The Deficiency Project

1 Framework & Findings Nikko-Ryan Santillan

The Deficiency Project Nikko-Ryan Santillan A thesis in partial fulfillment of the requirements for the degree of Master of Science in Communications Design.

School of Art and Design Pratt Institute May 2014 Received and approved:

Jean Brennan, Thesis Advisor

Jeffrey Bellantoni, Department Chair

Date

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ACKNOWLEDGEMENTS To my family, especially Mom and Erin: Your struggles with mental illness and nutrition formed the inspiration and lasting motivation to produce this project. Thank you for your endless support and for never giving up.

To Jean Brennan: You are amazing. Though I was skeptical of your process-oriented approach to teaching Thesis I/II, it was ultimately the best environment for me to be in. Thank you for always being a beacon of “calm”, and for pushing me to think one step further.

To John Olson: Thank you for being such a great friend and support system throughout this entire process (donuts or no donuts included).

We did it!

To Sara Chavez and Jacob Alvarez: Thank you for letting me vent without asking questions, and for always being two of my best cheerleaders (even if we’re 3,000 miles apart).

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PREFACE First and foremost, I am not a nutrition expert nor a scientist. I am simply a graphic designer proposing two solutions to the existing communication problem between Nutrition Facts labels and customers, specifically in terms of micronutrients, or vitamins and minerals.

Personally, just like many other people, I do my best to pay attention to Nutrition Facts labels. I interact with them on a daily basis, and I trust their accuracy to make better food choices that will benefit my body. Such ethnocentric analysis was the methodological basis of this thesis. By not only focusing on my own personal questions and nutritional intake, I sought to empathize with other food buyers and label users in an effort to challenge the question of what constitutes a healthy diet? Are calories, carbohydrates, fat, and protein, the macronutrients, the only values indicative of health? Why is there such a visual separation of macronutrients and micronutrients? Are vitamin and mineral values something that I or the general public should pay attention to? How does one’s diet affect their mental health as well as their physical health?

Questions like these echo my statement above that there is a communication problem between the food product and the food buyer. Very few people know how to accurately read and translate nutritional data in a way that builds a healthy diet, yet more and more people are attempting to make healthy dietary choices. So, how can they better educate themselves or bridge this communication gap that makes food buyers more proactive and aware of the information they are referencing? This is the essence of The Deficiency Project.

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“Micronutrient deficiencies affect nearly half of humanity.�

The Micronutrient Report

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FRAMING THE PROBLEM “Micronutrient deficiencies affect nearly half of humanity.”1 Though startling to read at first, especially when consumers are encouraged to examine food ingredients, purchase foods labeled “organic”, and/ or limit calorie consumption, the initial shock of this statement fades once one understands some of the social behaviors that foster this global epidemic.

In the United States, “...as many as 90 million Americans have inadequate literacy and numeracy skills to function in today’s healthcare environment. Numeracy, the ability to use and understand numbers in daily life, may play a particularly important role in patients’ ability to read and interpret nutritional information.”2 Even the organization of said How can people be nutritional information in the Nutrition expected to consume Facts Label imposes a hierarchy of content 100% Daily Values of that decreases in visual significance as one micronutrients when moves down the vertical black and white chart. most are not skilled to Micronutrient values are placed on the bottom interpret the numerical of the label under a thick, horizontal black data and/or engage line, while macronutrients are listed at the top with the Nutrition under calories. How can people be expected to Facts Label itself? consume 100% Daily Values of micronutrients when most are not skilled to interpret the numerical data and/or engage with the entire Nutrition Facts Label itself? Governments and healthcare professionals know that this global epidemic exists, yet minimal effort is placed on re-educating citizens about the importance of micronutrients in relation to one’s personal diet.

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Adequate micronutrient consumption ensures that the body sustains metabolic function, cognitive development, and immune system support to combat chronic illness. Although each individual person has different nutritional requirements in terms of micro-and macronutrients, supplying one’s body with these crucial vitamins and minerals is best achieved via food. “... ideally a balance of micronutrients should be obtained from a well balanced diet. If such a well-balanced diet cannot be consumed and there is evidence of inadequate micronutrient “... ideally a balance of intake, a well-balanced supplement of all trace micronutrients should elements and vitamins designed to deliver at be obtained from a well most the Reference Nutrient intake should be balanced diet. given.”3 It is important to note, though, that Alan Shenkin supplements should not be considered an alternative to directly consuming nutritious food. Oftentimes, supplements contain a significant amount of vitamins or minerals that exceed the recommended daily allowance for certain micronutrients, which may not be good for a person’s body and proper bodily function. This makes paying attention to the quality of food that much more important, because maintaining a well-balanced diet is certainly doable as long as consumers know how to make educated food choices.

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THESIS STATEMENT This thesis will study the experience of reading Nutrition Facts Labels in an effort to examine if consumers understand micronutrient data.

It will also explore ways to enhance the consumer’s experience with this data by designing two simple, visual projects that empower users to take a proactive approach to abating micronutrient deficiencies through nutrient tracking and education.

QUESTIONS Without knowing the direction that this thesis project would head or who the target audience would even be, a series of questions were developed regarding the topics of nutrition, percent daily values, and nutrition facts labels. Additionally, methodological exercises such as visual mind mapping, free writing, and affinity diagrams were employed to help guide the secondary research of each topic area or area of interest that resulted from the topic of micronutrients and nutritional well-being.

The questions that were developed for this exploration are divided into two categories: user-based questions and information-based questions. User-based questions evolved from my personal experience using Nutrition Facts Labels and curiosities involving similarities and differences with other people. Information-based questions, however, were more objective and emphasized the display and absorption of data by an audience. Analyzing and investigating each 10

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question through secondary research then helped determine which methodologies would be applicable for the visual project.

User-based questions: • How do people relate to food? How do they interact with it?

• Do people change their diets based on information that they read or hear about?

• Do people track percent daily values?

• How does a piece of technology or information entice people to “take the next step”? How do people act on this awareness?

Information-based questions: • How do I shift the social nutrition focus from macronutrients to micronutrients?

• Is the calories numbers game an accurate indicator of a “healthy diet”?

• What information is most relevant to people, or observed by them, on a Nutrition Facts Label?

METHODOLOGIES In addition to visual mind-mapping, free writing, and affinity diagrams mentioned previously, other specific methodologies were exercised during the development of this thesis. These were inspired by a set of IDEO Method Cards4, which will be elaborated upon in more detail individually within the Visual Project chapter. However, for the sake of this introduction, practiced methodologies include:

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• • • • • • • •

Personal Inventory/Self Study Competitive Product Survey Questionnaires Anthropometric Analysis Conceptual Landscape Flow Analysis Paper Prototyping Scenario Testing

RELEVANCE Micronutrient deficiencies are a significant problem. This is especially relevant to industrialized countries, where packaged and processed foods outweigh whole foods in terms of population consumption, and when rates of chronic diseases and mental illness are increasing. More people are consuming processed foods due to perceived convenience, and they are being manipulated by health claims broadcasted across food packaging to maintain this behavior. Motivated by profit, the food industry has shaped popular opinion and ultimately transformed consumer eating “The processing of habits to favor the quantity of food instead foods typically robs of the quality of it. “The processing of foods them of nutrients, typically robs them of nutrients, vitamins vitamins especially,” especially,”5 so really what’s the point of Michael Pollan calling food “food” if their nutritional values are diminished, scientifically altered, or not even naturally occurring?

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The intent of this thesis is not to say that micronutrients are better or more indicative of a healthy diet than macronutrients. However, the goal of this project is to question popular opinion of what constitutes a “healthy diet” using what already exists (Nutrition Facts Labels), and propose an alternative to popular culture’s obsession with calorie counting, carbs, fat, and protein--that micronutrients are a viable source of nutrition.

...so really what’s the point of calling food “food” if their nutritional values are diminished, scientifically altered, or not even naturally occurring?

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FINDINGS Hardly knowing anything about nutrition or micronutrients when I began this thesis journey, I now feel educated enough to make informed decisions concerning my own personal diet and confident enough to spark conversations with other people about the food industry. As a consumer, I am more hesitant to be influenced by health claims made on packaged food items, less likely to partake in new dietary fads, and more proactive about consuming whole foods and partaking in the traditional experience of cooking. As a designer, I feel more equipped to tackle design projects that involve heavy research and/or focus on improving user needs.

In terms of The Deficiency Project, I would like to see this project have a life after Pratt. I would like to know that my website could actually help educate someone about micronutrient deficiencies, and I am hopeful that the argument made within this document is validated in a cultural shift that places greater emphasis on understanding which vitamins and minerals are actually in a person’s food. As I stated in the beginning, the intent of this thesis was not to say that micronutrients are better or more indicative of a healthy diet than macronutrients.

Instead, my goal was to simply question popular opinion of what constitutes a “healthy diet� using what already exists (Nutrition Facts Labels), and spark a conversation between this project and its audience. The more people know about micronutrients, the greater the chances are that they will alter their diets to be more nutrientdense and thereby reduce their chances of developing vitamin and mineral deficiencies and chronic illness.

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SOURCES 1.

Mason, John B. “The Micronutrient Report: Current Progress and Trends in the Control of Vitamin A, Iodine, and Iron Deficiencies.” . The Micronutrient Initiative , 1 Jan. 2001.

Web. 20 Sept. 2013. <http://www.micronutrient.org/resources/ publications/mn_report.pdf>.

2.

Rothman, Russell L. “Patient Understanding Of Food Labels: The Role Of Literacy And Numeracy.” American Journal of Preventive Medicine: 391-398. Web. 19 Sept. 2013.

3.

Shenkin, Alan. “The key role of micronutrients.” Clinical Nutrition: 1-13. Print.

4. “IDEO Method Cards.” . N.p., 1 Jan. 2002. Web. 14 Sept.

2013. <http://www.ideo.com/work/method-cards/>.

5.

Pollan, Michael. In defense of food: an eater’s manifesto. New York: Penguin Press, 2008. Print.

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2 Secondary Research Nikko-Ryan Santillan

MICRONUTRIENTS A micronutrient is defined as “an organic compound (as a vitamin) essential in minute amounts to the growth and health of an animal.”1 However, in terms of the human body, they are defined more functionally as “vitamins and minerals required in small amounts that are essential to our health, development, and growth.”2 Micronutrients are essential to the body because they ensure that it sustains metabolic function, healthy cognitive development, and enough support for the immune system to combat chronic illness.

Since micronutrients are vitamins and minerals, they are naturally found in plant and animal-based foods. At the same time, however, these vital nutrients can also be synthesized in a laboratory and chemically induced into different foods in order to increase their nutritional value. Referred to as food fortification, this process typically only involves the alteration of staple foods such as salt, maize flour, wheat flour, sugar, vegetable oil, and rice2, and is commonly found in developing countries. Regardless of access and significance to one’s bodily functions, though, micronutrients should be consumed in small amounts—hence the term “micro”, meaning small. Consuming more than the recommended daily value of these micronutrients may be toxic to ones body.

So, what are the specific micronutrients that people should be aware of and what is their significance to the human body? Riordan Clinic, a non-profit medical, research, and educational organization, qualifies this data in figures 1.1–1.83.

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Macronutrients differ from micronutrients in the fact that they are not required in small dosages—they are required in large amounts.

Additionally, they are the “nutrients that provide calories or energy,”4 needed for ones body to function altogether.

There are three macronutrients: carbohydrate, protein, and fat.

Carbohydrates and proteins provide four calories per gram, while fat provides nine calories per gram. Although the ratio of calories per gram in fat is greater than carbohydrates and protein, consumption of fat should not contribute the most to ones overall daily calorie intake. “According to the Dietary Reference Intakes published by the USDA 20%-35% of calories should come from fat”4, compared to 10%-35% for protein and 45%-65% for carbohydrates. Consuming calories relative to these percentages is one indicator of a balanced diet. The only other consumable source of calories is alcohol, but it is not required for survival. Therefore, alcohol is not a macronutrient.

“vitamins and minerals required in small amounts that are essential to our health, development, and growth.”

Project Healthy Children

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HEALTH BENEFITS Unlike macronutrients that fuel the body, micronutrients help sustain metabolic function, ensure healthy cognitive development, and support defenses of the immune system. In addition to these general health benefits, studies have been conducted that suggest micronutrients play an important role in prolonging or reducing symptoms of various physical and mental conditions and diseases such as HIV, Alzheimer’s disease, and mental disorders.

HIV DISEASE PROGRESSION In 2010, Kieryn Graham of The AIDS Beacon, an online independent publishing company based in Princeton, New Jersey, wrote an article that highlighted presented research from the 2010 International AIDS Conference. Within “certain vitamins this research, three independent studies argue and minerals, known that “certain vitamins and minerals, known as as micronutrients, micronutrients, may help delay HIV disease may help delay HIV progression and improve immune health of disease progression people living with HIV.”5 and improve immune health of people living The hypothesis of the first study examined with HIV.” whether improved immune function and The AIDS Beacon the delayed onset of AIDS in HIV-positive adults in Botswana was possible through the prescription of micronutrient supplements containing vitamin B-complex, vitamin C, vitamin E, and Selenium.

