情報：農と環境と医療63号

Tadayoshi Shiba
President, Kitasato University

   I would like to start with some remarks on behalf of the organizer of Kitasato University's Eight Agromedicine Symposium.
   Preventive medicine in the 21st century will be dealing with issues such as the assessment, management and communication of risk, prevention of diseases, and improvement of the quality of health. It is extremely important for the sound development of society that the field of agricultural science actively addresses these present-day issues in the field of medicine. This is where the establishment, education, and spread of the science of "agromedicine" is eagerly awaited.
   There are several products of technological knowledge developed in the 20th century which suggest education, research, and promotion of agromedicine are essential in the 21st century world in which we live. A few major examples include the prevention of disease, improvement of human health, safety of food, agriculture that conserves the environment, and agriculture that heals. All of these will require the integration of knowledge accumulated in the fields of agriculture and medicine. In spite of some expressions which reflect ancient wisdom, such as "ishoku dogen" : good quality food in the best medicine, and "shindo fuji" : local soil production,and local food consumption for good health, there has been little emphasis placed on the importance of education, research, and promotion of agromedicine.
   Agriculture and medicine grew from the same roots. They continue to develop along similar paths. Medicine has alternative health care, and agriculture has alternative farming. The former is a concept of health care which replaces or complements modern health care dominated by western medicine, while the latter is a concept of farming methods that replace or complement intensive agricultural production which relies heavily on chemical fertilizers and pesticides. Both concepts have developed out of the pursuit of the science of life. In the 21st century, medicine completed sequencing the human genome, and agriculture completed sequencing the rice genome. These are also the results of the pursuit of life science by both agriculture and medicine.
   From such perspectives, Kitasato University has introduced a new word "No-I Renkei" which means agromedicine, and has disseminated relevant information to society since 2005. Specifically, to emphasize the necessity of agromedicine we have been organizing the Kitasato University Agromedicine Symposiums under such key topics as "Collaboration of agriculture, environment and healthcare", "Collaboration of alternative medicine and alternative agriculture", "A look at avian influenza from the perspective of agriculture, environment and medicine", "Effects of cadmium and arsenic on agriculture, the environment and health", "Global warming: Assessing the impacts on agriculture, the environment, and human health; and techniques for responding and adapting", "Food safety and preventive medicine", and "Health and the coexistence of humans with animals". Furthermore, we have published a booklet in English entitled "Agriculture-Environment-Medicine" from Yokendo to spread the idea of agromedicine.
   Dr. Shibasaburo Kitasato, the eponym of the university, described his belief in his "Ido-ron (Thoughts on the way of medicine)" that prevention is the foundation of medicine. He emphasized that academic studies are worthwhile only when their outcomes are widely used for the welfare of the people. Here, Dr. Kitasato advocates the necessity of applying wisdom to practice. Keeping Dr. Kitasato's philosophy in mind, we are holding this symposium under the title of "Agromedicine: Examples from the USA, Thailand, and Japan". We will be seeing how the science of agromedicine is being applied on the frontlines of agriculture and health care.
   We hope meaningful and practical discussions will flourish, and new ideas and suggestions with respect to the integration of agriculture, environment, and health will emerge from this Symposium. We would like to extend our heart-felt thanks to the presenters who have kindly agreed to present lectures, and to all of the attendees who have traveled from as far away as the United States and Thailand.
   Thank you.

Introduction


  Kitasato University developed the concept of "agromedicine" as a new discipline, and since the 2005 academic year, it has disseminated information on this area through eight "Agromedicine Symposiums in Kitasato University", nine issues of the "Kitasato University Agromedicine series", and 60 issues of "Newsletter: Agriculture, Environment and Medicine". The information on these events and publications is available on the University's website as well as in printed materials.
  The "Newsletter: Agriculture, Environment and Medicine" contains a section entitled "International Information on Agriculture, Environment and Medicine". This section is a survey of the current status and trends in research, education and the extension agromedicine on an international scale. It is a section specifically designed to advance the science of agromedicine in Japan. Taking advantage of "The 8th Kitasato University Agromedicine Symposium in Kitasato University: Agromedicine : Examples from the USA, Thailand and Japan", I would like to discuss world trends in the field of agromedicine.

International Nitrogen Initiative (INI)

  One hundred years has passed since the vast amount of nitrogen existing in the troposphere began to be fixed by the Haber-Bosch process. Up until one-hundred years ago, nitrogen was fixed on the earth through natural processes or lightening at about 90 to 140 Tg (T=1012) per year. Nowadays, in addition to the nitrogen fixed by natural processes, as much as 270 Tg of extra nitrogen is fixed on the earth every year through processes such as the production of fertilizers and the combustion of petroleum. This value has been steadily increasing year by year.
  With an electrical charge ranging from +5 to -3, elemental nitrogen changes its form in a variety of ways in nature. As a result, nitrogen cycles around the earth through soil, air, water, crops, and food. Because of this, excess nitrogen causes nitrate contamination of groundwater, acid precipitation, and eutrophication of lakes and rivers. In addition, nitrogen compounds in the atmosphere contribute to the destruction of the ozone layer, and also act as a greenhouse gas.
  This nitrogen cycle is changing on a global scale. Because of this, excess nitrogen has not only begun to add to environmental pollution and global changes but also to affect human health. The excess nitrogen carried around by air and water is linked to respiratory and heart diseases as well as a variety of cancers. The excess nitrogen also contributes to increasing pollen production which triggers allergies. An epidemic of obesity is also attributed to it. Nitrogen may even affect the activities of various pathogenic diseases, such as West Nile virus, malaria, and cholera.
  Aiming at the appropriate control of nitrogen in the face of the nitrogen load on a global scale and in the human environment, an international conference is held every three years. Five conferences have been held to date: the first conference in 1998 (Netherlands), the second in 2001 (USA), the third in 2004 (China), the fourth in 2006 (Brazil), and the fifth in 2010 (India). The details of these conferences are available at the INI website.
  The theme for the Fifth Conference was the "Reactive Nitrogen Management for Sustainable Development - Science, technology and policy", at which the following six sessions, the opening lecture, presentations, discussions and plenary discussions were held over the period from December 3 to December 7. The session topics included "food security", "energy safety and security", "health and environmental destruction", "ecosystem preservation and biodiversity", "climate change" and "knowledge integration".
  At the end of the third conference, the "Nanjing Declaration on Management of Reactive Nitrogen" was adopted as an action plan for the purpose of ensuring the compatibility between reducing nitrogen loads and increasing food and energy production and was delivered to the United Nations Environment Programme (UNEP). Information regarding the most recent conference is available at http://n2010.org/, and information regarding the International Nitrogen Initiative, the parent organization of the conference, at http://www.initrogen.org/.
  The author acted as the vice-chair for the third INI and was involved in the adoption and the submission to the UNEP of the Nanjing Declaration. The author also presented a lecture titled "Effect of Nitrous Oxide on Atmospheric Environmental Changes and Strategies for Reducing Nitrous Oxide Emissions from Fertilized Soils "at the opening of the Climate Change session at the Fifth Conference.

References

1. http://n2010.org/　
2. http://www.initrogen.org/
3. Newsletter: Agriculture, Environment and Medicine, No. 58, pp. 11-13 (2010)

International Geosphere-Biosphere Program (IGBP): Global Environment Change and Human Health (GEC & HH)

  The International Geosphere-Biosphere Program (IGBP) is a composite, interdisciplinary international joint research project which was adopted by the International Council for Science in 1986, and launched in 1990. The project has the lofty ambitions of explaining the totality of global systems and projecting what the Earth will look like one hundred years from now. The first phase of the IGBP was completed in 2003, and the activities of the 10-year second phase began in 2004.
  In this program, scientists in fields involved with the atmosphere, hydrosphere, geosphere, and biosphere formed a cross-disciplinary, cross-border network to carry out cooperative studies on a global scale. The IGBP aims to strengthen collaboration with other research projects relating to global environmental change. The Earth System Science Partnership (ESSP) is a part of this organization. One of the activities of the ESSP is to carry out joint projects. One of these joint projects is the Global Environmental Change and Human Health (GEC & HH). For details, refer to the original text.

References

1. T. Ogawa, T. Oikawa, K. Minami : Leading the Frontiers of Climate Change Research , Asahi Eco Books No.26 , Shimizu Kobundo (2010)

International Union of Soil Science, Food Security and Human Health

  The International Union of Soil Sciences (IUSS), established in 1924, held its 18th World Congress in Philadelphia, USA, from July 9 to 15, 2006. The Congress is divided into the following four divisions: 1) Soil in Space and Time; 2) Properties and Processes; 3) Soil Use and Management; and 4) The Role of Soils in Sustaining Society and Environment.
  The fourth division consists of five commissions. The session to be presented here is the second commission, 4-2) Soils, Food Security and Human Health. This commission roster included three presenters and a symposium titled "Soil and Human Health". Commission 4-2 also held a poster symposium titled "Soil Quality as it Affects Nutrients in Food Crops and Human Health". Details are available on the congress website.

