Transdisciplinary research to inform and shape dietary policies, interventions and the plant-based food environment

Research Line: Preserving Health / Seed Call: i4PH Oktober 2024

Current diets heavily reliant on animal-based proteins harm both public and planetary health, making a shift to plant-based and alternative proteins, termed the “protein transition”, urgent. The Dutch government aims to increase plant-based protein consumption from 43% to 50% by 2030, with the Dutch Health Council advocating for 60% to achieve sustainable, healthier diets without increasing nutrient deficiencies.

Whilst plant-based diets can reduce risks of kidney and vascular diseases, their health effects, particularly across different socioeconomic groups, are not well understood. Novel plant-based foods, though high in fibre, often contain additives and are ultra-processed, raising concerns about their impacts. Vulnerable populations, especially lower socioeconomic groups, face greater risks of diet-related health disparities, as current increases in plant-based consumption are concentrated among higher socioeconomic groups. Stronger policies and interventions are needed to reshape the food environment and ensure the transition supports sustainable, healthy, and equitable diets. Multidisciplinary research is crucial to guide policymakers, industry, and consumers.

Project Objectives

The project’s long-term goals are to:

• Deepen our understanding of optimal plant-based dietary strategies to shape a sustainable protein transition which will safeguard the long-term kidney and vascular health of men and women with different ages, socioeconomic settings and health status.
• Drive health equity promoting interventions, policies, guidelines, food (re)formulations and food choices, by informing and engaging with diverse stakeholders, including policymakers, industry, health care and consumers.
• Promote healthy, sustainable and just diet choices in lower socioeconomic and vulnerable groups, by developing interventions and (digital) tools.
• Develop policy recommendations to inform on optimal strategies for achieving healthy, sustainable and just diets amongst people from different socioeconomic groups.

Methods and Deliverables

To address critical knowledge gaps, the project focused on the following:

• Health effects of plant-based substitutes: Investigating the largely unknown impacts of plant-based meat and dairy substitutes, which are gaining popularity in diets.
• Impact of diet diversity on health disparities: Examining how contemporary plant-based diets affect kidney and vascular health across different socioeconomic positions, ages, sexes, and pre-existing health conditions to reduce inequities.
• Socioeconomic influences on dietary choices: Understanding how food environments, policies, and social factors shape healthy and sustainable food choices in various socioeconomic groups, ensuring the protein transition addresses health disparities.
• Personalized tools for vulnerable groups: Designing and implementing personalized interventions and digital tools to promote healthy plant-based choices, improving health and self-efficacy for those most in need.

The project combines traditional and novel study designs in a multidisciplinary approach, integrating data from ecological footprints, food costs, and population cohorts using advanced techniques to analyze the effects of plant-based diets on kidney-vascular health disparities. Citizen science trials assess the impact of plant-based substitutes on health and well-being, engaging low socioeconomic groups to collect personal health data using wearables and apps. Mixed-methods research explores the root causes of dietary inequalities to inform targeted interventions.

Key Results

The project enabled the development of a strong, interdisciplinary consortium, bringing together experts from nutrition, food environments, consumer behavior and computational biology, all dedicated to research that contributes to a protein transition promoting sustainability, kidney-vascular health and health equity. The team combines different approaches, including qualitative research, epidemiology and data science, to investigate the diversity of plant-forward diets in different socioeconomic and patient groups, concomitant effects on kidney-vascular health and health inequities.

Key activities included:

• Development of a detailed project plan for larger grant applications. The EWUU funding facilitated support from a consultancy in writing the full proposal. The proposal leverages the team’s multidisciplinary expertise, aiming to study how sustainable plant-forward dietary changes can improve kidney-vascular health outcomes amongst patients  with or at high risk of cardiometabolic disease and particularly amongst diverse low-SES groups.
• Initiating joint pilot research into plant-based dietary choices, food practices and attitudes amongst low-SES groups in the Netherlands (literature research and qualitative study, ongoing) and into sustainable, healthy eating in 4,365 post-myocardial infarction patients of the Alpha Omega Cohort, investigating differences across subgroups like sex, socioeconomic status and health status (adiposity, diabetes), as well as kidney health (quantitative analyses).

Preliminary results from these studies indicate the importance of considering SES and patient subgroups in research as well as policies and interventions to achieve an equitable and healthy plant-forward transition.

Multiple grant pre-applications were submitted to open calls in the area of cardiometabolic health, which formed a basis to develop a full proposal enabling the team to submit their research plans efficiently in response to future calls.

Contribution to Cross-EWUU Collaboration

The team consists of members from four departments across three institutes (WUR, TU/e, UU), bringing together a diverse range of expertise and career stages to enhance cross-EWUU collaborations. They specialize in areas such as nutritional epidemiology, kidney-vascular health, wearable technology, machine learning, personalized nutrition, sustainability, socioeconomic health disparities, policy, and social psychology. Joining forces within the alliance has been extremely valuable for developing and strengthening the consortium. Working together has helped develop a stronger, interdisciplinary research plan and to set up joint pilot studies, addressing sociodemographic diversity in plant-forward eating from a psychological (UU), sociological (UU/WUR) and nutritional/health context (WUR), and combining these underlying insights with different methods from data science (TU/e), epidemiology (WUR) and mixed-methods research (UU/WUR). The team continues to seek financial support to take their long-term research plans forward.

Team

• Marinka Steur (PI) – WUR Nutrition and Disease (Human Nutrition and Health)
• Sanne Djojosoeparto – WUR Consumption and Healthy Lifestyles (Social Sciences)
• Shauna O’Donovan – TU/e Department of Biomedical Engineering
• Tina Venema – UU Copernicus Institute of Sustainable Development
• Marianne Geleijnse – WUR Nutrition and Disease (Human Nutrition and Health)
• Gerda Pot – Alliantie Voeding in de Zorg