875 HIV-positive adults were enrolled in the study, and their white 4

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blood cell (CD4) counts were monitored for a 24-month period.

If their CD4 counts dropped below 250 cells per microliter, then their disease status had progressed to AIDS and were started on antiretroviral therapy (the use of anti-HIV drugs). Results of the study concluded that participants who were assigned the micronutrient supplement rather than the placebo had a reduced probability of their CD4 counts falling below 250 by 38 percent, supporting the hypothesis that select micronutrients do play an important role in delaying the onset of AIDS in HIV-positive adults.

The second study that Graham presented highlights the importance of zinc, specifically its role in the prevention of immune system failure in 40 HIV-positive adults who are on antiretroviral therapy. One of the primary functions of zinc in the body is to aid the creation of CD4 cells in support of healthy immune system function. If a patient experiences immune system failure, then that means that their CD4 counts are 200 cells per microliter or less. Through the assignment of either a zinc supplement or a placebo, results of the study concluded that only four participants (21%), experienced immune system failure over 18 months. Furthermore, “none of the participants taking zinc supplements experienced immune system failure”5, supporting the original hypothesis that the consumption of zinc supplements may help maintain immune system health in HIV-positive patients who are on antiretroviral therapy.

The final and smallest study discussed in this article tracks antioxidants and their support for a healthy immune system involving 25 HIVpositive adults on antiretroviral therapy. “HIV infection and longterm antiretroviral therapy have been associated with mitochondrial damage”5, which negatively impacts the immune system because cells do not have enough energy to properly function. Therefore, a 5

boost of antioxidants in the body can help reduce such cell damage by targeting those chemicals that damage DNA, proteins, and other molecules present in the body. Those involved in this study were randomly assigned either a placebo or an antioxidant supplement containing vitamin B-complex, vitamin C, vitamin E, zinc, selenium, N-acetyl cysteine, and α-lipoic acid for the course of eight weeks.

After those two months, results concluded that antioxidants did reduce mitochondrial damage, which means that they may help with immune system recovery of HIV-positive patients on antiretroviral therapy. However, the execution of a larger study over a longer period of time would need to be conducted, just like with the previous study, to determine whether these nutritional claims are truly valid.

ALZHEIMER’S DISEASE Alzheimer’s disease is the main cause of dementia, and it generally affects the elderly. In a study published by Barbara Cardoso et al regarding the major nutrients that are related to Alzheimer’s disease, it is estimated by Ferri et al that “4.6 million new cases arise every year, and if new prevention studies are not implemented, the number of affected people will exceed 81 million by the year 2040.”6 One such new prevention method is being aware of one’s dietary intake of nutrients.

“Alzheimer’s disease patients usually have insufficient levels of specific nutrients, and low intake of these nutrients is associated with an increased risk of developing Alzheimer’s disease”6, perhaps because low nutrient intake impairs healthy cognitive development and function. To justify this, Cardoso et al highlights the main aspects of antioxidants, and their observed role in possibly helping protect 6

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the brain from burdens imposed by pathogens and therefore help reduce the neurodegenerative processes that they create. Antioxidants specifically mentioned include selenium (Se) and vitamins C and E; transition metals such as zinc (Zn), iron (Fe), and copper (Cu); vitamin D; B-complex vitamins; and omega-3 fatty acids.6 The National Institutes of Health, in a website produced by the United States National Library of Medicine, state that antioxidants are “substances that may protect your cells against the effects of free radicals,” which are molecules produced by broken down food or certain environmental exposures that can damage cells and contribute to many diseases.6 Therefore, a reduced capacity of antioxidants in the body, can promote the presence of free radicals and indirectly cause oxidative stress on the brain because there are not enough antioxidants to interfere with the damaging processes associated with free radicals, or, in the case of Alzheimer’s disease, the inhibiting effects of Amyloid beta-protein (AB). AB “inhibits the electron transport chain in mitochondria, decreases the respiratory rate, induces the release of reactive oxygen species (ROS) and might also cause neurotoxicity through the direct production of ROS by its interaction with transition metals and lipid membranes.”6

a deficiency in selenium may increase the risk of dementia...

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A reduced capacity of antioxidants includes being deficient in micronutrients like selenium and vitamins C and E. Vitamin E supports immune system and metabolic function, while vitamin C promotes healing and is very important for connective tissue and the absorption of iron.7 Since a low intake of selenium has been associated with cognitive decline, Cardoso et al suggest that a deficiency in selenium may increase the risk of dementia, perhaps because its role in protecting vitamin E and the immune system from degradation is weakened.3 Likewise, a deficiency in transition metals can also promote a weakened state Likewise, a deficiency for the body. Zinc weakens proper growth in transition metals and development, production of antioxidant can also promote a defenses, and immunity, while a deficiency in weakened state for iron inhibits neurotransmitter production, and the body. a deficiency in copper is suggested to relate to impaired cognitive function.6 Other vitamin deficiencies that may promote Alzheimer’s disease include vitamin D because of its potential metabolization in other tissues throughout the body, and B-complex vitamins because of their ability to allow for healthy cerebral aging. Additionally, a healthy balance of omega-3 and omega-6 polyunsaturated acids may contribute to reduced neuronal damage caused by Alzheimer’s disease.

To help ensure that deficiencies in antioxidants, transition metals, and other vitamins do not lead to an increased risk of Alzheimer’s disease, Cardoso et al emphasize that diet can play an important factor in maintaining healthy cognitive and metabolic function.

“Dietary patterns that are predominantly composed of whole foods instead of refined foods have been associated with an improvement in cognitive performance and with a reduced risk of the development of mild cognitive impairment, or a progression from mild cognitive 8

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impairment to Alzheimer’s disease, and of the onset of Alzheimer’s disease itself.”6 The consumption of whole foods instead of refined foods is important, because refined foods and supplements typically embody artificial nutrients that are not as beneficial as natural ones. This is expanded upon by Cardoso et al during the discussion of vitamin E antioxidants, “because the vitamin E found in supplements is usually synthetic and is composed of only one of eight natural isoforms (α-tocopherol)”6, whereas dietary sources provide more variety, which may help prevent the onset of Alzheimer’s disease.

MOOD DISORDERS

“Dietary patterns that are predominantly composed of whole foods instead of refined foods have been associated with an improvement in cognitive performance and with a reduced risk of the development of mild cognitive impairment, or a progression from mild cognitive impairment to Alzheimer’s disease, and of the onset of Alzheimer’s disease itself.”

Cardoso et al

In 2008, an article by Shaheen E. Lakhan and Karen F. Vieira about nutritional therapies for mental disorders appeared in the Nutrition Journal that highlighted the importance of micronutrient consumption in aiding the treatment of major depression, bipolar disorder, schizophrenia, and obsessive compulsive disorder (OCD)—the four most common mental health disorders affecting the United States and other developed countries.8 Mental disorders are typically treated with the use of prescription medication, but these can often produce unpleasant side effects. To avoid this, alternative nutritional remedies are sought which, according to this article, may produce positive results.

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The presence of mental disorders in developed countries ranges between 4 percent (China) and 26 percent (United States)8, correlating to the increased presence of processed foods in the Western diet. For example, high fish consumption in Asian countries is associated with increased levels of omega-3 fatty acid intake, which has been shown to promote a decreased incidence rate of mental disorders.

Contrast this to the typical American diet which usually consists of a reduced consumption of fish, fruits, and vegetables and an increased consumption of processed foods, and the argument of diet directly affecting one’s mental health is better to understand.

Major Depression In terms of major depression, omega-3 fatty acids, folic acid, vitamin B-12, and magnesium have been shown to treat depression and/or reduce its symptoms. Those who suffer from depression typically exhibit “decreased mood, increased sadness and anxiety, a loss of appetite, and a loss of interest in pleasurable activities.”8 It has been known that depression is associated with deficiencies in certain neurotransmitters, but deficiencies in omega-3 fatty acids, vitamin B (e.g. folate), and magnesium are also linked to this disorder which can be resolved through nutritional supplements and perhaps adequate consumption via food.

Bipolar Disorder People who suffer from major depression may also exhibit symptoms of mania, debilitating depression or a mixture of both, which is diagnosed as bipolar disorder. Common characteristics of people with bipolar disorder tend to be Vitamin B-, Vitamin C-, and Omega-3 fatty acid deficient.8 It is estimated in Lakhan’s article that 80 percent of bipolar sufferers have a vitamin B deficiency, which can indirectly increase manic and depressive symptoms since there is not enough 10

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supply of this vitamin to combine with the body’s natural production of lithium to reduce these symptoms and calm the mind.

Additionally, while vitamin C helps protect the body from damage caused by excess vanadium, which causes mania, depression, and melancholy, adequate omega-3 fatty acid consumption can also reduce manic and depressive symptoms in bipolar patients because omega-3 oils are required by cells in the brain to sufficiently transmit signals that allow for proper thinking, moods, and emotions.

Common characteristics of people with bipolar disorder tend to be Vitamin B-, Vitamin C-, and Omega-3 fatty acid deficient.

Shaheen E. Lakhan

Schizophrenia The third case of mental health benefits arising from increased consumption of omega-3 fatty acids include the treatment and reduction of symptoms associated with schizophrenia. “A Danish study showed that better prognoses for schizophrenic patients strongly correlate with living in a country where there is a high consumption of omega-3 fatty acids,”8 because omega-3 fatty acid fish oils contain Eicosapentaenoic acid (EPA). EPA is known to help patients who suffer from depression, so EPA supplements like VegEPA may be encouraged by physicians to help patients balance their moods. Another recommendation for schizophrenic patients may be to decrease their consumption of refined sugar, because consistent results in a study highlighted by Lakhan indicated that increased refined sugar intake leads to a decreased state of mind for schizophrenic patients. Refined sugar is present in many processed foods and are considered by some to be toxic to the body because they provide “only empty calories lacking in other nutrients and minerals. In addition, they can drain the body of nutrients because of their demanding digestion requirements.”9 11

Obsessive Compulsive Disorder (OCD) Obsessive Compulsive Disorder is typically treated with medications that increase serotonin levels in the brain. However, nutrients like the amino acid tryptophan may also help reduce the symptoms of recurring stressful thoughts or obsessions which are followed by repeated, uncontrollable compulsions.8 Since tryptophan is the precursor to serotonin, consuming it in supplements or adequate nutrient-rich food can have positive effects. Sources of tryptophan include red meat, dairy products, nuts, seeds, legumes, soy and soybeans, tuna, shellfish, and turkey.10

WHOLE FOODS Whole foods are generally those that have not been processed or refined. Sometimes they may have undergone very slight refinement or processing, but, for the most part, they are in or as close to their natural state as possible and have a large amount of natural nutrients.

In a WebMD feature article by R. Morgan Griffin, Tara Gidus, RD, a spokesperson for the American Dietetic Association states, “When you eat whole foods, you’re getting the food in its natural state.

You’re getting it intact, with all of the vitamins, minerals, and other nutrients that are in the food.”11 In other words, this intactness is the true healthy part of food, rather than the minute traces or fortified vitamins and minerals that remain after processing.

According to Annemarie Colbin, PhD., founder and CEO of The Natural Gourmet Institute for Health and Culinary Arts, whole foods can be divided into various categories. “Whole foods of vegetable 12

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origin include vegetables and fruits; whole grains; beans and legumes; nuts and seeds. Whole foods of animal origin include eggs, small whole fish, seafood, and small fowl. When consuming larger animals, the idea is to use as many parts as possible to maximize nutrient intake.”12 Knowing this, it is easy to assume that people who consume one apple per day or bread made from 100% whole grains are Adapting a whole receiving greater nutritional benefits than foods diet does not those who alternatively consume apple juice necessarily mean to or white bread. Adapting a whole foods disregard processed diet does not necessarily mean to disregard foods altogether, it processed foods altogether, it just means to just means to consume consume more whole foods than processed more whole foods than foods. Colbin elaborates on this by estimating processed foods. that 70-80% of a person’s diet should be comprised of whole foods.12 Aside from consuming whole foods to increase one’s general nutrient intake, the capstone benefit of whole foods is that they contain phytochemicals, which are a “chemical compound occurring naturally in plants.”13 Some phytochemicals are antioxidants, which include flavonoids, carotenoids, and lycopene, all of which help protect the body’s cells from damage. An example of a carotenoid is beta carotene, which is precursor to Vitamin A whose function as a fatsoluble vitamin is to support “vision and bone growth, regulate the immune system, and promote healthy surface linings of the eyes and the respiratory, urinary, and intestinal tracts so that infections cannot get into the body through those openings.”14 Phytochemicals cannot be found in processed foods, they can only be mimicked. Additionally, Colbin argues that the human body can 13

distinguish between naturally occurring chemical compounds and fortified supplements. Therefore, the micronutrients available in whole foods would provide the best health benefits to consumers and, as a result, would indicate a healthy diet in terms of vitamins and minerals.

