Consumer Behavior and Food Science Innovations for Optimal Nutrition

Resources

Keynote address: USDA studies on consumer food choice

Golan E, Stewart H, Kuchler F, Dong D. Can low-income Americans afford a healthy diet? U.S. Department of Agriculture Economic Research Service. Amber Waves. 2008.

Kuchler F, Stewart H. Price trends are similar for fruits, vegetables, and snack foods. U.S. Department of Agriculture Economic Research Service. Economic Research Report No. (ERR-55). 2008.

Lin BH, Guthrie J. Nutritional quality of food prepared at home and away from home, 1977–2008. U.S. Department of Agriculture Economic Research Service. Economic Information Bulletin No. (EIB-105). 2012.

Mancino L, Andrews M. Can food stamps do more to improve food choices? An economic perspective—making healthy food choices easier: ideas from behavioral economics. U.S. Department of Agriculture Economic Research Service. Economic Information Bulletin No. (EIB-29-7). 2007.

Mancino L, Kuchler F. Dietary guidelines have encouraged some Americans to purchase more whole-grain bread. U.S. Department of Agriculture Economic Research Service. Amber Waves. 2012.

Todd J. Changes in eating patterns and diet quality among working-age adults, 2005–2010. U.S. Department of Agriculture Economic Research Service. Economic Research Report No. (ERR-161). 2014.

The elements of food

Appleton KM, Blundell JE. Habitual high and low consumers of artificially-sweetened beverages: effects of sweet taste and energy on short-term appetite. Physiol Behav. 2007;92(3):479-86.

Baer DJ, Gebauer SK, Novotny JA. Measured energy value of pistachios in the human diet. Br J Nutr. 2012;107(1):120-5.

Bolhuis DP, Lakemond CM, de Wijk RA, et al. Both longer oral sensory exposure to and higher intensity of saltiness decrease ad libitum food intake in healthy normal-weight men. J Nutr. 2011;141(12):2242-8.

Clemens R, Kranz S, Mobley AR, et al. Filling America's fiber intake gap: summary of a roundtable to probe realistic solutions with a focus on grain-based foods. J Nutr. 2012;142:1390S-401S.

Deckelbaum RJ, Palm C, Mutuo P, DeClerck F. Econutrition: implementation models from the Millennium Villages Project in Africa. Food Nutr Bull. 2006;27(4):335-42.

Ellis PR, Kendall CW, Ren Y, et al. Role of cell walls in the bioaccessibility of lipids in almond seeds. Am J Clin Nutr. 2004;80(3):604-13.

Hough RL. Biodiversity and human health: evidence for causality? Biodivers Conserv. 2014;23(2):267-88.

Just T, Pau HW, Engel U, Hummel T. Cephalic phase insulin release in healthy humans after taste stimulation? Appetite. 2008;51(3):622-7.

Katz DL, Meller S. Can we say what diet is best for health? Annu Rev Public Health. 2014;35:83-103.

Khoury CK, Bjorkman AD, Dempewolf H, et al. Increasing homogeneity in global food supplies and the implications for food security. Proc Natl Acad Sci U S A. 2014;111(11):4001-6.

Kirkmeyer SV, Mattes RD. Effects of food attributes on hunger and food intake. Int J Obes Relat Metab Disord. 2000;24(9):1167-75.

Mattes R. Effects of aspartame and sucrose on hunger and energy intake in humans. Physiol Behav. 1990;47(6):1037-44.

Mattes R. Soup and satiety. Physiol Behav. 2005;83(5):739-47.

Viskaal-van Dongen M, Kok FJ, de Graaf C. Eating rate of commonly consumed foods promotes food and energy intake. Appetite. 2011;56(1):25-31.

Physiology and psychology

Dansinger ML, Gleason JA, Griffith JL, et al. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA. 2005;293(1):43-53.

Hill JO, Wyatt HR, Reed GW, Peters JC. Obesity and the environment: where do we go from here? Science. 2003;299(5608):853-5.

Lando AM, Lo SC. Single-larger-portion-size and dual-column nutrition labeling may help consumers make more healthful food choices. J Acad Nutr Diet. 2013;113(2):241-50.

Morrot G, Brochet F, Dubourdieu D. The color of odors. Brain Lang. 2001;79(2):309-20.

Moskowitz HR. 'Mind genomics': the experimental, inductive science of the ordinary, and its application to aspects of food and feeding. Physiol Behav. 2012;107(4):606-13.

