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Food waste (FW) generates large upstream and downstream emissions to the environment and unnecessarily consumes natural resources, potentially affecting future food security. The ecological impacts of FW can be addressed by the upstream strategies of FW prevention or by downstream strategies of FW recycling, including energy and nutrient recovery. While FW recycling is often prioritized in practice, the ecological implications of the two strategies remain poorly understood from a quantitative systems perspective. Here, we develop a multilayer systems framework and scenarios to quantify the implications of food waste strategies on national biomass, energy, and phosphorus (P) cycles, using Norway as a case study. We found that (i) avoidable food waste in Norway accounts for 17% of sold food; (ii) 10% of the avoidable food waste occurs at the consumption stage, while industry and retailers account for only 7%; (iii) the theoretical potential for systems-wide net process energy savings is 16% for FW prevention and 8% for FW recycling; (iv) the theoretical potential for systems-wide P savings is 21% for FW prevention and 9% for FW recycling; (v) while FW recycling results in exclusively domestic nutrient and energy savings, FW prevention leads to domestic and international savings due to large food imports; (vi) most effective is a combination of prevention and recycling, however, FW prevention reduces the potential for FW recycling and therefore needs to be prioritized to avoid potential overcapacities for FW recycling.

Summary Future phosphorus (P) scarcity and eutrophication risks demonstrate the need for systems-wide P assessments. Despite the projected drastic increase in world-wide fish production, P studies have yet to include the aquaculture and fisheries sectors, thus eliminating the possibility of assessing their relative importance and identifying opportunities for recycling. Using Norway as a case, this study presents the results of a current-status integrated fisheries, aquaculture, and agriculture P flow analysis and identifies current sectoral linkages as well as potential cross-sectoral synergies where P use can be optimized. A scenario was developed to shed light on how the projected 2050 fivefold Norwegian aquaculture growth will likely affect P demand and secondary P resources. The results indicate that, contrary to most other countries where agriculture dominates, in Norway, aquaculture and agriculture drive P consumption and losses at similar levels and secondary P recycling, both intra- and cross-sectorally, is far from optimized. The scenario results suggest that the projected aquaculture growth will make the Norwegian aquaculture sector approximately 4 times as P intensive as compared to agriculture, in terms of both imported P and losses. This will create not only future environmental challenges, but also opportunities for cross-sectoral P recycling that could help alleviate the mineral P demands of agriculture. Near-term policy measures should focus on utilizing domestic fish scrap for animal husbandry and/or fish feed production. Long-term efforts should focus on improving technology and environmental systems analysis methods to enable P recovery from aquaculture production and manure distribution in animal husbandry.

The insertion of central venous access devices for patients requiring all forms of central venous therapy is expensive and time consuming, particularly if general anesthetic and operating facilities are used by medical personnel, By expanding the role of a nurse who specialized in parenteral nutrition and who had previous experience in critical care, this procedure was able to be performed percutaneously at the bedside, cutting costs, freeing medical staff time, and improving patient care.