Farming for Health. Agriculture & Human Health United: a Global Imperative

Ross M. Welch USDA-ARS U.S. Plant, Soil and Nutrition Laboratory Cornell University

Annually, What Global Risk Factor is Responsible for Causing the Most Human Deaths?

A.

Unsafe sex (HIV-AIDs, etc.)

B.

Unsafe water, sanitation, hygiene

C.

War and genocide

D.

Terrorism

E.

Malnutrition

Malnutrition -

will be responsible for 3,000 deaths globally, mostly women, infants and children,

during this lecture

!

•

Globally, one in three people are malnourished

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This global crisis is happening now!

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These deaths are preventable!

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What is the root cause of these deaths?

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What can we do to prevent them from happening in a sustainable way?

Some Major World Risk Factors Causing Deaths Some WHO Major Risk Factors Causing World Deaths in 2000 Occupational safety Unsafe water, sanitation, hygiene Alcohol Unsafe sex Tobacco Malnutrition

0 5,000 30,000 35,000 10,000 15,000 20,000

Number of Deaths (X1000)

(World Health Report, 2002) 25,000

Malnutrition accounts of ≈ 30 million deaths per year (about 1 death per second)

Why Does Agriculture Exist?

• • • • •

To produce food and fiber and provide livelihoods to farmers and profits to the agricultural and food industries alone?

Why do we need “food”? – Nutrients!

Agriculture is the primary source of all essential nutrients required for human life! Farmers are nutrient providers!

If food systems, based in agriculture, cannot provide all the essential nutrients in adequate quantities to sustain human life during all seasons, diseases ensue, societies suffer and development efforts stagnate.

Death

Figure from WHO, 2000

Agricultural technologies can be directed at improving the “healthiness” of foods to meet human needs, but this require the use of

Holistic Food System Perspectives to Assure Sustainable Impact

Holistic Food Systems Model

Food Systems, Diet and Disease

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Global food systems are failing to provide adequate quantities of essential nutrients and other factors needed for good health, productivity and well being for vast numbers of people in many developing nations.

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Green revolution cropping systems have resulted in reduced food crop diversity and decreased availability of many trace elements & micronutrients.

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Nutrition transitions (double burden of malnutrition) are causing increased rates of chronic diseases (e.g., obesity, cancer, heart disease, stroke, diabetes, osteoporosis) in many nations.

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Holistic, sustainable improvements in the entire food system are required to solve the massive problem of malnutrition and increasing chronic disease rates in developed and developing countries.

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Agricultural systems are a major factor affecting human health

Global Food Systems’ Problems

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Agriculture’s primary focus has been on production alone, with little concern for nutritional or health-

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promoting qualities of products. Nutritionists tend to emphasize unsustainable medical approaches to solve malnutrition problems

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supplements

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food fortificants

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Simplistic views are the norm – looking for “silver bullet” approaches for solutions

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Agriculture and human health have never been generally recognized as closely linked disciplines

The Known 51 Essential Nutrients for Sustaining Human Life * Air, Water & Energy (3) Protein (amino acids) (9) Lipids-Fat (fatty acids) (2) Macro Minerals (7) Trace Elements (17) Vitamins (13) Oxygen Water Carbohydrates Histidine Isoleucine Leucine Lysine Methionine Phenylalanine Threonine Tryptophan Valine Linoleic acid Linolenic acid Na K Ca Mg S P Cl Fe Zn Cu Mn I F Se Mo Co (in B 12 ) B Ni Cr V Si As Li Sn A D E K C (Ascorbic acid) B 1 (Thiamin) B 2 (Riboflavin) B 3 (Niacin) B 5 (Pantothenic acid) B 6 (Pyroxidine) B 7 /H (Biotin) B 9 (Folic acid, folacin) B 12 (Cobalamin) *Numerous other beneficial substances in foods are also known to contribute to good health.

Zinc Deficiency

The Ugly Face of “Hidden Hunger”

Iron Deficiency Vitamin A Deficiency Iodine Deficiency Ca Deficiency Rickets

Micronutrient malnutrition Causes.…

• • • • •

More severe illness More infant and maternal deaths Lower cognitive development Stunted growth Lower work productivity

• •

And ultimately Lower GDP, e.g. an estimated >5% annual loss in Pakistan Higher population growth rates

Global Micronutrient Deficiencies

(Map from USAID)

> 3 billion people afflicted

Prevalence of Vitamin A Deficiency

> 200 million children affected

Map from WHO

Other Malnutrition Problems

Se deficiencies Scurvy (vitamin C) Beriberi (thiamine/B 1 ) Rickets (both vitamin D & Ca deficiencies) Pernicious Anemia (cobalamine/B 12 ) Folic acid

