Search

There has been a lack of progress in changing dietary patterns in the Scottish population despite almost three decades of policy and government investment in interventions intended to address it. Self-reported dietary intake has been consistently poorer in more deprived households compared to more affluent households in Scotland and has declined further in recent years in the UK. Financial constraints and related stress and anxiety leading to reduced access to healthy foods, and reduced access to physical spaces and opportunities to practice physical recreational activities and food insecurity, all increase obesity risk.

Public health scientists have theorised that increased food insecurity, household economic disruption, household stress, and interruptions in healthcare will contribute to obesity and related co-morbidity. COVID-19 exacerbated existing health inequalities via the health effects of social and economic upheavals due to the pandemic, including job losses and social isolation. Therefore, it is likely that dietary patterns will further deteriorate in the post pandemic context unless dietary behaviour change interventions take account of household, socio-economic and individual circumstances in their design.

Social Prescribing

Many council areas in Scotland, including Aberdeen city, experienced declines in household income and increased health inequalities in 2020. Regeneration programmes have historically included interventions intended to improve nutrition in low-income communities. Such interventions are often designed and implemented in partnership with local communities and are commonly delivered via Health and Social Care partnerships in Scotland. One such is social prescribing (SP). SP recognises that people’s health and wellbeing are mostly determined by social, economic, and environmental factors, and seeks to address these needs in a holistic way. SP enables health professionals to refer people to a range of potentially beneficial, local, non-clinical services in addition to, or in place of conventional medical treatments. After initial referral from a primary care professional, a “link worker” evaluates the client’s needs and produces a “social prescription”, which either refers the client to a local enterprise offering a suitable form of support or directly prescribes a recommended course of action.

Social prescribing schemes are mainly focused on improving mental health and physical wellbeing, generally targeting people from lower income families who have a higher risk of suboptimal nutrition and mental health issues. Therefore, SP offers potential to support improved food practices in SP client households, which is currently under-realised: the social prescriptions issued are not necessarily based on the best scientific behaviour change evidence and may not be made with full awareness of all potentially relevant services offered by local authority and third sector partners.

Members of low-income families, living in the most deprived areas in Scotland are particularly at risk of suboptimal nutrition and obesity. While many different interventions and initiatives have been introduced into communities over the last 20 years to try and tackle obesity in lower income households, there is little evidence that such strategies have been successful and that they are rarely robustly evaluated. Uptake from individuals living in deprived communities is often low, and intervention design is often based on available community skills and resources rather than scientific evidence about what is required to change behaviour.

Generally, diets in Scotland are unhealthy and damaging to the environment. One solution is moving the population to more sustainable diets that are healthy and have a low environmental impact. For instance, a more plant-based diet, which comprise only small amounts of meat. Plant-based diets can have multiple health benefits when they include more whole foods such as fruit, vegetables, pulses, nuts, and whole grains. These diets typically have a lower environmental impact than meat-heavy diets.

Sustainable diets can have multiple co-benefits for health and the climate, which line with the Scottish Dietary Goals and Scottish Government emissions reduction targets to net zero by 2045. However, little is known about the type of food and meals people eat in place of meat and how it might change an overall diet. It can’t be assumed it will always be healthier. Hence, we need to be cautious about what we eat in place of meat. Plant-based convenience foods are increasingly available, but many are classified as highly processed which tend to be high in salt, sugar and fat, and if consumed regularly, could have negative consequences for health and the environment.

To support the right sort of dietary change, we need to understand barriers – both those people perceive and those they experience in the real world. While access and affordability are commonly cited barriers, social and cultural aspects of food choices are often overlooked, including the desire for convenience and familiarity. Understanding attitudes and personal, social, and situational factors driving or inhibiting the adoption of a more plant-based diet is critical for the development of policy interventions to change consumer behaviours and consumption patterns to create a healthier population and a more sustainable food system.

Studies suggest that there is, or has been, perceived value in the production of food and drink products with higher-value status in Scotland. However, the extent to which higher-value food and drink products generate additional economic value for their producers and regions of production has been much debated. The terms of that debate have become more complex since the UK left the European Union (EU).

Take, for example, EU schemes that protect food and drink products with specific geographical characteristics. The two main schemes - Protected Designation of Origin; and Protected Geographical Indication - are intended to provide consumers with reliable information and to promote fair competition, respect for intellectual property rights and the integrity of the internal market.

