DIETARY STRATEGIES TO SUPPORT PLANETARY HEALTH · food system –affects health of our patients Flooding, Drought, Heat, fire, Lost farmland because of development, Soil degradation,

DIETARY STRATEGIES TO

SUPPORT PLANETARY HEALTHPRESENTER: MARY PURDY, MS, RDN

LEARNING

OBJECTIVES

Describe the positive impact of consuming more plant based foods and wasting less food on planetary health

Strategize with and counsel patients on how to make realistic behavior changes to improve human and environmental health

Provide easy and palatable ideas for how to incorporate healthy and mostly plant basedfoods as well as low impact nutritional choices

2COPYRIGHT © BY MARY PURDY. ALL RIGHTS RESERVED.

United Nations. Climate Reports., 2019

INTERGOVERNMENTAL PANEL ON CLIMATE CHANGE (IPCC) REPORT

Global emissions are reaching record levels

The last four years: hottest on record

Sea levels rising

Coral reefs dying

Air pollution, heatwaves, floods and risks to food security

Human Influence established

i. https://www.un.org/en/climatechange/un-climate-summit-2019.shtml

“Human wellbeing

depends on reducing

social inequity and

protecting the

environment. “United Nations Development Program. Sustainable Development Goals. 2015

QUICK REALITY CHECK

The Goal:

IPCC: Limiting global warming to

1.5ºC would have clear benefits to

people and natural ecosystems

ensuring a more sustainable and

equitable society.

Impact is disproportionate

Affecting lower income communities,

elders, children, communities of color,

developing countries (2, 3)

Culture – Indigenous communities

National Climate Assessment

Poverty reduces resilience and increases

vulnerability (4)

1. IPCC Special Report 2. Brown 2018 3. National Climate Assessment 4. Columbia University, 2016

CDC. Center for Disease Control. Climate Effects on Health. 2019

MENTAL HEALTH EFFECTS & “ECO-ANXIETY”

Climate change-related natural disasters have had a profound negative impact on the mental health of survivors (1)

Suicides have increased, as have depression, anxiety, stress, grief, anger and PTSD. (2)

Patients may be concerned and anxious (3)

Think of how empowering it may be for them to know there is something they can do.

1. Hayes, 2018 2. American Public Health Association 3. Schlanger, 2017

COPYRIGHT © BY MARY PURDY. ALL RIGHTS RESERVED.

FOOD SYSTEM = ¼ OF GREENHOUSE GASES (1)

Food Production (2)

Biodiversity loss

Freshwater use

Interference with the global nitrogen and phosphorus cycles,

Land-system change

Chemical pollution.

It accounts for over 50% of US land use

80% of consumptive water use

16% energy use

http://css.umich.edu/factsheets/us-food-system-factsheet

Food Consumption

What we eat or don’t eat

Where we purchase

The food itself

Packaging

Transportation

What we waste

Our “FoodPrint”

1. Poore, 2018 2. Johns Hopkins,

COPYRIGHT © BY MARY PURDY. ALL RIGHTS RESERVED.

CONNECTING THE DOTS: FOOD SYSTEM ALSO AFFECTS HEALTH

Impact on the health of our

food system – affects health

of our patients Flooding,

Drought,

Heat, fire,

Lost farmland because of development,

Soil degradation,

Pesticides

Food and Agriculture Organization of the United Nations. “The State of Food Security and Nutrition in the World2019

COPYRIGHT © BY MARY PURDY. ALL RIGHTS RESERVED.

OUR SOIL HAS CHANGED BECAUSE OF CLIMATE CHANGE AND

FOOD SYSTEM

Less healthy

Degraded and nutrient depleted

½ topsoil of the earth has been lost

Carbon sequestering power diminished (1)

60 years of farming left if soil degradation continues.

(2)

Supporting Regenerative Agricultural Practices is key

1. World Wildlife Fund. 2017 2. Arsenault, 2014

TRANSFORMING OUR FOOD SYSTEM

COPYRIGHT © BY MARY PURDY. ALL RIGHTS RESERVED.

