Italian Popular Beef Preferred Fat of Southern Italy
PLoS One. 2017; 12(eight): e0182960.
Meat consumption reduction in Italian regions: Health co-benefits and decreases in GHG emissions
Sara Farchi
Section of Epidemiology of Regional Health Service, ASL Roma 1, Lazio Region, Rome, Italy
Manuela De Sario
Department of Epidemiology of Regional Health Service, ASL Roma 1, Lazio Region, Rome, Italy
Enrica Lapucci
Department of Epidemiology of Regional Health Service, ASL Roma one, Lazio Region, Rome, Italia
Marina Davoli
Section of Epidemiology of Regional Health Service, ASL Roma one, Lazio Region, Rome, Italian republic
Paola Michelozzi
Department of Epidemiology of Regional Wellness Service, ASL Roma 1, Lazio Region, Rome, Italia
Suresh kumar Subbiah, Editor
Received 2016 Oct 27; Accepted 2017 Jul 27.
- Supplementary Materials
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S1 Table: Scenarios of reduction of beef and processed meat consumption amongst Italian adult population. (DOCX)
GUID: CEBB4F27-2EE1-4648-97C9-C3B60A822061
S2 Tabular array: Estimate of avoidable deaths (No. and %) from colorectal cancer and CVD associated with different scenarios of reduction of beef and processed meat consumption (reduction: twoscore%, 63%, 80%). Italy, 2012. (DOCX)
GUID: 057644E5-56C5-4D1B-9317-0321135D5994
S3 Table: Annual GHG emission for baseline and Mediterranean scenario based on mass unit GWP coefficient for adult Italian consumers. (DOCX)
GUID: 0913E64E-1ED0-484F-9E96-3EF4EBCD86C9
S4 Tabular array: Annual GHG emission for baseline and Mediterranean scenario based on energy unit GWP coefficient for developed Italian consumers. (DOCX)
GUID: E1273C6E-713F-4DCB-B36A-2CEB08D1C6E0
S5 Table: Consumption of the main nutrient groups and GHG profiles associated with the baseline and Mediterranean scenarios past Italian regions. (DOCX)
GUID: FC66D32C-18F0-4F7A-BD7E-772D035E546F
- Data Availability Statement
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Data from the National Statistics Institute are available at http://dati.istat.it/Index.aspx. Dietary data are available at http://nut.entecra.information technology/710/I_consumi_alimentari__INRAN-SCAI_2005-06.html.
Abstract
Introduction
Animal agriculture has exponentially grown in contempo decades in response to the rise in global demand for meat, fifty-fifty in countries similar Italy that traditionally swallow a Mediterranean, found-based diet. Globalization related dietary changes are contributing to the epidemic of not-communicable diseases and to the global climate crisis, and are associated with huge carbon and water footprints.
The objective of the study is to appraise inequalities in wellness impacts and in attributable greenhouse gases-GHG emissions in Italy by hypothesizing different scenarios of reduction in red and processed meat consumption towards healthier consumption patterns more compliant with the recommendations of the Mediterranean nutrient pyramid.
Methods
We used demographic and food consumption patterns from national surveys and take a chance relationships betwixt meat intake and cardiovascular and colorectal cancer mortality from IARC and other meta-analyses.
From the baseline data (year 2005–2006, average 406 gr/calendar week beef and 245 gr/calendar week processed meat), we considered hypothetical meat reduction scenarios according to international dietary guidelines such as the Mediterranean pyramid targets. For each geographical area (Northwest, Northeast, Heart, and Due south) and gender, we calculated the number of avoidable deaths from colorectal cancer, and cardiovascular disease among the adult population. Moreover, years of life gained by the developed population from 2012 to 2030 and changes in life expectancy of the 2012 birth cohort were quantified using gender-specific life tables.
GHG emission reductions under Mediterranean scenario were estimated only for beef by applying the Global Warming Potential (GWP) coefficient to total consumption and to a low carbon food commutation in developed nutrition.
Results
The deaths avoidable (equally percent modify compared to baseline) according to the three reduction scenarios for beef consumption were between 2.3% and iv.five% for colorectal cancer, and between ii.1% and iv.0% for cardiovascular disease; higher benefits would be observed in Northwestern areas and among males. In parallel, v% and half-dozen.4% of colorectal cancer and CVD deaths would be avoided if the Italian population ate the brash quantity of processed meat. Life tabular array analysis suggests that the scenario that is fully compliant with the Mediterranean nutrition model would relieve 5 meg years of life lost prematurely amongst men and women over the side by side 18 years and would increase average life expectancy of future generations by over 7 months.
Considering the environmental affect, emissions associated with the bodily full intake of beef range from 12,900 to 21,800 Gg CO2 eq; emissions saved according to the Mediterranean scenario are in the range 8000–14000 Gg CO2 eq per twelvemonth. The per capita reduction is 263 KgCO2eq/twelvemonth/person with higher reductions in Northwestern and Central areas.
