Abstract
Diets link environmental and human health. Rising incomes and urbanization are driving a global dietary transition in which traditional diets are replaced by diets higher in refined sugars, refined fats, oils and meats. By 2050 these dietary trends, if unchecked, would be a major contributor to an estimated 80 per cent increase in global agricultural greenhouse gas emissions from food production and to global land clearing. Moreover, these dietary shifts are greatly increasing the incidence of type II diabetes, coronary heart disease and other chronic non-communicable diseases that lower global life expectancies. Alternative diets that offer substantial health benefits could, if widely adopted, reduce global agricultural greenhouse gas emissions, reduce land clearing and resultant species extinctions, and help prevent such diet-related chronic non-communicable diseases. The implementation of dietary solutions to the tightly linked diet–environment–health trilemma is a global challenge, and opportunity, of great environmental and public health importance.
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Acknowledgements
We thank M. Burgess, A. Clark and E. Hallström for their comments, K. Thompson for assistance with data collection, editing, and creating figures, and the LTER programme of the US National Science Foundation and the University of Minnesota Foundation for support.
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D.T. conceived this project and M.C. assembled data; both M.C. and D.T. analysed data and wrote the paper.
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All data used in our analyses are publicly available from the original sources that we list, and are provided in the Supplementary Information.
Extended data figures and tables
Extended Data Figure 1 Dietary composition.
The percentage of per capita total dietary protein (a) or calorie demand (b) that is met by each of ten food types is shown for each of five different diets: the global-average 2009 diet, the projected income-dependent diet for 2050, the Mediterranean diet, the pescetarian diet and the vegetarian diet.
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Supplementary Data
This file contains numerous data sets used by Tilman and Clark. Each dataset is indicated by a letter (A to H) and has a descriptive title. See Methods for more details. (XLSX 215 kb)
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Tilman, D., Clark, M. Global diets link environmental sustainability and human health. Nature 515, 518–522 (2014). https://doi.org/10.1038/nature13959
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DOI: https://doi.org/10.1038/nature13959
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Carlos Monteiro
The drivers of environmentally unsustainable food systems
The valuable and impressively researched paper by David Tilman and Michael Clark (1) rightly emphasises the simultaneous health and environmental effects of different dietary patterns, corresponding food systems underlying these patterns, and implications for food and nutrition policies and programmes.
A start has now been made in Brazil. The environmental, and also social, cultural and economic nature and significance of diets, as well as their effects on human personal health and well-being, are embedded in the new Brazilian official national dietary guidelines, published in November 2014 (2)
The analysis by Tilman and Clark sets out in great detail a global dietary transition in which traditional diets are replaced by diets higher in refined sugars, refined fats, oils, salt and meats. It also shows the huge global negative impact of these dietary changes on agricultural greenhouse gas emissions, land clearing, and the incidence of type II diabetes, coronary heart disease and other chronic non-communicable diseases. The dietary transition can be seen therefore as a driver of relevant environmental and health problems. However, we suggest taking the analysis a step further, to consider ?the driver of the driver?.
Methodical analysis of the rapid dietary transition now seen in lower-income countries in the global South shows that far and away the most powerful driver is the unchecked strategy of transnational food and drink manufacturers and caterers to displace long-established dietary patterns based on freshly prepared meals with their ultra-processed, ready-to-consume food and drink products. Such vast and deep penetration is not apparent now in most countries of the global North because their food supplies are already saturated with these products (3).
Any conclusion that urbanisation, rising incomes, and consumer choices, are driving changes in dietary patterns in ways that are pathogenic and also unsustainable, in our view does not get to the heart of the matter.
Carlos A. Monteiro (carlosam@usp.br)
Geoffrey Cannon (geoffreycannon@aol.com)
References
1	Tilman D, Clark M. Global diets link environmental sustainability and human health. Nature 2014, 515: 518?522.
2	Brazilian Ministry of Health. Dietary Guidelines for the Brazilian Population. Brasilia: Ministry of Health, 2014.http://189.28.128.100/dab/docs/portaldab/publicacoes/guia_alimentar_populacao_ingles.pdf
3	Monteiro CA, Cannon G. The impact of transnational ?Big Food? companies on the South: A view from Brazil. PLoS Med. 2012; 9(7): e1001252doi:10.1371/ journal.pmed.1001252.
Affiliation: Centre for Epidemiological Studies in Health and Nutrition, University of São Paulo, Brazil.
Ulli Weisz
Health co-benefits of environmentally less burdensome dietary patterns can be significant, as argued recently by Tilman and Clark in Nature (515, 518?522, 2014), as well as in a burgeoning literature (e.g. 1). In a commentary accompanying the Tilman and Clark article Stehfest (Nature 515, 501-502, 2014) mentioned few, if any, effective options to promote dietary transitions, largely focusing on better-informed individual choices and on measures targeting the production side. However, adverse health effects of food are mainly caused by eating (disproportionate amounts of) unhealthy products, not by producing them. Hence, we propose not to restrict attempts to implement regulations to the production side but rather on the negative long-term side effects of the products themselves. This broader perspective leads one to consider the role of industry and transnational corporation and their liability. The history of tobacco control clearly showed that manufacturers can be held liable for health effects related to their products and for the costs associated with them. There is strong evidence how effective legal measures against tobacco have been, while evidence that softer measures brought substantial change is lacking (2). This has motivated researchers to propose that the same line of argument can be used to hold manufacturers of other harmful commodities such as certain foods liable for the effects of their products (3, 4). Although food is different from tobacco in many ways, as are the respective industries, we can and should learn from the successes achieved in the case of tobacco and implement similar regulations that hold industries accountable for the long-term health effects of their products.
Ulli Weisz (ulli.weisz@aau.at), Helmut Haberl, Willi Haas
Institute of Social Ecology Vienna, Faculty of Interdisciplinary Studies, Alpen-Adria University Klagenfurt, Vienna, Graz
References
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2. Moodie, R. et al. Lancet, 381, 670-679 (2013)
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