A scientific presentation, inspired by personal experience and on behalf of Ora Taiao: New Zealand Climate and Health Council. Climate change, health and our diets cross section on many levels. This presentation is on how detrimental animal products and for our health but also the huge part they are playing in causing climate change. This gives us a powerful way to help ourselves and the wider world through increasing plant-based foods into our diet.
Doctors, nurses and other health professionals can be powerful social leaders, and for most of us acting on threats to public health is one of our responsibilities under our code of practice.
Stats from America but fairly relevant NZ imports 42% of worlds palm kernel More then whole EU and mostly from Indonesia and Malaysia (2015 figures, http://www.indexmundi.com/agriculture/?commodity=palm-kernel-meal&graph=imports )
Shifting diets from animal-based to plant-based at the global level is of paramount importance in achieving food security and sustainability goals. Decreasing consumption of meat and other animal products will free up large amounts of food that could be consumed directly by humans—for example, soy and grains. Foley et al (36) recently estimated the potential to increase the global food supply by shifting 16 major crops from the current mix of uses (eg, human consumption, livestock feed, and biofuels) to human food consumption only: they estimated a 28% increase in food availability, or the equivalent of a 49% increase in dietary energy for human consumption.
Sabaté, J. & Soret, S. (2014). Sustainability of plant-based diets: back to the future. Am J Clin Nutr. 100(1476S-482S). doi: 10.3945/ajcn.113.071522
Agricultural production, including indirect emissions associated with land-cover change, contributes 80%–86% of total food system emissions,
85% of the world’s fisheries are fully exploited, overexploited, depleted, or recovering. (United States Department of Agriculture, 2015)
50% of world’s population could face severe food shortages by 2100 from ↑ temperatures take their toll on farmers’ crops. (The Lancet, 2009. p1704)
Green Business | Wed Dec 23, 2015 8:12am ESTRelated: ENVIRONMENT up to 400,000 are suffering a severe lack of food due to crop failure In some places, people are forced to walk up to three hours to fetch water El Niño is predicted to peak in the first three months of 2016, and the situation could deteriorate substantially, it said.http://www.reuters.com/article/us-papua-elnino-aid-idUSKBN0U61C320151223
Several periods of rapid food and cereal price ↑ following climate extremes in key producing regions indicate a sensitivity of current markets to climate extremes among other factors (Field et al. 2014, pp. 4)
Italy has new food pyramid with less animal products due to health and environment. (Buchner et al. 2011) Health Council of The Netherlands - 2011 report based on an international workshop
1 calorie of animal protein = >10x fossil fuel input as a calorie of plant protein. (Pimentel & Pimentel, 2003). Note – Wet land rice is almost as much as dairy. Upland rice is fine.http://www3.epa.gov/climatechange/ghgemissions/global.html Transport is 14% of global emissions
NZ GHGs - 50% from Animal agriculture - 25% from dairy farming (Saunders & Barber, 2007) Global GHGs - 18% from Animal Agriculture. (United Nations Food and Agriculture Organization, 2006)
75% of water worldwide is used by farmers 1kg wheat - 1000L 1kg beef - 15 000L
Western diets - 5000L pp daily African/Asian vegetarian diets - 2000L pp daily (International Panel on Climate Change, 2007. pp.1720)
1/3rd of edible parts of food produced for humans gets wasted globallyFAO. 2011. Global food losses and food waste – Extent, causes and prevention. According to the IPCC (2007) and recent data from FAO (Tubiello et al., 2012), the largest contributors to agriculture emissions are enteric fermentation (38%), manure left on pasture (14%), synthetic fertilizer (13%), biomass burning (11%), rice cultivation (9%), manure management systems (7%), N2O emissions from organic soils (5%), crop residues (3%), and manure applied to cropland (2%). The following GHG aggregations were further considered.
We defined a ‘livestock’ emission category as the sum of emissions from enteric fermentation and manure emissions, plus emissions from cropland related to feed1. This represented over 80% of total agriculture emissions, in line with recent estimates (FAO, 2008; Leip et al., 2010).
1kg of beef =22 kg of carbon dioxide equivalent – 9.2 litres of petrol or driving 100 km ( NZ average fuel consumption). Keep in mind – this is not including the 51% of the worlds palm kernel NZ imports and the part it plays in rainforest destruction. 90% is from the farming process (62% belching, 17% from nitrogen from excretions), 10% once the animal leave the farm. Most of the impact is in the form of methane emissions from the animals gut. Pigs, chicken and fish don’t have the same gut type so are nowhere near as bad.
