Pub Date : 2024-06-01DOI: 10.1016/S2542-5196(24)00064-0
Noor M Wadi RD MSc , Kenza Cheikh RD BSc , Yan Wah Keung MSc , Rosemary Green PhD
Global food systems contribute 30% of global greenhouse gas emissions, threatening the global temperature targets of the Paris Agreement. Diets in high-income countries exceed the recommendations for animal-based foods, whereas consumption of fruits and vegetables is below recommendations. Shifting to a more plant-based diet can reduce up to 30% of greenhouse gas emissions from diet and also reduce risk of chronic disease. Interventions addressing sustainable dietary behaviour, defined by a shift in dietary patterns and food-waste practices, could therefore improve population and planetary health, but knowledge of the interventions that are likely to be most effective in changing sustainable dietary behaviour is so far limited. This systematic review aimed to investigate, classify, and assess the effectiveness of interventions that promote environmentally sustainable diets in high-income countries. We searched MEDLINE, Embase, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature for randomised controlled trials and quasi-experimental trials published from inception until June 16, 2022, evaluating the effectiveness of any intervention promoting environmentally sustainable dietary behaviour. Studies were eligible for inclusion if they included adults and children from high-income countries (as defined by the World Bank classification) and used individual-level behaviour change interventions. Online choice experiments and studies reporting results on only change in fruit and vegetable consumption were excluded. Interventions were classified using the nine intervention functions of the behaviour change wheel. Data were extracted on number of participants, intervention characteristics, diet change (eg, meat consumption and fruit and vegetable intake), food waste, greenhouse gas emissions, and health outcomes. 13 studies were identified and included in the systematic review. Articles were from six different countries (ie, Canada, the USA, Germany, the UK, the Netherlands, Italy). Six of the nine intervention functions of the behaviour change wheel were used. Interventions using education had the most robust evidence base, whereas interventions using persuasion had the strongest effect on reducing meat consumption. Overall, interventions using education in combination with other factors were most successful. Five studies had high risk of bias, five had some concerns of bias, and three had low risk of bias. This systematic review provides insight into the effectiveness of behavioural interventions to meet health and climate change goals through promotion of environmentally sustainable diets. Evidence supports the use of multicomponent interventions through education, persuasion, and environmental restructuring to provide opportunity for change. Little high-quality research was available, and more robustly designed intervention studies are needed to inform future guidelines and policies.
全球食品系统排放的温室气体占全球总量的 30%,威胁着《巴黎协定》的全球气温目标。高收入国家的膳食中动物性食物的摄入量超过了推荐值,而水果和蔬菜的摄入量则低于推荐值。转向以植物为基础的膳食可减少高达 30% 的膳食温室气体排放,还能降低慢性病风险。因此,针对可持续饮食行为(即饮食模式和食物浪费行为的转变)的干预措施可以改善人口和地球健康,但迄今为止,人们对可能最有效地改变可持续饮食行为的干预措施的了解还很有限。本系统综述旨在调查、分类和评估在高收入国家促进环境可持续饮食的干预措施的有效性。我们检索了 MEDLINE、Embase、PsycINFO 和 Cumulative Index to Nursing and Allied Health Literature,以查找从开始到 2022 年 6 月 16 日发表的、评估任何促进环境可持续饮食行为的干预措施有效性的随机对照试验和准实验试验。如果研究对象包括高收入国家(根据世界银行的分类定义)的成人和儿童,并使用了个人层面的行为改变干预措施,则符合纳入条件。在线选择实验和仅报告水果和蔬菜消费变化结果的研究除外。采用行为改变轮的九种干预功能对干预措施进行分类。提取的数据包括参与人数、干预特点、饮食变化(如肉类消耗量和水果蔬菜摄入量)、食物浪费、温室气体排放和健康结果。确定了 13 项研究,并将其纳入系统综述。文章来自六个不同的国家(即加拿大、美国、德国、英国、荷兰和意大利)。使用了行为改变轮的九种干预功能中的六种。使用教育进行干预的证据基础最为坚实,而使用说服进行干预对减少肉类消费的效果最强。总体而言,将教育与其他因素结合使用的干预措施最为成功。五项研究存在高偏倚风险,五项研究存在一些偏倚问题,三项研究存在低偏倚风险。本系统综述深入探讨了通过推广环境可持续饮食来实现健康和气候变化目标的行为干预措施的有效性。有证据支持通过教育、劝说和环境重组等方式采取多成分干预措施,以提供改变的机会。目前几乎没有高质量的研究,需要进行更多设计稳健的干预研究,为未来的指导方针和政策提供信息。
{"title":"Investigating intervention components and their effectiveness in promoting environmentally sustainable diets: a systematic review","authors":"Noor M Wadi RD MSc , Kenza Cheikh RD BSc , Yan Wah Keung MSc , Rosemary Green PhD","doi":"10.1016/S2542-5196(24)00064-0","DOIUrl":"https://doi.org/10.1016/S2542-5196(24)00064-0","url":null,"abstract":"<div><p>Global food systems contribute 30% of global greenhouse gas emissions, threatening the global temperature targets of the Paris Agreement. Diets in high-income countries exceed the recommendations for animal-based foods, whereas consumption of fruits and vegetables is below recommendations. Shifting to a more plant-based diet can reduce up to 30% of greenhouse gas emissions from diet and also reduce risk of chronic disease. Interventions addressing sustainable dietary behaviour, defined by a shift in dietary patterns and food-waste practices, could therefore improve population and planetary health, but knowledge of the interventions that are likely to be most effective in changing sustainable dietary behaviour is so far limited. This systematic review aimed to investigate, classify, and assess the effectiveness of interventions that promote environmentally sustainable