Vegan input given to Preventive Health Strategy inquiry

Vegan Australia recently made a submission to the Australian Department of Health on its Draft National Preventive Health Strategy. The submission (below) was made in response to this consultation survey.

Introduction

While Vegan Australia is in broad support of many of the policy areas covered by the National Preventive Health Strategy, this submission will focus on the promotion of a healthy plant-based diet and its evidence-based benefits to human health and the environment.

Vision

The vision given in the Strategy is "To improve the health of all Australians at all stages of life, through early intervention, better information, targeting risk factors and addressing the broader causes of poor health and wellbeing." Vegan Australia agrees with this strategy vision. A healthy diet in childhood is a major indicator of health in later life, so early intervention is important. Better information about health and diet is required to counter the adverse effects of marketing and lobbying by the processed food and animal agriculture industries. The Strategy should not overlook the vital opportunity to address these broader industry influences on poor health choices, policies and dietary guidelines. The Strategy should also place more emphasis on the preservation of the natural environment and the increased sustainability of agricultural sector practices, and how these strongly interplay with the health of the human population.

Aims

The aims are generally good but should also include: "Australians live in a healthy environment". The health of the planet's ecosystems is the basis for all human health and so should be intrinsic and fundamental to any preventive health strategy.

Principles

Vegan Australia supports the six principles included in the Strategy, with the following comments.

Multi-sector collaboration is required to address many of the issues currently facing Australia and the world. This should include partnerships with independent scientists, institutions, non-profits and the environmental sector to leverage off their ongoing work towards a liveable and sustainable planet.

Community engagement is necessary to drive prevention. This should be accompanied by broader, systemic efforts and policy changes to limit the influence of commercial interests which often act in opposition to good health outcomes through lobbying, marketing, advertising and other techniques to drive their profits.

Adapting to emerging threats and evidence. A major risk to our health is the previous, current and emerging threat of pandemics, with the most likely cause of future pandemics being human exploitation of both wild and domesticated animals. The Strategy should include measures to help prevent further pandemics and not just to adapt to them.

The equity lens. This should include access to healthy plant foods, including making them more accessible to all Australians as well as being more culturally acceptable, affordable and convenient.

Enablers

Vegan Australia has the following comments on the seven enablers. The comments also include the goal policy achievements for each enabler.

Leadership, governance and funding. The Strategy states that preventive health should be "informed by a national, independent governance mechanism". The Strategy should ensure that this mechanism is independent from any commercial interests and is based on unbiased evidence. It also states that cross-sectoral partnerships are important in addressing health. However, the agriculture and food industries should have no influence on these decisions, due to their inherent conflicts of interest.

Prevention in the health system. Since "most Australians value and act on advice from health care professionals", the Strategy should include measures to formally educate health practitioners, particularly GPs, on nutrition and the benefits of whole food plant-based diets. The Strategy suggests deeply embedding prevention as part of routine health service delivery. This should include ensuring more healthy plant-based meals are available in places where food is served, such as hospitals, aged care, schools and residential facilities. Medical doctors receive on average less than four hours of nutrition-related training during their undergraduate degree studies. Considering that diet-related chronic disease is the major contributor to five of Australia's top ten leading causes of death, it is crucial that medical professionals gain more evidence-based nutrition content embedded in university curricula. Career-stage medical professionals require opportunities to engage with Continuing Medical Education in the fields of both practical and clinical nutrition science. They can't pass on to their patients what they don't know and weren't taught!

Partnerships and community engagement. The Strategy states that "partnerships action must be protected from undue influence by any form of vested interest." This is especially true in the food sector through their targeted advertising, marketing and sponsorships aimed at influencing the public, institutions and government-based nutrition advice and guidelines. The Strategy should include measures to ensure such influence does not occur.

Information and health literacy. The Strategy states that "all Australians should have access to high quality, evidence-based information". To avoid the risk of people being deliberately misled by profit-driven messages that ultimately lead to food choices with dire health consequences, the Strategy should include recommendations that the advertising of unhealthy processed foods be prohibited. This should include all marketing and not just that directed towards children.

The preventive health literacy of health professionals should be developed through education about the key role diets play in preventing, halting and often reversing chronic diseases. Skills in how they can convey this information effectively to clients so that healthy lifestyle changes are more likely to be adopted for the long-term are also required.

Monitoring and surveillance. We agree that "prevention needs to address the social determinants or root causes of ill health". In particular, an indicator of progress would be an "increase in access to a nutritious and affordable food supply in food insecure communities".

Preparedness. As the Strategy explains, it is important that Australia builds preparedness for the emerging threats of climate change, future pandemics and antimicrobial resistance. But there is more that Australia could do to work towards preventing these threats from occurring, by finding the causes of these future health threats and addressing those base causes. Vegan Australia recommends that the Strategy include a specific section on the importance of reducing the risk of these emerging threats occurring.

