Looking to the future, reflecting on the past

In this issue there is a paper entitled Food availability and our changing diet, written by Foster and Lunn (2007) to commemorate the 40th Anniversary of the British Nutrition Foundation (BNF). The Briefing Paper reflects on the changes in diet over the past 40 years and more, and discusses the main factors that have influenced these changes, in particular government initiatives (both at national and EU level), industry innovation and consumer-led trends that have all influenced food availability. The annual National Food Survey, begun over 50 years ago, provides a unique body of information that enables household trends in food purchases and thereby nutrient intakes to be tracked. The picture is brought right up to date in an article by Burgon (2007) in this issue, which reports on the most recent trends emerging from the Expenditure and Food Survey, which superseded the National Food Survey a little over 5 years ago. It has been recognised for some time that nutrient intake is influenced by socio-economic status, but detailed information has been lacking until very recently. In this issue, Susan Church summarises the findings of the Low Income Diet and Nutrition Survey (LIDNS) published this summer (see Church 2007, p. 287). The new BNF Briefing Paper (see p. 187) discusses the advances in food science and technology that have enabled novel foods and foods with additional, potentially health-promoting, attributes (sometimes referred to as functional foods) to be widely available. With this trend has come a variety of claims, which will in future be regulated under new legislation that comes into force this July (see Buttriss 2007). However, not all of the details of the processes for this new legislation are yet available. One of the aspects still being elaborated is the nature of the nutrient profiling approach that is expected to be used to prevent the provision of nutrition or health claims masking the true nature of a food. The pros and cons of different approaches that might be used to set nutrient profiles is also explored in this issue by Trichterborn and Harzer (2007, see p. 295). Accompanying the new Briefing Paper is a set of forewords written by three eminent nutritionists who have helped to shape public health nutrition. The first (on p. 189) is by Professor John Waterlow, BNF's Chairman from 1976 to 1977, who is one of nutrition's pioneers, well known for his definitive work concerning stunting and wasting among the world's malnourished children. Professor Waterlow also led a group of scientists focusing on energy and protein metabolism while professor of human nutrition at the London School of Hygiene and Tropical Medicine, which is where I had the privilege of working for him briefly, as did our second contributor, Dr Juliet Gray (see p. 191). Dr Gray was appointed as BNF's Science Director in the early 1980s and has subsequently remained in touch with BNF. In recent years she has chaired the Editorial Advisory Board for Nutrition Bulletin. The third contributor is Professor Martin Wiseman (see p. 190), formerly of the Department of Health during an important time in nutrition policy when the association between food and health was becoming well recognised, fuelled by the publication of government reports highlighting the need to reduce saturates intake and to increase fibre intake, for example. Professor Wiseman chairs BNF's Scientific Advisory Committee and is a member of BNF's Council. One of the things that fascinates me about nutrition is that although it is many decades since vitamins and minerals were ‘discovered’, research continues to reveal additional functions for some of these nutrients, from time to time, often linked with the advent and application of new research approaches, such as nutrigenomics and metabolomics. An example of the concept of new functions for familiar nutrients is folate. The reference nutrient intake of 200 μg per day was established in connection with the amount required to prevent megaloblastic anaemia. However, it is now recognised that folic acid at higher intake levels can prevent the development of neural tube defects. As a direct result of this, mandatory fortification with folic acid was introducedin the USA, Canada and Chile some years ago, and following the advice of its Scientific Advisory Committee on Nutrition (SACN 2006), the Board of the Food Standards Agency (FSA) took the decision in May 2007 to recommend mandatory fortification to UK Ministers as part of a package of measures to help prevent neural tube defects (see http://www.food.gov.uk). The Board also asked for further work to consider whether bread or flour should be the vehicle for fortification and clarified that controls on voluntary fortification were an essential part of its recommendation. Also in this issue is a review on the role of physical activity in cancer prevention. Until recently, there was little attention paid to physical activity as a lifestyle intervention to reduce cancer risk, but now the evidence is mounting and physical inactivity is considered a well-established risk factor for colon cancer, especially in men, and breast cancer, especially in post-menopausal women. There is also consistent evidence emerging for lung cancer risk (see Miles 2007a, p. 250). Although considerable media attention has been directed towards the association between high meat intake and breast cancer risk (see Miles 2007b, p. 181), the body of evidence linking physical inactivity with cancer is considered to be more consistent and more robust.

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