diets in high-income countries. We searched MEDLINE, Embase, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature for randomised controlled trials and quasi-experimental trials published from inception until June 16, 2022, evaluating the effectiveness of any intervention promoting environmentally sustainable dietary behaviour. Studies were eligible for inclusion if they included adults and children from high-income countries (as defined by the World Bank classification) and used individual-level behaviour change interventions. Online choice experiments and studies reporting results on only change in fruit and vegetable consumption were excluded. Interventions were classified using the nine intervention functions of the behaviour change wheel. Data were extracted on number of participants, intervention characteristics, diet change (eg, meat consumption and fruit and vegetable intake), food waste, greenhouse gas emissions, and health outcomes. 13 studies were identified and included in the systematic review. Articles were from six different countries (ie, Canada, the USA, Germany, the UK, the Netherlands, Italy). Six of the nine intervention functions of the behaviour change wheel were used. Interventions using education had the most robust evidence base, whereas interventions using persuasion had the strongest effect on reducing meat consumption. Overall, interventions using education in combination with other factors were most successful. Five studies had high risk of bias, five had some concerns of bias, and three had low risk of bias. This systematic review provides insight into the effectiveness of behavioural interventions to meet health and climate change goals through promotion of environmentally sustainable diets. Evidence supports the use of multicomponent interventions through education, persuasion, and environmental restructuring to provide opportunity for change. Little high-quality research was available, and more robustly designed intervention studies are needed to inform future guidelines and policies.</p></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 6","pages":"Pages e410-e422"},"PeriodicalIF":25.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2542519624000640/pdfft?md5=3fc8f4ed97bb4692e43cd636cacf5d13&pid=1-s2.0-S2542519624000640-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/S2542-5196(24)00094-9
Anna Stubbendorff BSc , Dalia Stern PhD , Ulrika Ericson PhD , Emily Sonestedt PhD , Elinor Hallström PhD , Yan Borné PhD , Prof Martin Lajous ScD , Prof Nita G Forouhi FFPH , Prof Anja Olsen PhD , Christina C Dahm PhD , Daniel B Ibsen PhD
Different approaches have been used for translation of the EAT–Lancet reference diet into dietary scores that can be used to assess health and environmental impact. Our aim was to compare the different EAT–Lancet diet scores, and to estimate their associations with all-cause mortality, stroke incidence, and greenhouse gas emissions. We did a systematic review (PROSPERO, CRD42021286597) to identify different scores representing adherence to the EAT–Lancet reference diet. We then qualitatively compared the diet adherence scores, including their ability to group individuals according the EAT–Lancet reference diet recommendations, and quantitatively assessed the associations of the diet scores with health and environmental outcome data in three diverse cohorts: the Danish Diet, Cancer and Health Cohort (DCH; n=52 452), the Swedish Malmö Diet and Cancer Cohort (MDC; n=20 973), and the Mexican Teachers’ Cohort (MTC; n=30 151). The DCH and MTC used food frequency questionnaires and the MDC used a modified diet history method to assess dietary intake, which we used to compute EAT–Lancet diet scores and evaluate the associations of scores with hazard of all-cause mortality and stroke. In the MDC, dietary greenhouse gas emission values were summarised for every participant, which we used to predict greenhouse gas emissions associated with varying diet adherence scores on each scoring system. In our review, seven diet scores were identified (Knuppel et al, 2019; Trijsburg et al, 2020; Cacau et al, 2021; Hanley-Cook et al, 2021; Kesse-Guyot et al, 2021; Stubbendorff et al, 2022; and Colizzi et al, 2023). Two of the seven scores (Stubbendorff and Colizzi) were among the most consistent in grouping participants according to the EAT–Lancet reference diet recommendations across cohorts, and higher scores (greater diet adherence) were associated with decreased risk of mortality (in the DCH and MDC), decreased risk of incident stroke (in the DCH and MDC for the Stubbendorff score; and in the DCH for the Colizzi score), and decreased predicted greenhouse gas emissions in the MDC. We conclude that the seven different scores representing the EAT–Lancet reference diet had differences in construction, interpretation, and relation to disease and climate-related outcomes. Two scores generally performed well in our evaluation. Future studies should carefully consider which diet score to use and preferably use multiple scores to assess the robustness of estimations, given that public health and environmental policy rely on these estimates.
