SUSTAINABLE HEALTHY FOOD CHOICES: THE PROMISE OF ‘HOLISTIC’ DIETARY GUIDELINES AS A NATIONAL AND INTERNATIONAL POLICY SPRINGBOARD

A healthy diet is generally a sustainable diet. This point is illustrated in the large body of work exploring the interconnections between public health nutrition and environmental issues associated with food choices. Unhealthy diets and their contribution to diet-related noncommunicable diseases (NCDs) are receiving growing attention from international and national policy-makers. Dietary guidelines that inform consumers about food choices and that shape policy actions to enable choices in line with the guidelines are foundational to both national and international responses to diet-related NCDs. The purpose of this paper is to argue for holistic dietary guidelines as part of national and international policy responses to diet-related NCDs. Holistic dietary guidelines simultaneously address health and environmental sustainability to address common causes and harness synergistic solutions. They are based on evidence, and free of conflicts of interest. Moreover, they act as a policy springboard for effective regulatory action to change the food environment and not just as an education tool. Holistic dietary guidelines raise potential concerns under international trade and investment law, for example, to the extent that such guidelines promote local products as a means of supporting both nutritional and environmental health. These issues will be examined in more depth in a second paper in this special issue that follows on from this one.


INTRODUCTION
Global dietary patterns sit at the nexus of health and sustainability issues. They are associated both with public health issues, including a rise in diet-related non-communicable diseases ('NCDs'), and the environmental harms significantly caused by industrial agriculture, including biodiversity loss, climate change and water pollution. Indeed, the Sustainable Development Goals ('SDGs') established by the General Assembly of the United Nations ('UN') in 2015 1 recognise the twin problems of a sustainability crisis for agriculture and the need to feed more and more people nutritiously without overburdening the planet. Of the 17 Goals in the SDGs, twelve of these directly require, or otherwise relate to regulatory interventions into food systems. 2 For example, Goal 1 is to '[e]nd poverty in all its forms everywhere', including by eradicating 'extreme poverty' by 2030; 3 Goal 2 is to '[e]nd hunger, achieve food security and improved nutrition and promote sustainable agriculture'. Simultaneously, the SDGs recognise the need to '[t]ake urgent action to combat climate change and its impacts' 4 and to '[h]alt biodiversity loss'. 5 Although diet-related NCDs are not explicitly mentioned in the SDGs, good health (Goal 3) is integral to the SDGs and the SDG agenda includes a specific commitment to a target of reducing premature mortality from all NCDs by one third by 2030. 6 The SDGs thus recognise the need to address environmental, security and health goals holistically at international and national levels through coordinated action and governance. This paper suggests that international and national policy action to create more sustainable healthy dietary patterns is one promising way to address this agenda. International and national policy action on NCDs is already paying increasing attention to the need to change dietary patterns. The UN General Assembly proclaimed 2016 to 2025 the United Nations Decade of Action on Nutrition, 7 building on earlier international declarations and reports that recognise the growing burden of diet-related NCDs. 8 In 2013, for instance, the World Health Organization ('WHO') reported that 63 per cent of global deaths in 2008 were due to NCDs, 80 per cent of these being in low-and middle-income countries. 9 The 'common modifiable risk factors' of NCDs are recognised as 'tobacco use, unhealthy diet, physical inactivity and the harmful use of alcohol'. 10 Since the 1990s, many countries have used dietary guidelines as an important policy tool for promoting public health and nutrition. 11 At the international level, the WHO has promoted dietary guidelines as a foundational policy for addressing NCDs. 12 Moreover, there is increasing support from a range of civil society organisations for a global framework convention on diet-related NCDs, with dietary guidelines as a foundation. 13 Such a convention incorporating dietary guidelines is likely to face considerable resistance from much of the food industry and therefore considerable difficulty in attracting political commitment. Yet as we show in Part IIB below, dietary guidelines now play an established part in national and international policy and advocacy frameworks for NCDs and therefore warrant attention as a promising springboard for further policy innovation and international legal developments.

QUT Law Review: Law and Non-Communicable Diseases: International and Domestic Regulation of Food and Alcohol
Organization ('WTO') or under investor-state dispute settlement, and how they might be buttressed against such challenge. 19 Part II of this article outlines the policy context in which dietary guidelines that consider nutrition and ecological sustainability holistically are already gaining traction as a policy instrument at national and international levels with both state and non-state actors. The analysis in this section is three-fold. Firstly, we examine how holistic dietary guidelines can operationalise the connections between addressing intersecting health challenges, mitigating environmental crises and reducing financial and social exclusion. Secondly, we show how holistic dietary guidelines are already emerging in some countries and suggested at the international level. Thirdly, on the basis of the analysis in the previous sections we set out three main desiderata or defining features for holistic dietary guidelines, which we go on to consider in more detail in Parts III, IV and V of the paper.
Parts III, IV and V of this article set out three key features that sustainable and healthy dietary guidelines should possess. Part III briefly sets out the specific eating practices that healthy and sustainable dietary guidelines should promote. Holistic dietary guidelines acknowledge the interlinkages between nutrition and environmental sustainability, and integrate the traditional 'food pyramid'-type approach with information about the sustainability of food choices, including which types of foods consumers should eat more of or less of, and which production methods consumers should prefer. Part IV argues that dietary guidelines are most useful when they act as a policy springboard. They should be used to guide implementation of regulatory policy initiatives aimed at integrating measures for healthy eating through areas such as government procurement, planning, marketing and labelling regulation, industry standards, taxation, agricultural policy and so on. 20 Part V discusses the need for holistic dietary guidelines to be evidence-based and avoid conflicts of interest, and Part VI concludes. In the second paper in this special issue we consider the international economic law implications of our analysis. 21

