Intended for healthcare professionals


WHO pulls support from initiative promoting global move to plant based foods

BMJ 2019; 365 doi: (Published 09 April 2019) Cite this as: BMJ 2019;365:l1700
  1. Ingrid Torjesen
  1. London, UK

The World Health Organization pulled out of sponsoring a global initiative promoting healthier and sustainable diets across the world after pressure from an Italian official who raised concerns about the impact of the diet on people’s health and livelihoods.

The event—the launch of the EAT-Lancet Commission on Food, Planet, Health in Geneva, Switzerland on 28 March—still went ahead, sponsored by the government of Norway.

WHO dropped its planned sponsorship after Gian Lorenzo Cornado, Italy’s ambassador and permanent representative of Italy to the international organizations in Geneva, questioned the scientific basis for the diet which is focused on promoting predominantly plant based foods, and excluding foods deemed unhealthy, including meat and other animal based foods.

Cornado warned that a global move to such a diet could lead to the loss of millions of jobs linked to animal husbandry and the production of “unhealthy” foods, and destroy traditional diets which are part of cultural heritage.

The initiative “urging for a centralised control of our dietary choices” risked “the total elimination of consumers’ freedom of choice,” he added.

The commission says that its “universal healthy reference diet,” outlined in a report published in January,1 would provide major health benefits, and also increase the likelihood of attainment of the Sustainable Development Goals. It is running a series of events across the globe promoting the diet.2

The diet consists largely of vegetables, fruits, whole grains, legumes, nuts, and unsaturated oils, a low to moderate amount of seafood and poultry, and no or a low quantity of red meat, processed meat, added sugar, refined grains, and starchy vegetables.

The commission outlines a hierarchy of policy levers that can drive uptake of this diet,3 which begins with “soft” levers, such as providing consumers with information followed by guiding their behaviour through incentives and disincentives, and ends with “hard” levers restricting and then finally eliminating dietary choices.

“Hard policy interventions include laws, fiscal measures, subsidies and penalties, trade reconfiguration, and other economic and structural measures,” the document says. “Countries and authorities should not restrict themselves to narrow measures or soft interventions. Too often policy remains at the soft end of the policy ladder.”

Cornado wrote to permanent representatives to the United Nations and international organizations in Geneva to highlight concerns about the diet and question whether it was appropriate for WHO to back the event.

The letter, seen by The BMJ and dated 20 March, says that “a standard diet for the whole planet” regardless of the age, sex, general state of health, and eating habits “has no scientific justification at all” and “would mean the destruction of millenary healthy traditional diets which are a full part of the cultural heritage and social harmony in many nations.”

The dietary regime advised by the commission “is also nutritionally deficient and therefore dangerous to human health” and “would certainly lead to economic depression, especially in developing countries,” said Cornado.

He also raises concerns that “the total or nearly total elimination of foods of animal origin” would destroy cattle farming and many other activities related to the production of meat and dairy products. Companies involved in the production of foods or beverages regarded as unhealthy, such as sweets and wine, “will be forced to withdraw such products from the market and diversify their business,” warns Cornado, which would have “drastic consequences,” including the loss of millions of jobs.

Walter Willett and Johan Rockström, co-chairs of the EAT-Lancet Commission, defended their dietary approach in a letter, also seen by The BMJ.

They said their report “offers the most up-to-date scientific evidence for healthy diets,” explaining that “nowhere in the report do we advocate any form of centralised control” of dietary choices. They also disagreed with the assertion that their diet would destroy culinary traditions around the world. “Flexibility to adapt to local diets is inherent in the reference dietary targets,” they wrote.

Willett and Rockström tackle the accusation that their diet is nutritionally deficient and therefore dangerous to human health, saying, “We live in a world where more than 820 million people have insufficient food and many more consume low quality diets. Adoption of the dietary targets would greatly improve the nutrition and health status of most people on the planet.”

The argument that eliminating food of animal origin would lead to economic depression, especially in developing countries, is unfounded, they argue.

“Moving towards the healthy reference dietary targets would increase total dairy consumption across most of the developing world and the average per capita intake of red meat could approximately double in South Asia and remain roughly at today’s level on average across Africa,” they say.

The BMJ asked WHO several times why it had decided against sponsoring the Geneva event. WHO provided a statement saying only that its director of nutrition, Francesco Branca, who is a commissioner of the EAT-Lancet Commission, participated as a panellist in the 28 March 2019 Geneva event and talked about WHO’s work on sustainable healthy diets.

“[His] views and opinions are expressed in a personal capacity and do not necessarily reflect official WHO positions,” the statement said. “WHO considers the Geneva launch event and the EAT-Lancet Commission to be relevant to advance WHO’s work on healthy diets.”