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Nature of the evidence base and strengths, challenges and recommendations in the area of nutrition and health claims: a position paper from the Academy of Nutrition Sciences. Br J Nutr 2022:1-18. [DOI: 10.1017/s0007114522003300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
The regulation of health claims for foods by the Nutrition and Health Claims Regulation is intended, primarily, to protect consumers from unscrupulous claims by ensuring claims are accurate and substantiated with high quality scientific evidence. In this position paper, the Academy of Nutrition Sciences uniquely recognises the strengths of the transparent, rigorous scientific assessment by independent scientists of the evidence underpinning claims in Europe, an approach now independently adopted in UK. Further strengths are the separation of risk assessment from risk management, and the extensive guidance for those submitting claims. Nevertheless, four main challenges in assessing the scientific evidence and context remain: (i) defining a healthy population, (ii) undertaking efficacy trials for foods, (iii) developing clearly defined biomarkers for some trial outcomes and (iv) ensuring the composition of a food bearing a health claim is consistent with generally accepted nutrition principles. Although the Regulation aims to protect the consumer from harm, we identify some challenges from consumer research: (i) making the wording of some health claims more easily understood and (ii) understanding the implications of the misperceptions around products bearing nutrition or health claims. Recommendations are made to overcome these challenges. Further, the Academy recommends that a dialogue is developed with the relevant national bodies about Article 12(c) in the Regulation. This should further clarify the GB Guidance to avoid the current non-level playing field between health professionals and untrained ‘influencers’ who are not covered by this Article about the communication of authorised claims within commercial communications.
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A Cross-Sectional Audit of Nutrition and Health Claims on Dairy Yoghurts in Supermarkets of the Illawarra Region of New South Wales, Australia. Nutrients 2021; 13:nu13061835. [PMID: 34072130 PMCID: PMC8229526 DOI: 10.3390/nu13061835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 05/25/2021] [Indexed: 11/18/2022] Open
Abstract
Health and nutrition claims are used by consumers to guide purchasing decisions. In consequence, monitoring and evaluation of such claims to ensure they are accurate and transparent is required. The aim of this study was to investigate the use of nutrition and health claims on dairy-yoghurt products within select Australian supermarkets and assess their compliance with the revised Food Standards Code (FSC). Nutrition, health, and related claims on yoghurt products were assessed in a cross-sectional audit of five supermarkets in the Illawarra region of New South Wales. Claim prevalence, type, and compliance were assessed and products were compared against current rating measures. A total of n = 340 dairy yoghurt products were identified. Most products (97.9%) carried at least one nutrition and/or health claim, with nutrition-content claims (93.9%) the most prevalent. Most products (n = 277) met the nutrient profiling scoring criterion; while 87.9% of products did not carry the health star rating. Almost all claims surveyed (97.4%) were compliant with the FSC. Health and nutrition claims are highly prevalent across yoghurt categories, with the majority of these compliant with regulations. The ambiguity surrounding the wording and context of claims challenges researchers to investigate consumers’ interpretations of health messaging within the food environment.
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Kušar A, Žmitek K, Lähteenmäki L, Raats MM, Pravst I. Comparison of requirements for using health claims on foods in the European Union, the USA, Canada, and Australia/New Zealand. Compr Rev Food Sci Food Saf 2021; 20:1307-1332. [PMID: 33565710 DOI: 10.1111/1541-4337.12716] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/07/2020] [Accepted: 01/05/2021] [Indexed: 12/01/2022]
Abstract
Nutrition is recognized as one of the leading factors influencing the growing incidence of noncommunicable diseases. Despite society experiencing a global rise in obesity, specific populations remain at risk of nutrient deficiencies. The food industry can use health claims to inform consumers about the health benefits of foods through labeling and the broader promotion of specific food products. As health claims are carefully regulated in many countries, their use is limited due to considerable investments required to fulfill the regulatory requirement. Although health claims represent a driving force for innovation in the food industry, the risk of misleading of consumers need to be avoided. The health claim scientific substantiation process must be efficient and transparent in order to meet the needs of companies in the global market, but should be based on strong scientific evidence and plausible mechanisms of actions, to ensure highest level of consumer protection. The objective of this review is to compare the possibilities for using health claims on foods in the European Union, the USA, Canada, and Australia and New Zealand. In particular, we focused on differences in the classification of claims, on the scientific substantiation processes and requirements for health claims use on foods in the selected regions. Reduction of disease risk (RDR) claims are associated with relatively similar procedures and conditions for use, whereas several notable differences were identified for other types of claims. In all cases, RDR claims must be approved prior their introduction to the market, and only a few such claims have been authorized. Much greater differences were observed concerning other types of claims.
