The Climate Change, Food Security and Human Health Nexus in Canada: A Framework to Protect Population Health

Applying Digital Technology to Understand Human Experiences of Climate Change Impacts on Food Security and Mental Health: Scoping Review

BACKGROUND

The global impact of climate change ranges from intense heatwaves to extreme weather events that endanger entire ecosystems and people's way of life. Adverse climate change events place undue stress on food and health systems, with consequences for human food security and mental health status. Ubiquitous digital devices, such as smartphones, have the potential to manage existing and emerging climate-related crises, given their ability to enable rapid response, instant communication, and knowledge sharing.

OBJECTIVE

This scoping review aimed to identify digital apps being used to capture or address climate change impacts on food security and mental health to inform the development of a digital citizen science initiative.

METHODS

A scoping review was conducted using 3 peer-reviewed databases (PubMed, IEEE Xplore, and Web of Science) and manual gray literature searches of relevant organizational (ie, governmental and nonprofit) websites to identify articles and reports published between January 2012 and July 2023. Three separate searches were conducted in each database to identify digital apps focused on climate change and (1) food security, (2) mental health, and (3) food security and mental health. Two reviewers conducted initial screening, with a third reviewer resolving any discrepancies. Articles focused on climate change impacts on wildlife or agriculture (ie, not human food security) were excluded. Full-text screening was conducted for shortlisted articles, and a final data abstraction table was generated, summarizing key app features, contextual factors, and participant involvement.

RESULTS

From the 656 records screened, 14 digital apps met the inclusion criteria. The food security apps (n=7, 50%) aimed to capture traditional knowledge to preserve food systems, conduct food security assessments, and aid users in decreasing food insecurity risk. The mental health apps (n=7, 50%) assessed climate change-related stress and provided users with coping strategies following adverse weather events. No digital apps examined the intersection of climate change, food security, and mental health. Key app features included user-to-user communication (n=5, 36%), knowledge databases (n=5, 36%), data collection and analysis (n=3, 21%), gamification (n=1, 7%), and educational resources (n=2, 14%) to address climate change impacts on food security or mental health. In total, 3 approaches to participant involvement were used across studies, including contributory (n=1, 7%), collaborative (n=1, 7%), and cocreative (n=1, 7%) approaches, to ensure the relevance and use of digital apps.

CONCLUSIONS

Most digital apps identified provided a service to citizens to either prevent adverse climate change-related health impacts or manage these effects following an acute event or a natural disaster. The capacity of ubiquitous digital tools to enable near real-time communication, the involvement of various stakeholder groups, and their ability to share relevant educational resources in a timely manner are important for developing tailored climate change adaptation and mitigation strategies across jurisdictions.

Inverting social innovation to transform health system responses to climate change adaptation and mitigation in the global south

Systems thinking is aimed at understanding and solving complex problems that cut across sectors, an approach that requires accurate, timely, and multisectoral data. Citizen-driven big data can advance systems thinking, considering the widespread use of digital devices. Using digital platforms, data from these devices can transform health systems to predict and prevent global health crises and respond rapidly to emerging crises by providing citizens with real-time support. For example, citizens can obtain real-time support to help with public health risks via a digital app, which can predict evolving risks. These big data can be aggregated and visualized on digital dashboards, which can provide decision-makers with advanced data analytics to facilitate jurisdiction-level rapid responses to evolving climate change impacts (e.g., direct public health crisis communication). In the context of climate change, digital platforms can strengthen rapid responses by integrating information across systems (e.g., food, health, and social services) via citizen big data. More importantly, these big data can be used for rapid decision-making,a paradigm-changing approach that can invert social innovation, which we define as co-conceptualizing societal solutions with vulnerable communities to improve economic development with a focus on community wellbeing. However, to foster equitable and inclusive digital partnerships that invert social innovation, it is critical to avoid top-down approaches that sometimes result when researchers in the Global North and South collaborate. Equitable Global South-North partnerships can be built by combining digital citizen science and community-based participatory research to ethically leverage citizen-driven big data for rapid responses across international jurisdictions.

