Perspectives
Some of our blog posts are designed to share news on a recent development. The aim of others is to encourage debate or reflection on controversial issues, focusing on the strength of the evidence base underpinning these issues. Unlike our Position Papers, blog posts do not present an official opinion of the Academy.’
SACN’s statement on processed foods and health welcomed
The Academy of Nutrition Sciences welcomes the thorough and comprehensive statement on processed foods and health from the Scientific Advisory Committee on Nutrition (SACN), which concludes that the observed associations between higher consumption of (ultra-) processed foods and adverse health outcomes need to be treated with caution owing to limitations in the NOVA classification system, the potential for confounding, and the possibility that the observed adverse associations are covered by existing dietary recommendations. Studies are almost exclusively observational and confounding factors or key variables such as energy intake, body mass index, smoking and socioeconomic status may not be adequately accounted for.
The SACN statement also highlights the lack of evidence about the mechanism(s) via which processed foods might adversely affect health and the need for good-quality randomised controlled trials that may help establish potential mechanisms, and establish whether they are independent of energy density or other dietary factors. This recommendation is aligned with the message of a recent blog post from the Academy, which also highlighted the limitations of the dietary methods used in the observational studies. Furthermore, as the NOVA system does not consider nutrient contribution of foods, it fails to accurately distinguish processed foods with limited nutritional attributes from processed foods with recognised nutritional properties, many of which contribute to the nutrient intakes of families living on tight budgets.
SACN’s report, Feeding young children aged 1-5 years, published
The Academy of Nutrition Sciences welcomes the new report from SACN (the Scientific Advisory Committee on Nutrition), Feeding young children aged 1 to 5 years, published on 4 July 2023. The new report accompanies the Feeding in the first year of life report, which was published by SACN in 2018.
Feeding young children aged 1 to 5 years is the result of a comprehensive review of the scientific basis of current dietary recommendations for this age group. In line with best practice, the evidence considered was primarily systematic reviews and meta-analyses of randomised controlled trials, prospective cohort studies and non-randomised studies of interventions.
The report considers:
· national survey data on food and nutrient intakes and status, the prevalence of overweight and obesity, and dental caries in children aged 1-5 years
· evidence from systematic reviews examining a number of dietary factors and child, adolescent and adult health outcomes, as well as evidence on factors that influence eating and feeding behaviour, and diversification of the diet in the early years.
Feeding young children aged 1 to 5 years concludes that the current diet of young children in the UK, as captured in dietary surveys, does not meet current dietary recommendations for several nutrients, and a long list of recommendations to address this can be found in Chapter 12. SACN recommends that government considers a range of strategies and actions to improve the diets of children aged 1 to 5 years, and continues to monitor dietary intakes, and the nutritional, weight and oral health status of young children. A chapter is also devoted to research recommendations.
A series of annexes provide detailed information on the methods used (including literature search), data extraction evidence tables, quality assessment and grading of the systematic review evidence, and additional analyses.
The British Dietetic Association’s Obesity Specialist Group welcomed the report, commenting that it highlights the importance of early nutrition and a balanced intake of nutrients from foods. The early years are when many food habits are formed that can last into adulthood. For those working with young children and their families, ensuring that parents and carers are aware of appropriate portion sizes for age is an important message from this report. The authors found that a higher intake of energy and protein, from large portions sizes, was associated with a higher BMI in young children, as was a high intake of sugar from sweetened drinks. Dietitians and registered nutritionists are best placed to help with advice around early years feeding and portions sizes.
Understanding ultra processed foods and human health: a journey without a plan?
Rapid increases in obesity and diet-related diseases in countries undergoing nutritional transition from traditional food practices to use of more processed foods has prompted development of a food classification system which characterises people’s diets by the amount and type of processed foods they eat, rather than by nutrient content. Most prominent of these, the Nova classification system, assigns foods into four groups (Nova 1-Nova 4) according to increasing degree of processing and has been widely used in recent years to assess potential relationships between so-called ultra processed foods (UPFs), the most heavily processed category (Nova 4), and human health.
Reports of relationships between intakes of UPFs and higher risk of obesity and chronic disease have, not surprisingly, caused concern and have also resulted in a debate about the nature and quality of the scientific evidence. This was the topic of an expert group consensus meeting convened by the British Nutrition Foundation (BNF), the outputs from which have been reported in Nutrition Bulletin. The consensus findings included a number of key questions that need to be addressed: i) the validity of the Nova classification itself and its definitions, ii) the mechanisms underlying effects of UPFs on health and, iii) unintended consequences that might arise by the use in policy-making of a classification that has not been validated for purpose of use and is not yet uniformly accepted.
The elegant editorial by Forde which accompanied the consensus meeting report, welcomed the willingness of the meeting to go beyond repetitive scientific arguments about the pros and cons of individual association studies that has tended to dominate the debate so far. The editorial emphasises the need for mechanistic studies to test the wide variety of mechanisms put forward to explain the health effects of processed foods, but which as yet remain largely unexplored.
In the Academy of Nutrition Sciences’ first peer reviewed Position Paper on the ‘Evidence Base in Nutrition’, we described how advances in methodology for epidemiological association studies had enabled causal criteria, including consistency of findings, large effect sizes and dose responses to be accurately determined. However we noted that ‘biological plausibility’, also considered an important causal criterion, requires testable mechanistic studies which, when available, can provide support to the possibility that observed associations from epidemiological studies reflect causal relationships. For this reason our Position Paper, and a related paper, included recommendations that more emphasis be placed on the use of high quality mechanistic findings in policy-making in the area of diet and health.
As noted in the BNF consensus meeting report (Lockyer et al), there has been much debate about the strength and consistency of findings from association studies of UPFs and health and the lack of data from randomised controlled trials (RCTs). Supporters of the UPF approach argue that observed associations from epidemiological studies already provide compelling evidence for adverse effects of processed foods on health, with urgent public health action needed now. They consider that findings from two recent studies of UPFs and cancer (Chang et al 2023, Kliemann et al 2023), which show 10% increments (or decrements) in UPF consumption to be associated with differences in risk of cancers in the region of 2-27%, and other reported associations of UPFs with type 2 diabetes and cardiovascular diseases of similar magnitudes, could explain between- and within-country differences in rates of diet-related diseases.
However, another viewpoint articulated by Forde considers the present status of nutritional epidemiology research discussed by Lockyer et al. in Nutrition Bulletin to be insufficient in quantity, type and quality to justify policy implementation at the present time, with current research findings also unable to provide answers as to what types of intervention are needed. The Academy agrees with this viewpoint and, despite recognising the many advances in research quality of association studies, considers the dietary assessment methods used and the historical nature of the diet records raise particular questions about the accuracy of estimates of habitual consumption of processed foods.
In our first Position Paper we acknowledged the major developments in the field of nutritional epidemiology that have taken place over the past 50 years. Advances in study design and statistical analysis of association studies have reduced problems of bias and confounding, and the use of systematic reviews and meta-analysis have allowed examination of combined data to test evidence for causality of reported associations. Most of the association studies of UPFs and diet-related disease have deployed sophisticated statistical analyses to correct for a wide range of potentially confounding factors (using over 30 different covariates across a number of models), which address issues of confounding and estimates of effect size.