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Affiliation(s)
- Anita Kušar
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
| | - Katja Žmitek
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia.,VIST - Higher School of Applied Sciences, Ljubljana, Slovenia
| | - Liisa Lähteenmäki
- MAPP Centre, Department of Management, Aarhus University, Aarhus V, Denmark
| | - Monique M Raats
- Food, Consumer Behaviour and Health Research Centre, University of Surrey, Guildford, Surrey, UK
| | - Igor Pravst
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia.,VIST - Higher School of Applied Sciences, Ljubljana, Slovenia.,Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
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4
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Identifying objective quality attributes of functional foods. QUALITY ASSURANCE AND SAFETY OF CROPS & FOODS 2020. [DOI: 10.15586/qas2020.663] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Neale EP, Tapsell LC. Perspective: The Evidence-Based Framework in Nutrition and Dietetics: Implementation, Challenges, and Future Directions. Adv Nutr 2019; 10:1-8. [PMID: 30649173 PMCID: PMC6370257 DOI: 10.1093/advances/nmy113] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 09/06/2018] [Accepted: 11/15/2018] [Indexed: 12/31/2022] Open
Abstract
Decision making in nutrition is based on current available scientific evidence. However, we are currently living in a time of highly accessible information, and with the increase in accessibility has come a concomitant increase in misinformation and pseudoscience relating to nutrition. This presents a challenge to the nutrition research community, practitioners, and consumers, and highlights a need to critically examine the current evidence-based framework in nutrition, and identify strategies for future improvements. This narrative review outlines the current evidence-based framework and approaches to evidence-based practice in the nutrition field, focusing on policy and guideline development. Within the framework, systematic reviews are an important tool for evidence-based practice, underpinning translation guidelines and other implementation documents. Recommendations for consumption of nutrients, foods, and whole diets are required to guide consumers and practitioners; however, these resources must be updated regularly to remain timely and accurate. In turn, clinical practice guidelines guide practitioners in how to implement the evidence base for patients and clients, supporting practitioners to be positioned as a key conduit between scientific evidence and the public. In contrast, health claims may support marketing of food products, but require consideration of the strength and quality of the evidence to support health claims, with external oversight required to ensure claims are appropriate. Collecting, synthesizing, and translating the evidence base in nutrition remains an ongoing challenge, particularly in the current context of increased information availability. To address growing challenges in combating pseudoscience, nutrition researchers, policy makers, and practitioners must work together, and the role of practitioners in translating the evidence base and personalizing it to individual patients must be emphasized. Continuing to address current challenges, including increasing the timeliness and consistency of the approach to the evidence base, is required to ensure informed and robust nutrition policy, research, and practice into the future.