MICRONUTRIENT DEFICIENCY Micronutrient deficiency is when one’s body does not receive the necessary amount of vitamins and minerals to properly function. “At the subclinical level of micronutrient deficiency poor general health and decreased school and work performance are likely to result, and mortality risk increases. Known clinical outcomes of micronutrient deficiencies include impaired growth and cognitive development, poor birth outcomes, anaemia, cretinism, and blindness.”15 However, in addition to directly affecting the individual who is malnourished, micronutrient Large amounts of deficiencies can also significantly impact people who are the institutional frameworks of economic unhealthy in terms and social health in any given country. “... of vitamin and as the research of Bruce Ames and others mineral consumption suggest, the undersupply of micronutrients consequently increase may constitute a threat just as grave (as an healthcare costs and oversupply of macronutrients on health).”31 produce a less viable Large amounts of people who are unhealthy workforce, which thwart in terms of vitamin and mineral consumption economic progress. consequently increase healthcare costs and produce a less viable workforce, which thwart economic progress.

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In 2001, the Department of International Health at Tulane University, the Micronutrient Initiative, and the United Nations Children’s Fund (UNICEF) collaborated to publish “The Micronutrient Report: Current Progress and Trends in the Control of Vitamin A, Iodine, and Iron Deficiencies”, which uses and analyzes global data sets of specific micronutrient deficiencies in developing countries and the progress of programs to combat these health issues for those populations. Within this report, it states that globally, “more than 40% of women are anaemic, nearly 20% of the population suffers from iodine deficiency disorders (IDDs), and about 25% of children have subclinical vitamin A deficiency.”15 Additionally, in a second global report sponsored by the Micronutrient Initiative and the Government of Canada titled “Investing in the Future: A united call to action on vitamin and mineral deficiencies”, “approximately one third of the developing world’s children under the age of five are vitamin A-deficient, and therefore ill-equipped for survival. Iron deficiency anaemia during pregnancy is associated with 115,000 deaths each year, accounting for one fifth of total maternal deaths.”16 It is estimated that micronutrient deficiencies affect nearly half of humanity, or, figuratively, more than two billion people.17

TYPES OF MICRONUTRIENT DEFICIENCIES Typically associated with low-income and developing countries, the scale of micronutrient deficiencies also impacts industrialized nations because of vulnerable population groups like women, children, and the elderly. The Micronutrient Report published by John B. Mason et al in association with the Micronutrient Initiative states that the issue is so big, that micronutrient deficiencies affect “nearly half of 15

humanity.”15 In addition to vitamin A, iron, and iodine deficiencies mentioned in The Micronutrient Report, other prominent micronutrient deficiencies around the globe include folate and zinc.

Vitamin A Deficiency Vitamin A is a fat-soluble vitamin that plays an important role in “vision, especially night vision, bone growth, reproduction, cell division, and cell differentiation; helps regulate the immune system; may help lymphocytes fight infections; promotes healthy surface linings of the eyes and the respiratory, urinary, and intestinal tracts so that infections cannot get into the body through those openings.”14 Being deficient in vitamin A can therefore have negative consequences, such as blindness and an increased risk of severe illness.

The Centers for Disease Control and Prevention (CDC) state in its IMMPaCt (International Micronutrient Malnutrition Prevention and Control Program) that “improved vitamin A nutrition could prevent up to 2.5 million deaths annually among children under 5 years.”18 Additionally, for children, vitamin A deficiency is the most important cause of childhood blindness in developing countries, it increases the risk of illness and death from common childhood infections such as measles, and also increases the risk of mortality in pregnant women.

It is estimated that 200-300 million preschool-aged children are at risk for a vitamin A deficiency, and nearly 600,000 women die from childbirth-related causes that could be prevented or reduced through better nutrition consumption.18 Natural sources of vitamin A include colorful fruits and vegetables like carrots, cantaloupes, sweet potatoes, and spinach, eggs, and whole milk.

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“improved vitamin A nutrition could prevent up to 2.5 million deaths annually among children under 5 years.”

Centers for Disease Control and Prevention

Iron Deficiency Iron is a mineral found in many proteins and enzymes that plays a vital role in oxygen transport, specifically in hemoglobin and myoglobin found in red blood cells within the bloodstream.14 Iron deficiency is typically translated into physical symptoms, such as fatigue and poor work performance. However, it is also characterized by “decreased immunity, slow cognitive development, difficulty maintaining body temperature, and glossitis (inflammation of the tongue).”14 Having an iron deficiency can also cause iron deficiency anemia, which is a condition in which the body does not have enough healthy red blood cells to provide oxygen to various tissues throughout the body.19 The CDC qualifies this type of anemia as one of the most “severe and important nutritional deficiencies in the world.”18 It also estimates that more than 30% of the world’s population (2 billion 17

people) are anemic, while up to 60-80% of the global population (4-5 billion people) may just be iron deficient in general.18 Natural sources of iron include red meat, fish, poultry, lentils, beans, tofu, and spinach.14 Iodine Deficiency Similar to iron, iodine is a metal that helps produce thyroid hormones which regulate the body’s metabolism and other significant functions.

Thyroid hormones are especially important to the body because they are required for proper bone and brain development during pregnancy and infancy.14 Symptoms of iodine deficiency include “stunted growth, mental retardation, and delayed sexual development in a fetus; lower-than-average IQ in infants and children; decreased ability to work and think clearly in adults; and goiter.”14 The CDC claims that iodine deficiency is the biggest contributor to brain damage, which ...iodine deficiency is can be proactively avoided.18 This is especially the biggest contributor problematic for fetuses and young children, to brain damage... because such deficiency can lead to cretinism (severely stunted mental and physical growth due a lack of thyroid hormones) and negatively impact proper fetal brain development. This can directly lead to a 10-15% decrease in a child’s average intellectual quotient (IQ), which therefore affects social and economic vitality in various countries. “The World Bank has estimated that, combined with vitamin A deficiency and iron deficiency, iodine deficiency may lower the economic wealth of a nation by as much as 5% every year.”18 Adequate sources of iodine include iodized salt, fish, seaweed, shrimp, dairy and grain products, fruits, and vegetables.

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“...combined with vitamin A deficiency and iron deficiency, iodine deficiency may lower the economic wealth of a nation by as much as 5% every year.”

Centers for Disease Control and Prevention

Folate Deficiency Folate is a water soluble B vitamin (B-9) that is needed to make deoxyribonucleic acid (DNA) and ribonucleic acid (RNA). It helps produce new cells, maintain them, and also helps protect DNA from changes induced by chronic diseases like breast cancer, colon cancer, and heart disease.14,18 It may also help prevent anemia, similar to iron.

Folate deficiency can commonly plague pregnant mothers, which can thereby produce neural tube defects in the brain (anencephaly) or spinal cord (spina bifida), low birth weight, premature birth, and a general slow growth rate in infants and children.14 The CDC writes that “approximately 75%, 225,000, of affected births could be 19

prevented through increased consumption of synthetic folate, called folic acid, by all women of reproductive age.”18 Synthetic folic acid is available via supplements or fortified cereals, but other natural sources of folate include leafy green vegetables, citrus fruits, dried beans, and peas.

Zinc Deficiency Zinc is an important mineral for the body because it strongly supports the immune system, helps produce proteins and DNA, helps wounds heal, and aids in one’s sense of taste and smell.14 The scale of zinc deficiency is huge, with an estimated one third of the world’s population living in countries where such malnutrition is high, and the symptoms are incredibly vast.

The scale of zinc “Slow growth in infants and children, delayed deficiency is huge, sexual development in adolescents, impotence with an estimated one in men, hair loss, diarrhea, eye and skin sores, third of the world’s loss of appetite weight loss, problems with population living in wounds healing, decreased ability to taste food, countries where such and lower alertness levels”14 all characterize malnutrition is high... zinc deficiency, which ultimately contribute to as many as 800,000 child deaths per year.18 Recommendations for increasing zinc consumption can be either via supplements or a change in one’s diet. Natural food sources of zinc include red meat, poultry, seafood, beans, nuts, whole grains, and dairy products.

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NUTRITION FACTS LABELS Nutrition Facts Labels are essentially tables of information that appear individually on prepackaged food. True to their name, they list nutritional facts in terms of calories, macronutrients, and micronutrients, which are all based on a single serving size of that food item. Serving sizes vary per product, but they are always tallied to display how many total servings exist in the overall package. This comes in handy when customers interact with Nutrition Facts Labels, for example, when comparing products for nutritional value. If the listed calories, macronutrient, and micronutrient values are similar between packages, one product with a smaller serving size and larger amount of total servings may be more or less nutritionally beneficial than the other, which has a larger serving size and smaller amount of total servings. Determining which product is more nutrient-dense than the other, though, is dependent on the values of nutritional information provided.

Nutritional information is displayed by name and weight to the left of the label, while the percent Daily Value of that nutrient is quantified to the right. Percent Daily Value is calculated based on a 2,000 calorie diet and is depicted on a scale from 0-100%, while nutrient weights are stated in either grams (g) or milligrams (mg).

However, this â&#x20AC;&#x153;ruleâ&#x20AC;? only applies to macronutrients. The values of vitamins and minerals listed for micronutrients are just shown in percent Daily Value. One thing to note is that, while every nutrientâ&#x20AC;&#x2122;s value is quantified in terms of weight and percentage, exceptions to this informational treatment are Trans Fat, Sugar, and Protein. Those nutrition facts just list their weight because it is not yet known whether the daily values of these nutrients need 21

to be limited and quantified in a percentage of oneâ&#x20AC;&#x2122;s allotted daily nutritional intake.

To help consumers better understand percent Daily Values for their diet, the final component of nutrition facts labels is a footnote that provides the daily weight limits for total fat, saturated fat, cholesterol, sodium, total carbohydrates, and dietary fiber as based on a 2,000 or 2,500 calorie diet. It also educates consumers about how many calories per gram exist in terms of fat (9 calories per gram), carbohydrate (4 calories per gram), and protein (4 calories per gram). The weights of these three individual macronutrients within a product are multiplied by the appropriate value per calorie, and then added together to yield the total number of calories within a single serving of that product.

Micronutrient daily values are not listed as a contributor to oneâ&#x20AC;&#x2122;s daily 2,000 calorie diet, which may cause people to perceive these as not important or worthy of paying attention to.

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It is interesting and worthwhile to mention, though, that everything listed in the footnote is a macronutrient. Micronutrient daily values are not listed as a contributor to oneâ&#x20AC;&#x2122;s daily 2,000 calorie diet, which may cause people to perceive these as not important or worthy of paying attention to. However, micronutrients do have daily intake limits depending on the individual, and, as specified in the previous chapter, do play a very important role in proper bodily function and development.

Therefore, why is the Nutrition Facts Label biased against micronutrients?

The Deficiency Project

why is the Nutrition Facts Label biased against micronutrients?

HISTORY Nutrition Facts Labels have only been in existence since 1992, following the passing of the Nutrition Labeling and Education Act of 1990. That piece of legislation required that all packaged food should “bear nutrition labeling and all health claims for foods to be consistent with terms defined by the Secretary of Health and Human Services.”20 However, in 1992, that was when nutrition labels were restructured by the Food and Drug Administration and the Food Safety and Inspection Service of the Department of Agriculture to provide basic per-serving nutritional information and list “the most important nutrients in an easy-to-follow format”21 as based on the latest public health recommendations at the time. Although the label was intended to be easily understandable, the majority of critics and users of Nutrition Facts Labels today disagree with this claim altogether, forming a consensus with Harold McGee’s opinion that “it distracts and confuses with unimportant information, and obscures the important facts. As a table of numbers, it’s also difficult to read and interpret.”20 Harold McGee is a food writer for the New York Times.

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Preceding and following the introduction of nutrition facts labels in 1992, the discussions of food, consumer knowledge, and government regulation date back to 1880 when Peter Collier, chief chemist in the U.S. Department of Agriculture, conducted a series of food adulteration investigations and recommended that a national food and drug law be passed.21 Although his bill was defeated, his investigations and actions triggered more than 100 food and drug bills to be introduced in Congress during the next 25 years until the Food and Drugs Act was passed on June 30, 1906. Signed by President Theodore Roosevelt, the Food and Drugs Act â&#x20AC;&#x153;prohibits interstate commerce in misbranded and adulterated foods, drinks, and drugs.â&#x20AC;?21 More information regarding historical legislative events concerning food and dietary supplements, as well as nutrition labeling, can be read below.22 1862: President Lincoln launches the Department of Agriculture and the Bureau of Chemistry, the predecessor of the Food and Drug Administration (FDA).

