Making the case: sustainability and public health

1. Making the case: sustainability and public health Medical importance of food policy June 2011

4. Medical Importance of Food Policy • Cancer • Cardiovascular • Diabetes • Food borne illness • Obesity Acanthosis Nigricans

5. Cancer • “In high income countries about a thirdof the most common cancers and in low and middle income countries about a quarter, could be prevented by eating healthily, staying lean and being physically active.” • Sir Michael Marmot MB BS MPH PhD FRCP FFPH World Cancer Research Fund International University College London, United Kingdom Chair, Expert Report and Policy Report Panel ~ June 2011

6. Cardiovascular • Blood pressure increases with each year we age • Hypertension, which increases the risk of heart attack and stroke, can be reduced by half incidence eating a semi-vegetarian DASH diet generous in fresh produce • DASH diet meal planning prevents hypertension in the general population • Meat, fish, poultry once per week is semi-vegetarian • DASH is Dietary Approaches to stop Hypertension and uses a plant-based, but not vegetarian diet, that is sodium sensible Fraser, GE. Diet, Life Expectancy and Chronic Disease: Studies of Seventh-day Adventists and other vegetarians, 2003. Blackburn GL. The public health implications of the dietary approaches to stop hypertension trial. Am J Clinical Nutrition 74:1,2001.

7. Diabetes: Cheap Food • Food accounts for 10% of total household expenditures; an all time low [2010 data] • Eleven percent, 11% of Americans are victim to diabetes mellitus, most due to ubiquitous cheap food • Less healthy foods are cheap – refined white flour, hydrogenated frying oils, refined sugars in highly processed, shelf stable packaged snack foods and soft drinks (Reuters) - More than half of Americans will have diabetes or be pre-diabetic by 2020 at a cost to the U.S. health care system of $3.35 trillion if current trends go on unabated, according to analysis of a new report released November 23, 2010by health insurer UnitedHealth Group Inc.

8. Obesity:Abundant Cheap Food • America grows enough food to provide 3,900 calories per person per day • Forty percent [40%] of food produced for U.S. consumption will never be eaten • Food waste is 1,400 calories per person per day National Institute of Diabetes and Digestive and Kidney Diseases, published November 2010, Public Library of Science

9. Food Waste Jonathan Bloom, M.A., American Dietetic Association Food and Nutrition Conference & Expo speaker, Denver, CO, October 20, 2009

10. Virginia Tech Food Waste Audit Reducing Food Waste Schools When recess is scheduled before lunch, school children consume significantly more food and have less plate waste than children who recess after lunch. Also, when recess is scheduled before lunch, children consume more total nutrients, including calcium, vitamin A, iron Bergman EA, Buergel NS, Englund TF, Femrite A. The relationships of meal and recess schedules to plate waste in elementary schools. J Child Nutr Manage.http://docs.schoolnutrition.org/newsroom/jcnm/04fall/bergman/bergman2.asp

11. School Meals 2011 monetary data Lunch tray without 6¢ & with current policy Lunch tray with 10¢ & with ‘real food’ policy

12. Food Wasters Contributors and Culprits * Perfect Food slaves When in doubt, throw it out” mentality Serve sensible portion sizes Buy less; shop more often Keep fridge half-empty – avoid over purchase $200 of produce rots in the refrigerator vegetable bin [per family per year] 5-A-Day for Better Health [2007 data] www.WastedFood.com * Palmer, S. Paying the High Price of Food Waste, Environmental Nutrition , March 2010

13. What’s the Point! The Reporter – January 2011

14. Locally grown food Reduces the incidence of foodborne illness E. Coli 2011 Outbreak Deadliest on Record Helms, M; Vastrup, P; Gerner-Smidt, P; et al. Short and long term mortality associated with foodborne bacterial gastrointestinal infections: registry-based study. BMJ, 2003, 326-357.

