Reducing food waste to prevent hunger and improve diets: Does donated agricultural surplus improve the diet of food-bank users?

The proposed solution involves reducing food losses along production and supply chain
November 11, 2019
Reducing food waste to prevent hunger and improve diets: Does donated agricultural surplus improve the diet of food-bank users?


Nutrition and brain Health Laboratory, The Institute of Biochemistry, Food Science and Nutrition
The Robert H. Smith Faculty of Agriculture Food and Environment, The Hebrew University of Jerusalem

The global food and agriculture system must change profoundly if we are to nourish the 815 million people who are hungry today and the additional 2 billion people expected to be undernourished by 2050. However, ensuring an adequate, affordable, healthful, and environmentally sustainable food supply for the world’s growing population requires more than technological advances to boost agricultural production. We must dramatically reduce loss and inefficient use of the food that we presently grow.

Today, more than a third of the food produced globally goes to waste, exacting a tremendous environmental, economic and social cost. This does not only concern the developing world, but is in fact a crucial issue for high-income countries where abundant food is consumed in excess and wasted in vast amounts alongside persistent widespread food insecurity, and large persistent gaps between society’s wealthy and poor in income, access to food and health.
The United Nations Food and Agriculture Organization set an ambitious goal of cutting per capita global food waste by half by 2030 as an integral part of the Sustainable Development Goals of achieving “Zero Hunger” and “Ensuring Sustainable Production and Consumption Patterns”.

 

The proposed solution involves reducing food losses along production and supply chain as illustrated by the “Food Recovery Heirarchy” (figure 1).   This conceptual framework for reducing food waste promotes the intuitive idea that substantial waste-reduction can be achieved if surplus food were donated to food banks for redistribution to those in need. Indeed, charitable food banks have become an important source of aid and nourishment for the increasing chronically food insecure population of affluent countries, including Israel. 

Figure 1

 

While reducing waste and mitigating poverty and hunger may seem at first glance like a win-win proposition, the growing role of food banks in the social safety net is controversial for practical, ideological and ethical reasons. For example, food banks are generally intended to provide short-term emergency relief for people falling on hard times and they cannot sustain a healthy diet in the long-term for large segments of the population. Because they rely on donated food, they often fail to provide sufficient dietary diversity, quantity and quality to meet their user’s health and nutritional needs. Even if they could meet those needs, they consume substantial public and private philanthropic resource, while alleviating moral and political pressure on governments to deal with the root causes of hunger.

 

Furthermore, even if food banks collect and redistribute large amounts of salvaged food, they arguably constrain the autonomy and dignity of their recipients, restricting them to rely on second-rate salvaged food and produce that better-off members of society would not choose to buy or eat. If the food is unpalatable to poor aid-recipients, then passing on salvaged produce may simply push the point of food waste down the supply chain from the producers to the consumers.

There is also debate over the relative harms and benefits of distributing aid in the form of cash or commodities: On one hand, one can argue that for every dollar of donated rescued fruits and vegetables, 3-5 times more food can be provided than could be purchased by recipients than if they were given cash equivalents, and that their health and interests are served by providing them with fruit and vegetables.

The counter argument says that the benefits are smaller if the sunk costs to the farmers and the costs of the logistics and cold-chain are considered, and it is more dignified to provide people with cash and freedom to choose their own food. This raises the question as to what extent should limited public and philanthropic resources be directed towards improving the quality of the diet of those in need.

What is the appropriate balance between improving food quality and the imperative to extend the reach of the food safety-net and to alleviate hunger per se?  What are the relevant metrics for determining this balance?
We need better measures and data to inform decision and policy making with regard to both the moral justification for promoting food banking and its effectiveness. However, it is difficult to study the vulnerable populations that they serve, which may help to explain why research into these matters has been sparse.

Two extensive reviews of the scientific literature published in 2017, found only 9 studies of pantry food quality, and 16 studies of user diet quality. The review of these studies (which were conducted in the USA, Canada, Australia and France), concluded that the dietary intake of pantry users failed to achieve dietary recommendations and that the food pantries studied were largely unable to support healthy diets. The authors suggested that the distribution of more perishable foods might improve the quality of pantry users’ diets and have the potential to influence dietary quality in vulnerable groups. No study to date has directly examined the connection between the quality of the food-aid provided by food banks/pantries in affluent countries and the quality of aid-recipients’ diet and health.

Israel provides an interesting case in which to study this problem because of the high prevalence of persistent food insecurity, affecting approximately one fifth of the population and one quarter of its children, and because the government policy explicity relies on philanthropic food banks and pantries to distribute rescued food and agricultural produce to those in need.

