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Food And Health Research in Europe

Final Report Summary - FAHRE (Food and health research in Europe)

FAHRE was a 28 month Coordination and Support Action under the Seventh Framework Programme (FP7) (January 2010 - April 2012). It's activities were conducted by seven European partners:
- Sociedade Portuguesa de Inovação (coordinator)
- Euroquality SARL, France
- University College London, United Kingdom
- Skalbes, Latvia; Universiti Degli Studi Di Milano, Italy
- Dialogik gemeinnützige Gesellschaft für Kommunikations- und Kooperationsforschung mbH, Germany and
- SIK - Institutet for Livsmedel och Bioteknik AB, Sweden.

FAHRE provided several activities to support evidence-based policy making with the aim to strengthen the European Research Area (ERA) in food and health. These included reports mapping food and health research in 32 European countries (see http://www.spi.pt/fahre/ for details) from which a synthesis report was prepared (see http://www2.spi.pt/fahre/reports/FAHRE_Mapping_Synthesis.pdf online). Thematic experts in nine areas analysed food and health research needs (see http://www.spi.pt/fahre/ for details ). A synthesis report was prepared (see http://www2.spi.pt/fahre/reports/research_needs_synthesis.pdf online) from these contributions and an academic paper 'Research for food and health in Europe: themes, needs and proposals' published online at http://www.health-policy-systems.com/content/9/1/37. Furthermore, FAHRE collected data on funding programmes in an online database which can be accessed on the project website at http://www2.spi.pt/fahre/login.asp.

With this unique overview, we were able to dialogue with decision-makers and other stakeholders to develop proposals for ensuring closer cooperation, for improving funding and policies, and for ensuring the future direction of food and health research addresses the knowledge gap on how to influence unhealthy eating. These activities of consultation are summarised in its document 'Summary reports on consultation exercise' and separate reports are available on:
- its workshop 'Food and health research in Europe: Towards a vision for Europe', held in Berlin from 3 to 4 February 2011;
- e-mail consultation on its proposals 'Summary report on responses to FAHRE's draft strategy proposals';
- survey of small and medium-sized enterprises (SMEs) 'Food and health research in Europe. Report of SME survey';
- survey of large companies 'Food and health research: a key role for the private sector';
- meeting entitled 'Strengthening European food and health research: Young researchers as a key pillar for the future of the ERA', which are all available on the project website (see http://www.spi.pt/fahre for details).

Unhealthy eating causes up to one quarter of chronic diseases - which include heart disease, cancer, diabetes, stroke and dementia, the commonest causes of ill-health in Europe. FAHRE proposes more research on how to achieve healthier eating - for example, through changing food production, changing behaviours, and showing the impacts of better governmental policies and regulation. It also proposes improvements in the organisation of food and health research in Europe including better links between food research and medical research, and more use of social sciences to determine effective interventions. Food safety authorities' roles should support the new research effort. National research programmes must also be strengthened, with more joint action between countries. These proposals are summarised in FAHRE's position paper, which can be accessed at http://www2.spi.pt/fahre/reports/FAHRE position paper en.pdf and FAHRE's full final report can be accessed at http://www2.spi.pt/fahre/reports/FAHRE Final Report.pdf. Further details are provided on the project context and objectives in section 4.1.2 the main S&T results / foreground in section 4.1.3 the potential (project) impact in section 4.1.4 the use and dissemination of foreground in section 4.2 and the project's societal implications in section 4.3.

Project context:

The rationale behind this project and its methodology had its basis in the food and health research landscape of 2009 (when the proposal for the FAHRE project was submitted) as well as in recent developments in research funding and policy, in particular the strengthening of the European Research Area (ERA). The important concepts used by the project in its implementation are as follows:

1. Mapping and policy development methodologies
The development of the methodology of this project draws on the lessons learned and methodologies employed in other relevant policy support exercises. Particularly relevant examples include: EU AGRI MAPPING, ERAWATCH, and SPHERE.

2. Research fields that comprise the food and health area
Given the separate organisation of research funding and policy development in the complementary areas of food and health, a fully efficient 'food and health ERA' needed to investigate both agriculture / food and medicine/health research fields, and bring these together through a new 'trans-boundary' approach.

3. Structures and processes involved in research funding and policy development
Not only does the food and health area involve an extremely wide range of research fields, but the determination of research funding and policy in this area involves many different structures and processes. These involve a variety of organisations and initiatives each with a specific role to play - here too fragmentation exists.

4. Policy and programme evaluation at regional and national level
In order to determine the effectiveness of the structures and processes involved in research funding and policy development at regional and national level in cooperation and coordination, it is necessary to examine the programmes and policies resulting for their success in supporting and enhancing the ERA.

Following the development of the project methodology, there have been a number of developments relevant to food and health research that the project needed to take into account. These include:

- The Joint Programming Initiative (JPI) 'A healthy food for a healthy life'
The FAHRE interacted with JPI 'A healthy food for a healthy life' for dialogue and results exchange, attending three meetings organised by this initiative and providing the initiative with its reports and findings. Its scientific board were able to discuss FAHRE's food and health research needs analysis in a direct face to face meeting and FAHRE's final results were presented at one of the three workshops alongside the JPI's recent conference.