II THE POLICY CONTEXT FOR HEALTHY AND SUSTAINABLE (HOLISTIC) DIETARY GUIDELINES
In relation to diets, NCD risks are increased by, inter alia, 'elevated consumption of energydense, nutrient-poor foods that are high in fat, sugar and salt'. 22 Converging, global drivers have influenced a worldwide dietary shift towards nutrient-poor but energy-dense diets. 23 These drivers include urbanisation, improvements in transport, food processing and storage technologies, industrialisation of agricultural production, as well as the growth in international trade and foreign investment underpinned by international economic law. 24 With the number 19 Voon and Johnson above n 18. 20  of obese people now exceeding those underweight both globally and in most regions, 25 dietrelated NCDs impose significant health, economic and human development costs. Various domestic and international regulatory actors have developed holistic dietary guidelines to draw out more detailed, context-specific sustainable dietary advice aimed at certain populations. These guidelines are an emerging best practice that positions healthy sustainable dietary guidelines as a basis for active implementation of food systems policy by government, industry and civil society. In the first sub-section, we outline the global context in which holistic dietary guidelines are beginning to emerge. In the second sub-section, we explore how holistic dietary guidelines are emerging in international instruments (IIB.1) and in nation state and non-state actor policies and guidelines (IIB.2).
A Other key drivers of the nutrition transition include the liberalisation of food and agricultural markets, especially in the later part of the 20 th century, and the corresponding expanse of interdependent, industrial, and commercial food systems. It is widely documented that the liberalisation of food and agricultural markets, combined with advances in food processing and agriculture technologies, facilitated an influx of cheaper edible oils, animal products and valueadded, ultra-processed foods into food systems. 35  Sustainable Food and Agriculture

Global Trends and Policy Context for Holistic Dietary Guidelines
The nutrition transition is entwined with environmental challenges for food systems. As Burlingame et al have observed, 'High-input industrial agriculture and long-distant transport have increased the availability and affordability of refined carbohydrates and fats, leading to a simplification of diets and a reliance on a limited number of energy-rich foods'. 38 Diets high in ultra-processed foods rely on industrial agriculture to produce large amounts of uniform commodities that meet the demands of food processors for standardised, raw agricultural commodities. These raw commodities are transformed in a way that increases their palatability and allows for a long life, and are easy to transport and store. 39 Industrial approaches to agriculture entail high levels of external inputs (eg chemicals, hormones) with the aim of producing large amounts of a single crop variety or breed of livestock. Consequently, industrial standardisation and specialisation, as well as food processing and refining, have created food systems dependent on a low diversity of crops and breeds, and a restricted variety of food being consumed. 40 These challenges threaten to undermine long-term food and nutrition security. For instance, 75 per cent of the world's food is now generated from just 12 plant and five animal species. 41 Low levels of biodiversity on farms is one of the main threats to future food security, which requires diversity to decrease the need for external inputs and increase the resilience of agriculture to shocks and climate change. 42 Johns and Eyzaguirre have explained that '[d]egradation of ecosystems, simplification of diets and loss of species, and of knowledge of them, expose [humans] to new health challenges and undermine the adaptive resilience inherent in diversity'. 43 This kind of adaptive resilience is required urgently for the changing climatic conditions, given destabilised earth systems in the Anthropocene.
Indeed, food production and consumption are major contributors to the fact that, as a planet, we are fast approaching the 'planetary boundaries' for climate change, biodiversity loss, and the nitrogen and phosphorous cycles, all at the same time and with likely catastrophic interaction effects. 44 The contribution of agriculture to anthropogenic global warming, the vulnerability of food supply to climate change, and the imminent implications make it particularly urgent to ensure that dietary guidelines are also sustainable. 3

Sustainable Diets
The development of 'sustainable diets' as a concept, area of research and policy goal is the outcome of efforts to encapsulate the synergies between combating diet-related NCDs and reducing the environmental impacts of food systems. From this definition, some of the key dimensions of sustainable diets include sustainable agriculture and food systems, traditional or local food cultures, physical and economic access to food, food safety, inter-generational equity, and nutritional adequacy. However, the specific kinds of dietary patterns that would meet the definition of a 'sustainable diet' are not identified. This absence is, at least in part, due to the lack of reliable data on global food consumption and composition, coupled with the absence of a consistent methodology and research design for analysing the sustainability of diets. 46 In addition, the sustainability of a diet will depend on locations, cultures and climates. Thus the context-specific nature of sustainable diets further inhibits a clearer definition or standards. ensure the realization of this right, recognizing to this effect the essential importance of international co-operation'. Notably then, the human right to adequate food emphasises the need for international cooperation in regard to interventions designed to protect, respect and facilitate the right to adequate food.
The reference to 'adequacy' of food seems to encompass the qualities as well as quantities of food consumed, however, the right has been interpreted even more broadly. In reflection of the environmental challenges caused by and affecting food systems, and the interdependent relationship between natural environments and food, the Committee on Economic, Social and Cultural Rights interpreted the right as entailing both sustainability and satisfaction of dietary needs. According to their interpretation, the right to adequate food requires individuals to have access to food 'in a quantity and quality sufficient to satisfy dietary needs, free from adverse substances and acceptable within a given culture' while also ensuring that this access occurs 'in ways that are sustainable and do not interfere with the enjoyment of other human rights' such as the rights to life, water or health. 47 To make genuine, durable progress towards realising the human right to food then, states, together and in cooperation with each other, must address all forms of malnutrition in a way that also addresses the sustainability and equity of food systems. Production and consumption of food are connected and cannot be prised apart. 48 In making policy about healthy diets, therefore, we cannot ignore the need for sustainable production. Significant transformations of both production and consumption must occur in order for the right to food to be realised. As suggested above in the introduction to this paper, the SDGs recognise this on a broad scale, 49 as do a number of international and national policy instruments for dietary guidelines (as discussed in II.B below).

