Reports – Sustainability

Sustainability > Reports > Nutrition care

Greener Allied Health Professional Hub: Food & Nutrition (NHS, UK)

The UK National Health Service (NHS) has the third largest clinical workforce in the NHS. Allied Health Professionals (AHPs) play an important role in Delivering a Net Zero NHS, which is the overarching framework.

The “Greener Allied Health Professional (AHP) Hub” aims to provide:

Information on the importance of environmental sustainability for both population health and the health of the environment to provide clear actionable steps which AHPs can take to improve their own environmental sustainability.
Examples of the ways in which AHPs are already doing things which improve environmental sustainability to include ‘what good looks like’ for individual AHPs and their teams as well as wider examples demonstrating how AHPs can lead this work in their organisations.
Suggestions of how AHPs can contribute in relation to environmentally sustainable practice, digital, food and diet, use of equipment and public health and prevention.

Food & Nutrition is one of the focus areas for the Greener AHP Hub. As a food and nutrition professional, this NHS resource outlines key areas where you can make a difference in reducing the carbon footprint of healthcare food systems. It highlights your role in reducing food waste through optimizing mealtime support, promoting best practices, and utilizing technology for ordering and monitoring.

By advocating for healthy, low-carbon diets and minimizing packaging waste, you can address the broader impacts of food systems. This resource will help you implement strategies such as conducting waste audits, supporting patients in adopting better eating habits, and promoting the importance of nutrition and hydration among food service staff. Ultimately, this page equips you to link food, health, and climate change initiatives within the NHS, driving sustainable practices and better patient outcomes.

An example is the “Sustainability in Healthcare: Mildmay’s Low-Carbon Menu Transforms Patient Care“. Mildmay Hospital’s dietetics and catering teams, in collaboration with the NHS and dietetics students, developed a low-carbon menu tailored to vulnerable patients using recipes from the NHS England recipe bank. After iterative development and feedback, the winter menu achieved an 18% carbon footprint reduction and minimized food waste to 10% of portions served, while patient input led to further improvements like diverse recipes and a weekly cooked breakfast option for summer.

Nutrition policy critical to optimize response to climate, public health crises (2023)

Rifkin, M. (2023). Nutrition policy in the Anthropocene: Addressing chronic disease, climate change, and health care system vulnerabilities. Frontiers in Nutrition, 10, 1118753. https://doi.org/10.3389/fnut.2023.1118753

Note: This article is part of the Research Topic: Nutrition for Humanity in the Anthropocene – for Healthier People on a Healthier Planet.

The effects of unanticipated crises on health care and first-responder systems are reflected in climate-fueled environmental emergencies, to which human resilience is diminished by our chronic disease epidemic. For example, people who depend on specialized medications, like refrigerated insulin for diabetes, will likely face additional challenges in receiving treatment and care during extreme heat, floods, disasters, and other adverse events. These circumstances may be compounded by staff and equipment shortages, lack of access to fresh food, and inadequate healthcare infrastructure in the wake of a disaster. Simply put, our health care and first-response systems struggle to meet the demands of chronic disease without such crises and may be fundamentally unable to adequately function with such crises present.

However, nutrition’s primacy in preventing and controlling chronic disease directly enhances individual and public resilience in the face of existential threats. Highlighting the shared diet-related etiology clearly demonstrates the need for a national policy response to reduce the disease burden and potentiate mitigation of the sequelae of climate risks and capacity limits in our food and health care systems. Accordingly, this article proposes four criteria for nutrition policy in the Anthropocene: objective government nutrition recommendations, healthy dietary patterns, adequate nutrition security, and effective nutrition education. Application of such criteria shows strong potential to improve our resiliency despite the climate and public health crises.

Austrian Dietary Guidelines (2024)

The 2024 Austrian Dietary guidelines were developed by the Competence Center for Climate and Health of Austria GmbH (GÖG) together with the Austrian Agency for Health and Food Safety (AGES) and the Austrian Society for Nutrition (ÖGE). Both health and climate aspects were taken into account.

