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Eating Our Way to a Greener Planet How Food Choice ...
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Okay, great. Thank you all for joining today. We're going to have a webinar by Dr. Ali Saad on Eating Our Way Through Greener Planet, How Food Choices Can Combat Climate Change. Dr. Saad's work focuses on food connection between human and planetary health. He is board certified in neurology, stroke, and lifestyle medicine, and has been practicing for over 15 years. He completed a fellowship in climate change and health policy at the University of Colorado's Climate and Health Program, where he's now affiliate faculty. Dr. Saad is co-chair of the Neurology Member Interest Group of the American College of Lifestyle Medicine, and he also co-leads the neurologist's interest in climate and health. And I am proud to call him a friend, and I am so excited for you, Errol, to hear this talk from him today. Okay, thank you so much, Jia. It's great to be here and see you all on the other side of the mirror of the brain. I'm a neurologist, and I always just tell my residents psychiatry and neurology are two sides of the same mirror. And let me go ahead and share my screen. Can you see it without the notes now? Yes, yes. Okay, great. Go here. All right. So I have no relevant disclosures. And before I get into the learning objectives, I'd like to briefly tell you my origin story when it comes to climate medicine. And if you think of any questions throughout the talk, please put them in the chat, and we'll certainly address them at the end. So by 2019, I had been in attending for about five years. I realized that, right, at least I felt I wasn't really helping people. As a stroke doctor, I was providing lifesaving acute treatment in the hospital. But ultimately, I was sending people back into the same environments where they were exposed to unhealthy foods, smoking, low physical activity, air pollution, and all these things together account for about 90% of stroke risk. Just like heart attacks, it's mostly your environment. And so I became very interested in learning about lifestyle's role in preventing stroke and chronic disease. Yes. Oh, sorry. Sorry. Oh, yeah. I'm sorry. My, my problem. Yeah, sorry. Yeah, because I was not sure. Like, I wanted to like, what's your specialty? So yeah, sorry for that. No worries. And so I became very interested in these things totally unrelated to climate change. I wasn't really burnt out at work, I was bored, and I felt like my work was futile. Separately, I'd always been interested in the environment. So I do things like recycle compost, you know, pick up public transport, things that citizens do, but totally unrelated to medicine. And then I learned that the University of Colorado had this Climate and Health Fellowship. And mostly, I was just intellectually curious. And I thought that at the very least, it would be a fun thing to do for a year. But the fellowship blew me away, because up until then, I didn't realize just how much of our health was tied to that of the planet. And so climate medicine went from being an interest to a passion. And I then had to decide, how can I use my time most effectively. So I looked at the data for guidance. The main driver for climate change is greenhouse gases, in other words, air pollution from fossil fuels. And over 70% of them are from the energy sector. You can see it broken down here as industry, transport, construction, various components of the energy sector. And so if I want to help with climate change, by the numbers, fossil fuel divestment should be where my time is spent. But what avenues could I take to address the 73% of emissions? I could write review articles for medical journals, op-eds for newspapers, start a sustainability committee at my hospital, get public testimony. And that's what I started doing. And I continue to do these things. But at the same time, I realized there are a few problems with this kind of advocacy. Number one, as a doctor, I have the most influence for divestment from fossil fuels, specifically within the healthcare sector, not the energy sector. And healthcare only accounts for 8.5% of emissions in the US and 4.5% of emissions globally. So I felt this work was kind of ineffective. Secondly, climate advocacy was something extra that me or any doctor had to do on top of their day job. And it felt like it had nothing to do with direct patient care, even though pollution ultimately heavily influences social determinants of health and poor outcomes. But for people that do have the time and passion, as soon as they get busy with other areas of their life, this sort of work goes straight out the window, because direct patient care is always going to take precedence. So I felt like this kind of work wasn't super relevant to everyday medicine. Third thing, there's only so much I could do on my own. I needed help. And I wasn't really getting help from other doctors. A lot of them felt like it wasn't in their lane, or they didn't have the time. And I always had to explain the climate and health connection because it wasn't obvious. So it didn't feel relatable. And lastly, I ultimately had to depend on other people in positions of power to give the green light for policy changes, whether that's the board of directors at a hospital or politicians. So I felt kind of powerless. So then I took a step back and thought, okay, unless, you know, clearly fossil fuel divestment is not the best use of my time as a doctor, at least personally. So I went back to the drawing board. And I thought, okay, what brings me joy? I love to prevent problems before they happen, whether that's at home or at work. I like to automate tedious tasks. I like to make healthy choices, the easy choices by not keeping junk food in the house, leaving my gym clothes at the foot of the bed. In clinic, I would spend most of my time talking about disease prevention because stroke is largely preventable. What am I good at? I like, I'm good at being organized. I am good at mediating. I like to align values between people whose goals seem to be at odds. And I'm good at simplifying things and using metaphors. And lastly, what work needs to be done? For the planet, reduce greenhouse gas emissions. For people, we need to eat better because diet drives most chronic disease. And stroke is just a prime example of that. So then I went back to this graph and realized, okay, I'm not going to do energy. Food is the second biggest sector. It's that green area of the pie chart in terms of greenhouse emissions. And the remaining two sectors that you see here in blue and gray, waste and industry, together account for less than 10% of emissions. So big picture, they didn't matter as much. And food is the most important thing that needs to be addressed for health if you take climate out of the equation. And that's how I found my climate and health connection. And that's what I'm going to be talking to you about for the next half an hour, foods relation. So here are three objectives. I'll start with how food systems impact climate change. So most direct emissions from livestock come from ruminants. And livestock are the biggest components of emissions from the agricultural sector. So ruminants are cattle and sheep. They ruminate their food or they ferment their food prior to extracting nutrients, or to extract nutrients prior to digesting. And a byproduct of that rumination is anaerobic fermentation, which produces methane or natural gas. And contrary to what you may have heard, most methane from ruminants actually comes from burks rather than flatulence. And methane only lasts in the atmosphere for around 10 to 12 years, whereas CO2 lasts hundreds to thousands of years. The problem with methane is it's about 30 times more potent than CO2 