Food Insecurity in people living with Obesity (FIO Food)

Food Insecurity in people living with Obesity (FIO Food)

FIO Food - Food Insecurity in people living with Obesity - improving sustainable and healthier food choices in the retail FOOD environment logo

The overall aim of the project is to provide actionable evidence for policy on retail strategies to address dietary inequalities in people living with obesity and food insecurity, to support sustainable and healthier food choices in the UK food system.

About the project

Project Summary

A triple Venn diagram outlining Food Insecurity, Obesity and Environmental Sustainability with FIO FOOD (Food Insecurity in people living with Obesity) at the intersection of the three circlesAt both UK and global levels we need to change dietary patterns to address environmental, health, and inequality challenges. Despite considerable policy intervention, overweight and obesity has continued to rise in the UK, with obesity now a leading cause of death. Obesity is higher in areas of social deprivation and the current UK food system, including governmental policy, does not effectively address this; indeed, current behavioural approaches may even widen the inequalities gap.

The National Food Strategy team have extensively reviewed the UK food system with the remit for planning access “safe, healthy, affordable food; regardless of where they live or how much they earn”. In the detailed report, the key issues of obesity, reducing diet-related inequality and the environmental impact of the food system are described and discussed. The links between food insecurity and development of obesity and the potential effectiveness of interventions to prevent and reduce the impact of diet-induced health harms is not well evidenced in the UK retail food environment.

We address this call for evidence through a novel and multi-disciplinary collaborative approach with co-development as a key feature, through four inter-linked work packages, to combine our knowledge of large-scale population data with an understanding of lived experiences of food shopping for people living with obesity and food insecurity, to develop solutions to improve sustainable and healthier food choices.

About the project

Professor Alexandra Johnstone at Rowett Institute at the University of Aberdeen is leading this Strategic Priorities Fund UKRI grant, with an excellent team of academics and food partners.  The high levels of obesity in the UK represent a key public health issue, with 67% of the UK population living with overweight or obesity. Obesity remains a core government priority. The UK has yet to find an effective strategy to help reduce obesity levels, especially among low-income communities. We need better evidence on how we can change food purchasing and consumption behaviours for people living with obesity and food insecurity that can improve their health and wellbeing, while also be sustainable.

Funded by the Biotechnology and Biological Sciences Research Council (BBSRC) Strategic Priorities Fund (SPF), part of UK Research and Innovation (UKRI), we aim to research how the world can make healthy and environmentally sustainable changes to food choices for those living with obesity and facing food insecurity.

The Rowett Institute has over 100 years of experience investigating nutrition and disease process, adapting our research for the needs of the current population.

Our focus is now on addressing what sounds like opposite issues, the overconsumption of food and food insecurity, however the two are very much related. These problems are multi-dimensional, coming with their own complications. Our goal is to identify how we can provide realistic and robust solutions whilst paying close attention to the cost-of-living crisis. Obesity is at the core of many disease processes and is associated with mortality and morbidity. It places a burden on our healthcare system, and it is vital that we make swift progress towards providing solutions.

Definitions

The terms ‘food insecurity’ and ‘environmentally sustainable’ diets are themselves controversial. The extended FAO definition that refers to household level food insecurity (FI) underpins the Food Insecurity Experience Scale that we are using to identify food insecure participants is, ‘a lack regular access to enough safe and nutritious food for normal growth and development and an active and healthy life. This may be due to unavailability of food and/or lack of resources to obtain food’ (FAO, IFAD, UNICEF, WFP and WHO, 2021). We will use these working definitions below and apply the principles of the Eatwell Guide for a sustainable healthy diet (PHE, 2016).

  • Food insecurity (FI) The condition of not having access to sufficient food, or food of an adequate quality, to meet one's basic needs (Oxford Dictionary Definition).
  • Sustainable Healthy Diets are ‘dietary patterns that promote all dimensions of individuals’ health and wellbeing; have low environmental pressure and impact; are accessible, affordable, safe and equitable; and are culturally acceptable” (FAO and WHO, 2019).
  • Carbon Trust, The Eatwell Guide: A More Sustainable Diet (2016)
Resources

Research Briefs

PPI workshop vignette  - the Rowett Institute, 4th Oct 2022

TUKFS workshop vignette - Sheffield, 12th Sep 2022

Grant outline

Our approach

We need new ways of collaboration to effectively transform the food system into promoting healthy, environmentally sustainable, and equitable diets. Our multidisciplinary research approach is detailed in the project outline figure.

A description of the planned activities of the four workpackages 

WP1 - Lived Experience - Persons; Food System Stakeholders; Patients - Co-design of supermarket-based interventions that support people living with obesity and food insecurity to acquire healthy & sustainable food (Douglas, Brown & Hardman)

WP2 -  Population level - Utilising supermarket transactions and data science to understand the health and sustainability of population diet at scale (Morris, Gilthorpe & Green)

WP3 - Action level - Implementation of retail strategies to promote healthy and sustainability purchasing in consumers & patients (Gately, Griffiths & Sainsburys)

WP4 - Stakeholder engagement & impact delivery - Policy; Retail; Consumers - Share key project findings for transformative potential (Johnstone, Co-PI's, Stakeholder Group & Steering Group)

A visual representation of the planned activities of the four work packages 

Work Packages

Work Package 1

To capture and apply the lived experience to inform retail strategies 

AIM

Co-design of supermarket-based interventions that support people living with obesity and food insecurity to acquire healthy and sustainable food  

WHO IS INVOLVED

Dr Charlotte HardmanDr Charlotte Hardman, University of Liverpool

I am interested in psychological determinants of appetite and eating behaviour and in the application of this knowledge to interventions for health behaviour change. Charlotte is interested in psychological influences on eating and weight management.

