I’m a GP, so I talk to patients about their diets every day. Weirdly, doctors aren’t very well trained to do this, but when I started writing as The Vegan Doctor, I studied for a postgraduate diploma in Clinical Nutrition. This was partly to help readers and patients know that they can trust my advice, but also to learn more and to know that I am advising from a place of expertise, rather than from outdated NHS guidelines. Most of the discussions I have with patients are centred around their health, whether that’s because of a raised BMI (body mass index), or an increased cholesterol or blood sugar level. But I’ve recently been thinking that we might be best placed to have even deeper discussions about what and how we consume.
We know that the evidence shows that more plant-dominant diets like WFPB (whole-food plant-based), Mediterranean, and DASH (Dietary Approaches to Stop Hypertension) diets are brilliant for reducing the risk of conditions like heart disease, hypertension, and diabetes, but they can also reverse the effects of these diseases after they have already been diagnosed. Even so, these conversations can still be difficult. We know it’s hard to change your lifestyle, particularly when you’re busy at work, and have a family to feed. But (some) doctors are skilled at having these uncomfortable conversations, and making unpalatable changes seem like a sensible idea. So could we use this skillset to speak to patients about the impact their diet is having on the natural world? Moreover, do we have a duty to?
Doctors are also well-trained in accessing and critiquing scientific evidence. Anybody who has done this recently, with regards to the human diet, will be aware that how we are eating is significantly contributing to climate change. A recent adjustment to my day-to-day work has been switching inhaler prescriptions from those that deliver the medication through an aerosol mechanism, to more environmentally-friendly methods. This involves a chat with patients about the reasons behind the change to their prescription, and explaining that the carbon footprint of the old inhaler is much higher than the one we’re changing to. So if we’re being pushed to have these conversations, and we’re well versed in discussing not insignificant changes to a patient’s diet for disease risk reduction, why can’t we have the conversation about changing your diet for environmental reasons?
“Could we use this skillset to speak to patients about the impact their diet is having on the natural world? Moreover, do we have a duty to?”
Whilst encouraging patients to eat a plant-forward diet makes sense in the context of reducing the risk of diseases like type 2 diabetes, heart disease, stroke and bowel cancer, discussing how it can reduce their personal carbon footprint isn’t as inappropriate or strange as you might first think. The climate disaster should be everybody’s concern. This is our home, after all, and reducing your risk of chronic diseases might seem rather futile when your home is burning. But, if this still seems a bit too far into the realms of ethics and philosophy, why don’t we consider some of the connections between planetary and human health?
The animal agriculture industry is heavily contributing to global warming, being associated with increased carbon emissions and deforestation. Amongst the many detrimental effects of global warming, there is also the fact that increased temperatures can negatively impact human health. Extremes of temperature can lead to heat exhaustion and increased mortality rates, as well as worsening some chronic conditions like cardiovascular and respiratory disease. Increased global temperatures also provide the optimal conditions for infections to thrive, many of which are zoonotic in nature, meaning they have jumped from animals to humans, because of our ongoing use of animals. The way in which we’re farming also contributes to deteriorating air quality; fertilisers and livestock waste cause air pollution, thought to be responsible for 4.2 million premature deaths around the world in 2019. And that’s probably increased by now. We also need to consider the microplastics that are associated with cancer, hormone disruption, infertility, and kidney and cardiovascular disease; whilst these have more recently been found in drinking water, one common source that could easily be removed from our diet is fish. And whilst we’re considering the oceans – rising sea levels because of global warming are associated with flooding, which can cause excess deaths from drowning and the spread of deadly diseases.
The greenhouse gas emissions of vegans are around 25% that of meat eaters, and the difference is incremental; the less meat and dairy you consume, the smaller your emissions will be. If you have read any of my other articles, you’ll be aware of the direct benefits of plant-based eating for reducing disease risk and mortality. But when we add the indirect impact of climate change on human health, and consider how we can personally take part in improving this, I don’t think it’s unreasonable to expect to have these conversations when we see our GP. The UN has urged for a global move towards a vegan diet for many years, now. It really is time the NHS caught up.