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Adaptation tracking is crucial for understanding progress in responding to climate change impacts across space and time. However, adaptation tracking is constrained by the lack of agreement on how to measure adaptation. While there has been significant focus on government plans and other documented adaptation as the basis for adaptation tracking, emerging literature also advocates for inclusive approaches that consider multiple experiences and priorities when designing and using adaptation tracking indicators. However, little literature empirically investigates the specifics of what this integrated approach is or what it could achieve. We address this gap using a thematic analysis of 48 focus group discussions and of government policies to compare the perspectives of livestock keepers and governments in Eastern Africa on climate risks and adaptation in livestock systems. The results show considerable similarities in how they perceive climatic hazards, impacts, adaptation strategies, goals, and adaptive capacities, highlighting elements that could be recognized as relevant by both sets of stakeholders. However, the differences underscore the value of an integrated approach as it supports the recognition of variations in climate risks and adaptation options across contexts as well as capturing diverse effects of adaptation across scales. Insights from this paper contribute to discussions on developing integrated adaptation tracking frameworks that take into account the contextual nature of climate hazards, impacts, adaptation strategies, adaptive capacities, and adaptation goals. Key policy insights Governments and livestock keepers perceive climate hazards, impacts, adaptation strategies, adaptive capacity, and adaptation goals in largely similar ways. Differences in governmental and livestock keeper perspectives provide the basis for integrating them in the development of adaptation tracking indicators. Drawing on multiple experiences, priorities, and knowledges cou

Climate change is a key socioeconomic and environmental concern in South Africa. The South African government introduced several climate change initiatives to address the impacts of climate change, resulting in the proliferation of climate adaptation policies across spheres of government. This paper studies different climate change adaptation policies and climate policy paradigms (CPP) to understand the adaptation landscape; it explains and compares the changes in CPP in South Africa over time. We mapped 40 policy documents from 2004 to 2022, which shows 12 national policies, 12 provincial (sub-national) policy documents and 14 metropolitan city policy documents. We then used 12 national policy documents to illustrate and understand the CPP. The research shows that different stakeholders have shaped climate change adaptation policy, both private and public firms advised on climate change policy and there are a number of different funding partners supporting the adaptation policy like GEF, C40 and GIZ. The changing policy environment has introduced new frameworks, objectives and processes. Therefore, more efforts will be needed going forward to guide adaptation policy across national, provincial and local governments. We find that several CPPs have emerged, that is different paradigms encompassing a range of policy goals, framings and instruments. The present National CC Adaptation Strategy (NCCAS) mandates adaptation across all levels of government and allows all important stakeholders to address climate change consequences. This NCCAS increases the number and ambition of adaptation policy, encourages integrated approaches, policy coherence and clear direction on how to handle climate risks and impacts in varied South Africa and its global commitment. Changes in policy paradigm enable the use of new policy instruments, including funding and budget mechanisms. Finally, climate adaptation policy has become more ambitious and stringent, requiring all levels of governme

Climate change adaptation policies are urgently needed, but the large volume and variety of evidence limits the ability of practitioners to make informed decisions. Here, we create an evidence map of adaptation policy research, selecting and categorizing 8,691 documents using state-of-the-art transformers-based machine learning models. We combine policy-relevant categories, such as the NATO-typology and governance levels, with automatically extracted locations and a structural topic model to provide a detailed global assessment of the tools governments are using to address climate change risks and impacts. We find that international-level policies, as well as policies in North America and much of the Global South, emphasize financial instruments, whereas national policies, particularly in Europe and Oceania, favor authority-based legislation. Collaborative approaches are most common at the local level. Despite a rapidly expanding evidence base overall, we note persistent geographic inequalities and limited evidence on information-based policies, policy implementation, and structural reforms.

Advances in research on current and projected heat-related risks from climate change and the associated responses have rapidly developed over the past decade. Modelling architectures of climate impacts and heat-related health risks have become increasingly sophisticated alongside a growing number of experiments and socioeconomic studies, and possible options for heat-related health adaptation are increasingly being catalogued and assessed. However, despite this progress, these efforts often remain isolated streams of research, substantially hampering our ability to contribute to evidence-informed decision making on responding to heat-related health risks. We argue that the integration of scientific efforts towards more holistic research is urgently needed to tackle fragmented evidence and identify crucial knowledge gaps, so that health research can better anticipate and respond to heat-related health risks in the context of a changing climate. In this Personal View, we outline six building blocks, each constituting a research stream, but each needed as part of a more integrated research framework—namely, projected heat-related health risks; adaptation options; the feasibility and effectiveness of adaptation; synergies, trade-offs, and co-benefits of adaptation; adaptation limits and residual risks; and adaptation pathways. We outline their respective importance and discuss their benefits for health-related research and policy.

The original article has been corrected. In Table 1 of this article, the data in the third column headed Author type was incorrect. “Non-Party:” was in the fifth row and should have been in the forth row next to (23,313), the next row (9900) should then have been “off which IPCC”, and the final row (1981) should have been “of which Secretariat”. This has now been implemented in the corrected version. Figure 1 was updated for clarity.