Change in Prevalence of Iron Deficiency Globally 70 60 50 40 30 20 10 0 1960 1990 2000 Year

Data from WHO, 2002

Dietary Iron Density and % Anemic Women in S. Asia

7.0

100 South Asia 90 6.5

Dietary Iron Density

80 6.0

70 5.5

60

% Anemic Women

5.0

1970 1972 1974 1976 1978 1980 1982 1984 1986 1988

Year

50

Most Important Food Crops Globally rice + wheat + maize = 56%

Historical Trends in Iron, Zinc & Selenium in Grain of Hard Red Winter Wheat Varieties in USA (1873 to 2000) (From Garvin et al., J. Sci. Food Agr. 2006)

Comparative Nutritional Quality of Fonio to White Rice



Very high biological value of protein; rich in methionine and cystine



Rich in minerals



One of the world's best tasting cereals



World's fastest maturing cereal

>1000 >650 >1000 Data from National Research Council, NAS, 1996

% Changes in Cereal & Pulse Production & in Populations Between 1965 & 1999 250 200 Cereal Production Pulse Production Population 250 200 150 150 100 50 0 100 50 0

(FAO data, 1999)

Percent of People in USA Not Eating Adequate Intakes of Various Nutrients Riboflavin Niacin Se Fe Thiamin P Cu Folate Zn Vitamin B6 Vitamin C Vitamin A Mg Vitamin E 3 3 3 5 5 5 5 8 12 14 0 31 44 56 20 40 60 Inadequate Intakes < EAR (% ) 80 93 100 Moshfegh et al., NHANES 2001 2002.

Food Guide Pyramid

Changes Needed in U.S. Agriculture to Meet Dietary Guidelines

From Quantity to Quality

• • • • • •

Agriculture is no longer driven only by supply-side forces and stimulus of support policies (commodity agriculture) Now becoming demand-driven controlled by consumer food preferences These demands seek distinctive elements of food value Quality characteristics of foods can be fostered by farmers Profitable farms will shift form raw material producers to become genuine producers of “food” capturing some of the final value of the products consumed

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(e.g., Gerard’s Bakery, Mountain View Harvest Cooperative) “Quality agriculture” is the future of sustainable farms from an economic prospective

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e.g., high-selenium durum wheat grain

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e.g., packaged lettuce (1989 - $18 million; 2003 - $2.1 billion at the same production level).

(J. McInerney. 2002. The production of food: from quantity to quality. Proc. Nutr. Soc. 61: 273-279)

Table to Farm: A New Agriculture Paradigm (National Academy of Sciences Workshop - Exploring a vision: Integrating knowledge for food and health, 2003)

Rouse, T. I. & Davis, D. P. Exploring a vision: Integrating knowledge for food and health. A workshop summary. Board on Agriculture and Natural Resources, Division on Earth and Life Studies, National Research Council of the National Academies of Sciences. 1-88. 2004. Washington, D.C., The National Academies Press.

WHO Global Strategy on Diet, Physical Activity & Health 57 th World Health Assembly 2004 Agricultural policy and production have great effects on national diets (i.e., health).

Governments can influence agricultural production through many policy measures.

As emphasis on health increases and consumption patterns change, account in their Member States need to take healthy nutrition into agricultural policies .

International Obesity Task Force, Global Prevention Alliance (2006)

• • •

Nutrition criteria should be included in agricultural policy Agricultural policy should undergo health impact assessment Support should be provided for agricultural programs aimed at meeting WHO dietary guidelines

New 2006 Mandate for the Food & Agriculture Organization, UN

• •

Extended to encompass entire food chain – from farm to plate – food chain approaches Assistant Director-General, Louise Fresco

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“We are witnessing a ‘paradigm shift’ away from tonnes, calories and hectares towards issues of quality – quality of life, quality of environment, quality of nutrition”

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Puts improved nutrition & health goals into production agriculture goals

UNICEF & the Asian Development Bank – China (2006)

• • •

Agriculture forms the foundation for development of the food and nutrition industry globally Agricultural structural adjustments should be guided by nutritional science for better quality, safety and nutrition Include nutritional value as an important criterion to assess in agricultural production

Routs to Better Nutrition

(The World Bank) “… the HarvestPlus program is a promising initiative in which the international agricultural and research centers have begun to develop new breeds of staple foods that are rich in key vitamins and minerals using a new approach to fortification termed biofortification.” The World Bank, Directions in Development. Repositioning Nutrition as Central to Development.

