We live in a nutritionally-imbalanced world. It is estimated that about 2 billion people in the world are either obese or overweight and around the same number suffer from some nutrition deficiency. Poor diet has been blamed for one in five deaths globally, highlighting the need for us to ‘fix’ what we eat. Even after 23,000 years of practising agriculture, our food production has not been able to address our nutrition woes and has also deteriorated the health of the planet. Agriculture accounts for a whopping 23% emission of greenhouse gases and is a significant contributor to water pollution and loss of biodiversity.
To save our and the planet’s health, the EAT-Lancet Commission was set up to determine a diet that minimises disease risks and can be sustainably produced and consumed. The proposed diet, which provides 2503 kcal per day, is rich in fruits and vegetables, with proteins and fats sourced mostly from plant-based sources. The commission calls for a Great Food Transformation, where there needs to be a change in the way food is produced and consumed today by moving away from unsustainable practices and embracing feasible options.
Composition of the EAT-Lancet reference diet, by food group
It is estimated that this reference diet would cater to 10 billion people by 2050, and also restrict global warming, soil degradation and loss of biodiversity. On paper, this seems to be a win-win situation for the planet and us. However, how many of us can afford this diet? A first-of-its-kind study, published in the journal The Lancet Global Health, shows that the cost of food, which are part of the diet, exceeds the total household income per person for 1.6 billion people, mostly in Sub-Saharan Africa and South Asia.
The study, led by researchers from Tufts University, Boston, USA, calculated the costs of 744 food items that meet the reference diet in 159 countries. They obtained the prices of these goods from the International Comparison Program (ICP)—a database of representative prices for widely consumed products and services in a country—for the year 2011. They then converted the local currency prices to US dollars rates of 2011 using purchasing power parity exchange rates. This exchange rate measures how much local currency units are needed to purchase the same bundle of goods and services in each country. The researchers calculated the affordability of these goods using the World Bank’s PovcalNet system—a survey-based estimate of countries’ household income.
The findings showed that the average cost of the EAT-Lancet reference diet for a day, satiating 2503 kcal, was USD 2.84 in 2011. It was highest in Latin America and the Caribbean (USD 3.48) and the lowest in sub-Saharan Africa (USD 2.50). Among the food categories, fruits and vegetables were the most expensive, followed by legumes and nuts, meat, eggs and fish, and dairy. The trend was similar in South Asia, which includes India, Nepal, Pakistan, Srilanka, Bangladesh, Myanmar and Bhutan. Here, fruits and vegetables were the most expensive constituent of the diet, followed by meat, eggs and fish, and legumes and nuts. The researchers estimate that the reference diet, which costs USD 2.80 in the region, is beyond the reach of 38.4% or 627.31 million people.
Cost components of the EAT– Lancet reference diet for South Asia in 2011 international dollars
The gap between the recommended diet and affordability was the worst in sub-Saharan African countries, where 57.2% or 501.77 of the population could not afford this diet, costing about USD 2.50. This cost was higher than the mean daily household income in countries like Burkina Faso, Burundi, the Democratic Republic of the Congo, Guinea-Bissau, Lesotho, Madagascar, Malawi, Nigeria, Sierra Leone, and Yemen.
The study also found that, on average, the food items in the reference diet were 60% more expensive than foods needed to address nutritional needs. The researchers attribute this factor to the inclusion of larger quantities of fruits and vegetables and meat products, that tend to be expensive. Interestingly, the reference diet recommends a reduction in meat consumption in high-income countries and includes more high-cost foods than what poorer countries now consume.
So, what can make the EAT–Lancet reference diet affordable to all? A combination of higher incomes and lower prices, say the researchers. Lower prices of food produce can be achieved by improving their production, marketing, trade and making more low-cost options of food available. Considering that the inexpensive alternatives food sources include more vegetal foods and less animal-based foods to meet nutritional needs, these changes are good for the planet.
While the world must switch to a healthy, planet-friendly diet, making it pocket-friendly for all is the key, say the researchers. The findings of the study also call for changes in global food systems that shape food choices among affluent economies. With higher farm-productivity, lower food prices, greater non-farm earnings and social safety nets, the researchers hope the transition is possible.
“These factors allow people to shift consumption away from starchy staples and increase their intake of more nutritious but currently unaffordable animal-sourced and vegetal foods,” they conclude.