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STRATEGIC RESEARCH AGENDA [draft]

Joint Programming Initiative

A Healthy Diet for a Healthy Life

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Foreword

For the Joint Programming Initiative it took significant time to get up to speed. New partners from

different backgrounds, who were not used to work together, realised that to achieve their combined

vision collaboration, but foremost trust, was essential. In the past 10 years they agreed on a

common vision, developed a strategic research and innovation agenda (which has been regularly

updated since), two implementation plans on which they delivered, invested in over 14 joint actions

(with, but mostly without support, from the EC) and used a wide variety of instruments in these joint

actions (knowledge hubs, data sharing, training activities, joint calls, aligning research and policy,

etc.). The work and achievements of the JPI are of great interest. The website for instance has over

30.000 unique visitors from many different countries and there is interest from new countries to

join. Twenty-three of the 26 countries involved in JPI HDHL have participated in at least one Joint

Funding Activity and 14 in 3 or more funding activities. The results of 8 Joint Funding Activities (3 are

still in the decision making process at the publication date of this report) are 3 Knowledge Hubs and

25 research projects involving more than 200 research institutes in Europe and beyond [to be

updated at time of publishing SRA]. At this date, the research activities resulting from the first Joint

Actions of JPI HDHL have come to an end and provide a first example of the output and outcomes of

these investments. Great progress has been made in improving assessment of food choice drivers, of

objective food intake measures and of assessing the health effects of foods. A concrete example of a

JPI HDHL investment is the DEDIPAC Knowledge Hub, bringing together a multidisciplinary

consortium of over 300 scientists from 68 research centres from many different disciplines in 13

countries across Europe and working towards improving methods and insights regarding the causes

of the causes of chronic disease. Concrete results are an overview of the quality of measurement

methods for diet, physical activity, and sedentary behaviours summarised in an online toolbox;

overviews of the scientific state of the art in the determinants of dietary, physical activity and

sedentary behaviours; A toolbox to assist in the development, implementation and evaluation of

interventions and policies and the first steps towards cross-European surveillance with a detailed

roadmap.

This 2.0 version of the Strategic research agenda of JPI HDHL builds on the second edition of the

SRA, published in June 2015. The principle objective of the updated Strategic Research Agenda is to

attain greater integration of research within the realm of the Joint Programming Initiative “A Healthy

Diet for a Healthy Life” (JPI HDHL) to strengthen and improve the impact of research conducted

within the European Research Area (ERA), in collaboration with our international colleagues. Whilst

the overarching principles of the previous agenda remain, the research pillar model has been revised

in order to further the objective of greater integration.

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Content 1 Introduction .................................................................................................................................... 5

1.1 The Joint Programming Initiative A healthy diet for a healthy life ............................................... 5

1.1.1 The concept ............................................................................................................................ 5

1.1.2 Strategic goal, vision and science-policy interface ................................................................ 6

1.1.3 The model .............................................................................................................................. 6

1.1.4 This agenda ............................................................................................................................ 7

1.2 The societal challenge; the adverse effects of diet on health/ the rise in chronic diseases ........ 8

1.2.1 Sustainable Development Goals and the Rome Declaration of Nutrition ............................. 9

1.2.2 Whole Food System Approach ............................................................................................. 10

1.2.3 Why research & innovation is crucial to tackle the societal challenge ................................ 11

2 Area 1: Health for our Citizens ...................................................................................................... 13

2.1 Measurement & Understanding ................................................................................................. 13

2.1.1 Improvement in dietary and PA assessment towards standardised monitoring ................ 14

2.1.2 Prediction tools for health-related behaviours and their effects ........................................ 14

2.1.3 Analysis of social health inequality ...................................................................................... 14

2.2 Policy & Behaviour change ......................................................................................................... 14

2.2.1 Mechanisms of behaviour change/Nudging ........................................................................ 15

2.2.2 Strategies to reduce sedentary behaviour ........................................................................... 15

2.2.3 Healthy environment for healthy choices ............................................................................ 15

2.2.4 Implementation and evaluation strategies for effective intervention and policies ............ 15

3 Area 2: Food Systems : Food value chain for future healthy products ........................... 17

3.1 Sustainable and healthy foods ............................................................................................. 18

3.1.1 Sustainability and long term impact of diets ............................................................. 19

3.3.2 Transdisciplinary research on new and known bioactives and food sources .... 19

3.2 Understanding nutrient utilization and metabolism ...................................................... 19

3.2.1 Bioavailability of nutrients ........................................................................................... 20

3.2.2 Structure-function relationships of foods and effects of food processing ........... 20

3.2.3 Foodomics ......................................................................................................................... 20

3.3 Food Production for Personalised Health ......................................................................... 20

3.3.1 Development of "personalised nutrition" and respective products ..................... 21

3.3.2 Biomarkers reflecting food intake and health status .............................................. 21

3.3.3 Reformulation of foods .................................................................................................. 21

4. Area 3: Health and Diet-related Disease ....................................................................................... 22

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4.1 Malnutrition/Over-nutrition and contributing lifestyle factors ............................................ 23

4.1.1 Identification of mechanisms underlying malnutrition/over-nutrition ............................... 23

4.1.2 Prevention of unhealthy weight gain and obesity during childhood ................................... 23

4.1.3 Obesity prevention in adults ................................................................................................ 24

4.1.4 Define healthy diet for specific (vulnerable) target groups ................................................. 24

4.2 Adverse Reactions to Food ......................................................................................................... 24

4.2.1 Mechanisms of adverse reactions to food ........................................................................... 24

4.2.2 Prevention of food intolerances and allergies ..................................................................... 25

4.3 The Physiology of Food Behaviour .............................................................................................. 25

4.3.1 Nutrition and Chronobiology ............................................................................................... 25

4.3.2 Dietary influence on regulation of food intake .................................................................... 26

4.3.3 Gut-brain axis ....................................................................................................................... 26

5 Overarching issues & enabling interconnectivity ......................................................................... 27

5.1 Research Infrastructure for food, nutrition & health ................................................................. 27

5.1.1 Towards a Research Infrastructure ...................................................................................... 27

A future proof Research infrastructure ........................................................................................ 28

European Food and nutrition research infrastructure ................................................................. 28

Future needs ................................................................................................................................. 28

5.1.2 FAIR data Principle ............................................................................................................... 29

5.2 Dissemination: communication, knowledge and technology transfer to enhance impact ........ 29

Improve education, training and scientific career development, in collaboration with

stakeholders .................................................................................................................................. 30

Open access policies ..................................................................................................................... 30

5.3 Structuring the landscape: integration and synergies among networks and initiatives ............ 30

5.5 Key players .................................................................................................................................. 32

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1 Introduction

1.1 The Joint Programming Initiative A healthy diet for a healthy life

1.1.1 The concept

The Joint Programming Initiative A Healthy Diet for a Healthy Life (JPI HDHL) is an established

collaboration of 26 countries1 within and outside of Europe. A Joint Programming Initiative (JPI) is a

European process by which Member States engage on a variable-geometry basis in defining,

mapping, developing and implementing an agreed vision document with a common Strategic

Research Agenda (SRA) to address major societal challenges that no individual Member State is

capable of handling independently. The JPI HDHL focuses on research in the area of food, nutrition,

health and physical activity to help prevent or minimize diet-related chronic diseases. Within the JPI

HDHL, governments are collaborating voluntarily to increase the impact of research investments that

provide insights to work towards healthier societies.

In the context of the JPI “A Healthy Diet for a Healthy Life” (JPI HDHL), trans-disciplinary expertise,

knowledge, facilities and approaches, ranging from blue sky research to large population studies and

controlled trials, are needed to investigate the relationship between diet, physical activity and

health. In addition, there is a need to examine the influence of genotypes, individual genetic and

epigenetic differences, dietary patterns and lifestyles, including their interactions and changes over

the time, on health and disease susceptibility and morbidity. The JPI HDHL:

Stimulates national alignment and inter-ministerial exchange on the national level

through exchange between the JPI Member Countries and the development of

supporting materials to put the topic of R&I in food, nutrition and health on the national

agenda as well as through active participation in member state driven initiatives at a

European level.

