Innovation Sweet Spots: Food innovation, obesity and food environments

This chapter describes the findings from our engagement with food tech and food environment experts from across the public, private, and charitable sectors.  We undertook multiple stages of sensemaking and qualitative research into which innovations our experts deemed to be the most impactful in either reducing or increasing obesity: and they highlighted reformulated products, meal kits, weight loss injections, and personalised nutrition as the innovation categories most likely to help reduce obesity in the UK. 

They also pointed to the potential risks posed by takeaway delivery apps and rapid grocery delivery for obesity. The experts also expressed concern around the rise of innovations that introduce a greater distance between the consumer and food preparation, which means they are less well-informed about what they are eating and potentially results in less healthy food choices. 

The use of sensemaking methods to derive richer insights

To better understand the implications of the trends uncovered through our quantitative analysis, we engaged a diverse panel of experts from the private, public, and charitable sectors. This group sense checked our initial findings and provided insight into the potential impact of different food technologies and innovations on the UK’s wider food environment and population health. We used three sensemaking techniques at key points during our research: in-depth interviews, a strategic foresight workshop, and an online survey. 

In-depth interviews

First, we conducted one-on-one, in-depth interviews delving into the food innovation landscape. These interviews allowed us to speak to a diverse range of experts and examine the trends emerging from our initial analysis of venture funding and patent data. We discussed the likelihood of different food technologies making headway, and the experts highlighted areas of food innovation that we should examine more closely.

Applying the ‘Futures Wheel’ method to explore trends

Second, we convened the panel for a Futures Wheel workshop to discuss the long term consequences of three particularly compelling trends surfaced by the initial research and interviews. The trends were the continued growth of takeaway delivery apps, the expansion of personalised nutrition, and the rise of alternative proteins created by fermentation. These particular trends were chosen because they gave us the opportunity to look at different types of innovation and each presented a distinct starting point – delivery apps already appearing to be established in the industry, personalised nutrition beginning to make an impact and seeing high demand, and looking further into the future for alternative proteins by fermentation given their relative novelty and cutting edge processes.  

The Futures Wheel methodology allowed our experts to discuss and visualise the impact of the trends by putting them at the centre and proposing first, second and third order consequences. 

The value of this exercise is in taking the participants out of the here and now to project forwards to the wider and longer-term impacts of the trends in the food sector. This method does not aim to predict the future but rather map the range of possible futures. This made the Futures Wheel an ideal tool for exploring how emerging food technologies and innovations could impact the overall food environment and rates of obesity in the UK.

Online survey to rank innovations by their potential impact

Finally, we trialled an experimental surveying approach, inspired by Delphi techniques, using the All Our Ideas platform to evaluate whether 15 shortlisted food technologies might reduce or increase the level of obesity in the UK. This approach provided a simple mechanism to carry out rapid data collection, allowing us to compile a ranking that aggregated the experts' collective views on which technologies were likely to have a positive or negative impact on health. The All Our Ideas platform presents two options from across different categories of food technologies or innovations at a time (rather than the full list at once) and asks the participant to choose between the two: for example, “Which innovation is most likely to decrease obesity in the UK: reformulation or personalised nutrition?”. In this way, the methodology made it easier for our experts to make decisions about the impact of different innovations. 

The following sections summarise the key insights from the three stages of expert engagement.

What did we learn from the sensemaking process with experts?

Our experts stressed that, given the complexity of the food environment and the broader food and economic systems which surround it, there is no such thing as a technological magic bullet to tackle obesity. There was an overarching view that people are unable to access enough healthy food in the current food system.

While emphasising the complexity of the system as a whole and its inherent flaws, many experts expressed enthusiasm for the potential of a range of innovations such as reformulation, fermentation to produce proteins, and personalised nutrition for improving the food environment and tackling obesity. 

Unintended consequences of innovation

The unintended consequences of new technologies, both positive and negative, were frequently raised by our experts. There are certainly risks, such the knock-on effects of introducing more humanless interactions when ordering food:

However, some experts also identified positive unintended outcomes. They observed, for example, that recent heavy investment in areas like cultured meat could also boost the development of enabling technologies such as 3D printing, which could be used in turn to support other food technologies. 

Discussion revealed that there are still considerable challenges to be overcome for the trends we identified to have sustained growth. This is clearest for the rise of alternative proteins created by fermentation, where further regulatory approvals need to be obtained and it is less clear that customers will accept these technologies. While takeaway delivery apps appear to be the most established of the trends, they are still experiencing small profit margins, which could drive increasing charges or the need to reduce costs, potentially by introducing tech like kitchen robots. And for personalised nutrition, a core barrier to scale is the service demand and the testing and customer support infrastructure needed to meet this, with companies like ZOE having to operate by waitlisting prospective customers. 

