WHO Global Action Network on Nutrition Labeling:
6-7th February 2019 (Paris)
Taking action for better informed consumer choices in the Decade of Action on
Nutrition
Class 2 –
Combination of under-nutrition and obesity (with insufficient vitamin and mineral
nutrition) – double burden of malnutrition. Can’t divide people into those that
eat too little and those that eat too much, malnutrition is a multidimensional issue, most people are not eating right. Remarkable
convergence between the health movement and the environmental
movement
Different forms of malnutrition can be present throughout one’s life –
wasted/stunted children are more likely to develop obesity/hypertension later in
life, once exposed to an environment of excess caloric intake.
Need a comprehensive response to the challenges of nutrition:
 Poor water/sanitation
 Food system that is not providing the right nutrients to everybody
SDG 2: End hunger, achieve food security and improved nutrition and promote
sustainable agriculture
Countries asked to
make “SMART”
commitments during
this decade of action
on nutrition
Means of implementation: Action Networks
 Information coalitiosn of countries
 Advocate for the establishment of policies/legislation, allowing the
exchange of practices providing mutual support to accelerate
implementation
 Established at the request of one or more countries that have made formal
commitments and are prepared to implement policies
 Joint FAO/WHO Secretariat will disseminate action network information
 Nutrition Decade champions are frontrunners and lead by example
Specific Country Targets:
 Portugal  marketing foods to children
 Switzerland  reduction of sodium
 Norway  sustainable fisheries
 Chile  healthy food environments
 Nutrition labeling
 School food procurements
What is a HEALTHY DIET?
breastmilk
calories
protein
fat
carbohydrates
sugars
sodium
fruit n veg
Breastfeed exclusively for the first 6mo
and continuous breastfeeding until
2years old
Energy intake should balance energy
expenditure
Protein is needed in good quality and
adequate amounts to meet individual
needs according to factors such as
age, gender, and bodyweight
Keep total fat intake to less than 30%
of total energy intake, with a shift in fat
consumption away from saturated to
unsaturated fats, and towards the
elimination of industrial trans fats
Get most of the dietary energy from
carbohydrates, mainly as unrefined
complex carbohydrates
Limit intake of free sugars to less than
10% (or even less than 5%) of total
energy intake
Keep salt intake to less than 5g per day
Eat at least 400g (5 portions) of fruit
and vegetables a day
Class 3 – the modern political economy of food
With much of our global food system controlled by a handful of actors, what is the
new political economy of food and how do we promote health in this paradigm?
Include the complex and diverse relationships between private sector and policy
markers, including the concept of the commercial determinants of health and
disease
French Anti-Waste Law – no food waste allowed
Obligation for restaurants and bars to provide recyclable to-go containers
A subsistence economy:
 A growing population with underprivileged people
o 820 million people malnourished
o 2.4 billion people obese
o 2 billion people deficient on micro-nutrients
 Food Security
o Global food demand is expected to grow by 46% by 2050
 Food Waste and Food Aid
o 20kg food wasted/person/year (7kg unopened/still packaged);
global cost 12-20 billion euros (100-160 euros/person/year), 1/3 of
food wasted along supply chain
Class 4 – Guest: Prof Bernard Ruffieux Bernard.Ruffieux@grenoble-inp.fr
Econ food terms: Client Value, Willingness to Pay (WTP), Posted Price
All products in stores are presented as “ultimatums”
What is the unit you sell?  Ex. Michellin selling tires, OR selling kilometers
(safe kilometers). Ex. a Bar selling alcohol OR selling time (branded time)
Key Issues of Lecture:
 consumer (buyer) preferences and behavior (choice)
 information on the final market
 foresight (industry 4.0), business strategy and public regulation
Foresight – a glance at our possible desired future “out of the box”
Classical Economics
 based on homo Oeconomicus preferences and rationality
 Focus on Asymmetric Information (i.e. vs. monopoly power, externalities)
 Lesson: the need for “signals”  credible relevant information
 Public Regulation issue in this frame: “Nutrition Facts are crucial, FoPL is
useless”
Behavioral Economics
 Based on Homo Sapiens preferences and rationality (imported from
psychology)
 Focus on a sequential human response to information: exposure
(awareness), integration (understanding), valuation (assessment),
decision (purchase)
 Lesson: need for precisely designed information
 Dd???
Since the 18th century, we’ve lived four industrial revolutions:
1. Age of Adam Smith
2. Age of Fordism
3. Age of Toyotism
4. Age of Industry (4.)
1. Classical Economics Review
Market failures. We live in a market society; market is the first matching
institution between business and consumers. Public authorities should have
(good) reasons to interfere in the market exchanges between private agents
(B2B or B2C). Economics identifies a series of reasons for public regulation on
the market (i.e. asymmetric information, externalities (positive/negative) and
market power (monopoly, oligopoly, cartel))
Product design management follows business strategy:
 Value proposition: “A consumers target, a desire, a price”
 Profit – captured value – costs
Two Complementary Approaches of a product
 A Global View – An analytical view (“characteristics” or “attributes”)
 Food characteristics: price, hedonic, functional (e.g. convenience), brand,
production process, nutrition, impacts, etc
 Economics of Information: three types of characteristics (Search,
Experience, Credence)
Context of Classic Economics of Information
 Value and costs
Class 6 – EAT – Fabrice DeClerck
Norman Borlaug – maize and wheat
Background in agricultural and environmental studies, agronomist and ecologist
– working with Jessica Fanso (agriculture, environmental health and human
health)
Setting clear environmental targets, setting clear health targets as to the future of
public health, environmental health and agricultural policy
Health scientists and environmental scientists are starting to converge, exciting
time to pursue this fusion – pluri-disciplinary approaches
Columbia Univeristy – Jeff Sachs (an ecologists) on the millennial goals abt
hunger and health, transformative program for him and many others
Founded 6 years ago – founder brought together 50 ppl to figure out what we
know and what we don’t know about this relationship. EAT was formed as a
relationship between the STORM_ALLY foundation, Stockholm resilience center
and the welcome trust – one of the biggest donors globally in terms of public
hleaht and meidcla scietists
Science policy and business can have conversations around these challenges
and seek solutions, recognize that these challenges were environmental health,
human health and htat FOOD is a common theme
Stockholm Food Forum (annual event)
What is a shared vision in terms of where food needs to go? Can we create a
shared set of targets of aspirations for food addressing these multiple dimensions
Reocgnizing the scale of the problem – Yohan has been a visionary
Scale of human action on the environment has reached geological proportions –
there are consequences on a global scale, EAT wants to highlight its not just
climate consequences
Systems based interventions will be required if we’re going to address these
issues
We are not yet bending environmental curves
Ozone – 1960s, recognized planetary scale
When we look at other major environmental challenges, there is no sign of htat
curve bending – freshwater resources (ex. Capetown water shortage)
Can we bend the curve on biodiversity?
By 2020, can we bend the curve on CO2? 2017 we had a slight reduction
80% of freshwater resources go into food production, 80% of dead zones are
driven by agricultural production,
Feeding 7.5 billion people –
Lancet is seating the food system limits for the environmental boundaries, what
they don’t do is say how to do it! There are camps that are in agroecology,
camps in medical technology saying you should be using GMOs, other saying
other things, etc
Food systems failing the environment, we see the same thing when we talk about
health
3 forms of malnutrition are now spread rather globally – number of countries
facing burdens of malnutrition is becoming more complex
UNICEF used to have very targeted interventions, but now the challenges faced
by children globally are much more systemic, and UNICEF Is trying to take a
more food systems approach, you’re finding htat reflection ina growing number of
oganizations, increasingly they are being confronted with how are we dealing
with these systemic issues --- food, which should be a primary sources of wellbeing has become one of the sources of primary mortality. Food is failing on
health as well.
We need a systems based approach, how is food a unifying theme that tries to
address this. Then what is it about food systems change that
To what extent does diet have an impact on environment?
Can we define targets for health and sustainable goals for food production
systems ?
IFPRI - ??
Mixed policy people with environmental science, public health to try to get groups
that don’t typically speak to each other to try and tackle these issues.
Safe operating space for environment and health – if we exceed those, there are
societal consequences that we’ll pay for. What are those limits for food? And can
we bring food within those limits? Malleable part (white part of the oreo) – the
choices, what we produce, where we produce, gmo vs non, organic vs
conventional. This is the safe operating space, this is also the innovation space.
1. Define a healthy reference diet using the best available evidence
(controlled feeding studies, long-term cohort studies, randomized trials)
2. Define planetary boundaries for 6 key environmental systems and
processes (GHG, cropland use, water use, nitrogen, and phosphorus
application, extinction rate)
3. ?
4. ?
Health food production. What is a healthy diet?
 50% protective
 36% netural (refined grains, startches, potatoes)
 2% harmful – high fat, high sugar, high sodium
 12% PUFA
IHME – UNIVERISTY OF WASHINGTON
There might be a universal diet, but we need to differentiate pathways (based on
income level) to reaching that diet.
We’ve been tremendous on being able to provide enough calories for a global
diet. Can we produce enough food? YES. But is it the right food ?! Not even
close.
Focus? Quantity? Proportions?
Boston Medical Center  culinary prescriptions
Copenhagen kitchens  went from scissors to knives, from central kitchens to
school kitchens
Putting the staff in the kitchen 
Agro-diversity
Antibiotics, pesticides, plastics
fabrice@eatforum.org
5 strategies :
1. Seek international and national commitment to shift towards healthy diets,
food policy and agricultural policy are often antagonistic, agricultural targets
work in complete odds to env/health targets  can agricultural policy
become food policy ?!
 Paris “Strategie de Paris pour une alimentation durable”  producing within
a watershed
2. Reorient agricultural priorities from producing high quantities of food to
producing healthy food . network for 25 countries/40 cities/40 companies that
have agreed to challenge themselves with the EAT commission guidelines.
Create a safe space for the hard conversations . reorient food towards quality
rather than quantity
3. d
4. strong nad coordinated governnacen of land and oceans --
Class – PNNS: stakes, objectives
Objectives: why a national nutrition program in France? Which main strategies?
Some main actions: communication, nutria-score, reformulation
Why in France, a country proud of its gastronomy, there is a need to develop a
specific Programme since 2001?
Epidemiological transition away from infectious diseases with the help of magic
bullets, yes, but mostly SOAP!
Today we have chronic diseases, with a plethora of risk factors ranging from
lifestyle choices (i.e. smoking, diets, alcohol consumption, physical activities) to
environmental regulation. Individual perception plays a role here, freedom of
choice and autonomy are sacred, our diets are intertwined with our identities
Nutrition: food and physical activity: nutrients, foods, social, cultural, economic,
sensorial and cognitive determinants of food and physical activity behaviors.
Permanent evolutions
 The “way of life” des modes de vie (urbanism – work, hobbies –
communications)
 Food offer, purchase and food and physical activity behaviors
Development of the PNNS in France
 1998-1999: Rapport DGS (Hercberg & Basdevant) Objectifs nutritionnels
de santé publique pour la France
 1999-2000: Rapport du HCSP (Hercberg & Tallec): Pour une politique
nutritionnelle de sante publique: Enjeux et propositions
  Improve the health of the population by acting on Nutrition (food and
physical activity) one of its main determinants
 2001-2005: PNNS1
 2006-2010: PNNS2
 2011-2018: PNNS3 (+PO 2010-2013)
 2019-2023: PNNS4 (related SNSS, PNA, Feuille de route obésité)
Nutritional objectives SMAR: Sensitive, Measurables, Achievable, Realistic,
Time-bound
Within the social gradient, tendency of obesity rates to decrease as income
levels drop
Class
2007 – European strategy on nutrition overweight and obesity-related health
issues
The EU Platform activity and Health: representatives from the civil society
(ONG, scientists, economic actors) a forum for actors at European level who are
willing to commit themselves to engaging in concrete actions designed to contain
or reverse current trends.
The High Level Group on Nutrition and Physical Activity
 28 countries + Norway and Switzerland (+WHO) 2-4 meetings a year
It seeks European solutions to health issues related to obesity by:
 Giving an overview of the different national policies on nutrition and
physical activity;
 Helping public authorities to share their ideas and practices
 Improving communication between the public authorities and the
European platform on nutrition, physical activity and health.
2008 – European framework for national initiatives on the reduction of salt
intakes
2011 – European framework for specific nutrtients: calories, saturated fatty acids,
added sugars
2013 – European plan on childhood obesity prepared, set for 2014-2020.
Objective: halt the rise of obesity among children and adolescents (0-18 years
old) Suggest to MS 8 priority actions with operational objectives. MS are
encouraged to develop their own National plan of action.
1. Support a good start in life: increase the prevalence of breastfed
children, encourage pregnant women to have healthy eating habits and
regular physical activity
2. Promote healthier environments: especially in schools and nurseries,
promote the consumption of water and fresh fruits and vegetables at
school, make physical education more attractive to teenagers, educate
children about nutrition, physical activity at school
3. Facilitate the adoption of healthy behaviors: promote water
consumption, inform about portion sizes
4. Restrict communication and advertising: aimed at children, make
recommendations regarding food marketing on television, on the internet
and at events.
5. Inform and encourage families: promote the importance of time
together in a family or with friends, make nutritional information more
effective and understandable by all
6. Encourage the practice of physical activity: create urban
environments conducive to the daily practice of physical activities
7. Monitor and evaluate: harmonize school nutrition monitoring, health,
eating behaviors and physical activity levels of children, set up indicators
to evaluate the action plan.
8. Develop research: increasing financial support of national and
European research programs
European actions on Nutrition and Physical Activity ….


EU Council Resolution on health and nutrition (14 December 2000)
EU Council Conclusions on:
o Obesity (2002)
o Healthy lifestyle (2003)
o Promoting Heart Health (2004)
o Health in all policies (HiAP) (2006)
o Putting the EU strategy on nutrition, overweight and obesity-related
health issues into operation (2007)
o Action to reduce population salt intake for better health (2010)
o Innovative approaches for chronic diseases in public health and
healthcare systems (2010)
o Closing health gaps within the EU through concerted action to
promote healthy lifestyle behaviors (2011)
o Promoting health-enhancing physical activity (2012)
o Health Ageing across Lifecycle (2012)
o Recommendation on promoting health enhancing physical activity
across sector (2013)
o Nutrition and physical activity (2014)
o Improvement of food products (2016)
o Halt the rise of childhood overweight and obesity (2017)
o Healthy nutrition for children: the healthy future of Europe (2017)
Many research and intervention projects receive financial support form the
Commission: SALUS, HEPCOM, PoHeFa, EYTO, MOVE, FOOD, IMPALA,
PASEO, PREVACT, Healthy Children in Healthy Families, Obesity Governance
project, Community based Childhood Obesity, Econda Project, NOPA, COSI,
Toybox, Habeat, Healthy Eco Life Project, Equity action, Euro Hear II
JANPA organization
Class 11 – New Business Models (for prevention)
Dr. Hazel Wallace, Isabelle Grosmaitre, Sandrao Demaio
What is the role of innovation and social enterprise in driving a new wave of
health, prevention and promotion activities? What are tangible examples of
success, and what can be adapted or learnt from other sectors? Include role of
mixed-funding models and PPPs.
Catalyst – Danone
Role is to bring people together to best impact the lives of people, health of
people and health of the planet – businesses are playing a critical role, worked in
pharma, worked in health insurance, joined Danone 7 years ago b/c food is the
biggest challenge of the 21st century. Set up partnerships and collaborative
models. “Get the right people around the table.” Rebalance the unbalance.
A company the size of Danone can really change the landscape of the world.
Revolutionary thinking is needed to impact the world, need to bring new business
practices that will grow ….grow what? The business?
Need to act together, more about the skills and the attitude. The food generation
craving for change. Cannot talk about health and nutrition if we don’t consider the
health of the planet. Millennials are 1/3 of total consumption – looking for brands
that are doing good to the world
Strive to eliminate the trade off between economic
success and social progress.
B Corp  Certified B Corporations are businesses
that meet the highest standards of verified social and
environmental performance, public transparency, and
legal accountability to balance profit and purpose. B
Corps form a community of leaders and drive a global
movement of people using business as a force for
good.
Each time you eat and drink, you vote for the world
you want to live in.
A new food economy is being invented. Re-localization of the economy, big
companies are losing ground – in the last 5 years, big companies have lost 18
billion, whereas start ups and smaller companies are taking 46% of market
share. Issue with the mid-range businesses, smaller than Danone but bigger than
start-ups, who run a certain model and can’t afford a complete shake-up in the
name of sustainability, what are they supposed to do?
Danone wants to change the way they operate. Emmanuel Faber (Chairman &
CEO):
“People are changing the ways they eat and drink and the values they
attach to food. There is a growing expectation for integrity and
transparency, and for products that are grounded in local cultures. This is
the start of a revolution in food.”
Yogurt gives off 1.25kg of Co2 for every 1kg of yogurt produced. So Danone,
who are #1 in fresh dairy products and responsible for production of 27.8% of the
yogurt market share in the world, are creating a good deal of CO2.
Catalyzing collaborations. Example: Bill Gates. Embarking on a partnership with
Danone. Working with cities is important, because it can be difficult to forge
partnerships with countries.
A coalition of willing partners in service of the food revolution.
 setting up an Act Tank (vs. Think Tank)
Healthier hydration kids project:
fluid intakes survey  ‘mascot’ marketing campaign  business success and
healthy switch in kids’ drinking habits
Function in various sectors:
 Schools: teach children, teach staff, reward schools
 Stores: nudge & reward, healthier baskets, playful education, Danoners &
kids day
 Home: entertainment partnerships, connected hydration, home delivery
 Communities: farms visit, Danone nations cup, breakfast clubs, access
and support programs
Want to transform the system at scale. Beyond “license to operate” and beyond
“reputation” ? SDG provides an opportunity to transition from peripheral CSR
departments to new models where sustainability is actually integrated in the
company.
Generate profitable, sustainable growth. Growth nonetheless. You’re depending
on a consistent proliferation of the livestock industry, which we all know drives
emissions – energy use, land-use …. Largest slice of the pie when it comes to
food systems emissions …. Largest contributer of non-CO2 emissions, methane
roughly 30x more potent as a heat trapping gas due to enteric fermentation –
hilariously enough, cow burps
Carbon neutrality
As an aggregate buyer, how can they use their purchasing power to change
dietary behavior. Mayors are huge players in this game. Have their hands on the
biggest levers. … fortunate at the global stage.