1880: Peter Collier, chief chemist, U.S. Department of Agriculture, recommends passage of a national food and drug law, following his own food adulteration investigations. The bill was defeated, but during the next 25 years more than 100 food and drug bills were introduced in Congress.

1906: The original Food and Drugs Act is passed by Congress on June 30 and signed by President Theodore Roosevelt. It prohibits interstate commerce in misbranded and adulterated foods, drinks, and drugs.

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In the aftermath of “The Jungle” by Upton Sinclair, which detailed the horrendous sanitary and working conditions in the meatpacking industry, the Meat Inspection Act is passed.

1913: The Gould Amendment requires that food package contents be “plainly and conspicuously marked on the outside of the package in terms of weight, measure, or numerical count.”

1914: In U.S. v. Lexington Mill and Elevator Company, the Supreme Court issues its first ruling on food additives. It ruled that in order for bleached flour with nitrite residues to be banned from foods, the government must show a relationship between the chemical additive and the harm it allegedly caused in humans.

1924: In U.S. v. 95 Barrels Alleged Apple Cider Vinegar, the Supreme Court rules that the Food and Drugs Act condemns every statement, design, or device on a product’s label that may mislead or deceive, even if technically true.

1938: A revised and expanded Federal Food, Drug, and Cosmetic (FDC) Act of 1938 is passed. Highlights include: safe tolerances to be set for unavoidable poisonous substances, standards of identity, quality, and fillof-container to be set for foods, and authorization of factory inspections.

1939: First Food Standards issued (for canned tomatoes, tomato purée, and tomato paste).

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1949: FDA publishes guidance to industry for the first time. This guidance, “Procedures for the Appraisal of the Toxicity of Chemicals in Food,” came to be known as the “black book.”

1950: Oleomargarine Act requires prominent labeling of colored oleomargarine, to distinguish it from butter. (Yes, swindlers tried to sell folks cheap margarine in the guise of butter.)

1958: Food Additives Amendment enacted, requiring manufacturers of new food additives to establish safety. The Delaney proviso prohibits the approval of any food additive shown to induce cancer in humans or animals. Going forward, manufacturers were required to declare all additives in a product.

The FDA publishes in the Federal Register the first list of substances generally recognized as safe (GRAS). The list contains nearly 200 different substances.

1962: Consumer Bill of Rights is proclaimed by President John F. Kennedy in a message to Congress. Included are the right to safety, the right to be informed, the right to choose, and the right to be heard.

1966: Fair Packaging and Labeling Act requires all consumer products in interstate commerce to be honestly and informatively labeled, with the FDA enforcing provisions on foods, drugs, cosmetics, and medical devices.

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1969: The White House Conference on Food, Nutrition, and Health recommends systematic review of generally recognized as safe (GRAS) substances in light of FDA’s ban of the artificial sweetener cyclamate.

President Nixon orders FDA to review its GRAS list.

1971: Artificial sweetener saccharin, which was included in FDA’s original GRAS list, is removed from the list pending new scientific study.

1973: California Certified Organic Farmers (CCOF) is formed. Begins with 54 farmers mutually certifying each other’s adherence to its own published, publicly available standards for defining organic produce.

1976: Vitamins and Minerals Amendments (“Proxmire Amendments”) stop FDA from establishing standards limiting potency of vitamins and minerals in food supplements or regulating them as drugs based solely on potency.

1977: Bowing to industry pressure, the Saccharin Study and Labeling Act is passed by Congress to stop the FDA from banning the chemical sweetener. The act does require a label warning that saccharin has been found to cause cancer in laboratory animals.

1980: Infant Formula Act establishes special FDA controls to ensure necessary nutritional content and safety.

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The USDA Food and Nutrition Information Center (FNIC) publishes the 1980 Dietary Guidelines for Americans. The guidelines are to be updated every 5 years. In 1980 there were 7 relatively simple guidelines. In the 2005 Dietary Guidelines for Americans, there were 41 recommendations in a 71 page booklet.

1982: FDA publishes first “red book” (successor to 1949 “black book”), officially known as “Toxicological Principles for the Safety Assessment of Direct Food Additives and Color Additives Used in Food”.

1990: Nutrition Labeling and Education Act requires all packaged foods to bear nutrition labeling and all health claims for foods to be consistent with terms defined by the Secretary of Health and Human Services. The law preempts state requirements about food standards, nutrition labeling, and health claims and, for the first time, authorizes some health claims for foods. The food ingredient panel, serving sizes, and terms such as “low fat” and “light” are standardized.

1992: Nutrition facts, basic per-serving nutritional information, are required on foods under the Nutrition Labeling and Education Act of 1990. Based on the latest public health recommendations, FDA and the Food Safety and Inspection Service of the Department of Agriculture recreate the food label to list the most important nutrients in an easy-to-follow format.

1994: Dietary Supplement Health and Education Act establishes specific labeling requirements, provides a regulatory framework, and authorizes 28

The Deficiency Project

the FDA to promulgate good manufacturing practice regulations for dietary supplements. This act defines “dietary supplements” and “dietary ingredients” and classifies them as food. The act also establishes a commission to recommend how to regulate claims.

1995: Saccharin Notice Repeal Act repeals the saccharin notice requirements of 1977. People can get their saccharin without having to read about its risks.

American Heart Association (AHA) initiates a food certification program including AHA’s Heart Check Symbol to appear on certain foods. Criteria is simple – low in saturated fat and cholesterol for healthy people over age 2. Also, a certification payment to AHA by the food manufacturer. Now you know why sugary cereal is Heart Checked.

1996: Food Quality Protection Act amends the Food, Drug, and Cosmetic Act, enabling application of the Delaney proviso to pesticides.

2002: The 2002 Farm Bill requires retailers to provide country-of-origin (COOL) labeling for fresh beef, pork, and lamb. After repeated debilitation and stakeholder pressures, the law would finally go into effect only 6 years later, on Oct 1, 2008, and even then with many loopholes.

The National Organic Program (NOP) is enacted. It restricts the use of the term “organic” to certified organic producers.

Certification is handled by state, non-profit and private agencies 29

that have been approved by the U.S. Department of Agriculture.

2003: To help consumers choose heart-healthy foods, the Department of Health and Human Services announces that FDA will require food labels to include trans fat content, the first substantive change to the Nutrition Facts Label on foods since the label was changed in 1993. Labeling would not go into effect until 2006.

An obesity working group is established by the Commissioner of Food and Drugs, charged to develop an action plan to deal with the nation’s obesity epidemic from the perspective of FDA. In March 2004, the group releases “Calories Count: Report of the Obesity Working Group,” which addresses issues connected to the food label, obesity therapeutics, research needs, the role of education, and other topics.

The FDA announced plans to permit the manufacturers of food products sold in the U.S. to make health claims on food labels that are supported by less than conclusive evidence. From “significant scientific consensus” before a claim can be made, the industry can now rely on “Some scientific evidence” or “Very limited and preliminary scientific research” to make a health claim. Opponents criticize it as opening the door to ill-founded claims. Advocates believe it will make more information available to the public.

2004: Passage of the Food Allergy Labeling and Consumer Protection Act requires the labeling of any food that contains a protein derived from any one of the following foods that, as a group, account for the vast majority of food allergies: peanuts, soybeans, cow’s milk, 30

The Deficiency Project

eggs, fish, crustacean shellfish, tree nuts, and wheat.

Deeming such products to present an unreasonable risk or harm, FDA bans dietary supplements containing ephedrine alkaloids based on an increasing number of adverse events linked to these products and the known pharmacology of these alkaloids.

2006: Hannaford Brothers Supermarket Chain launches Guiding Stars intended to help customers choose healthy foods. Foods are ranked 0 to 3 stars, with three stars awarded to most nutritious foods. Only 20% of the supermarket stocked items are starred, but sales of these items increase by several percentage points.

October 2007: Kelloggâ&#x20AC;&#x2122;s Launches Nutrition at a Glance based on the European Guideline Daily Amounts (GDA) system. Front of Package information includes daily percentage values for 6 nutrients: calories, total fat, sodium, sugars, vitamin A, and vitamin C. September 2008: The nutritional value (NuVal) System is announced, scoring food on a scale of 1 to 100. The higher the NuVal Score, the higher the nutrition of a food product. The score is based on a complex and *top secret* Overall Nutritional Quality Index (ONQI) that takes into account 30 different nutrients in food.

October 2008: Smart Choices, a pan industry effort to promote a standardized benchmark for front of package labeling, is launched. Initial supporters include General Mills, Con-Agra, Coca-Cola, PepsiCo, and Unilever.

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Mars International launches GDA labeling of its foods and snacks in the United States.

January 2009: Sara Lee introduces Nutritional Spotlight front of package labels for bread, bun, and bagel products. This move is in contrast to an industry wide attempt by manufacturers to create a unified Smart Choice label. This label is similar to Mars’ and Kelloggs’ recent efforts.

SuperValu introduces nutritionIQ shelf signage at its Albertsons stores. The color-coded, easy-to-spot shelf tags, or cards, are supposed to aid shoppers in choosing low fat, high fiber and other good foods.

Regional Grocery Chain, United Supermarkets, Introduces TAG Nutrition Labeling Program. Five color coded shelf labels point to Heart Healthy/Diabetes Management, Gluten-Free, Organic, Lean/ Low-Fat for Meat and Dairy and Sugar-Free/Reduced Sugar products.

Summer 2009: Smart Choices launches formally with several hundreds of products labeled with the green check mark. Froot Loops becomes the poster child for everything wrong with an industry backed nutrition rating system.

October 2009: The FDA sends a “Dear Manufacturer” letter to boards of the Smart Choices Program and other Front of Pack nutrition rating systems, stating its concern with the potential to mislead consumers. A week later the Smart Choices program suspends itself.

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January 2010: Whole Foods Adopts ANDI Rating System – a new rating system for foods. There wasn’t too much follow-up to this pilot and it seems to have fizzled away.

October 2010: The Institute of Medicine recommends only 4 nutrients be considered when preparing front of pack labels: Calories, Saturated Fat, Trans-Fat and Sodium.

December 2010: The USDA requires cuts of meat to display nutrition as well, starting in January 2012.

January 2011: The Grocery Manufacturers Association announces Nutrition Keys, a new front-of-pack labeling system, just months before the FDA is to issue its guidance to industry on the matter.

February 2011: Safeway announces Simple Nutrition shelf tags, boasting 22 colorful encouragements for people to buy more, not less foods.

September 2011: The Grocery Manufacturer’s Association renames Nutrition Keys as Facts Up Front, allocating a $50 million budget to promote this initiative and preempt any regulatory ruling on the matter.

February 2014: The FDA proposes to update the Nutrition Facts Label for packaged foods in a press release.

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FACTS VS. BELIEFS While Nutrition Facts Labels are meant to inform consumers about the quantity of nutrients within a food item, sometimes the presentation of such facts is not enough to entice consumers to make healthy food choices. The ongoing shift of popular opinion due to various scientific studies and research, as well as news reports in mainstream media or personal experience, only contradict said studies and research findings which further confuses consumers. Yet, it is this constant shift in direction of what to eat or not eat from health celebrities like Dr. Mehmet Oz, trainer and television personality Jillian Michaels, or author Michael Pollan that proves more effective when changing peoplesâ&#x20AC;&#x2122; eating habits. People would rather be told to do something than actually do the work required to formulate their own conclusions about what to do. However, this viewpoint that popular opinion therefore means that this opinion must be true, is actually false. â&#x20AC;&#x153;As dietary fads alternate between diets high in carbohydrates, and others high in protein and fat, one thing has become very obvious, there is no one perfect diet for everyone.â&#x20AC;?23 While new information about food and nutrients is constantly being discovered and consumers are informed about them through the media, the complexities of food and its nutrient or chemical structure is far from completely known.

What is known, however, is the quantification of food in terms of nutrients (the facts) that exist on nutrition facts labels.

In 2010, Joe Keohane wrote an article about personal knowledge and belief that was featured in the Boston Globe. Although it was written in terms of Democracy and politics, the same perception of facts versus beliefs could apply to the nutritional system in terms of how consumers interact with food items and which foods they choose to eat.

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The argument between facts and personal belief revolves around the idea of misinformation. People who are misinformed generally do not always know that they are misinformed to begin with. As a result, this misinformation forms a belief, and beliefs are typically hard to change. Keohane elaborates on this by stating that “Facts don’t necessarily have the power to change our minds…facts could actually make misinformation even stronger.”24 The reason for this is because people do not want to admit that or be confronted with the notion that whatever they believe is wrong. Being wrong about something is embarrassing, so people emit “a natural defense mechanism to avoid that cognitive dissonance,”24 also known as Instead of facts shaping backfire. Therefore, instead of facts shaping beliefs, beliefs dictate beliefs, beliefs dictate facts that people choose facts that people to accept and can even cause people to twist choose to accept and facts to better fit with those beliefs. This can even cause people is probably why nutrition and diet are so to twist facts to better confusing to everyday consumers. fit with those beliefs.