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Affiliation(s)
- Elizabeth P Neale
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Linda C Tapsell
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
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Daliu P, Santini A, Novellino E. From pharmaceuticals to nutraceuticals: bridging disease prevention and management. Expert Rev Clin Pharmacol 2018; 12:1-7. [PMID: 30484336 DOI: 10.1080/17512433.2019.1552135] [Citation(s) in RCA: 133] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Nutraceuticals, up today, do not have a specific definition distinct from those of other food-derived categories, e.g. food supplements, herbal products, pre and probiotics, functional foods, etc. They have, however, a pharmacological beneficial effect on health. Many studies have been recently addressed to assess their safety, efficacy, and regulation since they are getting growing attention by market and research, with the aim to clear the difference between them and other market available food-derived products that claim beneficial effect on health. Areas covered: The understanding of the potential mechanisms of action of pharmaceutically active substances contained in nutraceuticals that may improve health and reduce the risk of pathological conditions while enhancing overall well-being is the challenge for nutraceuticals to be considered as a preventive and therapeutic efficient tool in facing some diseases. Expert commentary: It is of utmost importance to have a proper and unequivocal definition of nutraceuticals and a shared regulation. Nevertheless, there is a lack of clear information and, often, the claimed health benefits may not be properly substantiated by safety and by efficacy in vivo data, which can induce false expectations and miss the target for a product to be effective, as claimed.
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Affiliation(s)
- Patricia Daliu
- a Department of Pharmacy , University of Napoli Federico II , Napoli , Italy
| | - Antonello Santini
- a Department of Pharmacy , University of Napoli Federico II , Napoli , Italy
| | - Ettore Novellino
- a Department of Pharmacy , University of Napoli Federico II , Napoli , Italy
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Chakrabarti S, Guha S, Majumder K. Food-Derived Bioactive Peptides in Human Health: Challenges and Opportunities. Nutrients 2018; 10:E1738. [PMID: 30424533 PMCID: PMC6265732 DOI: 10.3390/nu10111738] [Citation(s) in RCA: 352] [Impact Index Per Article: 58.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 11/06/2018] [Accepted: 11/09/2018] [Indexed: 02/06/2023] Open
Abstract
Recent scientific evidence suggests that food proteins not only serve as nutrients, but can also modulate the body's physiological functions. These physiological functions are primarily regulated by some peptides that are encrypted in the native protein sequences. These bioactive peptides can exert health beneficial properties and thus are considered as a lead compound for the development of nutraceuticals or functional foods. In the past few decades, a wide range of food-derived bioactive peptide sequences have been identified, with multiple health beneficial activities. However, the commercial application of these bioactive peptides has been delayed because of the absence of appropriate and scalable production methods, proper exploration of the mechanisms of action, high gastro-intestinal digestibility, variable absorption rate, and the lack of well-designed clinical trials to provide the substantial evidence for potential health claims. This review article discusses the current techniques, challenges of the current bioactive peptide production techniques, the oral use and gastrointestinal bioavailability of these food-derived bioactive peptides, and the overall regulatory environment.
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Affiliation(s)
- Subhadeep Chakrabarti
- Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, ON K1A 0K9, Canada.
| | - Snigdha Guha
- Department of Food Science and Technology, University of Nebraska-Lincoln, Lincoln, NE 68588-6205, USA.
| | - Kaustav Majumder
- Department of Food Science and Technology, University of Nebraska-Lincoln, Lincoln, NE 68588-6205, USA.
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Santini A, Cammarata SM, Capone G, Ianaro A, Tenore GC, Pani L, Novellino E. Nutraceuticals: opening the debate for a regulatory framework. Br J Clin Pharmacol 2018; 84:659-672. [PMID: 29433155 PMCID: PMC5867125 DOI: 10.1111/bcp.13496] [Citation(s) in RCA: 174] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 11/29/2017] [Accepted: 11/30/2017] [Indexed: 12/14/2022] Open
Abstract
Currently, nutraceuticals do not have a specific definition distinct from those of other food-derived categories, such as food supplements, herbal products, pre- and probiotics, functional foods, and fortified foods. Many studies have led to an understanding of the potential mechanisms of action of pharmaceutically active components contained in food that may improve health and reduce the risk of pathological conditions while enhancing overall well-being. Nevertheless, there is a lack of clear information and, often, the claimed health benefits may not be properly substantiated by safety and efficacy information or in vitro and in vivo data, which can induce false expectations and miss the target for a product to be effective, as claimed. An officially shared and accepted definition of nutraceuticals is still missing, as nutraceuticals are mostly referred to as pharma-foods, a powerful toolbox to be used beyond the diet but before the drugs to prevent and treat pathological conditions, such as in subjects who may not yet be eligible for conventional pharmaceutical therapy. Hence, it is of utmost importance to have a proper and unequivocal definition of nutraceuticals and shared regulations. It also seems wise to assess the safety, mechanism of action and efficacy of nutraceuticals with clinical data. A growing demand exists for nutraceuticals, which seem to reside in the grey area between pharmaceuticals and food. Nonetheless, given specific legislation from different countries, nutraceuticals are experiencing challenges with safety and health claim substantiation.
