Download ASSOCIATE PARLIAMENTARY - All Party Parliamentary Food and

ALL PARTY PARLIAMENTARY
FOOD & HEALTH FORUM
Paleo diet, human microbiome & healthier processed foods
3.30-5pm, Tuesday 11 October 2016
Committee Room 2a, House of Lords
Minutes
Introduction
Lord Rea welcomed members and guests to the meeting being held to discuss the “paleo” diet, the
significance of the human microbiome and the scope for healthier processed foods. He then introduced
the guest speakers: Dr John Briffa, a practising doctor and author: Tim Spector, Professor of Genetic
Epidemiology & Director of the TwinsUK Registry at King’s College London; and Dr Christian Salles, Coordinator of the EU-funded TeRiFiQ1 research
Dr John Briffa
Dr John Briffa said that when we think about carbohydrates we usually think of starchy foods like bread,
potato, rice and pasta, but sugary foods are also ‘carbohydrate’, and the common factor here is sugar:
starch is essentially made of chains of sugar (glucose) molecules. Eating carbohydrate causes blood
glucose levels to rise, in response to which the body normally secretes the hormone insulin. Insulin
facilitates the uptake of sugar from the bloodstream into the cells, bringing blood sugar levels down again.
Ideally, the body should keep blood sugar levels quite stable. When instability occurs, it can cause
problems in both the short and long term. Low blood sugar levels can cause symptoms such as fatigue
and mental lethargy (typically in the mid- late-afternoon), sweet cravings and sleep disturbance. High
levels of sugar will tend to provoke gluts of insulin that can predispose to issues such as fat gain,
cardiovascular disease, type 2 diabetes and dementia.
Ensuring relatively stable levels of blood sugar and insulin in key to health and wellbeing, both in the short
and long term. A fundamental here is to base the diet on foods that release sugar relatively slowly into
the bloodstream. The speed and extent to which foods disrupt blood sugar is represented as a
measurement known as the glycaemic index (GI). Glucose and table sugar (sucrose) have GIs of 100
and 68 respectively. Many starchy foods including bread, potato, rice and breakfast cereals have GIs
approaching that or even higher than table sugar. This is compounded by the fact that many of these
foods tend to be eaten in quantity. So, while pasta and kiwi fruit have similar GIs, in reality pasta is likely
to be much more disruptive as a meal is often based on it, while kiwi fruit is generally eaten in much
smaller quantities. Also, fruit is generally reasonably nutritious, whereas a food like pasta is not; it is food,
but it could also be described as fodder. Carbohydrate foods that have lower GIs include green
vegetables, salad vegetables, beans, lentils and certain fruits including berries. Other foods that tend not
to disrupt blood sugar are those rich in protein including meat, fish, eggs and nuts.
John Briffa asked what common sense would dictate is the best diet for human health and said that one
answer is a diet based on the foods we have been eating the longest. We believe humans have evolved
over 2.5 million years and for the great majority of that time we ate only hunted and gathered foods (such
as meat, fish, eggs, fruits, vegetables and nuts). It appears we only started to eat grains about 10,000
years ago, so relatively recently from an evolutionary perspective. While the inappropriateness of grains
is theoretical here, in fact it is consistent with what we know about them: that they are disruptive to blood
sugar and insulin levels and are not particularly nutritious. However, while red meat is a primal food, it is
generally said to be unhealthy. There is inconsistency here: either the nutritional evolutionary theory is
correct, or red meat is unhealthy; it can’t be both.
1
Combining Technologies to achieve significant binary Reductions in Sodium, Fat and Sugar content in
everyday foods whilst optimising their nutritional Quality.