Developments in Holistic Dietary Guidelines
1

Public International
Besides the SDGs, discussed in the introduction, several international instruments have recognised the need to prevent and control NCDs through the adoption of dietary guidelines and global and multi-sectoral measures (summarised in instruments expressly promote dietary guidelines as a policy tool to educate the public and inform policy makers about healthy diets to address undernutrition (insufficient food intake), micronutrient deficiency (inadequate consumption of particular nutrients), and overnutrition (obesity and related NCDs). 51 For instance, the World Declaration and Plan of Action for Nutrition, which was adopted by 159 governments in 1992, stated that governments should: On the basis of energy and nutrient recommendations, provide advice to the public by disseminating, through the use of mass media and other appropriate means, qualitative and/or quantitative dietary guidelines relevant for different age groups and lifestyles and appropriate for the country's population. 52 In addition, international instruments concerning diet-related NCDs have tended to emphasise the need for policy interventions across various sectors, including agriculture, in order to address the multiple factors influencing the uptake of unhealthy diets. 53 For instance, the WHO's Global Action Plan for the Prevention and Control of NCDs 2013-2020 acknowledged that the prevention of NCDs requires 'health-in-all policies and whole-of-government approaches across sectors such as… agriculture, communication, education and… environment'. 54 Thus, the WHO advocates for integrated policy responses, the exploitation of co-benefits, and a move away from departmentalization of complex and multi-faceted issues. 55 Finally, many of these international instruments affirm the importance of global responses to diet-related concerns, given the increasingly globalised nature of diets, food supply chains and diet-related NCDs.

Sustainable Healthy Food Choices
This work is licensed under a Creative Commons Attribution 4.0 Licence. As an open access journal, articles are free to use with proper attribution in educational and other non-commercial settings. Advocated for the development, strengthening and implementation of multisectoral public policies to promote health education including information strategies Acknowledged the need to pursue policies that support the production and manufacture of, as well as access to, healthy foods by providing greater opportunities for use of 'healthy local agricultural products and food'. 59 Promoted the use of cost-effective regulatory interventions that reduce unhealthy aspects of diets (e.g. salt, sugar, trans-fats) by 'discouraging the production and marketing of foods that contribute to [  By 2030, double the agricultural productivity and incomes of small-scale food producers, in particular women, indigenous peoples, family farmers, pastoralists and fishers, including through secure and equal access to land, other productive resources and inputs, knowledge, financial services, markets and opportunities for value addition and non-farm employment  By 2030, ensure sustainable food production systems and implement resilient agricultural practices that increase productivity and production, that help maintain ecosystems, that strengthen capacity for adaptation to climate change, extreme weather, drought, flooding and other disasters and that progressively improve land and soil quality Promotes the adoption of food-based dietary guidelines as accessible and able to reflect epidemiological links between dietary patterns and low incidences of disease.
Does suggest need to take into account agricultural supply of relevant foods. In particular the instrument states that food-based dietary guidelines are inclusive of agricultural and environmental science. Furthermore, the instrument notes evidence that some developed countries (including Australia) cannot enable citizens to follow their dietary guidelines unless fruit and vegetable production increases. Finally, the instrument concludes that 'The need for sustainable food production using  By 2020, maintain the genetic diversity of seeds, cultivated plants and farmed and domesticated animals and their related wild species, including through soundly managed and diversified seed and plant banks at the national, regional and international levels, and promote access to and fair and equitable sharing of benefits arising from the utilization of genetic resources and associated traditional knowledge, as internationally agreed 67  Affirmed that consumers are empowered if they are provided with evidence-based health and nutrition information and education.
Adopted a food systems understanding of malnutrition.
Acknowledged that current food systems were constrained by 'resource scarcity and environmental degradation, unsustainable production and consumption patterns, food losses and waste, and unbalanced distribution'. Recognised that these constraints were restricting the ability of food systems to provide 'adequate, safe, diversified and nutrient rich food'. 72 Members committed to improve the sustainability of food systems by developing unified policies on the production and consumption of food and which apply across multiple sectors. 73

WHO 2000
Global  Consistent with these policy directions and recommendations, a range of stakeholders, including Consumers International and the World Obesity Federation, have recommended the creation of a Global Convention to Protect and Promote Healthy Diets. 87 The proposed convention positions dietary guidelines as foundational to developing policy interventions that prevent NCDs. 88 The proposed healthy diets convention is modelled in part on the WHO Framework Convention on Tobacco Control ('WHO FCTC'), 89 which is seen as 'the most powerful tool the international community has to help reduce the NCD burden'. The proponents of the healthy diets convention argue that:

Sustainable Healthy Food Choices
The WHO FCTC is also among the fastest treaties in history to be negotiated, adopted and entered into force, and provides new legal dimensions for global health cooperation. Unhealthy dietary patterns now rank above tobacco as the world's leading driver of preventable NCDs. The strength of commitment from the international community embodied in the WHO FCTC is now required to achieve a global transformation in diets. 90 The foundational obligation of the recommended convention would be that parties to the convention should, in accordance with their capabilities, 'develop and promote national nutritional recommendations, food-based dietary guidelines and nutrient profile models' with effective mechanisms for coordination and delivery of nutrition strategies, plans and programmes, and monitoring and reporting. 91 In addition, the proposed convention emphasises the need for policy coherence across food systems from food production to consumption. 92 International instruments are now drawing connections between diets and broader issues associated with how actors produce, process, distribute and retail food. This is especially evident through the instruments' acknowledgment of the need for multi-sectoral responses and policy coherence. Yet, global coordination around a holistic approach to diet-related NCDs is only in its early stages. International instruments generally do not expressly consider holistic dietary guidelines or the co-benefits of addressing the broader sustainability dimensions associated with diets and their health properties.
The FAO is the exception to this (see II.A.3). This UN agency has been relatively active in promoting the link between sustainable agriculture, biodiversity and healthy diets. In 2016 the FAO published a report based on the assumption that 'global populations need to move to diets that are both healthy and also respectful of environmental limits'. 93 The report advocates that '[o]ne important step that governments can take to signal their commitment to a more sustainable and healthy future, is to develop and disseminate food based dietary guidelines that embed health and sustainability objectives. These can then form the basis of policies seeking 87  Along with the efforts of the FAO, the incorporation of NCD prevention and control into the SDGs may enable a necessary increase in international responses and coordination. As noted in the Introduction to this article, the SDGs explicitly address food and its environmental sustainability and healthiness of diets in a number of ways that highlight the synergy between environmentally sustainable production and consumption of food and healthy diets. Parallel to the increased political momentum around initiatives like sustainable dietary guidelines is opposition from market-dominant food corporations and their industry bodies. At the international level, these corporate actors may choose to channel their opposition through the dispute resolution avenues open in international economic law, as has been the case with tobacco control measures. We will return to this point in section V of this paper, and the potential for international economic law challenges is comprehensively explored in the second paper in this special issue. 2

Nation States
According to the FAO, more than 100 states have created national dietary guidelines to address public health, with most first developed in the 1990s and early 2000s. 94 In recent years a number of countries and some non-governmental organisations have created dietary guidelines that incorporate sustainability considerations to varying degrees. These are summarised in Table 2.
On one end of the spectrum are five states that have integrated sustainability considerations fully into their official dietary guidelines: Brazil, Qatar, Germany, the Netherlands, and Sweden. Brazil's Dietary Guidelines are the most focused on sustainability considerations. 95 A principle underpinning its guidelines is the 'interdependence between healthy diets and the social and environmental sustainability of the food system', which is then incorporated throughout the guidelines. 96

Sustainable Healthy Food Choices
This work is licensed under a Creative Commons Attribution 4.0 Licence. As an open access journal, articles are free to use with proper attribution in educational and other non-commercial settings. Advocated for the development, strengthening and implementation of multi-sectoral public policies to promote health education including information strategies Acknowledged the need to pursue policies that support the production and manufacture of, as well as access to, healthy foods by providing greater opportunities for use of 'healthy local agricultural products and food'. 107 Promoted the use of cost-effective regulatory interventions that reduce unhealthy aspects of diets (e.g. salt, sugar, trans-fats) by 'discouraging the production and marketing of foods that contribute to [ No Explicitly address food and its environmental sustainability and healthiness of diets in a number of ways that highlight the synergy between environmentally sustainable production and consumption of food and healthy diets.
Goal 2 is entitled 'End Hunger, achieve food security and improved nutrition and promote sustainable agriculture'. 114 The preceding paragraphs expand on these goals. In particular, by 2030, the parties agreed to: Affirmed that consumers are empowered if they are provided with evidence-based health and nutrition information and education.
Adopted a food systems understanding of malnutrition.
Acknowledged that current food systems were constrained by 'resource scarcity and environmental degradation, unsustainable production and consumption patterns, food losses and waste, and unbalanced distribution'.
Recognised that these constraints were restricting the ability of food systems to provide 'adequate, safe, diversified and nutrient rich food'. 120 Members committed to improve the sustainability of food systems by developing unified policies on the production and consumption of food and which apply across multiple sectors. 121

WHO 2000
Global

Standards for Holistic Dietary Guidelines
From this emerging policy best practice, we identify three important, overarching features of holistic dietary guidelines: (a) They contain advice specific to eating practices that are based on an integration of health and sustainability concerns, not narrowly based on reductionist 'nutritionism', and reflect how particular social, environmental and cultural contexts shape eating practices (discussed in Part III below). (b) They are not just a communications tool aimed at individual behaviour change, but are also a springboard for policy coherence and the development of regulatory measures aimed at ensuring the whole food system provides conditions that support healthy eating (discussed in Part IV below). (c) They are evidence-based and not subject to conflicts of interest or undue influence by those who have a vested interest in the continuation of unhealthy dietary patterns (discussed in Part V below). Each is explained in more detail in the subsections below.

