Communication to Bridge the Gap Between Food Production and Nutrition and Health: Proceedings of a Workshop (2024)
Chapter: 3 Challenges and Successes in Communicating about Food Composition
3
Challenges and Successes in Communicating about Food Composition
The second session, moderated by Rodolphe Barrangou, North Carolina State University, delved into the challenges of communicating about the connection between the nutrient composition of food and the diet quality for consumers at the other end of the food system. While the primary emphasis was on food composition, this session also featured broader presentations and discussions about communication related to food and public health. During their opening remarks and the subsequent panel discussion, speakers addressed the complexity of the food system, specific food components, the population dimension of communication about food, and consumer trust in new technologies and innovation.
COMMUNICATING ACROSS THE FOOD SYSTEM
Michael Grusak, emeritus professor of pediatrics at Baylor College of Medicine, Center Director of the U.S. Department of Agriculture (USDA) Agricultural Research Service (ARS) Edward T. Schafer ARS Center, and Senior Advisor for Precision Nutrition and Cancer Moonshot in the Office of the USDA Under Secretary for Research, Education, and Economics Mission Area, said he believes communication about food composition or food quality is not always clear and consistent across the many groups involved in the food system (Figure 3-1). For example, different groups use various terminologies when they refer to food composition, such as healthy food; nutrient-dense food; vitamin-rich food; low in salt, fat, or sugar; and high in antioxidants. It is important to remember when talking about food crops, Grusak added, that healthy should refer to the nutrients the nutrition
SOURCE: Presented by Michael Grusak on May 30, 2024, at the workshop on Communication to Bridge the Gap Between Food Production and Nutrition and Health.
community deems essential and potentially health-beneficial components, such as bioactive phytochemicals. This understanding, he indicated, is not always clear to consumers or to other actors in the food system.
When addressing communication gaps between the different communities involved in food production, one thing to remember, said Grusak, is that farmers are generally paid on a weight basis, not a nutrient or compositional basis, but food quality can also play a role. In his experience, farmers are interested in producing nutritious, healthy food, but they are not always sure how to get there. Agronomists are studying how management practices can affect food composition and quality while also keeping yield in mind because that is the producer’s common denominator. Similarly, plant breeders are developing varieties that are more nutrient dense or contain higher levels of bioactive phytochemicals while also focusing on yield.
Grusak said the plant science community has found that communicating with the health and nutrition science community is important for understanding and identifying which compounds and nutrients they should focus on in terms of having the biggest effect on consumers’ health and nutrition. The International Food Policy Research Institute’s HarvestPlus initiative to breed staple food crops to be rich in iron, zinc, and vitamin A is an example of the different communities communicating with one another. More efforts such as this are needed, he said.
Another important aspect to consider is the role played by the food industry and food processing in retaining nutrients and the bioavailability of nutrients and bioactives, in addition to the role they play in food safety, said Grusak. Here, food processors need guidance from the health and nutrition community regarding which components are most important for maintaining or enhancing food compositional quality. He noted that
ultra-processed foods are getting a great deal of attention these days as to whether they have nutritional value.
Grusak said food product messaging to consumers provides some level of food composition information, though it is not always presented clearly. He noted, too, that government agencies play an important role in communicating dietary guidelines and food composition information. Examples include the Dietary Guidelines for Americans, USDA’s MyPlate, FoodData Central, and National Institute of Food and Agriculture (NIFA) websites and NIFA’s extension agents, who go into communities to spread knowledge and answer nutrition-related questions. In addition, consumer choice plays a role in determining what farmers and food companies produce, especially in creating higher demand for perishable fruits and vegetables, such as those promoted by USDA’s Gus Schumacher Nutrition Incentive Program, National Produce Prescription Collaborative, and Agricultural Science Center of Excellence for Nutrition and Diet for Better Health program. This consumer choice, he suggested, sends a message back to the food industry and producers that may ultimately result in changes in the nutrition and health of consumers.