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Affiliation(s)
- Antonello Santini
- Department of PharmacyUniversity of Napoli Federico IIVia D. Montesano, 49 ‐80131NaplesItaly
| | | | - Giacomo Capone
- AIFA ‐ Agenzia Italiana del FarmacoVia del Tritone, 181 ‐00187RomeItaly
| | - Angela Ianaro
- Department of PharmacyUniversity of Napoli Federico IIVia D. Montesano, 49 ‐80131NaplesItaly
| | - Gian Carlo Tenore
- Department of PharmacyUniversity of Napoli Federico IIVia D. Montesano, 49 ‐80131NaplesItaly
| | - Luca Pani
- Department of Psychiatry and Behavioral SciencesUniversity of Miami, School of Medicine33136‐1015MiamiFLUSA
| | - Ettore Novellino
- Department of PharmacyUniversity of Napoli Federico IIVia D. Montesano, 49 ‐80131NaplesItaly
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Winklhofer-Roob BM, Faustmann G, Roob JM. Low-density lipoprotein oxidation biomarkers in human health and disease and effects of bioactive compounds. Free Radic Biol Med 2017; 111:38-86. [PMID: 28456641 DOI: 10.1016/j.freeradbiomed.2017.04.345] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 04/16/2017] [Accepted: 04/18/2017] [Indexed: 12/14/2022]
Abstract
Based on the significance of oxidized low-density lipoprotein (LDL) in health and disease, this review focuses on human studies addressing oxidation of LDL, including three lines of biomarkers, (i) ex vivo LDL resistance to oxidation, a "challenge test" model, (ii) circulating oxidized LDL, indicating the "current in vivo status", and (iii) autoantibodies against oxidized LDL as fingerprints of an immune response to oxidized LDL, along with circulating oxysterols and 4-hydroxynonenal as biomarkers of lipid peroxidation. Lipid peroxidation and oxidized LDL are hallmarks in the development of various metabolic, cardiovascular and other diseases. Changes further occur across life stages from infancy to older age as well as in athletes and smokers. Given their responsiveness to targeted nutritional interventions, markers of LDL oxidation have been employed in a rapidly growing number of human studies for more than 2 decades. There is growing interest in foods, which, besides providing energy and nutrients, exert beneficial effects on human health, such as protection of DNA, proteins and lipids from oxidative damage. Any health claim, however, needs to be substantiated by supportive evidence derived from human studies, using reliable biomarkers to demonstrate such beneficial effects. A large body of evidence has accumulated, demonstrating protection of LDL from oxidation by bioactive food compounds, including vitamins, other micronutrients and secondary plant ingredients, which will facilitate the selection of oxidation biomarkers for future human intervention studies and health claim support.
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Affiliation(s)
- Brigitte M Winklhofer-Roob
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University of Graz, Austria.
