Part of the conference series

Transforming our future

Advancing the science

of human nutrition
Held on 4 December 2023

Conference report
Introduction
On 4 December 2023 the Royal Society hosted a hybrid conference on Advancing
the science of human nutrition. This meeting forms part of the Royal Society’s
Transforming our future series.

Image: Delegates at the meeting.

The Transforming our future conferences are unique, high- The conference series forms part of the Royal Society’s
level meetings featuring cutting-edge science. They bring Science and Industry programme which demonstrates the
together experts from industry, academia, funding bodies, Society’s commitment to integrating science and industry
the wider scientific community and government to explore across its activities, promoting science and its value,
and address key scientific and technical challenges of the building relationships, and fostering translation.
coming decade. These conferences are organised with
the support of the Royal Society’s Science, Industry and The programme for this meeting focused on nutrition was
Translation committee. organised by Dr Sarah Berry (King’s College London and
Zoe Ltd), Professor Richard Flavell CBE FRS (International
Wheat Yield Partnership), Professor Cathie Martin FRS
“At the end of the day, we all want to improve (John Innes Centre and University of East Anglia), and Dr
Andrew Morgan (Royal Society Entrepreneur in Residence,
the health of the population. To do this, we
University of Exeter).
need to use all the tools we have, including
pharmacological solutions, personalised
nutritional and lifestyle guidance, and
numerous other approaches.”
Dr Sarah Berry, King’s College London and Zoe Ltd

Advancing the science of human nutrition – Conference report 2

An opening keynote from Professor Julie Lovegrove This report is not a verbatim record, but a summary of the
(University of Reading) set the scene for the day by discussions that took place during the day and the key
discussing how nutritional research can inform government points raised. Comments and recommendations reflect the
policy to facilitate healthy outcomes, using recent work views and opinions of the speakers and not necessarily
on saturated fat as a case study. Three sessions of talks those of the Royal Society.
focused on: (i) nutrition-associated determinants of
health; (ii) bioactives and biofortification; and (iii) nutritional,
behavioural and pharmacological interventions. A panel “The Royal Society is dedicated to promoting
discussion explored several themes including how to
excellence in science for the benefit of
create a sustainable food system, rethinking science for
the sake of science, collaboration between academia and humanity. Exploring the future of human
industry to inform policy, and the importance of education. nutrition science is closely aligned to this aim.”
The event finished with a closing keynote from Henry
Professor Richard Flavell CBE FRS, International Wheat
Dimbleby MBE (LEON and the Sustainable Restaurant
Yield Partnership
Association) which explored the future paths the UK may
take in its efforts to tackle the challenges associated with
diet-related ill health.

Advancing the science of human nutrition – Conference report 3

Executive summary
Nutrition plays an important role in health and wellbeing. Poor nutrition is a leading
cause of chronic disease, including type 2 diabetes, non-alcoholic fatty liver disease,
cardiovascular disease, and various forms of cancer. With an increasingly overweight
and ageing UK population, the incidence of such diseases and the associated
healthcare costs continue to rise.

Image: Delegates at the meeting.

The Advancing the science of human nutrition conference

brought together speakers from industry and academia “Diets that tell you what not to eat are of little
to discuss how scientific breakthroughs can be translated interest. People want to know what foods
into effective strategies for improved health, including the are good for them and how they can improve
prevention and management of chronic disease. Topics
their health.”
covered during the meeting included:
Professor Cathie Martin FRS, John Innes Centre and
Evidence-based policy for prevention University of East Anglia
• Encouraging dietary change via nutritional guidelines can
be challenging. A case study showed how provision of
tailored foods (eg substituting saturated with unsaturated Nutrition-associated determinants of health
fat in dairy products) can contribute to compliance with • Novel technologies and community science approaches
current saturated fat recommendations. are now being used in combination with clinical, in vivo
and in vitro studies to offer new insights into nutritional
• Although pharmaceutical approaches may help tackle
science.
some issues associated with diet-related ill health, it is
important to consider the role of prevention and the need • A person’s genetics can influence their appetite, and
for large-scale changes to our food system. understanding this link can inform personalised treatment
for obesity as well as public health policy.

Advancing the science of human nutrition – Conference report 4

• Interactions between diet and the human microbiome
can shape health outcomes, which can be particularly
“The UK has an impressive range of capabilities
important for infants in terms of immune function and
disease susceptibility. in the multidisciplinary science
of human nutrition. We must continue to build
Bioactives and biofortification on this foundation to urgently find practical
• Machine learning approaches and multivariate analysis of solutions to the ever-growing problem of
metabolomes and metagenomes can provide insight into
diet-related chronic disease and ill-health.”
the chemicals produced by gut microbiota that impact
human health. Dr Andrew Morgan, Royal Society Entrepreneur in
Residence, University of Exeter
• Understanding how dietary bioactives impact the function
of gut microbiota will be key to future efforts to improve
health through new food products or food-based dietary
guidelines.

• Biofortification increases the nutritional value of food

pre-harvest and can be a useful tool for addressing
micronutrient deficiencies, particularly for populations
with limited access to a diversified diet.

Nutritional, behavioural and pharmacological interventions

• Interventions to encourage dietary change should be
tailored to target groups, taking socioeconomic status,
current diet and food insecurity into account.

• Interventions can be delivered cost-effectively and at

scale, as demonstrated by two studies that showed the
benefits of weight management therapies delivered in a
primary care setting and personalised nutritional advice
delivered over the internet, respectively.

• Analogues of the intestinal satiety hormone GLP-1 are

proving effective as a therapeutic option for weight loss
in obesity.

• Supermarkets can incentivise healthier and more

sustainable choices through data-driven approaches
to managing price, promotions, range, marketing and
merchandising.

Advancing the science of human nutrition – Conference report 5

 KEYNOTE

Policy to plate – The case of translating

dietary saturated fat guidance into practice
Professor Julie Lovegrove, University of Reading, explored the evidence for saturated
fat recommendations and discussed how food policy can be translated into practical
dietary change.
Cardiovascular diseases (CVD) are a major cause of death
globally. There is inequality in their prevalence in the UK,
as it is almost four times more likely to occur in low-income
groups. This is partially due to dietary differences between
income groups.

Metabolic syndrome is a collection of conditions that

signify a person is at risk from type 2 diabetes and CVD.
These conditions include obesity, insulin resistance, high
blood pressure, high blood triacylglycerols levels and low
concentrations of high-density lipoprotein (HDL) cholesterol.

The relationship between cholesterol and CVD is complex.

