Fixing the communication issues between academia, industry and the consumer

RM: Could you briefly explain why you’re here at Vitafoods, what you’re trying to communicate to the audience?

BdR: I think we’ve known for a long time that especially plant based foods, so fruits and vegetables, have proven health benefits, mostly in relation to cardiovascular disease but also in regards to cancer and metabolic diseases. But, generally speaking, in trials where we look at the effects of eating more fruit and vegetables, or the effects of eating dark chocolate or berries, or a whole range of foods, we see that some people react very favourably to these foods; perhaps their blood pressure goes down or their glucose metabolism improves, and yet for other people they don’t. They don’t react as favourably. So, if you do one trial and take the average response (as is the usual way of measuring benefit), you may not actually find a response. However, if you are to look at the results more narrowly, say in terms of groups of people, you might just find a response in certain groups.

To give an example, one of the studies I undertook concentrated on the effects of dark chocolate looking at blood platelet function and blood flow. What we found was that initially, when we looked at the results of the population as a whole, we didn’t see a very significant effect. However, when we looked at men and women separately, we found that predominantly the men reacted favourably to the dark chocolate, so by separating out the gender groups we found that actually there was an effect. And there have been similar trials where scientists have looked at, for example, the relationship between dark chocolate and blood pressure and found an effect in old people but not in young people, so it becomes clear that by subgrouping the results in a study we can pinpoint groups of people for whom eating a certain food would bring proven health benefits.

We are now beginning to be able to say rather than simply this food is good for you, whereby you mean everyone in general, instead this food is good for a specific group of people. And that’s what we’re trying to understand. In collaboration with more than 70 academic partners, with the food industry, with policy bodies, we’re trying to understand what the factors are that determine whether you’re going to be responsive to certain compounds.

RM: It’s about not diagnosing the entire population..

BdR: That’s what we have now; if you want find a health benefit you take an intervention group and a control group and you look for a difference between those groups. But if you don’t find a difference does that mean that there’s really no effect? Or does that mean that actually the effect may only be present in specific people? And it’s trying to understand what factors influence the response so that, ultimately, we will be able, based on your gender, your age, your BMI, your present diet, your metabolism, to predict whether a particular food is going to be good for you.

RM: You say you’re working with the industry on this?

BdR: We have them as our stakeholders. We’re working mostly between academic partners, because actually this whole field of study is fairly new. Initially the industry was a bit apprehensive of this approach. If we were to say that the health benefits of a certain nutrient are, in fact, only present in 10% of the population, then the initial response from the industry would be to ask why would they make special products for such a small percentage of consumers? Could they make a profit from this? But I think we’re starting to move away from this type of thinking now because we’re actually looking at a range of products. It’s for consumers to determine which product they purchase because they think it will have the greatest benefits for them. So, we’re not necessarily looking for the industry to make special, niche products for consumers, its actually about informing consumers if an existing product is specifically beneficial for them as a woman compared to a man or as a young, rather than old, person for instance.

RM: How do we inform consumers?

BdR: That is difficult. I think it would come through labelling, but the benefits have to be proven; it is important we take an academic and scientific approach. And in many ways, we’re already doing this for the industry. We are collating studies together, compiling a big data pool, and doing subgroup analysis of that data for a range of compounds. This information will become available in the next two years. The industry will be able to access it and decide how they want to use it. I think it has been shown that if marketing is more personalised then people are more enticed to buy particular products.

RM: Do you think the relationship between academia / science and industry is a problematic one?

BdR: Generally speaking, I don’t think it is. I have worked with the food industry on many occasions and have found that as long as both parties’ terms are clear at the start, the relationship works well.

Working with the industry doesn’t necessarily always take the form of a study together. As an academic, you can also offer consultancy, translate scientific evidence, work on health claims with the industry. Generally speaking the food industry is mostly concerned with looking at something specific to their products, whereas, as academics, we perhaps take a more general view of product groups, but I have never viewed this as problem. For us, we can do as many studies as we wish, but in the end if it’s not taken up by stakeholders it’s of less value, so if we can do something that’s of use to the food industry its more beneficial for all of us.

I personally believe, (and this is not a view I share with all scientists I should say), that if we want to change the health of the public we have to work together with the food industry, and look at the foods people have eaten for years, those they are not going to relinquish, and try to make them healthier. So as we gather more information about products that aren’t healthy now, perhaps we can change the composition to make them healthier. There were some really interesting talks at Vitafoods on this issue. For instance, Gary Williamson gave an example of foods that are normally high GI, but by adding a polyphenol we have the potential to make them low GI and lower their glucose response. I think these are really clever examples of how we can modulate the processing, the production of a food in order to make it healthier, and for that we need to work with the food industry.

RM: You say your opinion is not necessarily shared throughout the industry?