| | - Gernot Faustmann
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University of Graz, Austria; Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Austria
| | - Johannes M Roob
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Austria
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10
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Protocol for a Randomized Trial Assessing Consumer Evaluations of Pre-Packaged Foods that Systematically Vary by Nutrition Information and Product Attributes. BMC Nutr 2017. [DOI: 10.1186/s40795-016-0119-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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11
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Verhagen H, van Loveren H. Status of nutrition and health claims in Europe by mid 2015. Trends Food Sci Technol 2016. [DOI: 10.1016/j.tifs.2016.07.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Tan KYM, van der Beek EM, Chan MY, Zhao X, Stevenson L. Health claims on food products in Southeast Asia: regulatory frameworks, barriers, and opportunities. Nutr Rev 2016; 73:634-41. [PMID: 26269489 DOI: 10.1093/nutrit/nuv029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Association of Southeast Asian Nations aims to act as a single market and allow free movement of goods, services, and manpower. The purpose of this article is to present an overview of the current regulatory framework for health claims in Southeast Asia and to highlight the current barriers and opportunities in the regulatory frameworks in the Association of Southeast Asian Nations. To date, 5 countries in Southeast Asia, i.e., Indonesia, Malaysia, the Philippines, Singapore, and Thailand, have regulations and guidelines to permit the use of health claims on food products. There are inconsistencies in the regulations and the types of evidence required for health claim applications in these countries. A clear understanding of the regulatory frameworks in these countries may help to increase trade in this fast-growing region and to provide direction for the food industry and the regulatory community to develop and market food products with better nutritional quality tailored to the needs of Southeast Asian consumers.
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Affiliation(s)
- Karin Y M Tan
- K.Y.M. Tan and M.Y. Chan are with the Human Nutrition Research Centre, Newcastle University, Singapore, Republic of Singapore. E.M.v.d.Beek is with Nutricia Research, Danone-Nutricia Early Life Nutrition, Singapore, Republic of Singapore. X.J. Zhao is with Nutricia Early Life Nutrition (Shanghai) Co., Ltd, Pudong, Shanghai, People's Republic of China. L. Stevenson is with the Nutrition & Health Research Group, Liverpool John Moores University, Aigburth, Liverpool, United Kingdom.
| | - Eline M van der Beek
- K.Y.M. Tan and M.Y. Chan are with the Human Nutrition Research Centre, Newcastle University, Singapore, Republic of Singapore. E.M.v.d.Beek is with Nutricia Research, Danone-Nutricia Early Life Nutrition, Singapore, Republic of Singapore. X.J. Zhao is with Nutricia Early Life Nutrition (Shanghai) Co., Ltd, Pudong, Shanghai, People's Republic of China. L. Stevenson is with the Nutrition & Health Research Group, Liverpool John Moores University, Aigburth, Liverpool, United Kingdom
| | - M Y Chan
- K.Y.M. Tan and M.Y. Chan are with the Human Nutrition Research Centre, Newcastle University, Singapore, Republic of Singapore. E.M.v.d.Beek is with Nutricia Research, Danone-Nutricia Early Life Nutrition, Singapore, Republic of Singapore. X.J. Zhao is with Nutricia Early Life Nutrition (Shanghai) Co., Ltd, Pudong, Shanghai, People's Republic of China. L. Stevenson is with the Nutrition & Health Research Group, Liverpool John Moores University, Aigburth, Liverpool, United Kingdom
| | - Xuejun Zhao
- K.Y.M. Tan and M.Y. Chan are with the Human Nutrition Research Centre, Newcastle University, Singapore, Republic of Singapore. E.M.v.d.Beek is with Nutricia Research, Danone-Nutricia Early Life Nutrition, Singapore, Republic of Singapore. X.J. Zhao is with Nutricia Early Life Nutrition (Shanghai) Co., Ltd, Pudong, Shanghai, People's Republic of China. L. Stevenson is with the Nutrition & Health Research Group, Liverpool John Moores University, Aigburth, Liverpool, United Kingdom
| | - Leo Stevenson
- K.Y.M. Tan and M.Y. Chan are with the Human Nutrition Research Centre, Newcastle University, Singapore, Republic of Singapore. E.M.v.d.Beek is with Nutricia Research, Danone-Nutricia Early Life Nutrition, Singapore, Republic of Singapore. X.J. Zhao is with Nutricia Early Life Nutrition (Shanghai) Co., Ltd, Pudong, Shanghai, People's Republic of China. L. Stevenson is with the Nutrition & Health Research Group, Liverpool John Moores University, Aigburth, Liverpool, United Kingdom
