The future diet will be personalised and protective against non-communicable diseases and eco balanced both externally and internally
Describe your relationship to the place you’ve selected.
I have lived all my life in Skåne and Blekinge and the organisations involved are also situated here.
Describe the People and Place: Provide information that would be helpful for an outsider who has never been there and may have no context about this Place to better understand the area.
The Place in question is situated in the middle of Europe and in the South of Sweden.
The bridge from Malmö to Copenhagen, Denmark and the rest of Europe.
The turning building in Malmö as a symbol of innovative thinking.
Forests are more frequent in the northern part of the area.
The lanscape is mixed and mostly rural in the Southern parts.
In the winter there is sometimes snow but not every winter, especially not during the last decades due to the global warming.
The region in question consists of three counties, Skåne, Blekinge and Småland. It is an approximately 43,000 km2 large region in Southern Sweden consisting of 69 smaller administrative municipalities and 2.2 million inhabitants. The municipalities are mainly small but there are also three somewhat bigger cities with a population exceeding 100,000. In other words the region of Skåne is of a mixed urban / rural type. Outside the cities the landscape is varied with both forests and agriculture but mostly lowlands without any mountains. The climate is mild and suitable for farming. Due to the location almost in the middle of Europe migration has changed the demographics in the bigger cities. In Malmö with more than 300,000 inhabitants around 25% come from other countries. Consequently, the structure of the society is evolving. Even though a fairly high number of people are aware of the importance of a healthy diet many more are unaware and also have lower income that makes it even harder to buy and consume a diet with a healthy content. On the other hand, many international influences have a positive impact on the diversity of the food alternatives but still the vast majority of the people adjust to the Westernized diet, in this case typical north European diet with processed food containing a lot of unhealthy components such as sugar, salt and emulsifying agents. In parallel the BMI is increasing and more than 50% suffer from overweight, i.e. BMI > 25. The cardiovascular mortality has decreased over the last decades but now there is a substantial risk that this improvement will cease to exist. The prognosis – as for the rest of the world – is that around 10% of the population will suffer from diabetes within the next decades. When it comes to autoimmunity and allergy the situation is even worse. E.g. the incidence of Crohn’s disease has increased from 0 / 100,000 inhabitants per year in the middle of the 20th century to around 20 nowadays. Consequently, the place is situated in the middle of Europe with modern dietary habits adjusted to the 24/7 society with fast food solutions that risk to ruin our health but with an advanced food industry and a high scientific level that can tackle the challenges ahead. We have already a fairly good knowledge about health hazards with processed food leading to a deprived gut microbiota, an impaired gut function and following immune reactions resulting in chronic inflammatory conditions such as inflammatory bowel disease. Using modern technology the individual response to certain food components can be analysed in order to create personalised diets that can promote health and prevent development of immune mediated diseases.
Challenges: Describe the current (2020) and the future (2050) challenges that your food system faces.
The modern society has gone astray and chosen the easy way out to save time with processed fast food meals. The modern food deprived of fibres, fruit and vegetables, fish, polyunsaturated oils but “enriched” with different additives (salt, sugar, emulsifying agents among others) is believed to play a pivotal role for this change in disease pattern from communicable diseases to non-communicable. This epidemic may seem to be a problem predominantly in the developed countries but it is now spreading globally. Measures taken in one region could be beneficial for many other regions in the world that will not have to do the same journey into this type of skewed malnutrition. On a personal level it is necessary to let go of your food habits with consumption of junk food and a sedentary life style. In order to obtain a better health every citizen needs to take part in the evolution. This evolution demands food that is produced locally without additives and with participation of the people in the area. The infrastructure needs to be bilateral with interaction between people, society, food industry and the academic community. All individuals need to have their health profile analysed in order to adjust the diet and life style in general adjusted to the genetic setting as well as the environmental circumstances. The challenges ahead are several. One important factor to consider is the segregation. Many migrants came to the region in 2015. Some of them, but of course not all, have difficulties to get integrated in a new society. Hopefully they will not integrate western diet into their habits. At the same time many positive influences from these immigrants will contribute to improve the dietary habits in the region. In a technological 24/7 society people tend to forget the importance of the right food and outdoor living. The health hazards are vast and measures must be taken. Also politicians may be unaware of the risks and will not realize the importance of action. The challenge is the same both now and to some degree also in 2050. In order to solve the issues associated with this paradigm shift it is necessary to achieve the knowledge about our body and its needs but it is also necessary to educate the people about what our bodies really need. Without both an advanced food system and knowledge on the individual plane the food system will not be possible to evolve to its full extent.