Aimed to consider optimized solutions to the mix of food items in daily diets for a developed country population: New Zealand (NZ Conducted scenario development and linear programming to model 16 diets. Data inputs: nutrients in, prices, wastage and GHG emissions.
Identified daily dietary patterns that met key nutrient requirements from NZ$ 3.17 daily
Optimized diets could reduce GHGs from 10.1 kg CO2e/d to 1.62 kg CO2e/d
All of the optimized dietary patterns had likely health advantages over the current NZ dietary pattern, i.e., lower cardiovascular disease and cancer risk
Schools, jails and hospitals should serve the best identified diets as per current research.
Education and promotion in public for healthy eating, teaching skills around cooking, using systems that help consumers identify good choices, removing and applying tax to foods to encourage and reduce consumption,
Note: The different irons are not adjusted.Non-haem iron is absorbed approx 10% less as well. All vary with what it is being eaten with. Table 1, RDI values and information taken from www.nutritionfoundation.org.nz, Oliver, J. 200 g dairy-free dark chocolate (at least 75% cocoa solids)700 g silken tofu 160 g maple syrup 1 lime, zest of 1 Tbs vanilla bean paste 1 Tbs dark rum 1 large pinch of dried chilli flakes 1 large pinch of sea salthttp://www.jamieoliver.com/recipes/chocolate-recipes/vegan-chocolate-pots/#
RDI values taken from www.nutritionfoundation.org.nzLean beef values taken from ‘according to the accepted Monsen model, makes up about 40% of total iron. Non-haem iron is found mostly in plant-based foods, and makes up the remaining 60% of iron in animal products’ And…from: Total and haem iron content lean meat cuts and the contribution to the diet’‘ The type of iron (haem or non-haem) differs in bio-availability. In general, the rate of non-haem iron absorption is related to its solubility in the upper part of the small intestine. The presence of soluble enhancers (ascorbic acid) and inhibitors (phytates, polyphenols and calcium) consumed during the same meal will have a significant effect on the amount of non-haem iron absorbed.’ Beulah Pretorius, , Hettie C. Schönfeldt, Nicolette Hall Show more doi:10.1016/j.foodchem.2015.02.109 Food Chemistry Volume 193, 15 February 2016, Pages 97–101
Same meals, just remove/replace meat - Promote Meatless Mondays Give out leaflets
Titanic fame Also has a Walnut and a hemp farm. Since 2012, Cameron has bought at least 13 parcels of land worth tens of millions of dollars and totalling more than 1500 hectares. Last year, he sold 75,000 boxes of sprouts and 25,000 heads of broccoli.
Make the hospital a center that promotes nutrition and healthy food - Farmers' markets and/or community gardens on hospital grounds. Implement a step-by-step program to identify and adopt sustainable food procurement. Begin where minimal barriers exist and immediate steps can be taken, for example, by introducting organic fresh fruit in the cafeteria. Minimize and beneficially reuse food waste. For instance, compost food waste or use it as animal feed. Convert cooking oil waste into biofuel. Water Establish a framework that aspires to “net zero water use” within a hospital system. Implement water conservation strategies: install efficient faucets and toilets, Landscape grounds using drought-resistant plants to minimize water use. Consider harvesting rainwater and/or recycling water for process water uses. Eliminate bottled water facility-wide if high quality potable water is available. Develop joint projects with the community to improve and protect water supplies; support initiatives for public systems to improve water quality, water delivery and wastewater systems for the entire population.
– bring climate co-benefits into health advice – e.g. Greening the green prescription (instead of a gym prescription, encourage people to walk/cycle to work), healthy and sustainable nutrition advice…
– encourage your professional college to sign up to OraTaiao’s Health Call to Action (attached); use the Health Call to Action to write to your local MP – even better, go and talk to them in person; get involved in relevant policy submissions at a regional and national level – health professionals can be a influential voice for public good in urban and energy planning
Join the Global Green & Healthy Hospital 2020 challenge
US Health care: 8% of National Green House Gases (8) The NHS - 25% of total public sector emissions. (34)
Health professional organisation: Concerned about adverse health impacts of climate change Promotes population health gains from climate action
Incorporated society, over 450 members
Supports - individuals through to DHBs
Advocacy – Health professionals have a major role to advocate for the health of society at all levels. (59)
Promoting Health Sector sustainability – are affiliated with a carbon offsetting program that professionals can use to mitigate private and professional travel.