This is probably why People form an initial opinion about food nutrition and diet based on what they hear from others. Whether are so confusing to from a parent, friend, doctor, trainer, or author, everyday consumers. listening to or reading about information presented from an educated person, or just someone who is confident with the subject matter, influences and/or reinforces the beliefs of the audience to align with their preconceived ideas. Keohane refers to this as “motivated reasoning.”24 A prime example of backfire as it relates to food and nutrition is the topic of calories and calorie counting. The general public is told to limit their daily calorie intake to 2,000 calories, which will then translate into weight loss and being “healthy.” While the general premise of 35

this may be true, people are often misinformed about calories and are not aware of things, like the difference between good calories or bad calories. Therefore, by being told this information from credible sources, people may form the belief that consuming 1,800 calories per day, for example, will mean that they will lose those ten pounds they have been trying to shed. Or, by eating a particular food item that has fewer calories per serving than another item, that means that they are consuming a healthy diet. These viewpoints could be considered popular opinion or oneâ&#x20AC;&#x2122;s personal beliefs, and the idea that all calories are the same is a type of misinformation. Therefore, by using tools like calorie counters or sticking to low-calorie foods, tactics like these only reinforce preexisting beliefs. So, how does one go about changing popular opinion or personal beliefs?

It seems obvious that the answer to this question is education. Yet, is this not the goal of Nutrition Facts Labelsâ&#x20AC;&#x201D;to educate consumers about what nutrients exist in the packaged food item? While, yes, this is the goal of Nutrition Facts Labels, the presentation of this information is passive which is why it is often overlooked. People are encouraged to observe People are encouraged and read the listed items, but informed to observe and read learning is not as effective as interactive the listed items, but learning. In order to shift popular opinion informed learning about food and nutrition, a more interactive is not as effective as way to present label statistics is needed to interactive learning. make people more aware of label contents, make them actually analyze the data, and then form new beliefs based on those facts.

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PERCENT DAILY VALUES While it would be great to have a collective society that is attentive to all information listed on a Nutrition Facts Label, that level of social change is more expansive and cannot be solved with a design student thesis. Therefore, for this thesis, I want to draw consumers’ attention to micronutrients and the percent Daily Values of them in food. Micronutrients are generally overlooked because of their placement on a Nutrition Facts Label, which is below macronutrients towards the bottom, and percent Daily Values are difficult for some consumers to understand and/or calculate. By being more aware of micronutrient consumption, people can better strive for a healthy diet and become more aware of any micronutrient deficiencies that they may not know of.

In order to understand micronutrient density within food, consumers need to know the significance of percent Daily Values in relation to serving sizes, and how to track them. This requires people to interact with Nutrition Facts Labels more frequently. In a 1998 study conducted by undergraduate students of the Food Science and Human Nutrition Department at the University of Hawaii at Manoa, 145 shoppers at Honolulu supermarkets were sampled about their understanding and use of nutrition labels. Only one-half of shoppers reported using a Nutrition Facts Label while “only 36% of the shoppers could explain the meaning of a number in the % Daily Value column.”25 These results aligned similarly with a previous survey conducted by the Food Marketing Institute, which found that “31% of shoppers interviewed either said they did not know what % Daily Values meant or defined it incorrectly.”25

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By being more aware of micronutrient consumption, people can better strive for a healthy diet and become more aware of any micronutrient deficiencies that they may not know of.

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So, how does one get an audience to educate themselves about the benefit of understanding a list of percentages? Students involved with the University of Hawaii study employed an intervention method that focused on educating study participants with a set of materials that emphasized “how to use Nutrition Facts labels to understand serving size information, to adjust nutrient information for different serving sizes and/or energy needs, and to understand the meaning and correct use of % Daily Value information.”25 These materials included a printed shopping bag with a Nutrition Facts Label on the exterior and two educational inserts about the relationship of activity level to kilocalories (listed as “calories” on Nutrition Facts Labels) and the difference between daily value and percent Daily Value, a quiz about the Nutrition Facts Label, and a reference card for shoppers to use explaining serving size, calories, and daily values.25 Rather than simply inform the shopper, this educational packet informs shoppers through interactivity with a shopping bag, quiz, or actual Nutrition Facts Labels when grocery shopping. This interactive approach correlates perfectly with Joe Keohane’s article about informed learning versus interactive learning, and the relationship of facts and beliefs as discussed previously. These materials simply guide the consumer with necessary information that encourages better understanding and analysis of Nutrition Facts Labels (the facts), which empowers the customer to make more health-conscious decisions about their nutritional intake themselves (their beliefs).

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MATH AND LITERACY A Nutrition Facts Label revolves around two basic ideas: 1. the ability to read it; and 2. the ability to process it. Reading it involves simple literacy skills, while processing the information listed requires an understanding of numbers and mathematics. Since numeracy skills are generally more complex than literacy ones, perhaps this is why a large portion of consumers rely on what health celebrities broadcast about food? Perhaps by being told to eat more foods with fewer calories, this is why “low-calorie” foods came into existence? Although easier to digest from a consumer’s point of view, this limited “knowledge” is incorrect and not beneficial when making conscious choices about food in relation to “In a study conducted nutritional health. Playing a numbers game at a shopping mall, like calorie counting or eating foods with less 78% of subjects could carbohydrates requires more understanding compare two products, about how to interpret numerical figures and but only 20% could manipulate them to achieve a nutrient-dense correctly calculate meal—exercising math skills. “In a study the contribution of a conducted at a shopping mall, 78% of subjects product to a daily diet.” could compare two products, but only 20% Rothman et al could correctly calculate the contribution of a product to a daily diet, a task that required complex math.”26 In a 2006 article published in the American Journal of Preventive Medicine, Russell L. Rothman, MD, MPP, and a team of doctors conducted a cross-sectional study of 200 primary care patients and their understanding of food labels to test their two-part hypothesis that patients would deem food labels difficult to comprehend, and 40

The Deficiency Project

such poor comprehension would align with poor literacy and numeracy skills. “Literacy was measured with the Rapid Estimate of Adult Literacy in Medicine (REALM), and numeracy with the Wide Range Achievement Test, third edition (WRAT-3)”26 while an additional Nutrition Label Survey (NLS) was given to evaluate patient understanding of then current nutrition labels.

Although study results showed that 77% of patients had a minimum of 9th-grade level literacy skills, numeracy skills were very poor in comparison. “Numeracy skills for 63% of patients were less than 9th-grade level”,26 and only two-thirds (69%) of patients were able to correctly answer questions from the NLS. “The label assumes that all consumers understand percentages and daily values, what “The label assumes their usual caloric intake is and should be, that all consumers and how to convert the information on the understand percentages 27 label to their needs”, but how can people and daily values, what be expected to make informed decisions their usual caloric about nutritious food when they cannot even intake is and should process the information provided? This is be, and how to convert troublesome especially for interpreting percent the information on the Daily Value information because, as the study label to their needs”, found, “Some patients inappropriately read Washington Post the percent daily value information instead of the actual amount of a nutrient,”26 and this was attributed to the placement of the value itself as well as the label footnote, which provides daily values based on a 2,000 or 2,500 calorie diet. This confusion of information is a prime example of why 70% of patients surveyed would prefer a Nutrition Facts Label that is easier to understand.26

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The findings of this study clearly illustrate a need for people to better understand Nutrition Facts Labels, as well as prompt the question about reformatting the label itself to be easy to comprehend. Although efforts have been taken by individual companies, other countries, and even Pratt students to redesign food labels, the application of these ideas by the United States FDA to dictate a new industry standard has yet come to fruition. Therefore, new opportunities to improve consumer literacy and numeracy skills as well as general knowledge about nutrition should be emphasized to shift social perception of labels and “healthy” food, and influence better consumer habits.

CONSUMER SURVEYS As a consumer of whole and processed foods, I attempt to read the Nutrition Facts Label of every item I purchase. However, after reading the two studies conducted by students of the University of Hawaii and by Russell Rothman, MD, MPP, et al, I sought to test whether these results were still relevant and therefore designed two interactive surveys for people to take. Survey participants were average food shoppers, ranging in age from 22 to 35.

The first survey (figure 2) pertained to the University of Hawaii study by asking respondents to indicate: 1. which parts of a Nutrition Facts Label that they read first, second, third, or fourth; 2. how often they read them; and, 3. whether they employed accurate literacy and numeracy skills to calculate percent Daily Values per serving.

There were four questions total. Of the 15 survey respondents, 73% indicated that they referred to Nutrition Facts Labels “always” (20%) 42

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or “very often”(53%) when shopping for food. This was a huge improvement when compared to the “one-half of shoppers reported using a nutrition facts label”, presented by the University of Hawaii.

Of those who just read or glanced at Nutrition Facts Labels, 73.3% noted that they first look at serving sizes and/or calories, 60% reference macronutrient values second (fat, protein, carbohydrates), 33.3% view micronutrient values third (vitamins and minerals), and 46.7% look at the bottom servings table fourth. As for literacy and numeracy, 73.3% of survey takers were able to accurately read how many grams of total carbohydrates were listed on the provided label, while 26.7% of those same respondents were not able to calculate what the percent Daily Value of calcium would be for someone consuming two servings of it. Therefore, while results showed a significant improvement in the number of people who actually read Nutrition Facts Labels and can calculate basic percentages based on serving size, there was interestingly no improvement of one’s ability to read listed values on the Nutrition Facts Label itself.

The second survey conducted simply tested people’s knowledge of micro- and macronutrients in food (figures 3-4). Divided into two parts, the first survey asked respondents to draw their favorite fruit or vegetable in a given space and list what it was a good nutrient source of. The second part involved the same task, but for packaged food. Of the 34 people who participated in the first part of the survey, 65% of them were able to identify at least one nutrient available in the food that they drew. As for the second survey pertaining to packaged food, only 25% of 28 people were able to indicate a nutrient. These results further support the fact that the majority of people are not able to determine the nutrient level of packaged foods compared to whole foods. However, the ironic part of this statement is that whole foods 43

like fruits and vegetables do not even include a Nutrition Facts Label for people to reference. They are typically not even packaged. So, how is this possible? How are the majority of people able to identify specific nutrients in foods that do not contain a label, yet unable to identify nutrients in packaged foods that list names, weights, and percentages? Even with the consumer shift toward purchasing more packaged/processed foods than whole foods, the lack of consumer nutritional knowledge is worrisome. This, I believe, relates back to the fundamental perception that people do not know what it is that they are exactly eating when they purchase processed foods.

How are the majority of people able to identify specific nutrients in foods that do not contain a label, yet unable to identify nutrients in packaged foods that list names, weights, and percentages?

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CASE STUDIES The fields of nutrition and health are complex. Though grounded in science and data, their understanding is based on subjective opinions best conveyed through the media—television, magazines, books, and hollywood and health/fitness celebrities. This understanding also tends to focus primarily on only one level of nutrition, macronutrients, because people today are concerned more about physical appearance (weight loss) than physical bodily function and development. Both are intertwined but if focus is only applied to one half of this spectrum, this consequentially will lead to an imbalance and limit one’s capability to actually be “healthy”.

Drawing upon historical and contemporary nutrition pioneers, ideologies, and existing nutrition-related design projects, this chapter will highlight the significance of education, media, and the role of design on the general public by providing an overview of what has already been said and what has already been done in terms of nutritional health.

WESTON A. PRICE Dr. Weston A. Price was a Cleveland dentist trademarked as “the Isaac Newton of Nutrition.”28 Through travels, scientific exploration, and analysis, Price was able to deduce a correlation between minimal vitamin and mineral consumption and tooth decay and physical degeneration. The focus of Price’s study centered around primitive cultures, or those cultures who did not have an American/Western diet.

“These primitives with their fine bodies, homogeneous reproduction, 45

emotional stability and freedom from degenerative ills stand forth in sharp contrast to those subsisting on the impoverished foods of civilization-sugar, white flour, pasteurized milk and convenience foods filled with extenders and additives.”28 By comparing and contrasting native diets with modern diets of Americans, Price was able to identify significant increases in vitamin and mineral food values that were uncommon in processed foods.

Such value increases not only meant stronger teeth and physical health, but also mental health as well. Examining his research and conclusions one step further outside of the dentistry, Price ultimately formed the argument that a nutrient-dense diet would lead to better overall health, physically and mentally. “Learn of their accumulated wisdom, and if you do you too can have strong healthy bodies without so much disease as we suffer from these days.”28

NUTRITIONAL THERAPY “Nutritional Therapy is the application of nutrition science in the promotion of health, peak performance and individual care.”29 Employed by a registered dietician, the goal of nutritional therapy is to identify any nutritional imbalances within the body and correct them with a whole foods diet. Traditional cultures such as the Chinese have believed for centuries that this nutritional approach to medicine should be the first and foremost method for combating disease before imposing and relying on prescription medications. By focusing on nutritional imbalances within the body, nutritional therapy strives to correct the problem created by diseases rather than treat their symptoms.

