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HEALTH SUSTAINABLE DIET CLIMATE CHANGE The Connection and the Solution
HEALTH PROFESSIONALS’ REPORT 2009 UPDATE

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“Improving dietary habits is a societal, not just an individual problem. Therefore it demands a population-based, multi-sectoral, multi-disciplinary, and culturally relevant approach.”
WHO Global Strategy on Diet, Physical Activity & Health 2004

Contents
INTRODUCTION 7 HEALTH OVERVIEW 8
National and International Figures 8 Dietary Factors 8 Costs of ill Health 9

DISEASES 9
Obesity Cardiovascular Disease Diabetes Cancer Swine Flu The Link Continuing Trend Future Growth and Subsidies NHS Strategy Effects of Greenhouse Gases Emissions & Diet Locally Sourced Food Land and Water Use Food Insecurity Deforestation Species Extinctions 9 10 10 11 13 14 15 15 16 16 17 18 19 20 21 21

DIET, DISEASE AND GLOBAL WARMING 14

GLOBAL WARMING FACTS 16

DIET FOR GOOD HEALTH AND SUSTAINABILITY 22
The Move Towards Plant-based Alternatives 22

SOLUTIONS FOR BETTER HEALTH AND 23 ENVIRONMENT PRESERVATION CONCLUSION 25
APPENDIX 1 - FISH 28 APPENDIX 2 - QUOTES 30 REFERENCES 32

The contents of this publication have been endorsed by the following health professionals and scientists. Dr. Richard Schwartz USA, rschw12345@aol.com Diana Blicharski M.D. Assistant Professor, USA dianab@bcm.tmc.edu Khanhmei Wong, DPM USA, mchme1@gmail.com Professor Peter Mensz Research Scientist, Geophysicist, Poland, pmensz@gmail.com

INTRODUCTION
What we eat is important in the creation and prevention of major diseases such as cardiovascular disease, cancer, diabetes and obesity. The detrimental effects of saturated fats and lack of fibre are well documented in high profile studies, such as the European Prospective Investigation into Cancer (EPIC), the largest study of diet and health ever undertaken, and many other studies in respected scientific publications; these studies also show that a good diet including fruits and vegetables can be a powerful weapon for the prevention, even reversal, of chronic illness. Related to our health and diet is the pressing issue of climate change. In the report, ‘Managing the Health Effects of Climate Change’, a joint commission between the Lancet and University College London (UCL), lead author, professor Anthony Costello states: “there are major health benefits from low-carbon lifestyles, which can reduce obesity, heart and lung disease, diabetes and stress” (UCL News 2009). Our food choices, which are a contributory factor to major chronic diseases, also have a direct impact on climate change and our planet’s finite resources; similarly, climate change has direct and indirect impacts on human health. In its Carbon Reduction Strategy for England, the NHS recognises the urgency of climate change and commits to reducing 7 its carbon emissions by 80% by 2050, with a minimum reduction of 26% by 2020 (NHS 2009). As a pro-active ‘corporate citizen’, the NHS is not only leading by example, but showing that benefits are to be gained by improving health which contribute to sustainable development. This paper summarises the medical evidence which links the dramatic rise of major chronic disease worldwide to high intakes of saturated fats and animal protein, and the reversal of these once a healthful diet containing more vegetables, grains and legumes is adopted. It also highlights how these same food choices can have a very significant impact on Greenhouse Gas Emissions (GGEs) and climate change. The paper shows how eating further down the food chain is not only more sustainable and supports good health, but is also one of the quickest and most effective ways that we can help mitigate climate change – more than by reducing emissions from transport. It is hoped that through health professionals’ leadership vital plans can be promptly adopted for the implementation of such dietary measures for the benefit of people’s health, our national economy and for addressing the many environmental crises we are all facing.

HEALTH OVERVIEW

National and International Figures
In the UK, around 70,000 fewer people would die prematurely each year if diets matched nutritional guidelines on fruit and vegetable, saturated fat, added sugar and salt intake (Strategy Unit 2008). The EPIC Study has found that diets rich in fruit and vegetables are associated with reduced mortality (Am J Clin Nutr 2007). Globally, the WHO has stated: “Low intake of fruit and vegetables is estimated to cause about 31 percent of ischaemic heart disease, 11 percent of strokes worldwide and 19 percent of gastrointestinal cancers. Overall, 2.7 million deaths are attributable to low fruit and vegetable intake” (WHO 2004).

Dietary Factors
Data show a major change in diet at a global level since the middle of the twentieth century whereby traditional, largely plant-based diets have been replaced by high fat, energy dense diets that are micronutrient poor, with a substantial content of animal based foods (WHO/FAO 2003). This change, as well as an increase in sedentary lifestyles and smoking, has had disastrous effects on health, with the burden of chronic disease rapidly increasing worldwide. Many studies have implicated dietary factors in chronic disease: according to the WHO, a diet insufficient in fruit and vegetables is an independent risk factor for cardiovascular disease and cancer, including lung, stomach, colorectal and oesophageal cancers (WHO Media Centre 2007, CVD). In 2001, chronic disease caused approximately 60% of the 56.5 million reported deaths in the world and 46% of the global burden of disease (WHO 2002). Cardiovascular disease accounts for almost half of chronic disease deaths; obesity and diabetes are on the rise and appearing earlier in life (WHO/FAO 2003). The rapid increase in chronic disease is not limited to developed regions: developing countries are also plagued (WHO 2002). It has been estimated that by 2020, chronic disease will account for almost three quarters of all deaths worldwide (WHO 1998). Yet chronic diseases are largely preventable, and primary prevention is considered to be the most cost-effective and sustainable course of action (WHO/FAO 2003). There is strong evidence that vegetables and fruits are protective, whilst the rapid worldwide growth in meat consumption (which accounts for nearly one fifth of global GGEs) is both directly contributing to certain diseases and exacerbating climate change (Lancet 2007). However, although the consumption of fruits and vegetables plays a vital role in chronic disease prevention, at present only a small minority of the world’s population consumes their recommended average intake (WHO/FAO 2003). 8