at trapping heat and acting as a greenhouse gas. So while it's in the atmosphere, it's doing more damage than CO2. But the good news is, even though it does more damage, because it only lasts for about 10 to 12 years, if we reduce our emissions from livestock, there are many ways to do that, we can quickly pull it out of the atmosphere and help reduce temperatures. Whereas the CO2 that's been in the atmosphere that we've produced over the last hundred years is still hanging out and is going to continue to hang out and warm the earth. This is a different way of looking at the data. And it includes indirect emissions from things like transport and packaging included in the food system's emission. When you include these indirect costs, our food system now accounts for at least 26% of global greenhouse gases. And you can see these red, green, and brown areas are the largest sources of emissions within the food sector. And all three of these are related to livestock. When you combine these three sections, they account for over 50% of emissions within the agricultural sector. And it comes from the inordinate use of land needed to grow animal feed, as well as house the livestock. It's done by destroying forests, which are a plant's natural air filter that absorbs CO2 through photosynthesis. And so this is why agriculture is such a problem when it comes to food-related emissions, specifically livestock and more specifically ruminants. Although food waste isn't the largest component of our emissions, it's still a lot. If food waste were a country, it would account for, or sorry, it would be the third most polluting country after China and the US, as you can see here in this graph. And when we add food waste to our agricultural emissions, it balloons from 26% to 34% of global emissions. And, you know, as doctors think of all the food that's thrown out in hospitals alone, this could easily be given to patients, their families, and staff at the end of the day for minimal or no cost. And climate-smart policies, like charging hospitals for the trash they produce by weight, could incentivize food donation programs, where the primary goal would be addressing food insecurity, but it happens to have climate co-benefits. And the majority of patients we see in hospitals are on Medicare and Medicaid, and these are among the people most at risk for food insecurity and would therefore benefit from such programs. This shows us the food supply chain. The blue bars represent the carbon footprint at a particular point in the supply chain, whereas the orange bars represent the volume of food waste. You can see the greatest volume of food waste happens by overproducing grains at the first stage and having it go bad even before it's used. However, you can see the greatest carbon footprint is at the consumption level in the last set of bars, where food goes bad because we don't use it fast enough in supermarkets or restaurants or at home, and we end up throwing it out, and it sits in landfills and rots, producing nothing, the same gas that comes from ruminants, which is a very potent greenhouse gas. But the mechanism behind food's impact on climate touches so many aspects of our environment, and it goes way beyond the simple math of carbon emissions. So of course there's the direct air pollution from burning fossil fuels in order to supply the energy needed to grow that food, but there's also other considerations that you can see in this graph. So we use up half of our habitable land on earth to grow our food. We use 70 percent of our fresh water to irrigate our crops and livestock. This process also contributes to eutrophication. So eutrophication happens when we have things like manure, carcasses, fertilizer that are dumped by factory farms and agriculture into our waterways, and this becomes food for algae. The overgrowth of algae depletes oxygen levels in the water, making it uninhabitable for marine life like animals and plants. And so we get things like dead zones, like we have in the Gulf of Mexico, where there's no fish and there's no plants to feed those fish. And more directly for human health, overgrowth of algae also results in toxic red tides, where certain dinoflagellates on these algae will produce neurotoxins that then get consumed by shellfish and then humans eat the shellfish and they get food poisoning from these neurotoxins, which unfortunately are not destroyed by cooking. Here's an interesting trend of how meat production has changed from the 60s in various parts of the world. Increased meat consumption tends to be a marker of a country's becoming industrialized and increasing its standard of living. So in the 1960s, North America and Europe had largely achieved these goals in terms of industrializing and increasing standard of living, but look at how Asia's meat production has had a relative explosion in the last 30 years. And meat consumption is really just one marker of economic growth. 60% of the world's population lives in Asia. And so you can imagine as its population grows and its countries increase their standards of living closer to those of North America and Europe, that means that more production of greenhouse gases is going to occur and they're going to use more resources. And you can also see that Africa has been relatively flat over here, but Africa contains about 20% of the world's population and it hasn't even begun its boom. So we're going to see a contribution from Africa in terms of using resources and producing greenhouse gases. And they don't really have the finances to use greener technologies and so that's going to require using fossil fuels. Here's a representation of how carbon intensive red meat is relative to other foods. So generally plants and smaller animals, which you see at the bottom of this graph, will have the lowest emissions. And this is basic thermodynamics. So smaller organisms are going to need less time and less resources to reach maturity before they're consumed. And they can also be replenished more easily because they reach maturity quickly. By the same logic, larger animals like cows will require more resources to grow to maturity and will produce more emissions along the road. And of course this is compounded by the production of methane, which other organisms do not produce as much of. And you can see our top three most carbon intensive foods over here are ruminant sources. So beef, lamb, and dairy produce the most emissions. So you might think, well why don't we just eat local and everything will be fine. We'll just, you know, support our local farmers and our local economy and we're not going to import things and it'll be great. So this graph has pretty tiny print, but I just want you to focus on the colors. The y-axis shows us a list of common foods and the x-axis shows us the carbon footprints of those foods. The breakdown of carbon footprint is color-coded by areas in the supply chain. And you can see that the most common colors are green, brown, and orange. And these colors represent either direct or indirect land use for producing that food. So that means those emissions are going to happen regardless of where that food's produced, either locally or abroad. Whereas you compare the pink, blue, yellow, and gray parts of the graphs, you can barely see them for each individual food. And that's because their relative contribution to carbon footprint is very minor. And these colors represent food processing, transport, and packaging. So the key point is land use and farming are our biggest contributors to emissions in the food system. And this is why a diet that is plant-rich is one of the most important things we can do for climate change, and specifically within the agricultural sector. Interventions like reducing packaging, recycling, eating locally, eating organic, these have relatively