- New developments in the ERA context
Since FAHRE's analysis considered not only the European Union (EU) and national level food and health research and innovation context, but also the overall policy context, in particular that relating to the concept of the ERA, it also needed to consider the current public consultation whose initial results were summarised in the document 'Areas of untapped potential for the development of the European Research Area', which was presented and discussed at the 'ERA conference: Fostering efficiency, excellence and growth' (30 January 2012) and that will be used to formulate a proposal for an enhanced ERA framework that will be published before the end of 2012. Many of the opinions expressed in the summary on the public consultation regarding challenges and potential areas for improved functioning of the ERA are valid for food and health (they compare well to FAHRE's analyses of different stakeholder perspectives). With its proposals FAHRE has selected specific aspects that it believes are major areas for action with potential for greatest impact.

- Other new relevant initiatives
The FAHRE project also had to take into account the following initiatives for the implications they can have on its final strategy proposals: Horizon 2020 (food and health research will be supported within the programme 'Sustainable and competitive agri-food sector for a safe and healthy diet'), Knowledge and innovation community (KIC) FOOD4FUTURE ('sustainable food, supply chain, from farm to fork', proposed by the EU, from 2014), EU Platform for Action on Diet, Physical Activity and Health (re-established by DG SANCO), European Innovation Partnership (EIP) on Active and Healthy Ageing (established by DG SANCO) and on Agricultural Productivity and Sustainability (established by DG Agriculture).

Finally, it is important to highlight the definition of food and health research and innovation used within the FAHRE project.

Food and health research refers to research about the production, marketing, choice, regulation and policy for food as it affects health, and the mechanisms and control of diet-related diseases, nutrition and obesity. It covers positive and negative impacts of food on health as well as issues related to under and over consumption of food (under-nutrition and obesity). It draws on a wide range of disciplines including psychological, social, management and political sciences, laboratory sciences, clinical medicine, environment and epidemiology, and it is undertaken by public, independent and industry organisations.

Project objectives:

FAHRE aimed to increase the structuring of food and health research and support cooperation towards the ERA.

FAHRE addresses food and health research and innovation at European and country level (in 32 European countries). It considers food and health not only from the perspective of the wide ranging and interconnected research themes that comprise this area, but also the related structures and processes associated with food and health research and innovation governance or regulation, research funding, implementation and application of research. In particular, it considers the channels of communication / dialogue between the different actors in the diverse activities in which they are involved since these are especially important for achieving greater coordination of efforts, which can help avoid duplication, increase transparency and maximise the sharing of knowledge. Thus, while the range is European, proposals are equally important for member states within the ERA.

FAHRE aimed to provide:
- a comprehensive map of food and health research funding and policy development in the European Economic Area (EEA) identifying the key players and processes involved at regional, national, and transnational level;
- an assessment of needs and capacities in food and health research addressing aspects such as infrastructure, equipment, etc. to identify gaps and overlaps;
- interactions with decision makers through the project's dissemination and strategy building activities such as its website and project events, providing them with opportunities to consider the results of the mapping exercise and needs assessment;
- opportunities for exploring areas where greater cooperation between countries may strengthen the ERA in food and health and developed concrete proposals for its improved functioning in conjunction with decision makers.

Through these activities, it was expected that the implementation of the strategic proposals would make it possible to design better funding instruments in which there is mutual transparency, closer cooperation, and reduced duplication of efforts. Combining efforts to build up critical mass would also support increased innovation and competitiveness leading to better food, better public policies and a better quality of life for European citizens.

Project results:

During its 28 month operating period, FAHRE's multidisciplinary partnership, supported by sets of experts gathering information in 32 countries and across 9 different themes as well as dialogue with a wide ranging initiatives, including policy-makers, funding bodies, industry representatives from large companies to SMEs, civil society organisations, as well as researchers themselves (both experienced academics and early-stage researchers) combined to provide an innovative approach to the challenge of exploring ways to increase coordination of European food and health research and help ensure it addresses the key social challenges associated with promoting a healthy diet in Europe. However, while FAHRE has aimed at a broad based analysis, need to select areas for proposed action means that inevitably there are aspects that are less explored than others. These are conditioned by the information gathered using the methodology employed as well as the resources, particularly in terms of limited time available. For example, during the initial stages of the development of FAHRE's proposals for improving the food and health ERA, certain stakeholder groups were pinpointed as having particular issues for which proposals for action could be formulated. Thus, in addition to the overall proposals outlined in the executive summary of this report, initial proposals for large companies, SMEs and early-stage researchers have been formulated. This selection was also made with awareness that future efforts may take up different areas of the work covered by the topic of FAHRE. For example, the project partnership is linked to new efforts at European level to establish dialogue and mutual learning between research actors and society with the food and health area and to potential study of joint research infrastructures in this area , among others. These efforts can benefit from and build on FAHRE's resources.

