Global syndemic = två-flera pandemier, samtidiga, interagerar. Malnutrition dvs. fetma, undernäring, bristfällig kost.

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2 Global syndemic = två-flera pandemier, samtidiga, interagerar Malnutrition dvs. fetma, undernäring, bristfällig kost Klimatpåverkan, CO2 Lancets fetma kommission sedan 2016

3 Fetma, ett globalt problem 2 miljarder har övervikt, varav 1/3 har fetma Mellan en ökning på 36 % Fetma >svält Sjukdomar och för tidig död, 5 miljoner /år Individuellt lidande: DALY 148 miljoner/år Medför stora kostnader för samhället

4 Fetma speglar samhället: Fetmaframkallande miljö, Urbanisering Food deserts Socioekonomi, inkomstskillnader

5 Gemensamma drivkrafter till the global syndemic Kosten, big food : Jordbruket, storskaligt, industriellt bruk ensidiga grödor, hög vattenåtgång, mkt konstgödning Mark-användning, avskogning Mat-industrin: bearbetar kosten processed food Global marknad Fysisk aktivitet /inaktivitet: Urbana miljöer Transporter

6 Chicago s Union Stockyards, a facility that handled the slaughter, processing, packaging and distribution of cattle and swine. In operatation by 1865, it was amoung the earlierst U.S. examples of industrial Photo credit: Johan Vachon, Public Domain.

Broiler Chicken Supply Chain Soy growing Soy harvesting Chick hatchery producing Corn growing

represents the prevailing industrial model of poultry production in the U.S.

Environmental performance in the US broiler poultry sector: Life cycle energy use and

7 Broiler Chicken Supply Chain Soy growing Soy harvesting Chick hatchery producing Corn growing Corn harvesting Poultry feed processing Fish harvesting Poultry producing This example represents the prevailing industrial model of poultry production in the U.S. Distribution steps not shown. Adapted from Pelletier N. Environmental performance in the US broiler poultry sector: Life cycle energy use and greenhouse gas, ozone depleting, acidifying and eutrophying emissions. Agricultural Systems, 2008; 98, Photo credit: Farm Sanctuary.

8 Broiler Chicken Supply Chain (continued) Processing Retailing Preparing Consuming In this example, the chicken is minimally processed. Foods such as chicken nuggets would require additional processing steps. Distribution steps not shown. Adapted from Pelletier N. Environmental performance in the US broiler poultry sector: Life cycle energy use and greenhouse gas, ozone depleting, acidifying and eutrophying emissions. Agricultural Systems, 2008; 98, Photo credit: Farm Sanctuary.

9 Vad göra? Se det gemensamma i the global syndemic Ex: bilåkning utsläpp + inaktivitet negativa hälsoeffekter Omställning minskade utsläpp aktivitet ökar- positiv hälsoeffekt eller rött kött utsläpp kost-med negativ hälsoeffekt (T2D, Ca ) Omställning växtbaserad kost mindre utsläpp- positiv hälsoeffekt Undvik stuprörstänkande, samarbeta brett med alla aktörer Ex: läkare delta i brett upplagt folkhälsoarbete Befrämja starkt ledarskap på alla nivåer Ex: driva på att beslutade åtaganden genomförs, tex. FN konventioner; eller ge underlag för policys för att främja en hälsosam miljö, Minska de stora företagens inflytande på nationella /lokala riktlinjer o regler Ex: WHO koder för marknadsföring av bröstmjölksersättning Ex: lobby-ing i EU /USA

10 Övriga rekommendationer: Kost: o o o växtbaserad föda (EAT Lancet), reducera rött kött Implementera nationella kost-rekommendationer Sockerskatt, - /läsk Subventioner: Omdirigera regeringars kraftiga subventioner till fossila bränsle och mat-industrier (5000 miljarder dollar / år) till hållbar utveckling FN o o FNs mål för rätt till hälsa och mänskliga rättigheter Starta en FN-ledd framework convention on food system (jfr tobaksprevention) Forskning, mäta effekter och utkräva ansvar

13 TACK

18 Footprint red meat

19 Egger, 2010

21 Framing the issue 2019: the year for nutrition The Lancet called 2019: the year for nutrition Two commissions were formed in 2019 The Lancet Volume 393, Issue 10168, (January 2019) DOI: /S (19) Focused on what to eat for sustainability and health (January 2019) 2. Focused on the syndemic: overnutrition, undernutrition and climate (February 2019) The Lancet Volume 393, Issue 10168, (January 2019) DOI: /S (19)

25 Nordiska näringsrekommendationer:

29 What about the main conclusions in EAT and the Global syndemic reports in the Lancet? Do we support their main messages?: That the food we eat has a great impact on human health and the ongoing climate change. The common drivers behind these are important to identify That there has been transition since 1980th from a mainly local to a mainly global food production, marketing and consumption, beneficial to some extent, but also causing bad health and negative effects on the climate. It is necessary to change to a mainly plant based diet and reduce red meat in order to obtain better population health and less CO2 emission. More recourses' for Nutritional research in this context is needed Strong political national and international leadership is required to implement these changes. In support of this, academic groups play an important role, also individual participation is important (p 37 GS), e.g. by diet-change, use of consumer power and inducing political pressure..

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