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Rapid Responses: Rapid Responses published:
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Travel Rationing
- John R Moloney (16 February 2007)
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Let's Not Forget the Beef and Cheese Centered Dinners
- John McDougall, MD (17 February 2007)
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Timely editorial
- Aileen A O'Brien (19 February 2007)
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Reduce Waste
- Jeff Brock (20 February 2007)
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Climate Change and Medicine
- Ole Faergeman (20 February 2007)
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Choice of venue
- Danielle M Wheeler (13 March 2007)
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John R Moloney, Retired ENT Consultant Leicester Royal Infirmary LE1 5WW
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Three cheers for Dr Roberts and Dr Godlee.Travel,in all its forms,should be rationed;including petrol rationing;and us retirees should have a very small ration indeed. Competing interests: None declared |
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John McDougall, MD, physician Santa Rosa, CA 95404
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An amazingly simple win-win opportunity stares us in the face: a global switch to a plant-food based diet will solve the diseases of overnutrition and put a big dent in global warming with one U-turn—since the up-to now insatiable appetite for foodstuffs made from livestock (cows, sheep, pigs, and chickens) are at the root of both disasters. The 2006 United Nations report, Livestock’s Long Shadow –Environmental Issues and Options, concludes, “Livestock have a substantial impact on the world’s water, land and biodiversity resources and contribute significantly to climate change.” —accounting for 18 percent of the greenhouse gasses. The human health crisis is pandemic with more than 1.1 billion people overweight and 312 million obese, 197 million have diabetes, and 1 billion have hypertension.2 One final and fatal result of these three chronic conditions is 18 million people die of heart disease annually.2 Mounting levels of sickness march side by side with escalating environmental catastrophes: Extremes of weather are intensifying with droughts and severe flooding, many species of plants and animals are threatened with extinction, diseases are spreading, and crops are failing. You would think by now doctors worldwide would have launched serious measures to reverse all this human suffering by attacking the primary cause—eating meat and dairy products. An initial step of good faith would be to serve only vegan meals when medical conferences are held; providing an excellent example for others. 1) http://www.virtualcentre.org/en/library/key_pub/longshad/A0701E00.htm 2) Hossain P, Kawar B, El Nahas M. Obesity and diabetes in the developing world--a growing challenge. N Engl J Med. 2007 Jan 18;356(3):213-5. Competing interests: Founder of the McDougall Program where patients are treated with low-fat vegan diet and exercise |
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Aileen A O'Brien, Senior lecturer in psychiatry st. George's University of London
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Thank-you Roberts and Godlee for your timely and important editorial. Climate change will increasingly effect the health of underdeveloped nations as well as our own.. it is in our power to prevent it and flying in particular has become a moral and ethical issue. I congratulate the authors. Competing interests: None declared |
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Jeff Brock, Infectious Disease Pharmacist Mercy Medical Center, Des Moines, IA 50325
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Not only is the air travel contributing to the carbon foot print left by medical conferences, there are also numerous other wasteful practices that contribute to the bludgeoning of our environment contributed by these events. I'm always appalled at the lack of recycling available for the materials which are easily recycled such as paper, aluminum, and plastics. Hospitals and other medical facilities are also guilty of producing excess waste by this lack of social responsibility. Physicians and other healthcare providers must lead by example and push for reduction in waste and carbon emissions. Competing interests: None declared |
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Ole Faergeman, Emeritus Professor of Preventive Cardiology University of Aarhus, 8000 Aarhus C, Denmark
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Climate Change and Medicine In a recent editorial in BMJ, Roberts and Godlee correctly described how much air travel to medical conferences contributes to emissions of carbon dioxide and thus to global warming (1), and it is timely to reflect on the various connections between the world of medicine and climate change, apparently the greatest challenge to current forms of life. The medical literature on climate change has dealt almost exclusively with the important issue of human diseases that are likely to follow from climate change. They include famine, infectious diseases, thermal stress and many others (2-4). In contrast, the FAO (Food and Agriculture Organization), in a report on the impact on the environment and global warming of raising cattle, sheep, pigs and other livestock, has recently connected climate change with another group of diseases. The FAO estimated that raising livestock accounts for 18% of greenhouse gas emissions from human activities and noted that foods derived from animal products are associated with cardiovascular disease, diabetes and some cancers. Since the demand for such food increases with per capita income, the FAO wrote that “the environmental damage by livestock may be significantly reduced by lowering excessive consumption of livestock products among wealthy people.” The figure indicates the distinction between human diseases