Climate services are increasingly developed and used to plan for climate change adaptation, but it remains unclear what constitutes their success. In this global Delphi study, a wide range of experts evaluated 12 elements to be most relevant for defining success, clustered along 3 dimensions: climate service, production process, and results of production and/or use. Two possible ways of combining these elements into a definition received convincing support from the experts. The definition shows that user satisfaction is key. Moreover, climate service developers should acknowledge climate change uncertainties, and build trust and capacity with the users, while tailoring interactions. Ultimately, better adaptation decisions should follow. There was limited agreement on including elements regarding the process of how a service should be developed. This paper proposes a first global definition for successful climate services that is widely supported and can be used to develop, research, and evaluate climate services.

An unresolved dilemma facing many disciplines is how theory and practice can better work together to enhance the decision-making processes on the ground. This widely-known theory-practice gap often contributes to the misdiagnosis of problems and undermines the effectiveness of responses. Despite decades of research into why this gap remains, there is still a continuing and heated debate as to why it exists and how it could be resolved. This article examines the theory-practice gap through a systematic review that draws insights across diverse disciplines such as health, science, governance, and business. It builds a conceptual framework based on the findings, allowing for the analysis of the various drivers and solutions for addressing the gap. The findings show that to resolve this gap is necessary to change our perspective of the gap and understand it as a bilateral issue, where both theory and practice play a role in creating the gap. Thus, solutions to the gap need to follow a cyclical and integrative approach. As the gap may never be fully closed, the framework provides the tools to respond to it whenever it arises. Future research will be required to empirically test and advance the framework.

Climate related changes are already affecting every area of our world and will increasingly do so as global warming increases, resulting in compounding and cascading risks across multiple locations and sectors. Deliberative processes and anticipatory actions are required to adapt to the associated complex and uncertain systemic risks, with dynamic and long-term planning needed even where there is limited knowledge of the effectiveness of adaptation. In this focus article, we examine the adaptation pathways developed for the Europe Chapter of the IPCC AR6. We argue that illustrative pathways built on quantitative and qualitative assessment of adaptation effectiveness can inform adaptation planning to manage the increasing severity of risks. We find that as the global warming level increases adaptation pathways can diverge, leading to radically different futures, for example, adaptation responses to sea level rise. We illustrate how adaptation measures for different risks interact resulting in trade-offs, for example, increasing water scarcity. Although pathways offer a useful framework to address multiple adaptation challenges, other supporting conditions are needed for the successful implementation of adaptation, such as establishing legitimacy and buy-in through collaboration of various actors and effective governance. Ultimately, adaptation will be increasingly more complex and constrained in a warmer world, increasing risks of losses and damages to people and nature. This article is categorized under: Vulnerability and Adaptation to Climate Change > Institutions for Adaptation The Social Status of Climate Change Knowledge > Climate Science and Decision Making Assessing Impacts of Climate Change > Evaluating Future Impacts of Climate Change Vulnerability and Adaptation to Climate Change > Learning from Cases and Analogies.

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BACKGROUND: White matter hyperintensities (WMH) are associated with cognitive dysfunction after ischemic stroke. Yet, uncertainty remains about affected domains, the role of other preexisting brain injury, and infarct types in the relation between WMH burden and poststroke cognition. We aimed to disentangle these factors in a large sample of patients with ischemic stroke from different cohorts. METHODS: We pooled and harmonized individual patient data (n=1568) from 9 cohorts, through the Meta VCI Map consortium (www.metavcimap.org). Included cohorts comprised patients with available magnetic resonance imaging and multidomain cognitive assessment <15 months poststroke. In this individual patient data meta-analysis, linear mixed models were used to determine the association between WMH volume and domain-specific cognitive functioning (Z scores; attention and executive functioning, processing speed, language and verbal memory) for the total sample and stratified by infarct type. Preexisting brain injury was accounted for in the multivariable models and all analyses were corrected for the study site as a random effect. RESULTS: In the total sample (67 years [SD, 11.5], 40% female), we found a dose-dependent inverse relationship between WMH volume and poststroke cognitive functioning across all 4 cognitive domains (coefficients ranging from -0.09 [SE, 0.04, P=0.01] for verbal memory to -0.19 [SE, 0.03, P<0.001] for attention and executive functioning). This relation was independent of acute infarct volume and the presence of lacunes and old infarcts. In stratified analyses, the relation between WMH volume and domain-specific functioning was also largely independent of infarct type.CONCLUSIONS: In patients with ischemic stroke, increasing WMH volume is independently associated with worse cognitive functioning across all major domains, regardless of old ischemic lesions and infarct type.

Self-reporting is an important mechanism of the UNFCCC to collect information about what countries are doing to achieve their climate change mitigation and adaptation targets and how much progress has been made. Here we empirically test four hypotheses about what countries prioritise in their self-reporting through the National Communications. Using quantitative text analysis methods (structural topic modelling and keyness statistics), we analyse over 600 submissions (from 1994 to 2019) and find evidence that vulnerable countries highlight impacts, vulnerability, and adaptation rather than mitigation targets, whereas high-emitting countries tend to focus their messaging more on mitigation. Despite the Paris Agreement being considered a “watershed moment”, we find no statistically significant increase in focus on climate solutions post-Paris, and no significant increase in attention to adaptation. Our global assessment and the methods used offer a novel perspective to understand what gets framed as important by governments. Finally, we provide reflections on how self-reporting mechanisms can be used for global stocktaking of progress on climate action.