{"title":"A systematic evaluation of seven different scores representing the EAT–Lancet reference diet and mortality, stroke, and greenhouse gas emissions in three cohorts","authors":"Anna Stubbendorff BSc , Dalia Stern PhD , Ulrika Ericson PhD , Emily Sonestedt PhD , Elinor Hallström PhD , Yan Borné PhD , Prof Martin Lajous ScD , Prof Nita G Forouhi FFPH , Prof Anja Olsen PhD , Christina C Dahm PhD , Daniel B Ibsen PhD","doi":"10.1016/S2542-5196(24)00094-9","DOIUrl":"https://doi.org/10.1016/S2542-5196(24)00094-9","url":null,"abstract":"<div><p>Different approaches have been used for translation of the EAT–<em>Lancet</em> reference diet into dietary scores that can be used to assess health and environmental impact. Our aim was to compare the different EAT–<em>Lancet</em> diet scores, and to estimate their associations with all-cause mortality, stroke incidence, and greenhouse gas emissions. We did a systematic review (PROSPERO, CRD42021286597) to identify different scores representing adherence to the EAT–<em>Lancet</em> reference diet. We then qualitatively compared the diet adherence scores, including their ability to group individuals according the EAT–<em>Lancet</em> reference diet recommendations, and quantitatively assessed the associations of the diet scores with health and environmental outcome data in three diverse cohorts: the Danish Diet, Cancer and Health Cohort (DCH; n=52 452), the Swedish Malmö Diet and Cancer Cohort (MDC; n=20 973), and the Mexican Teachers’ Cohort (MTC; n=30 151). The DCH and MTC used food frequency questionnaires and the MDC used a modified diet history method to assess dietary intake, which we used to compute EAT–<em>Lancet</em> diet scores and evaluate the associations of scores with hazard of all-cause mortality and stroke. In the MDC, dietary greenhouse gas emission values were summarised for every participant, which we used to predict greenhouse gas emissions associated with varying diet adherence scores on each scoring system. In our review, seven diet scores were identified (Knuppel et al, 2019; Trijsburg et al, 2020; Cacau et al, 2021; Hanley-Cook et al, 2021; Kesse-Guyot et al, 2021; Stubbendorff et al, 2022; and Colizzi et al, 2023). Two of the seven scores (Stubbendorff and Colizzi) were among the most consistent in grouping participants according to the EAT–<em>Lancet</em> reference diet recommendations across cohorts, and higher scores (greater diet adherence) were associated with decreased risk of mortality (in the DCH and MDC), decreased risk of incident stroke (in the DCH and MDC for the Stubbendorff score; and in the DCH for the Colizzi score), and decreased predicted greenhouse gas emissions in the MDC. We conclude that the seven different scores representing the EAT–<em>Lancet</em> reference diet had differences in construction, interpretation, and relation to disease and climate-related outcomes. Two scores generally performed well in our evaluation. Future studies should carefully consider which diet score to use and preferably use multiple scores to assess the robustness of estimations, given that public health and environmental policy rely on these estimates.</p></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 6","pages":"Pages e391-e401"},"PeriodicalIF":25.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2542519624000949/pdfft?md5=e52a225bcd9eedcb2a2333845d79a064&pid=1-s2.0-S2542519624000949-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div><h3>Background</h3><p>Faced with climate change, hospitals are confronted with a dual challenge. On one hand, they need to embark on a far-reaching ecological transformation to reduce their contribution to greenhouse gas emissions and other environmental impacts; on the other hand, they need to limit the effects of climate change on their activities. We aimed to evaluate the knowledge, behaviours, practices, and expectations of health workers in French hospitals regarding climate change and environmental sustainability.</p></div><div><h3>Methods</h3><p>This multicentre, cross-sectional study was carried out in six French hospitals from June 1, 2021 to Dec 31, 2022. All health workers at the hospitals were eligible to participate and were recruited through internal publicity. We designed a structured questionnaire consisting of five parts: participant characteristics, knowledge and perceptions of climate change, pro-environmental behaviours, practices concerning environmental sustainability actions, and expectations. A multilevel logistic regression model was used to evaluate associations between the knowledge, behaviours, and practices of health workers and the characteristics of the health workers and hospitals.</p></div><div><h3>Findings</h3><p>Of 57 034 health workers across the six hospitals, 4552 (8·0%) participated in the study. Of those for whom gender data were available, 3518 (78·2%) participants were women and 979 (21·8%) were men. Participants considered energy consumption (71·0%) and waste and discharges related to medical activities (55·6%) and non-medical activities (50·2%) to be the three activities with the greatest environmental impact. On a scale of 1 (not a priority) to 10 (high priority), the median rating attributed by the participants to the commitment of their hospitals to ecological transformation was 5·0 (IQR 3·0–6·0). 1079 (23·7%) of 4552 participants had already initiated at least one environmental sustainability action in their hospital. Barriers reported by participants to the implementation of environmental sustainability-related projects were the lack of dedicated time (40·4%), hierarchical support (32·5%), methodological support (28·9%), and access to training (23·7%). The presence of a sustainable development steering committee, especially one with more than 5 years of activity, was positively associated with health workers feeling better informed about the ecological transformation of their hospital (adjusted odds ratio 1·78 [95% CI 1·29–2·45]), having better knowledge of the environmental impacts of their hospital (1·83 [1·32–2·53]), and initiating a larger number of environmental sustainability actions (1·74 [1·33–2·29]).</p></div><div><h3>Interpretation</h3><p>We showed that health workers in French hospitals seem to be committed to the ecological transformation of their workplaces, and identified some drivers and barriers to further support these essential transformations. There is an urgent need to bols