High levels of HDL cholesterol are associated with a
reduced risk of CVD. Conversely, high levels of low-
density lipoprotein (LDL) cholesterol, particularly small
dense LDL-cholesterol, increase the risk of CVD because
LDL-cholesterol is intimately linked to atherosclerosis,
accumulating in plaques in blood vessels, causing them Image: Julie Lovegrove, University of Reading.
to narrow.
A study of 543 men and women at risk of metabolic
Dietary intervention research syndrome examined how replacing dietary SFAs with either
There is compelling evidence that replacement of dietary mono-unsaturated fatty acids (MUFAs) or carbohydrates
saturated fatty acids (SFAs) can reduce the risk of CVD. impacted insulin resistance and other CVD risk factors2.
The degree of reduction depends on numerous factors Replacement of SFAs with either MUFAs or carbohydrates
including the type of replacement. had the beneficial effect of reducing LDL-cholesterol levels,
although only MUFA replacement had a beneficial impact
A meta-analysis of published randomised control trials on the clinically relevant total cholesterol:HDL-cholesterol
showed that replacing SFAs with poly-unsaturated fatty ratio. A different study followed 183 people at risk of CVD
acids (PUFAs) was linked to a 27% reduction in CVD and found that replacing SFAs with either PUFAs or MUFAs
events. However, replacement of SFAs with proteins or had beneficial impacts on both LDL-cholesterol and total
carbohydrates showed no significant reduction in cholesterol:HDL cholesterol ratio levels3.
CVD events1.

1. Hooper L et al. 2020. Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev. 8(8). See https://doi.
org/10.1002/14651858.CD011737.pub3
2. Jebb S.A. et al. 2010. Effect of changing the amount and type of fat and carbohydrate on insulin sensitivity and cardiovascular risk: the RISCK
(Reading, Imperial, Surrey, Cambridge, and Kings) trial. American Journal of Clinical Nutrition, 92(4), 748-758. See https://doi.org/10.3945/
ajcn.2009.29096
3. Vafeiadou K. et al. 2015. Replacement of saturated with unsaturated fats had no impact on vascular function but beneficial effects on lipid
biomarkers, E-selectin, and blood pressure: results from the randomized, controlled Dietary Intervention and VAScular function (DIVAS) study.
American Journal of Clinical Nutrition, 102(1), 40-48. See https://doi.org/10.3945/ajcn.114.097089

Advancing the science of human nutrition – Conference report 6

Current UK dietary guidance states SFAs should contribute CASE STUDY
no more than 10% of total dietary energy and be replaced
with unsaturated fat4. However, most people in the UK Low-SFA dairy
population exceed this recommendation. Replacing regular
dairy with SFA-reduced alternatives is one strategy for Dairy foods are nutritionally complex: they contain
reducing overall SFA intake (see case study). high levels of protein, bioactive peptides, minerals,
and some fermented dairy foods contain probiotics.
These foods are nutrient dense, particularly in terms
of calcium, phosphorus, iodine, riboflavin and Vitamin
“Provision of healthful foods with more
B12. Although dairy foods are the greatest contributor
balanced composition that are acceptable to to SFA in the average UK diet, studies have shown
the consumer is key to facilitating beneficial that consumption of dairy foods is not associated
change from policy to plate.” with significant detriment in terms of CVD risk, and
consumption of fermented dairy is associated with
Professor Julie Lovegrove, University of Reading a significant reduction in CVD risk5. This apparent
anomaly could be due to other beneficial components
of dairy foods, such as bioactive peptides and minerals.

Supplementing the diet of dairy cows with 1 kg per cow

per day of high-oleic sunflower oil resulted in modified
milk enriched in MUFAs and reduced in SFAs6. When
hard cheese and butter made from this milk was
consumed by men and women at risk from CVD for 12
weeks, it prevented the increase in LDL-cholesterol
observed after conventional dairy consumption and
improved blood vessel health. In trials, consumers
preferred the modified butter, due to
it being spreadable from the fridge, but not the
modified cheese compared with commercial
alternatives due in part to textural properties. Future
work on optimising texture and flavour properties of
SFA-reduced food products could further improve their
appeal to consumers.

4. Scientific Advisory Committee on Nutrition. 2019. Saturated fats and health. See https://www.gov.uk/government/publications/saturated-fats-and-
health-sacn-report (accessed 29 February 2024)
5. Markey O, et al. 2014. Dairy and cardiovascular health: friend or foe? Nutr Bull 39, 161-171. See https://doi.org/10.1111/nbu.12086 (accessed 6
February 2024).
6. Markey O, et al. 2017. Consumer acceptance of dairy products with a saturated fatty acid-reduced, monounsaturated fatty acid-enriched content.
Journal of Dairy Science 100(10), 7953-7966. See https://doi.org/10.3168/jds.2016-12057 (accessed 6 February 2024).

Advancing the science of human nutrition – Conference report 7

The future of diet-related disease
prevention: novel technologies and
community science?
Dr Sarah Berry, King’s College London and Zoe Ltd, discussed how remotely
delivered health interventions and large-scale remote app-based data collection
can be undertaken at scale and with the precision and breadth required to advance
the science of human nutrition.

Image: Dr Sarah Berry, King’s College London and Zoe Ltd.

Personalised nutrition tailors recommendations on what, Studies conducted by Zoe Ltd in collaboration with
when and how much to eat to optimise the health of King’s College London, outlined below, demonstrate how
an individual. Research in this area and its widespread innovative methodologies and digital tools can be used to
application requires large volumes of high-precision dietary, advance human health, and especially nutritional science,
lifestyle, physiological and multi-omic data. This has been research.
difficult to achieve in the past, as most data collection has
been either high precision but small in scale/breadth (eg COVID Symptom Study
randomised controlled trials) or large in scale/breadth but This health research project used a mobile app that was
low precision (eg epidemiological studies). created in response to the COVID-19 pandemic in 2020
by Zoe Ltd, King’s College London, Guy’s and St Thomas’
However, we are living in an exciting era of biological Hospitals. The app tracks users’ COVID-19 symptoms as
research. New ways of acquiring data using digital tools well as diet and lifestyle data. Within a week of launching,
(eg using wearable technologies or mobile phones) the app had one million users, and by four weeks this
and remote clinical testing are enabling a shift in how had grown to four million users. Information from the app
human health research is conducted. It is often no longer changed the World Health Organisation’s definition of
necessary to choose between high resolution and large- COVID-19 symptoms.
scale data collection.

Advancing the science of human nutrition – Conference report 8

Zoe Health Study
Following the Covid Symptom Study, learnings about
“There is no point in doing science for the sake
home-based, app-enabled data collection were leveraged
to research other health and lifestyle issues as part of the of science. We need to think about
Zoe Health Study. This platform has been used to conduct how we go about effecting change.”
several large-scale studies, including the Big IF Study. This
Dr Sarah Berry, King’s College London and Zoe Ltd
experiment examined whether intermittent fasting makes
an impact on human health. For a week, users logged the
start and end times of their meals, their mood, and energy
Looking ahead
and hunger levels. They next started an intermittent fasting
Novel data collection tools and methodologies must be
regime for a minimum of two weeks. Those who adhered
combined with traditional scientific approaches to expand
to the programme (approximately 37,500 people) recorded
or expediate aims; they are not replacements. It is also
improvements in mood, energy, hunger and weight, and a
critical to think about how these large volumes of data
dose response was observed: those who had longer fast
can be used to generate advice and effect change at a
periods or who followed the intermittent fasting regime for
population level.
a longer duration recorded greater weight loss. Adherence
was greater in older, physically active users. A caveat to
this study is that it was not a randomised trial, as people
self-enrolled in the programme. However, it was the
first study of its kind to explore the impact of a nutrition
intervention in a real-life free-living environment at this
scale and is reflective of the current transition to app-based
wellness approaches.

