Spieldenner, Jörg

Van der Horst, Klazine

English

Berner Fachhochschule: ARBOR

SIGHT AND LIFE I VOL.32(1) I 2018Jörg SpieldennerExpert lor lnnosuisse, the Swiss Innovation Agency,Bern, SwitzerlandKtazine van der HorstDepartrnent ol Heatth Professjons, Bern Uriiversity ofApptied Scjences, Bern, SwjtzerlandKey messages> Reformulation of food products has enormous potential toimprove nutrition without changing consumer behavior.> Voluntary reformulation by the food industry is not enough.Smart regulations are needed to drive innovation andimplementation of solutions for better foods.> Reformulation needs innovative solutions at the interfaceof sustainability, food science, and nutrition.Introd uctionThe tripte burden of malnutrition is a growing challenge world-wide that hampers the heatth of popu[ations. Virtuatly atI coun-tries in transition have to deaI not onty with undernutrition butsimultaneously with alarming rates of overweight, obesity, andrelated non-communicable diseases. In Western societies, thepreva[ence of obesity is soaring, wiih every third adult personin the United States being obese, generating healthcare expendi-tures of US$210 bittion per year.1 A heatthy diet and physicat ac-tivity are paramount to achieving a healthy weight. Most peopte,however, do not eat a healthy diet and are not physica[[y activeat the levels needed to maintain a heatthy weight. 0ne of thereasons is the changing food environment, which provides in-creasing[y [arge supplies of rather inexpensive, highly paLatabte,energy-dense foods that are easi[y accessible, convenient toconsume, and heavily marketed. This type of environment pro-motes excess caloric intake and eventuatly obesity.2 ProcessedREFORMULATING FOOD PRODUCTS FOR IMPROVED NUTRlTION 67and prepackaged foods provide extensive amounts of sodiumand added sugar to the diet in the US, Australia and Europe,3 butare at the same time an important contributor to the adequateintake of micronutrients.aAttempts to change consumer behaviorIn countries of economic transition, the higher incomes of agrowing middle class increase affordabitity of stapte foods andlead to diets rich in "empty" calories. Attempts to shift con-sumer preferences toward nutrient-dense foods rather thanenergy-dense foods using tabeling, fiscaI measures, and socialmedia campaigns have had limited success and impact on obe-sity. 0besity and matnutrition persist, as on[y a minority of thepopulation is truly interested in healthy eating. Most othershave different priorities concerning food, such as taste, price,convenience, family preferences, or simpty other problems todeal with rather than heatthy food choices - including unem-ptoyment, stress, work-tife balance, hea[th issues, disabilities,and many more. 0n top of alt this comes the sustainability dis-cussion, with the Sustainable Devetopment Goals putting thefocus on agricutture and nutrition - and, indeed, diets that arehigh in energy-dense but nutrient-poor foods have been high-tighted as less environmentalty sustainable.s Therefore, a morerealistic way forward to address ma[nutrition, obesity, and sus-tainability chaltenges is needed rather than trying to changepopulation behaviors."A more reatistic way to addressma Inutrition, obesity, a ndsustainabitity chatlenges is needed"Reformulation - a solution?To reformulate existing and commonly consumed processedfoods can be a highty reatistic approach and opportunity to im-prove the heatth of people and the health of the ptanet, with asubstantial estimated positive impact on obesity.6The reformulation of processed foods is defined as changingtheir content by either reducing the content of negative ingredi-Reformulali ng Food Produdtsfor Improved Nulrili on0r: How to improve processed foods quietlysource: https://doi.org/10.24451/arbor.5908 | downloaded: 5.3.202068 REFOR14ULATING FOOD PRODUCIS FOR IMPROVED NUTRITIONFIGURE 1: A systematic approach to manufacturing foods for better pubtic healthSTEP 4Evaluate Impact onBusiness & Society: HealthEconomics for Nutrition5TEP 3Improve Foods:Food Science, Technotogy &Nutrient Profilingents, such as sodium, saturated fats, trans-fats, and energy, and/or by increasing the content of beneflciaI nutrients, such as di-etary fiber, whole grains, fruits, vegetabtes, and micronutrients.Reformulation is appealing because it requires the least changein dietary behavior of the consumer. Reformulating foods overtime with graduaI changes may minimize consumer perceptionand negative attitudes, if both taste and palatabitity are pre-served, thereby keeping food purchasing and consumption pat-terns unchanged. The graduaI reduction of ingredients that areconsidered "baddies" (sugar, sodium, saturated and trans-fats)would go unnoticed by the vast majority of consumers and couldultimate[y reduce individual intakes.T But the nutritionat quatityof