Inspiring Nutrition Guide | Issue One by Food Matters Live

Managing Director Briony Mansell-Lewis Digital Editor Stef Bottinelli stef.bottinelli@foodmatterslive.com Client Growth Manager Marina Sanchez-Turon marina.sanchez-turon@foodmatterslive.com Phoebe Matthews phoebe.mathews@foodmatterslive.com Head of Content Marketing Carol Mahna Creative Direction Brita Lapatza Cover Illustrator Ane Arzelus Designer Julia Sabiniarz Contributors Stef Bottinelli Anna Turns Fiona Holland Ross Carter-Carver

Advances in nutrition will benefit the individual and society as a whole

Sustainable Nutrition 11

Sustainable diets: eating in harmony with the planet

Sustainability vs the cost of living – is it one or the other?

Is plant-based always better for you – and the planet?

Personalised Nutrition 26

Personalised nutrition: the rise of bespoke diets

Tim Spector: ‘Food is not a religion, the rules keep changing’

What impact can precision nutrition have on our health?

Functional Nutrition 40

Functional nutrition: the role of food in disease prevention and management

Nutrition and the menopause – can diet affect the symptoms?

Exploring the links between nutrition and irritable bowel syndrome

A joint approach? Exploring the links between nutrition and arthritis

Nutraceuticals 55

Nutraceuticals: understanding the function and benefits of nutritional supplements

How the world of nutraceuticals is evolving

Sports and Active Nutrition 68

Sports and active nutrition: the trends and products fuelling peak performance

Career conversations: The man elite athletes turn to for nutrition advice

The chef fuelling the Tour de France peloton

How nutrition can support mental health: what to eat, what to avoid, and the truth about good mood food

Reproductive health: the beneficial role of nutrition in men and women’s fertility

Inspiring Nutrition Event 102

Affordable nutrition for everyone is the key message at Food Matters Live’s Inspiring Nutrition

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10 key trends in nutrition and health of 2023 and beyond

Advances in nutrition will benefit the individual and society as a whole Stef Bottinelli Attitudes towards nutrition are changing. Dietitians, nutritionists and physicians are understanding that the one-size-fits-all approach doesn’t work and individuals are seeking nutritional plans tailored to their needs. 6

Every individual is unique, and our nutritional plans must be unique too.

Advances in nutrition are happening fast, with more investment allocated to researching functional ingredients that target specific needs. These days we understand that nutritional needs for women, men, different age brackets and levels of physical activity are different. General guidelines no longer work. Every individual is unique, and our nutritional plans must be unique too. Personalised and functional diets are gaining popularity, and with the number of adults and children living with obesity on the rise, understanding individual needs and tackling malnutrition is more important than ever. Good nutrition also goes beyond the body and mind. With food production being responsible for over a quarter of the world’s greenhouse gas emissions, eating sustainably to reduce further environmental and societal damage is of the utmost importance. Eating seasonal, organic food, grown locally where possible, and cutting down on animal produce is a key trend. We understand the importance of following a nutritious personalised and environmentally friendly diet, however, with food shortages and the cost-of-living crisis, this is not possible for everyone. The challenge now is to democratise nutrition and make it attainable to all, not just the few. The good news is that advances in nutrition are happening fast, and consumers are more aware than ever of the importance of food for a healthy lifestyle and a fairer society. There are exciting changes happening in this sector which could soon revolutionise our approach to nutrition and food, and hopefully benefit the collective as a whole. 7

Sustainable Nutrition

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Sustainable diets: eating in harmony with the planet Anna Turns Food sustainability incorporates many aspects. It’s about environmental impacts, carbon footprints and nature, but it’s also about the ethical and health effects on people. So deciphering what makes a truly sustainable diet is complicated. Depending on someone’s preferences and priorities, their location and buying habits, foods that make up a sustainable diet will vary. A sustainable or ‘climavore’ diet encourages people to eat with the planet and its changing climate in mind – that includes locally-sourced, seasonal and organic produce, drought-resistant crops in a period of water scarcity, plus plant-based protein instead of beef. Essentially, it’s flexible and adaptive – as the climate changes, so too will the recommended foods. The simplest advice is to try to ‘buy food with a story you know’. These wise words, from Patrick Holden, CEO of The Sustainable Food Trust and speaker at Food Matters Live’s Sustainable Food Forum this coming September, are a powerful reminder that, despite living within a globalised, convoluted and industrialised food system, we as consumers can and do have agency. 11

Vote with your fork

As Sara Roversi, founder and President of the Italian-based social enterprise Future Food Institute, states, “eating is an essential activity for human beings, but today it requires consciousness and awareness.” So perhaps eating more sustainably involves a mindset shift? “Don’t underestimate the power of your informed questioning,” says Holden who encourages curiosity. “Highlight to retailers and manufacturers that you really care.” So whether we buy food from the supermarket or a farm shop, we can start by considering how something was produced or processed, who grew it, where it’s from and how it was transported, whether it’s actually in season. “If you can’t get anything with a story you like, go to the customer service desk or write to them and say, I want locally-produced, sustainably-produced, in-season products, and they’ll listen,” says Holden. “If you can only afford to buy some of your fresh vegetables for instance from a box scheme or a farmers’ market, OK, that’s a huge step,” he adds. “If everybody in the country just even did 5% of their purchasing in a better direction that will change the system because in the end it’s us. We’re the powerful ones, not supermarkets. They’re only powerful as long as we’re passive. If we become active, if we become agents of change, they’ll listen because they’ll go out of business if they don’t.” In the current food landscape, decision-making is tricky. Depending on personal preferences, should we opt for organic veg wrapped in plastic or non-organic plastic-free produce? Should we choose homegrown tomatoes grown out of season in energy-intensive polytunnels or tomatoes that have been grown in warmer climes then transported by truck from the continent? Actually, although the answer is not always straightforward, likely the latter thanks to the Spanish sunshine.

We’re the people who eat the food and elect the politicians. If you go to Westminster today and ask the government or the opposition how important is all this stuff, they’ll say, ‘oh, not very important’. Well, we have to prove them wrong. Patrick Holden CEO, The Sustainable Food Trust

Food production is responsible for an astonishing one-quarter (26%) of the world’s greenhouse gas emissions, from supply chain logistics to crop production, land use and livestock farming. Perhaps surprisingly, stats show that eating local doesn’t always translate to low carbon, because transport only contributes to a small part of most food’s overall emissions. What you eat has more influence. Foods with the highest greenhouse gas emissions across their supply chains include beef, lamb and cheese, while emissions from plants such as nuts, citrus fruits, apples and root veg are tiny by comparison. Dr Chris Bryant, a Social Scientist and sustainable food expert at the University of Bath confirms that consumer dilemmas about aspects such as plastic packaging or food miles aren’t as important as the environmental impacts that occur before food leaves the farm gate, adds. “Thinking about animal product alternatives like plant-based meat, for example, it is far better for the environment to eat plant-based meat imported from America compared to eating cows reared in the UK,” he says.

The plant paradox

Adopting more plant-based diets would slash the food system’s environmental footprint, according to Bryant, while improving food security by reducing the amount of land needed to produce our food. “In the UK, we currently import vast amounts of crops to feed livestock animals, and this not only makes us reliant on food imports from other countries, it also increases the environmental impact massively,” he says. There are health benefits too. Bryant adds that “choosing a plant-based diet over a diet containing animal products will tend to mean more consumption of fibre and vitamins, and less consumption of cholesterol and saturated fat. The evidence overwhelmingly supports the view that plant-based diets are associated with lower risk of heart disease, cancer, diabetes, and obesity.” Bryant argues that energy is inevitably wasted during any meat production, because put very simply, animals are higher up the food chain and need to be fed by other plants or animals, unlike plants. “The vast majority of calories consumed by a chicken are not spent growing chicken breasts and thighs, but on heating the body, growing bones, and a range of other expenditures which are not at all useful to humans. Eating animals is always going to be an inefficient use of calories,” he says. But Holden argues that it’s not as simple as eating less meat and more plants. He mentions the renaissance in heritage crops that increase genetic variation, adaptability and climate resilience. But not all plants are sustainable. “There are lots of unsustainably-produced plant materials [such as palm oil], plant components of our diet which, actually, we need to eat less of or even give up eating because they come from intensive plant production systems often from the other side of the world which are part of the problem.” “It’s exactly the same with animals,” he says. “We need to differentiate between the animals and the plants which could and will form part of a sustainable farming system and those which are absolutely part of the problem and eat accordingly.”

In the UK, we currently import vast amounts of crops to feed livestock animals, and this not only makes us reliant on food imports from other countries, it also increases the environmental impact massively. Chris Bryant Director, Bryant Research

So, if you do eat meat, how much meat is sustainable? The Sustainable Food Trust’s Feeding Britain From the Ground Up 2022 study modelled a nation that switched to farming regeneratively ‘within planetary boundaries’. It found that current levels of food production could be maintained if we wasted less and ate a more sustainable diet. While some exotic crops such as tea, coffee and bananas, wouldn’t ever be grown here, Holden explains that most people should be basing their diet on regionally or nationally-sourced staple foods. “We’d have plenty of in-season vegetables and fruits, and enough grain to feed ourselves, but we wouldn’t have enough grain to feed intensive chickens, pigs and dairy cows. So that has huge dietary implications. It means no more cheap chicken, no more cheap pork from intensive pig systems, and no more dairy from mega dairies that feeds a lot of grains.” A sustainable agricultural transition would involve more mixed farming, says Holden. That includes more crop rotation of nitrogen-fixing crops to build richer soils and grass-fed sheep, beef and dairy cows on that land to ruminate and convert those crops into food. But what about the methane emissions? Holden explains that ‘old carbon’ already exists in the carbon cycle and it’s offset by the gain in soil organic matter. He grazes livestock on his 300-acre farm, the first in Wales to be certified organic. A recent audit found his system to be carbon negative: “It’s not just grass and clover that grows, we’ve got a dandelion festival going on here right now – the cows love them, they’ve got deep tap roots and they bring minerals up from the subsoil.” This holistic philosophy forms a central part of building a regenerative farming system, explains Holden. “Actually, the only way you can reliably build soil fertility at scale is with grazing animals. Paradoxically, now we actually need to eat the right kind of meat to help the transition.”

Eco-labelling to eat more sustainably Transparency is hard to come by. Denmark has proposed eco-labelling on foods to make their carbon footprint transparent to consumers. The Netherlands is looking into this option, and the UK Government is being urged by Tetra Pak and other businesses and organisations to implement environmental food labels. But Holden says that the truth is that it’s currently very difficult to go into a British supermarket and buy food, especially vegetables, that are part of the solution. That’s down to the fact that most supermarket food is sourced from intensive, extractive and polluting farming systems, he says, but also that the labelling currently in use doesn’t help consumers. “You just can’t tell [whether food is sustainable] so we need a new way of measuring on the farm and we need a labelling system which reflects the sustainable impacts of each farming system.” That’s why the Sustainable Food Trust has been working for eight years on developing a Global Farm Metric, that Holden hopes will one day become an international standard. It’s based on the concept of ‘true cost accounting’ which accurately measures the hidden negative and positive impacts of food production. By quantifying everything from microbial diversity in the soil to workers’ rights, the framework assesses the social, economic and environmental sustainability of both regenerative and industrialised farming systems in an evidence-based way. Holden explains that big corporations and multinational supermarket chains are showing ‘huge interest’ in using this metric, “because they know their own customers want to know this information”.

The social and health impact of a sustainable diet

A key part of knowing the story behind the food you eat involves understanding who grew or reared it – how were the farmers or producers treated, paid and supported? Is that food supply chain inclusive, equitable and regenerative? From cotton and tea to cocoa and coffee, more than 1.9 million farmers and workers across more than 71 countries are part of the growing Fairtrade movement, and both the Fairtrade label and B Corp certification – a rigorous measure of a company’s social and environmental impact – indicate that brands take this social responsibility really seriously.

Eating is an essential activity for human beings, but today it requires consciousness and awareness. Sara Roversi President, Future Food Institute

Informational measures including carbon labels and animal welfare labels can inform people about how to eat more sustainably, says Bryant, who outlines some of the ways policy could make sustainable diets more mainstream. Financial measures like taxes and subsidies can encourage people to eat fewer animal foods and more plant-based foods, he explains. ‘Command and control’ measures could also impose limits on food production and consumption: “For example, minimum standards for animal welfare, or limiting the meat and animal products served in public catering,” explains Bryant. And finally, governments can implement ‘nudges’ to encourage people to choose more sustainable options: “For example, presenting plant-based foods as the default, positioning them first in buffet settings, and having them make up a higher proportion of menus in public catering will all encourage people to cut their meat consumption,” he says.