Plassmann H, O'Doherty J, Shiv B, Rangel A. Marketing actions can modulate neural representations of experienced pleasantness. Proc Natl Acad Sci U S A. 2008;105(3):1050-4.

Sacks FM, Bray GA, Carey VJ, et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med. 2009;360(9):859-73.

Veldhuizen MG, Douglas D, Aschenbrenner K, et al. The anterior insular cortex represents breaches of taste identity expectation. J Neurosci. 2011;31(41):14735-44.

Veldhuizen MG, Nachtigal DJ, Flammer LJ, et al. Verbal descriptors influence hypothalamic response to low-calorie drinks. Mol Metab. 2013;2(3):270-80.

Wedel M, Pieters R. A review of eye-tracking research in marketing. In: Malhotra N, ed. Review of Marketing Research. Vol 4. New York, NY: M.E. Sharpe Inc.; 2007:123-46.

Social influence and consumer mindset

Buul VJ van, Tappy L, Brouns F. Misconceptions about fructose-containing sugars and their role in the obesity epidemic. Nutr Res Rev. 2014. [Epub ahead of print]

Gladwell M. The Ketchup Conundrum: Mustard now comes in dozens of varieties. Why has ketchup stayed the same? Taste Technologies. The New Yorker. 2004.

Nagler RH. Adverse outcomes associated with media exposure to contradictory nutrition messages. J Health Commun. 2014;19(1):24-40.

Moskowitz HR, Gofman A. Selling Blue Elephants: How to make great products that people want before they even know they want them. 1st ed. Upper Saddle River, NJ: Pearson Prentice Hall; 2007.

Spink J, Moyer DC. Defining the public health threat of food fraud. J Food Sci. 2011;75(9):57-63.

Technology and food selection

Clarke P, Evans SH, Hovy EH. Indigenous message tailoring increases consumption of fresh vegetables by clients of community pantries. Health Commun. 2011;26(6):571-82.

Evans SH, Clarke P, Koprowski C. Information design to promote better nutrition among pantry clients: four methods of formative evaluation. Public Health Nutr. 2010;13(3):430-7.

Kristal AR, Kolar AS, Fisher JL, et al. Evaluation of web-based, self-administered, graphical food frequency questionnaire. J Acad Nutr Diet. 2014;114(4):613-21.

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Which foods do consumers choose to eat, and why? What do consumers look for when food shopping? How does the food industry manufacture and market food products to meet consumer demand? How can consumer behavior be influenced to promote healthy food choices? These questions were the focus of the Consumer Behavior and Food Science Innovations for Optimal Nutrition conference, which convened speakers from academia, industry, the nonprofit sector, retail, and government.

The speakers agreed on the need to change the way food science is conceived and performed. To achieve a healthier, leaner population, we need to improve food manufacturing norms and shift consumers' eating habits. For the past half century, food science has been a reductionist endeavor, with scientists striving to identify the nutrient or compound responsible for a certain health condition, and then to artificially add it to the food supply if deficiency is the problem (vitamin D, folic acid) or to eliminate it if excess is the problem (salt, saturated fat, high fructose corn syrup). But we do not eat nutrients in isolation; we eat food. Several speakers discussed how to change the focus of food science from individual nutrients to whole foods.

There is also a need to restore dietary variety in developing countries and move away from approaches to malnutrition that focus on providing isolated nutrients. Food companies working to meet a particular health need must consider the complete product; simply eliminating one ingredient, such as sugar, often makes products unpalatable or difficult to store. Low-income consumers in the U.S. can obtain whole foods from food pantries but often need information about how to use unfamiliar foods. People seeking to lose weight usually keep track of food consumption, not nutrient consumption, and need dietary recommendations in the same format.

In her keynote address Joanne Guthrie discussed the many elements that influence food decisions, which include convenience, price, perceived health benefits, taste, messages conveyed by the media, and the opinions of friends. In the first session, Richard D. Mattes described the effects of texture on food choice and energy consumption. Liquid foods can be consumed faster and in higher quantities than solid foods and protein is less satiating in beverage form. Mattes showed that food form impacts how the body processes food and suggested that these "food form effects" could be incorporated into dietary recommendations and labeling decisions.

The next session focused on the perhaps surprising psychological factors that influence food intake. Maria Geraldine Veldhuizen demonstrated by relating a study on wine perception among sommeliers. When comparing dyed and undyed identical white wines, participants described the red-colored wine with typical red wine adjectives, such as "jammy," and the white-colored wine with its standard descriptors, such as "grassy." They also preferred wines reported as more expensive, not only claiming a preference but also showing heightened responses in brain areas associated with reward perception.

