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well, aiding the slides. You'll hopefully have read about me on the program. My name's Sharon purse. Um, I'm my day job is a consultant hemotologist it King's College Hospital. But a lot of my time outside of the NHS is spent on promoting education and advocacy on healthy plant based arts as one of the major solutions to not only the climate crisis but the crisis that we're facing and healthcare the ecological crisis on DTA Day. That's what I'm going to talk about. And I hope, well, I'll be able to call you all to action on get you all ready for the amazing plant based meal that we're going to enjoy at lunchtime. So outside of the NHS, as I say, I spend time as founder and director of plant based Health Professionals UK, a organization that is dedicated to providing education on healthy, plant based diets. On we're also a member organization of the UK Health Alliance on Climate Change, recognizing that a really important aspect off our action against the climate crisis is shifting the food system, and I provide education on this at Winchester University, and I'll come back to that at the end and always good to declare one's diet pattern when you're talking about doctor patterns. I've been vegan since 2013. So what we what I'm going to discuss today is the evidence supporting part based diets for personal and planetary help. Understand the international consensus on diet, nutrition and health on hopefully call you all to action by the end. So why are we talking about this? Well, you as an audience will know that our food system is a direct driver of a number of are interrelated crises. We've heard a lot about climate crisis already this morning. I have not heard the mention about food, food system change and changing the food and the NHS. So hopefully this will start a dialogue. We are in the six months extinction event were losing more plant and animal species at rates unprecedented. We are facing a health crises. More and more people are spending their last decade of life in ill health, and we have a crisis off ethics whereby we slaughter over 80 billion land animals every year. Let me say that again. Eight billion people on this planet slaughter 80 billion land animals. More than a trillion fish for a food that I will percent persuade you that we do not need on a narcotic, Ally wrote on World Poultry Day. To me, well, Poultry Day reminds me that we slaughter 50 billion chickens for food every year. So why is it so important to be recognizing the food system? In today's event? We'll animal agriculture is the leading driver off climate crisis. It is the leading cause of species extinction, ocean dead zones, water pollution, habitat destruction. We heard from human got Marie about the Amazon being destroyed, but we didn't hear the mention that 91% of that destruction is because we are demanding animals for food. It's being cleared to grow grain, to feed our animals and to graze animals. 70% of farmland in the UK is dedicated to raising animals for us to eat. When the health we know we need to be centering our diets around, tell theme foods and this shows it again. You can see in the graft on the right hand side that theme XXX shows the carbon emissions from the food that we eat and at the top is listed all of the animal products at the bottom. The lowest environmental impact is every single plant food you can think off regardless off the way we produce it, how we transport it. Every choice you make to consume a plant based product has significantly less carbon footprint. Um, then any single animal food with guard less of how you produce on transported. However, as I say, most of our resource is a going to raising animals for food. Yet on a global level, this animal food only supplies us with 18% of calories on 37% off protein. So something is very wrong, and we cannot spend this day without mentioning the associated crisis off antibiotic resistance. This paper published just really er this year shows that the trajectory is completely in the wrong direction. We are now losing 1.3 million people globally toe antibiotic resistant infections that makes this condition the 12th leading cause of death. It kills more people than HIV infection on malaria. On 70% of antibiotics that we use on this planet are given to animals raised for food. Without them, we would not be able to sustain factory farming in the squalid conditions that these animals have to live their lives, and we've heard about the eye. PCC report. The working group to report just published is all doom and gloom. We have less than a decade to change the trajectory. However. It puts the food system center off the plans to change this church trajectory. The single most impactful action week and all takers individuals is to change the food we eat in the report. It say it states. Reduction of excess meat consumption is among the most effective measures to mitigate greenhouse gas emissions with a high potential for my mental health, food security, buy diversity and animal welfare co benefits. And again, we want to stay within now probably the target of less than 2 C off warming. However, this paper in science from 2002 years ago really states that without changing the food system, we cannot meet any of these targets. Even if fossil fuels emissions were eliminated immediately, emissions from the global food system alone would make it impossible to limit warming toe 1.5 degrees on difficult enough to realize the target of 2%. We have to change the way we produce food, but there's health professionals. We are looking after people with chronic illness, health. Much of that is preventable, and we are a two state now, According to the Global Nutrition Report of 2021 where are global food system is responsible for for one in four deaths, that's one in four deaths that