A strategy for large scale action (2006)

Copenhagen Consensus 2008 Challenges

• • • • • • • • • Air Pollution Conflicts Diseases Education Global Warming

Malnutrition and Hunger

Hunger”) (includes “Hidden Sanitation and Water Subsidies and Trade Barriers Terrorism Women and Development

Linking Agriculture to Human Health: The Norway Example

• • • •

Necessary policy reorientation was made to increase available micronutrient-rich foods within local food systems Implemented agricultural and food production policies in a national nutrition plan of action Provided economic incentives for producer and consumer in support of healthful diets Resulted in sustained improvement in life expectancy and a reduction in deaths from cardiovascular disease and other chronic diseases From: FAO/WHO. Vitamin and mineral requirements in human nutrition, 2 nd ed. 2004

Agricultural Approaches to "Healthier" Food Crops

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Field Site Selection – (e.g., soils high in Se, Zn, etc.)

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Agronomic Practices



macronutrient fertilizers

–

nitrogen, phosphorus, potassium, sulfur, calcium, magnesium

–

effects protein, fats, vitamins, antinutrients, etc.

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micronutrient & trace element fertilizers

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Zn, Se, Co, Ni, I, Mo, Li, Cl - effective in increasing amount in plant seeds and grains

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Fe, Cu, Mn, B, Cr, V, Si - not very effective in increasing seed or grain levels

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farming system (no-till, organic matter, soil amendments)

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Cropping systems – design to maximize nutrient output

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crop rotations - effects micronutrient content

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use nutrient-dense varieties of food crops (HarvestPlus)

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diversification – soil health and human health

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Utilize indigenous plant foods and diversify food systems

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Genetically modify food crops to improve nutrient output and the “healthiness” of crops from farming systems

HarvestPlus Biofortification Program Strategy

Develop micronutrient-dense staple crops using the best traditional breeding practices and modern biotechnology to achieve provitamin A, iron, and zinc concentrations that can have

measurable

effects on nutritional status of target populations

• • •

The Importance of Bioavailability

Bioavailable amount of a trace element in a meal, not the total amount, is the critical factor for human health Most staple plant foods (cereal grains and legume seeds) fed alone contain very low levels of bioavailable Fe (e.g., about 5%) because of the antinutrients they contain (phytate, polyphenols, etc.) Increasing the bioavailability of Fe from 5% to 30% would have the same effect as increasing total amounts of Fe in staples by 6 fold

Agriculture's Agenda For Better Health

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Make human health and well being an explicit goal of agricultural systems in addition to productivity & environmental goals

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Re-diversify cropping systems & design for maximum nutrient output

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Make more use of indigenous nutrient-dense edible plant species, small livestock, & fish

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Use agricultural practices (e.g., fertilizers) that increase the nutritionally improved & “healthy” crops output of farming systems. “Traceability” and guaranteed quality is a key to profits

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Breed for and select for nutrient-dense staple food crops having nutrient efficiencies

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Genetically modify food crops to increase nutritional & health

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promoting quality factors Redefine sustainable agriculture to include adequate nutrient output and “healthy foods” for healthy & productive lives

Sir Albert Howard

• • • “related subjects as agriculture, food, nutrition and health have become split up into innumerable rigid and self-contained little units, each in the hands of some group of specialists. The experts, as their studies become concentrated on smaller and smaller fragments, soon find themselves wasting their lives in learning more and more about less and less. The result is the confusion and chaos now such a feature of the work of experiment stations and teaching centers devoted to agriculture and gardening. Everywhere knowledge increases at the expense of understanding.

The remedy is to look at the whole field covered by crop production, animal husbandry, food, nutrition, and health as one related subject, and then to realize the great principle that the birthright of every crop, every animal, and every human being is health .” – March, 1945 In: Rodale, J.I. 1945. Pay Dirt, Farming & Gardening with Composts. Rodale Books, Inc., Emmaus, Penn. p. vii.

“Western civilisation is suffering from a subtle form of famine – a famine of quality.”– November, 1947

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What can you do?

Become informed Promote food-based system approaches to finding sustainable solutions to malnutrition Advocate for a food systems program at Cornell University and at other universities Tell a friend/student/colleague about the critical role agriculture plays in human health Advocate for more nutrition education in elementary schools, high schools & medical schools Advocate for close ties between nutrition and agriculture, agriculture and health, health and nutrition at all levels in global food systems Advocate to include human nutrition & health as part of sustainable agriculture goals