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Advancing agriculture and nutrition: The fight against diet-related chronic disease

January 12, 2023

Patrick J. Stover is the director of the Institute for Advancing Health Through Agriculture (IHA) at Texas A&M AgriLife Research, which is supported by the United States Department of Agriculture's Agriculture Research Service and the state of Texas, is the world’s first research institute to bring together precision nutrition, responsive agriculture and behavioral research to reduce diet-related chronic disease while also considering its environmental and economic effects.

Today's food system was scaled to prevent hunger, and is now facing new demands and expectations, particularly in the healthcare space. However, with innovative advancements in agriculture and nutrition, we can wage battle against diet-related chronic diseases, which are a major driver of healthcare costs.  Dr. Patrick J. Stover, director of the Institute for Advancing Health Through Agriculture (IHA) at Texas A&M AgriLife Research, joins the Ag Future podcast to discuss how shifting focus from producing food, fiber and fuel to promoting human, environmental and economic health can create a more efficient and resilient system.

The following is an edited transcript of the Ag Future podcast episode with Dr. Patrick J. Stover hosted by Tom Martin. Click below to hear the full audio or listen to the episode on Apple Podcasts, Spotify or Google Podcasts.

Tom:                  Welcome to Ag Future, presented by Alltech. Join us from the 2022 Alltech ONE Conference as we explore our opportunities within agri-food, business and beyond.


                             I'm Tom Martin for the Alltech Ag Future podcast series. Diet-related chronic disease is among the greatest societal challenges facing the world, driving up healthcare costs and disproportionately affecting minority communities. Dr. Patrick Stover is director of the Institute for Advancing Health Through Agriculture at Texas A&M AgriLife Research, the world's first research institute to gather, under one roof, precision nutrition, responsive agriculture and behavioral research with the aim of reducing diet-related chronic disease while also considering the environmental and the economic effects.


                             An international leader in biochemistry, agriculture and nutrition, he has served as vice chancellor and dean of agriculture and life sciences at Texas A&M AgriLife and as director of the division of nutritional sciences at Cornell University. Dr. Stover joins us to talk about how shifting from a focus on producing food, fiber and fuel to promoting human, environmental and economic health has influenced expectations for the food system over the last decade. Thanks for joining us, Dr. Stover.


Patrick:              Thank you for the opportunity. It's a pleasure to be here.


Tom:                  Whenever we talk to a working farmer, we're nearly always struck by a realization that we're talking with a scientist. I thought we would begin by exploring that for a moment. Farming — it's inherently science, isn't it?


Patrick:              Oh, absolutely. This was recognized by President Lincoln in 1862 when he established the land-grant universities for the purpose of both advancing mechanics or engineering and agriculture. In every state in this nation, we have a land-grant university that is dedicated to advancing all aspects of agriculture, from understanding soil to understanding plants and plant breeding, animals and animal breeding, animal health, all the way to agricultural engineering — how can we mechanize better? How can we produce food faster, cheaper, more abundantly?


Tom:                  We have one of those here in Lexington: the University of Kentucky.


Patrick:              Absolutely — a very good one.


Tom:                  What is meant by “responsive agriculture”?


Patrick:              If you look at the food system that we have today, this really came out of the post-World War II era, where — during World War II, there were great demands on the food supply. There was rationing of food to make sure that our soldiers had the nourishment they need to perform well on the battlefield. At the same time, we have the Depression that led up to World War II and the post-Depression era, where there was a lot of hunger in this country. There became this sense that hunger was unacceptable, both in this country and abroad. You saw many efforts, humanitarian efforts, to scale up agriculture for the sole purpose of eliminating hunger — and again, both domestically and abroad.


                             That's the food system we have today. It was scaled to preventing hunger. Hunger is not a disease. Hunger is a physiological response to a lack of calories. Therefore, we scaled agriculture production to meet the caloric needs not only of the nation but of the world. That's the food system that we have today. But now, we see there are other demands on agriculture, new expectations. We see (that) the agriculture system we have today and the food system we have today makes hunger rare. It still exists, but it's not due to a lack of abundance of food. It's more (related to) access issues. But now, we see that there are other costs that food produces.