However the elephant in the room lies in the methods used for dietary recording and, in the present context, lack of information on how the estimates of processed food intakes were achieved using diet records completed 10-20 years earlier.
Food frequency questionnaires (and to a lesser extent multiple 24-hour dietary records) can provide reasonable estimates of habitual food and nutrient intakes and are the pragmatic methods of choice in most association studies. However we question whether they can accurately reflect habitual intakes (and compositions) of a wide range of processed foods, eaten both in and out of the home, and over prolonged periods of time when rapid changes in their consumption and composition will have taken place. These types of concern are heightened by noting that, in the UK Biobank studyreported above, although the aim was to record 5 separate 24-hour records, 35% of the participants only collected one 24-hour record, with only 19% providing five records. In another study, the majority of the cohort provided only two 24-hour records. We question whether a dietary record covering 24- or 48-hrs can truly reflect habitual exposure over 10-20 years?
The issue of under-reporting of diet is rarely dealt with in any detail in many of the reports on UPFs (or indeed many other dietary studies). National diet surveys estimate 25% of participants to show under-reporting of energy intakes in the region of 30% and estimates are higher in subjects with high BMI, in women, and for those consuming foods high in fat and sugar. These data indicate a potential for systematic bias in the diet records of consumers who fall into these categories and this may include high consumers of processed foods. Most association studies now deal with this complex matter by stating they remove records from outliers reporting > 5000 kcals/d or < 500 kcals/d as this indicates significant over- or under-reporting (e.g. Chang et al 2023, Kliemann et al 2023, Srour et al 2019). This approach cannot deal with the great majority of under-reporting consumers who fall inside these ‘safe’ values. For example, an individual who reports consuming 2500 kcals/d but under-reports by 25% will actually take ^3,000 kcals/d, which is well within these arbitrary limits. Furthermore any correction factors can at best only ‘correct’ for energy consumption and are not able to account for mis-reporting of specific foods or food types (e.g. high fat foods).
In his editorial, Forde proposed the intractable challenges of association studies in this area require a focus on randomised controlled trials (RCTs) and studies to address the mechanisms underlying the reported associations. The Academy agrees, and considers the present status of the research is insufficient to demonstrate a causal relationship between UPFs and diet-related diseases.
As a starting point we consider an RCT would be a good foundation study, designed along the lines of the DASH study,which was an intervention that examined the effects of fruit, vegetables and dairy products on blood pressure. As with DASH, many outcomes, including circulating markers of nutrition, metabolic status, processed foods consumption and markers of risk of diseases such as diabetes, cardiovascular disease and cancer, could be measured. Controlled metabolic studies for measurement of energy balance, appetite hormones, body composition and postprandial test studies, could be included, as part or separately, from the main RCT. Numbers of participants would need to be large, requiring a multi-centre investigation with need for public and private funding. One of the challenges the Academy recognised in its first Position paper was the lack of funding for nutrition studies of the type described above. This has been exacerbated since the transfer of nutrition from the Food Standards Agency where mechanistic research and RCTs had been well supported.
The risk of unintended dietary consequences of premature policy concerning UPFs is high, given that the classification system itself has been widely criticised for failure to discriminate foods that contribute beneficial nutrition from those that do not, and the proposed mechanisms involved are multiple and mostly under-investigated. The solutions will not be found in repetitive association studies but require a strategic approach to funding of nutrition research that is currently lacking in the UK.
Professor Christine Williams
Some of our posts are designed to share news on a recent development. The aim of others, such as this, is to encourage debate or reflection on controversial issues, focusing on the strength of the evidence base underpinning these issues. Unlike our Position Papers, such articles do not present an official opinion of the Academy or its Members.
Is the focus on environment sustainability risking delivery of micronutrient adequacy?
The aim of simultaneously achieving adequate nutrition for all globally, while protecting our planet and its resources, is far from being achieved. To support human health and wellbeing, the world’s food systems need to produce nourishing food that delivers adequate amounts of the essential nutrients needed to support growth and development and protect against disease whilst, at the same time, operating in a manner that protects planetary resources for future generations. Central to the challenge is that current food systems have adverse environmental impacts that need to be mitigated if crucial planetary resources such as water and biodiversity are to be maintained and climate change controlled.
Recent focus has rested on shifting to a heavily plant-sourced diet. For example, in 2019, the EAT-Lancet Commission proposed a planetary health diet, a set of recommendations for feeding the world’s population in which minimally processed plant-sourced foods predominate and animal-sourced foods are very restricted. However, concern has been expressed about the micronutrient adequacy of such a diet, especially those minerals and vitamins that are present in greater concentrations, and in more bioavailable forms, in animal-source foods. A new analysis led by the Global Alliance for Improved nutrition (GAIN) addresses some limitations of the EAT-Lancet Commission’s nutrient adequacy assessment, including its exclusive use of a food composition database not representative of global diets, the way in which food sub-group nutrient data was aggregated, lack of consideration of bioavailability for iron and zinc, assumptions used for calculation of energy requirements, and failure to take into account the higher iron requirements of women of reproductive age.
The new assessment of micronutrient adequacy of the EAT-Lancet Commission’s diet makes use of harmonised nutrient reference values proposed in 2020 and focuses on six micronutrients that are commonly insufficient globally, four of which they considered to be challenging to consume in adequate amounts when reducing the consumption of animal source foods – vitamin B12, calcium, iron and zinc. In addition, vitamin A and folate were also included as low intakes are prevalent. A globally aggregated food composition database was built from existing regional and national sources, with each food group comprising multiple individual foods in commonly consumed forms, and which also included three new foods groups not included in the original analysis. Bioavailability of iron and zinc was taken into account in the new assessment because of the potential impact of high phytate content of the planetary health diet on absorption and the low amounts of animal source foods. This analysis indicates that, for adults, estimated intakes of B12, calcium, iron and zinc were below the recommended levels. For women of reproductive age, estimated iron intake from the diet was just 55% of recommended level.
The proposed strategies from the authors for filling the micronutrient gaps, without relying on fortification or supplements are: increasing animal-source foods from the current level in the EAT-Lancet diet of 14% of energy to 27%, reducing dietary phytate by almost half to improve zinc and iron absorption, and allowing a 3:1 ratio of whole to refined grains. Such a focus on minimally processed, intrinsically nutrient-dense foods that are ‘more than the sum of a handful of well known nutrients’, provides the additional benefit of an abundance of other compounds bound within a food matrix, which can together benefit metabolism and health through, for example, nutrient absorption, satiety and the immune system.
