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The Guardian
5 days ago
- Health
- The Guardian
How to reduce your food footprint: if it's better for you, it's better for the planet
Food production globally accounts for nearly 30% of greenhouse gas emissions, with the average Australian diet contributing more than 3kg of Co2 per person per day. And what's worse, we waste about 35% of the food we bring home. If we keep this up, it has been estimated the already unsustainable environmental cost of the food system will nearly double by 2050. Calculating the precise impact your individual food choices have on the environment isn't simple, but research suggests the actions we can take to bring that impact down are – and they aren't just better for the environment, they're better for our health too. A 2021 CSIRO study found that sticking to its healthy eating guidelines while choosing lower-carbon options could reduce the climate impact of our diets by as much as 42%. Another released last year, which conducted life-cycle assessments on more than 60 thousand products available on Australian shelves, found that switching to lower-emission options within similar categories could bring our food footprints down by an impressive 71%. Prof Simone Pettigrew, program director of food policy at the George Institute for Global Health and an author of the latter study, says: 'There's four biggies that sit at the top of the list for being the least sustainable: traditional red meats, dairy products, and then to a lesser extent – but perhaps more upsettingly – coffee and chocolate.' Consumers, she says, can make a 'massive, massive difference' to the sustainability of their entire food basket simply by limiting or switching out those items. In practical terms this might look like choosing poultry, seafood or kangaroo instead of lamb or pork, switching dairy milk for plant-based options, drinking just one less coffee a day or choosing sweet treats with low or no cocoa content. Even if we can do that some of the time, the difference can be significant, according to Pettigrew. When it comes to carbohydrates and fresh produce, Pettigrew says a solid rule of thumb is the better it is for you, the better it probably is for the planet. Choosing fresh fruits and vegetables to snack on rather than processed biscuits or bars, for example, will dramatically reduce your diet's carbon footprint. And while there are production and processing differences between more nutritionally similar items such as pasta and rice, Pettigrew says overall they are largely comparable in terms of sustainability. 'Anything that is plant based is going to be much less environmentally costly than anything animal based. 'We understand it's hard for consumers to make really big changes in one hit, but it is relatively easy to make small incremental ones.' If you already eat a healthy, plant-rich diet, limit your ultra-processed food intake and are keeping your coffee and chocolate habits in check, you've made a great start. Beyond that, Dr Lilly Lim-Camacho, principal research scientist with CSIRO Agriculture and Food, says one of the most helpful things consumers can do to maximise these gains is to 'shop with intent'. Food waste accounts for more than a third of all household waste, so only purchasing what you need combined with small efforts such as 'learning how to use up leftover veggies in the crisper' and resisting impulse buying will not only make your diet significantly more sustainable, but healthier and more economical too. She urges people to also keep in mind that wasting unhealthy food is doubly bad. 'Not only do discretionary foods create more emissions, our bodies don't actually need them.' Those emissions are essentially being wasted regardless of whether you consume the food or not, she suggests. If you'd like to take things a step further, apps such as ecoSwitch, developed by the George Institute, get into the nitty gritty of comparing the carbon ratings associated with more specific items. This can help if you want to know, for example, which brand of tinned tomatoes or tofu is best. The George Institute study found that opting for near identical but lower-impact options alone could bring your food footprint down by 26%. Neither Pettigrew nor Lim-Camacho want to take the fun out of food or expect consumers to forgo the odd burger or chocolate ice-cream, but agree that by prioritising our health we will naturally make better choices for the planet, and vice versa. 'It's a win-win,' says Pettigrew. 'There is always going to be an environmental cost to our food. But it's important for people to know that you actually can make an enormous difference if you want to.'