Funds regular transnational competitive calls for proposals, knowledge hubs and other

networks in the three pillars of JPI HDHL.

Supports the development of the needed Research Infrastructure on Food, Nutrition &

Health by investment in identified gaps/ needs. The aim is to move towards such

activities as the standardisation of methodology and terminology in the different

scientific disciplines connected to the Nutrition & Health Challenge.

Invests in the policy – science and stakeholder-science dialogue by capacity building,

through network events and by implementing these principles in our own procedures –

for example, stakeholder involvement at the level of strategic programming,

communication activities and defining criteria for call for proposal.

Communicates and disseminates scientific results as well as scientific needs through

scoping workshops, strategic workshops, intergovernmental workshops, projects

workshops, and the international JPI HDHL conference every second year.

The country representations is handled via the Management Board in which representatives from

national governmental bodies like ministries of health, agriculture and science and science councils

1 Austria, Belgium, Canada, Cyprus (observer), Czech Republic, Denmark, Estonia (observer), Finland, France, Germany, Ireland, Israel, Italy,

Latvia, Netherlands, New Zealand, Norway, Poland, Romania, Slovenia (observer), Slovakia, Spain, Sweden, Switzerland, Turkey, UK.

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take seat. The management board meets 2 to 3 times per year and is supported by a secretariat as

well as two boards, a scientific and a stakeholder advisory board.

1.1.2 Strategic goal, vision and science-policy interface

The strategic goal of the JPI is to change dietary patterns based on developments in food-,

nutritional-, social- and health sciences and to develop evidence-based recommendations and

innovative product formats that will, together with concomitant changes in physical activity, have a

major impact on improving public health, increasing the quality of life and prolonging productive life.

The vision of the JPI A Healthy Diet for a healthy life is that by 2030 all citizens will have the

motivation, ability and opportunity to consume a healthy diet from a variety of foods, have

healthy levels of physical activity and that the incidence of diet related disease will have

decreased significantly.

The global dimension of JPI HDHL is strengthened through the connection with global political

commitments set by the UN (SDG) and WHO/FAO (Rome declaration on Nutrition) and by working in

collaboration with research funders globally to tackle this global societal challenge.

1.1.3 The model

The Strategic Research Agenda is structured into three areas (see Figure 1):

Area 1 : The citizen

Area 2 : Food systems

Area 3 : Health and Disease

In area 1, the Citizen, the citizens’ role is highlighted from the health perspective, as well as

appreciating that that citizen is also the consumer. Food Systems in Area 2 strives to encompass

primary food production, food processing and technological innovations towards availability of

healthier food, with more healthful food product choices being the objective. Health and Disease in

Area 3 is intended to focus on if, when and how diet and food consumption together with healthy

levels of physical activity can promote or maintain health for a longer time by attenuating disease

risk as well as disability and/or reversing modifiable risk factors of the common diet-related non-

communicable diseases.

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Figure 1: New schematic model of the research areas of the JPI HDHL

Interconnectivity of the research areas

Interconnectivity between traditionally distinct research areas is a strategic objective of JPI HDHL. Bi-

directional integration of knowledge and research capability between Area 1 Citizen and Area 2

Food Systems will advance HDHL research capacity and impact. For example, greater understanding

of health behaviours within countries will not only improve understanding of how best to re-

configure behaviour change interventions to enhance healthful dietary practices and physical

activity, but will also highlight gaps in the provision of food options by the food industry. More

exchange of knowledge and research understanding into Area 3 Health versus Disease from Areas

1 Citizen and 2 Food Systems is key in order to maximize translation of funded research. For

example, nutrition and health research tools from Area 3 need to be more widely available to the

food technology and food processing areas of the Food System. This will ensure that we can utilise

state-of-the-art platforms to define the potential efficacy of novel food products or to improve

existing foods and increase our capabilities to substantiate food claims that can support public

agencies such as the European Food Safety Authority.

1.1.4 This agenda

The Strategic Research Agenda is adopted by all the JPI HDHL member countries. The aim is that the

SRA not only serves as a foundation for the joint goals, objectives and strategies of the joint activities

on the level of JPI HDHL, but that national goals, objectives and strategies of the JPI HDHL member

countries will also be based on the Strategic Research Agenda to promote greater alignment with

this topic. Although the Strategic Research Agenda is written from the perspective of the JPI HDHL

member countries, this document could guide other governments, national and international non-

governmental organisations as well as the industry to advance the research in the areas of food,

nutrition and health.

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1.2 The societal challenge; the adverse effects of diet on health/ the rise in chronic diseases Many, if not all, countries struggle with both the societal and economic consequences of the

alarming rise in non-communicable diseases, such as cardiovascular diseases, diabetes, cancer and

chronic respiratory diseases. High blood pressure, overweight and obesity, hyperglycaemia and

hyperlipidaemia are four key metabolic/physio-pathological alterations increasing the risk of chronic

diseases. Unhealthy dietary habits and low levels of physical activity are known to cause

dysregulation of these sets of metabolic risk factors. Therefore, the promotion of healthy lifestyles

with better diets and increased levels of physical activity is of utmost importance for prevention of

the onset of diet-related chronic diseases in Europe and beyond. The trend however, which no

country has yet been able to reverse, is that an increasing amount of people consume an unhealthy,

unbalanced diet which puts people at health risk. At the same time, in many countries the

population is ageing and this increases the incidence of malnutrition, including underweight and

micro deficiencies in the growing older population. The double burden of malnutrition (DBM),

refered to by WHO, is characterized by the coexistence of undernutrition (stunting, wasting, vitamin

and mineral deficiency) along with overweight, obesity or diet-related non communicable diseases,

within individuals, households and populations, and across the life-course. The developmental and

economic impacts of this double burden are serious and lasting, with low and middle income

countries bearing the greatest burden. The DBM is united by shared drivers and solutions and

therefore calls for integrated nutrition action.

“Nearly 800 million people remain chronically undernourished and 159 million children under 5

years of age are stunted. Approximately 50 million children under 5 years are wasted, over two

billion people suffer from micronutrient deficiencies and 1.9 billion people are affected by

overweight of which over 600 million are obese. The prevalence of overweight and obesity is

increasing in nearly all countries” (WHO, http://www.who.int/nutrition/GA_decade_action/en/).

In Europe 80 percent of the deaths and 77 percent of the burden of disease are related to diet

related non communicable diseases such as diabetes, cardiovascular disease and cancer. It is

estimated that about 26 percent of the deaths are premature, meaning that people died below the

age of 70.2 The associated costs of overweight and obesity are 1.2 trillion dollar per year globally

(McKinsey Institute, 2014) – taking into account direct and indirect costs like the associated health

care costs, loss of productivity and quality of life. In Europe about 50 percent of the citizens are

overweight and over 20 percent are obese (Eurostat, 2016?).

The battle against various forms of malnutrition is interconnected with other societal challenges, in

particular the effect of climate change on the food production and the impact of food production

and consumption on the environment. The earth’s capacity to provide us with food is being

stretched, especially when taking into account the potential impact of climate change on food

production. The European Academies Science Advisory Council has stated that “the desired outcome

of food and nutrition security is access for all to a healthy and affordable diet that is environmentally

sustainable.” (EASAC, 2017). As healthy and environmentally sustainable food are not necessarily the

2 WHO (2013) Global action plan for the prevention and control of non-communicable diseases 2013-202

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same thing, a diet that is both healthy and sustainable should be the logical focus for anyone

working on these challenges.

1.2.1 Sustainable Development Goals and the Rome Declaration of Nutrition

Since the start of JPI HDHL the political commitment to battle malnutrition has grown. In 2016 the

United Nation agenda “Transforming Our World: 2030 Agenda for Sustainable Development”,

adopted by 193 countries, was published containing 17 sustainable development goals (see Figure 2).

