Diagnosing the performance of food systems to increase accountability toward healthy diets and environmental sustainability

To reorient food systems to ensure they deliver healthy diets that protect against multiple forms of malnutrition and diet-related disease and safeguard the environment, ecosystems, and natural resources, there is a need for better governance and accountability. However, decision-makers are often in the dark on how to navigate their food systems to achieve these multiple outcomes. Even where there is sufficient data to describe various elements, drivers, and outcomes of food systems, there is a lack of tools to assess how food systems are performing. This paper presents a diagnostic methodology for 39 indicators representing food supply, food environments, nutrition outcomes, and environmental outcomes that offer cutoffs to assess performance of national food systems. For each indicator, thresholds are presented for unlikely, potential, or likely challenge areas. This information can be used to generate actions and decisions on where and how to intervene in food systems to improve human and planetary health. A global assessment and two country case studies—Greece and Tanzania—illustrate how the diagnostics could spur decision options available to countries

Metal Contents in Fish from the Bay of Bengal and Potential Consumer Exposure—The EAF-Nansen Programme

Fish represent an important part of the Sri Lankan and Bangladeshi diet. However, fish is also a source of contaminants that may constitute a health risk to consumers. The aim of this study was to analyse the contents of arsenic, cadmium, mercury, and lead in 24 commonly consumed marine fish species from the Bay of Bengal and to assess the potential health risk associated with their consumption. Mercury and lead contents did not exceed the maximum limits for any of the sampled species, and consumer exposure from estimated daily consumption was assessed to be minimal for adults and children. Numerous samples exceeded the maximum limit for cadmium (58%), particularly those of small size (≤25 cm). However, consumer exposure was insignificant, and health assessment showed no risk connected to consumption. These data represent an important contribution to future risk/benefit assessments related to the consumption of fish.publishedVersio

Rigorous monitoring is necessary to guide food system transformation in the countdown to the 2030 global goals

Food systems that support healthy diets in sustainable, resilient, just, and equitable ways can engender progress in eradicating poverty and malnutrition; protecting human rights; and restoring natural resources. Food system activities have contributed to great gains for humanity but have also led to significant challenges, including hunger, poor diet quality, inequity, and threats to nature. While it is recognized that food systems are central to multiple global commitments and goals, including the Sustainable Development Goals, current trajectories are not aligned to meet these objectives. As mounting crises further stress food systems, the consequences of inaction are clear. The goal of food system transformation is to generate a future where all people have access to healthy diets, which are produced in sustainable and resilient ways that restore nature and deliver just, equitable livelihoods. A rigorous, science-based monitoring framework can support evidence-based policymaking and the work of those who hold key actors accountable in this transformation process. Monitoring can illustrate current performance, facilitate comparisons across geographies and over time, and track progress. We propose a framework centered around five thematic areas related to (1) diets, nutrition, and health; (2) environment and climate; and (3) livelihoods, poverty, and equity; (4) governance; and (5) resilience and sustainability. We hope to call attention to the need to monitor food systems globally to inform decisions and support accountability for better governance of food systems as part of the transformation process. Transformation is possible in the next decade, but rigorous evidence is needed in the countdown to the 2030 SDG global goals

The state of food systems worldwide in the countdown to 2030

This Analysis presents a recently developed food system indicator framework and holistic monitoring architecture to track food system transformation towards global development, health and sustainability goals. Five themes are considered: (1) diets, nutrition and health; (2) environment, natural resources and production; (3) livelihoods, poverty and equity; (4) governance; and (5) resilience. Each theme is divided into three to five indicator domains, and indicators were selected to reflect each domain through a consultative process. In total, 50 indicators were selected, with at least one indicator available for every domain. Harmonized data of these 50 indicators provide a baseline assessment of the world’s food systems. We show that every country can claim positive outcomes in some parts of food systems, but none are among the highest ranked across all domains. Furthermore, some indicators are independent of national income, and each highlights a specific aspiration for healthy, sustainable and just food systems. The Food Systems Countdown Initiative will track food systems annually to U. Rashid Sumaila, Maximo Torero Cullen, Francesco N. Tubiello, Jose-Luis Vivero-Pol, Patrick Webb & Keith Wieb

Sport Event Policy

Sport event policy refers to a) the public policy on hosting sporting events and b) the policies and strategies of sport governing bodies connected to sporting events. Sport event policies represent the formalisation of administrative procedures involving using public funding as annual budgets for sport events. The importance of governmental authorities and their policies play a major role for winning the bid of major sporting events with close relations with local authorities and sport organisations. The phase with the greatest policy focus in events is the bidding process, where the main goal is to win the bid and obtain rights from an event owner for hosting the event. State sport policy goals connected to hosting events are defined in such a way that the hosting of sport events creates benefits and thus serves broader sport-directed goals in the host city, region, and country. The content of the sport event hosting policies is tightly connected to and/or formulated within the state sport policy and to the concept of legacy. Not all countries have dedicated or formal sport event hosting policies. Sport event hosting policy content is often included in elite sport policies and in the elite sport strategies of national sport governing bodies. The event policies and strategies that national and local sport organisations formulate are also concerned with competency building in hosting sport events as well as the recruitment of volunteers and members and to increase sport participation. As policy goals are formulated to be fulfilled, sport events are politically required to deliver policy outcomes. However, the actions of event organisers and sport organisations often do not comply with their goals and the sport event hosting policies that the government has formulated.2.2.13</p

Nutrient composition of 19 fish species from Sri Lanka and potential contribution to food and nutrition security