Assessing the vulnerability of food supply chains to climate change-induced disruptions

Climate change is one of the most significant challenges worldwide. There is strong evidence from research that climate change will impact several food chain-related elements such as agricultural output, incomes, prices, food access, food quality, and food safety. This scoping review seeks to outline the state of knowledge of the food supply chain's vulnerability to climate change and to identify existing literature that may guide future research, policy, and decision-making aimed at enhancing the resilience of the food supply chain. A total of 1526 publications were identified using the SCOPUS database, of which 67 were selected for the present study. The vulnerability assessment methods as well as the adaptation and resilience measures that have been employed to alleviate the impact of climate change in the food supply chain were discussed. The results revealed a growing number of publications providing evidence of the weakening of the food supply chain due to climate change and extreme weather events. Our assessment demonstrated the need to broaden research into the entire food supply chain and various forms of climatic variability because most studies have concentrated on the relationships between climatic fluctuations (especially extreme rainfall, temperatures, and drought) and production. A lack of knowledge about the effects of climate change on the food supply chain and the underlying socio-economic consequences could result in underperformance or failure of the food supply chain.

Social supermarkets, nutritional implications and healthy eating: exploration of members and their views

BACKGROUND

The Covid-19 pandemic has increased the need for food support but simultaneously enabled substantial innovation in food support provision, including the evolution of social supermarkets (SSM). These allow consumers to choose from a range of low-cost products, minimise stigma and reduce food waste. Data from members of two Sussex SSM were gathered for their perspectives and experiences, as well as potential nutritional implications of the SSM.

METHODS

Questionnaires administered face-to-face during site visits and optional telephone interviews were used. Data were collected during three site visits; 111 participants completed questionnaires, and an additional 25 detailed interviews with members of the SSM were completed. All data were gathered between December 2021 and May 2022.

RESULTS

Overall, the SSMs were valued by their members. Social, economic and nutritional benefits were identified. SSM increased consumer choice and reduced stigma. Most members visited regularly, using SSM to supplement other food purchases. They valued the opportunity to choose their own foods and opportunities to socialise, in addition to the range of food and household items offered. The majority agreed that healthy eating was important but time and cost were barriers especially for younger members. SSM introduced members to novel foods and dishes, potentially diversifying dietary intakes. Challenges included restrictions on the amounts of food available, depending on the timing of visits. This was a greater challenge for those more reliant on SSM for household needs.

CONCLUSIONS

SSM represent an innovative and less stigmatising model of food support. Greater variety of food offered suggests their potential to diversify and improve dietary intakes. Challenges include ensuring stability of food supply and reducing stigma further.

Predicting the potential geographical distribution of onion thrips, Thrips tabaci in India based on climate change projections using MaxEnt

Onion thrips, Thrips tabaci Lindeman, an economically important onion pest in India, poses a severe threat to the domestic and export supply of onions. Therefore, it is important to study the distribution of this pest in order to assess the possible crop loss, which it may inflict if not managed in time. In this study, MaxEnt was used to analyze the potential distribution of T. tabaci in India and predict the changes in the suitable areas for onion thrips under two scenarios, SSP126 and SSP585. The area under the receiver operating characteristic curve values of 0.993 and 0.989 for training and testing demonstrated excellent model accuracy. The true skill statistic value of 0.944 and 0.921, and the continuous Boyce index of 0.964 and 0.889 for training and testing, also showed higher model accuracy. Annual Mean Temperature (bio1), Annual Precipitation (bio12) and Precipitation Seasonality (bio15) are the main variables that determined the potential distribution of T. tabaci, with the suitable range of 22-28 °C; 300-1000 mm and 70-160, respectively. T. tabaci is distributed mainly in India's central and southern states, with 1.17 × 10⁶ km², covering 36.4% of land area under the current scenario. Multimodal ensembles show that under a low emission scenario (SSP126), low, moderate and optimum suitable areas of T. tabaci is likely to increase, while highly suitable areas would decrease by 17.4% in 2050 20.9% in 2070. Whereas, under the high emission scenario (SSP585), the high suitability is likely to contract by 24.2% and 51.7% for 2050 and 2070, respectively. According to the prediction of the BCC-CSM2-MR, CanESM5, CNRM-CM6-1 and MIROC6 model, the highly suitable area for T. tabaci would likely contract under both SSP126 and SSP585. This study detailed the potential future habitable area for T. tabaci in India, which could help monitor and devise efficient management strategies for this destructive pest.

