The role of eating well to prevent the onset of dietary risk factors for ill health is once again a hot topic as more and more people come to realise that a nutritious diet is the basis for a long and healthy life. The media is rife with reports on the subject, timed aptly as we make new year’s resolutions, while celebrity chefs like Jamie Oliver are espousing the benefits via cookbooks like Everyday Super Food which is packed with recipes for a “healthier, happier you”. So how does the fresh produce business stand to gain and in what way can this industry play its part? Oxford University Professor Susan Jebb and Sainsbury’s brand director Judith Batchelar discuss why and how the UK food environment needs to change
Quoting the findings of a global study, Jebb, a Professor of Diet and Population Health at the University of Oxford, reveals that diet has overtaken smoking as the leading risk factor for ill health in the UK and many other economically developed countries.
Likewise, Batchelar at Sainsbury’s points to the 10-year outlook in the World Economic Forum Risk Report of last year, which, from a likelihood and impact perspective, places chronic and infectious diseases at the top of its list of concerns, along with other major global issues such as economic disparity, water and food security and biodiversity loss.
“Food really does matter for health,” argues Professor Jebb. “The risk factors for diet have soared, and it’s all related to what we eat. In effect, our food is killing us. Most people are eating more than they actually need, and we can’t afford to continue eating the way we do now.”
On the other hand, the professor points out that eating good foods is one of the most important things we can do to stay well. “Food won’t cure most diseases […] but food is more important than medicine when it comes to preventing diseases occurring,” she claims.
A bold statement maybe but one she backs up with research. According to calculations by her colleagues at Oxford University, an astounding 33,000 premature deaths could be prevented each year if the UK met the government’s dietary recommendations and consumed less saturated fat, less salt, more fibre and more fruits and vegetables.
At the end of this article, you can read about three research studies highlighted by Professor Jebb, which she says illustrate the benefits that a good diet, featuring fresh fruits and vegetables, can have on health.
Time for a re-think
With good food having such a beneficial impact on health, Professor Jebb says we need to think again about how valuable a healthy diet can be in terms of disease prevention. Importantly, although consumers themselves are already willing to make positive changes, she claims research indicates that much of what we eat is not a conscious decision, rather it is shaped by our habits or environment.
“Four out of five consumers say they want to eat more healthily but those good intentions don’t easily translate into what we put into our mouths,” she points out, adding that despite years of health promotion change in our diets has been slow.
Indeed, Batchelar adds that rather than consumers making a “real conscious change” to their eating habits, she says most improvements in macro-nutrition have been through “stealth” tactics – in other words, product reformulation.
“People are eating unconsciously,” Batchelar explains. “80% of what customers buy stays the same, and this pattern is exacerbated among those who shop online. There is less variety in customers’ diets. That’s a challenge.
“Also, the essential life skills of feeding yourself and your family nutritiously and well, are not being taught in schools. There is very little in the curriculum to teach and educate kids, although people are campaigning for this.”
So, how can we accelerate the rate of change?
“We can’t just leave it to individuals,” argues Professor Jebb. “We have to think about the entire food system that brings individuals to that point. “Much of what we eat is often not our decision at all – we are all easily ‘nudged’ into decisions. It’s affected by circumstance.
“For example, breakfast choices are a habit. Or, if you’re staying at a hotel, you eat what is provided. You’re a victim of your environment – your choices are framed by what is available to you.”
Batchelar agrees, noting that people are eating out more in an environment where they don’t necessarily know the quality of what they’re eating. “There’s no nutritional panel,” she says. “No one is really telling you the calorie content.”
Just last week (January 21) the Food Foundation released a report titled ‘Force Fed’ that goes even further; claiming that while families may think they have lots of choice about what they eat, their choices are constantly and systemically steered towards unhealthy foods by a “manipulating and incentivising food environment”.