The conference also featured discussion of how public–private partnerships could improve the food supply, as well as how to market products effectively to different types of consumers. The speakers highlighted the need to remedy widespread confusion among the public stemming from frequently conflicting nutritional information, particularly positive press about flawed nutritional science and negative press about well-controlled, rigorous science. The conference concluded with an exploration of how to use technology to improve nutrition. The goal throughout was to understand consumer behavior in the hope that companies can provide food that meets consumer demand and provides nutritional adequacy.

Keynote Speaker:
Joanne Guthrie, U.S. Department of Agriculture

Highlights

• American diets consistently fail to meet USDA recommendations, notably falling short in daily intake of fruits, vegetables, and low-fat dairy.
• Providing information about nutritional content to consumers can influence product choice and behavior.
• Behavioral economics, which recognizes that people often act irrationally, suggests using strategies to subtly influence, or "nudge," consumers to choose foods that promote healthy eating.

Understanding the influence of access, prices, knowledge, and nudges

American diets do not meet U.S. Department of Agriculture (USDA) recommendations, containing more than the suggested amounts of meat and grains and less than half the recommended fruit, vegetables, and low-fat dairy. The USDA Economic Research Service (ERS) provides resources to support policy and economic decisions regarding agriculture, food, environment, and rural development.

Keynote speaker Joanne Guthrie of ERS gave an overview of the organization's research into how food availability (supply) and consumer preferences (demand) influence food choice, as well as how to promote public health and improve consumer diets through policy making. She acknowledged that there are economic determinants of food choice but said the idea that healthy food is more expensive than junk food may be a misconception. Value comparisons that measure and report food prices per 100 calories can be deceptive. When price is calculated by weight or by average serving, rather than by energy content, fruits and vegetables do not turn out to be more expensive. Guthrie pointed out that consumers may need to shift their spending profiles to eat healthily and affordably, buying less junk food and more fresh produce.

American consumers underspend on vegetables but overspend on processed foods. (Image courtesy of Joanne Guthrie)

Price is only one consideration in deciding what's for dinner; accessibility is also critical. Limited access to grocery stores may make it harder to eat a healthy diet, but this problem affects only a small percentage of Americans and data suggest that access is improving. The number of households with access to nutritious food increased between 2006 and 2010 because more people had access to cars and fewer had to travel far to reach a supermarket. Technological advances in food manufacturing have also promoted the accessibility of healthy food; for instance, by allowing fresh produce to be stored and shipped over long distances and made available year-round.

Eating a healthy diet takes time in addition to money. The American Time Use Survey indicates that Americans tend to save time by eating out and even during the recent recession obtained a higher percentage of calories from outside sources than in the past. Food prepared outside the home is often associated with poorer dietary quality; however, ERS research suggests that Americans are making somewhat better choices, opting for meals that are lower in saturated fat and higher in dietary fiber. This trend could be attributable to recent labeling laws. When the 2005 dietary guidelines promoted whole grains, manufacturers introduced and consumers bought more whole grain products. Consumers have also responded to guidelines discouraging consumption of trans fats.

Traditional economics taught that behavior is consistent and can be changed through education. But cognitive psychology teaches that behavior is often irrational. Decisions about food are influenced by hunger, convenience, default options (such as soda with fast-food), societal norms and mores, and sensory stimuli. The Behavioral Economics–Child Nutrition Research Initiative, run by ERS and the USDA Food and Nutrition Service (FNS), explores how to "nudge" people into making healthier food choices. The initiative found that schools usually control which food choices are offered and how food is displayed. In behavioral economics terms, schools have control over the choice architecture. Successful approaches to changing student behavior include increasing the visibly and availability of healthy foods, shortening lunch lines, attracting attention with names like "rockin' broccoli," and creating nutrition report cards that hold children accountable and inform parents of their food choices. Similar tactics are being used to encourage low-income shoppers to buy healthier foods.

The ongoing National Household Food Acquisition and Purchase Survey (FoodAPS) should yield additional data on shopping access and purchasing trends. Initial data should be available later this year.

Speakers:
Juan M. Gonzalez, Mead Johnson Nutrition
Bruce Cogill, Bioversity International
Kees de Graaf, Wageningen University, Netherlands
Richard D. Mattes, Purdue University
Sanjiv Avashia, Tate & Lyle

Highlights

• Our food supply relies on a handful of commercial varieties of fruits and vegetables. As a result, thousands of heirloom varieties have disappeared.
• Wheat, rice, and maize—only three of the 50 000+ edible plants—provide more than half of the world population's food energy.
• The value of food cannot be measured solely by the sum of its isolated nutrients.
• Texture has a large impact on eating rate, which impacts food and energy intake.
• Recent advances in food ingredient development offer opportunities to develop nutritious products that consumers will accept.

