Willett, W., et al., Food in the Anthropocene: the EAT-Lancet Commission on healthy diets from sustainable food systems. Lancet, 2019. 393(10170): p. 447-492

1. Poltekkes Kemenkes Semarang
Food in the Anthropocene
healthy diets from sustainable food
systems
Kun A Susiloretni

2. MK. Pendekatan Promosi Gizi
Sarjana Terapan Gizi dan Dietetik
Poltekkes Kemenkes Semarang
2

3. Contents
• Introduction
• Food, planet, and health
• Integrated agenda for food systems
• Safe operating space for food systems
• Section 1: Healthy diets
• What is a heathy diet?
• Uncertainty in estimates of a healthy diet
• Status of knowledge
• Dietary components
• Summary of evidence describing healthy diets
• Analyses of total diets: nutrient adequacy and mortality
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4. Contents
• Section 2: Sustainable food production
• Earth system perspective on sustainable food production
• Uncertainty in estimates of sustainable food production
• Climate change
• Freshwater use
• Nitrogen and phosphorus flows
• Biodiversity loss
• Land-system change
• Scientific targets and strategic directions for sustainable food
production
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5. Contents
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• Section 3: Achieving healthy diets from sustainable food
systems
• Environmental effects of foods
• Environmental effects of overall dietary patterns
• Scenarios for achieving healthy diets from sustainable food systems
• Section 4: Framework for a Great Food Transformation
• Lessons from past successful global transformations
• Five strategies for a Great Food Transformation
• Tools for a Great Food Transformation

6. SDGs
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7. Poltekkes Kemenkes Semarang 7
Gizi & SDG

8. Definitions
• Anthropocene: A geological epoch that is characterized by
humanity being the dominating driver of change on Earth.
• Boundaries: Thresholds set at the low end of the scientific
uncertainty range that serve as guides for decision makers on
acceptable levels of risk. Boundaries are baselines, unchanging,
and not time-bound
• Planetary boundaries: Nine boundaries, each representing a
system or process that is important for regulating and maintaining
stability of the planet. They define global biophysical limits that
humanity should operate within to ensure a stable and resilient Earth
system—ie, conditions that are necessary to foster prosperity for
future generations.
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9. Definitions
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• Earth system
Earth’s interacting physical, chemical, and biological processes
consisting of land, oceans, atmosphere, and poles, and includes
Earth’s natural cycles— ie, carbon, water, nitrogen, phosphorus,
and other cycles. Life, including human society, is an integral
part of the Earth system and affects these natural cycles.
• Food system
All elements and activities that relate to production, processing,
distribution, preparation, and consumption of food. This
Commission focuses on two endpoints of the global food
system; final consumption (healthy diets) and production
(sustainable food production).

10. Food, planet, and health
In the past 50 years unhealthy diets that are
• high in calories
• heavily-processed
• animal source foods
 increasing
• the burden of obesity and diet-related noncommunicable diseases,
• also contributing to environmental degradation
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11. Food, planet, and health
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Food production is the largest cause of global environmental change
• Agriculture occupies about 40% of global land
• food production is responsible for
• up to 30% of global greenhouse-gas emissions
• 70% of freshwater use.
• Overuse and misuse of nitrogen and phosphorus causes
• Eutrophication (water pollution caused by excessive plant nutrients)
• dead zones in lakes and coastal zones.
• Marine system:
• 60% of world fish stocks are fully fished
• more than 30% overfished

12. Food, planet, and health
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Faced with the challenge of feeding
about 10 billion people
a healthy and sustainable diet by 2050

13. Integrated agenda for food systems
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The Paris Agreement 2016, focused on
• climate change,
• also addresses the effects on human health.
• limiting global warming to well below 2°C, aiming for 1.5°C, is not
possible by only decarbonising the global energy system.
• Transitioning to food systems that can provide
• negative emissions (ie, function as a major carbon sink instead of a major
carbon source) and
• protecting carbon sinks in natural ecosystems are both required to reach this
goal.
• A revolutionary change in food systems to support human health
and environmental sustainability is essential to the Paris Agreement