All 193 governments have committed to work towards comprehensive, integrated and universal

transformations. The vision developed in “Transforming our world: the 2030 Agenda for Sustainable

Development” (UN, 2015) is that of a world free of poverty, hunger, disease, and where all life can

thrive and where food is sufficient, safe, affordable and nutritious. This new agenda commits to end

hunger and to achieve food security as a matter of priority and to end all forms of malnutrition. In this

regard, UN reaffirms the important role and inclusive nature of the Committee on World Food Security

and welcome the Rome Declaration on Nutrition and the Framework for Action (see next page). It also

aims at promoting physical and mental health and well-being, and extending life expectancy for all.

Three of the seventeen Sustainable Development Goals presented in the agenda directly refer to the

societal challenge of diet, nutrition and health:

Goal 2. End hunger, achieve food security and improved nutrition and promote

sustainable agriculture

Goal 3. Ensure healthy lives and promote well-being for all at all ages

Goal 12. Ensure sustainable consumption and production patterns

Figure 2: Sustainable Development Goals

Though links with the diet related societal challenges are embedded within a great share of the 17

SDGs. Ban Ki-moon, UN secretary General, phrased the key role of nutrition in the following

way:“Nutrition is both a maker and a marker of development. Improved nutrition is the platform for

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progress in health, education, employment, empowerment of women and the reduction of poverty

and inequality, and can lay the foundation for peaceful, secure and stable societies.”3

In parallel with the establishment of the Sustainable Development Goals, the Rome FAO and WHO

Member Countries worked towards the Rome Declaration on Nutrition and Framework for Action,

which was first endorsed by 170 countries at the Second International Conference on Nutrition

(Rome 19-21 November 2014) and followed by the adoption of the United Nations General

Assembly via a resolution proclaiming the UN Decade of Action on Nutrition from 2016 to 2025. The

resolution aims to trigger increased action to end hunger and malnutrition worldwide, and ensure

access to healthier and more sustainable diets. Governments are invited to set national nutrition

targets for 2025 and milestones towards these targets, based on the agreed indicators. The FAO and

WHO have been pointed out by the UN resolution to lead the implementation of the so called

‘Decade of Action on Nutrition’. The Framework for Action commits governments to exercise their

primary role and responsibility for addressing malnutrition (that is undernutrition including micro

deficiencies as well as overweight and obesity), to reverse the rising trends in overweight and

obesity and reduce the burden of diet-related non-communicable diseases in all age groups.

Through the above described declarations and commitments, the battle against malnutrition, the

recognition of the alarming raise of specifically overnutrition and the need for research and

innovation to play a significant role in providing solutions and insight in the interconnectivity with

other domains/ challenges such as climate change, have become increasingly prevalent on the

global political agenda.

1.2.2 Whole Food System Approach

In light of these global challenges and international policy developments the European Commission

calls for an integrated Food System Approach, to work towards multi-sectoral policy making and

governance to make agri- and aquaculture more nutrition-health sensitive and to make consumer

behaviour/demand more environmental/sustainable sensitive and highlights the crucial role of

Research and Innovation (Food2030EU, 2016).

Food systems encompass the processes and infrastructure needed to feed a population: growing,

harvesting, processing, packaging, transporting, marketing, consumption and disposal of food and

food-related items. As stated in the European Research & Innovation for Food and Nutrition Security

policy framework (FOOD2030EU, 2016), food systems should insure Food and Nutrition Security

(FNS) by providing safe and nutritious food for healthy and sustainable diets.

In the European context, the FOOD2030 policy framework defines four priorities:

Nutrition for sustainable and healthy diets

Climate smart and environmentally sustainable food systems

Circularity and resource efficiency of food systems

3 Delivered as a message for the SUN Movement Strategy and Roadmap (2016-2020)

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Innovation and empowerment of communities, with closer partnerships with industry and

food producers, and development and implementation of FNS relevant policies at all

geographical scales.

The importance of Research and Innovation to enable a transition to a sustainable food system is

underlined in the EC’s FOOD2030 staff working document. This requires multidisciplinary and

integrated approaches, engagement of stakeholders and as well as the general public as well as

improved impact of R&I investments.

1.2.3 Why research & innovation is crucial to tackle the societal challenge

Research has increased our understanding of the links of diets and dietary components with health

and disease. Evidence from this research has informed policy so that governments, health agencies,

communities and individuals can take action to impact on dietary intake to move towards a more

healthy and sustainable diet and to reduce the risk of early onset of chronic disease.

For instance:

In recent years, the presence of trans fatty acids has been reduced in processed food, since

it was demonstrated that they increase the risk of cardio vascular diseases,

Governments advise consumers to limit their consumption of soft drinks and fruit juices,

because sugar sweetened drinks results in less satiety than solid sugar and increases the risk

of overweight.

A healthy diet and lifestyle can lead to the reduced occurrence of type 2 diabetes in at risk

individuals.

The importance of the food environment has been outlined as a major driver of intakes at

individual level. Science provided insight in the significance of the role of the food

environment on the dietary behaviour of individuals

However, there are still crucial gaps in our knowledge that, when filled in, will support policy-makers

to tackle the societal challenge of food, nutrition and health such as the need:

to better understand the interplay of biological, psychological, environmental and social

factors in the architecture towards a healthier diet and lifestyle,

for more insight on the relationship between diet and disease, e.g. the relationship between

diet components and several types of cancer,

to understand how to influence consumer behaviours, as science has shown that individual

interventions such as education about healthy/ sustainable food is not enough to change

behaviour,

to have more insight in the consequences of climate change scenarios on nutritional

composition of existing foods and the barriers/ opportunities for novel foods

how to develop and support multidisciplinary research actions for a better understanding of

the characterization of both a sustainable and health promoting diet as well as how to shift

dietary patterns towards such a more sustainable and healthy diet and lifestyle.

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Such knowledge-based research and innovation should work in conjunction with regulatory and

governance actions. For example, to feed into both health and sustainability aspects in dietary

guidelines, to address behavioural interventions in a more holistic way and have a tight connection

between knowledge needs for food safety regulation in parallel with boosting the development of

novel food.

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2 Area 1: Health for our Citizens To reach the vision of the JPI HDHL it is crucial to understand the most effective ways of improving

public health through interventions targeting diet and physical activity and to understand the

bottlenecks preventing citizens from choosing a healthy lifestyle. Research in this area will include

studies which aim to improve understanding of the different behavioural, biological, psychological,

motivational, environmental and socio-cultural factors that impact on health and the consumers’

food and physical activity choices, and how they interact. The basis for a profound understanding of

certain health-related behaviours is a comprehensive and reliable measurement of these

behaviours.

To measure and understand (chapter 2.1) health-related behaviours it is important to not only look

at the individual level but also at group level influences like the obesogenic environment. In

particular, dietary behaviour is not only driven by the personal motivation but also by the food

environment and the availability of affordable healthy and tasty foods which closely links this

research area to Area 2. The same is true for physical activity since the way the environment is built

strongly influences the likelihood for an active health-promoting lifestyle. Further, the systematic

and consistent measurement of physical activity and diet will also provide a strong data basis for the

interpretation of the influence of different health-related behaviours on various health outcomes.

These analyses will generate new evidence to develop effective strategies to prevent the citizens

from several non-communicable diseases and thus providing a strong link to Area 3.

Area 1 will deliver information to allow the effective development and implementation of evidence-

based interventions and policies to positively affect behaviours (chapter 2.2), also accounting for

and minimizing the existing social inequalities. Thus, the research results generated in this area will

be of importance for policy makers, professionals in the public health area as well as the food

industry thus contributing to maintain or improve health for all citiziens in Europe and other

Western countries.

2.1 Measurement & Understanding The systematic and consistent measurement of physical activity and diet across the Europe is a

valuable basis for other work in this research area (e.g. examining differences in socio-economic

status (SES), changing behaviours, informing policy makers) and beyond (e.g. understanding impact

on health). Detailed and reliable assessment of diet and physical activity is critical in terms of

understanding them as key determinants of health.

However, the intention of the JPI HDHL is to push this knowledge to the next level to go beyond

understanding and measuring health-related behaviours, towards action by also investing in tools

and methodologies to better predict health-related behaviours. This research area will benefit from

the recent availability of new valuable sources of information, which can be classified as “big data”,

e.g. the access to home scan and retail scan data on food purchases.