Political Engagement – influencing policy decisions and local projects eg TPPA, public transport plans, divestment
Public Engagement – Protests
Joining with others – locally and internationally
Climate Change and Health: Is Food a Major Player?
Climate Change & Health:
Is food a major player?
A Scientific Based Presentation
Inspired by Personal Experience: By Emily Rushton
Our Journey Today:
- Why do I care?
- Climate Change in a Nutshell
- The Issues
- Low Carbon diets and health benefits
- What’s happening?
- Where do you come in?
2005-07 National Student Unit, NZNO
2007-2010 Counties Manukau RN –
2011-12 UK – NHS and Taught Adult health
2012-13 Temped in Auckland, NZ
Feb 2014-Oct 2015 Received intense world
education on 22 month trip
Increasing global demand for food
GHG emissions from some foods are high
Environmental change = Food production disruption
Disease burdens related to our food choices
50% of world’s population could face
severe food shortages by 2100 44
Reduced wheat and maize yields for many
regions and in the global aggregate 19
Several periods of rapid food and cereal
For all countries recent climate extremes
are showing significant lack of
OraTaiao’s Main Areas of Action
Action Public Health Impact GHGE’s avoided by
Increase active and public
Increase physical activity
Reduce health damaging air pollution
Reduce road traffic injuries
Improve housing through
insulation, energy efficiency and
low-carbon heating and
Reduce illnesses from cold, damp home
Reduce fuel poverty
Reduce health damaging air pollution
Reduced emissions from
home heating and living
Enable a population shift to
healthier plant-based diets that
are lower in red meat and
animal fat through pricing,
economic and heath promotion
Reduce rates of cancer
Reduce cardiovascular disease
Improved drinking and recreational
Stop the extraction and burning
of coal for energy
Reduced burden of illness and premature
death from coal related air pollution
World Moving to Reduce Animals
Netherlands – Meat 2x weekly max. only one of which is red
meat. 62, 17
Italy - New food pyramid with less animal products due to health
UK – Reduce meat and eat more beans, legumes and nuts. 64
USA Has reduced 10% per capita, per year since 2007 = 400
million less animals consumed per year by 2014 52
A major cause of climate change
Global GHGs - 18% from Animal Agriculture. 50
75% of water worldwide is used by farmers 18
1 calorie of animal protein = >10x fossil fuel input 35
6 kg of plant protein is required to yield 1 kg of meat protein
80% from animal agriculture 48
9% from wet land rice 48
1kg of Beef = 100km driving 61
300gm Steak= 30kms
Sheep meat similar
UK Study 13
Showed a 40 % reduction was realistic
Health is a better motivator
Professionals should consider more then individuals health
‘Foods and dietary patterns that are healthy, low-cost,
and environmentally sustainable:
a case study of optimization modeling for New Zealand’ 60
Diets could be cheaper, healthier, lower-emissions
Suggest public institutions should adopt
Government should use education, tax and policy
Halve meat to save
lives and emissions
29% decrease in greenhouse gases
Save 5.1 million lives annually 65
Iron from Tofu vs Beef
This chocolate mousse:
- Easy to make
- Comparable on cost
RDI Chocolate Mousse
Iron Woman – 42%
Men – 94%
W – 20%
M – 45%
Calcium 43% 4%
Fibre 4.1g 0%
Soy - no proven risks but likely to reduce many cancers 62
Protein and iron is easier than you think
Plant based diets are cheaper 60
Iron and Protein Abundant: Iron
Legumes - Chick peas, beans (black, white, navy, kidney, mange
tout…), Lentils (brown, red, green…), Soy, peas etc.
Vegetables – Beetroot, mushrooms, green leafy vegetables,
asparagus, leeks, spring onions
Spices – Curry powder, turmeric, thyme, parsley, rosemary, pepper,
cumin, oregano etc.