In dit onderzoek is de maatschappelijke impact van eiwittransitie vastgesteld. Daartoe is het effect van al ingezet beleid voor 2030 bepaald waarna scenario’s waarin meer plantaardig eiwit wordt geconsumeerd (60%) zijn vergeleken met dit basisscenario in 2030. Het gaat om de impact op natuurlijk, sociaal en humaan kapitaal. Ook voor een scenario met verlaagde totale eiwitconsumptie is de maatschappelijke impact beoordeeld. Conclusie is dat tot 2030 vooral de milieu-impact gaat verminderen door forse verkleining van de veestapel. De eiwittransitie heeft een positieve impact op natuurlijk en humaan kapitaal.

Background: A transition to healthy and sustainable diets has the potential to improve human and planetary health but diets need to meet requirements for nutritional adequacy, health, environmental targets, and be acceptable to consumers. Objective: The objective of this study was to derive a nutritionally adequate and healthy diet that has the least deviation possible from the average observed diet of Danish adults while aiming for a greenhouse gas emission (GHGE) reduction of 31%, corresponding to the GHGE level of the Danish plant-rich diet, which lays the foundation for the current healthy and sustainable food-based dietary guidelines (FBDGs) in Denmark. Methods: With an objective function minimizing the departure from the average observed diet of Danish adults, four diet optimizations were run using quadratic programming, with different combinations of diet constraints: (1) nutrients only (Nutri), (2) nutrients and health-based targets for food amounts (NutriHealth), (3) GHGE only (GHGE), and finally, (4) combined nutrient, health and GHGE constraints (NutriHealthGHGE). Results: The GHGE of the four optimized diets were 3.93 kg CO2-eq (Nutri), 3.77 kg CO2-eq (NutriHealth) and 3.01 kg CO2-eq (GHGE and NutriHealthGHGE), compared to 4.37 kg CO2-eq in the observed diet. The proportion of energy from animal-based foods was 21%–25% in the optimized diets compared to 34% in the observed diet and 18% in the Danish plant-rich diet. Moreover, compared to the average Danish diet, the NutriHealthGHGE diet contained more grains and starches (44 E% vs. 28 E%), nuts (+230%), fatty fish (+89%), eggs (+47%); less cheese (−73%), animal-based fats (−76%), total meat (−42%); and very limited amounts of ruminant meat, soft drinks, and alcoholic beverages (all-90%), while the amounts of legumes and seeds were unchanged. On average, the mathematically optimized NutriHealthGHGE diet showed a smaller deviation from the average Danish diet compared to the Danish plant-rich diet (38% vs.

Four years after the EAT-Lancet landmark report, worldwide movements call for action to reorient food systems to healthy diets that respect planetary boundaries. Since dietary habits are inherently local and personal, any shift toward healthy and sustainable diets going against this identity will have an uphill road. Therefore, research should address the tension between the local and global nature of the biophysical (health, environment) and social dimensions (culture, economy). Advancing the food system transformation to healthy, sustainable diets transcends the personal control of engaging consumers. The challenge for science is to scale-up, to become more interdisciplinary, and to engage with policymakers and food system actors. This will provide the evidential basis to shift from the current narrative of price, convenience, and taste to one of health, sustainability, and equity. The breaches of planetary boundaries and the environmental and health costs of the food system can no longer be considered externalities. However, conflicting interests and traditions frustrate effective changes in the human-made food system. Public and private stakeholders must embrace social inclusiveness and include the role and accountability of all food system actors from the microlevel to the macrolevel. To achieve this food transformation, a new "social contract,"led by governments, is needed to redefine the economic and regulatory power balance between consumers and (inter) national food system actors.

This research analyzed data from the Belgian National Food Consumption Survey, conducted between 2014 and 2015 by Sciensano. The average meat consumption was 182.2 grams/day in this representative population sample of Belgian adults. The daily diets when individuals who consumed meat resulted in approximately twice the greenhouse gas emissions than those who did not consume meat: 5.99 kg CO2-eq/day and 3.02 kg CO2-eq/day for meat days and meat-free days, respectively. Similar patterns have been observed for land use, with 7.95 and 3.25 m2·year/day for meat days and meat-free days, respectively. If individuals were to replace meat by meat replacers (such as vegetarian or vegan meat imitates, eggs, legumes, and nuts/seeds) in their daily diets, it could potentially lead to a reduction in greenhouse gas emissions of 2.62 kg CO2-eq/day and land use of 3.64 m2·year/day, representing a decrease of 37.8% and 36.4%, respectively. Therefore, limiting meat consumption has the potential to substantially reduce the environmental impact of food consumption in Belgium.