Improving national dietary guidelines is a key step too, because replacing highly processed foods with nutritious, sustainable diets has knock on effects for the health of entire nations if successful. To some extent, it’s a human rights issue, especially as climate change impacts exacerbate food insecurity. There’s huge potential for the Mediterranean diet to be positioned as a sustainable diet model, with benefits for people’s health and nutrition as well as positive environmental impacts. A recent Israeli study concluded that both the Mediterranean and the EAT-Lancet dietary patterns should be included in national dietary guidelines for both public health and sustainability reasons. But none of this will happen without harnessing consumer power, says Holden: “We’re the people who eat the food and elect the politicians. If you go to Westminster today and ask the government or the opposition how important is all this stuff, they’ll say, ‘oh, not very important’. Well, we have to prove them wrong.”

10 ways to eat a healthy, low-impact sustainable diet

• Introduce more plant-based diversity into your diet, including plenty of wholegrains, legumes and field-grown veg that are less prone to spoilage (and won’t have to be air freighted). • If you eat meat, eat grass-fed meat in moderate quantities with a nose-to-tail philosophy. • Eat dairy and eggs in moderate quantities. • Eat small amounts of seafood from certified fisheries, taking stocks and capture method into consideration. • Opt for food produced using farming methods that minimise the use of antibiotics, hormones and toxic chemical inputs in food production. • Limit your consumption of foods high in fat, sugar or salt, and low in micronutrients. • Cook with more oils and fats rich in omega 3 such as olive and rapeseed. • Drink tap water instead of other soft drinks. • Minimise the use of plastic food packaging. • Discover creative ways to waste less food.

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Sustainability vs the cost of living – is it one or the other? Does making greener food choices always come with a cost? More specifically, is the cost of living crisis forcing consumers to act less sustainably? There is tons of research out there on how cost effective going green can be, some people say it is cheaper, while others claim it is simply too expensive. And it can be hard to get to the facts, especially when products labelled as eco-friendly often seem to be at a premium. The Independent newspaper even claims 6/10 shoppers say they have had to make less sustainable choices during the crisis due to costs. So what is the truth in all of this and how do we all, consumers and producers alike, arrive at a more sustainable future?

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Is plant-based always better for you – and the planet?

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Plant-based meat alternatives are supposed to be better for the planet and they are supposed to be good for you. But as they have grown in popularity, there are claims from some quarters that there is something of a halo effect at play, and that some of these health and environmental claims do not quite stack up. Evidence is offered which mentions the nutritional shortcomings of plant-based processed foods, as well as the carbon footprint being far higher than vegetables or legumes. In the midst of a climate crisis, where greenwashing is commonplace, this stuff really matters and it can be hard to cut through the noise to get to the facts. Which is where today’s guest on the Food Matters Live podcast, Chris Bryant comes in, he has reviewed a host of previous studies to see where we are up to. Chris Bryant PhD is a Social Scientist and an expert on alternative protein markets and marketing. He is a Research Associate at the University of Bath. He has published several papers on consumer acceptance of cultivated meat, plant-based meat, and fermentation-derived animal product alternatives. Through his company, Bryant Research Ltd, he works with alternative protein companies and non-profits, including Formo, Ivy Farm Technologies, Aleph Farms, WildType, and the Good Food Institute.

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Personalised Nutrition

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Personalised nutrition: the rise of bespoke diets

Anna Turns Cooking for my family of four is tricky. Two of us are vegetarian, my son doesn’t eat pork or shellfish for religious reasons, while my husband, a carnivore, doesn’t like eating the nuts, seeds, spicy flavours, lentils or wholegrains that I love. I’m constantly preparing multiple meals at once to keep everyone fed and hungry. This level of personalisation is solely based on our different personal priorities, likes and dislikes. But the new frontier of personalised nutrition is taking this one step further, adapting our individual diets to optimise our longterm health by taking everything from DNA and ethnicity to blood sugar responses and gut microbiomes into account. I want to find out how scalable – and feasible – this really is but first, let’s explore the meaning of personalised nutrition. 26

What is personalised nutrition?

There’s no official definition but broadly speaking, personalised nutrition is an approach that uses intricate information about individual characteristics to develop targeted nutritional advice or products that optimise your health. As Vimal Karani, Professor in Nutrigenetics and Nutrigenomics at the University of Reading, outlines, the relatively new field of personalised nutrition is rapidly evolving. “Ten years ago, personalisation of your diet was based mainly on your DNA or genetic makeup, but now with more advanced technologies, companies are starting to use genetic information alongside information about your gut microbiome, your metabolism, your ethnicity and lifestyle factors.” He calls this more comprehensive approach ‘precision nutrition’. But while some companies are looking at multiple factors, he says that, “there’s still a long way to go before we get a true picture about what exactly is happening. It might take another decade or two to implement precision nutrition.”

Forecasts suggest this sector could be worth anything between $15bn and $25bn within the next five years. In March, ZOE, the personalised nutrition programme and app founded by Professor of Genetic Epidemiology at King’s College London Tim Spector, received £2 million in investment from Dragons’ Den‘s Steven Bartlett. So far, 62,000 people have signed up to ZOE, a programme that involves various tests on blood fat, gut microbiome and blood sugar. As Spector explains, he studied how people respond after eating specially-developed test muffins and discovered huge variability: “We could categorise people in terms of response that you’re a bad carbohydrate responder and would get a high sugar peak or others might have a fatty meal and have a lot of fat lying around for six hours in their body …so we could start tailoring advice based on these metabolic responses,” he says. “And more tests are giving greater insights for everybody.”

ZOE, the personalised nutrition programme

There’s an obvious thirst for this from a consumer perspective, and the market is reacting. “There is an explosion of personalised nutrition products and companies out there now,” explains Dr Sarah Berry, an Associate Professor at King’s College London and Chief Scientist at ZOE, who has run more than 30 human nutrition studies. That includes PREDICT, the world’s largest in-depth nutritional research programme, run in collaboration with Spector. “The biggest point of concern for me is that many of these companies are doing single testing – testing on a single exposure or outcome, for example continuous glucose monitoring only or microbiome monitoring only or DNA monitoring only,” says Berry. “What’s very clear from our research and what we know in the nutritional science field, is that we’re very complicated. There are hundreds of pieces to the puzzle, and we need to look at all of these different pieces to deliver truly personalised advice.” ZOE uses gut health information plus blood parameters and lifestyle factors but not DNA testing. Karani sees this as a limitation: “The gut microbiome could be the same for two or three individuals, but the genetics are unique for each and every person. If you look at the genetic factors which predispose people to become obese, for example, the genetic factors that have been identified only explain 5-6% of total genetic variation for obesity – so nearly 94-95% of our genome hasn’t been explored yet.” He insists DNA testing of every individual is a must because providing a personalised diet based on a small amount of available data isn’t enough. However, Berry explains her thinking: “In our first PREDICT study of 1000 individuals who were mainly from the twins UK cohort led by Tim Spector, we did have DNA testing. We found that genetics did play a small role but, for most outcomes, other factors were more important, so we made the decision not to do DNA testing,” she explains. “We’ve been able to look at all of the pieces of the puzzle and ask: how important is that piece versus that piece? Let’s just look at the important pieces.” 28

A dietary dichotomy?

Traditionally, most public health guidance about what to eat is pretty broad. Dietary advice has been based on the population’s average responses to different foods. “You have those WHO dietary recommendations and some people reduce their sugar or salt intake, but we still see the levels of obesity, diabetes and cardiovascular disease increasing across the population – that means this one-size-fits-all approach doesn’t work well,” says Karani. As scientists unravel the complexities of nutritional science, more nuance becomes apparent. Pitting personalised nutrition against population-based nutrition is oversimplifying things way too much, says Berry who believes they can work together. “Personalised nutrition doesn’t have to be at the exclusion of population-based advice – everyone should eat more fibre, for example. But there’s a big gap between population-based advice and personalised nutrition advice. There is a massive chunk in the middle which is what we call stratified advice, where you group people based on a shared characteristic.” The PREDICT 1 studies showed how postmenopausal women and perimenopausal women have higher blood sugar responses than pre-menopausal women of the same age. “So we can learn from our data and give that stratified advice to be even more careful with your refined carbohydrates without anyone having to do a test,” she says.

The magic formula

Beyond the differences between groups of people, variations also exist within one person, and that’s exciting according to Berry: “For me, the real magic is overlaying on your biological personalisation with personalisation according to how we live our lives,” says Berry. “From our own research, we know that the time of day that you eat, how much sleep you had or your eating speed – those factors that we call how you eat – vary day to day.” Back to the Turns family. If we paid more than a grand for four bespoke programmes, would it make my shopping list longer and more expensive or is there scope to simplify things? Berry explains that, as with any personalised nutrition, we need to think about how that advice is applied. “In the family environment, I don’t think we should encourage anyone to sit down to a meal where each child is eating differently and you’re eating differently to your partner. At Zoe, we ask people what’s their situation, so we can take into consideration the environment in which you live and the preferences not just of you but of those around you. So we’d suggest meals that can be consumed by the whole family.”

I don’t think we should encourage anyone to sit down to a meal where each child is eating differently and you’re eating differently to your partner. 30

Karani’s research has found that behaviour change is the biggest challenge in terms of applying nutritional recommendations and making sure people don’t revert to previous habits once an intervention is finished. “To bring about change in a whole family and change what they’ve been doing for several decades – it’s not easy,” says Karani, whose hope lies in the future of precision nutrition. “Prevention is better than cure – once you develop a disease, it’s more about management. So personalisation is the only option we have for preventing all of the cardiometabolic diseases in the future.”

Three approaches to personalisation

Biomes – home test kits assess your gut microbiome to inform personalised nutritional recommendations.

Nutri-Genetix – plant-based nutrition shakes are recommended to improve your fitness following analysis of 30 well-researched genes in your DNA.

ZOE – tests of blood fat, gut microbiome, blood sugars and metabolism of standardised test muffins, plus other personal insights are used to design your healthy-eating plan.

Developing personalised nutrition is an expensive, challenging, complex and time-consuming task. In the future, better regulation could ensure ethical use of personal data and provide a guarantee that companies are doing what they say they’re doing. For now, Berry outlines five factors that indicate a company is taking steps to be rigorous:

5 steps to developing personalised nutrition

Scale: “We’re all so different, we have thousands of biological pathways that are different between each and every one of us,” says Berry who explains large sample sizes are essential for robust research. Resolution: “Just looking at the back of the food packet labelling is meaningless because we need to be collecting diet data as well as biological data at a resolution that’s good enough for personalised nutrition,” says Berry who taps into logged data on approximately 160,000 foods for ZOE. “We know that the 31

food matrix and the thousands of other chemicals in food modulate their health effects as much probably as their macronutrient composition.” Precision: There is some controversy regarding personalised nutrition, as Berry explains: “Are the tools we are using precise enough? We spend a lot of time validating our technology and recently published an AJCN article comparing a blood glucose monitor with another brand to see if it gives the same results.” Breadth: “You need a breadth of different outcomes. So there’s no point only looking at blood glucose levels,” she argues.

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Depth: “If you’re looking at the microbiome, there’s no point just looking at the diversity. We need to look at the different bacteria so we need that depth of analysis,” so, as Berry argues, more detailed information results in better, more specific nutritional advice.

Berry suggests asking four questions before you invest in a personalised nutrition product to investigate whether they’re really taking a robust approach: • Are they looking at WHO you are, what your family history is, what your biology is? • Are they properly looking at WHAT you eat?

• Are they looking at HOW you eat, how many meals you have at different times of day? • Are they looking at WHY you make those choices?

Case study, Michelle:

I know my gut is thanking me Michelle has been following a personalised nutrition proCase study, Ruth: gramme for three months and loves that the ZOE programme doesn’t involve restriction or calorie counting. “It’s based on science, and, to me, it makes perfect sense. This isn’t a five-minute wonder, it’s a life choice,” explains Michelle who has lost 7kg in weight and maintains that ‘with ease’, has more energy, without the acid reflux, IBS, or upset stomach she previously experienced. She’s also sleeping better, has clearer skin and her asthma has almost gone. “This isn’t a gimmick or a fad diet. This is a way to have the best healthy life possible from inside out. I know my gut is thanking me,” says Michelle whose attitude to trying new foods has now transformed: “I love going out to eat without worrying Ruth used the ZOE app for five months there will be nothing to eat – I ask and plans to continue eating ‘ZOEfor what I want, take seeds with me style’ forever. “I don’t consider it a diet as I everywhere ‘just in case’ and I’ve eat plenty and my hunger is easily satiated,” found my love for cooking.” says Ruth who can now confidently design a meal plan that’s tailored to her specific needs. “I’ve come to the conclusion that it was processed foods that were irritating my gut, sugar destroying my mood and concentration, and a range of seemingly healthy foods that just don’t suit me keeping me below par and stodgy.” Ruth adds that her efforts have been “absolutely worth it”. “I’m leaner than I was. My digestive system is more settled and I have less bloating,” she says. “My mood is much steadier. I have more energy and a clearer mind. I’m no longer on the sugar rollercoaster!”

