The importance of snacks in daily nutrition, an Italian review

A team of Italian experts, coordinated by the Nutrition Foundation of Italy, recently published, in the prestigious Journal of Food Science and Nutrition, a review of the “Snacking in nutrition and health”, gained through the analysis of scientific literature published around the world.

It may seem an oxymoron since in Italy snacking is regarded as the bad habit of uncontrolled eating at random in between meals without hunger, and so, from this point of view, it is difficult to associate it with a healthy lifestyle and a balanced diet.

The English term “snackingis used to indicate mid-morning and mid-afternoon snacks. These are very different from eating randomly between meals as they have a specific purpose within the dietary routine being taken at precise times during the day and must meet specific nutritional requirements.

There is a multitude of scientific evidence to support the fact that splitting the daily distribution of energy and the supply of nutrients into 4-5 occasions, instead of concentrating them in just 3 meals main factors, have a positive impact on the overall quality of the diet and metabolism:

  • Consuming a snack in mid-morning and/or mid-afternoon avoids digestive and metabolic overload.

  • It improves the control of calorie intake in main meals by contributing to body weight control, which is why these two meals generally take the name of “starvation break”. Having a small snack between meals helps in coming to main meals less hungry and, consequently, encourages greater thoughtfulness in the choice of the quality and quantity of the food at those main meals.

  • Splitting nutrients into several occasions helps to reduce the overall glycemic load of meals and makes it possible to maintain a constant concentration of circulating glucose, avoiding the occurrence of peaks and troughs glycaemic peaks and troughs and keeping insulin levels low.

  • For those who perform intense physical activity, starvation breaks help restore glycogen reserves and keep muscle tissues intact.

  • Lipolysis (i.e. consumption of triglycerides) becomes more active.

Obviously, snacks should not substitute for proper general nutrition and should not add additional calories to the daily intake. Snacks should be part of the balanced daily diet: basically, the quality and quantity of food eaten during breakfast, lunch and dinner should guide the choice of snack that best suits your habits and needs.

In general, the mid-morning snack should account for about 5-8% of the daily calorie intake while the mid-afternoon snack, as the time between lunch and dinner is generally longer than between breakfast and lunch, should be a little more complex and account for about 7- 10% of the total daily calories.

Snacks take on a different role during different stages of life:

  • In childhood, fitting in two snacks during the day serves to improve the qualitative index of nutrition and teaches children from the earliest age to acquire correct eating habits.

  • In adulthood, in contrast, snacks help regulate hunger and consequently promote balanced hormonal secretion as well as the control of blood sugar, body weight and lipid profile.

  • For the elderly, snacks help to round out the diet. Malnutrition in older people is quite common. It is mainly attributable to dietary choices that with increasing age become more limited and, at the same time, complex because they are influenced by both biological and environmental, and also social and psychological factors.

But which characteristics should a starvation break have in order to make a positive impact on nutrition?

Obviously, not all snacks are suitable for a healthy diet. Most packaged snacks on the market, for example, are rich in additives, sugars, salt and saturated or hydrogenated fats for the sole purpose of having a more appetising taste and texture. While it is true that snacks can also fill the role of “comfort food” (that is, a food that satisfies both from the point of view of taste and psyche), it is also true that the daily balance of nutrients and energy must be respected. This means that snacks must be studied and calibrated taking into account individual age, sex, lifestyle and level of physical activity.

Below are some foods that could become part of a balanced snack which provides a sensation of satiation and enjoyment:

  • Nuts and dehydrated fruits, for example, dehydrated prunes, which help maintain the state of satiety and have a low glycemic index;

  • Dairy products, such as natural yoghurt or low-fat cheese, or otherwise a protein food;

  • Fruits and vegetables, source of vitamins, minerals and fibre;

  • Bakery products are free of saturated or hydrogenated fats (preferably cereal products with a 50% wholegrain content).

Water is the best drink to accompany meals since it maintains hydration throughout the day, which is essential for the entire body to function correctly.

To sum up, it is internationally recognized that dividing up daily calories and nutrients into four to five occasions, rather than concentrating everything in the three main meals, is beneficial from the metabolic point of view. To avoid overeating, it is essential to always stick to a timetable with snacks mid-morning and mid-afternoon, to check the energy content and composition of the foods you choose to eat and to adapt them to your needs.