                             Some of those in the healthcare space, we see the diet-related chronic diseases, (which are) the major driver of healthcare costs. Diabetes alone costs about $160 billion to $170 billion a year — more than most state agencies receive in their funding. We see a total cost of about $4 trillion a year. No one can afford those costs — no government or individuals. At the same time, we also have expectations around the environment. Certainly, agriculture has an environmental footprint in terms of emissions and runoff and such. But we also see that agriculture can be the solution to some of our environmental issues and actually capture carbon from other sectors.


                             Of course, economic health is also critical. The margins in agriculture are so thin, and we are losing much of our precious farmland to other, more profitable purposes. Now we see, not only do we have to produce food to eliminate hunger, but we have to do it in a way that supports human health, environmental health and economic health.


Tom:                  A century ago, it was the Great Depression. Would you say that, today, climate change presents that same imperative to get ahead of the hunger curve?


Patrick:              Certainly, there are many concerns about climate. Climate affects agriculture, really, in two domains. Number one, we are seeing extreme variations in temperature over short periods of time. That plays havoc on our agriculture systems and our ability to produce food looking forward. Certainly, the climate has an effect on agriculture. We also see, again, that agriculture has an environmental footprint. The question is: How can we lower that environmental footprint?


There's so much innovation out there, from capture of carbon in soil to creating biomass — all of these innovations to reducing methane production from agriculture. All of these innovations we see are out there that really give us the promise of having agriculture not only have a very low environmental footprint but potentially even capturing environmental footprints from manufacturing, from travel and those other areas that have much larger environmental footprints.


Tom:                  I understand correctly that you're engaged in behavioral research. What can you tell us about what you're doing?


Patrick:              Absolutely. Well, that is really the third leg. That is so key. We can do all of this work to produce food in a way that better supports the environment and human health and the economy. We can produce food that the consumers want and (that) also supports their health. But if all this science is not accepted by society, we're not going to achieve our goal. That science will just sit on a shelf. So, what's absolutely critical is to understand human behaviors.


Everyone eats. Everyone makes food choices. We have to understand how people, how communities, how societies make those choices, and how we can use science and convince the population that a science approach to health behaviors will be better for them in the long run, for their personal health, for their community health. We have a long way to go in that public trust area, but the social behavioral science will be key so that we can adopt these important technologies to actually implement out in society.


Tom:                  What sorts of major impactful changes have occurred in recent years in each of these areas: farming, food production and nutrition? Let's take them one at a time — because it's a big question — beginning with farming.


Patrick:              Certainly. If you look at farming — and I'll put farming and food production together, if you don't mind.


Tom:                  Sure.


Patrick:              What we have seen is great efficiencies. In the United States, the average American spends less than 9% of their available resources on food. That's remarkable. It's not like that anywhere else in the world. It's never been that low anytime in human history. That's because of the great innovations that have occurred, all the way from what we grow to how we process food. We have created an unbelievably efficient system through advances in plant breeding, through advances in engineering and irrigation, through advances in pest control to how we process food. We have created a highly efficient, vertically integrated system like the world has never seen.


                             Now, during COVID, we saw some of the vulnerabilities where, while it was very efficient, it wasn't very resilient. So now, you're seeing other innovations that are trying to tap into this wonderful system that's been effective in producing food — but (we are trying to) add more resiliency through more local agriculture, through urban agriculture and other innovations that are enabling our system not only to be efficient but to be resilient, and technologies will be key to continue to drive that.


Tom:                  How about nutrition? What's been happening in nutrition that is exciting (and is) going on now?


Patrick:              Nutrition potentially is one of the most transformed fields (of) the past few years. If you look historically, the goal of nutrition has been to understand how much of all the various nutrients you need — how much iron you need, how much B vitamins you need, et cetera — and how those translate into foods you should eat so that you don't become deficient in any of these nutrients. That was the goal of nutrition, was to understand the chemistry and the biochemistry of these nutrients, and how much you needed to make sure you could carry out fundamental functions in your body.