Conclusions
In Italia, scenarios for reducing beef consumption are consistent with pregnant health and environmental co-benefits on current and futurity generations. Results back up introducing policies to promote healthier behavior towards cerise and candy meat in the developed population within an overall balanced and good for you dietary blueprint. Interventions should accost gender, vulnerable population groups, and geographical differences in guild to be more constructive.
Introduction
Climate change, land and h2o availability and biodiversity stand for the most important challenges of the xx-offset century and involve identifying mitigation policies that take both immediate and long-term health benefits. Agronomics is now a ascendant strength backside many of these environmental threats [ane]. Global livestock production in the globe has increased substantially since the 1960s and beef production has more than doubled, due to a growing demand associated with homo population growth, income growth and urbanization and the consistent fast lifestyles changes in nutrition and concrete action [ii, 3]. Diets in industrialized countries, and even in countries with food patterns typical of a traditional Mediterranean diet like Italy, are characterized past loftier consumption of animal products and, therefore, loftier intake of saturated fatty, above the recommendations of the World Health Organization (WHO) and World Cancer Enquiry Fund of 300–400 grams of cerise meat per week (including beef, veal, pork, lamb, goat, horse) [4, v].
The global food system is one of the major sources of greenhouse gas emissions (GHG). It is estimated that the agricultural sector contributes most one-fifth of total emissions and, of these about fourscore% are attributable to livestock [6, vii]. Of all meats, beef has the greatest impact on emissions, through production processes (CO2), the fermentation of ruminants (CHiv), the cultivation of fodder and the use of fertilizers (NO) [eight]. Information technology has become clear that meat production too significantly contributes to the water footprint (WF), water pollution and h2o scarcity. The WF of any creature product is larger–in some cases xx times than that of the WF of a crop with the same nutritional value. [9]
A diet rich in fauna fat and other lifestyle risk factors such as physical inactivity, tobacco utilize and alcohol consumption have been estimated to account for 80% of blazon 2 diabetes, coronary heart affliction, stroke and for ane-3rd of cancers. Without preventative measures, the number of deaths from non-communicable diseases will increase past 17% globally over the adjacent ten years according to estimates by the WHO [x]. A growing body of prove shows the clan between excess meat consumption, particularly of red and processed meat, and increased take a chance of premature death, in particular from heart illness, stroke, type ii diabetes [11,12], and certain cancers [13,fourteen]. Recently, IARC classified the consumption of red meat every bit probably carcinogenic to humans and the consumption of processed meat as carcinogenic to humans based on an evaluation of the evidence of colorectal cancer [15]. Recent systematic reviews shows also a higher risk of obesity among those who eat large amounts of cherry-red and processed meat.[16] Although the risks are not very high, the impact is huge since the exposed population, i.e. subjects who swallow meat, is large and condign fifty-fifty greater in high income countries and, at a faster rate, in emerging economies. Co-ordinate to the Global Burden of Disease Report [17], the risk factors related to nutrition contribute 10% to the entire global burden of disease.
The transition towards a western nutrition over the last decades has delayed mitigation solutions in the food sector in many countries [18]. In 2009, The Lancet included for the get-go time the reduction of animal products consumption (i.e. red meat, dairy products) amid policies to reduce GHG emissions associated with significant health co-benefits. In comparative scenarios in UK and Brazil, a 30% reduction in livestock production resulted in a fifteen% wellness proceeds on cardiovascular-related disability-adjusted life years (DALY) [eighteen]. A global touch on evaluation provided evidence of even greater reductions up to 10% in full mortality past 2050 due mostly to the reduction in red meat consumption [xix]. These co-benefits were associated with huge GHG reductions by 2050 (around 80–90%) [18,19]. Some studies propose even small changes in meat consumption can have a measurable environmental do good both in terms of GHG emissions and h2o footprint [20, 21]. A recent study, which used data on food consumption in Great Britain, suggested modifying the quantities of individual foods in the nutrition, according to nutritional recommendations of the WHO and acceptability by the English population, and consequent scenarios of reduced GHG emissions. The authors showed that even a minor modification in diet, with a reduction in meat consumption post-obit nutritional guidelines, can lead to a reduction in the society of 20% of GHG emissions produced by the agriculture manufacture [20]. Moreover, other recent studies have estimated the impact of a shift towards recommended quantity of meat on WF, with reductions ranging from 23% to 41% of WF in southern and Western Europe [21].
No health or environmental impact evaluation has been carried out in countries like Italy where the traditional Mediterranean nutrition is followed and the potential burden in terms of nutrition-related deaths is expected to exist relevant. In Italia, 13.5% of DALY are attributable to nutrition, making it the leading cause of premature mortality and disability [22].