Background: The growing consumption of ultra-processed foods (UPFs) among vegetarians and vegans may occur at the expense of the health and environmental benefits of plant-based diets. Objectives: This study aimed to investigate the associations of UPFs in plant-based diets with all-cause mortality and environmental impact. Methods: Analyses were based on 35,030 participants (20–70 years; 74% females) from the EPIC-NL cohort who were followed up from 1993 to 1997 through 2014. The Plant-Based Diet Index (PDI) and UPF consumption (g/2000 kcal) were calculated using a validated FFQ. Based on a median split of the PDI and UPF consumption, four dietary categories were created (e.g., high PDI score/low UPF consumption). Cox proportional hazard and multiple linear regression models were used to estimate associations with all-cause mortality risk, greenhouse gas (GHG) emissions, and blue water consumption. Results: Among diets high in plant-based foods, higher UPF consumption tended to be associated with a 5% (HR: 1.05, CI: 0.95, 1.16) increased all-cause mortality risk and was statistically significantly associated with 1.3% (95% CI: 0.7, 1.9) higher GHG emissions and a 2.5% (95% CI: −3.1, −1.3) lower blue water consumption compared to lower UPF consumption. Diets lower in plant-based foods were associated with a 15% (HR: 1.15, CI: 1.05, 1.26) and 24% (HR: 1.24, CI: 1.13, 1.36) increased mortality risk, 11.7% (95% CI: 11.4, 12.3) and 12.5% (95% CI: 11.9, 13.0) higher GHG emissions, and 8.8% (95% CI: −9.4, −8.2) and 11.3% (95% CI: −12.6, −10.7) lower blue water consumption for low and high UPF consumers, respectively, compared with diets high in plant-based foods and low in UPF. Discussion: UPF consumption did not counteract the health and (reduced) environmental impacts of adhering to a more plant-based diet, although special concern needs to be given to the high blue water consumption of specific plant foods. Future research should clarify whether this also holds for cur

Background and objectives: There is a compelling need for a more sustainable food system because of climate change and contemporary Western diets, which pose a threat to human and planetary health. The food system is a social–ecological system, consisting of both biophysical and social sub-systems which are interlinked. This implies that changes in one sub-system can lead to synergies and trade-offs elsewhere. To identify such synergies and tradeoffs, researchers are integrating work from a range of disciplines in optimization models. This has resulted in models that are unique but have a similar overarching aim: ‘to create a sustainable food system by understanding the implications of food system choices’. However, the results of these models may differ. Therefore, the aim of this paper was to understand the differences and complementarity of two optimization models to grasp the complexity of the food system. Methods: we compared the Circular Food System (CiFoS) model with the Sustainable, Healthy, Acceptable, Realistic, and Preferable diets (SHARP) model. CiFoS is a biophysical optimization model that aims to produce a healthy diet for a growing population within planetary boundaries. SHARP is a benchmarking model that optimizes current diets for health and sustainability for consumers. Both models propose a healthy and sustainable diet. While CiFoS is detailed on how environmental impacts are calculated, SHARP has a finer grid on the consumption aspects. Results: based on previously modelled scenarios that showed different results in diet composition, we identified that these differences could be explained by fundamental characteristics of the model (e.g., environmental impact calculations or the consideration of distance to the current diet), data input and scenario settings. Besides, the models work complementary regarding the time scale (i.e., solutions for the upcoming years versus upcoming decades), geographic scale and an individual versus population approa

Contribution of Working Group II to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change

Climate change adaptation (CCA) is an urgent global challenge that requires transdisciplinary efforts to deliver effective, aligned, useful, and sustainable outcomes. Current approaches and tools have been slow to translate into robust action, however, leading to a widening gap between adaptation theory and actual on the ground implementation. This theory–practice gap is a fundamental factor that is causing significant challenges to adaptation, yet it has seldom been directly defined or addressed. A better understanding of how this gap emerges, what drives it, and how it could be solved contributes to improving the way both adaptation theory and practice develop. This study critically examines the existence of this gap through a novel framework via a series of workshops with experts engaged in adaptation science, planning and implementation. The findings show that there are multiple gaps that interact with each other, generating a complex and challenging process of adaptation. There are diverse drivers such as motivation and values, knowledge, capacity, language, and funding, that shape the gap. Overall, we show that the gap can be tackled by integrating multiple solutions utilising the diverse sources of knowledge compiled in the framework. Possible solutions include improving knowledge creation and accessibility, enabling collaboration and communication between stakeholders, developing skills and capacity, improving context or circumstances, and introducing new roles and tools. These findings will be useful for scientists, practitioners and policymakers who are interested in developing more integrated theory–practice solutions for robust and effective climate adaptation.