III SPECIFIC EATING PRACTICES
A

Conventional Nutrients-based Dietary Guidelines
Generally, dietary guidelines aim to inform consumers about food choices that will foster health and well-being while reducing the risk of disease, sickness and illness. These guidelines can also set the basis for food and nutritional programs and policies within a country, and the information they contain is often widely disseminated through marketing campaigns. Although dietary guidelines can take the form of technical reports based on nutritional science, those guidelines designed to influence food choices tend to be food-based. Such an approach to dietary guidance is thought to be more informative and accessible as 'consumers think in terms of foods [eg olive, fish, fruits and vegetables] rather than of nutrients [eg calcium, omega-3, iron]'. 135 Hence, most of the technical advice and literature discusses the need for 'food-based dietary guidelines'. 136 International recommendations tend to focus on a few key messages and some specific nutrients. The WHO's previous and current editions of its Global NCD Action Plan, for example, focus on reducing the level of salt/sodium added to food, reducing saturated fat and trans-fat added to food (and replacing with unsaturated fat), reducing the content of free and added sugars in food and alcoholic beverages, and limiting excess calorie intake (eg reducing portion size and energy density of foods Critics of conventional food-based dietary guidelines suggest that they are still focused on the nutrient composition of foods. 139 Their concern is that the emphasis on the links between nutrition and bodily health is reductionist and, at times, counter-productive. It further alienates food from the cultural, social and environmental contexts in which people produce and consume food. Carlos Monteiro and his collaborators, who were chief architects of the Brazilian dietary guidelines, argue that: [c]onventional dietary guidelines typically understate the relationship between diet and health. They treat foods as mere carriers of isolated nutrients, largely ignore food processing, meals and the contexts of eating, overlook the cultural dimensions of diets and do not consider the link between diet and the social and environmental sustainability of food systems. 140 They suggest that conventional dietary guidelines ignore the fact that nutrients are components of foods that include other compounds, which interact with each other and in the human body and which are prepared as part of a meal in a social, cultural, environmental and economic context. In particular, Monteiro argues that conventional dietary guidelines: …are slow to respond to changes in food supplies and patterns of population health and wellbeing. Current examples of these changes are the conversion of countless national and local food systems into one monolithic globalised industrial system dependent on intense food processing, the increasing availability of relatively cheap, aggressively marketed ready-toconsume soft drinks and snack products, and the parallel pandemic of obesity and diabetes. 141 Thus, Monteiro and others have been critical of how conventional dietary guidelines do not draw connections between the ways in which food is farmed, processed, transported or sold, and the effects of how these activities are carried out on the end nutritional quality of food. 142 Not only is a nutrient-centred approach simplistic, but also the emphasis on nutrients arguably enables markets to make false and misleading statements about the health benefits of a particular product, namely nutritional supplements and 'super food' claims. 143 B A 'Real Meal' Based Approach As suggested above, the Brazilian dietary guidelines have taken a different approach compared to more conventional dietary guidelines. Based on data gathered through national surveys, Brazil's dietary guidelines include recommendations of real meals consumed by the one-fifth of Brazilians who are healthier and whose diet relies on natural or minimally processed foods, 139  freshly prepared. The guidelines do this in part by suggesting that Brazilians should prefer to prepare fresh food at home and eat with family and should reduce their consumption of ultraprocessed food in a commercial environment. They further recommend reducing consumption of animal-based products. In a way that directly addresses Monteiro's critique above, Brazil's dietary guidelines also examine broader food systems issues such as long transport networks that use excess non-renewable energy and generate pollution, and promote consumption of locally produced food and traditional Brazilian diets. As the guidelines explain: Food supplies and dietary patterns based on rice, beans, corn, cassava, potatoes, vegetables and fruits are socially beneficial. They encourage family farming and local economies, and living and producing in solidarity. They also promote biodiversity and reduce the environmental impact of food production and distribution. 144 In line with this recommendation, Brazil's dietary guidelines suggest that consumers themselves take some responsibility for changing the food system, advising: The more the people seek for organic and agro-ecological based foods, the greater will be the support received by agro-ecologic family farmers, and the more socially and environmentally sustainable food systems will become. 145 This is intended as a way of empowering consumers to help support healthy sustainable food systems, rather than putting the onus on consumers as individuals. Other policy actions aimed at food production and the food environment are also required (as discussed in Part IV below).

C Local Food Recommendations
As Brazil's dietary guidelines illustrate, some commentators and guidelines suggest that sourcing foods locally is an aspect of sustainable diets. Activists, scholars and food writers see developing local food systems as a way to: build connections with places and communities; enable connections between farmers and consumers that increase farmer income; and support ecologically sustainable methods of producing and distributing food. 146 Over the last decade, demand for locally produced food has increased especially in high-income countries. 147 The trend is associated with the environmental movement, which encourages people to consider the environmental impacts of long supply chains and intensive farming practices. The preference for locally produced and distributed food is also a response to mass-produced and imported foodframed as a rejection of 'food from nowhere' for 'food from somewhere'. 148 However, whether smaller food supply chains promote sustainable diets depends on the context and the actors. 149 Born and Purcell for example have critiqued the assumption that local-scale food systems necessarily lead to sustainable diets. They observe, 'Local-scale food systems are equally likely to be just or unjust, sustainable or unsustainable, secure or insecure. No matter what its scale, the outcomes produced by a food system are contextual: they depend on the actors and agendas'. 150 Because of these complexities, scientific studies comparing global to local food chains for particular foods have conflicting findings, methods and scopes. Some studies and reviews concerning fruit and vegetables have found that the method of agriculture employed to produce a food (ie greenhouse or field grown, using pesticides or organic, etc) is the greatest determinant of its environmental impact, rather than transportation. 151 Other research has found that fruit and vegetables imported by plane and not in season have a significantly larger carbon footprint than seasonal foods produced domestically. 152 Consequently, the notion that sustainable diets necessarily entail local food chains lacks conclusive evidence either way, and much will depend on the particular context. In addition, the scope and spatial limits of local food systems is subjectively constructed and dynamic, which further complicates claims that locally produced food is an important part of sustainable diets. 153 It is however clear that a diversity of food grown in different places is highly desirable to help ensure the resilience of the global food system in general and of each individual locale. For example, if a city were cut off from global transport chains by a flood (as occurred in Brisbane in 2011) then local peri-urban horticulture production could be quite important. 154 Similarly large mono-crop plantations in one location might be vulnerable to an adverse weather event or pest invasion; therefore multiple locations with diverse species are desirable. Schnell's research indicates that consumers use 'local food' as an umbrella term for a range of values that do not necessarily relate to the scale of a food system. Rather, Schnell suggests that local food refers to transparent food production and consumption embedded in social relationships and based on cultivating a sense of belonging and responsibility for specific ecologies. 155 Drafters of dietary guidelines and related regulatory instruments should acknowledge these underlying values as opposed to expressly promoting local food systems.
Such an approach may also be advisable in the context of international trade obligations discussed further in the second paper in this research project.