Zoe PREDICT studies

The Zoe PREDICT programme aims to unravel the
complexity in individual responses to food and predict
how dietary changes may affect an individual’s metabolic
responses7. It is underpinned by a two-week test phase
utilising wearable technologies, app-based data collection
and remote clinical testing. Participants use an app to
monitor everything they eat and drink as well as their mood,
energy and hunger. Stools are collected for microbiome
profiling, blood is collected for lipids analysis and
continuous glucose monitors are worn to measure glucose
levels. Collected data is used to examine the variability
between people and within individuals, what might explain
these differences, and whether machine learning can be
used to predict individual responses to a change in diet or
an individual food. The PREDICT programme is ongoing in
hundreds of thousands of individuals to further explore how
personalised dietary and lifestyle advice impacts health
outcomes, including the causal relationship between diet-
microbiome-health interactions.

7. Berry, S.E. et al. 2020. The current stage of the PREDICT programme aims to predict how individuals’ microbiomes may be shifted by a change in
diet. Nature Medicine, 26, 964-973. https://doi.org/10.1038/s41591-020-0934-0

Advancing the science of human nutrition – Conference report 9

Is obesity a choice?
Professor Giles Yeo MBE, University of Cambridge, explored the relationship between
genetics and body weight. He discussed how this knowledge can be used to improve
personalised treatment for obesity and inform public health policy.

Image: Professor Giles Yeo MBE, University of Cambridge.

People gain weight by eating more calories than they burn. Leptin deficiency
This is a well-understood function of physics. However, it is If an individual is unable to produce leptin, they are likely
less clear what drives some people to eat more than others. to be severely obese. The brain interprets the absence
Although discussions of obesity often focus on willpower of leptin as an absence of fat stores, thus enacts signals
and lifestyle decisions, obesity is not a choice. Genetic to increase food intake. The use of leptin-replacement
differences mean that some people are slightly hungrier all therapy can counteract this disruption and is associated
the time and therefore eat more than others. People who with reduced likelihood of obesity. However, leptin is not
are obese may be fighting their biology. a panacea. In an individual with a functional leptin pathway,
the presence of additional leptin does not cause reduced
The genetics of body weight is a study of how the brain food intake or weight loss.
influences feeding behaviour. The brain controls food
intake in response to signals about long-term energy stores POMC deletion
(eg volumes of fat in the body) and short-term energy A disruption of the POMC gene can have a similar impact
reserves (eg levels of glucose in the gastrointestinal tract). on weight and appetite. A study of Labrador retriever dogs
found that a deletion of 14 base pairs in the POMC gene is
Leptin is a protein hormone that regulates long-term energy associated with increased body weight and greater food
balance in the body. It circulates in the blood in proportion motivation8.
to the amount of fat in an organism (ie more fat, more leptin).
Leptin molecules act on pro-opiomelanocortin (POMC)
neurons in a brain region called the hypothalamus, which
in turn signal to receptors to influence appetite. Genetic
disruption at any level of this pathway may result in obesity.

8. Raffan, E. et al. 2016. A deletion in the canine POMC gene is associated with weight and appetite in obesity-prone labrador retriever dogs. Cell
Metabolism, 23(5), 893-900. https://doi.org/10.1016/j.cmet.2016.04.012

Advancing the science of human nutrition – Conference report 10

Melanocortin 4 receptor (MC4R) Summary
Mutations in the MC4R gene can also influence food intake For most people, weight is not significantly impacted by
and body weight. A recent study explored whether MC4R a single gene. Genetics brackets a set of possibilities for
deficient individuals had altered preferences for fat and an individual, but luck and lifestyle decisions can result in
sucrose compared to obese and lean controls9. In the different outcomes within these brackets.
fat test, participants were fed chicken korma with varying
levels of fat mixed in. MC4R deficient individuals consumed
a larger volume of the highest fat option compared to both “When I say I study the genetics of bodyweight,
lean and obese controls. In the sucrose test, participants
I become ‘the bad person’ because I am
were fed Eton Mess with varying levels of sugar. Individuals
deficient in MC4R demonstrated a reduced preference perceived as giving obese people an excuse.
for the high sugar variant compared to obese and lean If I were studying the genetics of dementia,
controls, suggesting that this mutation is associated with a this wouldn’t be the case.”
preference for fat over sugar.
Professor Giles Yeo MBE, University of Cambridge

9. van der Klaauw, A.A. et al. 2016. Divergent effects of central melanocortin signalling on fat and sucrose preference in humans. Nature
Communications, 7, 13055.

Advancing the science of human nutrition – Conference report 11

Early life nutrition and the microbiome
Professor Lindsay Hall, University of Birmingham and Quadram Institute, explained the
relationship between early life microbiome and health, and offered considerations for
establishing causal contributions of the gut microbiota on health.

Image: Professor Lindsay Hall, University of Birmingham and Quadram Institute.

Each person harbours their own unique microbiota. The Milk and microbes
composition of the microbiota evolves throughout life - Breast milk contains human milk oligosaccharides which,
from birth to old age - and is the result of different counterintuitively, are not metabolised by the infant. Instead,
external influences. Gut microbial communities play they pass undigested into the colon where they are broken
a critical role in human health. They regulate immune down by Bifidobacterium. Babies on a diet of human milk
system development, infection resistance and food have higher concentrations of these bacteria in their gut
digestion, including the generation of energy and microbiomes than formula-fed infants, which impacts
beneficial compounds, the extraction of nutrients, their immune systems. Low levels of Bifidobacterium are
and the bioconversion of metabolites. associated with a higher risk of infection.

The early-life developmental window Recent work has explored whether supplementing the
The first 1000 days of life (conception to age two) pre-term infant gut microbiota can be used to increase the
represents a critical developmental window. It is abundance of Bifidobacterium. Analysis showed that the
defined by rapid maturation of metabolic, endocrine, supplemented infants had a lower abundance of potential
neural and immune pathways, which strongly influence pathobionts and were able to metabolise human milk
infant development. The gut microbiome develops oligosaccharides.
concurrently with these pathways. In full-term newborn
infants, gut microbial communities closely match the Microbiota-directed foods
maternal skin, stool and/or vaginal microbiota, Microbiota-directed foods (MDFs) are a potential way to
depending on delivery mode. modulate the gut microbiome. They promote the growth
of microbiota associated with positive gut health. In the
context of early life nutrition, a recent study showed that
delivering an MDF dietary supplement to undernourished
children in Bangladesh changed the microbiota of the
children and boosted their overall weight gain.

Advancing the science of human nutrition – Conference report 12

The future of early life microbiota and nutrition • Ethical and societal implications: addressing questions
Emerging areas of interest in the field of childhood nutrition related to equitable access, commercial interests and
include: the societal impact of shaping the microbiome in early
• Precision nutrition for infants: investigating how tailored childhood.
dietary interventions during early life can optimise
microbial colonisation, immune development, and long-
term health outcomes ‘Most of our knowledge is based on data from
• Microbiome-targeted therapies: examining novel babies from high income countries. What we’re
interventions for infants (eg pro-, pre- and postbiotics) seeing at the moment is only a small piece of
and their potential to prevent or mitigate health issues.
the global health puzzle.’
• Long-term health consequences: exploring how
Professor Lindsay Hall, University of Birmingham and
nutritional choices during infancy may influence
Quadram Institute
microbiome composition and risk of diseases later in life.

