Global Forum on Food Security and Nutrition (FSN Forum)

Dear colleagues,

First of all I would like to thank HLPE and authors for this interesting and informative report that fills in an important knowledge gap regarding the multifaceted relations between nutrition (cf. diets) and food systems. A better understanding of these linkages is of paramount importance to foster transition towards sustainable food systems in the framework of sustainable food consumption. In fact, the report provides interesting insights on how food systems shape dietary outcomes including nutritional ones and vice-versa. The categorization of food systems, although challenging, is original in this sense.

The major objectives of the report are clearly reflected in the V0 draft. Moreover, the report is balanced (neither too technical nor too simplistic) and structure of the draft is comprehensive enough. However, more attention can be paid to the other dimensions of sustainability as in many parts of the report the focus is on health outcomes. Having said that, I think that no relevant aspects are missing.

However, I think that there is still room for improvement, which is quite normal as it is matter about a V0 version. You will find hereafter some comments and suggestions, that I hope will be helpful for this purpose.

As a representative of a Mediterranean organization, I think that the report can better valorize the work that has been done so far on the Mediterranean diet. In fact, CIHEAM and FAO started since 2010 a multifaceted cooperation program on sustainable food consumption and production with a particular reference to food systems sustainability and sustainable diets in the Mediterranean area. The Mediterranean diet is currently studied by CIHEAM and FAO as a case study for the assessment of the sustainability of dietary patterns in the Mediterranean area ([1])([2]). The Mediterranean diet is considered not only as a healthy dietary pattern but also as a sustainable lifestyle and cultural model. The perception of the Mediterranean diet solely as a “healthy” dietary pattern has until recently overshadowed other important socio-cultural, economic and environmental benefits. Therefore, I suggest to integrate box 12 (page 77) considering the above-mentioned elements.

Moreover, in table 3 (page 34), I do believe that the Mediterranean diet has positive health benefits not only in terms of type 2 diabetes and cardiovascular diseases. As a matter of fact, since the pioneer Seven Countries study, much scientific evidence has highlighted the health benefits provided by adherence to a Mediterranean dietary pattern to prevent chronic and degenerative diseases ([3]) and various types of cancers ([4]). The Mediterranean diet appears to have numerous other health advantages that are under current study such as: less peripheral artery disease ([5]), decreased inflammation and improved endothelial function ([6]), improved respiratory fitness ([7]), less allergic diseases ([8])and improved immunity ([9]), decreased mental disorders such as depression ([10]), as well as improved quality of life ([11]). Surveys have repeatedly shown that adherence to a Mediterranean diet pattern is also associated with a reduced obesity ([12]), and a lower incidence of the metabolic syndrome ([13]), and of type 2 diabetes ([14]). The Mediterranean diet may also positively influence the aging process ([15])and delay the evolution of cognitive decline linked to Alzheimer’s disease ([16])and vascular dementia ([17]). Moreover, the Mediterranean diet has also nutritional benefits. Subjects who adhere closely to a Mediterranean diet pattern fulfill most minerals and vitamins requirements much better than persons on a typical western diet ([18]).

Last but not least, and as the conceptual framework is concerned, it is clear that it provides an original schematic view regarding the different factors that determine the nutrition outcomes in relation to the food systems with a particular focus on food environment(s). I think that all drivers can be put in one rectangle and then connected through arrows to food environments, consumer behaviors and diets. In fact, sometimes the impacts are directly on diets without passing through consumer behavior and all types of drivers have impacts on all components of the conceptual framework. Moreover, there should be an arrow that shows feedback loop from diets to value chain actors choices since consumer behavior, so their effective diets, have also impact on the value chain decision making and choices. It seems a bit reductive to connect social impacts only to social equity as it is much broader. In addition, stability pillar of food security should be added. Governance should be as well considered alongside political institutions and institutional actions.

I would like to thank again all scientists and experts that were involved in drafting this outstanding report and I look forward to its upcoming publication in order to use it in research, education and cooperation activities of CIHEAM-Bari related to food and nutrition security.

Regards

Roberto Capone