14. Integrated agenda for food systems
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Lose-lose diets (ie, unhealthy and environmentally unsustainable),
characterised by
• high in calories, added sugars, saturated fats, processed foods, and red
meats
• environmental degradation exacerbate poor health
• Negative effects:
• premature deaths caused by poor air quality from biomass burning for agriculture
and land clearing
• reduced food security resulting from low yields due to changing climatic
conditions,
• diminished nutrient content of some crops due to rising atmospheric carbon
dioxide concentrations, and
• famine exacerbated by extreme weather events such as drought.

15. Safe operating space for food systems
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• Earth system
Earth’s interacting physical, chemical, and biological processes
consisting of land, oceans, atmosphere, and poles, and includes
Earth’s natural cycles— ie, carbon, water, nitrogen, phosphorus,
and other cycles. Life, including human society, is an integral
part of the Earth system and affects these natural cycles.
• Food system
All elements and activities that relate to production, processing,
distribution, preparation, and consumption of food. This
Commission focuses on two endpoints of the global food
system; final consumption (healthy diets) and production
(sustainable food production).

16. Safe operating space for food systems
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17. Poltekkes Kemenkes Semarang 17
PLANETARY
BOUNDARIES

18. Section 1: Healthy diets
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19. What is a heathy diet?
• Consuming 2500 kcal per day corresponds to the average energy
needs of a 70-kg man aged 30 years and a 60-kg woman aged 30
years whose level of physical activity is moderate to high.
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20. Referencedietintakesoffood
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What is a heathy diet?

21. Poltekkes Kemenkes Semarang 21
Diet gap between
dietary patterns in 2016
and reference diet intakes
of food
Diet gap
between
dietary
patterns in
2016 and
reference
diet intakes
of food

22. Analyses of total diets:
nutrient adequacy and mortality
1. a global comparative risk assessment framework
• High consumption of red meat (including beef, lamb, and
pork),
• low consumption of fruits, vegetables, legumes, nuts, and
fish, and being underweight, overweight, or obese
• endpoints  coronary heart disease, stroke, type-2
diabetes, site-specific cancers, and an aggregate of other
diseases
• adopting the reference diet could avoid about 11.1 million
deaths per year in 2030 and reduce premature mortality by
19%.
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23. Analyses of total diets:
nutrient adequacy and mortality
2. The Global Burden of Disease Collaborators
• Using a conceptually similar approach but different assumptions
and data sources
• Adoption of a diet similar to the reference diet would prevent 10.9
million deaths per year or 22.4% of adult deaths
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24. Analyses of total diets:
nutrient adequacy and mortality
3. The Alternative Healthy Eating Index 2010
• Using a conceptually similar approach but different assumptions and
data sources
• Adoption of a diet similar to the reference diet would prevent 10.9
million deaths per year or 22.4% of adult deaths
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25. MK. Pendekatan Promosi Gizi
Sarjana Terapan Gizi dan Dietetik
Poltekkes Kemenkes Semarang
25

26. Agenda
• Section 2: Sustainable food production
• Section 3: Achieving healthy diets from sustainable food
systems
• Section 4: Framework for a Great Food Transformation
. References:
• Willett, W., et al., Food in the Anthropocene: the EAT-Lancet
Commission on healthy diets from sustainable food systems.
Lancet, 2019. 393(10170): p. 447-492
• Dll ada pd masing2 slide
Notes:
• Kalau terlalu cepat atau lambat dapat disesuaikan dengan
setting di video anda
• PPT ada di sistem HELTI
Pertemuan 2
26

27. Sustainable food production
Section 2
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Willett, W., et al., Food in the Anthropocene: the EAT-Lancet Commission on healthy diets from sustainable food systems.
Lancet, 2019. 393(10170): p. 447-492.