CLIMATE CHANGE NECESSITATES A FOOD SYSTEM CHANGE

Can be achieved only by reducing

greenhouse gas emissions from all

sectors including land and food.

70 % of Amazon Rainforest has been

converted for use in commercial agriculture

Carbon Sequestering potential diminished

IPCC | Climate Change and Land (2019

1. United Nations Food and Agriculture Organization , 2019

Animal foods are

more resource

intensive than plant

based foods. (1)

Emissions per gram of protein

for beef and lamb are about

250 times those of legumes;

(2)

Twenty servings of vegetables

have fewer greenhouse gas

emissions than one serving of

beef. (2)

1. World Resources Institute 2. Tilman, 2014

OUR FUTURE

Livestock = 15 % of GHG = same amount generated by our transportation system. (1)

Cattle: milk and meat = 65%

Green Fact: 70% of the deforestation of the Amazon is to provide land for cattle ranches.

http://www.fao.org/3/a-i3437e.pdf

If continues as is:

80 percent increase in global greenhouse gas emissions from food production

Habitat destruction due to land clearing for agriculture around the world. (1)

What’s good for the planet is also good for human health!

COPYRIGHT © BY MARY PURDY. ALL RIGHTS RESERVED.

THE SPECIAL REPORT ON CLIMATE AND LAND BY THE INTERGOVERNMENTAL PANEL ON CLIMATE CHANGE (IPCC)

100 experts

Many from developing countries

Deforestation:

Releasing over 50 billion tonnes of carbon into the

atmosphere in 30 to 50 years

“Plant-based diets as a major opportunity for mitigating

and adapting to climate change”

Policy recommendation to reduce meat

consumption.

1. Schiermeier, Q, 2019

COPYRIGHT © BY MARY PURDY. ALL RIGHTS RESERVED.

EAT LANCET COMMISSION

2017

37 world-leading scientists from 16 countries

from various scientific disciplines.

Goal:

Healthful dietary patterns,

Large reductions in food loss and waste,

Major improvements in sustainable food

production practices.

The EAT-Lancet Commission on Food, Planet, Health, 2017.

COPYRIGHT © BY MARY PURDY. ALL RIGHTS RESERVED.

“THE GREAT FOOD TRANSFORMATION”:

“Red meat and sugar will need to decrease by 50% while consumption of nuts, fruits, vegetables and legumes must double.

Currently 216 lbs of meat per person/year

½ lb of meat/day

ESTIMATE:

Changes in food production practices could reduce agricultural GHG emissions in 2050 by about 10%

Increased consumption of plant-based diets could reduce emissions by up to 80%.

COPYRIGHT © BY MARY PURDY. ALL RIGHTS RESERVED.

DON’T TAKE MY BACON!

NO, YOU DON’T HAVE TO BE VEGAN!

BEANS

LENTILS

PEAS

GRAINS

NUTS/SEEDS

https://www.wri.org/resources/data-

visualizations/protein-scorecard

World Resources Institute. Shifting Diets for a Sustainable Food Future,

https://www.barillacfn.com/en/dissemination/double_pyramid/

RECOMMENDATIONS

AND SOLUTIONS

NO ONE HAS TO GO

VEGAN.

…OR BE A

DIFFERENT PERSON

COPYRIGHT © BY MARY PURDY. ALL RIGHTS RESERVED.

POSITION OF THE SOCIETY FOR NUTRITION

EDUCATION AND BEHAVIOR: THE IMPORTANCE OF

INCLUDING ENVIRONMENTAL SUSTAINABILITY IN

DIETARY GUIDANCE

“Dietary choices are a personal matter, but

many American consumers are motivated by a

concern for the environment and would

welcome sound advice from credentialed

nutrition professionals. ”

Rose, D, 2019

INCORPORATE

CLIMATE

CHANGE ISSUES

IN YOUR INTAKE

FORM

“How has climate change affected you?

What connections do you see between what is going on for you medically and climate change?”

Let me know if you are interested at all in hearing about how some of the recommendations we talk about around your health can also be beneficial for the environment.