Medscape
23-05-2025
- Health
- Medscape
Less Intensive Monitoring After Thrombolysis Is Safe
HELSINKI, Finland — Less intensive monitoring of patients with acute ischemic stroke who have undergone thrombolysis appeared to be safe in new findings that challenge current guidelines. The large international OPTIMISTmain trial showed that less frequent monitoring of vital signs and neurologic function during the first 24 hours did not compromise recovery or increase the risk for serious adverse events compared with standard protocols. 'The key message from our study is that it is safe to relax the monitoring of these patients, and this will allow nurses to be freed up from taking constant measurements so they can spend more time on delivering direct interventions and generally providing better care of the patients,' study investigator Craig Anderson, MD, George Institute for Global Health, Sydney, Australia, told Medscape Medical News . 'Another benefit will be less disruption to patients, which is especially important if they are trying to sleep.' The trial also showed that less intensive monitoring was feasible outside of an intensive care unit (ICU), which the researchers said would have benefits such as flexibility in nursing workflow and the release of intensive care resources. 'This trial result has wide applicability and is relevant all around the world, and we believe that hospitals could consider incorporating this approach to improve systems of care for acute stroke,' Anderson said. Anderson presented the results of the OPTIMISTmain trial on May 21 at the European Stroke Organization Conference (ESOC) 2025. The trial was also simultaneously published online in The Lancet . Nurse-Driven Research Anderson noted that this was a nurse-driven study and was the idea of co-lead author Debbie Summers, MSN, a senior nurse practitioner at Saint Luke's Hospital of Kansas City, Missouri, who questioned whether the high-intensity monitoring of patients with stroke after thrombolysis administration was necessary, given its high burden on nurses and level of disruption to patients. Current guidelines recommended 37 assessments within the first 24 hours after thrombolysis, including vital signs — such as heart rate and blood pressure — and neurologic checks using the Glasgow Coma Scale or the National Institutes of Health Stroke Scale (NIHSS). These are conducted every 15 minutes for 2 hours, every 30 minutes for the next 6 hours, and then hourly. The low-intensity monitoring protocol tested in the study involved 17 assessments over the same 24-hour period, with vital signs and neurologic checks conducted every 15 minutes for 2 hours, every 2 hours for the next 8 hours, and then every 4 hours. Investigators were also encouraged to implement the protocol in a stroke unit rather than an ICU, where hospital infrastructure allowed. Anderson explained that high-intensity monitoring was put in place when thrombolysis was first used in routine clinical practice, as this was the protocol used in the initial randomized clinical trial of alteplase for acute ischemic stroke in the mid-1990s. 'There was concern that use of thrombolysis in this setting could cause intracerebral hemorrhage (ICH), and the trial, therefore, included a careful monitoring strategy to detect any deterioration in the patient as quickly as possible. 'In addition, thorough monitoring and reporting was necessary in the evaluation of a new drug. Then, because this high-intensity monitoring program had been used in the trial, it was adopted after alteplase was approved for use in acute ischemic stroke and rolled out into clinical practice,' Anderson said. However, this high-intensity monitoring protocol has never been tested in a major study to determine if this intensive monitoring is actually necessary, he added. Lower Rates of ICU Admission Guidelines often recommend ICU monitoring for these patients due to the high level of nursing care required. While some countries have relaxed this requirement, others — such as the United States, where medicolegal concerns are more prominent — continue to manage these patients in the ICU. OPTIMISTmain was an international, cluster-randomized trial conducted at 114 hospitals across eight countries: Australia, Chile, the United Kingdom, the United States, China, Malaysia, Mexico, and Vietnam. It was designed to test the noninferiority of a new low-intensity monitoring protocol to the standard high-intensity monitoring protocol in patients with acute ischemic stroke who were clinically stable with mild to moderate neurologic impairment (NIHSS score < 10) within 2 hours of initiation of thrombolysis. The trial enrolled 4922 patients, with 2789 participants assigned to the low-intensity monitoring group and 2133 to the standard monitoring group. The primary outcome was the proportion of participants with an unfavorable functional outcome defined by a Modified Rankin Scale score from 2 (indicating some disability) to 6 (death) at 90 days. This occurred in 31.7% of patients in the low-intensity monitoring group and 30.9% of those in the standard monitoring group, giving a relative risk of 1.03 (95% CI, 0.92-1.15), satisfying the noninferiority criteria ( P noninferiority = .057). Symptomatic intracerebral hemorrhage occurred in five (0.2%) patients in the low-intensity group and eight (0.4%) patients in the standard monitoring group, a nonsignificant difference. The number of participants with a serious adverse event was similar between the low-intensity monitoring group (11.1%) and the standard monitoring group (11.3%). The low-intensity monitoring protocol was associated with lower rates of ICU admission, with 12.8% in the low-intensity group admitted directly to an ICU compared with 16.8% of patients in the standard monitoring group. Universally Applicable Results These figures and the differences between the protocols were much greater in the United States, where immediate ICU admission occurred in 47.1% of patients in the low-intensity monitoring group vs 77.1% of those in the standard monitoring group. 'This was a large trial with hard, accepted, patient-centered outcomes, and the results should be applicable across the world,' Anderson said. He pointed out that the trial also included process evaluations from the nurses and physicians involved, which he said were 'pretty much uniformly comfortable with the less intensive monitoring protocol.' 