The role of food science in ingredient functionality and food systems

Juan M. Gonzalez from the Pediatric Nutrition Institute at Mead Johnson Nutrition explained that food scientists use technology to develop ingredients to perform a specific function, such as to promote health, nutrition, or sensory experience. He described a model to study the development of food ingredients and predict their utility. As ingredients move from industry conception to consumer acceptance, the manufacturing process is influenced by considerations including functionality, health benefits, legal and economic concerns, and consumer preferences.

Salt is an ancient example of a functional ingredient, acting as a preservative to facilitate long-term storage and transportation and enhancing flavor and nutrient content. Gonzalez showed that it would fit his model if introduced today. Food scientists now use engineering and biological and physical sciences to improve food products for public consumption—but the factors dictating the success or failure of new ingredients have not changed. Functional ingredients that have recently been promoted include lipids such as DHA and ARA, which add nutritional value to infant formulas, and artificial sweeteners that aid in weight loss.

Several factors drive the development, functionality, and acceptance of food ingredients. (Image courtesy of Juan M. Gonzalez)

Biodiversity in food systems

Agricultural practices in the second half of the 20th century were geared toward increasing food production while decreasing costs, not toward maximizing food quality and retaining the health of ecosystems. The resulting biodiversity loss affects crops around the world. Rice, maize, and wheat provide over 50% of the world's plant-derived food supply and up to 70%–80% of the energy content in a typical daily diet in the developing world. But these crops have low to moderate protein content and are often low in micronutrients, overprocessed, and of poor quality. Thus, many people experience depleted dietary diversity, and with it profound micronutrient, protein, and essential-fat deficiencies.

As we have come to depend on a handful of commercial varieties of fruits and vegetables, thousands of heirloom varieties have disappeared. (Image courtesy of Bruce Cogill)

Bruce Cogill of Bioversity International expressed alarm about modern agriculture policies, noting that enhanced dietary diversity is strongly associated with better health. He insisted that scientists must abandon the reductionist approach to diet, which examines ingredients, nutrients, and deficiencies in isolation and has guided nutritional studies for the past half century. Instead, we need a holistic approach to dietary guidelines that acknowledges that people consume whole foods.

Cogill pointed to the interdependency among agriculture, the environment, and human health outcomes such as under- and overnutrition but said more research is needed to understand these interactions, especially to examine a "whole of diet" approach to nutrition. Although dietary diversity is associated with nutritional adequacy and positive health outcomes, such as reduced all-cause mortality and lower cardiovascular disease risk, studies do not clearly indicate how well biodiversity translates into nutritional diversity. Often, available foods are not well-utilized in local diets. Bioversity International aims to leverage local biodiversity and locally available foods to optimize nutrition and health. Cogill called for more research into biodiversity and dietary diversity, particularly to understand how to improve local diets to combat diet-related non-communicable diseases.

We need to move toward a "whole of diet" approach to under- and overnutrition, leveraging local biodiversity to improve diet. (Image courtesy of Bruce Cogill)

Food design and eating behavior: texture, taste, and odor

Eating a kilogram of grapes takes twenty minutes. Drinking juice made from a kilogram of grapes takes a minute and a half. Liquids and the soft but energy-dense foods like peanut butter that make up so much of the modern diet make it easy to eat quickly. Kees de Graaf of Wageningen University explained that texture substantially impacts eating rate, and perhaps surprisingly, has a more important effect than flavor on satiation. Thus, eating quickly usually leads to eating more, and liquid-form foods facilitate high energy intake over short periods of time.

De Graaf has also demonstrated that eating rate can overcome the effects of texture. Experimental subjects who drank apple juice never felt full, but those who consumed an isocaloric amount of solid apples or apple juice in soup-like form, one spoonful at a time, felt sated for over an hour. Satiation depends on our ability to taste food; thus, the more slowly we eat the more able we are to taste food, and we feel full more quickly and even stay full for longer. Awareness of the effect on satiety of texture, taste, and eating rate could be used to design foods to be eaten slowly, as a strategy to fight the global obesity epidemic.