In Italian republic, per capita meat consumption has tripled in the terminal 50 years with significant changes from the traditional Mediterranean dietary patterns, characterized by unprocessed and natural foods and a healthy contour of fat intake deriving more often than not from vegetables and legumes rather than on meat [23]. The about accurate survey of food consumption past Italians refers to the years 2005–2006 (Survey INRAN) and indicates a profound transformation in eating habits, compared to the dietary patterns in the mid-nineties, with a progressive increase of meat consumption relative to overall dietary intake, towards that of the northern European countries. This is due to changes in lifestyle, the availability of a broad range of products, and sociodemographic changes [24]. In the sample, average fruit and vegetable consumption was only above the minimum recommended, while consumption of meat was greater than recommended [4]. Compared with European countries, Italian consumers rank medium-high in terms of red meat, in item beefiness, and processed meat consumption [25].
This dietary transition has geographical differences, with greater intake of cherry-red meat and saturated fatty acids mainly in the northern regions of the country [24]. These underlying differences reflect dissimilar degrees of "penetration" of western lifestyle and may depend on urbanization levels, socio-economic factors, and traditional food habits possibly influenced by local agricultural production patterns, because most Italian livestock are raised in these regions [26]. The varying westernization is possibly related to the cultural safeguard of traditions that are stronger in sure areas of Italia than in others, especially in rural areas where thirty% of Italian citizens live. I possible caption of this cultural heritage is due to local products, with more than 250 products with a geographical indication logo, and culinary traditions, both varying across Italian regions, equally do dietary habits. For case, processed meat accounts for nigh forty typical products with more than 90% of the factories located in the north of the country. Preserving this heritage represents an important defence confronting the negative aspects of globalization, not only since the traditional rural areas are more than adherent to the healthy Mediterranean diet model [27], only too because their food habits prefer locally-produced food, lowering the ecology touch of the residents' diets.
The objectives of this study are to evaluate the health and environmental impact in Italy of shifting habits of meat eaters (red and processed) towards healthier consumption patterns more compliant with the recommendations of the Mediterranean nutrient pyramid [27]. Specifically, considering the heterogeneity of meat consumption attitudes, the aim is to investigate how gender and geographical differences contribute to inequalities in the bear upon of dietary changes.
Information and methods
Starting from actual quantities consumed, we supposed iii reduction scenarios of meat consumption past looking at beefiness and processed meat categories past gender and geographic expanse. According to the National Food Consumption Survey [24], "processed meat" is considered a unique food item while ruby-red meat comprises several meat items. Although the intuitive approach is to add up the amount of intake for each category, this approach would outcome in an over-estimate of consumption since information technology assumes that high-level consumers of one food are likewise high-level consumers of all of the others [25]. To overcome this problem, we used beef consumption as a proxy for all red meat.
Meat consumption scenarios
To define the baseline scenario (the quantity of beef and processed meat consumed) we gathered the latest available data on average daily consumption by adult meat eaters (aged xviii–64) by gender and geographical area from the National Food Consumption Survey (INRAN-SCAI) in 2005–2006 [24]. To ascertain the scenarios (S1 Table), we referred to three dissimilar consumption targets. The outset scenario, co-ordinate to the World Cancer Research Fund communication [5], is compatible with the consumption of about 300g per person/week of red meat, which represents twoscore% of the full meat consumption in Italy. By applying this to the meat categories studied, the get-go scenario causeless a target of 244gr person/week for beef consumers and 147gr person/week for processed meat consumers. The second and third scenario are based on the Mediterranean Pyramid Model of recommended quantities [27] for carmine meat (150gr/week which represents 63% of the cerise meat currently consumed in Italy) and processed meat (not more than than 50gr/week which represents 80% of processed meat currently consumed) respectively.
Wellness benefits
We calculated the wellness touch on due to reducing meat consumption in both annual chronic affliction burdens and the long-term impact on overall bloodshed.
Apropos the first health issue, for each geographical area and gender, we estimated the changes in cardiovascular disease (CVD) and colorectal cancer bloodshed that would occur if meat consumption were reduced from the baseline to the hypothetical scenarios. The assessment of avoidable deaths (Ad) was ascertained using the post-obit functions [28]:
Δ A D =y 0*(1 −e x p −βΔx )*P 0
Which combine the dose-response association with bloodshed (β) and changes (i.due east. departure) in consumption from baseline to suggested scenarios (ΔX) with data from developed meat-eaters (P0) and crusade-specific mortality rate (y0).
The exposed population (P0) was estimated using data come from the National Statistics Office Multipurpose survey on families showing frequency of food consumption, by gender, age and geographical area over the catamenia 2002–2012. In particular, referring to the most recent bachelor year (2012), we divers the exposed population through the percentage of adults (aged 20+ years) that regularly at to the lowest degree 1 a week eats beef and candy meat. Similarly, we used information from the National Statistics Office survey on deaths and causes of death 2012 from cardiovascular diseases (CVD) and colorectal cancer, by gender, age and geographical area to define the baseline bloodshed rate (y0). Lastly, the coefficient β is based on a log-linear relationship between relative run a risk and meat consumption defined past epidemiological studies:
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For red meat : a dose–response human relationship with colorectal cancer, with a 17% increased run a risk (95% CI 1.05–1.31) per 100 grams per mean solar day of ruby meat [15], and a 15% increased take chances of mortality from CVD (95%CI one.05–i.26) [12].