1
One major criticism of red meat is that fact that it contains so-called “saturated fat”, which we are told can
cause heart disease. The evidence used to convict saturated fat was essentially a single study published
in the 1970s (slide 16). This research, the Seven Countries Study, was epidemiological in nature,
meaning it can show associations between fat and heart disease but it does not prove causality. It also
looked at limited evidence and looking at additional available evidence from the time the data shows little
or no relationship between saturated fat and heart disease (slide 17). The most recent evidence we have
shows, if anything, a negative association between saturated fat and heart disease across counties (slide
20). None of the major meta-analyses of epidemiological evidence performed over the last few years
have found an association between saturated fat and cardiovascular disease (slide 21). Most importantly,
though, is the fact that in studies eating less saturated fat has not been found to translate into benefits in
terms of risk of heart disease, heart attacks, stroke, or overall risk of death (slide 22).
Paleo diets tend to be lower in carbohydrate than more traditional “low fat, high carb” diets, and this
feature of them tends to translate into a wide range of improvements in disease markers (slides 23, 24).
Dr Briffa suggested that other features of the paleo diet worth considering are that it is relatively simple,
requires no calorie-counting or portion control, and it does not leave individuals feeling hungry so they
are happy to eat this way in the long term. Dr Briffa added that his clinical experience is that adopting
this way of eating generally leads to sustained weight loss (where this is an issue) and considerable
improvements in vitality and general wellbeing.
Tim Spector FMedSci, Professor of Genetic Epidemiology & Director, TwinsUK Registry, KCL
Tim Spector said that for the last 25 years he has been studying twins at the TwinsUK Registry at King’s
College London. These people are among the most studied people n the planet and, with them and other
groups, over 100 genes for obesity have been discovered but they do not explain much of the difference
between people and Tim felt something was missing. A few years ago he decided that his next book
would be about the human microbiome. He wanted to look at what information we have about how to eat
healthily and lose weight.
Most of the official advice we have on healthy eating stems from the Eatwell Plate (see slide 3), which
exhorts us to count calories, regard all calories as equal, avoid high fat foods, eat starchy foods, not to
skip meals and to balance calories consumed with the calories we use in exercise. We have been
following this approach for decades while obesity levels and allergy levels have hugely increased.
Tim suggested that there is a lot of misinformation about diet and health, but there are some things on
which everyone agrees, such as the benefits of eating lots of vegetables and fruit. The Paleo approach
may be good for some people, but there is no real science behind it. We have evolved in the last 10,000
years to eat starch, grains, milk and drink alcohol.
Carbs and Fructose has been demonised by some people; others are very hostile towards high fat diets,
or dairy products; others don’t like red meat. If we were to follow all this advice, we would only be left with
a kale smoothie and vitamin pills! Tim emphasised that it is not quantity, but quality that we need to focus
on.
The PrediMed study published in 2013 (see slide 5) looked at the Mediterranean diet in 7000 people
versus a low fat diet over 5 years and showed clear and large differences across a range of health
outcomes that favoured the Mediterranean diet. They eat lots of saturated fat (olive oil) as well as a little
of everything!
We are not alone. We have 100 trillion microbes in our guts, which outnumber our genes 100:1. The
microbes in our gut weigh 2kg – about the same as our liver. We have evolved with them over the years
and it seems that the microbes in us will respond to our diet and they will vary hugely between individuals.
Our microbes have been shown to be more significant for our response to our diet than the GI content of
our food.
Tim and his colleagues have studied 3000 pairs of twins looking at the human microbiome. Humans are
born sterile in terms of microbes unless we are born by caesarean section; babies born by caesarean
section have a 20% higher risk of having food allergies and of being obese than babies born naturally.
We all possess a unique set of microbes a bit like a fingerprint, but we can modify our microbiome. Tim
and his colleagues found some microbes that are only found in lean people – christensenella and
akkermansia. When they transplanted christensenella into mice it protected them against obesity (see
slide 8). If we can understand how these microbes work and how we can develop more of them it could
have a huge impact on public health.
If you are overweight your microbiome is likely to resemble the Arizona desert, but in healthy people who
are not overweight the microbiome is likely a diverse English garden (see slide 9). Tim’s research found
that the more diverse your diet, the more diverse your microbiome.
