i3food: Information, Interventions and Inequalities in the UK food system

Every day, the UK is fed by a network of retailers, manufacturers, caterers, transporters, farmers, customs officials, environmental health officers, tech companies and many others. This food system is highly complex but does not provide optimal results - diets in the UK are often high in saturated fat, salt and sugar, low in fruit and vegetables, and are associated with unsustainable levels of environmental damage. Access to food is not equal in the UK, with more disadvantaged groups less likely to achieve healthy, sustainable diets. This finely balanced system can be disrupted by novel technologies (e.g. food delivery service apps) which create huge changes in purchasing over a short space of time. From a distance, the UK food system resembles a calm river threading its way around the country, but viewed closely it is a turbulent, ever-changing maelstrom. This new consortium of researchers will conduct multidisciplinary research aimed at capturing the dynamism of the maelstrom, understanding the turbulence and redirecting the flow of the river so that the food system is channelled towards healthy and sustainable outcomes for every group across Britain. To understand the food system you must understand the motivations of the people who interact with it. We will develop strong links with the food industry, public health policymakers and members of the public from disadvantaged groups. This will ensure that our research is focussed on plausible changes to the food system that have the potential to be implemented at scale.

The modern consumer expects easy access to food services and to the information required to make informed purchasing decisions. This has led to abundance of data about the food system being made freely available online (e.g. supermarket and fast food outlet websites, food delivery service apps). Meanwhile, data on food purchases are collected by retailers to inform their marketing strategies. We will harvest these data to build a constantly updating picture of the food system, including how that food system varies around the country and how food purchasing behaviour differs for different social groups. We will use these data to monitor how changes in the food system affect consumer purchasing decisions in different parts of the country and in different social groups. These changes may be due to 'system shocks', such as the fall in the value of the pound that has accompanied the possibility of a 'no deal' Brexit. Or they may be due to implementation of new policies, such as the regulation of volume-based price promotions (e.g. Buy One Get One Free).

With guidance from representatives of the public we will develop new tools to help consumers make healthy, sustainable food purchasing decisions, such as a smartphone app to allow people to monitor the nutritional quality and the environmental footprint of their shopping basket. After user testing with targeted groups, we will test the effectiveness of the tools using experimental studies. Alongside this, we will work with food industry partners to develop changes in the retail food environment, such as changing the position of healthy and sustainable foods to core selling areas within the shop. We will measure the effect of these changes on food purchasing behaviour using store sales data.

The data we collect and the results of these studies will inform models of the food system which will give us insight into what will have a lasting positive impact on health, inequalities and health care costs, and where are the critical areas of the food system that can trigger large impacts throughout the food system. We will feed our results back to the public, by running public engagement events such as school visits, pub talks, stalls at science conferences and shopping centre engagements. We will also ensure that the novel datasets that we collect are made available to the UK academic community, to strengthen public health research throughout the UK.

The UK food system is complex and produces suboptimal outcomes of unhealthy, unequal and unsustainable diets. The i3food consortium will use big data methods to monitor and intervene in the UK food system, identifying changes that will reduce dietary inequalities. Our work is organised into six work packages. WP1 will maintain existing and develop new relationships with the public, policymakers and food industry, ensuring studied interventions are plausible, deliverable and have public support. WP2 will harvest data from websites, loyalty cards and consumer panels. We will add to existing data on all food in seven UK supermarkets and from supermarket loyalty cards, by collecting postcode level data on fast food, deliveries and supermarket food and linking with environmental footprint datasets. WP3 will compare and validate these datasets against external measures. In WP4 we will use these datasets to conduct interrupted time series analyses of the impact of system shocks (e.g. Brexit) and public health policies (e.g. regulation of volume-based promotions) on the food marketplace and food purchases, with a focus on inequalities. In WP5 we will develop new interventions aimed at improving diets, including digital interventions (e.g. app giving a running total of the nutritional quality and environmental footprint of a basket) co-designed with representatives from disadvantaged groups, and retail store interventions (e.g. repositioning plant-based meat alternatives) co-designed with the food industry. These interventions will be evaluated in experimental and quasi-experimental studies. In WP6 we will model the long-term impact of system shocks, policies and interventions on health, NHS costs and inequalities, and build an agent-based model of the food system for identifying key areas where changes can cascade throughout the system. We will feed our results back through public engagement events, and develop a web portal for easy access to all i3food datasets.

This grant is funded by the UK Prevention Research Partnership (UKPRP) which is administered by the Medical Research Council on behalf of the UKPRP's 12 funding partners: British Heart Foundation; Cancer Research UK; Chief Scientist Office of the Scottish Government Health and Social Care Directorates; Engineering and Physical Sciences Research Council; Economic and Social Research Council; Health and Social Care Research and Development Division, Welsh Government; Health and Social Care Public Health Agency, Northern Ireland; Medical Research Council; Natural Environment Research Council; National Institute for Health Research; The Health Foundation; The Wellcome Trust.