little impact on emissions, provided we continue to eat animal products, and more specifically red meat, at the level that we're currently consuming them. And so a really simplified way to look at this is imported beans are far more sustainable than local steak. So then you might say, well we can't just eat fruits and veggies, we need protein-rich foods. Which of course is true from a personal health perspective as well. You need protein, you need iron, which can be obtained from meat, but they can also be obtained from legumes. And legumes are going to be your beans, your lentils, and your nuts and seeds. So here's a graph of just focused on protein-rich foods. And again, it's clear when you look above this dotted orange line, things that are very greenhouse gas intensive are all above this line, and they're predominantly animal products. Even when you look at things like fish and eggs, they're anywhere from three to ten times more greenhouse gas intensive than plant sources of protein, like tofu, beans, peas, and nuts. Another advantage you can see from plant-based proteins is the range of greenhouse gas emissions is much narrower. So that allows us to make better projections about emissions from certain foods. You can see how narrow the graphs are, the bell curves are for things like beans and peas, when in green, when you compare them to things like lamb and beef, which have these really wide, really wide curves in terms of their range of greenhouse gas emissions. Not only are we worsening climate change with our food systems, but climate change in turn worsens our food systems and threatens our food security. And this happens in three main ways. Number one is food availability. So natural disasters like wildfires, hurricanes, they destroy our crops and they destroy the infrastructure we need to grow and distribute the food that we produce. Number two is accessibility. People will have trouble accessing food when crops are destroyed, or sorry, when roads are destroyed, or when food becomes scarce, leading to export bans and interfering with international relationships and trade agreements. And number three, lastly, is usability of food. So aside from natural disasters, reducing food's availability and accessibility, increasing CO2 concentrations in the atmosphere, decrease nutritional yields of crops. Specifically, they drop the concentration of protein and key micronutrients like iron and zinc. And not by a lot, it's like in the single digits of the teens, but you can imagine populations that are already food insecure. These tiny drops in nutritional yield and already food insecure populations is going to have huge impacts. Also changes in ambient temperature affect the distribution of pests like invasive insects, microorganisms that can destroy crops and therefore destroy yields from those crops. And we've already seen the effects of climate stressors on our food supply that are periodically worsened by more frequent natural disasters like droughts, wildfires, and floods. And the issue is not that we don't have the availability to produce enough food. We currently have enough food in our system to feed the whole world several times over. The problem is that we're wasting a lot of it. It's getting thrown out and rotting. Or we're feeding it to livestock and then we eat the livestock. So it's not a really efficient way to consume those crops. And so the problems with our food system are that we're producing food that is expensive, inefficient, damaging the environment, and making people sick by contributing to chronic disease. And if we continue to eat in the same manner, there will not be enough food in the future. These are some projections in 2050 on how much we're going to need in terms of beef, pork, eggs, etc. If we continue to eat in the same manner that we're currently eating. And of course it's going to dramatically increase emissions and accelerate climate change. So when it comes to more sustainable diets, not even getting into the health benefits, here are a couple of takeaways. Number one, reduce food waste. So regardless of what you're eating, you can reduce food waste. Some things that I like to do, I like to keep healthy frozen meals from meal delivery services or leftovers that I freeze for when I'm too busy to cook or too tired to cook. I'll check my pantry in my fridge before I go shopping and I'll plan my cooking around whatever I happen to have in the house already. And when I have leftover ingredients, I used to compost them, but now I throw them into smoothies or I just put them in my dog's food. You know, things like broccoli stems, carrot tops, etc. And one other thing I do is when I cook too much, I'll share it with neighbors and this helps foster social connection and promote one of the pillars of lifestyle medicine. But now we also have a community where people show up to my doorstep now and they give me bread, they give me cookies. I had a neighbor come over the other day, she gave me some curry that she made and she used some of the pistachio butter that I had gifted to her. So now we've got, you know, everyone on our block, we're all just gifting food to each other occasionally, which is really nice. So there are all these direct non-environmental benefits of reducing food waste. And the second key takeaway is, of course, eating more plants and less animal products, specifically cutting down on red meat and dairy because they're the most greenhouse gas intensive. And patients are often hesitant about not getting enough nutrition when you tell them to eat more plants, especially, you know, when it comes to their kids, they get worried, I found. So I like to show them direct nutritional comparisons from this free website at the link at the bottom. So a serving of tofu, for example, has more calcium than a tall glass of milk. Lentils have more iron than steak. Meat is always going to have more protein per gram because it's muscle tissue, but lentils and beans are still very protein rich. And I think of them as the plant kingdom's version of meat, that's what I tell patients, because they provide those essential nutrients, but you also don't get the saturated fat, you don't get as much microplastics, you don't get as much heavy metals, you don't get the cholesterol, etc. And for people that are vegan and eat no animal products and get inadequate sun exposure, of course, I tell them, you know, you need to take vitamin D, you need to take B12 supplements, but also recognize that when you get these nutrients from animal products, the animals don't synthesize them. They're being supplemented to the animals as well. Our food system has become so sterile that neither we nor the animals get our B12 from the healthy bacteria in our soil, or the vitamin D from adequate sun exposure. So whether you're taking it from a supplement, or you're eating it in the form of an egg, or a fish, or what have you, you're probably eating a supplement regardless. So next I'll discuss the health benefits of a plant-rich diet. Let's forget about climate change for a second. Poor diets become the greatest modifiable risk factor for the majority of chronic disease, now surpassing smoking. So it's become the largest social determinant of health and should be a top public health priority. Here's data from the CDC. Six in ten Americans have at least one chronic disease, whereas four in ten Americans have at least two. When we see a patient without at least one of these diseases in the clinic or the hospital, that's now become the exception to the rule. Most people will have at least one of these. And food is a key driver for most of these diseases, with the exception of chronic lung disease. And of course it's also a risk factor for a lot of psychiatric disease, which you all know, but it's not become mainstream yet, and