  Presentation 1: Science for Health and Well Being
  Presentation 2: From Aspergillus to Timbuktu: African Dust, Coral Reefs and Human Health
  Presentation 3: Soils & Geomedicine
  Poster symposium: Soil Quality as it Affects Nutrients in Food Crops and Human Health

References

1. http://www.colostate.edu/programs/IUSS/18wcss/　
2. Newsletter: Agriculture, Environment and Medicine, No. 15, 1-6 (2006)

The Wageningen University and Wageningen Center for Food Science, Netherlands

  The Wageningen University of the Netherlands was born in 1998 as the result of the amalgamation and reorganization of Wageningen Agricultural University and the agricultural research institutes of the Dutch government into WUR (Wageningen University and Research Center). WUR subsequently merged with Van Hall-Larenstein School of Higher Professional Education to expand its scope of educational and research areas. Wageningen University offers five specialty programs (Plant Sciences, Animal Sciences, Environmental Sciences, Agrotechnology and Food Sciences, and Social Sciences), while Van Hall-Larenstein School offers three programs in applied sciences (Rural and Environmental Management, Animal Husbandry and Management, and Business and Management). Wageningen Graduate Schools (WGS) offer seven courses, including Nutrition, Food Technology, Agricultural and Bioresource Engineering, and Health (VLAG programs) in the field related to agromedicine. The acronym VLAG stands for Voeding, Levensmiddelentechnologie, Agrobiotechnologie en Gezondheid (Nutrition, Food Sciences, Agro-Biotechnology, and Health Sciences). It is a consortium of four universities and five research institutes, created to promote exchanges between the different disciplines of nutrition and health for innovation in technological areas of food engineering for the future.
  The Wageningen Center for Food Sciences, established in 1997, has been a leading institute for food and nutrition for the past ten years. Research programs of the Center consist of Nutrition and Health, Structure and Functionality, and Microbial Functionality and Safety.
  In the Nutrition and Health program, research projects focus on obesity with vascular complications, the relationship between metabolic syndrome and the barrier function and inflammation of the digestive system, the relationship between red meat and colorectal cancer, and the protective functions of fermented foods and indigestible carbohydrates. Research projects in the Structure and Functionality program include studies to develop foods which meet nutritional requirements (low fat, low carbohydrate, low sodium, or high protein). The Microbial Functionality and Safety program focuses on new approaches for safe management of food.

References

1. WUR website: http://www.wur.nl/uk/　
2. VLAG website:http://www.vlaggraduateschool.nl/particip.htm　
3. EPS website:http://www.graduateschool-eps.info/　
4. Newsletter: Agriculture, Environment and Medicine, No. 54, 10-12 (2010)

National Institute for Public Health and the Environment (RIVM), Netherlands

  The acronym RIVM stands for Rijksinstituut voor Volksgezondheid en Milieu. It is a national institute which integrates expertise in the areas of public health, nutrition, and environmental conservation. The RIVM works mainly for the Dutch government under the direction of the Ministry of Health, Welfare, and Sport; the Ministry of Housing, Spatial Planning, and the Environment; and the Ministry of Agriculture, Nature Management and Food Quality to address issues relating to policies and social problems. It is a national organization created as a result of a recognition of world trends.
  Since health risks and environmental problems transcend national borders by nature, collaborative efforts that transcend race and ethnicity are necessary if health and environmental threats are to be effectively reduced. RIVM cooperates on international efforts relating to health care and the environment by sharing expertise and research results.
  Experts and researchers of RIVM carry out joint research projects or participate in them as advisors and experts. RIVM maintains close relationships with specialized agencies of the United Nations, such as The World Health Organization (WHO), The Food and Agriculture Organization (FAO), The United Nations Environment Programme (UNEP), and The International Atomic Energy Agency (IAEA). The results of their research, monitoring, modeling, and risk assessments are used to support policies on public health, food safety, and the environment. RIVM employs more than 1,500 in its of four major divisions:

• Centre for Infectious Disease Control Netherlands (CID)
• Public Health and Health Services Division
• Nutrition, Medicines and Consumer Safety Division
• Environment and Safety Division

References

1. RIVM website: http://www.rivm.nl/en/　
2. RIVM brochure
3. Newsletter: Agriculture, Environment and Medicine, No. 54, 12-13 (2010)

University of Copenhagen

  The University of Copenhagen became the largest university in the Nordic region as a result of the merger of The Danish University of Pharmaceutical Sciences, The Royal Veterinary and Agricultural University, and the University of Copenhagen on January 1, 2007. The outstanding characteristics and strength of the University are the diversity of the research environments and scientific approach. The University consists of eight faculties: Faculty of Health Sciences, Faculty of Humanities, Faculty of Law, Faculty of Life Sciences, Faculty of Pharmaceutical Sciences, Faculty of Science, Faculty of Social Sciences, and Faculty of Theology.
  The animal research laboratory of the Faculty of Health Sciences is the largest of its in the Nordic region. This faculty oversees the following agencies and laboratories which form the core of education and services for all research groups inside and outside of Denmark: Experimental surgeries at the Experimental Medicine Department including transgenic mice, molecular imaging, whole-body X-ray radiation on laboratory animals, and gamma-cell devices; and behavioral disorders, biostatics, and functional genome research at the Wilhelm Johannsen Center, 3D laboratory, and Rodent Metabolic Phenotyping Center.
  The Faculty of Life Sciences has a long tradition under which outstanding research works have been carried out. The area of life science is, however, a field which understands the need for pursuing new and specialized research in step with the international community. In this faculty, the traditional fields of food, agriculture, and veterinary sciences are interlocked with areas which are strongly ethics-oriented, such as the emerging fields of nanotechnology, plant biotechnology, reproduction technology, biomedicine, and chemotherapeutics, the multi-task area of bio information science, and bioethics and research on animal ecology.

References

1. University of Copenhagen website: http://research.ku.dk/　
2. Newsletter: Agriculture, Environment and Medicine, No. 54, 13-14 (2010)

University of Maryland, USA

  Agromedicine is the field of science in which professionals in medicine and agriculture cooperate and collaborate in order to promote the health and safety of farms, farmers, and consumers. The agromedicine program at the University of Maryland also applies to non-farming residents who are exposed to environmental pollution. This program focuses on a wide variety of pesticides, and organizes workshops and educational activities specialized in health management. The University of Maryland is also the base for pesticide education programs and assessment of pesticides.
  These programs and activities are supported by educators in the county and region who disseminate information, internal specialists in dissemination of information, professionals in medicine and nursing, as well as the Maryland Poison Control Center, Maryland/Delaware Area Health Education Consortium (AHEC), and the Maryland Department of Agriculture.
  The agromedicine program at the University of Maryland provides seminars and educational materials to health care workers and other professionals on topics which include the definition of terminology, brief critiques of applicable laws and regulations, the use of agrochemicals and contamination patterns, potential effects of pesticides on human health, current concepts and issues of health relating to pesticides, history of contamination, diagnosis and treatment of diseases related to pesticides. Participants in the seminars are provided with two manuals relating to the principles of pesticides and the recognition and management of pesticide contamination both written for health care professionals. At present, the seminars are offered to nursing schools, hygienists, and physicians who treat immigrants and seasonal farm workers. The Agency for Toxic Substances and Disease Registry (ATSDR) carries out case studies in the area of environmental medicine.

References

1. Newsletter: Agriculture, Environment and Medicine, No. 55, 7-8 (2010)

Medical University of South Carolina (MUSC), USA

  The Agromedicine Program (AP) is one of the courses offered by the Division of Public Health and Public Service, Department of Family Medicine, of the MUSC. The program originated in collaboration with Clemson University in 1984. In 1986, the W.K. Kellogg Foundation recognized agromedicine as an innovative approach that linked medicine and agriculture and created the Agromedicine Program. The AP, now recognized nationally as a new leader in the field, carries out activities in the three areas of Public Service, Education, and Research.

〇　Public Service: It covers all 46 counties of South Carolina. The cooperative extension services and normal service program agencies of Clemson University regularly introduce the AP to assist their clients. Teachers and the staff of the AP provide health care professionals and the general public with more than 300 consultation sessions ranging from telephone inquiries to detailed literature reviews, discussions with specialists nationwide, and referral of appropriate agencies and health care service providers.
 The majority of these consultations involve the pesticide contamination of farms and homes. The AP staff also receives frequent inquiries relating to insects and spider bites, food safety, and water quality. The AP also acts as a library, containing professional literature, magazines and newspapers, as well as a computerized literature database developed by the Support and Consultation Committee.

〇　Education: The AP provides more than 50 lectures to several thousand participants across the state. About 60% of the lectures are intended for farmers, workers in agriculture-related industries and the general public, and the remainder for hospitals and health care professionals, and doctors and students at the MUSC. The AP operates seven educational websites for statewide family programs through which materials are distributed to state residents. Medical students of the MUSC can take the month-long AP as an elective subject. The residents who study family medicine are trained in agromedicine as part of the required subjects provided by the Occupational and Environmental Medicine Program.
 In addition to lectures, the faculty and the staff involved in the AP have developed a wide range of educational materials over several years, including booklets, videotapes, self-study monographs for doctors, and computer-assisted instructional modules. The AP conducts educational activities through publications as well:

〇　Agromedicine Program Update Newsletter: published monthly, and distributed statewide to professionals in agriculture and health care. The newsletter provides continuing education in the area of agromedicine as well as the latest information relating to the current development of the AP. "AG-MED: The Rural Practitioner's Guide to Agromedicine, Diagnosis and Management at Glance".

〇　Research: In addition to research on individual cases carried out through public service consultations, the AP also carries out research relating to agricultural medicine. Examples of research carried out over the years include epidemiological studies on pesticide contamination, diseases transmitted by ticks, farmer mortality patterns, protective clothing for pesticide exposure, noise-induced hearing loss in rural children, and farm family stress. The results of these surveys are incorporated into the educational programs to be shared by farmers and health care professionals.

References

1. Newsletter: Agriculture, Environment and Medicine, No. 55, 8-10 (2010)

Thailand

  Last time I was in Thailand, I visited Wat Pho Traditional Medical/Massage School, Damnoensaduak County Hospital (Ratchaburi Province), Chaophraya Abhaibhubejhr Hospital (Purachinburi Province), the "Agriculture-Environment-Health (Agromedicine) Seminar" hosted by the Department of Thai Traditional and Alternative Medicine Development (Ministry of Public Health), and Chonburi Vocational Training Center (Department of Vocational Education, Ministry of Education) to gather a variety of information. This time, Dr. Surat Lekutai, the director of the Damnoensaduak Hospital, and Dr. Prapoj Petrakard, Chief Advisor to the Department of Thai Traditional and Alternative Medicine Development (Ministry of Public Health) will be presenting in person a report on agromedicine in Thailand.
  Dr. Surat is very interested in agromedicine. He has developed kitchen gardens between ward buildings to raise vegetables using natural methods for patients. He also recommends recovering patients grow vegetables in the garden.

