Medical conferences are meant to fulfill a critically important role in the ongoing education of health care professionals. But should this be limited to the lectures we attend? Likely not. There are other ways to acquire knowledge and increase awareness toward better health. The food served during coffee breaks, at luncheon symposia, at congress dinners and in the opening ceremonies during medical conferences is one example of a potential and powerful educational tool, that has, however, long been neglected.

Diet is of crucial importance in the care of chronic kidney disease (CKD), probably more so than in the case of other chronic illnesses. Guidelines advise that adopting healthy dietary patterns, like those based on plant-based diets such as the Mediterranean diet, the DASH (Dietary approaches to stop hypertension) diet and others has a consistent, protective effect on the development and progression of CKD [1,2,3]. In addition, warnings on the importance of limiting preserved and ultra-processed foods, paying attention to avoiding foods with additives such as colorants, synthetic aromas, flavor enhancers and pollutants are increasingly being reported [4] and, it has been highlighted that food could be used as medicine in the treatment of CKD and other non-communicable diseases [5].

That said, we have been asking ourselves “why does food served during coffee breaks, lunch symposia and celebrations often include cookies, snacks, and breads full of sugar and fat, sandwiches with processed meat and cheese, and sweetened drinks?” In other words, food served at medical meetings is not aligned with what we preach in our lectures. We have found that the food served at congresses is often representative of “food deserts”, i.e. an area where there is limited access to nutritious food, and instead unhealthy, mostly ultra-processed food choices predominate [6]. Why are health professionals not adopting the advice they themselves give? The easy answers may include, “the food being served is not related to the conference aims…” or “we need tasty food…” or “we need food that lasts during the conference…” or “healthy food is trendy, but it is expensive…” or yet “healthy and sustainable food is just a fad”. All these answers implying that healthy food is not tasty and is more expensive are unfair.

All chefs agree that from the simple sandwich-panino to sophisticated meals, success relies on the choice of ingredients. Not by chance, the ingredients abundantly present in the Mediterranean dietary pattern, in the DASH Diet, Okinawan diet, Nordic diet and other plant-based diets are the ones we find in the best restaurants: fresh vegetables and fruits, grains and cereals, herbs and seasonings, olive oil and other vegetable oils. In many settings, at least in Europe, the quantity of meat or fish in the “main course” of many restaurants is being reduced in favor of a richer vegetable variety.

How can we ground our claims for healthier eating in medical conferences? First, the cost of fresh seasonal food from local producers can be similar to that of ready-to-eat food; the selection may be more time consuming, and a first glance at an “organic” apple may be less inviting than a first glance at sandwiches loaded with phosphate additives. However, even the most gourmand among nephrologists knows which is healthier and which one tastes better. Second, and mostly importantly, to cite Hippocrates and Feuerbach, food is the first medicine and “a man is what he eats”. Healthy eating, without limiting the pleasure of food, is a message that should be shared not only at home, but also in hospitals and clinics where we practice, as well as in the universities where our students study medicine, nutrition, nursing, and receive other health care education [7]. Food waste is another major concern that requires attention during medical conferences. Nowadays, about 30% of all food produced on our planet is never eaten. We suggest that menus be planned wisely to avoid food waste at conferences and that congress organizers should partner with food donation programs.

Being role models is the most efficacious way to set changes into motion, and not using conferences to promote healthy eating by adopting planet-friendly food choices is a true waste of opportunity. As stated by the Lancet Commission on Planetary Health, we live in the era of the Anthropocene, defined as a time when human activities have an important effect on the earth´s ecologic system [8]. Climate change, natural catastrophes and loss of biodiversity are examples of the dangerous consequences of human behavior on the planet, and food choices are key to planetary health: about 30% of greenhouse gas emissions derive from the food chain (production, processing, distribution, consumption, and waste management). Notably, the highest environmental cost from all foods derives from meat, specially from beef, lamb and pork since livestock production is associated with deforestation; food that could be used to feed humans is instead used to feed livestock; methane emissions derived from livestock are high and lastly, the animal suffering in livestock-farms should not pass unnoticed [8, 9]. Not surprisingly, the EAT Lancet Diet Commission on Food, Planet and Health supports a shift from a ‘lose-lose’ to a ‘win-win’ diet, meaning, changing from a diet based on animal protein and ultra-processed foods to a healthy, plant-based, sustainable diet which protects human health and the environment [8]. The food we eat during conferences should be both healthy and sustainable – i.e. a ‘win-win’ situation. The commission recommends a plant-based diet with a 50% reduction in meat and refined sugars and a 100% increase in fruits, vegetables, grains, legumes, and nuts in order to achieve the goal for a healthier planet [8]. Therefore, this message needs to be exemplified in medical conferences, and a ‘win-win’ diet may also start there.

Recently, an initiative at the Karolinska Institutet tested the feasibility of replacing, during nephrology meetings, the sweet snacks and ultra-processed sandwiches served during coffee breaks and lunches with fruits, nuts and sandwiches prepared with vegetables and non-processed white meat. The costs are comparable to the traditional catering which is mainly based on ultra-processed food. The simple rules we use to prepare these coffee breaks are reported in Table 1. The feedback could not be more positive: conference attendees note the difference, recognize the consistency within the lectures and value the importance of the initiative. It was clear that coffee-breaks, lunches, and dinners served at scientific meetings are live arenas for food education. Although this is just a start, and small conferences are of course easier to manage than large ones, this initiative can be implemented in large conferences as well. Another point to keep in mind is that plant-based food is not always synonymous of healthy food, and awareness needs to increase in this regard. As an example, intensive farming is not limited to livestock. The use of pesticides and fungicides to grow vegetables can also compromise sustainability and nutrient availability (Fig. 1).

To conclude, big changes start from small steps and there is no better place to start than in medical conferences and scientific symposia where our health is in the spotlight. Do not let our medical conferences represent ‘food deserts’ - the power is on your plate.

Table 1  A few golden rules for healthy eating aligned with the principles of planetary health regarding food to be served at medical conferences and scientific symposiums
Fig. 1
figure 1

An apple a day. Which apple would you choose? (a. Ecological apple; b. commercial apple). (https://timesofindia.indiatimes.com/city/guwahati/city-worried-over-harmful-chinese-apples/articleshow/64812589.cms) https://www.ewg.org/foodnews/dirty-dozen.php. Legend: Apples are among the most poisoned fruits since they are relatively easy to stock and maintained for long periods. The shiny red ones (1.b) look better at first glance but are usually treated with fungicides and made shiny with a coat derived from different sources, usually not declared. Since pesticides tend to concentrate in the seed and in the skin, the advice is to peel apples. Conversely, the skin of apples not treated with pesticides retains, even for some time after being harvested most of the healthy nutrients that give origin to the adage “an apple a day keeps the doctor away”.