Costs of ill Health
Diet-related ill health costs the UK National Health Service (NHS) £6 billion each year (J Epidemiol 2005). With the increase in major chronic diseases, medical costs are on the rise and those attributable to meat eating are substantial. The Physicians Committee for Responsible Medicine in the USA estimated that between $29-61 billion spent on US healthcare in 1992 was linked to meat consumption, adding that the cost would likely have been higher if stroke and other arterial disease had been included (Science Direct 1995).

DISEASES

Obesity
Obesity has reached pandemic proportions. There are at least 400 million obese adults and over 1.5 billion overweight people (age 15+) in the world; at least 20 million children under the age of 5 are overweight. The WHO estimates that 10% of children and 20% of adults in Europe and Central Asia will be obese by 2010 unless action is taken. In England, almost 1 in 4 adults are obese, and if it remains unchecked, by 2050, 9 in 10 adults will be overweight or obese. Worldwide, about 2.5 million deaths annually are attributed to overweight/obesity (WHO Media Centre 2006, Obesity). Costs of obesity are considerable: the NHS in the UK spends £4.2 billion/year on overweight/obesity, forecast to more than double by 2050. The cost to the economy is £16 billion/year, predicted to rise to £50 billion by 2050 (DoH, Obesity). Risk factors for obesity and overweight are rising dramatically (WHO Media Centre 2006, Obesity), but overweight, obesity and related chronic diseases are largely preventable (WHO Media Centre 2006, Obesity). A move from saturated to unsaturated fats, increasing consumption of fruit and vegetables, as well as legumes, whole grains and nuts, limiting sugar and increasing physical activity are recommended measures for prevention and control (WHO Media Centre 2006, Obesity). Cholesterol lowering foods, including viscous fibres (eg, fibres from oats and barley) and plant sterols, increase the effectiveness of diet in treating hypercholesterolemia (high blood cholesterol) (JAMA 2003). 9

Cardiovascular Disease
Globally, around 17.5 million people died from cardiovascular disease (CVD) in 2005: some 30% of all deaths. By 2015, the number of deaths from CVD is expected to be about 20 million (WHO Media Centre 2007,CVD). It is the world’s number one killer. CVD also places a heavy burden on national economies: it is estimated that China will lose $558 billion in national income from 2006-2015, due to heart disease, stroke and diabetes (WHO Media Centre 2007, CVD). Causes of CVD are well established: the most important are unhealthy diet, physical inactivity and tobacco use. At least 80% of premature deaths from heart disease and stroke could be avoided through healthy eating, regular physical activity and avoiding tobacco smoke (WHO/FAO 2003). A prospective study of over 6,000 participants examined the association of fruit and vegetable intake with longevity. The study recommended consuming 5-9 portions a day, associating this with a lower risk of all-cause, cancer, and CVD death (Am J Epidemiol 2004). Observational studies have found that those consuming large amounts of fruit and vegetables have less coronary heart disease and stroke (J Cardiovasc Risk 1999, Int J Epidemiol 1997). The Indian Experiment of Infarct Survival (IEIS) found a low fat diet enriched with fruit, vegetables, nuts and grains, compared with a standard low fat diet, was associated with about 40% reduction in cardiac events and 45% reduction in mortality after one year (BMJ 1992).

Diabetes
Diabetes has rapidly become a global pandemic. More than 180 million people worldwide have diabetes. This figure is expected to more than double by 2030 without intervention. In 2005, an estimated 1.1 million people died from diabetes. However, taking into account deaths in which diabetes was a contributory condition (such as kidney failure or heart disease), this figure increases to 2.9 million deaths per year (WHO Media Centre 2008, Diabetes). Type II diabetes comprises 90% of people with diabetes around the world. Until recently, this type of diabetes was seen only in adults but it is now also occurring in obese children. Type II diabetes, being a partly nutritional disease, is substantially preventable and sometimes reversible through nutritional methods and regular exercise. 10

The EPIC Study (Norfolk), with nearly 22,000 participants and a 12 year follow up, was the first large population-based prospective study to report that an energy-dense diet is positively associated with incident diabetes independently of baseline BMI, total energy intake and other risk factors (Am Diab Assoc 2008). Another prospective study involving 42,500 male participants with 12 years of follow up concluded that total and saturated fat intake was associated with a higher risk of type II diabetes (not independent of BMI) and that frequent consumption of processed meats may increase risk (Am Diab Assoc 2002). A 17 year prospective cohort study, involving over 8,000 people, concluded that a long-term diet including at least weekly meat intake, compared to a vegetarian diet (zero meat), was associated with a 74% increase in odds of diabetes; even after controlling for weight and weight change, meat intake remained an important risk factor (Ann Nutr Metab 2008). A comparison between vegetarian and non-vegetarian diets comprising over 60,000 participants over a 4 year period concluded that vegetarian diets were protective against type II diabetes after lifestyle and BMI were taken into account (Am Diab Assoc 2009). Diet trials and cohort studies have supported vegetarian diets or increased consumption of plant foods in the prevention of diabetes. Plant-based diets which contain a portfolio of natural products and food forms benefit both the carbohydrate and lipid abnormalities in diabetes. The use of soy protein, whole grain cereals and legumes, nuts and viscous fibres have been shown to be advantageous for prevention and treatment of type II diabetes and its complications, such as cardiovascular and renal disease (Am J Clin Nutr 2003).