Given the unequal distribution of health and well-being across Europe and within national

populations, a sound data basis and more research is needed to inform policy with respect to the

impact of social inequality on health and understand the economic and social drivers that affect

dietary choices and physical activity. A better understanding of health-related behaviours in

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different vulnerable groups by comprehensive measuring and evaluation of existing programmes

helps to better design effective interventions and thus to move “from evidence to action”.

2.1.1 Improvement in dietary and PA assessment towards standardised monitoring

The 1st joint action funded by the JPI-HDHL “Knowledge Hub on Determinants of Diet and Physical

Activity” (DEDIPAC KH) has provided some guidance about harmonized assessment of dietary,

physical activity and sedentary behaviour across the life course in Europe by standardizing

methodologies and avoiding redundancy. Building on these results as well as on new available data

sources, i.e. “big data” like food purchase data or geographic information systems (GIS) data, new

(ICT) tools and technologies need to be developed and validated to improve and standardise the

assessment of these health-related behaviours.

2.1.2 Prediction tools for health-related behaviours and their effects

There is a lack of validated predictive tools or models of interdisciplinary determinants of diet, food

choice and physical activity as well as sedentary behaviour and a healthy body weight. In particular,

knowledge about the role and effects of economic determinants is scarce. Since large controlled

trials are not possible in this field for feasibility or ethical reasons, there is a need for theoretical

models to predict effects of certain behaviours or changes in these behaviours.

2.1.3 Analysis of social health inequality

Data to quantify health inequalities and variations in health determinants across different

socioeconomic and minority groupings are limited. Both health and health behaviours (diet and PA)

are unequally distributed across socioeconomic positions and the reasons for this and implications

from this need to be better understood. Research should concentrate on the effects of interventions

on such inequalities with a particular focus on intersectionality in order to ensure that gaps are not

widened and are preferable narrowed.

2.2 Policy & Behaviour change Health behaviour change is one of the most important elements of chronic illness prevention and

management; therefore key factors at the individual level, as well as societal and environmental

drivers must be assessed with a view to understanding the status quo to ensure the implementation

of effective policies. Therefore, it is necessary to understand the full pathway from research

evidence to policy to behaviour change to health impacts.

Mechanisms of behaviour change range from both controlled and automatic influences on

behaviour and are still underexplored in the field of nutrition and physical activity. With a deeper

understanding of the behavioural landscape research can focus upon behavioural change strategies

to improve day-to-day and long term health through better dietary choices, more physical activity

combined with less sedentary behaviour through an improved built environment and foodscape.

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Thus, more attention must be given to finding effective strategies to increase people’s motivation,

abilities and opportunities to make healthy choices. Thus, future research needs to explore how

citizens can be motivated to change their health-related behaviours. This certainly does not only

relate to motivating the individual to change his or her behaviour but also to change the food and

nutrition as well as the built environment to ‘nudge’ people towards more healthy choices.

There is a need for research on implementation strategies and governance issues and the basis for

public decision making. It is not unusual for health-promotion interventions on a large scale (i.e.

national policies) to be dismissed for showing only limited effects. The problem is that the current

data and the nature of some of these policies do not really allow for a rigorous assessment of their

long-term consequences. Research could try to address these gaps, by setting up long longitudinal

studies that could capture the longer-term effects of policies.

2.2.1 Mechanisms of behaviour change/Nudging

Besides rationally controlled processes, human behaviour is to some extent governed by an

automatic system which responds to environmental and social cues, in a way that requires very little

conscious engagement. The concept of ‘nudges’ in shaping human behaviour acknowledges the

importance of the automatic system referring to small changes in the physical or social environment

that make specific behaviours more likely. Understanding the combination of both mechanisms of

change could help elucidate where best to target interventions.

2.2.2 Strategies to reduce sedentary behaviour

So far, little attention has been paied to strategies to reduce sedentary behaviour, although this has

lately been recognised as a separate important modifiable risk factor contributing to risk of obesity

and associated diseases. Negative health effects of sedentary behaviours that are independent of

physical activity are increasingly recognized and there is a pressing need to gain more insight in the

health effects of sedentary behaviour and to develop suitable strategies to prevent people from

spending more time sitting.

2.2.3 Healthy environment for healthy choices

Quite a lot is known about the influence of the built environment on physical activity whereas the

role of the food environment is more elusive, and the combination of the two is rarely addressed.

One of the reasons is that these two fields belong to different disciplines (i.e. physical activity

sciences and diet/nutrition) and still need to be further integrated. A key challenge is the integration

of group level influences like the built environment and individual influences like attitudes.

2.2.4 Implementation and evaluation strategies for effective intervention and policies

With DEDIPAC and PEN the JPI HDHL has initiated two important knowledge hubs to overcome the

current barriers for the implementation and evaluation of intervention and policies. Building on their

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work, best practice recommendations for new large scale interventions and evidence-based policies

need to be implemented and evaluated with appropriate standard measures to ensure efficacy.

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3 Area 2: Food Systems : Food value chain for future healthy products

Ensuring access to nutritious, sustainable, safe and affordable food for all citizens is crucial to deliver

on the vision of JPI HDHL. For this challenge, the whole food system needs to be taken into account,

spanning from primary production, through to manufacturing, processing and delivering to

preparation and cooking prior to consumption. In a holistic food value chain approach this wide

range of different factors that affect the availability and quality of food products on the market is

integrated and accounted for.

Supplying health-promoting diets for all citizens requires trans-disciplinary dialogue and the

exploration of current and emerging knowledge that is generated in food, health and consumer

research, taking into account all steps of the value chain.

The first step in this process is the supply of sufficient and highly quality raw materials and bioactives

for food production. For the long-term satisfaction of this need, the sustainability of the food

system (chapter 3.1), both with regards to environment and social acceptability is key. The impact of

the human on natural resources and the climate of which he himself is a victim, leads to conflicts

jeopardizing common goods such as the environment and biodiversity. Moreover, social and

economic disparities initiate regional conflicts and migration. A sustainable food system therefore

impacts a wide range of issues within the food value chain, such as security of the supply of raw

materials, known and new bioactives, health, affordability, a strong food industry in terms of jobs

and growth and, at the same time, environmental sustainability, in terms of climate change,

biodiversity, water and soil quality.

Further along the food value chain, the development of high quality food products and the

improvement of their health-promoting effects are crucial to meet the overall objective of supplying

nutritious food for all citizens. For this, more research is needed to provide a better understanding

of the way the food is metabolized in the body and how nutrients are being made available for

absorption (chapter 3.2). Based on this knowledge a more targeted design, production and/or

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processing of foods will be possible, influencing for example satiety effects or specific metabolic

aspects.

Importantly, research evidence shows large individual variations in nutritional status and metabolic

pathways, which strongly affect the personalised risks and benefits of new food products (chapter

3.3). In fact, inter-individual variability in responses to any nutritional intervention with food

products is a huge challenge. Typically 40% of a target cohort will respond in the expected direction

but 60% will not. Thus, a better understanding of these determinants is necessary to enable the

development and production of food products that meet the consumers nutritional, sensory, health-

and lifestyle-related needs. Knowledge from Area 3 can be drawn to understand if, how and why

sub-samples of populations respond positively, or not, to new food reformulations with regard to

health. In addition, knowledge obtained in Area 1 on the determinants influencing citizens’ health

behaviour and food choice is crucial for consumers’ acceptance and their willingness to buy such

products, and therefore essential for the development of successful new healthy food products.

3.1 Sustainable and healthy foods

Ensuring sufficient safe, nutritious and high-quality agricultural materials for direct consumption or

food production at an affordable price is a growing challenge. The change of the earth’s climate,

accompanied by a rise of the global temperature and increasing water shortage, has a highly

significant impact on all components of both the global and the European agricultural system. Vice

versa, the food system has a considerable impact on the climate and the depletion of natural

resources. This is further aggravated by a growing food demand, changing dietary patterns and the

increasing amount of food waste in all stages of the production chain.

