Judith L. Buttriss

Food reformulation: the challenges to the food industry

The role of the food industry (retailers, manufacturers and food service) in helping consumers eat healthily and sustainably has been receiving considerable attention in recent years. This paper focuses on the challenges facing the food industry and the role of food reformulation in meeting these challenges, through the lens of a public health nutritionist. Attention has been heightened by the Governments Responsibility Deal, launched in early 2011 by the Department of Health (England), by the UKs engagement with the global food security and food supply sustainability agendas and by the Government Office of Sciences Foresight report. The Responsibility Deals food network has to date focused on reduction of trans fatty acids, salt and calories and out-of-home calorie labelling (in food service settings). New pledges are expected soon on increasing fruit and vegetable intakes. Reformulation is a major feature of the Responsibility Deals approach, and along with other approaches such as portion control, choice editing and information provision, there is potential to increase the breadth of healthier choices available to the public. With the exception of fruit and vegetables, the emphasis has been almost exclusively on aspects of the diet that are in excess for many of the population (e.g. energy and salt). Evidence of low consumption of some key micronutrients by some groups of the population, particularly adolescents and young adults, often alongside excess energy intake compared with expenditure, is all too often overlooked. This paper summarises the progress made to date, the challenges faced and the opportunities that exist, with particular focus on reformulation. One of the biggest challenges is the relatively poor understanding of how to effect positive and long-term dietary behaviour change. The paper concludes that, in isolation, reformulation is unlikely to provide a complete solution to the challenge of improving eating patterns and nutrient provision, although it is a contributor.

Priority research questions for the UK food system

The rise of food security up international political, societal and academic agendas has led to increasing interest in novel means of improving primary food production and reducing waste. There are however, also many ‘post-farm gate’ activities that are critical to food security, including processing, packaging, distributing, retailing, cooking and consuming. These activities all affect a range of important food security elements, notably availability, affordability and other aspects of access, nutrition and safety. Addressing the challenge of universal food security, in the context of a number of other policy goals (e.g. social, economic and environmental sustainability), is of keen interest to a range of UK stakeholders but requires an up-to-date evidence base and continuous innovation. An exercise was therefore conducted, under the auspices of the UK Global Food Security Programme, to identify priority research questions with a focus on the UK food system (though the outcomes may be broadly applicable to other developed nations). Emphasis was placed on incorporating a wide range of perspectives (‘world views’) from different stakeholder groups: policy, private sector, non-governmental organisations, advocacy groups and academia. A total of 456 individuals submitted 820 questions from which 100 were selected by a process of online voting and a three-stage workshop voting exercise. These 100 final questions were sorted into 10 themes and the ‘top’ question for each theme identified by a further voting exercise. This step also allowed four different stakeholder groups to select the top 7–8 questions from their perspectives. Results of these voting exercises are presented. It is clear from the wide range of questions prioritised in this exercise that the different stakeholder groups identified specific research needs on a range of post-farm gate activities and food security outcomes. Evidence needs related to food affordability, nutrition and food safety (all key elements of food security) featured highly in the exercise. While there were some questions relating to climate impacts on production, other important topics for food security (e.g. trade, transport, preference and cultural needs) were not viewed as strongly by the participants.

Peanut sensitisation and allergy: influence of early life exposure to peanuts

The aim of the present systematic review was to evaluate the influence of early life exposure (maternal and childhood) to peanuts and the subsequent development of sensitisation or allergy to peanuts during childhood. Studies were identified using electronic databases and bibliography searches. Studies that assessed the impact of non-avoidance compared with avoidance or reduced quantities of peanuts or peanut products on either sensitisation or allergy to peanuts, or both outcomes, were eligible. Six human studies were identified: two randomised controlled trials, two case-control studies and two cross-sectional studies. In addition, published animal and mechanistic studies, relevant to the question of whether early life exposure to peanuts affects the subsequent development of peanut sensitisation, were reviewed narratively. Overall, the evidence reviewed was heterogeneous, and was limited in quality, for example, through lack of adjustment for potentially confounding factors. The nature of the evidence has therefore hindered the development of definitive conclusions. The systematic review of human studies and narrative expert-led reviews of animal studies do not provide clear evidence to suggest that either maternal exposure, or early or delayed introduction of peanuts in the diets of children, has an impact upon subsequent development of sensitisation or allergy to peanuts. Results from some animal studies (and limited evidence from human subjects) suggest that the dose of peanuts is an important mediator of peanut sensitisation and tolerance; low doses tend to lead to sensitisation and higher doses tend to lead to tolerance.

Sustainable diets: Harnessing the nutrition agenda

There has been rapid growth in the global population over the last century and estimates for 2050 are a global population of over 9billion. These mouths need to be fed and the nutritional quality of the food received will be a key determinant of future health. Alongside this expansion in the worlds population, rapid economic growth in China, India and South America is increasing demand for protein-rich foods, especially meat and dairy products, causing concern about the impact this may have on green house gas emissions. As economies strengthen and dietary and lifestyle patterns become more westernised, the so-called diseases of affluence are becoming ever more evident, often alongside malnutrition. This paper considers these challenges and the need to embed thinking about nutrition into discussions about sustainability of the food supply.

Trans fatty acids in a range of UK processed foods

A survey to determine the trans fatty acid content of a range of processed foods was carried out in response to recent reformulation work by the food industry to lower the artificial trans fatty acid content of processed products. Sixty two composite samples, made up of between 5 and 12 sub-samples, were collected in 2010 and were analysed for fatty acids, and a range of nutrients. The foods analysed included pizza, garlic bread, breakfast cereals, quiche, fat spreads, a range of fish and meat products, chips, savoury snacks, confectionery and ice cream. Levels of trans fatty acids were reduced considerably compared with previous UK analyses of similar foods where comparisons are possible. Concentrations of trans elaidic acid (t9-C18:1) from hydrogenated oils in all samples were <0.2g/100g food. These results confirm information provided by the food industry in 2007 on the levels of trans fats in key processed food sectors.