The main science and technology (S&T) results, which are publically available on the project website may be summarised as follows:

1. Mapping of food and health research programmes in Europe: synthesis of the 32 country reports (see http://www2.spi.pt/fahre/reports/FAHRE_Mapping_Synthesis.pdf for details).
2. 32 individual country reports in Europe, independently elaborated by country experts (also publically available at http://www.spi.pt/fahre online).
3. Online database with food and health research programmes (see http://www2.spi.pt/fahre/login.asp online).
3. Food and health research needs in Europe: synthesis of thematic expert reports (see http://www2.spi.pt/fahre/reports/research_needs_synthesis.pdf for details) from which a journal publication was also developed.
4. 9 individual thematic reports, independently elaborated by thematic experts (also publically available at http://www.spi.pt/fahre online).
5. Strategy development workshop and proceedings (see http://www2.spi.pt/fahre/workshop_berlin/FAHRE_Proceedings_final.pdf online).
6. Summary report on responses to FAHRE's draft strategy proposals (see http://www2.spi.pt/fahre/reports/FAHRE%20eConsultationresponses.pdf for details).
7. Food and health research in Europe report of SME survey (see http://www2.spi.pt/fahre/reports/FAHRE%20smesurveyreport.pdf online).
8. Food and health research: A key role for the private sector (see http://www2.spi.pt/fahre/reports/C3report%20for%20FAHRE.pdf online).
9. Strengthening European food and health research: Young researchers as a key pillar for the future of the ERA (see http://www2.spi.pt/fahre/reports/earlystageresearchers.pdf online).
10. Summary reports on consultation exercise (see http://www2.spi.pt/fahre/reports/FAHRE%20Consultation%20Report.pdf online).
11. Final FAHRE project strategy proposals report (see http://www2.spi.pt/fahre/reports/FAHRE%20Final%20Report.pdf online).
12. Food and health research in the EU: FAHRE strategy to address the challenge of non-communicable diseases (position paper) (available in English and French at http://www2.spi.pt/fahre/reports/FAHRE%20position%20paper%20en.pdf and http://www2.spi.pt/fahre/reports/FAHRE%20position%20paper%20fr.pdf respectively and also at http://ec.europa.eu/research/bioeconomy/index_en.htm).

Mapping of food and health research and innovation

FAHRE has conducted a mapping exercise on national activities in food and health research. For this, it appointed country experts to prepare reports for mapping food and health research funding and policy structures and processes in 32 European countries. The geographical coverage was the EU-27 plus Croatia, Iceland, Norway, Switzerland and Turkey (countries associated to the Framework Programme (FP)). These country reports are based on a synthesis of available literature, studies and databases, complemented by interviews of experts and followed a pre-defined template.

The country reports include an overview of the most important national policies / programmes / initiatives related to food, nutrition, diet and health at national level and those responsible. They outline the main public and private organisations implementing food and health research and current trends. The reports also describe the process of food and health research commissioning including the actors involved and their relationship. An overview of the main food and health research programmes is provided and experts were asked to identify any participation in joint programming, joint research infrastructures, comment on international cooperation in this area, the uses of food and health research as well as any foresight, evaluation and monitoring being conducted at national level. Furthermore, the analysis includes a discussion of potential strengths and weaknesses of the food and health research system as well as suggestions for improvement. The experts preparing these reports were instructed to work in the context of the definition of food and health research specified in the introduction to this report. The country reports can be consulted at http://www2.spi.pt/fahre/projectresults.asp.

The report 'Mapping food and health research programmes in Europe' synthesises the findings of 32 country reports prepared in mostly in the latter half of 2010 within FAHRE. Its objectives are:
(i) to describe existing national programmes dedicated to food and health research;
(ii) to identify strengths and weaknesses of the national food and health research systems; and
(iii) to identify practices that could effectively contribute to improve the coordination of food and health research in Europe.
This report is designed to be to be used together with other reports prepared in FAHRE project, in particular the report 'Analysis of gaps and overlaps for existing food and health research needs in Europe' which provides an assessment of food and health research needs. These two reports were one of the main sources of information used in the development of FAHRE strategic proposals on the improvement of food and health research in Europe.

A brief summary of some of the main findings follows. The full report can be accessed from the project website under project results at http://www2.spi.pt/fahre/reports/FAHRE_Mapping_Synthesis.pdf.

Summary of findings:

In terms of research capacity, it is estimated that 70 to 90 000 researchers are involved in food and health research in the 32 countries covered by the study. More than 470 research organisations have been identified. Research is mostly undertaken at universities and public research institutes and the number of private actors involved in food and health research is rather limited.

In terms of research programming, the 32 country reports identified 363 research programmes at national and regional levels. Among these 363 programmes, 155 are general research programmes that can support food and health research, 114 cover food and health research among other research priorities and 94 are specifically targeted at food and health research. The characteristics of the identified programmes are as follows:
- Researchers are the primary beneficiaries of the programmes, followed by industry (around 50 % of the programmes) including SMEs.
- The programmes include support to investigator-led basic research, subsidies, support to public-private partnerships or support to programme coordination. A small number of programmes include support to private investment, to loan financing or tax incentives.
- A wide range of activities is financed through these programmes including research and development, human resource development, demonstration activities and investment in research infrastructures.
- Regarding topics, the programmes concern in majority a focus on the 'biomedical' field (73 %), the 'population' field (50 %) followed by 'production' (40 %) and 'policy' (26 %) fields.
- Around two thirds of the programmes are financed through public funds only, one third are financed from public and private funds.
- Three groups of countries have been identified according to the importance of food and health research programmes. The first group (more than five programmes dedicated to food and health research) includes France, Germany, Ireland, the Netherlands, Norway and the United Kongdom. The second group (between one and five programmes dedicated to food and health research) includes Sweden, Finland Latvia, Poland, Czech Republic, Austria, Switzerland, Italy, Slovenia, Spain and Croatia. The third group is composed of countries that do not have any specific research programme dedicated to food and health: Portugal, Slovakia, Hungary, Romania, Bulgaria, Greece, Lithuania, Estonia and Turkey.

The diversity of national research systems makes it difficult to identify strengths and weaknesses that apply to all countries covered by the study. Nevertheless, the country reports allowed the identification of strengths and weaknesses at European level.