There is the need for healthy dietary concepts that are consistent with sensory and lifestyle-

related needs, and at the same time are sustainable, both with respect to economic and

environmental aspects. In particular, the investigation of the affordability, availability and consumer

acceptance of healthy and sustainable foods demands more research efforts. For this, a trans-

disciplinary dialogue will be fostered to better understand the collective impact of economic and

environmental factors on the production levels and market prices of health-promoting foods

including fruit, vegetables and seafood. This activity requires close collaboration with other

stakeholders and initiative, in particular JPI FACCE.

The better utilization of raw food material (animal and plant) is a particularly important factor for

meeting the challenge of depleting natural resources. So far, inadequate scientific evidence of

positive or negative health effects of not yet established food sources (i.e. insects, algae) is among

the limiting factors. Particularly new marine bioactives are unexplored and underutilized as a food

source. Huge amounts of residual raw materials from our global fisheries are today wasted, but

might have potential as food ingredients. Generating more evidence on health effects from new

and known bioactives and their effect in food matrices requires a transdisciplinary approach

involving nutritional scientists, physicians, and food engineers. Different actors in the food value

chain and relevant research disciplines might together contribute to a higher usage of underutilized

food resources and increased knowledge in food technology.

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3.1.1 Sustainability and long term impact of diets

More research is needed to investigate the availability, affordability, acceptance and consumption of

healthy, sustainable eating patterns. For example, there is a growing recognition that a diet

characterised by a low environmental impact, i.e. low animal and more plant-based diet, is generally

consistent with current dietary recommendations and guidelines. In contrast, the average Western

diet with high intakes of meat, fat and sugar is a risk for individual health, social systems and the

environmental life support systems. In addition, food safety is also part of a sustainable diet and

therefore environmental pollutants in our food (and their up-concentration during processing) and

their potential negative health effects need further investigation.

3.3.2 Transdisciplinary research on new and known bioactives and food sources

From a sustainable point of view, the global shortage of specific bioactive ingredients, such as

marine n-3 fatty acids, needs a transdisciplinary approach for future sustainable solutions by

modulation of other animal feed. In addition, there is also too little knowledge on the effects of n-3

fatty acids from plants and algae and whether they could provide similar health effects.

3.2 Understanding nutrient utilization and metabolism

Digestion can be described as a complex system of “chemical and enzymatic processing of food” in

order to make nutrients available for absorption in the intestine. During the passage through the

gastrointestinal tract a core task of digestion is to extract nutrients such as proteins, fats,

carbohydrates, minerals, and vitamins from the food matrix or to solubilise the matrix so that the

nutrients can be transferred into the blood via different steps of material transport such as

convection by peristaltic or diffusion.

More research is needed to improve the understanding of nutrient bioavailability, including

nutrient release and/or transport from the inner section of a food until the delivery of nutrients to

the site of absorption or utilization. This knowledge will open a lot of opportunities for food design

to influence the kinetics of nutrient transfer what might have an effect on satiety and on different

aspects of metabolism. Further, if the effects of the food structure and food processing on

nutritional and sensory characteristics of foods would be predictable, food industry would be able to

more efficiently design new foods in a way that meets the nutritional and sensory demands of the

consumers. The emerging research field of Foodomics may facilitate this process by developing

methodologies to screen and better characterize the composition of foods in contrast to the field of

food metabolomics that cover the metabolic changes in humans following food intake. This new

area helps to improve knowledge of food composition and quality and allows a range of fast, novel

screening techniques in food chemistry to support quality improvement.

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3.2.1 Bioavailability of nutrients

To facilitate the rationale design of foods and to improve the knowledge of bioaccessibility and

bioavailability of nutrients the fate of food during digestion in the gastrointestinal tract is an

important aspect and is affected by a large number of factors. Though in vitro modelling of such

factors may provide relevant clues to in vivo behaviour, human intervention studies are needed

during and after product development to verify the optimized effect of the final products. This is also

particularly relevant for industry in order to develop targeted products to affect the human

metabolism (e.g. adoption of production conditions to enhance bioavailability).

3.2.2 Structure-function relationships of foods and effects of food processing

The structure and the physical and chemical properties of food matrices are primarily influenced by

the composition and the properties of the ingredients, the processing parameters and the storage

conditions used by the food industry. There is a strong need for a better understanding and/or

prediction of the effects exerted by these factors on nutritional characteristics as well as sensory and

health attributes of food in order to develop new and innovative foods. To respond to industry’s

requirements for a safe and standardised production, it is essential that the total processing chain is

considered.

3.2.3 Foodomics

Foodomics has already provided a fast expansion of the knowledge of food composition and

variability and the technology supports the ability to track changes in food composition during

production and processing. Additional knowledge will on the on hand support faster development of

food composition tables as well as the development of processed foods with minimal losses of

bioactive constituents. On the other hand, Foodomics will facilitate the untargeted exploration of

new food constituents, an area of importance for food authenticity, for biomarker development (see

chapter 3.3.2) and for novel development of healthy foods.

3.3 Food Production for Personalised Health

Traditionally, dietary recommendations have been set at the average population level. However,

current research is increasingly showing that the risks, benefits and nutritional requirements

strongly vary between different population groups and even individuals, depending on their genetic

or other characteristics. For example, European citizens generally consume too high levels of salt,

sugar and saturated fat. However, there are significant individual differences in tolerance levels of

these food constituents among consumers. More research is needed to better define these

individual differences in health responses to diets by validated, nutrition and health-related

biomarkers, using also research competences from Area 3. This will provide the basis for researchers

and the food industry to develop strategies for future personalized food products targeted to

specific consumers..

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The potential effect of food reformulation on food choices further links this chapter with Area 1.

Evidence-based, motivation strategies targeted to specific consumers subgroups to reduce the

hunger for palatable ultra-processed food as well as “unhealthy” food components such as

respectively salt, sugar, possible saturated fat and food additives could lead to change in behaviour

and improved health.

3.3.1 Development of "personalised nutrition" and respective products

Research is needed on the development of ‘personalised nutrition’, i.e., soundly-based specific

nutritional products for different population groups like the elderly, pregnant women, children and

other specific population groups, targeting the specific dietary and sensory needs and at the same

time assess routes of placement and target-group specific marketing.

3.3.2 Biomarkers reflecting food intake and health status

The effect of certain foods on health is difficult to assess as demonstrated from the many rejections

of proposed health claims by the European Food Safety Authority. Assessment could be achieved

through identification or development of a much broader palette of validated biomarkers. There is a

need for biomarkers determining the intake of specific nutritiens or food components (for example

by using food metabolomics) and to complement the more traditional dietary assessment

methodologies in Area 1. Further, biomarkers that reflect the nutrition-related health status at both

individual and group levels are crucial to demonstrate the health effects of certain foods.

3.3.3 Reformulation of foods

Research is needed to enable targeted reformulation of food products to improve their nutritional

and health quality and/or consumer acceptance by improving sensory aspects. These factors are

important for acceptance of specific consumer subgroups and their willingness to buy, and therefore

essential for the availability of a broad range of healthy food products on the market.

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4. Area 3: Health and Diet-related Disease

A healthy life for the citizens is the ultimate goal of the JPI HDHL. A longer and healthier lifespan

requires using integrated food, nutrition and physical activity interventions over the lifecourse that

maintain and maximally enhance health and delay the development of chronic diseases. Research

has shown that nutritional needs and physical fitness differ across the continuum from health

towards disease and throughout the lifespan.

