This review makes a case for taking an integrated ‘food systems’ approach to explore the links between health and sustainability rather than treating them as separate topics. Unlike more linear ‘farm-to-fork’ conceptions, a systems approach emphasises the links between domains and sectors, helping avoid perverse effects where an intervention at one point in the system can have unanticipated consequences at other points. Adopting this approach, the review argues that food security and sustainability are as much a socio-cultural as a technical challenge requiring the combined forces of researchers from the natural and social sciences together with a range of stakeholders from government, business and civil society. Meeting the twin challenges of health and sustainability will require changes to intensive food production systems, dietary change and reductions in current levels of food waste. The review explores why dietary practices are so resistant to change seeking alternatives to the deficit thinking that pervades much advice on ‘healthy eating’. It explores the locus of responsibility for food system change, emphasising the asymmetrical power relations that shape contemporary dietary choices. The review includes an example of food system research, the H3 project (healthy soil, healthy food, healthy people), which seeks to transform UK food systems ‘from the ground up’, adopting the principles outlined in the body of the review.

Nutrient profiling systems (NPS) are used to classify foods according to their nutritional composition. However, investigating their prospective associations with health is key to their validation. The study investigated the associations of the original Food Standards Agency (FSA)-NPS and three variants (Food Standards Australia New Zealand Nutrient Profiling Scoring Criterion (NPSC), Health Star Rating NPS and the French High Council of Public Health NPS (HCSP-NPS)), with weight status. Individual dietary indices based on each NPS at the food level were computed to characterise the dietary quality of 71 403 French individuals from the NutriNet-Santé cohort. Associations of these indices with weight gain were assessed using mixed models and with overweight and obesity risks using Cox models. Participants with a higher dietary index (reflecting lower diet nutritional quality) were more likely to have a significant increase in BMI over time (β-coefficients positive) and an increased risk of overweight (hazard ratio (HR) T3 v. T1 = 1·27 (95 % CI 1·17, 1·37)) for the HCSP-Dietary Index, followed by the original FSA-Dietary Index (HR T3 v. T1 = 1·18 (95 % CI 1·09, 1·28)), the NPSC-Dietary Index (HR T3 v. T1 = 1·14 (95 % CI 1·06, 1·24)) and the Health Star Rating-Dietary Index (HR T3 v. T1 = 1·12 (95 % CI 1·04, 1·21)). Whilst differences were small, the HCSP-Dietary Index appeared to show significantly greater association with overweight risk. Overall, these results show the validity of NPS derived from the FSA-NPS, supporting their use in public policies for chronic disease prevention.

The role of diet in asthma is still debated. In France, a front-of-pack (FOP) nutrition label based on a modified Food Standards Agency Nutrient Profiling System/High Council for Public Health (FSAm-NPS/HCSP) has recently been implemented to help consumers to make healthier food choices during purchase. At the individual level, the FSAm-NPS dietary index (DI) has been shown to reflect the nutritional quality of the diet. The aim of the present study was to investigate the association between the FSAm-NPS DI and the asthma symptom score. In total, 34 323 participants (25 823 women and 8500 men) from the NutriNet-Santé cohort were included. The overall nutritional quality of the diet was assessed using the FSAm-NPS DI. Increasing FSAm-NPS DI reflects decreasing overall diet quality. Asthma was defined by the asthma symptom score (sum of five questions). Negative binomial regression was used to evaluate the association between the FSA-NPS DI and the asthma symptom score. Overall, mean participant’s age was 54 ± 14 years, and about 27 % reported at least one asthma symptom. We observed a significant positive association between less healthy diet, as expressed by higher FSAm-NPS DI, and the asthma symptom score. The adjusted OR were 1·27 (95 % CI 1·17, 1·38) among women and 1·31 (95 % CI 1·13, 1·53) among men. Unhealthy food choices, as reflected by a higher FSAm-NPS DI, were associated with greater asthma symptoms. These results reinforce the relevance of public health approach to orient consumers towards healthier food choices by using a clear and easy-to-understand FOP nutrition label based on the FSAm-NPS, such as the Nutri-Score.

In this paper, I first provide definitions of nutrient profiling and of a nutrient profile model. I set out the purposes of nutrient profiling: both general and specific. I give two examples of nutrient profile models that have been developed for regulatory purposes by the Food Standards Agency (FSA) in the UK and the WHO for its European Region – the UK FSA/Ofcom and the WHO-Euro models – and compare the way the models are constructed and function, how they have been developed, the extent to which they have been tested and validated and their use in regulation. Finally I draw some conclusions about the future use of nutrient profiling for regulatory purposes. I argue that its full potential has yet to be realised and give some reasons why. I pose some urgent research questions with respect to nutrient profiling.