Texture has a large impact on eating rate, and eating rate has a large impact on food and energy intake. Soup-form food is consumed slower and is more satiating than an isocaloric beverage that is sipped. (Image courtesy of Kees de Graaf)

Food form, energy balance, and appetite

While on the molecular level a calorie from one source is equivalent to a calorie from another, in practice the picture is more complex. Anyone who recognizes that some foods are more beneficial than others, said Richard D. Mattes of Purdue University, recognizes that "a calorie is really not a calorie." Mattes discussed how food form—a sensory property, less-recognized than taste and smell—influences food choice and how food is processed by the body. His data show that food form has cognitive and oro-sensory effects and influences food absorption and use. In an experiment examining how our expectations of food form inside the body influence our physiological responses, participants expecting a beverage to remain liquid in the stomach had elevated levels of ghrelin (which regulates hunger) compared to those who thought it would turn into a solid. The beverage, which remained liquid, was cleared faster in participants expecting liquid in the stomach. They also remained hungrier and felt less full. The expectation of food form in the stomach even predicted food intake throughout the day.

Mattes also spoke about cephalic phase responses (anticipatory physiological responses to sensory stimulation) and their relationship to food intake. Although small and transient compared to real physiological responses to ingestion, cephalic responses may modulate and even determine those physiological responses. For instance, a sweet taste induces a cephalic phase insulin response that predicts the metabolic response to actual sugar. Artificial sweeteners have been shown to induce a cephalic phase response, but there is conflicting data on their physiological effects. Artificial sweeteners do not deliver the energy the body expects, and a study investigating the effect of this discrepancy found that rodents exposed to artificial sweeteners consumed more energy overall, perhaps to compensate for unpredictable satiety. In humans, a study showed no difference in energy intake after unknowing consumption of some artificial or natural-only sugars, but there is evidence that knowing use of artificial sweeteners can prompt us to overeat based on a belief that calorie intake has been reduced.

Product development and consumer acceptability

Sanjiv Avashia of Tate & Lyle discussed research the company has conducted to help it design products to meet consumer demand. Surveys show consumers are most interested in the fat, energy, and sugar contents of food products, and many people want to manage sugar and energy intake, reduce salt consumption, and increase fiber intake. Of course, consumers also want tasty and affordable food.

In formulating new food products, companies need to balance consumer desires with factors such as texture, ease of manufacture, scalability, moisture retention, stability, and mouthfeel. Avashia described several Tate & Lyle products to demonstrate the development process. A reduced-sugar cheesecake, for example, uses a low-calorie artificial sweetener, as well as polydextrose (to retain texture lost through the removal of sugar) and an instant modified corn starch to add viscosity. The use of artificial sweeteners to reduce calorie content necessitates the inclusion of these bulking agents, which give products like cakes a creamy texture even after refrigeration and ensure that products do not separate into aqueous and starchy layers.

New functional ingredients enable companies to manufacture foods with favorable nutritional profiles that also taste good and appeal to consumers. When formulating these new food products, companies must consider how engineered ingredients will act in concert and balance each other to form a cohesive and palatable whole.

Speakers:
James O. Hill, University of Colorado
Serena C. Lo, U.S. Food and Drug Administration
Maria Geraldine Veldhuizen, Yale University

Highlights

• Compliance is key to the success of any diet plan, but it is difficult to maintain weight loss over the long term.
• Manufacturers often include voluntary statements on food labels, such as graphics, promotional information, or claims about the nutritional characteristics and health benefits of the product.
• Consumers find it difficult to compare products that have different serving sizes, and comprehension of food labeling is better among people who use labels regularly.
• We use sight, smell, social cues, and labels to judge food safety before eating. Expected and unexpected tastes activate different areas of the brain.

Lifestyle changes to improve and manage weight

From the mid-1970s to 2000, obesity rates among both adults and children in the U.S. skyrocketed. These rates have since stabilized, but James O. Hill of the University of Colorado expressed concern that the stabilization may have occurred because people at risk of obesity are already obese.

Obesity results from an interplay of physiological, behavioral, environmental, and inherited characteristics that cause an imbalance in energy intake and energy expenditure; it cannot be remedied by altering only the first while ignoring the second. Hill suggested that obesity does not represent broken physiology; rather, obesity is the appropriate physiological response to our broken modern environment, with its constant access to energy-dense foods and lack of physical activity.

There are so many contributors to the obesity epidemic—including fat and sugar consumption and time spent sitting—we cannot hope to reverse course by considering only one. Many different types of diet can lead to weight loss in the short term. But in the long term, the body adapts to diminished energy intake by reducing energy expenditure, making it difficult to maintain weight loss. The National Weight Control Registry has found that people who achieve long-term weight loss often completely change the structure of their lives and focus social and professional activities on maintaining their lower weight. Preventing weight gain might be simpler than achieving weight loss. Small changes, such as choosing milk and carrots with takeout food instead of fries and soda, or taking the stairs instead of the elevator, are often easier to implement than large changes. Hill concluded by noting that health and wellness should be viewed not as an output, something that must be worked for, but as an input—a baseline state that promotes a healthy life. Perhaps such a shift will gradually reduce the numbers of overweight and obese children and adults.