Fruit – Dried (Apricots, pears, figs, raisins…), berries
Tofu, soy products and seitan
Information is Easy
Google favorite recipes - ‘Vegetarian bolognaise’
Join Vege based social media groups - ‘Vegetarian NZ’
Vegetarian or vegan society websites – ’NZ Vegetarian Society’
Explore whole foods based websites - ‘Oh She Glows’
Clear, Simple Instructions
Initially aim to reduce by 60%
Reduce meat and dairy intake ideas:
- One product at a time
- Meatless every 2nd day
- Promote ‘Meatless Mondays’ in Community
Join plant based interest groups
From Angst to Action
James Cameron Converts from Dairy
Took intensive Dairy Farms → replaced with organic crops
Mung beans, alfalfa sprouts, lettuce, fennel, cauliflower, leeks,
pumpkins & kale
"We're relentlessly devastating the Earth's ecosystems, and we
need to wake up.“ 56
Others changing into hazelnuts, avocados, hemp and tea.
‘The latest report… indicates the contribution of science and
public health to one of the greatest predicaments facing
human and non-human life.
That contribution now needs to be embraced fully by health
professionals and medical scientists worldwide.”
Richard Horton, Editor in Chief, Lancet 44
What could be done locally?
Linking with local groups
Hospital or community facilities
Emission reduction program
Food in hospitals
Limiting meat meals
Buy local organic produce
Make hospital a ‘fast food free’ zone
Modify menus & practices to support healthier food purchases 57
Consider carbon impacts of your practice and the advice you are giving patients
Change own lifestyle and talk about the benefits of this with colleagues and
Join with other health professionals to amplify individual actions
Work with other health professionals to press for healthy action on climate
Join the ‘Sustainable Health Sector
National Network (NZ)’
Part of Ora Taiao: The NZ Climate & Health Council
Individual practices to DHB’s
Supported with direction and advice
Linked to global movements
The NZ Climate & Health Council
Links to others
‘Everyone here has the sense that right now is one of those
moments when we are influencing the future.’ -Steve Jobs
1. AFP. (2015, October 26). Persian Gulf could be too hot for humans by 2100. The Telegraph. Retrieved from
2. Aston, L.M., Smith, J.N., & Powles, J.W.(2012). Impact of a reduced red and processed meat dietary pattern on disease risks and greenhouse gas
emissions in the UK: a modelling study. BMJ Open. doi: 10.1136/bmjopen-2012-001072
3. Bao,W., Rong, Y., Rong, S., & Liu, L. (2012). Dietary iron intake, body iron stores, and the risk of type 2 diabetes: a systematic review and meta-
analysis. BMC Med. 10;10:119. doi: 10.1186/1741-7015-10-119. Review. http://www.ncbi.nlm.nih.gov/pubmed/23046549
4. Biermann, F., & Boas, I., (2010) Preparing for a warmer world: towards a global governance system to protect climate refugees. In Global
Environmental Politics, 10(1), (pp. 60-88).
5. Bowles, N. & Yadron, D. (January 7, 2016). Self-driving cars hog the road at CES. The Guardian. Retrieved from
6. Bouvard, V., (October 26, 2015). Carcinogenicity of consumption of red and processed meat. In The Lancet Oncology . France, Lyon: Research on
Cancer Monograph Working Group. Retrieved from
7. Buchner B, Fischler C, Fitousi JP, Monti M, Riccardi G, Ricordi C, Sassoon J, Veronesi U. 2011 double pyramid: healthy food for people, sustainable
food for the planet. Parma, Italy: Barilla Center for Food & Nutrition, 2011.
8. Chung J.W., Meltzer, D.O. (2009). Estimate of the Carbon Footprint of the US Health Care Sector. JAMA.;302(18):1967-1972.
doi:10.1001/jama.2009.1610. Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=184856
9. FAO. 2011. Global food losses and food waste – Extent, causes and prevention. Rome
10. Flannery, T. ( 2015, August 25). Bushfires, heatwaves and early deaths: the climate is changing before our eyes. The Guardian. Retrieved from
11. Food and Agriculture Organisation of the United Nations, (2015). Untitled image of Emissions per capita [Infographic]. Retrieved December 26,
2015 from http://www.fao.org/3/a-bb144e.pdf
12. Fuller, P., (April 1, 2015) James Cameron snaps up organic empire. Wairarapa News. Retrieved from http://www.stuff.co.nz/business/farming/67572692/James-
13. Green, R., Milner, J., Dangour, A.D., Haines, A., Chalabi, Z., Markandya, A., Spadaro, J., & Wilkinson, P. (2015). The potential to reduce greenhouse gas emissions in the
UK through healthy and realistic dietary change. Springer Science + Business.
