Connecting Diet and Climate

About the images above: The Canada Food Guide image suggests a model healthy 'plate' that is very similar to the EAT-Lancet Commission's 'Planetary Health Diet'

On Oct 30, 2020 I was pleased to present at a conference hosted by the Canadian Association of Physicians for the Environment (CAPE) titled The Climate Emergency: Diagnosis and Management. My talk was Why More Plant-Based Eating Will Help Your Patients and the Planet. Below are some ideas and resources I'm recommending for anyone who attended that presentation, and to address additional questions I get on this topic. I hope it's useful to any physician looking to highlight connections between diet, health, and planetary health.

But first...

Consider framing food-in-medicine as a national campaign

Expanding on the talking points mentioned in my presentation, I suggest that physicians who are bringing the topic of food (and its connections to personal and planetary health) into the clinic to consider framing it as part of a broad-based campaign. This will help patients understand that it's not just "your thing." It will also make clear to individual patients that they're not being singled out for a food choice/health/climate talk but rather are among a broad swath of people being offered useful information. I can imagine a physician saying something like:

“I'm part of a national group of doctors who are concerned about climate change, and who--at the same time --want to promote better health. We're offering information to all patients about dietary shifts that could help produce fewer greenhouse gasees, and also improve personal health.”

You're the clinical experts, and I welcome your comments, either below or to me directly at eleanor@eleanorboyle.com. 

Advancing the conversation about food choices, health, and climate change

1. Familiarize ourselves with the science on connections between dietary choices, health, environments, and climate

• Where's a credible scientific source on the contribution of our dietary choices to climate change? Have a look at the Intergovernmental Panel on Climate Change (IPCC)'s 2019 report on this topic. Or start with coverage of that report by this article in the prestigious journal Nature:"Eat less meat: UN climate-change report calls for change to human diet"
• Do our food choices have a big impact on the emissions we generate? Absolutely. Check out this study by Poore, J., & Nemecek, T. (2018). Reducing Food’s Environmental Impacts through Producers and Consumers Science, 360(6392), 987-992. It discusses, among other things, the widely varying emissions profiles of different foods--from one food to another (e.g. cheese or poultry), and within food types (e.g. cheddar versus parmesan, or different types of cheddar). A big takeaway from this article, though, is that plant-sourced proteins are far more climate-wise and less resource-consumptive and polluting than are animal-sourced proteins. This is an admittedly data-dense article. For a more accessible look at climate-friendly eating which refers extensively to Poore & Nemecek's work, check out the April 19, 2018 New York Times article Your Questions About Food and Climate Change, Answered.
• Is there a health case for talking about dietary choices (and their climate implications) with patients? Check out the Lancet's Global Burden of Disease reports, and in particular the report published in 2019. It concludes that "suboptimal diet is responsible for more deaths than any other risks globally, including tobacco smoking … highlighting the urgent need for improving human diet across nations."
• What are the latest science-backed recommendations from Canadian experts for a balanced diet? Canada's Food Guide. Now available in many languages, Canada's Food Guide has changed quite a bit over its 60-plus years. The latest edition is ahead of the curve internationally as it positions meat and dairy as options rather than nutritional must-haves, and it raises the profile of fruits, vegetables, and whole grains on our plates. It also goes beyond food to promote savvier food purchasing, healthier preparation of food, and more mindful eating habits. I love its appetizing and colourful illustration of what an ideal main meal might look like -- which closely resembles the EAT-Lancet's illustration of a planetary health diet (see images at the top of this post!)
• How do healthier food choices impact climate and environment? See this Dec. 2017 study by Paul Behrens, Jessica C. Kiefte-de Jong, Thijs Bosker, João F. D. Rodrigues, Arjan de Koning, and Arnold Tukker: “ Evaluating the environmental impacts of dietary recommendations.” It shows that dietary changes need not be radical to make a huge difference to our emissions profiles. Even if those of us in Canada, the US, Britain, and Australia merely followed our own governments' recommendations for healthy eating, like those in Canada's Food Guide, we can reduce our food-related GHGs by 13 to 24%.
• Is it possible to eat well, healthily, sustainably, and equitably feed people today and the populations to come? The EAT-Lancet Commission, a partnership of scientists from 16 countries and the prestigious journal The Lancet, says we can--and has spelled out the broad but highly customizable parameters of diets that enable us to do that. Its conclusions are laid out in the report Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems. 
• Is it really possible at this point to mitigate climate change? If you and your patients share the concerns of most Canadians about this, there's good news: Project Drawdown is a non-profit comprised of researchers, policymakers, business leaders, and activists from around the world, dedicated to researching when and how global warming can be reversed. Their aim is drawdown—a future time when atmospheric greenhouse gases actually decrease. Project Drawdown is tapping knowledge from multiple disciplines to map and model the top 100 technological, social, and ecological solutions to global warming. In 2017, the organization released the best-selling book titled Drawdown: The Most Comprehensive Plan Ever Devised to Reverse Global Warming. You can see up-to-the-minute versions of the plan at Drawdown.org. As you’ll see, Project Drawdown is not just counting on innovations yet to occur. All of the more than 80 solutions it has modelled are based on technologies and practices that are already available, understood, and used around the world. At least eight of its top 20 solutions relate to food. More plant-rich diets is one of the most potent.
  