D Broadly Supported Principles of Diets that are Both Healthy and Sustainable
A small but growing body of work has reviewed and gathered empirical evidence concerning the commonalities between diets that are healthy and diets that are sustainable, as well as how to shift diets towards delivering better health and sustainability outcomes. 156 From this body of work, we summarise the main commonalities between healthy and sustainable diets as follows:  Low consumption of ultra-processed foods high in sugars, oils, salts or trans-fats: In relation to sustainability, the processing of such products tends to be energy-intensive and involve the production of more waste products. 157 They are also nutrient-poor and energy dense, and as we have seen, all conventional dietary guidelines recommend reduced consumption for health reasons. In terms of specific eating practices, this can mean recommending reduced consumption of highly processed foods including confectionary, crisps and sugary drinks. 158 Garnett et al suggest that reducing consumption of palm oil and ensuring all palm oil consumed is produced sustainably are particularly relevant practices for both health and sustainability gains. 159  Balanced consumption, that is, balance between energy intake and energy needs: From a sustainability point of view, the over-consumption of foods represents preventable resource loss because food has been produced that is not required to meet a person's energy requirements. 160 From a health point of view, over consumption of food facilitates diet-related NCDs. 161 In terms of specific eating practices, this leads to a recommendation for many populations to limit consumption overall for both health and sustainability reasons.
 High diversity: Diverse diets are required to meet nutritional needs and preserve on-farm biodiversity. This coalesces with recommendations to eat diets high in minimally processed tubers, whole grains, legumes, fruits and vegetables, and including unsalted nuts and seeds. Some holistic dietary guidelines recommend fruit and vegetables that are field grown, 'robust' (less prone to spoilage) or otherwise reduce the demand for rapid and energy intensive transport modes, in order to avoid the environmental impacts of food waste and fossil fuel transport.
 Low consumption of meat (especially red meat and processed meat products) and moderate consumption of dairy products: Animal-derived products tend to be far more resource intensive than plant-based products. 162 It is also widely acknowledged that industrial food animal production can cause great pain and suffering for animals, arguably counter to the ethics underpinning sustainable development. 163 Although meat can be an important source of nutrition, higher consumption is also associated with various health risk factors. The WHO has classified processed meat as a 'Group 1' carcinogen for humans, based on sufficient evidence that it causes colorectal cancer, and red meat as a 'Group 2A' probable carcinogen to humans. 164 High intake of red and processed meat is also a risk factor for diet-related NCDs including type II diabetes, cardiovascular diseases, colorectal and other cancers and all-cause mortality. 165 Intensive livestock systems are also the locus for a range of public health hazards associated with the use of pharmaceuticals including antibiotics, and effluent management. 166 IV A SPRINGBOARD FOR REGULATORY POLICY Typically, regulatory interventions aimed at influencing diets have centred on providing information to citizens, through dietary guidelines and related marking campaigns, with the hope that informed citizens will make better food choices. 167 Evidence regarding the effectiveness of such an approach is limited, but worldwide the prevalence of diet-related NCDs is increasing, and over the last 33 years there have been no significant 'national success stories' of declines in diet-related NCD levels. 168 For example, social marketing campaigns aimed at influencing diets have been found, at best, to be one strategy that can contribute to the prevention of diet-related NCDs, 169 but at worst they can be counter-productive and increase the occurrence of weight discrimination. 170 Accordingly, commentators have called for more significant regulatory interventions because the many factors which contribute to dietary-related NCDs are outside the control of an individual. 171 As the opening article in a 2015 Lancet series on obesity argued, 'although individuals bear some responsibility for their health… environmental factors exploit biological, psychological, social, and economic vulnerabilities that promote overconsumption of unhealthy foods'. 172 Regulatory action, not just education and guidance, is positioned as a way to reduce the systems that facilitate and reinforce healthy eating, including as a way to break the negative feedback loops between a person's consumption of unhealthy foods, food marketing in their environment, and the market demand for unhealthy foods being produced and processed. 173 Holistic dietary guidelines should, therefore, be used as 'a "springboard" for other broader, health strategies' 174 including regulatory interventions. As Keller and Lang suggest, dietary guidelines can 'form the bedrock for governmental health strategies and in particular be used to align wider agriculture, food and nutrition policies' and thus become 'a policy and organising tool as well as a scientific tool'. 175 International instruments, as illustrated in Table 1, consistently support policy coherence and multi-sectoral approaches to diet-related NCDs.