Sources and insights:

Franca Marangoni, Daniela Martini, Silvia Scaglioni, Michele Sculati, Lorenzo Maria Donini, Francesco Leonardi, Carlo Agostoni, Gianluca Castelnuovo, Nicola Ferrara, Andrea Ghiselli, Michelangelo Giampietro, Claudio Maffeis, Marisa Porrini, Bianca Barbi & Andrea Poli (2019) Snacking in nutrition and health, International Journal of Food Sciences and Nutrition, DOI: 10.1080/09637486.2019.1595543–prevenzione-benessere-n-4—2019.aspx

Is it true that some types of added sugars are healthier than others?

It has now been scientifically proven that excessive consumption of added sugar is harmful to health.

On this aspect, however, it is important to make a clarification:

The term “simple sugars” conventionally refers to monosaccharides, consisting of a single molecule, and disaccharides, the latter consisting of two molecules of monosaccharides:

  • Monosaccharides: glucose, fructose and galactose;

  • Disaccharides: sucrose (glucose + fructose), lactose (glucose + galactose), maltose (glucose + glucose).

These simple sugars are also found naturally in foods, for example in fruit (fructose), dairy products (lactose), but also in germinated cereals (maltose). What is found in processed products are so-called “added sugars” or simple sugars extracted, processed and added to food during food processing.

When one talks about “sugar” in the singular, one is traditionally referring to common refined table sugar, or purified sucrose extracted from sugar beet, which is added to the product recipes.

It is important to make this clarification because, although naturally present sugars and added sugars are metabolised by the body through the same pathways, simple sugars naturally present in food have no particular contraindications to consumption while added ones are one of the causes of increased obesity, type 2 diabetes, cardiovascular diseases and also certain types of tumour.  

Sugars naturally present in foods are found in moderate amounts, and along with them, fibre and other nutrients that reduce the negative impact on blood glucose and are useful for maintaining a healthy body. By contrast, sugars added to processed foods mainly for reasons of taste have no beneficial effect on metabolism.

The primary sources of sugars added in the diet are sugary beverages and refined food, especially ultra-refined food.

There are many products on the shelves containing added sugars from different sources with many different, and more or less well-known, names.

You often come across the list of ingredients such as glucose syrup, high fructose corn syrup (HFCS), agave syrup, cane sugar, barley malt, dextrose, and maltose, fructose, and so on.

Since they are all added sweeteners, the question arises of which ones are a source of unnecessary calories for the body and whether there is any difference between the various types of sugars?

It is actually quite commonplace to regard some sugars as being healthier than others, which influences the consumers’ buying choices to favour one product over another. But is this really the case?

Are there really any added sugars which are ‘healthier’ than others?

An article published on the Harvard Medical School website explains that many of the sugars that are added to food are made up of both fructose and glucose (or either only fructose or only glucose). What differentiates them often is only the ratio between the two monosaccharides: table sugar (sucrose) for example consists of 50% glucose and the other 50% fructose, agave syrup is 90% fructose and 10% glucose, and so on.

Fructose and glucose follow two different metabolic pathways: glucose is absorbed via the intestine and passes into the blood by increasing glycemia (blood glucose levels); fructose is metabolized instead via the liver and, as a result, does not lead to an increase in blood glucose. However, over a long time period and at high concentrations (unlike natural fruit sugars), it increases the risk of developing liver disease.

In conclusion, whether an added sugar contains more or less fructose than glucose actually has only a minimal impact on health.

Except for special conditions, as in the case of diabetics, one type of added sugar is no better than another and in any case it is always better to limit all sources of added sugar and maintain them well below the recommended intake level which, according to WHO, should be around 5-10% of daily calories.

Sources and insights:

IDEFICS study: Too many simple sugars in the diet of European children

In Europe only the diet of twenty out of a hundred children complies with WHO guidelines, especially when it comes to intake of simple sugars.

This was a key finding emerging from the IDEFICS (Identification and Prevention of Dietary and Lifestyle-Induced Health Effects in Children and Infants) study, which began in September 2006 and ended in February 2012. Its goal was to collect data to carry out an international assessment of the problem of childhood obesity.

The study considered the consumption of simple sugars in the diet of 16,228 children in the age group 2-9 years in eight European countries, including Italy. 20% of children considered were overweight or obese.

The term “simple sugars” or “free sugars” on the label means both glucose, fructose and sucrose added to a processed food at the time of production, during cooking or before consumption, and the sugars naturally present in the food.

WHO suggests that simple sugars should not constitute more than 10% of the daily calorie intake.