processed foods can be improved not just by decreasing the"baddies"; reformutation can also bring positive nutrients - the"goodies" such as vitamins and minerals - into diets and enablefood fortification at Iow cost to increase nutrient density, whichis the ultimate goal of the reformulation process.People's Nutrition &Needs: Dietary IntakeResearchmitments andulations for Reformulationmore than 5Oo/o of the catorie intake in the US and Germany,thus playing a pivoial role in the diets of these populations. Re-search on dietary intake and eating behavior provides a clear-er picture of the types of foods that need to be reformulated,first through the identification of the foods that are consumedby the majority of the population and in the largest amounts.This research therefore identifres the foods for which reformu-lation will have the greatest impact on public health. In theUS, among consumers of pizza,36o/o of the daity sodium intakein the age range of 6 to 19 stems fiom this food item alone.With approximalely 20% of U5 children and adolescents con-suming pizza on any given day, this food item has a very highcontribution to sodium as we[[ as energy and saturated fat in-takes.e This ctearty hightights the need for sodium reduction inthis food category, as the overa[[ sodium intake is we[[ abovethe recommendations. A similar case can be made for sugar inbreakfast cereals, which are often considered a healthy break-fast item by consumers."Nutrient profi[ing is a tooI to guidesuccessfuI reformulation of foods"Diets - meaningfut targets - nutrient profrtingBut where to start and how to do it? Figure 1 describes a system-atic approach to manufacturing foods for better pubtic heatth.sProcessed and prepackaged foods make up an importantpart of diets across the world, accounting, for instance, forStGHT AND LIFE I Vor.32(1) | 2018r.t'&rti'&ä,In view ofthese examples, the need for a systematic approachand tools that can guide successfu[ reformulation becomes obvi-ous. "Nutrient profiting" is one such too[. It is described as thescience of ranking or classifrTing foods based on their nutrientcomposition for the purpose of preventing disease and promot-ing healthlo (see Figure 2).Some systemsll follow this approach, but nearty atl of themstruggle with the defrnition of meaningful reference values forthe amount of a specific food consumed. Two examples i[ustratethis challenge. The serving size of breakfast cereals - between25 g and 40 g - is defined by food producers in many countries.The actuaI consumption of a breakfast cereaI is, however, higher,REFORN4ULATING FOOD PRODUCTS FOR IMPROVED NUTRITION 69leading to a higher intake of sugar than that mentioned on thetabel. A more striking example is prepackaged pizza, with mostlabels reporting 2-4 portions per one whole pizza in a cartonpackage. De facto, the pizza (:OO-SOO g) is mostty eaten entire-ly by one person, resulting in an intake ofsalt that is severalfoldhigher than the [abeled intake per serving.SeveraI regulating bodies across the globe have introduceda per 100 g reference value as a concise anchor. This may seemsomewhat objective at first sight, but it does not take into con-sideration the reatity of consumption as shown in these two ex-amptes: 100 g of cereals/serving is too much, whereas 100 gof pizza is by far too little, making this a complex calculationexercise for the consumer. This ca[[s for clear, transparent, real-istic, and binding targets for critical ingredients in criticaI foodcategories, in this case sodium and sugar, in foods with highimpact on the diet, such as pizza and cereats. Such targets andstandards, in combination with mandatory portion or servingsizes reflecting true consumption patterns, will make productseasily comparabte for the consumer and subsequently drive re-formulation efforts and improved food offerings.Technological challenges and solutionsReduction of public health-sensitive ingredients such as sugarand sali is one of the "classic" ways to approach reformulation.The reach of this is, however, timited, as reduction alone lowersvolume and weight and this is perceived by the consumer as"less for more." Some regulations may define votumes, weight, oreven composition (product identity standards) in certain foodcategories. Possible solutions include replacement, for exampteof sugar with other "fi[[ers" to keep votume and weight stable.However, fitlers such as maltodextrin have similar physiologicaIeffects as sugar and are not recommended, even if permitted byFIGURE 2: Nutrient profi ling principtesFood CategorySpecifrc SystemFOUR KEY PRINCIPLESAge-SpecificTargets and ThreshotdsbT 2 3 4Strict Thresholds for) Energy> "Baddies": Sugar, Salt, etc.