Feeding junk food to mice has been shown to alter their microbes. Junk food in humans is little studied.
So Tim used a British student – his son – to test an intensive junk food diet for 10 days (burgers and
chicken nuggets, supplemented only by beer and crisps. After 4 days his son asked if he could stop
because he was beginning to feel unwell. He did survive the 10-day diet, but his microbiome suffered a
40% loss of diversity (see slide 11). It is not known for certain why this happened. It could be linked to a
mixture of high calories, high fat and sugar combined with a lack of fibre and so nutrients for the microbes
in the lower intestine. However it could be other effects of processed foods like the effect of emulsifiers,
and preservatives which have been shown by research in mice to reduce microbiome diversity. There
are many other things in highly processed foods that have an adverse effect on our microbiome diversity
but they have not been properly studied yet.
There are a lot of foods in the Mediterranean diet that would not be allowed in the Paleo diet and which
contribute significantly to a diverse microbiome and health. They also have a lot of polyphenols that
produce immune enhancing chemicals. Red wine, for example, has a high polyphenol count as does
coffee, green tea, nuts, seeds and 70% dark chocolate. Olive oil underpins the Mediterranean diet and
seems to be significant for health. The Mediterranean diet also includes probiotics which have been
shown to be good for unhealthy or frail people or people taking antibiotics, but which have had mixed
results for people who are healthy.
The last hunter gatherers on the planet, in Tanzania, eat about 600 different foods during the year,
compared with about 20 for people in the UK who eat a lot of processed foods.
The average 18-year-old in the UK has had about 17 courses of antibiotics and even 3-year-old babies
have had an average of 2.5 courses. Animals become obese when they are fed antibiotics – including
humans! Some 50% of antibiotics sold in the UK are used on animals or agriculture, (in the US 80%).
This means we are also getting antibiotics in small quantities from our food, which potentially disrupts the
microbes in our guts.
If we have taken too many antibiotics and cannot sort it out with probiotics, you can sort it out by using
donated microbes from the guts of healthy people, known in America as “crapsules”, which have really
helped people with serious illnesses, such as infectious colitis where it is the number one treatment, but
it is important that the donor is healthy.
Tim emphasised that we need to tend our microbiome by eating a diverse diet. He stressed the
importance of good food education, which he suggested should be a compulsory part of education for
everyone, including health professionals, as doctors only receive a few hours of instruction in nutrition
which is clearly insufficient. He suggested healthy eating guidelines should focus on Mediterranean diet
style diversity and fibre intake, not particular food groups. There should also be better education about
the side effects of excessive use of antibiotics, caesarean sections and processed foods. Tim also
encouraged the Government to stop subsidising low diverse processed foods and shake up nutritional
research, which needs to focus on more largescale and long term research, such as a UK version of the
Spanish Government funded PrediMed study.
Dr Christian Salles, Co-ordinator of TeRiFiQ research project
Dr Salles began by making the point that healthcare costs could be reduced and lives could be saved in
many developed countries if people significantly reduced their salt, fat and sugar intake, thereby reducing
their risk of certain chronic diseases.
Public health organisations would like to see many processed foods reformulated, but sodium, fat and
sugar are often key ingredients in these products playing an important role in the structure of food and
perception of flavour. In several cases, they are linked to multiple functionalities of the food, influencing
texture, flavour and mouth-feel characteristics. which have a large influence in terms of food acceptability
and thereby consumers’ preferences. So, any changes in their concentration or their substitution will
affect many properties of the food concerned.
The overall objective of the TeRiFiQ research project was to achieve significant binary reductions in the
sodium-fat and fat-sugar content of the most frequently consumed food products around Europe, whilst
ensuring the products’ nutritional and sensorial qualities, safety and affordability for both industry and
consumers, so as to ensure wide adoption of the project technology at European level.