Obesity is the result of an imbalance in energy intake and energy expenditure. We cannot hope to fix the obesity epidemic by focusing on one side of this equation while ignoring the other. (Image courtesy of James O. Hill)

Does food labeling affect food decisions?

In 2002 and 2008 the FDA fielded its Health and Diet Survey, a random-digit-dial probability-based population telephone survey, to over 2300 consumers in the U.S. About 50% of respondents in each year remembered an instance in the previous two weeks when reading the nutrition label changed their decision to buy or use a food product.

Food labeling includes but is not limited to nutrition labels. The principle display panel (the front of the container) must identify the food and list its quantity. Manufacturers often include additional voluntary statements on food labels, such as promotional statements, graphics, and claims about the nutritional characteristics or health benefits of the product. All information on food labels must be truthful and must not be misleading. The information panel on packaged food is located on the right of the principal display panel and must include the ingredient declaration and the Nutrition Facts label.

Serena C. Lo is a consumer science specialist at the FDA Center for Food Safety and Applied Nutrition, where she studies judgments people form when viewing factual nutritional information. She pointed to several ways to assess these judgments, including visual attention, comprehension, selection, behavior, and sales data. Lo has found that consumers rate products as healthier when serving sizes are smaller and find it difficult to compare products that have different serving sizes. Unsurprisingly, performance on comprehension and judgment tasks is better among people who use labels regularly, a group that includes women, people who have a higher level of education or an interest in nutrition, and people with specific dietary needs or health concerns such as allergies.

Eye-tracking research examining visual attention to the Nutrition Facts label demonstrates that nutrients located at the top of the label receive the most attention. Visual searches also take longer when information is found near the center of the label, and people with enhanced motivation to find healthy products pay more attention to nutritional information.

Top-down modulation of taste and flavor: role in ingestive behavior

Maria Geraldine Veldhuizen is a psychophysicist whose work focuses on the impact of taste, smell, and flavor perception on ingestive behavior. At the John B. Pierce Laboratory at Yale University, she incorporates neuroimaging of chemosensory perception into her research, using functional magnetic resonance imaging (fMRI) and advanced computational techniques such as network modeling and pattern analysis. Many considerations influence our food choices, including appearance, smell, labeling, and messages from friends and the press. When our expectations about taste do not match our sensory experience, and particularly if the mismatch is large, oral perception (flavor, taste, and texture)—not usually particularly sharp—takes on heightened significance and other inputs fade.

The brain circuits that mediate these interactions are unknown. Individual variation in eating style, body mass index (BMI), and sensitivity to rewards may create a vulnerability to overeating. A better understanding of how we make food choices may allow researchers to predict how food messages will affect people differently.

Using fMRI, which measures regional blood flow and is commonly used as a proxy for brain activity, Veldhuizen has shown that expected and unexpected tastes activate different areas of the brain. Compared to expected stimuli, unexpected stimuli, such as a tasteless liquid in place of something sweet, resulted in greater deactivation in fusiform gyri. This brain activity may reflect suppression of visual object regions while the brain tries to orient to and identify an unexpected taste. Verbal labels also affect the brain's response to flavor. When low-calorie drinks were described as treats, brain activity in the hypothalamus and midbrain mirrored activity when the subjects were actually given treats (milkshakes). Interestingly, the subjects reported that the altered labels did not change their perception of or desire for the low-calorie drink. Veldhuizen's data also indicate that high BMI may impair ability to learn from unexpected tastes.

Speakers:
Richard Black, PepsiCo
Howard Moskowitz, Moskowitz Jacobs Inc.
Fred Brouns, Maastricht University, Netherlands

Highlights

• We need more collaboration among the food industry, the public health community, and regulators to make needed changes to the food supply.
• iNovum has developed software intended to identify consumer preferences and guide users to healthy products.
• Conflicting health and food messages in the media confuse consumers, leading some to distrust information about food safety and health.

