Communication to Bridge the Gap Between Food Production and Nutrition and Health: Proceedings of a Workshop (2024)
Chapter: 4 Challenges and Successes in Communicating Health and Nutrition Needs of Consumers Across the Food System
4
Challenges and Successes in Communicating Health and Nutrition Needs of Consumers Across the Food System
The final session of the workshop, moderated by Susan C. Scrimshaw, former president of Russell Sage College, focused on ways to communicate information from consumers about their diet and health needs and preferences to actors across the food system. Speakers provided their insights on the importance of understanding community-oriented experiences, using evidence synthesis to communicate research findings and identify gaps in knowledge, translating research into clear messages for policymakers, and identifying the role of journalists to clarify the science for consumers. The workshop concluded with closing remarks from the interim chair, Rodolphe Barrangou.
COMMUNITY-INFORMED COMMUNICATION
Elizabeth L. Fox, assistant professor for practice at Cornell University College of Veterinary Medicine, recalled how she started her career working with infant and child feeding programs in San Diego and Haiti, and she found it striking that despite mothers coming from very different contexts and having different resources, they all had some idea of what and how they should feed their children. However, they faced many barriers to implementing those practices. “It was not so much a knowledge gap that needed to be filled or communicated but an ability to practice gap,” said Fox. “I’d argue the same is true for the general population.”
Many people, she said, have at least a big picture sense of what a healthy diet is. While they may need more information about the details, most people understand, for example, that incorporating fruits and veg-
etables into one’s diet is a good thing. What is keeping people from following advice they understand to be true, she posited, are upstream barriers across the food system that can affect whether they have access to these foods, whether they can afford them, and if they have time to prepare them or even know how to prepare them. “That is where I think challenges with communication get hung up,” said Fox.
The concept of food security, said Fox, highlights that nutrition is more than just meeting physiological needs of getting enough calories and nutrients each day. Rather, it emphasizes that people should have physical and economic access to safe and nutritious food that meet their dietary needs and food preferences. This is what makes communicating about nutrition so challenging given that everyone comes with different lived experiences and different preferences. “As such, we need to understand when we are communicating where people are coming from, what matters to them, and how they make food decisions,” she said.
Fox and her collaborators have found, for example, that price, quality, and taste are some of the important influences on the foods people choose. The challenge, then, is to align the things that matter to people with communication about nutrition and health and identify what food system actors need to do that effectively, she said.
In upstate New York, where Fox works, there are many local food system efforts to address some of the dynamics that affect the ability of people to follow a healthy diet. This includes a community-informed food system plan that successfully links and promotes communication between actors across the food system and local efforts to subsidize community-supported agriculture to increase access to affordable fresh fruits and vegetables during the growing season. She noted that many local farmers are partnering with local organizations, schools, hospitals, and food pantries to reach individuals in the community. The farmers are also investing in producing foods the community is interested in eating and working with local partners to provide information on how to prepare those foods quickly at home.
The challenge, she stated, is that small-scale producers are often those most closely linked to their communities. “They are already supporting community nutrition needs, but they do not always get the support they need to do their work,” said Fox. “They often struggle when competing with large-scale production systems.” In her region in New York, over half the local farms report net losses. As one producer told her, “the returns are low enough that you either have to be passionate about it or find something else to do.” Many of the small producers in her region work other jobs alongside farming to support their families.
In closing, Fox listed four main challenges she sees in the communication space about nutrition.
- Context and person define nutritional needs, including foods that people want as part of their diet;
- Researchers, policymakers, and others working to improve a population’s diet do not always ask what people want or need, but they should;
- Because people have different motivations and knowledge, there is no single policy or communication strategy that will work for every context or family; and
- Linking community partners and actors in the food system may better identify local nutrition gaps and needs to find effective ways to fill those needs.
EVIDENCE SYNTHESIS TO PROMOTE TRANSLATIONAL RESEARCH
Jaron Porciello, associate professor of practice in information and data science at the Lucy Family Institute for Data and Society at the University of Notre Dame, reiterated other speakers’ message about the importance of transforming complex scientific research into understandable and actionable information for everyone. This is particularly important, she added, when targeting communications to those who can do something with the evidence—donors, governments, and consumers—because they are often in the most strategic positions to make decisions based on the knowledge and inputs provided from the scientific community. The key challenge, then, said Porciello, is to “communicate the collective intelligence and knowledge from across our colleagues, from across the system, and do it in a way that is unbiased, transparent, and rigorous.”