Image: from left to right, Dr Sarah Berry, Professor Giles Yeo, Professor Lindsay Hall and Professor Susan Lanham-New – Chair of Session 1: Nutrition-
associated determinants of health.

Advancing the science of human nutrition – Conference report 13

Microbiome-derived bioactive metabolites:
moving from association to causation in
cardiometabolic health
Professor Marc-Emmanuel Dumas, Imperial College London, described how
innovative approaches improve understanding of how microorganisms in the
human gut can impact health.
The collection of microorganisms found in the human
digestive tract, referred to as the gut microbiome, has been
intensively studied for decades. Scientists have known
for at least 50 years that these microorganisms produce
compounds that may have beneficial, harmful or neutral
impacts on human health. The gut microbiome is now
recognised as a key driver of human metabolic health as
it shapes the pathophysiology and common low-grade
inflammatory components of obesity, type 2 diabetes and
cardiometabolic diseases. However, questions remain
about how these interactions work.

Research is now being done to identify the largely

unknown chemical signals sent from the gut microbiota
to the human host. These signals are often metabolites,
which are compounds like amino acids, lipids and sugars
that are produced or used when breaking down food,
chemicals, or tissues.
Image: Professor Marc-Emmanuel Dumas, Imperial College London.
Choline metabolism
Choline is an essential nutrient required for brain, liver and A recent study examined the impacts of a variety of
other bodily functions. Small amounts are produced in elements (diet, microbiome composition, age, sex, kidney
the liver, but diet is also an important source. People with function and presence of chronic disease) on TMAO
low-choline diets are at an increased risk of developing concentrations in blood10. Machine learning and multivariate
non-alcoholic fatty liver disease, which can result in serious approaches showed that age and kidney function are
liver damage. However, high intake of choline-rich foods the key variables impacting TMAO levels, with diet and
may also have harmful health impacts. microbiome composition having minor effects.

Microbiota in the human gut metabolise choline into

trimethylamine (TMA), which can be absorbed by the
intestine. In the liver, TMA is further metabolised into
trimethylamine N-oxide (TMAO). High levels of TMAO in the
blood are associated with increased risk of cardiovascular
disease, and while diet may be partially responsible there
are several other factors that may be at play.

10. Andrikopolous, P. et al. 2023. Evidence of a causal and modifiable relationship between kidney function and circulating trimethylamine N-oxide.
Nature Communications, 14, 5843. https://doi.org/10.1038/s41467-023-39824-4

Advancing the science of human nutrition – Conference report 14

Hippurate
Hippurate is an abundant metabolite associated with
“There are about 20 thousand genes in the
human-gut microbiota interactions. High levels of hippurate
are typically associated with a diverse gut microbiome. human genome. In comparison, there are
Conversely, conditions such as non-alcoholic fatty liver about 20 million microbial genes in our gut
disease and Crohn’s disease that are linked with low gut microbiome. This reservoir of functionality
microbiome diversity are also associated with low levels and chemistry is like a mini pharmaceutical
of hippurate. A recent study investigated the links between
plant in our body.”
hippurate levels, diet, microbiome composition and
markers of metabolic health11. By integrating metabolomics Professor Marc-Emmanuel Dumas, Imperial College
with metagenomics in a study of 271 middle-aged London
non-diabetic subjects, hippurate was identified as the
metabolite most significantly associated with microbial
gene richness, and data showed that hippurate is
associated with health benefits in individuals consuming
a diet rich in saturated fat.

Looking ahead
Further research is needed to better understand the diet-
microbiome-metabolite-immune axis. The full breadth of
metabolites impacting human health and the mechanisms
by which they work are still not well understood. Obesity
levels in the UK are rising and are associated with
decreased microbiome diversity. This ‘invisible extinction’
of microorganisms could also mean we are losing as yet
unknown but incredibly valuable metabolites.

11. Brial, F. et al. 2018. Human and preclinical studies of the host–gut microbiome co-metabolite hippurate as a marker and mediator of metabolic
health. Gut Microbiota, 70(11), 2105-2114.

Advancing the science of human nutrition – Conference report 15

Plant bioactives and health
Dr Maria Traka, Quadram Institute, discussed the scientific importance of bioactives
in fruit and vegetables for preventing disease.

Image: Dr Maria Traka, Quadram Institute.

Overwhelming epidemiological evidence suggests that

increasing the intake of fruit and vegetables decreases our ‘We need to improve nutrition education
risk of increasing weight and developing cardiovascular in our medical curriculum. Our doctors need
disease, cancer and type 2 diabetes. Alarmingly, fewer to understand the complexities of nutrition,
than one in five children and fewer than one in three adults
and how it can contribute to reducing the
in the UK eat the recommended five portions of fruit and
vegetables per day. disease burden.’
Dr Maria Traka, Quadram Institute
The dark matter of nutrition
While the vitamins and minerals found in fruits and
vegetables are well known to be nutritionally important, Bioactives have myriad effects on human health.
plants also contain non-essential bioactives (the ‘dark Epigallocatechin gallate (a polyphenol found in green tea)
matter of nutrition’) that impact health. Approximately reduces the viability of cancer cells12. Anthocyanins in red
5000 bioactives have been identified, although estimates wine have been shown to have antioxidant properties.
suggest there may be as many as 50,000 of these Cocoa polyphenols have been shown to improve
compounds across the plant kingdom. Only a few hundred cardiovascular health. Additionally, our gut bacteria
have been studied in detail. Plant bioactives can be further transform these food bioactives to more complex
classed into six groups: alkaloids, terpenoids, carotenoids, compounds which are largely unknown, so it is important
phytosterols, sulphur-containing metabolites and to concentrate research on these more biologically
polyphenols. There are also a host of subclasses which relevant forms.
introduce further complexity.

12. Yang, C.S. et al. 2009. Cancer prevention by tea: animal studies, molecular mechanisms and human relevance. Nature Reviews Cancer, 9, 429-
439. https://doi.org/10.1038/nrc2641

Advancing the science of human nutrition – Conference report 16

Plant science for health Plant bioactives affect gut microbiota
There is evidence that consumption of cruciferous The Dietary Bioactives and Microbiome Diversity (DIME)
vegetables is associated with a reduced risk of prostate study is investigating whether levels of dietary bioactives
cancer progression. This is largely attributed to the impact gut microbiota diversity13. Twenty healthy adults
effects of bioactives, such as sulforaphane (derived were placed on a high- or low-bioactive diet for two weeks.
from glucoraphanin in broccoli). To investigate the After a four-week ‘washout’, they were then placed on the
effectiveness of dietary interventions to reduce prostate alternate bioactive diet for two weeks. Participants used a
cancer progression, 49 men on active prostate cancer smartphone app to record their meals. Continuous glucose
surveillance were recruited to participate in a blinded monitors recorded blood glucose measurements and a
intervention study for 12 months. Individuals received wearable device was used to monitor activity and sleep
weekly 300 mL broccoli soup portions with standard levels. Stool and urine samples were analysed and showed
or enhanced glucoraphanin levels. RNA sequencing that having diets full of bioactives increases gut bacteria
was used to assess gene expression associated with diversity, which is an indication of a healthy gut.
oncogenic pathways in patient tissues obtained before
and after the study. Results showed a dose-dependent What next?
relationship between consumption of glucoraphanin-rich Developing robust bioactive composition data will be vital
soup and changes in gene expression consistent with for understanding what compounds are being consumed,
a reduced risk of cancer progression. in what amounts, and whether they act synergistically,
additively, or opposingly. Future research must focus on
whole foods rather than single compounds.