While reformulation is a highly promising approach, there are large scale barriers to its implementation

There were differing views on the efficacy of reformulation in reducing obesity with concerns that, like many technologies, it has the potential to create a new tier of healthier products only available to the wealthy. However, many of our experts believe that in the current context, where many diets include energy-dense and high fat, high sugar foods, reformulation has an important role to play in tackling obesity.  

Experts from multiple sectors highlighted the challenges faced by manufacturers in reformulating foods:

• Consumer resistance to changing products, often necessitating ‘reformulation by stealth’, in which the changes to the ingredients are done more gradually and without fanfare to make the shift more palatable, like the reduction in salt from products in the UK over the last decade.
• The technical difficulty in replicating the taste and ‘mouthfeel’ of a product when healthier ingredients are substituted in.
• High costs of reformulation caused by the need to change long-standing manufacturing processes and machinery, the extra cost of some alternative ingredients, and the risk of rejection by consumers which might reduce sales.

Experts from both the public and private sectors stressed the need to provide incentives to support manufacturers to reformulate products. 

An emerging paradox: convenient food which is further removed from the consumer

Over the course of the expert engagement, participants highlighted a trend towards consumers becoming more removed from the food they eat and how it is made. With the emergence of takeaway delivery platforms, ten minute grocery delivery services, and apps which eliminate the need to scan items when grocery shopping, for many consumers food has never been more convenient to access. Yet in other respects their distance from it continues to grow. 

Many of these innovations reduce an individual’s direct involvement in the preparation of food. This, combined with increasingly frictionless financial transactions, could lead people to make more and more unhealthy food choices. For example, takeaway delivery apps provide finished meals that consumers haven’t had a hand in preparing, and the technical scientific processes behind protein fermentation involve changing the core building blocks of foods in ways which few consumers understand.

This trend is exacerbated by uncertainty around the health impacts of certain foods and multiple messages which can make decision making around food even more difficult, these include:

• The current debate surrounding health and ultra processed foods, which some of our experts speculated may ultimately lead to a consumer backlash against plant protein products like the Beyond Meat burger.
• Consumers are conflating environmental sustainability of food with healthiness, which research suggests could be the case for many but not all products.
• Calorie and nutritional labelling on products, which is challenging for many consumers to understand, according to our expert panel.

Unequal impacts and the risks to low income groups

Finally, and most critically, it became clear from the expert engagement that disadvantaged groups could be left behind by these trends. The impacts of these different innovations are likely to have divergent effects on different groups, with those in the lowest income groups more likely to lose out as the least likely to be the first recipients of ‘good tech’. A number of futures mapped out in the Futures Wheel exercise looked at the possibility that those from deprived areas are more likely to be harmed as a result of expansion of these technologies; delivery apps, to use one example, may reflect already inadequate food environments rather than increasing access to healthy food. And personalised nutrition might never reach those that could most benefit, thus widening pre-existing health inequalities.

Ranking innovations by potential impact on obesity

Whilst no technology could be categorised as wholly ‘good’ or ‘bad’, we were keen to understand how experts ranked their potential impact on obesity in the UK (the goal of Nesta’s healthy life mission being to halve obesity by 2030). 

According to the aggregated scoring by our expert panel shown in Figure 46, technologies deemed most likely to contribute to a reduction in UK obesity levels in 2030 are (in order of relative impact):

• Reformulated products which are low calorie or high satiety
• Cook-at-home meal kits
• Weight loss injections and other medical interventions
• Personalised nutrition.

While there is some debate across the sector as to whether reformulated products are effective at reducing obesity, this approach appears to be a significant focus of industry (see Chapter 2). In recent years, the UK government has pushed reformulation as part of its obesity strategy, and Nesta’s recent report, The future of food, identified reformulation as one intervention to help to reduce obesity prevalence, alongside other methods. There is modelling data to suggest weight reduction benefits of reformulation in countries such as Mexico, which introduced a soft drink sugar tax in 2014.

Similarly, positive trials and subsequent approval of semaglutide (a drug designed to treat type 2 diabetes) by the UK’s National Institute for Health and Care Excellence (NICE) suggest that weight loss injections and related interventions may have a part to play in efforts to tackle obesity-related disease in future. While these developments will be helpful for those living with obesity, it does not address the root cause – the food environment – and our emphasis should continue to be on preventing obesity.