As detailed in the paper, these modifications to the EAT-Lancet Commission’s planetary health diet would increase its content of tubers and starchy vegetables, refined grains and seeds, fish, shellfish, eggs, meat (including beef) and poultry. To accommodate these changes, whilst still meeting the nutritional parameters set, the revised diet would include less pulses, nuts and wholegrains (which can be high in phytate). Compared with estimated current intakes of animal-source foods globally, this transition would still imply a decrease in intakes of red meat in many countries, alongside modest increases in eggs, fish, shellfish and dairy products, on average, globally. This transition is consistent with analyses of other diet optimization scenarios.
A new report from the FAO (the Food and Agriculture Organization of the United Nations) also raises the issues of delivery of essential micronutrients and makes a case for meat (unprocessed), eggs and milk as an ‘essential source of nutrients’. Following its analysis of 500 scientific papers and some 250 policy documents, the report concludes that these foods can help with meeting global nutrition targets set for 2025 and the Sustainable Development Goals related to reducing stunting and wasting among children under five, low birthweight, anaemia in women of reproductive age, and obesity and non-communicable diseases in adults.
In particular, the FAO report highlights the contribution these foods can make to intakes of bioavailable iron, zinc and calcium, selenium, vitamin B12, choline and various bioactive compounds such as taurine and carnitine. Globally, more than 1 in 2 preschool children (372 million) and 1.2 billion women of child-bearing age suffer from a lack of at least one of three micronutrients: iron, vitamin A and zinc. FAO advises that governments should promote the benefits of sourcing foods from land-based animals, alongside efforts to tackle challenges linked to livestock, including environmental issues.
The paper from GAIN stresses that human health and environmental preservation are integrally linked and acknowledges that trade-offs are almost inevitable, and that future policy making and programme planning need to be informed by context-specific solutions using locally relevant data. It poses several important questions that require a unified approach across society, governments, academia and civil society: (i) should intrinsically nutrient-dense foods be prioritized at the expense of the environment? (ii) should fortification and supplementation be prioritized at the expense of a diet comprising primarily intrinsically nutrient-dense foods? (iii) is environmental preservation prioritized at the expense of nutrient adequacy? and (iv) is minimising risk of non-communicable diseases prioritized at the expense of optimizing nutrient adequacy, or vice versa?
The Academy of Nutrition Sciences believes these recent contributions highlight the urgent need to consider human nutrition in tandem with strategies to transform food systems to manage their environmental impacts. Nutritionists (animal and human), agronomists, food scientists and environmentalists must work together to achieve such a transformation.
The importance of transparent frameworks for the assessment of evidence
The Academy of Nutrition Sciences has a strong interest in nutrition research excellence, development of the nutrition science discipline and application of rigorous nutrition science for public benefit. In 2020, it published its first Position Paper that addresses the evidence base underpinning dietary advice for populations for the prevention of non-communicable diseases such as cardiovascular disease and cancer. The paper summarizes the nature of the evidence base and the systematic processes used by expert panels to ensure rigor, relevance and consistency are brought to their conclusions. Accompanying editorials, highlighting the Academy’s recommendations, can be found in Nutrition Bulletin and the Journal of Human Nutrition and Dietetics.
The Position Paper also addresses some of the challenges inherent in studying diet-disease relationships and lessons learned over the past 45 years of evidence-based policy-making in dietary prevention of such diseases. One such challenge is investigation of the biological mechanisms underlying diet-disease relationships through experimental studies. Although mechanistic studies are considered as part of expert evaluation, a systematic process to assess the rigor, relevance and consistency of the overall findings is lacking. A recent publication by one of the Position Paper’s authors, Prof Christine Williams, considers why systemizing mechanistic data is so challenging and the topic is explored in a blog published by the Academy in November 2022.
Identification of plausible biological mechanisms is also a consideration in the authorization process for health claims and the Nutrition and Health Claims Regulation is the focus of the Academy’s second Position Paper on the use of nutrition evidence, published in November 2022 in the British Journal of Nutrition, focuses on the Nutrition and Health Claims Regulation. A blog discussing why health professionals need to know about the processes in place to regulate the use of such claims has been published on the Academy’s website and accompanying editorials appeared in Nutrition Bulletin and the Journal of Human Nutrition and Dietetics. These editorials summarise the recommendations and highlight the implications of the Regulation for nutrition and dietetic professionals.
Transparency in the way in which evidence is evaluated systematically and scientific opinions are reached is now seen as fundamentally important, and expert panels often publish the approaches they adopt. In the UK, SACN is the expert panel that provides independent scientific advice to the four UK governments on, and risk assessment of, nutrition and related health issues. In February 2023, SACN published an updated version of its framework and methods for the evaluation of evidence. The Academy welcomes the revised framework but notes the approach used for evaluation of mechanistic data lacks reference to the systematic selection and quality assessment of the available evidence base, referred to above
Also, in March 2023, a first iteration of the framework developed by the UK Nutrition and Health Claims Committee (UKNHCC) was published. UKNHCC was established following the UK’s exit from the European Union to provide scientific advice to the UK government on the substantiation of scientific evidence underpinning nutrition and health claims applications. Using these scientific opinions, the UK government and devolved administrations make decisions on whether to authorise use of particular nutrition and health claims.
These two frameworks have been developed with particular tasks in mind, namely to provide transparency on the approaches adopted by particular expert committees. But, in addition, they provide a wealth of useful information about methodological consideration when assessing the quality of different types of evidence, including risk of bias within the data and interpretation of statistical methods.
The Scientific Advisory Committee on Nutrition (SACN) has now published its annual report for the calendar year 2022
The Scientific Advisory Committee on Nutrition (SACN) has now published its annual report for the calendar year 2022.
This report provides a summary of the work of SACN and its working groups and subgroups, along with details of members’ declarations of interest and their biographies. It also includes updates on SACN’s various workstreams as well as its horizon scanning activity.
In addition to its annual report, SACN has also updated and now published its framework and methods for the evaluation of evidence.
Click here to read the full report.
Bonfire of EU Laws: FSA chair applauded for highlighting implications for food safety and public health of the Brexit Freedoms Bill
At the heart of the work and ethos of the Academy of Nutrition Sciences is promotion of an evidence based approach to the setting of food standards and public health policy.
Many of us may have thought the proposed ‘Bonfire of the EU Laws’ held little significance for those working in the area of food and nutrition. However this is not the case since many of the existing laws governing food and feed safety and nutrition are at risk of being removed before any new legislation is developed. The Trustees of the Academy therefore applaud the approach being taken by the FSA’s Chair, Professor Susan Jebb, to highlight the adverse implications of the current timetable for establishing domestic legislation following Brexit, with sunsetting of any EU regulations and directives not already replaced by new domestic laws by the end of 2023.
We agree there are profound implications for food safety and public health if this complex process is rushed. Whilst the UK’s exit from the EU provides an opportunity to review and reform existing legislation, which was retained for continuity at the point when the UK left the EU, there is a considerable risk that undue haste, particularly in the current climate, will result in ‘throwing the baby out with the bath water’.
We agree with the FSA that being outside the EU provides an opportunity for a “comprehensive rethink, tailored to the needs of the UK”, and that “developing policy in an evidence-based, open and transparent way is better for consumers and for businesses, but this takes time to get it right”.