Address the Challenges: Describe how your Vision will address the challenges described in the previous question.
In order to be able to produce local healthy food and to get an understanding of what is needed it is necessary to change the infrastructure of the society. In the future where the majority of the people live in cities it is mandatory to let the surrounding landscape to take its place inside the town as well. This change is already taking place to some extent. After some serious flooding episodes in the region some areas in some of the cities have been rebuilt in order to better cope with large amounts of water. From this respect a change of the society will take place regardless if we want it or not but it is better if it can take place in an orderly fashion and not as a result of disasters. The vision is that every individual will have its needs and demands mapped and that the society is organised so that this demand can be met. The infrastructure to obtain this vision is already on the way. In our network we are already cooperating with a vegan dairy company and a spice factory with interest in healthy food additives, such as polyphenols from spices and root vegetables. Furthermore we have a network based on research on gut microbiota and immunological reactions. In may countries the medical paradox, that there is always more to do than we can afford, is not solved. The reason is that we need to address the health issues before they are manifested as diseases. Now the time is right to do it. The challenge must be addressed in several steps. First we need to build the infrastructure – research facilities that can determine the health effects of specific food items, food companies that can produce the products needed and a structure of the society that enables this in a much interactive way than has been done this far. Finally, the degree of knowledge in society must be improved. The schools must be incorporated so that future generations realise that it is necessary to live with healthy food and exercise but not possible anymore to live without interaction with our planet and its needs. Knowledge is crucial for the vision. Current research has revealed that several food items may be detrimental to our health, among others saturated fat, salt, sugar and food additives can be mentioned. Gluten and meat are under debate. Even though we know that these components – when consumed in too large amounts – result in a deprived gut microbiota, an increased permeability in the gut and a resulting immune response the exact mechanisms must be clarified. These pathogenetic steps are now being mapped. Furthermore, these effects must be studied on an individual basis. In the future the individually based research on what is healthy for that specific person and the composition of the food must go hand in hand. In order to succeed with this the interaction between academic society and food industry must be tighter. It’s the question about a triple helix structure where the academic world, the industry and the society meet each other.
High Level Vision: With these challenges addressed, now provide a high level description of how the Place and the lives of its People will be different than they are now.
The disease pattern of today is ominous – an ecological disaster on the individual plane. With a palette of measures as described it will be possible to offer food with a high “dietary index”, i.e. healthy food that may restore both the microbial ecosystem in each individual as well as the ecosystem in our macro-environment. The key words of this paradigm shift are knowledge and communication. Fellow man must know more about what “healthy food” is and what is not, not only in general but on an individual basis. We must also communicate with our internal eco system (our microbiota and our body) and carry out the investigations indicated to evaluate any adjustment in the dietary regimen. We must communicate our needs to the local farming industry and out local shops. With analyses and understanding of the genetic factors behind and the effects in the body of certain food items every person can get their individual needs met to secure the wellbeing. The surrounding farming industry will provide the crops that are prescribed and with internet based solutions the delivery can be managed easily. The degree of knowledge will be sufficient so that every individual is aware of the importance of the correct food and enough exercise. Consequently, the society and especially the schools must be involved in the process.
Full Vision: How do you describe your Vision for a regenerative and nourishing food future for your Place and People for 2050?
