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Did the EAT-Lancet Study Bite Off Too Much?

The recently released EAT-Lancet report makes recommendations that its authors, a group of international researchers and academics, say are necessary to improve the health of both the planet and its inhabitants. The report says this can be done by minimizing agriculture-related greenhouse gas (GHG) emissions, particularly from the production of animal foods.

They argue that a drastic dietary shift toward a nearly vegan diet will be needed by 2050 in order to prevent worldwide food shortages and combat the effects of climate change.

The authors cite numerous research studies and even point out the world’s dietary excesses and deficiencies by region. These researchers have all worked in their fields for decades and have collectively published hundreds of papers and studies in respected, peer-reviewed journals; they expect this paper to be taken seriously and literally. It’s an intriguing academic exercise.

However, I cannot be a good clinician if I fail to acknowledge the importance of seeing each person, culture, or group as unique, with values that each holds dear. I find it unethical to ignore quality-of-life issues whenever dietary changes and recommendations are considered. The lack of such considerations in this report, and the implication that they are immaterial, are among the reasons why those of us who perform direct care see the report’s reference diet as impractical.

The full report is available online, but here’s a quick menu of its recommendations for how the world should collectively eat on a daily basis:

 

Red meat (total) ½ ounce
Poultry 1 ounce
Fish 1 ounce
Eggs ½ ounce
Whole milk or derivative equivalents 1 cup (or 1½ ounces of cheese)
Grains (whole grains recommended) about 4 cups of cooked grains, or 8 ounces of bread
Fruit and juice  (about 1 cup)
Beans and legumes  (about 1 cup)
Soy foods,  peanuts, tree nuts 25 grams (7/8 ounce) each

 

Plant foods are clearly favored, especially for lovers of grains and legumes (beans), although if you like fruit, you may have issues here. An average banana has about 120 calories, so that’s it for the day.

Butter is excluded. And if you prefer low-fat or fat-free milk, too bad; the dairy allowance requires whole-fat dairy foods only. (So swapping whole-fat dairy for low-fat dairy so you can have some butter on your bread won’t do.)

Confusingly, the report does allow two teaspoons of palm oil, which is more highly saturated than butter, and even a teaspoon of lard. You’ve pretty much had your last slice of pie. The report does recommend two tablespoons of liquid vegetable oils, such as olive oil and canola oil.

Got a sweet tooth? You’re allowed about two tablespoons of added sweeteners (sugar or honey).

The Problems with This Report

Despite the pedigree and diversity of the authors, their report has been criticized on many levels by nutritionists and the scientific community as flawed and impractical. It’s easy to see why:

  • The statistics used—or “selected”—do not represent current scientific thinking with respect to either contributions to GHG emissions or dietary quality.
  • Many of the statistics use global averages. This fails to consider the efficiency of farming in well-developed nations and the advances in agricultural science over the past 100 years that have made modern farms exponentially more productive, using fewer resources. Each food is assumed to be grown with similar efficiency around the globe, for instance, which is manifestly untrue.
  • The report boils the diet down to simply consuming a bunch of nutrients. While the authors purport to provide “sufficient scope for many global dietary preferences to be considered,” the specific limits of their dietary plans make such scope barely possible.
  • People make food choices not only for health reasons, but also as part of long-standing family customs, traditions, for pleasure, and food’s full range of sensory properties. While the report notes minimal meat consumption in Crete, for instance, were they happier?  For my own relatives, some who came from Crete, eating less meat was related to availability and affordability, not based on their preference.

The Report’s “Alternative Facts”

EAT-Lancet makes many incorrect assumptions. It states that food production is causing “major environmental risks.” But is it? The entirety of agriculture—plant and animal foods—accounts for only about 8.4 percent of U.S. GHG emissions. Animal foods, particularly meat and dairy, are cited as culprits, but there are many reasons to dispute this. Grazing animals feed on pastureland that is often unsuitable for other agricultural pursuits. The digestive systems of ruminant animals (think beef, dairy, and sheep) that feed on this type of land for most of their lives can “upcycle,” turning human-inedible nitrogen sources from grasses into high-quality protein. Cows can even turn the nitrogen from urea into usable protein.  Regardless, given the modest contribution of agriculture to total GHG emissions, reducing emissions from agriculture may not significantly impact total GHG emissions.

The vast majority of GHG is produced by the nonagricultural use of fossil fuels. Would efforts be better spent by focusing on reducing the 96 percent of GHG that doesn’t involve agriculture? Even if we focus on agriculture, would global policies best be directed at helping agriculture systems in developing countries operate more efficiently? Global crop losses can exceed 40 percent annually, and most farmers just accept this, simply because they are unable to afford modern farming practices. Losing less of their crop yields each year would certainly make more food available; it would also improve developing economies. Even in wealthier countries, such as the United States, where agricultural losses are lower, food waste by consumers accounts for as much as 40 percent of our edible food output.

Among EAT-Lancet’s weaknesses are a failure to acknowledge the realities of GHG, and the practical barriers to implementing the report’s recommendations.

The Single Biggest Barrier

We all want to have a single answer for each of the world’s ills. But such simplicity hasn’t helped me motivate people to make healthier choices when eating. If it were that easy to get people to change their eating styles, I’d merely have to give them a printed page of instructions and send them on their way. Instead, I know from experience that their needs are driven by a host of social and personal factors that can’t be ignored. This report proposes that we drastically change systems and develop global policies that enforce compliance with its recommendations. That’s not a recipe for change, it’s dictatorship—and a foundation for rebellion.

It’s a lesson EAT-Lancet should have understood.

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Keith-Thomas Ayoob, ED.D.

Keith-Thomas Ayoob, ED.D.

Dr. Ayoob is associate clinical professor, pediatrics emeritus at Albert Einstein College of Medicine.

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