Context to the review of food legislation
In summary, the UK voted to leave the EU, its nearest and biggest trading partner, in 2016 and officially left on 31 January 2020. However, both sides agreed to keep many things the same until 31 December 2020, to allow enough time to agree terms for a new trading deal.
From 1 January 2021, EU regulations and tertiary legislation, including those relating to general food law and to nutrition, were retained as UK law, in accordance with the European Union (Withdrawal) Act 2018. Retained EU law includes over 2400 pieces of law across 300 policy areas and 21 sectors of the economy (The Retained EU Law (Revocation and Reform) Bill 2022 - GOV.UK (www.gov.uk). An interactive dashboard tool is available that illustrates the status of existing Retained EU law across government departments and by topic Retained EU law dashboard - GOV.UK (www.gov.uk)
The Retained EU Law (Revocation and Reform) Bill will automatically ‘sunset’ all Retained EU law on 31 December 2023 unless Ministers have decided to extend, preserve or replace each individual piece of legislation. This means that any remaining Retained EU laws with be repealed automatically. The aim of the legislation is to enable the UK government to create regulations tailor-made to the UK’s own needs, cutting red tape and supporting businesses to invest, stimulating economic growth across the UK economy. However, the timeframe for establishing new domestic law represents a challenging task for those advising Ministers, as outlined by Prof Susan Jebb (Chair's stakeholder update - Food safety must be carefully considered in Brexit Freedoms Bill | Food Standards Agency).
It is understood that the Food Standards Agency (FSA) has responsibility for more than 800 pieces of law covering food and feed safety and standards in England, this includes legislation covering the safety of novel foods and ingredients, animal feed products and genetically modified products. Feed and food safety and standards are devolved matters in the UK. The FSA has produced a guide to food and feed law (food-and-feed-law-guide-july-2020.pdf ).
In relation to nutrition legislation, the Nutrition (Amendment etc.) (EU Exit) Regulations 2019 and the Nutrition (Amendment etc.) (EU Exit) Regulations 2020 transferred responsibilities and functions to legislate, in respect of nutrition legislation, from the EU Commission to the competent authorities in Great Britain (GB), including the devolved nations. Nutrition related legislation includes that related to nutrition labelling, nutrition & health claims, addition of nutrients to foods/ fortification, food supplements, and foods for specific groups. More details can be found at Nutrition legislation information sheet - GOV.UK (www.gov.uk). Under the terms of the Protocol on Ireland/Northern Ireland (NIP), EU law continues to apply for goods produced or sold in Northern Ireland, including most food and feed law.
Pertinent work from the Academy
In offering our support to the FSA’s position, we advised that the Academy has very recently published a Position Paper in the British Journal of Nutrition that considers the regulation of nutrition and health claims, around the world but with a specific focus on Europe (Nature of the evidence base and strengths, challenges and recommendations in the area of nutrition and health claims: a position paper from the Academy of Nutrition Sciences | British Journal of Nutrition | Cambridge Core).
The Position Paper summarises current health claims regulations for the EU and GB, with comparisons to approaches used by other countries where different levels of claims are permitted (e.g. so-called ‘qualified claims’ that require less robust substantiation in the USA and the self-substantiation option that operates in Australia & New Zealand). The Academy Position Paper emphasises the strengths of the current UK approach used to determine authorisation of health claims and the learnings gained through the implementation of the European Food Safety Authority (EFSA) evidence-based process for assessment of proposed claims, and the corresponding risk assessment process that is now undertaken independently in GB by the UK Nutrition and Health Claims Committee (UKNHCC). It also identifies aspects of risk assessment/ management that may warrant review and potential reform, making recommendations that focus on remaining challenges for nutrition science, consumer understanding and for key stakeholders, including practising health professionals.
An important part of the EFSA approach to ensuring public safety from unfounded health claims for novel foods, new to the market, is the separation of safety from efficacy. Thus, putting a new food onto the market occurs in two phases; the first demonstrating that the food is safe, and then the second showing that the food has an effect on a biomarker for disease. These two stages can be carried out in parallel, but that both are achieved is essential for public health and wellbeing. We consider that this approach is effective and, indeed, in the UK we have the structure in place to achieve this, with the Advisory Committee on Novel Foods and Processes (ACNFP) running in parallel with UKNHCC.
The Academy has also published a Position Paper focused on the nature of the evidence base used in nutrition science and frameworks underpinning dietary recommendations for prevention of non-communicable diseases such as cancers and cardiovascular diseases (http://dx.doi.org/10.1017/S0007114520005000). The Academy considers that these two publications together provide a useful basis for consideration of the governance of closely linked activities such as food safety and food efficacy in terms of nutrition.
It is also important that the UK has a robust system of regulation and standards for animal feed ingredients. While recognising that consumption of animal-derived foods, as a proportion of total food consumed, is likely to decline in coming decades in line with dietary recommendations for health and environmental impact, it is vital to ensure the sustainability of the remaining livestock sector, not least because of the nutrient dense nature of such foods. In the post-Brexit era, opportunities exist for the UK to utilize its internationally-recognised strengths in food and feed technologies to address this challenge. These include development of animal feed with a lower environmental impact and human-edible protein sources using novel ingredients, which are expected to include novel plant sources, insects and single cell organisms, and potentially the use of novel technologies. In this context, transparent, evidence-based and fit-for-purpose legislation will be vital to ensure the health and welfare of both livestock and consumers, and to support growth of UK business.
The Academy strongly supports the FSA’s call for a realistic time frame for the important programme of work required to determine whether individual pieces of Retained EU Law (REUL) should be preserved, extended or replaced. We also support the idea of integrating all pertinent legislation into a new UK Food and Feed Bill.
The ANS proposes a call to action for development of systematic approaches to assess quality and relevance of mechanistic research in the development of nutrition policy.
Academy of Nutrition Sciences (ANS) warmly welcomed the BBSRC’s new response mode funding Spotlight initiative, which will focus on proposals which help to build a stronger understanding of the biological basis underlying effects of nutrition on human health (BBSRC launches new responsive mode spotlight pilot – UKRI).
This considers mechanistic research in nutrition to be vital in providing evidence of causal relationships between diet and health and central to the formulation of effective public health policy in nutrition..
However, the policy relevance of many cell and animal mechanistic studies is frequently questioned because of insufficient attention given to key aspects of study design. It is certainly the case that compliance to experimental diets can be more readily assured, and measured more accurately, in cell and animal models compared with humans. Nevertheless the literature includes many examples where extreme dietary exposures, which are unfeasible or potentially harmful in humans, are fed. Lack of relevance of the models themselves, or unfeasibility of the diets, means the data have limited applicability in making policy recommendations for human populations.
A challenge raised in this blog is whether such studies should continue to be funded where extrapolation of the data to humans, and consequent impact on human health, is known at the outset to be low? Is there opportunity to strengthen the value and impact of cell and animal research to human nutrition?
