Building Global Consensus on Nutrition Metrics to Support Food System Transformation: A Dairy Case Study : Nutrition Today

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Building Global Consensus on Nutrition Metrics to Support Food System Transformation: A Dairy Case Study

Miller, Gregory D. PhD, FASN; McMahan, Joe MBA; Ragalie-Carr, Jean RDN, LDN, FAND; Maisano, Megan MS, RDN; Brown, Katie EdD, RDN

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Nutrition Today 58(1):p 39-46, 1/2 2023. | DOI: 10.1097/NT.0000000000000591
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More than 3000 companies and financial institutions have rallied around the Science-Based Targets Initiative (SBTi) to consistently measure and demonstrate progress toward reducing greenhouse gas emissions (GHGs). Can a similar and complementary effort be undertaken to bring uniformity to the measurement of progress against nutrition and health targets? There is currently great variation in how this domain is measured. Yet, in an era of food system transformation, what—and how—progress is measured matters.

“Sustainability” is not measured in isolation: making decisions based on one aspect of food systems, such as the environment, without accounting for other domains, such as nutrition and health, may result in unintended consequences. It is essential that considerations for diet quality, diversity and nutrient density, food security, affordability and accessibility, noncommunicable disease risk reduction and outcomes, and other health-related topics be addressed by quantitative, consistent metrics that motivate efforts in the pursuit of food system transformation.

Sustainable Development Goals: The World's Blueprint for Prosperity

The United Nations (UN) Sustainable Development Goals (SDGs) were unanimously adopted by nearly 100 UN member countries, aiming to end poverty, protect the planet, and ensure peace and prosperity for all by 2030.1 Although these goals encompass all 4 domains of sustainability—nutrition/health, environmental, social, and economic—global stakeholders committed to food system transformation, to date, have more narrowly prioritized the environmental aspects of sustainable food production and diets.

2021 marked a “catalytic moment” for the role of food systems in the SDGs, as the UN held its first ever Food Systems Summit (UN FSS). The UN FSS, in conjunction with the 2021 UN Climate Change Conference (COP26) and the Tokyo Nutrition for Growth (N4G) Summit, unequivocally established that in order to achieve the SDGs, society must transform how the world is fed. These landmark events sparked a myriad of conversations and commitments around food system transformation and how it could be mobilized and measured.

Building Global Consensus on Nutrition Metrics to Support Food System Transformation

In this piece, we are calling for a more holistic approach to food system measurement by relying on robust nutrition and health-focused metrics and indicators (M&I) to accompany measures of environmental, social, and economic impact. Although the 4 domains are equally important, we chose to focus on nutrition/health because of this domain's inextricable relationship to food and agriculture and because new research demonstrates it is underrepresented across current frameworks and reporting mechanisms. If a diet does not provide adequate nutrition, it is not sustainable.

Recognizing there are only 8 years left to achieve the SDGs, we audited a variety of efforts intended to motivate and measure sustainable food system progress. This assessment revealed an opportunity to rebalance food system measurement and put the health of people around the world on equal footing with the health of the planet.

A new assessment revealed an opportunity to rebalance the focus of food system measurement and put the health of people around the world on equal footing with the health of the planet.

The goal of our assessment was 2-fold: (1) to better understand the landscape of existing M&I and (2) to identify opportunities for improvement and alignment specific to the nutrition/health domain.

This research consisted of 2 parallel tracks: one focused on how third parties measure and evaluate country- and/or company-level progress and the other on how companies commit to and measure their own contributions to healthy diets and sustainable food systems. The research revealed that across both third-party and proprietary measurement frameworks, efforts to track progress against nutrition/health, social, and economic targets lag behind efforts to track progress against environmental targets.

The lack of M&I on nutrition/health is concerning, because a food system that does not deliver adequate nutrition cannot be sustainable. Poor diets are responsible for more deaths globally than any other risks.2 In fact, dietary improvements could potentially prevent 1 in 5 deaths worldwide.2 Such sobering statistics underscore that coordinated efforts to improve diet through systematic interventions and evaluation systems are urgently needed. As aptly summarized by researchers affiliated with Countdown to 2030, one of the third-party frameworks in the audit, “Healthy diets are essential for nutrition and health. Sub-optimal diets are a direct cause of malnutrition in all its forms, including undernutrition and diet-related noncommunicable diseases (eg, diabetes mellitus, cardiovascular disease, hypertension, stroke).”3 Although most recommendations to make food systems more sustainable focus on environmental issues, a 2022 research paper by Béné et al4 finds that efforts aimed at the nutrition and social domains “are projected to have a greater effect on the sustainability of food systems” compared with interventions for the economic and environmental domains.

