Climate Change: What we can do as Health Professionals

Climate Change & Health:Is food a major player?

BenevolencePreventionEducationNon-Maleficence

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A Scientific Based PresentationInspired by Personal Experience: By Emily Rushton

The Boring Tidbits

And questions

Our Journey Today:Why do I care?Climate Change in a Nutshell The IssuesLow Carbon diets and health benefitsWhats happening? Where do you come in?

About Me

2005-07 National Student Unit, NZNO

2007-2010 Counties Manukau RN Disproportionate inequality

2011-12 UK NHS and Taught Adult health classes

2012-13 Temped in Auckland, NZ

Feb 2014-Oct 2015 Received intense world education on 22 month trip

Doctors, nurses and other health professionals can be powerful social leaders, and for most of us acting on threats to public health is one of our responsibilities under our code of practice.5

Climate Change Basics

Figure 15

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The IssuesIncreasing global demand for food

GHG emissions from some foods are high

Environmental change = Food production disruption Disease burdens related to our food choices

Stats from America but fairly relevantNZ imports 42% of worlds palm kernel More then whole EU and mostly from Indonesia and Malaysia(2015 figures, http://www.indexmundi.com/agriculture/?commodity=palm-kernel-meal&graph=imports )

Shifting diets from animal-based to plant-based at the global level is of paramount importance in achieving food security and sustainability goals. Decreasing consumption of meat and other animal products will free up large amounts of food that could be consumed directly by humansfor example, soy and grains. Foley et al (36) recently estimated the potential to increase the global food supply by shifting 16 major crops from the current mix of uses (eg, human consumption, livestock feed, and biofuels) to human food consumption only: they estimated a 28% increase in food availability, or the equivalent of a 49% increase in dietary energy for human consumption.

Sabat, J. & Soret, S. (2014). Sustainability of plant-based diets: back to the future. Am J Clin Nutr. 100(1476S-482S). doi:10.3945/ajcn.113.071522

Agricultural production, including indirect emissions associated with land-cover change, contributes 80%86% of total food system emissions,

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InjusticeFood50% of worlds population could face severe food shortages by 2100 44

Already:Reduced wheat and maize yields for many regions and in the global aggregate 19

Several periods of rapid food and cereal price increases19 For all countries recent climate extremes are showing significant lack of preparedness. 19

85% of the worlds fisheries are fully exploited, overexploited, depleted, or recovering. (United States Department of Agriculture, 2015)

50% of worlds population could face severe food shortages by 2100 from temperatures take their toll on farmers crops. (The Lancet, 2009. p1704)

Green Business|Wed Dec 23, 2015 8:12am ESTRelated:ENVIRONMENTup to 400,000 are suffering a severe lack of food due to crop failureIn some places, people are forced to walk up to three hours to fetch water El Nio is predicted to peak in the first three months of 2016, and the situation could deteriorate substantially, it said.http://www.reuters.com/article/us-papua-elnino-aid-idUSKBN0U61C320151223

Several periods of rapid food and cereal price following climate extremes in key producing regions indicate a sensitivity of current markets to climate extremes among other factors (Field et al. 2014, pp. 4)

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Taking Responsibility

OraTaiaos Main Areas of ActionActionPublic Health ImpactGHGEs avoided byIncrease active and public transportIncrease physical activityReduce obesityReduce health damaging air pollutionReduce road traffic injuriesReduced transport emissionsImprove housing through insulation, energy efficiency and low-carbon heating and electricityReduce illnesses from cold, damp home environmentsReduce fuel povertyReduce health damaging air pollutionReduced emissions from home heating and livingEnable a population shift to healthier plant-based diets that are lower in red meat and animal fat through pricing, economic and heath promotion mechanisms Reduce rates of cancerReduce cardiovascular diseaseImproved drinking and recreational water qualityReduced agricultural emissionsStop the extraction and burning of coal for energyReduced burden of illness and premature death from coal related air pollutionReduced energy emissions

World Moving to Reduce AnimalsNetherlands Meat 2x weekly max. only one of which is red meat. 62, 17

Italy - New food pyramid with less animal products due to health and environment. 7

UK Reduce meat and eat more beans, legumes and nuts. 64

USA Has reduced 10% per capita, per year since 2007 = 400 million less animals consumed per year by 2014 52

Italy has new food pyramid with less animal products due to health and environment. (Buchner et al. 2011)Health Council of The Netherlands - 2011 report based on an international workshop 17

Animal agriculture:

A major cause of climate change

Global GHGs - 18% from Animal Agriculture. 50

75% of water worldwide is used by farmers 18

1 calorie of animal protein = >10x fossil fuel input 35

6 kg of plant protein is required to yield 1 kg of meat protein 35

1 calorie of animal protein = >10x fossil fuel input as a calorie of plant protein.(Pimentel& Pimentel, 2003).