The first Academy paper in the Evidence-base series (Nature of the evidence base and frameworks underpinning dietary recommendations for prevention of non-communicable diseases: a position paper from the Academy of Nutrition Sciences | Semantic Scholar) emphasised how research in nutritional epidemiology has been strengthened by the development of methods and criteria for systematically selecting and assessing the quality, consistency and relevance of epidemiological findings to human diet-disease relationships. This approach has not only improved the quality and consistency of findings but is also widely used by groups working in nutrition policy.
Could similar approaches be used to enhance the relevance of mechanistic research? A recent review in the Proceedings of the Nutrition Society (https://www.doi.org/10.1017/S0029665122002750) emphasised the importance of mechanistic research in nutrition and its potential to confirm the causality of relationships shown in observational epidemiological studies. The review described early findings from a series of studies conducted by a group of diet and cancer researchers in Bristol and was funded by the World Cancer Research Fund. Their aim was to develop and validate a systematic framework for selecting, assessing and integrating data from cell, human and animal studies in the area of diet and cancer (https://www.semanticscholar.org/paper/Developing-the-WCRF-International%2FUniversity-of-for-Lewis-Gardner/a99c0eccea144e5b58a36df60055b6594e8bba35 ).
The proposed framework has demonstrated valuable early findings but also a number of significant challenges which include the heterogeneity of within and between species data and lack of agreed standards and criteria for cell and animal work involving diet.
As a nutrition community, should the challenge of defining agreed standards and criteria for cell, animal and human mechanistic research be a greater priority for us than has been the case to date?
Funding for human nutrition research – past successes and future opportunities
When it comes to funding of human nutrition research in the UK, the Diet Research Industry Club (DRINC), led by the Biotechnology and Biosciences Research Council (BBSRC) has been a success story. A particular feature of DRINC has been its public-private nature – a genuine collaboration between a publicly funded research council and a consortium of food businesses. The structure of DRINC is described in an editorial published this month (Buttriss 2022; The BBSRC‐DRINC Research Programme: Successes and future perspectives - Buttriss - Nutrition Bulletin - Wiley Online Library), which accompanies a curated Virtual Issue of Nutrition Bulletin that draws together over 20 papers published in the journal describing research funded through the DRINC process (https://onlinelibrary.wiley.com/doi/toc/10.1111/(ISSN)1467-3010.BBSRC-DRINC-Research-Programme). All of the included papers are ‘free to read’.
The Academy of Nutrition Sciences notes that the DRINC initiative has now come to an end, to be succeeded by the Diet and Health Open Innovation Research Club (Diet and Health Open Innovation Research Club: Innovation Hubs – UKRI), positioned to respond to future industry challenges, and to meet policy aims across UK Government and the Devolved Administrations. It was referenced in the Government’s Food Strategy published in June 2022 (Government food strategy - GOV.UK (www.gov.uk)). A summary of the aims of the two-phase initiative can be found in the editorial mentioned above (Buttriss 2022). The successful hubs are expected to be announced shortly.
A further opportunity for researchers in the field of human nutrition is a one-year spotlight on human nutrition (BBSRC launches new responsive mode spotlight pilot – UKRI). But those interested will need to get their skates on as it will run only until October 2023. The theme of the spotlight is ‘building stronger biological understanding of the role of nutrition on human health across the life course’, and is one of three spotlights in a new responsive mode spotlight mechanism that will be active for one year (i.e. over the next three responsive mode rounds), from October 2022. BBSRC is piloting this new funding mechanism to better signal and communicate areas of strategic interest to the bioscience community.
Nutrition scientists have for some time been calling for a greater focus on human nutrition in funding programmes. Research is the cornerstone of practice in nutrition and dietetics, and of well-grounded food policy - robust research is crucial to understand the origins, mechanisms and management of nutrition-related diseases. The Academy of Nutrition Sciences encourages the nutrition science community to rise to the challenge afforded by this one-year pilot, stressing the importance of interdisciplinary research in the context of BBSRC’s 5-year strategy Forward Look for UK Bioscience (ukri.org).
The Academy of Nutrition Sciences welcomes the nutrition spotlight mechanism for research funding
The Academy of Nutrition Sciences welcomes the nutrition spotlight mechanism for research funding announced by BBSRC (the Biotechnology and Biological Sciences Research Council) yesterday (19 October 2022). BBSRC launches new responsive mode spotlight pilot – UKRI
Nutrition, specifically ‘building stronger biological understanding of the role of nutrition on human health across the life course’, is one of three spotlights in a new responsive mode spotlight mechanism that will be active for one year (i.e. over the next three responsive mode rounds), from October 2022. BBSRC is piloting this new funding mechanism to better signal and communicate areas of strategic interest to the bioscience community.
BBSRC’s stated purpose is ‘to support research, innovation, people, infrastructures and partnerships to advance the frontiers of biology and drive towards a healthy, prosperous, and sustainable future. Its unique remit enables us to bring together different communities and sectors, e.g. acting as a nexus for interdisciplinary research that links agriculture (crops and livestock), food, diet, nutrition, and health to plant-based bio-materials, food security, environmental sustainability, and biodiversity, as a highly interconnected system’ - see BBSRC Strategic Delivery Plan 2022-2025 (ukri.org).
Research is the cornerstone of practice in nutrition and dietetics. Robust research is crucial to understand the origins, mechanisms and management of nutrition-related diseases. The Academy of Nutrition Sciences encourages the nutrition science community to rise to the challenge afforded by this one-year pilot, and stresses the importance of interdisciplinary research in the context of BBSRC’s 5-year strategy Forward Look for UK Bioscience (ukri.org).
The Academy also highlights the importance of reciprocal engagement between nutrition scientists and the BBSRC’s peer review process for grant applications, including Panel memberships, to ensure the right balance of skills is available to BBSRC.
Vitamin D: One hundred years on
The year 2022 will feature in history books for a number of reasons; but in the world of nutrition, it marks the Centenary of the landmark investigation by Dame Harriette Chick and her co-workers. Exactly 100 years ago, working with malnourished children in a clinic in Vienna (Austria) shortly after the First World War, they showed that rickets in children could be prevented or cured by cod-liver oil supplementation. Cod liver oil was subsequently recognized as a particularly rich source of vitamin D (Chick et al. 1922).
A century later, vitamin D remains at the forefront of research and a specially curated Virtual Issue of Nutrition Bulletin, available free-to-access online at Vitamin D: 100 years of research - 1922-2022: Nutrition Bulletin (wiley.com) has drawn together 14 papers published in the journal over the past 10 years on the topic. Included among these is an editorial (Buttriss & Lanham-New 2022) which summarises the history of vitamin D over the last century.
Dame Harriette Chick was awarded the British Nutrition Foundation (BNF) Prize in 1974 for her contribution to nutrition research. By then already a Centenarian, she chose her ground breaking research on vitamin D in Austria, 50 years previously, as the theme for her BNF Annual Lecture (Chick 1976), presenting the chemical, clinical and sociological aspects of her story. Dame Harriette worked at the Lister Institute of Preventative Medicine, London, UK from 1905 to 1970, and she and colleagues were sent to Vienna by the Accessory Food Factor Committee of the Medical Research Council to investigate whether the diseases affecting the population were the result of vitamin deficiencies.