Across the global landscape, efforts to track progress against nutrition/health, social, and economic targets lag behind efforts to track progress against environmental targets.

Research Track I: Third-Party Frameworks

Sustainability reporting is complex and has become a crowded field with more than 600 reporting provisions globally.5 For that reason, we selected a sample of frameworks that are relevant to the food and agriculture sector, listed as follows:

  • Access to Nutrition Index6
  • Coller Farm Animal Investment Risk and Return Protein Producer Index7
  • Countdown to 20303
  • Dairy Sustainability Framework8
  • World Benchmarking Alliance's (WBA's) Food and Agriculture Benchmark9
  • Global Nutrition Report's (GNR's) Nutrition Accountability Framework10
  • SASB Standards for Meat, Poultry & Dairy11
  • Sustainable Dairy Partnership12

Several frameworks were not available at the time this article was written including the UN FSS Stock Take; SBTi's sector guidance for Forest, Land and Agriculture, and Global Reporting Initiative's Sector Standard Project for Agriculture; and Aquaculture and Fishing.

The audit revealed a good showing of nutrition/health metrics within the third-party frameworks, compared with the other domains of sustainable food systems (95 metrics for nutrition/health, 67 for environment, 56 for economic, and 55 for social). However, if Access to Nutrition Index was removed, the results are starkly different, with the focus on nutrition cut by a third: 36 metrics for nutrition/health, 61 remained for the environment, 47 for economic, and 48 for social. This demonstrates a clear focus on the environment across the majority of third-party frameworks and indicates an opportunity for more balance across the nutrition/health, social, and economic domains—and nutrition/health in particular as it lags behind most significantly (Figure 1).

Domains of sustainable food systems.

As illustrated in Figure 2, WBA's Food and Agriculture Benchmark and Countdown to 2030 are the most balanced in their approach to the distribution of metrics across all 4 domains. Access to Nutrition Index and GNR's Nutrition Accountability Framework are entirely focused on nutrition/health.

Areas of emphasis within published sustainability frameworks. After categorizing the metrics and indicators (M&I) within existing sustainability frameworks by topic and domain,1 as shown in Figure 1, we calculated the number of M&I within each framework that ladder up to the 4 domains. The results of this exercise depict the relative area(s) of emphasis within each framework.

We recognize that the associated impact of each M&I will vary, and simply achieving an even distribution of metrics across the 4 domains does not translate to a balanced, standardized approach to food system measurement. However, establishing more consistent and quantitative measures across the 4 domains is a critically important step in addressing the challenge of sustainable food system transformation and would be useful to inform models that evaluate the tradeoffs across domains.13

To illustrate the importance of balance across the 4 domains of sustainable food systems, consider how protein diversification is addressed in various third-party frameworks. The Coller Farm Animal Investment Risk and Return Protein Producer Index7 tracks M&I focused on a shift from animal-source proteins to plant-based and laboratory-grown protein sources, as shown in Figure 3, but the model does not account for the nutritional tradeoffs that could arise in pursuit of these targets. Similarly, WBA's Food and Agriculture Benchmark9 assesses protein diversification as shown in Figure 4, but does not account for how the shift could impact protein quality, nutritional intake, and health outcomes.

Coller Farm Animal Investment Risk and Return (FAIRR) Protein Producer Index.7
World Benchmarking Alliance's (WBA's) Food and Agriculture Benchmark.9

Research Track II: Company Frameworks

In addition to auditing third-party frameworks, we assessed how private sector companies track their own contributions to healthy diets and sustainable food systems. Many companies' measurement and reporting structures align with 1 or more third-party frameworks.

To gain insight into current best practices, we selected a mix of retailers, consumer packaged goods companies, multinational corporations, and quick-service restaurants based on their market presence, involvement in the dairy category, and public commitment to sustainability-focused disclosure and actions:

  • ALDI14
  • Arla Foods15
  • Danone16
  • Fonterra17
  • McDonalds18
  • Nestlé19
  • Schwarz Group (parent of Lidl and Kaufland)20
  • Starbucks21
  • Unilever22
  • Walmart23

The company-level audit bore out that, consistent with several third-party frameworks, the private sector largely prioritizes the environmental domain with nutrition lagging behind, as shown in Figure 5. Across companies in the audit, there were 202 metrics related to the environment, compared with 84 for the nutrition/health domain, 45 for economic, and 75 for social.

