Where you can make a positive impact towards net zero

The impact of our food systems

Globally, nine of the top fifteen risk factors for morbidity, including high body mass index (BMI), high blood pressure, cardiac disease, diabetes and malnutrition, are associated with poor diet.

Two-thirds of the British adult population are overweight, and 27% are living with obesity. The effects of poor diet are unevenly distributed, with individuals from the lowest socioeconomic areas having double the prevalence of obesity, compared to the least deprived (36% compared to 20%). Fruit and vegetable consumption also follow a social gradient, with adults and children in the lowest income decile eating, on average, 42% less fruit and vegetables than recommended.

The NHS in England provides 140 million inpatient meals per year, spending £633 million on inpatient food provision. The retail revenue in hospitals, most of which is from food and drink sales, is estimated at £2-3 billion a year. The NHS in England prescribes over 300,000 Oral Nutritional Supplements(ONS).

The link between food, health, and climate change is clear. Food is responsible for around one quarter of the UK’s carbon footprint, predominately from fertiliser use, livestock food production and food waste. It is estimated that food and catering services in the NHS produces 1,543 ktCO2e – each year, which make up around 6% of the NHS’s total emissions.

Reducing food waste and promoting healthy and low carbon diets, high in seasonal fruit and vegetables, beans, pulses and other lower carbon sources of protein, will help bring health benefits as well as carbon emissions reduction.

AHPs, including dietitians, occupational therapists and speech and language therapists, will interact with the food system in various ways and have a unique opportunity to be agents for change.

Food is an important part of an individual’s recovery and health. Many AHPs will work with vulnerable patients and a range of communities, and not every approach to sustainability will be appropriate or applicable. This section explains how we believe AHPs can contribute to the green agenda in relation to food within the NHS and wider health and care settings.

Food waste

9.5 million tonnes of all food produced is spoiled or wasted in the UK every year. Some of this is an avoidable waste of resources and produces ‘unnecessary’ emissions. WRAP estimates that up to 18% of food in hospitals may be wasted (equivalent to 1 in every 6 meals wasted). All the carbon emissions generated through growing, transporting and preparing a meal is wasted when it is thrown away. Food that is not eaten also has no nutritional value and is not supporting a patient’s recovery. Research has shown that reducing food waste is a key means of addressing the environmental impact of food in health and care settings.

In a hospital setting, AHPs, where possible, should also consider how they can directly support patients to eat as part of their practice in order to improve nutritional status and reduce food waste. Protected mealtimes are widely used within the NHS and care homes, but for many AHPs this is a point at which they leave so as to minimise disruption. Instead consider how you could use your skills to support patients to eat better and waste less. Many AHPs can (and already do) play a role here.

Packaging waste

Recycling has become a common part of life for many of us, and the “5 Rs” (Reduce, Reuse, Reprocess, Renewable, Recyclable) also apply to food packaging (see link to 5Rs explanation in equipment section). However, it can seem that we leave this approach at the door when we go to work. Although patient needs and safety must always be a top priority, AHPs like all health and care staff can do more to reduce packaging waste whether it is recycled or goes to landfill.

Prescribed food or nutrition products (such as ONS) are a significant source of waste both in terms of packaging and money for health services when they are prescribed inappropriately. These products are used widely in hospitals, often as a cheap and easy alternative to meeting a patient’s nutritional requirements when malnourished. Dietitians in particular can play a key role in ensuring more appropriate ONS prescribing practice, in both hospitals and community/primary care settings. This may include reducing or changing the form of ONS provided, adopting a “food first” approach or making simple changes like trialling ONS with a patient for palatability.

All AHPs should be encouraging good hydration and may need to provide fluids as part of treatment. Reusable containers are a key means of reducing plastic waste.