Over the past century, many researchers – far too many to mention here – have contributed to our current understanding of vitamin D and its role as a pro-hormone. Notable among these was a British doctor, Dr Edward Mellanby (Mellanby 1919), who had become concerned about the very high incidence of rickets in the UK, especially in Scotland. Following a series of trials, Mellanby realised that puppies fed a diet based on the oatmeal-rich Scottish diet (and coincidentally housed indoors), developed rickets which could be prevented or cured by the addition of cod liver oil. Mellanby concluded that it “seems probable that the cause of rickets is a diminished intake of an anti-rachitic-factor which is either fat-soluble factor A”, (later known as vitamin A) “or has a similar distribution”.
Again in 1922, a key experiment by McCollum and co-workers (McCollum et al. 1922) showed that heated, oxidized cod liver oil could cure rickets in rats but could not prevent xerophthalmia (now known to be a symptom of vitamin A deficiency). The antirachitic factor was given the name vitamin D (as B and C had already been used for water-soluble factors and the anti-scurvy factor, respectively).
Meanwhile, an entirely different cure for rickets had emerged, namely ultraviolet (UV) light. It had long been acknowledged that fresh air and sunshine were effective in the prevention of rickets, and in 1921 it was proposed that the seasonal incidence of rickets was due to seasonal variations in sunlight exposure (Hess & Unger 1921). Support for this was evident in the work of Chick et al. in Vienna, who observed that sunlight would cure rickets in young children just as well as cod liver oil (Chick et al. 1922). Using X-ray analysis, Dame Harriette and her co-workers showed conclusively that rickets had a marked winter incidence; that protection against its development in young children in winter could be achieved by diet (none of the infants given cod liver oil developed rickets) and that infants in the first 6 months of life were particularly susceptible to rickets.
In his 1973 BNF Prize Lecture, Dr Egon Kodicek (a researcher in Cambridge) described how understanding of the role of UV light, in converting a precursor of vitamin D in the skin into an active form of the vitamin, followed on a few years after the work in Vienna. He also summarized work by himself and others, over the following 50 years, that built on these important discoveries a century ago (Kodicek 1974a; Kodicek 1974b). In 1969, a specific binding protein for vitamin D, the vitamin D receptor, was identified and the metabolism of vitamin D in the liver and kidney to its active forms was elucidated. It was Fraser and Kodicek (1970) who demonstrated the conversion in the kidney of the liver-hydroxylated vitamin D metabolite, 25-hydroxy vitamin D3 (25-OH-D3), to what was later identified as calcitriol (1,25-(OH)2D3) (Holick et al. 1971).
In a relatively recent historical overview, Professor Hector DeLuca from Wisconsin University (USA) (DeLuca 2008), summarizes keys discoveries such as the conversion of vitamin D to its hormonal form, its regulation and the evolving picture of its molecular mechanism of action. He discusses how it has long been recognized that calcitriol circulates as a hormone in the blood, regulating the concentrations of calcium and phosphate in the bloodstream and promoting growth and remodelling of bone. Furthermore, over time, evidence continues to emerge to show that vitamin D’s role extends far beyond mineralization of the skeleton to include, for example, muscle function, the immune system, and treating the skin disorder psoriasis (see Lanham-New et al 2022).
During the coronavirus pandemic, vitamin D’s role in the immune system (Hewison 2012; 2022) was explored in considerable depth by researchers as well as policy makers (Lanham-New et al. 2020), in part triggered by the higher incidence of extreme coronavirus symptoms in communities recognised to be at greater risk of lower serum vitamin D concentrations. A paper in Nutrition Bulletin (and included in the Virtual Issue) by Gibson Moore (2021) provides a summary of work in this area.
These developments in understanding the role of vitamin D, which began more than a century ago, underpin the science that supports policies to tackle the incidence of rickets that continue to this day. Progress is brought right up to date in a summary of a ‘hot topics’ workshop held in 2021 (Lanham-New et al, 2022; available in the Virtual Issue).
A longer version of this article (Buttriss & Lanham-New 2022) – link below - outlines the success (or otherwise) of efforts to eradicate rickets and improve vitamin D status over the past 100 years, summarising current UK government policy and the Department of Health’s call for evidence on strategies to improve intakes and health disparities, and the on-going challenges and options for future public health strategies in relation to vitamin D, including new government legislation allowing gene editing (e.g. vitamin D enriched tomatoes). The paper also provides a flavour of the vitamin D papers published in Nutrition Bulletin over the past 10 years; the full papers can be accessed in the Virtual Issue at Vitamin D: 100 years of research - 1922-2022: Nutrition Bulletin (wiley.com) and a longer version of this blog is here Vitamin D: One hundred years on - Buttriss - Nutrition Bulletin - Wiley Online Library
Fact sheets for the general public on vitamin D are available from the British Dietetic Association (BDA) - Vitamin D | British Dietetic Association (BDA) – and from the British Nutrition Foundation (BNF) – Vital vitamin D! vitalv-3.pdf (nutrition.org.uk)
AUGUST 11, 2022
Balancing the global protein economy is more than just switching from animal-based to plant-based foods
from sewage in the USA, protein quality in Malawi to vulnerable older people here in the UK
There has been increasing recognition that the production of dietary protein is having deleterious impacts on the environment. In addition, there is evidence that high consumption of some animal-based protein sources, particularly red and processed meat, impact on risk of developing various chronic diseases, particularly colorectal cancer. These concerns were reflected in Henry Dimbleby’s recommendations for a national food strategy, published last year1, which referred to ‘a protein transition’ which included:
· Investment in technology to reduce methane production in ruminants
· Investment in alternative proteins that can replace some animal products
· Nudging consumer behavior through industry action and public sector procurement.
In June, the UK government’s response to Dimbleby’s recommendations2 highlighted ongoing investment in alternative protein research, the value of British grown pulses and beans and briefly mentioned non-traditional livestock protein sources. Such a response perhaps under-estimates the scale of the transition needed, with the most recent NDNS data3 showing that UK adults (19-64y old) currently on average obtain 59% of their protein intake from animal sources, 24% from cereals and only 8% from vegetables (the remaining 9% coming from ‘other’ sources)’.
It is also important to consider global issues in protein production and consumption. Two recent publications have highlighted very different issues in different parts of the globe, one of excess quantity of protein intake (and environmental impact) and one of inadequate protein quality (and health impact).
The first study shows nitrogen pollution of water supplies could be reduced in the United States with lower protein consumption4. Protein consumption in the United States, from both plant and animal sources, ranks among the highest in the world. When a body takes in more protein than it needs, excess amino acids are used as an energy source and their nitrogen-based breakdown products excreted in urine, which are released through the wastewater system.
The second study estimates that in Malawi the protein consumed is often of relatively low quality, associated with a high risk of lysine deficiency in the poorest households5. The study showed that the poorest households in Malawi obtain 80% of their dietary protein from cereal crops, predominately maize, which is known to be relatively poorly digestible, with low concentrations of specific essential (indispensable) amino acids, in particular lysine.