hopefully it will be in the future. And it's not just in the U.S. We see the same trends happening globally, and they're all getting worse. This is a list of chronic diseases from the WHO, ordered by greatest to least mortality globally. The green diseases are infectious or communicable diseases, while the blue ones are lifestyle-related diseases or non-communicable diseases. The white dots represent where mortality was in the year 2000, whereas the colored dots represent where mortality is in 2019. And as you can see, people have been dying of more of these blue diseases, these non-communicable diseases, and they've been dying less of the communicable or infectious diseases, meaning most diseases are now lifestyle-related. Again, with the exception of chronic lung disease when it comes to diet and stuff. But the rest of them, diet is a huge risk factor, if not the primary risk factor. So things like ischemic heart disease, stroke, Alzheimer's, diabetes, kidney disease, all heavily related to diet. And the U.S. National Climate Assessment, which is a federally commissioned document, has now recognized the connection food has for human and planetary health. It concluded that revamping our food systems is not only important for climate change, but necessary to address the bloated cost of treating chronic disease, which is mostly driven by the food people have available to them. So of course, it's much cheaper to prevent disease than to treat it. And so even though we should be changing our food system for our health, it's also essential to do it for our economy. And what does a healthy diet look like? So one of the main guidelines I look to as a stroke doctor is the American Heart Association's guidelines, and they've updated them recently. So, you know, broadly speaking, most of our food should, of course, be minimally processed and coming from plants, but now they explicitly say, what I've highlighted in pink, that most of our protein should be coming from plants. We don't necessarily need to be vegan or vegetarian, just mostly plants, which I think is closer to what I would call flexitarian, what a lot of people think flexitarian is, just eating more plants. And so you can rest assured that if you recommend a plant-rich diet nowadays, it is no longer fringe, and it is no longer considered an equally healthy option among many. It is now the mainstream dietary recommendation of the American Heart Association, a plant-rich diet, and that can take many forms, Mediterranean, mind, whatever, but it's got to be plant-rich. And this is concordant with most dietary guidelines for vascular disease in many high-income countries like Canada, UK, Australia, New Zealand, and Switzerland, just to name a few. And there are clear climate co-benefits from encouraging healthy living, and that doesn't just mean eating more plants, but also taking active transport, so encouraging our patients to walk, to bike, to use public transport over personal vehicles. This is important for people's health by reducing people's physical inactivity, but also reducing emissions and people's exposure to emissions. A lot of the things that we should be doing for our health just so happen to be the same things that are good for the planet. A lot of the time, we don't have to go out of the way to do something extra for the planet. We should be doing these things for their direct health benefits. And so I like to think of lifestyle medicine as indirect climate medicine. We see these same inefficiencies in our health care systems. Again, health care systems account for 8.5% of greenhouse gases in the U.S. and 4.5% globally, just from the operating costs of hospitals. And we can do things like install solar panels in hospitals, we can compost the cafeteria food, and we should be doing these things. They're great. They help. But what's even more effective for our patients and for our environment? Keeping people out of the hospital to begin with, so they don't need these carbon intensive ICU stays, surgeries, medical devices, medications that are bad for the planet, but then also drain people's health ban and drain their wallets. Because the greenest health care is the kind that never needed to happen in the first place. At the beginning of the talk, I said that the energy sector is the biggest emitter of greenhouse gases on a global level, whereas food systems are the second biggest emitter. That's true. However, when we reframe things and look at emissions from a individual perspective and personal action perspective, that order flips. So this data is from Project Drawdown. They rank the impact of various behaviors in terms of reducing carbon emissions. And you can see these three columns. So starting on the left, the first column is a particular behavior action. Column two is the sector that's a part of, like agriculture, electricity, whatever. And then the third column is the gigatons of CO2 equivalents that are reduced by implementing that action. And of these top 10 actions, you can see that the top three are all health solutions. And these are things we should be doing for our patients irrespective of climate change. Number one, making sure we're giving people food, addressing food insecurity, and not wasting food. Number two, feeding people more plants without necessitating veganism or vegetarianism, just eating more plants. And number three, making sure our patients are educated so they can be health literate and make the best decisions for themselves. All actions well within our lane as clinicians without even touching on climate change. And eating more plants can be done in a way that's both palatable and translatable across different cultures. So a study called the Eat Lancet Commission did the math to figure out how can we feed a projected population of 10 billion without depleting our resources and being sustainable. And the conclusion they came to was this Eat Lancet diet. They calculated that the average person can consume up to a maximum of two servings of animal products per day. And the way they broke that down as by way of example is one serving of dairy and one serving of anything else. With the caveat that if red meat is consumed, it should only be up to once a week because it's more greenhouse gas intensive than other animal products. So an example of what someone's diet would look like, a sustainable diet in a day, would be yogurt with toast and fruit in the morning, a salad or a grain bowl for lunch, and then chicken or fish with some veggies and rice for dinner. This is not a very restrictive diet. It allows for far more consumption of animal products than people would think is permissible from a sustainability standpoint. And I like to share this link at the bottom from something called the Gables Institute out of Harvard. They let you plug in your diet and then you can make little micro adjustments to your diet and it tells you the changes in carbon emissions you have as a result of that. And they have a version for healthcare professionals and they also have a version for the for LA audience. And here's some more reasons why dietary intervention is such a powerful tool for climate change. Food waste alone accounts for three times the global emissions from air travel. The most sobering but also the most hopeful message I've come across in the climate and health literature in the last two years is this. Even if fossil fuel emissions were eliminated immediately, that means we stop producing CO2 or methane and all the stuff we're doing right now. Even if we did that today, food emissions alone would jeopardize the achievement of the 1.5 degrees Celsius target. And that target refers to the temperature target reached by the Paris Climate Agreement in terms of avoiding the worst climate disasters, staying below 1.5 degrees of global warming compared