Mechanisms underlying food insecurity in the aftermath of climate-related shocks: a systematic review

Food insecurity is prevalent, affecting 1·2 billion people globally in 2021. However, the effects of food insecurity are unequally distributed across populations and climate-related shocks threaten to exacerbate food insecurity and associated health consequences. The mechanisms underlying this exacerbation at the household level are largely unknown. We aimed to synthesise the available evidence on the mechanisms connecting extreme climate events to household-level food insecurity and highlight the research gaps that must be addressed to inform better food security and health policy. For this systematic review, a comprehensive literature search was done by a medical librarian in February, 2021 for articles about food security and climate-related shocks. Relevant publications were identified by searching the following databases with a combination of standardised index terms and keywords: MEDLINE, Embase, CINAHL, GreenFILE, Environment Complete, Web of Science Core Collection, and Global Health. Searches were limited to human studies published in English. Included studies measured food security outcomes using indicators developed by the UN Food and Agricultural Organization (ie, consumption patterns, livelihood change, malnutrition, and mortality) and explained the mechanism behind the household-level or population-level food insecurity. Purely theoretical, modelling, and review studies were excluded. Quality assessment was conducted using the appropriate Joanna Briggs Institute Critical Appraisal Tool. Data were analysed using thematic analysis of the categories of mechanism (interpreted using internationally accepted frameworks), risk and resilience factors, and author policy recommendations. We found a paucity of data with only 18 studies meeting criteria for inclusion out of 337 studies identified for full-text review. All the studies that were included in our analysis showed worse food security outcomes after climate-related shocks. Food availability was the most common mechanism cited (17 studies), although most studies addressed at least one additional mechanism (15 studies). Studies were of mixed methodologies with nuanced discussions of risk and resilience factors, and of policy recommendations. This systematic review shows that there is an incomplete assessment of food security at the household and community level after climate-related shocks in the literature and finds that food availability is the primary mechanism studied. The low number of studies on this topic limits subgroup analysis and generalisability; however, the good quality of the studies allows for important policy recommendations around improving resilience to climate shocks and suggestions for future research including the need for a more granular understanding of mechanisms and feasible adaptation solutions.

Exploring mitigating role of zinc nanoparticles on arsenic, ammonia and temperature stress using molecular signature in fish

BACKGROUND

The pollution and climate change in aquatic ecosystems are major problems threatening the aquatic organisms for existence in the recent timeline, which promotes the extinction of the fish species. However, the present study dealt with zinc nanoparticles (Zn-NPs) in mitigating arsenic, ammonia and high temperature stresses in Pangasianodon hypophthalmus.

MATERIALS AND METHODS

To studying different gene expressions, an experiment was conducted to mitigate the multiple stressors using dietary Zn-NPs at 0, 2, 4, and 6 mg kg^-1 diets. In the present investigation, the gene expressions studies were performed for growth hormone regulator 1 (GHR1), growth hormone regulator β (GHRβ), growth hormone (GR) in liver and gill tissue as well as myostatin (MYST) and somatostatin (SMT) in the muscle tissue. The anti-oxidative genes CAT, SOD and GPx in liver and gill tissues were also analysed. Expression studies for stress responsive heat shock protein gene (HSP70), DNA damage inducible protein, inducible nitric oxide synthase (iNOS), immune related genes such as interleukin (IL), tumour necrosis factor (TNFα), toll like receptor (TLR) and immunoglobulin were performed. At the end of the experiment the fish were infected with Aeromonas hydrophila to evaluate the immunomodulatory role of Zn-NPs.