In 2022, Porciello and partners at CABI founded the Juno Evidence Alliance to establish an evidence synthesis platform for agricultural research similar to the Cochrane Collective, which performs evidence syntheses in the health and medical area. For Porciello, evidence syntheses promote translational research, both because of the knowledge they provide by making information discoverable and because they provide opportunities to raise scientific standards for the entire system. “To me, it is a reinvestment of all our research dollars,” she said. Evidence synthesis is also about communicating and making research findings accessible to consumers, policymakers, extension agents, and agricultural producers.
There is an opportunity to expand communication in science and agriculture, said Porciello, by improving the feedback loop within food systems to gain an understanding of what knowledge and data are missing from the perspective of policymakers and consumers. One tool used in evidence synthesis is an evidence gap map that shows where there is varying information on a particular topic. However, those maps are driven from the
research perspective, not the policymaker, donor, or consumer perspective, Porciello stated.
Porciello then discussed the positive and negative aspects of using artificial intelligence (AI) to synthesize data and extract knowledge and how these aspects are communicated. AI, she explained, can make a tremendous difference in terms of optimizing time and efficiency, bringing unstructured and dissimilar data sets together, identifying patterns and trends, predicting future needs, and providing personalized nutrition advice. She said there are many opportunities for AI to make a quality-driven impact on how researchers interpret and optimize data. One concern she has is making sure researchers consistently communicate the risks of using AI for data synthesis and decision making without fear mongering or overselling its potential. The problem is that how AI models work is often opaque. “If we do not understand what is taking place in a model, how do we effectively communicate both the risk and potential?” she asked. “If I cannot explain something, it makes it very difficult then to want to recommend it and use it for decision making purposes that can impact millions of people.”
IMPROVING FOOD SYSTEM DECISION MAKING WITH BETTER FOOD SYSTEMS SCIENCE
Jessica Fanzo, professor of climate and food, director of the Food for Humanity Initiative, and interim director of the International Research Institute for Climate and Society at Columbia University Climate School, said communicating about food systems is challenging because these systems are complex, dynamic, and exist at scales ranging from global to hyperlocal (Figure 4-1). Food systems also have many actors working at different scales and with different vested interests. In addition, every day, everyone interacts with food systems multiple times. Fortunately, decades of research have generated a great deal of knowledge about how food systems are working and not working.
While there is more knowledge than ever and new technologies, such as AI, that can extract information from data at faster speeds, the challenge lies in how this knowledge is used, she said. From Fanzo’s perspective, policymakers are a key audience because they can use knowledge to shape, shift, and orient food systems to better provide healthy diets and nutrition. “Food system transformation is urgent, requiring rigorous, science-based monitoring to guide public and private decisions and support those who hold decision makers to account,” said Fanzo. However, she said, policymakers are often in the dark with regard to how food systems are performing, the potential near-term and long-term risks to food systems, and where to intervene.
Fanzo and her collaborators have examined the problem of how to translate science to policy and society and what the interfaces are regarding
SOURCES: Presented by Jessica Fanzo on May 30, 2024, at the workshop on Communication to Bridge the Gap Between Food Production and Nutrition and Health; EEA, 2016. CC BY 4.0.
that. These policy-science-society interfaces, she stated, are meant to engage stakeholders, build capacity, and ensure data is accessible so they can enable assessing, forecasting, and developing forms of diplomacy to better inform stakeholders about the science and the different kinds of data and perspectives of interpreting that data across food systems to have meaningful change and transformation.
Fanzo cited work showing different narratives and entry points for how people think about what food systems are and what they should do (Figure 4-2). In this framing, agronomists and agricultural economists talk about how to feed the world and close food production gaps, while nutritionists talk about the need for food systems to deliver healthy diets for better nutrition and food security, which means closing nutrient gaps. There are narratives focusing on justice and equity and on environmentalism and climate change. These narratives are all correct, she said, so the challenge lies in bringing them together. Otherwise, said Fanzo, what policymakers are left with is confusion. “Which narrative do they follow? Which one has the biggest bang for their buck? Where should they invest?” she asked. “We need to be thinking about how we collectively bring these messages into one single narrative that is easy to digest for policymakers.”
Working with food system scientists around the world, Fanzo and her colleagues created the Food Systems Dashboard1 and Food Systems Countdown Initiative2 to take the vast amount of data across systems and display them in a less complicated, more visually appealing manner that is easier to understand for policymakers, who can then make informed decisions on food systems.