28. Earth system perspective on sustainable food production
• develop and use sustainable food production practices
• Conservation agriculture - perlindungan
• Sustainable and ecological intensification,
• agroecological and diversified farming systems,
• precision agriculture, and
• organic farming
• focus on sustainability at the farm scale
• Improvement of soil carbon concentrations,
• reduction of nutrient leakage from fields, and
• enhanced efficiency of water use by crops
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29. Earth system perspective on sustainable food production
• The Anthropocene, pace and scale of local environmental
effects have grown exponentially since the mid-1950s
• Humans dominating drivers of change, and
• food production the largest source of environmental
degradation and has the greatest effect on the Earth system
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30. • At the field scale can be
• sistem tanpa kebocoran gizi ke air tanah dan sungai
(N&P)
• diangkut ke kota-kota atau pasar  polusi gizi sebagai
limbah makanan atau eutrofikasi yang tidak diolah
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Definitions: sustainable food production

31. Definitions: sustainable food production
• A universal definition
• harus menggunakan penilaian sistem terhadap dampak
lingkungan dari serangkaian parameter komprehensif di
berbagai skala:
• Emisi gas rumah kaca,
• penggunaan tanah dan air,
• aplikasi nitrogen dan fosfor,
• hilangnya keanekaragaman hayati, dan polusi bahan kimia dari
herbisida dan pestisida semakin banyak dinilai
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32. Climate change
Sistem produksi makanan penghasil gas rumah kaca
• Sawah2 meluas: melepaskan karbon dioksida tambahan
ketika hutan ditebangi, lahan basah dikeringkan, dan tanah
digarap
• Nitrous oxide
• 280 kali potensi pemanasan global karbon dioksida
• muncul dari mikroba tanah di lahan pertanian dan padang rumput
• dipengaruhi oleh manajemen kesuburan tanah: aplikasi pupuk
• Metana:
• 56 kali potensi pemanasan global
• diproduksi selama pencernaan pada ternak ruminansia: sapi dan
domba,
• diproduksi selama dekomposisi anaerobik bahan organik
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33. Poltekkes Kemenkes Semarang 33
Projections of
global
emissions to
keep global
warming to
well below 2°C,
aiming for
1·5°C

34. Status of emissions associated food production
• Metana dan dinitrogen oksida dari produksi pertanian  5,0-5,8 Gt
CO2 eq / tahun
• Emisi CO2 dari konversi ekosistem alami: hutan menjadi lahan
pertanian dan padang rumput  2,2–6,6 Gt CO2 eq / tahun
• jumlah kecil dari pembakaran biomassa  0,3 Gt CO2 eq / tahun
• mesin pertanian  pada 1,0 Gt CO2 eq / tahun
Sumbangan produksi makanan  8,5-13,7 Gt CO2 eq/th
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35. Freshwater use
Produksi makanan adalah sektor pengkonsumsi air terbesar di
dunia.
• 84% lahan yang ditanami menggunakan air tawar dari hujan,
• 16% menggunakan irigasi (yaitu air di danau, sungai, dan
akuifer air tawar)
• 70% dari semua penarikan air global digunakan untuk irigasi
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36. Freshwater use
• Water is the bloodstream of the biosphere
• Gerten et al offer a conservative global freshwater
planetary boundary of 2800 km3/year for all human use
• Consumptive water use
• all human activities 1800–2100 km3/year,
• food production uses  1400–1800 km3/year
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37. Penerapan N dan P yang berlebihan
dalam produksi pangan memiliki
konsekuensi substansial,
• Mengalir ke sungai dan sungai,
mendorong eutrofikasi ekosistem
air tawar dan laut
• Perkembangan selanjutnya dari
kondisi hipoksia (bebas oksigen)
yang menyebabkan ikan mati dan
kerusakan lingkungan lainnya
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Nitrogen and phosphorus flows