The professor believes industries need to think about the interplay between individuals and their environment. “People have to take some responsibility but we need to encourage them to make better choices,” she explains. “We need to make the hill a little less steep to make healthy choices a much easier choice.”
The role the food industry can play
When it comes to changing the food environment, Professor Jebb claims this relates to supermarkets – who exert a “powerful influence” over what people put into their trolleys via marketing, special offers and product positioning – and manufacturers who “affect our health” through the composition of their products as well as promotions.
She also believes primary production has a key role to play on the road towards healthier diets.
“The basic ingredients we produce are at the heart of a healthy diet but the relative proportions of foods in our diet are out of sync with what our bodies really need,” she explains. “If we are to have a sustainable food system, we need to produce what we need to eat for optimal health, and within environmental limits.
“We need people to consume more fruits and vegetables, more cereals and grains, probably about the same milk and dairy products, rather less meat, and, for sure, less of the highly processed foods that are high in fat, sugar and calories but with few essential nutrients.”
In short, the professor says the UK needs to change its entire food environment; the way food is produced, processed, distributed and sold, so it’s geared towards a more nutritious diet. “It’s only by changing supply and demand that we can create a more sustainable and healthier food system,” she claims.
Here are Professor Jebb’s top tips for food for a fitter future:
Further research. “More research is needed to increase yields in agriculture and horticulture, whilst also enhancing nutritional value yet maintaining the ecosystem.”
New varieties. “We need to look again at the varieties we grow to get the highest concentrations of vitamins and minerals, and all the other plant compounds that we know contribute to health benefits – like flavonoids. So much research tells us more fruit and vegetables is a crucial component of a healthy diet. It’s not just the vitamins and minerals – it’s down to a whole range of plant compounds, which we’re only just beginning to understand.”
Reconnect with consumers. “We really need to reconnect with consumers so they discover the real taste of good food and think a whole lot more about what they put in their mouths. All the behavioural research I’ve done shows if you can make people think a bit more you can have progress. People are eating too unconsciously. A better informed consumer will learn to prioritise quality over quantity and to accept the real costs of food production.”
Protecting production. “We need to conserve the nutritional value of the soil; to plan rotations that return nutrients to the land and to maintain mineral levels using fewer fertilisers.
Improve flavour. “We need to find ways to make food tasty and palatable for consumers, while retaining the nutrients and as much of the fibre as we can. Ideas like 50:50 white and wholemeal bread are good. Most people don’t eat wholemeal bread, so if we can move them to a halfway house we can have a significant impact.”
Balance land use. “We need to consider the balance of land use for animals and crops. While global production will need to increase to meet the demands of a growing population, in the UK we need to reduce amount of meat we consume, both for health and sustainability of environment.”
More reformulation. “I’d like to see more product reformulation to reduce the saturated fat, sugar and, in some cases, the calories. Reformulation has helped reduce salt intake in the UK by 15% in the last decade – that is phenomenal progress.”
What Sainsbury’s is doing
According to Batchelar, Sainsbury’s is already doing “quite a good job” when it comes to improving the nutrition of products on its shelves, noting that the retailer’s interventions are planned where they “matter most” and will have the “greatest impact”.
Here is Batchelar’s run-down of Sainsbury’s actions to date:
Multiple traffic light labelling. “It works. We’ve been using these labels since 2005 and we have evidence that it does make a difference to customers’ shopping habits. It also changes the behaviour of the teams that I work with in terms of seeking to offer healthier products to customers.”
5-a-Day. “A huge amount of work has been done on 5-a-Day for our customers. We have worked hard on ensuring shorter supply chains for fresh fruit and vegetables, extending the British season and using less stored product so we can preserve the “nutrient freshness and quality” of fresh produce.”
New varieties. “Sainsbury’s is working hard to grow varieties that have lower sugars or fortified nutrients. We have tested fresh product extensively across the seasons and across different varieties and origins to understand the impact on nutrient content so we can label with more confidence and avoid ‘typical values’. We are exploring biofortification in a number of areas, including a variety of watercress, called Boldrewood, that’s high in nutrition thanks to enhanced levels of PEITC, as well as a lettuce that high in antioxidants.”
