This document discusses the connections between human health and planetary health, and calls for aligning agendas and efforts to address these interrelated issues. It notes that diet-related diseases are among the top global causes of death and disability, while food systems are responsible for a major portion of global emissions and environmental impacts. Achieving healthier, more sustainable diets could significantly benefit both human health and the climate by reducing emissions and environmental degradation from the food system. The document advocates exploring synergies between health, sustainability, and development goals to achieve food systems that support healthy people and a stable planet.

1. Comment
www.thelancet.com Published online July 16, 2015 http://dx.doi.org/10.1016/S0140-6736(15)61044-3 1
Human and planetary health: towards a common language
With less than 5 months until the Conference of the
Parties to the UN Framework Convention on Climate
Change is held in Paris, France, the world has a unique
but fast-closing window of opportunity. It is vital
that the global community recognises that human
and planetary health are two sides of the one climate
coin, and that together they present a critical road for
comitigation. But as we enter the second half of 2015—
a year that will bring a new global development agenda
with the Sustainable Development Goals, a World EXPO
on Feeding the Planet, Energy for Life, and a defining
juncture for climate action—it is the intersections of
sustainability and health and their effect on climate
mitigation that must be recognised, prioritised,
and leveraged. Reflecting the strong stewardship of
The Lancet and others, planetary health is increasingly
understood as a global health issue. Translating this
understanding into action is now key, as outlined
in the report of The Rockefeller Foundation–Lancet
Commission on Planetary Health.1
Finding a common
language for this translation is a crucial step.
When the 2013 Global Burden of Disease Study
ranked the top causes of global disability and deaths,
it was no surprise to many of us that diet-related,
non-communicable diseases (NCDs) topped the list.2
Simultaneously, as the world looks to curb and reduce
climate emissions and protect major freshwater,
land, and ocean resources, our food systems are now
responsible for an estimated 32% of global emissions—
more than from all land, sea, and air transport
combined.3
Agriculture is also the world’s single largest
consumer of freshwater, undermining the resilience
of land-based ecosystems, which function as critical
carbon sinks and habitats for biodiversity, and the
largest source of nitrogen and phosphorus loading,
causing eutrophication of freshwater and marine
systems and emissions of nitrous oxide, a greenhouse
gas.4
If we can get it right on food, we will have come a
long way to getting it right for people and the planet.
Moreover, timelines are tight because humanity has
now entered the Anthropocene. Science can say with
disturbing certainty that our modern world constitutes
a global force of change at the planetary scale; that
humanity can disrupt the Earth’s natural systems
and therefore the Earth’s life support processes.5–7
To
safeguard our planet, and enable a prosperous future
for humanity, we must keep global warming below
2°C, which means zero carbon emissions by 2050 or
soon thereafter.8
To achieve such dramatic change
will require a global transformation, so we must look
to new opportunities that reach across traditional
communities. Our food system is pivotal for us to
succeed and represents important shared ground. The
collective question we must now answer, for human
health, wealth, and for a safe climate future on a stable
and resilient planet, is how can we feed 9–10 billion
healthy people within planetary boundaries?
Healthier diets have the potential to reduce not only
rates of NCDs and undernutrition, but also our climate
emissions.2,3,9,10
For much of the planet, this would
involve reducing intakes of ultra-processed foods, red
meat, saturated fats from animals, and unsustainable
oils such as palm oil, and instead increasing
consumption of plant-based diets. Reducing red meat
consumption in many high-income countries alone,
for example, could reduce the carbon intensiveness
of diets, lead to a decrease in certain cancers and
heart disease, and have profound effects throughout
the food system—including water and land savings
through a reduction in ecosystem and climate
degrading monocultures of grain and other animal
feedstocks.9,10
From common risks to common opportunities, a
more united global agenda must align planetary and
YvaMomatiuk&JohnEastcott/MindenPictures/Corbis
Published Online
July 16, 2015
http://dx.doi.org/10.1016/
S0140-6736(15)61044-3
See Online/
The Lancet Commissions
http://dx.doi.org/10.1016/
S0140-6736(15)60901-1

2. Comment
2 www.thelancet.com Published online July 16, 2015 http://dx.doi.org/10.1016/S0140-6736(15)61044-3
human health targets, and their translation. We should
immediately explore the potential synergies between
the Global Action Plan for the Prevention and Control
of NCDs,11
the Sustainable Development Goals, and
efforts to close the nutrition divide manifested in the
triple burden of malnutrition; all within the Earth’s
critical and non-negotiable planetary boundaries.8
Comitigation policies need to build in health and
ecosystem externalities through appropriate and
progressive pricing mechanisms; protect freshwater
resources; tackle and reduce food waste; invest in
scalable plans and financing models for implementing
renewable energies, emphasising the potential
indirect health gains through lower rates of pollution-
related disease; and encourage regional investment in
urban active transport infrastructure which benefits
both the cardiovascular health of populations and
environmental health. These are just some of the
examples of win–win policies that must be fought for,
from all sides.
