 Hello everyone, welcome to this Meet the Pioneers of Nutrition and Food Science session. It is part of the Sustainability Pioneers series that showcases entrepreneurs and innovators tackling today's major challenges to achieve sustainable development goals. One of these many challenges centres around our food system and food security. This topic could not be more timely, not least because today marks the start of the UN Food Systems Summit, only the sixth to be ever held and the first to have its agenda shaped directly by an officially appointed scientific group. Obesity, malnutrition and antibiotic resistance as a result of intensive farming are all threats to the health of economies and societies in the years to come. How can the latest insights from biology, agriculture and nutrition science be turned into practical approaches to protect people's lives and to ensure their health and well-being? I am Magdalena Skipper, Editor-in-Chief of Nature, a weekly science journal and I am particularly excited to be moderating this session as Nature has been proud to support, vet and disseminate so much of the original research into the food system. With me to discuss these burning issues, I have Dr. Lamice Jomar who is a tenured associate professor at the Department of Nutrition and Food Science at the American University of Beirut in Lebanon. Other affiliations include the North Carolina Central University and Pennsylvania State University in the U.S. Her work centers around the interlinkages between food security, migration and health and her main interests include the assessment of food and nutrition security status of vulnerable population groups. Welcome Lamice. We also have here Dr. Jennifer Rongholm who is assistant professor at McGill University in Canada and her interests are primarily in understanding the role of the microbiome in determining susceptibility of individuals, both humans and agricultural animals to infection. Welcome Jennifer. Before we start the conversation as part of this session I wanted to engage with you who are listening to us here with a question, a question to which we will return at the end. I would like you to, so you will see a link in the chat which I think has just been posted there. You will see a link to a question which is which of the following would persuade you most effectively to change your diet? Is it ability to hold, to hold biodiversity loss, reducing your carbon footprint? Is it reducing antimicrobial resistance or animal welfare or indeed improving your own health? So I can see you are voting already, I'll give you one second to make your vote. Animal welfare is leading, oh there are some changes. So what seems to be emerging most strongly at the moment is reducing the carbon footprint and animal welfare and although improving your own health is coming in as well I was just going to make a comment that we have very altruistic audience with us but that's of course very important. So this is great. If I can ask you to remember how you voted in response to that question because we will come back to this question at the end of our session. So let me now throw an opening question to both of you. Our food system is broken is a statement of fact that we hear from science and political leaders and a key problem is indeed intensive food production practice. Are we thinking creatively enough about how to reimagine food production? What is your bold idea or initiative that you believe we should be embracing? If I can turn to Lamise first. Sure, thank you Magdalena for the introduction and thank you for starting with this very important question. The statement that you've said cannot come any true, especially post the COVID-19 pandemic and what the world has been undergoing. But I think there are a lot of lessons to be learned even before the pandemic and afterwards we're trying to understand why is our food system broken. If I were to just present briefly and in one statement globally the world is not on track on meeting and achieving unfortunately any of the nutrition indicators that we have set for ourselves. That includes all malnutrition indicators that we discussed be it from the under nutrition and hunger, food insecurity, micronutrient deficiencies and overweight and obesity. And that is where we say this is where the food system has been heavily focused for years on feeding people and as important as that is and as important as the development that we've seen in that in that perspective what we should be thinking about is of course to nourishing of the human body and to ensure that we can do that sustainably. And today with the initiation of the Yen Food Summit and all the preparation meetings before the discussion is how can we transform our food systems. They are our room for change. It is a very complex system and it does interact actually with other systems. It interacts with the health system, it interacts with the agri food and with so many other systems that we have to take into play and there are ways to intervene at many levels and there are trade-offs to be made and I'm happy to discuss further what kind of innovative ideas are out there being tested in multiple contexts because we cannot assume that the world has to have the same answers or solutions across the board. They are context-specific solutions be it for higher income countries or lower to middle income countries and definitely there's no one-size-fits-all and I think today in the summit at the World Economic