Environmental concerns now in Sweden’s newly launched dietary guidelines

As a researcher it is easy to get frustrated by the slow uptake of scientific evidence in society. However, a few weeks ago, I had reason to feel genuinely proud and happy to be both Swedish and a researcher in the field of sustainable food systems, when the Swedish Food Agency (SFA) announced the launch of its new dietary guidelines. For the first time these are not based solely on what is a suitable diet from a human health perspective; they take into account the health of the planet.

As far back as 2009 the SFA had tried to communicate advice on less environmentally damaging food consumption but it was hindered by the EU Commission who objected to the way the SFA recommended the purchase of locally produced foods to spare food miles, on the grounds that this would give Swedish producers an advantage. Later, after having reworded and updated information to comply with EU requirements, the advice was stopped by the Swedish government who had taken on board the warnings of the Swedish National Board of Trade that the advice risked undermining the principle of free trade. While the ambition to formally launch new advice was scrapped, some of the material was published on the SFA web page as information on the environmental impact from food production.

Finally, after years of debates, workshops, seminars, reports and discussions involving researchers, politicians, several different government agencies, trade organisations and NGOs, on the 27^th of April 2015, the time was finally ripe to present the new eating advice.  Today the advice is presented as part of a ‘Sustainable big picture’ stressing the need to focus not just on individual nutrients but to take a holistic view that also includes physical activity and environmental concerns.

In brief, the advice is:

“Eat greener, not too much and be active!” 

In this blog post I give some background to the development of the guidelines, briefly summarise the advice (a full version in English is available here) and write a little about the controversy arising during their development. I also include some questions to Monica Pearson, who together with Anna-Karin Johansson, was responsible for developing the environmental aspect of the guidelines at the SFA.

Background

According to Swedish regulations the SFA should “inform consumers, businesses and other stakeholders in the food chain of the current regulations, dietary advice and other important conditions in the food sector”.  Thus one main tasks of the SFA, as for food agencies in most countries, is to work to promote good eating habits among the population and one important aspect of this is to develop and communicate dietary advice. The last time dietary advice was developed by the SFA was in 2005, and at that time it only considered health aspects.

However, since the beginning of 2000, the SFA has been encouraged by the government to work towards social, economic and environmental sustainability within its area of concern, based on Swedish environmental objectives and the overarching ‘generational goal’ which says that:

“The overall goal of [Swedish] environmental policy is to hand over to the next generation a society in which the major environmental problems are resolved, without causing increased environmental and health problems outside Sweden.”

(If you want to know more about the Swedish environmental objectives here is information in English including a short film.)

Already in 2008 an investigation was commissioned by the SFA that looked into how the agency could work not only to address its direct environmental impact (energy use in offices, travels and paper use etc.) but also what it could do in terms of its indirect impacts. Naturally, the influence the agency has on peoples’ eating habits will affect this indirect impact.

The advice

The new advice is based on the 5^th edition of the Nordic Nutrition Recommendations (NNR) (English), evaluations performed by the SFA themselves concerning risks and benefits of the consumption of raw and processed meat as well as nuts, and a series of reports on the environmental impact of food production commissioned by the SFA to the Swedish research institute SIK and the Swedish University of Agricultural Science (all these in Swedish). The NNR is published every eight years.  It is prepared by more than 100 leading scientists across the Nordic countries (Sweden, Finland, Norway, Denmark and Island).  It is a rigorous scientific process carried out over several years and entails reviewing and summarising a vast amount of health and nutrition research. The work is funded by the Nordic governments and the NNR are then used as an anchor stone for the nutrition profession in all these countries. (More on this process can be found here.) The NNR provides advice on specific nutrient intake requirements and physical activity levels and also provides a description of dietary patterns that achieve nutritional recommendations and help reduce the risk of cardiovascular disease, obesity, type 2 diabetes and cancer. For the first time, in this 5^th edition of the NNR (published in 2014) a chapter on the environmental impacts of food production was also included. In the development of the Swedish guidelines, this information was used, together with information on the specifics of current Swedish consumption patterns, cultural preferences and dietary challenges, and translated into  dietary advice on food intakes in Sweden that are easily interpreted by and relevant for most of the population.

The advice consists of nine recommendations, centering on the following themes; fruit and vegetables, fish and shellfish, exercise, whole grain, fats, dairy, meat, salt and sugar and finally, balancing intake and expenditure -  i.e. eating just enough. The advice is presented on the SFA webpage (Swedish) and is also downloadable in a pdf-report (Swedish and English). There is also a background report (Swedish) with more comprehensive information on health as well as environmental impacts from different food choices, and on how this knowledge was incorporated in the development of the advice.