Background: A transition to healthy and sustainable diets has the potential to improve human and planetary health but diets need to meet requirements for nutritional adequacy, health, environmental targets, and be acceptable to consumers. Objective: The objective of this study was to derive a nutritionally adequate and healthy diet that has the least deviation possible from the average observed diet of Danish adults while aiming for a greenhouse gas emission (GHGE) reduction of 31%, corresponding to the GHGE level of the Danish plant-rich diet, which lays the foundation for the current healthy and sustainable food-based dietary guidelines (FBDGs) in Denmark. Methods: With an objective function minimizing the departure from the average observed diet of Danish adults, four diet optimizations were run using quadratic programming, with different combinations of diet constraints: (1) nutrients only (Nutri), (2) nutrients and health-based targets for food amounts (NutriHealth), (3) GHGE only (GHGE), and finally, (4) combined nutrient, health and GHGE constraints (NutriHealthGHGE). Results: The GHGE of the four optimized diets were 3.93 kg CO2-eq (Nutri), 3.77 kg CO2-eq (NutriHealth) and 3.01 kg CO2-eq (GHGE and NutriHealthGHGE), compared to 4.37 kg CO2-eq in the observed diet. The proportion of energy from animal-based foods was 21%–25% in the optimized diets compared to 34% in the observed diet and 18% in the Danish plant-rich diet. Moreover, compared to the average Danish diet, the NutriHealthGHGE diet contained more grains and starches (44 E% vs. 28 E%), nuts (+230%), fatty fish (+89%), eggs (+47%); less cheese (−73%), animal-based fats (−76%), total meat (−42%); and very limited amounts of ruminant meat, soft drinks, and alcoholic beverages (all-90%), while the amounts of legumes and seeds were unchanged. On average, the mathemati

Background The Healthy Reference Diet (HRD) was created to formulate dietary guidelines that would be healthy and sustainable. We aimed to construct a diet score measuring adherence to the HRD and to explore its association with cardiovascular events and environmental impact. Methods and Results We included 35 496 participants from the population-based EPIC-NL (European Prospective Investigation into Cancer and Nutrition-Netherlands) study. HRD scores were calculated using data from food frequency questionnaires (0-140). Data on morbidity and mortality were retrieved through linkage with national and death registries. Data on environmental impact indicators were obtained from life cycle assessments. Associations between adherence to the HRD and cardiovascular events were estimated with Cox proportional hazard models. Linear regression analysis was conducted for the adherence to the HRD and each environmental indicator. High adherence to the HRD was associated with 14%, 12%, and 11% lower risks of cardiovascular disease (hazard ratio [HR]Q4vsQ1, 0.86 [95% CI, 0.78-0.94]), coronary heart disease (HRQ4vsQ1, 0.88 [95% CI, 0.78-1.00]), and total stroke (HRQ4vsQ1, 0.89 [95% CI, 0.72-1.10]), respectively. High HRD adherence was associated with 2.4% (95% CI, -5.0 to 0.2) lower greenhouse gas emissions, 3.9% (95% CI, -5.2 to -2.6) less land use, 0.5% (95% CI, -2.6 to 1.6), less freshwater eutrophication, 3.3% (95% CI, -5.8 to -0.8), less marine eutrophication, 7.7% (95% CI, -10.8 to -4.6), less terrestrial acidification, and 32.1 % (95% CI, 28.5-35.7) higher blue water use. Conclusions High adherence to the HRD was associated with lower risk of cardiovascular disease, coronary heart disease, and modestly lower levels of most environmental indicators but a higher level of blue water use.

Background: Increased urbanization has been linked to transitions in dietary patterns. However, evidence on the impacts of urbanization on diet quality, and environmental impact, and diet cost is limited. The aim of this study was to investigate the time trends of these three dietary sustainability in China over the period 1997–2011 and to examine their associations with urbanization. Methods: Food consumption of 8,330 participants (18–64y) of the China Health and Nutrition Survey cohort (1997, 2000, 2004, 2006, 2009, and 2011) were examined and diet quality was assessed using the Chinese Healthy Eating Index 2016 (CHEI2016). Dietary related environmental impacts on Greenhouse Gas Emissions (GHGE), Total Water Use (TWU), and Land Use (LU) were estimated using the Chinese Food Life Cycle Assessment Database. Monetary cost of diet was calculated using the community market prices of food items. Multilevel mixed-effects models were used to estimate associations between the time trend of dietary sustainability indicators and degree of urbanization. Results: From 1997 to 2011, the CHEI2016 score increased by 10.6%, GHGE by 23.8%, LU by 29.1%, and the inflation-corrected cost of diet by 80%. Urbanization was positively associated with these time trends, which remained after adjustment for sociodemographic and lifestyle factors (all P < 0·05). Conclusion: The rapid urbanization in China over the past two decades has been followed by an improvement in the overall dietary quality, but this has been accompanied by an increase in the environmental impacts and higher cost of the diet, especially in communities with lower urbanization index.

National contexts play a critical role in shaping the transposition of international laws and agreements, such as the Paris Agreement. However, the relevance of national contexts when assessing global progress in adaptation to climate change has received little theoretical and empirical attention. To bridge this gap, we conduct a comparative study of government systems for producing and using policy knowledge on the livestock sectors of three Eastern Africa countries. We find distinct features within and between countries, which may explain variations in how adaptation progress is tracked. In particular, our study shows that prevailing administrative structures influence horizontal and vertical coordination, with implications for the flow of knowledge within government. The extent of coordination and the establishment of knowledge production procedures and accountability mechanisms affect the compatibility of the various knowledge streams in each country which, in turn, determines the potential for integrating adaptation tracking across the various administrative units. Our findings suggest that the effectiveness and feasibility of tracking adaptation progress over time and space will depend on the adequacy and successful linkage of tracking programs with existing systems of knowledge production and use. These findings underscore the relevance of a fit-for-context approach that examines how adaptation tracking can effectively be integrated into existing structures and processes while developing strategies for improving knowledge production and use.