{"title":"Knowledge, behaviours, practices, and expectations regarding climate change and environmental sustainability among health workers in France: a multicentre, cross-sectional study","authors":"Jérémy Guihenneuc PhD , Guillaume Cambien PhD , Pauline Blanc-Petitjean PhD , Emeline Papin , Noëlle Bernard MD , Bernard Jourdain , Isabelle Barcos , Cécile Saez , Prof Antoine Dupuis PhD , Sarah Ayraud-Thevenot PhD , Prof Virginie Migeot PhD","doi":"10.1016/S2542-5196(24)00099-8","DOIUrl":"https://doi.org/10.1016/S2542-5196(24)00099-8","url":null,"abstract":"<div><h3>Background</h3><p>Faced with climate change, hospitals are confronted with a dual challenge. On one hand, they need to embark on a far-reaching ecological transformation to reduce their contribution to greenhouse gas emissions and other environmental impacts; on the other hand, they need to limit the effects of climate change on their activities. We aimed to evaluate the knowledge, behaviours, practices, and expectations of health workers in French hospitals regarding climate change and environmental sustainability.</p></div><div><h3>Methods</h3><p>This multicentre, cross-sectional study was carried out in six French hospitals from June 1, 2021 to Dec 31, 2022. All health workers at the hospitals were eligible to participate and were recruited through internal publicity. We designed a structured questionnaire consisting of five parts: participant characteristics, knowledge and perceptions of climate change, pro-environmental behaviours, practices concerning environmental sustainability actions, and expectations. A multilevel logistic regression model was used to evaluate associations between the knowledge, behaviours, and practices of health workers and the characteristics of the health workers and hospitals.</p></div><div><h3>Findings</h3><p>Of 57 034 health workers across the six hospitals, 4552 (8·0%) participated in the study. Of those for whom gender data were available, 3518 (78·2%) participants were women and 979 (21·8%) were men. Participants considered energy consumption (71·0%) and waste and discharges related to medical activities (55·6%) and non-medical activities (50·2%) to be the three activities with the greatest environmental impact. On a scale of 1 (not a priority) to 10 (high priority), the median rating attributed by the participants to the commitment of their hospitals to ecological transformation was 5·0 (IQR 3·0–6·0). 1079 (23·7%) of 4552 participants had already initiated at least one environmental sustainability action in their hospital. Barriers reported by participants to the implementation of environmental sustainability-related projects were the lack of dedicated time (40·4%), hierarchical support (32·5%), methodological support (28·9%), and access to training (23·7%). The presence of a sustainable development steering committee, especially one with more than 5 years of activity, was positively associated with health workers feeling better informed about the ecological transformation of their hospital (adjusted odds ratio 1·78 [95% CI 1·29–2·45]), having better knowledge of the environmental impacts of their hospital (1·83 [1·32–2·53]), and initiating a larger number of environmental sustainability actions (1·74 [1·33–2·29]).</p></div><div><h3>Interpretation</h3><p>We showed that health workers in French hospitals seem to be committed to the ecological transformation of their workplaces, and identified some drivers and barriers to further support these essential transformations. There is an urgent need to bols","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 6","pages":"Pages e353-e364"},"PeriodicalIF":25.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2542519624000998/pdfft?md5=5f7ed40814bd02b858b9123f637015a2&pid=1-s2.0-S2542519624000998-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/S2542-5196(24)00048-2
Myles Sergeant MD , Olivia Ly MD , Sujane Kandasamy PhD , Prof Sonia S Anand MD PhD , Russell J de Souza SD
Health care contributes 4·4% of global net carbon emissions. Hospitals are resource-intensive settings, using a large amount of supplies in patient care and have high energy, ventilation, and heating needs. This Viewpoint investigates emissions related to health care in a patient's last year of life. End of life (EOL) is a period when health-care use and associated emissions production increases exponentially due primarily to hospital admissions, which are often at odds with patients’ values and preferences. Potential solutions detailed within this Viewpoint are facilitating advanced care plans with patients to ensure their EOL wishes are clear, beginning palliative care interventions earlier when treating a life-limiting illness, deprescribing unnecessary medications because medications and their supply chains make up a significant portion of health-care emissions, and, enhancing access to low-intensity community care settings (eg, hospices) within the last year of life if home care is not available. Our analysis was done using Canadian data, but the findings can be applied to other high-income countries.