I don’t consider it a diet

Tim Spector: ‘Food is not a religion, the rules keep changing’ In 2015 a book was published that, for millions, was their first introduction to the gut microbiome. “The Diet Myth: The Real Science Behind What We Eat” looks at the relationship between microbes, genetics, and diet. A few years later, along came “Spoon-Fed” – a book which claimed to expose the bad science behind many government diet recommendations. The author of both is, of course, Tim Spector, one of the most interesting, engaging, and knowledgeable speakers in the world of food. He is also one of the most qualified. He is Professor of Genetic Epidemiology at King’s College London, honorary consultant physician at Guy’s and St Thomas’ hospital, and he is one of the top 100 most-cited scientists in the world. He has been on the podcast before, and we were delighted to welcome him back to talk about his new book “Food For Life”. 34

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Tim Spector, Professor of Epidemiology Tim Spector is a medically qualified Professor of Epidemiology and Director of the TwinsUK registry at King’s College London. His current work focuses on the microbiome and nutrition, and he is co-founder of the data science company ZOE Ltd which has commercialised a home kit for personalised nutrition. He is also the lead researcher behind the world’s biggest citizen science health project – the ZOE Covid study of over 4 million people, for which he was awarded an OBE. Having published more than 900 research articles, he is ranked in the top 100 of the world’s most-cited scientists by Google. He is the author of four popular science books, including The Diet Myth, Spoon-Fed and the most recent Food for Life which is a Sunday Times bestseller. He makes regular appearances on social and mainstream media.

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What impact can precision nutrition have on our health?

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Everyone knows that we are not all the same, there is wonderful diversity in our bodies, our genetics, our lifestyles, and our preferences. And yet, when it comes to nutrition, the most successful public health messages are the broad guidelines, which suggests one size can fit all. Think five-a-day, taking vitamin D through the autumn and winter, and so on. At the same time, the science behind nutrition, the understanding of our metabolism and of our gut microbiome, has been increasing at a fantastic rate. The question is: how do you bring these two worlds together? How do you bring the best of intricate nutritional science to a broader population? Could the answer lay in precision nutrition? It is an emerging and exciting field which helps tailor dietary recommendations and nutritional guidelines, and there is some evidence it can have remarkable health impacts. It is an area which seems to offer huge potential, but exactly how much is yet to be discovered.

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Functional Nutrition

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Functional nutrition: the role of food in disease prevention and management Anna Turns Few cookbooks begin with a health warning. The pages often start with an evocative introduction about when the author first learnt to cook or discovered a new hero ingredient, surrounded by deliciously-composed photos, perhaps of vibrantly coloured dishes on a rustic table. But in his foreword of The Diabetes Weight-Loss Cookbook by Katie and Giancarlo Caldesi, Dr David Unwin writes: “I believe we have eaten our way into this epidemic of diabetes and obesity and that we can eat our way out of it.” Aside from great recipes, it’s a fascinating read – about personal connection to food, positive behaviour change and the management of blood sugar levels through diet. Unwin, who has worked as a GP since 1986, aims to empower people to take control of their health by changing what they eat. And for good reason.

The link between diet and diabetes

For certain conditions like type 2 diabetes, diet can influence the ‘disease burden’, or level of impact on a person’s health. Diet can also play an instrumental role in disease remission. As Duane Mellor, Registered Dietitian and Senior Lecturer at Aston University, explains, “For some people, [changing diet] is a way of reversing the physiology to bring the glucose under control [in the case of those susceptible to type 2 diabetes].” The Norfolk Diabetes Prevention Study found that, for people with pre-diabetes, losing just a few kilograms in weight and sustaining small lifestyle changes that included a healthy diet and regular physical activity for two years, reduced their risk of developing type 2 diabetes by up to 47%. Unwin, an advocate for low-carb diets, has run studies that have demonstrated the reversal of diabetes in a number of his patients, while a 2014 study by the Second University of Naples showed that a lowcarb Mediterranean diet (including oily fish, colourful fruit and vegetables, and olive oil) increases the rates of remission in people with type 2 diabetes. After one year of following the diet, 15% of participants achieved remission and, after six years, the percentage was 5%. At a population level, this is enormously significant because, according the charity Diabetes UK, some five million Brits are diabetic, with a further 13.6 million now at increased risk of type 2 diabetes nationally.

Prevention is better than cure

“In many conditions, you are working with someone’s medical issue to optimise their quality of life and health, so diet is a very powerful tool but not a direct, curative tool,” according to Mellor. “It’s a way of manoeuvring the situation to maximise health in people with a clinical condition.” He explains that a varied, simple and healthy diet has a big role in reducing risk of disease: “Multiple sites of cancer are associated with dietary risk factors and other lifestyle risk factors, including higher body weight. Colon cancer links to exercise [studies have shown that those who do regular physical activities have a lower chance of developing this type of cancer] and Mediterranean diets are associated with a lower risk of cardiovascular disease.” In fact, the in-depth Lyon Diet Heart Study, carried out during the 1990s, outlined how a Mediterranean-type diet drastically cut the risk of a second heart attack. “Reducing risk of heart disease involves lowering cholesterol and blood pressure – you can take a tablet for that,” says Mellor. “Diet is not as powerful at pushing any one of those risk buttons, but it pushes across so many different buttons, it will reduce your risk of other things as well.” So it’s about taking a holistic view, finding ways to enjoy eating a variety of healthier foods and sustaining those habits.

Immunity starts in the gut

The gut contains more than 70% of your immune cells. Registered Dietitian Lucy Kerrison explains that the trillions of bacteria within your gut microbiome affect your body’s response to disease. “The gut microbiome is part of our immune system … and your gut bacteria can rapidly change, depending on the foods you are eating, within just a few weeks,” she says, adding that the diversity and health of your gut microbiome also depends on non-food factors such as sleep and exercise. The gut acts as a barrier to pathogens that may cause infectious disease: “If you have a slightly more robust gut and a more diverse set of gut bacteria, that can strengthen the gut walls,“ she adds. “There’s something called ‘leaky gut’ that’s potentially linked to poor gut health, poor diet or an untreated medical condition, whereby the cells in your gut lining become slightly more leaky and you’re more likely to get pathogens entering.”

Multiple sites of cancer are associated with dietary risk factors and other lifestyle risk factors, including higher body weight. Duane Mellor, Registered Dietitian and Senior Lecturer at Aston University

The gut links to hormonal health, too: “Your gut bacteria change during perimenopause and menopause to a less diverse set so your risk of cardiovascular disease goes up, the way that you retain weight goes up and your metabolism changes too,” explains Kerrison, who works with clients experiencing chronic conditions including irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), an autoimmune condition.

“My work often involves looking at symptom management and then improving gut health and gut bacteria,” she adds. “In IBD essentially the gut is attacking its own tissue, and the flares happen for different reasons so it’s impossible to tie them down to particular foods.” She highlights that there is some evidence that probiotics can help ulcerative colitis, a form of IBD, and she adapts advice depending on where the gut is damaged. If the flare is in the lower gut, she might recommend a lower fibre diet, for example. “Once that condition is in remission, usually with medication, then we’d look at expanding the diet, improving gut bacteria, working towards an anti-inflammatory diet, introducing more omega 3s, fewer omega 6s and improving gut health.” Kerrison adds that clients with IBS won’t be able to tolerate all the foods that she’d love to add in to improve their gut health. “So it’s about working towards a diet that suits them and optimises as much as possible within their personal limits, and that might look slightly different for every person.”

Improving gut health with food

When Kerrison first considers improving gut health, she looks at the diversity of plant-based foods. “We know that diversity of plant-based products is really important, so if you are eating more than 30 plant-based products a week, which isn’t just fruit and vegetables but also beans and pulses, nuts and seeds, herbs and spices, you’ll have a more diverse set of gut bacteria than those eating less than 10,” she says. “That diversity is key in terms of improving your gut health generally, but also that is linked to your immune health and chronic conditions such as diabetes and cardiovascular disease.” Essentially, many plant-based fibres (e.g. garlic, onion, pulses, stone fruits) contain prebiotics that feed the gut good bacteria, and Kerrison also suggests adding in fermented foods such as kefir and kombucha to help those healthy bacteria grow in your gut.

Exercise can independently change your gut microbiome and make it more diverse. We know that good sleep and keeping low levels of stress can improve diversity of gut bacteria. Lucy Kerrison Registered Dietitian

Another important dietary factor is the total level of fibre. Government guidelines recommend 30g of fibre per day, but Kerrison explains that “If we’re looking at chronic diseases and prevention, we know that you can gain even more benefit for aiming for a slightly higher fibre diet, more like 50g fibre per day. With diabetes, a higher fibre diet means your absorption of carbs is a little steadier, so you’re less likely to get those spikes in drops in blood glucose levels, [plus] your gut bacteria play a role in blood sugar control too.” For a pre-diabetic client, Kerrison would look at the order of the foods they are eating: “Having veggies first, then protein, then carbs within a meal, means they’ll be absorbing fibre and protein first – that slows down carb absorption [reducing] those spikes and dips in blood sugar levels.” Kerrison also takes non-diet factors into consideration: “Exercise can independently change your gut microbiome and make it more diverse. We know that good sleep and keeping low levels of stress can improve diversity of gut bacteria.”

The link between gut and liver

There’s also a strong link between the gut and the liver, an organ that acts as the body’s metabolic hub. “Your liver is where you store your glucose. It’s involved in your circadian rhythm and bile acid release, which helps digest fats, so it’s really involved with digestion,” says Kerrison. Some of her clients have a fatty liver or might be moving towards the stages of longer-term liver disease or cirrhosis. “If I was seeing a client for fatty liver, the first steps would be to look at an overall balanced diet, the types of fat, then the types of carbohydrates – looking to wholegrain carbohydrates – then we’d look at diversifying your diet in terms of gut health. So looking at fats, then types of carbs, then improving overall gut health.” Because fat adaptation is important, she’d aim to increase omega 3s (oily fish, olive oil, nuts and seeds) and reduce omega 6s (vegetable oils, coconut oils, saturated animal fats) to help the liver and the gut. “Omega 3s and oily fish are also prebiotic so they feed your gut bacteria too.”

Food as medicine?

Of course, food is never a replacement for professional medical advice or prescribed drugs, and registered dietitians always adapt any recommendations on a case-by-case basis, taking any contraindications into account. “For every chronic condition, the advice differs, and then it would be slightly different depending on that person,” summarises Kerrison. To complicate matters, gene expression can change depending on environmental circumstances through what’s known as ‘epigenetics’. Scientists are still unravelling exactly how genetic makeup influences susceptibility to disease, and how nutrition might interact that. “We’re not yet clear about how adult genes are switched on and off in various cell types because that’s complicated to measure,” says Duane Mellor. Over the course of a lifetime, the food that we eat impacts our susceptibility to certain conditions and infectious diseases and healthy-eating patterns have multiple positive impacts, some of which go beyond the nutrients. As Mellor summarises, focusing on single superfoods is never a good idea, it’s about looking at a person’s whole dietary pattern and social connectivity is also really important in terms of disease prevention. “It’s not just the food on the plate, it’s how you interact over it,” he concludes.

Nutrition and the menopause – can diet affect the symptoms?

// PODCAST EPISODE Is there a link between nutrition and the health changes associated with the menopause? It’s an area that traditionally has not received as much attention as one might hope, but things are perhaps changing. There has been a lot of recent media interest in the menopause, notably Davina McCall’s TV programmes, Scotland First Minister Nicola Sturgeon’s interviews, and other celebrity interventions getting lots of coverage. But while this public discussion is a welcome change, it has also helped highlight that far-from-enough is known about the health issues associated with the menopause. And the question of menopause and nutrition is an area unfortunately still swamped in myth and pseudoscience. That is where our guest, Dr Sarah Berry comes in. She is Reader in the Department of Nutritional Sciences at King’s College London and is Chief Scientist at the health science company ZOE. ZOE has been studying the effect of the menopause on body composition, sleep, heart disease risk, gut microbiome composition, and the impact our diets can have on these factors. Listen to the full episode to get a proper definition of what the menopause is, and how the symptoms compare to those experienced during the perimenopausal phase. We also find out how what you eat could potentially affect symptoms, and why this latest ZOE research could act a springboard for more to come.

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Exploring the links between nutrition and Irritable Bowel Syndrome Irritable Bowel Syndrome (IBS) affects more than one in 20 people worldwide. It occurs in populations all over the planet and it can be debilitating. But what role can food, diet, and nutrition play in managing IBS flare ups? The causes of IBS are not currently well understood, which makes managing it very difficult for sufferers. There is a lot of research underway into the role diet and nutrition can play in managing the condition though. So, in this episode of the Food Matters Live podcast, we look in detail at which foods might cause flareups, the foods you should eat and those you should avoid, and we look at nutrition and lifestyle strategies for dealing with IBS.

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A joint approach? Exploring the links between nutrition and arthritis Arthritis is a debilitating condition which affects millions of people around the world. In the UK alone, there are up to 10 million people living with it and it affects people of all ages. So, what role can what we eat play in preventing and managing the condition? Spoiler alert – there is no one-size-fits-all miracle diet. But while we can be sure there is no miracle diet for arthritis, there are many foods which appear beneficial in fighting inflammation and joint pain. So a greater understanding of the role of diet and nutrition is really important. In this edition of the Food Matters Live podcast, we discuss which foods might be useful and which to avoid. We also ask whether supplements can play a role, and whether current research into areas like the gut microbiome might bring new solutions.

