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Breakout Group Discussions
In the final session of the workshop, participants were divided into eight
discussion groups and asked to discuss five questions related to food and health
integration. The discussion format provided an opportunity for every participant
to respond to earlier presentations and to offer their own ideas and
recommendations on the subject. A rapporteur in each group took notes and
presented a summary of the group's discussion to the entire gathering. The
groups' ideas and recommendations reflected many of the themes discussed
earlier in the workshop, but also included fresh perspectives and suggestions.
Question One: Are food and health research and
education currently conducted and managed to maximize
scientific progress, incentives for collaboration, and
benefits to the public health?
Rapporteurs for all the breakout groups reported that discussants felt that better
integration, coordination, and collaboration among all the entities involved in
food and health were needed. Building on this general feeling and in response
to Question Two, discussants identified a number of particular issues that
contribute to the problem, as well as examples of successful attempts to
overcome it.
45
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EXPLORING A VISION
Question Two: What activities, programs, or initiatives
currently exist in your institution, organization, or agency
to address the challenges of improved integration of
agriculture and health sciences? What gaps remain?
INSTITUTIONAL INFRASTRUCTURE
Many participants were positive about a number of new collaborative entities
springing up, including research teams, centers, institutes, and various
coordinating groups, mostly in the academic realm. It was discussed that there
is a need to motivate the various government agencies to collaborate as much as
the researchers and educators. Even so, researchers were believed to be often
ahead of the universities, agencies, and corporations that employ them, and
integration was often ad hoc and based on individual relationships rather than
strategically planned integrated programs. Because public educational
institutions are often resource-driven, faculty members are required to become
entrepreneurial, responding to the opportunities presented to them.
Agency interaction is often hindered by current structures to provide joint
resources, some participants thought. Historically, funding institutions support
particular types or topics in research, with the larger grants often going to the
more traditional research models. Some institutions, such as NIH, offer large
grants that provide the level of overhead support that universities require.
Others agencies, such as USDA, and private associations, such as the American
Heart Association, have limitations on how much of their funding can be used
for overhead (sometimes no more than 10 per cent). Potentially integrative
proposals presented by one agency to another, in which the originating agency
would like to marry pools of funds, may be looked at by the recipient agency
(often with a much larger portfolio) with suspicion. It was suggested instead
that institutions try to focus on common interests.
Some participants identified a need for more and better collaboration across
sometimes insular agencies and institutions to overcome the "silo effect." This
applies to both government agencies and the various colleges at universities that
deal with these issues. As on participant stated "tInstitutional] silos are real.
They are as prevalent as the silos you see on the rural landscape around
America." In many cases, schools of agriculture, nutrition, or family and
consumer sciences and medical and public health schools are on separate
campuses, some distance apart in many cases, and some participants felt that this
creates a substantial barrier to communication.
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BREAK OUT GROUP DISCUSSIONS
47
There was a perception on the part of some discussants that funding from one
agency is "better than funding from another agency," and that raises some
problems in getting interagency cooperation. It may be a result of differences in
facilities and administration costs among agencies. It may also result from
differences in probability of funding or of getting a proposal funded by different
agencies, which is related to the overall amount of funds available from different
agencies. There was also some concern that training programs emphasized
individual investigations and reductionist methods, and not team research, which
they felt is needed to address the kinds of questions that were posed during the
workshop.
There was a feeling among some participants that there were differences in
funding-agency perspectives, among review panels, and among program leaders,
who in different agencies might have more or less narrow views of their
responsibilities. There was also a feeling that there were no programs to
integrate across all needs and that research was looked at on a project level,
rather than on a program level in terms of priorities. Some participants pointed
out that it is important to look beyond food-related diseases, especially obesity,
and to consider the relationship between food and wellness.
Some discussants felt that promoting interdisciplinary research or bridging the
gaps in different institutions was not currently a priority. One participant noted
that even when institutions encourage interdisciplinary activities generally,
young investigators are cautioned to be careful about getting too involved in
team research, because that may not be the way to get promoted.
