by Dr. Kalidas Shetty

Professor of Plant Sciences, North Dakota State University, Fargo, ND 58102

Summary: To advance global food security and to address associated human health challenges we must understand global food systems with its ecological diversity for sustainable solutions. The world faces the most critical ecological challenge from climate change and essential urgency to reduce the carbon footprint affecting food production challenges as we address concurrent health challenges. Global food security challenges present the double burden of undernourishment and excess calories (from hyper processed macronutrients with deficiency in micronutrients), which also has consequences on reduced immunity due to higher co-morbidity risks. The rapidly increasing burden of excess calories is leading to a rapid increase in non-communicable chronic disease (NCD) such as type 2 diabetes and cardiovascular disease complications and the burden of such co-morbidity is closely linked to immunity breakdown as seen in the current COVID19 pandemic.

Essential solutions to these challenges require harnessing the benefits of more climate resilient food diversity of the overall food systems and across all diverse ecologies of the world to improve the health targeted quality of the food systems to counter NCD and associated co-morbidity risks. To harness the health benefits of diverse foods for countering emerging health challenges, metabolic innovations grounded in sound ecological, metabolic, and cellular biochemistry using systems rationale must be the basis of health-targeted and climate resilient food innovations. The approach to using systems rationale means the critical control points of overall metabolic processes both in the food production domain and associated nutrition-linked health outcomes must be integrated from food production to processing to delivery for health and wellbeing.

Dr. Kalidas Shetty and I are colleagues who go back many years. I am not sure where we first met, but we visited with each other at professional meetings. Our research projects on lipid oxidation were related as he has interests in phenolic antioxidants resulting in me reviewing manuscripts and proposals of his. He may have been a reviewer of some of mine as well. My respect for Dr. Shetty and his research is immense. I asked him to weigh in on diet and health issues. His presentation here is more scholarly than normal posts on this site, but his voice is one that needs to be heard. His perspective on current diet diversity and its effects on immunity in light of the current pandemic and future challenges due to climate change are timely.   

Introduction: The health-targeted and climate resilient rationale for advancing global food systems based on food diversity is well aligned to current challenges where there is rapid emergence of diet-linked chronic diseases that represent a new reality of food security (1-3, 5, 6). This recent global increase in diet-linked non-communicable chronic diseases (NCDs) is resulting in a heavy burden on long-term health care management and overall costs in aging societies as well as demographically younger emerging countries, thus consuming higher levels of national health care budgets (5).

A critical overall burden of NCDs and associated co-morbidities involves series of progressive metabolic malfunctions that manifests itself in enhancing oxidative stress (i.e., respiration-driven oxygen function breakdown associated with energy needs) at many cellular and organ levels (5, 6, 8). NCD health-targeted functional diets designed for management of respiration-driven oxidative stress for management of optimum metabolic energy needs will be an important part of the overall solution to combat NCDs (5, 6). Therefore, the most cost-effective strategies of metabolic innovations for NCDs are improved design of food crops and non-crop foods (herbs, spices, and medicinal crops) based on agro-ecological diversity with optimized health-targeted impacts on NCDs (5, 6, 8). 

Improved health-targeted food design must contain balance of both macronutrients and micronutrients as ingredients, including bioactive compounds that can counter oxidation-linked malfunctions of NCDs.  Such bioactive enriched foods are also essential in advancing community-wide nutrition and health, while concurrently increasing the agro-ecological diversity (i.e., plant biodiversity) of local food crops with deep-rooted cultural influences shaping food choices.  These efforts will greatly benefit the global ecology where climate resilience will be the most important challenge to manage food production and impacts of its quality on better health and across diverse global communities (5, 6).

Ecology-Driven Systems Strategies: Based on above rationale current understanding global food and nutritional security model must be adjusted to generate adequate and resilient global food production system from a wide diversity of crops in diverse ecologies that will meet macro/micronutrient needs along with phytonutrients (e.g., phenolic antioxidants as one example) to counter obesity linked NCDs (5, 6).  The NCD epidemic and its co-morbidities impacting failure of immunity response to infections represents a large financial burden on health care systems worldwide and is more evident in the current COVID19 pandemic.

