Sustainable and Equitable Increases in Fruit and Vegetable Productivity and Consumption are Needed to Achieve Global Nutrition Security

Increased intake of fruits and vegetables (F&V) is recommended for most populations across the globe. However, the current state of global and regional food systems is such that F&V availability, the production required to sustain them, and consumer food choices are all severely deficient to meet this need. Given the critical state of public health and nutrition worldwide, as well as the fragility of the ecological systems and resources on which they rely, there is a great need for research, investment, and innovation in F&V systems to nourish our global population. Here, we review the challenges that must be addressed in order to expand production and consumption of F&V sustainably and on a global scale. At the conclusion of the workshop, the gathered participants drafted the “Aspen/Keystone Declaration” (see below), which announces the formation of a new “Community of Practice,” whose area of work is described in this position paper. The need for this work is based on a series of premises discussed in detail at the workshop and summarized herein. To surmount these challenges, opportunities are presented for growth and innovation in F&V food systems. The paper is organized into five sections based on primary points of intervention in global F&V systems: (1) research and development, (2) information needs to better inform policy & investment, (3) production (farmers, farming practices, and supply), (4) consumption (availability, access, and demand), and (5) sustainable & equitable F&V food systems and supply chains. The Aspen/Keystone Declaration A new Community of Practice has formed with a shared mission to synthesize data and generate the knowledge needed to better inform actions and interventions leading to more diverse, equitable, nutritious, resilient, and sustainable global F&V food systems. Position Paper: Sustainable & Equitable Increases in F&V Needed for Global Nutrition Security 3 The graphic on this flyer was produced by Ellie Barber of the Aspen Global Change Institute to help summarize the desirable food system outcomes discussed at the workshop. The side-event mentioned in this flyer showcased workshop outcomes and was held alongside the 2018 Global Climate Action Summit. Prepared comments from the panelists were followed by Q&A and interactions with the 40 gathered participants. Position Paper: Sustainable & Equitable Increases in F&V Needed for Global Nutrition Security 4 Background & Introduction To improve public health and nutrition, populations across the globe must consume more F&V on a daily basis.1 However, the current state of global and regional food systems is such that both F&V availability and the production required to sustain them are severely deficient to meet this need (Miller et al., 2016; Bahadur et al., 2018). While innovations in technology and production methods can improve production efficiency and increase the yield of F&V systems, yield alone is insufficient to guarantee crop nutritional quality, system sustainability, and F&V access and demand by consumers. Research has shown that there is tremendous variation in F&V consumption across the world; however, in general, the majority of the world’s population consumes far fewer F&V than recommended by the World Health Organization (WHO) and this is related to numerous poor health outcomes (Hall, Moore, Harper et al. 2009, Casagrande, Wang, Anderson et al. 2007). One of the major leading causes for poor health and disease worldwide is poor diet (Lim et al., 2012) and accordingly six of the top nine global diseases risk factors are linked to poor dietary quality (Forouzanfar et al., 2015). Approximately 16.0 million disability adjusted life years (DALYs), and 1.7 million deaths worldwide are related to low F&V consumption (WHO, 2018). F&V are among the few food groups with positive outcomes for both undernutrition (e.g. micronutrient deficiencies) and overnutrition (e.g. cardiovascular disease, overweight and obesity). According to the United Nations State of Food Insecurity in the World 2017 report (FAO., 2017), 815 million people suffered from calorie deficit hunger in 2016. Micronutrient deficiencies afflict many more people throughout the world—estimated at over 2 billion—while roughly one-third of the global population is overweight or obese (Ng et al., 2014; WHO, 2018 ). Approximately one-third of women of reproductive age are anemic, mainly due to iron deficiency, and one in four children suffer from stunting due to malnutrition in the first 1000 days post-conception2 (from the womb to two years of age) (SOFA, 2018 ). Consumption of sufficient F&V per day (a minimum of 400g, according to the WHO) has been consistently shown to reduce risk of many chronic diseases, including multiple gastrointestinal cancers, cardiovascular disease, and stroke (Jansen 2001;WHO 2005). A systematic review of studies relating F&V consumption to reduced rates of