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Neutraceuticals

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Nutraceuticals: understanding the function and benefits of nutritional supplements Stef Bottinelli The nutraceuticals and nutritional supplements market has been booming in the last few years. According to statistics, the global dietary supplements market was valued at over $163 billion in 2022, and it’s forecasted to reach $350.96bn by 2032. Although these figures vary according to which market insights agency you listen to, there’s no doubt that this sector is growing exponentially and consumers are relying more and more on nutraceuticals to improve their health and performance. The UK supplements market is currently valued at £520 million, up 17% in the 2017-2022 period. According to the Food Standards Agency, 48% of adults in the UK take supplements, with 38% taking them daily, says Mintel. The most popular nutritional supplements include multivitamins, vitamin C, fish oils, vitamin D – which has received a boost since the pandemic – iron and vitamin B. Probiotics have also become popular, with more and more people becoming aware of the gutbrain connection. 55

Are nutritional supplements for everyone?

Many dietitians, nutritionists and GPs believe that nutrients should come directly from food, and with the right diet, there’s no need for supplements, however busy lives and the cost of living crisis often prevent us from having a nutritionally sound eating regime. “When we look at the general needs of the population we do hope that most people may be able to eat in a way that provides all of their nutritional requirements, however when we take into account people’s lifestyle, working, reliance on convenience foods - also those of us who are living on a tight budget - it’s very unlikely that people are able to meet all of their nutritional requirements on a daily basis through their diet,” says Sophie Medlin, registered Dietitian, Chair for the British Dietetic Association for London and co-founder of nutritional supplement brand Heights. “I think it’s really important to consider the potential benefits of nutritional supplements and nutraceuticals to support a well-balanced diet and really importantly, anyone who’s cutting out any food groups from their diet, such as dairy, animal products, etc, needs to consider supplementation. In my opinion it would be very useful for food banks and other places, where people are getting food where they are not able to make necessarily the most healthful choice about their diet, to make nutritional supplements available to those individuals.” During the pandemic, the Government recommended taking vitamin D as studies found that it boosts antiviral defences against some respiratory viruses. Sunlight helps to make vitamin D naturally, but with the UK – along with Ireland and Iceland - receiving the least amount of hours of sun in Europe, many Brits have a vitamin D deficiency. But that’s not the only nutrient we seem to lack in our diet in Britain. “The most common deficiencies we’ve seen are B vitamin deficiencies, these can be linked back usually to

reduced intake of animal products, like meat and dairy, in the diet. We’ve seen more vitamin B12 deficiencies and thiamine deficiencies - which are really important for energy and people may be experiences things like brain fog and other symptoms that can easily be linked back to B12 deficiencies,” explains Medlin. “I regularly recommend omega 3 supplements to my patients who are not having enough oily fish in their diet. I also often recommend B vitamin supplements to those who are reducing animal products,” she adds. “We often recommend vitamin D to everybody as well as vitamin K2 to those who are at risk and we’re seeing far more peripheral deficiency such as iodine deficiency, and multiple B vitamin deficiency within our practice these days. As people’s diets evolve we are seeing vitamin deficiencies that used to be uncommon as becoming more and more common as our food supply chain adjusts and changes with time, but also as our dietary habits adjust and adapt to various different social pressures and ethical considerations.” However, despite the prevalence of some deficiencies, not everyone needs or should take a supplement. “I think what’s really important to recognise is that multivitamins and vitamin products in general are not right for everybody and taking supplements isn’t necessarily benign,” says Sophie. “So some people who have a specific medical problem or take any medications need to speak to a pharmacist or their GP before they start on any nutritional supplement at all – or a dietitian. So it’s definitely not a one size fits all when it comes to nutritional supplements.” Yet, despite not always needing them, it seems consumers can’t get enough of added nutritional sup-

plements and the food industry is happy to oblige, continuously launching products with added nutrients. “I notice lots of products now being fortified with various vitamins and minerals so that they [brands] can make health claims,” explains Medlin. “For example drinks having added B vitamins, so they can make energy health claims. The risk with this is always that people end up taking too much of different things and causing themselves harm without realising that they were taking a product that was fortified with vitamins, and then taking a multivitamin and then taking another product on top of that. So whilst it’s interesting and exciting to see these markets develop and the understanding for the consumer, it can definitely cause people harm and it’s not a particularly good way of doing things.” I have certainly been guilty of this. As a regular taker of probiotics and a lover of fermented foods and drinks, I have accidentally overdosed on the stuff, not thinking that drinking kombucha, eating tempeh, and popping the supplement all in one day, would not help my digestive system, but rather have the opposite effect.

It’s definitely not a one size fits all when it comes to nutritional supplements. 58

It’s also not just about what we supplement our diet with but in which form we take nutraceuticals. “I’m very anti gummy supplements,” says Sophie. “The main ingredient in it will always be a binder, or filler, or sugar or even non-nutritive sugar - like sugar alcohols - which cause gut health problems. They are products that can only contain a small amount of active ingredients and they are not effective in the long term for people, but they are very popular with consumers.” So, is there a supplement Medlin couldn’t live without? “This is a cliché but I take both my Heights Smart supplement and my probiotic every day and I’m glad to be able to do that and I find they make a massive difference to me with ADHD and dyslexia and dyspraxia and the brain health Smart Supplement is very beneficial for my focus and concentration and also for my sleep.”

Good gut health: understanding prebiotics, probiotics and postbiotics

With more and more people educating themselves about the link between the brain and gut, probiotics have been enjoying huge popularity in the last few years. Dr Megan Rossi, a clinician and gut health expert, founded The Gut Health Doctor in 2017 and soon after she launched Bio&Me, a line of granola, muesli, porridge and yoghurts targeting good gut health. She explains the difference between, prebiotics, probiotics and postbiotics: “Prebiotics are the fertiliser for those good microorganisms in your gut. Generally speaking, if you’re getting a good diverse range of plants in your diet (including legumes and wholegrains) which naturally contain prebiotics then a prebiotic supplement is not typically needed. All our gut-loving Bio&Me products are a great source of prebiotics, and allow us to say our products are officially ‘good for the gut’. “Probiotics are live microorganisms that have been associated with health benefits. There are thousands of different types and each different type does different things. Taking one particular probiotic is not going to cure all, they are indication-specific, kind of like medications. Fermented food like live yoghurt, sauerkraut and kimchi is a tasty way to enjoy adding more microbes to your diet.” Recently there’s been much talk about postbiotics too, although there seems to be a bit of confusion about what they actually do, or are for that matter. “Postbiotics are those beneficial chemicals or by-products that the bacteria (or probiotics) produce when they are fed (including prebiotics), which have associated benefits,” says Dr Rossi. “This explains why you tend to find postbiotics in fermented food, like a Bio&Me live yoghurt. Although taking a postbiotic supplement is great in theory, the research is currently lacking, so best to stick to food sources for the time being.” Just like every other supplement, probiotics aren’t beneficial to everyone. “We don’t have any strong

evidence that people who have generally good gut health or don’t have any gut health issues should be taking probiotics,” says Sophie Medlin, “However when we consider the environment that we live in now and how different it is to how we’ve evolved we are noticing people’s gut microbiome being very different to what we would hope it would be for general health and those who struggle to eat a very varied diet including multiple different plants – we recommend 30 different plants a week – would probably benefit from a probiotic supplement.” Dr Megan Rossi is of the same opinion: “Probiotic supplements aren’t for everyone, and some types may indeed exacerbate gut symptoms like bloating. Generally speaking, if you’re in good health, the evidence for taking a probiotic at this stage is actually pretty weak. If there is something in particular that you’re aiming to manage, for example, a gut symptom or a health condition, then, in some cases, it may be advisable.”

Probiotic supplements aren’t for everyone, and some types may indeed exacerbate gut symptoms like bloating. 60

When it comes to gut health, it’s important to pay attention to one’s body, and recognise the symptoms of gastrointestinal issues. “Anyone who struggles with bloating, abdominal discomfort, diarrhoea, constipation, excess gas - even belching - may benefit from a probiotic supplement. If these symptoms are new for you, it’s very important that you see a doctor rather than self-medicate with probiotics, because there may be a more serious underlying problem,” explains Medlin. It’s important to bear in mind that not all probiotics are the same. “It all comes down to your specific condition and whether there is any evidence for a particular type of probiotic,” says Dr Rossi. “It’s also worth recognising that different probiotics do different things and therefore have different indications. It’s like medication – you wouldn’t take a painkiller to improve your cholesterol. There is no point taking one just for the sake of ‘good gut health’ - there is no science to back that up. And if you think about it, [with] the amount of diversity and quantity that already exists in your gut,

taking one to ‘top up’ the number in your gut is equivalent to adding a drop in the ocean.” With so many different strains of bacteria and the myriad of brands on the market, it can be confusing for consumers to choose the right probiotic for any gut symptoms they might be experiencing. “Probiotics have evolved now into a world where we can be much more tailored and specific with the strains that we are using for specific purposes so it’s really helpful for a consumer to understand exactly what symptoms they are hoping probiotics would target and take some guidance on which specific strains and products would be helpful for them,” explains Sophie. “Of course this isn’t particularly accessible to everybody for that reason, [for] someone in the general population that doesn’t have the ability to do some further research it’s a good idea to take a broad spectrum probiotic - seven strains or more - and to try and look for one that’s delivered directly to you rather than one that’s sat on shelves for a while, because that will significantly affect the live bacteria that remains in the product.” For Megan Rossi, before deciding to take probiotics, it’s important to think about whether there’s any evidence of the symptoms that one might be experiencing, by doing research, reading up about what microbes have shown benefits, what their effective dose is, what the reliable brands on the market are, how they should be consumed, and how long it would take to see a benefit.

Pills vs food Those who struggle to take pills could benefit from taking some foods and beverages which are either naturally good sources of probiotics, such as kimchi, kombucha and tempeh, or are fortified. These days there are many good products on the market, such as Fhirst, a line of sugar-free, flavoured sodas packed with active cultures and plant-fibre, MIM Habits’ range of bread loaves containing postbiotics and Bio&Me prebiotic granola, muesli, porridge and yoghurts. However, it’s important to be vigilant when it comes to fortified food and drinks, according to Megan Rossi. “Despite some food products showcasing the inclusion of ‘PRObiotics’ (live cultures), there are sadly a few reasons why this is misleading: 1 - probiotic strains are very specific, as each strain does different things. Having a random probiotic in a cereal simply hasn’t been shown to help when looking at gut health benefits, even if it does ‘survive’ the acidic stomach. 2 - the money spent on putting these ‘probiotics’ into cereal products, for instance, will usually mean compromising on quality for the rest of the ingredients, so they can still achieve a lower price point. 3 - to help the bacteria survive in an ‘artificial’ environment like cereal they often need to add in other things such as saturated fat, sugars and food additive emulsifiers… which somewhat contradicts the gut health goal.” Dr Rossi is keen to point it out that whilst these foods are not ‘bad’, it’s important not to expect them to do wonders for one’s gut health. Megan and Sophie agree that eating 30 different types of plants a week (including spices and herbs) can help the microbiome, so unless there are some underlying conditions, those without any gastrointestinal issues can benefit from a diet rich in fruit, vegetables, legumes and wholegrains.

The future of nutraceuticals

We are seeing the general consumer understanding more about probiotics, prebiotics and even postbiotics.

Much research is taking place at the moment to study adaptogens and nootropics that benefit human health, such as mushrooms, herbs and roots. Omega 3, and polyphenols are also big trends, and with so much research into the microbiome, the pre, pro and postbiotics sector is only going to grow bigger. “I think the gut health market is an exciting and fast-moving market at the moment,” says Sophie Medlin. “We are seeing the general consumer understanding more about probiotics, prebiotics and even postbiotics, which I think is exciting and innovative. I think we are going to continue to see women’s health market expand and develop over the next few years which is much needed and I’m excited for both of those markets to develop and become more prominent and to see how that leads to product development.” Nutraceuticals for sports and active nutrition are also seeing a huge growth, with more and more people using nutritional supplements to improve their performance, speed up recovery, tackle inflammation and support bone and joint health. Focus is also on nutraceuticals that help improve the health of older people. With the average lifespan for men and women increasing, individuals want to stay healthy and active for longer, and with all the advances being made in the sector, there’s no reason why they shouldn’t.

How the world of nutraceuticals is evolving For the past few years, nutraceuticals have been a wild success story. Whatever a customer has needed, there has been a team of researchers, product developers and marketeers bringing new solutions to aid gut health, sleep, mood, immunity, sports performance, and so on. During the pandemic, when we all became more focused on our health, the sector continued to innovate. So as we move into a time where the world is opening up, where we perhaps have a different perspective on our personal and collective health, which areas in nutraceuticals are seeing the most demand? It is a question worth asking, because nutraceuticals are big business. And the people who can spot consumer trends and shifts in the market, will flourish. Gauging the size of the market though, is difficult. There are so many different types of products that fall into the category, it is tricky to quantify exactly how big it is.