The picture below shows the page with the advice concerning fruits and vegetables. The general advice for this theme is to ‘Eat more fruits and vegetables’ and to choose fibre-rich vegetables like roots, cabbage, cauliflower, broccoli, beans and onions. Underneath is a list of tips on how to incorporate fruits and vegetables in the diet. To the right is a box which contains information on the health implications of eating fruits and vegetables as well as information on the environmental impacts.  For fruits and vegetables, these include information that fibre-rich robust vegetables like carrots and cabbage have a lower carbon footprint and are easier to store than less fibre-rich perishable ones like tomatoes and cucumbers, and to look for eco- labelled products in order to reduce the use of pesticides.

In summary, the other advice is:

• Eat fish and shellfish two to three times a week – vary the type of fish and look for products with sustainability labels
• Exercise at least 30 minutes every day
• Switch to whole grain for pasta, bread and cereals – all cereals have low carbon footprints and pesticide use is low
• Choose healthy fats like rape seed oil – butter has a higher carbon footprint than vegetable oil
• Choose low fat, un-sweetened dairy products fortified with vitamin D. Methane from cows affect the climate. Therefore do not consume too much cheese and other dairy products; 0.2-0.5 litres of milk (not including cheese) a day is enough for calcium. However, cows can contribute to biodiversity conservation through the grazing of pastures
• Eat less red and processed meat – a maximum of 500 g red and processed meat per week (no limitation on chicken or other white meat) – meat is the food product that affects the climate and the environment the most, and it is therefore important to consume less
• Choose foods with less salt
• Reduce intake of sweets, cake, ice cream and other sugary foods – these unnecessary food cause environmental impact without any nutritional gains
• Try to find your energy balance by eating just enough

Hence, when it comes to the inclusion of environmental impacts the focus is (rightly) on the need to decrease red meat and dairy consumption, which also goes hand in hand with health, as numerous studies have now concluded -  see for example here, here and here.

Controversy

As Samuel Lee-Gammage of the Food Choice Task Force summarized in a recent FCRN blog post, the inclusion of environmental sustainability into the 2015 U.S.  Dietary Guidelines has been heavily opposed by food industry.

So how has the new Swedish guidelines been received in Sweden?

Prior to the final launch, the suggested new advice was available for public consultation and approximately 50 comments were received from different organisations. Many of these were generally positive, including those from the meat industry, which has accepted the health reasons to limit consumption. However, the dairy industry and associated organisations were initially critical.  Arla and LRF Dairy Sweden, the organisation representing Swedish dairy farmers, called the new advice ‘unacceptable’ and strongly questioned how recommended calcium levels could be achieved  if milk consumption was restricted to 0.2 – 0.5 litres per day.  As an answer to this, the final version of the background material contains an appendix which shows how recommended calcium intake can be achieved through consuming a combination of dairy and other calcium-containing foods.   

The dairy organisations did however express their support for the ambition to incorporating environmental sustainability in the advice, but LRF Dairy Sweden claimed that the research regarding the environmental impact from food is still in its infancy and that the SFA does not have the needed expertise in this area. Therefore, in their opinion it is too early for advice based on both human and planet health. Further, these organisations stressed the importance of grazing animals for biodiversity conservation in Swedish semi-natural pastures and the importance of milk as a food product that naturally contains many important nutrients, as opposed to fortified plant-based alternatives.

Contrary to the dairy industry, several organisations explicitly asked for the inclusion of alternatives to milk in the advice and the final text included the following paragraph:

“Drinks made of oats and soya are eco-friendly. Choose the ones enriched with vitamins and minerals – you'll see this information on the packaging.”

In summary, opposition in Sweden has been nothing in comparison to that in the U.S., which probably is a result of less powerful lobby organisations in Sweden, in general a long standing acceptance of and support for state regulation and involvement, and an almost 10-year long debate in Sweden on the issue of sustainable food, a debate which has involved meat and dairy trade associations and industry from the outset.

Will anything change?

Cynically, one could question all this fuss about dietary advice, since few eat according to these recommendations anyway. In terms of the Swedish eating patterns they have a very limited direct impact on global environmental issues, given Sweden’s population of only 10 million. A commonly voiced objection to any food policy in Sweden seeking to reduce consumption of animal products is “well, think about all the Chinese…” And in addition, “here in Sweden we have the most sustainable animal production systems in the world with higher requirements when it comes to environment and animal welfare than anywhere else – it does not make sense to reduce production here”.  Regarding the first argument, most people quickly realize the absurdity of justifying the right to consume more than the ‘globally fair’ part of resources just because you happen to belong to a small group of people (Swedes). The second argument shows the importance of differentiating between production and consumption of food. If Sweden can produce ‘better’ (better needs to be defined broadly including also social aspects) than somewhere else in the world and these Swedish products really replace other worse production and don’t just add products to the market that are not really needed, then it does make sense to place production in Sweden. But production in Sweden cannot be sustained through high consumption in Sweden. It is like arguing for an increase in all electricity consumption so as to stimulate wind power expansion.