The seriousness and scale of the physical, psychological, economic and societal consequences relating to poor diets, inactivity and obesity is unprecedented. Consequently, the contextual factors underpinning the work of a nutritionist in the civil service are complex and significant; however, there are real opportunities to make a difference and help improve the health of the nation. The present paper describes the delivery of public health nutrition through two work programmes, namely action to support young people develop healthier lifestyle choices and more recently the investigation and deployment of local insights to develop action to tackle obesity. Combining the application of nutrition expertise along with broader skills and approaches has enabled the translation of research and evidence into programmes of work to better the public's health. It is evident that the appropriate evaluation of such approaches has helped to deliver engaging and practical learning opportunities for young people. Furthermore, efforts to build on local intelligence and seek collaborative development can help inform the evidence base and seek to deliver public health approaches, which resonate with how people live their lives.

In 2003, the UK Food Standards Agency and the Department of Health began attempts to reduce national salt intakes via reformulation of processed foods and a consumer awareness campaign on the negative impacts of salt on health. The present study uses large nationally representative samples of households in England to assess whether discretionary salt use was affected by the national salt reduction campaign. Large cross-sectional datasets from the Health Survey for England were used to analyse trends in adults adding salt at the table between 1997 and 2007. Since 1997, there has been a steady decline in salt use at the table. Ordinal logistic regression analysis controlling for age, sex, total household income, region, ethnicity and background trends revealed that the reduction in salt use was significantly greater after the campaign (OR 0·58; 95 % CI 0·54, 0·63). Women (OR 0·71; 95 % CI 0·68, 0·74), non-white ethnic groups (OR 0·69; 95 % CI 0·62, 0·77), high-income households (OR 0·75; 95 % CI 0·69, 0·82), middle-income households (OR 0·79; 95 % CI 0·75, 0·84) and households in central (OR 0·90; 95 % CI 0·84, 0·98) or the south of England (OR 0·82; 95 % CI 0·77, 0·88) were less likely to add salt at the table. The results extend previous evidence of a beneficial response to the salt campaign by demonstrating the effect on salt use at the table. Future programmatic and research efforts may benefit from targeting specific population groups and improving the evidence base for evaluating the impact of the campaign.

The present report summarises a workshop convened by the UK Food Standards Agency (Agency) on 25 March 2010 to discuss the current Agency's funded research on the use of metabolomics technologies in human nutrition research. The objectives of this workshop were to review progress to date, to identify technical challenges and ways of overcoming them, and to discuss future research priorities and the application of metabolomics in public health nutrition research and surveys. Results from studies nearing completion showed that by using carefully designed dietary and sampling regimens, it is possible to identify novel biomarkers of food intake that could not have been predicted from current knowledge of food composition. These findings provide proof-of-principle that the metabolomics approach can be used to develop new putative biomarkers of dietary intake. The next steps will be to validate these putative biomarkers, to develop rapid and inexpensive assays for biomarkers of food intake of high public health relevance, and to test their utility in population cohort studies and dietary surveys.

The UK Food Standards Agency convened a group of expert scientists to review current research investigating folate and colo-rectal cancer risk. The workshop aimed to examine current research and establish research priorities. The timing of folate exposure with respect to carcinogenesis, as well as the dose and form of folate, were considered key issues for future research. Also, the need to study further the influence of genetically defined subgroups was highlighted for future research.

The Food Standards Agency undertakes a range of activities with the aim of improving the dietary health of the population and determining how best to communicate key messages to achieve dietary change. Activities include obtaining sound evidence from research and surveys, and seeking advice from independent experts. Work is also undertaken to inform and motivate the population about diet and to identify ways of improving their diet. The effectiveness of the work is monitored in order to inform future policy decisions and interventions and to understand cost implications.

The UK Food Standards Agency convened a group of expert scientists to review current research investigating the effect of dietary lipids on vascular function. The workshop highlighted the need for intervention studies to be sufficiently powered for these measures and that they should be corroborated with other, more validated, risk factors for CVD. Work presented at the workshop suggested a beneficial effect of long-chain n-3 PUFA and a detrimental effect of trans fatty acids. The workshop also considered the importance of the choice of study population in dietary intervention studies and that ‘at risk’ subgroups within the general population may be more appropriate than subjects that are unrepresentatively healthy.

The UK Food Standards Agency convened a group of expert scientists to review current research investigating emerging diet-related surrogate end points for colorectal cancer (CRC). The workshop aimed to overview current research and establish priorities for future research. The workshop considered that the validation of current putative diet-related surrogate end points for CRC and the development of novel ones, particularly in the emerging fields of proteomics, genomics and epigenomics, should be a high priority for future research.