The main strengths include:
(1) the importance of food and health in the national research landscape;
(2) the research excellence for some areas of food and health; and
(3) the trend towards greater cooperation at all levels of the research system (more cooperation between research organisations, more coordination between ministries for research programming, more initiatives for public-private partnerships etc.).

The main weaknesses include:
(1) the fragmentation of the research capacity at national level in many countries;
(2) the lack of national strategy reflected by a low of coordination for food and health research in many countries;
(3) the insufficiency of the budget allocated to food and health research and, in some countries; and
(4) the insufficient resources in terms of both number of scientists and research infrastructures.

The reports also allowed the identification of national initiatives contributing to effectively improve:
(1) public and private partnerships (e.g. French Foundation for Food and health, competence centres in Estonia, strategic centres for science, technology and innovation in Finland);
(2) the cooperation between public research organisations (e.g. centres in Germany, Alliance in France, foundations in Greece, international cooperation);
(3) the sharing of research infrastructures (e.g. competence centres in Estonia, special funds for infrastructure in Denmark, European project from ESFRI and the Sixth Framework Programme (FP6)); and
(4) The coordination for research orientations (examples from Austria and Bulgaria).

Mapping food and health

FAHRE has conducted an analysis of food and health research needs. For this, it contracted nine experts to examine themes forming a spectrum across food, society and health. These bring together both core disciplines and multidisciplinary approaches and include:
- food production and processing;
- food safety;
- consumer behaviour and what influences it;
- population surveys, causes and control;
- health policy for food, nutrition, diet and obesity;
- diseases related to food (excess, imbalance, sensitivity);
- nutrition micro-elements, malnutrition, gene interactions; regulation, claims, and food policy for health;
- research structures.
The experts worked to a template developed and agreed during their contracted period and were instructed to use only secondary information, including the FAHRE country reports, the internet and their professional knowledge.

The thematic reports outlined research at European level, providing examples of programmes and project. They list some examples of major research groups, networks, training programmes, publications and conferences. They analyse knowledge needs for the area, significant research questions and ways of organising research including priorities, developing agendas. They assess the interaction between public research and industry and pinpoint gaps and overlaps for further research.

A brief summary of some of the main findings follows. You can access the synthesis report on the project website under project results at http://www2.spi.pt/fahre/reports/research_needs_synthesis.pdf

Summary of findings

FAHRE thematic experts have reviewed research across the EU and assessed needs, gaps and overlaps for research and research structures. There is a pressing need for multidisciplinary research on 'healthy eating' to achieve appropriate intake and reduce risks.

While food is needed for life, our diets at present cause up to one third of chronic disease - including heart disease, diabetes and some cancers, as well as obesity - as a result of nutritional imbalance and intake. To address the relevant research, a typology of eight thematic fields, and one on structures, was developed with the experts.

The EC's Research Directorate has programmes covering both health and biotechnologies, agriculture and food. There has been strong programme support for food safety, nutritional supplements and epidemiological research, and the EC's Health Directorate has supported demonstration projects on food safety and nutritional surveillance.

National research is mainly sited within universities and research institutes: there is relatively little contribution from industry. Countries usually commission research on food and on health separately, and few countries have combined strategies or programmes. Postgraduate training and research outputs are strong for some disciplines.

National food policies, based on epidemiological evidence and endorsed by the World Health Organization (WHO), recommend major changes in food intake. While food processing research relevant to health has focused on improving nutritional content, including supplementation, research should now address how macro-diets, rather than micro-nutritional content, can improve health.

Protection against contamination and infection is important in food processing. Food safety and consumer protection research now needs to make an 'epidemiological transition' from acute to chronic diseases, and promote multidisciplinary research involving industry, regulators and civil society together.

National surveys of diet and health status are crucial to inform and complement policy, supported by research on the effects of market changes and interventions. Biomedical research on 'nutrio-genomics', possible 'individualised' diets and pharmaceutical interventions, is likely to yield less return on public investment than research on population-level interventions to change diets.

Research strategies and policy should be developed together between the ministries of health, food and science, with the national research councils. Joint programming can be supported by the EC. Research should review the impact of existing European and national research programmes, and ensure that investment for innovation has health impacts as well as economic returns.

FAHRE database of funding programmes

The FAHRE database, which can be accessed on the project website at http://www2.spi.pt/fahre/login.asp is designed to describe food and health research programmes, including research within related broader programmes or smaller activities within universities departments. For some countries, specific research projects are reported. Activities that support research e.g. training of human resources, networking or research infrastructures may also be included. It gathers data from national funding programmes in 32 countries across Europe. It can provide information on what kinds of topics are being funded, for what types of activities and targeting which types of beneficiary. Due to the diversity of the types of funding and the fact that it was not possible to separate the food and health component of a number of funding programmes, it is not possible for policy makers to know the total funding allocated to this area with any degree of certainty.

An explanation of the information contained the main fields present in this database can be accessed at http://www2.spi.pt/fahre/docsdb/database_guide.pdf. It should also be mentioned that the information in the database was gathered by the country experts and for the most part it was these experts that filled the database. The database has the option to be accessed by two kinds of user: programme managers who may be permitted to introduce and update data and other users. The data can be searched by the programme name, type of beneficiary, type of support, type of activity, or country. The search results are displayed for the user in a list.