{"title":"Managing greenhouse gas emissions in the terminal year of life in an overwhelmed health system: a paradigm shift for people and our planet","authors":"Myles Sergeant MD , Olivia Ly MD , Sujane Kandasamy PhD , Prof Sonia S Anand MD PhD , Russell J de Souza SD","doi":"10.1016/S2542-5196(24)00048-2","DOIUrl":"https://doi.org/10.1016/S2542-5196(24)00048-2","url":null,"abstract":"<div><p>Health care contributes 4·4% of global net carbon emissions. Hospitals are resource-intensive settings, using a large amount of supplies in patient care and have high energy, ventilation, and heating needs. This Viewpoint investigates emissions related to health care in a patient's last year of life. End of life (EOL) is a period when health-care use and associated emissions production increases exponentially due primarily to hospital admissions, which are often at odds with patients’ values and preferences. Potential solutions detailed within this Viewpoint are facilitating advanced care plans with patients to ensure their EOL wishes are clear, beginning palliative care interventions earlier when treating a life-limiting illness, deprescribing unnecessary medications because medications and their supply chains make up a significant portion of health-care emissions, and, enhancing access to low-intensity community care settings (eg, hospices) within the last year of life if home care is not available. Our analysis was done using Canadian data, but the findings can be applied to other high-income countries.</p></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 5","pages":"Pages e327-e333"},"PeriodicalIF":25.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2542519624000482/pdfft?md5=6f8cf9c628b4976dbaab23dd187646bf&pid=1-s2.0-S2542519624000482-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140894114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/S2542-5196(24)00047-0
William Gilbert PhD , Prof Thomas L Marsh PhD , Gemma Chaters PhD , Wudu T Jemberu PhD , Mieghan Bruce PhD , Wilma Steeneveld PhD , Joao S Afonso PhD , Benjamin Huntington BVetMed3 , Prof Jonathan Rushton PhD
Background
Increasing awareness of the environmental and public health impacts of expanding and intensifying animal-based food and farming systems creates discord, with the reliance of much of the world's population on animals for livelihoods and essential nutrition. Increasing the efficiency of food production through improved animal health has been identified as a step towards minimising these negative effects without compromising global food security. The Global Burden of Animal Diseases (GBADs) programme aims to provide data and analytical methods to support positive change in animal health across all livestock and aquaculture animal populations.
Methods
In this study, we present a metric that begins the process of disease burden estimation by converting the physical consequences of disease on animal performance to farm-level costs of disease, and calculates a metric termed the Animal Health Loss Envelope (AHLE) via comparison between the status quo and a disease-free ideal. An example calculation of the AHLE metric for meat production from broiler chickens is provided.
Findings
The AHLE presents the direct financial costs of disease at farm-level for all causes by estimating losses and expenditure in a given farming system. The general specification of the model measures productivity change at farm-level and provides an upper bound on productivity change in the absence of disease. On its own, it gives an indication of the scale of total disease cost at farm-level.
Interpretation
The AHLE is an essential stepping stone within the GBADs programme because it connects the physical performance of animals in farming systems under different environmental and management conditions and different health states to farm economics. Moving forward, AHLE results will be an important step in calculating the wider monetary consequences of changes in animal health as part of the GBADs programme.
Funding
Bill & Melinda Gates Foundation, the UK Foreign, Commonwealth and Development Office, EU Horizon 2020 Research and Innovation Programme.
