Linear agro-food production systems have led to a high social impact, translated into a growing spread of chronic diseases and prolonged health costs. This obvious disconnection between food networks and health systems has often led consumers to make unhealthy food choices. The problem, in its complexity, is currently mainly faced by exponents of the Integrative Medicine, without however reaching transversal dissemination. Through the analysis of representative projects aimed at managing and resizing the problem, the purpose of this article is to identify new fields of investigation and action for systemic designers, who deal with the re-planning of food and health experiences of the individuals who wish to protect their health. This happens through the creation of relationships, the mediation of different languages and the sharing of knowledge. Furthermore, the paper traces the foundations for the definition and development of future design solutions in the field of Food for the Healthcare

Menzardi, Paola

Peruccio, PIER PAOLO

Savina, Alessandra

Vrenna, Maurizio

English

Savina Alessandra

Peruccio Pier Paolo

Vrenna Maurizio

Menzardi Paola

PORTO@iris (Publications Open Repository TOrino - Politecnico di Torino)

The impact of food production on public health: Systemic strategies for a diffused and transversal prevention plan

Nowadays talking about industrial agro-food production also means referring to different environmental, economic and social repercussions. Although attention given to the way in which the food is produced has grown, the social costs linked to food production have been investigated with a more superficial approach. In many cases the most common mistake is to separate the quality of production processes of our food from our health, forgetting that social costs also translate into health costs if they become burdensome and prolonged over time for the majority of people. An insufficient and fragmented level of information about the strong link between food’s undeclared contaminants and chronic diseases reduces the consumer’s capability of choice in the purchase of food, further diminished by food primary selection executed by the large-scale retail trade. 

While smoking is a choice, today getting sick through unreported contaminants contained in our food is not. Smoking is a bad habit, food is a necessity and as such it should not “poison” humans. In fact, diabetes and obesity are not the only disorders related to the quality of food production processes, where production processes refer to all the activities carried out along the entire production cycle, from seed to sale. In this complex scenario, the systemic approach acts as a tool for reading and analysing linear agri-food supply chains, characterized by chemical inputs such as antibiotics, hormones and pesticides (Bistagnino, 2011). However today the range of such contaminants is widening, especially if we consider all the chemical additives used during the extensive phases of food processing and all those substances released from polymeric packaging in the industrial or domestic conservation phase. In the human body they act as endocrine disruptors, interacting with other contaminants assimilated during the years (Maga, 1995). 

This systemic phenomenon is deeply connected to two concepts, Chemical Body Burden, that represents the accumulation and interaction of chemical contaminants in the body and Acceptable Daily Intake (ADI), that is the quantity of pollutant legitimated to be swallowed daily without any apparent risk to health (Robin, 2012). The effects and the mutual interaction of these substances not chosen by the consumer are responsible for what the World Health Organization defines as an “epidemic” capable of perturbing the health of future generations. The list of diseases related to industrial food production is destined to longthen especially considering the current system of reproductive dysfunctions, neurodegenerative diseases and cases of teratogenesis in the fetus. In fact, most future pathologies will be of fetal origin: the transgenerational effects will gradually increase. For this reason, it is necessary to translate the concept of sustainable development and the same sense of environmental responsibility also in the field of public health. It is indispensable to start from the prevention of current generations to defend the health of future generations. 

On the basis of this assumption, systemic design can lead to a behavioral change in people and in the actors involved in the health and agri-food field. In order to allow the future population to enjoy an optimal state of health a paradigm shift needs to take place within the management of public health, involving a focused and widespread prevention system, starting from the control of the pollutants included in the agri-food production system.



Since the ‘30s industry has controlled and influenced research on the toxicity of products, counterfeting the veracity of scientific results (Robin, 2012): this fast growing phenomenon has allowed higher thresholds of ADI and the legitimization of new hazardous substances. This is the reason why a multidisciplinary figure like that of the designer is essential to lead an improvement that starts from the bottom and works simultaneously on two different fronts through a shared change. This means firsly collaborating with professional figures closely linked to the epidemiological and nutritional fields and with public and private health facilities; and secondly by interacting with the patients and less aware individuals, so that a system of prevention and precaution can be put in place, extending also to those who are not affected by any diseases but who seek a balanced state of health.