'It is not for us to recommend what guidelines do,' he added. 'But we have suggested that hospitals should consider implementing this intervention according to local circumstances to improve the efficiency of their care.' While a cost analysis has not yet been published, Anderson said the less intensive monitoring protocol is expected to save costs. 'Just the observation that there was a significant reduction in the use of ICU beds, especially in the United States, will result in significant cost savings,' he noted. 'This trial shows that we can use our nurses in a more efficient manner, and we don't need to send all our patients to the ICU; we can use our regular beds or stroke unit beds better and be a bit smarter,' he added. Anderson added that over the many years of using thrombolysis for acute ischemic stroke in clinical practice, it has become apparent that the incidence of ICH is low and that such strict monitoring might not be required. 'We have become more confident about how to use thrombolysis and which patients are at higher risk.' However, he cautioned that the low-intensity protocol would not be appropriate for all patients. 'This study only included patients who had a moderate level of disability when they presented. Patients also had to be alert, with good blood pressure control, heart rate, and respiration, and without other complicating health problems. We estimate that this would account for at least a third, maybe half, of all the stroke patients that come through hospitals around the world,' said Anderson. 'Less Is More' Commenting on the OPTIMISTmain trial, Valeria Caso, MD, PhD, professor of neurology and consultant neurologist at Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy, and a past president of the European Stroke Organisation, said she was 'very impressed' with the study. She pointed out that nurse-led trials are important as so much of stroke care is carried out by nurses. 'This trial is another example of 'less is more' that we are seeing in several aspects of stroke medicine,' said Caso. 'I think we will implement this lower-intensity monitoring protocol for less severe stroke patients in Italy. Nurses are in high demand, and we need to prioritize the resources we have. These results will allow us to prioritize the nursing resources regarding intensive monitoring in the first 24 hours for patients with severe strokes.'
The Guardian
15-04-2025
- Health
- The Guardian
Swapping out red meat and creamy pasta sauce could significantly cut household emissions, Australian research finds
Simple grocery swaps – including substituting red meat for chicken or plant-based alternatives, opting for dairy-free milk and yoghurt and choosing fruit toast instead of muffins – could substantially cut household greenhouse gas emissions, new research has found. A report by the George Institute for Global Health found switches could reduce a household's climate pollution by 6 tonnes a year, which it said was roughly equivalent to the emissions from an average household's grid-based electricity use. Researchers estimated the emissions for more than 25,000 everyday grocery items available at supermarkets including Aldi, Coles, Woolworths, Harris Farm and IGA. They found replacing 1kg of beef mince with chicken each week could cut more than 2 tonnes of carbon dioxide emissions annually, while switching to a meat alternative would save 2.5 tonnes. Switching one creamy pasta sauce to a tomato-based option each week could remove 270kg CO2 over a year. Prof Simone Pettigrew, the George Institute's head of health promotion and a professor at UNSW Sydney, said food was a necessity that contributed to about 30% of global emissions. Sign up for the Afternoon Update: Election 2025 email newsletter 'Australians are deeply concerned about the climate, and many people want to do the right thing. But it's hard to know which products are more sustainable when that information is not available on pack.' While researchers had known for some time that meat was worse in terms of emissions, and that vegetables were better, Pettigrew said there was a 'mountain of products that sit in the middle, and they tend to be the types of packaged foods that sit on our supermarket shelves'. To make it easier for consumers, the institute has translated its findings into a 'planetary health rating' ranging from 0 (worse for the planet) to 5 stars (better). Individual product ratings are available via a free ecoSwitch app, which also suggests alternatives with lower emissions. If consumers found some swaps too challenging – such as cutting coffee or chocolate – there were plenty of options across other categories like snack bars, pasta sauce or salad dressing, Pettigrew said. 'There are quite substantial amounts of difference that people can make through relatively minor switches as part of their grocery shopping.' In Australia, there was currently no requirement for companies to include greenhouse gas emissions information on food labelling, something the George Institute would like to see change. Sign up to Afternoon Update: Election 2025 Our Australian afternoon update breaks down the key election campaign stories of the day, telling you what's happening and why it matters after newsletter promotion 'In the future, we hope that the data and ratings we use in ecoSwitch could inform a national front-of-pack labelling system to provide more information for all consumers, and to incentivise industry and supermarkets to meet the demand for more sustainable foods.' Research by the Consumer Policy Research Centre previously found nearly half (45%) of Australians considered sustainability 'always' or 'often' when deciding what to buy. But the centre's chief executive, Erin Turner, said 'greenwashing', in the form of unsubstantiated, vague or misleading environmental claims, made it more challenging for people to make better choices. 'We think about the solution to greenwashing in two ways; you've got to get rid of the bad information, and get good quality information in front of people,' she said. Independent, science-backed information – such as the George Institute's data – was helpful, along with clearer definitions for commonly used terms like compostable, biodegradable and recyclable, she said. 'Consumer action does matter, and the choices you make can reduce your individual emissions. But also, we want to think about ways that our systems can encourage companies to do more and do better.'