> "Goodies": Vitamins, MineralsReference Valueper Actua[[y ConsumedUnit, e.g., Portionor GramsJörg Spieldenner: "One pizza: is that really 2 to 4 portions?"aI!sbloII oE5r.XInternational and NationalDietary RecommendationsProfiting System Nutrient and Energy Targetsfor Food Formulation7O REFOR|\4ULATING FOOD PRODUCTS FOR IMPROVED NUTRITIONmost regulations. Another possibitity is to change the food com-ponent itself by changing its physicat structure. An interestingexample is "hollow sugar," obtained by hottowing out sugar par-tictes so they dissolve more quickly on the tongue. This createsthe perception of an almost identical sweetness as before, butwith much less of the ingredient.l2Reduction ihrough decreasing the particle size and effectinga different distribution in the food product or the food matrix isanother approach. Enhancing taste perception through surfaceoptimization and a more taste-sensitive positioning of the nu-trient is another reduction technique. For instance, sa[t crystalscan be placed on the bottom of the crust of the pizza so thatthe particles touch the tongue immediately for the perceptionof the salty taste. Improvement of the nutrient as such is anoth-er option - for exampte, sodium through a mix of sodium andpoiassium chloride instead of sodium ch[oride onty, given thewidespread inadequate potassium intake. Another possibility isto reptace food components with similar components, as is donewith the reduction of palm oil by partly replacing it with otheroils or oiI mixtures.Another important reformulation front concerns nutrientabsorption. Mixes of minerals and vitamins that are more bio-avai[ab[e and have higher bioefficacy are being developed andtested. Regulations are stitl focused on the amount of the nutri-ent in food content ctaims but without taking into account itsbioavailability, which can be a true game changer in fortification,particularly with iron.Nutrition and sustainabilityReformutation according to nutritional and sustainabte criteriain the spirit ofsustainable nutrition is stitI in its infancy. System-atic evaluations of nutrition and sustainabitity in conjunctionare stitI in the research and concept stage and are yet to be im-ptemented at [arge scale.In short, innovative approaches to reformulation do exist butcome with a cost increase most of the time. This cost increasewill generally be passed on to the consumer, who needs to beconvinced to buy a better product. This means a change in themarketing approach to an inte[ligent way of se[[ing a productwith added nutritionat and sustainabiLity vatue - an endeavorthat needs to be carefutly balanced with silent reformulation andsieering clear of the breaking point of consumer acceptance."Reformulation has thepotentiaI to improve dietsand thus address obesity andnutrition-retated diseases"$ '! ri*.=Conclusion: The context for a successfulimptementationReformutation has the potentiaI to improve diets and thus ad-dress obesity and nutrition-re[ated diseases. The impact onnutrient intake in the diet is immediate without consumersneeding to change their eating habits in a profound way. How-ever, reformulation witI not replace a heatthy diet, and somefood products can never be considered heatthy options. 0nly acombination of voluntary measures and regulations a[ongsideindividuaI behaviorat changes can achieve effective dietaryshifts. Voluntary reformutation based so[e[y upon the good willof the food industry is not sufficient. Why shoutd a food compa-ny invest in and lower its margins for better nutrient density inthe absence of consumer demand or clear-cut regulation if thecompetition is not doing it? It is for nationaI authorities to setregu[ations, creating a levet playing fietd based on their popu-lation's diet and nutrient-density needs. These regulations (nu-trient and composition targets) need to be smart, encouragingfood producers and retaiters to increase nutrient density whilenudging consumers to increase their purchasing of reformu[at-ed foods. Smart regulations as wetI as consumer demand wi[[drive innovation and investment into the food sector that oth-erwise would not be generated. Research investment in foodtechnology, behavior science, effectjveness evatuation (e.g.,heatth economics in nutrition), and at the crossroads of agri-culture, nutrition, and sustainabitity wilt foster interdisciplin-ary knowledge generation and innovative sotutions. Certainly,a mandatory "quiet" improvement of processed foods throughreformutation wi[[ create quite some noise from farmers tofood manufacturers to retailers - yet it is a sine qua non forimproved nutrition.:{ Es" q tf;lr:'1.ts!lA'lt(.-tJrrlIKlazine van der Flbrst: "Although pereeived as\F,gcereals contain large amounts of

Reformulating food products for improved nutrition : Or: How to improve processed foods quietly

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Reformulating food products for improved nutrition : Or: How to improve processed foods quietly

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