Normalize

https://eatforum.org/content/uploads/2019/01/EAT-

Lancet_Commission_Summary_Report.pdf

https://eatforum.org/eat-lancet-commission/eat-lancet-commission-summary-report/

COPYRIGHT © BY MARY PURDY. ALL RIGHTS RESERVED.

EAT LANCET

COMMISION

https://eatforum.org/eat-lancet-commission/eat-lancet-commission-summary-report/

COPYRIGHT © BY MARY PURDY. ALL RIGHTS RESERVED.

EATING FOR PLANETARY HEALTH GUIDELINES

Proteins should primarily be sourced from plants where possible

Fish or other Omega 3 sources 3X/week

6oz/week

Note: fish – sustainable? (More later)

Modest eggs and chicken

6 oz chicken/week

Very little red meat: 3 oz/week

Nuts: 1/3 -1/2 cup/day

Beans: At least ½ cup day

Carbohydrates:

Grains - mostly whole grains

1 cup of grains/day

<5 % added sugar

Tubers or starchy vegetables

1/2-c up to 1 cup

> 5 servings of fruits and vegetables/day

Dairy: moderate and optional

0 – 16oz

COPYRIGHT © BY MARY PURDY. ALL RIGHTS RESERVED.

PROTEIN: REALISTICALLY- WHAT DOES THIS LOOK LIKE?

½ cup beans/lentils = 7-9 grams of protein

½ cup nuts/seeds = 10 grams of protein

1 oz meat/fish = 7 grams of protein

3 oz tofu = 10 grams of protein

Bkfst: 1 cup oatmeal with 1/3 cup nuts/seeds = 12

grams protein

Lunch: 1 cup lentil soup = 18 grams of protein

Snack: ½ cup hummus and veggies = 5 grams

protein

Dinner: 3 oz fish = 21 grams of protein

Other foods throughout the day = 5-10 grams

TOTAL = 55-65 grams of protein

THE HOW OF CHANGEWHY IS IT HARD TO

CHANGE DIET?

RELATIONSHIP WITH FOOD

Food is emotional

Food is personal

Food can be comfort

Food choices may be dictated by:

Stress, busy lifestyle, convenience, food access, finances, environment, lack of education, culture

COPYRIGHT © BY MARY PURDY. ALL RIGHTS RESERVED.

EXPLORE RELATIONSHIP TO FOOD

Food is very personal.

Hear their story

ASK:

“What is your relationship to food?”

“What does food mean to you?” History? Childhood?

“What do you crave?” “When?”

“How do you feel about your intake of __________”

POSSIBLE SOLUTIONS:

Talk with/explore with patient his/her relationship with

food.

Explore negative self talk and encourage neutral talk

Encourage awareness of patterns and behavior

Nothing can change if we aren’t aware

Ensure that they aren’t skipping meals or lacking balance in

meals that can increase cravings.

Reminder: Balanced plate

ACCESSING AND ACKNOWLEDGING THE MOTIVATOR

ASK!

“What is your relationship to food?”

“What does food mean to you?” History? Childhood?

Find out what matters to them

What do they care about?

Children/Grandchildren/Future generations?

Do they spend time in nature?

Hear their story

Reflect back to them

Bottom Line: Many recommendations that you might

give to support health are going to support the planet

ACKNOWLEDGE!

Point out and acknowledge the efforts they have already

made

Validate successes

Even just showing up!

Celebrate their awareness

“When a person feels accepted for who they are and what they

do, it allows them the freedom to consider change rather than

to defend against it. “

Bill Miller

HELPFUL QUESTIONING ABOUT FOOD PREFERENCES

EXPLORE WITH THEM

What flavors do you love?

Which vegetables do you enjoy?

What’s your favorite bean?

Favorite fruit?

What do you love about________?

“Tell me and I forget. Teach me and I remember. Involve

me and I learn.”

- Benjamin Franklin

INCLUDE THEM

How would you feel about ________?

What might you be ready to shift?

What’s the biggest barrier?

What do you think you could do?

What would make it easy for you to make that happen?

What do you think the benefit might be?