Such geographical protection came under UK control in January 2021. Products with existing EU protection were registered automatically but new registrations must now be made in Great Britain, to protect the name here, and also in the EU, to protect the name there and in Northern Ireland. To add to this complexity, some countries the UK is eager to secure trade deals with, such as the USA and Australia, have been reluctant to recognise such geographical protection

This project provides evidence to help policymakers and businesses understand the economics of higher value food and drink products and the impacts of the EU exit and other trade developments on them.

A key challenge for researchers and policymakers is to produce and implement evidence-based guidelines for the UK food system to reduce obesity trends. Some 65% of the Scottish adult population is classified as living with overweight or obesity. In general, the Scottish diet is poor quality being too high in calories, processed foods, fats, sugar, and salt; it is equally too low in fibre, oily fish, and vegetables. Poor diets are a major contributory factor driving diet and health inequalities. Diet inequalities are notably socially patterned according to socio-economic status, where overweight and obesity prevalence is higher in socially disadvantaged groups.

Dietary fibre is found inherently in plant derived foods and is indigestible in the small intestine but can be a substrate for fermentation by the microbiota that primarily inhabits the lower gut. This can result in a rise in fermentation products such as short-chain fatty acids which are thought to confer several health benefits, including appetite control and suppression of food intake. Although increased fibre intake can be helpful, it is still a relatively underexploited dietary approach to tackle obesity. Therefore, foods containing fibre, that promote satiety and reduce energy intake, may be promising tools in weight management.

Further, food additives, such as artificial sweeteners or non-nutritive sweeteners, could influence the response to dietary fibre via the gut microbiota, which are tiny bacteria that live in the gut.  There is emerging evidence that some sweeteners could disturb the normal balance of the gut microbial ecosystem. Replacing sugar with non-nutritive sweeteners may inhibit the growth of bacteria for a healthy gut microbiome and may even promote harmful bacteria and/or metabolites. For humans to benefit from dietary fibre, fermentation is essential. This will not happen effectively if additives reduce the beneficial bacteria needed for this process. Furthermore, some non-nutritive sweeteners may prevent weight loss if microbiota disruption adversely affects satiety signalling from the gut. Indeed, reports suggest that some non-nutritive sweeteners are associated with weight gain and obesity as well as disrupted blood sugar control, thereby being potentially as harmful as the sugary drinks they replace.

In Scotland, there is a ‘fibre gap’, with the population consuming well below the recommended levels for good health. It is crucial to explore the reasons for inherently low fibre intake by considering the attitudes of Scottish consumers to dietary fibre and its link to health using a consumer survey approach. Furthermore, there is a need for a move away from a meat-based diet towards increased fibre intake for health reasons, as well as to transition towards a sustainable, environmentally friendly food supply. These issues appear to be being largely missed or ignored by consumers in Scotland.

The consumer has a right to know what is contained in the food they eat. There is significant risk in the food supply chain of fraud, where food is replaced by a cheaper or inferior alternative. The risks are particularly high for several food and drink products produced within Scotland that attract a premium because of their higher quality and consumer desirability (for example, whisky, beef and honey). It estimated that 4.4% of spirit sales in 2016 were lost to counterfeiting across the European Union. Given the premium nature and high demand for Scotch Whisky, the losses are likely to be larger. At the current rate, of £4.7 billion in exports, this equates to £207 million every year. Following the UK’s exit from the European Union and the need to develop more global food chains, the potential for food fraud has increased. There is a critical need to develop new methods to confirm the provenance of food substances across the food supply chain.

While DNA-based approaches are often used to assess food fraud, they are limited to foods that contain DNA of sufficient quality and quantity to allow polymerase chain reaction (PCR) based methods. Thus, DNA-based approaches are unsuitable for liquids, and there have also been recent concerns in processed foods that DNA may be too degraded to be reliably detected during PCR tests. Mass spectrometry metabolomics and proteomics workflows hold great promise for food authentication and understanding the provenance of a range of foods including meats, fish, honey and alcoholic drinks. Proteomics is the large-scale analysis of the protein complement of a biofluid, tissue, organism or food while metabolomics is the large-scale analysis of the small molecule composition of a biofluid, cell, tissue, organism or food. While most approaches of these two ‘omics’ have been applied to biomedical applications, there is increasing realisation that these approaches could be used in food science.

