Understanding the Planet Healthy Diet – Eat-Lancet Commission Report

Last week saw the publication of the report from the EAT-Lancet Commission.  EAT-Lancet outlines how to achieve a globally fair and nutritious diet. They are aiming to feed the 10 billion humans on the planet by 2050. It is the first report to consider the impact of nutrition on the natural environment.

  “Transformation to healthy diets by 2050 will require substantial dietary shifts. Global consumption of fruits, vegetables, nuts and legumes will have to double, and consumption of foods such as red meat and sugar will have to be reduced by more than 50%. A diet rich in plant-based foods and with fewer animal source foods confers both improved health and environmental benefits.”

Eat-Lancet Report

Target 1 is healthy diets. I have analyzed the report and created a table (below) with the food intake in standard portions. A copy of the report summary can be downloaded here. This is for people wanting to read the second target (sustainable production) and the 5 goals.  I examine a planetary healthy diet in comparison to current NZ eating patterns .

Food Item g/day    (range) Portion size Notes
Whole grains 232 30g 7.7 portions/day
Starchy vegetables 50 80g 3 portions/week
All other vegetables 300 80g 3.75 portions/day
Fruits 200 80g 2.5 portions/day
Dairy Foods 250 250g1 portion/day
Protein sources  
Meat and poultry 43 100g3 portions of 100g/week
Eggs 13 58g1.6 eggs/week
Fish 28 100g2 portions of 100g /week
Legumes 75 90g5-6 90g portions /week
Nuts 50 30g11-12 30g portions/ week
Added fats  
Unsaturated fats 40 1 tsp8-9 tsp/day
Saturated fats 11.8 1tsp2.5 tsp/day
Added sugars  
All sugars 31 1 tsp 6 tsp/day

This represents a fairly strict flexitarian diet.  Most people could achieve this eating patter with planning. It would be more difficult to eat like this if you were time poor or had limited cooking skills. Food manufacturers and retailers would have to change their offerings to be part of a sustainable food system.

Key differences

  1. Whole grains: We eat mostly refined grain foods  in NZ. It would involve both a shift to whole grains and increased amounts of whole grains in the diet.
  2. This would be less potato, kumara or taro than currently eaten.
  3. For most people this is a significant increase in non-starchy vegetables.
  4. Most people would be increasing their fruit,
  5. This a significant reduction in dairy intake.
  6. Only 6 of the 14 non-breakfast meals would have animal source protein, the rest would have legumes or nuts as primary protein.
  7. There would be a tight limitation on butter, with a liberal allowance of oil.  Added fat intake means frying and foods with added fats (baked goods) would be an occasional treat.
  8. The added sugar at 6tsp per day represents a big shift away from sugar sweetened foods. It would be biggest in the diet of younger people. 

Nutritional Adequacy

Concern has been expressed over iron and calcium intake from this diet. Again, this diet relies on good cooking practices to maximize non-meat source minerals. The caloric intake provided by this diet is approximately 10.5MJ or 2500kcal. This is approximately an “average” diet for an adult and some variation would be needed.

Many people would be reluctant to make these kinds of changes. If humanity is to protect the environment, while feeding 10 Billion people, we need to start making changes now and this is a good start. On a personal level following a diet like this will both reduce the risk of long term health conditions including Type 2 diabetes and heart disease as well as managing them more effectively than the current diet.

I support and endorse the principles of this diet. Where possible I will demonstrate how to cook and eat within the limits outlined in the EAT-Lancet report. Please subscribe if you want to learn more.

Corn, Quinoa and Chickpea Salad

This salad is suitable either as a main or a side. This contains seasonal vegetables as of the date of publication. Corn could be replaced with courgette or lightly cooked pumpkin.

  • ½ C quinoa cooked as per directions to give you 1 C cooked quinoa
  • 2 TBSP of canola oil
  • 1 C of corn kernels (with fresh corn, the amount off 2 corn cobs)
  • 1 C chickpeas drained and rinsed
  • 1 red or yellow capsicum chopped into small pieces
  • 2 spring onions finely sliced
  • ½ C fresh parsley or coriander
  • ¼ C olive oil
  • 2 TBSP lemon juice
  • 2 TBSP rice or white vinegar
  • 1 tsp brown sugar

Prepare the quinoa and drain in a sieve. Allow to cool.