Forum and at the UN Food Summit and Food Systems Summit the conversation is along. People's voice must be heard and there are ways to get about this. It's a challenge that we are all addressing and we should do it now. We cannot wait any longer. Thank you for this very important number of strong themes emerging and of course you alluded to the fact that the Food Systems Summit has a subtitle of people's summit as well and the fact that we cannot wait any longer but you also pointed out of course that no one-size solution would fit all problems in all contexts and then also importantly the fact that there is that interlinkage of a number of systems and solving or offering solutions to the food system has to be done in a context. Thank you for this and we look forward to coming back to some specific examples that you promised us but Jennifer what about your ideas of where should we be looking to re-imagining food system for production better? Yeah it's a great question. So I'm primarily an infectious disease person and how infectious disease interacts with our food systems and there are some bigger cracks in this system that are getting bigger every year and we know how to fix a lot of them but they're complicated problems that deserve that need massive change to fix them if we're going to go with the ways we know about change is very difficult. It requires economic political will and we don't always have that. So one example that I'm going to bring up is the Salinas Valley in North America. We produce a lot of our food there. We produce a lot of our beef and our lettuce there. The beef is beside the lettuce and this is leading to massive outbreaks of salmonella and E. coli throughout North America. We could move the beef or we could move the lettuce but both of these are very complicated politically and economically. So my idea is can we separate the disease transmission from the beef to the lettuce and be creative in that way through modifying the microbiome of these environments and solve the problem other than these big complicated solutions. But it is something that's affecting all of us and that we do have to move on. Really, really interesting and the potential solution of what you draw attention to this link between food production the way food production is done an infection. It's a link which is not often talked about is often underappreciated. So I think that's very important that you point this out. And I'm sure we will be talking more about the microbiome because I know that's lies at the core of your research. But before we move further could you briefly remind us what we what do you mean what we mean by the microbiome. Sure. So there's a community of microbes, bacteria, viruses, parasites that live in and on us and our bodies on our skins. This community also exists in animals in their bodies on their skin in their mammary glands. And these microbial communities are very important for our health and for the health of agricultural animals and for the health of environments for that matter. That's great. Thank you. And of course, indeed, it's good to remember that we are never alone in this context of a microbiome. And of course, as you just alluded at the end of your explanation, but of course, there is environmental microbiome as well, which very much feeds into the topic that we're discussing the food production as well. So I wanted us to spend a little bit of time talking about malnutrition. But before we do so, I want to engage the audience one more time. And so if we can turn to the slider again, you'll have the link to the question in the chat. This time, very simple. What is one word that comes to your mind when you think about malnutrition? Just one word if you can type that into the some really interesting responses, greed, waste, very interesting children, starvation. Yeah. So waste is emerging as a as a dominant theme, very interesting. Thank you. Very interesting. And of course, my reason for engaging with this is that I now want to turn to our panellists and talk about what do we mean about malnutrition? And in the same context, when we talk about combating the issue of malnutrition, of course, we talk about healthy and sustainable diet. Both of you alluded to this already. And the fact that one size is unlikely to fit all. Can I ask you to comment on this? How should we think about malnutrition? And then what is the best path towards sustainable and healthy diet? Lamise, can I turn to you first? Sure. As the nutritionist, I cannot but always start by saying that malnutrition comes in many forms. And not to complicate matters, but I did see that our audience are engaging with us and mentioning starvation and hunger. And that's a very important component of how we assess malnutrition or inadequate diets. But there are of course other parameters that we look into. When we think about malnutrition, we think about both. And you alluded to that, Magdalena. We look at the under nutrition, be it from the underweight, the stunting and the wasting that we unfortunately still see among children under five and that unfortunately the pandemic has exacerbated these rates. We were doing fine, but somehow around the 2013-2014, we started seeing that kind of going off track again on food insecurity, on many of the other parameters of under nutrition. In parallel to that, the improvements that we were seeing and the tapering off of the stunting, if you wanted the wasting, was also unfortunately in parallel with an