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Ameratunga R, Crooks C, Simmons G, Woon ST. Health Risks and Adverse Reactions to Functional Foods. Crit Rev Food Sci Nutr 2014; 56:318-25. [DOI: 10.1080/10408398.2012.751895] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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14
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Gazing into the crystal ball: future considerations for ensuring sustained growth of the functional food and nutraceutical marketplace. Nutr Res Rev 2013; 26:12-21. [DOI: 10.1017/s0954422412000236] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Over the last decade the concept of functional foods and nutraceuticals (FFN) has gained support from various stakeholders including the food industry, scientific and academic community, government institutions or regulators, producers and consumers. However, as one begins to evaluate the global FFN industry, several issues emerge including (i) a lack of consensus across jurisdictions for acknowledging safe and efficacious FFN, (ii) challenges regarding the classification of novel food-derived bioactives as FFN or drugs, and (iii) a disconnect between nutrient requirements and dosages of FFN required to facilitate health benefits. The objectives of the present review are to discuss the role of existing stakeholders within the FFN marketplace and identify performance indicators for growth within the FFN sector. In addition, the following report provides feasible resolutions to present and future challenges facing the global FFN industry to ensure sustained long-term growth.
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Abstract
EU legislation on nutrition and health claims made on foods (Regulation (EC) No. 1924/2006) specifies that health claims should be only authorised for use in the Community after a scientific assessment of the highest possible standard is carried out by the European Food Safety Authority (EFSA). This paper focuses on the scientific substantiation of health claims within the context of the EU Regulation. The evaluation of the substantiation of health claims is carried out by the EFSA Scientific Panel on Dietetic Products, Nutrition and Allergies (NDA). The EFSA has published extensive guidance to assist applicants in the preparation of applications for authorisations of health claims. This guidance summarises the general principles applied by the NDA Panel in the evaluation of health claims, including the scientific criteria for substantiation, as well as the scientific requirements for the substantiation of specific health claims. To date, the EFSA NDA Panel has concluded that a wide range of health claims has been substantiated. These include claims for many well-established functions of nutrients, as well as beneficial effects of foods and food constituents on a range of body functions. In addition, claims have been substantiated on the role of nutrients in growth and development of children and on the effects of nutrients and food constituents on reduction of risk factors for disease. EFSA evaluations and guidance have made an important contribution to the understanding of the scientific substantiation of health claims which will help to set new directions for research and will guide future innovation.
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Ameratunga R, Woon ST. Anaphylaxis to hyperallergenic functional foods. Allergy Asthma Clin Immunol 2010; 6:33. [PMID: 21144046 PMCID: PMC3020168 DOI: 10.1186/1710-1492-6-33] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Accepted: 12/13/2010] [Indexed: 01/19/2023] Open
Abstract
Background Food allergy can cause life threatening reactions. Currently, patients with severe food allergy are advised to avoid foods which provoke allergic reactions. This has become increasingly difficult as food proteins are being added to a broader range of consumer products. Patients and methods Here we describe our investigations into the allergenicity of a new drink when two cow's milk allergic children suffered anaphylaxis after consuming Wh2ole®. Results Our studies have shown that in comparison with cow's milk, Wh2ole® contains at least three times the concentration of β-lactoglobulin. β-lactoglobulin is one of the dominant allergens in bovine milk. Conclusions These studies have shown that modern technology allows the creation of "hyperallergenic" foods. These products have the potential to cause severe reactions in milk allergic persons. Avoiding inadvertent exposure is the shared responsibility of allergic consumers, regulatory authorities and the food industry.
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Affiliation(s)
- Rohan Ameratunga
- LabPlus, Auckland City Hospital, Park Rd, Grafton, Auckland, New Zealand.