There is growing evidence that early environmental exposures play a pivotal role for development

and health status later in life, possibly even affecting future generations. Beginning with maternal

health and nutrition during pregnancy and during early childhood, this metabolic programming leads

to permanent changes in physiology and metabolism, for example pre-disposing to obesity and

related diseases. Nutrition and physical activity both play important roles and may interact in

influencing metabolic programming. The same applies for cognitive development and the

maintenance of cognitive functions in later life, however the exact mechanisms how diet and other

lifestyle factors affect brain functions is still largely unknown. The complex interactions of nutrients,

eating and activity patterns and health status become more and more critical, especially with the

aging populations in Europe. A growing share of the elderly population is suffering from poor

nutrition, imbalanced energy intake and insufficient physical activity. Importantly, in this context

malnutrition not only refers to the lack of specific nutrients, but also overnutrition (chapter 4.1)

and excessive energy, increasing the risk for obesity and related diseases. Malnutrition plays an

important role on a whole variety of body functions and clinical outcomes, for example sarcopenia,

frailty and neuro-degenerative diseases. But also a well-balanced diet can cause negative health

effects for some individuals across all age groups. The fact that one third of the general population

suffers from adverse reactions to food (chapter 4.2) or believes to suffer from it, has not only

impact for the quality of life of the European citizens, but also an enormous impact on medical

resources (doctors consultations, repeated examinations) and lack of work, thus on economic

resources. Therefore, prevention of food intolerances and allergies must become a major goal in the

food and health policy across Europe.

Importantly, dietary intake and food behaviour is dependent on a complex interplay of various

physiological factors (chapter 4.3) that in turn affect the health status. For example, there is

growing evidence that that not only composition and quantity of foods, but also the chronobiology,

i.e. frequency of dietary intake and its interaction with the circadian timing are affecting health

outcomes over the life course. Further, current research shows that the regulation of appetite, body

weight and metabolic homeostasis by the central nervous system is being strongly influenced by

nutrients and nutrient-related signalling, also involving the gut and its interaction with brain

functions. The complex interrelations between diet and neurological and cognitive performance

significantly impact overall health and well-being in various life stages, although this relationship is

still relatively poorly understood. However, physiology is certainly not the only key factor in the diet-

disease relationship. Importantly, lifestyle is to be viewed as an integration of individual health

behaviours, including diet, physical activity, sedentary behaviour, thereby exhibiting close links to

Area 1. Such an integrated approach also includes the food environment, especially the availability

and accessibility to healthy and safe food products that are meeting the special nutritional and

sensory needs of specific sub groups (Area 2).

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4.1 Malnutrition/Over-nutrition and contributing lifestyle factors

Malnutrition comprising all facets from micronutrient deficiencies to overnutrition and obesity is a

long-standing and highly relevant threat for nearly all societies all over the world concerning several

population groups differently. Although the lack of sufficient physical activity and an unbalanced

energy intake together with other associated lifestyle factors and the aging population are already

defined as the prime factors for mal- and overnutrition, there are still severe knowledge gaps on

other genetic or metabolic influences. In order to decrease this societal burden it is thus of utmost

importance to also gain more insight into the causes of and biological mechanisms that lead to

malnutrition and overnutrition.

Although in particular obesity is the type of malnutrition that is present during the whole life-course

it is important to investigate the potential causes and contributing lifestyle factors separately in the

different life stages and identify specific prevention strategies tailored to the metabolic state and life

circumstances in each age group . Although the prevention of childhood obesity has been

prioritised in many research agendas all over the world, only little progress has been made so far in

finding effective strategies. In particular, more knowledge in pre-natal and early childhood

programming needs to be gained to make progress here. To further advance these research efforts

into a life course approach it is also important to draw attention to specific vulnerable groups of

adults to prevent them from obesity in particular during life-changing transitions which have not

been so much in the focus of research so far.

A promising approach how to tackle the wide-ranging forms of malnutrition is the development of

“precision nutrition” based on the specific definitions of a healthy diet for different target groups

rather than the “one size fits all”-approach that was used during the last decades and did not prove

to be successful. Successful strategies for reducing obesity rates must target all age groups and use a

life-course approach by combining knowledge and expertise from all three research areas of the JPI

HDHL.

4.1.1 Identification of mechanisms underlying malnutrition/over-nutrition

There is the need for more advanced technologies allowing to study the effects of diets on each level

along the flow of biological information from the genome to the transcriptome, proteome and

metabolome and, thus, the human phenotype. When embedded into the different life stages this

research can identify relevant mechanisms or pathways to improve assessments of disease risk and

provide new knowledge for preventing or even treating those diet-related diseases.

4.1.2 Prevention of unhealthy weight gain and obesity during childhood

In order to prevent excessive weight gain during infancy and childhood it is crucial to understand the

importance of early environmental exposure for development of obesity, diabetes and othe related

disease sooner or later in life. These research results will help to optimise foetal and early postnatal

development.

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4.1.3 Obesity prevention in adults

Research on maintaining a healthy body weight and preventing weight gain as well as a deeper

understanding of obesity mechanisms across the life-course, especially in adulthood is an under-

researched area, whereas the period of childhood has been given lots of emphasis in recent years.

The key age group and moment for changes in health behaviours (linking this chapter to Area 1) are

“middle agers” (30-60 years of age), because obesity prevalence increases strongest in this group

and finally affects health during the retirement period (especially considering the aging of the

European populations).

4.1.4 Define healthy diet for specific (vulnerable) target groups

Understanding the complex food-gut-metabolism interactions and their impact on the health and

risk status of specific subgroups in the population (i.e. those in critical life periods such as pregnancy,

lactation, infancy, childhood and old age) or even individuals are an important prerequisite for the

development of more targeted dietary recommendations in the continuum from health to disease.

4.2 Adverse Reactions to Food For the most part, food intake has positive impacts on the body providing energy and nutrients, as

well as healthful energy-free food components. However, adverse reactions to food are rapidly

increasing and affect in the meantime about one third of the general population. In particular, food

intolerance is a growing issue, but also food allergies steadily increase. Therefore, JPI HDHL seeks to

underpin approaches that can define the extent to which food reformulation, food processing and

eating habits can attenuate the risk of adverse reactions to food. Adverse reactions to food include

immune-mediated food allergies as well as non immune-mediated food intolerances. In particular

for the latter, not all of the reported symptoms are an inevitable proof for food intolerance;

therefore it is hard to estimate how many people are truly affected. There is a strong need for a

better understanding of the underlying mechanisms of adverse reactions to food in their different

forms. Further, more research is needed to understand and identify potential allergens. This

knowledge will provide a crucial basis for the development of targeted prevention strategies for

food intolerances and allergies. These could include the adaption of production processes and food

processing to avoid possible hazards and/or food reformulations as well as the development of new

foods to attenuate the risk of food intolerance.

4.2.1 Mechanisms of adverse reactions to food

The underlying mechanisms of adverse reactions to food need to be further unravelled. In the

medical field, great efforts have been made to understand the hosts reactions to particular food;

however, this approached did not allow to curtail the high prevalences of food intolerances and

allergies. In contrast, the food itself was rather poorly investigated. In particular, effect of breeding,

processing, and food additives need further investigation.

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4.2.2 Prevention of food intolerances and allergies

The growing number of patients with adverse reaction to foods calls for more trans-disciplinary

research efforts to develop a better understanding of the underlying mechanisms of the various

forms of food intolerance and food allergies. Based on this prevention strategies can be developed.

For example, by involving industry partners the usage of potential allergens during food production

for technical reasons and other biochemical and microbiological hazards in foods need to be

identified and this knowledge can then be applied in the development of new food products.

4.3 The Physiology of Food Behaviour

Food behaviours including food choice and intake control are highly complex processes that are

influenced by a variety of physiological factors, which in turn affect the individual health status.

For example, there is clear evidence that hunger/satiety and energy production vary in a circadian

pattern. Therefore, the timing of food consumption during the day may possibly exert an effect on

health outcomes like weight gain, however the exact implications of nutritional chronobiology for

disease risk remain controversial.

Energy balance and metabolic homeostasis are controlled by neurological processes which in turn

are strongly influenced by diet and/or dietary components. More research is needed to clarify the

mechanisms how dietary factors affect central nervous processes like food reward and appetite

regulation and how this causes alterations in food choices and food intake control, potentially

conditioning to obesity and the development of metabolic disorders. Further, there is also growing

evidence that diet and dietary components affect other cognitive functions, such as perception,

reasoning, thinking, memory and/or cognitive processes. This includes cognitive development in

early childhood as well as the maintenance or decline of cognitive functions in later life, both being

influenced by the nutritional status. This interrelation between diet and cognitive functions appears

to be at least partly mediated by a direct interaction between the gut, gut microbiota and the brain

(gut-brain axis), however, the exact mechanisms of this remain to be elucidated.