to pre-industrial averages. So combining this conclusion with the fact that poor nutrition is now the single largest modifiable risk factor for human health, irrespective of climate change, food is clearly the single strongest lever to optimize both human and planetary health. Here's a little more data. So this is a graph of emissions related to different diets. In the x-axis we can see various diets. So we have our current U.S. diet as the first bar. We have what's recommended by our national, our federal national dietary guidelines. We have the Atlanta diet, and then we have other diets like pescatarian, vegetarian, vegan. And in the y-axis we have carbon emissions from those diets. And they color code things by not food group but type of food, I would say. So red, for example, represents red meat, blue represents dairy, and other foods are represented in other colors. But green represents carbon sinks or carbon sequestration, meaning whenever you take animal products out of the equation, you are allowing the land used to produce the feed and the land used to house those animals to be rewilded, meaning to become natural forests and rainforests again. And these things act as natural carbon sinks, and so that's why they're green and they reduce emissions. So if we just look at our current diet, clearly it's all above this zero line. It's clearly producing carbon. But let's say we switch to the national dietary guidelines, not even the eat lancet, just the national dietary guidelines. If we do that, this reduces, not eliminates, but reduces our red meat intake to the point where enough land can be rewilded. And now we are producing 600 million metric tons of CO2, but we're absorbing 700 million metric tons, meaning we're slightly carbon negative and technically we're sustainable. But to be even more sustainable, by following the eat lancet recommendations, we're reducing our emissions even more and producing even more carbon sequestration. And I don't want you to think that I'm, you know, I'm like a vegan hater. I'm not against veganism. I'm actually an ethical vegan. But whenever I'm talking about being vegetarian or vegan from a sustainability standpoint, I don't think we have adequate evidence to say that it's significantly superior to what the eat lancet recommends. So you'll see over here, comparing the eat lancet to something like vegetarian or vegan, you have slightly more carbon sequestration, but the bulk of the gains have been made just by following the eat lancet where we are limiting our consumption of animal products. We don't necessarily need to eliminate them from a sustainability perspective. And I think that the same can be said from a health perspective. You know, with alcohol, we have our toxic dose, which is, you know, if you're consuming more than, you know, 0.5 to two drinks per day, it's clearly harmful. Depending on the study you look at, it's either neutral, harmful, or some would say beneficial, but I disagree with that. When you're consuming anywhere from 0.5 to two drinks per day, we don't really have that toxic dose for animal products. So we just say, you know, don't eat a lot of it. It shouldn't be the biggest component of your plate and kind of leave it there. But I don't think we have adequate data to say that veganism, vegetarian is clearly superior, superior to simply being plant rich and plant based. And when we look at the mortality data related to diet, it mirrors the emissions data. So most of our mortality in our current diet, which you can see in the first bar, can be traced back to red meat consumption. And we can reduce our dietary mortality in the world by substituting a big portion of our red meat and red with lentil, or sorry, not lentils, but more broadly legumes, and gray. So you see here in the East Lancet, they reduce the amount of red, but they also increase the amount of gray at the top. Because legumes are what we see in all of these blue zones around the world, right? Whether you're talking about Okinawa, or you're talking about Central America, or the Mediterranean, they all have some kind of legume as a core component of their diet. And so this is one of the things that contributes to longevity. And again, we see when we switch from the East Lancet to vegetarian or vegan, yes, we do see a drop in mortality, but the bulk of our gains are simply eating less animal products, more specifically red meat. So dietary intervention is the climate advocacy that I think is most accessible to most... We can't see what's behind that blue box. Do you want to... Oh, that was the other slide. Okay, got it, got it, got it. Oh, sorry about that. Yeah, it's the same slide. I was just showing the climate stuff before and now the diet stuff, or the mortality stuff, I should say. So I think of dietary intervention as the climate advocacy that is most relevant to the everyday physician or everyday clinician without necessarily being committed or heavily involved in climate medicine. And what I found is you don't have to necessarily believe in climate change or even care about it. If you do what's right for patient health, planetary health will follow naturally. Here are some models of what our global land use could look like if our diets were more plant rich. Even partially reducing our consumption of animal products is a huge win for the planet. So look at this. If we cut out red meat, we're down to half of our current land use. That's still eating dairy, just cutting out red meat, half of our current land use. If you cut out dairy, we reduce 75% of our current land use. So that means we're still eating seafood, we're still eating eggs, we're still eating poultry. We freed up 75% of our agricultural land. And 75% of our agricultural land amounts to the size of North America and Brazil combined. That's a lot of land. And so when red meat and full fat dairy are consumed in excess, they're among the worst things for our health by being associated with vascular disease, metabolic syndrome, and several cancers, but also the worst things for our planet. So whenever I counsel patients, I never guilt them about climate change or even bring it up because I'm not there to talk to them about climate change. I'm there to be an advocate for their health and, you know, talk about their health. So I think when it comes to influencing public policy as clinicians, we need to be using the same tools we're using with our patients when we're talking about medications or any other intervention. We recognize the patient's values and use them as opportunities to promote their health. We use motivational interviewing. We focus on common values and goals. We stay nonpartisan. And most clinicians are not going to dedicate their careers to climate medicine. They should be seeing patients. We all need to be seeing patients. But the same actions that promote human health promote planetary health, which in turn also promotes human health because of the climate effects on health. And so there's this dual benefit of food as well as the other components of lifestyle medicine. And one of the greatest lessons I've learned in the last couple of years in the climate and health space is that our beliefs don't have to be aligned as long as our actions are aligned. And I'm going to end with some opportunities to advocate both within direct patient care and outside of direct patient care. So starting at the federal advocacy level, the Medical Society Consortium is one of the main advocacy groups we have in climate medicine. It's a collection of 50 major medical societies that have acknowledged climate change's impact on human health. They have 51 societies representing 70% of U.S. physicians. And they connect these individual medical societies with lawmakers to advocate for nonpartisan bills that support health but also happen to be