RESULTS

In the present investigation, the growth hormone regulator 1 (GHR1), growth hormone regulator β (GHRβ), growth hormone (GR) in liver and gill as well as myostatin (MYST) and somatostatin (SMT) in muscle were noticeably altered, whereas, Zn-NPs at 4 mg kg^-1 diet improved gene expressions. The anti-oxidant gene viz. CAT, SOD and GPx in liver and gill tissues were upregulated by stressors such as As, NH₃, NH₃+T. As+T and As+NH₃+T. Therefore, anti-oxidant genes were noticeably improved with dietary Zn-NPs diet. The stress protein gene (HSP70), DNA damage inducible protein, inducible nitric oxide synthase (iNOS) was significantly upregulated, whereas, Zn-NPs diet was applied to the corrected gene regulation. Similarly, immune related genes such as interleukin (IL), tumour necrosis factor (TNFα), toll like receptor (TLR) and immunoglobulin were highly affected by stressors. Dietary Zn-NPs at 4 mg kg^-1 diet was improved all the immune related gene expression and mitigate arsenic, ammonia and high temperature stress in fish.

CONCLUSION

The present investigation revealed that Zn-NPs at 4.0 mg kg^-1 diet has enormous potential to modulates arsenic, ammonia and high temperature stress, and protect against pathogenic infections in fish.

Enhancing the resilience of food production systems for food and nutritional security under climate change in Nepal

Background

Climate change in Nepal has posed a considerable challenge to agricultural productivity and has threatened food and nutritional security at multiple levels. This study aims to assess the impacts of climate change on national food production and food and nutritional security as well as document issue-based prioritized adaptation options for a resilient food production system.

Methods

This study considers temperature, precipitation, and their anomalies as the key factors affecting food production in Nepal. Nationwide precipitation trends along with their association with the annual production of major cereal crops in Nepal were assessed using data from the last three decades (1990–2018). The annual productions of the major cereal crops were summed and normalized to calculate the production index scores in the districts. Scores were plotted and visualized into maps using the Geographical Information System. In three ecological regions, the distribution of flood and extreme rainfall events and cases of malnutrition from 2005 to 2018 were plotted. The effects of climate change and highest priority adaptation options at the district level were documented through a review of national policies and literature studies and qualitative research based on Focus Group Discussions (FGDs).

Results

Between 1990 and 2018, the overall average production of major cereal crops in Nepal was increased by around 2,245 MT annually. In the district level index analysis, the highest production score was found for Jhapa and Morang while the lowest production score was found for Humla. Cases of malnutrition in some districts coincided with flood and heavy rainfall events, indicating that climate change and extreme climatic events have a role to play in food production and security. Growing drought-tolerant crops, changes in crop cycle, riverbed farming practices, developing short-term strategies, such as contingency crop planning, changing planting dates, planting short duration varieties, schemes evacuation, and long-term strategies, such as encouraging out-migration of population to safer locations, resettlement programs with transformative livelihood options, and sustainable agricultural practices were found to be key prioritized adaptation measures for a resilient food production system.

Conclusion

In Nepal, climate change and the increasing frequency and magnitude of extreme climatic events adversely affect the food production system, which has become a serious threat to food and nutritional security. The implementation of evidence-based practices to build a resilient food system specific to climate-vulnerable hotspots at the district and local levels is the nation's current need.