The systemic designer has a responsibility in this sense, not only as a activator of relationships, but above all as a processor of a sustainable action strategy that necessarily includes a reversal of the approach to chronic diseases and the consumption/production of food.



On one hand, the doctor should keep his mentorship rebuilding it with greater awareness about the link between diseases and food production, investigating the food chemical exposure suffered by the patient, evaluating his eating habits and pursuing a systemic analysis of his disorders, interpreting the human organism as a set of strictly related organs (Capra,1997). On the other hand, it is also necessary a direct involvement of those who have not yet revealed any disturbance, so that a possibility of protection can be realized through the dissemination of information.



However, it is important that this system also involves food producers, so that they can move towards a production free from chemical contaminants, which follows the season and favors the local varieties. It is also essential to adopt recognized certifications and labels to reassure, inform and guide the user towards conscious consumption.

In this double context the systemic designer draws a dense network of relationships among different actors, within which the patient and the healthy individual to be protected represent the center, active part of the system, directly involved in the treatment and prevention process, where prevention means knowledge, conscious purchase, even self-production.

It is legitimate to ask why the designer represents the fulcrum of this network of relationships. The first answer is represented by the fact that he is simultaneously planner and user of food/health systems, consumer and health seeker (Jones, 2013). The real motivation lies instead in his transdisciplinary education, which supports him in comparison with other branches of knowledge.



Working in the perspective of sustainability and territoriality, it responds to global challenges with ethics and great intellectual honesty, always taking into consideration the peculiarities of the places and the communities in which it operates, which become an integral part of a sustainable, functional, efficient project. Nevertheless, there is another aspect that is not negligible: the systemic designer stands above all conflicts of interest, moving away from the will of the big agro-industrial and pharmaceutical corporations, planning for a sustainable well-being shared by all the collectivity involved, that does not allow tampering and disinformation. Therefore he plans a path that can become a guide towards a behavioral change, through educational projects that stimulate daily qualitative actions and choices (Wendel, 2014). Products, services and territorial strategies change their focus, moving from the profit to the health of individuals and the environment in which they live. However, in order for the connections designed between users, producers, food and health institutions to be constructive and lasting, the designer undertakes to create a dialogue between disciplines, languages and distant professions, minimizing conceptual and communicative obstacles, reconciling different cultural backgrounds. Thus its mediator role becomes fundamental for the achievement of sustainable compromises between different visions, through the objectification of critical points and possibilities. He, therefore, stands as a designer and observer of the system, avoiding imbalances in terms of costs and benefits.



Today there are many case studies developed to bring people closer to the theme of well-being achieved through food, however, most of them rarely collaborates with a team of specialized figures. The largest number of cases helps the users find local and seasonal products and meet direct producers. Some platforms aim to guide users towards a more conscious purchase through complete descriptions in terms of nutritional values, composition, etc. Almost all use tools such as apps and sites to facilitate online purchase, but the downside is the absence of a reliable source of this information and that of specialized support fugures.



Moreover, there are some very interesting isolated cases, which although they do not consider the involvement of the designer profession, they assist the interaction among patients, medical figures, food-producers and chefs for the prevention of the diseases. (an example is Diana 5 Project, conducted by the Dr. Franco Berrino and the “National Cancer Institute, based in Milan). Through this type of projects the level of awareness achieved is higher, thanks to the direct involvement of the patient in the production process of the daily meal. In addition, they represent an excellent example of design application, because it takes strength from relationships, experience and direct comparison. The aims of this research are intended to be part of the Health System for Sustainable Living sector and are not far from the approach pursued by the Medical Design frontier, but with an additional variable: the consideration of the constant chemical exposures to which man is subjected.