Background: The adverse health effects of high ultraprocessed food and drink (UPFD) consumption are well documented. However, the environmental impact remains unclear, and the separate effects of ultraprocessed foods (UPFs) and drinks (UPDs) on all-cause mortality have not been studied previously. Objectives: To assess the association between levels of UPFD, UPF, and UPD consumption and diet-related environmental impacts and all-cause mortality in Dutch adults. Methods: Habitual diets were assessed by a Food Frequency Questionnaire (FFQ) from 1993–1997 in 38,261 participants of the Dutch European Prospective Investigation into Cancer and Nutrition cohort. The mean follow-up time was 18.2 y (SD = 4.1); 4,697 deaths occurred. FFQ items were categorized according to the NOVA classification. Associations between quartiles of UPFD, UPF, and UPD consumption and environmental impact indicators were analyzed using general linear models and all-cause mortality by Cox proportional hazard models. The lowest UPFD, UPF, and UPD consumption quartiles were used as comparator. Results: The average UPFD consumption was 181 (SD = 88) g/1000 kcal. High UPF consumption was statistically significantly inversely associated with all environmental impact indicators (Q4vsQ1: −13.6% to −3.0%), whereas high UPD consumption was, except for land use, statistically significant positively associated with all environmental impact indicators (Q4vsQ1: 1.2% to 5.9%). High UPFD consumption was heterogeneously associated with environmental impacts (Q4vsQ1: −4.0% to 2.6%). After multivariable adjustment, the highest quartiles of UPFD and UPD consumption were significantly associated with all-cause mortality (HRQ4vsQ1: 1.17, 95%CI: 1.08, 1.28 and HRQ4vsQ1: 1.16, 95%CI: 1.07, 1.26, respectively). UPF consumption of Q2 and Q3 were associated with a borderline significant lower risk of all-cause mortality (HRQ2vsQ1: 0.93, 95% CI: 0.85, 1.00; HRQ3vsQ1: 0.91, 95% CI: 0.84, 0.99) whereas Q4 was not statistical

Rationale and objective: Improving diet quality while decreasing environmental impacts is an important challenge for a healthy and sustainable food system. Therefore, this study aims to analyze the most common dietary patterns per female household member and explore the diet quality and environmental impacts of these patterns. Methodology: The nationally representative General Nutrition Survey of 2009–2010 (n = 8,225 households) was used to derive dietary patterns using principal component analysis (PCA) based on 18 food groups as input variables. Quintiles of the highest adherence (Q5) and lowest adherence (Q1) were generated based on the factor score of each dietary pattern. Nutrient adequacy and dietary diversity scores (DDS) were calculated to measure diet quality, and greenhouse gas emission (GHGE) and blue water use (BWU) were selected as environmental impact indicators. Results: Using PCA, three distinct dietary patterns were identified: an Omnivorous, Traditional, and Pescatarian pattern. Compared to the Traditional pattern, the Omnivorous and Pescatarian patterns (Q5s) were associated with a higher nutrient adequacy, with mean probability of adequacy of 0.51 in both patterns, compared to 0.45 in the Traditional pattern. However, environmental impacts in terms of GHGE and BWU per 2,000 kcal were considerably higher in the Omnivorous pattern (6.14 kg CO2-eq. and 0.15 m3/kg) compared to all other pattern’s Q5s. The GHGE was lowest in the Traditional pattern (4.18 kg CO2-eq.) and the Pescatarian pattern has the lowest BWU (0.12 m3/kg). Conclusion: Despite that diet quality was slightly better in all three patterns compared to the average diet of the total population, environmental impact was also higher. Therefore, future research is needed to develop a more optimal diet that considers both diet quality and environmental impact to explore the trade-offs between diet quality and environmental impact.

PR, IFPRI3; ISI; CRP4; 2 Promoting Healthy Diets and Nutrition for all, Nutrition, Diets, and Health (NDH); Food and Nutrition Policy; A4NH, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Rationale and objective: Improving diet quality while decreasing environmental impacts is an important challenge for a healthy and sustainable food system. Therefore, this study aims to analyze the most common dietary patterns per female household member and explore the diet quality and environmental impacts of these patterns. Methodology: The nationally representative General Nutrition Survey of 2009–2010 (n = 8,225 households) was used to derive dietary patterns using principal component analysis (PCA) based on 18 food groups as input variables. Quintiles of the highest adherence (Q5) and lowest adherence (Q1) were generated based on the factor score of each dietary pattern. Nutrient adequacy and dietary diversity scores (DDS) were calculated to measure diet quality, and greenhouse gas emission (GHGE) and blue water use (BWU) were selected as environmental impact indicators. Results: Using PCA, three distinct dietary patterns were identified: an Omnivorous, Traditional, and Pescatarian pattern. Compared to the Traditional pattern, the Omnivorous and Pescatarian patterns (Q5s) were associated with a higher nutrient adequacy, with mean probability of adequacy of 0.51 in both patterns, compared to 0.45 in the Traditional pattern. However, environmental impacts in terms of GHGE and BWU per 2,000 kcal were considerably higher in the Omnivorous pattern (6.14 kg CO2-eq. and 0.15 m3/kg) compared to all other pattern’s Q5s. The GHGE was lowest in the Traditional pattern (4.18 kg CO2-eq.) and the Pescatarian pattern has the lowest BWU (0.12 m3/kg). Conclusion: Despite that diet quality was slightly better in all three patterns compared to the average diet of the total population, environmental impact was also higher. Therefore, future research is needed to develop a more optimal diet that considers both diet quality and environmental impact to explore the trade-offs between diet quality and environmental impact.