NONESSENTIAL BIOACTIVE COMPOUNDS
Daniela Barile, professor of food science and technology at UC Davis, said she and her colleagues are moving away from the reductionist approach of looking at one food component at a time. Instead, they are integrating data from glycomics, metabolomics, peptidomics, and lipidomics to try to understand what is on the consumer’s plate. These technologies, she noted, can help provide a better understanding of the effect of food processing and digestion on nutrient and nonessential bioactive component availability.
Nonessential bioactive components in food, said Barile, have the potential to be beneficial for health. This is important, she said, because obesity, diabetes, and metabolic syndrome are major public health concerns, especially with the early onset of these conditions in young people. Carbohydrates, she said, have been attributed to many of these health problems, especially simple sugars. However, carbohydrates can also have beneficial effects on health, depending on their composition and their structure. Fiber, for example, is a form of carbohydrate that is considered a nonessential bioactive component that could prevent or delay the development of chronic diseases; however, current average dietary fiber intake among U.S. adults is half the recommended intake (UCSF, 2024). “If we close the gap and increase fiber intake, using the right fiber, we could reduce significantly not only diabetes and cardiovascular diseases but also cancer,” said Barile.
Carbohydrates are a heterogenous and complex class of compounds making it a challenge to determine the carbohydrate content of food, Barile
stated. Measuring is done by difference; after using multiple methods to directly measure moisture, proteins, lipids, and minerals individually, the remainder is assumed to be carbohydrate. Besides being inaccurate, she said, this approach is nonspecific and provides no information about the type and structure of carbohydrates in food. Barile noted that some food companies are now putting information about simple sugars and total fiber on food labels by using assays designed to directly measure these components, but there are many more compounds with unique functionalities that are still not being captured.
Barile said this is where foodomics comes in, combining food chemistry, biological sciences, and data analysis. Determining the specific carbohydrates in a food is challenging because of their great diversity in structure and compositions. Recent advances in technologies, such as mass spectrometry, are making it possible to study smaller types of carbohydrates known as oligosaccharides and determine how food processing is damaging or protecting these molecules (Durham et al., 2021). It is also possible now, she said, to use these technologies to measure carbohydrate levels in biological fluids to elucidate the effect of dietary oligosaccharides on human health.
To more fully understand the interactions of food carbohydrates and the gut microbiome, Barile and her collaborators have developed a method to break down polysaccharides into oligosaccharides and obtain a reliable fingerprint and accurate quantification (Bacalzo et al., 2023; Paviani et al., 2024). This technique is time-consuming, but it can be performed with reasonable throughput. “This will help us understand the interaction of the food we eat with our gut microbiome,” said Barile.
She and her colleagues are now depositing quantitative and qualitative oligosaccharide results in USDA’s FoodData Central database, starting with data on the naturally occurring oligosaccharides in plant-based milk products (Huang et al., 2023). They are also profiling pulses (the edible seeds of legumes), mushrooms, and other foods.
THE POPULATION DIMENSION OF COMMUNICATION ABOUT FOOD
Alfredo Morabia, professor of epidemiology at Queens College, professor of clinical epidemiology at Columbia University, and editor-in-chief of the American Journal of Public Health, said he has been tracking the evolution of diet and food and nutrient consumption in the population of Geneva, Switzerland, using a random sampling technique. He noted that the goal of communication is to act at the level of the population given the difficulty of getting meaningful change by working at the individual level. It is one thing to know what individuals eat, but a population approach provides the context and trends over time and how one community differs from another.
Morabia said the first essential element for communicating about diet is to have a rigorous health monitoring system so that we can understand what people are consuming and how it evolves over time. The United States, for example, has the National Health and Nutrition Examination Survey (NHANES), but today’s technologies could allow more intense health monitoring at the population level and attain that information in real time rather than waiting on the two-year release cycle for NHANES data.
The second element, said Morabia, is there are inequities across communities regarding access to dietary information and access to food. Health monitoring, he stated, can provide that information. “If we know what communities are doing in terms of their diet, we can also design interventions,” he said.