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But it is clear that it is growing and it is growing across multiple sectors of society. Covid-19 changed a lot of people’s perspectives and behaviours, with people of all demographics looking at their long-term health. The question is: Are those changes going to last and form a long-term trend? Listen to the full episode to find out what a nutraceutical is, what is driving the latest trends in the sector, and what role regulation might play in how the market develops.

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Sports and Active Nutrition

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Sports and active nutrition: the trends and products fuelling peak performance

Fiona Holland Sports and active nutrition has been popular with professional athletes for some time – helping them consume the right foods and supplements to shorten recovery time, prevent injury and boost overall performance. Nowadays, the sector doesn’t solely target people playing sports for a living, but also the growing number of ‘weekend warriors’, moderate exercisers and amateur athletes looking for ways to maintain a healthy lifestyle and support their fitness goals.

The category has grown immensely post-pandemic, with more consumers recognising exercise and nutrition as a gateway to good health. Statistics shared by Lonza in a recent Food Matters Live webinar show the active nutrition space is currently a $23 billion market opportunity for innovation. In 2022, the global sports and active nutrition market size reached nearly $43 billion and is predicted to increase at a CAGR of 7.4% between now and 2030. The US has the largest market opportunity for sports and active nutrition products, according to Lonza, at $13.60 billion, whilst in the UK, sector product sales increased by 30.8%, and consumer spending reached £134 million between 2021-2022.

The importance of macronutrients for active living The key macronutrients supporting exercise are carbohydrates, protein, and fat. Carbohydrates give the body the energy it needs to perform well during exercise, but it’s important to consume the right ones. Those with an active lifestyle and doing regular exercise should prioritise complex over simple carbs, such as wholegrains, fibrous fruits, vegetables, and legumes, rather than fizzy drinks, white bread, confectionary and cereals packed with sugar. Complex carbs are released more slowly in the body and provide it with enough energy for the entire workout period. Consuming protein is essential no matter the type of exercise or dietary ambition an individual has, says Dr Juliette Strauss, Senior Lecturer in Exercise & Health Metabolism at Liverpool John Moores University and co-founder, Director, and Performance Nutritionist at Total Endurance Nutrition. Protein encourages the repairing of tissue and cells 69

in the body after exercise. It can also keep us feeling fuller for longer, helping with weight management. The amount of protein someone needs depends on a person’s exercising habits, says Strauss, with athletes needing between 1.2-2.0g per kg of body weight daily and 0.8-1.2g per kg for the general population. For example, an athlete weighing around 70kg would need between 84-140g of protein a day, depending on their goals, while a moderate exerciser of the same weight would need 56-84g, according to what they want to achieve. For the best effect, it’s recommended to consume complete proteins containing all the nine essential amino acids – histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine. While animal products such as eggs, lean meat, and fish have all of these, plant-based protein is often incorrectly presumed to lack them. Products such as tofu, tempeh, mycoprotein, edamame, quinoa, chia seeds, hemp, and buckwheat are all considered complete proteins. Saying this, not all sources contain the same amount. A 100g serving of buckwheat grain for instance will provide approximately 11g protein and 71g of carbohydrates, while the same amount of tempeh offers around 21g protein and 1.8g of carbs. Combining incomplete proteins to form complete ones is another way to boost protein intake. For example, consuming legumes by themselves will provide large amounts of lysine, threonine, and tryptophan, but not enough methionine, but pairing them with wholegrain 70

rice will provide methionine, making it a complete protein combination. Other foods like oatmeal, nuts like almonds or pistachios, and leafy greens like kale or spinach also contain protein that can contribute towards an individual’s daily intake. Hydration is also key to replenish the body with the liquids it loses from sweating. Drinking water is recommended for activities lasting under an hour, while sports drinks are advised for more intensive training. These are packed with extra minerals including magnesium, sodium, potassium, and calcium, which can regulate the heartbeat, prevent cramping, and maintain joint and bone health. Many sports drinks also include carbohydrates like added sugars or sweeteners which give the body energy, and protein and electrolytes. Electrolytes regulate the level of water in the body and the nervous system, rebalance the pH level, rebuild damaged tissue, and move nutrients towards and waste out of your cells. The amount of protein and carbs an individual needs however depends on how often they exercise and the intensity of the training. For instance, someone training for a marathon or completing high-intensity workouts will need more carbohydrates to provide the muscles and brain with enough energy for long periods. “The types of food and amounts of food required will vary depending on the type of sport and/or the goal of the exercise”, Strauss says. 71

Supplements: can they help? Often, when people start a fitness plan, they take supplements to support their progress. There are several that can support an active lifestyle – from fish and algae oils, which improve flexibility and help individuals maintain strong joints, to magnesium, which boosts muscle performance and supports normal nerve function. Vitamins D, C, potassium, sodium, and zinc are also beneficial for supporting the immune system, reducing oxidative stress post-exercise, easing muscle cramps, and replenishing the body with essential minerals. Energy and pre-workout products have become very popular, coming in the form of powders, gummies, and gels. These products contain a range of vitamins and minerals, with some also boasting caffeine and branched-chain amino acids, such as leucine, isoleucine, and valine, which help to build protein in the muscle and prevent fatigue. Some also contain L-citrulline which encourages nitric oxide production and relaxes the arteries to boost blood flow around the body. This non essential amino acid can also help with muscle soreness and fatigue. Some supplements are essential particularly for vegan athletes and exercisers, says Jenaed Brodell, Founder and Lead Sports Performance Dietitian at Nutrition and Co. “Athletes requirements are higher

than the general population for certain vitamins (vitamin D, b12, calcium, iron) and therefore careful planning is needed.” It is quite easy to source these vitamins in plant-based foods, she says, such as dairy-free products which tend to be fortified with all the necessary vitamins. Protein supplements dominate the sports and active nutrition market. From powdered or gel forms of whey and vegan protein, to bars, yoghurts, puddings, drinks and fortified cereals, protein is probably one of the easiest to find, with plenty of options available. Despite protein intake being important, there is no need to rely on supplements. As Strauss explains: “Protein supplementation can be useful to support recovery as it helps the muscles to repair after strenuous exercise, however protein can also be consumed in the form of food. A protein supplement should only be used to help an individual consume enough protein or when the need for convenience dictates.” British Heart Foundation For sports supplements to advice agrees with Strauss, stressing that have an effect of course, protein supplements should not replace a individuals must exercise balanced diet. regularly and shouldn’t take them for any purpose Another well-known supplement is crebesides improving physical atine, which in 2020 was worth $262.2 milperformance and recovery. lion in annual sales in the US alone. The organic compound is produced naturally in small amounts in the kidney and liver, but it can also be found in red meat and fish, and is also available in supplement form. It is known to help the body push itself during high intensity workouts such as powerlifting, sprinting, football and swimming, by giving the muscles extra energy, shortening recovery time, and helping to build muscle mass. Demand for the supplement emerged following the 1992 Barcelona Olympic Games, when British athletes Linford Christie and Sally Gunnell said it helped them in their training and ultimately win gold. Despite being a top selling product in the active nutrition market, a small number of studies in the past have suggested the supplement can damage the 73

kidneys. Most recent research however argues such claims aren’t scientifically credible and that enough assessments have been carried out to prove creatine consumption is perfectly safe for healthy adults. This being said, moderate exercisers are not advised to take the supplement, says Strauss. “Supplements like creatine are fairly specialist and not needed by the general population” she explains. For sports supplements to have an effect of course, individuals must exercise regularly and shouldn’t take them for any purpose besides improving physical performance and recovery. Strauss explains: “Sports nutrition products are safe for everyone to consume, however if they are not needed for a specific type of exercise or training goal, they would not be needed as part of a healthy diet, and some could in fact lead to consuming excess calories.”

The rise of carbohydrates In the endurance sports market, a growing trend besides protein-based products is in carbohydrate-rich nutrition. “We have seen a growth in high carbohydrate products with upwards of 80g of carbohydrate per serving”, says Strauss. “This is becoming even more popular as professional endurance athletes report consuming (upwards of) 120g of carbohydrate per hour. Brands such as Maurten, OTE and Styrkr are leading the way with these products with Styrkr offering a drink mix with 90g of carbs per serving.” The market for high-intensity training nutrition products could also see huge growth in the future, says Strauss. “CrossFit and Hyrox are growing in popularity. This may mean we see slight variations in formulations of products to include lactate buffering agents such as sodium bicarbonate.” Such a supplement is said to be able to decrease the acidity in working muscles to help the body engage in high intensity exercise for longer. 74

New trends As the sports and active nutrition sector develops, it will also need to recognise its changing audience. There’s no question the demand for plant-based active nutrition products is growing. According to 2022 Glanbia insights, vegan claims grew nearly 40% in UK sports nutrition products launched between 2019 and 2020. They also made up close to one in five of new sport nutrition products by 2021. As Janaed explains: “With the push in more sustainable eating, plantbased diet’s popularity is increasing. The public just need to ensure they are educated enough to make informed choices on a plant-based diet ensuring [they get] enough protein and all the right nutrients.” Another growing market is for older adults nutrition. Recent data from Mintel shows nearly 60% of sports and active nutrition users over 55 said they would be interested in more ‘age-inclusive’ products. Older athletes and regular exercisers require a higher level of protein in their diets, says Strauss. “The main requirements that change as we age is our protein need which increases to 1.21.5g/kg body mass. Again this can, and should where possible, be achieved through food rather than supplements as food will contain additional vitamins and minerals which a single source supplement will not.” Older adults engaging in regular or intensive exercise must also ensure they don’t lose muscle. Brodell explains: “This loss of muscle mass and strength is known as sarcopenia. It’s a major cause of weakness, fractures, and poor health among the elderly. Eating more protein could help your body maintain muscle mass combined with resistance training.” Adding in extra supplements alongside a healthy diet will also help, she adds, such as vitamin D, calcium, and vitamin B12. As more people seek to boost their fitness level and improve their health, the sports and active nutrition sector will continue to remain an essential market to help individuals achieve their personal exercise goals. If it is to retain its high demand though, it must continue to adapt and become more inclusive for its changing audience. 75

C A R E E R C O N V E R SAT I O N S:

The man elite athletes turn to for nutrition advice “I used to struggle at university,” Dr James Morehen says. “I really had to put the effort in if I wanted to get a good grade.” James says that struggle remained part of his studies through his undergraduate degree, his Masters and his PhD. “I had to re-sit a module during my Masters,” he tells Elisa Roche in the latest in our Career Conversations series. But he says that was when he knew he had to show some resilience and prove himself.

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He certainly has done that. As well as completing his PhD, James has worked with some of the world’s top athletes, including the England Women’s football team and West Ham United. He is currently working as the Performance Nutritionist at the rugby union side, the Bristol Bears. And those early struggles during his studies must seem like a distant memory now, as he has recently released a book The Performance Nutritionist. In this episode, James sets out the main differences between what he does for a living and what other nutritionists do, as well as giving advice on the best way to follow his career path. Listen on to find out how James set about embarking on his incredible career, the importance he places on a “no d*ckhead” policy, and how something called the Dunning-Kruger effect left him standing in an empty room instead of a sold-out seminar.

LISTEN NOW

The chef fuelling the Tour de France peloton

“Rice for breakfast is absolutely standard,” says James Forsyth, Performance Chef for elite cycling team the INEOS Grenadiers. That’s just one of the many, slightly odd, things he has to think about as part of his role. His job is to prepare meals for all members of the cycling team, as they compete at major events such as the Tour de France. So much thought goes into what the athletes eat and it varies depending on what role the individual cyclist has within the team. One thing is for certain, a lot of food needs to be consumed to make sure the riders are fit and ready to compete at the very top level. 78

// PODCAST EPISODE

“It’s about the volume of what they eat at each mealtime,” James tells Elisa Roche in this episode of the Career Conversations podcast series. “Each meal would probably equate to around six or seven meals.” The INEOS Grenadiers, formerly known as Team Sky, are one of the most successful cycling teams of recent years. Geraint Thomas, who won the Tour de France in 2018, currently rides for them, and former team members include Bradley Wiggins and Chris Froome. An INEOS Grenadiers rider has won the Tour de France in seven of the last ten years. James says he wasn’t sure he had the right qualifications to become one of the team’s chefs, and his career did start in a very different setting. He started off as a chef in a country restaurant, before moving on to work in Michelin-starred restaurants in London. Listen to the full episode to find out how he managed to make the move to one of the world’s leading sports teams, what it’s like working on the road for so much of the year, and why you “sometimes get an evil eye across the table” when dealing with riders with different roles within the team. James also has some top tips for landing yourself a job just like his.