Foods belonging to different groups have been regarded as sources of simple sugars:

  • plants;
  • cereals and bakery products;
  • sugary beverages;
  • coffee,
  • teas and herbal teas;
  • milk and dairy products in general;
  • fruit juices;
  • sweets, chocolate snacks and desserts;
  • potatoes;
  • nuts and oilseeds;
  • ready-made seasonings and sauces (mayonnaise, ketchup, and so on.);
  • ready-made soups and broths.

The analyses showed that:

  1. Fruit juices and sugary beverages provide the highest proportion of free sugars. This is not so surprising considering a 500ml bottle of tea of the most famous brands contains about 50g of sugar – roughly the equivalent of about ten sugar cubes.

  2. Milk and derivatives come next after soft drinks. In addition to sugars occurring naturally in these products, it is not uncommon for them to be added, for example, to yoghurts, especially flavoured ones. By reading the nutritional labels, you can see how some yoghurts labelled as ‘light’ contain more than 10g of sugar (almost two and a half 5g cubes of sugar). Fat content in what is branded as ‘light’ yoghurts should be reduced and ideally replaced by proteins, however, more often than not they are replaced by sugar.

  3. Third on the list are confectionery and sweets.

On average, European children consume about 18% of daily calories in the form of simple sugars. Unlike German children — who are the ones who misuse them the most (27.2%) — Italians are among the most virtuous (13.3%), although they are still above the limit recommended by the WHO.

Italy is, however, one of the countries with the highest rate of overweight or childhood obesity.

As reported by a 2019 WHO study on more than 600,000 children from 21 countries of the European community (Prevalence of Severe Obesity Among Primary School Children in 21 European Countries), in Italy about one in two children is overweight, while one out of five is clinically obese, with a higher incidence among males than females.

The IDEFICS study confirms that, although there are considerable differences, European children aged between two and nine generally consume far higher amounts of free sugars than recommended by WHO.

These figures paint a rather disturbing picture in that it is almost the norm that foods targeted at young children are enriched with simple sugars to make them far more attractive to them.

Although simple sugars added to foods are accused of being one of the leading causes of obesity and other chronic diseases such as type 2 diabetes, the differences detected between different countries must be taken into account in designing specific educational interventions directed not only at the population but also to the food industry.

Sources and insights:–i-bambini-italiani-sono-i-piu-moderati.aspx




Mediterranean diet UNESCO heritage site

When talking about a “proper diet”, we mean a diet that ensures the right intake of all macronutrients and micronutrients essential for development, growth and maintenance of a person’s state of health.

In this context, the Mediterranean Diet – or what should be more accurately defined as the “Mediterranean food model” and was inspired by the food models followed by countries bordering the Mediterranean – is undoubtedly the closest to an optimal diet.

The first scientific evidence of the validity of the principles of the Mediterranean Diet dates back to the 1950s with the “Seven Countries Study” promoted by Ancel Keys (1904 — 2004; biologist, physiologist and epidemiologist, and considered to be the first nutritionist biologist in history and founding father of food science). He involved seven nations from four regions of the earth (United States, Italy, Finland, Greece, Yugoslavia, the Netherlands and Japan) and studied the relationship between lifestyle, diet, heart disease and stroke. The results showed that the farther away from the diet typical of the Mediterranean countries, the higher the incidence of cardiovascular diseases.

In 2010 UNESCO recognized the Mediterranean Diet as an “intangible heritage of humanity” acknowledging its paternity to Italy, Greece, Morocco, Cyprus, Croatia and Portugal.

The Mediterranean Diet represents “a set of skills, knowledge, practices and traditions ranging from landscape to table, including crops, harvesting, fishing, conservation, transformation, the preparation and, in particular, the consumption of food”.

Its hallmarks are cereals – especially whole grains – fresh fruits, nuts, vegetables, olive oil and spices accompanied by a modest consumption of animal derivatives such as dairy products, meat, and fish.

Even wine – especially red wine rich in polyphenols and when consumed in moderation – is part of the Mediterranean diet alongside ordinary and herbal teas and infusions that are part of the different traditions of each country.

The beneficial effect on the prevention of chronic degenerative diseases associated with this diet, in particular on conditions affecting the cardiovascular system, is attributable to the wealth of substances such as unsaturated and polyunsaturated fatty acids (Omega-3 and Omega-6), dietary fibre and antioxidant compounds typical of plant-based foods, and calorie balancing as one of the ranges of nutritional principles.