Public Health Aspects of Climate Change Adaptation in Three Cities: A Qualitative Study

Climate change presents an unprecedented public health challenge as it has a great impact on population health outcomes across the global population. The key to addressing these health challenges is adaptation carried out in cities through collaboration between institutions, including public health ones. Through semi-structured interviews (n = 16), this study investigated experiences and perceptions of what public health aspects are considered by urban and public health planners and researchers when planning climate change adaptation in the coastal cities of Söderhamn (Sweden), Porto (Portugal) and Navotas (the Philippines). Results of the thematic analysis indicated that participating stakeholders were aware of the main climate risks threatening their cities (rising water levels and flooding, extreme temperatures, and air pollution). In addition, the interviewees talked about collaboration with other sectors, including the public health sector, in implementing climate change adaptation plans. However, the inclusion of the public health sector as a partner in the process was identified in only two cities, Navotas and Porto. Furthermore, the study found that there were few aspects pertaining to public health (water and sanitation, prevention of heat-related and water-borne diseases, and prevention of the consequences associated with heat waves in vulnerable groups such as children and elderly persons) in the latest climate change adaptation plans posted on each city's website. Moreover, participants pointed to different difficulties: insufficient financial resources, limited intersectoral collaboration for climate change adaptation, and lack of involvement of the public health sector in the adaptation processes, especially in one of the cities in which climate change adaptation was solely the responsibility of the urban planners. Studies using larger samples of stakeholders in larger cities are needed to better understand why the public health sector is still almost absent in efforts to adapt to climate change.

Climate Change and Food Security Prioritizing Indices: Applying Analytical Hierarchy Process (AHP) and Social Network Analysis (SNA)

Food security and climate change are multidimensional issues. Therefore, a lack of knowledge about the most essential variables made these concepts more complex for decision-making and highlighted the need for credible decision support methods. Here, we aim to develop an accurate tool by using the analytic hierarchy process (AHP) method to explore the priority indicator of food security under climate change in Iran and social network analysis (SNA) to support decisions. The following steps were conducted for the AHP approach: a literature review, a Likert questionnaire and experts’ interviews for variable selection and the variables’ weight determination and prioritization by pairwise comparison questionnaire, designed based on the hierarchy matrix of the criteria and sub-criteria of food security and climate change. The SNA was employed to understand the robustness of the informants’ points of view for indicator selection. After the analysis, 61 criteria were extracted. Sustainability was the important criterion, weighted 0.248. The most important sub-criteria (indicators): groundwater sources, household income, underweight adolescent ratio, food wastage and an annual average of precipitation, weighted 0.095, 0.091, 0.125, 0.227 and 0.236, respectively. The SNA showed that professionals with academic origins focused on the sustainability component. The AHP tool is a credible technique to distinguish the most important criteria. The results might be employed to estimate or predict food security under climate change and simplify decision making in Iran.

Climate change, behavior change and health: a multidisciplinary, translational and multilevel perspective

The climate crisis provides a critical new lens through which health and health behaviors need to be viewed. This paper has three goals. First, it provides background on the climate crisis, the role of human behavior in creating this crisis, and the health impacts of climate change. Second, it proposes a multilevel, translational approach to investigating health behavior change in the context of the climate crisis. Third, it identifies specific challenges and opportunities for increasing the rigor of behavioral medicine research in the context of the climate crisis. The paper closes with a call for behavioral medicine to be responsive to the climate crisis.

Cooling the City? A Scientometric Study on Urban Green and Blue Infrastructure and Climate Change-Induced Public Health Effects

