Food fads

It’s time to eat better

If 10 billion people are to be fed we need to drop fashionable, damaging diets that have no evidence base and get behind rational advances in food science.

“You are what you eat” may not be a religious chant but, in the prosperous West, it may as well be – as food has become tantamount to a religion for many. Go to any supermarket or restaurant and you are as likely as not to hear somebody fussing over what they will or will not eat: they may be detoxers, vegans, dairy-avoiders, alkaline dieters, low-carbers, gluten-frees. Or an emerging, far more militant type: a “clean eater”, in which almost all modern processed foods and additives – even the healthy ones – are eliminated from their diet.

Such an interest in the ethical and nutritional background of people’s diets should be a good thing. And it would be if such diets had any scientific evidence base – but many don’t. The upshot of this is that, in a world in which 800 million people are undernourished, fussy, faddy eaters with full access to all the food they could want are, bizarrely, voluntarily under-nourishing themselves.

Don’t take my word for it. Take the gluten-free diet as an example of how a fad is working in practice. Check the shelves in any supermarket and a rash of gluten-free options will be readily apparent. But ditching foods containing gluten, a protein complex found in wheat, barley, rye and oats, is a medical measure advised only for people who suffer from coeliac disease, an auto-immune disorder of the gut lining. So the numbers of people on a gluten-free diet, and those diagnosed with coeliac disease, should be pretty similar.

In September, however, a team of gastroenterologists led by Hyun-Soek Kim at Rutgers New Jersey Medical School revealed in the journal JAMA Internal Medicine that they are not – far from it. In figures from 2013 to 2014, they found that 0.58% of the US population were living with coeliac disease. But 1.69% of the population was adhering to a gluten-free diet. So almost three times as many people were avoiding gluten than medically required. “This seems to confirm that the rising popularity of gluten-free diets is not accounted for by any increase in clinically proven coeliac disease,” says Ian Johnson, a nutrition researcher at the Institute of Food Research in the UK. “The origins of the gluten-free movement remain mysterious, but at least it has led to a valuable increase in the range of gluten-free products for those who do need them.”

That last point speaks to the corporate world’s overt willingness to provide products that fuel a fad. “The food industry certainly caters to the latest trends, some of which are positive and some negative,” says Sophie Medlin, who teaches nutrition and dietetics at King’s College in London. “The booming market for gluten-free foods, as a result of gluten being demonised, has led to great improvements in gluten-free foods in terms of availability and palatability, which is really beneficial to coeliac-disease sufferers with a legitimate gluten intolerance. The same can be said of the milk industry and lactose intolerance.”

But there are two big negatives: ditching gluten when you do not need to deprives your body of key nutrients including calcium, iron, fibre and some B-group vitamins, according to the global weight loss organisation Weight Watchers. And the fad has impacted coeliac-disease sufferers, too, says Medlin, because their health problem is now being taken less seriously thanks to it being associated with a fad.

This is just one example of a single food fad at work, one driven by largely unqualified nutrition bloggers. “The internet has amplified the problem as it has given a platform to people who wouldn’t have been able to get a publication deal for a book, or be given a voice on television in the past,” says Medlin. “That in turn has opened up the market for nutritional supplements and diet pills with very convincing marketing campaigns that lead people to believe they have found a quick fix to their health problems.”

They want to believe

So, just what is it about food fads that makes people want to believe them so much? Well, the notion that “we are what we eat” is deeply ingrained – and it’s not just an English-language phenomenon, either. The saying originated in France in 1826 as: “Dis-moi ce que tu manges, je te dirai ce que tu es”, which translates to “tell me what you eat and I will tell you what you are.” In German, in 1863, it was recorded as: “Der Mensch ist, was er ißt.” – or “Man is what he eats.” The English version did not appear in print until 1923. “Fad diets have been around a long time,” says Medlin. “The cabbage soup diet started in the 1960s, while the 1970s was all about diet pills. Then we had the Scarsdale diet in the ’80s, the Atkins in the ’90s and today we have fads like the paleo diet, clean eating, detoxing and the alkaline diet.”

Trying to convince anybody they are following an irrational, unproven diet is tough. As well as lecturing at King’s College, Medlin works as a community dietician. She finds people both hyper-defensive of their particular food fads and eager to “recruit” others to join them in their foodstuff fandom. Sound like any other walks of life? “I have heard people liken nutrition to religion and politics and I can see the similarities,” says Medlin. “I spend a lot of my time trying to explain that nutrition is science and not [religious or political] opinion.”

At the root of it all is the fact that we all eat and so we all have opinions about it and consider ourselves experts. The trouble is, the World Wide Web gives anyone with a hare-brained food theory an instant outlet for it – and social media channels like Facebook, Instagram and Snapchat lend a super-quick way to advertise it to the gullible. “Often this comes from a genuine desire to help. People think: I am thin so I can help you to be thin; I am full of energy so I can help you feel the same. But unfortunately, this saturates people with dietary advice that then leaves them sceptical about the credibility of scientifically valid advice,” says Medlin.

