Several unhealthy dietary patterns contribute to NCDs. Therefore, understanding which dietary risk factors are driving the quantified health hidden costs and the variations among agrifood systems categories is crucial for identifying which aspects of consumption patterns need to be addressed to promote healthier diets.
Figure 8 provides this breakdown in four panels detailing the dietary patterns that result in the under-consumption of foods (fruit, legumes, milk, nuts and seeds, vegetables, and whole grains) and nutrients (polyunsaturated and omega-3 fatty acids), shown on the left, and over-consumption of foods (processed meat, red meat and sugar-sweetened beverages [SSBs]) and nutrients (sodium and trans-fatty acids), shown on the right. Moving from traditional towards industrial agrifood systems, standardized disability-adjusted life year (DALY) rates due to NCDs associated with most dietary risk factors first increase and then decrease, exhibiting a pattern similar to the Kuznets curve.h, 13 This is observed with diets low in whole grains – the leading risk in all agrifood systems categories, except for protracted crisis and traditional (Figure 8). The average standardized DALY rates (per 100 000 people) due to diets low in whole grains increase from traditional to diversifying agrifood systems, where they peak. Diets low in polyunsaturated and omega-3 fatty acids (Panel C) and high in sodium (Panel D) follow a similar pattern.14
FIGURE 8 Dietary NON-COMMUNICABLE DISEASE risks of under- and over-consumption of foods and nutrients by agrifood systems category
SOURCE: Authors’ own elaboration based on Global Burden of Disease Collaborative Network. 2024. Global Burden of Disease Study 2021 (GBD 2021): Results. [Accessed on 7 June 2024]. https://vizhub.healthdata.org/gbd-results
The notable exceptions to the Kuznets curve are diets low in fruits and vegetables (Panel A) and diets high in red and processed meat (Panel B). While DALY rates due to diets low in fruits and vegetables are highest in crisis and traditional categories and mostly decrease over other categories, DALY rates due to diets high in red and processed meat show an ever-increasing pattern. Red meat, despite the attention received in the media, falls within the top five DALYs only in the industrial category.
The dietary risks for NCDs quantified here represent components of an unhealthy diet, and the relative differences in food groups and nutrients across agrifood systems categories should not be interpreted as silver bullets to meet the challenge of enabling healthy diets for all. Policy interventions to address health hidden costs due to NCDs while countries transform their agrifood systems can be more effective if these patterns are considered when designing packages of interventions. This includes the design of food-based dietary guidelines (FBDGs) to ensure a healthy diet for all that is also environmentally and socially sustainable, as well as the use of other levers such as labelling, information, nudges, taxes and subsidies – discussed in detail in Chapter 3 and Chapter 4.3
This edition of The State of Food and Agriculture highlights the importance of a detailed understanding of dietary risks causing NCDs, combined with a holistic assessment of healthy diets within a TCA approach for effective policy design. Phase two assessments required to achieve this would need to go beyond the national-level patterns summarized here and account for heterogeneities across different geographies and socioeconomic groups, especially for the most vulnerable populations.