Heat the oil in a heavy pan over medium heat. Add corn and well drained chickpeas and cook for about 5 minutes stirring regularly until they start to brown.

Transfer into a bowl. Add quinoa, pepper, onion and parsley or coriander

Mix the remaining ingredients in a bowl and mix. Drizzle over salad just before serving.

If you don’t have quinoa, you can use brown rice, but always follow food safe practices when cooling and storing grain foods.

How do you get 30g fibre in your diet daily?

There has been a lot of media coverage about fibre in the diet. A high fibre diet reduces the risk of heart disease. We know that 90% of people are failing to get enough fibre.  So how do you improve your dietary fibre intake? How do you do it on a low income?

Fibre occurs in plant-based foods. The relevant Eating statements for adult New Zealanders are:

Enjoy a variety of nutritious foods every day including:

  •              plenty of vegetables and fruit
  •              grain foods, mostly whole grain and those naturally high in fibre
  •            some legumes, nuts, seeds, fish and other seafood, eggs, poultry (e.g., chicken) and/or red meat with the fat removed.

Choose and/or prepare foods and drinks:

  •    that are mostly ‘whole’ and less processed

I demonstrate how I would address each eating statement below. In the lists I only show the fibre containing foods. There would be other things added to the meals such as milk, cheese, yogurt, meat and cooking oils etc

Plenty of vegetables and fruit

I used the “what’s fresh” website to select seasonal fruit and vegetables based on the day of writing the blog. Eating seasonally can be a challenge if you have strong likes and dislikes.  It is important to encourage ongoing “tries” of vegetables to encourage a wide variety. Frozen vegetables are acceptable

Item Amount (as eaten) Fibre
Green Beans 80g 2.7
Corn on the cob – 1 medium 90g 2.4
Lettuce 50g 1.0
Tomato – medium 50g 1.7
Cucumber – 4 slices with skin 50g 1.5
Strawberries – 4 large 80g 1.2
Orange – 1 medium 90g 3.1
  TOTAL 13.6g

In this instance I imagined that the salad would go with lunch, and the cooked vegetables would go with dinner.

grain foods, mostly whole grain and those naturally high in fibre

The most common complaint I get is the cost of wholegrain bread. For the purpose of this exercise I am going to use a $1 loaf of bread. This will illustrate cheap bread can still help you meet your fibre intake. I am suggesting you use a sandwich slice and choose the wheatmeal bread

Item Amount (as eaten) Fibre
3 slices wheatmeal bread ($1 range) 94g 4.2g
Oats 45g 5.8g
Pasta (white own brand) 200g (100g dried) 4.0g
  TOTAL 14g

some legumes*, nuts, seeds, fish and other seafood, eggs, poultry (e.g., chicken) and/or red meat with the fat removed.

Item Amount (as eaten) Fibre
Peanut butter 20g 1.2g
Almonds 15g 1.3
Lentils 15g 1.6g
  TOTAL 4.5g
  • 20g peanut butter – see below
  • 30g of almonds consumed every second day
  • If you had two vegetarian meals each week e you would meet this goal. Each meal contains at least 50g (120g cooked) of lentils or other beans. If you are not able to sneak vegetarian past your family use lentils mixed in with your mince.

Choose and/or prepare foods and drinks: that are mostly ‘whole’ and less processed

 One of the biggest ways to improve fibre intake is have snacks that are mostly whole and less processed.

Snacks arranged here are not the usual processed cakes, biscuits and crackers.

  •               1 slice bread with 20g peanut butter daily (afternoon tea)
  •               1 piece of fruit as snacks (supper time)
  •               30g almonds every second day (morning tea)

This is a fairly basic diet.  Not everyone is going to stick to this all the time. Following the 80% rule (make good choices 80% if the time) then you can get a good fibre intake

If you would like to know more about fibre in the diet and have a diet makeover to increase your fibre intake, then make an appointment to see me.

Individualized Nutrition – what this means and why it is important

Our population is getting both older and sicker. One reason for the increasing incidence of poor health is the increasing weight on the average New Zealand adult.
On an individual level excess body weight is a poor predictor of health. On a population level, people who have excess weight are more likely to develop long term health issues. So with this change in the population body weight adult New Zealanders are developing long term conditions such as diabetes, heart disease and kidney disease younger.