14. Greger, M. (2015, June 5th). The safety of Heme vs. Non-heme Iron. [Video File]. Retrieved from http://nutritionfacts.org/video/the-safety-of-heme-vs-non-heme-iron/
15. Hales, S., Kovats, S., Lloyd, S., & Campbell-Lendrum, D. (2014). Quantitative risk assessment of the effects of climate change on selected causes of death, 2030s and
2050s. Retrieved from http://apps.who.int/iris/bitstream/10665/134014/1/9789241507691_eng.pdf?ua=1
16. Health Care Without Harm, (2013). Menu of Change: A 2013 Program Report with Highlights, Awards and Survey Results. Retrieved from https://noharm-
17. Health Council of the Netherlands. Guidelines for a healthy diet: the ecological perspective. The Hague, Netherlands: Health Council of the
Netherlands/Gezondheidsraad, 2011. (Report no. 2011/08E.) Available from:http://www.gr.nl (cited 23rd January 2016).
18. International Panel on Climate Change, (2007). Climate Change 2007: Synthesis Report. Retrieved from
19. International Panel on Climate Change. (2014). Summary for policymakers. In: Climate Change 2014: Impacts, Adaptation, and Vulnerability. Cambridge University Press,:Cambridge, United
Kingdom. and New York, NY, USA,
20. Jackson, R. (2015). The consequences of climate change. Retrieved December 28, 2015, from http://climate.nasa.gov/effects/
21. Fast lane for electric cars.[Chart] (October 16, 2015). Norway is a model for encouraging electric car sales. International business. Retrieved from
22. Food and Agriculture Organisation. (2011). Global food losses and food waste – Extent, causes and prevention. Rome
23. Food and Agriculture Organisation of the United Nations, (2015). Untitled image of Emissions per capita [Infographic]. Retrieved December 26, 2015 from http://www.fao.org/3/a-
24. Kaluza, J., Larsson, S.C., Håkansson, N., & Wolk, A. (2014). Heme iron intake and acute myocardial infarction: a prospective study of men. Int J Cardiol. 1;172(1) (pp.155-
60). doi: 10.1016/j.ijcard.2013.12.176.
25. Kay., & A. Travers., (1st ed.). Climate change and the coast: Building Resilient Communities (pp.285–310). Florida: CRC Press.
26. Kiribati Climate Change, (2012a). Map of Kiribati 2 [Map]. Retrieved from http://www.climate.gov.ki/about-kiribati/map_kiribati/
27. Kiribati Climate Change, (2012b). Kiribati Adaptation Program. Retrieved from http://www.climate.gov.ki/category/action/adaptation/kiribati-
28. Kolmannskog, V., & Trebbi, L., (2010) Climate change, natural disasters and displacement: a multi-track approach to filling the protection gaps. In
International Review of the Red Cross, 92(879), (pp. 713-730).
29. Lam, T.K., Rotunno, M., Ryan, B.M., Pesatori, A.C., Bertazzi, P.A., Spitz, M., Caporaso, N.E., & Landi, M.T. Heme-related gene expression signatures of
meat intakes in lung cancer tissues. Mol Carcinog. 2014 Jul;53(7):548-56. doi: 10.1002/mc.22006.
30. Mathiesen, K. (2015, June 9). No Beer, chocolate, coffee. How Climate change will ruin your weekend. The Guardian. Retrieved from
31. Michaëlsson, K., Wolk,A., Langenskiöld, S., Basu, S., Warensjö Lemming, E., Melhus, H., & Byberg, L. (2014). Milk intake and risk of mortality and
fractures in women and men: cohort studies. BMJ, 349, doi: http://dx.doi.org/10.1136/bmj.g6015
32. Nurse, L.A., McLean, R.F., Agard, J., Briguglio, L.P., Duvat-Magnan, V., Pelesikoti, N., Tompkins, E. & Webb, A. (2014). Small islands. 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. United Kingdom, Cambridge: Cambridge University Press. (pp. 1613-1654).
33. Oliver, J. (n.d.). Vegan chocolate pots. Retrieved on November 24, 2015 from http://www.jamieoliver.com/recipes/chocolate-recipes/vegan-
34. Pencheon, D., Cointet, S., Brown, J., Howley, J., Tennison, I., Greensmith, H., ... & Brockway, P. (2009). Saving carbon, improving health: NHS carbon
reduction strategy for England. Sustainable Development Unit, Cambridge, UK.