Different stakeholder perspectives

Consultation and dialogue with different actors that need to be involved in European food and health research and innovation and it associated policy-making is an important part of FAHRE's strategy proposal development methodology. A considerable effort was made to consult with policy-makers, programme managers, researchers from academia and industry at differ stages of their career, SMEs and civil society organisations in their individual capacities or as those responsible for EU and national initiatives in this area. This strategy allowed us to capture different perspectives and make proposals that support the different roles and contributions that each can make to improving European food and health research.

An iterative process was followed. Participants at a workshop 'Food and health research in Europe: Towards a vision for Europe', 3 - 4 February 2011 in Berlin, discussed the first phase results (see http://www2.spi.pt/fahre/workshop_berlin/FAHRE_Proceedings_final.pdf for details) and proposed areas of focus and important issues to investigate further. The proceedings were used as input for a two-week online discussion by food and health research funders, researchers and industry representatives, using a web-based tool: FAHRE risk cartography (see for results: http://p116655.typo3server.info/ws20/index.php online). Thereafter, the strategy has also drawn on work by 'facilitators' addressing particular groups of stakeholders, conducted e-mail consultation on its proposals as well as attending events, at which it could gather information to feed into the development of its proposals, disseminate the current project results and dialogue with relevant actors.

A 'Consultation report', which can be access at http://www2.spi.pt/fahre/reports/consultationreport.pdf describes this set of activities in detail, relating the results of the online discussion, the email consultation, the events attended and their particular purpose within the strategy development process, as well as the activities conducted with particular stakeholder groups.

Regarding the email consultation, it should be mentioned that a draft document was circulated for consultation in 2011, following which a summary of the responses received was prepared and sent to those who provided feedback (see http://www2.spi.pt/fahre/reports/econsultationresponses.pdf online). Consideration of these comments, together with further dialogue with different stakeholders (at EU and national level) lead to the production of the position paper that forms the first part of the executive summary of this report.

Since a significant response was received from food and health research and innovation governance and research funding actors to the email consultation, other activities were addressed at different specific groups, for which previous evidence had shown the potential to formulate proposals that would contribute to improving the food and health ERA. These groups include: Large companies, SMEs, and early-stage researchers. The results of the activities with these three stakeholder groups are summarised as follows.

Large companies

To facilitate its work with Large companies, FAHRE contracted the organisation C3 Collaborating for Health (see http://www.c3health.net/ for details) - a charity that believes that only by working together can we make it easier to be healthy and works with many different people and organisations to promote three behaviour changes: stopping smoking, eating a better diet (including avoiding the harmful use of alcohol) and increasing physical activity, and which demonstrated strong links with large companies in the food and health sector at the previously mentioned workshop in Berlin.

Given the importance to the private sector of research into food and health - for the health of consumers of food products, and for the health of the bottom line of the companies themselves - FAHRE has been keen to incorporate the views of major food companies into the consultation it is holding on its strategy proposals on strengthening European food and health research.

C3 Collaborating for Health, on behalf of FAHRE, sent a survey to major food companies in Europe to ascertain their views on food and health research, particularly around partnership and coordination. After some direct follow-up including telephone interviews, a report was prepared that examines the role of the private sector, partnership approaches, comments on food and health research by European companies, the barriers encountered to great participation in and the incentives that would be needed to improve this situation. It outlines the advantages and disadvantages that companies perceive to a more coordinated approach in Europe and the kind of structure that it could have.

The report may be accessed at http://www2.spi.pt/fahre/reports/c3report.pdf and the main conclusions of the survey may be summarised as follows:

- The companies regard themselves as having an important role to play in food and health research in Europe, engaging in a range of research activities including reducing levels of fat, sugar and salt, as well as drivers of consumer behaviour.
- The companies see cooperation as essential for effective research in this area, and are already actively collaborating with a range of stakeholders.
- There are a number of barriers to further research - regulatory restrictions, the risk of low returns from high investment, and intellectual property issues - and incentives could help to overcome these barriers and encourage higher levels of research.
- A more coordinated approach to research in Europe in this area would have advantages - including helping set priorities, avoid duplication, and share best practice - as well as disadvantages, including the difficulty posed by differences between countries.
- Suggestions made for the structure of further coordination fell into three categories: a virtual structure, a small steering / strategy group, or a cross-industry forum led by the private sector.

SMEs

To facilitate its work with SMEs, FAHRE contracted Robert Sanders of the European BIC Network (EBN). EBN is now the leading non-governmental pan-European network bringing together 200+ business and innovation centres (BICs) and similar organisations such as incubators, innovation and entrepreneurship centres across the enlarged Europe. Robert Sanders is Head of International Projects at EBN and has over 10 years retail experience with SMEs in the food and agri-business sector, including the launch of innovative food products.

