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Effects of environmental change on agriculture, nutrition and health: A framework with a focus on fruits and vegetables

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      Abstract

      Environmental changes are likely to affect agricultural production over the next  decades. The interactions between environmental change, agricultural yields and crop quality, and the critical pathways to future diets and health outcomes are largely undefined. There are currently no quantitative models to test the impact of multiple environmental changes on nutrition and health outcomes.

      Using an interdisciplinary approach, we developed a framework to link the multiple interactions between environmental change, agricultural productivity and crop quality, population-level food availability, dietary intake and health outcomes, with a specific focus on fruits and vegetables. The main components of the framework consist of: i) socio-economic and societal factors, ii) environmental change stressors, iii) interventions and policies, iv) food system activities, v) food and nutrition security, and vi) health and well-being outcomes.

      The framework, based on currently available evidence, provides an overview of the multidimensional and complex interactions with feedback between environmental change, production of fruits and vegetables, diets and health, and forms the analytical basis for future modelling and scenario testing.

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      Most cited references 83

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      Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

      Summary Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation.
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        The story of phosphorus: Global food security and food for thought

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          Bee declines driven by combined stress from parasites, pesticides, and lack of flowers.

          Bees are subject to numerous pressures in the modern world. The abundance and diversity of flowers has declined; bees are chronically exposed to cocktails of agrochemicals, and they are simultaneously exposed to novel parasites accidentally spread by humans. Climate change is likely to exacerbate these problems in the future. Stressors do not act in isolation; for example, pesticide exposure can impair both detoxification mechanisms and immune responses, rendering bees more susceptible to parasites. It seems certain that chronic exposure to multiple interacting stressors is driving honey bee colony losses and declines of wild pollinators, but such interactions are not addressed by current regulatory procedures, and studying these interactions experimentally poses a major challenge. In the meantime, taking steps to reduce stress on bees would seem prudent; incorporating flower-rich habitat into farmland, reducing pesticide use through adopting more sustainable farming methods, and enforcing effective quarantine measures on bee movements are all practical measures that should be adopted. Effective monitoring of wild pollinator populations is urgently needed to inform management strategies into the future.
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            Author and article information

            Affiliations
            [1 ]Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
            [2 ]Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, WC1H 9SH, UK
            [1 ]CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), International Food Policy Research Institute (IFPRI), Washington, DC, USA
            [1 ]Oxford Martin Programme on the Future of Food, Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK
            [1 ]Oxford Martin Programme on the Future of Food, Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK
            London School of Hygiene & Tropical Medicine, UK
            [1 ]CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), International Food Policy Research Institute (IFPRI), Washington, DC, USA
            London School of Hygiene & Tropical Medicine, UK
            Author notes

            All authors contributed to the development of the framework. HT and PS wrote the first draft of the manuscript. All authors were involved in the revision of the draft manuscript and have agreed to the final content.

            Competing interests: No competing interests were disclosed.

            Contributors
            Role: Conceptualization, Role: Writing – Original Draft Preparation, Role: Writing – Review & Editing, ORCID: https://orcid.org/0000-0002-5971-8354
            Role: Conceptualization, Role: Visualization, Role: Writing – Original Draft Preparation, Role: Writing – Review & Editing, ORCID: https://orcid.org/0000-0002-6209-2284
            Role: Conceptualization, Role: Writing – Review & Editing
            Role: Conceptualization, Role: Writing – Review & Editing
            Role: Writing – Review & Editing
            Role: Conceptualization, Role: Writing – Review & Editing
            Role: Conceptualization, Role: Funding Acquisition, Role: Project Administration, Role: Writing – Review & Editing, ORCID: https://orcid.org/0000-0001-6908-1273
            Journal
            Wellcome Open Res
            Wellcome Open Res
            Wellcome Open Res
            Wellcome Open Research
            F1000 Research Limited (London, UK )
            2398-502X
            31 October 2017
            2017
            : 2
            5814744
            10.12688/wellcomeopenres.11190.2
            Copyright: © 2017 Tuomisto HL et al.

            This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

            Product
            Funding
            Funded by: Wellcome Trust
            Award ID: 106924
            The work was supported by the Wellcome Trust ‘Our Planet, Our Health’ programme [106924].
            The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
            Categories
            Research Article
            Articles
            Agriculture & Biotechnology
            Global Change Ecology
            Global Health

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