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For processed meat : eighteen% increment in chance of colorectal cancer (95% CI 1·ten–one·28) per 50 grams per twenty-four hours [15], and a 24% risk of mortality from CVD (95%CI i.09–ane.40) [12].
In addition, 95% confidence intervals were calculated to evaluate the range of the variation of attributable deaths.
To judge the long-term impact of healthier meat consumption habits we used life table methods based on the IOMLIFET model [29]. Split up life tables were constructed for the baseline scenario and the hypotheticals. Nosotros computed life tables distinctly for each geographical expanse and gender by populating them with the population of 2012 with age and sex activity-specific mortality rates for that year. Nosotros used a fourth dimension-horizon of 106 years to predict gains in the 2012 newborn cohort life expectancy, while we emphasized the impact over the beginning xxx years (2030) for the 2012 population. The Mediterranean scenario was computed by applying the relative risk of overall mortality and meat consumption based on a meta-analysis of cohort studies:
For red meat consumption : RR = 1.21 (95%CI 1.15–ane.26) for men and RR = 1.14 (95%CI i.00–one.thirty) for women; For processed meat consumption RR = one.23 (95%CI 1.10–1.37) for men and RR = 1.34 (95%CI one.09–1.66) for women [12].
Based on these estimates, nosotros calculated the decrease of age-specific mortality rates (anile 20 and above) corresponding to the departure in meat consumption between baseline and Mediterranean pyramid model scenarios.
Environmental benefits
Owing to the high contribution of livestock ruminants to GHG emissions [7], evaluating the environmental bear on focused only on beef consumption by comparing the baseline and the Mediterranean scenario.
We explored the potential beef contribution to GHG emissions attributable to full consumption (grams), consumer's choices (free energy intake) and dietary patterns (low-carbon nutrient substitutions).
All the analyses estimated GHG emissions by coupling the mass and type of nutrient with the specific Global Warming Potential (GWP) coefficient. We used GWP coefficients from life cycle assessment studies (LCAs) [7, 30, 31] since they allow calculating the environmental bear on of a product throughout its lifecycle [32].
With respect to the assessment based on total intake, we estimated annual GHG emissions attributable to the total intake of beef in the diet of the adult meat-eating population. We provided 2 estimates. The first is based on the specific Italian livestock production chains (from cradle to subcontract gate), assuming that all the consumed meat was raised in Italy [thirty]. The second is based on a world boilerplate GWP coefficient that includes both the post-farm gate processes and the variability of beef production procedure among LCAs [vii].
With respect to the cess based on consumers' choices, nosotros evaluated the almanac differences in GHG emissions from baseline to the Mediterranean scenario by varying the beefiness quality from maximum energy intake (low quality) to minimum energy intake (high quality) in the diet of adult meat-eaters [31]. These differences depend by and large on fatty contents. The minimum and maximum energy intakes were retrieved from all the beefiness cuts regularly consumed in Italy [33] and measured as kcal/100 grams of edible portions. An edible portion corresponding to baseline and Mediterranean beef consumption was calculated using FAO correction coefficients [34].
Concerning dietary pattern assessment, nosotros followed the approach of the Australian case study proposed past Clune and colleagues [7] that employed the GWP coefficient to approximate environmental impact for dissimilar sustainable diet substitution scenarios. We compared total GHG and food specific contributions for adult weekly per capita consumption at baseline and under the Mediterranean scenario with depression-carbon food substitutions for beefiness. The beefiness substitute was proposed past the Italian Establish of Diet to preserve the overall nutritional balance [35]. We stratified this analysis by geographical surface area to account for the heterogeneity in the dietary patterns beyond Italy.
Results
Table 1 presents average weekly meat consumption by the adult population and by regular beef and processed meat consumers. Average weekly meat consumption by the Italian population was 791 1000, with clear geographical variations and differences past gender. Cerise meat is the about important component and beefiness by itself accounts for 40% of total meat consumption. Adult beef consumption per week was 406 grams, with large geographical and gender variations. Northwestern consumers had the highest intake (483gr/calendar week) and also had the largest gender variation (546gr/week in males and 427gr/week in females), while southern consumers ate 343 grams of beef per week, and in that location was more homogeneity betwixt the sexes. Candy meat consumption was less varied between areas, and ranged from 231gr/week in the Northwest to 259gr/week in the Northeast. Again, gender differences were more pronounced where consumption was college (110gr/week more for males in the Northeast).
Table ane
Average weekly meat consumption by adults (total meat, beef and processed meat consumers), and reduction (%) to achieve Mediterranean target past gender and geographical area.