Alliances to change diets: public–private partnerships

Richard Black of PepsiCo argued that we need more collaboration between the food industry and the public health community to make needed changes to the food supply. Particularly, he pointed out that research in the public health sphere is not always made available to the food industry and argued for greater transparency to enable the food industry to be engaged in changing consumer behavior. There has not traditionally been a great deal of trust among the food industry, the public health community, and government regulators. However, Black encouraged participants to seek partnerships in areas where collaboration is needed. The USDA and Agricultural Research Service public–private partnership ATIP (Agricultural Technology Innovation Partnership) Foundation, founded to enable the private sector to commercialize USDA research, exemplifies such collaboration.

To effect change, all stakeholders need to have a robust knowledge of the food supply. Black mentioned that the ATIP Branded Foods Products Database for Public Health, established in 2011, will greatly expand access to information. Food companies provide "nutrient compositions of branded foods and private label" data on a yearly basis, and the information is publicly available and vetted and housed by USDA. The USDA databases previously included less than 10% of available foods, so this effort will substantially expand public access to food information and provide a better basis for policy decisions. Black also noted that the expanded database will allow companies to monitor the food supply, which changes substantially from year to year as products come on and off the market.

Sequencing the genome of the consumer mind

Howard Moskowitz is CEO of Moskowitz Jacobs Inc. and chairman of iNovum, a new company that aims to use predictive analytics in commerce to direct consumers to healthy products, using software called MindGenomics. Moskowitz hopes the system will benefit consumers and producers, who will respectively be directed to products that match their needs and be able to more effectively target products to increase sales.

The software divides people into three to five types for any particular product or service, based on their reactions to consumer messaging and answers to simple questions. The idea is to categorize consumers based solely on these reactions, not on demographic data or prior knowledge about an individual. The messages can be about health claims, sensory claims, environmental claims, or price points. The software then provides information about healthy products while the consumer shops. Each person receives specific, tailored messages, which are intended to resonate and encourage behavioral change.

An epidemiological approach has historically been used to influence consumer behavior, relying on questionnaires about lifestyle and habits to create appealing advertisements and packaging. But this approach has never worked well and is especially difficult to implement for new or small-scale products because large data sets are needed. It also generates generic messaging and does not provide data specific to each consumer. Moskowitz described the iNovum approach as aiming to uncover the "mental genome" of each individual for each product, so that companies can create messages that appeal to consumers and foster brand loyalty.

Eating for personal health: carbs, fats, gluten, "processed," or "whole-natural"?

Fred Brouns from Maastricht University began by noting that is difficult for the public to sort out the many confusing health claims touted by the media. If messages change frequently and conflict with one another, he argued, consumers will be tempted to disregard all information about nutrition, even well-founded recommendations about exercise and fruit and vegetable consumption. Part of the problem is that rigorous science is seldom sensational, but shocking news—"Fructose is toxic!"; "Gluten makes us fat and sick!"; "Caffeinated energy drinks may kill you!"—sells newspapers. Biased publications and industry-supported research compound the confusion.

The pubic does not know whom to trust, and therefore turns to social media, pop science, and other unregulated venues, or makes food decisions based on convenience, price, and taste. In fact, this distrust is not unjustified: doubts are often validated by shady practices in advertising and inconsistent legalities, such as unregulated product marketing in developing countries using claims that are prohibited in the West for lack of evidence. Brouns pointed out that whether companies "cheat," making statements that are false or that embellish the truth in food labeling, is not at issue—clearly, they do. Commonly fraudulent foods include olive oil, fish, milk, and organic foods. He also said that interdependency between science and its industry funders detracts from the credibility of some studies. Consumers need to know how to respond, and what to look for.

Brouns thinks we need to control and regulate health claims to prevent fraud. We need more transparent and effective regulations, with significant enforcement and penalties, including sufficient financing for regulators. To avoid the spread of "bad science," universities should shift part of their focus from publishing in journals to using social media and public or web-based lectures to disseminate research findings. Open-access publishing could increase transparency, but there must also be safeguards against pay-for-publication models. Effective public outreach could ensure that opinion leaders perceived as experts by consumers are well informed.

Speakers:
Peter Clarke, University of Southern California
Susan H. Evans, University of Southern California
Jodi Kahn, FreshDirect
Rick Weiss, Viocare Inc.

Highlights

• Forty million Americans use food pantries. Mobile applications incorporating nutritional information and recipes can help consumers to use the ingredients provided.
• Online food retailers can promote healthy food choices by providing easily accessible nutritional information.
• Tracking food intake is known to lead to weight loss but difficult to sustain. Cell phone applications could make the strategy easier to implement.