As the father of Western Medicine (Hippocrates) stated himself, “Let thy food be thy medicine and thy medicine be thy food.”30 46

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“Let thy food be thy medicine and thy medicine be thy food.”

Hippocrates

MICHAEL POLLAN One of the most respected voices in the debate about food is bestselling author, Michael Pollan. Famously known for his book, “The Omnivore’s Dilemma”, Pollan wrote an additional book in 2008 titled, “In Defense of Food: An Eater’s Manifesto” (figure 5), that challenges the meaning of food and examines how modern society relates to food in general. By summarizing his book into “Eat food.

Not too much. Mostly plants.”, Pollan argues that the adoption of a holistic, whole foods diet can help significantly decrease the rates at which “Western diseases” are consuming American culture and shift popular opinion that nutritionism is advancing the food industry and overall human health.31 “The rise of nutritionism reflects legitimate concerns that the American diet, which is well on its way to becoming the world’s diet, has changed in ways that are making us increasingly sick and fat. Four of the top ten causes of death today are chronic diseases, diabetes, stroke, and cancer.”31 Nutritionism refers to the ideology of reducing food to its nutrient parts, which therefore translates into 47

The criticism here is that food therefore becomes a process of science rather than nature, which, in Pollan’s opinion, does not allow this product to be called “food” at all.

the scientific process of fortifying foods with vitamins and minerals to make them more “nutritious”. The criticism here is that food therefore becomes a process of science rather than nature, which, in Pollan’s opinion, does not allow this product to be called “food” at all. Yet, it is this scientific approach to food that has influenced government regulation and the manipulation of consumers by the food industry—by simply slapping health claims on packaged food.

“A diet based on quantity rather than quality has ushered a new creature onto the world stage: the human being who manages to be both overfed and undernourished, two characteristics seldom found in the same body in the long natural history of our species.”31 Such human being can be characterized as the typical American who consumes too many empty calories, does not eat enough fruits and vegetables, and does not get enough physical activity. In response to this typical American and their reliance on unhealthy food that is fast, cheap, and easy, Pollan challenges readers to “ invest more time, effort, and resources in providing for our sustenance.”31 By referencing other cultures like the Italians and the French who value traditions of food and the historic practices of gathering and preparing food as a key part of everyday life, Pollan directly makes the claim that our lack of value and appreciation for food are holding us to a strong disadvantage in terms of economic, social, and personal health.

“Thirty years of nutritional advice have left us fatter, sicker, and more poorly nourished. Which is why we find ourselves in the predicament we do: in need of a whole new way to think about eating.”31

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â&#x20AC;&#x153;Thirty years of nutritional advice have left us fatter, sicker, and more poorly nourished.

Which is why we find ourselves in the predicament we do: in need of a whole new way to think about eating.â&#x20AC;?

Michael Pollan

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REFERENCE INTAKE (RI) LABELING Formerly known as Guideline Daily Amounts (GDA), the Reference Intake (RI) food labeling system used in the United Kingdom and Europe functions similar to the Nutrition Facts Label used within the United States, but in a more visual format. RI values were established by the UK Ministry of Agriculture Fisheries and Food (MAFF) in 1996 as Daily Guideline Intakes (DGI), and were used for the purpose of listing fat, saturates (saturated fat), sodium, sugar, and fibre (fiber) in grams per day for men and women to reference.32 Today, that list of values has expanded to include eight identified main nutrients on the back-of-pack label—calories, protein, carbohydrates, sugars, fat, saturates, fibre, and salt—with calories, sugar, fat, saturated fat, and salt specifically highlighted in a front-of-pack label.32 Significance Although this labeling system is easier to understand than previous efforts and has proven successful in helping consumers make better food choices, there are some criticisms when comparing this label system to the issue of micronutrient deficiencies. Similar to the Nutrition Facts Label, front-of-pack and back-of-pack labels mainly account for macronutrients and further diminish the presence of micronutrients in foods, which only perpetuates the “numbers game” consumers already play. By focusing consumer attention solely on macronutrients and the idea of “quantity”, it gives the impression that limiting or paying attention to these values will decrease the prevalence of common Western Diseases like high blood pressure, heart disease, diabetes, etc. In other words, a macronutrient-focused label disguises the real nutritional values of vitamins and minerals in food (“quality”), and is therefore ineffective in combating these various diseases. Greater effort should be placed on not just making 50

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the quantitative values of food more visually appealing and easier to glance at, but rather more visually reflective of nutrient consumption in terms of a person’s daily diet.

FACTS UP FRONT “Facts Up Front is a voluntary initiative led by the Grocery Manufacturers Association, which represents more than 300 of the nation’s leading food and beverage companies, and the Food Marketing Institute, which represents more than 1,500 food wholesalers and retailers. It was developed in response to First Lady Michelle Obama’s request that the industry move farther and faster to provide consumers with the products, tools, and information they need to consturct a healthy diet for themselves and their families.”33 Claimed to be grounded in nutrition science, the Facts Up Front initiative is advised by a diverse third-party panel of health, nutrition, and medical professionals.

Similar to RI labeling, Facts Up Front strives to make calorie, saturated fat, sodium, and sugar information more accessible to consumers by placing these numbers on the front of food packaging (figure 6). Highlighting these specific nutrients would therefore better equip Americans in the fight against Obesity. However, instead of only listing a set number of nutrients on the front side of packaging, Facts Up Front also provides the flexibility to display one or two other “good nutrients” like fiber, calcium, protein, iron, potassium, Vitamin A, Vitamin C, or Vitamin D.33 “These ‘encouraged’ nutrients will only appear on a package if the product contains 10 percent or more of the daily value per serving of the nutrient and meets the FDA requirements for a ‘good source.”33 51

Significance A strong feature of the Facts Up Front initiative is its educational online platform.33 Presented as a website, this resource provides interactive tools to help users better understand the design/structure of the labels and calculate their specific nutritional requirements as based on gender, age, height, weight, and activity level. This visual, interactive education is important because further empowers consumers to make educated food choices when considering how that food items will either benefit or hinder their dietary health.

In relation to this thesis project, Facts Up Front is an admirable initiative because it takes what already exists, the numerical data (percent daily values and weight measurements) on Nutrition Facts Labels, and highlights it on the front of food packaging based on a set criteria per serving. This makes consumers better aware of what is and is not a good source of nutrition, regardless of macro- or micronutrient-specific focusâ&#x20AC;&#x201D;it allows both types of nutrients to be highlighted. Although more informative when compared to the RI labeling system in Europe, the same criticism applies to this initiative as solely focusing on the presentation of numbers as opposed to the nutritional quality of food products.

TELLSPEC SCANNER TellSpec is a handheld scanning device that fuses spectroscopy and mathematical algorithms to translate food and beverages into data and information (figure7). â&#x20AC;&#x153;The TellSpec handheld scanner beams a light at the food you wish you analyze, measures the reflected light with its spectrometer, and sends the data via your smartphone, computer, or table to the TellSpec servers in the cloud.â&#x20AC;?34 Once those 52

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servers dissect the composition of that food item and use it to verify any allergens, chemicals, nutrients, calories, or ingredients that the user specifies within the software, those results will be returned back to the user’s digital device in a visual format. This entire process takes about three seconds to complete.34 Aside from solely being a food scanning device, the functionality of TellSpec is even greater because it expands beyond reporting information that may be decipherable via a Nutrition Facts Label.

It records calorie and macronutrient consumption in numerical and percentage formats, educates users about unfamiliar ingredients in a glossary-like presentation, alerts users to any food sensitivities that they may have by inputting allergy-related side effects, advises users to limit toxic chemical intake (e.g. mercury), and even tracks vitamin and mineral intake while providing food recommendations for boosting individual micronutrients.

Significance Currently only available for pre-order, the functionalities of TellSpec and its presentation of information is remarkable. It seems to be a product meant entirely for consumer education and empowerment, and will also thrive entirely based on user-generated information (scans). “Each time you scan food products, you improve TellSpec’s food analysis system. The system compiles all the data and learns from each scan, making the analysis more accurate and more detailed with each scan.”34 This will allow users to help and educate one another, broaden the global conversation about health and nutrition, and foster the analysis of regional and cultural eating patterns. TellSpec is all-inclusive, and is probably the biggest competitor and inspiration for the visual projects of this thesis project.

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HEALTHSIMPLE HealthSimple evolved from Type1Tools, which is a line of kid-friendly educational products that make learning about and dealing with the complexities of diabetes more digestible for anyone with this disease.35 By emphasizing large colorful graphics, imagery, and minimal yet important information in a 3”x5” flashcard (figure 8), HealthSimple helped revolutionize the healthcare industry by employing a design approach to simplify the complexities of scientific information.

Aside from just being a set of informational flashcards, HealthSimple tools include: a “DataWise” logbook, which provides spaces for users to record glucose levels and document insulin vials; Carb Count stickers that can be placed on leftover food for remembering portion sizes and total carbs per serving for pre-made meals; CarbWise Cheat Sheets, which allow parents to easily log their child’s meal details like dates, food items, and carb measurements, etc.; Care Plan Worksheets to help regulate or establish a daily diabetic person’s routine; and FlashCarbs magnets, which are colorful, educational magnets that list a food item and its correlating carbohydrate information.36 Significance Though adopted by McNeil Nutritionals, a division of Johnson & Johnson, the real success of HealthSimple resides in the fact that it was conceived and developed by two parents who experienced a communication issue when trying to educate themselves about Type 1 diabetes in response to their daughter’s diagnosis.35 The simplicity of scientific information, emphasis of colorful visuals, and practical application of the various tools made nutrition tracking and personal health something fun to learn about and do for both kids and parents, and could easily be used as a model to 54

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apply to other population groups or anyone interested in learning about health- and nutrition-related topics.

NUTRITION FACTS LABEL UPDATE In a News Release posted on February 27, 2014, the FDA “proposed to update the Nutrition Facts label for packaged foods to reflect the latest scientific information, including the link between diet and chronic diseases such as obesity and heart disease.”37 A redesign 20 years in the making, the new structure of the label would: reflect current research and findings to properly depict serving sizes based on how much people actually eat; add an “added sugars” category to inform consumers about how much additional sugar was infused into the product; remove “Calories from Fat” since research indicates that focus should be placed on the type of fat instead of the amount of fat within a product; require the inclusion of potassium and vitamin D values since many Americans are deficient in those nutrients; and declare the inclusion of Vitamins A and C as voluntary. Using typographic hierarchy and a two-column grid structure to present the information, the overall goal of the new label design is to improve readability (figure 9).

Significance While the hierarchy of information makes reading the label more visually appealing and easier to comprehend, the label itself still places emphasis on the number of calories and macronutrient values.

However, because serving size information is bolder than currently exists on the label, the relationship of the nutrient values to the food product may make users more aware of how much they are eating while they are eating it.

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One criticism of the new label redesign is no longer requiring Vitamins A and C to be listed on it. Sure it is noteworthy of the FDA to be aware of and responsive to current American micronutrient deficiencies, but just because one deficiency is now greater than previous ones should not justify their removal. Removing these crucial vitamins may make consumers not as aware of their significance to their daily diet and may potentially lead to a repeat national deficiency that parallels that of other global populations. This is especially worrisome for a country whose rates of cancer, mental illness, and reliance on prescription medications is increasing, since both Vitamins A and C may help abate those symptoms and habits.

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Figure 1.1

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Figure 1.2

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Figure 1.3

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Figures 1.4 & 1.5

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Figure 1.6

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Figure 1.7

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Figure 1.8

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Figure 2

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Figure 3

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Figure 4

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Figure 5

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Figure 6

Figure 7

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Figure 8

Figure 9

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SOURCES 1. “Micronutrient.” Merriam-Webster.com. Merriam-Webster, n.d. Web. 4 May 2014. <http://www.merriam-webster.com/ dictionary/micronutrient>.

2. “Importance of Micronutrients.” Project Healthy Children. N. p., n.d. Web. 13 Sept. 2013.

3. “Micronutrients/Minerals.” Orthomolecular.org: Therapeutic Nutrition Based Upon Biochemical Individuality. N. p., 2007.

4. “Macronutrients: The Importance of Carbohydrate, Protein, and Fat.” Web. 25 Oct. 2013.

5.

Graham, Kieryn, and Danielle Rothman. “Micronutrient Supplements May Be Beneficial For People With HIV (AIDS 2010).” The AIDS Beacon. News. N. p., 19 Aug. 2010.

6.

Cardoso, Bárbara, Cominetti, and Cozzolino. “Importance and Management of Micronutrient Deficiencies in Patients with Alzheimer’s Disease.” Clinical Interventions in Aging (2013): 531. CrossRef. Web. 26 Sept. 2013.

7. “Antioxidants.” U.S National Library of Medicine. U.S. National Library of Medicine, 20 Feb. 2014. Web. 9 Nov. 2013. <http://www.nlm.nih.gov/medlineplus/antioxidants.html>.