{"title":"Quantifying cost of disease in livestock: a new metric for the Global Burden of Animal Diseases","authors":"William Gilbert PhD , Prof Thomas L Marsh PhD , Gemma Chaters PhD , Wudu T Jemberu PhD , Mieghan Bruce PhD , Wilma Steeneveld PhD , Joao S Afonso PhD , Benjamin Huntington BVetMed3 , Prof Jonathan Rushton PhD","doi":"10.1016/S2542-5196(24)00047-0","DOIUrl":"https://doi.org/10.1016/S2542-5196(24)00047-0","url":null,"abstract":"<div><h3>Background</h3><p>Increasing awareness of the environmental and public health impacts of expanding and intensifying animal-based food and farming systems creates discord, with the reliance of much of the world's population on animals for livelihoods and essential nutrition. Increasing the efficiency of food production through improved animal health has been identified as a step towards minimising these negative effects without compromising global food security. The Global Burden of Animal Diseases (GBADs) programme aims to provide data and analytical methods to support positive change in animal health across all livestock and aquaculture animal populations.</p></div><div><h3>Methods</h3><p>In this study, we present a metric that begins the process of disease burden estimation by converting the physical consequences of disease on animal performance to farm-level costs of disease, and calculates a metric termed the Animal Health Loss Envelope (AHLE) via comparison between the status quo and a disease-free ideal. An example calculation of the AHLE metric for meat production from broiler chickens is provided.</p></div><div><h3>Findings</h3><p>The AHLE presents the direct financial costs of disease at farm-level for all causes by estimating losses and expenditure in a given farming system. The general specification of the model measures productivity change at farm-level and provides an upper bound on productivity change in the absence of disease. On its own, it gives an indication of the scale of total disease cost at farm-level.</p></div><div><h3>Interpretation</h3><p>The AHLE is an essential stepping stone within the GBADs programme because it connects the physical performance of animals in farming systems under different environmental and management conditions and different health states to farm economics. Moving forward, AHLE results will be an important step in calculating the wider monetary consequences of changes in animal health as part of the GBADs programme.</p></div><div><h3>Funding</h3><p>Bill & Melinda Gates Foundation, the UK Foreign, Commonwealth and Development Office, EU Horizon 2020 Research and Innovation Programme.</p></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 5","pages":"Pages e309-e317"},"PeriodicalIF":25.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2542519624000470/pdfft?md5=04cd7a402da83bc8651ebb8d215de713&pid=1-s2.0-S2542519624000470-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140894118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div><h3>Background</h3><p>Pregnancy air pollution exposure (PAPE) has been linked to a wide range of adverse birth and childhood outcomes, but there is a paucity of data on its influence on the placental epigenome, which can regulate the programming of physiological functions and affect child development. This study aimed to investigate the association between prenatal air pollutant exposure concentrations and changes in placental DNA methylation patterns, and to explore the potential windows of susceptibility and sex-specific alterations.</p></div><div><h3>Methods</h3><p>This multi-site study used three prospective population-based mother–child cohorts: EDEN, PELAGIE, and SEPAGES, originating from four French geographical regions (Nancy, Poitiers, Brittany, and Grenoble). Pregnant women were included between 2003 and 2006 for EDEN and PELAGIE, and between 2014 and 2017 for SEPAGES. The main eligibility criteria were: being older than 18 years, having a singleton pregnancy, and living and planning to deliver in one of the maternity clinics in one of the study areas. A total of 1539 mother–child pairs were analysed, measuring placental DNA methylation using Illumina BeadChips. We used validated spatiotemporally resolved models to estimate PM<sub>2·5</sub>, PM<sub>10</sub>, and NO<sub>2</sub> exposure over each trimester of pregnancy at the maternal residential address. We conducted a pooled adjusted epigenome-wide association study to identify differentially methylated 5‘–C–phosphate–G–3‘ (CpG) sites and regions (assessed using the Infinium HumanMethylationEPIC BeadChip array, n=871), including sex-specific and sex-linked alterations, and independently validated our results (assessed using the Infinium HumanMethylation450 BeadChip array, n=668).</p></div><div><h3>Findings</h3><p>We identified four CpGs and 28 regions associated with PAPE in the total population, 469 CpGs and 87 regions in male infants, and 150 CpGs and 66 regions in female infants. We validated 35% of the CpGs available. More than 30% of the identified CpGs were related to one (or more) birth outcome and most significant alterations were enriched for neural development, immunity, and metabolism related genes. The 28 regions identified for both sexes overlapped with imprinted genes (four genes), and were associated with neurodevelopment (nine genes), immune system (seven genes), and metabolism (five genes). Most associations were observed for the third trimester for female infants (134 of 150 CpGs), and throughout pregnancy (281 of 469 CpGs) and the first trimester (237 of 469 CpGs) for male infants.</p></div><div><h3>Interpretation</h3><p>These findings highlight the molecular pathways through which PAPE might affect child health in a widespread and sex-specific manner, identifying the genes involved in the major physiological functions of a developing child. Further studies are needed to elucidate whether these epigenetic changes persist and affect health later in life.</p></div