Achieving these goals will be crucial, but powerful
corporate and political interests exist that have the
potential to impede progress. With this in mind, we
must forge and grow new partnerships for action.
Linking health and environmental sustainability across
science, business, politics, and civil society, the EAT
Initiative strives to do just this. A multistakeholder
platform that uses food as a vector for change, EAT
identifies and exploits common solutions to these
global challenges and aims to realise a sustainable
food system for all.
We commend the report of The Rockefeller
Foundation–Lancet Commission1
and call on the global
community to focus on synergies between human and
planetary health. Communities, leaders, scientists,
and advocates from both sides must align thinking,
language, and points of action. Ours is a shared
agenda and the stakes could not be higher. These
risks to both human and planetary health are issues
we, as humanity, have created and therefore can and
must solve. The future health of our planet, and our
populations, depends on it.
*Alessandro R Demaio, Johan Rockström
Harvard Global Equity Initiative, Harvard Medical School,
Boston, MA 02115–6018, USA (ARD); School of Global Health,
Department of Public Health, University of Copenhagen,
Copenhagen, Denmark (ARD); and Stockholm Resilience Centre,
Stockholm University, Stockholm, Sweden (JR)
demaio@sund.ku.dk
We are both members of the EAT Advisory Board. We declare no competing
interests.
1 Whitmee S, Haines A, Beyrer C, et al. Safeguarding human health in the
Anthropocene epoch: report of The Rockefeller Foundation–Lancet
Commission on planetary health. Lancet 2015; published online July 16.
http://dx.doi.org/10.1016/S0140-6736(15)60901-1.
2 GBD 2013 Mortality and Causes of Death Collaborators. Global, regional,
and national age–sex specific all-cause and cause-specific mortality for
240 causes of death, 1990–2013: a systematic analysis for the Global
Burden of Disease Study 2013. Lancet 2015; 385: 117–71.
3 Bellarby J, Foereid B, Hastings A, Smith P. Cool farming: climate impacts
of agriculture and mitigation potential. Amsterdam: Greenpeace, 2008.
4 Rockström J, Karlberg L. The quadruple squeeze: defining the safe
operating space for freshwater use to achieve a triply green revolution in
the Anthropocene. Ambio 2010; 39: 257–65.
5 Folke C, Jansson Å, Rockström J, et al. Reconnecting to the biosphere.
Ambio 2011; 40: 719–38.
6 Field CB, Barros VR, Mastrandrea MD, et al. IPCC, 2014: summary for
policymakers. In: Climate change 2014: impacts, adaptation, and
vulnerability. Contribution of Working Group II to the Fifth Assessment
Report of the Intergovernmental Panel on Climate Change. Cambridge:
Cambridge University Press, 2014.
7 Field CB, Barros VR, Dokken DJ, et al. IPCC, 2014: Summary for
policymakers. In: Climate change 2014: impacts, adaptation, and
vulnerability. Part A: global and sectoral aspects. Contribution of Working
Group II to the Fifth Assessment Report of the Intergovernmental Panel
on Climate Change. Cambridge: Cambridge University Press, 2014: 1–32.
8 Steffen W, Richardson K, Rockström J, et al. Planetary boundaries: guiding
human development on a changing planet. Science 2015; 347: 1217.
9 Food and Agriculture Organization of the United Nations. Tackling
climate change through livestock. Rome: Food and Agriculture
Organization of the United Nations, 2010.
10 Pan A, Sun Q, Bernstein AM, et al. Red meat consumption and mortality:
results from 2 prospective cohort studies. Arch Intern Med 2012;
172: 555–63.
11 WHO. Global action plan for the prevention of noncommunicable
diseases 2013–2020. Geneva: World Health Organization, 2013.