8.

Lakhan, Shaheen E.; Vieira, Karen F. “Nutritional Therapies for Mental Disorders.” Nutrition Journal 7.2 (2005). Print.

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9.

Kirby, Sharon. “What Are Health Benefits of Micronutrients?.”

LIVESTRONG.COM. LIVESTRONG.COM, 16 Aug. 2013. Web. 26 Sept. 2013. <http://www.livestrong.com/ article/441906-what-are-health-benefits-of-micronutrients/>.

10. “What is tryptophan and where does it come from?.” The World’s Healthiest Foods. N.p., n.d. Web. 9 Oct. 2014. <http:// whfoods.org>.

11. Griffin, Morgan. “Healthy Whole Foods: Making NutrientRich Choices for Your Diet.”WebMD. WebMD, 1 Jan. 2007.

Web. 25 Oct. 2013. <http://www.webmd.com/diet/features/ the-benefits-of-healthy-whole-foods?print=true#>.

12. Colbin, Annemarie. “Why Should We Eat Whole Foods? - An Article by Annemarie Colbin, Ph.D..” Why Should We Eat Whole Foods? - An Article by Annemarie Colbin, Ph.D.. N.p., 1 Jan. 2002. Web. 26 Oct. 2013. <http://www.foodandhealing. com/articles/article-wholefoods.htm>.

13. “Phytochemical.” Merriam-Webster.com. Merriam-Webster, n.d. Web. 4 May 2014. <http://www.merriam-webster.com/ dictionary/phytochemical>.

14. “The Mighty Micronutrients.” . Rice Diversity, n.d. Web. 6 Oct. 2013. <http://www.ricediversity.org/outreach/educatorscorner/ documents/Micronutrients.pdf>.

15. Mason, John B. “The Micronutrient Report: Current Progress and Trends in the Control of Vitamin A, Iodine, and Iron Deficiencies.” . The Micronutrient Initiative , 1 Jan. 2001.

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Web. 20 Sept. 2013. <http://www.micronutrient.org/resources/ publications/mn_report.pdf>.

16. “Investing in the Future: A United Call to Action on Vitamin and Mineral Deficiencies.” . N.p., 1 Jan. 2009. Web. 26 Sept. 2013. <http://www.unitedcalltoaction.org/documents/ Investing_in_the_future_Summary.pdf>.

17. Tulchinsky, MD, MPH, Theodore H. “Micronutrient Deficiency Conditions: Global Health Issues.” Public Health Reviews 32.1 (2010): 243–255. Print.

18. “Micronutrient Facts.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 26 Feb. 2014. Web. 26 Sept. 2013. <http://www.cdc.gov/immpact/ micronutrients/index.html>.

19. “Iron Deficiency Anemia.” Iron deficiency anemia. U.S. National Library of Medicine, 3 Mar. 2013. Web. 22 Mar. 2014. <http://www.ncbi.nlm.nih.gov/pubmedhealth/ PMH0001610/>.

20. Renato Martins Thesis Martin, Renato. “------.” MS Thesis. Pratt Institute, 20--. Print.

21. “Significant Dates in U.S. Food and Drug Law History.”

Significant Dates in U.S. Food and Drug Law History. U.S. Food and Drug Administration, 1 Jan. 2014. Web. 1 Oct. 2013. <http://www.fda.gov/AboutFDA/WhatWeDo/History/ Milestones/ucm128305.htm>.

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22. Weingarten, Hemi. “1862 - 2014: A Brief History of Food and Nutrition Labeling | Fooducate.” Web. 5 May 2014.

23. “About Nutritional Therapy Association”. Nutritional Therapy Association , 1 Jan. 2014. Web. 30 Apr. 2014. <http:// nutritionaltherapy.com/about-nta/>.

24. Keohane, Joe. “How facts backfire.” Boston.com. The New York Times, 11 July 2010. Web. 20 Sept. 2013. <http://www. boston.com/bostonglobe/ideas/articles/2010/07/11/how_facts_ backfire/?page=full>.

25. Dooley, Dian; Novotny, Rachel; Britten, Patricia. “Integrating Research into the Undergraduate Nutrition Curriculum: Improving Shoppers’ Awareness and Understanding of Nutrition Facts Labels.” Journal of Nutrition Education 30.4 (1998): 225-231. Print.

26. Rothman, Russell L. “Patient Understanding Of Food LabelsThe Role Of Literacy And Numeracy.” American Journal of Preventive Medicine: 391-398. Web. 19 Sept. 2013.

27. Belser, Burkey. “No appetite for changes to the FDA’s Nutrition Facts label.” Washington Post. The Washington Post, 25 Apr. 2014. Web. 30 Apr. 2014. <http://www.washingtonpost.com/ opinions/why-fdas-proposed-changes-to-nutrition-facts-labelare-problematic/2014/04/25/97269852-c99e-11e3-95f77ecdde72d2ea_story.html>.

28. “The Weston A. Price Foundation.” The Weston A. Price Foundation - Weston A Price Foundation. N.p., n.d. Web. 22 74

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Apr. 2014. <http://www.westonaprice.org>.

29. “About Nutritional Therapy.” About Nutritional Therapy.

British Association for Applied Nutrition and Nutritional Therapy (BANT) , n.d. Web. 25 Apr. 2014. <http://bant.org. uk/about-nutritional-therapy/>.

30. Suttie, Emma. “Curing Disease with Nutrition – Using Food as Medicine.” Chinese Medicine Living Curing Disease with Nutrition Using Food as Medicine Comments. N.p., 1 Sept.

2013. Web. 22 Apr. 2014. <http://www.chinesemedicineliving. com/blog/acupuncture/curing-disease-with-nutrition/>.

31. Pollan, Michael. In defense of food: an eater’s manifesto. New York: Penguin Press, 2008. Print.

32. “GDAs explained.” GDA:. N.p., 28 Jan. 2014. Web. 25 Apr. 2013. <http://www.gdalabel.org.uk/gda/explained.aspx>.

33. “Facts Up Front.” Facts Up Front. N.p., n.d. Web. 25 Apr. 2014. <http://factsupfront.org>.

34. “TellSpec.” TellSpec RSS2. N.p., n.d. Web. 30 Sept. 2013. <http://tellspec.com>.

35. “HealthSimple.” Schwartz Powell Design:. N.p., n.d. Web. 14 Sept. 2013. <http://schwartzpowell.com/>.

36. T., Amy. “HealthSimple: Coolest Carb Count Toolkit Yet.” DiabetesMine the all things diabetes blog. N.p., 2 July 2008.

Web. 27 Apr. 2014. <http://www.diabetesmine.com/2008/07/ 75

healthsimple-coolest-carb-count-toolkit-yet.html>.

37. “U.S. Food and Drug Administration.” FDA proposes updates to Nutrition Facts label on food packages. N.p., 27 Feb. 2014. Web. 2 Mar. 2014. <http://www.fda.gov/NewsEvents/ Newsroom/PressAnnouncements/ucm387418.htm>.

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3 Visual Project Nikko-Ryan Santillan

OVERVIEW For this thesis, I wanted to create a visual project that focused on micronutrient education and used this newfound consumer awareness to positively impact consumer culture. By addressing intuitive questions like, “am I eating a healthy diet?” or “could I eat better?”, the challenges associated with education and behavioral change become significant factors when designing a solution to enhance the “user experience” of consumers with food products.

“User experience (UX) focuses on having a deep understanding of users, what they need, what they value, their abilities, and also their limitations.” (usability.gov) In other words, designing for the user experience requires a strong degree of empathy and understanding of various perspectives. Therefore, when I began brainstorming visual project options for this thesis, I focused my thinking primarily around two questions: 1. How can I create a visual solution to abate micronutrient deficiencies that improves the relationship quality of consumers with Nutrition Facts Labels?; and 2. How can I alter consumer perception of micronutrient values as a worthy indicator of a healthy diet? Parallel to the questions I sought to answer in my secondary research, these questions are divided into two categories— user-based and information-based.

The final visual projects designed for this thesis are an educational website and a mobile micronutrient tracking application prototype.

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designing for the user experience requires a strong degree of empathy and understanding of various perspectives.

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METHODOLOGIES In order to design an educational website and mobile micronutrient tracking application prototype that improve consumer education and alter consumer culture, I found it critical to interact with consumers to investigate micronutrients and Nutrition Facts Labels. As mentioned in the introduction, methodologies exercised in the development of these two visual projects were adopted from the IDEO Method Cards1 and include: Personal Inventory / Self Study • How: Document the things that people identify as important to them as a way of cataloging evidence of their lifestyles.

• Why: This method is useful for revealing people’s activities, perceptions, and values as well as patterns among them.

• Approach: Investigating the question, “am I eating a healthy diet?”, I thought it would be beneficial to keep track of everything I ate for about one month via a popular mobile application—MyFitnessPal. I also sought to test whether logging food consumption could indicate any micronutrient deficiencies.

• Outcome: Results proved successful in increasing my personal awareness of nutrition, and therefore shifted my attention and desire to consumer more nutritious whole foods.

Competitive Product Survey • How: Collect, compare and conduct evaluations of the product’s competition.

• Why: This is a useful way to establish functional requirements, performance standards, and other benchmarks.

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• Approach: Mentioned above, I used MyFitnessPal to track my food consumption for about one month. The popular calorie and fitness tracker is mainly used as a tool to help people lose and/or maintain their weight, and therefore focuses on macronutrient consumption and information display.

• Outcome: Using this popular tool formed the basis of my argument that macronutrient tracking is a numbers game, and helped guide the design direction of Mood Foods (micronutrient tracking mobile application prototype).

A Day in the Life (Questionnaire) • How: Catalog the activities and contexts that users experience throughout an entire day.

• Why: This is a way to reveal unanticipated issues inherent in the routines and circumstances people experience daily.

• Approach: As discussed in the Nutrition Facts Label chapter, I designed a questionnaire that focused around the user experience and literacy and numeracy skills of consumers when using Nutrition Facts Labels.

• Outcome: Cataloging this activity helped drive the development of a visual prototype for a micronutrient tracker, which goes against the typical linear, verbal structure of a Nutrition Facts Label.

Anthropometric Analysis (Questionnaire) • How: Use human population measurement data to check the coverage and suitability of the design solution for the target user group.

• Why: This helps to identify a representative group of people for testing design concepts and evaluating the general usability of product details.

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• Approach: As part of the questionnaire mentioned above, I asked people to indicate how often they read Nutrition Facts Labels and what information they pay attention to first, second, third, and fourth.

• Outcome: Results indicated that while most people claim to read Nutrition Facts Labels, less than half of them pay attention to micronutrient data.

Conceptual Landscape • How: Diagram, sketch, or map the aspects of abstract social and behavioral constructs or phenomena.

• Why: This is a helpful way to understand people’s mental models of the issues related to the design problem.

• Approach: Conceptualizing the user landscape formed the overall goal to create two visual projects that ignite consumer awareness and therefore encourage lifestyle changes in personal diet. Focusing on the individual consumer, I wanted to create design solutions that entice them to take the next step in their personal lives, which would eventually translate into social change through peer influences and nutritional dialogues.

Flow Analysis • How: Represent the flow of information or activity through all phases of a system or process.

• Why: This is useful for identifying bottlenecks and opportunities for functional alternatives.

• Approach: This methodology was used during the creation of site maps for the educational website and micronutrient tracking application prototype. Content, navigation, and functionality were dependent on emphasizing the user 6

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experience principles of usefulness, usability, desirability, findability, and credibility.

Paper Prototyping • How: Rapidly sketch, layout, and evaluate interaction design concepts for basic utility.

• Why: This is a good way to quickly organize, articulate, and visualize interaction design concepts.

• Approach: Sketching and analyzing website and mobile application concepts via wireframes shaped the overall design of the two visual projects. At least two wireframe designs were sketched and analyzed per page of each visual concept.

Scenario Testing • How: Show users a series of cards depicting possible future scenarios and invite them to share their reactions.

• Why: Useful for compiling a feature set within a possible context of use as well as communicating the value of a concept to clients.

• Approach: Using an online polling tool called Polar, I employed scenario testing to gain feedback about information visualizations. Which display of information did people better understand, and why? Feedback helped determine which user interfaces would be better to implement in the Mood Foods prototype.