Italy, 2005–2006.
| Area/ gender | meat consumption (grams/week*) | Beef | Candy meat | ||||
|---|---|---|---|---|---|---|---|
| % consumers ‡ | grams/ week consummed | Δ% (to 150 gr/week) | % consumers | grams/ week consummed | Δ% (to l gr/week) | ||
| NORTHWEST | |||||||
| Males | 910 | 74.0 | 546 | -72.5 | 69.2 | 266 | -81.2 |
| Females | 672 | 66.9 | 427 | -64.ix | 59.6 | 203 | -75.four |
| Total | 777 | 70.4 | 483 | -68.nine | 64.four | 231 | -78.four |
| NORTHEAST | |||||||
| Males | 945 | 66.two | 427 | -64.9 | 67.seven | 315 | -84.i |
| Females | 644 | 54.4 | 350 | -57.ane | 55.4 | 203 | -75.4 |
| Total | 784 | 60.three | 385 | -61.0 | 61.5 | 259 | -80.7 |
| Fundamental | |||||||
| Males | 1022 | 75.1 | 455 | -67.0 | 67.iv | 287 | -82.half-dozen |
| Females | 756 | 70.9 | 385 | -61.0 | 55.4 | 210 | -76.2 |
| Total | 868 | 73.0 | 413 | -63.7 | 61.three | 245 | -79.6 |
| SOUTH/ISLANDS | |||||||
| Males | 868 | 73.5 | 378 | -lx.3 | 70.9 | 280 | -82.1 |
| Females | 665 | 68.6 | 315 | -52.four | 59.ix | 203 | -75.4 |
| Total | 763 | 71.0 | 343 | -56.3 | 65.3 | 245 | -79.6 |
| ITALY | |||||||
| Males | 917 | 72.3 | 448 | -66.5 | 69.2 | 287 | -82.6 |
| Females | 679 | 65.7 | 364 | -58.8 | 58.ane | 203 | -75.four |
| Total | 791 | 69.0 | 406 | -63.1 | 63.6 | 245 | -80.0 |
Time trends of bovine meat consumption show a steady decrease since 2006—stronger after 2010—in the proportion of regular beef eaters, while candy meat consumption fourth dimension tendency has been stable from 2002. ( Fig one ).
Time trend of regular beef and processed meat consumers, by gender.
Italy, 2002–2012.
Regarding the per centum of deaths avoidable, the more marked is the reduction of meat consumption, the greater are the health gains (S2 Table). If the Italian adult population would consume the recommended amount of beefiness, 3.7% and 3.3% of colorectal cancer and CVD deaths would be avoided. In parallel, five% and half-dozen.4% of colorectal cancer and CVD deaths would be avoided if the Italian population ate the advised quantity of processed meat. As expected, the health gains of decreasing beef consumption are reflected in the diverse consumption patterns of different population groups: higher for men and n westerners, less for women and southerners. There are articulate gender and geographical differences in the benefits accomplished ( Fig 2 ).
Percentage of avoidable deaths from colorectal cancer associated with unlike scenarios of reduction of beef and processed meat consumption (reduction: 40%, 63%, 80%) by gender and geographical expanse.
Italy 2012. a. Males. b. Females.
Tabular array 2 shows results of the IOMLIFET arroyo. Life tabular array assay suggests that if regular consumers reduced the amount of beef to 150 grams per week, globally over 30 years it would salve nine million of years of life lost (YOLL) prematurely, and if the intake of candy meat were 50 grams per calendar week, almost 20 meg YOLL would be saved. Differences between geographical areas and sexes are evident for beef, but less marked for candy meat.
Table 2
Life years gained past the Italian population over the menses 2012–2030 given consumption of 150 grams per calendar week of beef and 50 grams of candy meat.
| Geographical expanse | Beef | Processed meat | ||||||
|---|---|---|---|---|---|---|---|---|
| Life years gained over 30 years (1000) | Days per person | Life years gained over 30 years (m) | Days per person | Life years gained over xxx years (thousand) | Days per person | Life years gained over thirty years (thousand) | Days per person | |
| Males | Females | Males | Females | |||||
| Northwest | 2231 | 107 | 1037 | 46 | 2627 | 125 | 2531 | 113 |
| Northeast | 1108 | 73 | 525 | 32 | 2264 | 148 | 1764 | 109 |
| Centre | 1261 | 82 | 652 | 39 | 2103 | 137 | 1956 | 118 |
| South-Islands | 1634 | sixty | 761 | 26 | 3516 | 128 | 3085 | 106 |
| Italia | 6234 | 79 | 2943 | 35 | 10631 | 135 | 9255 | 110 |
Considering the Italian birth cohort in 2012, an increase in boilerplate life expectancy of over 200 days for men and over 100 days for women would exist observed if they decreased beef consumption, and over 400 days for men and women if they ate less processed meat. Again, gender and geographical differences are strong only for beef reduction in consumption ( Fig 3 ).
Change in life expectancy at nativity (days gained) given consumption of 150 grams per calendar week of beef and fifty grams of candy meat.