LISTEN NOW 79

How nutrition can support mental health: what to eat, what to avoid, and the truth about good mood food Anna Turns Grilled fish with a green salad and a drizzle of olive oil. Or a quick pasta and sauce. Perhaps, a drivethrough burger if you’re rushing. What’s on your dinner menu? Nutrition has an impact on our physical and mental health, so how exactly does what one eats alter what’s going on emotionally and inside the head?

Fuel for thought

“On a really basic level, the brain is just an organ, full of cells that need fuel,” explains Alison Holloway, a Registered Dietitian trained in cognitive behavioural therapy, neurolinguistic programming and hypnotherapy. The brain uses 20% of all the energy your body needs, so having steady blood glucose levels helps brain function. “If we’re missing meals, missing nutrients, we’re not fuelling our brain or those cells. That’s the physiology,” says Holloway. “I’d want to see someone eating regular meals [because otherwise] they’d be missing out on nutrients and have dips in energy during the day which doesn’t help our mental health or concentration, plus missing meals might create feelings of wanting to binge later on,” she explains. Next, she’d consider the balance of those meals, the mix of carbohydrate, protein, vegetables, not only for nutrients but also for feeling full and satisfied. “My patients, many of whom are autistic or have ADHD, have varying difficulties with food so it’s not always that easy to get that balance. A lot of my patients have disabilities, so ready meals – with extra veg – can be really accessible, and good for people who struggle with memory or making decisions about food.” Beyond basic nutrition, she factors in what makes that person happy, from joyful movement to creativity as well as favourite snacks. “Normally advice is so restrictive and if you eat something that you ‘shouldn’t’ you then end up feeling guilt and shame,” warns Holloway. “You are allowed to eat things that have no nutritional benefit that make you happy and boost our happy brain chemicals – our dopamine and endorphins. We should be able to enjoy a chocolate bar without being judged,” insists Holloway who values the mental health benefits associated with food that come from socialising, connecting as a family and celebrating cultural events.

Gut health and mental health

There is a bi-directional relationship between gut health and the way that you eat. Increased stress levels often mean there’s less time to plan meals or cook from scratch. If you’re feeling withdrawn, it might be harder to enjoy the social aspect of meals. And if you experience gut symptoms, you may then limit your diet and in the longterm, that can actually worsen any symptoms. “The most important thing for your gut microbiome is diet diversity,” advises Sophie Medlin, Registered Dietitian and founder of City Dietitians. “Cutting loads of things out of your diet could also make people more anxious about what they should or shouldn’t be eating and create further stress and anxiety.”

The most important thing for your gut microbiome is diet diversity. Sophie Medlin Registered Dietitian

Medlin explains that people who have depression and anxiety have particular microbial patterns within their microbiome. “We know [their guts contain] different types of bacteria, they are more likely to be B vitamin deficient and missing some essential amino acids but we don’t know whether the nutritional changes or the microbial changes happened first and then they developed their symptoms or whether they happened as a result of your symptoms and the way you are feeling.”

Three ways to connect

Both mental and emotional wellbeing are intrinsically linked with physical health. “It’s super important to get your diet right to look after your mental health,” says Medlin, onscreen expert for Channel 4’s ‘Know Your Sh*t‘ TV series about gut health. She highlights three pathways between your gut and brain: • Hormonally via the HPA (hypothalamic-pituitary-adrenal) axis. About 100 trillion microbes from a thousand diverse species live in your gut. “Your gut microbiome is talking to your hormones,” says Medlin who explains that the gut microbiome can activate this HPA axis, and dysregulation of this complex hormone system can lead to increased cortisol reactivity: “So, some people are jumpy because they’re producing an inappropriate amount of cortisol in response to everything.”

• Physically via the vagus nerve that runs from the brain down to the internal organs in the abdomen and signals can go both ways. “When we are mentally unhappy, that has a physical impact on our gut and we’d recognise that through having a nervous tummy and having diarrhoea or constipation when struggling with mental health,” she explains. • Chemically via neurotransmitters, the chemical messengers in your nervous system. The happy hormone serotonin is made using an amino acid called tryptophan which is present in fish, eggs, spinach, nuts and seeds. B vitamins are needed to make neurotransmitters and a high-fibre diet may be ‘neuro-protective’. “Gut bacteria are producing neurotransmitters, releasing signals and things like butyrate [a fatty acid produced during fermentation of fibre] which then interact with the rest of the body.” Stress causes more stomach acid to be released, changing the pH of the gut and affecting which bacteria thrive and survive. Medlin explains that when people with chronic stress develop irritable bowel syndrome (IBS), a change in pH allows different strains of bacteria that are prone to rapid fermentation to ‘take over’. “So effective stress management will prevent cortisol impacting your gut microbiome,” Medlin says. Having a strong anti-inflammatory microbiome can help prevent conditions like depression. Good bacteria release anti-inflammatory properties and recent studies indicate that butyrate (a metabolite released by good bacteria in the gut) seems to protect against COVID-19, while some ‘less positive gut bacteria’ are prone to releasing more ‘pro-inflammatory’ metabolites into the gut when fed red meat or processed foods, says Medlin.

Good mood menu

Eating a Mediterranean diet could reduce your risk of depression, according to research by scientists at University College London. The findings were “compelling” according to lead author Dr Camille Lassale. Thousands of participants who stuck to a traditional Mediterranean diet had a huge 33% lower risk of developing depression than people whose diet least resembled a Mediterranean diet. “This relationship [between the quality of your diet and your mental health] goes beyond the effect of diet on your body size or other aspects of health that can in turn affect your mood,” says Lassale.

Cutting loads of things out of your diet could also make people more anxious about what they should or shouldn’t be eating and create further stress and anxiety. Sophie Medlin Registered Dietitian

For good mental health and longer term brain health, Medlin recommends the MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet which combines the Mediterranean diet with the DASH or Dietary Approaches to Stop Hypertension diet. Designed by researchers at the Rush University in Chicago in 2015, the MIND diet involves eating at least three servings of wholegrains, a salad and one other

vegetable every day. Recommended snacks include polyphenol-rich berries. “Blueberries are one of the more potent foods in terms of protecting the brain,” said Dr Martha Clare Morris, a Nutritional Epidemiologist at Rush University who led the research. Eating foods rich in metabolites known as polyphenols, like fruit, cereals, tea and coffee, increases beneficial bacteria, but with stimulants, there’s a payoff. Drinking too much caffeine speeds everything up from a digestive perspective, as Medlin explains: “You’ll end up with more substrate in your colon leading to more symptoms and your body doesn’t have time to digest everything as you would normally. Of course, caffeine can induce anxiety in most people and that can be bad for our microbiome too.” Red wine also contains polyphenols, but as Medlin points out, the negative effects of alcohol counteract any potential benefits. It’s unclear whether improved brain health is linked to specific nutrients within the MIND diet or perhaps the resulting healthier gut microbiome, but as Medlin says, “ultimately, [following the MIND diet] for both reasons is a really good way of doing things.”

Developing lifelong healthy habits

How quickly might you notice improvements once you’ve transformed your diet? That depends on your starting point, the level of damage to your gut microbiome and other factors but Medlin expects to see some benefits within a couple of weeks: “If you start looking after yourself a bit more, you may feel better and have more energy to exercise. Our gut bacteria love exercise and that helps you reduce stress too. It’s all linked.” “Some things can be quick, for example, staying well-hydrated helps your concentration, that’s a quick win,” comments Holloway. “Initially, you get a real buzz, mentally

Our data really highlight the central role of eating a healthier diet and taking regular exercise to act as a viable treatment to help people with low mood. Dr Brendan Stubbs King’s College London

feeling more in control and doing something positive for yourself, plus you might receive positive feedback from others. Then the physical benefits [inside your body] perhaps take a bit longer.” Establishing lifelong healthy-eating habits is positive for your future mental health and there’s no need to get too overwhelmed by the details. In 2022, researchers found that late-life depression was associated with changes in neurogenesis – the process by which new neurons are formed. They discovered that diet may be driving these changes, although the mechanisms haven’t yet been understood. Another 2019 study indicates that various healthy diets can ease symptoms of depression and concluded that highly-specific or specialised diets are ‘unnecessary for the average individual’. “Our data really highlight the central role of eating a healthier diet and taking regular exercise to act as a viable treatment to help people with low mood,” says Dr Brendan Stubbs at King’s College London who led the study. “Your overall diet and the way that you’re eating is going to have an impact on your medium and longterm brain health and function. Remember for gut health, it’s mostly about adding things in rather than taking anything away,” concludes Medlin.

Mental health encompasses a wide spectrum of disorders, from mild anxiety to extreme psychosis. Food won’t ever be a cure all and is certainly not a substitute for prescribed medications. But some diets play a role in making it less likely we’ll suffer from depression, for example, a condition that affects about 5% of adults globally. For more information and support, visit mental health charity Mind’s website and speak to your GP.

FOODS T O

NUTS

FOODS

BERRIES

T A

E L

POULTRY

F O SS

OLIVE OIL WHOLEGRAINS AND LEGUMES

F RE O

DRINK PLENTY OF WATER

(such as sauerkraut and kimchi)

FERMENTED FOODS

BEANS

VEGETABLES

FISH

(especially green, leafy ones)

RED MEAT FRIED FOOD CAFFEINE

(in tea, coffee, cola, energy drinks and chocolate)

ALCOHOL

BUTTER AND MARGARINE

CHEESE

ULTRA-PROCESSED SNACKS AND SWEET TREATS

Reproductive health: the beneficial role of nutrition in men and women’s fertility

Anna Turns Take this magical supplement, drink this bright green smoothie or eat that particular superfood every day to transform your fertility. Couples trying to conceive are so often the target market for brand advertisers because when you really want a baby, why would you compromise? But can nutrition really help fertility and reproductive health? Of course, food is no quick fix, but certain ingredients and eating habits can improve overall health and wellbeing, while optimising one’s reproductive health too. 90

Fertility is not just a female issue

“Often, in traditional female-male couples, the woman takes on this role [of improving her nutrition],” says Registered Dietitian Cordula Henggeler who specialises in women’s health. But fertility isn’t solely a female issue and taking a whole-couple approach benefits both partners, as she explains: “Sperm quality has gone downhill in recent years and up to 30% fertility problems are linked to male factors such as reduced sperm quality or quantity. We don’t talk about this enough.” Good nutrition positively impacts egg quality, can improve one’s chance of having a viable baby, and helps regulate periods too, according to Henggeler who takes a holistic view: “People come to me when they have problems with fertility and I see such positive outcomes by making dietary changes, but … couples may need to have a doctor supporting them, perhaps a physio to help with endometriosis. Nutrition is a big part of the puzzle, but if someone is struggling with their fertility, we should look beyond what they eat, at what is going on inside the body and work with a team of specialists.” Even with medical support or assisted conception, fertility journeys can be overwhelmingly complicated. Registered Dietitian Monika Bettney, also a specialist in fertility, adds that managing stress, sleep, movement and emotional regulation alongside nutrition is vital. “Even with periods, some women don’t ovulate properly as a result of high stress, too much exercise or not enough nutrition,” says Bettney. So those connections aren’t always obvious. 91

How the Mediterranean diet can aid fertility Lightly grilled sardines, a wholesome lentil casserole or fresh green leafy salads with feta, sun-blushed tomatoes and a drizzle of extra virgin olive oil… deliciously healthy? Yes. The best nutrition to optimise your reproductive health? Apparently so. A Greek study of 244 women highlights that a varied Mediterranean diet is associated with better IVF outcomes for over 35s. This same diet is associated with higher sperm concentration, total sperm count and sperm motility. “The most researched dietary pattern that’s helpful in terms of fertility for both natural conception and IVF is the Mediterranean diet,” explains Bettney. “It’s not to say other patterns like Japanese or South-East Asian diets aren’t as good….it’s about looking at the principles and thinking about which nutrients you’d be having then adapt it to any other cuisine.” So it’s flexible rather than prescriptive and Henggeler advises to simply ‘aim for colour on the plate’: “[Mediterranean food] includes lots of healthy fish with omega 3 fats [to improve egg and sperm quality and implantation], increases antioxidant intake [to help your body repair cell damage] and consumption of fruit and veg, with a little meat if people eat that, plus legumes that are cheap and full of fibres and minerals.”

Added extras: the importance of micronutrients in fertility Pregnancy is a nutrient-intensive process, and Henggeler recommends a pre-natal multivitamin for simplicity: “I see it as an insurance policy – we don’t eat perfectly every single day and there are a few nutrients that we know pregnant women are at risk of being low in such as iron and iodine.” Some supplements such as Omega 3 tend to be quite expensive, but others are more easily available. Free NHS Healthy Start vitamins contain folic acid combined with vitamins C and D, which is recommended for everybody in the UK but also helps improve reproductive health.

Sperm quality has gone downhill in recent years and up to 30% fertility problems are linked to male factors such as reduced sperm quality or quantity. We don’t talk about this enough. Cordula Henggeler, Registered Dietitian

Guidelines recommend that women trying to conceive should take 400 micrograms of folic acid daily, for at least three months before trying to conceive. That’s because most women won’t know they are pregnant until they have missed a period, but folic acid is essential during those first 21 days of pregnancy. Perhaps one day, this same precautionary approach could apply to any other micronutrients.

