food insecurity, to develop solutions to support more sustainable and healthier food choices in the UK retail food environment.     

Losses,Gains, and Changes to the Food Environment in a Rural Kentucky County during the COVID-19 Pandemic

The COVID-19 pandemic has caused alterations to be made in the way many people access, prepare, and consume food. Rural communities are particularly impacted due to pre-existing structural vulnerabilities, i.e., poverty, lack of infrastructure, and limited fresh food options. This study aimed to characterize experiences of one rural Appalachian community’s changes to the food environment during the pandemic. In April 2021, six focus groups were conducted with residents of Laurel County, Kentucky. Using grounded theory, we identified losses, gains, and overall changes to the community food environment since the onset of COVID-19. Seventeen Laurel Countians (17 female; ages 30–74) participated in the six focus groups. Three main themes emerged regarding food environment changes—(1) modifications of community food and nutrition resources, (2) expansion and utilization of online food ordering, and (3) implications of the home food environment. Rural communities faced considerable challenges during the COVID-19 pandemic, in part, due to gaps in existing infrastructure and loss of pre-existing resources. This study illustrates the complexity of changes occurring during COVID-19. Using the preliminary data obtained, we can better understand pre-existing issues in Laurel County and suggestions for future programming to address the inequitable access and response during public health emergencies and beyond.     

Consumer citizenship: acting to minimise environmental health risks related to the food system

Public health practitioners interested in supporting consumers to make healthy, sustainable food choices need to understand consumer motivations to reduce food system risk. Increasingly food technologies that have enhanced access to food supply are being recognised as also impacting on the sustainability of the food system. This study explored the actions taken by Australian participants in response to their concerns about perceived food related threats to health and environment. Variance in willingness to act is analysed within the context of environmental and ecological citizenship, and a continuum describes the range of positions held. From the outset some participants self-identified as environmentally concerned and proactive, while others indicated a secondary interest in the environment. The catalyst for action for the majority was the priority of individual health and such self-interest can be a powerful motivator for change. Others related health to the environment and described efforts to minimise individual impact. Equally important for action to occur is being at a stage in life where other demands do not compete for the time and energy necessary to take citizenship actions. These results provide insight into the support that public health practitioners can offer to consumers who wish to make sustainable food choices.     

Scientific substantiation of claims in the USA: focus on functional foods

Although functional foods are currently regulated the same as conventional foods by the US Food and Drug Administration (FDA) there is some concern that they should not be. One concern is whether functional foods can/should carry the same type of health and nutrition labeling claims as conventional foods. For example, the type of nutrient content claim that describes a level of the nutrient such as “good or excellent source” presents a problem for functional foods since these claims relate back to a standard value for nutrients (the daily value or DV). At this time the bioactive or functional components in a functional food do not have daily values so they could not take advantage of this type of claim. Structure/function claims are also at issue since they are required to relate to the food’s attributes of taste, aroma, and nutritive value, rather than attributes of functionality (which would pertain to functional foods). There appear to be three categories of issues concerning the regulation of functional foods: safety; efficacy; and their effect on the overall diet. Since bioactive components can be synthesized or extracted and concentrated, the concern is that the amounts of these substances in functional foods might reach levels which are actually injurious to health or they may negate beneficial effects of substances in the same food. Most people/organizations consider that functional foods need to document their functionality. This means that unlike conventional foods, all functional foods, by definition, would have to apply for a health claim. Finally, the long term overarching concern is what will be the impact of a functional food-driven market on overall health. It is of interest to see how the regulatory environment for functional foods evolves in the next few years and what impact that environment has on the future of these foods.     

Feeding inequality: food insecurity,social status and college student health

A growing but limited body of research has identified the college student population as one that is particularly vulnerable to food insecurity. Early estimates of food insecurity prevalence among college students range from 14 to 60 per cent. The present study utilises original survey data collected from a random sample (n = 300) of college students enrolled at an urban university in the Midwest region of the United States of America (USA). This study examines the impact of food insecurity on health outcomes and the mediation of this relationship by subjective social status among college students. Ordinary least squares (OLS) and logistic regression analyses find that food insecurity is related to worse self-rated, physical and mental health among college students, and Sobel-Goodman tests find that subjective social status plays a significant mediating role in the relationship between food insecurity and health among college students. The implications of these findings in a university context are discussed using a psychosocial framework and insights from the stress process model. In doing so, I discuss food insecurity among college students with an emphasis on the social significance of food and food insecurity.     

A Novel Dietary Assessment Method to Measure a Healthy and Sustainable Diet Using the Mobile Food Record: Protocol and Methodology

The world-wide rise in obesity parallels growing concerns of global warming and depleting natural resources. These issues are often considered separately but there may be considerable benefit to raising awareness of the impact of dietary behaviours and practices on the food supply. Australians have diets inconsistent with recommendations, typically low in fruit and vegetables and high in energy-dense nutrient-poor foods and beverages (EDNP). These EDNP foods are often highly processed and packaged, negatively influencing both health and the environment. This paper describes a proposed dietary assessment method to measure healthy and sustainable dietary behaviours using 4-days of food and beverage images from the mobile food record (mFR) application. The mFR images will be assessed for serves of fruit and vegetables (including seasonality), dairy, eggs and red meat, poultry and fish, ultra-processed EDNP foods, individually packaged foods, and plate waste. A prediction model for a Healthy and Sustainable Diet Index will be developed and tested for validity and reliability. The use of the mFR to assess adherence to a healthy and sustainable diet is a novel and innovative approach to dietary assessment and will have application in population monitoring, guiding intervention development, educating consumers, health professionals and policy makers, and influencing dietary recommendations.     

The importance of harmonising and sustaining food composition data across Europe

Summary  Food composition data are essential for a wide variety of activities, including public health nutrition, research, food labelling and government policy. Food composition data play a particularly important role in four sectors in Europe, namely health, trade regulation and legislation, agriculture and the environment. The need to continue the harmonisation of food composition data already achieved through European collaboration can be clearly identified and evidenced. Harmonisation is not exclusively a technical issue, but also entails creating durable and sustainable structures to maintain the viability of food composition data. These and related issues are currently being addressed by the EuroFIR Network of Excellence (project number FP6-513944, http://www.eurofir.net ).     

Feeding the planet: an unprecedented confluence of pressures anticipated

The report from the UK government's Foresight team, The Future of Food and Farming: Challenges and Choices for Global sustainability, published in January 2011, explores the pressures on the global food system between now and 2050, and identifies the decisions that policy makers need to take today and in the years ahead in order to ensure that the future global population can be fed sustainably, and underlines the need for the public health and food supply sustainability agendas to be harnessed together. The global population is now 6.8 billion and is estimated to reach over 9 billion by 2050. Not only is the world's population expanding but it is also undergoing rapid development, and with this comes increasing demand for protein rich foods, especially meat and dairy products. As economies strengthen, the so‐called diseases of affluence are often found alongside chronic malnutrition, in India for example, making the public health challenges particularly complex. The Foresight report concludes that, without change, food production will continue to degrade the environment and compromise the world's capacity to produce sufficient food in a sustainable way, as well as contributing to climate change and destruction of biodiversity. The report also emphasises that the use of new technologies as a partial solution, such as genetic modification and livestock cloning, should not be excluded a priori on ethical and moral grounds. But the question remains ‘what should be done in terms of dietary advice?’ This paper considers some of the issues.