occur globally. On in Europe, 31% of deaths are due to unhealthy diet. And in addition, as we've heard, the food system is creating 35% of all greenhouse gas emissions. More than 50% of that comes from raising and consuming animals for food. In 2019, we had a in depth analysis from the Global Burden of Disease Study Group, looking at dietary risk factors from 195 regions around the world. At that time, only one in four deaths premature deaths were caused by an unhealthy diet, and that was only got worse. But in depth detail showed us that the key dietary risk factors were diet high in sodium, which is of course, a reflection of our reliance on pre prepared and packaged foods. And in the UK, more than 50% of what we put into our shopping basket is classified as ultra process food 2nd and 3rd and 4th and 5th to that is the fact that we are not consuming enough healthy plant foods. That's whole grains, fruits, nuts and seeds lagoons on D vegetables. And this is leading to excess death and chronic illness from cardiovascular disease, type two diabetes and cancer. And this problem has been further highlighted during the pandemic, it was quite clear that people with underlying health conditions fared worse and had a much higher risk of dying from the pandemic virus. On the left hand side is the report from the 17 million GP health records analyzed by the open safely, Um, study that showed that in the first wave, 90% of people who died from covert 19 had another little underlying health condition. On the right hand side, you can see an analysis from the US A million people admitted to hospital for covert 1960% of those admissions could have been prevented if these individuals did not have four conditions hypertension, heart failure, obesity and type two diabetes. These conditions that eminently preventable through a diet and lifestyle approach. So what is a healthy diet for humans on for the planet where the work has been done for US. 2019. The Eat Lancet Commission published there. Planetary Health Plate. They brought together 37 scientists from 16 countries around the world devisor diet that not only was healthy for us but would keep the food system within planetary boundaries boundaries that we've already breached on. Here it is. You can see that half the plate is dedicated to fruits and vegetables around a quarter whole grains. The green here is plant derived protein. There's unsaturated fat fatty acids from plant sources, limited sugar on. Then you can see here that a small portion is giving you an allowance to continue eating animal foods. But it clearly says we do not need animal products in the dark to make it healthy, certainly for sustainability, we should eliminate all animal products if we can, but if you choose to continue to eat, it should be less than 13.5% of your energy or calories on a daily basis. This amounts on the right hand side to one portion of red meat, less than 100 g, two portions of poultry on around three eggs per week, and this is put into a graphical form here, using data from the most extensive analysis farm to four canalys of the Environmental Impact of Food, published by Joseph Poor in the journal Science and 2018 and you can see Encircled and green are the foods that not only promote our personal health but have the lowest environmental impact. And they are fruits, vegetables, whole grains, beans, nuts and seeds. And we have to remind ourselves that if everyone on this planet ate like people in the UK, we would need seven planets to feed the world. This paper, published just a few weeks ago, and allies, is the co benefits the Personal Health and Planetary Health. In a perspective, cohort studies of the epic study has nearly half a million participants from 10 European countries followed for around 14 years, and they assess the impact of the Eat Lancet planetary health plate on what that would mean for personal health on what it would mean is, if we were a Deering as best we could to those guidelines, we could reduce the risk of premature death by 63%. We could prevent up to 40% of all cancers, Onda. Thankfully, we could reduce greenhouse best emissions from the food system by 50% on a free up 62% off all of farmland globally. That is huge. So what if we decide today to adopt 100% plant based or vegan diet? Is it safe? Is it healthy? Is that nutritious? The answers are absolutely yes. We have all the Data Dietetic Association from around the globe, including the British one telling us that vegan diet Concert fort How healthy living in people of all ages that's cradle to grave. So this is undisputed. How do we know this? Well, we've got populations around the world. Terms of the Blue zones, which were defined defined by the demographer Dan Beutner and presented his research, was presented in the Natural Geographic magazine. He described regions around the world where people live the longest and healthiest lives, and you can read their where these regions are, and this is a picture of a sentence very in Arkansas were still living a vital on healthy life, contributing to society. Now, of course, there's more than one aspect of their lifestyles that they share. Theres in about nine lifestyle factors that they all share in common. But today's focuses on diet on. When you look here, taken directly from the website, you can see that 95 200% of their diet is plant based. They go holy on minimally processed plant foods. They have a daily dose of beans. Now beans is the source of the main source of plant. Protein is key to these areas where people live long, healthy lives. Drink water, the thirst, snack or nuts. Go away from fish, eliminate eggs, slash the sugar, reduce the dairy retreat from me So the health healthy planetary diet would fit the criteria. What about more robust data? We have perspective Cohorts studies the's. The data from the