4.3.1 Nutrition and Chronobiology

Different kinds of foods or meal compositions as well as the frequency and timing of consumption

might have an influence on the internal clock and health status since our organs function at their

best during certain times of the day. To gain more insight in these mechanisms, more research is

needed on the interaction between circadian timing of intake and potential health outcomes, e.g.

gut microbiome, weight gain, metabolic syndrome, and cancer. A deeper understanding of the

effects of biological rhythms on nutritional response may have implications for improving dietary

recommendations as well as new prevention strategies.

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4.3.2 Dietary influence on regulation of food intake

Food intake, food choice and eating behaviour are controlled by central nervous system nutrient

signaling, however the exact implications of this influences are still unknown. In particular, there is a

need for research directed towards the association between neurological processes, micro- and

macronutrient composition of the diet and health outcomes such as obesity, metabolic disorders

and degenerative diseases.

4.3.3 Gut-brain axis

Besides other health outcomes, the composition and activity of the human gut microbiome have

been linked with brain function and neuropsychological diseases. Diet is one of the main factors

modulating the composition and function of the gut microbiome, although the mode of action is not

fully understood. In particular, more research is needed to better understand how diet-related

variations in the gut microbiota composition impact on health, especially development, maintenance

and decline of cognitive functions throughout the life cycle.

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5 Overarching issues & enabling interconnectivity

Research in food, nutrition and health is becoming increasingly complex. It has distinct and discipline

specific requirements for analytical as well as physiological methods, including specific research

procedures. Nutrition research is also driven by progress in genetics, epidemiology, biobanking,

biomedicine, molecular biology, systems biology and material sciences. Food science similarly is

driven by advanced analytical technique, biotechnology and nanotechnology, material science,

chemometrics and IT. Regulatory demands relating to health claims and novel foods regulations

demand comprehensive safety assessment procedures and scientific evidence derived from human

studies. To ensure a holistic approach looking not only at the societal challenge of health or diet

related chronic diseases, but connecting towards the Food and Nutrition Security angle, a European

Research base should also integrate research expertise on agriculture, food production and climate

change/ environmental aspects. Such an integration means bringing together research in different

domains. Although the European research base and expertise in nutrition and food science is unique,

it remains highly fragmented and, in some areas and countries, is below the critical mass needed for

a sustained and competitive future.

For each Research Area, research priorities and challenges are defined. However the three research

areas do not stand alone, but are related to each other. In order to achieve the overall vision and the

goals of the JPI HDHL, it is therefore crucial that integration across the three Research Areas is

achieved. Next to the integration across the three Research Areas there are also overarching issues

that need to be address which would benefit the three Research Areas.

5.1 Research Infrastructure for food, nutrition & health To further improve the impact of research investments an open and sustainable European data

infrastructure and stimulation of the circulation and reuse of scientific data are vital. Research

Infrastructures are the backbone of a Research domain and crucial to more efficient investments.

Research Infrastructures (RIs) are facilities, resources and services that are used by the research

communities to conduct research. Research infrastructures are making the state-of-the art available

to new generations of researchers and companies, thereby strongly furthering novel developments

in science, technology and business. Research Infrastructures can be ‘single-sited’, ‘virtual’, or

‘distributed’. They enable data collection, management, processing, analysing and archiving and can

include for example major scientific equipment (or sets of instruments); skilled personnel engaged in

services, competence development and outreach; knowledge-based resources such as collections,

archives or scientific data; and e-infrastructures, such as data and computing systems and

communication networks. While the agricultural and health care sector have (advanced) Research

Infrastructures in place, it has been acknowledged by ESFRI that to study the relationship between

food, nutrition and health such an infrastructure is lacking.

5.1.1 Towards a Research Infrastructure

Research Infrastructures are costly to establish and often also costly to maintain. The establishment

of a research infrastructure is beyond the remit of JPI HDHL, though at the same time of key

importance to deliver towards the vision of JPI HDHL. Therefore JPI HDHL will invest in the dialogue

and contribute to components and developments that work towards the desired research

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infrastructure and search for alliances with actors that could accelerate the development of the

research infrastructure.

A future proof Research infrastructure

It is important to identify with care which achievements or novel demands in the fields of nutrition,

food science and related health sciences that are new landmarks to be transformed into

infrastructures, and how to build them in the most efficacious way. The fast pace of science and

technology will also make infrastructures obsolete as time goes by. Most modern infrastructures are

e-resources allowing information to flow to those needing it, however they still need manpower to

update and curate the information. The food composition databases, gene banks and large chemical,

proteomic and metabolomics databases are typical examples where sustainable knowledge is

gathered, stored, and retrieved. Standardization efforts are another kind of infrastructures needed

to define “best practice” in science and related business development. They need frequent updates

to avoid stalling development and progress. Nutrition recommendations and standards for analytical

procedures are a typical outputs in this category.

The next generation of infrastructures are more interactive allowing users to interact with their data

or problem to get a useful feedback. They allow searching and combining information in an

interactive way to speed up scientific procedures and they are typically add-ons to databases or

“spider”-structures (like Chem-spider®) allowing automatic search and data analysis across multiple

databases. Literature search engines and web crawlers are good examples.

European Food and nutrition research infrastructure

The vision for a ‘European food and nutrition research infrastructure’ has been developed through

several framework projects and network activities. The essence is the wish for an integration tool

allowing to draw on all the collective knowledge in the field in a structured way. A prerequisite is

that this collective knowledge is online in a structured fashion. So this vision has elements of all

three kinds of infrastructure, database, standards and tools for tailored analysis.

The JPI-HDHL project, ENPADASI, is one of the latest in the series of European efforts to formulate

and build such a structure and the resulting DASH-IN (DAta SHaring In Nutrition) structure may be

seen as an early prototype for the infrastructure. It allows connectivity between distributed

databases (structured as dbNP or XX nodes) containing structured records of nutritional studies.

There is no limit to study design and DASH-IN is compliant with the latest data-safety legislation and

compatible with the FAIR principle. Minimal requirement for information content in study data to

enter ENPADASI, a first Ontology for Nutrition Science, and an online data quality assessment tool

have been drafted and published as part of the ENPADASI project. There is a need though to develop

this structure further, making it sustainable with minimal amounts of static manpower and to create

many more nodes at all European universities as well as implementing it into the planning, granting

and publication systems.

Future needs

In view of JPI HDHL the establishment of the Research Infrastructure should:

have broad support (may already exist as multiple competing ‘prototypes’ in different

research environments),

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be immediately useful for a larger community (highly needed),

be self-sustainable by a business model or at least dependent on a strong demand.

Include a platform for harmonisation and standardisation in nutrition and in food research

and technology, for data storage and handling, and for open sharing of nutrition and food

research specific information as a basis for more sustained research conducted in a

collaborative setting with experts from all over Europe and supporting interaction with

leading scientist from third countries.

support the establishment of a sustainable European Nutrition and Health Cohort with sub-

cohorts in all JPI HDHL countries, becoming a critical open access internet resource for

research on health, food and prevention of related diseases from early development,

including pregnancy, infancy and childhood, to adulthood and older populations.

support standardised large multi-centre nutritional interventions with long-term follow-up

throughout Europe;

include capacity building on big data science and the potentiel impact of big data science on

prevention strategies of diet related disease at individual and population level

offer a platform for continuing education for all stakeholders, including young researchers,

experts in R&D from academia and industry with an emphasis on SMEs.

