How About These Apples?

By By Stacia Clinton, RD LDN & Kendra Klein, PHD on January 12, 2015

HowAboutTheseApplesEnvironmental Nutrition redefines healthy food beyond simple diet. 

Twenty years ago, in a side room of the national Food and Nutrition Conference, a group of dietitians sat down to ask an unconventional nutrition question: How will we keep growing food on a planet threatened by energy crises, soil erosion, water pollution and a host of other environmental problems? That group became the Hunger and Environmental Nutrition Dietetics Practice Group of the Academy of Nutrition and Dietetics (HEN).

Since then, the environmental nutrition question has moved steadily from the margins to the mainstream. An environmental nutrition approach understands that healthy food cannot be defined by nutritional quality alone. From this perspective, not all apples are created equal: A given apple’s path from farm to plate can result in greater or lesser health, social and environmental benefits. While traditional nutrition asks how much vitamin C and other nutrients are in an apple, environmental nutrition guides us to ask a broader set of questions, such as whether the apple was grown with toxic pesticides, whether the workers who grew it were treated justly and which communities had access to purchasing it. To rework a familiar saying, we might ask which apple a day is more likely to “keep the doctor away.”

HEN, along with a growing number of health professionals and hospitals participating in the Healthy Food in Health Care program of Health Care Without Harm and the Healthier Hospitals Initiative, is using an environmental nutrition approach to put food at the center of prevention-based care.

“The environmental perspective on nutrition [in Environmental Nutrition: Redefining Healthy Food in Health Care] is essential for the long-term well-being of humans and our planet. Traditional nutrition remains a central part of this; we must provide essential nutrients and minimize unhealthy aspects of diets, but if we produce this food in ways that are unsustainable and damaging to the soil, atmosphere and water supplies upon which life depends, the consequences for health are dire. … Hospitals and other elements of the health care systems should be leaders in this effort as we have a special responsibility to support the health of those for whom we care, and also because our actions can carry important credibility in this effort.”

—Walter Willett, MD, Dr.PH
Professor of Epidemiology and Nutrition,
Harvard School of Public Health

Healthy Food in Health Care: A Role for Health Care Institutions

As a striking signal of the growing support for an environmental nutrition approach among leading social institutions, sustainability is being considered for the first time as part of the 2015 Dietary Guidelines for Americans. The guidelines are the official word on healthy food, directing government dollars and such public education campaigns as My Plate that advise Americans on how to eat.

Last year also culminated HEN members’ efforts to embed an environmental nutrition approach within the official standards that guide dietetics curriculum with the release of the Standards of Professional Practice in Sustainable, Resilient, and Healthy Food and Water Systems by the Academy of Nutrition and Dietetics. This provides a much-needed framework from which health care professionals can evaluate current knowledge and identify areas for professional growth to forge a new culture that embraces environmental nutrition as the norm.

Finally, to focus the momentum building around an environmental nutrition framework, Health Care Without Harm recently released a white paper, Environmental Nutrition: Redefining Healthy Food for the Health Care Sector, emphasizing the central role health care plays in fostering this new nutrition paradigm.

What does all this mean? Above all others, the health care sector has an important opportunity to harness its expertise and purchasing power to create a healthier, more sustainable food system. With the help of the Healthy Food in Health Care program and Healthier Hospitals Initiative, hundreds of hospitals nationwide are already transforming food supply chains by sourcing sustainably produced foods including organic produce, hormone-free dairy and meats raised without routine antibiotics.

Health care institutions are also leveraging the moral authority associated with health care credentials. Within hospital walls, food service staff and clinical dietitians model sustainable food choices for patients, employees and visitors. Institutional policies, such as UCSF Medical Center’s resolution providing guidance for the hospital to phase out procurement of meat produced with nontherapeutic antibiotics, highlight the complex intersections of medicine, public health, agricultural practices and the ecosystems in which we live.

Beyond hospital walls, health professionals are also crucial advocates for public policies that create the conditions for a food system that guarantees environmental stewardship, maintenance of local economies, animal welfare and protection of public health for all citizens, now and into the future. The Agriculture Act of 2014, otherwise known as the Farm Bill, is an ideal example of a federal policy that will benefit greatly from the expertise and perspective of health care professionals.

An apple a day is clearly no longer enough. It is up to health professionals to apply this kind of systematic approach to fostering a healthy, affordable food supply to help further transform nutrition and agricultural policies.