The third element is evaluation, and that requires looking at how diet changes over time, which again requires population-based health monitoring. It is critical to measure, he added, to understand the diversity of the diet in a population for an intervention to be effective. “Those are the three elements that I think are indispensable in communicating about food, diet, and nutrients because the population dimension provides a lot of information that is impossible to access at the individual level,” said Morabia. The American Journal of Public Health is trying to enable evaluations by reporting those types of data, though it needs to be standardized and understandable if the goal is to share with the public.
BUILDING TRUST IN INNOVATION
Laura Fernández Celemín, director general of the European Food Information Council (EUFIC), explained that EUFIC is a 29-year-old consumer-oriented nonprofit organization whose mission is to turn complex food and health science into information anyone can digest and understand easily. The goal, she said, is to have a positive effect on people’s lives by inspiring and facilitating healthier and more sustainable diet and lifestyle choices. “We do that through engaging information and activities rooted in science,” said Fernández Celemín. She added that her organization is driven by the philosophy that improving people’s knowledge about food and health can make a difference in their lives and in the health of the planet.
Fernández Celemín said EUFIC has four long-term goals:
- Build food and health science literacy;
- Facilitate a healthy and sustainable dietary shift;
- Support the prevention of diet and lifestyle-related noncommunicable diseases; and
- Empower food waste reduction by citizens.
EUFIC has an effect in these areas by engaging the public, conducting awareness-raising campaigns, and providing a mutual platform for evidence-based dialogue with different stakeholders and building capacity of different actors. Examples of the latter include training healthcare professionals to be better science communicators and supporting the media with its efforts to improve science reporting. In all activities, EUFIC puts the consumer at the center of its efforts by performing and using consumer research and by using behavior change communication techniques to underpin its activities.
People worldwide have inadequate diets that lead to deficiencies and excesses in energy and nutrients. Over time, these may result in ill health and premature death. In Europe, said Fernández Celemín, noncommunicable diseases are responsible for 80 percent of the disease burden and avoidable death. Years ago, the EAT-Lancet Commission published a report showing the link between diet, health, and the environment (Loken and DeClerck, 2020). The report showed that it is possible to feed a future population of 10 billion people but only with a transformation of eating habits, food waste reduction, and improvements in food and production systems. “To reach that ambitious goal of achieving a healthy and sustainable food system will require not only entrepreneurship and innovation but also the engagement of citizens, of consumers,” said Fernández Celemín. She added that when citizens are enabled and empowered to make healthier and more sustainable food and lifestyle choices, the necessary changes can occur at scale.
Consumers, said Fernández Celemín, need to be open to innovation because innovation is one of the instruments that can help achieve a sustainable and healthy food system. Europe, she explained, has the TrustTracker tool,1 developed by the European Institute of Innovation and Technology Food,2 to measure trust in the food system and its various sectors. The tool has been deployed in 18 European countries since 2018 and has surveyed over 100,000 people. The latest version of TrustTracker showed that only 37 percent of Europeans say they would be open to adopting new foods in their diet if the food was derived using “innovative techniques.”
That result, said Fernández Celemín, shows there is a clear gap between innovation and consumer trust. “We need to know how to bridge that gap and how to engage and empower citizens to change their diets and lifestyles and accept innovation,” she said. Building trust in the food system, she added, requires honesty, transparency, and openness as the first steps to helping people accelerate their transition to sustainable food choices and their acceptance of innovation.
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1 https://www.eitfood.eu/projects/consumerobservatory/trusttracker (accessed July 11, 2024).
2 https://www.eitfood.eu/ (accessed July 11, 2024).
In addition to building trust, raising awareness about healthy, sustainable diets, along with education and training, for all parties in the food production system is needed to accelerate change. This communication effort needs to be based on behavior change and communication science. Finally, said Fernández Celemín, it is important to have an environment that provides people with the opportunity to make the right choices. Such an environment would provide access to healthy, affordable, and sustainably produced foods for everyone, which will require new policies and a mix of action from different food system sectors.