References

1. Various brochures
2. Newsletter: Agriculture, Environment and Medicine, No. 57, 15-21 (2010)

1.　Introduction

  At Kitasato University, we hold "agromedicine" to be one of the more important actions for education and research. In the area of education, the Department of Animal Science of the School of Veterinary Medicine and the School of Medicine jointly play a central role. In the 2009 academic year, the new "Agromedicine Education Program" was added to the curriculum of the Department of Animal Science of the School of Veterinary Medicine with cooperation of the School of Medicine. This program was adopted by the Ministry of Education, Culture, Sports, Science and Technology as part of its 2009 "Program to Promote University Education ￣ Theme A: Promotion of University Education and Scholarship Programs", resulting in the acceleration of efforts to develop agromedicine. At this symposium, we would like to describe the current state of the Agromedicine Program and the outlook for the development of agromedicine education.

2.　Necessity for nurturing talented people through collaborative education between agriculture and medicine

  "Agriculture" and "medicine" once shared the same roots. Today, the science of agriculture is still intertwined with medicine as it contributes to human health through the multi-faceted functions of supporting the food supply as well as protecting the environment. In academia, however, agriculture and medicine have developed into separate fields of science to pursue their respective objectives. There is little active collaboration between them in the area of education, such as nurturing of talented people. Faced with pressing issues, such as loss of food safety causing health problems, or the emergence and spread of infectious diseases common to both animals and humans, the ability of human beings to develop a sustainable society is threatened. We believe that we must solve diverse problems by means of education through the collaboration of the sciences of agriculture and medicine.

3.　Junction between the fields of animal science and medicine/medical care

  The conventional field of animal science has developed within the realm of agricultural science by focusing on "solving various problems arising from production to the consumption of food derived from animals". Specifically, education in this field has focused on providing scientific knowledge and technologies relating to animal husbandry, animal functionality, and animal products. In response to the needs of students and society, our education and research projects focus on the areas of "animal and human health", "understanding the phenomena of life" and "food and health".
  As the field of education and research in animal sciences expands, we see an increasing emergence of factors which require collaborative education at the junction of animal science and medicine. One of the contemporary issues we see at the junction between the fields of animal science and medicine is the "safety of foods derived from animals". In order to supply safe foods to consumers, do we not need to not only ensure the safety of foods (materials) at the production stage but also to know whether these foods contain any ingredients which might be harmful to consumers? In other words, in order to ensure the safety of food we eat, we must know all aspects of food production ￣ finding what makes healthy soil, water, and air that are involved in food production; finding what food contributes to human diseases; and understanding the knowledge relating to pathogens, chemical substances, cancers, and the immune system as well as the technologies for testing for them. In short, what is required now is to develop people with leadership qualities who have a comprehensive understanding of all aspects of food, from the production to consumption, and human health.
  We all know that the last year's Nobel Prize for Medicine was awarded to Dr. Robert Edwards who successfully carried out the in-vitro fertilization of the world's first test-tube baby. Who, then, was the researcher who introduced the in-vitro fertilization technology for mammals for the first time in Japan? It was Dr. Yutaka Toyoda who worked at the Department of Veterinary Science which preceded the present Department of Animal Science. With this historical background, the Department of Animal Science has taken a great interest in education and research of in-vitro fertilization. Today, in-vitro fertilization technology has been adopted into assisted reproductive techniques (ART) in the treatment of human infertility. More than 10 graduates from the Department of Animal Science find a job in fertility clinics each year. With many students finding their career in fields so close to medicine, we have a strong feeling that it is imperative for us to develop a system for providing education covering areas of health care and medicine.
  We have discussed mainly food safety and ART as examples of the juncture between the fields of animal science and medicine. In reality, however, more students graduating from our school are expanding their career opportunities into related areas of medicine and health care, such as pharmaceuticals and experimental animal facilities in the medical field. However, the conventional curriculum up to now has included few studies in the fields of medicine or health care, and it posed a problem when we consider the career paths of our graduates. As a consequence, we decided that we must develop a systematic curriculum through the collaboration of agriculture and medicine.

4.　Assurance of the quality of undergraduate education through agromedicine education

  There have been a variety of recommendations regarding the assurance of quality of university education over the last dozen years. What is quality assurance of education? University teachers who do not specialize in education tend to think it as a very difficult subject. In its 2008 report, "On Development of Undergraduate Degree Programs", the Central Council for Education suggested that the quality of education could be assured through the nurturing of talented people with international perspectives and comprehensive practical ability consisting of the knowledge, skills, and attitude to function in an increasingly globalized knowledge-based society. Furthermore, with respect to the direction of the quality assurance of university education, the Council suggested that it could be achieved by shifting from conventional teacher-centered education to a student-centered approach through the development of an outcome-based education system, by the increased motivation of students to learn, and by the promotion of communication among teachers as well as concerted efforts toward education for the development of new educational programs.

5.　Objectives of the Agromedicine Education Program

  Based on the above, and motivated among other things, by agromedicine education, we at the Department of Animal Science decided to offer the Agromedicine Education Program as an education system with which to assure the quality of education.
  The ultimate goal of university education is to develop and supply talented people of use to society. Accordingly, the quality of university education cannot be assured without clear goals for nurturing of talented people, or, in other words, the goal to be achieved by students by the time of their graduation. In introducing the agromedicine education program, the Department of Animal Science set the goals of developing problem-solvers (or generalists) who, with multi-angle perspectives of agriculture and medicine, have developed a foundation of all-round competency in ethical views on life, ability for creative thinking, ability to seek challenge, and communication skills and the ability to disseminate information. In addition, we have the additional goal of developing specialist-type talented people by offering advanced specialty programs, such as ART, food safety, laboratory animals, and animal-aided therapies, to the students who wish to pursue careers in these areas. In order to reach these goals, we designed the new　"Agromedicine Education Program" which focuses on agromedicine education (see the above figure). With the full cooperation of the Faculty of Medicine, we set out to enrich the teaching of the subjects in the junction area between agriculture and medicine. We also reviewed the curricula of the entire department to introduce new programs and improve teaching techniques.

6.　Specific examples of the Agromedicine Education Program
 (1) Presentations at agromedicine education seminars
  In the Agromedicine Education Program, we organized agromedicine seminars as a venue for the students to present their report on practices at the School of Medicine as well as their ideas on the issues they uncovered themselves. Two seminars have been organized to date. We expected that these seminars would encourage students to shift their learning to the "Find-a-problem/Find-the-solution" approach. Although students had been given opportunities for presentation in the past, such as the ones as a graduation exercise, effect of these seminars is different from the graduation exercises in terms of the objectives of "finding a problem, thinking about it, and presenting the result". Many students have commented that the seminar was useful in their job hunting by providing them with an opportunity to conduct public presentations as early as in the third year of their university education.

 (2) Practice at the School of Medicine
  The Agromedicine Education Programs provides the students with advanced specialty practice courses at the School of Medicine in their third year of study if they choose these courses with a view to their career paths. As the students feel it is not appropriate to select a subject for their practice without due consideration, because they will be taking it at the School of Medicine, it appears that they do consider carefully according to their intended career and motivation to study.
  Practice courses at the medical school are offered in four areas of "animals for medical experiments", "food safety", "assisted reproductive techniques", and "animal-aided therapies".

7.　Fruits of the Agromedicine Education Program

  As the Program is only two-years old, we have yet to be able to assess its effectiveness for nurturing talented people. However, the program has started to bear fruit, as summarized below:
From the perspective of students

• New appreciation of the importance of agriculture science from the point of view of its link to life
• Gradual stimulation of the recognition of career paths and professions starting at an early stage
• Arousing of positive motivation to take action and the development of the ability to judge during the course of the program
• Development of the ability for presentations
• Development of new human relationships and increased opportunities to be in touch with teachers
• Acquisition of the habit of self-learning and self-study
• Development of affection and pride for Kitasato University

From the perspectives of teachers

• Identifying issues with conventional teaching:
  • Uncertainties of specific goals for nurturing talented people
  • Organization of the course of study with simple enumeration of individual subjects and topics, i.e. the lack of linkage or progressivity among subjects and the duplication or absence of study topics
• Increased opportunities for teachers to exchange opinions and ideas and the reduction of distance between teachers and students
• Expansion of the perspectives of education through exchanges with teachers in different discipline

8.　Issues and future outlook of agromedicine education

  As we have discussed so far, the current agromedicine education at Kitasato University is largely the responsibility of the Department of Animal Science of the School of Veterinary Medicine and the School of Medicine. During the course of the first year undergraduate program, however, part of the agromedicine theory is taught at the Department of Veterinary Medicine and the Department of Bioscience of the School of Veterinary Medicine. In addition, we offer Agromedicine Theory as a liberal art subject (elective). However, from the perspective of the university as a whole, we have yet to see an expansion of the program.
  In addition to its renowned faculties in medicine and health care, this university is characterized by the presence of faculties in agricultural sciences, such as veterinary medicine and marine life science. These faculties form the foundation of the framework for the agromedicine education, which is a priority for the university. Accordingly, we believe these characteristics should be ed in future education.
  Teaching the significance of agromedicine, in terms of how the natural environment (soil, water and ecosystems) and food contribute to maintenance and enhancement of human health, will add another dimension to the characteristics of the university which was built on the education of life sciences. By instilling the students of all faculties with this idea, we believe the university as a whole will be able to turn out talented people. For an example, we propose here developing the "find-a-problem/find-the-solution" approach to education programs based on hands-on practice, and offer it across all faculties as part of the first year of undergraduate study. For example, the use of the university's campuses, practice facilities, and stock farms in the Tohoku and Hokkaido regions will enhance the recognition and understanding of the present state of the global environment and ecosystems based on the actual experience gained at real food production sites. This will prompt the students to shift their learning style from passive memorization to active thinking and acting through education that encourages them to consider the finiteness of resources and human health. We can also expect this experiential learning to encourage the students to develop autonomy and better communication skills, thereby having an immeasurable positive impact, not only in subsequent university life but also for the rest of their lives.

