Food systems are at the center of a brewing storm consisting of a rapidly changing climate, rising hunger and malnutrition, and significant social inequities. At the same time, there are vast opportunities to ensure that food systems produce healthy and safe food in equitable ways that promote environmental sustainability, especially if the world can come together at the UN Food Systems Summit in late 2021 and make strong and binding commitments toward food system transformation. The NIH-funded Nutrition Obesity Research Center at Harvard and the Harvard Medical School Division of Nutrition held their 22^nd annual Harvard Nutrition Obesity Symposium entitled “Global Food Systems and Sustainable Nutrition in the 21^st Century” in June 2021. This article presents a synthesis of this symposium and highlights the importance of food systems to addressing the burden of malnutrition and noncommunicable diseases, climate change, and the related economic and social inequities. Transformation of food systems is possible, and the nutrition and health communities have a significant role to play in this transformative process.

This Analysis presents a recently developed food system indicator framework and holistic monitoring architecture to track food system transformation towards global development, health and sustainability goals. Five themes are considered: (1) diets, nutrition and health; (2) environment, natural resources and production; (3) livelihoods, poverty and equity; (4) governance; and (5) resilience. Each theme is divided into three to five indicator domains, and indicators were selected to reflect each domain through a consultative process. In total, 50 indicators were selected, with at least one indicator available for every domain. Harmonized data of these 50 indicators provide a baseline assessment of the world’s food systems. We show that every country can claim positive outcomes in some parts of food systems, but none are among the highest ranked across all domains. Furthermore, some indicators are independent of national income, and each highlights a specific aspiration for healthy, sustainable and just food systems. The Food Systems Countdown Initiative will track food systems annually to 2030, amending the framework as new indicators or better data emerge.

Background: Empirical evidence on the link between agro-biodiversity and dietary diversity appears to be inconclusive. Thus, arises a need to determine other factors that could significantly influence dietary diversity in different agro-ecological zones as factors may vary from region to region. Objective: This study assessed the determinants of dietary diversity (DD) among women of reproductive age in two different agro-ecological zones of Rongai Sub-County in Kenya; with agrobiodiversity being the main independent predictor. Design: A cross-sectional study targeting 400 women aged 18-49 years was conducted. Agro-biodiversity was measured using Shannon-Wiener index, species richness/count and production diversity score. A 24-hour dietary recall was used to determine minimum dietary diversity for women (MDD-W) of reproductive age. Results: Although the level of agrobiodiversity was different between the low and high agro-ecological zones (using Shannon-Wiener index); the women dietary diversity was not different (P>0.05) between low (3.78 ± 0.99) and high potential areas (3.84 ± 1.05). In multivariate logistic regression, there was no association (P>0.05) between agro-biodiversity indicators and dietary diversity across the two agricultural zones. Other factors influenced dietary diversity and varied across the two agro-ecological zones. In low potential areas, women education level positively influenced dietary diversity while in high potential areas household gender, women education level, woman’s age and household size influenced MDD-W. Conclusion: This paper informs that factors other than agrobiodiversity influenced dietary diversity among women of reproductive age and these determinants varied across the agro-ecological zones. Therefore, it is recommended that nutrition interventions focusing on lessening malnutrition and improving dietary quality should pay special attention to differences in agro-ecological zones to develop region specific interventions instead of generalized interventions.

Due to complex interactions, changes in any one area of food systems are likely to impact—and possibly depend on—changes in other areas. Here we present the first annual monitoring update of the indicator framework proposed by the Food Systems Countdown Initiative, with new qualitative analysis elucidating interactions across indicators. Since 2000, we find that 20 of 42 indicators with time series have been trending in a desirable direction, indicating modest positive change. Qualitative expert elicitation assessed governance and resilience indicators to be most connected to other indicators across themes, highlighting entry points for action—particularly governance action. Literature review and country case studies add context to the assessed interactions across diets, environment, livelihoods, governance and resilience indicators, helping different actors understand and navigate food systems towards desirable change.