Digitization of the approach to food and nutrition respecting individual health values

Abstract

Japan’s aging population and increasing medical costs threaten the sustainability of its healthcare system. Society 5.0, Japan’s growth strategy, calls for a paradigm shift in healthcare based on digital technology. Health is a topic of great public concern, and diet and nutrition are at the heart of health. Many different values are used to define health, and Society 5.0 focuses on creating personalized values for different styles of eating and health. Health is already at the core of global business, and Japan, which is ahead of the rest of the world in its super-aging society, has a unique opportunity to be the first to create new business solutions for diet and nutrition.

business, digitalization, health value, Japan, Society 5.0

INTRODUCTION

In Japan, half a century after the achievement of universal health insurance coverage, the sustainability of the healthcare system is threatened by the aging population and the growth of health expenditures.¹ In 2015, a healthcare advisory panel to the Japanese Minister of Health, Labor, and Welfare created a vision of Health Care 2035 with the aim of rebuilding a sustainable healthcare system. This is a medium- to long-term vision for a healthcare policy that looks 20 years into the future and makes the power of data an important pillar.² Japan’s new national growth strategy, Future Investment Strategy 2018, also calls for a shift to a data-driven Society 5.0 (which is interlocked with the sustainable development goals) where big data and new technologies (ie, information and communications technology) are anchored in a people-centered approach. The strategy cites the construction of a fully data-driven, new healthcare system as one of the flagship projects leading this shift.³

PARADIGM SHIFT IN JAPAN’S HEALTHCARE

There are 3 major paradigm shifts in healthcare as advocated by Health Care 2035 and Society 5.0.^2,4 The first is a shift from cure, which focuses on the treatment of diseases, to the care and prevention of diseases, such as lifestyle-related diseases. The second is personalized healthcare that respects an individual’s health values (eg, why is health desirable, how do people want to stay healthy)—from standardized care for average patients and symptoms to personalized care tailored to the different health values of each individual—so individuals can receive the prevention, care, and treatment that they need at the right time. The third is the independent health management of individuals. In the past, health maintenance was managed by medical professionals, but now individuals are able to manage their own health through wearable technology and by using the accumulated personal data. For example, by analyzing personal health and social life data, it is possible to predict the risk of illness before it occurs and to encourage individuals to take actions to avoid illness.⁵

APPROACHES TO DIET AND NUTRITION ISSUES IN THE SOCIETY 5.0 ERA

The beginning of the Society 5.0 paradigm shift is digital innovation with artificial intelligence (AI), Internet of things (IoT), and other digital technologies and data. In the Society 5.0 era, in which individuals take the initiative in health management, it is important to learn how to support individual lifestyles through digital technology.⁴ For example, it is important to encourage people who, through public or private health examinations, are found to be at risk for a disease or condition to visit a medical institution at an early stage, to confirm whether they actually visited a medical institution, and to follow up on them,⁶ but this cannot be done without considerable administrative and programmatic effort.^7–9

Digital technology, however, should make such an endeavor easier.¹⁰ For example, text messaging is used to follow up with patients after they have been treated for cancer. Although the signs of cancer recurrence are difficult to detect,^11,12 the survival rate of cancer might be improved simply by asking certain questions regularly in a chat post and encouraging patients to return to the hospital, depending on the answer. In this way, existing communication tools can be used to scale things that used to be difficult and expensive to do.^13,14

Although medical and clinical care are important pillars of the health system, better outcomes come from a prevention-oriented approach (ie, measures to prevent people from getting sick) not only in the clinic but also in social life.^15,16 A previous report argued that there is a substantial return on investment in prevention, specifically, there is a 6-fold return on investment per dollar of prevention.¹⁷ In the Society 5.0 era, the goal is to encourage individuals to take the initiative in their health by providing them with information that will make them aware of themselves or that they will be happy to engage in. These measures will be a major target in the future healthcare system. By leveraging the information gathered from IoT and data from smartphones, it is possible to support lifestyles, including prevention, which has never before been possible.¹⁸

For example, with regard to exercise, the lack of which is one of the major risk factors for lifestyle-related diseases,¹⁹ it is already becoming possible to take a preventive approach by using smartphones. Pokémon Go—a smartphone game that fuses the real world with the digital world, allowing players to explore their neighborhoods to find creatures and treasures for in-game use—is a gaming application with 1 billion users worldwide, but it has also become a fun health companion thanks to a combination of features that make walking more fun.²⁰

In Japan, an unhealthy diet and nutrition are the second most important risk factors, after smoking, contributing to health impairment, accounting for approximately 10% of disability-adjusted life-years (a mixed index of death and disability).^19,21 Various nutrition applications already exist in Japan. For instance, Calorie Mama AI, a Japanese AI dieting and health application, is a smart-camera application that uses food image recognition to simplify calorie and nutrition tracking, automatically tracks physical activity, and provides diet and exercise planning for weight loss. Registering food items one by one on a smartphone can be a heavy burden for users, making it difficult to guarantee continuity. Although there is still room for improvement in accuracy, efforts to predict diet calories and nutrition through image analysis are growing. Asken Diet is another Japanese dieting application that can motivate other application users by sharing the user’s eating habits. In addition, an algorithm supervised by nutritionists provides application users with dietary guidance (eg, information about what diets are associated with what disease risks). By visualizing eating habits in this way, we will be able to make users aware of and improve their eating habits. This is an effort to provide a wide range of users within a digital framework the services that nutritionists have been providing individuals.

COMMERCIALIZATION OF DIETARY AND NUTRITIONAL APPROACHES

Globally, technology giants are also moving into healthcare.²² By taking advantage of their strengths in combination with medical data stored in hospitals, efforts to use daily information (ie, a life log) collected from smartphones and IoT have been initiated. Digitizing an approach to a problem depends on whether it can be commercialized.²³ Service providers need to make it a viable business to maintain the continuity and sustainability of their services. The ability of service providers to monetize a service allows many people to continue to enjoy using the service. In other words, only when a service can be commercialized can it be expected to contribute to health.

Although the sustainability and long-term health impacts of these digitized health-related applications remain debatable,²⁰ in the case of Pokémon GO, collecting creatures and treasures results in increased walking and health. In addition, visiting historic sites, enjoying flowers of the 4 seasons, eating delicious food, and other activities are connected to the enjoyment of each user, and the use of the applications is expected to be more sustainable for the user.²⁴ Eating is fun and a source of entertainment, but it will also be important to consider whether the enjoyment is sustainable.

CONCLUSIONS

Digital technologies contributing to sustainable development goals are an important policy issue for Society 5.0. Among the competing areas, such as education, environment, and security, health is the most tangible aspect for the public, with food and nutrition at the core. There are many different views regarding how to live and be healthy, and how to enjoy food and be healthy. Thus, it is important for Society 5.0 to propose various styles and values for each individual. Health is already at the heart of global business, and technology giants already have health as a primary target for their business strategies. In the case of Japan, the country is in the forefront of advancing the super-aging society and will be faced with a variety of issues associated with the aging society (eg, lifestyle-related diseases, complications, soaring medical costs). The positioning of health is also important in business in Japan, and it is an opportunity to create new solutions to diet and nutrition issues ahead of the rest of the world.

Acknowledgments

Author contributions.All authors contributed to the conceptualization of the paper, led the drafting of the paper, and contributed to and agreed up on the submitted version of the manuscript.

Funding. None

Declaration of interest. All authors declare no competing interests.