Epigenetics is concerned with information in the genome in addition to that contained in the DNA base sequence. It comprises several mechanisms that involve chemical modification to the genome with functional consequences. It is emerging as a key mechanism through which the environment can directly influence the genome in ways that may be short term or may persist over decades, or even more than one lifetime, with significant consequences for biological function and health. Epigenetic regulation is important in species that contribute to the human food chain. An increasing number of reports cover the epigenetic changes following exposure to stress, toxicants and infectious disease, procedures such as artificial reproduction and cloning, both in the animals directly exposed and the offspring produced. These phenomena have been studied in sheep, cattle, and pigs and aquatic species, such as salmon and sea fish.

Such studies point to the epigenome as a record of a wide range of environmental exposures, physiological states, and reproductive and dietary histories relevant to multiple species that can be used to track provenance and many other aspects of the food chain. The task is to identify the genomic locations where the signals of interest reside, the conditions under which they can be used, and to use this information to develop reliable, precise, accurate, rapid, and low-cost, tests.

Stable-isotope ratios and elemental composition have also been used extensively to establish provenance in a wide range of foods including, shellfish, salmon, meat, sea fish, and milk and in regulatory systems designed to identify foods with Protected Designation of Origin. We have developed stable isotope natural abundance analytical techniques to trace food origin, provenance, and the flows of nutrients through the whole food system - from primary production and processed food to individual consumption - to explore the potential value of a Food Systems approach. The next required step relates to the sub-fractionation of organics (primarily the various saturated, mono- and poly-unsaturated fatty acids), their analysis for both H2 and C13 isotopes, and the interpretation based on knowledge of metabolic transformations.

Farm animals are a major source of key zoonotic pathogens of humans, including those causing enteric disease like Campylobacter spp., Salmonella spp., enterotoxigenic Escherichia coli and Clostridioides difficile. There are around 2.4 million cases of foodborne pathogen infections annually in Scotland, with a financial burden of £9 billion. Reducing the carriage of zoonotic pathogens within the gastrointestinal tract of farm animals has clear potential to reduce the incidence of human foodborne disease. Importantly, many bacteria (both pathogenic and those commensal bacteria inhabiting the gastrointestinal tract) carry antimicrobial resistance genes, often located on mobile DNA. The transfer of AMR genes between unrelated bacteria contributes both to the environmental spread of AMR and to the evolution of multidrug resistance (MDR) pathogens.

Given the rise of MDR pathogens, and the need to reduce antimicrobial use, alternative approaches are required to reduce pathogen carriage in animals, and subsequent transmission to humans. One of the most potent defences animals have against invading pathogens is their indigenous microbiome. This dense community of beneficial microbes provides a robust defence against incoming pathogens by outcompeting or killing them, thereby reducing their colonisation, disease-causing activity, and onward transmission. This has led to increasing interest in developing gut bacteria as “Live Biotherapeutics” and their associated bioactive products, as alternatives to antibiotics.

In short, it is paramount to further understand the role of zoonotic pathogens in the dual crises of foodborne pathogens and antibiotic resistance and to identify novel avenues for interventions to reduce the incidence of foodborne disease derived from pathogens and AMR transmission from the environment.

Scotland’s future landscape will look very different having to accommodate increased urban spread, larger areas of afforestation and peatland restoration. Simultaneously, there is an immediate necessity to produce our food in the most efficient and environmentally friendly way possible, but mindful of restoring and enhancing important habitats for biodiversity. 

Mainstream agriculture will have to quickly adapt to incorporate novel crops with the potential to contribute to Scotland’s emission targets. We must also identify opportunities for nature-based solutions as they could be pivotal in mitigating and adapting to climate change whilst restoring nature. Within this, there is a role for underutilised semi-natural and urban land to contribute best practices for the provision of Scotland’s nutrition, while protecting our natural capital.

Delivering a sustainable food system requires ambition to think beyond domestic agriculture, more widely than from farm to fork. While contributing to the economy, people’s livelihoods, and the health of the nation, it must also contribute to the protection of Scotland’s natural habitats. Wild plants are naturally resilient to pests and climate fluctuation, their ability to grow on marginal lands necessitates a need to thrive in poorer soil, without additional water or energy requirements. Their productivity does not compare to domesticated crops developed to depend on high nutrient and pesticide demands. However, their role to support the food supply chain should be revisited. Furthermore, many species grow within much-needed wildlife habitats, an important example being forests, which will be an increasing feature of Scotland’s Landscape.