Cancer
Cancer is a leading cause of death worldwide, accounting for 7.4 million deaths in 2004; this figure is projected to rise, with an estimated 12 million deaths in 2030. Lung, stomach, colorectal, liver, and breast cancer cause the most cancer deaths each year. More than 30% of cancer deaths could be prevented by avoiding key risk factors, which include tobacco and alcohol use, being overweight, low fruit and vegetable intake and physical inactivity (WHO Media Centre, Cancer 2009). The EPIC Study has found that bowel cancer risk increases by a third for people who consume two daily 80g portions of red or processed 11

meat, compared with those who eat just 20g a day (J Natl Cancer Inst 2005). The World Cancer Research Fund recommends reducing consumption of red and processed meats in its 2007 report, stating them to be a convincing cause of colorectal cancer (WCRF and AICR 2007); and a meta-analysis of prospective studies published through March 2006 also confirmed that high consumption of red and processed meat is associated with increased risk of colorectal cancer (Int J Cancer 2006). There is growing evidence linking red meat to pancreatic and stomach cancers: EPIC found that people eating over 100g of meat a day had over 3 times the risk of stomach cancer (J Natl Cancer Inst 2006), while another study, involving over 500,000 individuals over 5 years, found that those consuming most red or processed meat have a 40-50% higher risk of pancreatic cancer (Cancer Epidemiol 2007). Prostate cancer is associated with the intake of animal fat, especially fat from red meat, which was the conclusion of a prospective study involving 51,000 participants (J Natl Cancer Inst 1993). Breast cancer has also been associated with saturated fat intake, by a study of over 13,000 women over a four year period (Lancet 2003a). There is a further health risk associated with meat consumption: cooking meat at high temperatures (eg. by frying) which produces Heterocyclic Amines (HAs) which are associated with increased risk of colorectal adenoma (Cancer Res 2005). Another study supports the association between HA exposure and diet related tumours (Mutat Res 1997). To protect against cancer, many studies have demonstrated the positive effect of an increased intake of fruits, vegetables and fibre. Intake of high fibre foods was found by EPIC scientists to reduce risk of bowel cancer by 40%, for those who doubled their fibre intake from a low average (Lancet 2003b); many large studies confirm these findings. EPIC has also found that a diet rich in fruit and vegetables reduces the risk of mouth and oesophageal cancers (Cancer Causes Control 2006) and showed an inverse association between fruit consumption and lung cancer risk (Int J Cancer 2004). Evidence from the Greek EPIC cohort study shows that consumption of vegetables and fruits is inversely associated with the incidence of cancer overall (Cancer Epidemiol 2008). These findings clearly reveal that meat consumption is a contributory and significant risk factor in cancer, and that increasing consumption of fruit and vegetables is important in its prevention. 12

Swine Flu
Swine Flu, now with over 255,000 officially reported cases worldwide, has highlighted the exposure of humans to animal pathogens. The pandemic has been linked by experts to factory farms, which are perfect breeding grounds for new viruses such as H1N1, the genetic lineage of which has been traced to a strain that emerged in US factory farms in 1998, when it spread and mutated at an alarming rate (Wired Science 2009). A comprehensive report by the Pew Commission, USA, on Industrial Farm Animal Production has stated that IFAP practices are a cause of concern to human health. The potential for pathogen transfer from animals to humans is increased in IFAP because so many animals are raised together in confined areas. The Commission states that ‘The continual cycling of viruses and other animal pathogens in large herds or flocks increases opportunities for the generation of novel viruses through mutation or recombinant events that could result in more efficient human-to-human transmission’ (Pew Commission). The World Organisation for Animal Health (OIE) tells us that 60% of human pathogens and 75% of recent emerging diseases, including TB, are zoonotic (OIE 2005). All areas of meat, poultry, egg, and dairy production (e.g. meat transportation and processing, animal rendering, manure handling practices) can contribute to food contamination and zoonotic disease (Env H Persp 2007). Several high profile recalls involving E. Coli O157:H7 and Salmonella serve as reminders of the risk. In the United States, approximately 73,000 illnesses each year, leading to over 2,000 hospitalisations and 60 deaths, are caused by E. Coli O157:H7 infection (Emerg Infect Dis 1999). Costs associated with E. Coli O157:H7–related illness are estimated at $405 million annually (J Food Protec 2005). Consumption of food and water contaminated with animal wastes is a major route of human infection. 13

Other meat-related diseases which can be fatal, such as CJD, Blue Tongue Disease, Avian flu and Listeriosis, have also been a cause of increased concern, and question the safety of eating meat. Meat recalls around the world are becoming more frequent with millions of kilos of meat found to be contaminated.