TeRiFiQ focussed on the 4 major food categories targeted by the European Commission (EC): bakery,
meat, dairy and ready-to-eat foods, which are the main vectors for sodium, fat and sugar. TeRiFiQ
involved 17 partners and covered 9 EU countries2. The project ran from January 2012 until the end of
2015. The 3 first years were dedicated to research at lab scale and the last year was dedicated to
demonstrating that the reformulations developed in the lab could be easily transferred and developed at
industrial scale.
The first role of salt in cheese is to regulate and control the fermentations, which control the ripening
process and affect the final quality (texture, functionalities, taste, aroma). TeRiFiQ obtained salt
reductions with a good acceptability for cheeses such as Brie, Raclette and Trappist semi-hard cheese
(up to -30%). However, for “smear” soft cheeses, a reduction of salt of only 10% lead to an unacceptable
product because of the growth of micro-organisms on the surface of the cheese. The unsaturated fatty
acids content in these cheeses was improved using particular sources of milk fat obtained from cow fed
with linen seeds. TeRiFiQ produced, for example, a Brie cheese with -30% salt content and -8% saturated
fat content.
In processed meat products such as cooked and dry fermented sausages, salt provides 2 further
important functions: increasing microbial safety, thereby extending shelf life; and improving functional
properties such as texture, water binding, and cohesiveness. Simply reducing the salt content in meat
products has a negative impact on these sensorial, processing and microbial factors. However, TeRiFiQ
developed cooked sausages with -20% salt and -24% fat content; and 2 dry fermented meat products:
dry sausages (fuets) with -35% salt and -70% saturated fat content; and chorizo with -30% salt and -40%
fat content; using different strategies for each product. Different strategies were examined in combination
such as: use of multiple emulsions; use of lean meat to decrease fat content; and use of prerigor meat,
additives, optimisation of the technological conditions; and pre-drying of raw meat material to reduce
water activity (in the case of dry meat products).
Fat and sugar are both structural ingredients in bakery products. TeRiFiQ considered 2 types of cakes:
muffins and madeleines, using slightly different technologies for each of them. The main strategy focused
on the combined use of double emulsion, water-in-oil-in-water; polymers such as inulin and polydextrose;
and the use of natural and high potential sweeteners and aromas associated with sugar. Using this
technological approach, the main challenge was the stability of the double emulsions, which should
become an applicable ingredient in bakery products in terms of structural, textural and sensory properties.
TeRiFiQ was able to develop muffins with -25% sugar and -40% fat content and madeleines with -30%
sugar and -30% fat content.
The fat content of sauces used in ready meals was mainly reduced by the use of multiple emulsions.
Where possible, sodium and sugar reduction strategies were investigated using different strategies such
as the use of aromas, spices, and natural sweeteners. A pizza sauce (high fat, high salt, low sugar) and
a sweet cream (high fat, low salt, high sugar) were investigated for reformulation and TeRiFiQ developed
pizza sauces with -20% salt and -30% fat content; and sweet cream with -30% sugar and -30% fat
content. The potential of multiple emulsions to reduce the fat content in sauces significantly was high
because only a small effect was observed on the sensorial properties of the food, which could be
optimised by the droplet size and interfacial structure of emulsions.
All the reformulated foods developed by TeRiFiQ have good nutritional, safety, sensory properties and
consumer acceptance.
Knowledge on mechanisms controlling in-mouth perception processes and cross-modal perceptual
interactions were also developed so that they could be used in the development of innovative
reformulation strategies. These can interact and the overall perception of flavour depends upon different
sensory perceptions, including taste, aroma, chemosensitivity and texture. Perceptual interactions were
studied as a putative lever to compensate for salt, sugar and/or fat reduction. TeRiFiQ found that salt2
Belgium, France, Germany, Italy, the Netherlands, Norway, Romania, Spain & UK
associated aromas and fat associated aromas can enhance saltiness and fat perception in different solid
foods but these effects are highly dependent on the composition and the texture of the food matrix.