13. Bernuzzi, F. 2022. DIME study explores how bioactives help the microbial eco-system in our gut. https://quadram.ac.uk/blogs/dime-study-
explores-how-bioactives-help-the-microbial-eco-system-in-our-gut/ (accessed 28 February 2024).

Advancing the science of human nutrition – Conference report 17

Advances in biofortification
Jenny Walton, HarvestPlus, spoke about the work being done to combat micronutrient
malnutrition through systemic food system transformation.

Image: Jenny Walton, Head of Commercialization and Scaling at HarvestPlus.

Deficiencies in micronutrients are associated with a suite Randomised control trials are continuously conducted
of health issues including compromised immunity, anaemia to determine the efficacy of biofortified crops in improving
and stunted growth in children. Recent global estimates nutrition. While there is clear evidence that the nutrients
suggest that over half of pre-school aged children and in biofortified crops are bioavailable, and are present in
two thirds of women of reproductive age are deficient in quantities sufficient to make a difference and positively
at least one micronutrient14. Increasing micronutrient levels influence consumer health symptoms, it is too early to
in crops may help address this challenge. gather large-scale epidemiological evidence for impact
assessment.
Biofortified crops
HarvestPlus specialises in the biofortification of crops pre- Climate impacts
harvest, specifically targeting wheat, rice and maize. These Environmental factors such as declining soil health and
staple crops constitute 60% of global calorie consumption. extreme weather events affect crop nutritional value. For
Other biofortified crops developed by HarvestPlus and example, as global temperatures and CO2 levels rise, crops
partners include pearl millet, beans, sweet potato and reach peak yield faster and the plant is unable to assimilate
cassava. Conventional breeding techniques are used as much nutrition as it otherwise would. Biofortification may
to increase the density of commonly deficient nutrients be needed just to maintain micronutrient levels in response
(iron, zinc, vitamin A) in high-yielding crop varieties. to climate change impacts. To further ensure crops are
Genetic modification approaches are not used due to climate-smart, HarvestPlus uses varieties that are bred for
limited consumer and government acceptance, although tolerance to heat, aridity, and drought.
regulations in some countries are beginning to change.

14. Stevens, G.A. et al. 2022. Micronutrient deficiencies among preschool-aged children and women of reproductive age worldwide: a pooled
analysis of individual-level data from population-representative surveys. The Lancet Global Health, 10(11), E1590-E1599. https://doi.org/10.1016/
S2214-109X(22)00367-9

Advancing the science of human nutrition – Conference report 18

Scaling up India serves as an example of how a country can facilitate
There are now over 100 million people in farming families the scale-up of biofortified foods. They have incorporated
eating biofortified food, and an additional 400 million nutrition benchmarks into their agricultural policy, and
consumers buying it in markets. HarvestPlus aims for one publicly endorse biofortified foods in their nutrition and
billion to regularly consume biofortified foods by 2030. food policies. Furthermore, by easing their labelling
Enablers for scaling up the use of biofortification include: legislation to allow producers of staples to make health
• Policy solutions, such as setting micronutrient targets claims about lower levels of micronutrients, India is actively
in agricultural policy. encouraging the regular consumption of nutrient-rich foods.

• Procurement and processing solutions, such as

public and private procurers requiring nutrient-enriched
raw materials. ‘We have to biofortify staples just to keep up
with climate change.’
• Consumer solutions, such as the ability to purchase
nutrient enriched foods at the same price. Jenny Walton, Head of Commercialization and Scaling
at HarvestPlus

Image: from left to right, Jenny Walton, Dr Maria Traka, Professor Marc-Emmanuel Dumas and Professor Cathie Martin (Chair of Session 2: Bioactives and
biofortification).

Advancing the science of human nutrition – Conference report 19

Strategies and barriers to improving diet
quality across the lifecourse
Professor Louise Dye, University of Leeds and University of Sheffield, highlighted
the challenges associated with improving diet quality in low agency groups in the
UK and strategies for overcoming these barriers. She also discussed the
psychological impacts associated with food insecurity.

Image: Professor Louise Dye, University of Leeds and University of Sheffield.

For the UK population, diet quality and nutritional intake Targeted behaviour change interventions
are intrinsically linked with socioeconomic status. Fibre Encouraging behaviour change through targeted policy
intake levels clearly reflect socio-economic gradients. interventions is often proposed as a means to reduce
Lower socioeconomic status groups have the lowest fibre dietary-related health inequalities. An ‘intervention ladder’
intake, with consumption increasing as income rises. This can provide a framework for thinking about how different
is also true for consumption of key micronutrients. Despite approaches can be used to encourage behaviour change15.
public health campaigns and reformulation and innovation Levels of interventions range from monitoring / doing
in the food industry, fibre consumption amongst UK adults nothing (bottom of the ladder) to eliminating all choices
remains well below the current recommendation of 30g available to consumers via regulation (top of the ladder).
per day across all groups. Deciding on a proportionate intervention requires certain
questions to be answered, such as whether the likely
A key driver of this disparity is the cost, both real and benefits justify the cost and disruption.
perceived, of healthy diets. Increased costs, longer
preparation and cooking time, and a lack of cooking
skills contribute to the avoidance or abandonment of
high-fibre diets. Additionally, consumer perception is that
starchy, high-fibre foods are linked with weight gain and/or
digestive discomfort.

15. Nuffield Council on Bioethics. 2007. Public health: ethical issues. Available from https://www.nuffieldbioethics.org/publications/public-health/guide-
to-the-report/policy-process-and-practice (accessed 27 February 2024).

Advancing the science of human nutrition – Conference report 20

However, behaviour change interventions can have Food insecurity and well-being
differential effects depending on socioeconomic In 2022, more than 11 million people in the UK struggled to
status16. Some dietary interventions may have smaller access diets which deliver adequate nutrition. Of these,
effects on low socioeconomic populations and thus may 4 million are currently suffering from severe food insecurity.
disproportionately benefit higher socioeconomic groups, It is these people who are most impacted by shocks to the
leading to ‘intervention-generated inequalities’. In addition food system because they lack the financial and psycho-
to limited economic resources, lower socioeconomic social or cognitive resilience to plan and organise food
groups may have less social support, prioritise provision in financially efficient ways.
convenience over health and/or have limited health literacy.
Strategies to improve nutritional intake and reduce health
inequalities need to take into account the agency of the “We’ve talked about the amazing things we can
target population and the resources required to achieve a
do with diet - the missing link is getting people
healthy diet, which have been significantly reduced by the
cost-of-living crisis. to do these things.”
Professor Louise Dye, University of Leeds and University
In terms of fibre consumption, interventions can be of Sheffield
modified or tailored to the level of agency of the target
group17. A fibre information leaflet might be taken up by
high agency groups, but the need to read the information,
understand it, buy high-fibre foods, cook them and
eat them are all points of attrition particularly for lower
agency groups. Low-agency interventions could include
incorporating high fibre foods into children’s breakfast
clubs and school meals, or adding fibre to popular,
low-cost foods.