• Would more climate-friendly (that is, more plant-rich and less meat- and dairy-centered) diets also help prevent pandemics? Yes! For a brief look at this topic, see this April 2020 article by Jonathan Safran Foer and Aaron S Gross in The Guardian titled "We have to wake up: Factory farms are breeding grounds for pandemics." Then dive into Dr. Michael Greger's 2020 book, How to Survive a Pandemic. It looks deeply at the connections between factory farming and pandemics. See also Greger's website and his nonprofit site which reviews the science and offers a wealth of resources on whole-foods plant-based eating at nutritionfacts.org
• Does the standard Canadian diet, which provides far more protein than we physiologically need, and mostly from animal sources, have any bearing on the effective stewardship of antimicrobial drugs? Absolutely. Here's a quick-read article from Radio Canada International article, published on Oct. 16, 2020, on the topic of over-use of these drugs in animal agriculture: "Overuse of antibiotics in animals seen as dangerous to public health." For a deeper dive, read this 2020 publication from the Canadian government titled Canadian Antimicrobial Resistance Surveillance System Report, which confirms that in 2018, a full 79% of antimicrobials (mostly antibiotics) used in Canada were for the ‘animal sector’.

2. Check out some excellent resources crafted to help health professionals broach these conversations

• The EAT-Lancet Commission's Brief for HealthCare Professionals.
• The Canadian Association of Physicians for the Environment's Climate Change Toolkits for Health Professionals. Module 8, titled Engaging in Climate Change Solutions as Health Care Professionals, is particularly helpful.

3. Recommend resources like these to receptive patients -- provide links on your clinic website and/or screen or POST in waiting rooms.

• Canada's Food Guide, now available in many languages. Order or download to print beautiful full-size colour posters of images like the one at the top of this post from here. That link also has many other high-quality free-to-use downloadable images for your blogs, newsletters, and other publications, including some focused on indigenous diets.
• Documentary on Netflix or free on Youtube with Spanish subtitles: What the Health. This 2017 film offers an evidence-based critique of the health impact of meat and dairy product consumption and explores the benefits for health and beyond of a more plant-based diet.
• Documentary on Netflix or free on Youtube: The Game Changers. This new, acclaimed documentary takes an evidence-based look at the benefits for health, environment, climate of plant-based diets. It profiles high-achieving athletes who made the switch, and entertainingly debunks the idea that plant-based eating is less "masculine."
• Dr. Michael Greger's book How to Survive a Pandemic , and his nonprofit website which reviews the science and offers excellent resources on whole-foods plant-based eating at nutritionfacts.org
• A touching 3-minute video about the evolution of farming titled Back to the Start. It's produced by the Chipotle Cultivate Foundation. Bonus: Its soundtrack features Coldplay's haunting classic, "The Scientist," performed by country music star Willie Nelson.
• In BC, anyone can 'Dial-a-Dietitian,' by phoning 811 for a free consultation, Monday – Friday 9am-12pm and 1pm-4pm.  Some other jurisdictions have similar services; check in your province.

What about you?

I would love to hear ideas and experiences from physicians broaching these topics in their practice. Feel free to comment below or drop me a line at eleanor@eleanorboyle.com ... and please download some key take-away resources I've assembled for you below.