climate smart. But the focus is always, let's support human health. They also host an On the Hill meeting in D.C. every year and give you the opportunity to speak with the offices of your members of Congress if you choose to attend. And the consortium includes major mainstream medical societies, including the American Psychiatric Association. It also has 25 locally run state chapters, and it doesn't cost anything to join. You can join as an individual. You can join as a member of your medical society, as a member of your state society. It doesn't matter. It's open to all. And so here are some tools depending on what level you want to advocate at. So for direct patient care, I like Greener by default. It's a non-profit that will provide free financial and free patient satisfactory data on promoting a plant-rich diet and the menus that people get in their hospital beds, but also in the cafeterias and hospitals. And so they don't make everything vegan or plant-rich. They just take the featured dish and make it all plants. They don't give it a label like plant-based or anything. They just say, this is our featured dish. It's, you know, we made enchiladas today or whatever it is. And it all just happens to be a plant-rich food. And it allows people to order chicken or beef or whatever it is they want. It's on the menu. It's just not the first thing on the menu. So they use nudge theory. And I really like that they respect people's autonomy and choice and use that nudge theory. For people that are in medical education, the Planetary Health Report cut is a nonprofit started by medical students, and they rank hospitals as well as medical schools by how well they incorporate sustainability into their education within the medical school and then how well they, how sustainable the operations are. And they provide actual letter grades to various metrics for med schools operations and educational curriculum. So they provide free curriculum that you can use in your medical school, free data. And if you wanna educate, Columbia has this program where you go on this website and you can look up an organ system like the brain, the lungs, and it'll give you this nice plug and play presentation where you get a PowerPoint, a facilitator guide, learning objectives, a quiz, whatever it is you need, and you can just present it as part of the didactics in a clerkship or an elective or in residency didactics focused on your particular organ system and how it interacts with climate change. So I just did one on stroke and air pollution, for example, that's gonna come out very soon. And they're always looking for faculty to contribute and create new modules. And then here's another source for people that are in positions of power within healthcare systems. Practice Green Health will help you collect sustainability data for your hospital and show you opportunities to improve. And then based on meeting certain benchmarks, it provides you with public facing awards of excellence. So that's kind of the incentive for hospitals. And over 1,500 hospitals nationwide have joined. Outside of your day job, there's the Gables Institute that I showed you. So you can see how your personal dietary choices impact climate change. If you wanna just play around with it, it's kind of like those calculators where you can see the emissions related to your travel. This is for diet. There's the link to the Medical Society Consortium. And there's the link to the APA's section on climate and health on their website. And that's it. Here's my contact info. Thanks for letting me speak to you all. I'm happy to provide a PDF of my slide, my slide set. And I'm happy to take any questions. None are offensive or silly or divisive. Ask whatever you like. And I wanna learn from you and I'm open to criticism. Thanks very much. Thank you so much. Would you mind stop sharing, Ellie, so we can have a little conversation? Beautiful. Thank you so much. Thank you so much for sharing this with you, sharing this with us. Very enlightening. You improve your slides every time you present it. So this is better than the last time I heard you. So this is amazing. I'm sure there's questions. Why don't, please just unmute yourself and talk or raise your hand, whichever you feel like. Joanna, I see you hitting your button. I know, I know. I see you. Sorry, I'm like trying to press it. This was a great talk and I really enjoyed it. Again, I apologize. My oldest is still awake. So there might be a little noise in the background. Thank you. I, you know, my husband and I, we've really tried to embrace. I liked kind of how you did the different diets and like each one is a little bit of a further step. But what was coming to mind for me, I think something that's worked for us is that, so I live in Philadelphia, but I actually have backyard chickens. And so I do eat eggs because I eat my chicken's egg, but they're so excellent for food waste. Like my food waste in our house is like nil because I have a dog who will eat any, I'm not gonna lie, I still got the cheese going a little bit. I still have a little cheese, but anything like any cheese or dairy that's gonna go bad, the dog eats. And then any plant, anything like, my compost is actually suffering because of the chickens now. Cause they get every vegetable scrap, every fruit scrap, everything. And I guess I know that doesn't really come as an easy recommendation of just get backyard chickens, but it really has been helpful. Yeah. So a lot of people have guilt when it comes to their diet, but so my motivation for being vegan is not climate change. I do it for animal ethics, but when you're talking about sustainability, you should not be feeling guilty for having dairy products or occasional meat or whatever, because it's not what we eat. It's the way that we're producing this food. Like for example, you've got your backyard chickens. That's very different from factory produced eggs, right? It's the way we're producing it and it's the amount that we're consuming. And so people will come with these arguments of like, what about the small family farmer? What are you gonna do about them? And that's really a small, a straw man argument because our current food system does not support the small family farmer. 99% of our animal products come from large companies that contract with these small family farmers and the farmers do not have autonomy. They do not set the price for these products. They do not set the quality for these products. So if you really wanna support your small family farmer, you buy directly from them. And we changed our food system to really support that small family farmer. And so, as much as I'd love to see a vegan world from an ethical perspective, I know that that's not realistic. And I think a compromise that would be good for human and planetary health and our farmer's wallets would be really getting our animal products from small family farms in small amounts because then they're producing enough and they're producing enough quality and they're charging the true cost of producing those things. So, you've got your backyard chickens. What a lot of people do with backyard chickens is they actually keep some of the eggs and they feed it back to the chickens because you take fowl who haven't been domesticated. When they lay eggs, it's like having a period. You should have one a month on average. You should be having 13 a year. But we've bred these chickens to produce all of these eggs. And so it depletes their calcium. And so they end up getting these bone deformities if they're producing a lot of eggs. So a lot of people will feed their eggs back to their chickens and it's actually not cruel to the chickens. Great point, wow. Yes, we do that here. When my daughter does not finish her scrambled egg in the morning, sometimes the chicken or the dog