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Mariotti F, Kalonji E, Huneau JF, Margaritis I. Potential pitfalls of health claims from a public health nutrition perspective. Nutr Rev 2010; 68:624-38. [PMID: 20883420 DOI: 10.1111/j.1753-4887.2010.00322.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The European Union is implementing a new regulatory framework for nutrition and health claims (HCs) that will greatly impact the communication of health messages on foodstuffs. In particular, approved HCs will be included in a positive register of generic claims. In the currently available literature, assessment of the relevance of HCs has mainly been related to scientific substantiation, and the issue of relevance in terms of public health has tended to be overlooked. Interestingly, the new regulation states that claims must be well understood by the average consumer. This article delves beyond the issue of scientific substantiation of claims and reviews possible discrepancies between consumer perception/understanding of HCs and the public health nutrition reality, which can confuse or mislead the consumer and ultimately impact public health nutrition. Six pitfalls are described herein and a comprehensive overview of the critical examination of any HC is proposed.
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Affiliation(s)
- François Mariotti
- AgroParisTech, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior, F-75005 Paris, France.
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Marinangeli CPF, Jones PJH. Functional food ingredients as adjunctive therapies to pharmacotherapy for treating disorders of metabolic syndrome. Ann Med 2010; 42:317-33. [PMID: 20486826 DOI: 10.3109/07853890.2010.484026] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Abstract Information regarding the use of functional foods and nutraceuticals (FFN) in combating disease is rarely communicated to health care practitioners as medicinal strategies for patients. Metabolic syndrome (MetS) is an ideal paradigm for demonstrating the therapeutic properties of FFN. Encompassing multiple etiologies, including atherogenic dyslipidemia, insulin resistance, and hypertension, MetS affects over a third of American adults. However, as disease-related risk factors accumulate over time, guidelines for treating disorders of MetS progressively de-emphasize the use of FFN. Using marine omega-3 fatty acids, plant sterols, fiber, and tomato extract as examples, the purpose of this review is to endorse FFN as long-term adjunctive therapies to pharmaceutical treatment for disorders and risk factors for MetS. An additional goal is to compare physiological and molecular targets of FFN against corresponding prescription medications. Results reveal that FFN are viable treatment strategies for disorders of MetS, complementing pharmacological interventions by targeting and improving the biological processes that foster the development of disease. Thus, efficacious FFN therapies should be emphasized throughout all stages of treatment as adjuncts to pharmacotherapy for disorders of MetS. Accordingly, new developments in FFN research must be implemented into clinical guidelines with the prospect of improving disease prognoses as accessories to prescription medications.
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Affiliation(s)
- Christopher P F Marinangeli
- The Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Manitoba, R3T 2N2, Canada
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Abstract
BACKGROUND Within the framework of Codex Alimentarius, attempts are being made at international level to establish guidelines for use of nutrition and health claims. An important issue that has to be addressed is the process of scientific substantiating of claims on foods. OBJECTIVE To provide an insight into the current step procedure of the proposed draft recommendations on the scientific basis of health claims. These Codex recommendations are intended to facilitate governments' own evaluation of health claims made by the industry. METHODS Review of comments of governments, observers and non-governmental organizations (NGOs) and relevant references to the proposed draft recommendations of the last sessions of the Codex Committee on Nutrition and Food for Special Dietary Uses (CCNFSDU). A literature search was performed using the PubMed database. RESULTS/CONCLUSIONS Several proposed draft recommendations on the scientific substantiation of health claims have been considered and amended by the CCNFSDU in recent years but the work is not yet complete. The current work draws on the work of FUFOSE and PASSCLAIM and also on that of WHO and FDA. Given the important role of Codex in food safety, the draft recommendations emphasize circumstances where additional evaluation of safety or nutritional safety needs to be considered. High quality human intervention studies are the prime evidence needed to substantiate claims but there is recognition that, in some cases, only observational studies may be available. Animal and in vitro studies will also be evaluated as part of the totality of the evidence. It has been suggested that the recommendations should include re-evaluation of claims after a certain time period, or if new evidence calls into question the scientific validity underpinning the claims. Setting out a common approach for the substantiation of health claims is an important step in the use of health claims around the world. There is a need to reflect emerging as well as consensus science. The substantiating evidence should be proportionate to the claim. Further progress in the elaboration of this relevant Codex text is needed to reach consensus.