But what about the situation in the UK? Closer to home, there are also potential problems in providing sufficient high-quality protein for our ageing population. There is increasing recognition that as we age, protein requirements increase. Deficient intakes, coupled with reduced exercise, increase the likelihood of muscle wasting and sarcopenia. The reference nutrient intake (RNI) for adults currently stands at 0.75 g/kg body weight per day which equates to 56 g/day and 45 g/day for men and women (assuming body weights of 75 and 60kg respectively). NDNS data indicates that mean protein intake in 75+ year-old males is 68.8g/d and for females 59.2/g.
However, recent research is suggesting that intake should be considerably higher in older age groups and, even in healthy individuals, intake should be increased to between 1.0-1.2 g/kg6. Taking a value of 1.1 g/kg, this would equate to an increase in requirements of this age group to 82.5 g/d and 66.0 g/d for men and women respectively, both (particularly for men) above the average current intakes in this age group. The wide range of current intakes, including low intakes, is also noteworthy in this context. Furthermore, a shift from animal- to plant-derived protein sources, without access to a wide range of plant sources with complementary indispensable amino acid profiles, may decrease the overall quality of the protein consumed in terms of both indispensable amino acid consumption and digestibility. With the 75+ age group, which currently obtains 62% of protein from animal-derived foods (and a further 24% from cereals), set to increase by 75% by 20507 in the UK (with similar rises in many high -income countries), this highlights the caution that must be taken in ensuring any transition of our food systems is mindful of the needs of the most vulnerable in our societies.
The Academy of Nutrition Sciences (ANS) recognizes the need to diversify our choice of protein sources and reduce our dependence on animal products as a primary source of protein. For some individuals this could simply mean consuming less meat (with little need to replace this with anything else as protein intakes are already adequate). However, the ANS is acutely aware that the high-quality-protein provided by meat, and other animal derived foods – milk and dairy products, fish and eggs - will remain a vital part of the diet of vulnerable individuals, within both low- and high-income countries, and that in the poorest parts of the world consumption is likely to increase. Therefore, in addition to changing human diets to better align them with both healthy eating and sustainability guidelines, further efforts are required to improve the environmental impact of livestock production. In addition to the methane reductions highlighted by Dimbleby, other strategies include replacement of human-edible crop sources of protein (such as wheat, maize and soya) as ingredients of animal feed, which represents almost 50% of global production, with alternative and more sustainable protein sources such as single-cell organisms and insects. While industries producing these are appearing, there is an urgent need for further research to ensure the safety, affordability and sustainability of such alternatives.
Our food systems need to change, and this includes a reduction in our dependence on animal-derived foods, in high-income societies in particular. However, the issues highlighted above demonstrate that this should be done cautiously, with due regard to the most vulnerable. While recent years have seen significant shifts toward vegan and vegetarian diets, 86% of individuals still eat meat in the UK. There needs to be a realistic acknowledgement that animal products will remain a fundamental part of our diet for decades to come, but much could be done to improve the sustainability of livestock production. It is not simply a case of swapping beef burgers for plant burgers.
1) https://www.nationalfoodstrategy.org/
2) https://www.gov.uk/government/publications/government-food-strategy/government-food-strategy
4) https://esajournals.onlinelibrary.wiley.com/doi/10.1002/fee.2531
5) https://www.mdpi.com/2072-6643/14/12/2430
6) https://www.mdpi.com/2072-6643/10/3/360/htm
7) https://population.un.org/wpp/
Professor Andy Salter, University of Nottingham
Government Food Strategy recognizes that nutrition and sustainability are interrelated and need to be tackled together
The Government’s Food Strategy (for England), published on 13 June 2022, takes a long-term focus to ‘support a resilient, healthier and more sustainable food system that is affordable to all’, and is complementary to other recent government initiatives. The objectives for this Food Strategy are to deliver:
1. A prosperous agri-food and seafood sector that ensures a secure food supply in an unpredictable world and contributes to the levelling up agenda through good quality jobs around the country.
2. A sustainable, nature-positive, affordable food system that provides choice and access to high quality products that support healthier and home-grown diets for all.
3. Trade that provides export opportunities and consumer choice through imports, without compromising our regulatory standards for food, whether produced domestically or imported.
It also emphasises the importance of collaboration across government and with the devolved administrations, the agri-food sector and civil society; and summarises how the government is supporting children and families on low incomes to learn and eat healthily through various initiatives such as healthy start, free school meals, breakfast clubs and the Holiday Activities and Food Programme (HAF).
The 33 page report (Government food strategy (publishing.service.gov.uk) comprises three main chapters, that focus on:
· Food security and sustainable production
· Healthier and sustainable eating
· The UK as part of a global food system.
The Academy of Nutrition Sciences is pleased to see recognition in the White Paper that nutrition and sustainability are interrelated and neither should be tackled in isolation, and that attention is to be given to mitigating the environmental impact of conventional protein sources as well as innovation of plant-derived sources. Also particularly welcomed are: the announcement about the Food Data Transparency Partnership to support collation of robust and transparent data; the funding of research to identify evidence based interventions to encourage and enable healthier and more sustainable diets; and the focus on schools.
The Academy plans to respond to formal consultation in due course. In the meantime, aspects that are particularly noteworthy from a nutrition/health perspective are listed below. We look forward to more details over the coming months.
Healthier and sustainable eating
· Health targets: Halving childhood obesity by 2030, decreasing the Healthy Life Expectancy gap by 2030 and adding 5 years to Healthy Life Expectancy by 2035, decreasing the prevalence of diet-related illness and, to support this, increasing the proportion of healthier food sold
· Schools: An ambition of sparking a school food revolution, embedded in a whole school approach to food that focuses on all aspects as well as the curriculum (building on the Levelling Up White Paper, which announced introduction of a suite of measures to improve school food and build a strong food curriculum, including the £5 million school cooking revolution pilot and a new pilot for local authorities to assure school compliance with school food standards).
· Funding for interventions: A programme of randomised controlled trials to develop a suite of evidence based and value for money interventions to encourage and enable healthier and more sustainable diets. Findings will be used to channel resources towards the most effective interventions for largescale and long-term policies to shift diets
· Robust & transparent data: Recognition that nutrition and sustainability are interrelated and neither should be tackled in isolation. In this context, a Food Data Transparency Partnership is to be established to: develop a robust framework for tackling some of the fundamental questions for our food system, increasing transparency and responsibility; and to provide consumers with the information they need to make more sustainable, ethical and healthier food choices, and to incentivise industry to play its part. The Partnership will bring together government, the Devolved Administrations, representatives across the food chain and civil society, to develop consistent and defined metrics to objectively measure health, environmental sustainability and animal welfare. Flowing from this, consumer information will be optimized and based on a set of overarching principles defined by government. This will include mandatory methodology for eco-labels, labelling information on nutrition building on learnings from current front-of-pack labelling, and consideration of improvements to current animal welfare and country of origin labelling. The White Paper states that the work of the Partnership with be joined with existing work across government on healthy food choices, so that government can speak with one voice to industry on these matters. More detail on cross-government working is promised in the future Health Disparities White Paper from the Department of Health and Social Care.