cancer, cardiovascular disease, and premature death (Aune et al. 2017) found that there were significant benefits to intake of up to 500 g fruit/day and 800 g vegetables/day (twice the WHO minimum recommended intake level) and that 13.4 million3 premature deaths per year could be prevented globally by increasing population-level F&V consumption. At the same time, because F&V production uses significant quantities of natural resources, it is imperative that their consumption is aligned with production levels to prevent the waste of natural resources. Additionally, because of their perishability, F&V are the second most wasted food product category after seafood in many countries (NRDC, 2017). When F&V are diverted to the garbage instead of eaten they contribute to increases in greenhouse gas (GHGs) emissions in the 1 As a quick word of initial explanation, this document has not been edited to the standards of a peerreviewed journal. Many declarative statements, such as this one, have not been referenced. But many have been, and there are more than six pages of references. This document was “crowd-sourced” by the workshop participants (all of whom volunteered their time). A more tightly edited and shorter version will be submitted to a peer-reviewed journal soon. In the meantime, this report will be made available to others (via the AGCI web-site), as the first of the tangible workshop outputs and in order to facilitate next steps (e.g. proposals). 2 While increased F&V consumption is generally understood to be beneficial during the first 1000 days, the greater need in some regions may actually be for higher amounts of animal-based foods in the diet. 3 It should be noted there is considerable variation in the literature on this number. Position Paper: Sustainable & Equitable Increases in F&V Needed for Global Nutrition Security 5 process of decomposition. Food system transformations are needed to ensure closer linkages between producers and consumers, in order to improve such alignment. Globally, public investments in F&V systems pale in comparison to major cereal crops. The World Vegetable Center, an international agricultural research institution dedicated to research and development for vegetable crops, spends approximately $20 million/year, as compared to roughly $920 million/year by the CGIAR system, which is devoted primarily to staples and has no specific F&V component.4 This represents a global public investment of only 3-5% in vegetable breeding and systems relative to total expenditures on staple grains and other heavily-traded commodities produced in the Global South (World Vegetable Center, 2018). It is important to note that there are strong private sector investments in F&V systems in both the Global North and the Global South, particularly in the area of hybrid and commercially-important vegetables (e.g., tomato, onion, pepper, lettuce, cucumber) and fruits (e.g., orange, apple, pineapple, mango, banana). There is also an opportunity for greater investment in additional crops that are not currently commercial targets, including regional or indigenous species and varieties. As the global trend towards urbanization shrinks farming populations (in most areas) and increases the distance between production and consumption, ensuring continued access to locallysourced F&V becomes more daunting. Urban and rural poor alike increasingly have greater access – through both lower price points and heightened marketing and sales – to ultra-processed, highsugar foods produced from commodity crops than they do to fresh produce. Cumulatively, these diet-related factors contribute to the triple burden of malnutrition—combined underweight, overweight, and micronutrient deficiencies—across populations in both the Global North and Global South. Additional challenges for sustainably producing enough F&V to achieve global nutrition security include a growing global population (PRB, 2017), a degraded and contaminated resource base due to current production practices, increasing competition for freshwater resources, and a changing climate. Given the critical state of public health and nutrition worldwide, as well as the fragility and constraints of the ecological systems and resources on which they rely, there is a great need for research, investment, and innovation in F&V systems to nourish our global population. Here, we review the challenges that must be addressed in order to expand production and consumption of F&V sustainably and on a global scale. To surmount these challenges, we subsequently present opportunities for growth and innovation in F&V systems. The paper is organized into five sections based on primary points of intervention in global F&V systems: (1) research and development, (2) information needs to better inform policy & investment, (3) production (farmers, farming practices, and supply), (4) consumption (availability, access, and demand), and (5) sustainable and equitable F&V food systems and supply chains. 4 In noting these figures, it is acknowledged that the total glob