As a nation, we don’t eat iodised salt, despite Unicef’s global movement to add iodine to edible salt and protect healthy brain development in utero. The recommended 150 micrograms of iodine aids healthy menstruation and good thyroid function. Other essentials for conception include zinc, vitamin B12 and choline, a lesser-known nutrient naturally found in a number of foods, such as eggs and broccoli, that plays a critical role in foetal development. 93

Better nutrition, fewer restrictions

The odd takeaway or chocolate walnut whip won’t matter. Both Henggeler and Bettney are swift to avoid demonising fast or processed foods. For both dietitians, the priority is to put delicious, healthy, nutrient-rich and affordable food on the menu most of the time, rather than restricting anything. Alcohol is one exception to that rule because at high levels, it can increase the risk of birth defects or lower the chance of a healthy pregnancy. At low levels, it could impact egg and sperm quality. “Even with the permitted amount [14 units of alcohol per week when not pregnant], alcohol can be problematic when it comes to ovulation or IVF,” says Bettney. A recent US study of more than 400 women found that moderate drinking (3-6 drinks per week) was associated with a reduced chance of conception by 44% compared to non-drinkers, and research suggests that women who want to conceive should avoid alcohol in the last two weeks of their cycle after ovulation. The science isn’t as clearcut with caffeine, although one British Medical Journal review outlines that pregnant women should be advised to avoid caffeine. For those wishing to conceive, Henggeler advises not to drink “too much” coffee or caffeinated cola, although what that means exactly is debatable because after drinking, the time it takes for caffeine to halve in concentration varies between 3-7 hours. “It’s about nourishing yourself and what I recommend to people varies so much on the individual,” says Bettney who suggests taking gradual steps. “If people are struggling to find time to cook, ready meals might be a compromise to start with.” 95

More than food: why cooking methods matter It’s not just the ingredients we eat that matter. The way we cook can influence our reproductive health too. During high heat cooking, ‘advanced glycated end-products’ or AGEs are formed when sugars attach to proteins. Through increased inflammation, this can affect male and female reproductive health at high levels. “Imagine you create char marks on blackened toast or barbecue grilled food,” describes Henggeler. “These AGEs can significantly affect egg and sperm quality. Steaming and stir fries are great, and even boiling if you don’t overcook veg.” Synthetic chemicals also get into food, either through farming, processing or packaging. A few of these – known as endocrine-disrupting chemicals or EDCs – disrupt hormones. Some pesticides are associated with increased risk of endometriosis, but they are impossible to avoid completely and organic food can often be expensive. Henggeler recommends using the Clean Fifteen and Dirty Dozen lists, published annually by the US-based NGO Environmental Working Group, for more of a steer on this. Chemicals known as phthalates and bisphenols can interfere with hormones if they leach out from plastic packaging, especially at high heat, so microwaving your leftovers in plastic containers isn’t the healthiest option. Opt for microwave-safe ceramic, glass or metal food storage containers wherever possible. Studying the nuanced effects of EDCs on female reproductive health is expensive, slow and complex. Most toxicity research focuses on males because the parameters won’t change with menstrual cycles, pregnancy and menopause. Now, an EU-wide project called Freia is calling for more research and better regulation to protect women and their fertility. 96

The timeline

Once you’ve adopted a Mediterranean diet and the right pre-natal vitamins, how quickly might these changes in nutrition improve your reproductive health? The answer: it depends. An organic diet can rapidly reduce the amount of glyphosate (a common pesticide) in the body by 70% after only six days. Henggeler explains that certain B vitamins could replenish quite quickly if they are taken every day, while an iron deficiency (diagnosed following a blood test) may take a couple of months to rebalance and perhaps six if someone has little or no periods or polycystic ovary syndrome. The more time you give yourself to improve your diet before conceiving, the better, she says: “Our eggs mature over three-month cycles, sperm takes 72 days so in terms of egg and sperm quality, it’s never too late to make improvements. [Nutrition] won’t be an overnight fix but even just eating an extra portion of fruit or veg every day is good.” Bettney cautiously suggests improving your nutritional intake at least three months before conception, but adds “that would be a mad rush” depending on what your baseline is like: “If you’re starting from further away, it will take longer. Habit change takes time.”

Optimal nutrition, now and for future generations Even before conception, environmental factors can determine which genes will be activated or deactivated in the DNA within an egg or sperm. As Henggeler explains, when egg or sperm is being produced, external influences can affect the baby’s risk of having type 2 diabetes, perhaps, or heart disease later in life. This ‘epigenetics’ demonstrates the importance of looking after your health before you conceive, not just when you’re pregnant. Babies born to undernourished mothers during the Dutch famine of 1944-1945 were more susceptible to conditions such as breast cancer and coronary heart disease as adults. Those health effects differed according to the specific timing of maternal undernourishment during gestation. Beyond that, one’s health influences one’s grandchildren too. When a women is pregnant with a girl, the foetus is already forming all the eggs she’ll ever have inside her ovaries. Californian epidemiologist Barbara Cohn has followed 15,000 pregnant women and their families since 1959 in a multigenerational research project that highlights the longevity of toxic chemical exposure. She found that granddaughters of women exposed to the now-banned insecticide DDT (dichlorodiphenyltrichloroethane) tended to start their menstrual periods before the age of 11, and had an increased breast cancer risk. So as Henggeler puts it, “If we can keep quality of eggs and sperm better we can influence the health of the baby in the future too.” “The principles for fertility and healthy pregnancy are the same essentially for general health for women at any life stage,” explains Bettney. “If we make these changes in a way that’s sustainable in the longterm, this way of living, with better sleep, exercise and healthy eating, will not only help you through pregnancy but also through motherhood, perimenopause and old age. This is your nutrition for life.” 98

lim it

Foods to incor po ra Foods t o

Suppleme nts to

iet d e h t n i te • Extra virgin olive oil • Colourful mix of fruits and vegetables, including frozen options which are often cheaper, preferably at least 30 different types of plants per week • Wholegrains such as bread, rice and oats

• Some white meat • Pulses such as beans, chickpeas and lentils • Nuts, eg walnuts, and seeds eg sunflower seeds • Tinned or fresh fish such as mackerel and other oily fish • Some yoghurts, dairy products and eggs

d i o v a r o • Alcohol (avoid completely if possible) • Caffeine (reduce to less than 200mg per day ideally) • Trans fats and saturated fats such as margarine • Red meat and highly processed meats • White bread or pasta

y t i l i t r e f d i a The British Dietetic Association (BDA) recommends the following supplements to those who want to conceive and during pregnancy: • Folic acid • Vitamin D • Omega 3

• Iodine • Iron • Vitamin B12

• Calcium • Zinc • Choline

Inspiring Nutrition Event

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Affordable nutrition for everyone is the key message at Food Matters Live’s Inspiring Nutrition

Stef Bottinelli Contributor: Ross Carver-Carter Nutrition should be affordable and accessible to everyone, that was the key message at Food Matters Live’s Inspiring Nutrition event, which took place at London’s Wellcome Collection on 23 and 24 of May. Dr Kavita Karnik, Global Head of Nutrition, Regulatory and Scientific Affairs at Tate & Lyle, the Inspiring Nutrition session partner, stressed the importance of making nutrition democratic and reaching all sections of society, not just the few – a concept also brought up by Aoife Marie Murphy PhD, Sustainable Nutrition Manager at global ingredients, taste and nutrition company Kerry, in the keynote speech 10 key trends in health and nutrition that opened Inspiring Nutrition.

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Dr Karnik who took part in The importance of nutrition research in improving human health and longevity panel with Dr Richard Siow, Director of Ageing Research at King’s College, London, chaired by Dr Lindsay Keir, Director of Science and Policy at Policy Cures Research, highlighted the need to translate food and nutrition science to consumers, so that they can make informed decisions. After all consumers don’t think about nutrients she said, but about food. Dr Siow agreed, pointing out the importance of finding ways to interact with consumers for better health, not in GP surgeries, but at the supermarket, which is where people buy most of their food. Years ago nutrition science started in home economics classes, where individuals not only learned some invaluable cooking skills, but were also educated about the science behind what they were eating, Dr Siow said. Learning about food should start at a young age, and he remarked that food education should start in the kindergarten, yet a large number of children – and adults – know little about where food comes from. This point was shared by Chief Scientific Officer and co-founder of food company Field Doctor, Sasha Watkins, who spoke on The future of nutrition and health: the health of practitioners perspective. For Sasha too better nutrition should be taught early in life. She added that, in her experience, people do want to eat better, but lack the necessary cooking skills. Good nutrition should be evidence based, she stated, and governments should work harder on their nutrition and science policies. She also suggested that countries’ quality of life index should be measured on 103

the health of their citizens too, and wondered why such a measurement isn’t yet in place. A strong point indeed, especially considering the escalating number of overweight and obese people in the world, who either can’t cook or can’t afford nutritious food. Statistics from 2021 show that 63.5% of adults in England were overweight or living with obesity. Worryingly this trend affects children too, with 23.4% of year six (age 10-11) classified as obese, and a further 14.3% deemed overweight. Speaking on the same panel, Dr Kiran Sodha pointed out the lack of nutrition training when he studied medicine at university, adding that a new NHS fund, ARS, has now allocated money to GP practices to provide health coaches or paramedics, to teach patients about good nutrition, yet that should perhaps be the job of a general practitioner. Keynote speaker Dr Elizabeth Thompson also made this point in her presentation, saying that healthcare professionals of the future should be taught to have conversations about food and stressing that daily rituals determine our health and longevity.

Funding nutrition research Global ingredient supplier Tate & Lyle’s research is done independently, not in house. The company works with 100 universities to carry out studies on nutrients and ingredients and research must continually progress if we want to feed 9 billion people, said Dr Karnick. Making this research available and understandable to consumers is also of the utmost importance and it’s crucial to dispel misinformation when it comes to nutrition. “We should spend more time on good science rather than fighting bad science,” she stressed. Dr Siow agreed, stating that despite the fact that there is much more nutrition technology these days, more funding into the science and into food formulation is needed. 104

How human connection can aid good nutrition The importance of human relationships was highlighted by many experts at Inspiring Nutrition. In her speech, keynote speaker Dr Elizabeth Thompson spoke about the need for human connection, a theme that was prevalent throughout the two days of Inspiring Nutrition. Sasha Watkins concurred, adding that individuals are more likely to make necessary dietary changes if they do it with friends and family. Eating together, socialising around food is one of the basis of the Mediterranean Diet, deemed the healthiest and most nutritious of them all. Yet in many households, families don’t even have a dining table and often eat convenience food in front of the TV or laptop. Compassion is important for good health too said Dr Thompson, as well as being active, always learning, giving our time, words and presence to those we care about and taking notice of our surroundings. So no TV or laptop, but communication, connection and good nutritious food, full of plant-based produce with little meat, fish and dairy. 105

More nutrition, less prescription Dr Kiran Sodha, who spoke about the lack of nutrition science in his medical training, said he wouldn’t know what kind of doctor he would be without his prescription pad, because physicians are encouraged to prescribe pharmaceuticals. Dr Thompson was of the same opinion, stating that around 10% of all prescribed drugs are not required. Prevention rather than prescription was also a hot topic, yet in the UK we are more likely to cure rather than taking care of our health before an ailment or disease rears its head.

The microbiome in the gut and beyond The microbiome remains a key consumer concern, although focus is expanding beyond digestive health. Microbes live in many other areas of the human body, such as the mouth, skin, respiratory and urogenital tracts for instance. This message needs to be delivered to consumers, and a more holistic approach to the microbiome will be seen more and more in the next few years. As well as pre- and probiotics, postbiotics, the ‘new kid on the block’, are also emerging as a key trend for 2023. But it’s important too that consumers understand that whilst taking probiotics may be beneficial for some individuals, a varied diet comprising of 30 different plants a week can do wonders for the gut. 106

Women’s health stands out Women’s health featured prominently throughout the event, with multiple speakers bringing attention to gender gaps in health research. Shockingly, we heard that up to 85% of nutritional research is confined to male participants, with the industry historically treating women as if they were simply ‘small men’. Nothing could be further from the truth. As Aoife Marie Murphy shared in her keynote speech, women have unique nutritional needs throughout their lifespan, beginning at puberty and moving throughout pregnancy into menopause and beyond.

Up to 85% of nutritional research is confined to male participants, with the industry historically treating women as if they were simply ‘small men’.

Despite the dynamic nutritional needs of women’s health throughout their lifespan, the industry has historically treated them as homogenous. Thankfully, this looks set to change as new products targeting women’s specific needs are hitting the market at a rapid pace.

