[FOOD, MEDICINE & HEALTH]
by Mary Christ-Erwin & Roger Clemens
Jumping the Indifference Curve on Nutrition
T
he Dietary Guidelines for
Americans—the 2010 ver-
sion of the musculature of
the nutrition policy of the United
States—have arrived. The sig-
nificant investment of time and
thought leadership by a highly
credentialed group of scientists
has again yielded evidence-
based, consumer-directed
recommendations designed to
improve food and fitness pat-
terns and, ultimately, public
health. While the Guidelines
have evolved since their incep-
tion in 1980, the guidance they
provide has been consistent
and grounded in what most
consumers—and stakehold-
ers—acknowledge as a healthy
approach to eating patterns.
As with any policy document,
it is critical to examine how con-
sumers have responded to the
guidance. In the case of the
Dietary Guidelines for Americans,
it also is time to explore what
additional scientific disciplines
may be needed to enhance the
Guidelines dialogue to meet the
needs of all end users, including
the food industry, which is
charged with bringing these
nutrition recommendations to life
at point of purchase.
Currently, nutrition science is
the core driver of the Dietary
Guidelines. However, once the
status of the direction driven by
the nutrition science is deter-
mined, the food must be made,
necessitating a key role for food
science and technology in the
discussion. Take, for example,
two key directives of the 2010
pg 20 04.11 • www.ift.org
Guidelines: increased consump-
tion of fruits and vegetables and
reduction in sodium.
The intriguing question
around fruits and vegetables
is this: If all Americans did
reach the goals set in the 2010
Guidelines, would enough pro-
duce be available to meet
Food
Science & Nutrition
Technology Science
Behavioral
Economics
Food science & technology, nutrition science,
and behavioral economics should all have a
role in shaping dietary guidance.
consumer demand? In a study by
the Economic Research Service
of the U.S. Dept. of Agriculture,
based on the 2005 Dietary
Guidelines, Buzby et. al. (2006)
determined that Americans
would need to increase daily fruit
consumption by 132% to meet
dietary recommendations. The
additional demand could require
U.S. producers to more than dou-
ble harvested fruit acreage to 7.6
million acres (up from 3.5 million
acres). To meet the dietary rec-
ommendations for vegetables,
daily consumption would have
to increase by about 31%, and
the mix of vegetables consumed
would have to change, requiring,
for example, a 431% increase in
the consumption of legumes and
a reduction of 35% in the con-
sumption of starchy vegetables.
To meet this demand, the areas
harvested for vegetables would
need to increase by about 137%
from 6.5 million acres to 15.3 mil-
lion acres. Issues of concern in
the U.S. include the amount of
arable land available with favor-
able climate conditions, water
availability, adequate numbers
of farm workers, cold chain
management considerations,
appropriate means of transpor-
tation, and the occurrence of
natural disasters that could sig-
nificantly impact harvest. With
all of these considerations, it is
likely that imports could continue
to increase and new technologies
for increasing the capacity to
grow and harvest product would
have to be seriously exploited.
These include vertical farming,
hydroponics, and aeroponics,
as well as other novel and inno-
vative production methods.
On sodium, the Dietary
Guidelines report noted that evi-
dence of a direct relationship
between dietary sodium intake
and cardiovascular disease in
humans has been sparse and that
there is further need for random-
ized clinical trials in humans to
indicate a relationship with the
impact of dietary sodium intake
and other disease states. Still,
the ultimate recommendation
was to reduce daily sodium
intake to less than 2,300 mg/day
overall, with further reduction to
1,500 mg/day among persons
who are 51 and older and those
who are African American or
who have hypertension, diabe-
tes, or chronic kidney disease,
which applies to about half of the
U.S. population. One of the great-
est challenges for the food
industry—and the food scientists
in industry—is to develop nutri-
tious products and identify
processes that significantly
reduce the sodium while assuring
the safety of those products. This
reduction will require radical
changes in consumer-acceptable
sensory qualities of foods, explo-
ration of new, cost-effective
technologies to duplicate the
functional properties of sodium
chloride, and even close exami-
nation of food regulations.
With issues like these on the
table, why has the role of food
science in the Dietary Guidelines
Advisory Committee been
focused primarily on home food
safety issues? Shouldn’t consid-
eration be given to encouraging
full engagement of the nutrition
and food science disciplines in
the examination of how nutrition
science recommendations can be
realized in the marketplace, pos-
ing questions about what
technologies are available, how
soon they can be employed, and
at what cost.
The ultimate question, of
course, is what impact have
the Dietary Guidelines had on
the way consumers approach
food choices. Research dem-
onstrates that behavior change
does happen, albeit slowly. Why
the slow pace? According to
Shahram Heshmet of Rensselaer
Polytechnic Institute, “Healthy
behaviors such as eating
habits and exercise have con-
sequences which are realized
only after long periods of time.
They involve incurring a current
cost (sacrifice) in exchange for
a chance of some future ben-
efit.” Do the Dietary Guidelines
and the communications that
surround them offer consumers
enough incentive to make fun-
damental changes in something
as routine as food? Ultimately,
the true impact of the Dietary
Guidelines is consumer buy-
in that tracks to improvements
in public health. To date, while
food science and technology has
been given a relatively minor
voice in the dialogue, behav-
ioral economics has not been
represented in the Guidelines
Committee at all—a significant
gap given the behavioral changes
required to stem the obesity
epidemic, overcome nutrient
shortfalls, and ultimately identify
realistic measures to motivate
consumers to adopt sustain-
able healthier eating patterns.
Some insight on consumer
willingness—and ability—to
make recommended modifica-
tions in diet and exercise
patterns is offered by Porter
Novelli’s ConsumerStyles data-
base. Since 1995, Porter Novelli
has surveyed thousands of U.S.
consumers, tracking key health
issues (including obesity) and the
traction they get over time when
it comes to health behaviors.
Since 2000, the statement, “My
current body weight is a threat to
my health,” has been included. In
that year, 29% of the total popula-
tion agreed with the statement,
with 71% disagreeing or remain-
ing neutral. Given the sheer
abundance of messages and
media coverage on the topic of
obesity since 2000, one might
surmise that these attitudes have
significantly changed. Yet in 2010,
the responses were identical to
those in 2000.
Fundamentally, food isn’t
nutritious until it’s eaten. As the
nation ramps up to the 2015
Dietary Guidelines review of the
science, should the door be open
to broader engagement of the
scientific disciplines of nutrition,
food science and technology,
and behavior, putting into prac-
tice the adage, “the whole is
greater than the sum of its
parts?” If not, do we risk advanc-
ing nutrition recommendations
that cannot be delivered upon in
a timely and cost-effective way
04.11 • www.ift.org
by the food industry? Similarly,
do we risk a decline in consumer
relevance and attention?
Consumers look at food and
nutrition from multiple perspec-
tives. Shouldn’t the Dietary
Guidelines do the same? FT
Susan Borra, Joy Dubost, Bob
Gravani, Shahram Hushmat, Brian
Wansink, and Adam Burns con-
tributed to this column.
Mary Christ-Erwin, Contributing
Editor • Partner & Global Director
Food, Beverage & Nutrition,
Porter Novelli Public Services •
Washington, D.C.
• MChristE@porternovelli.com
Roger Clemens, Dr.P.H.,
Contributing Editor
• Chief Scientific Officer,
ETHorn, La Mirada, Calif.
• rclemens@ethorn.com
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