increase in overweight and obesity, which is where we talk about the excessive or over nutrition, excessive consumption of energy dense foods that are rich in and high in fat, in sugar and salt, which have been associated, of course, with higher incidences and prevalence of noncommunicable diseases of all sorts, which are the leading causes of death in both high and low to middle income countries. Of course, in parallel to the infectious diseases that are affected by malnutrition. So when we think about malnutrition, we think about, again, the numbers. And if I want to just kind of portray these, and these are based on the state of food insecurity report that was published earlier this year. And I'm looking just to kind of get the exact numbers here and the weight of them. So when we talk about 22% of children under five that were found to be stunted, this is, we're talking translating to $149 million in 2020 and at global level. Of course, these differ by continents and there are certain regions in Asia and Africa and sub-Saharan Africa where the rates are unfortunately higher. When we look at wasting, which is too thin for height, we're looking at 45 million. So almost approaching 7% of the children under five and we have 38.9 million children who are suffering from overweight and obesity also under five. An age group that we were for a long time as nutritionists worried about to reach to a point where we're having to fight the under and the over nutrition when we are at that time, unfortunately. And parallel to that and to add more complexity to the matter, the adult obesity rates are quite high. The pediatric overweight and obesity, we're talking here about adolescents. We're talking about school age population and age group that's very close and dear to my heart and the research work that we've been doing to try to combat that and whatever progress we've been doing, unfortunately, hasn't been catching up as much as the challenges that we're facing or the shocks that we're facing. And if I also want to highlight something you've mentioned, it's very important and it's the talk of the town, as you say. It's when we talk about the solution and this transformation of the food system that we're calling for, it has to be with healthy and sustainable diets. Pre-pandemic, three billion people did not have access to healthy and nutritious food. And these numbers are where we're only further exacerbated with the pandemic. The system definitely needs to improve to be pro-people, to be more equitable and to ensure that all people, rural, urban, higher, low-middle income country, residents, refugees, internally displaced, are capable and have access. So the definition of food security acts as to all people at all times, the right to food. And this is something that have been published in many reports over the past couple of years, the high-level panel of experts on food security and nutrition have been calling for that. They've put a lot of excellent food systems framework in place. And the discussion today at the food summit is how can we translate these frameworks into actions, into actual solutions, then we can then test them and test those trade-offs that we talk about between environment, health, economics. How can this be translated into specific context solutions? That's where the challenge lies. And that's why there's a galvanized effort to talk about sustainability. If you want to stop this trend and improve it and meet the SDG goals, we cannot continue business as usual. This is definitely a pivotal time for us. Absolutely, very good point. And indeed, even though increasingly we're talking about food system, we're talking about interconnection of systems, we'll come back to this in a minute. As you just emphasized, we need to zoom in on specific solutions. So, Jennifer, I wanted to turn to you. What you're proposing, where you would like all of us collectively to focus our attention, is one specific solution. So through microbiome, focus on the microbiome, you can see a way forward towards a much more healthy diet, more productive food system also. And there is, of course, another important element that ties in with this, and that is reducing antimicrobial resistance. Can you tell us more about that specific solution? Yeah, so it is one of the possible solutions. Much of the antibiotics we use in agriculture today goes towards improving productivity of farms. So making the animals get bigger faster. It also goes towards preventing disease in agriculture, so keeping them healthy so they can get bigger faster. This works because healthier animals grow faster. So one way to remove some of the reliance on antibiotics for both productivity and for animal health is to actually make the animals healthy through modifying their microbiomes, through optimizing their microbiomes. And in the work we're doing, we're seeing that it might be possible. There are specific microbiomes that do seem to resist infection, thus reducing our reliance on antibiotics. In several of our trials, we've lost, the antibiotics don't promote growth any better than our modified microbiomes, so it's very encouraging. But beyond that, producing food with lower bacteria levels will also help waste. We lose a lot of food through wastage, through outbreak recalls, and we lose a lot of food through spoilage. So making these more microbial, with higher microbial integrity, will actually reduce the food wastage in those perspectives as well. Really, really