BACKGROUND: Poststroke cognitive impairment (PSCI) occurs in about half of stroke survivors. Cumulative evidence indicates that functional outcomes of stroke are worse in women than men. Yet it is unknown whether the occurrence and characteristics of PSCI differ between men and women. METHODS: Individual patient data from 9 cohorts of patients with ischemic stroke were harmonized and pooled through the Meta-VCI-Map consortium (n=2343, 38% women). We included patients with visible symptomatic infarcts on computed tomography/magnetic resonance imaging and cognitive assessment within 15 months after stroke. PSCI was defined as impairment in ≥1 cognitive domains on neuropsychological assessment. Logistic regression analyses were performed to compare men to women, adjusted for study cohort, to obtain odds ratios for PSCI and individual cognitive domains. We also explored sensitivity and specificity of cognitive screening tools for detecting PSCI, according to sex (Mini-Mental State Examination, 4 cohorts, n=1814; Montreal Cognitive Assessment, 3 cohorts, n=278). RESULTS: PSCI was found in 51% of both women and men. Men had a lower risk of impairment of attention and executive functioning (men: odds ratio, 0.76 [95% CI, 0.61-0.96]), and language (men: odds ratio, 0.67 [95% CI, 0.45-0.85]), but a higher risk of verbal memory impairment (men: odds ratio, 1.43 [95% CI, 1.17-1.75]). The sensitivity of Mini-Mental State Examination (<25) for PSCI was higher for women (0.53) than for men (0.27; P=0.02), with a lower specificity for women (0.80) than men (0.96; P=0.01). Sensitivity and specificity of Montreal Cognitive Assessment (<26.) for PSCI was comparable between women and men (0.91 versus 0.86; P=0.62 and 0.29 versus 0.28; P=0.86, respectively). CONCLUSIONS: Sex was not associated with PSCI occurrence but affected domains differed between men and women. The latter may explain why sensitivity of the Mini-Mental State Examination for detecting PSCI was higher in wom

De belangrijkste aanbevelingen voor beleidsmakers bij overheden om de eiwittransitie te bevorderen in een breed scala van publieke organisaties zijn te vinden in deze beleidsbrief.

De belangrijkste aanbevelingen voor publieke organisaties t.b.v. het versnellen van de eiwittransitie in hun inkoopbeleid zijn te vinden in deze beleidsbrief.

Door de bestudering van Handelingen van de Tweede Kamer en Memories van Overgave van aftredende residenten wordt in deze thesis onderzocht op welke manieren de Nederlandse overheid macht uitoefende op lokale zelfbesturen in Nederlands-Indië. De hervormingen die tussen 1901 en 1918 werden geïntroduceerd door de Nederlandse overheid onder de noemer van de ethische politiek vormen hierbij het afgebakende onderzoeksveld. De ethische politiek was beleid dat werd gevormd en geïmplementeerd door de Nederlandse overheid om in Nederlands-Indië de Indonesische bevolking te ontwikkelen richting zelfbestuur naar westers model onder reëel Nederlands gezag. Er is gebruikgemaakt van drie verschillende perspectieven om de uiteenlopende manieren waarop de Nederlandse overheid macht uitoefende in Nederlands-Indië te ontleden: decision-making power, non-decision-making power en ideological power. Dit theoretische kader maakt het mogelijk om de machtsverhouding tussen de Nederlandse overheid, De Indonesische bevolking en lokale zelfbesturen te ontleden. De thesis toont aan dat Nederland onder andere vanwege haar militaire superioriteit het gedrag van de lokale zelfbesturen kon bepalen en de politieke agenda in Nederlands-Indië beheerste, maar laat ook zien dat het koloniale gezag faalde om de idealen van de Indonesische bevolking te controleren. Uit het onderzoek zijn enkele conclusies te trekken die van toepassing zijn op het huidige debat over koloniale verleden van Nederland. Ten eerste, de onderdrukker kan niet de voorwaarden bepalen van toekomstige omgangsvorm met degene die onderdrukt werden. Ten tweede, een verlangen naar verzoening moet gepaard gaan met onbaatzuchtige maatregelen.

