3 DECEMBER 2021 ausdoc . com . au
PAGE 34 effect of high temperatures occurs on the first and up to three days after exposure . If a heatwave is predicted , increasing patient awareness , social networking , access to air-conditioned environments , physician and hospital preparedness , and heatwave alert response systems help prevent heat-related deaths . 284
Australia ’ s carbon emissions
In the year to March 2020 Australia produced 528.7 million tonnes of carbon dioxide equivalent . 293 The percentage of emissions by sector is shown figure 3 .
Greenhouse gas reduction and cardiac co-benefits
Measures to reduce greenhouse gas ( GHG ) emissions can have cardiac health benefits ( see box 1 ).
Plant-based diet
Agriculture was responsible for 12.9 % of Australia ’ s GHG emissions , the third-largest source after energy and transport . 293 Direct livestock emissions account for nearly 70 % of these GHG emissions , and ruminant livestock accounts for 52 % of Australia ’ s methane emissions . 321
Diets rich in plant-based food and lower in animal products are healthier and associated with less environmental impact . 322-324 Compared with a Western diet , the Mediterranean diet is estimated to decrease GHG emissions by 72 %, land use by 58 % and energy consumption by 52 %. The Western diet increased the previous descriptors by 12-72 %. 325
Reducing red and processed meat , or consuming only foods whose production involves low GHG emissions , leads to significantly lower GHG emissions and has health benefits .
326 , 327
Plant-based diets could reduce mortality from stroke , type 2 diabetes , CHD and cancer by 6-10 %, and reduce diet-related GHG by 29-70 % by 2050 compared with a standard diet . 328 The Mediterranean , Dietary Approaches to Stop Hypertension ( DASH ) and Nordic diets are associated with lower mortality and reduced non-communicable diseases . 329 , 330 The Mediterranean diet decreased severe CVE among individuals with significant risk factors for CVD . 331 Similarly , the DASH diet ( mainly plant-based foods , some animal products , low and non-fat dairy products ), decreased allcause mortality in adults with hypertension . 332 The Nordic diet ( high in plant-based foods , whole grains , nuts , dairy , fish , shellfish and free-range livestock ) has beneficial effects on cardiometabolic function . 333
Vegetarians have a lower risk of IHD and diabetes compared with non-vegetarians . 334 A meta-analysis of vegetarians and vegans vs omnivores noted vegetarian diets were associated with a lower incidence of cancer and mortality from IHD ; vegan diets were associated with a lower risk of cancer . 335 Mediterranean-like , pescetarian and vegetarian diets reduced the RR of type 2 diabetes , cancer and CAD mortality by 10-40 %; however , all-cause mortality was reduced only by the Mediterranean and pescetarian diets . 336
Not all plant-based diets are beneficial in terms of chronic disease risk . Plant-based diets containing higher amounts of healthy foods such as whole grains , fruits , vegetables , nuts , legumes , oils , tea and coffee were associated with a lower risk of CAD
Box 2 . How to mitigate climate change
• Reduce your personal carbon footprint :
• Transport changes : — Reduce motor vehicle use — walk , cycle , carpool , use public transport . — If driving , plan your route to avoid heavy-traffic areas and additional pollution from idling vehicles , avoid rush hour , use alternate routes . 341 — Use a low- or zero-emission vehicle ( hybrid or electric ).
• Dietary changes : — Reduce ruminant meat , dairy . — Reduce packaged / takeaway foods . — Buy local , seasonal , organic , and sustainably produced foods , cook more at home . — Grow an edible garden .
• Conserve energy : — Turn off lights and devices when not in use and switch off at the power point : standby mode uses up to 90 % of energy compared to fully on . 342 — Avoid leaving devices charging overnight . — Change to LED light bulbs . — Insulate your home . — Set thermostat at 18-20 ° C during winter and 25-27 ° C in summer to cut bills . 343 — Install a smart meter .
• Reduce food waste : — Australians throw away 3.1 million tonnes of food per year . 344 Food waste generates 8 % of global GHG emissions . 345 — Start composting . — Get FOGO ( Food Organics , Garden Organics ) in your local council .
• Conserve water : — Use a low-flow showerhead , four-minute showers , use half flush , wash with full loads , fix leaks , use cold instead of hot water .
• Reduce personal / home / work waste : first reduce , then re-use , then recycle : — Think about the life cycle of products . — Reduce single-use products / plastics . — Buy in bulk . — Re-use : divert waste from landfills , give away or sell unwanted products . — Repair , repurpose , ‘ upcycle ’. — Buy second-hand . — Buy recycled and / or environmentally responsible products . — Recycle appropriately : hard / soft plastics , paper , e-waste , batteries ( see figures 6 , 7 and 8 ). — In the workplace : reduce , re-use , recycle , rethink , research . 346 — Reduce paper use and printing .
• Reduce ( personal ) fashion footprint : — The fashion industry contributes to 8-10 % of global CO 2 emissions , 20 % of industrial water pollution and 35 % of oceanic microplastic pollution , as well as consuming 79 trillion litres of water per year . 347-350
351 , 352
— A large amount of textile waste ( more than 92 million tonnes per year ) also ends up in landfill . — In Australia , every 10 minutes , six tonnes of clothing and textiles go into landfill . 353 Most is comprised of artificial fibres which take 200 years to break down . — Avoid ‘ fast fashion ’: buy less , choose quality clothing and make it last . Extending the life of garments by nine months reduces the water footprint by 5-10 %. 354 — Buy natural and sustainable fibres . — Support ethical , fair-trade and responsible brands . — Shop locally made , second-hand / vintage / op shops . — Recycle , repair , ‘ upcycle ’ your old clothes : donate to charity , give away , swap and sell unwanted clothes .
• Reduce air travel , thus reducing CO 2
: — Rethink attending conferences requiring air travel , use video . 355 — Holiday locally . — Carbon offset flights .
• Financial divestment : — Change investments to those not investing in fossil fuel and related companies , and those that do invest in renewable energy . — Support local , sustainable and ethical brands / companies .
• Switch to renewable energy sources : — Switch work and home to renewable sources or to an electrical provider using energy from renewable sources .
• Consider environmental sustainability in clinical decisions : — Avoid unnecessary pathology testing , limiting CO 2 emissions from pathology collection consumables . 356
• Keep patients out of hospital : — The carbon footprint attributable to healthcare was 7 % of Australia ’ s total . 357 — Hospitals account for nearly half and GP clinics 4 % of total healthcare CO 2 emissions .
• Join and support advocacy / environmental organisations : — Join advocacy groups . — Influence government policy : contact politicians regarding the health implications of climate and energy policy . 358 — Increase public awareness to protect human health . 359
Figure 6 . Recycle responsibly .