How could you see yourself getting in more/less

Beans

Veggies

Sugar

Soda

MANY STUDIES SHOWING BENEFITS OF PULSES

Improved glycemic profile

Reduction in HTN

Improvement in body weight

Associated with decreased CHD

Antioxidant Benefits

Reduced Inflammation

431. Ha, V, 2014, 2. Sievenpiper, J, 2009,3. Singh B, 1., 2017

CREATIVE WAYS TO

INCORPORATE BEANS

Chili

Bean burgers

Lentil soup

Black bean

Hummus & Bean dips

Add to salads

Combine with meaty flavors

HAVE RECIPES, CANNED OPTIONS AND COOKBOOK EXAMPLES

Recipes for Beans/Legumes

https://pulses.org/recipes/

COPYRIGHT © BY MARY PURDY. ALL RIGHTS RESERVED.

CREATIVE WAYS TO INCORPORATE NUTS AND SEEDS

(GET OUT OF THE ALMOND RUT)

Throw atop cereals and yogurt

Add to grains

Sprinkle on salads

Bake into muffins

Tahini Salad Dressing

Make nut milks: Blend ¼ nuts + 8-10 oz water

Add to smoothies

Smear nut butter on banana or apple

Health Benefits: ¼-1/2 cup/day (1)

Improved lipid profiles

Support health weight

Hemp Seeds: (2)

High-yielding

Low inputs

Positive impact on the environment

1. Sabate, J, 2010 2. Tang K, 2018

EASE INTO TRANSITIONS:

NO NEED TO GO “WHOLE HOG” (“WHOLE CHICKPEA?”)

START WITH ADDING!

Bacon WITH Greens

Meatloaf/Burgers WITH more vegetables or ½

mushroom

Sandwiches WITH more vegetables

Scrambled Eggs/Omelette WITH vegetables

ADD beans to soups

COMBINE FOODS & COMBINE

FLAVORS THEY ENJOY

Soups/Stews with meat AND beans

Tacos/burritos with chicken and beans

Curry using tofu in place of meat/chicken

OFFER ALTERNATIVES

SUGAR & SWEETS

Naturally sweet fruits/dried fruit

Dates, Figs, Raisins, Prunes

Frozen berries, banana

Banana or apple with nut butter

Sweet veggies

Squash, sweet potatoes, beets, carrots, onions,

Baking with honey, maple syrup

REFINED FLOUR CHIPS

Nuts and seeds

Baked veggies

Whole grain crackers

Crunchy veggies:

Snap peas

Carrots

Celery

YES, YOU CAN HAVE LENTILS/BEANSFOR BREAKFAST AND DESSERT!

BREAKFAST

Lentil muffins

Lentil and egg quiche

Beans in smoothie

Lentil nut balls

https://www.lentils.org/10-prep-ahead-breakfasts-to-

make-this-month/

DESSERTS

Black bean brownies

White bean blondies

Garbanzo bean “Cookie Dough”

https://www.popsugar.com/fitness/Chickpea-Cookie-

Dough-Recipe-28371473

https://ohsheglows.com/

HAVE SAMPLES AND FOOD EXAMPLES ON SHELVES IN YOUR OFFICE

FOR EDUCATION AND INCREASED FAMILIARITY/EDUCATION

HAVE RESOURCES AND VISUAL AIDS FOR PATIENTSON YOUR WALL, IN YOUR

WAITING ROOM

https://www.usapulses.org/consumers/resources

PROMOTE POSITIVE ASSOCIATIONS WITH IMAGES ON WALL OR WAITING ROOM

FARMER’S MARKETS,

RECYLCLING

https://www.freepik.com/free-photos-vectors/reduce-reuse-recycle

REDUCE FOOD WASTE WITH EDUCATION: “BEST BEFORE” THE DATE BY WHICH A FOOD COMPANY ESTIMATES THAT A FOOD WILL TASTE ITS BEST. NOT ABOUT SAFETY

SUPPORT AND ENCOURAGE ORGANIC

AND REGENERATIVE AGRICULTURAL

FARMING WHEN POSSIBLE

Healthier for humans

Improves soil microbial population

Fewer pesticides

Fewer energy needs

Less pollution

Less water usage

Stores more carbon

Improves bio-diversity

More resilient to climate change

1. Food and Agriculture Organization of the United Nations. “Organic Agriculture and Climate Change”.

COPYRIGHT © BY MARY PURDY. ALL RIGHTS RESERVED.