Company commitments and metrics emphasize environmental domain. The company-level audit, which covered 10 of the most comprehensive and longstanding proprietary sustainability frameworks, bore out that the private sector largely prioritizes the environmental domain with nutrition/health lagging behind. Across companies in the audit, there were 202 metrics related to the environment, compared with 84 for the nutrition/health domain, 45 for economic, and 75 for social.

Specific to the nutrition/health domain, there is great variation in how companies measure their efforts. Figure 6 summarizes the most common types of nutrition commitments and associated metrics. Compared with the environmental domain, nutrition measures tend to be less quantitative and less consistent, indicating a key opportunity to develop a unifying set of M&I to guide companies in selling more nutrient-dense products and pursuing more meaningful health strategies.

Proprietary company nutrition commitments and metrics.

Working Toward Consistent Nutrition/Health M&I

Science-Based Targets Initiative plays a key role in driving consistent and quantitative metrics for the environmental domain, as all companies assessed have declared a science-based target—in addition to the more than 3000 companies and financial institutions that use SBTi to consistently measure and demonstrate progress toward reducing GHGs.24 No such equivalent exists for the other domains of sustainable food systems, but should be explored. The following M&I are suggestions for measures that could ultimately be refined and socialized using an SBTi-like approach so all stakeholders can work toward common nutrition/health goals as part of the overarching food system transformation movement.

Among the third-party frameworks assessed, Access to Nutrition Index, WBA's Food and Agriculture Benchmark, Countdown to 2030, and GNR's Nutrition Accountability Framework are strongest vis-à-vis nutrition/health metrics. Considering the nutrition/health M&I used by these third-party frameworks, in combination with those used by companies, we believe there is an opportunity to drive consistency in the use of metrics that track the indicators featured in Figure 7.

High-priority nutrition/health indicators and metrics.

Looking Within: Current US Dairy Sustainability Reporting

To fully understand the M&I landscape, the frameworks currently used by the US dairy industry were also audited. These include the following:

  • US Dairy Stewardship Commitment: annual reporting by processors and cooperatives representing 75% of US milk supply25
  • Dairy Sustainability Framework: aggregate reporting of sustainable practices globally; covers 30% of world milk supply8
  • US Dairy Sustainability Report: biannual progress report tracking efforts led by national industry organizations26
  • National Milk FARM (Farmers Assuring Responsible Management) Program: annual summary of animal care science and verification of dairy farmer adherence to guidelines27

While the US dairy industry frameworks were developed with a focus on environmental, social and economic metrics such as GHGs, animal care, and workforce development to align with the global discourse, nutrition/health has always been a key priority for dairy companies and dairy farmers. We are engaged in ongoing efforts to strengthen nutrition/health metrics, reporting, and commitments within these frameworks and commit to continue doing so in conjunction with this consensus-building effort.

Calling for Cohesive, Consistent, and Meaningful Nutrition/Health M&I

Global, regional, and local food system transformation is needed to ensure food is produced in nourishing, climate-resilient, and equitable ways. Although the environmental footprint of food production is critical and must be reduced, the food and agriculture sector cannot lose sight of opportunities to improve public health by improving access to and consumption of nutritious, culturally relevant, affordable foods that contribute to health-promoting dietary patterns. Developing and reporting against consistent, quantitative M&I that span all domains of sustainable food systems are an important step in working toward a unified aspiration for food system transformation. Holistic accounting will help ensure food systems serve both public health and planetary needs.

Much like the SBTi has rallied stakeholders around consistent environmental targets, global stakeholders committed to food system transformation will need to adopt a set of M&I focused on nutrition/health. To be successful, nutrition/health M&I must be measurable and evidence-based and accurately reflect benefits and harms to public nutrition and health. Another key consideration: farmers and those in the food industry deserve a respected and supported voice in discussions about M&I. As these stakeholders have significant responsibilities and resources to achieve collective goals, their voice at the table is essential, and they should be engaged as proactive collaborators.

While this perspective prioritizes the importance of accounting for nutrition and health in food system measurement, we recognize any holistic accounting of the food system must also account for social and economic considerations. Fostering an equitable and just food system is critically important to this discussion. We call for the institutionalization of nutrition/health M&I not to discount the environmental, social, and economic domains of the food system, but rather to demonstrate where the food system's potential to make an immediate, positive impact on society is clearly apparent.

    Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc.