Can eating dinner make you healthier, save the planet, and help people in Mozambique?

A Review of Can Fixing Dinner Fix the Planet? by Jessica Fanzo, PhD (published 2021 by Johns Hopkins University Press)

(I started out to write this as a book review in which I would briefly touch on the book’s content and the author’s point of view and then critique the good and disappointing parts of the book and recommend who might most benefit from reading it.  I ended up writing more of a book commentary in which I incorporated some of my own ideas into a detailed description of this rather excellent book.  Then it got rather long.  So, my apologies to Dr. Fanzo, the author, for taking advantage of her text to express my own views.  It’s good we agree so much.)

An article I read recently recommended this book and since it fell in my sweet spot of professional interests. I thought I would review it and possibly recommend it to my blog friends. So, in short, I do recommend it and in short, we can help fix the planet by what we fix for dinner.

But before getting to that, I want to step back a bit and address a larger question that has been bothering me and really applies here.  The implication of this book is that we ought to change what we eat at our own dinner tables to help people halfway around the world.  Why should we do that?  What is this called, this idea that we somehow owe it to society to pitch in on these big social problems?  Well, I looked, and I have found a phrase for this; it is called Social Responsibility.  This is the idea that we somehow owe it to the larger society around us, however that gets defined, to pitch in and do our part for the whole.  We don’t get much back from this individually except a better functioning society to live in and a warm feeling that we have helped somewhat.  It sounds vaguely like an echo of that familiar saying, “Do unto others as you would have done unto you.”

Now based on your own political leanings or religious likings, you, my dear reader, may have a range of willingness to contribute to this Responsibility.  But interestingly, we are all already doing a considerable amount of this social contribution and may not realize it.  For example, do you recycle your plastics and glass; do you vote; do you donate to a charity; do you and your children get vaccinated; do you pay taxes, abide by the rules of your HOA?  Do you know anyone who has served in the armed forces?  All of these are forms of social responsibility.  You are often giving back to society more than you yourself are benefitting.

Now, we are about to talk about a book that is going to suggest a new form of social responsibility, that what we eat may have social consequences that we should consider.  Interestingly, we will see that what we choose to feed our families has three interlocking effects.  What’s on our dinner table affects our own family’s health, the health of the planet, and the availability of food for others.  And most encouragingly, for the most part, changing our diets in one direction can benefit all three at once.

And now to the book.

Can Fixing Dinner Fix the Planet? is by Dr. Jessica Fanzo, a professor at Johns Hopkins University and an expert in global nutrition.  She has vast experience in health and diet in many countries including the US.  She has done a masterful job of bringing a huge and complex set of interlocking problems to an understandable level for a lay audience.  The book has only five chapters in 188 pages.  The first chapter covers the scope of problems we face as a society. She states, 

“The foods we eat are much more than just a source of sustenance.  They have direct and substantial impacts on the nutrition and health of individuals and populations, the planet’s natural resources and climate change, and structural equity and social justice challenges of societies. Food connects us to the world.  It also dictates, to a degree most people don’t realize, the kind of world we live in today and the kind of world we will occupy in the future. —- Without drastically altering course, we’ll soon struggle to feed, shelter, and treat our growing human population, some of that behavior centers around our diets and what’s on our dinner plate.”

In the second chapter, Dr. Fanzo draws from her long experience in poorer countries to explain the causes and effects of malnutrition. She brings a wealth of important and pertinent facts and statistics to bear on food insecurity both at home and abroad.  She explains the complexity of the problem, “Poverty both causes and results in food insecurity. — Malnutrition harms a person’s ability to earn a living, creating a vicious cycle between poverty and malnutrition.”  This leads to a paradoxical “double burden” of both malnutrition and obesity in the same communities and even the same families.  “Empty calorie diets that either lack variety [think poorer countries] or rely on highly processed foods [think US] can cause weight gain without providing nourishment.”  Much of this can be blamed on the increased availability of ultra-processed foods in supermarkets.  In 1990 about 15% of folks in Latin America shopped in supermarkets; only 10 years later, with increased urbanization, that had risen to almost 60%, with a concurrent rise in obesity.

Malnutrition is compounded by poor access to clean water, contaminated foods, micronutrient deficiencies, and childhood diseases like diarrhea and pneumonia.  Dr. Fanzo concludes, “Without healthy humans, there can’t be a healthy planet, and with poor planet health there will be poor human health.”  All of this will be complicated by climate change, depletion of aquafers, depletion of fisheries, erosion of arable land, urbanization, increased resistance to pesticides, and increasing trade tariffs.

Do you think about the ethics of what is on your dinner table?  Until I read this book, I didn’t.  Many actions we take in life are a balance between the privilege of certain freedoms we have and the ethical responsibilities we bear.  I have the privilege to water my lawn all I want.  But in a drought, I might want to consider the responsibility I bear to my neighbors for the water I use that would not be available to them.  I may have the privilege of playing Death By Decibels all night long, but do I bear some responsibility to my neighbor’s children for my habit?  If I eat beef every dinner seven days a week since I can afford it, who bears the costs that I may not see, and do I owe anything to them?  That is essentially the question of Chapter 3 of the book. “We need to collectively grapple with and resolve these issues if we want to ensure that everyone has equitable access to healthy and sustainable diets. — On the global balance sheet, what do wealthy nations “owe” impoverished nations that struggle to grow food because of climate change caused largely by the actions of industrialized nations and multinational corporations?”

Serious food insecurity affects about a billion people worldwide.  This varies from year to year depending on trade and crops and weather.  These folks are spending about 50-80% of their entire income on food and very poor quality food at that.  They are faced with global trade forces they can’t control, and climate changes and local conflicts that make daily meals a constant worry.

And that brings us to meat, really a central ethical issue on our plates, dinner plates that is.  Dr. Fanzo reminds us that the average American consumes 40 times more meat than the average citizen of Bangladesh.  Meat consumption worldwide has quadrupled in the last 80 years and still growing rapidly, especially in middle income countries.  This is one of those privileges that we described above.  Unfortunately, meat comes with costs that we don’t see in the supermarket.  While ruminants (mostly cows) can be raised on pastureland, only about 1/3 worldwide are and almost none in the US.  Beef comes at an enormous environmental cost.  It takes up to 30 pounds of grain to get a pound of beef.  Other meats, including pork and poultry are more efficient.  This is grain and land that could be used for human food directly.  You may have heard about “cow farts” and how they contribute to greenhouse gases.  A true fact, except that it is actually cow burps.  About 40% of all greenhouse emissions related to the livestock industry come from this source.

One of the pleasures of this book is being introduced to new concepts and vocabulary.  In economic terms an externality is the cost of something that is not included in the price one pays.  Since much of the corn and soy that is grown in our midwest goes to raising our T-bones and sirloins, it does not go to the global market; thus, small households in Latin America are paying more for their tortillas and vegetable (soybean) oil.  We are also experiencing climate change at an alarming rate in part due to millions of cows and their burps.  Other foods that could be grown in those midwest fields are not being grown (think other grains and other healthier fruits and vegetables). So those costs are higher than they need to be.  Since corn and soy require so much fertilizer that runs into the Mississippi River, we have an anoxic zone, a dead zone, in the Gulf of Mexico where nothing lives that can be fished.  We also have enormous, concentrated animal feeding operations (CAFOs) that fatten up cattle for market.  These create clouds of stench and dust and probably resistant bacteria strains. None of this is on the price tag in the store but someone is paying for it, one way or another.

There is a solution.  It has been estimated that the world would only need to decrease animal consumption by 30% to meet global greenhouse goals.  This is a complex issue covered recently by a carefully researched article in The Atlantic that concluded that we don’t all have to become vegans.  A lot depends on big changes that can be made to the livestock industry.  However, what is very clear is that by eating less beef, we can embrace our social responsibility for a number of global problems at once: global warming, world hunger, ocean dead zone, and better health.

Gosh, I forgot to mention that part about better health.  Less red meat including beef is healthier.  So less red meat means that I can benefit while the world (climate, oceans, crops, poor countries) also benefits.  That’s called a win-win-win-win-win.  An interesting research article just came out in ATVB that found that meat consumption hurts us in a whole new way.  We all know that cholesterol and high blood pressure can kill you.  This article found that besides these, meat contributes a new chemical, synthesized in our gut from meat ingredients, that gets in our blood and contributes to heart disease and stroke.  Other research has previously shown how red meat also contributes to diabetes risk.

So, in answer to the title question, can fixing dinner fix the planet?  The first and most important answer is less red meat on the dinner menu, especially a lot less beef.

Chapters 4 and 5 address solutions.  Chapter 4 addresses policy solutions and chapter 5 solutions by individuals.  Admittedly, due to the nature of public policy, Chapter 4 is a bit of a dry read.  The complexities of effective public policies make this a difficult arena in which to work but also a place that many millions of folks can be affected at once.  Another new concept that Dr. Fanzo introduced to me in this book is the food system.  This is the enormous enterprise that brings us food.  It starts with the folks who create new seed varieties, then to all the supplier of other goods for farmers, then to agriculture itself, then to the processors, storers and movers of foods, then to the retailers of raw, processed, and cooked foods, then to us at home.  But don’t forget the advertisers, trade unions, packagers, and other groups involved.  And each of these groups has a firm on K Street in Washington pushing their own special interests.  Now throw in the rest of the world and their interconnecting food systems and we have a behemoth that is almost unmovable. Now try to control this with 230 different national and territorial governments and you see the scope of the problem.  And if we have a policy to control an aspect of foods for health purposes alone, will it be equitable to Manhattanites and also villagers in Botswana?  Will it have unforeseen environmental impacts in northern Pakistan?  Will it cross the religious sensitivities of Buddhists in Vietnam?  Will any of a hundred special interest groups complain?

An interesting example are the incentives placed by the US government to make ethanol for fuel from corn.  Due to these incentives, a thriving ethanol-from-corn industry has developed.  The US corn crop has grown by about a third and about a third of that crop now goes to ethanol.  As a fuel, this process is barely energy efficient, with about 1.5 units of energy generated for each unit of energy invested.  By comparison, for gasoline the ratio is 11.  The price of corn has also tripled and partially blamed for the spike in food prices in 2007-2008 and the continued rise since then.  Also, much land that was used for other crops or was environmentally sensitive is now growing corn.  So, one policy change for apparently good environmental reasons at the time has helped only marginally.  It is also negatively affecting food prices and the environment all at the expense of US taxpayers.

What policies then might be both healthy for people and the planet?  Another fine word in Dr. Fanzo’s vocabulary list is a “nudge.”  These are rather modest policy changes that move the behaviors of constituents to be healthier without them hardly noticing.  One nudge that has been used in some US cities is a tax on sugary beverages, just a few cents per bottle.  Will this prevent all obesity and diabetes?  No, but when combined with other nudges it will move things in the right direction.  One nudge that I would favor would be to fund the reclamation of the Gulf of Mexico dead zone with a fee on fertilizers.  This would be passed on the farmers and on the beef producers and on the beef buyers.  It would address an externality with a nudge into the food system.  There now, I have used all three of our new vocabulary words in one sentence. 

While I have agreed with most everything that Dr. Fanzo has written, one question kept coming up in this chapter in particular.  Dr. Fanzo has great reverence for the small family farmer, in the US and especially in poorer countries.  She championed policies that tended to protect this way of life.  While I admire this, I found myself asking why that was necessary.  Certainly, I would not favor violent or destructive means of forcibly ending family farming.  However, when I look over the span of human history, I see many people moving and changing jobs and locations in response to changes in technologies and policies.  Every single one of us Americans (I could also include Canadians, Australians, and New Zealanders) who are not First Nation natives, can attest to this trend.  Also, if we are asking livestock ranchers in the US to change jobs and grow less beef, then can we not expect improved technology in Uganda to displace family farmers?

One major problem to also consider is that healthy food is expensive.  The USDA puts out a wonderful guide on what a healthy diet should consist of.  One simple problem, the healthiest food aisle in the grocery store is the most expensive aisle, the produce aisle.  The cheapest and healthiest food in the store is a bag of dried beans on the bottom shelf of aisle 4.  The second healthiest is a big jar of peanut butter. (Well, that may not be exactly true, but it is nutrient dense, and I really like peanut butter.)  Also, we need to remember that not one size fits all especially in Zimbabwe.  We do rightfully recommend less red meat to Americans, but a little more meat, up from almost none, might be the best thing for parts of rural Zimbabwe.