Nowadays a real revolution of public health is urgently necessary and this can happen only by starting from education, training and interaction, so that knowledge can become an instrument of power, while food an instrument of prevention rather than a cause of a global system of growing diseases

Peruccio, Pier Paolo

OCAD University Open Research Repository

OCAD University Open Research Repository2018 The impact of food production on public health: Systemic strategies for a diffused and transversal prevention planSavina, Alessandra and Vrenna, Maurizio and Menzardi, Paola and Peruccio, Pier Paolo Suggested citation: Savina, Alessandra and Vrenna, Maurizio and Menzardi, Paola and Peruccio, Pier Paolo (2018) The impact of food production on public health: Systemic strategies for a diffused and transversal prevention plan. In: Proceedings of RSD7, Relating Systems Thinking and Design 7, 23-26 Oct 2018, Turin, Italy. Available at http://openresearch.ocadu.ca/id/eprint/2734/Open Research is a publicly accessible, curated repository for the preservation and dissemination of scholarly and creative output of the OCAD University community. Material in Open Research is open access and made available via the consent of the author and/or rights holder on a non-exclusive basis. The Impact of Food Production on Public Health:Systemic Strategies for a Diffused and Transversal Prevention PlanA. Savina, M. Vrenna, P. Menzardi, P. P. PeruccioPolitecnico di Torino, ItalyRSD7 - Relating Systems Thinking And Design 7 TurinOctober 24-26 . 2018INDUSTRIAL AGRI-FOOD PRODUCTIONThe real costs of our daily foodINDUSTRIAL AGRI-FOOD PRODUCTIONECONOMIC COSTS ENVIROMENTAL COSTS SOCIAL COSTSINDUSTRIAL AGRI-FOOD PRODUCTIONECONOMIC COSTS ENVIROMENTAL COSTS SOCIAL COSTSAlready widely investigatednot just in the Design Sector.INDUSTRIAL AGRI-FOOD PRODUCTIONSOCIAL COSTSAnalyzed with superficiality, especially if we consider...INDUSTRIAL AGRI-FOOD PRODUCTIONSOCIAL COSTSAnalyzed with superficiality, especially if we consider...HEALTH RISKS- Cancer- Diabetes and Obesity- Neurodegenerative DiseasesHEALTH COSTSBurdensome and prolonged over time for most individuals.- Genetic Repercussions- Fetal Taratogenesis- Reproductive MalfunctionsIndividual STATE OF HEALTHCOMMON MISCONCEPTION:Division of two extremely connected conceptsQUALITY of the Food Production ProcessDISORDERS and CHRONIC DISEASES INSUFFICIENT AND FRAGMENTED INFORMATION LEVEL about the links betweenCONTAMINANTSpresent in foodREDUCED POSSIBILITY TO CHOOSE(Primary selection of foods made by organised large-scale distribution system).REDUCED ABILITY TO CHOOSE BY CONSUMERIT IS WORTH MAKING A COMPARISON...FOOD is a NECESSITY.NOBODY SHOULD GET SICK FOR IT.SMOKING is a BAD HABIT. Getting sick for it is a CHOICE.Why has current food become so dangerous to our health?FEED PROCESSINGBREEDINGFOOD EXTRACTIONAGRICULTURAL PRODUCTIONFOODPROCESSINGFOOD PRODUCT CONSERVATIONSALESTAGES OF THE LINEAR FOOD PRODUCTION PROCESSSYSTEMIC DESIGNTool for reading and analysinglinear agri-food supply chainsPHASES OF ADMINISTRATION OF CHEMICAL TOXIC POLLUTANTS INSIDE THE AGRI-FOOD PRODUCTION CHAINAntibioticsGrowth hormonesFood supplementsHerbicidesPesticidesFertilizers...SweetenersTaste extendersThickenersGellifiersEmulsifiersAcidifiers...VOLUNTARY INPUTStabiizersPreservativesAntioxidants...INVOLUNTARY INPUTSubstances issuedfrom predominantly polymeric packaging(Bisphenol A,Phtalates, ...)pRODUCTIVITY GROWTHFOODPROCESSINGCONSERVATIONCHRONIC CHEMICAL EXPOSUREAntibioticsGrowth hormonesFood supplementsHerbicidesPesticidesFertilizers...SweetenersTaste extendersThickenersGellifiersEmulsifiersAcidifiers...VOLUNTARY INPUTStabiizersPreservativesAntioxidants...INVOLUNTARY INPUTSubstances issuedfrom predominantly polymeric packaging(Bisphenol A,Phtalates, ...)DAILY MEALTHE CONCEPT OF“CHEMICAL BODY BURDEN”THE CONCEPT OF“CHEMICAL BODY BURDEN”mg/KgADIaReference: Robin, M.M. (2012) Il veleno nel piatto. I rischi mortali nascosti in quello che mangiamo. Feltrinelli Editore.ADI - ACCEPTABLE DAILY INTAKELegitimated quantity of pollutant to be ingested