DISCUSSION
Session moderator Rodolphe Barrangou remarked that the goal is to achieve better diets and nutrition to promote human health and alleviate, moderate, sometimes cure, and prevent disease. At the same time, the presentations have demonstrated that there is a lack of clarity and consistency in the messages meant to convey the necessary information. “Are we too vague? Are we too technical? Are we too confusing?” asked Barrangou, prompting the panelists to comment on how the field can simplify, clarify, or customize its messages. From a plant science perspective, Grusak said, there is a need for the community to understand what the important components of food are that, if addressed, would improve the food supply. “We have all the biotech tools that we can use. We have management tools that could be attempted, but we need to know where to put our effort,” said Grusak. He suggested simplifying the message by focusing on the top food components, whether nutrients or bioactives, that will have the most effect on human health.
Morabia said that nutrition and food are complicated domains, so it is important to simplify and have messaging that is relevant to the community so that they become part of the common knowledge. He pointed to the importance of identifying key markers of diet, nutrition, obesity, and other elements and measure them consistently over time. Barile noted the need to have well-defined, pure ingredients in clinical studies and to measure disease outcomes and biological markers of disease, particularly regarding probiotics and their effect on the microbiome.
Barrangou commented that in many ways, the field is trying to have it all. “We want something that is health promoting, affordable, sustainable, scalable, and global, and we may get there in the end, but I think there are some challenges inherent to having something that’s the most nutritious but may not be the most sustainable. The most affordable may not be the most nutritious.” His question to the panel was how to balance these different attributes and promote health. Fernández Celemín replied that achieving such a balance is challenging, but there are simple messages that will help
people’s choices and can be applied across the board; that is what should be transferred to the consumer consistently and in an accessible and actionable way. She said it is important not to get lost in the scientific details that may be relevant to the scientific discussion and debate but can confuse the consumer and create mistrust. Regarding sustainability and healthy, affordable eating, one message is to increase the plant-based elements in one’s diet, which should be given through practical examples people can adopt. Conveying to people the idea that reducing their food waste not only helps sustainability, but it can also save money by incorporating elements into recipes that would normally be discarded, which can have additional benefits like improving their fiber content.
Barile said that one challenge is the accumulation of feedstocks that are poorly characterized, and even when they are characterized for protein and carbohydrates, there is no common language, which makes it difficult to query databases for nutritional information. In addition, the databases that are available do not talk to one another. “There is a need to develop a common language so that we can understand variation from season to season, from region to region,” said Barile. “We need to measure more but also start speaking the same language and make an effort to communicate that bioinformatically.”
Morabia commented that balancing the different decisions and communication about food and sustainability cannot be done solely from the top down. Efforts must engage and involve communities to identify solutions that are acceptable, ethical, and sustainable.
Barrangou asked the panel what they would recommend the field focus on, with the data available today, if it was developing a one-minute public service announcement to the general public. Morabia said, as a journal editor, he would focus on ultra-processed foods given the attention they are receiving today. Grusak said that providing a consistent, simple message around nutritional requirements is important, such as the current Dietary Guidelines for Americans. However, that is a one-size-fits-all message, and there is a growing recognition that different groups, based on their genetics and environment, may have different nutritional needs. USDA, he noted, is trying to develop culturally appropriate messaging for different population groups in an effort to spread the word about dietary requirements and the best approaches for improving health in underserved communities.
From a communication perspective, said Fernández Celemín, we indeed know that specific population groups have less interest in health and sustainable eating, so a one-size-fits-all approach will not work. For example, young male adults living by themselves tend have poor quality diets and tend to eat less sustainably. This is also true for low-educated consumers, she noted. Both groups deserve a specific, targeted communication effort
based on understanding their needs, the available levers for change, and the barriers they face.
Barrangou asked the panelists to suggest what they would like to see discussed at a future workshop. Morabia said health monitoring of nutrition, diet, and food intake because that is the basic information needed to have a population dimension to these discussions. Fernández Celemín suggested having processed or ultra-processed foods be the topic of the next workshop, given the amount of emerging science and misunderstanding in the general public that makes their decisions difficult.
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