Visit the link to also download the brochure “Healthy eating, good for the climate” (in German) or it can be accessed or ordered via the brochure service of the Ministry of Social Affairs. The brochure contains healthy and climate-friendly recipes based on the plate model. It was developed by three universities of applied sciences for dietology on behalf of the Ministry of Health.

A pathway to personal, population and planetary health for dietitians and nutrition professionals (2023 Nov)

MacKenzie-Shalders, K. L., Barbour, L., Charlton, K., Cox, G. R., Lawrence, M., Murray, S., Newberry, K., Senior, N. M., Stanton, R., & Tagtow, A. M. (2023). A pathway to personal, population and planetary health for dietitians and nutrition professionals. Public Health Nutrition, Advance online publication. https://doi.org/10.1002/puh2.137

Abstract

Background

Earth and all its inhabitants are threatened by a planetary crisis; including climate change, deforestation, biodiversity loss and pollution. Dietitians and nutrition professionals have a responsibility to lead transformational change in contemporary food and health systems to help mitigate this crisis. The study aims to develop a conceptual framework to support dietitians towards personal, population and planetary health.

Methods

Non-empirical methods were used by the co-researchers to explore and explain the application of an international framework ‘Next-Generation Solutions to Address Adaptive Challenges in Dietetics Practice: The I + PSE Conceptual Framework for Action’. (I+PSE = Individual plus Policy, System, and Environmental)

Results

A non-sequential pathway guide to personal, population and planetary health for nutrition professionals was developed including several key guiding principles of Agency, Action, Ascension, Alignment, Alliance and Allyship, and Advocacy and Activism. Each guiding principle features descriptors and descriptions to enhance dietitian and nutrition professional

Agency (i.e. vision, self-belief, confidence, strength and responsibility),
Action (i.e. start, shift, translate, achieve and commit),
Ascension (i.e. build, overcome, manage, challenge and progress),
Alignment (i.e. leadership, transparency, diplomacy, values and systems),
Alliance and Allyship (i.e. support, collaborate, represent, community and citizenship) and
Advocacy and Activism (i.e. disrupt, co-design, transform, empower and urgency).

The framework and its descriptors support enhanced understanding and are modifiable and flexible in their application to guide the participation of dietitians and nutrition professionals in transformational change in personal, population and planetary health. This guide acknowledges that First Nations knowledge and customs are important to current and future work within this field.

Conclusions

Alongside the international body of work progressing in this field, this framework and visual guide will support dietitians and nutrition professionals to achieve urgent, transformational change in personal, population and planetary health.

JHND Special Issue: Sustainable Food Systems and Dietary Patterns in Nutrition and Dietetic Practice (2023 Dec)

The British Dietetic Association’s Journal of Human Nutrition and Dietetics (JHND) published a Special Issue on Sustainable Food Systems and Dietary Patterns in Nutrition and Dietetic Practice edited by: Liesel Carlsson, Angela Madden, and Kalliopi-Anna Poulia (Volume 36, Issue 6, Pages: 2121-2350, December 2023).

Twelve of the sixteen articles are open access and cover a wide range of practice settings.

Open Access – Conceptualising sustainability in Canadian dietetic practice: A scoping review – Dietitians are well-positioned to promote sustainable food systems and diets. This research identifies practice activities described in the Canadian published literature and compares these with dietetic competency standards. Increasing practitioners’ ability to analyse issues using systems thinking will help address complex challenges. Updates to competency standards and curricular supports are needed to support this area of practice.

Open Access – Meat versus meat alternatives: which is better for the environment and health? A nutritional and environmental analysis of animal-based products compared with their plant-based alternatives – Plant-based meat products were analysed to understand which are more healthy, environmentally friendly and affordable. Plant-based products were found to contain less saturated fat, protein and calories; more fibre and sugar; and similar salt content. They were more expensive but had less emissions. Plant-based and meat products were classed as ultra-processed.

Environmental imprints of agricultural and livestock produce: A scoping review from South Asian countries – Diversification in food production and cultivating additional coarse cereals (millets) offer opportunities for green house gas (GHG) reduction in South Asian countries.

