The Planetary Health Alliance
The short and longer-term impacts of a large-scale, unanticipated environmental shock on the health of young children are investigated. The 2004 Indian Ocean earthquake, among the largest earthquakes in recorded history, spawned a major tsunami. The disaster resulted in over 170,000 deaths in Aceh, Indonesia, displaced half a million people and devastated large swathes built infrastructure, arable land and natural resources along the coast of Aceh. The disaster was followed by the largest reconstruction effort undertaken in any developing country.
We examine the impact of the disaster and subsequent reconstruction on the trajectory of child linear growth during the first five years of life. The shock reflects the combination of elevated maternal psycho-social stress, reduced access to food and reduced resources, broadly defined. The reconstruction effort, which took several years to scale up, resulted in rapid increases in resource availability.
Using innovative population-representative longitudinal survey data collected before the tsunami and annually after the tsunami, the Study of the Tsunami Aftermath and Recovery, child height after the tsunami of those children who were in utero at the time of the tsunami with cohorts of children not similarly exposed are contrasted. Whereas there are substantively large and statistically significant deficits in child linear growth among exposed cohorts in the shorter-term these deficits are eliminated for the vast majority of children within five years of the tsunami. This important new result provides evidence of substantial scope for catch-up growth in child height after a large-scale natural disaster and extremely successful reconstruction effort. However, heights of children whose mothers reported very high levels of post-traumatic stress reactivity do not catch up to the height of their peers, suggesting maternal stress is a key pathway for persistent deficits in linear growth. The longer-term implications for future health and well-being are discussed.
Food production is a major driver of environmental change, while dietary risks are the leading cause of global disease burden. Dietary shifts in high-income countries (HICs) can provide benefits for both health and the environment. However, little is known about such options in developing countries, which often face high burdens of both undernutrition and diet-related chronic disease. As an example, we assessed the changes in greenhouse gas (GHG) emissions, water footprints (WFs), and land use (LU), from shifting current nationally-representative patterns of Indian food consumption to healthy diets.
Dietary data were derived from a national 2012 household expenditure survey. We modelled the changes in consumption of 36 food groups necessary to meet Indian dietary guidelines. These changes were combined with food-specific data on GHG emissions, calculated using the Cool Farm Tool, and WF and LU data adapted from the Water Footprint Network and FAO, respectively.
Shifts to healthy diets nationally required a minor increase in calories (3%), with larger increases in fruit (12%) and vegetables (20%). Percent of calories from fat and protein were adequate. Meeting healthy guidelines marginally increased environmental footprints, between 1-4% for GHG emissions, WFs, and LU. However, these national averages masked substantial variation within sub-populations. For example, shifting to healthy diets among those at risk of undernutrition would require increases of 11% in GHG emissions, 28% in WFs, and 39% in LU, while decreasing environmental impacts from those who currently consume above recommended calories. Environmental impacts also varied markedly between six major Indian sub-regions.
Providing healthy diets in India, a country of 1.3 billion, may only necessitate modest increases in environmental footprints. However, major efforts could be required to prevent widespread business-as-usual shifts to caloric- and environmentally-intensive affluent diets.
Africa is the hotspot for malaria transmission where more than 90% of malaria deaths occur every year. The impact of climate change on malaria transmission in Africa has been controversial. Malaria is a major vector-borne parasitic disease transmitted to humans by Anopheles mosquitoes. Malaria transmission is an intricate function of climatic factors, which non-linearly influence the development of vectors and parasites. In this study, we project that the risk of malaria will increase towards the end of the 21st century in East Africa (EA), but decrease in West Africa (WA).
We combine a novel malaria transmission simulator, HYDREMATS, that has been developed based on comprehensive multi-year field surveys both in EA and WA, and the most reliable climate projections through regional dynamical downscaling and rigorous selection of GCMs from among CMIP5 models. We define a bell-shaped relationship between malaria intensity and temperature, centered around a temperature of 30 °C. Future risks of malaria are projected for two highly populated regions in Africa: the highlands in EA and the fringes of the desert in WA. In the highlands in EA, temperatures are significantly colder than this optimal temperature; warmer future climate exacerbate malaria conditions. In the Sahel fringes in WA, temperatures are around this optimal temperature; warming is not likely to exacerbate and may even reduce malaria burden. Unlike the highlands in EA, which receive significant amount of annual rainfall, dry conditions also limit malaria transmission in the Sahel fringes in WA. The study illustrates disproportionate future risk of malaria due to climate change and should have an impact on guiding strategies for climate adaptation over Africa.