35. Pimentel D, Pimentel M. Sustainability of meat-based and plant-based diets and the environment. Am J Clin Nutr 2003;78(suppl):660S–3S.
36. Reisinger, A., Lawrence, J., Hart, G., & Chapman R. (2014). From coping to resilience: The role of managed retreat in highly developed coastal regions
of New Zealand. In Climate change and the coast: Building Resilient Communities. DOI: 10.1201/b18053-18
37. Richey, A., Thomas, B., Lo, M., Famiglietti, J., Swenson, S., & Rodell, M. (2015). Uncertainty in global groundwater storage estimates in a Total
Groundwater Stress framework. Water Resources Research, AN AGU Journal, 51(7). doi: 10.1002/2015WR017351
38. Ruddick, G. (December 11, 2015). Ford to invest £3bn in electric cars. The Guardian. Retreived from
39. Saunders, C., & Barber, A. (2007). Comparative energy and greenhouse gas emissions of New Zealand's and the UK's dairy industry (No. 297).
Christchurch, New Zealand: Lincoln University
40. Saunders, A.V., Craig, W. J., Baines, S.K., & Posen., J. S. (2013). Iron and vegetarian diets. Med J Aust. doi: 10.1016/j.ijcard.2013.12.176.
41. Singelenberg, J., Stolar, H., & Mccall M.E., (2014). Integrated Service Areas: An Innovative Approach to Housing, Services and Supports for Older
Persons Ageing in Place. Journal of Community & Applied Social Psychology. 24 (pp.69–73) DOI: 10.1002/casp.2175
42. Statistics New Zealand. (2010). Are New Zealanders Living Closer to the Coast? Internal Migration. Retrieved 2016, January 13 from
43. Tai, V., Leung, W., Grey, A., Reid, I.R., & Bolland, M.J. (2015). Calcium intake and bone mineral density: systematic review and meta-analysis. BMJ, 351
44. The Lancet. (2009). Managing the health effects of climate change. (vol 373) . Retrieved from http://www.ucl.ac.uk/global-health/project-
45. The Lancet. (2015). Figure 1 [Diagram]. Retrieved from http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60854-
46. Foote, K. & Joy, M. (2014). The true cost of milk: Environmental deterioration Vs. profit in the New Zealand dairy industry. Massey University, Palmerston North, N.Z. Paper presented at the 2014 NZARES
Conference Tahuna Conference Centre, Nelson, New Zealand. August 28-29, 2014.
47. Tucker, K.L., Rich, S., Rosenberg, I., Jacques, P., Dallal, G., Wilson, P.W., & Selhub, J., (2000). Plasma vitamin B-12 concentrations relate to intake source in the Framingham Offspring study. American Journal of
Clinical Nutrition;71(2), (pp.514-22).
48. Tubiello, F.N., Salvatore, M., Rossi, S. & Ferrara, A. (2012). Analysis of global emissions, carbon intensity and efficiency of food production. Food and Agriculture Organisation. Retrieved from
49. United Nations Development Programme, (2011). World Resources Report 2010-2011:Decision Making in a Changing Climate. Retrieved from World Resources Institute website: http://www.wri.org/node/39606
50. United Nations Food and Agriculture Organization, (2006). Livestock’s Long Shadow. Retrieved from http://www.fao.org/docrep/010/a0701e/ a0701e00.htm
51. United States Department of Agriculture. (2015). Scientific Report of the 2015 Dietary Guidelines Advisory Committee. Retrieved from http://health.gov/dietaryguidelines/2015-scientific-report/PDFs/Scientific-
52. United States Department of Agriculture (2016). National Agricultural Statistics Service . Retrieved from http://www.nass.usda.gov/
53. Wilson, L. (n.d.). The food wastage footprint is big. Retrieved Janurary 20th, 2016 from http://shrinkthatfootprint.com/the-big-footprint-of-food-waste
54. Who.int,. (2014). WHO | 7 million premature deaths annually linked to air pollution. Retrieved 5 January 2016, from http://www.who.int/mediacentre/news/releases/2014/air-pollution/en/
55. Yang,W., Li,B., Dong,X., Zhang, X.Q., Zeng, Y., Zhou, J.L., Tang, Y.H., & Xu. J.J. (2014). Is heme iron intake associated with risk of coronary heart
disease? A meta-analysis of prospective studies. Eur J Nutr. 53(2):395-400. doi: 10.1007/s00394-013-0535-5.