Fish is an important part of the Sri Lankan diet. However, existing data on the nutrient composition of fish in Sri Lanka is highly outdated and limited. The aim of this study was to report the nutrient composition of commonly consumed marine fish species in Sri Lanka and assess the potential contribution of selected key nutrients in fish to recommended nutrient intakes (RNI). Fish were sampled during a survey with research vessel Dr. Fridtjof Nansen around Sri Lanka. Species were categorised as either small (25 cm, n = 7), and three composite samples from each species were analysed using accredited methods. Small species commonly consumed whole contained significantly higher concentrations of micronutrients such as calcium (960 mg/100 g), iron (3.3 mg/100 g), zinc (2.1 mg/100 g), vitamin A (295 μg/100 g), and EPA and DHA (0.14 and 0.32 g/100 g, respectively) than larger species where only the fillet is consumed. Several species were identified to contribute ≥25 % of the RNI of women of reproductive age for multiple essential nutrients. These data may represent an important contribution to the future development of the Sri Lankan food composition database.publishedVersio

The Effectiveness of a Multidisciplinary Electronic Discharge Readiness Tool: Prospective, Single-Center, Pre-Post Study

BackgroundIn the face of hospital capacity strain, hospitals have developed multifaceted plans to try to improve patient flow. Many of these initiatives have focused on the timing of discharges and on lowering lengths of stay, and they have met with variable success. We deployed a novel tool in the electronic health record to enhance discharge communication. ObjectiveThe aim of this study is to evaluate the effectiveness of a discharge communication tool. MethodsThis was a prospective, single-center, pre-post study. Hospitalist physicians and advanced practice providers (APPs) used the Discharge Today Tool to update patient discharge readiness every morning and at any time the patient status changed throughout the day. Primary outcomes were tool use, time of day the clinician entered the discharge order, time of day the patient left the hospital, and hospital length of stay. We used linear mixed modeling and generalized linear mixed modeling, with team and discharging provider included in all the models to account for patients cared for by the same team and the same provider. ResultsDuring the pilot implementation period from March 5, 2019, to July 31, 2019, a total of 4707 patients were discharged (compared with 4558 patients discharged during the preimplementation period). A total of 352 clinical staff had used the tool, and 84.85% (3994/4707) of the patients during the pilot period had a discharge status assigned at least once. In a survey, most respondents reported that the tool was helpful (32/34, 94% of clinical staff) and either saved time or did not add additional time to their workflow (21/24, 88% of providers, and 34/34, 100% of clinical staff). Although improvements were not observed in either unadjusted or adjusted analyses, after including starting morning census per team as an effect modifier, there was a reduction in the time of day the discharge order was entered into the electronic health record by the discharging physician and in the time of day the patient left the hospital (decrease of 2.9 minutes per additional patient, P=.07, and 3 minutes per additional patient, P=.07, respectively). As an effect modifier, for teams that included an APP, there was a significant reduction in the time of day the patient left the hospital beyond the reduction seen for teams without an APP (decrease of 19.1 minutes per patient, P=.04). Finally, in the adjusted analysis, hospital length of stay decreased by an average of 3.7% (P=.06). ConclusionsThe Discharge Today tool allows for real time documentation and sharing of discharge status. Our results suggest an overall positive response by care team members and that the tool may be useful for improving discharge time and length of stay if a team is staffed with an APP or in higher-census situations

Metal Contents in Fish from the Bay of Bengal and Potential Consumer Exposure—The EAF-Nansen Programme

Fish represent an important part of the Sri Lankan and Bangladeshi diet. However, fish is also a source of contaminants that may constitute a health risk to consumers. The aim of this study was to analyse the contents of arsenic, cadmium, mercury, and lead in 24 commonly consumed marine fish species from the Bay of Bengal and to assess the potential health risk associated with their consumption. Mercury and lead contents did not exceed the maximum limits for any of the sampled species, and consumer exposure from estimated daily consumption was assessed to be minimal for adults and children. Numerous samples exceeded the maximum limit for cadmium (58%), particularly those of small size (≤25 cm). However, consumer exposure was insignificant, and health assessment showed no risk connected to consumption. These data represent an important contribution to future risk/benefit assessments related to the consumption of fish

Nutrient Composition of Demersal, Pelagic, and Mesopelagic Fish Species Sampled Off the Coast of Bangladesh and Their Potential Contribution to Food and Nutrition Security—The EAF-Nansen Programme

Fish is a major part of the Bangladeshi diet, but data on the nutrient composition of marine fish species are sparse. Mesopelagic fish may be a new potential resource of food and nutrients; however, nutrient composition data are lacking. The aim of this study was to provide nutrient composition data of fish species sampled off the coast of Bangladesh and determine their potential contribution to recommended nutrient intakes (RNI). Seven species from the pelagic, mesopelagic, and demersal zones were sampled from the coast of Bangladesh with Dr. Fridtjof Nansen in 2018. Three pooled samples containing 15-840 individuals from each species were analysed at the Institute of Marine Research, Norway. The demersal species contained substantially lower concentrations of nearly all nutrients, whereas the mesopelagic species generally were more nutrient dense. All species, except for the demersal species Bombay duck (9% dry matter), were found to contribute ≥100% to the RNI of vitamin B12, eicosapentaenoic acid, docosahexaenoic acid, and selenium. All species, except for the demersal fish species, contributed ≥25% to the RNI of six or more nutrients. The data presented in this paper are an important contribution to the Bangladeshi food composition table and contribute to the understanding of fish as an important source of micronutrients