Dietary patterns in North and South India: a comparison with EAT-Lancet dietary recommendations – Very few studies have compared Indian diets with the EAT-Lancet dietary recommendations. The present study performed such a comparison using primary dietary consumption data, finding that Indian diets were mainly plant-based, being high in dairy but lacking in nutrient-rich foods such as vegetables and fruits.

Determinants of dietary diversity and drivers of food choice among low-income consumers in urban Kenya, Malawi and Zimbabwe – From the Nairobi responses, convenience (40% of respondents) was the main factor influencing food choice, whereas price was the most important factor in Bulawayo (31% of respondents) and Lilongwe (67% of respondents). Price and convenience are important factors to consider for improving diet diversity in urban low-income settlements.

Open Access – The association between food environment, diet quality and malnutrition in low- and middle-income adult populations across the rural—Urban gradient in Vietnam – Geospatial mapping of food outlets and the Diet Quality Index were used. Longer distances to food outlets were associated with higher diet quality, whereas lower outlet density increased the odds of underweight among women. Socio-economic factors consistently correlated with diet quality and malnutrition.

Open Access – Local food procurement by hospitals: a scoping review – There is a paucity of peer-reviewed studies describing local food procurement by hospitals. Details of local food procurement models were generally lacking: categorisable as either purchases made ‘on-contract’ via conventional means or ‘off-contract’. If hospital foodservices are to increase their local food procurement, they require access to a suitable, reliable and traceable supply, that acknowledges their complexity and budgetary constraints.

Open Access – Benefits, limitations and implementation issues for integrating organic foods into hospital foodservices: a systematic review – This review identified opportunities for the implementation of organic foods into hospital foodservices, but there are numerous barriers to be overcome through strategies including organisational support and staff training.

Open Access – What is the climate footprint of therapeutic diets for people with chronic kidney disease? Results from an Australian analysis – The climate footprint of the current Australian diet, the usual renal diet, a plant-based renal diet and the Australian-adapted Planetary Health Diet were analysed. No diets were climate neutral. A plant-based renal diet was superior to usual care. Animal and discretionary foods increase the climate footprint.

Open Access – Moving towards more sustainable diets: Is there potential for a personalised approach in practice? Personalised nutrition feedback can be used to encourage change to more sustainable diets. Personalisation uses individual factors (e.g., sex, age, dietary intake, etc.) and relevant criteria (e.g., environmental impact, nutritional adequacy, healthfulness, diet acceptability) to provide an individual with actionable feedback recommendations for dietary change.

Open Access – Commercial weight-loss diets, greenhouse gas emissions and freshwater consumption – Commercial weight-loss diets had GHGe footprints on average 4.4 times the EAT-Lancet target recommended for planetary health. Bovine meat was by far the largest contributor of GHGe in most diets that included it. Three commercial diets had water footprints above the US baseline.

Sustainable diets among youth: Validity and reliability of a questionnaire assessing knowledge, attitudes, practices, and willingness to change – The study describes the validity and reliability of a questionnaire examining the perception of sustainable diets among youth in the United Arab Emirates. This tool is essential for the development of evidence-based interventions aiming to promote sustainable food consumption among young adults.

Open Access – Fix my food: An urgent call to action from adolescents on how they experience and want to see change in their food systems – Global food systems are failing adolescents. Workshops were conducted with 640 adolescents aged 10–19 years across 18 countries. Three key themes emerged, which included experiences of food, challenges to food systems and strengthening food systems. Adolescents called for inclusion in decision-making from local food practice to large global policy development.

Open Access – Nutrition quality and food and packaging waste associated with the school food system: A pilot, citizen science study in an Irish secondary school – This pilot study included adolescents as citizen scientists for a hands-on audit of waste and nutrition quality within their school food system. They were surprised and saddened to discover waste volume and contamination that prevented recycling or repurposing. Solutions proposed considered individual, community and organisational level factors.

Open Access – Collaborative leadership to support sustainability in practice for dietitians as allied health professionals – There is an urgent need for allied health professionals (AHP) to embrace the National Health Service Net Zero (Green) agenda. As advocates for environmentally sustainable diets and food systems, dietitians are well positioned to step into collaborative leadership roles as advocates for transformational change towards greener healthcare practices.