Dr Adrian BrownDr Adrian Brown

My research is research interests centre around obesity, type 2 diabetes, bariatric surgery, weight stigma and the use of formula-based diets in different patient populations. I have recently focussed on weight-related terminology used by healthcare professionals, and the impact of COVID-19 on people living with obesity.

Professor Flora DouglasProfessor Flora Douglas

Flora contributes to a number of national and local steering and advisory groups concerned with addressing household food insecurity and health in Scotland. Her particular focus is on providing expert input on the evaluation of interventions intended to address food poverty in Scotland.

Robert Gordon University Aberdeen logo University of Liverpool logo UCL logo

Work Package 2

Use food purchasing data to understand inequalities in dietary behaviours and identify how to nudge people to healthier and sustainable diets

AIM

Utilising supermarket transactions and data science to understand the health and sustainability of population diet at scale.

WHO IS INVOLVED

Associate Professor Michelle MorrisAssociate Professor Michelle Morris, University of Leeds

Michelle is an interdisciplinary researcher with a background spanning: health informatics, geography, nutritional epidemiology and health economics. Michelle is a University of Leeds University Academic Fellow in Health Data Analytics and a Turing Fellow. Currently, she directs the multidisciplinary ESRC Strategic Network for Obesity and has developed a diverse teaching portfolio, including spatial analytics and visualisation for health. With this unique career history she is well placed to achieve her vision to cross discipline boundaries bringing together people, data and methods to improve health through informatics - specifically combining consumer analytics with health informatics and using 'big data' to benefit patient outcomes.

Professor Mark GilthorpeProfessor Mark Gilthorpe, University of Leeds

Mark is Professor of Statistical Epidemiology in the School of Medicine and the Leeds Institute for Data Analytics (LIDA), and a Fellow of the Alan Turing Institute for Data Science and Artificial Intelligence. Trained as a mathematical physicist, Mark's driving interest centres on improving our understanding of the observable world through modelling.

Dr Mark GreenDr Mark Green, University of Liverpool

Mark is currently Reader in Health Geography, within the Department of Geography & Planning at the University of Liverpool. Mark's research examines how new forms of (big) data (e.g., images, text, loyalty card records) can supplement traditional administrative datasets (e.g., mortality records, surveys, hospital admissions data) for understanding the social and spatial drivers of health inequalities.

University of Leeds logo University of Liverpool logo

Work Package 3

Implementation of UK wide, in-store retail strategies to promote sustainability in consumers & assess the feasibility and acceptability within a MoreLife patient cohort.

AIM

Implementation of retail strategies to promote healthy and sustainability purchasing in consumers & patients. 

WHO IS INVOLVED

Professor Paul GatelyProfessor Paul Gately, Leeds Beckett University

Paul is Professor of Exercise and Obesity in the Carnegie School of Sport. He is also a Co-Director of the Obesity Institute. Paul’s work in the Institute holds the voice of people living with obesity at the core of what we do, we also recognise the complexity of the problem and we are developing ways and tools to overcome this societal problem.

Dr Claire GriffithsDr Claire Griffiths, Leeds Beckett University 

Claire’s research interests include obesity and the environment. She is particularly interested in investigating how the environment, including access to food outlets and opportunities for physical activity and lifestyle behaviours that influence obesity. 

MoreLife provide programmes and services to individuals that will help them change their behaviours and make a difference to their overall health and wellbeing. Their aim is to make the lives of individuals healthier, through healthy lifestyle behavioural interventions such as weight management, giving up smoking, NHS Health Checks, healthy eating or improved physical activity. They work with individuals on their own, with their families, within groups from the local community, school or workplace.

Ms Nilani SiratharanMs Nilani Siratharan, Healthy Living Manager, at Sainsbury’s plc

The Sainsbury’s Group bring notable added value to this project. They will share, their nectar card loyalty records with the research team for studying food purchasing patterns. They have around 1.7 million primary shoppers who are defined as low affluence (based on income, tenure, and savings). We will be collaborating with Sainsburys so that we can tackle the cost-of-living crisis directly with those involved in the supply chain. We will be analysing Nectar customers food habits and utilising survey’s, focus groups and initiating a national digital intervention study. 

Leeds Beckett University logo Sainsburys's logo

Work Package 4

Stakeholder engagement and impact delivery 

AIM

To share project findings for transformative potential with key stakeholder through engagement & impact delivery, throughout the grant period

WHO IS INVOLVED

Professor Alexandra Johnstone

Professor Alexandra JohnstoneStakeholder Group 
Steering Group 
Advisory group 

University of Aberdeen - The Rowett Institute logo

Research

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