The current food production practices and economics associated with it favor highly processed carbohydrate-enriched foods and are dependent on a narrow selection of major cereal crops such as rice and wheat with corn for animal foods (5, 6).  These cereal crops currently are less resilient and robust in responding to and dealing with climate change extremes being developed for yields rather inducible responses to abiotic stress (e.g., salinity, droughts, and temperature).  Another critical challenge the world faces is that global food security currently is dependent on petroleum fossil fuel-based nitrogen that contributes to the unsustainable addition of nitrogen wastes, which affect ecology and human health especially along water bodies that link global river systems to oceans (5, 6).  Nitrogen in the soil has more than doubled in the last 100 years around the world and excess nitrogen is a third ecological dimension of the food cycle that further worsens increasing carbon emissions and hastens poor water quality further burdening human health in terms of for examples; vascular hemoglobin function and global ecology (e.g., worsening algal blooms and associated toxins) (5, 6).

Overall, the lack of food diversity, from an unsustainable ecology focused on restricted food crop choices and animal foods and excess fertilizer application, coupled with high consumption of hyper-processed carbohydrates and lipids, without micronutrients and oxygen stress protecting phytonutrients, is contributing to increasing ecological imbalance and associated NCDs globally.  The challenges affecting global food security require solutions that are integrated, systems-based strategies that use nutrition and health-targeted food-based food security for advancing human and animal health with an improved and sustainable agroecology that is based on crop and food diversity and promoting diverse ethnic food concepts built from all human experiences (3, 5-7).

From this systems-based foundation of climate resilient and health-targeted foods, crop and animal metabolic innovations based on ecological rationale must emerge (1, 5, 6, 8).  This overall approach has the potential benefits of addressing both food processing and especially primary agricultural production challenges and improving their resilience to climate change.  These integrated systems must be part of overall solutions to more resilient and multi-purpose agricultural systems and supporting ecologically diverse food systems that better address global food security, through crop and food diversity models, both for climate adapting ecological sustainability that is more resilient as well as an improved approach to addressing the challenges of human health (3, 6).

NCD Co-Morbidities and Post-COVID Implications: Based on above background and realities facing global food security-linked health challenges with rapid emergence of climate change, the current global pandemic is providing early insights on the challenges we face. The COVID-19 pandemic caused by RNA virus, Coronavirus 2, or SARS-CoV-2 results in severe acute respiratory syndrome and further multi-faceted metabolic disorders. The rate of infection, mortality and associated medical complications without specific drug to target or vaccine under developmental stages or emergency use approval stages has challenged the global community with limited solutions. Impacts around the world are diverse with Europe and Americas being affected the most with case mortality rates in several countries reaching over 1000 deaths per million.

Meanwhile in Asia and Africa and even in countries with food security challenges in the traditional calorie model and poor health infrastructure have mortality in one segment at 1 death per million and range of other countries in Asia and Africa at 10-100 deaths per million. What are the reasons for these differences? Suggestions have been from strict adherence to mask, social distancing and sanitation to authoritarian rules following communities to better natural immunity to many other reasons from social health care to food systems.  One aspect is clear that susceptibility to COVID19 and infections are far higher in people with co-morbidities linked to NCD coupled to aging and close living in multi-generational families.

A rationale basis for integrated health-targeted strategies to explore improved food and nutritional management must be advanced while pharmacological and vaccine strategies are being pursued. While current primary critical essential strategies for prevention and management are effective use of face mask, physical distancing and sanitization techniques, potential enhancement of overall innate immunity via improved nutritional strategies for both prevention of infection and managing subsequent complications can be part additional integrated management strategies.  Based on epidemiological data across many health challenges, it is established that food and nutrition play a major role in the development of immunity.

Early indications point to less incidences of infections in regions of the world with diversity of food with balanced calorie density and have low cases of co-morbidity from diet linked NCD.  This must be explored deeply with more evidence as potential of improved diet diversity that counter co-morbidities linked to NCD has also potential to countering infections. However, as we move forward it is important to understand the chemistry and biochemical functionality of the food systems and design and subsequent effect and benefit to health of communities.

Considering the manifestation of clinical symptoms and complications of COVID19, it is currently very challenging to extrapolate the information or outcome from previous studies. Information needs to be developed for dietary designs for supporting the further validation of infectious disease management outcomes associated with NCD co-morbidities emerging from poor diet with severe imbalance of macro or micronutrients from failures of the food system, We must build on the success of technologies that has allowed world to conquer hunger and malnutrition in large parts of the world and refine strategies to address new emerging challenges of building climate resilient and health targeted food systems based on food diversity across diverse ecologies.

Next Week: The Five Reasons Why We Eat and Drink What We Do by Allan Griff

References:

1. Sarkar, D. and Shetty, K. (2014a). Diabetes as a Disease of Aging, and the Role of Oxidative Stress. In V. Preedy (Ed.), Aging: Oxidative Stress and Dietary Antioxidants. Elsevier, Oxford, UK. Chapter 6, pp 61-69.

2. Sarkar, D. and Shetty, K. (2014b). Metabolic Mobilization Strategies to Enhance the Use of Plant-Based Dietary Antioxidants for the Management of Type 2 Diabetes. In V. Preedy (Ed.), Aging: Oxidative Stress and Dietary Antioxidants. Elsevier, Oxford, UK, Chapter 27, pp 289-296.

3. Sarkar, D., Walker-Swaney, J. and Shetty, K. (2020). Food Diversity and Indigenous Food Systems to Combat Diet-Linked Chronic Diseases. Current Developments in Nutrition, Volume 4 (Supplement 1), 3–11, (https://doi.org/10.1093/cdn/nzz099)

4. Sarkar, D. and Shetty, K. (2014). Metabolic stimulation of plant phenolics for food preservation and health. Annual Review of Food Science and Technology, 5: 395-413.

5. Shetty, K. (2014). Systems Solutions to Global Food Security Challenges to Advance Human Health and Global Environment Based on Diverse Food Ecology. Pages 65-73. A policy position paper presented at the conference on Food Safety, Security and Defense: Focus on Food and the Environment, convened by the Institute on Science for Global Policy (ISGP), on October 5-8, 2014 at Cornell University, Ithaca, New York, U.S. (ISBN: 978-0-9861007-0-3).

6. Shetty, K. and Sarkar. D. (2018). Editorial: Advancing Ethnic Foods in Diverse Global Ecologies through Systems-Based Solutions is Essential to Global Food Security and Climate Resilience-Integrated Human Health Benefits. Journal of Ethnic Foods, 5: 1-3. (https://doi.org/10.1016/j.jef.2018.02.003).6.

7. Shetty, K. and Sarkar, D. (2019). Introduction: Metabolic-Driven Ecological Rationale to Advance Biotechnological Approaches for Functional Foods. In: Food Biotechnology Series, K. Shetty and D. Sarkar (Ed.), Functional Foods and Biotechnology: Sources of Functional Foods and Ingredients. CRC Press (Taylor and Francis Group), Boca Raton, USA, Chapter 1, pp 1-4.

8. Shetty, K and Wahlqvist, M.L. (2004). A model for the role of proline-linked pentose phosphate pathway in phenolic phytochemical biosynthesis and mechanism of action for human health and environmental applications; A Review. Asia Pacific J. Clinical Nutrition, 13: 1-24.

Dr. Kalidas Shetty is currently the Associate Vice President for International Partnerships & Collaborations and Founding Director of Global Institute of Food Security and International Agriculture-GIFSIA & Professor of Plant Sciences at North Dakota State University, Fargo, ND, USA.  Dr. Shetty’s research interests focus on critical role of cellular and metabolic basis of oxygen biology for advancing new innovations in Life Sciences and especially Agricultural and Food Innovations that advance global food security and health in a sustainable environment. His specific research interests focus on redox pathway-linked biochemical regulation of phenolic phytochemicals in food crops to advance climate resilient food security solutions in addition to malnutrition and hunger challenges. In particular, he has developed an innovative “crops for health” research platform to counter diet-linked chronic diseases.

He has published over 220 manuscripts in peer-reviewed journals and over 50 as invited reviews and in conference proceedings. He holds 6 US patents. In 2004, Professor Shetty was selected by US State Department as the inaugural Jefferson Science Fellow to advice on scientific issues as it relates to International Diplomacy and International Development. Dr. Shetty has widely traveled and has been invited to present lectures and seminars in the areas of Food Biology, Eco-Biological Basis for Evolving Healthy Food Systems for Food Security & Health, Functional Foods and Dietary Phytochemicals and Food Safety in over 40 countries in Asia, Europe, Africa and the Americas.

His current passion and commitment are to develop “Sustainable and Ecological basis for healthy food systems and diverse food choices to drive global food security” based on local crops and food diversity, traditional fermentations and ethnic food systems and effective food imports that incorporates understanding of comparative cellular biochemistry of plant and animal systems and their interactions with microbial systems in diverse ecologies. This system based integrated model and “outside the box” research platform based on cellular basis of oxygen biology of food plants and plant-microbial interactions as the basis for new and innovative Agro-Food solutions to advance sustainable basis for food security and health.