9.　Conclusion

  We have presented at this symposium the ways and ideas of agromedicine education according to the present state of Kitasato University. We believe it is possible for other universities to provide agromedicine education which is tailored to their unique requirements. In order for humankind to maintain and enhance its affluence and continue sustainable development into the future, it is essential to nurture talented people who can connect the environment and food to life and health. With this perspective, we hope that the idea of agromedicine education will spread beyond the walls of Kitasato University and across the country and around the world.

Business profile

Crops: Rice, soybeans, wheat, vegetables (approx. 40 varieties)
Farm is designed to ensure the annual production of 400 units of each variety of vegetables
Farm area: 6 ha (paddy rice: 90 a; vegetables: 200 a; soybeans: 250 a; wheat: 300 a)
Labor source: Spouse and parents
Distribution: Marketed as a "vegetable set" (about 400 sets) to national restaurant chains and local organic food processors

Overview

  The small town of Kamisato, where I live, is in the northern end of Saitama Prefecture, adjacent to Gunma Prefecture across the Karasu and Kanna Rivers, and within an 85-kilometer radius of Metropolitan Tokyo. We experience less drastic changes in temperatures and less rain than most other parts of the country, with relatively more sunshine.
  I inherited a natural farming method from my father who developed it over many years. Although I still make wrong decisions at times, I work hard at our way of farming, believing in the power of nature, and respecting and learning from its aspects and workings.
  Through trial and error, I have learned about soil conditions as well as the art of using various techniques. Mastering the techniques that are appropriate for our farm has reduced pest problems and made weeding easier. I am now able to grow and harvest good-tasting crops using less labor than before.

Crop selection and soil preparation

  Our farm has five types of soil: alluvial soils (sandy soil, sandy loam, and clay),volcanic ash soil (loam), and a mix of alluvial and volcanic ash soils. We plant crops that are suitable for each soil type.
         Sandy soil: Sweet peppers, eggplants, garlic, wheat/soybeans (in rotation)
         Sandy loam/clay: Green onions, carrots, Chinese cabbages, leafy vegetables, paddy rice/wheat (double cropping)
         Mixed soil: Cabbages, broccoli
         Volcanic ash soil: White radishes (daikon), turnips, spinach
  We try to choose crops according to soil conditions and the season. The sowing season for broccoli is late July in this region. Yet crops of broccoli sown at his time tend to be poor because of pest problems. Then there was the time when we could not sow broccoli until the 3rd or 4th of August because of our work schedule, but we took a chance and sowed the seeds anyway. As it turned out, we did not have problem with pests, and the crop was good. Since then, we have been sowing broccoli seeds in early August. The timing of sowing broccoli, however, is shifting to after August 9 due to the recent trend of rising temperatures.
  To prepare the soil, we purchase weeds collected from the riverbank and baled as rolls. The weeds are composted and turned over for about two years; we apply these to the farm soil a rate of slightly under 1 tonne per 10 a per year, depending on the crop which will be planted in the soil. We also grow nitrogen-fixing green soybeans (edamame) to amend the soil.

Cultivation techniques

• We level-plant green onion sets using a hole digger called a "rocket", and soil is added as part of the weeding. Accordingly, the furrows have to be wide enough to build up the ridges to a certain height.
• As for Chinese cabbage, we sow seeds directly in the soil. We used to raise and plant out seedlings before we encountered a problem with the plants not forming heads. When I saw that my mother was growing a good crop in her own garden using a direct sowing method, I tried the same technique on the farm, and found that the plants were resistant to disease and pests. As a result, we adopted this method on the farm. I believe that direct sowing leads to success by ensuring the development of tap roots which enable the plant to respond well to changes in its environment.
• As for white radish, we use a single-seed sowing technique to reduce the chore of thinning as well as for a better germination rate.

Promotion of natural farming across the region

  When I started to work with my parents, I had no friends my age in the area who understood the natural farming. I only had older people of the Kamisato Natural Farming Club to look to. As I wanted to promote natural farming among the younger generation, I asked the farmers in my generation to eat my vegetables. They found my vegetables tasted different, and became interested in learning the natural farming techniques. The number of those who were interested gradually increased. I now have 13 fellow farmers who give me moral support.
  Now I have great hopes that we are building a network of natural farming promotion groups in neighboring municipalities so as to develop the region into a place where people can live with peace of mind.

Agromedicine makes farming worthwhile

  Since 2001, we have been supplying our crop to a medical institution in the Takanawa district of Tokyo's Minato Ward. The hospital promotes integrated health care, and uses our vegetables in meals for its patients. Registered dieticians at the hospital told me that their patients were impressed by the taste of our vegetables and that their appetites had improved which helped the patients eat more and become healthier. Appreciative feedback of this kind makes me appreciate the power of vegetables grown by natural farming techniques.
  In another example, a child in Gunma Prefecture suffered from severe atopic dermatitis. The child's mother, Mrs. K, tried every treatment available, and fed him organically-grown vegetables she bought from farms but to no avail.
  Mrs. K. was desperate when she came to our farm by referral of a pediatrician. She took home some vegetables grown in my home garden and cooked them for her child. According to her, the child visibly enjoyed eating them. The next day, Mrs. K found ulcerated wounds covering her child's body were oozing less. She was surprised, and immediately called us to tell us of her joy and appreciation. I was as pleased as if the child were my own. I couriered her a package of vegetables every week, and received a kind letter describing how her child's condition had improved every time.
  Being blessed with the joy of being appreciated by other people is largely due to my efforts in promoting natural farming. I think it is I who must send my appreciation to those who eat my vegetables.
  The more I come to realize that there are so many people who suffer from these modern diseases, the more I feel motivated by the benefits these people are getting from natural farming. It makes me want to continue working hard while appreciating the workings and power of the nature, by gathering seeds and finding vegetables that are suited the best to the land through natural farming.

My dream for the future

  I sense that the number of collaborators and supporters is increasing in diverse fields both inside and outside Japan. In future, I would like to involve governments and help build communities and regions based on a healthy diet. I hope the crops produced by natural farming are not just sold and purchased as commodities. I hope that the people who learned of natural farming through their diet or involvement in environmental issues and sympathize with its ideas and the way of life will come together to share their techniques and ideas, and expand their cooperative activities in building livable communities and regions like rings that ripple out. I hope all these will help us build a better society.

  Agriculture is a short-lived human experiment, the results of which are as yet inconclusive. We and other alleged "higher life forms" rely on the original inventions of single cell organisms, that yet represent two-thirds of all life's diversity on this planet, for most of our metabolic functions. Humanoids diverged from a common ancestor shared with chimpanzees some 5 to 6 million years ago. Primatologist Richard Wrangham argues in Catching Fire that Homo erectus invented cooking some 2 million years ago, opening the nutritional path to our big-brained Homo sapiens present. Though cooks, we intelligent Homo sapiens pursued hunting and gathering from natural ecosystems for 95% of our history as a species, until quite recently.
  Evolutionary biologists generally agree our pre-agricultural diets were nutritionally superior, having afforded humans greater wellbeing and freedom from disease. In response to population pressures during a former period of climate change, 10,000 years ago, human communities began domesticating plants and animals. Original agricultural "homelands" developed independently in as many as nine unique locations around the globe over the next six millennia according to biogeographer Jarred Diamond. From these few locations sprang the world's major food crops and an agricultural revolution that transformed intimate human communities into complex civilizations characterized by geometrically expanding populations. Hunter-gatherer societies have all but vanished in this process, but humans' bodies still crave the richly varied diets of agricultural prehistory to which our physiology is yet more evolutionarily adapted.
  Agriculture's recent industrialization, propelled by the century-old artificial synthesis of nitrogen, has been a high performance engine driving immense increases in grain production, more than tripling our human population in merely three generations. Both the hybrid and green revolutions are key milestones in global agriculture's recent explosive productivity. Government sponsored studies in both the U.S. and Great Britain have documented significant declines in the nutrient density of industrially grown foods over a fifty year period. High-yield agriculture appears to be delivering atremendous supply of cheap calories to today's hungry world, but with fewer nutrientsper calorie consumed. Biological fertility, employed in organic farming systems, appears to partially mitigate this "dilution effect" by avoiding liberal applications of stimulative chemical nitrogen common to conventional agriculture.

  Incorporating greater mimicry of natural systems function into agriculture may illuminate a path towards improved nutrition, health and sustainability for the cultivated gardens upon which the human community now inextricably depends.  

1. In order to be responsible critics of modern agricultural practice we must look at our predicament through a wider biological lens and a deeper historical perspective. The title of my presentation suggests an intention to convince you, that present circumstance requires us all to scratch earth and drop seeds.
  The book of Genesis admonishes us: "Thou art of soil and unto soil thou shalt return." Cutting edge science continues to reveal how literally true our Western creation myth's counsel may have been.

2. Humans are a "Johnny come lately" entrant in a parade of life which began on this space rock some 3.5 billion years past. We are understandably biased in favor of the world we can see but our planet is "owned and operated" by organisms like these.
  Bacteria, enjoying a 2 billion year head start, pretty much first invented every significant metabolic function we associate with so called "higher life forms", including: photosynthesis, the ability to safely breathe oxygen, digestion and fermentation, the electrochemistry our brains employ, the rapid recombination of DNA we are currently so enamored of toying with and cell genetic engineering, the production of vitamins and the energy intensive processing of atmospheric nitrogen into forms usable by all living beings.

3. Gould reminds us to humbly recognize we occupy just "one of the three little twigs on only one branch among three grand domains of life".
  I quote the late evolutionary biologist, Stephen J. Gould: "On any possible, reasonable or fair criterion, bacteria are-and always have been - the dominant forms of life on Earth." Biologist Lynn Margulis continues, "The result is a planet made fertile and inhabitable for larger forms of life by a communicating and cooperating world-wide super organism of bacteria." It's increasingly being revealed to us that our species are merely guests on a planet upon which the most highly evolved and dominant modal organisms are bacterial. Our early, hard to displace, notions that such microorganisms are only responsible for disease have made us dangerously ungrateful guests.
  Carl Woese's "Tree of Life" correctly shows bacteria claim two thirds of all Earth's biodiversity. Recent discoveries of bacteria's ubiquity in the open oceans and miles deep in fissured rock suggest this life form may represent our planet's greatest biomass as well, outweighing all plant and animal life.

4. The short history of our "new kid on the block" species got under way some five-six million years back when a sub group diverged from a common ancestor we share with chimpanzees. A peculiar practice was developed by these ancestral relatives asthey evolved into Homo erectus around two million years ago: These descended from the forest canopy, learned to tame fire and cook food. We'll take up the significance of this startling innovation, unique to the animal kingdom, in a moment.
  The thoroughly novel domestication of plants and animals we know as agriculture is a very short-lived experiment, representing barely 5% of our 200,000 year history as Homo sapiens. The results of this ongoing experiment are as yet unclear.

5. Evolutionary biologists have been contentiously debating the driving force behind our human big brain since the time of Darwin. Just last summer, Harvard primatologist Richard Wrangham proposed an elegant but simple hypothesis never before considered: "It's the cooking, stupid." Employing fire to heat foods, by effectively denaturing protein and gelatinizing starch, vastly increases the amount of energy humans' bodies obtain from what they eat.

6. Human ancestral "cooking apes" no longer needed to spend 6-8 hours daily chewing raw leaves up in a forest canopy as do our primate relatives yet today. We gradually evolved smaller, more efficient digestive organs which freed a remarkable amount of energy for a very demanding organ: the brain. Today, likely owing to our invention of cooking, we big-brained apes, Homo sapiens can shuttle an unprecedented 20% of our entire metabolic energy to the brain, an organ only comprising 2% of a body's total weight.

7. We sailed along for the first 190,000 years of our 200,000 year history simply plucking the low hanging fruit from a beneficent nature as hunter gatherers, but don't forget, also cooks.
  Unlike current Western diets Paleolithic fare emphasized more green leafy Vegetables and fruits, providing higher levels of vitamins E & C, overall fewer fats with a balanced 1:1 consumption of omega-6 to omega-3 essential fatty acids, higher intake of plant antioxidants, calcium and potassium but less sodium than today. Such hunter-gatherer diet is one to which our bodies and genetic profile are still more well evolved and programmed for. Many of us today consume a frightening 10-25 times more omega-6 than omega-3 in our grain dominated diets.
  Evolutionary biologists generally agree that as hunter-gatherers we were less burdened by work, enjoyed a better nutritional condition which provided adults with a taller, upright stature and less plagued by disease.

8. Jared Diamond, author of this ground breaking Pulitzer Prize awarded study on the origins of agriculture and its consequences asserts: "Plant and animal domestication is the most important development in the past 13,000 years of human history." So why did we even do it, if nature's, "Garden of Eden" provided our prehistoric ancestors such an idyllic, well-nourished existence? Apparently, about 10,000 years ago, at the waning of the Pleistocene, in response to less predictable climate, decreases in big-game species to hunt and population pressures in desirable habitats, humans started planting seeds and herding animals.

9. The earliest of as many as nine locations around the globe where plant and animal domestication arose independently over the next 6,000 years were the Fertile Crescent and parts of China. It's obvious from this image that these original centers of food production a.k.a. agriculture shows little correlation to the worlds most productive "bread basket" regions today.
  Diamond argues domestication arose from these few locales as a result of biogeographical luck. Of 200,000 or so wild species of higher plants world wide only about 100 have ever proven valuable for domestication. Likewise of the world's 148 large mammalian herbivores and omnivores, only 14 have been successfully domesticated over 10 millennia. Agricultural Homelands were "merely those regions to which the most numerous and most valuable domesticable wild plant and animal species were native."
  Fertile Crescent : Wheat, barley, pea, muskmelon, olive, Sheep, goat
  China : Rice, millet, soybean, hemp, Pig
  Mesoamerica : Corn, common bean, squashes, cotton, The Turkey
  Andes : Potato, Lima bean, peanut, sweet potato, Llama
  West Africa/Sahel : Sorghum, cowpea, watermelon Eastern U. S. : Goosefoot (spinach), squash, sunflower
  New Guinea : Sugar cane, yams, taro.


10. Though this gentleman hardly evokes "Attila the Hun" Jared Diamond states, "The history of the past 13,000 years consists of tales of hunter-gatherer societies becoming driven out, infected, conquered or exterminated by farming societies in every area of the world suitable for farming."
  Human cultivators sufficed for the next 10,000 years by manipulating nature's microbially based fertility recycling scheme. We employed slash and burn, animal and plant manures, plus fallowing and rotational techniques to feed ourselves and produce storable surplus. Continuous reselection of plants and animals for desirable traits, and application of animal power, coupled with plowing technologies were the main hallmarks of our success as cultivators until recently. Elaborations of these rudimentary agricultural skills gave humans the capacity to feed larger sedentary communities of increasing complexity on principally grain-based diets.


11. Today, as many people of conscience flee from modern industrial animal agriculture to vegetarianism, it is wise to study and appreciate our species' intimate history with domesticated animals.
  Just as you may now share your homes with pet cats and dogs, vast numbers of humans over the past 10 millennia have lived in close domestic quarters with the animals upon which they depended for meat and milk.
  Many infectious diseases, unknown to humans in pre-agricultural history, and the resulting immunities we have since acquired to these originate from intimate associations with our domestic animal species.
  Indeed vaccination is derived from vacca, the Latin word for cow. These animal associations are why European invaders of the Americas killed more natives, quicker with their germs than they ever did with guns.
  We and our co-evolved animal partners have made each other more successful as species and should continue our mutualism by rekindling a profound respect that has been tragically eroded by recent industrial practices.

12. "Survival of the fattest" is a cleverly turned phrase and book title coined to describe Homo sapiens' unique reliance on specialized fatty acids for our "big brained" intelligence.
  Marine algae and phytoplankton, plus terrestrial green leaves and grass produce the essential omega-3 fatty acids from which we can obtain these vital brain selective nutrients. Seafoods are an important source but our domestic ruminant animals, designed by nature to harvest grass, are also a critical link to these omega-3 fats, howeveronly if we keep them on pastures where they belong.
  The currently popular aversion to fats is an ignorant denial of human evolutionary history and a dangerous notion to act on. The true issue is the kinds and quality of fats in the foods we consume.

13. This pair of now relatively unknown chemical sorcerers, early in the 20th century, upended an entire trajectory of human food production history, opening the door wide for modern high-yield agriculture.
  Nitrogen, though comprising 78% of earth's gaseous atmosphere, is supplied stingily by nature in the "fixed" forms available to biological life. Only 1% of atmospheric nitrogen has been "fixed" to bio-reactive forms over eons by specialized Rhizobium bacteria hosted on the roots of leguminous plants. By 1908 Fritz Haber, mimicking this bacterial miracle in a laboratory, had discovered the rudimentary process of synthesizing gaseous nitrogen into ammonia by employing high pressure and temperature combined with an iron catalyst. This artificial synthesis was further developed for mass industrialization by a fellow German chemist, Carl Bosch by 1930. These two were awarded Nobel Prizes for what astute observers point out is likely the 20th Century invention having produced the greatest impact on human life.

14. Humans, manipulating both the biological and industrial processes now synthesize or fix twice as much nitrogen as do the planet's natural ecological systems annually.
  Three quarters of all this ammonia fixed world wide in Haber-Bosch plants is applied to agricultural lands but only a minor fraction of it is taken up by growing crops; the rest escapes into our larger environment where it creates significant mischief.

15. Half the world's current 7 billion human souls owe their very existence to Haber and Bosch's momentous century-old invention.
  More often cited explanations for the population explosion, unleashed over the last three generations, are the germ theory of disease, or advances in sanitation and antibiotics. It can't be denied however that if these folks could not be fed, they would not be here. Several more now relatively unheralded geniuses were about to play a significant role in that effort.

16. A younger contemporary of Haber and Bosch was born amongst Iowa cornfields, to a family of well-known farm journalists, whose lifelong fascination with his state's　signature crop would launch the Hybrid Revolution and a singular political career.
  Henry Agard Wallace, mentored by George Washington Carver as a youth, avidly followed the groundbreaking work of several prominent plant breeders of the time, hybridizing corn. He bet his wife's small inheritance on a scheme to commercialize this promising novelty, peddling his own hybrid seed to Mid Western farmers from the trunk of his car. Determination, genius and hard work propelled Wallace to found the successful Pioneer Hi-Bred Seed Company ultimately sold to Dupont for $10 billion several decades after Henry's death.

17. Though Wallace bred the most productive hybrid corns of that era and then turned his remarkable skill to equally improving the egg-laying capacity of hens, he never attempted to patent any of his biological innovations, believing such advances should be the endowment of all of humanity.

18. Quickly recognized for his capabilities by FDR, Wallace served as Secretary of Agriculture for the first two terms of Roosevelt's administration, largely responsible for crafting New Deal farm policy. Wallace became Vice President following the successful 1940 election which he pretty well ran for a more distracted FDR. To decompress before Inauguration he and wife Ilo motored a green Plymouth sedan nearly the entire length of Mexico, while the earthy V.P. waded into practically every cornfield they came across. Wallace returned stateside gripped by a desperate desire to improve low productivity of the Mexican nation's agriculture and alleviate the suffering of its hungry people. His pressuring the Ford and Rockefeller foundations to take action following his return produced fateful consequences for all human cultivators.

19. Rockefeller's Foundation soon dispatched another Iowa farm boy, educated as a plant pathologist, to Mexico as an early agricultural improvement missionary in 1943. The idealistic, young Norman Borlaug profoundly moved by the depression's misery and "Dust Bowl" conditions he'd experienced, accepted a then unenviable assignment to improve Mexican grain production, including wheat.

20. Wheat, considered an extensive rather than intensive crop, rarely received fertilization as resulting tall straw bearing heavier heads of grain often lodged or fell over, diminishing and complicating the harvest. Borlaug, noting a postwar glut of cheap fertilizer emanating from decommissioned munitions plants, set out to reduce the stature and increase yields of wheat dramatically if possible. Borrowing dwarfing genes of Japanese strains, he set about crossing these with American wheats, selecting for broad adaptability across climates and simple genetic resistances to pest and disease.

21. Other foundation colleagues, working with Asian rice, followed Borlaug's lead and by the early 1960's his "miracle wheat" and their "miracle rice" had spawned what came to be known as the global "green revolution."
  By transferring the most powerful high yield technologies of modern agriculture to the developing world, Borlaug and colleagues spawned a near tripling of world grain output over 40 years for which they are collectively credited with saving as many as one billion human lives from starvation. Norman Borlaug was deservedly awarded the Nobel Prize for Peace in 1970. He died just 18 months ago in relative obscurity at the age of 95, his altruistic life's work now somewhat clouded by controversy.

22. As the title of this report suggests: "No good deed goes unpunished." Evidence continues to accumulate indicating we've traded nutrient density in our food crops for the high yields achieved over the last half-century and more. Faster growing plants that produce more and larger fruits and vegetables tend to weaken nutrient concentrations, a phenomenon labeled the "dilution effect" by scientists in the early 1980's.

23. High levels of soluble nitrogen, common to conventional farming systems, reduce concentrations of other nutrients and the intensity of flavors, often resulting as well in crops more vulnerable to pests and disease. The above set of historical USDA data is further corroborated by similar long term comparisons from Great Britain. High yield agriculture is delivering a tremendous supply of cheap calories to a hungry world but with fewer nutrients per calorie consumed.

24. Organic farming systems, by eliminating toxics, minimizing stimulative nitrogen inputs and enhancing soil biology appear to offer advantages to conventional production in certain nutrient categories. Plants that grow on a steady, slowrelease diet in the form of manure, compost, or nutrients bound up in decomposing organic matter accumulate higher nutrient concentrations than plants that receive larger pulses of soluble chemical fertilizer.

25. Unintended consequences of synthetic nitrogen and phosphorous applications result in run off of these materials into waterways and their eventual concentration in marine zones and mouths of rivers. Here escaped nutrients trigger massive algal blooms overwhelming aquatic food chains. Dying algae sink and microbes decomposing them consume all available oxygen excluding other forms of marine life. Four hundred hypoxic "dead zones" have now been identified around the globe.

26. Comparing a total of 65 matched pairs of organic and conventional raw plantbased foods for the minerals phosphorous and potassium 34 of the organic samples tested higher for the minerals while 29 conventional did. The difference appears to be rather inconsequential.

27. The rapidly available nitrogen in the conventional farming system diverts sugar from photosynthesis to produce more proteins and a spike in vegetative growth.
  Whereas in the organic system, the slower and prolonged supply of nitrogen does not trigger a spike in plant growth, allowing more photosynthetic sugars to be available for other metabolic functions such as producing more Vitamin C, other health protective antioxidants, and flavor enhancing polyphenols. The differences in these matched pairs looking at vitamins seems to favor organic samples substantially.

28. In the category of antioxidants, evidence favoring organic food samples is 3:1 over conventional.
  More interesting than just adding up the win/loss column is examining the magnitude of differences when they occur. Higher nutrient concentration of large magnitude 20%-50% or greater overwhelmingly favor organic samples.

29. In organic systems where herbivores are required to be fed as herbivores, on grass, nutritional advantages have also been identified.

30. Milk from pasture grazed cows can produce as much as a five fold increase of a rather recently discovered fatty acid, Conjugated Linoleic Acid, which exhibits anti-oxidant, anti-cariogenic and immuno-enhancing properties. Pastured milk and meat, including poultry, also exhibits substantially increased ratios of omega-3 to omega-6 fatty acids.

31. At T&D Willey Farms we subscribe to geneticist Wes Jackson's "ignorance based worldview" which asserts, "we are a Billion times more ignorant than we are knowledgeable about nature's complexities."

32. Soil ecologist, Elaine Ingham instructs: "There are billions to hundreds of billions of soil microorganisms in a mere handful of healthy soil. That single handful might contain thousands of different species of bacteria (most of which have yet to be classified), hundreds of different species of fungi and protozoa, dozens of different species of nematodes plus a goodly assortment of various mites and other micro arthropods. Almost all of these countless soil organisms are not only beneficial, but essential to the life giving properties of soil."
  Always mindful of Jackson's admonition, I go about the care and feeding of these valuable "no see 'em" allies, my soil livestock, which are largely responsible along with trusted employees for any success I've achieved as a farmer.

Introduction

  The exponential advancement of science and technology in the 20th century gave rise to a number of problems, such as the depletion of resources, the destruction of environment, and increases in chronic diseases. As a consequence, we human beings face a challenge of historic proportions in finding ways to build a society in which we can sustain ourselves with limited resources while still maintaining a satisfactory quality of life. According to the Science Council of Japan, scientists have responded to a national demand for solutions to the problems by advocating in their 2002 report, Japan Perspective. Their proposition was a concerted and organic collaboration for the reorganization of human wisdom and knowledge, which might be called a meta-paradigm change. Such advocacy has helped increase activities such as a fusion of sciences and humanities, global research, and tripartite collaboration of industry, government, and academia. These activities have produced certain results, such as the establishment of the Sustainability Science Consortium.

Health issues in modern Japan

  Medicine and agricultural science represent practical sciences which are rooted in everyday living. Inseparable from social conditions and problems￣and in stark contrast to the amazing advancement of the sciences￣conditions of food and soil, and the suffering of humans continue to worsen. The frontlines of health care have seen particularly sharp rises in the prevalence of cancers, lifestyle diseases, and depression. This is directly reflected in rising health care costs, increasing difficulties in obtaining nursing care for elderly, or patients with cancer, and increasing number of suicides. These problems, however, are only the tip of the iceberg. There is a mountain of problems covering all demographics which humans have yet to solve: there are issues of refusal to attend school, withdrawal from society, and bullying among youth; metabolic syndrome and mental health issues among people at the prime of their working careers; and problems of social isolation, dementia, and being bedridden among the elderly. For many of these problems, social conditions, such as declining birthrates, aging population, and recession, are held to blame. Nonetheless we may regard them generally as health-related problems of modern Japan.

Medicine and health care

  Although medicine is practiced mainly in the field of health care, in Japan it is regulated by an economic system whereby medical treatment is carried out under a government funded health insurance scheme. This acts to protect the quality of health care (e.g. science-based, safe, efficient, and ethical). Because diagnosis and treatment based on the personal experience of individual physicians may not sufficiently protect the quality of health care, the idea of EBM (evidence-based medicine) has been introduced in recent years.
  At the same time, the increase in chronic diseases has the potential to strain the finances of the central and local governments. While demands for services which promote healthy living and preventive medicine are increasing, it is rare for the services to have the cooperation of doctors because they are not covered by medical insurance.
  In order to address the situation, the Japanese government has been exploring solutions outside the framework of the medical insurance system through legal provisions covering dietary education, organic farming and utilization of rural resources, as well as measures to combat cancer, suicide and metabolic syndrome.
  At the same time, all is not well in the state of health care backed by science and technology. There are a number of urgent problems, including inadequate cost-effectiveness, inequities in local health care provision and the distribution of obstetricians and pediatricians, lawsuits arising from drug-induced health problems and malpractices, and the insufficient ability to deal with the issues of quality of life and palliative care.

Contemporary significance of agromedicine

  Medicine has an inherent mandate to go beyond its framework of healthcare to perpetually enhance the health of people and society as a whole. In modern times, an idealistic theory of medicine is not useful to solve serious problems in the society. However, a specific disciplinary field has yet to be developed in response.
  On the other hand, the science of agriculture, which shares the same mandate, has moved a step ahead of medicine and is changing its thinking in the areas of environmental protection and action against injury to human health. Crops, soil, and humans, which are the subjects of agriculture and medicine, form a complex system within a natural environment. They have the common characteristics in that applying the results of a closed research system is not necessarily effective in producing the expected outcome. Consequently, we expect that agromedicine will prompt agriculture and medicine to reorganize themselves so as to fulfill their inherent mandate and build a new paradigm.
  Specifically, Kitasato University advocates agromedicine with a strong determination to make it responsive to the demands of the times with a phylosophycal perspective that the "disease of compartmentalization" poses a challenge of historical proportions to humans.