DIET, DISEASE AND GLOBAL WARMING

The Link
In the recent report of a year-long commission held by the Lancet and University College London, which included academics from many different disciplines across the university, Professor Anthony Costello, lead author, director of UCL’s Institute for Global Health and paediatrician, described climate change as a ‘clear and present danger’, the impacts of which will be felt ‘in our lifetimes and those of our children.’ (Times Online 2009). According to Professor Costello, climate change will change patterns of disease, food security, water and sanitation and extreme weather events for the worse. The report states that governments need to address patterns of food consumption. “One starting point is to define and promote a sustainable diet, which could mean reductions of the incidence of heart disease, cancer, diabetes, and obesity. R K Pachauri, chair of the IPCC, recently suggested that a reduction in meat consumption would be a practical and helpful way for an individual to contribute to lower greenhouse gas emissions. Such policy would lead to reductions in colorectal cancer and, probably, ischaemic heart disease” (Lancet 2009). Data show that the sharp increase in meat production and consumption in the last 50 years has not only been linked to chronic disease reaching pandemic proportions (WHO/FAO2003), but has also caused environmental devastation, responsible for our planet’s dwindling resources of land and water, further threatening food security, among other things. Many sectors contribute to global warming. However, one sector is the largest producer of two of the most significant Greenhouse Gases (GHGs), methane and nitrous oxide, both much more potent than carbon dioxide (UN FAO 2006). This sector is also our single largest user of land and water; a major cause of deforestation, wide-scale land degradation and species loss; and a major polluter of our rivers, oceans and drinking supplies: it is animal agriculture. The UN’s 2006 report, ‘Livestock’s Long Shadow’, cites livestock production ‘as one of the most significant contributors to the world’s most pressing environmental problems, at every scale from local to global’ (UN FAO 2006).

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Continuing Trend
Meat is the principal component in most people’s diet, and as such is a main source of protein and iron for the majority: it has become tradition to serve certain meat dishes in many cultures. Meat is also a source of high saturated fat, lacks fibre and some micronutrients, and if not organic, contains a multitude of chemicals, antibiotics and hormones, all detrimental to human health. High profile studies such as EPIC and others clearly cite the effects of too much saturated fat and lack of fibre, absence of sufficient fruit and vegetables in the diet and physical inactivity as contributory risk factors to many of our chronic but largely preventable diseases; statistics from WHO show this trend is likely to continue unless concerted action is taken. Most people do not know they are able to replace protein from animal flesh with protein from pulses, grains, nuts and vegetables with their many advantages and without detrimental health effects.

Future Growth and Subsidies
Livestock production is a significant contributor to GHGs and a main cause of climate change; it is also the fastest-growing agricultural sub-sector. Global meat consumption has increased five¬fold since the 1950s; by 2050, it is expected to be more than double that of 1999. Growing demand for meat is having a serious detrimental impact on our health and the environment, and the FAO warns: “The environmental costs per unit of livestock production must be cut by one half, just to avoid the level of damage worsening beyond its present level” (UN FAO 2006). Despite this very real threat to the planet and its inhabitants, huge subsidies are given for meat production every year: EU interventions and direct support to the livestock industry in 2007 cost over 15

3.5 billion Euros. This figure does not include the financial aid given for marketing (GUE/NGL 2007). If the meat industry fulfils its predicted growth, with staunch monetary support from governments, we must be prepared for serious adverse consequences with regard to global health, financial costs and runaway (uncontrollable) global warming.

NHS Strategy
The NHS Carbon Reduction Strategy for England prioritises tackling its carbon footprint by reducing emissions from buildings (22% of footprint) and transport (18%), although it also calls for more use of seasonal, local food, and sustainable, nutritionally valuable produce, such as fish (see appendix 1), reducing reliance on meat, dairy and eggs. Although food accounts for only 2% of the footprint, provision of support for patients to reduce and eliminate meat results not only in addressing today’s prevalent and rising diet-related diseases, but also creates huge environmental benefits on a global scale in the vital short term period. The link between an unhealthy, and unsustainable diet and the major chronic diseases of today, hangs obtrusively over an impending and certain global threat – climate change. Never before have advice, education and a concerted effort towards a sustainable and healthy eating regimen, which reduces and/or eliminates meat from our diet, been of more importance, regardless of the wider habitual dietary practices

GLOBAL WARMING FACTS

Effects of Greenhouse Gases
In discussions about GGEs, emphasis has mainly been put on carbon dioxide, the most abundant GHG in the atmosphere. However, methane, the second most prevalent GHG, has shown some disproportionately rapid increase in recent human history: global methane has risen by 148% over the past 255 years, while carbon dioxide emissions increased by 35% over the same period of time (IPCC 4th Assessment). Since methane has 72 times the global warming potential (GWP) of carbon dioxide, over a 20 year period (IPCC 4th Assessment 2007), its sharp increase could have devastating impact. As a result of rising temperatures, large areas of permafrost are now melting and the subsequent release of methane is a “ticking time bomb”. Frozen bubbles in Siberian lakes are releasing methane at