Based on the specific Italian livestock's product concatenation, a shift in beefiness consumption from the current 406 grams/calendar week/person to the Mediterranean scenario (150 grams/week/person) could potentially salve more than 8000 GgrCO2eq/year. This estimate ranges from 9713 up to 13776 GgrCO2eq/yr when the analysis was based on earth average GWP (S3 Table).
The results of GHG emissions related to energy intake of specific beef cuts show that in the baseline scenario the GHG could range from 5302 (depression quality) to 3193 GgrCO2eq/year (high quality). The Mediterranean scenario coupled with the consumers' choice of consuming better cuts of beef could save more than 4000 GgrCO2eq/year (S4 Table).
Looking beyond simply beef consumption—a full dietary option at baseline is associated with 888.half-dozen kgCo2eq/person/yr with beef accounting for 47% of GHG emissions. A shift to the Mediterranean scenario with low-carbon food substitutions reduces total dietary GHG emissions (625.6 kgCo2eq/person/year) past redistributing the GHG contribution of each nutrient ( Fig 4 ).
Full GHG and food contribution (%) associated with mean weekly per capita consumption by Italian adults at baseline and Mediterranean scenario.
This assay highlights geographical differences in dietary patterns of other foods. In item, the eye and due south of Italian republic have the highest consumption of pork (119g/week/person) while chicken consumption ranges from 119 in the Northwest to 168 in the Center. The Northwest has the lowest consumption of pork (59 grams/week/person) and grains (below 1000 grams/week/person). Legumes consumption in all areas is below that needed for substitution quantity (run across S5 Table).
The low-carbon nutrient substitution scenario shows the greatest GHG reduction in Northwestern and Central areas of Italy. Yet, this reduction comes from unlike dietary changes. In Primal Italy, it derived by and large from reducing in ruddy meat consumption (beefiness and pork), and slightly increasing chicken consumption. In the Northwest on the contrary, the emission reduction derived from both eating less beef and making more low-carbon substitutions (mainly chicken, grains and legumes). The emission reduction was 244 Kg COii /year/person in the North- east and even lower in south (193 Kg COii /yr/person).
( Fig 5 ).
Differences in GHG emissions under the Mediterranean scenario with low carbon nutrient substitutions, by Italian regions.
Discussion and conclusions
Health co-benefits
This study is the get-go to provide bear witness of health and ecology (in terms of GHG emissions) benefits deriving from reducing red and processed meat consumption by the Italian adult population to the levels recommended by international and national healthy diet guidelines. Our written report estimates the health impact of eating less ruby-red and processed meat in Italy. It shows that a relevant proportion of colorectal cancer and CVD deaths are attributable to meat intake. It also demonstrates that a change in dietary habits in Italy, coherent with the national guidelines, would bring benefits in term of life expectancy.
Nosotros chose the Mediterranean pyramid model equally a reference since nosotros assumed information technology was meliorate suited for a Mediterranean country similar Italy [27]. If Italian meat consumers would follow the Mediterranean pyramid model [27], which indicates consuming a maximum of 150 grams of beef per week, it would event in a one.2% to 6.0% reduction in bloodshed from colorectal cancer and betwixt 1.two% and five.2% from CVD. In parallel, eating 50 grams of processed meat per week would represent to between 3.0% and 7.2% fewer deaths from colorectal cancer and 2.7%-9.three% from CVD. Considering full mortality, the reductions proposed are able to better life expectancy in a 2012 birth cohort past 4–9 months by 2030.
The Mediterranean targets are coherent with the recommended consumption limits recognized to be safe for people of all ages [37, 38]. Recommendations regarding ruddy meat are guided by the principle of limiting saturated fats, which have a detrimental effect on total and LDL cholesterol past increasing the chance of cardiovascular disease [39].
Comparing these results with those from other countries, especially those from Great Britain [18, twenty, 40], where most of the studies have been carried out, is not immediately possible, since reduction scenarios and the health outcomes considered are often different. Notwithstanding, the results are consistent with those summarized in a 2013 review, which reported the burden of disease went downwardly by betwixt one and xvi% [41].
Previous studies provided reductions in full mortality in the range of 0–18% [31], or 6–10% [19, 40] associated with global livestock or ruby meat reduction consumption. Other studies have evaluated the touch of hypothetical alter in specific nutritional factors, such every bit saturated fats intake, leading to reductions in cardiovascular burden in the range of 6–x% in 9 European countries [42] and of 14% by 2025 in Sweden [43].
It is important to stress that in studies based on food frequency questionnaires, a possible misclassification of food consumption may occur that can event underestimate take chances: for instance, in the Epic study the estimated take chances for colon cancer associated with 100 grams increases of meat consumption jumps from 1.25 to one.55 due to systematic and random dietary intake measurement errors [44].
Information technology is therefore possible, given that we used nutrient frequency data surveys to estimate meat consumption, that the results of the nowadays study are underestimated and that the health gains could exist even higher. It should be highlighted also that eating ruby meat is a risk factor for other diseases, such as stomach cancer, diabetes and obesity, diseases that were not taken into consideration in this analysis. It has also been postulated that reducing meat consumption would result as well in improved dietary choices, for instance an increase in fruit and vegetable intake, assuasive further health benefits [19]. In the present report, health impacts were calculated based on the relative risks estimated in meta-analysis studies of meat consumption.