Positioning holistic dietary guidelines as the basis for other regulatory interventions is, therefore, an approach broadly supported at the international level.
Indeed a number of authors have set out the range of legal, market-based, self-regulatory, soft law, and political regulatory tools necessary to create healthy food environments and reduce global obesity. 176   strengthened tax measures (more and higher) against less healthy foods;  powerfully-imaged hard hitting counter-advertising (for example a NYC advertisement in which a man is shown drinking gobs of human fat from a soda bottle);  stricter labelling requirements (eg incorporating symbols such as traffic lights or stop signs);  zoning and planning rules (eg stopping fast food restaurants in certain areas);  financial incentives to make healthy food more physically and economically accessible;  health and sustainability conditions on procurement of food for schools, hospitals and government agencies;  restrictions on marketing unhealthy food (especially to children);  greater regulatory scrutiny of health claims on foods;  regulation requiring the reformulation of products (eg banning the use of transfats in processed foods); and  health services screening and targeting of high risk individuals. 177 A pluralised approach in which a network of government, industry and civil society actors all have a role to play in implementing these measures is consistent with broader regulatory studies approaches too. 178 A useful framework for such interventions was developed by Hawkes et al. 179 They proposed the NOURISHING food policy framework for the World Cancer Research Fund International, as a way of systematising the range of policy measures that might address food related NCDs. NOURISHING is an acronym referring to 10 types of policy actions that can be taken across three broad categories:  The food environment: o Nutrition labelling and regulating the claims on foods; o Offering healthy foods in public institutions via procurement standards; o Using economic approaches, such as food taxes or targeted subsidies; o Restriction of food advertising and other forms of commercial promotion of certain foods; o Improving nutritional quality of the whole food supply chain; and o Setting incentives and rules for healthy retail and food service environments.  The food system: o Harnessing both food supply chain and other actors to encourage healthy behaviours through both health-related and non-health-related policies.  Behaviour change-communication: o Informing people about food and nutrition through public awareness campaigns; o Nutrition advice through health care visits and nutrition-counselling interventions; and o Giving nutrition education and skills.
The NOURISHING framework illustrates a full range of regulatory interventions possible in relation to diet-related NCDs. Moreover, it exemplifies the kinds of approaches promoted by international instruments that emphasise the need for whole-of-government and multi-sectoral approaches to diet-related NCDs (see Table 1).
Most of the literature on specific policy and regulatory initiatives has not, however, focused on policy initiatives that integrate health and broader sustainability concerns, despite the emerging literature and policy practice in holistic dietary guidelines. 180 Taylor et al suggested that: Arguably, the most progressive policy regimes for combating obesity today are multi-sectoral, integrated programs that link systems of food production and transport with food distribution and trade in ways that promote the health of the environment and the health of people by making healthy food choices maximally available. 181 Finding and updating the evidence as to what production and eating practices and which policy tools will promote healthy sustainable diets best is likely to be a challenge, especially where multi-sectoral, integrated programmes are required. Besides the political challenges of introducing such measures in countries with a strong free market ethos and powerful industry, international trade and investment agreements may act as another significant barrier. Broadly, these agreements seek to restrict signatories from introducing measures that may influence the supply or demand for particular products. Moreover as Taylor et al also point out, 'companies must sell less food if the population is to lose weight'. 182 We might add that increased trade and investment may depend on increased consumption, which may be in conflict with measures to prevent diet-related NCDs. The second paper in this research examines the potential for international trade and investment laws to influence the introduction and implementation of holistic dietary guidelines and related measures.