Note Wet land rice is almost as much as dairy. Upland rice is fine.

http://www3.epa.gov/climatechange/ghgemissions/global.html Transport is 14% of global emissions18

NZ GHGs - 50% from Animal agriculture - 25% from dairy farming (Saunders & Barber, 2007)

Global GHGs - 18% from Animal Agriculture. (United Nations Food and Agriculture Organization, 2006)

75% of water worldwide is used by farmers1kg wheat - 1000L 1kg beef - 15 000L

Western diets - 5000L pp daily African/Asian vegetarian diets - 2000L pp daily (International Panel on Climate Change, 2007. pp.1720)

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Food emissions

80% from animal agriculture 48

9% from wet land rice 48

Yann

1/3rd of edible parts of food produced for humans gets wasted globallyFAO. 2011. Global food losses and food waste Extent, causes and prevention.

According to the IPCC (2007) and recent data from FAO (Tubiello et al., 2012), the largest contributors to agriculture emissions are enteric fermentation (38%), manure left on pasture (14%), synthetic fertilizer (13%), biomass burning (11%), rice cultivation (9%), manure management systems (7%), N2O emissions from organic soils (5%), crop residues (3%), and manure applied to cropland (2%). The following GHG aggregations were further considered.

We defined a livestock emission category as the sum of emissions from enteric fermentation and manure emissions, plus emissions from cropland related to feed1. This represented over 80% of total agriculture emissions, in line with recent estimates (FAO, 2008; Leip et al., 2010).22

35% From Wasted food 52

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1kg of Beef = 100km driving 61300gm Steak= 30kmsSheep meat similar

=

1kg of beef =22 kg of carbon dioxide equivalent 9.2 litres of petrol or driving 100 km ( NZ average fuel consumption). Keep in mind this is not including the 51% of the worlds palm kernel NZ imports and the part it plays in rainforest destruction.90% is from the farming process (62% belching, 17% from nitrogen from excretions), 10% once the animal leave the farm. Most of the impact is in the form of methane emissions from the animals gut. Pigs, chicken and fish dont have the same gut type so are nowhere near as bad.

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UK Study 13Showed a 40 % reduction was realistic Health is a better motivator Professionals should consider more then individuals health 2

Local Research Foods and dietary patterns that are healthy, low-cost, and environmentally sustainable: a case study of optimization modeling for New Zealand 60Diets could be cheaper, healthier, lower-emissionsSuggest public institutions should adoptGovernment should use education, tax and policy

Aimed to consider optimized solutions to the mix of food items in daily diets for a developed country population: New Zealand (NZConducted scenario development and linear programming to model 16 diets.Data inputs: nutrients in, prices, wastage and GHG emissions.

Identified daily dietary patterns that met key nutrient requirements from NZ$ 3.17 daily

Optimized diets could reduce GHGs from 10.1 kg CO2e/d to 1.62 kg CO2e/d

All of the optimized dietary patterns had likely health advantages over the current NZ dietary pattern, i.e., lower cardiovascular disease and cancer risk

Schools, jails and hospitals should serve the best identified diets as per current research.

Education and promotion in public for healthy eating, teaching skills around cooking, using systems that help consumers identify good choices, removing and applying tax to foods to encourage and reduce consumption, 27

Halve meat to save lives and emissions 29% decrease in greenhouse gases Save 5.1 million lives annually 65

Low-carbon, plant based diets reduce disease burden

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Iron from Tofu vs Beef

This chocolate mousse:Easy to makeComparable on cost

RDIChocolate Mousse (180g)Lean Beef180gIronWoman 42%Men 94%W 20%M 45%Calcium43%4%Protein (45g)27% 91%Fibre4.1g0%

Note: The different irons are not adjusted.Non-haem iron is absorbed approx 10% less as well. All vary with what it is being eaten with.Table 1, RDI values and information taken from www.nutritionfoundation.org.nz, Oliver, J.

200 g dairy-free dark chocolate (at least 75% cocoa solids)700 g silken tofu 160 g maple syrup 1 lime, zest of 1 Tbs vanilla bean paste 1 Tbs dark rum 1 large pinch of dried chilli flakes 1 large pinch of sea salt

http://www.jamieoliver.com/recipes/chocolate-recipes/vegan-chocolate-pots/#

RDI values taken from www.nutritionfoundation.org.nzLean beef values taken from according to the accepted Monsen model, makes up about 40% of total iron. Non-haem iron is found mostly in plant-based foods, and makes up the remaining 60% of iron in animal productsAndfrom: Total and haem iron content lean meat cuts and the contribution to the dietThe type of iron (haem or non-haem) differs in bio-availability. In general, the rate of non-haem iron absorption is related to its solubility in the upper part of the small intestine. The presence of soluble enhancers (ascorbic acid) and inhibitors (phytates, polyphenols and calcium) consumed during the same meal will have a significant effect on the amount of non-haem iron absorbed.Beulah Pretorius,,Hettie C. Schnfeldt,Nicolette HallShow moredoi:10.1016/j.foodchem.2015.02.109 Food ChemistryVolume 193, 15 February 2016, Pages 97101

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Myth Busters

Soy - no proven risks but likely to reduce many cancers 62

Protein and iron is easier than you think

Plant based diets are cheaper 60

Iron and Protein Abundant: IronLegumes - Chick peas, beans (black, white, navy, kidney, mange tout), Lentils (brown, red, green), Soy, peas etc.