56. Fuller, P. (April 1, 2015). James Cameron snaps up organic empire. Wairarapa News. Retrieved from
57. Global Green and Healthy Hospitals. (2011). A Comprehensive Environmental Health Agenda for Hospitals and Health Systems Around the World.
Retrieved from http://greenhospitals.net/wp-content/uploads/2011/10/Global-Green-and-Healthy-Hospitals-Agenda.pdf
58. Climate action tracker. (2015). New Zealand. Retrieved February 7th, 2016 from http://climateactiontracker.org/countries/newzealand.html
59. World Health Organization. (1998 ). Health promotion glossary retrieved from http://www.who.int/hpr/NPH/docs/hp_glossary_en.pdf
60. Wilson, N, Nghiem, N., Mhurchu, C. N., Eyles, Baker, M. G. & Blakely, T. (2013). Foods and dietary patterns that are healthy, low-cost, and
environmentally sustainable: a case study of optimization modeling for New Zealand. Plos one. DOI: 10.1371/journal.pone.0059648
61. Lieffering, M., Ledgard, S.F., Boyes, M. &Kemp, R. (2012). A Greenhouse Gas Footprint Study for Exported New Zealand Beef. [Report]. Retrieved
62. Voedings centrum. (March 2016). Nutrition Guidelines. Retrieved from http://www.voedingscentrum.nl/
63. Gustin, G. (March 23, 2016). Another Nation Trims Meat From Diet Advice . National Geographic. Retrieved from
64. Public Heath England. (March 23, 2016). Eatwell Guide. Retrieved from
55. Springman, M., Godfray, H.C.J., Rayner, M. & Scarborough, P. (2016). Analysis and valuation of the health and climate change cobenefits of
dietary change. Proceedings of the National Academy of Sciences of the United States of America. Retrieved from
Kai Tiaki: Nursing New Zealand. (February 2006). Students-Nursing’s future. [Cover].
Figure 1. Rushton, E. (2014). Children of a mountain village, Hsipaw, Burma. [Photograph].
Figure 2. The Carbon Cycle [Infographic]. (2016). Retrieved January 19, 2016, from http://www.sccs.org.uk/education-and-
Figure 3. Basic Needs of a Living Organism [Image]. (2015). Retrieved January 10, 2016, from http://eschooltoday.com/
Figure 4. Rushton, E. (2014). Boys of a mountain village, Hsipaw, Burma. [Photograph]
Figure 5. One Green Planet. (N.d). Eat for the planet. Retrieved from http://www.onegreenplanet.org/animalsandnature/eat-for-the-
Figure 6. Co2 Emissions per Capita. (2015) Food and Agriculture Organisation of the United Nations.
Figure 7. Shrink that footprint. (2011). Annual food waste by region. [Table]
Figure 8. New Zealand’s Greenhouse Gas Emissions. [Infographic]. (2011). Retrieved December 29, 2015 from
Figure 9. Oliver, J. (n.d.). Vegan chocolate mousse. [Photograph]. Retrieved from http://www.jamieoliver.com/recipes/chocolate-
Figure 10. Rushton, E. (2015). Tofu vs Beef. [Table]. Data from www.nutritionfoundation.org.nz and
Figure 11. United Nations. (n.d.). Eradicate extreme poverty and hunger. [Infographic]. Retrieved from
Figure 12. Global Green and Healthy Hospitals . (n.d.).,Agenda Goals. [Image]. Retrieved fro m http://greenhospitals.net/en/
Figure 13. Figure 6. Rushton, E. (2014). Mountain People Refuge, Huai Xai, Laos . [Photograph].
Figure 14. Rushton, E. (2014). Young boys at Wae Rebo Village, Indonesia . [Photograph].
Figure 15. The Lancet. (2015). Figure 1 [Diagram]. Retrieved from http://www.thelancet.com/journals/lancet/article/PIIS0140-
Figure 16. Ring, W. (2015). Do no harm: Energy investment for community health. [Presentation]. Retrieved from
Figure 17. Ora Taiao: NZ Climate and Health Council. (2014). Briefing to the incoming minister of health. [Briefing]. Retrieved from
Figure 18. World Resource Institute. (2016). Protein Scorecard. Retrieved from http://www.wri.org/resources/data-visualizations/protein-