In the final phase of the project, TeRiFiQ selected the most promising reformulated products in each food
category to study at industrial scale according to both technological and sensorial criteria. Each of 11
SME partners involved in the project then applied the reformulations developed by TeRiFiQ in the lab at
an industrial scale using and adapting existing processing lines.
The quality of the industrial reformulated products was evaluated in term of acceptability by the consumer,
overall quality and affordability. Consumers’ response to the reformulated products was evaluated in
“real life” conditions when consuming at home for both their appreciation and their willingness to pay. The
new products were also compared to the non-reformulated products and commercial products in the
same category.
Among the tested products, the reformulated chorizo and dry sausages were significantly more
appreciated than the initial, reformulated products. For the semi-hard cheese and muffins, no difference
in appreciation was found between the reformulated and non-reformulated ones. Only the reformulated
cooked sausages were less appreciated by consumers than the non-reformulated ones; apparently this
was mainly due to their texture, not their flavour. Consumers were willing to pay more for the reformulated
chorizo and dry sausages than for the non-reformulated ones, but for the semi-hard cheese, cooked
sausages and muffins, no difference in willingness to pay was found between the reformulated and nonreformulated ones.
In all the cases, a positive correlation was reported between appreciation of the products by consumers
and the maximum price they are willing to pay. The willingness to pay before and after the consumers
know the real price of the food were maintained for the Trappist cheese, chorizo, dry sausages and
muffins though they try to adjust their willingness to pay to the real price. The willingness to pay after
knowing the real price increased significantly only for the reformulated cooked sausages in comparison
with the non-reformulated one. There was no difference in consumer ranking between the reformulated
and non-reformulated semi-hard cheese and muffin and they were both ranked with a higher value than
similar commercial products. The reformulated chorizo and dry sausages were ranked with a higher value
than the non-reformulated products and with the same value as the store brand; but the reformulated
cooked sausages were ranked with a lower value than the non-reformulated product, the store and the
trademark brands. Surprisingly, in most of these cases, the trademark brand had the tendency to be
ranked with a lower value than the store brand. TeRiFiQ found that consumers are willing to pay up to
12% more for the “quality” of the most appreciated reformulated products and this margin could be used
by the food industry to cover the additional costs of the reformulation process.
The biggest success of TeRiFiQ is that several reformulated food products developed in the project are
already being marketed, including dry sausages and chorizo in French and Italian supermarkets, and
more reformulated products will be more widely distributed in the near future, including a reformulated
Trappist cheese in the local shop of Orval Abbey in Belgium. Several other food products developed by
the TeRiFiQ project are ready for launch onto the market, such as muffins, cooked sausages, tomato
sauces and sweet filling cream. Some SMEs are also in contact now with the ProBio project (H2020) to
pursue the development of new food products and their marketing. Dr Salles emphasised that there is
no universal strategy for food reformulation but different strategies can be adapted and fine-tuned to suit
different foods.
Questions
Lord McColl suggested that the rationing system used in the UK during the war – when people had small
portions of everything and wholemeal carbohydrates were consumed - produced an ideal diet and the
health of the nation has never been better. Tim Spector agreed that there were lower levels of illness
during the war, fewer heart attacks and fewer complaints, but perhaps this was because people had other
things to worry about. People ate less red meat during the war, but their diet was much more diverse
and they tended to eat the whole animal, wasting much less.
Dr Lynn Fitzgerald of St George’s University London (SGUL) noted that Christian Salles said that
emulsifiers were essential to make processed foods palatable and to make them last, but Tim Spector
suggested they could be problematic for microbiome diversity and asked the speakers to comment on
this. Tim Spector said it was interesting that debate has focussed so much on a few ingredients, such
as saturated fat and sugar, when the evidence does not show that sugar is directly responsible for our
health problems and it is time we looked more carefully at what we are adding to processed foods, which
could be causing more problems. He said it is good to know that these foods can be reformulated and
still be attractive to consumers, but we have not studied the impact of all the chemicals we add in
combination to processed foods. Nigel Dickie of Heinz UK emphasised that Heinz does not add
emulsifiers to any of its products – Heinz Tomato Ketchup only contains 5 ingredients – not least because
the founder of the company was an advocate of pure foods and avoided adding extra ingredients, so you
can enjoy Heinz products without concern! He asked Christian Salles to comment on the companies that
have benefited from the TeRiFiQ research project. Christian Salles said that apart from the 11 SMEs
involved in the research project, guidelines have been produced for other companies and new products
are being developed, but TeRiFiQ has not worked directly with any other companies.