Vegetables Beetroot, mushrooms, green leafy vegetables, asparagus, leeks, spring onions

Spices Curry powder, turmeric, thyme, parsley, rosemary, pepper, cumin, oregano etc.

Fruit Dried (Apricots, pears, figs, raisins), berries OlivesCoconutTofu, soy products and seitanFortified products

Protein Scorecard

Figure 18

Alternatives for Everything

MinceSteakSausagesBurgers

Rice

MilkButterCheeseIce creamYoghurt

Information is Easy

Google favorite recipes - Vegetarian bolognaiseJoin Vege based social media groups - Vegetarian NZVegetarian or vegan society websites NZ Vegetarian SocietyExplore whole foods based websites - Oh She Glows

Clear, Simple InstructionsInitially aim to reduce by 60%

Reduce meat and dairy intake ideas:- One product at a time - Meatless every 2nd day- Promote Meatless Mondays in Community

Join plant based interest groups

Same meals, just remove/replace meat- Promote Meatless MondaysGive out leaflets36

From Angst to Action

Positive FramingFigure 16

We can do it!

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James Cameron Converts from DairyTook intensive Dairy Farms replaced with organic crops

Mung beans, alfalfa sprouts, lettuce, fennel, cauliflower, leeks, pumpkins & kale

"We're relentlessly devastating the Earth's ecosystems, and we need to wake up. 56

Others changing into hazelnuts, avocados, hemp and tea.

Titanic fame Also has a Walnut and a hemp farm.Since 2012, Cameron has bought at least 13 parcels of land worth tens of millions of dollars and totalling more than 1500 hectares.Last year, he sold 75,000 boxes of sprouts and 25,000 heads of broccoli.

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Health Professionals to Lead

The latest report indicates the contribution of science and public health to one of the greatest predicaments facing human and non-human life.

That contribution now needs to be embraced fully by health professionals and medical scientists worldwide.

Richard Horton, Editor in Chief, Lancet 44

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What could be done locally?CommunityPot lucksEventsLinking with local groups EducationSchools

Politically

Hospital or community facilitiesEducation staff/patientsFood programGarden InitiativesEmission reduction program

Personally

Food in hospitalsLimiting meat meals

Buy local organic produce

Make hospital a fast food free zone

Educate

Modify menus & practices to support healthier food purchases 57

Make the hospital a center that promotes nutrition and healthy food - Farmers' markets and/or community gardens on hospital grounds.Implement a step-by-step program to identify and adopt sustainable food procurement. Begin where minimal barriers exist and immediate steps can be taken, for example, by introducting organic fresh fruit in the cafeteria.Minimize and beneficially reuse food waste. For instance, compost food waste or use it as animal feed. Convert cooking oil waste into biofuel.WaterEstablish a framework that aspires to net zero water use within a hospital system.Implement water conservation strategies: install efficient faucets and toilets,Landscape grounds using drought-resistant plants to minimize water use.Consider harvesting rainwater and/or recycling water for process water uses.Eliminate bottled water facility-wide if high quality potable water is available.Develop joint projects with the community to improve and protect water supplies; support initiatives for public systems to improve water quality, water delivery and wastewater systems for the entire population.

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Facilitating Positive Change

Our Responsibilities:

Consider carbon impacts of your practice and the advice you are giving patients

Change own lifestyle and talk about the benefits of this with colleagues and patients

Join with other health professionals to amplify individual actions

Work with other health professionals to press for healthy action on climate change

bring climate co-benefits into health advice e.g. Greening the green prescription (instead of a gym prescription, encourage people to walk/cycle to work), healthy and sustainable nutrition advice

encourage your professional college to sign up to OraTaiaos Health Call to Action (attached); use the Health Call to Action to write to your local MP even better, go and talk to them in person; get involved in relevant policy submissions at a regional and national level health professionals can be a influential voice for public good in urban and energy planning

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Join the Sustainable Health Sector National Network (NZ)Part of Ora Taiao: The NZ Climate & Health Council

Individual practices to DHBs

Supported with direction and advice

Linked to global movements

Join the Global Green & Healthy Hospital 2020 challenge

US Health care: 8% of National Green House Gases (8)The NHS - 25% of total public sector emissions. (34)

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OraTaiao: The NZ Climate & Health Council

SupportsAdvocacyPromoting SustainabilityPolitical EngagementPublic EngagementLinks to others

Health professional organisation:Concerned about adverse health impacts of climate changePromotes population health gains from climate action

Incorporated society, over 450 members

Supports - individuals through to DHBs

Advocacy Health professionals have a major role to advocate for the health of society at all levels. (59)

Promoting Health Sector sustainability are affiliated with a carbon offsetting program that professionals can use to mitigate private and professional travel.

Political Engagement influencing policy decisions and local projects eg TPPA, public transport plans, divestment

Public Engagement Protests

Joining with others locally and internationally

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Everyone here has the sense that right now is one of those moments when we are influencing the future. -Steve Jobs

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