Climate change causes global effects on multiple levels. The anthropogenic input of greenhouse gases increases the atmospheric mean temperature. It furthermore leads to a higher probability of extreme weather events (e.g., heat waves, floods) and thus strongly impacts the habitats of humans, animals, and plants. Against this background, research and innovation activities are increasingly focusing on potential health-related aspects and feasible adaptation and mitigation strategies. Progressing urbanization and demographic change paired with the climate change-induced heat island effect exposes humans living in urban habitats to increasing health risks. By employing scientometric methods, this scoping study provides a systematic bird’s eye view on the epistemic landscapes of climate change, its health-related effects, and possible technological and nature-based interventions and strategies in order to make urban areas climate proof. Based on a literature corpus consisting of 2614 research articles collected in SCOPUS, we applied network-based analysis and visualization techniques to map the different scientific communities, discourses and their interrelations. From a public health perspective, the results demonstrate the range of either direct or indirect health effects of climate change. Furthermore, the results indicate that a public health-related scientific discourse is converging with an urban planning and building science driven discourse oriented towards urban blue and green infrastructure. We conclude that this development might mirror the socio-political demand to tackle emerging climate change-induced challenges by transgressing disciplinary boundaries.

Linking Climate Change Adaptation Strategies and Nutrition Outcomes: A Conceptual Framework

BACKGROUND

The relationship between climate adaptation strategies and nutrition security is poorly understood and often unclear. Although several adaptation strategies have been implemented to mitigate the impact of climate change, there is still a lack of conclusive evidence or studies on the interrelationships between adopted climate change adaptation strategies and nutrition outcomes.

OBJECTIVE

This study aimed at developing a conceptual framework that links climate change, adaptation strategies and nutrition and show the indicators that can be used to assess the impact of climate adaptation strategies on nutrition.

METHODOLOGY

The proposed conceptual framework was developed through a literature review.

RESULTS

A generic conceptual framework that could be used to assess the impact of adopted climate change adaptation strategies on nutrition outcomes was developed. The framework consists of 5 key elements: Agro-food system, context characteristics, adaptation strategies, climatic shocks and stress, and system output. The principles used in designing the conceptual framework include systems approach, contingency theory, and system output.

CONCLUSION

The developed framework offers a channel to evaluate adopted climate change adaptation strategies and their impact on nutrition outcomes. Such a conceptual framework can also be used in selecting and identifying more suitable climate adaptation strategies given specific contextual environments.

Multidimensional Food Security Nexus in Drylands under the Slow Onset Effects of Climate Change

Hyperarid, arid, semiarid, and dry subhumid areas cover approximately 41% of the global land area. The human population in drylands, currently estimated at 2.7 billion, faces limited access to sufficient, affordable, and nutritious food. We discuss the interlinkages among water security, environmental security, energy security, economic security, health security, and food security governance, and how they affect food security in drylands. Reliable and adequate water supply, and the prevention of water contamination, increase the potential for ample food, fodder, and fiber production. Protecting woodlands and rangelands increases food security by buffering the slow onset effects of climate change, including biodiversity loss, desertification, salinization, and land degradation. The protection of natural lands is expected to decrease environmental contamination, and simultaneously, reduce the transfer of diseases from wildlife to humans. Biofuel production and hydroelectric power plants increase energy security but generate land-use conflicts, deforestation, and ecosystem degradation. Economic security generally positively correlates with food security. However, economic growth often degrades the environment, changes tenure rights over natural resources, and stimulates migration to urban areas, resulting in lower food and health security. Moreover, civil unrest, political instability, and armed conflicts disrupt local economies in drylands. Maintaining food security is crucial for health security; conversely, malnourished populations and unresponsive health systems decrease economic security, and adversely affect environmental, energy, and food security. Climate change is expected to deteriorate health security by spreading vector-borne diseases. Effective governance and timely interventions can substantially shorten periods of food insecurity, lower their intensities, and accelerate recovery from inevitable crises, and are therefore crucial in preventing humanitarian crises. Since global drylands population will nearly double by 2050, and since drylands are among the most susceptible areas to climate change, integrated multi-hazard approaches to food security are needed.

Childhood food insecurity and incident diabetes: A longitudinal cohort study of 34 042 children in Ontario, Canada

AIM

To examine the association between childhood food insecurity and incident diabetes.