Nurses Health Study and the health professionals follow up studies from Harvard University that followed more than 170,000 men and women, pretty much nurses and health professionals for the best part of three decades. Now they've looked at the impact of healthy diet alongside other healthy lifestyle factors. So if you think about people who have never smoked a healthy weight, healthy diet, regular physical activity and moderate rather than excessive alcohol, when you deep deep more deeply into the dietary risk factors. They score the diet highly if you consume lots of fruits, vegetables, whole grain unsaturated fatty acids from plant foods and omega three fats, which obviously come from plants or fish sources and it's a healthy diet is low in processed and red meat and also in processed foods in general. So what happens after 30 years of a healthy diet and lifestyle? Well, if all you do is adapt your diet to a healthy plant predominant diet, you can reduce your risk of dying from cancer by 30%. Cardiovascular death, cardiovascular death reduction by 33% If you have all five healthy lifestyle factors, cancer death is reduced by 65% and cardiovascular death by 82%. There is absolutely no pill or procedure we can prescribe that will have these health outcomes. What about the health of vegan? Say we all decide in this room to a doctor vegan diet because it's the most impactful action you can take it and individual to combat the climate and ecological crisis. Would our health be adequate? We have data from the Adventist tell study two in the US on it. Here in the UK, the epic Oxford study large cohorts followed for decades and around a third of participants are vegetarian or vegan. So what do we know? So just summarizing the data briefly. We know that as you remove meat from the diet or all animal products from the diet, you are more likely to be a healthy weight. So from omnivorous to vegan, be a my back in the normal range. Omnivorous to vegan. You can stash your risk of type two diabetes by around 50%. Vegans have a 63% reduce risk of high BP, and hence the dash diet that is a therapeutic intervention for people to treat. Hypertension was modeled on the vegan and vegetarian diet on. You're much more likely to have a healthy cholesterol. Now, if we're not talking about preventing ill health, we are not going to meet climate targets because to reduce the impact of healthcare on the climate, we need to use much, much less off it. What about other populations? I've shown you data from Caucasian population here is the cohort of vegetarian and vegan is from Taiwan. The sushi study nearly six, they're over 6000 participants, of whom a third of vegetarian and vegan and I have summarized a large number of studies that they've published, showing exactly the same better control of body weight. Lower risk of type two diabetes, less fatty liver less. Goldstone's less stroke and I'll come back to medical expenditure because we need to talk about that. Recently published UK data from the UK by bank has given us another cohort where we can look at the health of people who do not eat meat on this particular analysis. Looked at the incidence of cancer in people following a meat free diet. It lumped together both vegetarians and vegans in the same analysis on what we showed was that as you remove meat from the diet, you can reduce your risk of cancer by 14% on for certain cancers like breast cancer, women reduce their risk by 18% on men, reduce their risk of prostate cancer by 31% so there is no detriment to your health if it's removing meat on. If we want to reduce the carbon footprint off the health care industry, we need to reduce our reliance on the healthcare system we need to promote soft reliance of health on the sushi study showed us that they're vegetarian. Participants used 15% less medical expenditure on that was from going less to the outpatient department. Less medications than their arm never risk counterparts. So it's a click bait headline that article I contributed to. But if you translate that into the NHS, that's 30 billion lbs we can potentially save by adopting a healthy, plant based diet. And now we have proof that this could have helped us reduce the severity of covert 19 in the UK population. We all are well aware of the famous cove. It is Oh yeah, study that I'm sure many of us have contributed to. They collected our dietary data up front on this study, analyzed a half a million participants and have contributed to that study and contributed their doctorate data on. They showed that a healthy plant based diet centered around fruits, vegetables, whole grains, beans, nuts and seeds reduce your risk of acquiring covert 19 by 10% on the severity by 40%. Now I fully appreciate that diet and lifestyle choices are very much tied into associate economic determinants of health. We need to address both. We need to address access affordability off are healthy foods so that all the population can access this on. This study showed that if we both addressed diet and socioeconomic risk factors that are determining our health outcomes, we could have prevented a third of covert 19 related deaths. That is huge. Now. The comment that is always put to us as vegans is well, it's more expensive. Well, it is absolutely not. And now we've got this study from Marcus bring them from the Oxford University who analyzed different types of sustainable diets, whether you call it flexitarian Pescatore in on, he analyzed data from 150 countries using food prices at the time from the World Banks International Comparison Program and in high income countries like the UK. Actually adopting a healthy vegan diet would reduce your food bill by a third, so this narrative has now been debunked. It is not more expensive to eat a healthy plant based on in the UK. So what is the international consensus when