The Strategy states that "climate change is likely to be the biggest challenge to health". The two main drivers of climate change are fossil fuel burning and animal agriculture. To prevent the worst effects of catastrophic climate change, we must tackle both fossil fuel burning as well as the emissions, deforestation and food insecurity inherent in animal agriculture. Whilst technology, research and development can be used to find ways to supplement animal feed in order to reduce emissions, the most immediate and cost and resource-effective method is to reduce the number of animals passing through the animal agriculture system and invest in plant-based agriculture. The Strategy should recommend a bold and urgent shift away from animal agriculture and a corresponding shift to plant-based diets, for environmental reasons.

In several places, the Strategy discusses the COVID-19 pandemic and its effect on the health of Australians. There have been many warnings that the COVID-19 pandemic may well be a 'dress rehearsal' for future pandemics caused by animal agriculture, with intensive animal agriculture being a 'perfect breeding ground' for the 'spill-over' and development of viruses and mutations that could spark future pandemics. A new virulent emerging disease would be catastrophic to the health of Australians and our overall economy. The Strategy should prioritise the prevention of such diseases from emerging. Again, the Strategy should recommend a shift away from animal agriculture and a corresponding shift to plant-based diets, for the reason of preventing future pandemics.

The Strategy mentions antimicrobial resistance as an emerging threat, but more emphasis should be placed on this serious risk to the health of Australians. The widespread prophylactic use of critically important antibiotics by the animal agriculture industry is increasing the risk of antibiotic resistance. In Australia, antibiotics are given to farmed chickens (both for egg production and chicken meat production), cattle and pigs. This high use of antibiotics can lead to bacteria evolving to become resistant to the antibiotics. If this new antibiotic-resistant bacteria then crosses the species barrier and infects humans, the infection may not be treatable. As for the other emerging threats, the Strategy should recommend a shift away from animal agriculture and a corresponding shift to plant-based diets, for the reason of preventing dangerous antimicrobial resistance.

Focus areas

Vegan Australia has the following comments on the seven focus areas. The comments also include the targets and goal policy achievements for each focus area.

Reducing tobacco use. The Strategy states that "tobacco smoking is the leading cause of preventable burden in Australia" yet in other places it states that "27,500 people die a preventable death each year from an unhealthy diet" and "tobacco use was estimated to contribute to almost 21,000 deaths." We suggest that the first sentence be modified to say "While more people die from an unhealthy diet, tobacco smoking is the leading cause of preventable burden in Australia" and then go on to explain how 'preventable burden' is different to number of deaths.

Improving access to and the consumption of a healthy diet. We support the statements: "Many Australians are consuming a diet with a low intake of fruits, vegetables, wholegrains, nuts and seeds, and a high intake of processed meats, salt, red meat and free sugars" and "Many diseases are caused or exacerbated by a poor diet, with the top five in 2015 including: coronary heart disease, stroke, type 2 diabetes, bowel cancer and lung cancer. Furthermore, five of the seven leading factors that have been identified as contributing to the health gap between Aboriginal and Torres Strait Islander people and non-Indigenous Australians are related to poor dietary intake: obesity, high blood cholesterol, alcohol consumption, high blood pressure, and low fruit and vegetable intake".

The Strategy should put increased emphasis on a healthy diet. The Australian Burden of Disease Study 2015 ranks "All dietary risks" just below "Tobacco use" as a risk factor. However, many of the other risk factors may also be in part caused by unhealthy diets, including high blood plasma glucose, high blood pressure, high cholesterol, impaired kidney function, iron deficiency, low bone mineral density, overweight & obesity. Putting these together may mean that diet is the leading cause of harm.

The statement "Food access (including cost, affordability, availability and location) is one factor that contributes to food security" should refer to healthy plant-based foods, especially for "those who live in rural and remote locations, people who are of low socioeconomic status, and Aboriginal and Torres Strait Islander communities."

To make healthy plant-based foods more affordable, Vegan Australia suggests that the Strategy recommend that subsidies and government support for animal agriculture be removed and support for plant foods, especially fruit and vegetables be increased.

One of the goal policy achievements listed is "Relevant guidelines and policies are regularly updated using the latest scientific evidence". There should also be a goal policy achievement that the agriculture and food industries have no involvement in such reviews and that studies be rejected that show possible bias by vested interests, such as through funding.

Note: there is a small typographic error on page 49 for the dot point "In 2007-08, 67% of adults were overweight or obese, up from 63.4% in 2014-15". The first date should be "2017-18"

Protecting mental health. Vegan Australia supports the target of "zero suicides for all Australians". As noted in the Strategy, improved physical health is linked to improved mental health and healthy diets play an important role in improving physical health.

We recommend that the Strategy include the concept of cognitive dissonance of eating meat. This refers to the mental discomfort people may feel when their behaviour (eating animal products) conflicts with their beliefs (that they oppose cruelty to animals). 63% of Australians live with companion animals, giving this country one of the highest rates of pet ownership in the world1. At the same time, Australians consume almost 100kg of meat per person per year, one of the world's highest meat consumption rates. These two behaviours are inherently contradictory and can lead to mental stress. By following a plant-based diet, a person can reduce the effect of cognitive dissonance.

Additional comments

Vegan Australia would like to make some comments on other sections of the Strategy not explicitly mentioned in the questions above.

Knowing the causes: The root causes of poor health.