                             Well, we've now moved the needle. Because we see that food is a major driver of healthcare costs, Congress essentially said of the National Academy of Sciences — which is charged with determining how much of each nutrient you need every day, the so-called RDAs — said, “Well, we don't really have diseases of deficiency anymore. What we have is diet-related chronic disease. So, rather than setting these nutrient standards based on preventing diseases, let's have the endpoint as a chronic disease so we can use food to lower healthcare costs.”


                             That, essentially, was the advent of food as medicine. This becomes a much more complex problem, because people respond differently to diets in terms of their disease risk. Virtually all populations — if you make them deficient in a nutrient, everyone in the population responds the same, and you can have population-based guidance, whereas, when you have a chronic disease outcome, people respond differently based on our population history. Now you have responders and non-responders — and this whole idea that, if we're going to use food to lower healthcare costs, we have to understand how food interacts with an individual at that level.


Tom:                   I guess most of us are walking around not really realizing or appreciating that what we consume, the food that we eat, actually has the ability to switch on and switch off genes.


Patrick:              Oh, it's incredible. Again, if you look throughout all of human history, populations emerged all over the globe. Those that were able to survive and expand were those that adapted to their local food environment and their local pathogen environment. That's what you had to do to survive. If you look at populations in northern Canada, they metabolize fat very, very differently than native cultures there. And the native populations metabolize fat very, very different than you and I do. If you look at Scandinavia, there's very little iron in the soil. Therefore, there was this selective pressure genetically to get every little bit of iron out of food. But now, when you put those individuals on an iron-rich diet (through) a global food system, you see hemochromatosis, and they result in cancers and other types of, essentially, diet-related chronic diseases. You can look at lactose intolerance. It goes on and on.


                             So certainly, the food systems out there, around the globe, have really shaped who we are. In turn, the foods we eat turn our genes on and off. It's a very complex system. We are all different based on our population history, but that's the opportunity to use food as medicine to understand those differences — how we interact with that food, how food changes us, and how, historically, we have adapted to food systems to understand that diet-disease connection at the level of the individual.


Tom:                  Could agriculture, food production and nutritional intelligence be made — or maybe they do work in concert — to improve public health?


Patrick:              Well, that's the big challenge. Historically, we have siloed the food system at the level of science, at the level of public policy. Even in the Farm Bill, you have the nutrition title over here, you have the ag component over here, and they don’t talk to each other — yet we know (that) if we are going to make agriculture the solution to human health, environmental health and economic health, that's what the mandate is. We have to consider this as the complex system that it is.


                             When we change dietary guidelines, that has a ripple effect back across the food system. When we have soil erosion, we lose quality components in that soil, (and) that affects the food system in the other direction. We have to understand and make decisions respecting the fact that this is a very complex system that goes from farm inputs to consumer behavior. And we have to make sure that the research that we do considers that. We have to make sure that the public policy that we have considers that.


Tom:                  We've touched on hunger earlier. Food scarcity and malnutrition remain significant issues, even in developed countries. What is agriculture's role not only in producing enough food but in producing enough nutritious food?


Patrick:              This is the challenge, and it gets down to definition. Certainly, the world population is growing. By 2050, there'll be another two billion people on this planet. And as you said, we already have food insecurity and lack of food in some places, so we have to make more. But we also recognize that we have to make better, if you will — that we have to make food that is better aligned with human health, environmental health and economic health. Technologies have to be the answer there. We're going to have to continue to be more efficient so that we can produce more and feed the world, but we have to do it in a way that both respects cultures — because there's a strong cultural component to food — so that people accept the food that's being produced. But we also have to use these technologies to make sure that it can be medicine to these populations, that it lowers healthcare costs.


Tom:                  Is there an appetite today for finding ways to more tightly coordinate these disparate sectors of the industry, the entire food ag value chain, as a strategy to bring about those improvements?


Patrick:              Well, that's a big focus of our institute, is to try to make sure that we do have this better-integrated, systemic approach. To do that, everyone needs a seat at the table. We need to do this to be successful. But, for instance, we have technologies through gene editing to create plants that have virtually any quality we want in terms of disease resistance, in terms of nutrient value, et cetera. But we have to bring along the regulators to make sure that we are producing something that not only is going to benefit society but is going to be safe as well.