ENCOURAGE COOKING/MEAL PREP: THE GREAT CONNECTOR

Better for Health & Environment

Relationship with and Connection to food

Purchase an herb plant if possible.

Connection to community

Connection to culture and tradition

Way to slow down and be mindful

Saves money

Reduces waste

How can they ENJOY it?

HEALTHCARE CONTRIBUTES TO

9% OF OVERALL GHG (1)

“HEALTHCARE WITHOUT HARM” IS PAVING

THE WAY. ( 2.)

1. FOOD SERVED

2. SUPPORTING LOCAL/SUSTAINABLE

AGRICULTURE

1. Francis, D et a; How healthcare can help heal communities and the

planet 2. https://noharm.org/

RESOURCES FOR

HEALTHCARE

WORKIERS

FOR HEALTHCARE WORKERS: https://eatforum.org/lancet.../healthcare-professionals/

FOR CULINARY PROFESSIONALS: https://eatforum.org/lancet.../food-service-professionals/ "

HANDOUTS FOR PATIENTS ON CLIMATE CHANGE: https://noharm-uscanada.org/content/us-canada/patient-education

https://www.epa.gov/sustainable-management-

food/food-recovery-hierarchy

COPYRIGHT © BY MARY PURDY. ALL RIGHTS RESERVED.

WHAT YOU CAN DO PROFESSIONALLY: SPEAK UP!

University Connections:

Promote these concepts both in the classroom but at the institutional level

Recycling? Compost? Plant based foods in cafeteria?

Social Media Platforms

Promote plant food, organic, sustainable practices

Keep the messages positive

Conferences where you serve food:

Vegetarian options

Modify menus –ask what customers may want to reduce waste

Less styrofoam, plastic water bottles

Let participants know this is an initiave so they make different choices

GOAL:

These practices become the norm!

WHAT YOU CAN DO PERSONALLY

Buy local/organic

Add in more plant based foods

Bring containers to coffee shops/restaurants

Ask restaurants and chefs to serve more plant

based options.

Have these conversations with friends and

colleagues

Contact your local and state representatives

Keep an eye on the “Farm Bill”.

QUESTIONS TO

ASK YOURSELF

What are you already doing?

What have you thought about doing that you aren’t doing but could do?

How could you see yourself as an agent for change both in personal and professional life?

What is one thing you commit to doing this week?

RESOURCES TO SHARE WITH PATIENTS

SERVICES

American Community Garden Association https://www.communitygarden.org/

https://www.imperfectfoods.com/

https://thewallyshop.co/

http://www.greeneatz.com/foods-carbon-footprint.html

Documentaries:

The Need to Grow: lost ¼ of its farmable soil in the last 40 years

PlANT BASED RECIPE SITES

https://pulses.org/recipes/

https://ohsheglows.com/

https://www.whitneyerd.com/category/recipes

https://sharonpalmer.com/recipes/

http://www.nourishingmeals.com/

https://minimalistbaker.com/

COPYRIGHT © BY MARY PURDY. ALL RIGHTS RESERVED.

RESOURCES FOR FURTHER EDUCATION

Planetary Health Alliance: https://planetaryhealthalliance.org/

Clinicians for Planetary Health: https://www.planetaryhealthalliance.org/clinicians-for-planetary-health

Food Tank: https://foodtank.com/

Barilla Center for Food and Nutrition Foundation: https://www.barillacfn.com/en/

The Food Sustainability Index:http://foodsustainability.eiu.com/

Center for Biological Diversity https://www.biologicaldiversity.org/about

World Wildlife Fund: https://www.worldwildlife.org/

Marion Nestle: https://www.foodpolitics.com

World Resources Institute: https://www.wri.org

World Wildlife Fund:

https://www.wri.org/blog/2016/04/sustainable-diets-what-you-need-know-12-charts

Natural Resources Defense Councilhttps://www.nrdc.org/

International Panel on Climate Change:

https://www.ipcc.ch/about/

Environmental Health: An Integrative Approach (2018-2020) https://integrativemedicine.arizona.edu/education/online_courses/enviro-med.html

COPYRIGHT © BY MARY PURDY. ALL RIGHTS RESERVED.