38. Nitrogen and phosphorus flows
Dampak lingkungan dan kesehatan lainnya:
• eutrofikasi ekosistem terestrial,
• mengurangi keanekaragaman hayati dan mengubah fungsi
ekosistem
• Pengasaman air dan tanah oleh emisi amonia;
• Emisi nitro oksida - gas rumah kaca yang potensial;
• kontaminasi air tanah oleh nitrat secara negatif mempengaruhi
kesehatan manusia;
• penciptaan oleh amonia dari partikel partikulat atmosferik yang baik
dan membahayakan kesehatan manusia
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39. Biodiversity loss
Biodiversity enhances ecosystem services necessary for human
wellbeing, including
• food production,
• pollination,
• pest control,
• heat regulation,
• carbon sinks, and
• moisture feedback for rainfall.
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40. Biodiversity
loss
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• 80% dari ancaman
kepunahan terhadap
spesies mamalia dan
burung disebabkan oleh
pertanian
• Biomassa serangga telah
berkurang sebesar 75%
dalam 30 tahun
• peternakan burung
sebesar 30% dalam 15
tahun

41. Biodiversity loss
Produksi makanan sebagai pendorong hilangnya keanekaragaman
hayati
• Hilangnya habitat daratan dan perairan,
• fragmentasi habitat,
• perubahan iklim,
• polusi kimia,
• spesies invasif, dan
• Panen spesies liar yang unsustainable telah diidentifikasi sebagai
pendorong utama
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42. Land-system change
• the net area for food production has remained constant since the
mid-20th century
• substantial reductions in agricultural land have occurred in
temperate regions of Europe, Russia, and North America,
• whereas substantial expansion of agricultural land has occurred in
biodiversity-rich tropics
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43. Land-system change
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• Food production is the largest driver of land use and land-use
change through clearing of forests and burning of biomass.
Between 2000 and 2014,
• Brazil lost on average 2·7 million ha/year of forest,
• the Democratic Republic of Congo lost 0·57 million ha/year with a
2·5 factor increase since 2011,
• Indonesia lost 1·3 million ha/year, with 40% occurring in primary
forest.

44. Half Earth strategy
Proposal untuk dapat menghentikan hilangnya keanekaragaman
hayati dan melestarikan setidaknya 80% kekayaan spesies
praindustri dengan melindungi 50% bumi yang tersisa sebagai
ekosistem yang utuh.
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45. Achieving healthy diets from
sustainable food systems
Section 3:
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46. Environmental effects of foods
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47. Environmental effects per serving of food produced
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48. Scenarios for achieving healthy diets from sustainable
food systems
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Dietary shift Reference (table 1);
• vegetarian: meat-based protein sources replaced by a mix of plant-based
proteins and fruits and vegetables (eggs and dairy consumed);
• vegan: all animal-based protein sources replaced by a mix of plant-based
proteins and fruits and vegetables (no eggs and dairy consumed);
• pescatarian: meat-based protein sources replaced by a mix of seafood
and fruits and vegetables (eggs and dairy consumed)
Improved
production
practice
(PROD)

49. Scenarios for achieving healthy diets from sustainable
food systems
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Dietary shift
• vegetarian: meat-based protein sources replaced by a mix of plant-
based proteins and fruits and vegetables (eggs and dairy
consumed);
• vegan: all animal-based protein sources replaced by a mix of plant-
based proteins and fruits and vegetables (no eggs and dairy
consumed);
• pescatarian: meat-based protein sources replaced by a mix of
seafood and fruits and vegetables (eggs and dairy consumed)

50. Scenarios for achieving healthy diets from sustainable
food systems
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Improved production practice (PROD)
• Standard level of ambition for improved food production practices
including closing of yield gaps between attained and attainable
yields to about 75%;
• rebalancing nitrogen and phosphorus fertilizer application between
over and under-applying regions;
• improving water management, including increasing basin efficiency,
storage capacity, and better utilization of rainwater; and
• implementation of agricultural mitigation options that are economic
at the projected social cost of carbon in 2050, including changes in
irrigation, cropping and fertilization that reduce methane and nitrous
oxide emissions