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Measure it to manage it

Quantifying the societal damage is tough: you can’t easily measure mistruths per minute on foodie Youtube channels. But one organisation that has had a go at measuring the degree to which people are being misled by food claims is the European Food Safety Authority. In July 2016 a literature review in the journal Trends in Food Science & Technology, by Hans Verhagen and Henk van Loveren of the National Institute for Public Health and the Environment in Bilthoven, the Netherlands, revealed EFSA results of an analysis of foods labelled and advertised with various health claims. It found that only 250 products out of 3,000 – just 8.3% – performed as advertised, in for example providing the stated lower levels of calories, saturated fat, salt or sugar – or boosting vitamins and dietary fibre. “The large majority of health claims were not supported by scientific evidence,” the pair say.

“It is a fact: there are a lot of unscientific health and nutrition claims about food,” says Francesco Stellacci, head of the Integrative Food and Nutrition Centre (CNU) at the École Polytechnique Fédérale de Lausanne in Switzerland. “These claims come from consumers, from organisations, from the web and from food companies. The problem is there is no truly authoritative place that can counter such claims.” What is needed, he says, are more nutrition research centres worldwide that will allow a global consensus to be reached. Medlin thinks one focus should be on fighting online diet disinformation too: “There needs to be a regulatory body working to discredit the poor dietary messages that are being touted online. That said, we can’t even find a way to stop children watching porn online so it won’t be easy.”

Desperately seeking rationality

Pursuing irrational food fads – and the shameful waste of food in the West – cannot happily continue, however: a food crisis looms and only hard science can answer it. So people are going to have to learn to trust scientists. That crisis? By 2050, the UN estimates, the world population will have grown from today’s 7.5 billion to 10 billion, a potential calamity that needs to presage a sea change in attitudes to food. “We are at a crossroads. How are we going to feed that size of world population?” asks Stellacci. “And in a world where close to 800 million people are currently undernourished how can we still throw away enough food every year to feed 1.2 billion? That’s between 25% and 30% of total food production.”

To answer such questions he set up the CNU. Feeding the 10 billion is going to take some serious food science and technology, involving everything from new ways of farming – moving it into cities, for example, with vertical farms in skyscrapers – to creating artificial protein-engineered meat and milk, to new strains of crops. All will need rational consumers who are willing to stomach it, rather than faddishly refusing it.

The CNU encourages interdisciplinary research in fields from artificial intelligence to augmented reality to genetic sequencing of the bacteria that live in our stomach and bowels – the “gut microbiome”. These are fields, Stellacci says, which are now looking promising for improving nutrition. How so? Future augmented-reality glasses could allow people to glance at a meal and get an instant readout of the firm’s true – science-based – “healthiness”. Such technology has already been tested on diabetes patients, with glucose content flashed before their eyes on a Google Glass headset. And machine-learning algorithms designed to predict crop health from multispectral satellite imagery could aid farming, too, by helping predict agricultural output.

Backing the “you are what you eat” notion strongly, says Stellacci, are the frequent research revelations on what the gut microbiome actually does. “There is a lot of research now showing that the bacteria that live in the gastrointestinal tract might be linked to conditions like depression, attention deficit and even Alzheimer’s.” He stresses that many studies are on animals and that human studies are needed – but his hunch is that food scientists will need a strong focus on the gut microbiome. “The European Commission should put a lot more money into this type of research, as it affects our future fundamentally,” he says.

Another aspect of that future is climate change. New strains of crops able to cope with drier soil and warmer weather may be needed – but Stellacci sees no pressing need to use genetically modified strains that will raise concerns amongst the food fad fraternity. Instead of GMOs he suggests using genetically selected organisms (GSOs) chosen through conventional crossbreeding but with a computational twist. By using big data analyses of the world’s existing, highly biodiverse crop variety genomes, he thinks it will be possible to breed plants with just the right climatic tolerances.

The cattle industry’s high carbon, water, energy and land impact will also be challenged on sustainability by the development of plant-protein-based artificial meat: steaks and burgers fashioned from mass produced plant proteins. At the University of Wageningen in the Netherlands, for instance, Harry Wichers and his colleagues are in the midst of a fascinating three-year programme to develop meat substitutes based on chickpea protein. In the US similar attempts at meat-free burgers and non-cow “cow’s milk” are ongoing. They are going the right way, says Stellacci: “We need a lot more research on how to grow alternative proteins for growing populations.” But, he adds, it might also be worth reducing how often we eat “meat” – even if it is from animal-free artificial protein.

“Some projections say that if we just eat vegetable-based foods we might be okay for feeding 10 billion people. But which vegetables? How many will go to make artificial meat protein? “I don’t think anybody has the answer and we need to get working on that,” Stellacci says. Whatever happens, there’s one concept all the machine learning analyses and artificial food in the world won’t change: “In the end nutrition is everything. From the time you’re a child it determines your development. And what you eat and how active you are will determine your quality of life.”

Ian Johnson (nutrition researcher at the Institute of Food Research in the UK), Sophie Medlin (teacher at King’s College in London), Francesco Stellacci (head of the Integrative Food and Nutrition Centre (CNU) at EPFL)