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  • But consider the alternative outcomes of so called virtuous

    2019-06-10

    But consider the alternative outcomes of so-called virtuous plate-clearing. If the additional portion does not displace other consumption—ie, the amount eaten subsequently is not reduced—then total consumption will have increased. A lack of displacement means no reduction in demand for agricultural commodities and no environmental benefits. If nutritional needs were already being met, increased bodyweight could result with associated health implications (eg, heart diseases and diabetes). Although additional food intake should be regulated by body homoeostasis; as a society we appear increasingly unable to control our weight, with an eighth of the global population being obese in 2014, treble the rate in 1975. Sedentary lifestyles, processed foods, and larger portion sizes are all implicated in this trend, imposing increasing costs on health services. For example, 13% (£16 billion) of the UK\'s health budget in 2014 was spent on medical costs associated with diabetes and conditions related to being overweight or obese.
    “It is easier to build a strong child than to repair broken men”, is a statement widely attributed to Frederick Douglass, whose early years in slavery had given him a poor start in life. Our early years matter because the environment shapes our future health and resillience to unhealthy environments later in life. The risks to a child\'s health if the mother is obese, smokes during pregnancy, or develops pre-eclampsia or gestational diabetes, or if the child\'s diet is high in sugar, salt, and trans-saturated fat, are well known. However, the unrecognised risks to the health of future generations are increasingly concerning. WHO has published an Atlas on children\'s health and the environment, noting that “26% of the deaths of 5·9 million children who died before reaching their fifth birthday could have been prevented through addressing environmental risks—a shocking missed opportunity”. Environmental risks such as air pollution, contaminated food and water, and exposure to environmental toxic substances, can affect developing organs and physiological systems at all critical life stages, from the embryo through childhood and into adolescence (). The ability of tissues to repair damages and the opportunities to reverse any detrimental effects decreases with age. Although the prevalence of morbidities such as ag1478 and obesity are increasing in childhood, the effects of some conditions caused by the environment might not manifest until many years later. For example, in low-income and middle-income countries, an adverse environment during childhood might prevent 43% of children from reaching their full neurocognitive potential. An assessment of disease risk at different life stages indicates that governmental health policies should focus on the health of young people, especially since adolescents account for nearly one fifth of the world\'s population. Although the UN General Comment 4 of the Convention on the Rights of the Child states that “adolescents are in general a healthy population group”, they can be on a high-risk trajectory to develop non-communicable diseases, even if they appear outwardly healthy. Importantly, many adolescents at high risk do not have access to primary health care because of their place in society and thus are unlikely to be informed about the risks to their health. Moreover, we now understand that individuals can pass the risk of non-communicable diseases to their children, for example via epigenetic mechanisms. These biological processes can occur before the mother knows she is pregnant and accesses health care, and so the cycle of risk is perpetuated. A new WHO initiative aims to highlight how early life exposure to environmental toxic substances can be avoided and has proposed a plan to address the issue. WHO already has detailed information on various environmental toxicants from many reports and their initiative calls for this information to be better communicated to all health-care professionals, alongside new WHO-supported educational packages. Public health departments and communities need to be better informed about how exposure to toxicants during early life is of concern and can be minimised or avoided altogether. At an individual level, education of men and women before they conceive a child is an ideal opportunity to promote awareness of healthy habits. Daily exposure to environmental toxicants can cause bioaccumulation, which, in a pregnant mother, can expose her unborn child to higher than expected concentrations of toxicant and produce additive effects—this phenomenon occurs even if the level of exposure to or concentration within the mothers\' body of the toxicant is considered safe, if an acceptable level of exposure is known. Additionally, fathers are not excluded: bioaccumulation of toxins can affect offspring development via epigenetic effects on the sperm.