Open Access – The role of Australian civil society organisations in food system governance: Opportunities for collaboration in dietetics practice – A survey of 43 Australian civil society organisations (CSOs) identified their engagement with food system governance, including influencing policy outcomes, contributing to more inclusive and democratic forms of governance and leading community-based food system policies. Dietitians can engage with CSOs in education, research and advocacy roles for food system transformation.

Swedish Dietitians Work to Reduce Food Waste (2020)

Supported by great resources from the Swedish Food Agency (https://www.livsmedelsverket.se/en), dietitians are reducing the amount of food wasted in Swedish institutions, including schools, long-term care facilities, and hospitals.

Swedes throw away about 25% of the food and drink that we purchase per person, per year! For individuals and households, it is because we buy too much, store it improperly, and throw away leftovers instead of using them. This is bad for the environment: food is produced unnecessarily, and food waste contributes to climate variability and environmental challenges. It is also costly for households.

The goal moving forward is to halve the global food waste production per year, and Sweden has a plan that dietitians can contribute to. Three Swedish agencies related to food, farming and the environment have put forward a collaborative action plan, ”Fler gör mer,” that outlines strategic actions for various actors in the food system. Dietitians and food service workers are part of that.

In the public sector (schools, hospitals, care facilities, etc.), food services have an important role in reducing food waste and being good role models for cultural change. Built on a successful model in Gothenburg, the Swedish Food Agency (SLV) has produced a handbook ”Handbok för minskat matsvinn” that explains food waste and includes how-to information for reduction and measurement. The goal is that everyone involved in public sector food service will use this measurement model so that we can track and reduce our food waste accurately. This is absolutely not easy!

These resources are only in Swedish, but Google Translate might be able to help 🙂

SWEDISH

I Sverige slänger vi ca 20 kg ätbar mat/person och år, plus 25 kg mat och dryck som hälls ut i slasken! Det är ungefär 25% av all den mat vi handlar/person och år. Som privatpersoner är det för att vi köper för mycket mat, förvarar maten fel och kastar överbliven mat istället för att använda resterna. För miljön är det dåligt med svinn. Mat produceras i onödan, och det belastar klimat och miljö. Och för ett hushåll blir det mycket pengar. Målet framåt är att halvera det globala matsvinnet per person. I Sverige har man ( Livsmedelsverket, Jordbruksverket och Naturvårdsverket) tagit fram en handlingsplan för minskat matsvinn 2030 ”Fler gör mer”.

De offentliga måltidsverksamheterna har en viktig roll i svinnarbetet, och kan vara goda förebilder för sina matgäster. I Göteborgs kommun har man tagit fram en ”Göteborgsmodellen för mindre matsvinn”. Efter den har SLV tagit fram en ”Handbok för minskat matsvinn” som bygger på Gbg modellen, men har tillägg om ex tallrikssvinn, konsumtionsmätningar och SLVs nationella mätmetod för matsvinnsmätningar. Mätningarna vill man att alla offentliga kök ska börja med. Inte helt lätta kan jag försäkra!

submitted April 6, 2020

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Impacto ecológico de la alimentación en España (2022)

Presentamos la nueva edición (31) de Cuadernos de las Cooperativas de Consumidores con un monográfico sobre el «Impacto ecológico de la alimentación en España». Nuestros hábitos de alimentación y el sistema actual de producción y consumo de alimentos tienen un indudable impacto en la salud del planeta, de manera que las decisiones de compra y consumo deberían ser tomadas con la mayor información posible.

Como sociedad, es necesario avanzar hacia modelos más sostenibles y todos los eslabones de la cadena alimentaria deben contribuir a mitigar el impacto ambiental de nuestras prácticas y actividades. Analizado en términos de oportunidad, el camino hacia la sostenibilidad se presenta como un buen momento para transformar nuestro sistema alimentario.

