Over 800 million people go hungry every day, yet one third of all food currently goes to waste. Obviously, there are basic logistical challenges to getting the surplus to the hungry, but at a fundamental level this should be solvable.

In turn the food industry bears responsibility for the fact that over 650 million people are obese, yet it’s governments and taxpayers that pick up the cost of treatment in most cases.

Large industrial-scale farms use copious quantities of water to irrigate crops, again it is taxpayers who foot the bill for the water scarcity that can follow. Overuse of agrochemicals and their effects on the health of people and ecosystems are also borne by governments as well as people and nature. Governments and their funders are also about to find themselves shouldering the costs of biodiversity loss and mopping up agriculture’s contribution to greenhouse-gas emissions.

These supposedly hidden costs must be met, and last month a landmark report by the food and land use coalition estimated them to be somewhere in the region of US$12 trillion a year, rising to $16 trillion by 2050. That is a staggering figure — equivalent to the gross domestic product of China.

They also did the sums to calculate the costs that business and governments would have to bear in the transition to a more sustainable food system. That estimate comes to somewhere between $300 billion and $350 billion annually. The good news is that a more sustainable food system could yield a further $5.7 trillion a year by 2030 in new economic opportunities, offsetting the $350-billion price tag by many multiples.

Governments can use a stick and carrot approach to encourage change, and customers can make their choices clearer. They can also offer incentives, by encouraging producers and resellers all along the supply chain to invest in sustainable approaches to production and supply.

What are you doing, do you make conscious decisions to shop locally, eat organic where its available and ensure that all the items you buy are used? It’s not easy, and as part of the interaction we have with people looking to use nutrition as a mechanism to regain or maintain their health, these are daily decisions that can be embedded in your clinical recommendations.

The authors of the report say that leaving these systems to continue on current trends, means sleepwalking into a scenario wherein climate change, sea-level rise and extreme-weather events increasingly threaten human life, biodiversity and natural resources are depleted, people increasingly suffer life-threatening, diet-induced diseases, food security is compromised, and socioeconomic development is seriously impaired. Such a pathway would place the Sustainable Development Goals and the Paris Agreement targets out of reach and within a few decades threaten our collective security. Transformation of food and land use systems thus needs to become an urgent priority globally – for leaders in the public and private sectors, and for civil society, multilateral institutions, the research community, consumers and citizens.

Perhaps keep this in mind when next the opportunity to support local food producers presents itself, or consider growing some of your own, you never know you might enjoy it!

A healthy diet, mostly plant based seems to provide a good starting point, but do not underestimate the nutritional value of meat and in the UK the effective use of ruminants to convert inedible foods into edible foods, rich in nutrition.

Implementing transitions will not be easy. Each faces barriers, whether related to policy, regulation, finance, innovation or behaviour. The current system is fragmented, with vested interests defending their turf. However, practical examples of critical transitions are already up and running across the world, driven by policy, business, farming, community and social entrepreneurs and activists. Why not get engaged, be the power of change and promote healthy eating and healthy planetary goals at the same time, after all the BMJ made a big thing of this back in 2018, and we know how conservative they are!

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