· Public sector food: A consultation is to take place on public sector food and catering policy, with the potential that its scope is made mandatory across the whole public sector, including schools. And that more emphasis is placed on local sourcing and the environment, potentially introducing an aspirational target that at least 50% of food spend must be on food produced locally or certified to higher environmental production standards.
· More research needed: Henry Dimbleby’s 2021 report referred to so-called ‘ultra-processed foods’ in relation to obesity trends. In its White Paper, government comments that more research is still required to determine the exact role of ultra-processed foods in this context.
Food security and sustainable production
This chapter focusses on the government’s strategy to reduce Greenhouse Gas (GHG) emissions and the environmental impacts of the food system, in line with the Government’s Net Zero commitments and biodiversity targets and to prepare for the risks from a changing climate. Points of note include:
· A land use framework will be published in 2023
· Steps to increase self sufficiency in horticulture and seafood. As recommended by Henry Dimbleby, a ‘what works centre’ is being established to share best practice across the industry and to improve the quality of advice on the practical implications for agriculture of goals such as net zero. This will be complemented by the new Institute for Agriculture and Horticulture (TIAH), due to launch this summer, which will help farmers and growers to access the right skills to run professional, sustainable and profitable businesses.
· Support for research and innovation in alternative protein sources
· The White Paper states that sustainable sources of protein do not have to be new or novel or displace traditional sectors. Also that regenerative farming will provide a more sustainable production of traditional protein sources; using livestock to benefit the environment in balance with food production is already being championed by many small-scale farmers. The Farming Futures research and development (R&D) Fund will help the livestock and protein sectors embrace ‘climate-smart farming’ and innovative technologies. To support this, there will be a Call for Evidence to better understand the challenges associated with the use of feed additives and materials that can reduce methane emissions from livestock.
· Support for farmers, e.g. to invest in new equipment where there is scope to boost productivity and to help farmers to identify and develop low carbon farming practices and carbon storage opportunities.
· Ongoing work to reduce food waste and mitigate barriers and bureaucracy associated with legislation post-Brexit.
The UK as part of a global food system
This chapter focuses on strengthening global food security and maximising the benefits of new trade agreements post-Brexit; harnessing export opportunities and supporting our agri-food industry; maintaining our world-leading food and animal welfare standards; and championing a nature-positive global food system.
Transition to more sustainable food systems must be driven by strong evidence-based nutrition
As we approach the Cop26 conference, it is not surprising that the sustainability of our Food Systems is making headlines within the media.
In the statement below, the Trustees of the Academy of Nutrition Sciences acknowledge the urgent need for a transition to more sustainable and healthy food systems. However, they emphasise that such changes:
1. must be built on full nutrition composition data from strong evidence-based nutrition science.
2. must take account the impact on health, livelihoods and wellbeing of the entire global population.
Call to ensure that strategies to sustainably transform global food systems put human health and nutrition at their centre
Cop 26 and Global Net Zero
On 31st October World Leaders will come together in Glasgow at Cop26 to discuss how we are to achieve ‘Global Net Zero’ by 2050. Inevitably, and quite rightly, transforming global food systems to reduce carbon footprint, land use and pollution will be a key topic of discussion. For many, such a transformation is envisaged as a partial move away from animal-derived foods and towards more plant -based diets. While the Academy of Nutrition Sciences is generally supportive of this, we also feel it is vital that all future strategies for transforming our food systems are developed with adequate consideration of strong, evidence-based nutrition science and with due consideration of all demographics of our global population, as well as safety, affordability and accessibility.
Meat in focus
While there is little doubt that both the health and environmental footprint of those eating large amounts of red and processed meat would benefit from a reduction in consumption, for others, these foods in moderation represent an affordable source of high-quality protein and a range of micronutrients, particularly iron and zinc. This includes not only the most economically deprived individuals, but also many of the oldest in our ageing societies. While the UK has clearly seen a movement towards more plant-based diets, as of 2019, 79% of the population still identified themselves as meat-eaters. Nevertheless, consumption of meat, especially red and processed meat, has been falling over the past decade. The recent recommendations for a National Food Strategy from Henry Dimbleby noted that if everyone complied with the 70g/day maximum, consumption of red and processed meat would fall by at least 27%.
Livestock production represents a major source of income for some of the poorest individuals in the world. Of course, the livestock industry does not only produce red meat, but also poultry, dairy products, eggs, fish and other aquatic animals. All these foods generally have fewer negative impacts on human health and represent vital sources of nutrition for many individuals. However, production of each represents a challenge to our changing environments, for example, drawing upon large areas of land for production of feed (and wild aquatic resources for fish feed) and contributing to pollution of our land and waterways. Furthermore, livestock systems are associated with untenable levels of waste, with as much as two-thirds of animal protein lost during production and processing as well as at the retail and consumer level.
Not just about protein
Understandably, the food industry is recognizing growing levels of concern within the general public about the impact of the livestock industry. As a result, we have seen a plethora of meat and dairy alternatives emerge. However, there is a real danger that the public will automatically assume that they not only have a lower environmental footprint but that the nutritional value of such products is at least as good nutritionally as those which they replace. However, of course, this is not always the case. As recognized at a recent BBSRC Food Systems Dialogue (https://summitdialogues.org/dialogue/29617/official-feedback-29617-en.pdf?t=162705701), better information is needed both on the full environmental impact of plant-based alternatives and their nutritional value. There is a significant risk that they will have a poorer nutritional profile, often with reduced micronutrient content, and/or poor digestibility and absorption due to the presence of anti-nutritional factors, and often accompanied by presence of relatively high levels of salt and/or saturated fat. Protein seems to have become the primary focus in product development: yet, in reality, the foods derived from livestock typically deliver a parcel of essential nutrients alongside their protein content.
Full nutrition composition needs more consideration
The Academy of Nutrition Sciences calls for routine consideration of full nutrition composition in life cycle assessments of foods. It fully supports a transformation to more sustainable food systems and accepts that this will include a move away from such a heavy dependence on animal- derived foods. However, this needs to be done cautiously, with full consideration of the requirements of the entirety of humankind, not only our own country, but the world. In high-income countries, it is likely we will see a reduction in the production of livestock for the domestic market, but for the foreseeable future it is important that we maintain viable production systems to support those consumers who remain dependent on them. This must include more sustainable production systems, perhaps drawing on a range of novel feed ingredients, including insects, single cell organisms and food waste, together with introduction of novel land management strategies and, possibly, greater use of biotechnological interventions. Again, nutrition science has a major role to play in establishing such novel practices. Guided by a strong evidence-base, we should ensure an appropriate transition of our food systems. One which makes us less dependent on animal products but continues to provide adequate and safe sources of nutrition to maintain health for all sections of our populations, whilst reducing the environmental impact of food production and consumption.