To better understand the vision of European SMEs within the food and health sector, incorporating views on coordination, communication, regulation and innovation with regard to food and health research. A survey was developed that asked SMEs were about their current level of involvement in research and about barriers, opportunities and requirements necessary to gain access to funding and / or to become more involved in food and health research. The SME expert also conducted a number of telephone interviews with SMEs. The issues raised by this activity were then detailed in a report, which can be accessed at http://www2.spi.pt/fahre/reports/smesurveyresults.pdf and whose main conclusions may be summarised as follows:

- SMEs recognised that food and health research and innovation are key to business growth and the success of the sector, but acknowledged that involvement in research programmes is not generally given priority within their businesses.
- The potential benefits of engaging in research programmes need to be more effectively communicated to SMEs to encourage participation. There is a clear need for better communication channels across the European Member States to enable SMEs to find out about current research, access published results and reach potential research partners. These channels would help to prevent duplication of research and should lead to more funding opportunities. Some SMEs have started to see public research as a strategic resource, but others need a simple route to access this information.
- Communication of food and health research results and opportunities must be tailored to suit SMEs specific needs and delivered in a clear and understandable format. Some scientific communicators are believed by SMEs to be 'too scientific'. Respondents praised the efforts that have been made to improve the communication of results in FP7 projects; this success should be built upon.
- SMEs have embraced networking within their field and community and emphasise the benefits of collaboration and coordination. Networking opportunities within food and health research are limited and should be developed. New partnerships and networks aimed at bringing universities, research institutes and the business community closer together would be supported by SMEs.
- More opportunities need to be created for SMEs to work more collaboratively with research organisations related to food for health and play a more prominent role in research agenda setting. More than 50 % of the SMEs surveyed believe that they should be much more involved in multidisciplinary research projects that include scientific and social scientific partners.
- Innovation and research priorities for SMEs in the food and health sector can help to deliver the goals to provide safe, healthy sustainable food that meets consumer demand, complies with regulations and lessens the impact on the environment. Food security and initiatives to progress the healthy food agenda to healthy eating are also priorities. Projects working on one or more of these needs are more likely to attract the participation of SMEs.
- Research programmes for SMEs should develop technologies that suit their specific needs and have a strong focus on application and implementation within their businesses. Collaborative research projects should deliver clear benefits to the SMEs that participate in them.
- SMEs reported that financial barriers, particularly lack of skilled resources and time, lack of in-house funds and difficulty in assessing return on investment prevent them from committing to collaborative research. Additional financial support is needed for SMEs to drive food and health research and innovation as a primary element of their business development strategy.
- Access to funds from private investors, venture capital or funding from global food and health businesses are likely to encourage greater SME participation in collaborative research.

Early-stage researchers

The work with early-stage researchers was undertaken by the coordinators of FAHRE, SPI using the networks available among the project partnership such as the Young Gasteiner's Network and also its own wide ranging network connected to research and innovation (including, for example, Eurodoc, ISEKI food association, national organisations representing researchers, and the European Network for Gastrointestinal Health Research).

The current public consultation on the ERA has already highlighted potential for improvement regarding issues facing early-stage researchers and researchers in general. In March 2012, SPI organised a meeting addressing early-stage researchers in food and health. This meeting provided participants with opportunity to learn about FAHRE's results and exchange views on the FAHRE proposals and to discuss issues relevant researchers' careers in food and health research, particularly from the perspective of those at an early-stage in their career. Participants from nine European countries were present, many representing or connected to European wide initiatives / organisations of relevance to early-stage researchers and/or food and health research and innovation. Their expertise ranged from direct research experience to research policy-making and included different areas of food and health research. Examples of such organisations include: the Young Gasteiner's network, Eurodoc, and the European Network for Gastrointestinal Health Research.

The report on this event may be accessed at http://www2.spi.pt/fahre/reports/earlystageresearchers.pdf and the main suggestions resulting from the meeting were as follows:

- There should be greater transparency in recruitment of early-stage researchers including removing language barriers in this process. %l - There is a need for gathering information on food and health research organisations and their available positions in one widely used, up to date location online.
- There is also a need for enhancing the professional status of early-stage researchers, for example by using the term early-stage researcher (or similar) rather than 'student' in order to reinforce the professional position and status of PhD candidates and postdoctoral researchers at the beginning of their careers.

FAHRE position paper

Food and health research in the EU: FAHRE strategy to address the challenge of non-communicable diseases

In September 2011, the United Nations (UN) held a landmark meeting in New York on what is now recognised as a major global challenge: non communicable diseases (NCDs). According to WHO, NCDs represented 83 % of death in the EU and 63 % worldwide in 2008. NCDs include cardiovascular disease, cancer, chronic lung diseases and diabetes, and their associated conditions of heart attacks, stroke, bronchitis and obesity. They share four risk factors: tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diet.

NCDs are a major challenge for the EU. At the UN, John Dalli, European Commissioner for Health and Consumer Policy declared: 'The EU welcomes today's Declaration and its commitment to reducing the heavy burden of non-communicable diseases across the world (…) This worrying trend can be reversed through action on the risk factors influencing these diseases - such as smoking, poor diet, insufficient physical activity and harmful alcohol consumption - as well as through addressing underlying social, economic and environmental factors'.

Eating, non-communicable diseases and food security

-Unhealthy eating is recognised as one of the major risk factors of NCDs. Better diets will contribute importantly to reducing obesity and meeting the EU target of lengthening life by two healthy years by 2020.
- Changing diet is also required to address food security: with current trends, feeding the world population of 9 billion people in 2050 will require an increase of up to 90 % in production of plant calories, while this increase could be limited to 35 % with a change of diet.

There is a knowledge gap on how to influence diets and eating: we need research to better understand behaviours, policies (including regulation) and actions that will effectively change dietary patterns.

FAHRE was a 28 month project with objectives to identify needs and gaps for food and health research and to recommend coordinating structures to meet future challenges. In surveys across 32 countries, FAHRE identified 470 organisations involved in food and health research, 363 programmes that may finance research in the area and provided a review of research activities across 8 broad research areas.

