Nutrition ARISE REVISITING STUNTING AS AN INDICATOR ⇢ page 10 PRODUCT INNOVATION 30 35 90 THE FUTURE OF NEW PROTEIN THE FOOD INNOVATION FORTIFICATION SOURCES ECOSYSTEM 72 Innovation and Human-Centered Design 78 New Maps for Healthy Dietary Trajectories and Food Product Innovation 84 Network-centered Innovation to Fuel Food System Change Contents 90 Enabling Entrepreneurship in Nutrition 98 Innovating for Sustainability 05 Editorial Special Feature 08 Infograph: People and Planet should be at the heart of the food innovation journey 104 Sizanani Mzanzi Marketing Mix – Product & Price Food for Thought 114 Appropriate Eating: The Mediterranean Diet in Homer’s Odyssey 10 Nutrition ARISE – New Frontiers for Public Health Nutrition Obituary 16 What Electric Cars Can Tell Us About Redesigning 120 Phyllis Elaine Bowen (1940−2018) the Food System The Bigger Picture 20 Commentary 122 A Day in the Life of Mark J. Manary, MD Research-Based Evidence Congress Reports 22 Development of High-protein Spreads for Pregnant and Lactating Women in India 128 The 10th Asia Pacific Congress on Clinical Nutrition Perspectives in Nutrition Science 132 Affordability, Accessibility, and Sustainability Key to Improving Nutrition 30 An Innovation Evolution 136 The 21st International Congress of Nutrition in 35 New Protein Sources Buenos Aires, Argentina 40 Ready-to-use Therapeutic Food (RUTF) and Field Reports Ready-to-use Supplementary Food (RUSF) 140 Leveraging the Food System for Child Growth 46 Nutritional Programming and Later Life 144 What’s new 53 Probiotic Fermented Foods 156 Letters to Sight and Life 62 Improving Iron Bioavailability with Prebiotic Galacto-oligosaccharides 158 Reviews & Notices 67 Reformulating Food Products for Improved Nutrition 162 Imprint ⇢ 04 05 Welcome Innovation for a planet free from malnutrition Food product innovation Innovation is one of the most studied and debated themes in so- In this issue, we focus on product innovation – specifically, food cial sciences, management, and business. Diverse views abound product innovation, which implies some degree of food trans- concerning what it is and what makes it successful.1 “Change formation or processing, be it artisanal, lab-based, or indus- that creates a new dimension of performance” is the manage- trial. We live in exciting times. The food and beverage industry ment theorist Peter Drucker’s pithy definition;2 others describe is going through a period of intense innovation, which can be innovation as “the generation, acceptance, and implementation appropriately characterized as a revolution, influenced by the of new ideas, processes, products, or services”,3 “the creation of broader Fourth Industrial Revolution.7 This food industry revo- new knowledge and ideas to facilitate new business outcomes,” 4 lution is propelled by a number of factors. There is growing and “the effective application of processes and products new to realization of the unsustainability of the world’s current ap- the organization and designed to benefit it and its stakehold- proach to food. Poor diets lead to the double burden of con- ers” 5 – to cite but a few. current undernutrition and overnutrition, which substantially contributes to the unsustainable burden of non-communicable Creating value for people diseases on health systems. Many agricultural practices imper- However we define it, innovation is about change created by il our ability to adequately nourish nearly 10 billion people by people to create value for people, and therefore should have 2050 and indeed threaten the survival of the planet itself. Ad- people, rather than technology or processes, at its heart. In- vances in food and nutrition sciences and increased access to novation can modify or generate new products, processes, nutritional knowledge are transforming consumer preferences. services, or systems. In speaking about innovation, we may Both aging populations and millennials are demanding health- be referring to the process involved, or to the outcome of ier, transparently sourced and produced, and also sustainable that process, or indeed to both. Recent emphasis on inno- foods. Having learned the lesson that they are not adequately vation as a disciplined and repeatable process has some- positioned to develop and market disruptive food innovations, what obscured the fundamental role that creativity plays in large food companies are investing in myriad venture capital it. Whatever the process and its outcome, it is the human funds and startups to innovate with healthier and more cred- creative spark that fuels innovation. As Mauro Porcini puts ible products. These products are novel along the various di- it, “what really drives innovation is not the process, it’s the mensions of food – experience, function, convenience, health, mind, the soul, the heart of whoever drives that process.”6 accessibility, and sustainability – and the multiple associated That creative spark emerges from multiple sources: the curi- product attributes. osity to gain insight into what makes people tick and operate the way they do; the openness to look at a problem from fresh, completely different angles; the attitude of becoming one “ The food and beverage industry with those whose lives one aspires to change for the better; is going through a period the sharp attunement to the major trends shaping humanity and to scientific and technological breakthroughs; the ex- of intense innovation, which ploration of adjacent or analogous fields of knowledge; the can be appropriately characterized synthesis of new ideas from previous ones; the observation of outliers and positive deviances; the passionate pursuit of as a revolution” the question “why not?”; and so forth. 06 EDITORIAL: INNOVATION FOR A PLANET FREE OF MALNUTRITION We are delighted to publish in this issue of Sight and Life history – food fortification. An interesting frugal innovation re- magazine contributions from a broad range of authors, span- search effort to produce high-protein-quality spreads for preg- ning the public, private, social, and academic sectors. Our nant and lactating women in India is presented by Andrew Tony- thanks go to them all. Contributors from the private sector, in Odigie from Bern University of Applied Sciences and coauthors. particular, carried out a task not usually included in their job Simon Billing and Heidi Spurrell from the Protein Challenge descriptions, and for that we are especially thankful. Their per- 2040 Initiative at Forum for the Future walk us through the spectives highlight not just the vital role the food and beverage effervescent landscape of new protein sources and the promise industry has to play in overcoming malnutrition, but also the they hold. Mark Manary and Meghan Callaghan-Gillespie from sincere commitment so many industry professionals share with Project Peanut Butter expand on the past, present, and future professionals from the other sectors to meaningfully contribute of another highly successful, life-saving innovation: ready-to- to a healthier world. use therapeutic foods. Mark is also featured in our A Day in the Life interview as a bright example of an entrepreneurial The process of innovation scientist who has spent most of his career innovating for im- A number of articles featured in this issue address the process pact in low-resource settings. Danone’s research-driven effort of innovation. Lynda Deakin from IDEO discusses the applica- to improve nutrition during the first 1,000 days is described tion of some of the intriguing design approaches her firm has by Eline van der Beek from Danone Nutricia Research. Together successfully employed in other domains to food system inno- with colleagues from Yoba for Life and PATH, we explore the po- vation. Jörg Spieldenner from Innosuisse and Klazine van der tential for innovation drawing on emerging microbiome science Horst from Bern University introduce us to the evolutionary ap- to improve nutrition and gut and overall health, particularly proach of food product reformulation. A thought-provoking ap- using probiotic fermented foods. Panam Parikh and Rolf Bos proach and tools that draw on dietary trajectories to facilitate from FrieslandCampina highlight the potential of prebiotics to, optimal choices for both food innovators and consumers are combined with iron supplements and micronutrient powders, presented by Heribert Watzke from Watzke Heribert Consulting. more effectively and safely combat iron deficiency in vulnerable Various facets of the concept of innovation and the relevance of populations. Human-Centered Design to food innovation and public health We can also relish in this issue another delicious serving problem-solving are explored by Alain Labrique from Johns of Jonathan Steffen’s Nutrition in Literature series, this time Hopkins University, Cesar Vega from Mars, Inc., and their coau- thoughtfully exploring references in Homer’s Odyssey to the thors. David Ball and his colleagues at SecondMuse familiarize Mediterranean Diet. us with the concept of network-centered innovation and argue that “collaborative equilibrium” in an innovation ecosystem “ Transforming ideas and leads to more and better innovation than a purely competitive model. Simone Frey from the Nutrition Hub gives us an illumi- science into nutrition and health nating tour of the thriving food innovation ecosystem. Henk impact for people is a noble Bosch from DSM broadens our perspective on food innovation by addressing its ever more important dimension of sustain- and high-value endeavor” ability.