                             We need to bring along the regulatory community. We need to bring along the general public. They have to accept this food that is produced that is going to improve their health, and they have to have trust in that food. We need to bring the farmers and the ranchers. They need to understand how this is going to help their bottom line. Their margins are very thin. They have to be risk-averse or they don't succeed in their business. We have to convince them that this is good for them, good for their operations. We need the related policies and incentives, again, so that technologies — so that advances in crops and crop breeding will be accepted by that group.


                             Everyone needs a seat at the table, and we need to start with the endpoints. We have a very segmented approach to addressing the food system and constituencies across the food system. We have consumers who blame producers and food manufacturers, who then say — well, they blame the consumer, because (their belief is), “We just respond to consumer demand.” We need to not have a food fight. We need to bring everybody to the table (to) decide: What are these endpoints that we want, and how can we reverse-engineer back to the food system to achieve those goals that are so critical to our society right now?


Tom:                  There is a lot of risk in farming. I'm just wondering how this holistic approach reduces at least some of that exposure to the uncertainty and the stress that it causes.


Patrick:              Certainly. If you look, currently, at the food system we have today, we have to understand that farmers and ranchers — which make up just about 1% of our society today; 1% of the population produces food for the rest of the 99% — they are businesspeople. They make decisions every day (about) what they grow, how much they grow, when they grow it, based on what the market will bear. They are businesspeople. The biggest threat to their operation is uncertainty, because their margins are so thin. With a couple of bad years, their enterprises are in danger. That has to be the role of science, and that will be the role of our institute at Texas A&M.


                             We need authoritative voices out there about what the science says related to any question around the agriculture and food value chain, from farm inputs all the way to consumer behavior, and we have to be very clear about what the science says. Right now, much of our food system is driven by preferences, values and beliefs, on both the health side (and) on the environmental side. And often, people quote their favorite study — “Well, this study says this,” “But my study says that” — rather than looking at the totality of the scientific literature like we do in medicine, where we actually don't look at papers individually, but we combine all of the research together in a statistically appropriate way. And we say, “Well, our current scientific knowledge is X, Y or Z, based on that synthesis, and this is how certain or strong it is.”


                             We don't have that in food and agriculture. That's something at Texas A&M that we would like to see happen in this country, is to have science lead. People will always have preferences, values and beliefs around the food system. There's a deep cultural component — a deep moral, if you will, component — to food, but that's not science. We have to say what the science says so that people out there who make decisions can weigh between what the science says and, then, what individual values, preferences and beliefs are.


Tom:                  Dr. Stover, we've witnessed the sudden disruption of an important source of the world's grain, and I'm talking about the war in Ukraine. Has this development inspired new thinking about the resources needed to feed the world and to keep them secure?


Patrick:              Certainly. What we're seeing going on in Ukraine is a tragedy, but there will always be wars. In fact, Norman Borlaug once said, “You can't build a peaceful world on empty stomachs and human misery. Food is fundamental to a peaceful world.” What we have to ensure is that all countries around the globe have the capacity to feed their populations; (it’s) absolutely essential. This was the work of Norman Borlaug in international agriculture: to build that agriculture infrastructure in every region, in every country, to avoid hunger.


                             Now, local agriculture is imperative, (but) we also need that global agriculture system as well, because sometimes there are droughts. There are catastrophes that happen that limit a given region's ability to produce food, and they need to tap into the global food system. But we need to think very carefully about how we marry capacity to grow food in every region with a global food system and how those two are integrated together to ensure that we have peace, to ensure that we have food for everyone.


Tom:                  Dr. Patrick Stover, director of the Institute for Advancing Health Through Agriculture at Texas A&M AgriLife Research. Thank you so much.


Patrick:              Thank you. It's a pleasure to be here.


Tom:                  And for the Alltech Ag Future podcast, I'm Tom Martin. Thank you for joining us. Be sure to subscribe to Ag Future wherever you listen to podcasts.