INTRODUCTION: Impact of white matter hyperintensities (WMH) on cognition likely depends on lesion location, but a comprehensive map of strategic locations is lacking. We aimed to identify these locations in a large multicenter study.METHODS: Individual patient data (n = 3525) from 11 memory clinic cohorts were harmonized. We determined the association of WMH location with attention and executive functioning, information processing speed, language, and verbal memory performance using voxel-based and region of interest tract-based analyses.RESULTS: WMH in the left and right anterior thalamic radiation, forceps major, and left inferior fronto-occipital fasciculus were significantly related to domain-specific impairment, independent of total WMH volume and atrophy. A strategic WMH score based on these tracts inversely correlated with performance in all domains.DISCUSSION: The data show that the impact of WMH on cognition is location-dependent, primarily involving four strategic white matter tracts. Evaluation of WMH location may support diagnosing vascular cognitive impairment.HIGHLIGHTS: We analyzed white matter hyperintensities (WMH) in 3525 memory clinic patients from 11 cohorts The impact of WMH on cognition depends on location We identified four strategic white matter tracts A single strategic WMH score was derived from these four strategic tracts The strategic WMH score was an independent determinant of four cognitive domains.

This article provides a stocktake of the adaptation literature between 2013 and 2019 to better understand how adaptation responses affect risk under the particularly challenging conditions of compound climate events. Across 39 countries, 45 response types to compound hazards display anticipatory (9%), reactive (33%), and maladaptive (41%) characteristics, as well as hard (18%) and soft (68%) limits to adaptation. Low income, food insecurity, and access to institutional resources and finance are the most prominent of 23 vulnerabilities observed to negatively affect responses. Risk for food security, health, livelihoods, and economic outputs are commonly associated risks driving responses. Narrow geographical and sectoral foci of the literature highlight important conceptual, sectoral, and geographic areas for future research to better understand the way responses shape risk. When responses are integrated within climate risk assessment and management, there is greater potential to advance the urgency of response and safeguards for the most vulnerable.

A scientific consensus acknowledges that climate change has increased wildfire activity in the Russian Arctic, a trend projected to continue in response to further warming. Regional governments across Russia have started to design and develop adaptation policies and plans (i.e. outputs) to this end. Our comprehensive understanding on the state of wildfire adaptation in policy is limited. In this article we systematically review policies and plans developed to adapt to wildfires in the Russian Arctic. Using systematic approaches, we identify 12 wildfire adaptation outputs adopted between 2008 and 2020. Our findings indicate that wildfire adaptation outputs are aimed at reducing the risk of wildfires and improve wildland fire response, implemented through legislative and regulatory mechanisms, developed at the regional level, adopted in response to national mandates, and mainstreamed into existing forest management policies. Although there is evidence of wildfire adaptation planning occurring in the Russian Arctic, we find that the nature and extent of wildfire adaptation outputs are not sufficient to address the seriousness and severity of climate change, with key shortcomings found in relation to the scientific, human, and management characteristics. We argue that expanding the profile of climate change research in the Russian Arctic and improving the dialogue among researchers, local and Indigenous peoples, and decision-makers are critical for providing useful recommendations for policy makers to accelerate wildfire adaptation in the Russian Arctic.

Purpose: To reduce the environmental impact of Western diets, a reduction of meat consumption and a substitution by plant-based protein sources is needed. This protein transition will affect the quantity and quality of dietary protein. Therefore, the aim of this study was to evaluate the protein adequacy of diets optimized for nutritional health and diet-related greenhouse gas emission (GHGE). Methods: Data from 2150 adult participants of the Dutch National Food Consumption Survey were used, with diet assessed using two non-consecutive 24 h dietary recalls. Utilizable protein of current diets per day was based on meal composition and the Protein Digestibility-Corrected Amino Acid Score and was compared to protein requirements. Optimized diets were derived as linear combinations of current diets that minimized GHGE and maximized the Dutch Healthy Diet 2015 score, with/without constraints to keep dietary change within 33% of current consumption. Protein adequacy was evaluated in both current and optimized diets. Results: In all age and gender strata, the healthiest diets had higher GHGE, the most sustainable diets had the lowest dietary quality, though higher than current diets, and protein adequacy remained sufficient. When limiting dietary change to 33% of current consumption, in the most promising trade-off diet GHGE was reduced by 12–16%. The current diet provided 1.4–2.2 times the required amount of utilizable protein. Conclusion: These results suggest that a realistic aim for the next decade might be to reduce diet-related GHGE to 12–16% of the current levels without compromising protein adequacy and diet quality. To achieve global targets, upstream food system transformations are needed with subsequent dietary changes.

Organising effective policy coordination has become a key principle of EU policymaking in recent decades. Within the European Commission, interservice consultations (ISCs) play an important role to coordinate between the different directorate-generals. In spite of this importance, ISCs have so far not been analysed in a systematic way. This paper addresses this gap by systematically analysing the numbers, types and content of comments made in ISCs around climate change adaptation. Our analysis shows that ISCs were primarily used to provide substantive comments, related to problem analyses, objectives or instruments, as well as to strengthen or weaken connections with policy efforts in adjacent domains. Institutional comments, related to mandates or resources, proved rare. Moreover, we find that the types of comments given in ISCs are mediated by institutional factors that shape the temporal dynamics of policy processes. Rather than reflecting the ideal types of ‘negative’ and ‘positive’ coordination, the overall pattern of policy coordination in the ISCs typifies an in-between form of ‘incremental policy coordination.’.