{"title":"Placental DNA methylation signatures of prenatal air pollution exposure and potential effects on birth outcomes: an analysis of three prospective cohorts","authors":"Lucile Broséus PhD , Ariane Guilbert MsC , Ian Hough PhD , Itai Kloog PhD , Anath Chauvaud MSc , Emie Seyve MSc , Daniel Vaiman PhD , Barbara Heude PhD , Cécile Chevrier PhD , Jörg Tost PhD , Rémy Slama PhD , Johanna Lepeule PhD","doi":"10.1016/S2542-5196(24)00045-7","DOIUrl":"https://doi.org/10.1016/S2542-5196(24)00045-7","url":null,"abstract":"<div><h3>Background</h3><p>Pregnancy air pollution exposure (PAPE) has been linked to a wide range of adverse birth and childhood outcomes, but there is a paucity of data on its influence on the placental epigenome, which can regulate the programming of physiological functions and affect child development. This study aimed to investigate the association between prenatal air pollutant exposure concentrations and changes in placental DNA methylation patterns, and to explore the potential windows of susceptibility and sex-specific alterations.</p></div><div><h3>Methods</h3><p>This multi-site study used three prospective population-based mother–child cohorts: EDEN, PELAGIE, and SEPAGES, originating from four French geographical regions (Nancy, Poitiers, Brittany, and Grenoble). Pregnant women were included between 2003 and 2006 for EDEN and PELAGIE, and between 2014 and 2017 for SEPAGES. The main eligibility criteria were: being older than 18 years, having a singleton pregnancy, and living and planning to deliver in one of the maternity clinics in one of the study areas. A total of 1539 mother–child pairs were analysed, measuring placental DNA methylation using Illumina BeadChips. We used validated spatiotemporally resolved models to estimate PM<sub>2·5</sub>, PM<sub>10</sub>, and NO<sub>2</sub> exposure over each trimester of pregnancy at the maternal residential address. We conducted a pooled adjusted epigenome-wide association study to identify differentially methylated 5‘–C–phosphate–G–3‘ (CpG) sites and regions (assessed using the Infinium HumanMethylationEPIC BeadChip array, n=871), including sex-specific and sex-linked alterations, and independently validated our results (assessed using the Infinium HumanMethylation450 BeadChip array, n=668).</p></div><div><h3>Findings</h3><p>We identified four CpGs and 28 regions associated with PAPE in the total population, 469 CpGs and 87 regions in male infants, and 150 CpGs and 66 regions in female infants. We validated 35% of the CpGs available. More than 30% of the identified CpGs were related to one (or more) birth outcome and most significant alterations were enriched for neural development, immunity, and metabolism related genes. The 28 regions identified for both sexes overlapped with imprinted genes (four genes), and were associated with neurodevelopment (nine genes), immune system (seven genes), and metabolism (five genes). Most associations were observed for the third trimester for female infants (134 of 150 CpGs), and throughout pregnancy (281 of 469 CpGs) and the first trimester (237 of 469 CpGs) for male infants.</p></div><div><h3>Interpretation</h3><p>These findings highlight the molecular pathways through which PAPE might affect child health in a widespread and sex-specific manner, identifying the genes involved in the major physiological functions of a developing child. Further studies are needed to elucidate whether these epigenetic changes persist and affect health later in life.</p></div","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 5","pages":"Pages e297-e308"},"PeriodicalIF":25.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2542519624000457/pdfft?md5=cc5ae087e945591d992264eb795355ea&pid=1-s2.0-S2542519624000457-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140893442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/S2542-5196(24)00049-4
Luis Fernando Chaves PhD , Mariel D Friberg PhD , Prof Mercedes Pascual PhD , Prof Jose E Calzada DVM PhD , Prof Shirley Luckhart PhD , Luke R Bergmann PhD
The impacts of climate change on vector-borne diseases are uneven across human populations. This pattern reflects the effect of changing environments on the biology of transmission, which is also modulated by social and other inequities. These disparities are also linked to research outcomes that could be translated into tools for transmission reduction, but are not necessarily actionable in the communities where transmission occurs. The transmission of vector-borne diseases could be averted by developing research that is both hypothesis-driven and community-serving for populations affected by climate change, where local communities interact as equal partners with scientists, developing and implementing research projects with the aim of improving community health. In this Personal View, we share five principles that have guided our research practice to serve the needs of communities affected by vector-borne diseases.
{"title":"Community-serving research addressing climate change impacts on vector-borne diseases","authors":"Luis Fernando Chaves PhD , Mariel D Friberg PhD , Prof Mercedes Pascual PhD , Prof Jose E Calzada DVM PhD , Prof Shirley Luckhart PhD , Luke R Bergmann PhD","doi":"10.1016/S2542-5196(24)00049-4","DOIUrl":"https://doi.org/10.1016/S2542-5196(24)00049-4","url":null,"abstract":"<div><p>The impacts of climate change on vector-borne diseases are uneven across human populations. This pattern reflects the effect of changing environments on the biology of transmission, which is also modulated by social and other inequities. These disparities are also linked to research outcomes that could be translated into tools for transmission reduction, but are not necessarily actionable in the communities where transmission occurs. The transmission of vector-borne diseases could be averted by developing research that is both hypothesis-driven and community-serving for populations affected by climate change, where local communities interact as equal partners with scientists, developing and implementing research projects with the aim of improving community health. In this Personal View, we share five principles that have guided our research practice to serve the needs of communities affected by vector-borne diseases.</p></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 5","pages":"Pages e334-e341"},"PeriodicalIF":25.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2542519624000494/pdfft?md5=6532800c9a8c6752bf0a224bcb772ae7&pid=1-s2.0-S2542519624000494-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140894115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/S2542-5196(24)00023-8
Joel Methorst PhD
