Jun 15, 2015

Julie: One day, each swipe of your grocery store loyalty card could help you lead a healthier life, up next on The Scope.

Announcer: Examining the latest research and telling you about the latest breakthroughs. The science and research show is on The Scope.

Julie: I'm talking with Dr. John Hurdle, professor of biomedical informatics at the University of Utah. Dr. Hurdle, if you would see me at the grocery store yesterday, you would have looked in my shopping cart and seen some fruits and vegetables, some chicken and beef and some cookies. But it turns out that this snapshot is very valuable. Why is that?

Dr. Hurdle: Well, that snapshot is valuable because it says something about the patterns of the foods you consume and we know that over time, that pattern is indicative of what we call the diet quality shoppers. And if you look at that over time, you have a nice picture of what it is that households bring into their house. And we know that about 60% to 70% of the calories that people eat, almost certainly 70% of the calories that children eat, come from the retail grocery stores. We think it's a useful source of data if we could follow it over time. We can perhaps detect important healthy or unhealthy patterns, and then try to find a way to improve it.

Julie: And you've actually come up with a way of monitoring exactly this kind of data.

Dr. Hurdle: Julie, there are a lot of tools out there a lot of people would be familiar with. My Fitness Pal where you have an app where you enter the foods that you eat. There are other systems that are based on grocery stores where you put stickers on food, sort of rank individual cereals, for example, like this one is more healthier than that one. There's nothing necessarily wrong with that except that it puts a lot of burden on the shopper to have to examine...find the best item of everything that they're buying and it's just looking at a very narrow snapshot.

One of the beauties of our tool, QualMART, is they can look at the entire market basket and do so over any length of time. You can do that without asking anything special of the shopper except to shop.

Julie: So how does your tool go about measuring how healthy the things that you're buying from the store are?

Dr. Hurdle: So we figured out a way to map those little barcodes that appear on all the products that you buy into various nutrition databases at the USDA. Using that, we can use the Dietary Guidelines for Americans, which is what the USDA is recommending the people eat to maintain a healthy diet, and then assess the quality of a market basket for household or thousands of households over time.

Julie: So your tools can be a way for families to track the healthfulness of what they're buying at the grocery store, with the hopes of being able to change bad habits over time, I would think.

Dr. Hurdle: I think the first step, and it's probably a baby step, is to have the household look at their own patterns just like we do now when we get an electric bill. Not sure about you, but when I get an electric bill, it shows me how I'm doing over the year and how that compares to my neighbors and how that compares to my really efficient neighbors. One could imagine the same thing with food, and that's a very self-motivated approach. Because we know the kinds of foods that these households prefer to eat and we know the gaps and what they are eating now, we envision building a recommendation system that would move that one more step beyond just self-motivation and actually say, "If you bought more of this and bought less of that, your overall food quality would be even better." But I would like to stress, we're only envisioning doing this with families that opt-in to a program.

Julie: And I could imagine that in partnering with the grocery store, you can take that a step further rather than just having a list of recommendations. You can have coupons that encourage people to buy more leafy greens.

Dr. Hurdle: Exactly right. It's both good for their family, it's good for the store. It's this one plan we've been discussing with University of Utah; health plans where we actually would provide rewards program if you can maintain a consistently more healthy diet than you used to have. Maybe we can send you a shopping card for the grocer and you could buy even more stuff, so you would have both the incentive in terms of the card as well as the information you would need to act in a more healthy shopping way.

Julie: And you've developed a partnership with the grocery store chain, Smith's. Why did they decide to become involved?

Dr. Hurdle: It's just very much part of their mission; watch out for the health and welfare of their customers. I think, it's mainly altruistic, but it's also good business if you can convince customers that you're interested in their health, and that might encourage them to come more to your store.

Julie: You had told me about one project; that you're performing with the Diabetes Prevention Program here and I think that's a really good example of how you can use this type of information.

Dr. Hurdle: That's right. You have a good memory, Julie. So we are partnering with Dr. Tim Graham and Dr. Julie Metos who are running a Diabetes Prevention Program. So they're seeing if they can find ways to motivate through improving exercise and diet these pre-diabetic individuals. So they have all clinical markers for a person who may tip over into full-blown adult-onset diabetes, which is a huge problem in this country. So we are planning on recruiting a subset of those patients, get them to opt into our program. And of course, they have to be primarily shoppers at Smith's because that's our local contact at the moment. And we will be able to tell Dr. Graham and Dr. Metos just how much effect they had, if any, on the diet, at least, what people are buying. So we would look back at what they did buy, what they bought during the year of the program. Then we could follow them after to see if that change persists and that's evaluation, which is pretty much impossible to do any other way.

Julie: The beauty of all this is that this data already exists. You're just capturing it in a different way and processing it in a different way so that you can get this valuable nutrition data out of it.

Dr. Hurdle: That's right. That's why this data is so appealing, because it's there anyway. It's cheap to collect. So we would like to see wellness plans sign up and as soon as people are getting incentives to go to a particular store, that would be good for the store because it would tend to drive customers into their doors. And our long-term goal is to recruit a whole variety of grocery store chains so that we can scale this up. This, I think, is something that could profit real people in real a demonstrable way and as you said, the data is there, so why not try to find a way to use it?

Announcer: Interesting, informative, and all in the name of better health. This is The Scope Health Sciences Radio.

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