Dr. Fanzo spends a lot of time in this chapter describing her work with the EAT-Lancet Commission Report on Food, Planet, and Health.  This group published a monumental report in Lancet in 2019 on just this very topic of how to create a diet that is healthy, provides food for everyone, and also saves the planet.  It is a highly controversial report with push back from almost every special interest group you can imagine.  However, it moved forward the very important conversation of how we feed a growing population and save the planet at the same time.  They even provided a graphic of a dinner plate for how individuals should eat.  As you might suspect, about half the plate was fruits and vegetables, a quarter was whole grains, and the rest was proteins from sources that were safe for the planet.  She acknowledged that “nearly 1.6 billion people don’t have the financial means to follow the Planetary Health Diet” and that it “does not account for cultural differences in diets around the world.”  But it is a good start.

So public policy is tough but an important part of changing the way we eat and prepare for the future.

Chapter 5 is where it comes to our own dinner tables. Dr. Fanzo starts by assuring us that there is no one single healthy diet.  Here are her three rules. “First, we need to reduce the over consumption of calories.  Second, we need to avoid unhealthy, highly processed foods.  Third, [Americans] need to reduce their consumption of animal source foods, beef in particular.”  One of my favorite and famous quotes from Michael Pollan sums this up more succinctly from his book In Defense of Food. “Eat [whole] foods, not too much, mostly from plants.”

Thinking more globally, Dr. Fanzo continues, “When health and sustainability align, choices become easier.  If beef consumption in high-consuming countries declined to about 50 calories a day, it would nearly eliminate the need for additional agricultural expansion and associated deforestation.”  So, what does 50 calories of beef look like?  Using 90% lean ground beef as an example, that would be about 1 ounce per day or one juicy half pound steak per week.  If we all shifted to a vegetarian diet, greenhouse gases would decrease by about a quarter.  The Mediterranean diet is also a good alternative.

When I taught Global Nutrition to college students, I would ask them in one class what they had for breakfast and then ask how much thought they put into those choices.  Of course, breakfast is the meal that we think least about.  We are often half asleep and on autopilot.  Of the three or four things we usually have, we pick one and go with it.  But if we back off a bit and consider what people eat for breakfast around the world, we will realize that we are severely bound by culture and habit and family traditions and cost and time and creativity to a very limited breakfast menu.

Our food consciousness (another new concept from the book) is very limited at breakfast time.  How much thought do we put into the food choices we make?  Our choices are partially limited by our food literacy, another new concept.  How broad is our actual knowledge of foods, where to get them and how to prepare them?  As we walk through the grocery store the usual questions that we ask ourselves are about the cost of foods, our preference for foods based on past experience, and the convenience of foods.  But what if we also asked about our health and the sustainability of foods?  What if we were willing to broaden our food literacy with a new brand or new food?  Could we just cast our eyes to the bottom shelves and see new things like bags of beans.  How about ground turkey instead of ground beef?  What if we worried more about food waste, especially with the fresh produce we buy?  Will I really use a whole 3 lb. bag of apples before they are too soft for my taste?

This is where Dr. Fanzo is taking us, to a more deliberate and thoughtful choice of foods, to a wider consideration of issues as we make our way through the grocery store and prepare dinner.  When you see that pound of ground beef, you should see the 30 pounds of grain that went into making it.  Then compare that to the 2-3 pounds of grain for the chicken breast in the same cooler. Also see the CAFO where the cattle were raised and the dead zone it created.  Yes, a pound of chickpeas takes longer to cook and is outside your experience. However, it has about the same amount of protein as the ground beef.  Chickpeas also goes a small way to lower the price of grain halfway around the world and also to lower carbon emissions and is also better for your health.  Here is where our social responsibility about our dinner plates starts.  We can win for our family’s health at the same time that we win for the planet and our global neighbors.

Back to the premise of the book:  What’s on our dinner table affects our own family’s health, the health of the planet, and the availability of food for others.  And most encouragingly, for the most part, changing our diets in one direction can benefit all three at once. Dr. Fanzo is suggesting that simply decreasing the amount of red meat we eat, we can increase our own health by decreasing heart and stroke risk, increase the health of the planet by decreasing greenhouse gases that contribute to global warming, and provide more food for others by decreasing the amount of feed and water necessary for animal growth. As socially responsible citizens of this planet, this can be an easy start.