it comes to health? Can we be promoting this type of eating foot to our patients to live a longer, healthier life where the answer is absolutely yes. This is embedded in international guidelines. So the American College of Cardiology that is a chapter off the British Society of Cardiology has published guidelines in 2019. For the price primary Prevention of cardiovascular disease, they recommend to diet patterns, plant based or Mediterranean. When it comes to consensus on treatment of Type two diabetes, all patients should strive to attain and maintain an optimal weight through a primarily plant based meal plan. What about cancer? Died lines in my specialty? Well, yes, absolutely. In green, you can see eat a diet rich and whole grains, vegetables, fruits and beans, it says. Limit red and processed meat, I would say eliminate. There is no health or climate and argument to support the consumption of red and processed meat process. Red meat has been classified as a group one carcinogen. It is criminal that we still serve this in our hospitals. We need to change this. And what about national doctor guidelines? While they're catching up, I always ask my audience to have a look at the health thie dietary guidelines from Canada and tell me what they do not see there as a food group that we've been so used to seeing and all our guidelines. But what you can see is that it's very similar to the eat lance that planetary health plate, half fruits and vegetables called whole grains and a quarter protein onda make water your drink of choice when it comes to protein, it clearly says, for the co benefits the health on the planet. Choose plant sources. Beans, not seeds, legumes, pulses. The latest guideline that he found was from Denmark. You can read their eat not rich, very did. Not too much. And what about the UK? What are we doing? Well, it was great to read the document from the National Food Strategy. It's a really valuable document. Actually, if you haven't read it, I would urge you to. Sadly, for me, the recommendations are slightly watered down because actually, to meet the requirements of the Eat Lancet planetary health play, we would have to slash our meat consumption. There you cable I 80% but you can't argue this is the right direction we need to promote fruit and vegetable consumption. At the moment are patients only 28% of U K citizens of consuming five portions of fruits and vegetables. The average fiber consumption is 18 g when we need to be aiming for more than 30 g. And, of course, our reliance on ultra processed foods is far too much, and that needs to to change. And there's vegans. We get fed up of hearing that the diet is restrictive on nutrient deficient. It is far from that you only have active adopted a plant based diet for a few months to know how abundant it is. The fact is that our global diet is restrictive. 60% of global calories come from four plant foods. Wonder if anyone knows what they are. Wheat, rice, soy a maze, 60% of calories. That is not a problem with the plant based on it. It's a problem with global diets, and that needs to change. But this analysis of 141 studies and a meta analysis looked at the dark tree adequacy of different diet patterns, and you can see vegan, vegetarian and meat eaters, and every diet pattern needs to be planned. Doesn't matter how you choose to eat. You need to make sure you're getting your nutrients on a plant based on is no different. Of course, I would be a mist, um, not mention B vitamin B 12 not found in animals or plants on day formed by microorganisms. We need to get that from a supplement if we're following 100% plant based diet. But in summary, the authors conclude that as plant based diets are generally better for health and the environment, public health strategies should facilitate the transition to a balance start with more diverse, nutrient dense plant foods. I could not agree more. And if we are really interested in climate, justice, climate health, then we need to think about our food choices as a social justice problem for our fellow humans. None of us grew up with the ambition to be a slaughterhouse worker, yet we expect our fellow humans to slaughter those 80 billion land animals every year. This paper is just one of many in the literature just showing the detrimental effects off sort of house working on the individual, the human that has to do it, and covert 19 highlighted how meat packing plants were a really sort of center of covert 19 outbreaks for the reasons that I don't need to explain. But this study highlights once again the mental and physical detrimental effects that this type of work has on, by definition, marginal populations who have absolutely no choice but to turn up to this sort of work every day. Now you need to invite me back for another talk to talk about the profound health benefits that are up for grabs in treating people with a healthy, plant based diet. But I just thought I would highlight my father's case. So he was 77 in September 2020. Sadly, like many South Asians, he had developed metabolic syndrome. He was overweight, should be aiming for less than 23. For us South Asians with high risk of visceral fat and type two diabetes. His triglyceride were through the roof. He had been front diagnosed with prediabetes. Now it was a surprise to me. It taken so long for him to develop prediabetes, given that he had had a Whipple procedure removing half of his pancreas in 2000 and 4 50% of patients that told they'll become diabetic and I didn't know whether it was even vaguely possible to reserve reverse a directory, but we weren't willing to give up, so he saw my friend on DCAA League and Rainy. But Jaeckel, you put him on a healthy, culturally appropriate plant based, our daily walks resistant exercise. And within seven months he's reversed that trajectory and kept there, Um, all