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Shaping what we choose to eat

Our overarching theme this year forges connections between health, wellbeing and sustainability. This meeting is the second in a series of three about diets and lifestyles and the panel of witnesses helped us to explore factors that shape and drive what people choose to eat.

Our first witness was Professor Martin White, a clinical academic who leads the food behaviours and public health interventions group at the Centre for Diet and Exercise Research (CEDAR), based within the MRC Epidemiology Unit at the University of Cambridge.

He joined Bee Wilson, a food journalist and historianwho is particularly interested in ways in which our experience as children shapes what we like and what we choose to eat, and Professor Charles Godfray, the Director of the Oxford Martin Programme on the Future of Food, who will help us to to put questions about choice in the context of health environment co-benefits of diet change.

Research gaps

Professor Martin White and CEDAR aim to generate new knowledge that helps promote a healthier diet at a population level, which is often more effective, efficient and equitable than at the individual level. Dietary choices can be considered as the product of both a complex commercial food system and various systems that affect consumer choice, which are chiefly socio-economic in nature. How can we distribute resources so as to allow people to make healthier choices and get the food industry to support public health goals? The latter can be achieved through voluntary changes by the sector, which have not been forthcoming, or regulation. The soft drink industry levy is an example of regulation but this may have unintended consequences, such as the cost being passed on to consumers, even in healthier product lines. The research community needs to know how the food industry influences diet; how it can influence the food market offer in the interests of public health; how it can interact with the food industry without compromising scientific integrity; and how much can the public influence the industry. All the above principles can also be applied to changing sustainability-related behaviours.

Bee Wilson highlighted that a key element of food choice is preference and this area is often neglected in food policy actions. If people like a foodstuff they will not need to be told to eat it. Our food preferences are deeply malleable and learnt through exposure at childhood, or even during pregnancy. Currently happy childhood memories tend to revolve around obesogenic foods, and these habits persist into adulthood; however, there need be no intrinsic reason why one type of food is more enjoyable than another, and healthy and sustainable plant-based diets could be as appetising as high-sugar treats. Flavour preferences on an individual and population level can, in theory, be relearnt as the human olfactory system remains adaptable. To instil change, interventions must tackle the food environment that encourages unhealthy food preferences and educate children about taste, such as through deploying in schools the Sapere method based on sensory experience.

Professor Charles Godfray discussed the overlap between health and environmental sustainability and analysing their significant, if not universal, co-benefits in an economic framework. Following a WHO recommended diet could globally reduce deaths by 5 million a year and also substantially reduce greenhouse gas generation by the food system. Each population requires a different approach, perhaps best exemplified by the range of income percentage spent on food (e.g. 9% in the US versus 40–50% in developing countries). Current interventions have merit but face challenges: certification schemes often lack a good evidence base and creating food labels for a multi-dimensional issue such as sustainability may be reductive and disregarded by consumers. Environmental sustainability narratives also can be appropriated by different advocacy groups, which generate conflicting and disorientating advice. Research into health and environmental co-benefits is needed, and at Oxford a project is examining these with regard to animal-sourced foods. 

Wicked problems and questions generated by the open discussion

How can policy makers be empowered to make population-level public health interventions? Politicians often know what needs to be done, but may be constrained by adverse public perception. There are also problems regarding the relative power of the food and drink industry and concerns regarding potential job losses and GDP pressures from a policy change. Public discourse has to be stimulated so that people are supportive of government-led interventions, and we need more data regarding how and why public discourse changes.

How can policy makers in different areas collaborate to create mutually beneficial initiatives? Different aspects of health, food and the environment will often be the responsibility of different government departments resulting from anachronistic divisions. Collaboration and clear decision-making pathways are needed. 

Can we apply lessons from marketing to public health interventions? Marketing and advertising companies can often gain quick insights without being constrained by the need for time-consuming randomised control studies. Researchers need to engage with industry as well as generate evidence and get it into policy faster to avoid the addressed policy question no longer being relevant by the time action is taken.

How can we effect change in society’s relationship with food? This is an area that has become very complicated, as there are often conflicting, evolving or overwhelming levels of advice that can lessen the efficacy of public health messages. Researchers need do a better job of being an honest broker of knowledge, summarising what is and is not a good diet for people to construct advocacy positions.

How severely does the growing urban environment impact on our food habits? Urbanisation is happening at an unprecedented rate and this is changing our relationship with and knowledge of the food system. Understanding the social, cultural, economic and physical environments that influence our food choice is crucial.

Should measures to improve diet be led by supply or demand? At the moment the former takes precedent, but perhaps this should not be the case. How can we encourage people to demand something different and make the ‘right’ demands? Does this require more education or the encouragement of public curiosity?

Is it better to focus on a pleasure principle instead? Our understanding of food can be cultural and ritualistic. Can we use food rituals to build a web of value around healthy food? Encouraging pleasure to be associated with healthy food may be more effective than negative messaging about health. Conversely, overcoming disgust (or redirecting it towards unhealthy food) could be a future avenue of research.

To find out more about this theme or the meeting, please e-mail Dr Rosamunde Almond ().

Rosemary Ostfeld is currently researching strategies to communicate the link between diet choice and the environment, and she is developing a sustainable food smartphone application and online platform to help consumers make affordable, nutritious, and environmentally sustainable diet choices.

Read her article

Bee Wilson's recent book, FIRST BITE, draws on current research from both neuroscience and psychology, and her experience parenting three children and visiting numerous school canteens, as well as talking to dieticians, biologists and consumer researchers, to look at where our food habits come from; and what it would really take to change them for the better.

Read a review of the book