Environmental: Climate change. The Strategy rightly mentions 'renewable energy sources' as a way to deal with climate change. While this will be necessary to prevent run-away global warming, it will not be enough. The catastrophic effect of meat, dairy and egg production on the environment will also need to be addressed. According to the Worldwatch Institute, livestock-based emissions account for 51% of worldwide emissions. A similar figure was found by Australian researchers.

Animal agriculture is not only a leading cause of climate change, but of many other environmental issues. The United Nations has identified animal agriculture as 'one of the most significant contributors to today's most serious environmental problems', including global warming, species extinction, loss of fresh water, rainforest destruction, spreading deserts, air and water pollution, acid rain, soil erosion and loss of habitat. Vast areas of forest are cleared to grow crops to feed farmed animals.

The United Nations has also found that animal agriculture has a particularly heavy impact on biodiversity and species extinction. They have identified livestock production (grazing and feedstock) as the single largest driver of habitat loss, with grazing areas for cattle accounting for about 25% of the world's ice-free land.

Animal agriculture uses about 54% of the Australian landmass and puts a huge strain on our water resources, compromising our water security. Producing beef, lamb, pork and other animal products takes over 20 times more water than growing an equivalent amount of plant foods, like grains, beans, fruit and vegetables. Promoting a plant-rich diet will help create a sustainable food system.

A healthy environment provides functioning ecosystems that supply humans with oxygen, clean air and water and many other ecosystem services. An environment which is unliveable, with an unhealthy and deteriorating ecosystem, will cause great harm to humans. This Strategy should take measures to ensure a liveable and sustainable environment for all.

Environmental: Vector borne diseases

The current COVID-19 pandemic has been predicted for many years. Scientists from the UN, WHO, the European Food Safety Authority and elsewhere have been stressing the link between human and animal health for decades. The production of animal foods allows otherwise harmless viruses to mutate and jump from animals to humans and is thus the underlying cause of many infectious diseases.

Most human infections originally came from an animal source. According to the US Centers for Disease Control and Prevention (CDC), 75 percent of new or emerging infectious diseases in people come from animals. Even diseases such as measles, smallpox and tuberculosis originated from the domestication of herd animals. See Animal origins of human infectious disease, by R A Weiss, University College London. Scientists have been able to determine this by genetic sequencing of the viruses. Even the common cold may have come from domesticated cattle. These diseases are known as zoonotic diseases, meaning they are transmitted from animals to people, in most cases through animal agriculture or hunting.

Other zoonotic diseases include Coronavirus, Ebola, MERS, Swine Flu, SARS, Bird Flu, Mad Cow Disease, AIDS and Spanish Flu. These diseases started from human use and exploitation of animals but are now mainly spread from human to human. Over the last few decades, diseases have originated from animal exploitation industries across the globe: from USA, Mexico, China, United Kingdom, Africa and the Middle East.

Diseases originating from farming, hunting or eating animals have infected billions of people and killed many millions. In addition, the economic cost has been high. In the last few decades, diseases from animals have cost hundreds of billions of dollars.

The human cost has been even greater for non-European people. Shockingly, livestock-derived zoonotic diseases contributed to the loss of as much as 90% of the native American population. The Australian aboriginal population was similarly impacted by animal-derived diseases brought by European settlers.

We can help prevent the future spread of new, possibly more severe, zoonotic diseases by phasing out the production and consumption of animal products. Governments should recognise the underlying cause of these diseases and take urgent action. We now know that rapid change is possible: the governments of the world have reacted within weeks and months of the first case of coronavirus. This proves that governments can act quickly and strongly and they should put the same effort into phasing out animal agriculture and educating the public about alternatives to animal products.

References for this section can be found here: Coronavirus and other diseases caused by animal farming and hunting

Commercial determinants of health. Vegan Australia suggests that more focus should be placed on this determinant in the Strategy. As it states "The commercial determinants of health are defined as factors that influence health which stem from the profit motive" and "these also encompass the strategies and approaches used to promote products and/or choices that are detrimental to an individual's health".

The meat, dairy and egg industries, as well as unhealthy processed food manufacturers, all promote their products using marketing and advertising to mislead the public. These businesses also lobby government and government agencies to act in their favour. More about these behaviours should be exposed in the Strategy and recommendations made to reduce their negative impact.

As the Strategy says "the evidence is clear; tackling influencing factors outside of the health system is crucial for improving the health of target populations and benefitting all Australians overall." One of these influencing factors is the power of commercial interests.

Conclusion

In this submission Vegan Australia has put forward that case that Australia's National Preventive Health Strategy should

  • promote a healthy whole food plant-based diet for its benefits to human health and the environment
  • ensure access to healthy plant foods
  • be evidence-based
  • be independent from commercial interests
  • recommend that marketing of unhealthy processed foods be prohibited
  • include measures to formally educate health practitioners on nutrition and the benefits of whole food plant-based diets
  • recommend that subsidies for animal agriculture be transferred to the fruit and vegetable industry
  • recommend a shift away from animal agriculture and a corresponding shift to plant-based diets to help avert
    • climate change and other serious environmental problems
    • future pandemics
    • antimicrobial resistance

References can be found in these other submissions by Vegan Australia:

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