September 18, 2018

Thin Fare: The Challenges Of Developing Evidence-Based Approaches To Healthy Diets On A Global Scale

Healthy diets are fundamental building blocks of healthy populations. Each day brings choices about what we’ll eat, and those choices are critical components of our wellbeing, doing everything from providing essential nutrients for our bodies to giving us energy to get through busy schedules. The key word here is choice – consumers want the ability to self-select their approach to healthy diets. And while robust nutrition policies which promote healthy eating and preserve consumer choice are difficult to manage, they are necessary for both a healthy and a happy population.

Overall, the process of drafting strong, balanced policies is a difficult endeavor. As policymakers formulate plans to help achieve certain societal outcomes, such as promoting healthy lifestyles, they must cut through biased positions to find accurate information that best reflects reality. On top of that, they must inclusively weigh all information available to come up with the best solutions to the problem at hand.

Recent months have seen new policy proposals from various groups that attempt to create novel paths for robust, ambitious policies that tackle health, environmental, and other concerns. The EAT-Lancet report, for example, presents its advocacy for a global plant-based diet predicated on the desire to address serious environmental challenges.

Taken at face value, the recommendations seem like a silver bullet for a variety of issues that merit serious attention and discussions – malnutrition, food insecurity, climate change, and more. Diving deeper into the report, the strategies at this stage seem little more than a set of top-down directives on what people should or should not eat. What’s more, the directives are based on population-level hypotheses, many of which still require further study.

The diet itself falls short in some fundamental areas. First, it rests on a weak scientific basis, as it relies solely on epidemiology and does not cite any clinical trials to back up the notion that a vegetarian or vegan diet promotes sound health and prevents disease. Indeed, the most recent U.S. Dietary Guidelines Advisory Committee, which has recommended a vegetarian diet to the American public alongside healthy U.S.-style and Mediterranean-style diets, reviewed scientific evidence and found that “the power of this [vegetarian] diet to fight any nutrition-related disease was ‘limited’— the lowest rank given for available data.”

Another way the diet falls short is in the nutritional value it provides for individuals and different groups of people. U.K. researcher Zoe Harcombe, Ph.D, found that the recommended diet would not provide adequate nutrition, as it lacked in major vitamins, minerals, and protein. Moreover, the authors of the report noted that the diet would not provide enough nutrition for “growing children, adolescent girls, pregnant women, aging adults, the malnourished, and the impoverished — and that even those not within these special categories will need to take supplements to meet their basic [nutritional] requirements.”

Without looking under the surface, it’s easy to take this recommended diet and use it to create recommendations and policies for the public. Creating more comprehensive policies, however, requires that we take another look.

Evidence-based policies are important for driving meaningful innovation and change. What’s needed for effective policymaking? First, greater transparency in hypothesis development and data collection. Policymakers need to have a clear idea of how others come to conclusions. Those solutions themselves must be backed by a continuum of hard evidence – in the case of EAT-Lancet’s reference diet, this would include both epidemiology and randomized clinical trials to provide a wider range of evidence. Beyond transparency and evidence, greater dialogue and representation in advisory groups from a variety of stakeholders also provides policymakers with a 360-degree view of the problem and its potential solutions. It is through including outside groups in conversations and throughout the review process that we can ensure policies are inclusive and able to deliver real results. Just as the food we choose to eat affects how much energy and nutrition we have for the day, the way we approach policymaking ultimately shapes the actual implementation and results of the policies we create.