'The Value of Food: Savoir Vivre = Savoir Manger'

Our daily health is in our own hands through our food choices

On 26 September 2022 - on her 68^th birthday - Irene Lenoir-Wijnkoop is defending her PhD thesis titled ‘The Value of Food: Savoir Vivre = Savoir Manger’. In her thesis, which she completed further to various positions at Danone’s R&D Centre, she argues that despite the relevance of focusing on specific nutritional needs in combatting disease, for promoting health we should not forget that our daily nutritional needs can actually be met by a regular and balanced food intake in general. Future Food talked to Irene about her career, her research and the enjoyment of completing a PhD later in life.

Irene Lenoir-Wijnkoop, graduated as nutritionist, has had an extensive career in pharmacology and medical health. Her first job was in a cancer clinic, which is where she became interested in the interactions between chemotherapy and nutrition. After this, she moved to a research position at the pharmaceutical company Upjohn France (now Viatris, a division of Pfizer). Getting slightly worn-out by heavy pathologies, she decided to turn to the brighter side of health and nutrition. She joined Danone R&D Centre, where she was in charge of research projects aiming to provide evidence on health benefits of specific products. 

What was it like to write a PhD thesis later in life, after such a long and diverse career? Did you enjoy the experience?

Yes, I found it extremely enjoyable and I would recommend it to anyone who has the possibility to do this. At the end of a successful international career, my only driver was a profound desire to share my conviction about the importance of good, balanced nutrition and to make people aware how much of our daily health we have in our own hands through our food choices.

In your research, you combine two different disciplines into one new methodology that has come to be known as ‘nutrition economics’; a combination of nutrition research and health economic evaluation methods. Could you shortly introduce this term and explain why you have used it?

Until now, no systematic or specific approach has been developed for the assessment of the impact of food products on daily health or health-related quality of life. Combining health economic evaluation and nutrition may be an interesting way to systematize such an approach.

Health economic evaluation combines different types of data sources, by using modelling techniques. This allows to translate evidence from randomized clinical trials into standard practice, to generalize trial results for broader (patient) populations, etc. From this viewpoint it is very relevant for nutrition interventions as well. But there are also major differences. The link between the consumption of a food product and future health status is much more difficult to establish than the direct effect of a drug treatment. A cause-effect relationship can often only be confirmed after a long time span and requires huge numbers of subjects. In the healthcare environment reimbursement is important for prescription modalities, which is not the case for general nutrition. The choice of our food product can be very versatile and is also influenced by habits, taste, convenience, expectations and perceived benefits; and of course commercials. These and many other contextual aspects have to be taken into account for getting meaningful outcomes.

Health economic assessments make it possible to take many different factors into account as well as many (in)direct consequences (on healthy growing – development of physical and cognitive capacities; healthy ageing – maintenance of muscle mass and bone strength, etc). The health impact of our diet results from the concomitant interplay between macro- and micronutrients, the food matrix, various bioactive substances and the physio-metabolic functioning of our body.

The idea to combine nutrition and health economics was very innovative and it was important to determine first whether specialists from both fields considered that there was a rationale, a need to undertake this. A multidisciplinary panel came together for a consensus meeting in 2011 and the definition ‘nutrition economics’ was coined at the end of the day as the result of lively discussions. This is reported in the 2nd chapter of my thesis. In the last chapter I have indeed been able to conclude that after 10 years of existence, nutrition economics is now a generally adopted and widely used term.

In addition to the importance of ‘nutrition economics’ to establish the effects of food on specific illness or conditions, you also stress the significance of ‘nutritional literacy’. Why?

I strongly believe that an appropriate food intake is not only of value for people with a specific health condition, but for all of us whether diseased, sub-healthy or in great shape. This means that it is important for us to have the capacity to acquire, process and understand the health nutrition information that is needed to make appropriate decisions on their eating patterns. This is why improving nutritional literacy is crucial. It will benefit policy makers, health care systems, individuals and society on the whole.

It appears that information campaigns and educational efforts to change unhealthy eating patterns are often failing, due to an important information gap on the drivers of food choices in daily life. I think that citizen science can play a critical role here.

Why do you put such great trust in citizen science?

I think that the collaboration between academic researchers and citizen scientists will not only help to gain insight in the most suitable triggers for inducing durable behaviour changes, but it will also engender a two-way exchange with the participating citizen volunteers who, over the course of the project will gradually increase their own knowledge and understanding of nutritional issues that are key for a healthy way of life. It can be expected that they will share their experience in their own environment and thus informally discuss nutrition information among fellow-citizens. This will contribute to improve the level of nutritional literacy in general.

What kind of citizen science project could be valuable in this field of research?

This is something I hope to discuss soon with colleagues, because selecting the right option calls for multidisciplinary reflection. Different topics may be considered, depending on the research question or the target group. In the beginning, it will be best to identify a segment of the population that is receptive and attracted by the idea of being involved, for example future parents concerned by the health of their baby; or citizens with a known alimentary lifestyle, like vegetarians. Of course, the relevance of the data to be collected and analysed will be crucial and as said above, their value lies in bridging from both sides the existing information gap.

In general though, I think these projects will have a great future, partly because of the current availability and generalized use of apps. It is time to make the next step by generating new knowledge about the determinants of daily food choices. As often, the proof will be in the pudding, but I am convinced that it will be worthwhile to see where we will be standing after the next decade and write a thesis on the topic.

Would you like to write another PhD thesis in 10 years?

Absolutely, I would love to do that.