5.1.2 FAIR data Principle

The JPI HDHL adopted the FAIR data principles in 2016, meaning that all the research that is funded

through a JPI HDHL funding activity should now take into account the FAIR data principles. FAIR

refers to the findability, accessibility, interoperability and reusability of data. Findability refers to

data that are assigned with a global unique and persistent identifier, with rich metadata which

clearly and explicitly include the identifier of the data it describes and are registered or indexed in a

searchable resource. The accessibility requires that (meta)data are retrievable by their identifier

using a standardized communications protocol, which is open, free and universally implementable

and allows for an authentication and authorized procedure, where necessary. Metadata should be

accessible, even when the data are no longer available. The interoperability entails the use of formal,

accessible, shared and broadly applicable language for knowledge representation, the use of

vocabularies that follow FAIR principles for the inclusion of qualified references to other (meta)data.

Finally the re-usability of data demands that (meta) data are richly described with a plurality and

relevant attributes; are released with clear and accessible data usage license; are associated with

detailed provenance and meet domain-relevant community standards.

5.2 Dissemination: communication, knowledge and technology transfer to

enhance impact Communication and the exploitation of the outcomes of research programs are essential to ensure a

large degree impact of JPI HDHL by reaching important policy makers as well as the general public. It

is important across all its scientific areas, in order to translate research results to the benefit of the

variety of stakeholders.

Given the scope of the JPI, there is a huge variety of stakeholder groups with different needs: the

scientific community, policy-makers, research funding bodies, food producers, industry, public

health organizations, health care, and civil society as well as consumer organizations.

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Transfer of knowledge and technology is the driver for innovation and a key-focus for improvement

in industry.

Communication is also important to optimize interactions between themes, to allow the various

stakeholders to gain the maximum benefit from ongoing activities and to ensure that these

stakeholders are regularly updated. For example, enhanced flow of knowledge and research

understanding into the area of “health and disease”, from areas “consumer/citizen” and “food

systems” will allow to maximize translation of HDHL funded research.

Improve education, training and scientific career development, in collaboration with

stakeholders

JPI activities go beyond the classical borders of scientific disciplines; diversification and specialisation

are intrinsic features of modern science. Yet, societal challenges require trans-disciplinary

competence and a better interaction between different science cultures (biosciences, human and

social sciences) as well as a better understanding of the needs of key players in the food systems.

To get more impact of the research, training of the scientists must be connected to the needs of the

policy, industry, (public) health professionals and citizens (e.g. stakeholders). To this end, the JPI

HDHL will exploit the various programs available in Europe and define a pan-European project for

continuing education/ lifelong learning in the Research areas targeted to scientists in academia and

experts in industrial R&D.

A particular concern is that highly specialised sciences with high impact publications have

established ranking and incentive systems, whereas the multidisciplinary approaches and knowledge

translation areas in most cases cannot measure up to these. To ensure that the Research Areas

covered in this JPI are attractive for the best students and scientists, the reputation of the science

disciplines needs to be improved. This also applies to science career perspectives and to the mobility

of researchers from participating countries. JPI HDHL will foster alliances with key actors in the R&I

landscape of food, nutrition and health as well as within the Joint Programming Community to work

towards solutions for important barrier.

Open access policies

For the JPI HDHL Knowledge sharing, including open access of research output is of crucial

importance to address the societal challenge of the JPI. The JPI HDHL expects its applicants to

consider the exploitation and dissemination strategy already at the stage of drafting their proposal

and the development of a data sharing plan and consortium agreement at the start of the project.

JPI HDHL follows herewith the open access policy aims of the EC, meaning that all publically funded

research should be openly accessible. This in the view that open science and open access will

contribute to better and more efficient science and to innovation in public and private sectors.

5.3 Structuring the landscape: integration and synergies among networks

and initiatives In order to increase its impact, and due to the transdisciplinary and applied objectives of JPI HDHL, it

is critical to enhance its connections with existing large initiatives and institutions at the European

and global level. By doing so, it will be possible to achieve a Food and Nutrition platform in Europe,

based on natural and social science, “from field to fork”. A first inventory of more than 100 such

initiatives and structures, related to the scope and objectives of JPI HDHL, has been identified and

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presented on the website, identifying the potential or existing relationships based on HDHL research

areas.

It is important to facilitate the connection between the JPI HDHL and different scientific and policy

areas that are associated with the societal challenge of JPI (e.g., nanotechnology, water, agriculture,

economics) so that the JPI is optimally cross-disciplinary science based.

The future will require a more coherent and comprehensive coordinated approach when designing

policies, while at the same time putting issues of health and healthy lifestyles at the center of these

policies (e.g., education, innovation, agriculture, city-planning).

In addition, increased attention for a global perspective on policy and the topics of the JPI HDHL is

important.

Through its instances (Scientific and Stakeholders advisory boards, Management Board) the JPI in

itself represents a network spanning many (European) countries and all relevant scientific,

technological, and business, as well as policy, areas.

In addition, the JPI is committed to interacting as effectively as possible with relevant European

initiatives and programs for optimal information flow and transparency and to create valuable

synergies.

The following links deserve to be highlighted:

with the JPIs FACCE and OCEANS (Agriculture, Food security and Climate change; Healthy

and Productive Seas and Oceans), and with related ERA-NETs from the Societal Challenge 2

of H-2020 (e.g. SUSFOOD2 on sustainable food production and consumption)

Following the grand debate co-organized at Expo Milano (2015), and several scientific

workshops, a common position paper from the three JPIs has been published on “Food and

Nutrition Security: a multi-disciplinary integrative food system approach”. Ensuring F&NS is a

complex issue, requiring an integrated food systems perspective. Together, the three JPIs

cover the necessary scientific fields to ensure integrated research across the whole food

system, and therefore have the opportunity to create a bigger impact towards tackling

societal challenges related to F&NS. This research is expected to contribute to the

implementation of the EC’s FOOD 2030 strategy (see below) and also to the UN Sustainable

Development Goals.

The implementation options include building a Knowledge Hub, to define a roadmap for

productions systems and improvements for F&NS, at the level of production, processing and

transformation, and food consumption.

with the FOOD 2030 policy framework of the European Commission (DG R&I), whose

objective is to develop the contribution of EU Research & Innovation to the major global

challenge of ensuring F&NS. This strategy is based on four priorities, Nutrition for

sustainable and healthy diets, Climate smart and environmentally sustainable food systems,

Circularity and resource efficiency of food systems, and Innovation and empowerment of

communities.

The JPI HDHL, together with FACCE and Oceans, is strongly involved in the CSA FIT4FOOD

2030, which develops new instruments such as Policy Labs, City Labs and EU Thinktank. The

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final objective is to create a sustainable multi-stakeholder FOOD 2030 platform for

transformed R&I systems for F&NS.

In connection with FOOD 2030, HDHL also participates to the SCAR-Strategic Working Group

on Food Systems, an initiative from Member States.

with the actions of the DG Santé (Health & Food safety) of the European Commission, and

the High Level Group on Nutrition and Physical activity, in relation to prevention and

promotion of health. So far, information has been exchanged on knowledge gaps and

research priorities from the public health policy point of view, and on how this relates to the

SRA of HDHL. DG Santé is represented in the SHAB of the JPI.

with different initiatives or platforms involving professionals from Food industry.

The ETP Food for Life (with the support of FoodDrinkEurope) and the ETP Plants for the

future are active members of the SHAB of the JPI.

There are also links with EIT-FOOD, a Knowledge and Innovation Community supported by

EIT, based on a pan-European consortium devoted to entrepreneurship and innovation in

the food sector.

with different associations or organisations, which opens the possibility to improve

communication and outreach towards the general public. This is done through several SHAB

members, such as EUFIC (European Food Information Council), EPHA (European Public

Health Association), EFAD (European Federation of the Associations of Dietitians).

with other important stakeholders, at the global level. Alignment, at national, European and

international level is also an objective for the JPI. For instance, comparative analysis and

exchanges have taken place with the USA roadmap for Nutrition, issued by their Interagency

Committee on Human Nutrition, involving NIHs and USDA.

5.5 Key players Stakeholders can become key players and in this way play a significant role in achieving the overall

vision and goals of the JPI HDHL and its Research Areas/ Therefore, the key players of JPI HDHL, their

role and how they can participate in the implementation of the SRA is described in the

Implementation Plan of JPI HDHL, which will be published every 2-3 years.