Activities relating to agromedicine at the MOA Okuatami Clinic

  The clinic was chosen for agromedicine practice because of its location on the premises of Ohito Farm, an organic agriculture demonstration farm, and the resulting proximity to crops and fields that use no pesticides or chemical fertilizers.
  At the Ohito Farm, which opened in 1982, experts in agriculture and other disciplines, including professors emeriti of the Faculty of Agriculture of Shizuoka University, have been carrying out scientific studies of organic agriculture. As the understanding of environmentally-friendly agriculture practice has increased in recent years, the number of collaborative projects between the central and regional governments has also increased. The large flower garden at the Ohito Farm is open to the public. Any visitors including patients who suffer from chemical hypersensitivity are welcome and enjoying this environment.
  Since the original purpose of the Ohito Farm was to build a healthy and sustainable society (SOHAS: Society of Health and Sustainability), it opened a wellness promoting facility in 2006 offering to teach natural methods for enhancing health. At the same time, a separate and insurance-covered medical clinic opened to treat internal and psychosomatic illnesses. I was appointed to head the Clinic because of my career-long interest in rural medicine which started when I was sent to work at a farmers' co-operative hospital, as well as my experience in field research in health promotion as an occupational health physician in the Ohito Farm.
  The visitors of the Ohito Farm can choose programs which are often described as practices of agromedicine. The programs include a therapy based on Japanese diet, using organic farm products, working in the fields, a horticultural therapy, a therapy using woods, changing of air, and a therapy interacting with animals. While these methods for health promotion may be practical in the fields of leisure, education, and social welfare, it is difficult for a health care institution to adopt them because they are not eligible for coverage by medical insurance. When the Clinic offers there therapies under the medical insurance system, it could be the violation of medical law. As a consequence, it is difficult for us to accumulate evidence systematically even if we see patients whose conditions might have been improved by these therapies.
  However, since its opening the Clinic has been providing consultation on preventive health care in response to demand from local communities and the farm. In this area we provide health guidance for the prevention of metabolic syndrome, provide consultation on workplace mental health issues, provide children's mental health counseling, and are involved in a project for the prevention of suicide and depression. In this context, we feel that agromedicine has the potential to find clues for solving health issues in, at least, local communities. I also act as supervising doctor for a "free school" which deals with solving the problems of refusal to attend school and developmental disorders by using the natural environment of the Ohito Farm and I provide diagnostics and counseling services. The efforts of the free school are receiving certain recognition in society, including an educational coaching accreditation last year by the Japan Youth Development Association.

Outlook

  I have worked in diverse areas of medicine, including research at universities, research projects of the Ministry of Health, Labor and Welfare, advanced medical techniques, community health care, children's health care, labor hygiene, and health promotion. Through my actual observation of activities in the field of agromedicine inside and outside Japan, I have come to hold the following personal opinion: We need to unite the western EBM (evidence-based medicine) and a traditional EBM (experience-based medicine) based on thousands of years of experience to create a global EBM which will contribute to the wellness of society and humankind as whole.
  Dr. Erwin von BAlz was a German doctor who came to Japan on the invitation of the Meiji government. He made an enormous contribution to the establishment of modern medicine in Japan but, at the same time, advised the government to protect and study the traditional Japanese diet and medicine. Dr. BAlz was a person with penetrating insight who advocated wellness-oriented medicine and family healthcare. It could not have been an idle interest in an alien culture. He must have expected that the validity of our traditional diet and medicine would be scientifically proven one day.
  In a similar fashion, it is possible that Japanese traditional way of thinking, such as respect for nature, indivisibleness of humans from their local soil, the equation of proper diet to medical treatment, and the unity of our mind and body, can complement the undeveloped aspects of the sciences to steer the humankind in the right direction. The view point of the "disease of the compartmentalization" is an excellent one. The agromedicine needs to be scientific, safe, efficient, and ethical through the collaboration of industry, government, academia and the people. As a result, we may be able to find evidence for the improvement of health and take a step forward to achieve a SOHAS. I have a great expectation that the findings from these activities will form a foundation for the field of agromedicine, and help reorganize the wisdom and knowledge of humankind.

Overview

1.Use of herbs within Thai traditional medicine:
     - The past
     - The present
2.Practical example: Damnoensaduak Hospital

Introduction

  Thailand is a country rich in natural resources and with high levels of botanical diversity; and some of its plants are used as the basis for medical treatment by Thai traditional medical practitioners.

The Past

  Thai traditional medical practitioners have passed on their wisdom and knowledge regarding Thai traditional medicine from generation to generation for more than a thousand years, primarily at Buddhist temples and shrines which have acted as local hospitals. This practice flourished and was accepted practice within royal family circles and amongst the general population up until 300 years ago, as documented in palm-leaf scriptures; though much of this documentation was destroyed during the nation's wars.
  It was not until 200 years ago (Rattanakosin-Bangkok Era) that there was a concerted effort to collect together the works documenting local medical knowledge. This collated knowledge, detailing the various treatments, the use of herbs and Thai massage; physical exercises and other treatments, was then transferred on to stone scripts.
  Just over 100 years ago, Western medicine began to be introduced to Thailand, and in 1930, Siriraj Hospital and its modern medical school were established. After this, there was a rapid development in medical techniques and a widespread acceptance of the need for priority to be given to science based medical treatments in Thailand, something which led to a decreasing role for Thai traditional medicine.

The Present

  As a result of the global economic crisis in 1997, increased attention began to be paid to the re-establishment of Thai traditional medicine, a movement geared towards relying less on Western practices and the use of readily available local resources, in addition to the development of a more 'natural' lifestyle.
  In accordance with this development, in 1999 the 'Institute of Thai Traditional Medicine' was established, operating under the Ministry of Public Health.
  Following that, in 2001, the 'Department for Development of Thai Traditional and Alternative Medicine' was established at the Ministry of Public Health, with its objective being to improve knowledge regarding Thai traditional medicine, and this has since led to a greater knowledge of and additional research into the use of Thai herbs for medicinal purposes.

The Use of Herbs within Thai Traditional Medicine(TTM)

 TTM was originally comprised of three elements, these being:
 a. The use of Thai herbs for medicinal purposes
 b. Thai massage and herbal compressions, and
 c. Religious or supernatural rituals.

  Recently, the use of herbal medicines, Thai massage and herbal compression has been promoted; though, rather than being a part of people's everyday life as in the past, these medical practices have instead been integrated into the community and health services provided by hospitals. Both the public and private sector have played a part in developing and promoting the use of Thai traditional medicine on a number of levels, as follows:

Government Level:

• Have established government Thai herb offices on various levels, such as the institution, department and division levels at the Ministry of Health
• Provide undergraduate and graduate study programs on traditional medicine at state and private colleges and universities
• Promote education on research into the use of herbs
• Have established standards for traditional herbal products and practices
• Monitor safety and quality control, the aim being toreach international medical standards
• Have added a list of herbal medicines to the 'National List of Essential Medicines', and Have integrated herbal medicine into the national healthcare system.

Public Level:

• Have invested in and promote the herbal medicine and cosmetics industry, and Have invested in the agricultural sector, with the aim of improving plant resources.

Public and Community Level:

• Have increased the level of use of traditional Thai herbs; linked to the promotion of self-reliance in terms of health care
• Have promoted and expanded the organic agriculture sector
• Disseminate knowledge on Thai herbs, and Promote herbal and organic products as healthy foods.

Practical Example: Damnoensaduak Hospital

  Damnoensaduak Hospital is a 300 bed general hospital, with 24 doctors and a total staff of 500.

Thai Herb Related Projects and Activities Carried out at Damnoensaduak Hospital

1. Study and disseminate knowledge on herbal medicines and their efficacy
2. Help to expand and integrate Thai traditional medicine within the hospital health care services system
3. Produce Thai medical and cosmetics products
4. Provide health tour programs
5. Provide medical spa services; for example, 'Damnoen Spaya'
6. Carry out research into herbal products, including:
   1. The pain-relief effects of herbal compression treatment for Osteoarthritis patients
   2. The pain-relief effects of herbal compression gels for osteoarthritis patients
   3. The educational effectiveness and side effects of drug products which use film coated tablets (with extract of Cissus quadrangularis Linn - a drug used in the treatment of hemorrhoids).
7. Help to rejuvenate and support the local anti-chemical organic agricultural movement.

The Future:

  Collaboration at both the national and international level in terms of sharing and developing knowledge and technologies related to medicinal herbs is critical, and should be supported, as it will lead to people enjoying better lives, becoming more independent and living in a healthier environment. Furthermore, people will eventually lead happier lives as a whole.

  Food is related not only to the security of the Health System but also to the sovereignty of the country. After the world crisis of food during 2007-2008, the World Health Organization (WHO), the World Bank, and industrialized countries arranged international meetings on this issue as well as a meeting on Food Security Creation among the Member States of the Association of Southeast Asian Nations (ASEAN).
  Food is the fundamental right of a human being; everyone must have access to safe and nutritious food, based on his or her cultures and must have adequate quantity and quality of food to live a healthy life with dignity.
  Thailand is one of the food-exporting countries. However, it was found that 17% of Thai people still did not have adequate food between 2004 and 2006. In 2008, the net value of food export was 778.1 billion baht, or 13.3% of the total export value of the country or 2.3% food export value of the world. Moreover, Thailand is among the top exporters of many items of food such as rice, tuna and chicken, at 33%, 47% and 25% of the world market, respectively. These make Thailand the number seventh food-exporting country of the world.
  Although farmers produce food, only 29.7% of farming families depend on the food they produce, and this number continues to decrease. On the contrary, the use of chemical fertilizers and pesticides is increasing. These cause health problems not only for the farmers but also the consumers. The problems of food production do not only reflect the food and health systems but also the world and national consumers' attitudes, national policy, social structure, social justice, as well as farmer's and consumers' rights, etc. The participation of communities in national policy formulation on food self-reliance and production based on local food culture is the important means to solve the problems.

Causes of food insecurity

1. Decrease in food resources
  Degradation of soil quality-This is one of the important causes of the reduction in the amount of food. The monoculture of plants as well as the overuse of chemical fertilizers and pesticides causes salty and acidic soil, lacking organic humus.
  Poor water management -The annual rainfall continues to decrease by 0.4% in the country. The lack of water in the dry season and the flooding in the rainy season reflect the problem of water management. Global warming also affects water resources management in Thailand and other Asian countries.