Urgent reform of our food systems is needed if they are to provide high quality nourishment and at the same time protect the environment. Currently one in three people worldwide suffers from micronutrient deficiencies while 2 billion are overweight or obese. Agriculture, food systems and diets have been greatly simplified over the past century. Policies and investments have been too focused on maximizing productivity and economic returns of a few major staples ignoring the significant portfolio of nutritious foods which agricultural biodiversity has to offer. So much so that global production of fruits, vegetables, nuts and seeds falls way short of what is required globally. Agricultural and food policies and actions have become disconnected from nutrition policies and programmes highlighting the urgent need to re-align food systems to focus on nourishing people whilst sustaining the planet. This presents unique opportunities to better mainstream food biodiversity into production and consumption systems. Referring to examples from two ongoing initiatives to mainstream biodiversity for improved diets and nutrition – minor millets in India and neglected native fruit species in Brazil – this presentation highlights that sustainable solutions for transforming food systems are indeed possible. Effective actions include building extensive research partnerships to establish the nutritional value of targeted biodiversity, value addition and creation of short supply chains, supporting production of food biodiversity through public procurement strategies and school feeding. Policies promoting diverse, healthy native foods in dietary guidelines and making nutrient-rich biodiversity more available, advocacy and awareness-raising activities are also highlighted. The presentation will conclude by highlighting how an ‘Agrobiodiversity Index’ can help policy makers assess dimensions of agricultural biodiversity to guide policies and investments for sustainable and nutritious food systems.
Since the preindustrial era, atmospheric CO2 levels have been rising steadily at a pace that is projected to continue unless concerted action is taken to reduce anthropogenic emissions. Meanwhile, several studies have shown that the edible portions of many food crops — namely wheat, rice, field peas, potatoes — contain 4–10% less zinc, iron and protein when grown at CO2 concentrations that are anticipated within the next fifty years. Our study examines which populations around the world may be most vulnerable to the effect of CO2-related nutritional declines based on their diets. We model scenarios under both ambient and elevated CO2 concentrations and estimate the loss of nutrients at the population level for each of 152 countries that would occur as a result of anthropogenic CO2 emissions. We find that populations in lower income countries relying particularly on wheat and rice as staple foods and with low amounts of animal-source food in the diet— India, Southeast Asia, sub-Saharan Africa, Middle East — are at highest risk. Furthermore, because of the disproportionate burden on poorer countries, these areas also lack the resilience to combat these effects due to greater reliance on subsistence farming, reduced dietary diversity, lower caloric intake, and greater prevalence of concurrent diseases that could worsen the health effects of nutritional deficiency. Future changes in dietary patterns may alleviate these trends without additional intervention, but they could also exacerbate them. Within the most vulnerable countries— in particular India, which is found to be the highest risk country globally — ongoing monitoring and awareness of the effect will be important in order to stave off potentially higher rates of malnutrition.
Anthropogenic environmental impacts of food production and processing, alongside diets that fail to meet nutritional requirements, are contributing to a food system that is unhealthy as well as unsustainable. It is critical going forward that nutritional health be considered alongside the ecological effects of food decisions. However, our ability to evaluate dietary sustainability is limited by the lack of coherent, standardized methods that consider both the overall quality of our diets and the environmental effects of those diets, and as a result, we know little about the sustainability of healthy dietary patterns. To address this gap, a Dietary Environmental Index (DEX) was developed as an assessment tool to gauge environmental costs against nutritional quality for a wide range of foods consumed in the United States. For a nationally representative selection of foods reported in the 2007-2008 National Health and Nutrition Examination Survey (NHANES), life cycle assessment (LCA) indicators of land and water resource utilization, eutrophication, and greenhouse gas emissions were combined into an aggregate environmental impact score (EIS). The EIS was then standardized by nutrient density, as determined using the Nutrient Rich Foods Index 9.3, to calculate the DEX values for each NHANES food item. Results obtained from this research will provide insight on how food product choices may enhance the nutritional quality of the diet while reducing harm to the environment.