the all the way until today. My parents, the 79 they eat a healthy, plant based or vegan diet. So I leave you with this. Almost leave you with this. It's time for us to demand a plant based food system. Our food choices matter without addressing food production. We cannot meet our climate targets. Health professionals should be leading by example in supporting patients to make healthy choices that will improve their quality of life on those of future generations. So I hope I've persuaded you that there's a large body of evidence to support plant based arts for personal and importantly, planetary health. National and international guidelines have caught up with this evidence on. We cannot think about our personal choices without considering the global planetary health context. So what? Um, I take home action points. Here we go. Think about your favorite meals and decide how you're going to make the more plant based swap. The minutes for beans, adding more leafy greens, decide to take a plant based challenge myself in my colleague L. J. Smith at King's College Hospital, he was talking. I would urge you to listen to you later. Running the No Meat May International campaign at King's College Hospital, asking people to ditch meat in May and beyond. Ask your patients about their diet is the single most important risk factor leading to their chronic illness. And ultimately, they're premature death. Those online might have to scan this viral code at plant based health professionals. We have a 21 day plant based else challenge free. You can find it on the website. Sign up. You'll get daily e mails, fact sheets, videos that will start you on your plant based journey. It really is not difficult. I hope I've inspired you to learn more. Educating ourselves is the first important step. Take my course that Winters to university has fabulous feed about running for three years. It's part of the greener impact. Talk it all of your GPS. You can take it as part of your Silver Award on day, you'll find me at the stool. Come and ask me questions there. I haven't had time for questions in this short half hour talk today. My first book, Out on the Left, is available. Teo By but to fill the gap in the healthcare textbook market, we have got an editor textbook just on this topic coming out in September. Thank you very much. Thank you very much. Started some this very, uh, powerful facts on a noise personal story at the end. Thank you. Just quickly. Before we move onto questions, there's a talk about Begin by Danielle it in the lower the room. So the one just upstairs. That is about the evolution off operating theater. A tire. So anyone that works in the theater, that's a good one for for you to 10 on. But we'll move on to Judy, who's also out now. But just lately we've got some a couple minutes for questions. Eso Does anyone have any questions out on the floor? Got to at the back there. Could you get me the person front first? Hi. Sorry. Just want to ask the omnivorous a group of patients in order for people in a lease studies. Are they on healthy, omnivorous based diets? Or are they your average kind of population? Because I'm just wondering if they're not a healthy, balanced diet in that category than is the study a bit biased, a reflection of most sort of study sign ups. Things like the ethic, Oxford Studying and Adventist tell study that generally, when the diet has been analysis a much healthier than the standard diet of the UK American population. So just being part of the advent, it's health community. People live 10 years longer than their fellow US citizens, for example. Similarly, in the epic Oxford study, that sort of healthy user bias more of the healthy people had sort of signed up for this. So, yes, it is a comparable diet, and you can see that through their fiber consumption and fruits and vegetables being mawr than you would typically expect. On the typical UK diet, we had another question just behind Hello, thank you. I just wanted if there's going to be any further directional guidance for any just providers regarding feed, you know, I speak into my kating manager and he was so horrified at the thought of making plant based food really available. He put on the menu every single day. So I think it needs to come from the top. And I just wanted you knew what was happening. Yeah, we could not agree more. L J and I are battling this at a local basis. So in our green plan, it says we're going to move to a plant based food environment. We're going to remove process red meats from the menu. It's been a year of us trying to actually get this into action. So I put this question too. Nick, what's I don't know where he is. But I would like to ask why is food not center of the HS green plan? Any any other questions, but one of the head. So I just want to ask as more vegan alternatives and substitute to become available. A lot of them are starting to get more and more like processed food. And what sort of things to avoid that area? Yes, So I'm not talking about a diet that's replacing one ultra process food with another ultra process food. You know, our food system is created and driven by corporate and financial interests. And they will continue to produce products they think we want eat by replacing like for like so, just shifting from an ultracet Western diet to an ultracet plant based on Well, of course, help the animals in the environment. Probably, but it's not going to help our patients in our personal health. So I think, like with all things we need to keep our ultracet consumption minimal. Clearly it's useful in social situations when we want to find alternatives on the go. But I haven't talked a tall about that that type of diet as the ideal. We're talking about censoring our diets on really cheap, affordable, accessible foods like fruits, vegetables, whole grains, etcetera.