En este trabajo se aborda, desde el punto de vista del sector de la alimentación, cómo nuestros comportamientos y decisiones de consumo generan considerables impactos ambientales y qué se necesita para minimizar los efectos de nuestros hábitos cotidianos con respecto a los alimentos. Esta publicación forma parte del Proyecto “Impacto ecológico de la alimentación”, subvencionado por Ministerio de Consumo, y cuenta con el apoyo y colaboración del Ministerio de Agricultura, Pesca y Alimentación.

Hemos conseguido reunir las reflexiones de responsables en la materia y reconocidos especialistas, incluyendo los aspectos normativos y nutricionales, dando voz al sector de la producción y la distribución comercial. Cada artículo se aproxima al problema con un punto de vista diferente, configurando un completo trabajo de lectura recomendada.

Las personas consumidoras quieren reducir su huella ecológica y ya apuestan por las empresas que se comprometen y actúan para reducir tanto sus emisiones como los impactos ambientales. Pero cada día es más patente la gran distancia que existe entre la intención y la acción. A esto se añade el aumento del coste de la vida, que impide tomar decisiones de forma responsable con el planeta. En esta situación, el precio se ha convertido en una barrera para el comportamiento sostenible, por lo que debemos tener en consideración a aquellos colectivos de personas vulnerables para que no se queden fuera en estos momentos y avancen igualmente en el camino hacia la reducción del impacto ambiental de los hábitos de compra y consumo de alimentos.

En la apuesta por la sostenibilidad, compartida de forma unánime por todos los sectores, hay muchas lagunas y la persona consumidora, como último eslabón de la cadena, reclama más información y un compromiso real y contrastable del sector de la alimentación con el medio ambiente, para que se ofrezcan productos que nos permita seguir unos patrones de alimentación más saludables, a la vez que sostenibles.

Con este Monográfico también queremos hacer, en nombre de las cooperativas de consumo un llamamiento al compromiso sincero con la sostenibilidad, impulsando innovaciones y nuevas oportunidades empresariales, que permitan avanzar hacia un sistema alimentario más sostenible y respetuoso con el planeta y las personas.

Green Healthcare: Healthy and Sustainable Food (website)

For over 20 years the Canadian Coalition for Green Health Care has been helping those working in health care facilities, non-governmental and governmental organisations, individuals, students and businesses to share green health care best practices and to become better equipped to deal with the growing demands placed upon them to be environmentally responsible health service workers and individuals. There are at least 3 sections on Nutrition specifically and 40+ on sustainable food system. Their page on Food Waste has reports, flyers, tools, and strategies for reducing waste. This website contains transparent and dynamic information that is freely available regarding topics around environmental and social sustainability. A membership is available, but not required for access to the resources found on this website.

Food & Society at the Aspen Institute

Food & Society at the Aspen Institute brings together public health leaders, policymakers, researchers, farmers, chefs, food makers, and entrepreneurs to find practical solutions to food system challenges and inequities. Current initiatives include a definitive and widely distributed set of food worker safety guidelines in kitchens and dining rooms during Covid-19; developing a research road map for the use of food as medicine, to increase the data supporting an exciting movement to treat and prevent diet-related chronic illnesses; protecting the physical and financial health of the most vulnerable food-service workers and increasing opportunities for people of color to move into management and especially ownership positions in the food-service industry; creating a draft framework to regulate gene-edited crops and ingredients in the food supply, to ensure public trust; and finding common ground in current soda-tax initiatives to bring about meaningful health improvements. The common goal is to help people of all income levels eat better and more healthful diets—and to enjoy them bite by bite.

Food is Medicine Massachusetts (Website)

Food is Medicine Massachusetts [FIMMA] is a multi-stakeholder coalition that materialized from the Massachusetts Food is Medicine State Plan, which provides a blueprint to building a health care system that recognises the critical relationship between food and health and ensures access to the nutrition services that state residents need to prevent, manage, and treat diet-related illness.

In addition to the plan, in FIMMA developed: 2020 The Massachusetts Food is Medicine Case Study to translate planning to implementation; 2020 Food is Medicine: Peer-Reviewed Research in the U.S. 2021 Advocacy Agenda; Legislation for Establishing and Implementing a Food and Health Pilot Program; and the 2022 Food is Medicine Research Action Plan (2022 Jan)