All the same, the life table arroyo allows to estimate the impact on all-cause bloodshed and has been acknowledged to exist especially suited to express effects of long-term exposures such as diet [45]. This method is benign since it is able to provide a clear estimate of the public health significance of proposed reductions in the consumption of red and processed meat.
This analysis considered only adults, considering proposed reductions in red and cured meats are applicable only to the healthy adult population in whom we observed significant health benefits such equally reducing cardiovascular and cancer risks. Results cannot be transferred to susceptible subgroups, such as children, women of childbearing age, or the elderly who may be more vulnerable to iron or zinc deficiencies [46].
Geographical and gender differences
Few studies have evaluated the impact of geographical differences within the country of reduction scenarios of meat consumption, considering that health and environmental gains differed depending on variations in nutrient production and consumption patterns [xviii, xix]. Our study showed potential health benefits deriving from the proposed dietary changes, which could be greater in northern areas where people tend to swallow more. Such heterogeneity is consequent through the different analytical approaches we used (cause-specific mortality reductions in 2012 according to counterfactual scenarios, life years gained past Italian adults to 2030, improvement in life expectancy in future generations). Across Italian areas, there are slightly different culinary traditions and typical foods, but also differences in demographic and socioeconomic determinants that may bear upon attitudes towards a specific food. Processed meat consumption is uniform throughout Italy. There is a strong tradition of processed meat production, which includes ham, salami and other varieties. A survey conducted by the Italian Institute of Rural Folklore in 2002 counted more than 650 typical products from all Italian regions [47]. However, this could be partly due to the higher costs of beef compared to processed meat, which makes consumption patterns hands influenced by social and economic conditions.
In all regions, there are fewer women who are regular consumers of red and processed meat, and they consume less than men practise. Gender differences in specific food attitudes are well documented in western societies and peradventure influenced past personal factors such as degree of health consciousness, and weight control that are more mutual in females than in males. In our report, Italian women not just eat less carmine meat but they also accept a different baseline mortality run a risk for cardiovascular and colorectal cancer compared with men. These results underline the importance of developing gender-specific nutritional goals for the general population.
GHG emission impact
Current beef consumption past Italian carnivores has an environmental impact in the range of 12,900 to 21,800 Gg CO2eq. per yr of GHG emissions. Emission savings according to the Mediterranean pyramid model are between 8000 and 14000 Gg CO2eq. per year. The Mediterranean scenario with low-carbon food substitutions reliable for the Italian population [35] produced an overall per capita reduction of 263 kg CO2eq./year. These potentially avoidable emissions thanks to dietary change are not negligible since overall annual per capita emissions from all sources (non only agronomics) are estimated to be around 7 tons CO2 eq./twelvemonth [48]. The Italian Institute of Nutrition study produced a net ecology benefit like to ours (114,6 kg CO2 eq. per capita saved per year) but information technology did not analyse regional variations [35]. Our report suggests that assessing the ecology impact needs to business relationship for geographical heterogeneity in dietary habits across Italia. The depression-carbon food substitute highlights that the greatest GHG benefits tin be obtained in the Northwestern and Central regions where baseline beef consumption is higher. Moreover, GHG reductions in the same corporeality were obtained from different dietary changes.
Other studies accept provided similar estimates of environmental benefit like the GHG emissions in the range of 29–70% associated with reddish meat consumption reductions [nineteen], or have evaluated overall dietary changes, i.e. shifting to a vegetarian diet with reductions betwixt 22–29% [49] or a Mediterranean diet (GHG reductions in the range x–30%) [l]. Scenarios for reducing beef consumption at Mediterranean targets in Italian republic seem non but in line with recommended nutritional levels but also address reduction goals of GHG, which the European Spousal relationship agreed to in Paris in November, 2015 [51]. The Paris agreements conceptualize, in fact, a reduction of at least xl% in domestic emissions past 2030 and 80% by 2050. Various studies have stressed that adopting a diet that conforms to the guidelines would contribute to a substantial reduction in GHG emissions associated with food consumption [3]. According to the FAO, meat consumption is expected to increase past almost 73% by 2050 due to population and income increases, fifty-fifty in developing countries [23]. To balance this increase, policies to reduce consumption are essential in order to achieve tangible benefits on population wellness and the surround. Nosotros used two GWP coefficients associated with beef production activity, one from an Italian LCA report [30] and some other from a published meta-analysis of LCA studies including postal service-subcontract emissions which provided comparable food-specific coefficients on which we based the substitution analysis [7]. We as well used a third coefficient based on energy units, to business relationship for different cuts of beef consumed [31]. Although we followed a methodology previously suggested past others [seven], our estimates are a simplification, since they do non correct the amount of food produced for the quantity really consumed, stored, cooked, and wasted in the Italian context.