BdR: No, I know some people working in the public health area will argue that the food industry itself is partly responsible for the fact that people are now obese, that we’re eating too much. They argue that unhealthy foods are too cheap and healthy foods are not cheap enough, so they see the food industry almost as an enemy. But if you never talk you can never hope to improve things, we need to find some common ground, and it has worked in the past.

This was seen in the 90s when we discovered that trans fats increase cholesterol even more than saturated fat. Following this, the bigger food industry partners were the first to omit trans fats from their foods. Since we realised that salt is linked to high blood pressure, the industry has been proactive in trying to lower salt content. Academia and the food industry have been working together to help the health of the population.

However, it is not always as simple as this to improve consumer health. Research has shown that if you have a product with a label stating it to be low in salt, often the first thing a person does is to add salt to that food once it’s cooked. Effectively, the consumer cancels out the health benefit that’s been given to them. This is where consumer responsibility also comes into play. And I think this will be interesting in the future with the potential sugar tax looking to reduce sugar content.

RM: Do you think the sugar tax is a good idea?

BdR: in the end, I think we need some nudging. The healthier choice needs to become the easier choice, the cheaper choice. There’s no escaping the fact that high fat, high sugar foods sell well and are cheap – both to produce and purchase. Without regulation the industry doesn’t have an incentive to make those products healthier. We know that we can prevent up to 80% of heart disease just by eating a healthier diet and if you look at how much our bad health costs the NHS, I think the responsibility we all share, is obvious. I think we probably need some innovation, and if the innovation is driven by law then perhaps this is something we need to do.

RM: When we say we need this, or we need a nudge, is this the UK? Or Europe?

BdR: Everywhere, because food is global. We import and export a lot of our foods, and I think we need to take a much more global view. There are lessons to be learnt by observing other countries of the world. Admittedly, there have been initiatives in other countries in Europe that haven’t worked effectively, but if one country implements an initiative, and it does work well, then often you see it being adopted by other countries. We have seen it across Europe, with the smoking ban, for example.

RM: In taking this better approach towards diet, towards eating more healthily, do you think this is something that will be regulator driven, industry driven, or consumer driven?

BdR: Essentially I think it will be consumer driven because, ultimately, if a product doesn’t sell then there’s little point in producing it. However, we all have to work together, we have to work with the consumer to see what they want. If you look at personalised nutrition for instance, because that’s what I believe we’re heading towards, the consumer has to want to buy the product, the industry has to be able to produce it effectively and profitably, and as academia we have to be able to prove its health benefits for particular group(s) of people.

Obviously we need the food industry to make this work because they need to be able to market their products to specific groups and make it easier for consumers to pick those products. This is where our intelligence needs to be proven and tested. So we really have to work together, and I think that’s happening more now within EU projects.

RM: What is the greatest challenge that presents the food industry in 2017 in the UK?

BdR: I think the greatest challenge, and I’m not sure the food industry can actually solve this, is that people generally eat too much.

RM: So its quantity?

BdR: It’s quantity. People are overweight and that is not always due to eating the wrong foods, it’s actually often due to eating too much food. It really is a challenge. Some industries are being proactive and actively reducing portion size, but then are receiving bad publicity for being seen as ‘ripping people off’ so it’s a difficult issue.

Another challenge, as I mentioned earlier, is how we can work with the industry to make healthier products which are the easy option for consumers to choose and also the easy option for the food industry to produce (and make profit), and this is where we probably need legislation.

We can comment that products need to be healthier, or portion sizes need to be reduced, but in the end what are people looking for? They’re looking for cheap products, they’re looking for easy products. In the UK, KantarWorldpanel have looked into where people are willing to pay more. Their research showed that consumers are willing to pay more for something that is easy, that, for instance, already has a sauce on it, could be just put in the microwave and instantly provides them with a high-quality meal. And they’re willing to pay about 200% more for those products. The same people were only willing to pay 5% more for a healthy product, so the challenge is clear to see.

Nowadays people only tend to become interested in healthy foods as they get older and start to see their health deteriorating, perhaps with high blood pressure, high cholesterol. We need to change perceptions, really educate and get children eating healthily as a matter of habit from a young age. If you look at many diseases, take heart disease for instance, at what age do you think that starts?

RM: I’m not sure, aged 20 perhaps?

BdR: The clotting of arteries starts from birth. So, of course, no one would have a heart attack straight away, but by the time they reach 40 they’ve actually been developing heart disease for those 40 years. So it’s incredibly important that we get our young people, our children eating healthily because that is a process you can influence really early on. We are starting to see diabetes appearing in teenagers, heart disease appearing in those in their 20s rather than their 40s which is very worrying, but by starting healthy eating at a very young age this could be reversed.

RM: Imagine we’re having this conversation in a years’ time, what will have changed in the industry?

BdR: I really admire the level of innovation in the industry, finding niches where people are developing healthier products, better tasting products, and hopefully that will continue. I hope the field of personalised nutrition will come to the forefront and we will see many developments in this area over the coming years.