In the EU, new initiatives have been launched including the following:

- The Joint Programming Initiative (JPI) 'A healthy diet for a healthy life' which is developing a research strategy and a research agenda in 20 countries. The initiative is led by Member States.
- In the new EU Framework Research Programme Horizon 2020, food and health research will be supported within the programme 'Sustainable and competitive agri-food sector for a safe and healthy diet'. Sub-areas include (1) informed consumer choice and (2) healthy and safe foods and diet for all. On the health side, the programme 'Health, demographic change and well-being' will include activities of understanding causes of diseases, and health promotion.
- In 2014, a Knowledge and Innovation Communities (KIC) 'Sustainable food supply chain from farm to fork' will be launched. The KIC is managed by the European Institute of Technology.
- DG SANCO established the first European Innovation Partnership (EIP) on active and healthy ageing, and DG Agriculture an EIP on Agricultural Productivity and Sustainability. These are overarching coordination initiative led by the EC.

FAHRE considers that there are significant risks of weak coordination between all these European-level initiatives, and that they do not necessarily feed into understanding research needs and agendas. Moreover, as the greater share of all European research funds is national, it is important to coordinate EU and national research agendas, and vice versa, and to promote exchange of information and cooperation between all the 27 Member States.

FAHRE proposals

Proposal 1: Establish a research strategy
FAHRE supports the recommendations from the expert group on food and health research set up by DG Research and Innovation to establish a research strategy for food and health research. As the biggest challenge is to reduce NCDs, FAHRE proposes updating the 'EU Strategy on nutrition, overweight and obesity-related health issues' established in 2007. The research strategy for the EU should address health challenges, and coordinate national food and health strategies, including collaborative work through the JPI.

Proposal 2: Address the research gap on changing diets
In order to change food consumption patterns by influencing consumer's behaviour, more social and consumers sciences are needed as well as policy and intervention research on food and health. Modifying diet will contribute to tackle the public health issues linked to NCDs and the challenge of feeding the world with a reasonable production increase. FAHRE's second proposal emphasises the need for more social and consumer research within national and EU food and health programming.

Proposal 3: Implement an overarching coordination between European initiatives
There is a need to implement an overarching coordination between the different European initiatives, in particular for the coordination of the research programmes financed through the JPI and Horizon 2020. FAHRE proposes the creation of an 'EC inter-service group' on food and health issues. This inter-service group will gather programme owners from DG Research and Innovation, DG Agriculture, DG SANCO, possibly other DGs and will establish close relationships with the Management Board of the JPI 'A healthy diet for a healthy life'.

Proposal 4: Coordinate research programme at national level
Agriculture and medical research are already major receivers of national funds: for example, the annual budgets of French National Institute for Agricultural Research and of the United Kingdom Medical Research Council are each in the range of EUR 800 million. Yet the World Economic Forum has estimated the cost of diabetes in 2010 to be USD 500 billion, and for cardiovascular disease USD 863 billion. By contrast, to meet this challenge, the current allocation from the FP7 project 'Food, health and well-being' in the range of EUR 80-100 million annually, and no funding is directly identifiable within the health research programme. FAHRE proposes a more ambitious approach to effectively integrate the research programmes in all EU countries. This approach is described in the strategic proposal, which follows.

How to meet the challenge: FAHRE strategic proposals

What is needed?
To effectively address the challenge of non-communicable diseases, a strategy for European research is needed. This strategy should be based on simple and clear objectives and on a mechanism to monitor progress in the implementation of the actions towards the objectives.

In a context of limited resources, FAHRE recommends focusing on the most important research need: how to influence eating. National specificities need to be taken into account, as consumer behaviours and research capacities vary from country to country.

Reaching the objectives does not necessarily require further research programmes: FAHRE identified 470 organisations involved in food and health research and 363 research programmes. The challenge is to improve coordination between existing initiatives - the national research programmes, and Horizon 2020, JPI, KIC, EIP etc.

Currently, there is no monitoring of food and health research and weak mechanisms for communication between initiatives at both EU and national level. The need is to establish simple mechanisms that will allow programme owners to be informed of proposals, progress and achievements in other programmes. FAHRE proposes that each programme (Horizon 2020, JPI, KICs and also key national programmes) exchange annual (or bi-annual) reports on activities relevant to food and health research. A summary of progress towards shared objectives, with recommendations for future programming, should also be provided.

How to make it happen?
In the short term, three main tasks need to be implemented:
1) prepare strategic orientations for food and health research in Europe;
2) collect annual reports from existing programmes;
3) provide feedback to the programmes.

Who should be in charge?
The draft 'FAHRE strategic proposals report' published for consultation in October 2011 proposed the creation on the EU-level of a coordinating research agency, with budget and representation from the three EU Directorates Agriculture, Health and Research, the Member States, and non-governmental stakeholders including and civil society and industry. Corresponding 'food and health research agencies' in the Member States, bringing together national policy-makers and stakeholders, were also proposed. Around 60 stakeholders from 24 countries provided feedback on the report. This consultation revealed little support for creating new entities, and recommended building on existing structures.

Three options are considered:

Option 1: European forum on food and health research
The option proposes a forum gathering representatives of the EC services (DG Research and Innovation, DG Agriculture, DG SANCO) of the European Institute of technology (EIT in charge of the KIC), of the JPI and of national research agencies and ministries. The secretariat could be provided by the EC (as it is the case for the SCAR for example) and a rolling presidency could be in charge of organising the annual conferences. The first conference will focus on the preparation of the strategy. Further conferences will provide reviews of annual activities of the different initiatives and feedback for programme owners.

