Nestlé’s head of public health nutrition Dr Jörg Spieldenner told us there was a place for philanthropic acts – especially in food crisis situations where the food industry needed to assume its responsibilities – but that sustainable changes in diet and nutrition that deliver real improvements in health and lifespan were best achieved when corporate and public health goals aligned.
Big food companies like Nestlé are oft-criticised for being a factor in the spread of non-communicable diseases like obesity and diabetes with less healthy food offerings but all are engaged in shifting their portfolios to the healthier end of the spectrum, and their capacity to deliver benefits with fortified offerings to malnourished populations can be overlooked.
“The food industry is a commercial enterprise – that won’t change – but it has immense power to bring nutrients to the populations that needs them the most,” Dr Spieldenner said.
“To be the most effective, we need a multi-stakeholder approach. Otherwise it won’t work.”
Positive food marketing
Dr Spieldenner cited a case in the Philippines where a marketing campaign for its Bear Brand iron-fortified milk product raised anaemia awareness resulting in improved health outcomes and higher sales of Bear Brand. The Philippines government supported the initiative.
“We sat around a table with seven government ministries to deliver something with the greatest impact,“ he said.
“It is not so easy to engage the food industry with public actors. We want to lead the way and do it in a way that is based on research and science. Not only counting output of nutrients but impact on health.”
He added: “The food industry is criticised for pushing people to bad food choices. But this is an example of positive food marketing delivering public health benefits.”
With programmes like this, Nestlé says it will deliver 200 billion micronutrient fortified servings of foods and beverages in 2016 “helping to address global micronutrient deficiencies with a special focus on children and women of child bearing age.”
He said the problem of affordability could be addressed via systems such as food vouchers, or partnerships with school meal structures.
Dr Spieldenner, who used to work in the Swiss Ministry of Health, praised the work of malnutrition-focused NGOs like Scaling Up Nutrition (SUN) and the Global Alliance for Improved Nutrition (GAIN) even as Nestlé is barred from working with them because they stipulate they won‘t work with infant formula manufacturers.
“We would like to work with GAIN and maybe that can happen at some point in the future. They have some very interesting approaches and are achieving a lot.”
Intervention … and the cost of not intervening
He cited another project in India where surveys showed children consuming iron-fortified cereals dramatically reduced anaemia rates in a country where many are vegetarian and more prone to iron deficiency.
Cognitive issues driven by nutrient deficiencies cost India 1.3% of its GDP (gross domestic product), he said.
Fortification of popular foodstuffs remained an under-exploited avenue to significant health improvements.
Iodine-fortified salt in China had almost completely removed the deficiency there, and folic acid fortification of flour in many countries had shown dramatically reduced rates of neural tube defects (NTD) in newborns.
When such actions could be taken in cost-effective and formulation-effective ways the question to be asked was “what prevents us from NOT changing foods, consumer habits and improving diets?”
“If you don’t need to change much why not do it? Folic acid is a wonderful example linked to defined health outcome in NTD.”
However some fortified foodstuffs encountered problems of nutrient decline, with the Dr citing the case of some fortified rices where humidity and sunlight-driven oxidisation could reduce the nutrient payload of the food at the point of consumption.