Scientific Targets for Healthy Diets* Food group Food subgroup Reference diet (g/day) Possible ranges (g/day) Whole Grains All grains 232 0 to 60% of energy Tubers/Starchy Vegetables Potatoes, cassava 50 0 to 100 Vegetables All vegetables 300 200 to 600 Fruits All Fruits 200 100 to 300 Dairy Foods Dairy Foods 250 0 to 500 Beef, lamb, pork 14 0 to 28 Protein Sources Chicken, other poultry 29 0 to 58 Eggs 13 0 to 25 Fish 28 0 to 100 Dry beans, lentils, peas 50 0 to 100 Soy 25 0 to 50 Nuts 50 0 to 75 Added fats Unsaturated oils 40 20-80 Added sugars All sweeteners 31 0 to 31 * See Table 1 for a complete list of scientific targets for a 2500 kcal/day healthy reference diet The Commission has integrated, with the quantification of universal healthy diets, global scientific targets for sustainable food systems. The objective is to provide scientific boundaries to reduce environmental degradation arising from food production at all scales. The quantification of scientific targets for the safe operating space of food systems in the world, was done for the key environmental systems and processes where food production plays a dominant role in determining the state of the planet. There is strong scientific evidence that food production is among the largest drivers of global environmental change due to its contributions to greenhouse gas (GHG) emissions, biodiversity loss, freshwater use, eutrophication, and land-system change (as well as chemical pollution, which is not assessed by this Commission). In turn, food production depends upon the continued functioning of these biophysical systems and processes in regulating and maintaining a stable Earth system. These systems and processes thereby provide a necessary set of globally systemic indicators of what constitutes sustainable food production. The Commission concludes that these quantitative scientific targets for sustainable food systems, constitute universal and scalable planetary boundaries for the food system, (Table 2). However, the uncertainty range for these food boundaries remain high, due to the inherent complexity in Earth system dynamics from local ecosystems to the functioning of the biosphere and the climate system. Scientific Targets for Sustainable Food Production Earth system process Control variable Boundary Uncertainty Range Climate change GHG (CH4 and N2O) emissions 5 Gt CO2-eq yr-1 (4.7-5.4 Gt CO2-eq yr-1) Nitrogen cycling N application 90 Tg N yr-1 (65-90 Tg N yr-1) (90-130 Tg N yr-1) Phosphorus cycling P application 8 Tg P yr-1 (6-12 Tg P yr-1) (8-16 Tg P yr-1) Freshwater use Consumptive water use 2,500 km 3 yr-1 (1000-4000 km 3 yr-1) Biodiversity loss Extinction rate 10 E/MSY (1-80 E/MSY) Land-system change Cropland use 13 M km 2 (11-15 M km 2)

Background Suboptimal diet is an important preventable risk factor for non-communicable diseases (NCDs); however, its impact on the burden of NCDs has not been systematically evaluated. This study aimed to evaluate the consumption of major foods and nutrients across 195 countries and to quantify the impact of their suboptimal intake on NCD mortality and morbidity. Methods By use of a comparative risk assessment approach, we estimated the proportion of disease-specific burden attributable to each dietary risk factor (also referred to as population attributable fraction) among adults aged 25 years or older. The main inputs to this analysis included the intake of each dietary factor, the effect size of the dietary factor on disease endpoint, and the level of intake associated with the lowest risk of mortality. Then, by use of diseasespecific population attributable fractions, mortality, and disability-adjusted life-years (DALYs), we calculated the number of deaths and DALYs attributable to diet for each disease outcome. Findings In 2017, 11 million (95% uncertainty interval [UI] 10-12) deaths and 255 million (234-274) DALYs were attributable to dietary risk factors. High intake of sodium (3 million [1-5] deaths and 70 million [34-118] DALYs), low intake of whole grains (3 million [2-4] deaths and 82 million [59-109] DALYs), and low intake of fruits (2 million [1-4] deaths and 65 million [41-92] DALYs) were the leading dietary risk factors for deaths and DALYs globally and in many countries. Dietary data were from mixed sources and were not available for all countries, increasing the statistical uncertainty of our estimates. Interpretation This study provides a comprehensive picture of the potential impact of suboptimal diet on NCD mortality and morbidity, highlighting the need for improving diet across nations. Our findings will inform implementation of evidence-based dietary interventions and provide a platform for evaluation of their impact on human health annually. Funding Bill & Melinda Gates Foundation.

The food system is a major driver of climate change, land-use change, depletion of freshwater resources, and pollution of aquatic and terrestrial ecosystems by excessive nitrogen and phosphorus inputs. Here we show that as a result of expected changes in population and income levels, the environmental impacts of the food system could increase by 60-90% between 2010 and 2050 in absence of technological changes and dedicated mitigation measures, and reach levels that are beyond planetary boundaries that define a safe operating space for humanity. We analyse several options for reducing the environmental impacts of the food system, including dietary changes towards healthier, more plant-based diets, improvements in technologies and management, and reductions in food loss and waste. We find that no single measure is enough to simultaneously stay within all planetary boundaries, and combining each measure synergistically will be needed to sufficiently mitigate the projected increase in environmental pressures.

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Both the global average per capita consumption of meat and the total amount of meat consumed are rising, driven by increasing average individual incomes and by population growth. The consumption of different types of meat and meat products has substantial effects on people’s health, and livestock production can have major negative effects on the environment. Here, we explore the evidence base for these assertions and the options policy-makers have should they wish to intervene to affect population meat consumption. We highlight where more research is required and the great importance of integrating insights from the natural and social sciences.