REPORTING ON NUTRITION FOR THE PUBLIC
Alice Callahan, a reporter for the Well desk at the New York Times, explained that her beat covers nutrition writ large, which enables her to report on a wide range of topics, such as food safety in the time of avian influenza spreading among U.S. dairy cattle and ultra-processed foods. As a former instructor of college-level nutrition courses, she would spend time on media literacy and have her students critique nutrition and health messages from different sources to identify where they fell short or where the information was misleading or confusing.
At the Times, Callahan writes for a consumer audience, which is a challenge given that consumers hear many mixed messages about food and nutrition. “So yes, people probably understand they should be eating more fruits and vegetables than they do, but they get a lot of other types of
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1 Available at https://www.foodsystemsdashboard.org/ (accessed July 22, 2024).
2 Available at https://www.foodcountdown.org/ (accessed July 22, 2024).
SOURCES: Presented by Jessica Fanzo on May 30, 2024, at the workshop on Communication to Bridge the Gap Between Food Production and Nutrition and Health; Béné et al., 2019, CC BY-NC-ND 4.0, https://creativecommons.org/licenses/by-nc-nd/4.0/.
information from influencers, podcasters, book authors, and companies that are marketing supplements or different diets,” said Callahan. “Those voices often speak with a lot of certainty, and the truth about nutrition and health is much more complex and nuanced.” In addition, the science is evolving and imperfect, leaving researchers trying to draw conclusions from data that come with many caveats.
At the same time, people must eat, and consumers are looking for credible sources to translate what the evolving, imperfect data mean for them and how they should eat. “That demand, that very natural desire to have an immediate translation from science to practice has led us to this point where there is often this cliched frustration with nutrition,” said Callahan. Consumers, she said, are overwhelmed and frustrated, they are unsure of who to listen to and what to believe, and they are unsure of where to put their attention. Therefore, her overarching goal is to connect consumers’ attention, which is this limited vital resource in today’s busy world, with evidence-based expertise from people who hold the most knowledge in those areas.
When reporting on a subject, Callahan tries to clearly explain the limitations and caveats in the research and put findings into context with previous studies to show how scientific understanding builds over time to improve certainty. She also seeks input from well-informed and diverse experts that bring knowledge and perspective from different areas. As part of this, she tries, when possible, to provide the background story, particularly when a new finding contradicts previous advice, such as the rise and fall of the health halo around red wine.
Callahan believes that if consumers can develop a clearer understanding of what is known and unknown about food and health, they will ultimately feel more confident in the choices they make about their diets, which comes with a great deal of power. For example, over the last decade or so, some consumers have prioritized reducing gluten in their diets, which drove innovation that has benefitted the segment of the population that cannot consume gluten. “If we had a similar amount of attention put on having more lower-sodium products available, I bet that would drive a huge amount of innovation in that space,” she said. Given sodium’s contribution to hypertension, that could be powerful.
DISCUSSION
Session moderator Susan C. Scrimshaw asked the panelists if there are different strategies to take with large producers versus small farmers when trying to communicate what communities and individuals want and need. Porciello replied that when contemplating strategies, it is important to consider which modalities will best reach small farmers, as opposed to
those that will best reach large producers, and who the trusted messengers are for those different communities. In a rural area of low connectivity, for example, radio broadcasting, face-to-face, or WhatsApp may be the best communication modality, she said.
Scrimshaw then asked the panelists for their thoughts on how to manage dubious influencers and contradict bad information. Callahan replied that this is a significant challenge given that the number of people following many of these influencers, who are promoting various messages and often profiting off them, can sometimes be greater than the audience of the New York Times. One challenge she and her colleagues face is deciding whether to tackle a topic receiving a great deal of attention on social media based on a false narrative. “Are we just giving more attention to this?” she asked. The hope is that she and her colleagues can address a claim and bring in experts who can speak directly to the readers about whether there is any truth to the social media narrative.
Callahan said that journalists and communicators in academia and government need to do a better job communicating to consumers about what goes into developing policy, such as the Dietary Guidelines for Americans, for example. There is a great deal of distrust in that process and in similar policy processes, in part, she said, because people do not understand who is involved in developing policy and how they decide which evidence to consider. “This is more about trying to illuminate the process of science and how we grapple with these questions and translate them into actionable advice,” she said.