51. Scenarios for achieving healthy diets from sustainable
food systems
Improved production practice (PROD+)
• High level of ambition for improved food production
practices on top of PROD scenario, including additional
increases in agricultural yields that close yield gaps to 90%;
• a 30% increase in nitrogen use efficiency, and 50%
recycling rates of phosphorus; phase-out of first-generation
biofuels, and
• implementation of all available bottom-up options for
mitigating food-related greenhouse-gas emissions
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52. • Reduced food waste and loss (halve waste)
• Food losses and waste reduced by half, in line with
Sustainable Development Goals target
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Scenarios for achieving healthy diets from
sustainable food systems

53. Poltekkes Kemenkes Semarang 53
Scenarios for achieving healthy diets from
sustainable food systems
• Climate change
• Land-system change
• Freshwater use
• Nitrogen and phosphorus application
• Biodiversity

54. Poltekkes Kemenkes Semarang 54
Environmental
effects of overall
dietary patterns

55. Framework for a Great Food
Transformation
Section 4
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56. Five strategies for a Great Food Transformation
• Strategi satu: mencari komitmen internasional dan nasional untuk
beralih ke diet sehat
• Strategi dua: reorientasi prioritas pertanian dari memproduksi
makanan dalam jumlah besar ke memproduksi makanan sehat
• Strategi tiga: mengintensifkan produksi pangan secara
berkelanjutan, menghasilkan keluaran berkualitas tinggi
• Strategi empat: tata kelola lahan dan laut yang kuat dan
terkoordinasi
• Strategi lima: setidaknya membagi dua kehilangan dan
pemborosan makanan, sejalan dengan SDG global
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57. Five strategies for a Great Food Transformation
Strategi satu: mencari komitmen internasional dan nasional untuk
beralih ke diet sehat
1. meningkatkan ketersediaan dan akses ke diet sehat dari sistem
pangan berkelanjutan
2. diet sehat dari sistem pangan berkelanjutan harus terjangkau
3. upaya baru oleh pemerintah, industri, dan masyarakat diperlukan
• untuk membatasi iklan dan pemasaran makanan yang tidak sehat dan tidak
berkelanjutan,
• untuk mendukung diskriminasi positif diet sehat dari sistem pangan
berkelanjutan.
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58. Five strategies for a Great Food Transformation
Strategi satu: mencari komitmen internasional dan nasional untuk
beralih ke diet sehat
4. individu harus dididik tentang diet sehat dari sistem pangan
berkelanjutan
5. diet berkelanjutan yang rasanya enak dan sesuai secara budaya
harus dipromosikan
6. dokter dan pekerja layanan kesehatan dapat terlibat dengan
industri lain untuk mendesain ulang penyediaan makanan publik,
seperti makanan sekolah dan rumah sakit, dan memberi saran
kepada industri makanan -food service industries
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59. Ten Critical Transitions (CT) to
Transform Food and Land Use
CT 1. Promoting Healthy Diets
CT 2. Scaling Productive and Regenerative Agriculture
CT 3. Protecting and Restoring Nature
CT 4. Securing a Healthy and Productive Ocean
CT 5. Investing in Diversified Sources of Protein
CT 6. Reducing Food Loss and Waste
CT 7. Building Local Loops and Linkages
CT 8. Harnessing the Digital Revolution
CT 9. Delivering Stronger Rural Livelihoods
CT 10. Improving Gender Equality and Accelerating the
Demographic Transition
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60. Ten Critical Transitions (CT) to
Transform Food and Land Use
Ct 1. Mempromosikan pola makan sehat
Ct 2. Scale pertanian produktif dan regeneratif
Ct 3. Melindungi dan memulihkan alam
Ct 4. Mengamankan lautan yang sehat dan produktif
Ct 5. Berinvestasi dalam diversifikasi sumber protein
Ct 6. Mengurangi kehilangan makanan dan limbah
Ct 7. Membangun perputaran (loops) dan hubungan lokal
Ct 8. Memanfaatkan revolusi digital
Ct 9. Memberikan penghidupan pedesaan yang lebih kuat
Ct 10. Meningkatkan kesetaraan gender dan mempercepat transisi
demografis
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