METHODS

Using health administrative databases linked to the Canadian Community Health Survey, we conducted a population-based cohort study of children aged <18 years from Ontario, Canada. Children without diabetes who had a household response to the Canadian Community Health Survey Household Food Security Survey Module were followed for a median of 9.5 years for incident diabetes. Multivariable Cox proportional hazards models were used to examine the association between childhood food insecurity and incident diabetes, adjusted sequentially for important clinical and socio-economic risk factors.

RESULTS

We included 34 042 children, of whom 5.3% lived in food-insecure households. There were 184 new cases of diabetes, diagnosed at a median age of 16 and 18.5 years in food-secure and food-insecure children, respectively. In unadjusted analysis, childhood food insecurity was associated with an increased risk of incident diabetes (hazard ratio 1.69, 95% CI 1.01 to 2.81). When adjusted for clinical and socio-economic confounders, the relationship was no longer statistically significant (hazard ratio 1.55, 95% CI 0.91 to 2.66, adjusted for clinical confounders; hazard ratio 1.30, 95% CI 0.72 to 2.37, adjusted for clinical/socio-economic confounders). Our results remained robust in sensitivity analyses.

CONCLUSIONS

Although food-insecure children are a medically and socially vulnerable population, they do not appear to be at increased risk of incident diabetes over a median of 9.5 years.

The association between extreme temperature and pulmonary tuberculosis in Shandong Province, China, 2005-2016: a mixed method evaluation

BACKGROUND

The effects of extreme temperature on infectious diseases are complex and far-reaching. There are few studies to access the relationship of pulmonary tuberculosis (PTB) with extreme temperature. The study aimed to identify whether there was association between extreme temperature and the reported morbidity of PTB in Shandong Province, China, from 2005 to 2016.

METHODS

A generalized additive model (GAM) was firstly conducted to evaluate the relationship between daily reported incidence rate of PTB and extreme temperature events in the prefecture-level cities. Then, the effect estimates were pooled using meta-analysis at the provincial level. The fixed-effect model or random-effect model was selected based on the result of heterogeneity test.

RESULTS

Among the 446,016 PTB reported cases, the majority of reported cases occurred in spring. The higher reported incidence rate areas were located in Liaocheng, Taian, Linyi and Heze. Extreme low temperature had an impact on the reported incidence of PTB in only one prefecture-level city, i.e., Binzhou (RR = 0.903, 95% CI: 0.817-0.999). While, extreme high temperature was found to have a positive effect on reported morbidity of PTB in Binzhou (RR = 0.924, 95% CI: 0.856-0.997) and Weihai (RR = 0.910, 95% CI: 0.843-0.982). Meta-analysis showed that extreme high temperature was associated with a decreased risk of PTB (RR = 0.982, 95% CI: 0.966-0.998). However, extreme low temperature was no relationship with the reported incidence of PTB.

CONCLUSION

Our findings are suggested that extreme high temperature has significantly decreased the risk of PTB at the provincial levels. The findings have implications for developing strategies to response to climate change.

Mitigation of emerging implications of climate change on food production systems

Crops, livestock and seafood are major contributors to global economy. Agriculture and fisheries are especially dependent on climate. Thus, elevated temperatures and carbon dioxide levels can have large impacts on appropriate nutrient levels, soil moisture, water availability and various other critical performance conditions. Changes in drought and flood frequency and severity can pose severe challenges to farmers and threaten food safety. In addition, increasingly warmer water temperatures are likely to shift the habitat ranges of many fish and shellfish species, ultimately disrupting ecosystems. In general, climate change will probably have negative implications for farming, animal husbandry and fishing. The effects of climate change must be taken into account as a key aspect along with other evolving factors with a potential impact on agricultural production, such as changes in agricultural practices and technology; all of them with a serious impact on food availability and price. This review is intended to provide critical and timely information on climate change and its implications in the food production/consumption system, paying special attention to the available mitigation strategies.