15. Food-borne Infection Higher ambient temperatures Outdoor eating Faster growth of food-borne pathogens Eight percent [8%] increase in food borne illness per each degree C above normal average temperature Reported cases of Campylobacter, E coli, Salmonella by week and temperature. Alberta, Canada 1992-2000. Fleury. Int J Biometeorology (2006) 50:385-91

16. Green Dining Sample Best practices Community Supported Agriculture [CSA] Sustainable Food Transport

17. Green Dining Sample Best practice Tray less Dining

18. Green Dining Beverage liquid waste 38 gallons per day saved - 53% reduction Post-consumer food waste 275 # / day - 38% reduction Paper trash waste 11# - 9% reduction Posters and table tents advocating benefits (pre-trials) and results (post-trials), the University of Kansas Dining Services, 2008.

19. Green DiningTray less Sample Best practice 80,000 gallons water saved each quarter

20. A Great Leader Strategic Plan for Wise Nutrition

21. A Leader models eating well Makes breakfast and work lunches contribute fruit, vegetables, whole grains and low fat dairy Keeps an emergency desk kit of healthful foods for time crunches Heeds the # of discretionary calories they need based upon age, sex and activity level to guide food selection

22. A Leaderpractices healthy behavior Shops at farmers’ markets and buys local produce Selects foods that reduce chronic disease even when no one is looking Files a survival shopping list to prepare speedy suppers with quick recipes in ≤ 30 minutes during periods of work stress

23. A Leadermotivates colleagues Encourages co-workers to access their personal eating plan at www.MyPlate.gov Suggests a work group to advocate local foods in the work site cafeteria and vending Adds employee incentive and recognition programs that reward healthful eating behavior goals

24. A Leaderstewards others Creates a healthy legacy by selecting foods that nourish significant others according to evidence based nutrition Rewards the work place food service with patronage of healthy choice selections Supports colleagues efforts to dine at restaurants offering variety, improved food selections and reasonable portions

25. A Leader changes work place policy Arranges catering that upholds dietary guidelines Empowers cognitive performance by including fruits and vegetables in complimentary lunches Questions routines detrimental to nutritional health; like food as reward & suggests alternatives Recommends work place vending of fresh foods rather than all packaged and processed items Financial services’ Sherry Carter selected an afternoon snack in the Westwood Atrium, the University of Kansas Hospital ▪ the University of Kansas Medical Center eXpress newsletter, June 2-8, 2011.

26. A Leaderexpects paradigms to shift Asks “what is impossible to do today, but if it could be done, would fundamentally change nutrition lifestyles?” Advocates composting in government, hospital and worksite kitchens Creates systems that support food as medicine Designs an environment where real foods are available

27. All citizens, regardless of income, need access to “real food”. ~A key message proposed for 2011 Food Day Kansas City Adrienne Moore Baxter MS RD LD Membership co-chair, Greater Kansas City Food Policy Coalition Clinical Instructor, School of Health ProfessionsThe University of Kansas Medical CenterDepartment of Dietetics and Nutritionabaxter@kumc.edu

28. @ KCFoodPolicy.org

31. U.S. government's 2011graphic symbol of nutritional advice

33. Web Resources • Acquaint yourself with the Declaration for Healthy Food and Agriculture at www.FoodDeclaration.org • Estimate the carbon dioxide emissions of your meal at www.eatlowcarbon.org • Evaluate your ecological intelligence at www.GoodGuide.com • Sign the pledge to choose tap water over bottled water whenever possible and support policies that promote clean, affordable tap water for all, www.takebackthetap.org • A Healthy Food in Health Care Pledge exists for your institution’s Food Team to sign, visit Health Care without Harm at http://www.noharm.org/us_canada/issues/food/pledge.php

34. References and recommended readings • Center for Science in the Public Interest. Eating green. Available at: http://www.cspinet.org/EatingGreen/index.html. Accessed April 1, 2011. • Food & Water Watch. About us. Available at: http://www.foodandwaterwatch.org/about/. Accessed April 1, 2011. • LocalHarvest, Inc. Community supported agriculture. Available at: http://www.localharvest.org/csa/. Accessed April 1, 2011. • Monterey Bay Aquarium. Seafood recommendations. Available at: http://www.montereybayaquarium.org/cr/cr_seafoodwatch/sfw_recommendations.aspx. Accessed April 1, 2011. • Thegreenmentality.com. Get a green diet: good for you and our planet. Available at: http://www.thegreenmentality.com/green_diet.html. Accessed April 1, 2011.