V EVIDENCE-BASED AND NOT SUBJECT TO CONFLICTS OF INTEREST
Dietary guidelines are generally derived from public consultations, available information about nutritional trends within a society, and scientific evidence about relationships between nutrient intake and disease prevalence. 183 The evidence may be formulated both by the in-house government department formulating the guidelines and by either corporate or university-based researchers. Generally, epidemiological studies and clinical trials provide the main source of scientific evidence. 184 The collated information is then reviewed and considered by a government-mandated special working group representing stakeholders and experts. 185 The working group considers and translates the evidence into advice for ordinary, non-specialist citizens. These working groups tend to be made up of, for instance, representatives from relevant government departments (education, agriculture, health), nutritional and medical experts and food industry representatives. 186 Commonly, stakeholder participation, including through working groups, centres on nutrients and dietary patterns, and overlooks how nutrition policies influence, or should influence, other food system activities and outcomes. 187 However, the complex structural and personal causes of diets that contribute to NCDs mean there are still large gaps in the public health literature, making it difficult to draft cogent internationally applicable standards 188 Holistic dietary guidelines present additional challenges for collecting an adequate evidence base, as information will be required not only about the health impact, but also the environmental impact of specific eating practices, as well as the possibility for synergies and conflicts between healthy diets and environmental sustainability. 189 Moreover, in order to justify certain policy interventions, evidence on the effectiveness of different policy interventions is also required. This type of evidence often does not become available until a government acts and intervenes, but governments may want evidence of likely policy effectiveness before intervening. 190 We therefore suggest that standards and measures must be dynamic in response to new and emerging evidence and different contexts. Procedures and regulations to reduce personal, technical or disciplinary biases should be embedded within institutional arrangements around the gathering and evaluation of evidence required to create and update holistic dietary guidelines and situations. 191 Moreover, an effort should be made to collect different types of evidence relevant to both health and sustainability goals, and the interaction between them and the broader food system. Such procedures and institutional rules should focus, in part, on dealing with inherent uncertainty and complexity. 192 There is also a need for ongoing and systematic monitoring and evaluation to collect further evidence about what are appropriate eating practices and policy interventions, using multiple criteria from different stakeholders' bodies of knowledge (eg including traditional dietary knowledge, as in the Brazilian dietary guidelines, as well as nutritionists' recommendations) and different stakeholders' potential for action (eg government regulation, industry self-regulation, and health services' interventions). These suggestions are consistent with literature on evidence-based policy, and specifically the work regarding the kinds of institutional arrangements necessary to bridge evidence and social policy in a democratically legitimate way. 193 A number of NGO initiatives model the kinds of institutional arrangements that may be possible between the public sector and other stakeholders. For example, the NOURISHING framework, outlined above, is used by the World Cancer Research Fund as a systematic basis for collecting and disseminating evidence about policy initiatives and their effectiveness. Supporting the NOURISHING framework, Boyd Swinburn (University of Auckland), the World Obesity Federation, and a range of public interest groups have created INFORMAS (the International Network for Food and Obesity/Non-communicable Diseases Research, Monitoring and Action Support) to 'monitor, and support public and private sector actions to create healthy food environments and reduce obesity and non-communicable diseases (NCDs) and their related inequalities'. 194 There are also emerging initiatives collecting evidence about integrated healthy and sustainable eating practices and policy initiatives, as discussed previously. 195 Even where institutional arrangements are such that evidence is effectively used to inform holistic dietary guidelines and related regulatory interventions, it is the political willingness to take action that generally influences the interpretation of the evidence regarding, inter alia, diet-related NCDs, rather than the evidence influencing political willingness to intervene through regulatory mechanisms. 196 This point is somewhat captured in the recommendation (above) that holistic dietary guidelines be the output of procedures that seek to reduce bias in the creation and evaluation of evidence.
Regardless, the social and economic systems around bodies of evidence will influence the significance apportioned to a finding, and the methods used to formulate and share the relevant evidence. Where governance arrangements are embedded in capitalist systems, as the governance arrangements of WTO member states must necessarily be to an extent, evidence that does not challenge the notion of self-regulating markets is likely to be more influential over dietary guidelines and related regulatory interventions. Consistent with this observation, Monteiro et al suggest that the dominant, medicalised, nutritionist approach to collecting an evidence base for conventional dietary guidelines indirectly favours processed food companies (who can play the game and manipulate the evidence) and devalues understandings of healthy sustainable diets 'implicit in long-established tried-and-tested dietary patterns developed as part of human evolution and adaptation'. 197 Drawing on this observation, holistic dietary guidelines transcend the rift between humanity and ecology supported by capitalist food systems, the commodification of food, and the distance between producing and consuming food in especially developed countries. Accordingly, evidence and understanding that support the closure of this rift come into conflict with the premises of capitalism, while nutritionistbased evidence maintains the divide, and so has garnered, and is likely to continue to garner, strong political support. 198 Besides seeking to dilute indirect influences on evidence underpinning dietary guidelines, holistic dietary guidelines should be free from the undue influence of food industry actors. All the international recommendations for dietary guidelines emphasise the need to 'ensure that the processes for the development of nutrition recommendations, [dietary guidelines] and nutrient profile models are free from undue influence from non-state actors with commercial interests'. 199 Yet 'big food' corporations naturally have an interest in selling more of the type of (processed) food that much of the public health and environmental evidence suggests should be consumed less. The food policy literature details the various direct and indirect ways in which 'big food' has successfully influenced national and international policy and rule making, and even evidence collection, as well as public perceptions of their products and activities. 200 One way in which it may seek to hinder the establishment or scope of holistic dietary guidelines is through challenges on the basis of international trade and investment law. The second paper from this research will therefor examine critically the possibility of challenge on the basis of international trade and investment law and potential strategies to buttress the use of holistic dietary guidelines against such attack.
Where dietary guidelines have been developed with a strong and balanced evidence base, this can make it very difficult for even strong pressure groups to oppose the guidelines. The Planet, Plates, Pyramids report gives the example of the Swedish guidelines, which included such a strong risk and benefit management report that it was very difficult for even the dairy industry to oppose the recommendations. 201 However in both the US and Australia, even with strong evidence bases for including sustainability considerations in dietary guidelines, industry lobbying and political considerations succeeded in taking sustainability out of the guidelines. 202 There are also serious concerns about the influence of the food industry on international standard-setting in regard to food at the Codex Alimentarius (the main international body harmonising international standards for food). 203 Strong national and international NGOs that also collect independent evidence (as noted above) can provide a bulwark even where official institutions are affected by conflict of interest. Finally, basing holistic dietary guidelines on evidence about meals that people actually prepare can act as a safeguard against the interests of processed food companies, particularly in countries where traditional diets are still intact to some extent.

VI CONCLUSION
Although adopted only by a handful of countries, holistic dietary guidelines are an emerging, yet promising development that aligns with achieving the Sustainable Development Goals. These guidelines reflect the complex interactions within foods and between the environment and the nutritional quality of foods. These guidelines represent the first attempt by regulators to influence food consumption in ways that help human activities stay within planetary boundaries. To be significantly innovative and influential, holistic dietary guidelines must act as a springboard for other regulatory interventions into food production and consumption. However, their adoption as a policy springboard may have implications for, or be restrained by international economic law, which will be examined in the second article from this research. 201 Gonzalez and Garnett, above n 93, 59. 202 Ibid 60. 203