ADDITIONAL RESOURCES FOR READING AND GROUPS TO JOIN

Article From Food Print:

https://foodprint.org/issues/how-our-food-system-affects-climate-change/

Rodale Institute Blog:

https://rodaleinstitute.org/blog/

Catering to the Climate: How Earth Friendly Menus at Events Can Help Save the Planet:

https://www.takeextinctionoffyourplate.com/pdfs/environmental_catering_report_catering_to_the_climate_final_report_2019.pdf

Meatless Mondays Campaign Group Via Center for a Livable Future:

https://meatless-monday.hivebrite.com/topics

Planetary Health Alliance FB Group:

https://www.facebook.com/groups/planetaryhealthcollective/

QUESTIONS?

66

Podcast/Webseries: “Mary’s Nutrition

Show” Available on iTunes

www.MaryPurdy.co

[email protected]

Copyright © 2019 by Mary Purdy. All Rights Reserved.

REFERENCES

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American Public Health Association. Making the connection: climate changes mental health. Website: https://www.apha.org/~/media/files/pdf/topics/climate/climate_changes_mental_health.ashx Accessed October 2019

Arsenault, C. Only 60 Years of Farming Left If Soil Degradation Continues. Scientific American. Website. https://www.scientificamerican.com/article/only-60-years-of-farming-left-if-soil-degradation-continues/ Published December 5, 2014. (Accessed Oct 2019)

Brown, S. The Impact of Climate Change on Communities of Color. The Greenlining Institute. Website: http://greenlining.org/press/2018/the-impact-of-climate-change-on-communities-of-color/ Published October 2018. Accessed October 2019

CDC. Center for Disease Control. Climate Effects on Health. Website: https://www.cdc.gov/climateandhealth/effects/default.htm Updated September, 2019. Accessed October 2019.

The EAT-Lancet Commission on Food, Planet, Health. EAT-Lancet Commission Summary Report. https://eatforum.org/eat-lancet-commission/eat-lancet-commission-summary-report/ 2017. Accessed October, 2019

Columbia University. National Center for Disaster Preparedness. Earth Institute. The disproportionate consequences of climate change. Website: https://ncdp.columbia.edu/ncdp-perspectives/the-disproportionate-consequences-of-climate-change/ Published February, 2016. Accessed October 2019

Food and Agriculture Organization of the United Nations. “The State of Food Security and Nutrition in the World: Building Climate Resilience for Food Security and Nutrition.” IFAD, UNICEF, WFP and WHO, 2018. http://www.fao.org/3/I9553EN/i9553en.pdf Accessed OCtober, 2019

Food and Agriculture Organization of the United Nations. “Organic Agriculture and Climate Change”. Website: http://www.fao.org/organicag/oa-specialfeatures/oa-climatechange/en/ Accessed October 2019.

Fourth National Climate Assessment. Chapter 15: tribes and indigenous peoples. Website: https://nca2018.globalchange.gov/chapter/15/ Accessed October 2018

Francis, D et al. How healthcare can help heal communities and the planet. BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l2398

Ha V, Sievenpiper JL, de Souza RJ, et al. Effect of dietary pulse intake on established therapeutic lipid targets for cardiovascular risk reduction: a systematic review and meta-analysis of randomized controlled trials. CMAJ. 2014;186(8):E252–E262. doi:10.1503/cmaj.131727

Hayes K, Blashki G, Wiseman J, Burke S, Reifels L. Climate change and mental health: risks, impacts and priority actions. Int J Ment Health Syst. 2018;12:28. Published 2018 Jun 1. doi:10.1186/s13033-018-0210-6