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rates “five times higher than previously estimated.” This could create an uncontrollable feedback effect, dramatically warming the atmosphere, which would in turn warm the land, lakes and seabed, further melting the permafrost and releasing more methane. Once that threshold is reached, there will be nothing humans can do to reverse it (Nature 2006). Research at the University of Alaska, USA, has shown that a two to three-degree rise in air temperature could cause the Arctic tundra to change from an area of carbon sink to one of carbon source releasing into the atmosphere carbon dioxide, methane and other gases (Science Daily 2008). The fast release of methane into the Earth’s atmosphere 55 million years ago caused rapid warming and mass extinction, disrupting the climate for more than 100,000 years. Another catastrophe, 251 million years ago, came close to destroying nearly all life on Earth due to the release of methane (Energy Bulletin 2004). The very quality of methane that makes it so damaging also points to a quick and effective way to halt global warming – by significantly reducing anthropogenic methane; the primary source of which is livestock production. However powerful it is, with a net life cycle of 8.4 years in the atmosphere (c.f. carbon dioxide, 100 1000 years) and reduced warming potential in longer time frames, any reduction in methane can quickly translate into alleviation of the warming effect. Overall, livestock production contributes to 9% of global anthropogenic carbon dioxide emissions, 37% of anthropogenic methane emissions and 65% of nitrous oxide emissions, the latter having 275 times GWP of carbon dioxide over 20 years (UN FAO 2006). Overall, the GHGs produced by the livestock sector account for about 80% of emissions from agriculture, and nearly one fifth (18%) of total GGEs from human activities (UN FAO 2006). This is calculated over a 100-year period and the figure does not take into account transportation, refrigeration in transport or the amount of energy used at home for storing meat.

Emissions & Diet
A study commissioned by Foodwatch, conducted at the Institute for Ecological Economy Research in Germany, compared the GGEs of meat versus non-meat consumption. The study found the emissions attributable to an average meat-containing diet over one year were equivalent to driving a mid-sized car 4,758 kilometres (nearly 3,000 miles). A vegetarian diet was found to reduce these 17

Agriculture as Climate Killer
Greenhouse effect from different kinds of eating habits, per capita and per annum, presented in car kilometres*

Veganism
281 km 629 km

Organic Farming Conventional Farming

Vegetarianism
1978 km 2427 km

Diet includes Meat
4377 km 4758 km
*equivalent to the CO2 emissions of a BMW 118d with 119g CO2 /km Source: Foodwatch

emissions by half, while an animal-free vegan diet produced less than 1/7th the GHGs of a meat diet, representing emission savings of 86%. An organic vegan diet was calculated to reduce emissions by 94%. The study, which took into account animals’ methane production, feed and fertilizer manufacture, concluded: “Production and consumption, first and foremost, of beef and milk must be cut drastically” (Foodwatch 2008). Another paper shows that avoiding meat for just one day a week in the UK would prevent 13 megatons of carbon dioxide emission. This is a greater carbon saving than taking 5 million cars off the road (10.4 megatons of carbon dioxide), and almost equal to replacing a billion conventional light bulbs with low-energy ones (Inst Env Studies 2008).

Locally Sourced Food
Whilst locally sourced food has obvious environmental advantages of fewer “food miles”, our food choices have a greater environmental impact than buying locally sourced food. A comprehensive 18

audit of the GGEs of our food choices, comparing transportation vs food production emissions has shown that locally sourced food does not have a significant impact on GGEs because the emissions associated with food are dominated by the production phase, not by its transportation. The report concludes that dietary shift is a more effective means of lowering carbon footprint than buying locally, and “shifting less than one day per week’s consumption of red meat and/or dairy to other protein sources or a vegetable based diet could have the same climate impact as buying all household food from local providers” (Carnegie Mellon University 2008).

Land and Water Use
Water use is a key feature of the NHS’s carbon reduction strategy. One billion people in the world do not have access to clean water; more than 2 billion do not have proper sanitation. The UN Food and Agriculture Organization (UN FAO) estimates that by 2025, there will be 1.8 billion people living with absolute water scarcity, and 2/3 of the world’s population could be living under water-stressed conditions (UN FAO 2006). With global population expected to reach 8.1 billion by 2030, 14% more fresh water would be required for agriculture to keep pace with the growing demand for food (UN FAO News 2007). But even now, the global amount of fresh water available per person is falling rapidly (UNEP 2002). In the face of such scarcity, water usage continues where it is least sustainable. The raising of livestock, particularly the production of animal feed, “consumes large amounts of critically important water resources and competes with other usages and users” (UN FAO 2006). A report presented to the UN, ‘Saving Water: From Field to Fork’ shows that 70% of global fresh water is used in agriculture, and most of that is used for livestock production. Industry accounts for 20% and households only 10% (SIWI and IWHI 2008). The amount of water per kilo required to produce food groups such as meat and dairy can be 10 times that required for grains and vegetables (SIWI and IWHI 2008). In the United States, the ratio is even greater: 1kg of animal protein requires about 100 times more water to produce than 1kg of grain protein (Am J Clin Nutr 2003).

• •

1kg of beef requires 5,000 – 20,000 litres of water 1 kg of wheat requires 500 – 2,000 litres of water

Meat production also uses up to 20 times more land than grain and vegetables to support the same number of people (WHO/FAO 2003). 19

One hectare of land produces:

• • • •

potatoes rice lamb beef

for

22 people 19 people 2 people 1person

Hence, meat production uses the majority of agricultural land (70%) – which can be rendered infertile for years due to overgrazing, compaction and erosion. Seventy percent of all grazing land in dry areas is considered to be degraded (UN FAO 2006). The livestock industry is the single largest user of land and water in the world (UN FAO 2006). Our diminishing reserves of land and water cannot sustain a growing human population while mainly being used for, and damaged by, the raising of 58 billion livestock each year (FAOSTAT).