2. Unsustainable food production system
  The monoculture agriculture causes many problems such as:
  Biodiversity of food resources:More than 90% of rice farmland in Thailand grows only 10 varieties of rice. Vegetable and corn seeds are monopolized by five large companies. The planting of genetically modified organisms or GMO food plants is expanding illegally in Asian countries; five kinds of such plants have been founded in Thailand.
  Use of chemical fertilizers and pesticides:The import of chemicals for agricultural use has been increasing. Between 1999 and 2009, the amount of imported chemicalfertilizers rose from 1.763 million tons to 4.117 million tons and that of chemicalpeticides to 0.126 million ton. The cost of such chemical substances is one-third of the total farming cost.

3. Land ownership and the rights to access resources
  Approximately 60% of Thai farmers rent land for farming; more than 800,000 farm families are landless. Moreover, only 10,000 families have very small plots of land on which to earn their living. In the near future, the conflict of land for farming will be very severe and will affect the food production system.

4. The role of large wholesalers and modern trade in food distribution
  In the next 10 years, the numbers of small wholesalers and community markets will markedly decrease. The farmers will contact and send their agricultural products to large wholesalers, and the diversity of food will depend on the direction of large markets. These will affect the community culture of food production and consumption; the amounts of local vegetables will decrease and many species will become extinct.

5. The effects of global warming
  The Intergovernmental Panel of Climate Change (IPCC) estimated that the world temperature will increase by 1.4-5.8 degrees Celsius in the year 2100. This will cause the mean sea level to rise by 0.9 meter. IPCC forecasted that within the next 20 years, 70% of agriculture land in China, India, Middle Asia, the Middle East, and the USA will become a desert. Nevertheless, coastal countries will have more frequent floods, which will affect the growth of plants and biodiversity.

6. Health problems resulting from food system
  In 1998, the chemical pesticide level blood tests revealed that 77,789 out of 369,573 farmers or 21% were found positive with a high-risk toxicity level. In 2008, the blood tests performed on 924 farmers and housewives in Chiang Mai province showed that 75% of them were positive at a high-risk level; and the blood tests were 89% positive on 1,412 consumers in the province.

Sustainable agriculture movement in Thailand

  The paradigm of sustainable development started around 30 years ago has been widely accepted. Nongovernmental organizations (NGOs) working on agriculture have adopted this paradigm in their activities, which has changed the way of agricultural thinking in Thailand. Sustainable agriculture has been known as sustainable agriculture, alternative agriculture, natural agriculture, or Buddhism-based agriculture, etc.
  The movement of NGOs and community networks has raised the awareness of people at all levels especially middle-income consumers. The need for organic vegetables and food has caused a lot of development efforts to be made so as to gain the knowledge and technology of organic farming.
  Moreover, networks of NGOs, civil society organizations and communities have also drawn up a Food Resources Plan for 2007-2010 and a follow-on Food Security Program for 2010-2013 with funding support from the Thai Health Promotion Foundation (Thai Health). Their goal is to develop and study 50 community food safety models in 439 communities across the country especially in relation to the self-reliance of organic and natural foods.

Agro-medicine movement in the Ministry of Public Health (MoPH)

  At least 20 government hospitals are more concerned about the issue of food and health especially that for patients. This movement began with the awareness of　the severe effects of chemical pesticides in vegetables, unnaturally processed food and the increasing incidence of cancer. At the same time, the MoPH's Department for Development of Thai Traditional and Alternative Medicine (established in 2002) promotes the consumption of macrobiotic diet, local food, and health food. Macrobiotics has a strong influence in those hospitals in providing macrobiotic diet for their patients with cancer or chronic diseases. Therefore, the hospitals have to encourage and support local farmers to produce and supply them with sufficient amounts of organic vegetables, rice, fruits, etc.
  Moreover, the Ministry of Public Health in cooperation with the Ministry of Agriculture and Cooperatives has been growing an organic vegetable garden in the MoPH's compound since 2008, to produce organic vegetables for MoPH personnel. The organic garden will be the model for raising awareness of and taking responsibility for agro-medicine and health for other government agencies.

National Strategic Plan on "Food Management of Thailand"

  To resolve the problems of food insecurity mentioned above and with the heightened health conscience of consumers, Thailand has formulated a five-year National Strategic Plan (2011-2016) on "Food Management of Thailand". The vision of the plan is: "Thailand produces high-quality and safe food, with sustainable food security, for Thais and the world population".
  The four strategic issues of the plan are Food Security, Food Quality and Safety, Food Education, and Food Management.
  The goal of the strategic issue of "Food Quality and Safety"is to promote the quality and safety of food in the food chain system, and protect the consumers and trade domestically and internationally. The strategic means are food safety standardization, primary agricultural product development, capacity building for community-and industry-based production, marketing promotion, and quality/safety control system strengthening.

Strategic Framework for Food Safety and Nutrition, Ministry of Public Health

  Being concerned about the food safety issue, the Ministry of Public Health has developed a Strategic Framework for Food Safety and Nutrition (Fiscal Years 2012-2016), focusing on the safety and nutritive values of food in the markets so that the staple foods consumed daily by the people are free of agrochemicals such as pesticides, antibiotics, and other toxic substances as well as pathogens. The six main strategies issues are Food and Nutrition Education, System and Structure Development, Legislation Development, Community Organization Development, Standardization of Laboratories, and Information System Development.
  The development of agriculture and food products for health under the Safety and Healthy Food Hospital Project is one of the strategic means in the System and Structure Development strategic issue.

Closing comments

  About 10,000 years ago, human beings cultivated rice; that was the beginning of the agriculture era, leading to changes in the ways of life of human beings from　hunting to farming. The culture of agriculture villages occurred and developed into a civilization culture. Nowadays, globalization has made everything and every country interconnected and changed the way of agriculture. The food produced in one cultural area is sent to another area that is far away. The aim of food production for　human health was neglected and unconcerned about. Thus, agro-medicine, sustainable agriculture, and organic agriculture are the new culture of the world of agriculture. With strong participation and movement, the new agricultural approach will create a healthy world community.

  "The doctor of the future will give no medicine, but will educate his patients in the care of the human frame, in diet, and in the cause and prevention of disease" Thomas A. Edison (1847-1931)
  Modern nutritional science developed as a result of discovery that specific dietary insufficiencies caused a multiplicity of human diseases. It was found that vitamin C could treat scurvy, thiamine abated the effects of beriberi, niacin came to be used for pellagra, vitamin A was found to help night blindness, Vitamin D abated rickets, iron was used for anemia, and iodine was administered for goiter. The contribution of diet to the increasing incidence of cardiovascular disease, diabetes, obesity, and cancer is well recognized today.
  Food is the single greatest contributing factor to optimal wellness and personal performance. However, nutrition education in medical schools was not emphasized until the two recent decades primarily in response to consumer's demand. As a physician in primary care, I feel the importance of taking time to educate the public on diet and also on hazardous materials entering the household from the air, water, soil and food, all of which can have major relevant impact on a person's health and that of the community.
  With the increased awareness of the relationship of the environment to health, The American Academy of Environmental Medicine (AAEM) was founded in 1965 and is an international association of physicians and other professionals interested in the clinical aspects of humans and their interactions with their environment. There is a joint conference with the American College for the Advancement of Medicine (ACAM) on November 16-20, 2011 in Portland, Oregon.
  Our relationship to food is a topic that includes different types of food chain interactions, how food is grown and prepared, the humane treatment of farm animals, and the transport and safety issues of food. Clinical tests for vitamins and minerals, heavy metal toxic screen can be performed and used to diagnose and monitor health conditions.
  In May, 2010, the President's Cancer Panel, a three-person panel which was established in 1971, submitted their yearly recommendations that they were "particularly concerned to find that the true burden of environmentally induced cancer has been grossly underestimated". Their report to President Obama stated: "The Panel urges you most strongly to use the power of your office to remove the carcinogens and other toxins from our food, water, and air that needlessly increase health care costs, cripple our Nation's productivity, and devastate American lives." They also gave a list of recommendations for the average person to reduce cancer risk, including eating organic, particularly for children who "are far more susceptible to damage from environmental carcinogens and endocrine-disrupting compounds than adults." One other interesting recommendation is to remove shoes before entering the home and to wash work clothes separately from other family laundry.
  The question is, how can we develop a conscious collaboration between farmers, consumers, health practitioners, and environmentalists to reduce our carbon footprints and improve our health based on our food choices.
  I will share my experience of practice of health care in California:
  After graduating from Loma Linda University Medical School and completing my internship, I practiced in a private medical clinic for two years. I realized that if I hope to effectively change people's health habits and lifestyle, I need time to educate and interact with them which is difficult to achieve in the typical 15 minutes office visits. With encouragement from friends and colleagues, I started my own practice with emphasis on prevention and wellness. In 1978, I co-founded the Health Integration Center in Torrance, California, an innovative educational and holistic medical center offering Eastern and Western therapies with goals of assisting individuals to attain balance of their body, mind and spirit.
  Integrative medicine combines and integrates the proven scientific ideas and treatments of conventional medicine and practices used in complimentary/alternative medicine. Integrative medicine does not reject conventional medicine nor does it embrace alternative medicine uncritically. It operates from a new paradigm of learning and work from the premise that the body can heal itself if given a chance. The relationship between the physician and health participant (formerly called patient) is emphasized with a consensual partnership being developed for the transformation of the person's health. Prevention and wellness is the primary focus of Integrative medicine. Health is defined not as the absence of illness but the restoration of balance and harmony of the whole person with their environment.
  I am honored to participate in the 8th Agromedicine Symposium at Kitasato University whose founding father, Dr. Shibasaburo Kitasato, and Dr. Hisayuki Omodaka, early lecturer at the medical faculty, declared that "medicine is a discipline that should encompass the treatment and prevention of illnesses, the maintenance and improvement of health, as well as the solution of spiritual aspects. In order to fulfill these mandates, it is important for us to maintain wholesomeness and safety of food (agriculture) and the environment that are the basis for the life". This is the foundation of Integrative medicine, the balance of body, mind and spirit.