<div><h3>Background</h3><p>An increasing body of research has examined the link between biodiversity of birds and human mental health, but most studies only use cross-sectional data. Few studies have used longitudinal or repeated cross-sectional data to investigate the mental health benefits of bird diversity. The aim of this study is to analyse the relationship between bird diversity and mental health at the national level using a unique repeated cross-sectional dataset.</p></div><div><h3>Methods</h3><p>I used repeated cross-sectional health data from the German National Cohort health study, collected between March, 2014, and September, 2019, and annual bird citizen science data to investigate the effects of bird-diversity exposure on mental health. Mental health was measured using the summary score of the Patient Health Questionnaire depression module 9 (SumPHQ) and the Short Form Health Survey-12 Mental Health Component Scale. As a proxy for bird diversity, I created a unique indicator called reporting-rate richness and combined it with the health data. Reporting-rate richness measures the number of bird species within postcode areas across Germany in probabilities while accounting for variation in survey efforts. Alternative indicators of bird diversity, such as bird-species richness or abundance, were also calculated. Associations between bird diversity and mental health were estimated using linear regression with region and time fixed effects, adjusted for a range of sociodemographic and environmental confounders and spatial autocorrelation. Interaction terms between income levels and reporting-rate richness were also analysed to examine the moderating effect of socioeconomic status.</p></div><div><h3>Findings</h3><p>I did the analyses for an unbalanced (n=176 362) and balanced (n=125 423) dataset, with the balanced dataset comprising only regions (postcode areas) in which health data were available for each year. The linear fixed-effects regression analysis indicated a significant negative association between reporting-rate richness and SumPHQ, as observed in both the unbalanced dataset (β –0·02, p=0·017) and the balanced dataset (β –0·03, p=0·0037). Similarly, regression results with both datasets showed a positive relationship between reporting-rate richness and Mental Health Component Scale (MCS; unbalanced β 0·02, p=0·0086; balanced β 0·03, p=0·0018). The moderator analyses revealed a significant influence of socioeconomic status on the relationship between reporting-rate richness and mental health. The robustness of these findings was confirmed through sensitivity analyses.</p></div><div><h3>Interpretation</h3><p>The results suggest that a greater likelihood of having many different bird species in a person's area of residence might positively contribute to mental health, especially for people with lower socioeconomic status. These findings could have implications for biodiversity conservation and health policy decisions, as governmen
{"title":"Positive relationship between bird diversity and human mental health: an analysis of repeated cross-sectional data","authors":"Joel Methorst PhD","doi":"10.1016/S2542-5196(24)00023-8","DOIUrl":"https://doi.org/10.1016/S2542-5196(24)00023-8","url":null,"abstract":"<div><h3>Background</h3><p>An increasing body of research has examined the link between biodiversity of birds and human mental health, but most studies only use cross-sectional data. Few studies have used longitudinal or repeated cross-sectional data to investigate the mental health benefits of bird diversity. The aim of this study is to analyse the relationship between bird diversity and mental health at the national level using a unique repeated cross-sectional dataset.</p></div><div><h3>Methods</h3><p>I used repeated cross-sectional health data from the German National Cohort health study, collected between March, 2014, and September, 2019, and annual bird citizen science data to investigate the effects of bird-diversity exposure on mental health. Mental health was measured using the summary score of the Patient Health Questionnaire depression module 9 (SumPHQ) and the Short Form Health Survey-12 Mental Health Component Scale. As a proxy for bird diversity, I created a unique indicator called reporting-rate richness and combined it with the health data. Reporting-rate richness measures the number of bird species within postcode areas across Germany in probabilities while accounting for variation in survey efforts. Alternative indicators of bird diversity, such as bird-species richness or abundance, were also calculated. Associations between bird diversity and mental health were estimated using linear regression with region and time fixed effects, adjusted for a range of sociodemographic and environmental confounders and spatial autocorrelation. Interaction terms between income levels and reporting-rate richness were also analysed to examine the moderating effect of socioeconomic status.</p></div><div><h3>Findings</h3><p>I did the analyses for an unbalanced (n=176 362) and balanced (n=125 423) dataset, with the balanced dataset comprising only regions (postcode areas) in which health data were available for each year. The linear fixed-effects regression analysis indicated a significant negative association between reporting-rate richness and SumPHQ, as observed in both the unbalanced dataset (β –0·02, p=0·017) and the balanced dataset (β –0·03, p=0·0037). Similarly, regression results with both datasets showed a positive relationship between reporting-rate richness and Mental Health Component Scale (MCS; unbalanced β 0·02, p=0·0086; balanced β 0·03, p=0·0018). The moderator analyses revealed a significant influence of socioeconomic status on the relationship between reporting-rate richness and mental health. The robustness of these findings was confirmed through sensitivity analyses.</p></div><div><h3>Interpretation</h3><p>The results suggest that a greater likelihood of having many different bird species in a person's area of residence might positively contribute to mental health, especially for people with lower socioeconomic status. These findings could have implications for biodiversity conservation and health policy decisions, as governmen","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 5","pages":"Pages e285-e296"},"PeriodicalIF":25.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2542519624000238/pdfft?md5=35d294b17c4374a11d80a8fdc07d6df6&pid=1-s2.0-S2542519624000238-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140894117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}