A mobile app for better nutrition among food pantry clients

Low-income consumers can obtain fresh produce at community pantries. Forty million people use food pantries, but often these consumers do not know how to use unfamiliar foods, leading to wastage and lost opportunities to improve nutrition. Researchers from the University of Southern California, Peter Clarke, a professor of communication and preventive medicine, and Susan H. Evans, a research scientist at the Annenberg School for Communication and Journalism, have collaborated to provide this population with nutrition help. They developed an application for cell phones that offers two kinds of customized content, VeggieBook and Secrets to Better Eating.

VeggieBook provides recipes and food-use tips about commonly distributed fresh vegetables. Each recipient decides which recipes and tips to use from among hundreds of specially designed recipes provided in English or Spanish. Users customize their VeggieBook by answering 21 questions such as: Do you want recipes for soup? With meat or chicken? Using a blender? Kid-friendly? Preparing food for a person with diabetes? Research has shown that customized recipes and tips led to a 40% increase in clients’ use of vegetables, compared to standardized versions.

Secrets to Better Eating invites clients to browse five chapters covering topics about breakfasts, lunches, dinners, snacks, and food shopping. The content presents 80+ practical, no-cost strategies on themes such as limiting fats and sugar in the diet, establishing a psycho-socially beneficial atmosphere at meals, curtailing overeating, involving children in meal preparation, introducing children to new tastes, and engaging in bargain-conscious grocery shopping.

Both types of content allow clients to print materials at a pantry and view materials on a cell phone. Clients can also order extra printed copies for friends, email the content, or post to social media.

Online grocers bringing healthy options to the table

Alice Waters once famously said that 80% of cooking is shopping. Jodi Kahn, chief consumer officer for FreshDirect, agrees. Market research has shown that when shopping for and preparing food, most consumers focus on health and aim to exert control over their food choices, looking for the healthiest foods and fresh, whole ingredients. But consumers face challenges when buying and preparing food, such as time constraints or lack of inspiration to satisfy everyone at the table.

According to Kahn, online grocery stores like FreshDirect can meet these consumer needs. People like to search by ingredient or allergen and prefer to shop when they want to—including on-the-go or in multiple shifts—and then to have groceries delivered. Technology can provide these features while also exposing people to new food options (through product suggestions and coupons) and nutritional information, thus helping them to make better food choices.

Using technology to evaluate nutritional content

Rick Weiss of Viocare Inc. reiterated the idea that studies aiming to find relationships connecting the food supply, diet, and disease should measure intake of whole foods not isolated nutrients. Food frequency questionnaires (FFQs) commonly used by dietitians are time-consuming, costly, and often incorrect because consumers recall food intake inaccurately. VioScreen, a web based FFQ, aims to change the way dietary patters are assessed.

VioScreen is an online tool designed to capture an accurate 90-day dietary history in 20 minutes by collecting information about foods that are regularly consumed. Users complete the assessment before their first visit with a clinician, selecting foods consumed at least once a month and identifying frequency and portion sizes. Weiss reported the screen is more accurate than other FFQs. Food and portion size options are selected by choosing pictures of actual food from among the software's over 1200 images. Reports provide a personalized basis for dietary counseling by comparing observed dietary behaviors to recommended dietary guidelines, suggesting foods to overcome dietary deficiencies and offering guidance to achieve a healthy diet, not just weight control.

Viocare is also building a Mobile Food Intake Tracking Program to make it easier for people to track consumption patterns. Tracking food intake is known to drive weight loss. Rather than reporting food intake by selecting pictures, users photograph or videotape a plate of food using a cell phone and the program classifies the food by type and estimates its volume using a two-step pose estimation followed by a 3D surface reconstruction procedure.

Viocare's Mobile Food Intake Tracking Program estimates the foods and volumes that people eat based on images captured on their cell phones. (Image courtesy of Rick Weiss)

Panel discussion

The panel discussion focused on the role of technology in food selection. The panelists emphasized that it is important for consumers to feel that they are in control of their food choices. To empower consumers, digital platforms focus on personalization. Clarke and Evans noted that food pantry users are highly motivated to use all the ingredients provided by the pantry. Kahn mentioned that FreshDirect could improve its capacity to customize the quantities of foods that can be ordered, as plated.com does. Weiss spoke about applications that can be used alongside his food-tracking device to collate favorite recipes. In response to an audience question, Kahn noted regional differences in FreshDirect ordering patterns; interestingly, suburbanites order more fruits and vegetables than do city dwellers. New technologies that monitor eating and movement patterns should be evaluated regularly by companies to comply with regulations and test efficacy, but the panelists noted evaluation can be difficult because of privacy and proprietary issues.

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