daily without apparent impact on the body.THE CONCEPT OF“CHEMICAL BODY BURDEN”mg/KgADIaReference: Robin, M.M. (2012) Il veleno nel piatto. I rischi mortali nascosti in quello che mangiamo. Feltrinelli Editore.mg/Kg ADIb+ADI - ACCEPTABLE DAILY INTAKELegitimated quantity of pollutant to be ingested daily without apparent impact on the body.THE CONCEPT OF“CHEMICAL BODY BURDEN”mg/KgADIaADI - ACCEPTABLE DAILY INTAKELegitimated quantity of pollutant to be ingested daily without apparent impact on the body.Reference: Robin, M.M. (2012) Il veleno nel piatto. I rischi mortali nascosti in quello che mangiamo. Feltrinelli Editore.mg/Kg ADIb+mg/KgADIc+THE CONCEPT OF“CHEMICAL BODY BURDEN”mg/KgADIamg/KgADIcmg/Kg ADIbFailure of ADI (Acceptable Daily Intake) and NOEL (No Observed Effect Level).++Reference: Robin, M.M. (2012) Il veleno nel piatto. I rischi mortali nascosti in quello che mangiamo. FeltrinellI Editore.The effects come into sinergy and multilply themselves.The result is larger then the sum of the effects of the individual pollutants.ADI - ACCEPTABLE DAILY INTAKELegitimated quantity of pollutant to be ingested daily without apparent impact on the body.This is the responsible of an “epidemic” that can also disrupt the health of future generations.World Health Organization (WHO)DISEASES AND DISORDERSRELATED TO INDUSTRIAL FOOD PRODUCTION- Cancer- Diabetes and obesity- Neurodegenerative diseases- Cardiovascular diseases- Behavioral disorders- Fetal taratogenesis- Reproductive malfunctionsCocktails of pollutants inside the umbilical cordsPermeability of the placentaGROWTH OF TRANSGENERATIONAL EFFECTS...TO THE DEFENSE OF THE HEALTH OFFUTURE GENERATIONSFROM HEALTH PREVENTION OF THE CURRENT POPULATION...SUSTAINABLE DEVELOPMENT IN THE HEALTH SECTOR:A CHANGE OF PARADIGM IN THE MANAGEMENT OF CURRENT PUBLIC HEALTHOn the basis of that assumption,SYSTEMIC DESIGN CAN LEAD TO BEHAVIORAL CHANGEHow? Through the creation of a network of relationships between local actors involved in the prevention process.Systemic DesignerInterdisciplinary professional figureHow? Through the creation of a network of relationships between local actors involved in the prevention process.PeopleAgri-food CompaniesHealthcare facilities(public and private)MothersFamiliesIndividuals suffering from chronic diseasesSystemic DesignerInterdisciplinary professional figureHow? Through the creation of a network of relationships between local actors involved in the prevention process. PeopleAgri-food CompaniesHealthcare facilities(public and private)MothersFamiliesIndividuals suffering from chronic diseasesBiologistNutritionistPathologistGeneral PractitionesEpidemiologistFarmers Small Indipendent Local ProducersAgronomists and Agricultural expertSmall ShopsNotified Inspection BodySmart Sustainable Distribution SystemSystemic DesignerInterdisciplinary professional figureHow? Through the creation of a network of relationships between local actors involved in the prevention process.Medical SpecialistGuidance / Interaction / Collaboration “Prevention rather than treatment”Medical SpecialistGuidance / Interaction / Collaboration “Prevention rather than treatment”- Consideration of the link between diseases  | nutrition | food production.- Evaluation of the individual’s eating habits.- Identification of the human body as an interconnected system.3 Starting Points- Consideration of the link between diseases  | nutrition | food production.- Evaluation of the individual’s eating habits.- Identification of the human body as an interconnected system.Medical SpecialistGuidance / Interaction / Collaboration “Prevention rather than treatment”- Conscious purchase and a genuine tasty food preparation.- Knowledge of food properties.- Resize and prevent disorders and diseases through food3 Starting Points Guidance to:Food ProducerProduction Monitoring from seed to sale.“Clean food without pollutants”- Production without chemical inputs, which follows the seasonality of the products.- Adoption of recognized labels and certifications that guide, orient and reassure consumers.