Time to come research avenues
Our results confirm significant wellness impacts of reducing carmine meat consumption to the Mediterranean target (150 grams/week/person) and propose as well of import environmental gains. Although using scenarios is a simplification, information technology opens the way to studies investigating more than in-depth alternatives to crimson meat in the dietary pattern, that tin account not only for quantities and nutritional balance simply likewise for costs, acceptability, and regional culinary traditions. Also, different age groups have unlike dietary needs and substitution patterns, making further study necessary.
Policy implications
The main public health message from this study is that pocket-sized changes in habits towards red and processed meat, towards higher quality and smaller quantities, tin maximize health impacts and minimize the ecology burden in terms of GHG emissions. Due to the heterogeneous health and ecology touch on, policy recommendations will need to target specific Italian areas. Overall, the reductions in red meat consumption nosotros propose are compatible with a Mediterranean-type diet, which indicates a variety of proteins (meat and poultry, fish, milk and dairy products, legumes) and does not suggest radical choices, such as the adoption of a vegetarian or vegan diet [27]. For example, diets with fewer animal-sourced foods typically include more legumes, nuts and whole grains which bear witness suggests have health benefits and are probable to increase the number of avoided deaths [31, forty, 42, 43].
Possible interventions to reduce emissions from livestock production are based on technologies and practices that amend product efficiency, just mitigation and adaptation options have to include public wellness policies to reduce meat consumption. In practice, people may exist informed and invited to reduce portion size or frequency of consumption of red meat and processed meat. Nonetheless, how to reach these goals is challenging and should take into business relationship factors influencing food selection, and the external economical and social context in which choices are made. One possible solution is pricing food-related GHG emissions that have been proved to be effective in Australia [19]. Such policies need to address wellness inequalities by income since poorer people are more decumbent to make unhealthy choices and are more than resistant to possible changes than richer subgroups. The Australian written report partly addressed this issue by proposing the use of revenue enhancement of GHG emissions from red meat and other foods for wellness promotion in the poorest population subgroups [19]. Some other information action is dietary guidelines to raise sensation of population of ecology impacts of the so-called "discretionary" nutrient, emphasizing that following guidelines is good not only for i'south wellness but as well for the environment [37]. Examples of interventions focusing on achieving a full good for you nutrition approach rather than on a single objective such equally reducing red meat consumption are becoming widespread especially in the Us, but also in Europe. These interventions promote healthy eating through educational interactive textile (website, app for mobile phones). To accost depression income families, specific tools are used, such as meetings, support groups, and, more recently, food subsidy programmes (e.g. food vouchers) that take plant to improve diet quality in the UK [52].
Dairy and beef fat typically contains around 3–6% TFA (wt. % of total fatty acids), while levels in lamb and mutton can be somewhat higher
The TFA content of fat from pork and poultry are mostly beneath 1% of total fat acids, simply the content may vary, primarily depending on the TFA content of the feed (Aro et al., 1998a).
Among the specific efforts to be set up in this field, in that location is the demand to raise sensation of the environmental affect of different kinds of food, to promote model nutrient consumption which result in the everyman greenhouse gas emissions and sufficient, balanced amounts of protein and micronutrients, and which may be more sustainable.
Experts take highlighted that climate change mitigation policies are difficult to implement in part because their effects are non geographically limited, and also because they volition have touch on decades from now. Empowering both the full general population and policy makers is then a crucial goal [41].
Conclusions
This study provides, for the first time in Italy, evidence supporting a reduction in ruby-red meat consumption toward the Mediterranean target of 150 grams/calendar week per capita. The expected health and environmental gains are huge, merely heterogeneity across geographical areas suggests the importance of detailed investigation of local determinants of the observed variations. Strategies to empower citizens to make dietary changes could be improved in Italy past accounting for local differences. At the same time, the environmental consciousness of the general population needs to expand. Now and in the time to come public health volition play an important role in prioritizing the resources and protecting the vulnerable groups most affected past unhealthy lifestyles and by environmental injustice.
Supporting information
S1 Tabular array
Scenarios of reduction of beef and candy meat consumption among Italian adult population.
(DOCX)
S2 Tabular array
Estimate of avoidable deaths (No. and %) from colorectal cancer and CVD associated with unlike scenarios of reduction of beef and processed meat consumption (reduction: 40%, 63%, fourscore%). Italy, 2012.
(DOCX)
S3 Tabular array
Annual GHG emission for baseline and Mediterranean scenario based on mass unit GWP coefficient for adult Italian consumers.
(DOCX)
S4 Table
Almanac GHG emission for baseline and Mediterranean scenario based on energy unit GWP coefficient for developed Italian consumers.
(DOCX)
S5 Table
Consumption of the main food groups and GHG profiles associated with the baseline and Mediterranean scenarios by Italian regions.
(DOCX)
Acknowledgments
Authors would like to thank Margaret Becker for language revision and proof reading.
Funding Statement
The authors received no specific funding for this piece of work.
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