Considerable time and money is spent promoting public health messages. Although many people believe healthy behavior is an individual responsibility, it is economically sensible to reduce harm through public health campaigns. The majority of public health campaigns focus on these areas of physical health.

4 ways we can all improve our health are:

  • Don’t smoke, or if you smoke stop
  • Drink alcohol within the safer drinking limits
  • Be active at least with 30 minutes of moderate intensity activity daily.
  • Eat plenty of vegetables and fruit, get your 5 servings daily.

Mathematical models suggest that if everyone followed these recommendations, we would have a very healthy population, with far less chronic disease.
At this high level there are only two messages associated with nutrition. Anyone who eats food will tell you that there are many more things suggested as important. So where do these other messages fit in?
Many of the other messages are around factors have smaller influence on health outcomes than these big 4. Take for example reducing the amount of saturated fat into your diet to the recommended level of 10%. If you modify your fat intake it may reduce your risk of heart disease by ½, which is a relatively small margin. Whereas with smoking the risk of heart disease is 5 times that of a non-smoker. If you stop smoking, you reduce your risk by a big margin. It is simpler to understand if you try to explain it as a fraction of populations.

  • If you have 1000 smokers, 200 to 400 of them die from heart disease directly caused by their smoking
  • If you had 1000 people who had a diet high in saturated fat, 20 to 40 of them will die from heart disease directly caused by their diet.

Many people look at the risk of death associated with saturated fat intake and say they are willing to live with those odds and stick with the diet they like. What they miss is that heart disease deaths is only one factor influenced by the saturated fat. Other health consequences including disability and other conditions such as Type 2 diabetes are influenced by saturated fat intake. Many risk factors are cumulative, so high saturated fat and low vegetable intake magnifies risk. Other risk factors such as genetic history or childhood experiences are often unmodified by lifestyle change.

When it comes to dietary advice, we are now on the edge of a revolution in thinking. Dietary advice could be individualized based on genetic and epigenetic testing, giving the “best diet” for your genes. That holds some promise, but it fails to recognize one thing. We eat for many reasons. Food is not just nutrition, and the other reasons are why we need to get individualized advice.

As a clinician my heart sinks if someone asks me for a diet sheet. I have never met someone who has stuck to one in 20 years of practice. Some people can make a good attempt, but others are completely unable to follow a prescribed diet and in that case we need to individualize the advice to take into account non-nutritional eating.

Recently I had a lady who was eating broccoli. She HATED broccoli, but broccoli was a super food, so she was having it daily. I helped her see there were foods that were just as useful to her as broccoli that she liked. What was the difference between her eating broccoli and not? It was the advice of a dietitian.

Why see a dietitian

A dietitian is a registered health professional. They have to have a post-graduate qualification in dietetics after an appropriate undergraduate. To maintain registration they must demonstrate life long learning. Dietitians must abide by a code of practice and can be disciplined if there is a breach of ethics or a significant complaint.

Dietetics is the interface between the science of nutrition and medicine. It involves modifying the diet to optimize well-being of individuals. The ultimate goal of dietetic intervention is either to prevent or manage health problems which have a dietary component.

I supervise young Dietitians and love that part of my job. Initially young Dietitians will struggle because they have license to practice but don’t feel competent. In supervision I liken the experience to riding a bike. Initially you have to concentrate on the skills needed to ride a bike. After practice you become a skilled bike user. You can start enjoying the scenery and navigating complicated terrain. Dietetic practice starts with giving advice based on theory and develops over time as the practitioner becomes more skilled to include practical knowledge about how to make changes. Dietitians are trained in the science of nutrition. Their skill is to help the patients translate the science into a diet they can eat. A competent dietetic practitioner practices holistically. The British Dietetic Association poster I am using as the image on this article is my favorite representation of the complex process in my head when I talk food to someone. As we discuss their diet I am gathering knowledge, as we start discussing intervention I am looking for cues and clues that this intervention will work for them in their current life stage. Ultimately I would hope to form a relationship with them and they come back for further assistance as their life circumstances change.


As of January 2019 I have started a major refresh of my blog. Lots of my blog will be about the science of nutrition. Some will be about the art of making the vegetable eating more possible. Other topic suggestions are welcome. With the pace of nutrition science I am not always going to be answering what you want…so please feel free to ask me questions or send me information you would like me to discuss.