- Distribution on a small scale and for pre-established periods to avoid the use of preservatives.Food ProducerProduction Monitoring from seed to sale.“Clean food without pollutants”3 Starting Points- Production without chemical inputs, which follows the seasonality of the products.- Adoption of recognized labels and certifications that guide, orient and reassure consumers.- Distribution on a small scale and for pre-established periods to avoid the use of preservatives.Food ProducerProduction Monitoring from seed to sale.“Clean food without pollutants”3 Starting Points- Rediscovery and enhancement of varieties with high nutritive power.- Preference to the cultivation of local varieties.- Indication of products suitable for certain recipes.Enhancement of the productionPeopleAwareness / Involvement / Interaction“Good health through good food”PeopleAwareness / Involvement / Interaction“Good health through good food”- Information on the adverse effects of highly processed food and chemical contaminants used during production.- Recognition and correct perception of food risk.- Conscious purchase guide through the ability to read and recognize labels and certifications.KnowledgePeopleAwareness / Involvement / Interaction“Good health through good food”- Information on the adverse effects of highly processed food and chemical contaminants used during production.- Recognition and correct perception of food risk- Conscious purchase guide through the ability to read and recognize labels and certifications.- Workshops, cooking and self-production courses in health facilities, farms, city districts.- Incline towards simple, little processed, organic foods.- Willingness to pay a higher price for healthier food.Knowledge Application and participationCase studiesDesign-Food-HealthcareExamples of existing categoriesCATEGORY 2Guidance to a conscious choice of food.NaturMiaIl cibo come natura insegnaAn example:CATEGORY 1Finding local food products and meeting direct producers.L’alveare che dice si!Mangiar bene, mangiar giusto.An example:- Recovery of local and artisanal products.- Direct comparison with food producers.- Purchasing online, through app or website.UsersWho want to put aside the product of large retailers, seeking the link with the territory and a quality product.- Categorization of food products by season.- Descriptive sheets about nutritional values, composition, ingredients, etc.- Advice for the preparation of seasonal recipesUsersWho wants to improve their purchasing choices for a healthier and more sustainable diet.CATEGORY 3Interaction between patients, medical figures, food-producers and chefs for the prevention of the diseases.The “Diana 5 Project” and the healthy cooking courses with the cancer patientsDr. Franco Berrino Fondazione IRCCS “Istituto Nazionale dei Tumori” (INT)An example: - Direct comparison between the project actors.- Use of food products characterized by high properties and benefits.- Seasonal and organic products recovered from local farms.- Food education of the patient, through his involvement in the production process of the daily meal.- Generating a higher level of awareness.UsersCancer patients or individuals with chronic diseases who want to reduce their problems and prevent their deterioration.NEED FOR A DOUBLE REVOLUTIONIn the management of Public HealthIn the production of Daily FoodNEED FOR A DOUBLE REVOLUTIONIn the management of Public HealthIn the production of Daily FoodRe-Design of the overall systemKnowledge/Awareness takingInstrument of power, self-protection.HealthConsideration of the chemical exposures suffered through food.Systemic prevention starts from changing food and its production.FoodPrevention tool, not the cause of a growing disease system.Thank you for attentionalessandra.savina@polito.itmaurizio.vrenna@polito.itpaola.menzardi@polito.itpierpaolo.perccio@polito.itREFERENCESA. 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The impact of food production on public health: Systemic strategies for a diffused and transversal prevention plan

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