important points. And this idea of microbiome engineering, so to speak, modifying the microbiome in animals, and of course, we should also remember, correct me if I'm wrong, but it's also relevant in the context of aquatic food, not just terrestrial food, right? And then of course, there is quite a lot of awareness about looking after our own microbiomes, which of course contribute to our ability to just assimilate food appropriately. I wanted to turn, we touched on the issue of antimicrobial resistance, which is incredibly significant. It has knock-on effects on of course, medical applications also. I wanted to do another little poll with our audience briefly to ask the question for again, for your voting, there'll be a link in the chat. If you could cast your vote as to what the proportion of all antibiotics manufactured is used in the food sector. So you will, when you look at the possible poll, you'll have a number of ranges, but with exception of one, there's a 50%, the others are ranges, please cast your vote. What is the proportion of all antibiotics manufactured that are used in the food sector? There you go, we have split votes. Yeah, so essentially most, now we have a much more divided vote, although it is a complex picture. Jennifer, I'm going to turn to you to tell us exactly actually what the proportion is. Yeah, it's a really hard thing to measure and it's based on self-reporting in a lot of instances, but our best guess is that it's somewhere in the 70 to 80% range of all antibiotics manufactured are used for food production. I think this is such a powerful, forget to remember, most of us would not guess, even maybe around 50%, but not the vast majority of antibiotics produced are used in the context of food production. Thank you for that. I wanted to come back to the issue of the food system. We increasingly talk about the importance of food production as a system. We touched on this a couple of times already. Can I ask you to elaborate a little more why it is so important that we talk about the system, the food production as a system? Lamise, you talked about trade-offs at the very beginning when in your first set of statements, could you maybe pick up that topic first? Sure. I think I want to just also take a step back and define how we see food systems. You've mentioned something very important, which is food production being an integral component of it within the food supply. However, the food system is definitely more complex and within the food supply chain, we're talking about food production, we're talking about food processing, distribution, then talking about a very important component, which is the food environment, where people are accessing the food, what kind of labeling is going on, what kind of promotional work or campaigns have been? Access to the supermarket's distance from the supermarket, economic access to the food, if we have access to healthy nutritious food. So when we think about food systems, there is the food supply, there's the food environment, and of course, something that is very important in our work, which is the consumer behavior, what the consumers are deciding to consume. So not just what we are providing or producing, but rather the consumers' own decisions that really push the supply demand whole conversation. And the demand has been in more healthy and sustainable diets, which is why a lot of the private industry and a lot of the big corporations have been tackling issues from the production to the processing and distribution to tackle many of the issues that we face. You've mentioned, and my colleague, Jennifer, mentioned food waste, and that's like one third, 30% of the food of the world is being lost, lost in the post-harvest losses or even making it all through the food system to the consumer choices and then to the food waste at that level. And of course, there's specific definitions for food loss and food waste, not to go into the depths of it, but I just wanted to make sure that when we think about it, that system is complex by itself. So then when we talk about healthy and sustainable diets, the decisions when we call agriculture should be more nutrition sensitive or the interventions and programs should be more nutrition sensitive, it doesn't start at the environment. It does start from the beginning of how we produce the food and whether the food we produce is safe, it's enough to ensure the rural livelihoods and the economic productivity of the farmers or if the fisheries and so on and so forth, but it also ensures that we can do this sustainably so they can continue to produce food to feed healthy and nutritious food. So that's an important thing to talk about. Also, another thing I've been mentioning and I really also wanna make sure that that's clear, the sustainable diet term that we are using and that is where the trade-offs come in. So to answer your question here, the trade-offs that I talked about are the trade-offs that are embedded within when we say a sustainable diet. It's a diet that takes nutrition and health on one side of the equation and they are the dietary patterns that should promote healthy bodies, healthy being productive and all of the good stuff. Excuse me. In addition to that, you should take into consideration all the other factors that affect sustainability which are the environmental parameters which includes, for example, our carbon footprint or the greenhouse gas emissions, the water footprint, the energy and so on and so forth. So