16. Bull, E.R. et al. 2014. Are interventions for low-income groups effective in changing healthy eating, physical activity and smoking behaviours? A
systematic review and meta-analysis, BMJ Open, 4, e006046.
17. Adams, J. et al. 2016. Why Are Some Population Interventions for Diet and Obesity More Equitable and Effective Than Others? The Role of
Individual Agency, PLoS Medicine, 13(4), e1001990.

Advancing the science of human nutrition – Conference report 21

Diet for disease prevention and remission
Professor John C Mathers, Newcastle University, shared learnings from two innovative
studies that could inform the design of more effective dietary interventions that can
be delivered cost-effectively, and at scale, to improve health equity.

Image: Professor John C Mathers, Newcastle University.

Improving eating habits is a critically important global public Food4Me study

health challenge. In 2017, poor diet was responsible for The Food4Me study was designed to test the hypothesis
11 million deaths and 255 million disability-adjusted life that personalised nutritional advice would improve eating
years (a measure of disease burden, representing number behaviour and health markers to a greater degree than
of years lost to ill-health)18. standard dietary recommendations20. The study was
internet-delivered. Participants from seven European
Despite ongoing efforts to improve diets using nutritional countries were randomly assigned to one of four treatment
guidelines and generic advice, there has not been a groups:
substantial shift in eating habits. The disease burden 1. Generic dietary advice that integrated guidelines from
associated with poor diet continues to grow. several European countries (control).

2. Individual diet based on current diet and lifestyle.

“Even for someone who is 70 years old, life 3. Individual diet based on diet, lifestyle and phenotype
(anthropometry and blood biomarkers).
expectancy can be extended through improved
diet – it is never too late to eat better19.” 4. Individual diet based on diet, lifestyle, phenotype and
genotype (five genetic markers).
Professor John C. Mathers, Newcastle University

18. GBD 2017 Diet Collaborators. 2019. Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of
Disease Study 2017. The Lancet, 393(10184), 1958-1972. https://doi.org/10.1016/S0140-6736(19)30041-8
19. Fadnes, L.T. et al. 2023. Life expectancy can increase by up to 10 years following sustained shifts towards healthier diets in the United Kingdom.
Nature Food, 4, 961-965. https://doi.org/10.1038/s43016-023-00868-w
20. Celis-Morales, C. et al. 2017. Effect of personalized nutrition on health-related behaviour change: evidence from the Food4Me European
randomized controlled trial. International Journal of Epidemiology, 46(2), 578-588. https://doi.org/10.1093/ije/dyw186

Advancing the science of human nutrition – Conference report 22

After six months, participants receiving personalised After one year, 4% of the control group were in remission
nutrition advice (categories ii – iv) consumed less red compared to 46% of the intervention group. In both groups,
meat, salt and saturated fat and had bigger improvement likelihood of remission was linked to degree of weight
in overall diet healthiness than those in the control group. loss. None of the participants who gained weight over the
However, the type of personalised advice (ie inclusion of course of the study achieved remission, whereas 86% of
phenotypic and genotypic data) did not matter. This study participants who lost 15 kg or more were in remission. Type
showed that personalised nutrition works and that internet- 2 diabetes does not have to be a life sentence. This study
based intervention delivery is effective. showed that sustained dietary change is an effective tool in
the treatment of type 2 diabetes.
DiRECT study
An estimated 500 million people have diabetes, and
numbers (particularly of type 2 diabetes) are growing. It
is associated with significant health consequences and
treatment can be very expensive.

The DiRECT study examined whether effective weight

management achieved via dietary changes delivered in the
primary care setting could produce sustained remission of
type 2 diabetes21. Participants had been diagnosed with
type 2 diabetes within the previous six years, had a body-
mass index of 27–45 kg/m2 and were not receiving insulin.
They were randomly assigned to either receive best-
practice care according to NHS guidelines (control) or take
part in a weight management programme (intervention).
Those receiving the intervention had their antidiabetic and
antihypertensive drugs withdrawn and underwent total diet
replacement (liquid diet for 12 weeks) followed by food
reintroduction based on the Eatwell Guide (weeks 12–18),
then a weight-loss maintenance phase.

21. Lean, M.E.J., et al. 2018. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial.
The Lancet, 391(10120), 541-551. https://doi.org/10.1016/S0140-6736(17)33102-1

Advancing the science of human nutrition – Conference report 23

Gut hormones as therapeutic targets
for appetite suppression
Dr Tony Goldstone, Imperial College London, discussed the burgeoning use of gut
hormone-based interventions to address obesity, over-eating and addictive behaviours.

Image: Dr Tony Goldstone, Imperial College London.

Appetite is regulated by hormones, especially from Bariatric surgery changes appetitive hormone levels
the gut and fat tissue. These circulating hormones act In recent decades, obesity has been increasingly treated
on the brain to influence when and how much people via bariatric surgery, which is generally considered the
eat. Hormone levels in the blood change in response gold-standard amongst weight loss interventions. Gastric
to food intake. Appetitive gut hormones that reduce bypass surgery is associated with an average weight
appetite increase in concentration as more calories are loss of 25% and reduces the risk of death, cardiovascular
consumed. As hormone levels rise, subsequent signalling disease and several cancers. Following surgery, food is
via the vagus nerve, the hypothalamus and brainstem delivered to the intestine in a largely undigested form. This
inhibits further eating (satiety). Only one hormone is results in enhanced secretion of gut-based hormones
known to stimulate appetite: ghrelin levels from the regulating appetite, especially intestinal satiety hormones
stomach decrease with food consumption. Some of these glucagon-like peptide 1 (GLP-1) and peptide YY (PYY).
hormones may also act to change the brain responses
to food pictures and can potentially impact the appeal of Gut hormone analogue therapies
and craving for food, especially high-energy foods. There is growing interest in the use of GLP-1 analogues
alone and in combination with other gut hormone-based
treatments as therapeutic options for weight loss in obesity.
These mimic the functions of the natural hormone(s).
Several of these drugs are already licensed for treatment
of type 2 diabetes mellitus (T2DM) and obesity. However,
more people with T2DM tend to lose less weight when
using these drugs than people who do not have T2DM.
The reason for this is unclear.

Advancing the science of human nutrition – Conference report 24

Second generation GLP-1 analogues (eg Liraglutide, Looking ahead
requiring daily subcutaneous injections) produce mild There is growing evidence that targeting the GLP-1 system
to moderate weight loss. The third generation drug may also be of benefit for attenuating addictive behaviours
Semaglutide is given as weekly subcutaneous injections unrelated to food consumption. Studies suggest GLP-1
and achieves greater weight loss (10–17%). It is licensed for analogues may have potential as a treatment to encourage
obesity and T2DM. If injections are stopped, patients regain cessation of smoking and alcohol22,23,24.
weight. Orforglipon is a later generation GLP-1 analogue
(currently unlicensed) that can be taken orally every day. It There are also novel potential therapeutic targets. The
produces ~15% weight loss in people with obesity without recently discovered liver-foregut satiety hormone LEAP2
T2DM. Notably, as this is a non-peptide drug, it will be is an endogenous (naturally occurring) antagonist for the
cheaper and easier to manufacture. appetite stimulating stomach-derived hormone ghrelin25,26.
Future research may explore therapies mimicking the
We are now on the fourth generation of gut hormone action of LEAP2 to suppress food intake in obesity and
interventions which utilise multiple targets in combination. potentially also treat addiction.
Tirzepatide is a medication licensed to treat T2DM. It
is both a GLP-1 analogue and a glucose-dependent
insulinotropic polypeptide (GIP) analogue and achieves “GLP-1 analogues are a game-changer for
an average weight loss of 16-23%. There are also several
patients with obesity.”
as yet unlicensed fourth generation drugs undergoing
clinical trials, including dual GLP-1/amylin analogues, such Dr Tony Goldstone, Imperial College London
as Semaglutide/Cagrilintide, and triple GLP-1/GIP/glucagon
analogues, such as Retatutride.