To adress these issues, Dana Efrati Philip and Ghada Baransi, two outstanding graduate students in our lab (figure 2), examined the quality of food-aid baskets and the quality of individual aid-recipients’ diets among the clients of food pantries that receive some of their fruit and vegetables provided from “Leket Israel”,  Israel’s largest national food bank. Leket Israel specializes in the rescue and redistribution of agricultural produce to over 200 local food pantries serving over 200,000 people throughout the country. Working with Leket Israel provided access to 16 representative local food pantries distributed throughout the county and enabled us to recruit more than 100 individuals who agreed to participate in our survey. 

 

Figure 2: From left to right: Ghada Baransi, Aron Troen, Dana Efrati Philip


Together with Prof. Danit Shahar of Ben Gurion University, we developed innovative, practical methods to collect the necessary information, including a new healthy food basket index for Israel and a telephone survey consisting of demographic, food frequency and food security questionnaires in both Hebrew and Arabic.

From the nutritional data that we obtained we derived  a “healthy portions score” to capture the energy, protein and nutrient content of the food-aid baskets, allowing us to compare their contents with the dietary requirements of the households that received them, as a function of the Israel Ministry of Health nutrition guidelines.  We also calculated an individual Nutrition Density Score to capture the quality of each survey respondent’s nutrient intake as compared to their individual nutrition and health requirements according to international dietary guidelines. We then characterized the quality of the food-aid recipients’ habitual diets, and asked to what extent the food baskets met the food-aid recipient’s needs, and whether quality of the food-aid influenced or predicted the quality of the recipients’ dietary habits.

Our findings, which were published in the peer-reviewed journal Frontiers in Nutrition , were striking:  45.7% of the study participants reported living in a food insecure household with moderate or severe hunger. Less than two thirds of those surveyed met their estimated energy requirements, and the population’s intake of many essential micronutrients was well below the recommended daily allowance (RDA).

Over a third of the population reported having metabolic syndrome or cardiovascular disease and more than a third of the study population were obese. A little more than one third had experienced iron-deficiency anemia. As for the food aid, the average basket provided less than a third of a household’s required energy, 55% of their protein, and varied with respect to important macro and micronutrients. Importantly, the rescued vegetables and fruit made up two thirds of the total number of healthy portions and ~90% of the fruit and vegetable portions in an average basket, nearly half of the fiber, 66% of the vitamin C, 55% of the calcium, 44% of the vitamin A, and between 26-36% of the content of vitamin B1, B5, vitamin E, Folate and Magnesium. What was most interesting was that the basket Healthy Portion Score was positively and highly significantly correlated with the individual dietary nutrient density,

despite providing only a fraction of the household’s food.

The study demonstrated the proof-of-concept and feasibility of using an innovative structured telephone survey to study the impact of food-aid quality on the nutrition and health of food pantry users in Israel, in the context of the challenges faced by food banks and pantries in affluent countries. This approach can be emulated elsewhere to advance research on these vulnerable populations. As we predicted, our study population had a high burden of chronic nutrition-related non-communicable diseases and a high level of food insecurity. Whereas part of the population consumes excess calories and others fail to meet their energy needs, the majority of diets were deficient in essential micronutrients.

Although the quantity and quality of food provided in the aid-baskets leaves much to be desired, the fruit and vegetable portions significantly improve quality of the food-aid by contributing less than 15% of the basket calories with a significant amount of dietary fiber, vitamins and minerals.

This is potentially impactful, since despite their relatively small contribution to recipients’ caloric and nutritional needs, food baskets with a higher quality of nutrition were correlated with healthier diets among the recipients and with better health. It is possible that simply providing fruits and vegetables creates a behavioral “nudge” that helps people make healthier choices in the rest of the food that they purchase. In other words, providing food pantry users with fruits and vegetables may have a larger impact on health and diet that goes beyond the absolute cash and nutritional value of the food.

These important findings suggest that the behavioral impact of providing fruit and vegetables to those in need should be considered when wheing whether to invest in maximizing the number of people served by food banks and alleviating hunger per se, or whether to optimize the effect on their well being by investing the necessary effort to rescue and distribute vitamin - and mineral - rich  food (i.e. fresh fruits and vegetables) in addition to less expensive macronutrients (i.e. staples). 

 

In the face of arguments against paternalism and for individual autonomy or of calls to provide the needy with cash rather than commodities, the research provides preliminary evidence that it is possible to alleviate not only the hunger of food insecurity, but also the malnourishment that accompanies it, when resources are specifically ear-marked for this end. Ultimately, this research advances our understanding of the complex relationships linking food-waste reduction to food security, and will help in efforts to achieve more equitable, sustainable and healthful food systems.