Fanzo said she has had firsthand experience with getting hate mail and death threats from being involved with a certain report. “I think it is very dangerous to start having dialogue with some of these mis- and disinformation sources as scientists because a lot of the times it is not about the science, it is about the scientists and attacking the scientists,” said Fanzo. She advises researchers to not engage in social media but to keep fighting the good fight through strong evidence and data and to share information with sound media sources who do investigative research and writing. This, she said, gets to the question of how to encourage academics to communicate more with the public and to provide them with better training on how to talk about their work to the general public. She noted that when the Food Systems Countdown Initiative published a peer-reviewed paper, it also issued a policy brief and a press release, held a webinar, and talked to many media members. Scrimshaw added that there is often a lack of incentives for academics to communicate their research findings in accessible ways to broader audiences. To address this, she said, leaders in academia need to support and encourage their faculty to take on the challenge of effective science communication.
Porciello agreed that media training is essential for academics, and she also called for institutions to ensure that research teams, not just individual
scientists or the principal investigator, receive media training. This would enrich the perspectives of those speaking to the public, but it also would help protect people by creating opportunities to present findings as a group or tackle misinformation on social media as a group. Fox suggested having community members and partners be part of the group communication process.
An unidentified workshop participant asked the panelists to provide tips for communicating nutrition science to diverse communities. Fox pointed to the need to understand what motivates different people or communities to eat and produce certain foods. Scrimshaw said the key is to not assume uniformity, that there is a community of people all behaving the same way and desiring the same things. There is tremendous diversity around food and food preferences, which are very important culturally, she noted.
Another unidentified participant wanted to understand how scientists and producers know what is in food and how to dispel myths about food as medicine. Fanzo replied that while there is a better understanding of what is in food now than there was 25 years ago, nutritionists and agronomists would acknowledge that they still do not completely understand food. This is the reason for projects like the Periodic Table of Food Initiative, which is mapping macro and micronutrients in food as well as the bioactive components in food. Scrimshaw noted that part of this question is about the variation in nutrition education across medical curricula. Fanzo concurred, emphasizing the need to address this knowledge gap given that dietary factors are top contributors to disease risk.
Alfredo Morabia wanted to know how consumer trust in food and nutrition is measured. Fox said it is mostly via survey. She noted that when she and Fanzo asked people about the information they trusted and where they got it, the answers varied. “I think oftentimes you trust things that reflect your own background or something that resonates with you, and trying to disentangle and create awareness of individuals to critically think about the information that they are receiving is key,” said Fox.
Responding to a question about whether it is harder to address gaps in understanding given the globalization of the food system, Fanzo said it is daunting for consumers to wrap their heads around how global food trade works, what its effects are on the availability of nutritious food, and how to fix some of the problems arising from global food trade. Porciello added that even though the food system is global, ultimately, policy and consumer decisions occur at the local level. Scrimshaw noted that how information is received in a community has cultural and gender aspects.
When asked for final thoughts, Porciello emphasized the importance of understanding the role of women in agricultural and food systems. Callahan reiterated the value of media training for scientists and policymakers and encouraged people to work with the communications office at their institution. Fanzo noted the importance of working with communi-
ties to understand their lived experiences and to sit down with policymakers to better understand their needs for information. Fox pointed to the need to create alignment across different groups with policymakers to inform producers about the types of foods that people want on their plates. Doing so requires dialogue and being open to and participating in different forums for that dialogue. She encouraged everyone to find those opportunities locally and engage with different stakeholders across the food system.
CLOSING REMARKS
In his remarks to conclude the workshop, Rodolphe Barrangou noted several themes that ran throughout the presentations. The first was about the importance of considering more than the science and data when crafting messages and thinking about who the messengers are, the media through which the message will be disseminated, and how to balance the use of professional communicators and scientific experts. Yes, media training is important, and yes, there can be risks and backlash associated with delivering messages that some might not want to hear, but the scientific community, he stated, needs to have the courage and wisdom to partake in communication activities.
Another theme he heard was the importance of teamwork and the need for collaboration when communicating with the public and policymakers. Translating science for policymakers and the public can be difficult, but it is necessary to translate knowledge into action. He also heard the importance of engaging with unfamiliar media to engage with diverse audiences, including women and underrepresented and underserved populations.
Barrangou said at a time when precision nutrition is advancing and there is a heightened understanding about diversities across gender, age, health and disease state, economic stages, and educational background, it may be the right time to rethink how to combine targeted, customized approaches for different stakeholders and mix and match the messages to those different populations. “Combining emerging technologies and emerging tools with current problems and challenges on the short-term horizon is going to be a means for us to collectively address those challenges,” said Barrangou.
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