will get it. Oh yeah, and the dogs get so many of our scraps now and I've saved so much money. Between me, my husband and our two dogs, I'm now spending $1,100 a month on food and restaurants and everything because now we're cooking for them most of the time. And we still buy frozen food for them that we thaw, but we're doing most of their food is cooking, which has been great. It's a money saver, it's better for their health. Everyone wins. Thank you, thank you so much. Ashok. Hi, I just wanted to thank you for this great talk. It's a wonderful topic. Dr. Raju, he's actually on the call here. He's the one that told me about this conference and I was excited because I've been talking about this for almost two decades now. The relationship between food, health, planetary health, animal welfare, things like that. I'm also an ethical vegan myself. So one thing I was gonna push back a little bit on is I think we do have time to talk about not only health related topics with our patients, but also a lot of our patients have climate anxiety. I'm a child and adolescent psychiatrist, so I see a lot of people that are younger. I work down the street from Northwestern University actually in Evanston, Illinois, just outside of Chicago. And so a lot of these kids are coming in, these young college students, they're aware of these existential issues, but they're feeling helpless. They're not getting educated about things they can do. Like you were just talking about nutrition and how we could use that as a weapon, not only to optimize health, but to reduce water waste and reduce land waste, reduce greenhouse gas emissions, fight climate change. And a lot of times they feel empowered and they have less what we call climate anxiety. No, I do feel like it's not like you can, you have to spend much time on it. You can say, hey, you look at these resources when you get time, here are some websites you can look at, here's some documentaries, whatever. They can come back and discuss it with you. No, absolutely. I think when psychiatrists and psychologists, I think you're the exception to the rule where you're definitely gonna see a lot more and it's more relevant to your direct patient care because you'll have, especially younger people, they'll express some climate anxiety. So absolutely. And even when it comes to my stroke patients, I don't necessarily talk about climate change, but I do talk about air pollution because it's become such a huge risk factor. So now when you look at the World Stroke Organization's top 10 risk factors for stroke that account for 90% of the attributable risk, air pollution now accounts for 20%, which is a huge number. And I don't think that's representative of the US, but it largely reflects the air pollution that's happening in lower income countries where they get exposed to more air pollution and therefore their attributable risk of stroke from air pollution is higher than what we would see in the US, but it's become a huge risk factor globally. And so, when I see my stroke patients, I'll educate them about air pollution. I'll tell them, hey, you should check your AQI. But depending on if you decide to exercise outdoors that day, you might wanna limit how much time you spend outdoors, especially in Colorado when we get wildfires happening locally or blowing over from California. Great point. Yeah, climate anxiety is real and it's not even in the children. I see it in the adults as well. So, I'm seeing it quite a bit in the adults that I see. I'm a child psychiatrist as well, but I see it in the adults. I had somebody else wanted to say something. Yes, Sylvia, yes. Hi, Ali. Wonderful presentation. I just wanted to share the idea about sharing food. I mean, sharing the life of a child is awake right now. So, it's a wonderful idea. And that's, yeah, great idea. And I have just kind of really incorporate in my lifestyle. Thank you so much for this advice. That was mind blowing. So simple, but so powerful. No, of course. Thank you. And when you brought up, when you guys brought up climate anxiety, let me show you this one graph actually. Roll this up. Yeah, let's just do this. So, you see over here. So, this is from a study done at Boston Children's Hospital. And they found that more people were worried about climate anxiety than people who weren't worried. And not only that, it's not really a privileged position to have that happens in higher income nations. They saw it across the board in both high and lower income countries. Most people were very concerned about climate, not just children, but younger people as well. So, you can see here, the people that were not worried or just a little bit worried were green or purple. And that's the minority across the board for all of these countries. Most people were either extremely worried or at the very least, moderately worried. You know, it's so funny because I see this a lot in the adolescents and young adults nowadays, the college age students. And they're almost like flippant. They're like, you know, why should I care about the world? They get into this sort of thing of, you know, the world's gonna, we're not gonna make it anyway. So, they go from anxiety to almost like we don't care. So, you guys have failed us. And then it gets into the whole issue of hierarchy. We don't trust you people because you have failed us and you put us here. So, why should we study? Why should we care? And it's a very concerning spiral that I've seen quite a bit in that. So, yes, thank you for bringing that up. That's a good thing to think about. Yeah, and we hear this doom and gloom argument of like, well, it's already too late. We're definitely gonna exceed 1.5, but it's not really an all or none black and white thing when it comes to climate change, right? Because the goal is not to be perfect and get back to where we were in 1800. That's not gonna happen, right? We are going to have permanent damage. And the way I think of that, especially when I'm talking to neurologists is I think of it like a stroke. Like let's say someone comes in and we see a little bit of hypodensity on their head CT. We're starting to see the beginning of the stroke. We don't say like, oh, they're already starting to stroke out the hell with it. No, we evaluate them. We give them tenecteplase or TPA. They go for thrombectomy. We know they're not gonna leave the hospital with no deficits, but there's a difference between leaving with a bit of a face droop and having a total hemiplegia, right? So, it's about reducing mortality, but also reducing morbidity and disability adjusted life years because our actions do matter, even if we have or we were expected to exceed that 1.5 degree target. Yes, great. Christina, Christy. Hi there. I'm actually at Denver Health and Dr. Pandya and Dr. Zastrow on this call are fellows at the University of Colorado. So, I'm a Denverite and super appreciate this. Gonna be bringing it to the Child and Adolescent Psychiatry Fellowship, but just wanting to chime in with some of this climate anxiety information and thinking about it. Recently, I'd heard Heather White talk and she's the author of One Green Thing, this idea that we all can just do one thing each day to move the sustainability effort forward. But her argument was really, if we will have a wellbeing practice, sustainability needs to be part of it. And I never heard them linked like that before and just love the idea that like sustainability has to be intricately linked with our wellbeing practice. And coming back to this idea of like giving us agency at the personal level, I feel like a lot of the times for like burnout or climate, a lot of it's like systems change and it comes back to like what we can do on a personal level. So, super appreciate some of the resources that you've given today. Of course, thank you. And children