“Calorie balancing” means the optimal distribution of calories consumed daily among different nutrients: in an optimal diet protein should account for 10-15% of calories introduced daily, carbohydrates 55-60%, and fats 25-30%.

The CREA (Italian Council for Research in Agriculture and the Analysis of the Agricultural Economy) has issued a set of Practical Guidelines, inspired by the principles of the Mediterranean Diet, which states that in order to follow a healthy diet regime, people should:

  • Consume daily at least five servings of fresh fruit and vegetables and about 30g of oily nuts, as indicated by the LARN (Portion Standard);
  • Reduce consumption of saturated fats, which include not only butter and animal fats but also palm oil. It is vital to substitute saturated fats in the diet with unsaturated fats, such as olive oil or seed oils, preferably used raw, which can help normalise the blood cholesterol levels and thereby contribute to the prevention of pathologies affecting the cardiovascular system;
  • Try to introduce most of the daily calories (about 50-60%) through the consumption of complex carbohydrates including cereals (spelt, barley, rye, and so on), pasta, bread and rice, preferably wholemeal. Wholegrain cereals are an excellent source of fibre compared to those produced using refined flour.
  • Promote the consumption of vegetable proteins, such as legumes by creating combinations that allow the intake of all essential amino acids. Consumption of animal proteins should be limited.
  • When consuming products of animal origin it would be better to choose fish and white meat and limit consumption of red meat, sausages and dairy products (especially fatty ones). Consumption of the latter should be reduced to a maximum of 2 times a week.
  • Reduce consumption of sugar and simple sugars added products (packaged snacks, confectionery, sweets, packaged biscuits, and so on).
  • Reduce the consumption of salt, following the measures provided by the Italian Ministry of Health.
  • Drink plenty of water (one litre and a half per day) and limit the intake of canned soft drinks and, above all, alcoholic beverages.
  • Vary a lot of your food choices every day.

In 1992, the Food Pyramid was designed to convey the principles of the Mediterranean Diet in a way that was easy to understand and intuitive.  In more recent times (2005) the pyramid has undergone a substantial revision due both to changes in lifestyle and habits of the population and to new scientific discoveries in the food sector:

  • Refined cereals (pasta, white bread, potatoes) have been moved from the base to the top of the pyramid, among the foods to be consumed in moderation.  In fact, attention has shifted from the level of complexity of carbohydrates to how fast or how slowly they increase blood glucose. Wholegrain cereals have a lower glycemic impact than refined ones and are preferable.
  • Lipids have also undergone a change. While only occasionally eaten animal fats have stayed at the apex, vegetable fats (such as olive oil) have moved to the base as an everyday staple.

Among the pillars of the Mediterranean diet, which would ideally also be at the base of the food pyramid, there are also aspects that go beyond proper nutrition itself to complete the picture of the perfect nutritional diet.

  • The pleasure and conviviality of meals, rediscovering the pleasure of cooking and, whenever possible, sharing meals: all of these contribute to people’s well-being.
  • Seasonality of products: choosing the most suitable and nutritious products according to season.
  • Keeping your weight under control,
  • Always remember to accompany a healthy diet with daily physical exercise. There is no need to overdo it. Just half an hour of moderate aerobic exercise, such as walking, swimming breast or backstroke, or riding a bike is all that is required.

And we should always remember that a healthy lifestyle in itself will nourish our well-being and longevity.

Sources and insights:

G. Liguri; Nutrizione e dietologia – Aspetti clinici dell’alimentazione; Zanichelli


A teaspoon to discover added sugar

Carbohydrates are a class of basic nutrients, often referred to under the generic term of sugars.

Based on the complexity of the molecules, they are divided into monosaccharides and disaccharides (also known as “simple sugars”) such as glucose and sucrose, and polysaccharides (“complex sugars”), such as starch.

There is a fundamental distinction between sugars naturally present in food, such as those found in fruit (fructose) and dairy products (lactose), and refined sugars extracted by industrial process from sugar cane, beets and cereals, which are added to foods during processing.

In terms of nutrition, this separation is important for two reasons:

  1. Natural and refined sugars are assimilated differently by the body (fibres and other compounds naturally present in unprocessed foods).
  2. While natural sugars present no particular problems for consumption, refined ones, widely added in industrial processing, are recognized as one of the causes contributing to the spread of obesity and related diseases.

The health issue resides not so much in the sugar itself as in the immoderate use that the food industry makes in the interests of taste, processing technology and conservation: sugar added to the foods have significantly increased average consumption of simple sugars.

The term ‘simple sugars’ includes both sugars naturally present in food and the more than 50 different forms in which the food industry adds it to snacks’, drinks’ and other products’ ingredients: glucose syrup, maltose, dextrose, golden syrup, molasses, etc.

Companies’ abuse of added sugar has made it almost impossible for consumers to calculate the exact amount of sugar they are consuming.

Here are some data to give an idea of the extent of the problem:

  • 80% of processed foods contain added sugars
  • sugar consumption has increased by over 46% worldwide over the past 30 years (Source Credit Suisse Report, 2013)
  • annual per capita consumption of sugar in Italy (Source WHO, 2015) is 27 kg

In addition to this data on the state of health of the Italian population the following should also be added:

  • 10% of Italians are obese (Source: Osservasalute Report , 2017)
  • 1 child in 3 is overweight (Source: Italian Ministry of Health, 2016)
  • 3.2 million people in Italy say that they are suffering from diabetes (Fonte Istat, 2016)

So how can we find out how much sugar we are actually eating?

Counting sugar spoons is a simple trick which can produce great results.

Even though they do not differentiate between natural and added sugars, food nutritional tables always show the number of grammes of simple sugars.

To get an idea of how many sugars we are eating, just remember that one teaspoon contains an average of 6 grammes and that, according to the World Health Organization, 4 to 5 teaspoonfuls are the daily ration recommended for an adult, which is about 5% of the daily energy intake.

  • One soft drink (200 ml) contains on average 22 grammes of sugar, equal to 3.6 teaspoonfuls
  • Ten grammes of sweets contain 6.2 grammes, equal to 1.2 teaspoonfuls
  • A brioche weighing 37 grammes contains about 9.5 grammes of sugar, equal to 1.6 teaspoonfuls
  • A glass of fruit juice (200 ml) contains on average 4 teaspoonfuls of sugar

While the harmful nature of added sugars is now well known, the same thing does not apply to natural sugars on which, to date, the WHO does not express negative opinions because there is no scientific evidence to show they are harmful. Calculating with spoons is an easy first step in understanding how used we have become to exceeding the limit that the WHO has set to protect us from sugar used all too casually by the food industry.

Changing your habits is always difficult, but starting with a better awareness of your eating behaviour is a fundamental step. And quantifying sugar intake can be a very good way to start.

Sources and insights:

A Sustainable Diet is possible: for us and for the planet

On 17 January in Oslo, the EAT-Lancet Commission presented the report of a three-year research and review project aimed at laying the foundations for the definition of a universal diet that is healthy and environmentally sustainable.

This study has proved necessary as it is becoming increasingly apparent that the choice of food and the way it is grown, processed, transported, consumed and wasted have a clear impact on the health not just of individuals, but also of the entire planet.

There is strong evidence that food production is one of the largest producers of greenhouse gases and one of the main factors responsible for global environmental changes, and in particular for climate change, biodiversity loss, freshwater exploitation, interference with global nitrogen and phosphorus cycles, and changes in the terrestrial system. At the same time, unhealthy diets are among the main risk factors for the onset of diseases such as diabetes, cardiovascular disease and cancer worldwide. It is estimated that the impact of a poor diet on the causes of mortality is higher than that of alcohol, drugs, tobacco and unprotected sexual intercourse combined. Added to this is the high level of global malnutrition in developing countries: today more than 800 million people do not have enough food for their livelihoods, while many other countries follow very poor diet regimens made of excessive portions and wrong combinations of foods that cause overweight and obesity.

In the light of these considerations, it is clear that the transformation of the food system must be radical, urgent and mandatory.

To do this, the Commission has focused on two fundamental aspects of the food supply chain:

  • Final consumption: to identify which diet is best suited to keep the population healthy

  • Production: identify the changes to be implemented in the food production chain to make it sustainable

The team, made up of over 30 top experts working in different fields (human health, agriculture, political science and environmental sustainability) from all over the world, has been working on defining a universal reference diet to estimate the effects on health and the environment derived from an alternative diet compared to current standard diets which are often high in unhealthy processed food.

In addition to having positive health effects, the universal diet will have to be able to cope sustainably with the strong demographic growth expected in coming years: the United Nations estimates say that by 2050 the world’s population will reach about 10 billion people.

The Commission’s working groups considered five key issues:

  • What is a healthy diet? That is a diet based on solid scientific evidence which optimizes health understood as both the absence of disease and a state of complete well-being (physical, mental and social).
  • What is a sustainable food system?
  • What are the trends shaping diets today? In other words: what is actually on people’s plates in different countries around the world?
  • Can we create healthy diets from sustainable food systems? How?
  • Which solutions and policies can we adopt? A set of guidelines that governments, businesses and consumers should follow to achieve the planet’s health and well-being goals.

The result is a varied diet, with a daily calorie intake of 2,500 kcal, which takes the Mediterranean diet with few tweaks as its basic model.

The healthy and “sustainable” diet should consist predominantly of a wide variety of fruits, vegetables and proteins of vegetable origin (nuts and pulses), reduced amounts of food of animal origin ( moderate quantities of fish and poultry, little or no quantity of red meat and processed meat); it should also choose unsaturated fats over saturated and consumption of limited quantities of refined cereals, highly processed foods, and added sugars.

Below is a table summarizing the main recommendations for a “sustainable diet”:

FOOD Macronutrients in grammes to be taken per day (possible interval) Daily calorie intake (kcal)
Wholegrain cereals 232 811
Starchy tubers or plants 50 (0-100) 39
Vegetables 300 (200-600) 78
Fruit 200 (100-300) 126
Dairy products 250 (0-500) 153
Red meat 14 (0-28) 30
Poultry 29 (0-58) 62
Eggs 13 (0-25) 19
Fish 28 (0-100) 40
Pulses 75 (0-100) 284
Nuts 50 (0-75) 291
Unsaturated fats 40 (20-80) 354
Saturated fats 11.8 (0-11.8) 96
Added sugar 31 (0-31) 120


This transformation of eating habits can only occur through a multisectoral and multilevel action involving the entire supply chain, from the producer to the final consumer.

The changes to be implemented involve:

  • A substantial shift in eating habits towards purely vegetable diets with a 50% reduction in meat and sugar consumption and a doubling in the consumption of fruit, vegetables, nuts and pulses,

  • A sharp reduction in food loss and food waste,

  • Implementation of important changes and improvements in food production practices.

The report closes with five strategies to be implemented in order to make the so-called “Great Food Transformation” possible:

  1. We must commit ourselves, at both national and international level, to promoting a transition to a healthier diet.
  2. Redefining agricultural priorities: moving from production of large quantities of food to production of quality food.
  3. A new agricultural revolution: increasing quality food production sustainably through system innovation.
  4. Sustainably controlling and coordinating the management of land and oceans without further uncontrolled expansion of agricultural land and overfishing.
  5. Halving food waste at all levels, in line with the UN Sustainable Development Goals.

The data available to date is already more than enough to justify immediate action; if nothing is done, future generations will end up inheriting a seriously degraded world where a large part of the population will suffer from malnutrition and preventable diseases.

The Great Food Transformation is both necessary and achievable.

Euro Company absolutely agrees with this study’s findings that it is essential forthe entire food industry to make it its goal to produce healthier and more wholesome food, and to do so responsibly and sustainably

  • Every day we care that our nuts and our 100% vegetable products are both wholesome, healthy, without added sugar and processed as little as possible.
  • At the production level we buy electricity produced from renewable sources and we have reduced our CO2 emissions by 15%.
  • In 2 years we have reduced packaging waste by 24 tonnes and expect to make our packaging 100% compostable by 2020.

Every company and every individual should do its part in this ambitious project, for our sake and that of our planet.

Walter Willett, Johan Rockström, Brent Loken, Marco Springmann, Tim Lang, Sonja Vermeulen, Tara Garnett, David Tilman, Fabrice DeClerck, Amanda Wood, Malin Jonell, Michael Clark, Line J Gordon, Jessica Fanzo, Corinna Hawkes, Rami Zurayk, Juan A Rivera, Wim De Vries, Lindiwe Majele Sibanda, Ashkan Afshin, Abhishek Chaudhary, Mario Herrero, Rina Agustina, Francesco Branca, Anna Lartey, Shenggen Fan, Beatrice Crona, Elizabeth Fox, Victoria Bignet, Max Troell, Therese Lindahl, Sudhvir Singh, Sarah E Cornell, K Srinath Reddy, Sunita Narain, Sania Nishtar, Christopher J L Murray; Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems; The Lancet Commissions; January 16, 2019.