22. Yammine L. et al. 2021. Exenatide Adjunct to Nicotine Patch Facilitates Smoking Cessation and May Reduce Post-Cessation Weight Gain: A Pilot
Randomized Controlled Trial. Nicotine & tobacco research, 23(10), 1682-1690. https://doi.org/10.1093/ntr/ntab066
23. Quddos F. et al. 2023. Semaglutide and Tirzepatide reduce alcohol consumption in individuals with obesity. Scientific Reports, 13(1), 20998.
https://doi.org/10.1038/s41598-023-48267-2
24. Leggio L. et al. 2023. GLP-1 receptor agonists are promising but unproven treatments for alcohol and substance use disorders. Nature Medicine,
29(12), 2993-2995. https://doi.org/10.1038/s41591-023-02634-8
25. Mani B. et al. 2019. LEAP2 changes with body mass and food intake in humans and mice. The Journal of Clinical Investigation, 129(9), 3909-3923.
https://doi.org/10.1172/JCI125332
26. Bhargava R. et al. 2023. Postprandial Increases in Liver-Gut Hormone LEAP2 Correlate with Attenuated Eating Behavior in Adults Without Obesity.
Journal of the Endocrine Society, 7(7). https://doi.org/10.1210/jendso/bvad061

Advancing the science of human nutrition – Conference report 25

Supporting the nation’s health: a retailer’s
perspective
Julie Dean, Asda, described how supermarkets can use price, promotions, product
range, marketing and merchandising to incentivise healthier and more sustainable
choices. She focused on retailers’ responsibility to support lower socioeconomic
communities in accessing healthier options.

Image: Julie Dean, Asda.

Supermarkets are an integral part of the UK food system. Strategic partnerships

Decisions made by food retailers influence the accessibility In partnership with Nesta, Asda is undertaking a
and affordability of nutritious foods at several levels, from programme of work to validate, test, trial and evaluate
farm to shelf. They can support farmers, food processors their health strategy. They have conducted large-scale
and manufacturers to use approaches that optimise consumer research across the UK to gauge attitudes
nutritional profiles. They can use distribution, pricing and barriers to healthy dietary choices. Of the ~4,000
and promotion to promote healthy options. Signposting, customers surveyed, 95% want to be healthier, citing
labelling and product placement can guide customer nutritional, physical, mental and lifestyle goals. Key barriers
decision-making, and marketing can be used to educate are motivation, cost and time. Needs, goals and barriers
and incentivise healthy choices. vary significantly according to socioeconomic status. This
research led Asda to identify distinctive customer health
The supermarket chain Asda has a disproportionate segments that differ in their willingness and ability to cook
presence in the most deprived communities in the UK from scratch or exercise regularly, amongst other health
compared to other retailers. Many of its customers have characteristics. Different interventions to support healthy
a limited understanding of what constitutes a healthy eating are being designed to target each segment based
and sustainable diet, thus Asda is undertaking a suite of on their requirements.
activities to support healthier choices.

Advancing the science of human nutrition – Conference report 26

Image: from left to right, Professor John C. Mathers, Dr Tony Goldstone, Julie Dean, Professor Louise Dye and Dr Andrew Morgan (Chair of Session 3:
Nutritional, behavioural and pharmacological interventions).

Asda is also working with the Leeds Institute for Data Although there are myriad complexities associated with
Analytics to explore data-driven solutions that support retail collaborations, there are also significant benefits
customers in managing budgets while making healthy food to all parties involved. These may include transfer of
choices. They have held an ideathon and a hackathon to knowledge, access to specialised skills and resources, the
begin the process of testing and trialling interventions. One practical application of academic research and generation
focus area has been on the impact of merchandising on of application-derived research questions, increased
meat-free purchasing in the meat aisle. credibility and the building of extended networks.

Complexities of retail collaborations

Partnerships with retailers can be challenging. Issues “How can we support consumers to not only
around data privacy and security, relationships with
make healthier choices while shopping, but to
suppliers, timelines, regulatory considerations, and
potential commercial risk complicate the context of prepare and cook it, want to eat it, enjoy it and
the research. These are not necessarily barriers to buy it again?”
collaboration, but understanding these complexities
Julie Dean, Asda
is key to success.

Advancing the science of human nutrition – Conference report 27

PANEL DISCUSSION

Improving health through diet

A panel of experts shared their thoughts on how improved nutrition can improve
health in the UK and globally. The session was chaired by Sarah Berry, King’s College
London and Zoe Ltd.

Image: from left to right, Nusrat Kausar, Professor John O’Brien, Professor Tim Spector, Dr Emma Williams and Professor Sumantra Ray.

Collaboration is necessary to achieve meaningful Some of the key themes highlighted in the wide-ranging
change from nutrition science. Linking efforts across panel discussion are summarised below.
industry, academia and the healthcare system is crucial
for driving innovation and realising real-world impact Rethinking science for the sake of science
from lab-based research. • A huge range of tools are now available for research
purposes (eg multi-omics, machine learning) and
A panel of speakers was convened to provide diverse enormous volumes of data are being gathered. These
perspectives on the future of human nutrition research. data must be translated into interventions and tangible
Panellists included Nusrat Kausar, Primary Care Dieticians, advice to improve the health of the UK population.
NHS and Nutribytes; Professor John O’Brien, Ulster
• Data from nutritional research can be used to inform
University and Trends in Food Science and Technology;
policy. Policies relating to diet should be evidence-based
Professor Sumantra (Shumone) Ray, NNEdPro, University
and developed in consultation with a wide range of
of Cambridge, and Ulster University; Professor Tim Spector,
stakeholders including industry and academia as well as
King’s College London, and Dr Emma Williams, Nutritionists
the populations they are targeting.
in Industry.
• Misinformation about food (eg on social media) is a major
barrier to improving healthy diets. The nutritional science
“Children need to be given the skillset to deal community in both industry and academia are the
custodians of information reaching the consumer. They
with the complex food environment of the
have a responsibility to share their knowledge. Science is
future.” trusted because it is social and collaborative.
Professor John O’Brien, Ulster University and Trends in
Food Science and Technology

Advancing the science of human nutrition – Conference report 28

Working with industry • Incentivising the consumption of plant-based and
• Industry has access to consumers. Working with industry minimally processed foods, or possibly taxing
(eg retailers) is an invaluable route to applying scientific environmentally damaging or unhealthy ultra-processed
research in a real-world environment and achieving foods, could support both a more sustainable food
meaningful impact. system and improved health.