INCENTIVES
To break down the silos, some participants felt that a policy review at the federal
level could play a valuable role in promoting progress. Some thought that what
is needed is a single agency to volunteer to take the lead in promoting research
and education in food and health: "Until the big guys fund and frame the
research in the interdisciplinary area, identify funding for it and specify that is
what it is for, we are not going to get very far in getting it done." Some
participants suggested that the White House Office of Science and Technology
Policy could play a leading role, declaring interdisciplinary food and health
research to be a priority and developing cross-agency budgets. Another
suggestion was the creation of a group within the federal agencies that would
broker grants, allowing researchers to get advice on where to submit
collaborative, integrative research programs for the greatest probability of
success.
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EXPLORING A VISION
In the academic realm, some participants identified the lack of incentives to
encourage university faculties to be more interdisciplinary, particularly with
respect to promotion and tenure, as a problem. Modification of the reward
structure is needed, so that collaboration between different fields of research and
between research and education is more straightforward. New institutional tools
could be made available by institutions to foster better collaboration, such as
matching funding, fellowships, and other special incentives.
For investigators actively interested in crossing the divide between food and
health research, low funding levels are a disincentive. That is especially true for
food and agricultural scientists, given that health research has more funds
available than other general research. Indirect costs were also identified as an
obstacle to developing new and integrative research programs. It was suggested
that it is important to look beyond single institutions and to enhance both current
and new regional research efforts
PRODUCER AND PUBLIC INVOLVEMENT
Some participants noted that most of the health concerns revolving around food,
nutrition, and health were "life-choice diseases." It was pointed out that as a
nation we are not successfully educating the public to bring about substantial
behavioral change for improved health even people who have a need and now
get the information, do not use it properly. An improved message with regard to
food and health is needed, as is improvement in how that message is used by
those who receive it. One suggestion was for USDA to use its extension
network to get the message out and to bring food and health research together,
which might require additional funding. One group of discussants thought that
an effort could be made to increase the focus on making this link in the early
grades, rather than waiting to work with an adult audience, and attract new
partners, such as the Howard Hughes Medical Institute and the National Science
Foundation, which have innovative programs to bring science to the lower
grades. Agricultural producers and food processors were also identified as
important partners in improving knowledge of the relationship of food and
health.
EXAMPLES
.
Fight BAC! is a public-education campaign focused on safe food
handling, whose goal is to educate consumers on steps that they can
take to fight foodborne bacteria and reduce their risk of foodborne
illness. Initiated in 1996, the campaign is now supported by public and
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BREAK OUT GROUP DISCUSSIONS
.
.
.
.
49
private organizations from all aspects of the food and consumer
industry, including meat and produce marketers, allied trade groups,
consumers, public-health organizations, and government agencies. For
more information see www.fightbac.org.
The Center for Science in the Public Interest has established Eating
Green, a campaign to improve the public's health and the environment
by advocating for a more plant-based diet through policy change and
public education.
The Food and Society Initiative (FAS) is a Food Systems and Rural
Development program of the W. K. Kellogg Foundation. The FAS
Initiative is based on a vision of a future food system that provides, for
all segments of society, a safe and nutritious food supply grown in a
manner that protects health and the environment and adds economic
and social value to rural and urban communities. The purpose of the
FAS Initiative is to support the creation and expansion of community-
based food systems that are locally owned and controlled,
environmentally sound, and health-promoting. For more information
see www.wkkf.org/Programming/Overview.aspx?CID=l9.
USDA's National Research Initiative Competitive Grants Program
(NRI) is the office in the Cooperative State Research, Education, and
Extension Service that is charged with funding research on key
problems of national and regional importance in biologic,
environmental, physical, and social sciences relevant to agriculture,
food, and the environment on a peer-reviewed, competitive basis. The
goals of the NRI are to increase the competitiveness of U.S. agriculture;
to improve human health and well-being through an abundant, safe, and
high-quality food supply; and to sustain the quality and productivity of
the natural resources upon which agriculture depends. For more
information see http://www.reeusda.gov/nri/.
