Impact case study database

As a direct result of the research outlined in this case study, key players across the food industry now have a greater understanding of how saturated fatty acids (SFA), particularly from dairy products, affect both human health and greenhouse gas emissions from dairy farming. What is more, the research has provided ways to mitigate these negative effects by changing farming practices. The team’s studies have provided evidence of the importance for our cardiovascular health of reducing SFA and replacing them with unsaturated fats. This knowledge has informed UK Government and WHO dietary policy on SFA and clarified for the public how dietary SFA intake affects their health.

Impact on the dairy industry – from production to retail

The team’s early finding – that the SFA content of milk fat could be reduced from approximately 70 to 60% of total fatty acids (TFA) by replacing palm oil with oleic acid-rich rapeseed in the diet of dairy cows – formed the basis of a 2014 REF impact case study. That case study reported the introduction of a new policy by M&S in October 2011 requiring its milk producers (38 dairy farms) to reduce the SFA content in their milk by at least 6% for an extra payment [E1, E2]. This policy, continued in the current REF period, resulting in further sales of approximately 380,000,000 litres of milk and led directly to the removal of approximately 4,750 tonnes of palm oil (1,000 tonnes per year) from the diets of cows across the M&S milk supply pool, and 400 tonnes of SFA (84 tonnes per year) from their supply chain under this practice [E1]. M&S is one of the UK’s leading food retailers and sells 80,000,000 litres of milk to around 1,500,000 customers each year [E2]. Assuming two people per household, the highlighted evidence on the M&S activity represents an estimated 3,000,000 people per year in the UK who have benefited from reduced SFA/increased MUFA in their diet over the current REF period.

Later studies by the Reading team, which demonstrated a health benefit from the consumption of milk with reduced SFA and increased MUFA, have led the Finnish company Valio to invest in the co-development of new dairy products (butter and cheese) from milk with a saturated fat content of approximately 60% TFA. Valio processes 1,800,000,000 litres of milk from 4,500 farms per year and is a major supplier to the international dairy ingredients market, with subsidiaries in Russia, Sweden, the Baltics, USA and China. Since January 2018, over EUR 400,000 has been co-invested in product development and consumer acceptance studies supported by EIT Food (an EU Horizon 2020 initiative). Between 2018 and 2019, Valio and academic partners at the Universities of Reading and Helsinki undertook extensive consumer testing on UHT milk, cheese and butter made from the modified milk. In acceptance tests, subjects were very positive about the products containing less SFA compared with standard products [E3]. Valio has stated that work at Reading, demonstrating the substantial reductions in methane obtained from feeding oilseeds (including rapeseeds) to dairy cows, has “helped the development of our policy on carbon reduction” as well as stating that they have been “encouraging our milk producers to adopt approaches to reduce the production of methane” [E4]. Furthermore, feeding strategies developed through the EIT Food project, and based on earlier work at Reading, have been incorporated into a book for Finnish farmers, called ‘Climate-Wise Farm Enterprise’. The book was distributed to subscribers of the leading Finnish farmers magazine Käytännön Maamies (print run 17,000) in 2019 [E5].

Influence on Government dietary policy

Lovegrove’s more than 250 scientific papers have made a significant contribution to understanding the importance of dietary fats in relation to CVD risk. This expertise has underpinned her appointment to a number of senior advisory roles that shape government policy and industry policy and practice, and, in turn, impact upon public health. Notably, she has been a member of the UK Government’s Scientific Advisory Committee on Nutrition (SACN) since October 2009 and SACN Deputy Chair since June 2020.

In June 2014, SACN agreed to undertake a priority review of the evidence on the role of SFA on health. This decision followed a request for specific advice by the then Food Standards Agency (Scotland) and was based on Lovegrove’s advice, underpinned by her own research findings that there was convincing evidence to warrant updating the 1994 guidelines on SFA [E6]. SACN convened a working group in October 2015 with Lovegrove a key expert on fats and CVD. She drafted the review’s chapter on cardiovascular disease and subsequently contributed to the whole report and development of recommendations arising from the evidence review. The ‘Saturated Fats and Health’ report was published in August 2019 [E7]. It was based primarily on the committee’s expert assessment and grading of evidence from systematic reviews and meta-analyses of randomised controlled trials and prospective cohort studies [E6].

The report reinforced existing public health policy by recommending that the population average contribution of saturated fatty acids to total dietary energy should be reduced to no more than 10%. However, SACN made an important clarification, advising for the first time that SFA should be replaced with unsaturated fats. This explicit recommendation followed the conclusion in Lovegrove’s cardiovascular diseases chapter, that there was more evidence for polyunsaturated fats, but insufficient evidence to support substitution of SFA with either carbohydrates or protein for improved cardiovascular disease health outcomes. It has since been incorporated into Government policy and public health advice, for example as part of the NHS live well, eat well guidance [E6, E8]. Respected societies and organisations welcomed these clarifications. Speaking on the day that the report was published, The Head of Nutrition Science at Public Health England, said: “SACN’s review supports and strengthens current advice. We recommend eating foods high in saturated fat less often and in smaller amounts and swapping to unsaturated fats to help achieve a healthy, balanced diet.” In addition, a statement from the British Nutrition Foundation (BNF) said: “The effect of saturated fat on health has been hotly debated in recent years and the relationship between saturated fat and cardiovascular disease (CVD) has been called into question. As the SACN report highlights, we have evidence from clinical trials that replacing saturated fat with unsaturated fats (especially polyunsaturated fats) can have a beneficial effect on blood cholesterol levels and CVD risk.” The Director General of the BNF added: “What is really important when it comes to reducing saturated fat is what you eat instead.” [E9]

Since its publication, the SACN report on Saturated Fats and Health and updated public health guidelines has helped to support the food industry to take action on high saturated fat containing food products. For example, a Food Standards Agency report (September 2020) on a survey of the nutritional content of cheesecake sold by food businesses across Northern Ireland (NI), found that some cheesecake portions sold in restaurants exceeded the advised daily recommended intake for saturated fat. As a result, the report made recommendations for a number of targeted interventions to support food businesses across NI to reduce the saturated fat content of cheesecakes and other desserts [E10].

Furthermore, the team’s research has informed the development of the World Health Organisation’s (WHO) draft guidelines on SFA intake target, which were published for consultation in May 2018. This document cited a meta-analysis on dairy and CVD risk, co-authored by Givens and Lovegrove, as ‘emerging evidence’ that different SFA-containing foods, such as dairy, may have different effects on CVD risk [7]. As a result, the draft WHO guidelines recommended that further research comparing the effects of SFA from different food sources on CVD and mortality was needed [E11].

Summary: Evidence from the University of Reading has steered the policies of a major milk processor and retailer, influencing practice change by dairy farmers across the UK and EU. UK retailer M&S has provided evidence that this policy led directly to the removal of significant amounts of SFA and palm oil from their supply chain. Over 1,500,000 M&S customers have benefited from consuming this healthier milk over the REF period and the removal of an estimated 1,000 t/year of imported palm oil and reduction in methane emissions from the M&S supply chain has played an important role in meeting the company’s corporate and social responsibility targets. Methane reduction in dairy cattle is also a key target for Valio, and their suppliers are being encouraged to change practice based on Reading research as part of the company’s carbon reduction policy. UK and international health guidelines have also been shaped by the research, providing clarity to UK public health advice and with the WHO recommending that further research comparing the effects of dietary SFA on CVD and mortality be carried out as a result of the team’s evidence.