How about the indirect influence of the Swedish dietary advice? When it comes to changing consumption patterns in Sweden to the extent needed to reach environmental objectives, I firmly believe that a range of policy instruments is required, including strong financial instruments like greenhouse gas taxes, regulations on advertising and production side measures and choice editing by retailers, restaurants and industries. If such policy is ever to be accepted, information is needed as well as clear leadership from government agencies and other public institutions. Here I see the new dietary advice as an indispensable piece in the puzzle. In addition, in Sweden, free school meals are served to all children up to the age of 18 and here the advice from the SFA has always played an important role in determining the type of food being served. The SFA is also actively working to turn the free school meal into a place for learning, providing a unique opportunity to influence attitudes towards food among today’s young. In many schools this is already happening and as pupils learn more about the implications of food production some are also demanding healthier and more sustainable food in school and at home. For example, several schools in Sweden have introduced meat free days and a few even turned completely vegetarian on request from the children.

When it comes to the global picture, due to its size, Sweden can only function as a role-model. I think this role should not be neglected. For example, in the summary of the U.S. Dietary Guidelines Advisory Committee’s report by Johns Hopkins Center for a Livable Future, Sweden together with some other countries is mentioned:

“The DGAC is not alone in their approach to health and sustainability: Germany, Sweden, the Netherlands, Australia, and Brazil have all incorporated sustainability into their nutrition policies, and the United Nations, the Sustainable Development Commission in the United Kingdom, the Institute of Medicine, the Academy of Nutrition and Dietetics, and the National Research Council have all commissioned reports on sustainable diets.”

So hopefully, the new Swedish dietary advice can play a role in the development and acceptance for dietary advice and other food policy development in other countries where such guidelines have a much larger reach, as for example, again in the U.S. 

Finally, some questions to Monika Pearson, SFA, who has been involved in the process of incorporating environmental sustainability into the Swedish dietary advice from the start back in 2006.

What has been the most challenging part of merging environmental impacts and health aspects into dietary guidelines?

The most challenging part has been to merge them together where they don’t walk hand in hand. For instance with the consumption of meat, butter and fish, where the health aspects and the environmental aspects diverge (see below).

However, it must be pointed out that most challenging of all were the free trade issues, after we notified the EU of the intention to produce our eco-smart food guidelines in 2009.

Can you expand on the goal conflicts between health and environment that you have been struggling with? 

Yes, they are meat, dairy and fish. We need grazing animals to fulfil some of our environmental objectives in Sweden, such as to keep large parts of our vast Swedish land area open, to have a varied landscape and promote biodiversity. However, grazing animals work in the opposite direction of other environmental objectives concerning climate and eutrophication. But the domestic production of beef from grazing animals amounts only to half the national beef consumption, and about half from that is connected to the dairy system.

Butter has also been an issue. From a health point of view we want do restrict the consumption of butter due to the high content of saturated fatty acids. But from an environmental point of view, we should use all the products we get from any food system. Now palm oil is increasingly used in the food industry where saturated fats are needed. The health gain is lost, and the environmental impact has increased.

We really want to promote increased fish consumption. It is a saviour when it comes to essential long-chained fatty acids, vitamin D and iodine. But with the problems of overfishing and disastrous environmental impacts of the fish farms in some areas of the world, fish has to be purchased with caution. We recommend consumers to be guided by established environmental labelling systems.

From 2006 until now, how has the discussion on climate changed as regards the need to decrease meat and dairy consumption in Sweden?

The discussion on climate has really coincided with our work, especially for meat. The health reasons of cutting down the consumption of red meat and processed meat has been understood. Simultaneously, there has been an increased understanding of the climate issue. But, what you say as a consumer is one thing, how you act is a completely other issue. And in fact meat consumption is not decreasing substantially.

How do you think these new advice can contribute to a more sustainable food system? 

It is an important step I believe. Many NGOs and other organisations have been making these arguments for a long time, but when a governmental agency talks about sustainable food, it will help to push the issues forward and make more people listen, question and act. Knowledgeable and well informed consumers also put pressure on the retailers and others in the food chain to act. When media also raises the issue of sustainable food it generates discussions. There is definitely a demand for knowledge.