Option 2: Food safety authorities

This option relies on existing agencies and authorities in charge of food safety. The European Food Safety Authority (EFSA), together with the 27 national authorities, set the strategy for food and health research and implement the monitoring. This option would build on a network of cooperating structures at both EU and Member States (EFSA for the EU, ANSES in France, AESAN in Spain, AGES in Austria, etc.) which have successfully addressed the challenge of food safety. The food safety authorities are independent of the public entities in charge of research, health or agriculture, and the interests of the food industry. Considering the current attention on food and health matters, it now seems relevant to extend the scope of food safety authorities from safety to health issues in addressing the public health challenge of NCDs.

Option 3: Research agencies
In this option, the EC's Directorate for Research and Innovation, in cooperation with national research agencies and ministries, take charge of preparing the strategy and implementing monitoring system. The commitment of the involved parties would be high, with better coordination of existing programmes and with the possibility of raising more funds for food and health research. Implementation of this option would depend on political factors external to the food and health research: it mainly relies upon the progress towards achieving the ERA, for which the EC is expected to publish a Communication in June 2012.

Conclusion: From EFSA to EFHA

A strategy is needed to tackle the knowledge gap on healthy eating and to monitor progress in addressing the challenge of chronic diseases and food security. FAHRE considers that food safety authorities at both EU and national level represent the best option to effectively implement such strategy: a transition from the EFSA to a European Food and Health Authority (EFHA) will accompany the evolution of the societal challenges from food safety to food and health issues.

This position paper was prepared in April 2012 by Olivier Chartier (olivier.chartier@euroquality.fr) and Elodie Cluzel (elodie.cluzel@euroquality.fr via e-mail) from EUROQUALITY with contributions from Mark McCarthy from UCL and Rachel Newton from SPI. FAHRE was coordinated by Sociedade Portuguesa de Inovação (SPI) and involved six partners: Euroquality, University College London, Skalbes, Universiti degli Studi Di Milano, DIALOGIK, and SIK.

Potential impact:

FAHRE aimed at a broad based analysis with potential to impact at European, national and regional level. Its position paper contains proposals for improving food and health research funding, which, if implemented, could significantly improve the efficiency of funding resources, transparency between funding programmes, and ensure that research addresses current challenges related to healthy eating and diet related disease. The proposals are designed to offer a number of concrete actions that can be taken at different levels of funding (EU / national / regional) and have particularly considered the current difficult economic climate. The proposed instigation of an inter-service group for monitoring purposes provides an example of such a cost effective solution whose implementation could significantly support improved coordination while requiring little additional resources. Again the structures in place at national level addressing food safety could provide a good basis around which national food and health research funding could be developed and monitored.

FAHRE's findings among specific stakeholder groups align well with other related findings and thus add weight to these. For example, the findings from early-stage researchers closely reflect those of the current public consultation on the ERA. A survey of SMEs indicated the need for improved communication channels with the researchers and policy-makers including tailored information regarding research results, increased opportunities for networking and participation in partnerships. Access to skilled labour and the ability to allocate sufficient time to research and innovation continue to be barriers to participation. Such conclusions are typical for the participation of this group of stakeholders in research and have been highlighted by the European Technology Platform 'Food for life' previously in its strategic agenda and currently specific efforts have been taking place to increase participation in the Framework Programmes for research.

Beyond the project's strategy proposals, the project offers other results that may have an impact on European food and health research. For example, the individual countries reports mapping food and health research in 32 countries may be used by policy-makers examining individual country performance, benchmarking purposes or form the basis of other initiatives addressing the organisations in this research area.

During the implementation of project the expert group on food and health research and the scientific board of the JPI 'A healthy diet for a healthy life' also took into consideration FAHRE's results and reports.

The project is also aware of other projects that will exploit FAHRE's results:

INPROFOOD - Towards sustainable food research
An FP7 project, INPROFOOD aims to foster dialogue and mutual learning between industry, academia and civil society already in the earliest stages of the research processes directed towards developing innovative approaches (technical and social) for dealing with the food and health related problems. FAHRE partners SPI and Dialogik have important roles as project partners in INPROFOOD, also bringing in their expertise gathered with the FAHRE project, thus extending the project impact beyond its duration. INPROFOOD is currently building on the mapping activities carried out in FAHRE.

EURO DISH - Study on the need for food and health research infrastructures in Europe
Also an FP7 project (currently under contract negotiation), EURO DISH aims to provide advanced and feasible recommendations to the European Strategy Forum on Research Infrastructures (ESFRI) and future European funding programmes as well as other stakeholders for food and health Research Infrastructures development. SPI will be present on the project advisory board, constituted by the expertise of 8 representatives of the stakeholders.

SUSFOOD - Sustainable food production and consumption
The FAHRE project is also a member of the advisory board of SUSFOOD, an FP7 project which aims to maximise the contribution of research to the development of food systems aiming at more sustainability from production to consumption.

Furthermore, as evidenced by this report, FAHRE will continue to present the results of this project at relevant meetings beyond its duration. Several events that have already taken place or that are due to take place are recorded in the dissemination activities conducted by the report.

FAHRE's results continue to be publically available beyond the duration of the project on the project website, which also links to the project Inprofood so that the latest relevant activity can be accessed.

Project website: http://www.spi.pt/fahre For further information about the project: rachelnewton@spi.pt