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USER-EXPERIENCE DESIGN User experience design, commonly referred to as UX, is a derivative of user-centered design, which focuses on designing an experience based on how a user understands or interacts with a product.2 While usercentered design refers to a design process, UX refers to the research and analysis of understanding what it is that users want in terms of usability and the emotions associated with such an interactive experience. This focus on the user and their needs have become the basis for web- and mobile-based design today—what experience do we want to give users of our product?3 “UX best practices promote improving the quality of the user’s interaction with and perceptions of your product and any related services.”4 To achieve this, UX design focuses on identifying and catering to a set of criteria developed by Peter Morville. Morville believes that in order for there to be a valuable user experience, information must be useful, usable, desirable, findable, accessible, and credible (figure 1). Visualized in a honeycomb structure, each hexagon fosters the opportunity for a designer to analyze each facet, expand their vision, and therefore surpass their limitations in order to improve the user experience.5

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SELF STUDY The focus of my thesis revolves around data and consumer feedback in regards to the experience of interacting with Nutrition Facts Labels. Enhancing this user experience and making the data more comprehensible therefore requires a strong degree of empathy and understanding of user needs, which is what I sought out to accomplish by doing a self study on personal nutrition habits. Fitting within my target audience of people aged 22â&#x20AC;&#x201C;30, I conducted nutritional and visual research on a personal scale that helped inform later investigations with other consumers.

SCOPE In mid-October 2013, I began tracking my food consumption via the popular calorie-tracking mobile application, MyFitnessPal, for about one month (figure 2). The reason why I used this medium was because it is linked to a large database of nutritional information harvested and populated by the people who use it. This made it easy to enter nutritional information manually or by scanning barcodes of food items that I had purchased. As for why I chose to do this study for one month, I figured that 30 days would be ample time to establish and recognize personal eating habits and generate enough significant data to make dietary conclusions.

Although the nutritional information within MyFitnessPal is primarily calorie- and macronutrient-based, it also features some micronutrient tracking of Vitamin C, Calcium, Iron, and Potassium depending on the food item in the database. However, it does not display or track 9

this micronutrient information visually like it does for calories, carbs, protein, and fat via a pie chart. Therefore, because my thesis topic is grounded in paying attention to micronutrient data and using that information as an indicator of a “healthy diet”, I documented both the macronutrient and micronutrient values harvested by MyFitnessPal into a Google Spreadsheet, averaged all daily totals for the duration of the 30-day study, and calculated the percentage difference between these averages and the Recommended Daily Allowance- (RDA), Dietary Reference Intake- (DRI), and Dietary Reference Intake Upper (DRIu) limits listed by the U.S. Department of Agriculture’s nutrition.gov website for a 24-year old male. Similarly, I calculated the percentage difference between calories, carbs, fat, and protein collected by MyFitness Pal with the daily goal values that it sets based on my age, height, weight, activity level, and weight loss goal. All of the data that was collected and calculated can be viewed in figure 3.

DATA COLLECTION & VISUALIZATION After collecting and calculating the data, I sought to translate these numbers visually. This resulted in two visual formats based on circles (figure 4) and the idea of striving to obtain 100 percent Daily Value of nutrient “x”. Circles are the primary shape that is most easily understood by viewers, which makes its use that much more beneficial as an education tool. Both formats (option A and option B) were then presented in a public poll in which people could vote on which visual presentation they best understood for tracking nutrient “x” to reach a 100 percent Daily Value (figure 5). Results from this poll would then help inform the data visualizations presented in the Mood Foods application prototype.

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REFLECTION Without this self study, the strength and practicality of this thesis project would probably not be as strong. It not only alerted me to certain micronutrient deficiencies that I had, but it proved my argument that the visual presentation of micronutrient information can empower someone to change their eating habits in attempt to have a more healthy diet. Once I learned that I was largely calcium deficient, I researched calcium-rich foods that did not have dairy because I am lactose-intolerantâ&#x20AC;&#x201D;which makes sense as to why I was calcium deficient anyway. This research informed me of whole foods that I could consume, which inspired me to seek out food options that were not packaged or processed, or to solely rely on a calcium supplement to maintain 100 percent daily value of calcium.

I believe that this process of awareness, research, and altering eating habits would be the same for anyone who used this self study methodology. The impact of linear data is not as significant as visual data, which only confuses consumers more because they are not always able to accurately read or calculate data for cumulative purposes. This makes consumers unaware of their true eating patterns and habits, which may conflict with their belief that they are eating healthy. Therefore, how could I change this? How could I inspire social change and alter consumer perceptions and interactions with foods that ensure that their body is being supplied with 100 percent Daily Values for proper metabolic function, cognitive development, and immune system support? Furthermore, how could I ignite this change through design? These were the questions I asked myself while I explored solutions for my visual projects.

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THE DEFICIENCY PROJECT Initially envisioned as a name for the first visual project--an educational website—I later realized that The Deficiency Project also encapsulated the entire purpose of my thesis, which involved quantitative and qualitative investigation, analysis, and a call to action. I compared this to a documentary film, which very much follows the same process but in a different medium. By questioning the nutrition guidelines determined by the government and food industry and proposing an alternative meaning of the phrase “healthy diet”, I wanted to label my project in a simple way that would provoke conversation and call attention to the global epidemic of micronutrient deficiencies.

IDENTITY The identity system created for The Deficiency Project evolved from the question of how to communicate the focus of my thesis in a visual symbol or identifier (figure 6). To achieve this, I separated “The Deficiency Project” into two parts, “deficiency” and “project”. The term deficiency means that there is a lack of something to be obtained,6 and when applied to the nutritional consumption of micronutrients, this definition specifically addresses the fact that nearly half of humanity consume less than their 100 percent Daily Value of certain vitamins and minerals. It is because of this “less than” statement that a red, leftfacing arrow was called out in the identity system, which is similar to the symbolic use of this shape in mathematics.

As for the term “project”, I wanted this label to reflect all of the conceptual thinking, investigative research, and practical application 12

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of visual “solutions” that I accomplished throughout this thesis journey. The journey mimics the thorough process that is typical of studio classes at Pratt, which entail a topic/mission statement (my thesis statement), a plan of action/process (my secondary research and self study), and a visual execution (my two visual projects).

Structurally, I decided to create the visual layout of the identity in a way that resembled a Nutrition Facts Label. The thick line above the title symbolizes the division between macro- and micronutrient information, and the bold presentation of the identity metaphorically calls attention to something that consumers typically do not pay attention to—micronutrients.

In terms of the overall system of this identity, I imagined what the application of this identity onto various products and mediums could look like. The identity itself is small and compact, but what would this look like as an icon? Could it be used as just a symbol? What it if it was overlayed on a piece of merchandise? These scenarios determined the need for modified versions as well as an overall design lockup that could be used for the thesis book cover, separate from the established identity described above. Therefore, the “symbol” would be used for digital media, specifically as an icon for when the logo is reduced beyond visibility. As for an “overlay”, this would be used for collateral or as an awareness tool that could be applied to existing Nutrition Facts Labels beside or on top of micronutrient values to capture consumer attention.

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EDUCATIONAL WEBSITE The first visual project for this thesis is an educational, interactive website that informs people about micronutrient deficiencies and whole food sources to combat them. Too often I discovered that people were not sure of what the term “micronutrient” meant, let alone certain symptoms associated with micronutrient deficiencies.

Knowing this, I sought to increase public awareness about this global epidemic and decided to use an interactive medium to make public education more effective (refer back to book 2, Facts vs. Beliefs).

Since the science of micronutrients and the food industry are so complex, I wanted this website to be simple in both structure and functionality. Primarily image-based, the website itself is divided into two main pages—deficiencies and foods—that use the same filter system (figure 7). “Deficiencies” encompass information about the five micronutrients that plague the globe—Vitamin A, Folate, Iodine, Iron, and Zinc—and “foods” embodies a grid of whole food images that filter according which micronutrient they are good sources of. For example, if a user clicks “Vitamin A” under the “foods” navigation option, only foods that are good sources of Vitamin A will display (figure 8).

I decided to focus on the display of whole foods only because, as indicated through research, whole foods are the best sources of vitamins and minerals. Processed foods are only fortified with specific micronutrients, which are chemically derived and do not possess the same quality of nutrients that ensure the body functions at its optimum ability. This supports my overall argument that processed foods and whole foods are not equal in quality, regardless of how many vitamins 14

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and minerals are injected into these packaged items. Therefore, public consciousness should shift towards seeking out and consuming these nutrient-dense foods when striving for a healthy diet.

MOOD FOODS APPLICATION Mood Foods is a mobile application prototype that was prototyped to function similar to a calorie tracker, but solely for the purposes of visualizing micronutrient consumption and educating people about the significant impact of food on mental health (figure 9).

If someone is deficient in certain vitamins and minerals, they may experience recognizable side effects that can be overcome by eating specific foods. Learning about these foods and the mood states that correlate with them would be one way to utilize this application while striving to consume 100% Daily Values of nutrients as listed on Nutrition Facts Labels.

Although there are a variety of vitamins and minerals embedded within foods, only eight of those micronutrients are profiled and logged in this applicationâ&#x20AC;&#x201D;Vitamin A, Vitamin C, Calcium, Folate, Iodine, Iron, Potassium, and Zinc. Aside from this being a prototype, the reason why only eight micronutrients are referenced in Mood Foods is due to the global prevalence of five vitamin and mineral deficiencies mentioned throughout this thesisâ&#x20AC;&#x201D;Vitamin A, Folate, Iodine, Iron, and Zincâ&#x20AC;&#x201D;and the tracking of Vitamin C, Calcium, and Potassium with the use of MyFitnessPal. Certainly it is important to maintain a healthy balance of all vitamins and minerals through a variety of whole food sources, but for the purpose of creating a 15

tool to help solve a global problem and contrasting that tool with an existing popular product, only eight micronutrients were included in this application prototype.

Capitalizing on the organic, natural characteristic of whole foods and the sustainability movement, hand drawn typography and illustrations were incorporated into the application to make this tool more approachable for personalizing the data-driven process of tracking food. Similarly, deep vibrant colors were used to present this information to further encourage usability and embody “health”.

Functionality-wise, the application is user-centric. Users can create a profile to calculate their recommended daily intake (RDI) levels of specific micronutrients, as well as record their history of micronutrient consumption through a visual log. This log will ultimately help users determine whether or not their eating habits should be altered based on any micronutrient deficiencies that may arise through such tracking. The way users interact with this product is through a simple presentation of choices and dialogues of information that are colorcoded and categorized depending on their relationship to “moods” or “foods”. Although only encompassing whole foods, again, foods and moods can be searched for or selected based on the top three of each that users frequently experience or consume (figure 10). Users of the application can also learn about the significance of each tracked micronutrient in terms of what benefit they provide to particular bodily functions and development.

A special feature incorporated into Mood Foods is its integration with social media platforms, Facebook and Twitter. Using both platforms’ APIs and word-specific algorithms, Mood Foods would filter through status updates and tweets that include a negative “feeling” and thereby 16

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alert the user to suggest a food item that they should eat to help alleviate this feeling or mood. Although this social media analysis and alert feature are dependent on user-granted access to these social media accounts, analysis of this collected data could help determine regional or neighborhood eating patterns as generated by users of this application. Regardless of user-granted access to social media accounts, though, Mood Foods would still alert users with suggested foods at specific times of day depending on their logged percentages of micronutrients consumed. For example, if a user has only consumed 30% of his/her recommended intake for Vitamin C at 3 oâ&#x20AC;&#x2122;clock in the afternoon, an alert would display on the userâ&#x20AC;&#x2122;s phone suggesting to eat an orange to boost that value.

The strength of Mood Foods lies in its practical application to a personâ&#x20AC;&#x2122;s lifestyle and its shift in perspective of what exactly constitutes a healthy diet. By focusing on the micronutrients of foods, whole foods, and mental health, Mood Foods allows users the opportunity to attain a nutrient-dense diet that may produce positive physical and mental well-being.

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Figure 1

• Useful: your content should be useful and fulfill a need • Usable: site must be easy to use • Desirable: Image, identity, brand, and other design elements are used to evoke emotion and appreciation • Findable: Content needs to be navigable and locatable onsite and offsite • Accessible: Content needs to be accessible to people • with disabilities • Credible: Users must trust and believe what you tell them

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Figure 2

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Figure 3

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Figure 5

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Figure 6

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Figure 7

Figure 8

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Figure 9

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Figure 10

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SOURCES 1. “IDEO Method Cards.” . N.p., 1 Jan. 2002. Web. 14 Sept.

2013. <http://www.ideo.com/work/method-cards/>.

2. “Introduction to User-Centered Design.” Usability First -. N.p., n.d. Web. 28 Apr. 2014. <http://www.usabilityfirst.com/aboutusability/introduction-to-user-centered-design/>.

3.

Gube, Jacob. “What Is User Experience Design? Overview, Tools And Resources.”Smashing Magazine. Smashing Magazine, 5 Oct. 2010. Web. 1 May 2014. <http://www. smashingmagazine.com/2010/10/05/what-is-user-experiencedesign-overview-tools-and-resources/>.

4. “User Experience Basics.” N. p., 19 Feb. 2014. Web. 9 Apr. 2014.

5.

Morville, Peter. “User Experience Design.” User Experience Design. Semantic Studios, 21 June 2004. Web. 30 Apr. 2014.

6. “Deficiency.” Merriam-Webster.com. Merriam-Webster, n.d.

Web. 5 May 2014. <http://www.merriam-webster.com/ dictionary/deficiency>.

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