NIH's Community Based Participatory Research Program was
started by the National Institute of Environmental Health Sciences in
1995. The purpose of awards in this program is to develop community-
based public-health research approaches to diseases and health
conditions that have an environmentally related etiology and to
determine the value of the methods. Awards are intended to stimulate
further advances in the design and implementation of prevention and
intervention methods that are appropriately applied to environmental
health; to accumulate and evaluate data, making assignments of
environmental etiologies of diseases more plausible; and to develop,
implement, and evaluate community-based exposure-assessment
protocols. For more information see
http ://www.niehs.nih.gov/translat/cbpr/cbpr.htm.
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EXPLORING A VISION
.
The mission of the Illinois Council on Food and Agricultural
Research (C-FAR) is to secure additional resources to fund relevant,
high-quality research, and related outreach programs that lead to
profitable, consumer-sensitive, and environmentally sound food and
agricultural systems in Illinois and the nation. C-FAR will foster
public confidence in food and agricultural research through public
participation in the planning and evaluation of the process and impact
of research activities. For more information see http://www.ilcLar.org/.
Question three: What potential national initiatives could
be implemented to address the challenges of improved
integration of agriculture and health sciences?
An interdisciplinary, multi-institutional initiative was repeatedly put forward by
the discussion groups as a mechanism to promote the integration of food, food-
system, and health research and education. To accomplish this, some
participants envisioned the federal and state governments working as a unit to
create a funding program with that focus. To encourage an integrative research
approach, the initiative could support programming that carried mechanistic
work through public-health outcomes, requiring scientists to demonstrate from
the onset of their research program how their work could be translated to other
food, agriculture, and health fields. Research programs could also be combined
with education and outreach. Substantial up-front funding for existing programs
that demonstrated those linkages was believed to be useful, rewarding those who
were creating new intellectual and organizational relationships. Some
discussants suggested more diverse grant-review panels that represented a
broader range of backgrounds and expertise. Academic institutions could
promote integrative programming by allowing cluster hires, cross appointments,
and reorganization of colleges and departments, including agriculture and
medical schools, extension programs, and state health departments. The
systematic evaluation of research programs at the termination of a grant to
assess the success of a program in making linkages is also important, as is a
planned terminal evaluation of the initiative itself.
Some participants reiterated the need for more coordination and a body
responsible for it, which was envisioned by different participants as either an
individual, center, institute, or agency willing to take the lead and serve as
champion, or as an interagency working group to provide program direction.
Some participants believed that it would be useful for Congress to consider a
farm bill that would be more responsive to nutrition and health needs, rather
than commodity- and support-focused, to provide the push needed to develop
this leadership, and that it was important to convey this message to legislators.
The 2002 Farm Bill has already created a taskforce to evaluate the merits of
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BREAK OUT GROUP DISCUSSIONS
51
establishing one or more national institutes focused on disciplines important to
the progress of food and agricultural science. Many participants also
emphasized the need for diverse membership of the guiding bodies, including
the Centers for Disease Control and the Department of Defense. Other entities
that might be included in the initiative in some fashion are schools of public
health, economists, private health insurers, the private sector, and, of course, the
consumer.
In terms of targeting a specific food and health issue, a number of participants
felt that we should focus on childhood nutrition, including expanded elementary
education programs. Alternative suggestions included obesity, diabetes, or other
chronic diseases; food safety; and food security. Others felt that a consumer-
behavior approach was needed to look at overall eating patterns rather than
specific issues, such as the role of functional foods. Some felt that an initiative
that would enhance the public's understanding of the agricultural system and its
impact on public health was needed.
The NSF's National Nanotechnology Initiative (NNI) was cited as a good model
to follow. Initially funded in FY 2001, the NNI is an effort to strengthen critical
scientific disciplines and encourage interdisciplinary research and education to
develop a long-term vision, establish federal priorities, and coordinate the
national program.