these are the trade-offs that we talk about. And in the field of our research and many other researchers, of course, but I have to mention that in my institution at AUB, we've been looking at this water energy food health nexus from the former dean, Rabia Mahattar, to our colleague, Dr. Hwalla and many others on the teams that I work with. We've been providing models of what a sustainable diet means and we've been providing them using linear modeling techniques to take into consideration those trade-offs. We're providing some scenarios of what could be a sustainable diet or sustainable food-based dietary guidelines for specific age groups. And there are those examples that I'm happy to elaborate on. I just wanted to make sure that when we talk about those that it's clear that also we're pushing for trade-offs across the food system so that we can ensure that we are really doing things sustainably and not just promoting healthy diets but not necessarily taking into consideration whether we can continue to do that for the future generations. Over to you. Absolutely, very, very important point. And I wanted to bring in Jennifer here because in this very broad umbrella discussion that we're now having rightly so, almost at every point in this discussion I can see a role of, for example, fundamental research into the nature of the microbiome and how can that be engineered or tinkered with. Jennifer, would you like to come in and make a comment on that? How that synergy can be remembered and brought out? Yeah, and I think that really plays in to the systems approach we've been talking about. We're not separate from what happens on farms and farms are not separate from what happens in our societies. When we're looking at this, I think it's really important to remember how bad the microbiome or the antibiotic resistance crisis is going to get. The current projections are that 10 million people a year are gonna die by 2050 of resistant infections which is a huge number. So every time we try to up production on the farms by using antibiotics, we're contributing to this crisis because these genes don't stay on our farms. They move into our farmers whose health I'm very concerned about and then they move into our communities when we see them in the hospitals. So this whole idea of coming up with ways to cut this chain so we don't see the consequences in our clinics and in our farmers and in our communities is something we really have to think about because we don't fully understand food systems at this level and how what we do on our farms affects us and why. So it's an important part to look at the basic science of that and try to understand it so we can intervene. Absolutely, so thank you for that reminder. And so we see how the food, the environment, the food with as many aspects, the environment, health, how they're all interconnected. And yet, this year we have the, well today starting UN Food Systems Summit, later in the year we'll have the Climate COP and then of course in the spring of next year, the Biodiversity Summit in Kunming. Very briefly, because unfortunately we're coming to the end of our time, isn't there a missed opportunity that we compartmentalizing these events in this way? What do you think? Should we not make a greater effort to bring them together? Jennifer, do you want to jump in on that? Yes, sure. Yeah, I mean all of these are going to clash eventually like climate is driving emergence of disease, which is driving emergence of more interventions on farms. Like we have to talk about these as the interconnected issues that they are. We can't be separate and we have to do that from the basic research perspective as well because all of these things are going to come crashing into each other. Absolutely, let me final word on that. I just want to say that earlier today there was an excellent talk about breaking silos for food and climate security. And I think that I just kind of taking up from that concept, the FAO director, WFP director and many other of the attendees were really promoting the idea that we should break the silos. And that goes back to your question. I'm going to look at it from a positive angle that we do have several summits and events that are galvanizing, again the efforts in bringing stakeholders from all across sectors to talk about such complex systems that come into play. So I think from that angle it's good, but breaking silos is very important. I don't think we can continue business as usual. I think we are, the house is on fire, the world is on fire as the video started. We cannot sit there and watch and think maybe in 10 years how we can act. I think we all feel the pressure, especially with the climate change and the crises that are happening, not to mention the pandemic, the ongoing protracted conflicts and wars, they're all triggering this economic recessions, which triggers more wars and more climate disasters. So it's about time that we work together. Thank you very much for your powerful words, both of you and your suggestions. We don't have time to repeat the last question of the Slido poll, but those of you who are listening, I think you will now probably appreciate that there are many reasons. You will agree that there are many reasons for which to change your diet and think about food from a sustainable, but also a holistic interconnected perspective. Thank you, Lamise. Thank you, Jennifer. And thank you for all of you for joining our session. Thank you very much. Bye-bye.