Food Insecurity
There are more than 1 billion people in the world who do not have enough to eat. Hunger claims 25,000 lives every day and every six seconds a child dies of hunger. (WFP Hunger Stats). Meanwhile, 760 million tons of grain are fed to animals every year (UN FAO Food Outlook 2008). During 2007-2008, 36% of the global grain utilised was to feed animals, whilst 47% was used for feeding humans, and 5% used on bio-fuel (UN FAO Crop 2008). During the same period about 70% of the global soya consumption was in the form of animal feed whilst only 16% was used for humans (USDA Review 2008). Farm animals are inefficient converters of plants to edible flesh because much of their food is converted into energy for movement, used for the growth of body parts not eaten by people or excreted as manure. It takes more than 10 kg of grain to produce 1 kg of beef, 4 to 5.5 kg of grain to produce 1 kg of pork, and 2.1 to 3 kg of grain to produce 1 kg of poultry meat (USDA AgStats 2008). This is based on net live-weight production of meat. If measured by consumable ready-to-cook weight, the ratio would be even higher. In its report ‘Environmental Food Crisis’, the United Nations Environment Programme (UNEP) has estimated that in 2050 “...feeding the cereals to animals instead of using the cereals directly as human food represents the annual calorie need for more than 3.5 billion people” (UNEP 2009). Similarly, the UN FAO has stated: “Livestock consume more edible human protein than they produce” (UN FAO 2006). 20

Raising animals for human consumption is one of the major causes of world hunger (EVANA).

Deforestation
Forests play a key role in mitigating climate change. Apart from storing carbon, they act as a climate buffer, generate rainfall, store water, stabilise the soil, maintain biodiversity and much more (GCP). Decimating them for pasture has a very high environmental cost. Every year about 2.4 billion tons of carbon dioxide is released into the atmosphere as a result of deforestation for livestock maintenance (UN FAO 2006). By 2010 cattle are projected to be grazing on some 24 million hectares of neo-tropical land that was forest in 2000 (UN FAO 2006). The declaration signed by 300 climate experts at the 2007 United Nations Conference in Bali says: “If we lose the forests, we lose the fight against climate change.”

Species Extinctions
In 306 of the 825 terrestrial eco-regions identified by the Worldwide Fund for Nature, livestock are identified as “a current threat”, while 23 of Conservation International’s 35 “global hotspots for biodiversity” - characterized by serious levels of habitat loss - are affected by livestock production. The International Union for Conservation of Nature (IUCN) estimates that species loss today is 1,000 to 10,000 times higher than the expected natural extinction rate. Livestock production is a major culprit, contributing to all the most important direct drivers of biodiversity loss, such as climate change, habitat change, invasive alien species, and pollution (UN FAO 2006).

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Tropical forests hold half of the world’s species and many have become or are becoming extinct at an alarming rate, largely for meat production. The few species of animal raised for meat and milk now account for about 20% of the total terrestrial animal biomass, and this proportion is still growing ‘invasively’. “The sheer quantity of animals being raised for human consumption is a threat to the Earth’s biodiversity” (UN FAO 2006). Raising animals for the production of meat is also responsible for 64% of global Ammonia emissions (UN FAO 2006), contributing to acid rain and affecting biodiversity. The current rapid loss of biodiversity is a cause of grave concern. The IUCN has warned that life on Earth is disappearing fast and will continue to do so unless urgent action is taken.

DIET FOR GOOD HEALTH AND SUSTAINABILITY

The Move Towards Plant-based Alternatives
In their most recent and extensive position on the subject, the American Dietetic Association has confirmed that a healthy vegan or vegetarian diet is appropriate for all stages of life, including during pregnancy, lactation, infancy, childhood, adolescence and for athletes (ADA 2009). The ADA states that: “appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate and may provide health benefits in the prevention and treatment of certain diseases” (ADA 2009). They report that vegetarians have a lower body mass index, lower blood cholesterol, lower blood pressure and rates of clinical hypertension, less type II diabetes, and a lower incidence of prostate and colon cancer. Vegetarians also have lower rates of death from ischaemic heart disease (ADA 2009). A vegetarian diet prevents meat-related diseases and can reverse some of them: Research over the last 30 years has demonstrated that coronary atherosclerosis can be reversed through comprehensive lifestyle changes, including a vegetarian diet; and more recently, a randomized controlled trial showed that comprehensive lifestyle changes may stop or reverse the progression of prostate cancer (JAMA 1998). The American Journal of Clinical Nutrition has also published studies showing the benefits of a vegetarian diet in the prevention and treatment of type II diabetes as well as its significant impact on cardiovascular disease (Am J Clin Nutr 2003). A study earlier this year by the Netherlands Environmental Assessment Agency found a global food transition to less meat, or even

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a complete switch to plant-based foods could wipe 80%, or US$ 32 trillion, off the cost of fighting climate change. Hence, dietary changes could play an important role in climate change mitigation policies (New Scientist 2009) as well as preventing chronic disease. In addition, decreases in meat production/consumption would almost immediately reduce the effects of methane as ruminant animals can be removed from production in as little as 1-2 years and methane cycles out of the atmosphere in about 8 years, whilst the lifetime of cars and power plants, etc, can be decades, and carbon dioxide remains in the atmosphere for centuries. Introducing new techniques and further research into cutting methane emission from livestock would take many years and a cut in carbon dioxide involves fighting powerful and wealthy business interests while vegetarian foods are readily available at every mealtime (Earth Save International 2005). The trend toward plant-based foods has already gained momentum as consumers learn about meat’s harmful effect on health and the environment. Reducing or eliminating animal products from our diet has major health benefits, will save billions of dollars in healthcare and climate change costs and has the added benefit of being the quickest, most effective way to curb methane emissions.