REFERENCES

History of Agriculture. Johns Hopkins Center for a Livable Future Website. http://www.foodsystemprimer.org/food-production/history-of-agriculture/index.html Accessed October 2019

Intergovernmental Report on Climate Change. SPECIAL REPORT: Global Warming of 1.5, . Website: https://www.ipcc.ch/sr15/ Accessed October 2019

Intergovernmental Report on Climate Change. IPCC | Climate Change and Land (2019) IPCC Special Report on Climate Change, Desertification, Land Degradation, Sustainable Land Management, Food Security, and Greenhouse gas fluxes in Terrestrial Ecosystems, August, 2019 https://www.ipcc.ch/site/assets/uploads/2019/08/4.-SPM_Approved_Microsite_FINAL.pdf

Nelson, M. Hamm, M, H, F. et al. Alignment of Healthy Dietary Patterns and Environmental Sustainability: A Systematic Review. Advances in Nutrition, Volume 7, Issue 6, November 2016, Pages 1005–1025, https://doi.org/10.3945/an.116.012567

Poore, RJ, Nemecek, T. Reducing food’s environmental impacts through producers and consumers. Science 01 Jun 2018: Vol. 360, Issue 6392, pp. 987-992 DOI: 10.1126/science.aaq0216

Reganold, J, Wachter, J. Organic agriculture in the twenty-first century. Nature Plants volume 2, Article number: 15221 (2016)

Ranganathan, J, Vennard, D, Waite, R, et al. Shifting Diets for a Sustainable Food Future. Creating a Sustainable Food Future, Installment Eleven. World Resources Institute. Website. https://www.wri.org/publication/shifting-diets

Rose, D, et al. Position of the Society for Nutrition Education and Behavior: The Importance of Including Environmental Sustainability in Dietary Guidance. Journal of Nutrition Education and Behavior, Volume 51, Issue 1, 3 - 15.e1, January 2019.

Sabate, J, Oda, K, Ros, E. Nut Consumption and Blood Lipid Levels. A Pooled Analysis of 25 Intervention Trials Arch Intern Med. 2010;170(9):821-827. doi:10.1001/archinternmed.2010.79

Schlanger, Z. We need to talk about “ecoanxiety”: Climate change is causing PTSD, anxiety, and depression on a mass scale. Website: https://qz.com/948909/ecoanxiety-the-american-psychological-association-says-climate-change-is-causing-ptsd-anxiety-and-depression-on-a-mass-scale/ Published April 2017. Accessed, Oct 2019.

REFERENCES

Schiermeier, Q. Eat less meat: UN climate-change report calls for change to human diet. Nature. Website: https://www.nature.com/articles/d41586-019-02409-7?fbclid=IwAR23nlSfnF-soU93JEiVnC7ii69vResJUegRO8Y6IPy-eCfcF5BMAIFNFo4 Published August, 2019. Accessed October 2019

Sievenpiper, J.L., Kendall, C.W.C., Esfahani, A. et al. Effect of non-oil-seed pulses on glycaemic control: a systematic review and meta-analysis of randomisedcontrolled experimental trials in people with and without diabetes Diabetologia (2009) 52: 1479. https://doi.org/10.1007/s00125-009-1395-7

Tang K, Fracasso A, Struik PC, Yin X, Amaducci S. Water- and Nitrogen-Use Efficiencies of Hemp (Cannabis sativa L.) Based on Whole-Canopy Measurements and Modeling. Front Plant Sci. 2018;9:951. Published 2018 Jul 16. doi:10.3389/fpls.2018.00951

United Nations, Climate Action Summit, 2019. Website: https://www.un.org/en/climatechange/un-climate-summit-2019.shtml Accessed, October 2019

United Nations. Climate Reports. Website: https://www.un.org/en/climatechange/reports.shtml Accessed October 2019

United Nations Development Program. Sustainable Development Goals. Website: https://www.undp.org/content/undp/en/home/sustainable-development-goals.html, Published 2015. Accessed October 2019

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