that share causes with climate change and human diseases that follow from climate change. The former are associated with physical inactivity as well as eating food from animal sources. It is certainly possible to be sedentary without burning oil or coal, but we rely primarily on the automobile and numerous other forms of the motorized equipment, directly or indirectly fueled with oil, coal or natural gas, to avoid physical activity. The connections between climate change and diseases of affluence are fairly obvious, but specialization, a hallmark of contemporary medicine, discourages interest in the larger societal contexts of disease, and current strategies for prevention are based primarily on drugs and individual life-style changes. Population-based strategies have been shown to work (5), but they enjoy less attention than preventive efforts directed at individuals. Indeed, advances in identification and treatment of individuals at high risk of cardiovascular disease seem to justify arguments that population-based preventive efforts are no longer competitive (6). The connections indicated in the figure present a sombre, new opportunity for population-based prevention of obesity, type II diabetes and cardiovascular disease in the measures that government, industry and agriculture must adopt to try to mitigate the consequences of global warming and climate change, and recent impetus for political action comes in fact from reports from national and international government (7-9). Whether reductions of fossil fuel consumption are motivated by concern about climate change or energy security, some of the measures taken could be fashioned in a manner that will also combat diseases of affluence. Agricultural policies that encourage farmers to produce less livestock and more fruits, vegetables and grains for human rather than animal consumption would simultaneously reduce our ecological footprint and rates of obesity, diabetes, etc.. And driving a hybrid car rather than a four wheel drive vehicle reduces emissions of carbon dioxide by 70% (10), but it does not increase physical activity. Biclycling, made safe by planning cities with bicycle paths, reduces emissions of carbon dioxide by much more than 70%, and it obviously increases physical activity. Cars fueled only with a petroleum product or bioethanol do not need to be fully replaced by newer technology cars. Professional societies of physicians and clinical scientists should consider explicitly supporting the advice that the FAO and colleagues in climatological research have provided to poltitical and industrial leaders. They can argue that it will be easier and cheaper to mitigate the consequences of climate change if effective measures to reduce obesity, type II diabetes and cardiovascular disease are entered into the equation.
The arguments can be made electronically. They don’t require air travel. Reference List (1) Roberts I, Godlee F. Reducing the carbon footprint of medical conferences. BMJ 2007; 334:324-325. (2) Leaf A. Potential health effects of global climatic and environmental changes. N Engl J Med 1989; 321(23):1577-1583. (3) Godlee F. Health implications of climatic change. BMJ 1991; 303(6812):1254-1256. (4) McMichael AJ, Woodruff RE, Hales S. Climate change and human health: present and future risks. Lancet 2006; 367(9513):859-869. (5) Pekka P, Pirjo P, Ulla U. Influencing public nutrition for non- communicable disease prevention: from community intervention to national programme--experiences from Finland. Public Health Nutr 2002; 5(1A):245- 251. (6) Manuel DG, Lim J, Tanuseputro P, Anderson GM, Alter DA, Laupacis A et al. Revisiting Rose: strategies for reducing coronary heart disease. BMJ 2006; 332(7542):659-662. (7) Stern Review: The Economics of Climate Change. Cambridge: Cambridge University Press, 2006. (8) Steinfeld H, Gerber P, Wassenaar T, Castel V, Rosales M, de Haan C. Livestock's long shadow. Environmental issues and options. Rome: Food and Agriculture Organization of the United Nations, 2006. (9) Intergovernmental Panel on Climate Change. Climate Change 2007: The Physical Science Basis. 2007. Geneva. (10) Flannery T. The Weather Makers. The History & Future Impact of Climate Change. Melbourne: Text Publishing, 2005. Figure: connecting medical and climatological concerns Competing interests: None declared |
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Danielle M Wheeler, Research Manager Cochrane Child Health Field, Westmead, NSW, Australia 2145
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The impact of international conferences can be mitigated by more than the decision not to fly. Choice of venue could do much to send a message to conference organisers and governments. I first heard Ian Roberts' concerns about excessive conference air miles at the Cochrane Colloquia in Australia (he sent a letter), a country which refuses to ratify the Kyoto protocol, is the second largest global producer of greenhouse gases per capita and is suffering the worst drought in recorded history. A boycott of this country by all international medical conference attendees would send a clear message to conference organisers, and indirectly to governments, that Australia's ignorance and arrogance about climate change is not acceptable to the thinking people of this planet. Our next door neighbour, New Zealand, has a much better track record. Given that the air miles are about the same, New Zealand is a better choice. The same could be said for Canada compared with the US. Then hold the conference in a conference centre run on renewable energy, with stringent waste and water recycling. Surely those fabulous market forces can drum up something of the kind! And while we're at it, I'd be very happy to never again receive a tacky conference bag, tattooed with drug company logos and made in a sweat shop. Danielle Wheeler Competing interests: Danielle Wheeler is a contributor and editor for the Cochrane Collaboration and Research Manager of the Cochrane Child Health Field |
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