Jerome Burne, a freelance journalist, noted that trans fats, now phased out, had been used by the food
industry because of the technical advantages they conveyed and he wondered if we reduced the
saturated fat content of processed foods we might replace it with something worse. John Briffa said it
was a good question and there is a risk in swopping one ingredient for another, but we will not know what
affect new foods have on people until they eat them. He does not believe they will be rigorously tested
on people before they are introduced and he would not eat them himself, not least because he does not
think there is sufficient evidence that saturated fats are bad for health. Tim Spector said that, as we had
just heard from Christian, food scientists are great at making processed foods which taste good and
individually all these additives may be OK in themselves, but we do not know how they work in
combination with other enzymes and ingredients in processed foods.
Lucy Jones of the British Dietetic Association (BDA) said that we had heard 2 approaches to healthy
eating from John Briffa and Tim Spector, neither of which were “low fat” diets, although the Mediterranean
diet contains lower amounts of fat as the proportion of dairy products involved is relatively low. She asked
whether the merits or harm associated with eating saturated fat depends upon what you replace it with.
She suggested that clarity is really important in talking to the public about healthy eating so it helps if you
can say, for example, that eating grains and seeds is OK. John Briffa said that the Cochrane review
that he referred to in his talk (see slide 22) found no benefit from reducing saturated fat intake on clinical
endpoints. He agreed that there may be other foods which are healthier than foods high in saturated fat,
but emphasised that the evidence does not show that saturated fat is bad for health. He noted that there
are other differences between the Mediterranean diet and paleo diet and asked if Lucy would recommend
the former, which includes grains, for a person with insulin resistance. Lucy Jones said she would
recommend such a person ate wholegrains, although portion sizes are important, and whether they
remained insulin resistant would depend on their weight. John Briffa suggested that if an insulin resistant
person removed grains, including wholegrains, from their diet this would reduce the glycaemic nature of
their diet, improve blood sugar control and may improve insulin sensitivity. He said he would not
personally recommend grains to an insulin resistant person because it essentially increases the chances
that they will remain in a pre-diabetic or diabetic state. Tim Spector suggested that we need to separate
diets for diabetics and diets for healthy individuals. For a healthy person carbohydrates and calories
probably do not matter too much. There isn’t any good, long-term evidence for the paleo diet one way or
the other. The evidence suggests to him, based on the big studies of outcomes, that the Mediterranean
diet which includes a little of everything, including significant quantities of olive oil, which is also used in
cooking, is supportive of health. It is not proven that the paleo diet is better or worse than a low fat diet.
We are evolved to digest milk, grain and alcohol and diversity is the key to health. It is more important to
eat a diverse diet than to cut out any individual foods.
Lord McColl asked the speakers if they would agree that you cannot be obese unless you are eating too
many calories and that obese people do not have to increase activity levels to lose weight. John Briffa
and Tim Spector both agreed that while exercise may be good for you it does not necessarily help people
lose weight. Tim Spector added that calories alone are not the only answer; it depends on what you eat
and the same foods will have a different effect on different people.
Catherine Collins of SGUL said that Christian Salles had talked about empowering people to eat a
healthier diet and she noted that carbohydrates do deliver a lot, including acting as a basis for other foods
and bacteria. She asked John Briffa how he decides which carbohydrates people should exclude from
their diet and the evidence to substantiate those choices. John Briffa said that the paleo diet does include
carbohydrate, such as fruits and vegetables, and he was critical of the carbohydrates he thinks are most
problematic for health. He referred the evidence set out in his slides which showed that some starchy
carbohydrates are very disruptive for blood sugar and insulin levels, particularly when eaten in quantity.