Cook-at-home meal kits and personalised nutrition both have the potential to counter the harmful trend of greater distance between people and food preparation. For example, in one of the positive scenarios envisaged for personalised nutrition in the Futures Wheel workshop, the personalised dimension of technology meant that people became far more knowledgeable about health and diet, leading them to make better food choices. 

Technologies judged by our experts as most likely to contribute to an increase in UK obesity levels in 2030 were (in order of relative impact):

• Ten minute grocery delivery services
• Takeaway delivery apps
• Apps and automatic touchscreens replacing staff at shops and restaurants
• Dark kitchens.

All of these innovations foster a more remote, albeit more convenient, relationship between consumers and their food. They also all increase the availability of often energy dense foods. This is certainly the case for takeaway delivery apps, as out of home meals have been found to be 21% more calorie dense than home-cooked food. Replacing staff with an electronic system or kiosk at takeaway restaurants has also been linked to increased spend, with this being attributed to the removal of an employee making the customers feel judged or pushed into particular eating habits. It is worth noting that personalised apps will also be able to target individual consumers to upsell more effectively than any in-store promotion possibly could. 

The potential health gains from food technologies offer much to be excited about. But such enthusiasm needs to be tempered with a clear understanding of potential risks, particularly around the growing distance between people and food preparation. 

Methodology

In-depth interviews

Separate interviews took place with 15 participants, who prior to interview were provided with a deck showing initial quantitative findings from venture capital and patent analyses as well as an overview of the project and its aims and goals. A set of interview questions were drafted in advance, but were merely used as a guide as opposed to a strict checklist.

The Futures Wheel exercise

This exercise initially involved identifying three potential trends from the interviews to explore should they become mainstream. This was followed by a half-day workshop involving seven experts. The identified trends are listed below.

• The expansion of personalised nutrition
  Advice on what and how a particular individual should eat based on analysis of characteristics such as genomics, gut microbiota, lifestyle, and metabolism. For example, ZOE offers personalised nutrition plans, and in premium versions one-to-one coaching, off the back of a battery of tests including two weeks of continuous monitoring of blood glucose, blood fat and the gut microbiome.

• The continued growth of takeaway delivery apps
  Platforms such as Deliveroo and Uber Eats offer quick and easy access to a broad range of restaurant and takeaway foods. Meals are produced by restaurants and by specialist outsourced dark kitchens, which prepare food solely for takeaway delivery apps, and do not serve food on the premises.

• The rise of proteins created by fermentation
  For our purposes this area splits into two main categories. The first is proteins created using genetically altered microorganisms as in precision fermentation. The second was proteins created using naturally occurring non-GM microorganisms, or ‘wild type’ fermentation. 

The participants initially discussed each trend separately in smaller groups, then came together to consider common themes and reach conclusions. 

'All Our Ideas' platform

To assess the overall relative likelihood of a particular technology reducing or increasing obesity levels within the UK, we used the All Our Ideas platform. The platform enables rapid social data collection, asking questions that involve pairwise comparisons from a list of pre-loaded options. 

In this instance, we asked respondents to vote between different food technologies – such as “Personalised nutrition vs. Lab meat” – in response to two different questions:

1. “Based on the evidence from our research and your expertise in the field of food tech, on balance in 2030 which technology do you think is most likely to contribute to reducing obesity in the UK population as a whole?"
2. “Based on the evidence from our research and your expertise in the field of food tech, on balance in 2030 which technology do you think is most likely to contribute to increasing obesity in the UK population as a whole?"

We determined which technologies should be included based on the insights gathered throughout the project: 

• Apps and automatic touchscreens replacing staff at shops and restaurants
• Cook-at-home meal kits
• Dark kitchens
• Fermentation to produce proteins (precision and traditional)
• Kitchen robots for industry and food service
• Lab meat
• Non-personalised dietary supplements
• Personalised nutrition
• Plant-based meat and dairy products
• Reformulated products which are low calorie or high satiety
• Smart consumer kitchen tech
• Smart packaging which reduces spoilage
• Takeaway delivery apps
• Ten minute grocery delivery services
• Weight loss injections and other medical interventions

As a follow-on stage we also asked respondents to suggest potential interventions to maximise the beneficial outcomes and minimise harmful outcomes with respect to the 15 technologies they had just been evaluating, particularly for lower opportunity groups.