or adults, they need to be given very concrete actions that have immediate benefits in the short term, right? So, one of the reasons I think that lifestyle really worked for cardiology with the Dean Ornish program is people get on a healthier diet, they're having less exertional dyspnea, they're getting less exertional angina, right? So, they can feel it and they can see it immediately. And similarly, we don't need kids to become UN ambassadors and trying to change the world for the most part. If we can just get them to plant trees on their streets, that reduces the ambient temperature by 10 degrees Fahrenheit. If we can get them to start a garden in their school or in their apartment complex, this is something where they can reap direct benefits. They have agency and they have something to hold in their hands and show for it. And they've actually improved the quality of life in their community. And it's something that they've improved for their health, their mental health, their physical health. And again, there's climate co-benefits and maybe their motivation is climate, but there are sustained benefits beyond climate that remain relevant. Well said. Ashok, another thought, and then there's some question in the chat if you wanted to look at that next, Ali. Sorry, I don't wanna monopolize here. I was just gonna say that the other benefits that I've talked about with patients that have had a severe heart disease, family history of heart disease, sudden cardiac death, as I talk about Dr. Esselstyn's research, that preventing and reversing heart disease through completely whole foods plant-based type of diet, but also the healthiest type without oils and things like that. So I think the more you introduce the health benefits, the better and mitigate reducing cholesterol and things like that. So I just wanted to add that in. Also at the top, you were listing on the project drawdown list of interventions. I would say the top three out of five actually have something to do with agriculture. Is that fifth one about tropical forest deforestation? 90% of deforestation I think is due to livestock, raising livestock. Is that correct? Yeah, so most deforestation is to raise livestock, but more specifically to clear the land to produce the crops for the livestock. Right, has something to do with the raising of livestock. Right, exactly. Okay, anyway, I just thought I would point that out. I know it's minor. No, thank you for that. Sure. And actually regarding that question in the chat, I'm not aware of any studies, but there's this great scientific statement that came from the American Heart Association. And I'm going to take a screenshot and put it in the chat. Let's see here. Can I drag it actually from the, let me do that here. So there's all these popular dietary trends people will hear about and doctors will hear about them. They often have very little guidance in terms of how to counsel patients. People will say they're on Atkins, they're on South Beach, they're on paleo. And so the American Heart Association released 10 popular dietary trends and how well they align with the principles of the American Heart Association's principles of healthy diets. So I couldn't pull the picture, but I put the PDF link in the chat. And interestingly, very low carb is ranked as the worst. It's in terms of how well it aligns with what's considered a healthy diet per the American Heart Association, because there's really only three food groups, right? You're not going to eat either fats, carbs, or protein. And if you're cutting out your carbs, then you're left with high fat and high protein. And what people often use as high protein tends to be animal products because they tend to be delicious, cheap, easy, culturally acceptable. So this is something I like to show people when they tell me they've lost a lot of weight on a particular diet like paleo or Atkins. And I'll talk about, yeah, that's great you've lost weight, but it's not great for your insides and your health span in the longterm. And then I have something to back it up. It's not just some crazy opinion. This is the first time in a long time I've heard somebody say that animal protein is delicious. So it's for someone that's... I haven't heard that in a while. So thank you for reminding me that most people think it's delicious. I mean, we gotta be real with ourselves, right? So I mean, some people are grossed out by it, but when people tell me like, how can I eat healthier? Rather than telling them to eat more plants, my first thing is to tell them, learn how to cook. Make something delicious before you make something nutritious. Because once you get into the habit of cooking and find it easy and enjoyable and you're making things that you like to eat, then you can start making substitutions and make it healthier. So it's more about changing that habit and changing that mindset of like, I can't cook. I make crappy food. Learn to make good food. Once you make good food, you can make modifications and make it healthier. Great point. Wow. Beautiful. So we're past time. Thank you so much. Any last minute questions? I think this was wonderful. Thank you so much, Dr. Seid. We really appreciate you joining us. You know, I think we've mobilized and activated quite a few people in here. So hopefully we'll continue this. So I think for those of you who are gonna attend the May annual meeting, we will have a caucus meeting there. I still don't know the date, when we're gonna have it, but I will see you all there in New York. And those that are not attending, we will come back and do our next webinar after the May meetings. Okay. I'm gonna wait to schedule it till after that. If anybody has any ideas of what they wanna hear, always you can email me or message me on the website. And I look forward to seeing you all shortly live. Okay. Thank you again, Dr. Seid. We'll see you guys soon. Bye.
Video Summary
In a recent webinar, Dr. Ali Saad discussed the critical impact of food choices on climate change and human health. With a background in neurology, lifestyle medicine, and climate change policy, Dr. Saad highlighted the intricate connection between diet and environmental health. He emphasized that the main driver of climate change is greenhouse gases, with food systems accounting for a significant portion due to the high emissions from livestock, particularly methane from ruminants like cattle and sheep.<br /><br />Dr. Saad pointed out that reducing meat consumption, especially red meat and dairy, can significantly lower these emissions. Shifting towards a plant-rich diet is beneficial for both human health and the environment. He stressed that many chronic diseases, including heart disease, stroke, and diabetes, are linked to poor diet, making dietary changes a powerful tool for improving public health and reducing healthcare costs.<br /><br />The webinar also addressed climate anxiety, particularly among young people, and the need for actionable solutions. Dr. Saad suggested practical steps such as community gardening and personal dietary adjustments to empower individuals. He emphasized that actions benefiting personal health, like eating more plants, align with sustainability goals, thereby addressing climate concerns indirectly.<br /><br />Dr. Saad concluded by advocating for more sustainable practices within healthcare systems and individual choices, highlighting that even partial reductions in animal product consumption can vastly free up land and reduce emissions. Through simple lifestyle changes, people can contribute to a healthier planet and mitigate climate change impacts.
Keywords
climate change
food choices
human health
greenhouse gases
plant-rich diet
chronic diseases
climate anxiety
sustainability
lifestyle changes
healthcare systems
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