• For results to be trusted, research collaborations with

Education is key
industry must be conducted transparently.
• Education about healthy eating is particularly effective
• There is a role within industry, from an educational when it is tailored to the person. However, personalised
perspective, to help consumers make informed decisions. nutrition advice is not just about a person’s biology. It also
For example, Waitrose has employed Healthy Eating involves looking at their family, the generation to which
Specialists trained to speak to customers about what they belong, their resources, and their community.
constitutes a healthy, balanced diet.
• It is important to educate consumers of all ages as well
as the businesses within the food supply chain on what
Creating a sustainable food system
constitutes a healthy and sustainable food product and
• Consumer demand for sustainable food products is
how nutrition can be optimised.
growing, although an understanding of what makes
a food item sustainable is limited. • Formal education at a range of levels (in schools, in
universities) should include a focus on both emerging
• Efforts to enhance the sustainability of the food
areas of nutritional research (eg microbiome science) and
system must try to ensure there are no unintended
technical skills including food preparation.
consequences. For example, switching to more
sustainable food production methods has the • The discussion around ultra-processed foods currently
potential to drive up price or reduce supply, which lacks precision and clarity in terms of categorisation.
could restrict access to a healthy diet for those in Better classification systems are needed for food in
lower socioeconomic groups. general, not just for ultra-processed foods.

“In healthcare settings, personalised nutritional “Nutrition science is a very lateral discipline,
advice should look at the whole person – going from molecules to mankind. Additionally,
their cultural heritage, family history and the global challenges that we face in food
socioeconomic circumstances. A holistic security need concerted efforts without
approach that accounts for these contextual borders to enable nutrition science to better
factors is essential.” serve society”
Nusrat Kausar, Primary Care Dieticians, NHS and Professor Sumantra (Shumone) Ray, NNEdPro Global
Nutribytes Institute; Fitzwilliam College at the University of
Cambridge; Ulster University

“I think the future is going to be in personalised

nutrition and making microbiome science into “It’s time to liberate science from the lab and
a mainstream study. It needs to be seen as a ignite real-world impact. This entails a dynamic
core part of nutrition science.” conversation with all players, including the
food industry, to turn theory into powerful,
Professor Tim Spector, King’s College London
practical solutions.”
Dr Emma Williams, Nutritionists in Industry.

Advancing the science of human nutrition – Conference report 29

At a crossroads: Hacking the food system
or hacking our bodies?
Henry Dimbleby MBE, LEON and the Sustainable Restaurant Association, argued that
the UK is at a crossroads in the future of our health, and advocated for better cooking
education and more government regulation of unhealthy food. Key themes from his
talk have been summarised below.

Image: Henry Dimbleby MBE, LEON and the Sustainable Restaurant Association.

Predictions made by scientists in the mid-20th century The Green Revolution, pioneered by the agronomist
regarding the future of the planet painted a bleak picture. Norman Borlaug, transformed the relationship between
For thousands of years, it was standard practice to use food production and land use. By developing crops with
more land as more food was needed. However, in 1945 desirable qualities (eg high yield, disease-resistance,
the world’s human population was projected to rise from structural strength) and increasing the use of chemical
2.8 billion to 8 billion over the next 50 years, and viable fertilisers, pesticides and irrigation, the rate of food
agricultural land was becoming increasingly scarce. As a production for the same area of land increased dramatically.
result, it was estimated that the next century would be rife However, the increased intensity of global agriculture is
with wars over resources, starvation and mass migration. driving a wide range of other issues including biodiversity
collapse, freshwater pollution, water shortages, soil
degradation, and deforestation.
‘Passing a law is often necessary, but it is not
The food system and health
sufficient to create change. We need people
In addition to its environmental impacts, the food system
to come in behind those laws who care, to also influences human health. The world now produces
implement change at a local level.’ double the number of calories per person compared
to 1945. Correspondingly, the number of people in the
Henry Dimbleby MBE, LEON and the Sustainable
UK who are overweight or obese has risen dramatically.
Restaurant Association
Over-consumption of food is now the greatest cause of
avoidable ill health, outweighing smoking (Figure 1). The risk
of diet-related ill-health increases in poorer areas.

Advancing the science of human nutrition – Conference report 30

 FIGURE 1 At a crossroads
There are two potential futures ahead. One involves
Proportion of years lost to avoidable ill-health continuing down the current path and exacerbating the
and death by cause. junk food cycle. In this future, it is possible that more than
40% of the UK population will be using weight loss drugs
permanently. Such drugs are extremely useful to some
patients, but do not address the root of the food problem.

The other future involves changing the food landscape

and escaping the cycle. Often-cited solutions for this are
exercise and education on what is good to eat. However,
while exercise is excellent for health and wellbeing, it may
not obviously or quickly result in weight-loss. Many people
who exercise in an effort to reduce their weight become
discouraged. Data shows that around 90% of the UK
population know what a healthy and balanced diet looks
like and know they should be eating less processed food.
Education on what to eat is not the problem.

There are three solutions that can potentially mitigate the

problems the current food system has propagated:
Source: National Food Strategy: The Plan, 2021. 1. Cooking skills: Improving the provision of food
technology education in schools is vital. Efforts to enable
school kitchen teams to prepare delicious and nutritious
To solve this system-wide problem, the National Food food for children, as well as help them learn how to cook
Strategy: Part one (2020)27 highlighted the need to examine for themselves, must be supported.
feedback loops and understand what is malfunctioning
within the food system. One of these feedback loops is the 2. Government intervention: Mandatory taxation
junk food cycle. encourages food companies to reformulate their
products and reduces the consumption of such products.
Humans have an evolutionarily developed appetite for For example, three years after the Soft Drinks Industry
calorie-dense foods. Modern calorie-dense foods are Levy was introduced, the average sugar content of soft
highly processed, high in fat, salt and sugar (HFSS) and drinks had decreased by 29%.
often suppress satiety responses. As such, consumption 3. Local initiatives: Individuals have the power to change
of such foods is higher than that of non-processed foods. the food culture within their communities and social
Increased demand leads to higher investment of time groups. Engaging communities in the conversation can
and money within food companies in the development help us escape the junk food cycle.
and production of processed foods. This in turn increases
consumption in a vicious cycle.

27. Dimbleby, H. 2020. The National Food Strategy: Part one. https://www.gov.uk/government/publications/national-food-strategy-for-england

Advancing the science of human nutrition – Conference report 31

The Royal Society is a self-governing Fellowship of many
of the world’s most distinguished scientists drawn from all
areas of science, engineering, and medicine. The Society’s
fundamental purpose, as it has been since its foundation
in 1660, is to recognise, promote, and support excellence
in science and to encourage the development and use of
science for the benefit of humanity.

The Society’s strategic priorities emphasise its commitment

to the highest quality science, to curiosity-driven research,
and to the development and use of science for the benefit
of society. These priorities are:
• The Fellowship, Foreign Membership and beyond
• Influencing
• Research system and culture
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Cover Image: ©iStockphoto / sagarmanis.

Issued: June 2024 DES8414_6

Advancing the science of human nutrition – Conference report 32