President Bush's HealthierUS Initiative is based on the premise that increasing
personal fitness and becoming healthier is critical to achieving a better and
longer life. Extensive research has shown that making small adjustments and
improvements in the activities of daily life can improve overall health and
prevent disease and premature death. The HealthierUS Initiative uses the
resources of the federal government to alert Americans to the vital health
benefits of simple and modest improvements in physical activity, nutrition, and
behavior. The initiative will encourage all Americans to be physically active
every day, eat a nutritious diet, get preventive screenings, and make healthy
choices to prevent diseases associated with obesity, such as heart disease,
cancer, stroke, chronic obstructive pulmonary disease (for example., bronchitis,
emphysema, and asthma), and diabetes.
Question four: How can education and outreach
contribute to improved research integration?
Building on the suggestion to require demonstration of a broader scientific
perspective in research proposals, discussants felt that education and outreach
components also needed to be built into research programs from their initiation.
In addition, there was a feeling that the effectiveness of tools for education and
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EXPLORING A VISION
outreach needed to be the subject of research. The Food Guide Pyramid was
cited as an example of a well-known public-outreach program, which is not
useful if no one follows it. New technology could also be investigated to
improve outreach. Discussants identified the need for greater integration and
greater breadth in the primary and continuing-education programs for food and
health professionals, including animal health. Professional societies and
associations might be called upon to help develop more integrated and
collaborative approaches.
The public needs to become a partner in the effort to bring agriculture, food, and
health sciences together, some discussants felt. Communities have a role in
disseminating information, as well as receiving it. With the public's increased
awareness and support, there would be an additional driver for better integration
at the government and academic levels. The proposed expansion of the federal
food and nutrition program could be used to focus integrated research and
extension by reaching out to those who need information and technical
assistance immediately to improve their life choices. An additional issue
identified by discussants was that the consuming public does not know what is
factual in food and health claims. There is no good means of identifying what is
scientifically sound, so some mechanism of establishing a seal of approval for
accuracy was suggested.
Increased targeting of educational efforts was identified as an issue of growing
importance. Extension and other outreach programs could focus on low-income
audiences, because they are often at greater food and health risk. One
participant identified the individualized client plan model that is being used at
Alcorn State University, where outreach workers try to solve the problems of the
family in totality not only economic problems, but health, education, and any
other problems with which a family is afflicted
At the same time, it is important to educate schoolchildren, who can take the
message home to their parents, so that entire families can embrace healthy
changes. Students need to have early exposure to the need for research and to
what is involved. Some felt that there should be incorporation of more
discussion into the whys of food choices and the bows of food production, rather
than just saying that one should eat this or that food. Most young people do not
see the direct connection among foods, the school lunch program, and the
research associated with foods and the good outcomes associated with eating
particular ways (nor do their parents with the food-stamp program). To
accomplish these goals, some participants felt that state governments needed to
ensure that teachers and administrators had the necessary resources.
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BREAK OUT GROUP DISCUSSIONS
Question five: Which technical research fields would be
most amenable or of high importance to initial integration
efforts?
53
Discussants responded to this question in two ways: Some suggested a
paradigm shift in food and agriculture research programming: first determine the
health benefit desired or the population most susceptible to a health condition,
and then work backward from there to the development of a product that is
acceptable to the public. Other discussants offered up a variety of suggestions
for priority topics:
· Behavioral psychology of food choice and health
Bioactive components of foods
Comparative medicine
Diabetes
Economics of preventing long-term chronic illness related to diet and
nutrition
Emerging diseases
Environmental health
Evaluation of research
Food engineering
Genomics (toxicogenomics, nutritionomics)
Geography
Intellectual-property rights
Marketing, education, and behavior
Nutraceuticals
Obesity
Physical exercise and physical activity
Probiotics
Satiety
Sustainable agriculture
Toxicology
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Representative terms from entire chapter:
integrative research