SOLUTIONS FOR BETTER HEALTH AND ENVIRONMENT PRESERVATION

In a 2007 article in the Lancet, analysing the link between livestock, energy, climate change and health, the authors advocate reducing the average worldwide consumption level of animal products and the intensity of emissions from livestock production (Lancet 2007). A recent WHO/FAO report recommends the consumption of a minimum of 400g of fruit and vegetables per day (excluding starchy tubers) for the prevention of chronic disease as well as for the prevention and alleviation of several micronutrient deficiencies (WHO 2004). Many steps are being taken to curb climate change all over the world, such as the use of renewable energy, eco friendly cars and aeroplanes, recycling and planting trees, to name a few. Even the meat and dairy industries are moving to reduce their environmental footprint through less packaging, improving fuel efficiency, reducing water use, etc. Clearly, all of these are important and much needed. Yet, even collectively, they are not sufficient to resolve the environmental crisis we are facing now within a short time-frame, if we continue to raise 58 billion animals for human consumption every year (FAOSTAT). Nor would a continuation of current levels 23

of meat consumption reduce the worldwide pandemic of chronic disease. Increasing scientific evidence shows that the high saturated fats and lack of fibre in meat not only have a direct role in the increase in major chronic diseases, but also, animal agriculture in its current levels of production is literally stripping the planet of its finite resources, as well as having a major role in global warming, affecting many eco-systems. Furthermore, the rearing of billions of animals in factory farms is breeding new and virulent pathogens, as evidenced by the recent pandemic of Swine flu, posing an even greater threat to human health and lives. Based on the above studies showing how our dietary choices can have a significant impact on our health and well-being as well as an enormous impact on our planet’s resources and climate change, NHS, GPs and other health practioners can implement novel environmentally and economically effective measures such as:

Encouragement of change on an individual level towards a healthier plant-based diet, through education and advice on the link between meat and obesity, heart disease, diabetes and some cancers; and the positive consequences of becoming vegetarian. Provision of healthy protein-bearing pulses and nuts with whole grains, vegetables and fruit, in hospital meals, canteens and cafes, showing their nutritional and health benefits along with their greater environmental value.

Proactively encouraging individuals towards a more healthful diet of less animal proteins and fats through the above measures has multi-faceted advantages, desperately needed at this time – in the face of global health and environmental crises.

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CONCLUSION

The 20th century change from largely plant-based diets to energydense diets high in fat and animal foods has played a key role in the upsurge of diet-related, preventable health problems: obesity, cardiovascular disease, type II diabetes and some cancers; even the swine flu pandemic has been clearly linked to meat production and consumption. The healthiest individuals are those who consume a diverse, plant-based diet, rich in whole grains, fruits and vegetables. The environmental impact of meat consumption extends far beyond that of GHG generation: land and water wastage and pollution, deforestation and species extinction and world food shortages. The focus on CO2 emissions, whilst important, is not the short term solution that is required, because even if the entire world switched to a zero carbon economy and lifestyle today, it would take 100 to 1000 years for CO2 to dissipate out of the atmosphere. It becomes very clear then why many scientists are now placing a greater importance on limiting shorter term GHGs, such as methane, as a better and essential strategy for mitigating global warming. This would have a major influence in slowing planetary heating, giving us valuable time to deal with CO2 emissions. Much experimental and epidemiological evidence supports the healthcare benefits of plant-based foods. At the same time, the cost of ill-health to our economy and the NHS would be reduced by billions of pounds. Thus, a plant-based diet with its advantages on many fronts, must become a serious consideration as it offers win-win solutions to some of humanity’s most pressing problems: easing the health care burden while at the same time improving public health and helping to mitigate global warming.

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As Professor Tim Lang, adviser to the Government on food security and tackling obesity, has said: “We’ve got to have new criteria that take into account all the new concerns – sustainability, water shortage, climate change, obesity, malnutrition and so on.” He advises cutting down on eating animals and dairy foodstuffs to reduce the amount of GHGs produced in rearing livestock (Daily Telegraph 2008). Decision makers in Government, national bodies, public health departments, healthcare trusts, GPs and other health practitioners can all be very influential in bringing about this required change through education and advice, personal example and the provision of these foods where possible. We can no longer afford NOT to make these fundamental and urgent changes, as a truly sustainable, effective solution to many of our global crises today. Please help lead the way.

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Appendix 1

FISH
Fish is linked to many health benefits including protection from cardiovascular disease. Until the publication of DART-2 Trial in 2003 (Eur J Clin Nutr 2003), evidence appeared to show that Omega 3 from oily fish or supplements reduced the risks of fatal myocardial infarction, sudden death and overall mortality among people with existing disease (Am J Med 2002). Surprisingly, DART-2 did not confirm this (Eur J Clin Nutr 2002) and more recently, in 2006, a high quality systematic review was published in the British Medical Journal which drew attention to uncertainties of comprehensive benefits of consumption of Omega 3 fats (BMJ 2006). The claim that Omega 3 fats reduce the risk of cancer was not supported either (JAMA 2006). Earlier in 2004, the US Food and Drug Administration suggested that women of child-bearing age, pregnant women, nursing mothers and very young children should not eat long-lived predatory fish to minimize exposure to methylmercury (EPA/FDA 2004). Clearly, this is a field in which knowledge is still evolving. Mercury is only one of the dangerous toxins found in fish. The US Agency for Toxic Substances and Disease Registry documents high levels of mercury exposure causing permanent damage to brain, kidneys and liver, even damaging the developing fetus (ASTDR 2007). Fish, particularly predatory fish, such as swordfish, golden bass and king mackerel, accumulate Polychlorinated Biphenyls (PCBs), dioxins and other toxic substances such as lead, arsenic and chromium in their flesh which reach levels that may be many thousands of times higher than in surrounding water. Dioxins, PCBs, cadmium, arsenic and mercury are all cited as possible carcinogens (ATSDR 2008). Environmentally, overfishing is the single greatest threat to the marine environment and our eating habits are driving many aquatic species to the brink of extinction. Overall, 80% of global fish stocks are either fully exploited or overexploited. Only 20% of stocks are moderately exploited or underexploited (UN FAO Fisheries 2009). It is worth noting that 53% of global fishmeal production is used by

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the livestock sector for feed which is seriously affecting the world’s fish population (UN FAO 2006). Aquaculture (fish farming) is not the solution. This practice consists mainly of raising carnivorous fish, such as salmon, blue fin tuna and sea bass, on a high protein diet of fishmeal and fish oils. It takes 2.5 – 5 kg of feed fish to make just 1 kg of farmed carnivorous fish (UNEP 2009). In 2006, aquaculture accounted for 47% of the 110 million tons of food fish (UN FAO Fisheries 2009). Fish farming has increased more than seven fold between 1980 and 2000. In order to meet the growing fish demand aquaculture will have to produce an additional 28.8 million tons (80.5 million tons overall), just to maintain per capita fish consumption at current levels (UNEP 2009). This means that global fish stocks will be under even more pressure. Due to increasing concern about the state of our oceans and fisheries and the safety of eating fish, alternative sources of long chain polyunsaturated fatty acids (LCPUFAs) have been or are being developed. One such lipid is stearidonic acid (SDA), a naturally occurring (n-3) PUFA that may have similar biological properties to eicosapentaenoic acid (EPA), a major (n-3) PUFA in fish oil. Existing and novel plant sources rich in SDA are being cultivated and promoted as potential alternatives to marine-based (n-3) PUFA (J Nutr 2009). Given the state of severe crisis of our global fisheries, the health risks in fish consumption and the incomplete knowledge surrounding its health benefits, it would seem responsible to refrain from advocating to people in developed countries that they increase their intake of long chain Omega-3 fatty acids through fish consumption. Vegetarians lead healthy lives without the need to consume fish, receiving their Essential Fatty Acids from sources such as flaxseed, rapeseed, soya, seeds and nuts, with spirulina and chlorella providing valuable sources of EFAs and DHAs as well as a host of other nutrients.

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Appendix 2

REDUCING MEAT CONSUMPTION FOR OPTIMUM HEALTH AND FOR THE PLANET

“The doctor of the future will give no medicine, but will interest his patient in the care of the human frame, in diet and in the cause and prevention of disease.”
Thomas Edison , Inventor

“I don’t understand why asking people to eat a well-balanced vegetarian diet is considered drastic, while it is medically conservative to cut people open and put them on cholesterol-lowering drugs for the rest of their lives.”
Dean Ornish, M.D., Director of Preventive Medicine Research Institute

“When we kill the animals to eat them, they end up killing us because their flesh, which contains cholesterol and saturated fat, was never intended for human beings, who are naturally herbivores.”
William C. Roberts, M.D., Editor of The American Journal of Cardiology

“The best solution would be for us all to become vegetarians.”
UN, Yvo de Boer, Executive Secretary of Framework Committee on Climate Change

“Nothing will benefit human health and increase chances of survival for life on earth as much as the evolution to a vegetarian diet.”
Albert Einstein, Physicist, Nobel Prize 1921

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“People often say that humans have always eaten animals as if this is a justification for continuing the practice. According to this logic, we should not try to prevent people from murdering other people, since this has also been done since the earliest of times.”
Isaac Bashevis Singer, Author, Nobel Prize 1978

“The thinking man must oppose all cruel customs no matter how deeply rooted in tradition and surrounded by halo. When we have a choice, we must avoid bringing torment and injury into the life of another, even the lowliest creature; to do so is to renounce our manhood and shoulder a guilt which nothing justifies.”
Dr Albert Schweizer, Nobel Prize 1952

“Non-violence leads to the highest ethics, which is the goal of all human evolution. Until we stop harming all other living beings, we are still savages.”
Thomas Edison, Inventor

“People ask me how I look so young. I tell them I look my age. It is other people who look older, what do you expect from people who eat corpses?”
George Bernard Shaw, Playwright

“For as long as men massacre animals, they will kill each other. Indeed, he who sows the seed of murder and pain cannot reap joy and love.”
Pythagoras, Mathematician

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“One of the most helpful is actually a vegetarian diet, it produces much less greenhouse gasses than a meat diet.”
Dr. James Hansen, Director, NASA Goddard Institute for Space Studies

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