Reformulation. “We have been reformulating products to decrease the amount of salt, sugar and fat, while increasing nutrients like fibre. And because we know how much we sell and what’s in it, we can look at the biggest area of concern and target our activities accordingly. This isn’t new – we’ve been doing it since 1981.”
Click here to read about further progress made by Sainsbury’s as part of its 20×20 CSR and sustainability plan.
Optimising nutrition through agriculture
But helping to improve consumers’ diets is not just about “taking things out” of food (product reformulation), according to Batchelar. Rather, she says it’s about “putting things in” and optimising food through micronutrients.
“That is where the agriculture industry comes in,” she says. “Health is an opportunity for UK agriculture. In the much broader sense of the health agenda, agriculture is key because soil, plant, animal and human health are all inextricably linked.
“Historically, we have traded off yield and productivity for nutrition but we can’t afford to do that anymore. We have to optimise as much as possible and optimising nutrition has to start with primary agriculture. If it’s not there in the first place, we [retailers] can’t do a lot.”
Batchelar is confident the UK food industry can deliver better nutrition through crops, dairy and livestock but only if it applies itself via an end-to-end value chain approach. “We all have to work together in an integrated way – the growers, manufacturers and retailers,” she adds.
In addition to Sainsbury’s own work – with salad leaves and watercress, for instance – Batchelar says biofortification is happening across the globe in line with key areas of micronutrient deficiencies identified by the United Nations. By 2030, estimates suggest 1 billion people will benefit from eating biofortified foods.
Closer to home, she points out that industries are already looking at better animal feed for meat with reduced saturated fat, as well as better plant varieties with enhanced iron and fibre and better soil management to improve levels of magnesium, potassium and selenium.
“We can tailor these initiatives to address the micronutrient challenges we are aware of,” Batchelar notes. “It’s perfectly possible and makes perfect sense but it’s not common practice. The technology is there too and it’s more affordable than ever, plus we have data like never before that’s increasingly accessible.
“The future is already here, it’s just unevenly distributed. This is a huge opportunity for primary agriculture. We just we need to get on with it.”
The role of diet in health: three research studies
Professor Jebb singles out the following three research studies as cases in point where a good diet – that features fresh fruits and vegetables among other foods – has been proven to help prevent ill health and disease.
1. DASH trial – the role of diet in hypertension
This trial tested the effects of diets containing three different levels of salt; high (close to what the UK diet contained in 2000), medium (the UK target), and low (the amount of salt we actually need to survive).
The aim was to lower blood pressure. A diet was created that was rich in fruit, vegetables and low-fat dairy products.
The results indicated that as salt intake is lowered, blood pressure comes down too. Plus, at every level of salt intake, those consuming more fruits, vegetables and low-fat dairy had additional benefits – their blood pressure was significantly lower.
2. Finnish Diabetes Prevention Study
This study encouraged 2,000 people at high risk of diabetes to lose weight by eating less and especially by cutting down on fat, while eating more fibre and becoming more active.
The intervention lasted four years and participants’ health was monitored for three years thereafter.
After seven years, the incidence of people developing diabetes was almost halved and recently-published data shows that the benefit has persisted even now, 20 years on, and despite weight tending to have been regained.
3. Study of heart attack sufferers
This was a secondary prevention trial among people who had already experienced a heart attack.
The theory was if they changed their diet they could significantly reduce their chances of having a second and potentially fatal heart attack.
The focus was on Mediterranean-style diet – replacing saturated fat with unsaturated fat, eating less meat and more oily fish, and more fruits and vegetables.
Over the next five years of the study the deaths decreased by 20% among those who adopted the Mediterranean diet.
Professor Susan Jebb and Judith Batchelar were speaking at the Oxford Farming Conference 2016