As we heard from Holland and Barrett’s Senior Nutritionist Alex Glover, red clover extract is trending due to its naturally high levels of isoflavones, a plant compound that exerts oestrogen-like effects. Likewise, sage has also seen renewed interest owing to its purported ability to alleviate hot flushes. 107

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Personalised nutrition takes centre stage Personalisation took centre stage at Inspiring Nutrition, emerging as a key trend across the panels on nutraceuticals, sports, functional and performance nutrition. As research shows that we respond differently to the same foods, consumers increasingly want nutritional solutions tailored to their unique biology – not the average of non-representative nutritional studies. James Morehen, Performance Nutritionist at Bristol Bears Rugby, England Rugby Roses, highlighted the dangers of a one-size-all-fits-approach to nutrition whilst discussing Consumer trends across sports, performance and active nutrition. Whilst consulting for a professional female football team, James discovered that blank nutritional advice resulted in numerous players over-fuelling and others under-fuelling by up to 2000 calories. Despite the fact the women played in different positions and had variable energy expenditures, they were treated as homogenous. The story offers a microcosm of society as a whole and shows that dietary advice needs to be tailored to activity levels, genes and other variables.

The ‘AND’ consumer is driving rapid change in the food and drink industry Today’s consumers want more from their products, seeking out natural, premium, and local taste experiences. On top of this, they also want more convenient, affordable options that are sustainably sourced – what Kerry calls ‘the AND consumer’. 109

The consumer appetite for sustainable products is accelerating innovation in plant-based alternatives.

Sustainability issues fuelling plant-based innovation As we heard in Kerry’s keynote speech, sustainability is a ‘mega-trend’ driving the rise of plant-based foods, alternative proteins and cellular, slaughter-free animal protein. With food production accounting for over a quarter of global greenhouse gas emissions, consumers care about the sustainability credentials of nutritional products. This consumer appetite for sustainable products is accelerating innovation in plant-based alternatives. In the closing panel covering Sustainable and responsible nutrition, Huel co-founder and Head of Sustainable Nutrition James Collier raised concerns about the NOVA classification system, suggesting that ultra-processed food is an unhelpful categorisation that could stifle plant-based protein alternatives. As consumers begin to demand more than meat mimicry and challenge the heavily processed nature of plant proteins, Kerry’s Aoife Marie Murphy raised a provocative question: should we be re-imagining plant-based proteins, taking the best of meat items to create a unique plant-based proposition?

‘Biohackers’ are driving a shroom boom Whilst traditional ingredients such as turmeric, ginger, and saffron remain popular with consumers, there are novel ingredients taking the functional ingredients industry by storm. 110

Adaptogens are a key area of focus Adaptogens are herbs, roots, and other plant substances (like mushrooms) purported to help our bodies manage stress. Adaptogens were a prominent point of discussion across both days, representing the fastest growing key ingredient trend across both functional nutrition and nutraceuticals. Speaking on The future of nutraceuticals panel, Alex Glover told us that ashwagandha is the most popular adaptogen on the market – and the best studied. Whilst adaptogens and nootropics can be consumed in multiple formats, coffee appears to be the most popular conduit for both. These ingredient trends all reflect the growing interest in cognitive health, as identified by Kerry.

Mind and mood matter Topping consumer concerns were energy and alertness, with supplements seeking to fight fatigue and enhance cognition boasting the most product launches in 2023. Within this wider theme omega 3, polyphenols, and adaptogens all stand out as key ingredient trends. Related to this, the gut-brain axis is a key area of focus, with people turning to probiotic supplementation and other products targeting the brain via the gut.

Biological data is a valuable currency The growing demand for personalised nutrition has fuelled a renewed interest in wearables such as blood glucose monitors and smart watches, although concerns have been raised about data privacy – ‘a new currency’ in the words of Vityl’s Roxane Bakker. Going forward, regulation on the storage and use of this data will be paramount. 111

10 key trends in nutrition and health of 2023 and beyond Stef Bottinelli Innovation and interest in nutrition and health and their trends are gaining momentum, and with obesity in the UK and around the world skyrocketing, the need for good, healthy food is more important than ever. In England alone, 25.9% of adults are obese and a further 37.9% are overweight. Three quarters of English adults aged 45-75 suffer from obesity, and children don’t fare much better, with 23.4% of year six (age 1011) classified as obese and 14.3% as overweight. The need to improve the nation’s nutrition is not solely for health reasons, but for environmental ones too. Cutting down on meat, fish and dairy consumption and eating more sustainably is of the utmost importance if we want to reduce the damage humans cause to the planet. But that’s not all. New advances and discoveries are highlighting areas where nutrition needs to be improved and expanded, and where food can help to support our physical and mental health. Aoife Marie Murphy PhD, Sustainable Nutrition Manager at global ingredients, taste and nutrition company Kerry, was a keynote speaker at Food Matters Live’s Inspiring Nutrition event, which took place at the Wellcome Collection in London on 2324 May. In her insightful talk, Aoife discussed the 10 key trends in nutrition and health for 2023 – and an extra mega trend – in depth, highlighting the importance of developing and optimising these areas for the health of humans and the planet. 113

Mega trend: sustainable nutrition It’s estimated that by 2050 the population will increase to a whopping 9.7 billion. There are currently two billion men, women and children in the world who are overweight or obese, whilst 690 million are malnourished or don’t have enough food to eat, yet 30% of food produced globally is wasted every day. These figures are certainly sobering, but they can and must be reversed. Upcycling ingredients to be used in food production, eliminating food waste, transforming food systems to ensure resilience to climate change, safeguarding and promoting biodiversity and implementing ecolabelling are some of the most important changes happening in sustainable nutrition.

Functional flourishing Consumers are looking for functional food and drink products with added health and beauty benefits more than ever. According to research carried out by Kerry, 51% want products that support skin health, 44% that strengthen the immune system, 44% that help improve the look and health of hair, 43% are after food and beverages that aid weight management, 42% that support gut and heart health, 39% that help with muscle recovery after a workout and that support their energy, 38% look for items that improve their sport endurance, whilst 38% want food and drinks that promote bone health. Consumers want functional food and beverages backed by science and whose benefits are demonstrated with scientific studies. 114

Women’s health As we are moving from the concept of ‘one diet fits all’ in nutrition, the importance of targeting products for the unique physiological needs of women is a huge trend in 2023. The nutritional needs of females are very different from males’. Women are at higher risks of osteoporosis for instance, in particular postmenopause, and require different dosages of calcium. Ingredients and products that address their nutritional needs during pregnancy, breastfeeding, infertility, menopause, premenstrual tension, gut health, immunity and cardiovascular health are being researched and developed, and will be available in the near future. Botanicals, such as liquorice root extract which reduce menopausal symptoms, have the potential to be a game changer for women’s health. “Female-specific symptoms and diseases are numerous and widespread yet our understanding of the female body is not comparable to what we know about men,” says Aoife Marie Murphy. “Building credible scientific evidence in females is a priority, to develop products that meet the needs of women of all ages.” Kerry Health and Nutrition Institute will be running a webinar on women’s health, Innovating for Women’s Health: Optimising Wellness Across Lifestages on 14 June 2023. For more information visit their website here. 115

Advanced activity With more and more people doing physical activity, joint and heart health at any age is in focus. Athletes, amateurs, and the average gym goer want to ensure their body is in top condition now and as it ages. Products that support joint and cardiovascular health, reduce inflammation and enhance performance are a huge trend at the moment, with Ayurvedic and botanical extracts proving particularly effective, according to Niamh Hunt, PhD, Global Marketing Manager for Immune and Joint Health at Kerry.

Cognitive health Nootropics and adaptogens that promote and improve cognitive health are getting much attention at the moment. Consumers have recognised the need for food and drinks that help them focus, improve their memory, balance their mood and help them complete tasks in their personal and work life. Berry-derived flavonoids, omega-3 fats, mushrooms and the evergreen shrub ashwagandha are just some of the ingredients found to be aiding cognitive health. This trend is getting bigger and more money is being spent on research.

High stages for sugar and salt All eyes are on sugar and salt – specifically the high content of the two ingredients in many foods. The UK Government has gone back and forth on its legislation of advertising and promotion of HFSS foods, much to the disappointment of organisations such as Action on Sugar and the Obesity Health Alliance (OHA). There’s no denying that too much salt and sugar (and saturated fats) is detrimental to human health and legislation such as the Sugar Tax has actually proven successful in the reduction of the white stuff in products, so 2023 will see more action being taken to regulate the use and promotion of both. 116

Protein production of the future Innovation to produce proteins away from factory farms is moving fast. With there being an urgent need to cut down greenhouse gases and feed a growing population, finding new ways of producing protein is of the utmost importance. Cultured meat and precision fermentation are two of the most talked about technologies. Whilst the sale and consumption of cultured meat for instance is currently only allowed in Singapore, it won’t be long until other countries pass positive legislation on these novel foods. The FDA has already sent No Questions Letters to cellular agriculture start-ups GOOD Meat, Remilk and Upside Foods, so it’s only a matter of time before cell-based meat, dairy and fish are allowed for human consumption in the USA. “Food connects the people and the planet, and this trend has great potential to advance both. The rapid developments in artificial intelligence, big data, pharma technologies, and agri-tech have been adopted by a new generation of scientists, fuelled by purpose to save the planet and keep the food system sustainable,” says Adriana de Camargo, Kerry’s Global Technology Innovation Program Lead. “They are transforming the food industry – this has been accelerated by large investments – bringing to life many start-ups that are willing to disrupt the way we produce food. Personally, I believe more efforts must be taken to prepare the introduction of these new products – we do not know yet how consumers will adopt these novel foods.” 117

Microbiome: beyond digestive health The microbiome has been receiving much attention in the last few years, but mainly for digestive health. But the microbiome is not just about the gut, microbes live everywhere in our system – our mouths, skin, respiratory and urogenital tracts for instance. Microbiome research is becoming more holistic and is looking at all the different parts where microbes reside in our system, how they affect our health, and the benefits of a healthy microbiome. This trend is going to be huge and will shed light on the importance of good bacteria for human health. “Microbiologists are identifying more and more bacteria with interesting properties,” says Dr. Mathieu Millette, Scientific Director at Kerry’s Bio-K+ division. “These bacteria can be isolated from humans, foods, animals, or the environment. With the proliferation of bacteria and formats, it is also critical to develop and implement modern and innovative methods to ensure the quality, integrity, and bioactivity of bacteria throughout the supply chain. It is of tremendous importance that the probiotic products deliver the benefits they are claimed to. These are key challenges to be solved for development of any probiotic-linked benefit. ”

Hydration optimised In the West we are very lucky to have plenty of access to clean, potable water, yet many of us don’t drink enough of it. Whilst severe dehydration is not a problem in Europe, many struggle to drink the recommended amount. Low sweetness flavoured sparkling water and electrolyte powders containing some sodium and glucose to accelerate the absorption of water are big trends in this realm, but consumers are moving away from sugary water and drinks, preferring healthier options instead. 119

Plant-based and plant forward Plant-based food has been a huge trend in the last few years, and despite some questionable articles popping out here and there hailing the end of vegan food, animal-free produce is going nowhere and in fact it’s still very much a growing category that will deliver much more innovation in the years to come. Novel plant-based solutions will provide more when it comes to taste, texture and nutrients. Whilst there are many excellent products and brands that mimic the taste and mouthfeel of meat, fish and dairy, more advances are being made to create nutritious vegan food. This trend will see more whole-muscle cut textures, healthier plant fats that will deliver succulence, less ultra processed plant-based meat that will use fewer ingredients and will go through fewer processes, and new technologies, such as high moisture extrusion. Plant-forward products focus on what the plant is and what it naturally contains, so the focus in this category is for instance fibre, legumes and wholegrains. The future of this trend is succulent, delicious plant-based food that’s minimally processed, has a high nutritional profile and will have a more satisfying taste, texture and mouthfeel. David Hamilton, Global Creative Insight Officer at Kerry explains: “Consumers are starting to want more than meat mimicry and are challenging the heavily processed nature of plant proteins and beginning to suggest they want novel food experiences. In the future non-mimicking could create endless opportunities, it would allow us to reimagine plant-based proteins. This is only just starting to raise its head as we dig deeper into consumer trends and reports but shouldn’t be ignored.”

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Affordable nutrition COVID-19, the effects of the war between Russia and Ukraine, and inflation have left many out of pocket, but good, nutritious food should be affordable and enjoyed by all. Beans, wholegrains, fruit and vegetables are inexpensive, highly nutritious and versatile, and can form the basis of some new healthy products that can be afforded and enjoyed by anybody. This trend will kickstart the democratisation of nutrition and will allow everyone to have a delicious and healthy diet. “Inflation is at a 40 year high with many foodstuffs and value chains from cereals to proteins disrupted and consumer products impacted,” says Juan Aguiriano, Group Head of Sustainability & Technology Ventures at Kerry. “Affordable sustainable nutrition has never been more critical, with the population set to grow to 8.5 billion people by 2030. Food innovation is not only focused on premium novel ingredients, but also on how can we make the food system more economically sustainable by maximising the nutritional density and affordability of a wide variety of foods to nourish communities globally.” 121