The modern society is regarded as advanced from a technological point of view with food that is supposed to be healthy. Unfortunately, the food transition has resulted in junk food and passive inhabitants, where sitting is the new smoking. Even more depressing is the fact that this so called modern life style is spreading all over the world resulting in three epidemics, “diabesitas” (i.e. obesity and diabetes), immune driven diseases (i.e. autoimmunity and allergies) and mental ill-health (due to stress, bad food, light pollution etc). Now is the time to set the clock right again. In order to do this it is necessary to listen to our own bodies and their demands, to listen to the people and to adjust the society in accordance with our original stone age designed bodies that need open fresh air, exercise, food without unhealthy ingredients and communication between one and each other. Instead of a separation between towns and rural areas where the environment in the towns are polluted by combustion gases, inability to drain water, too much light etc. a mix with more trees and plantations in the town areas will provide a much more friendly surrounding with health benefits. Instead of large monocultures the farming could be integrated in the populated areas. In view of the three epidemics with “diabesitas”, several different autoimmune diseases and mental ill-health the avoidable environmental factors that may contribute to these diseases must be addressed. In order to be able to stay in good health the dietary composition should be based on evidence based principles. The general concept can at least partly be built upon the Mediterranean diet. Several studies have confirmed that this diet significantly reduces the risk for mortality in cardiovascular disease or cancer as well as the risk for neurodegenerative disease. In order to succeed with this shift it is necessary to increase the general knowledge among people about healthy food, to improve the possibilities for farming of nourishing and health promoting products and to facilitate the transports of food items produced nearby. However, in order to achieve the best possible outcome on the disease pattern a more specific mix of ingredients should be based both on both taste preferences and the evidence based health promoting effects of a diet that is balanced in agreement with the individual genetic and environmental needs. This is probably possible in the future when we have mapped the interaction between genes and environment, i.e. the food, to a much larger extent than today. With this knowledge a personalised food composition will be possible thus preventing onset of several diseases that are driven by pro-inflammatory processes.
Besides health promoting food in general specificantiinflammatory components may have a substantial additive effect. Forexample, in a previous EU-based project we tested a wide variety of naturalantioxidants in order to hinder lipid peroxidation and subsequent inflammation.We found significant effects of phenolic antioxidants extracted from certainvegetables, berries and spices. All antioxidants successfully inhibited oxidationat low physiologic concentrations. E.g. a specially designed spice mix powderat only 200 ppm was the most successful antioxidant, inhibiting oxidation to 16% in an experiment with meatballs. Mice that were given these antioxidantsdeveloped a more healthy microbiota in both colon and the small intestine. Theabundance of different bacterial genus and species also differed with andwithout these particular antioxidant preparations, respectively. Differenceswere also found for several types of immune cells. This indicates that someimmunological reactions are influenced by addition of antioxidative extracts.The beneficial effects of these compounds will now be confirmed in patientswith inflammatory bowel disease. According to our findings in vitro and in vivothis consumption of plant polyphenols with prebiotic and antioxidative capacitywill counteract dysbiosis and lipid oxidation and thus result in lessinflammation in the intestine with a reduced disease burden. As anotherconsequence of this reduction of inflammation there may probably also be areduced risk for colon cancer development in the long run. The reduction ofinflammation seems to be of specific value for patients with inflammatory boweldisease but it might also be of value as a primary preventive measure againstinflammatory driven diseases in general.
As we see it this is the first step towards a new personalised health promoting diet. Whether the effects in gastrointestinal disease are valid also in other immune driven diseases remains to explore but in view of the general health effects of the Mediterranean diet it may very well be so. In order to live within the existing ecosystems it is necessary to live in conjunction with the systems, not from it depleting it from its different components. The infrastructure must be bilateral allowing the landscape and animals and plants to live in tune with the human ecosystem. This region in the middle of Europe is today a mix of the whole world. The best from every region can be used in building a multicultural food market, thus taking advantage of the global community. In order to be able to estimate the interaction between food components, microbiota and immune system thus enabling an individually based food composition it is necessary to utilize the new possibilities with AI to make an algorithm that can be adjusted after each person’s own make-up from this respect. The intriguing aspect of AI from this respect is the possibility to invent a system that is bidirectional, i.e. the effects of certain food components can be determined in every person and the recipes can then be adjusted accordingly. The key factor that is driving this paradigm shift is knowledge through education and science. The school children must learn about healthy food because they can change the way their parents think and because they will take over. The science can change the recipes of the everyday food so that it can be health promoting. The components in the food that is driving inflammation is now being determined and the factors that are beneficial are also registered and these circumstances will change our ways of living. Policy must therefore be involved in order to change the circumstances that could hinder the necessary societal adjustments. The policy must also address the global perspective that are consequences of these discoveries in every decision.