Tim Spector said that there is no evidence that reducing saturated fat intake has any long-term effect on
human health. Catherine Collins said that as nutritionist seeing diabetic patients she would be very
concerned about putting them on a low carbohydrate diet because of the associated CVD risk and she
asked if the speakers’ message today was “keep things in balance”. John Briffa said that the diet he
would recommend for human health was as set out in his presentation. He said that fundamentally
diabetes is a problem with people not being able to control their blood sugar levels and when you restrict
their carbohydrate intake you generally get a massive improvement in their condition, with many of them
returning to a non-diabetic state and other associated improvements, and this is true for a wide range of
individuals. He suggested that unbiased doctors would generally be delighted with the improvements
their patients achieve eating this way.
Lucy Jones of the BDA referred to the Newcastle study funded by Diabetes UK, which examined 11
people with diabetes who reduced their food intake to 800 calories per day for 8 weeks. It found that 3
months later, 7 of the 11 people studied were free of diabetes. Tim Spector said that diabetics are a
separate group and it is important to prevent people from becoming obese and developing diabetes. He
said we need to change the balance in our approach to food and instead of focussing on calories or
individual ingredients such as fat, sugar or protein, focus instead on our overall diet. He said that Public
Health England (PHE) has decided to focus on processed foods and foods promoted to the public –
because 40% of all the food we buy is bought in supermarkets on special promotions. He said he is very
concerned about this, as he is by the excessive use of antibiotics, and we need to educate people so that
they think about their gut health. We should not see food simply as fuel and starting to introduce prebiotics
into food would be a good step forward. He emphasised that it does not matter if you have the odd
burger, so long as you have a healthy microbiome, but if you only ever eat processed foods then you will
not be healthy.
Dr Jenny Lisle of the Royal Colleges of Physicians Faculty of Public Health said the food industry does
make very attractive food, but there is a conflict between what people should eat and what they are being
offered and modern lifestyles leaves many people with little time to cook. She added that it is difficult to
convey simple clear messages on healthy eating to the public and she asked the speakers what they
would suggest based on their understanding of current evidence. John Briffa said he would suggest
eating a diet based on natural, unprocessed food. Tim Spector said people should eat real food, more
fruit and vegetables and more fibre, but the problem is that people want cheap and convenient foods,
which is why PHE has shifted the focus of its work. The quality of food eaten has a real impact so perhaps
we should encourage people to eat unprocessed foods on alternative days. He said people can change
their microbiome for the better in a month by eating high fibre bars and retailers could support people to
eat more fruit and vegetables by including them in price promotions and offering simple recipes with them.
Professor Jack Winkler noted that Tim Spector had suggested there isn’t enough good research on
nutrition and he had been critical of rat-based research and he asked if Tim thinks we will ever get the
sort of long-term, big studies of people, which is difficult to secure funding for and difficult to do because
of the practical difficulties involved in controlling what people eat. Tim Spector said he believes the UK
could do this and he referred to the study of the Mediterranean diet carried out in Spain for 10 years which
he thinks is a good example for other countries. He suggested a British version of this might look at
optimum diet and the capacity for changing people’s long-term habits. Jack Winkler said his wife was a
member of the UK biobank and he had been appalled by the quality of the questionnaires she had been
asked to complete, which he did not think would generate good evidence. Tim Spector said he could
not comment on the questionnaires, but the UK Biobank had produced fantastically valuable evidence
for studies of genetics and other countries are copying our lead on this. He added that as David Cameron
had championed certain research fields, we need a champion to lead support for research on obesity and
diabetics.
Conclusion
Lord Rea thanked the guest speakers and announced that FHF members will meet next on Wednesday
30 November when the only guest speaker will be Dr Liam Fox, Secretary of State for International Trade,
talking about Brexit.
CLC, October 2016