Projected health effects of realistic dietary changes to address freshwater constraints in India: a modelling study

James Milner, Edward J. M. Joy, Rosemary Green, Francesca Harris, Lukasz Aleksandrowicz, Sutapa Agrawal, Pete Smith, Andy Haines, Alan D. Dangour

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BACKGROUND: The availability of freshwater for irrigation in the Indian agricultural sector is expected to decline over the coming decades. This might have implications for food production in India, with subsequent effects on diets and health. We identify realistic and healthy dietary changes that could enhance the resilience of the Indian food system to future decreases in water availability.

METHODS: In this modelling study, we optimised typical dietary patterns in an Indian population sample to meet projected decreases in the availability of water per person for irrigation (blue water footprint) due to population growth (to 2025 and 2050). The optimised diets met nutritional guidelines and minimised deviation from existing patterns. Resulting changes in life-years lost due to coronary heart disease, stroke, diabetes, and cancers were modelled using life tables, and changes in greenhouse gas emissions associated with the production of diets were estimated. The primary outcomes of the model were changes in life-years per 100 000 total population over 40 years (to 2050).

FINDINGS: The optimised diets had up to 30% lower blue water footprints and generally contained lower amounts of wheat, dairy, and poultry, and increased amounts of legumes. In the 2050 scenario, adoption of these diets would on average result in 6800 life-years gained per 100 000 total population (95% CI 1600-13 100) over 40 years. The dietary changes were accompanied by reductions in greenhouse gas emissions. The magnitude of the health and environmental effects varied between dietary patterns.

INTERPRETATION: Modest changes in diets could help to address projected reductions in the availability of freshwater for irrigation in India. These dietary changes could also simultaneously reduce diet-related greenhouse gas emissions and improve diet-related health outcomes.

FUNDING: Wellcome Trust.

Original languageEnglish
Pages (from-to)e26-e32
Number of pages7
JournalThe Lancet Planetary Health
Issue number1
Early online date12 Apr 2017
Publication statusPublished - Apr 2017

Bibliographical note

This study forms part of the Sustainable and Healthy Diets in India project supported by the Wellcome Trust's Our Planet, Our Health programme (grant number 103932). LA's PhD is funded by the Leverhulme Centre for Integrative Research on Agriculture and Health. SA is supported by a Wellcome Trust Capacity Strengthening Strategic Award-Extension phase (grant number WT084754/Z/08/A). We would like to thank Zaid Chalabi (London School of Hygiene & Tropical Medicine) for providing valuable guidance on the modelling methods.


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