Cultivation of wild plants is achievable across much of Scotland’s lands, particularly semi-natural lands, but also underutilised urban and coastal areas. It is amendable to scale providing opportunities from small independent producers to commercial scale on land not currently suitable for mainstream domestic agriculture. The wide range of species presents opportunities for unique locations, supporting a wide range of both rural and urban communities. Incorporation of wild plants into the food supply would not only supplement nutritional requirements but would help relieve part of the demand placed on a limited variety of crops to supply nutrition, which is undesirable from both a food security and biodiversity perspective.

In Scotland, climate change is expected to increase both the average temperature and the variability in precipitation patterns. These changes will increase the frequency of both drought and waterlogging events, with disproportionate effects on susceptible crops. Changes in soil water availability will impact and interact with nutrient availabilities; reductions in nutrient inputs to minimise agricultural greenhouse gas emissions will require crops that can cope with the reduced availability of key nutrients. In addition, the changes in cloud cover bought about by changing weather patterns will impact light quality which will have a profound effect on crop quality, particularly berries. Many of these stresses have been studied in isolation, but rarely have they been considered in an integrated way.

Increasing temperatures in Scotland are likely to alleviate the limiting impact of minimum temperature for growth for many crops and when combined with elevated carbon dioxide in the atmosphere, may create an opportunity to enhance the sustainability of production. However, this will only be possible if genotypes and cropping systems can cope with the allied abiotic stresses and nutrient limitations. While agricultural intensification has successfully delivered food and fuel, it has simplified agricultural landscapes, reducing biodiversity, depleting natural resources, and threatening ecosystem services. This loss of diversity might also reduce resilience to abiotic stress, creating uncertainty about the effects of changing climate on agricultural production and environmental degradation.

There are still major gaps in our knowledge about how crops respond to environmental stress scenarios. Perennial fruit crops are grown in significant quantities in Scotland and beyond and have strategic importance because of their high value, health-related attributes, and their potential environmental benefits from being long-lived crops. It is becoming increasingly difficult for growers to schedule varieties for optimum harvest with predictable yield. We need to understand the genetic, epigenetic, and environmental drivers controlling key developmental traits that impact yield.

With a value of around £14 billion each year, the food and drink industry is a significant contributor to the Scottish economy. This significant capacity has underpinned Scotland’s reputation as a land of high-quality, healthy food and drink. All of this has helped formulate Scotland’s Food and Drink Ambition 2030, which aims to double the value of the food and drink sector by 2030 to £30 billion. 

The increasing problems of climate change, in terms of long-term basic environmental change and increased weather extremes, are making production increasingly challenging. The challenges of adaptation and mitigation have seen the sector pull together to both maintain output whilst reducing emissions. This recognises Scotland’s commitment to reduce baseline greenhouse gas (GHG) emissions by 75% by 2030 and transition to net zero by 2045.

The drive to net zero was accelerated by the update to the Scottish climate change plan with the associated potential to transform the agricultural and food production system. At the same time, it is well recognised that GHG emissions from agriculture and related land use accounted for 24% of the total emissions in 2017, down 29% from the baseline levels of 1990. This is complemented by and aligns with, the circular economy strategy for Scotland which aims to progress toward resource efficiency and zero waste and has an immediate target of cutting food waste by a third by 2025. Tansforming the sector will require the adoption and application of low-emission technologies throughout the whole sector, maximising efficiencies, and outputs, minimising inputs and taking advantage of precision farming.

Vertical farming (VF) is an emerging food manufacturing process with the potential to change the way food is produced and distributed in rural and urban environments. It allows food to be produced reliably and can significantly reduce the need for resource inputs and minimise the production of waste. Additionally, VF facilities can be located anywhere which reduces pressure on agricultural land use and allows food production to potentially take place closer to consumers thereby shortening supply chains and reducing transportation requirements. However, if this technology is to be more widely adopted there is a need to establish associated baseline energy use, GHG emissions and inputs/outputs, which will be explored in this case study.