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Affiliation(s)
- Rolf Grossklaus
- Federal Institute for Risk Assessment, Thielallee 88-92, 14198, Berlin, Germany
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20
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Walls HL, Peeters A, Loff B, Crammond BR. Why education and choice won't solve the obesity problem. Am J Public Health 2009; 99:590-2. [PMID: 19150894 DOI: 10.2105/ajph.2008.156232] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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21
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Abstract
As the health benefits of ingesting live bacteria become more evident, foods are now being produced that contain probiotic bacteria. The data to support label health claims for probiotic products are often difficult to provide. The experimental evidence to identify probiotic microorganisms and to demonstrate their efficacy in clinical trials is more challenging than for other potential functional foods because effects are mediated by living microorganisms and may therefore be influenced by the status of these microorganisms. Clinical trials to show efficacy are expensive. Obtaining appropriate samples is difficult. A scientific consensus is building to support the claim that the ingestion of certain probiotic bacteria reduces lactose intolerance and can reduce the duration of rotavirus diarrheas. Some probiotic bacteria have "generally accepted as safe" status; proof of the safety of any probiotic is essential. Japanese health regulatory officials, using their Foods for Specific Health Use system, have approved human health claims for over 20 probiotic products. On the other hand, at this time, no probiotic product is sold in Canada that carries a label health claim. This illustrates the considerable discrepancies across countries in perception of health effects of probiotics.
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Affiliation(s)
- Edward R Farnworth
- Food Research and Development Centre, Agriculture and Agri-Food Canada, Saint Hyacinthe, QC, Canada.
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22
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Abstract
Interest in the health effects of foods by both industry and consumers has put a spotlight on the role of health claims on foods in Canada. The current regulatory framework governing the use of different health claims on foods in Canada is described and compared with international approaches. Similarities were observed in how risk-reduction claims for serious diseases are managed in the United States, European Union and proposed by Food Standards Australia New Zealand, including the need for premarket authorization and the requirement for a high level of certainty based on the totality of evidence in substantiating this type of claim. However, approaches to permitting function claims other than those for the well-established functions of known nutrients are divergent among the jurisdictions compared. Canada also differs from other jurisdictions in not establishing core nutritional criteria for foods carrying disease risk-reduction claims. A brief overview of the status in Canada of a number of disease risk-reduction claims that have been approved in the United States, based on significant scientific agreement under the Nutrition Labeling and Education Act or through authoritative statements under the Food and Drug Administration Modernization Act, is also provided.
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Affiliation(s)
- Mary R L'abbé
- Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Canada.
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23
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Jew S, Vanstone CA, Antoine JM, Jones PJH. Generic and product-specific health claim processes for functional foods across global jurisdictions. J Nutr 2008; 138:1228S-36S. [PMID: 18492862 DOI: 10.1093/jn/138.6.1228s] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Worldwide consumer interest in functional foods and their potential health benefits has been increasing over the past 10 y. To respond to this interest, regulatory bodies have developed guidelines for assessing health claims on functional foods. The objective of this article is to investigate the type and amount of evidence needed in various jurisdictions on a worldwide basis to substantiate both generic and product-specific health claims. Two types of health claims were examined using separate case studies. Analysis of generic health claims was highlighted by (n-3) fatty acids and their relation to heart health; whereas examination of product-specific health claims was conducted using probiotics and their association with gastrointestinal well-being. Results showed a common core for use of convincing high-quality human data, especially in the form of randomized controlled trials (RCT), but there was significant variability in the type and amount of scientific evidence needed to substantiate health claims, both generic and product specific, across different jurisdictions. Product-specific claims tended to use human RCT as the main basis for claims, whereas generic claims tended to base their statements on a wider spectrum of literature.
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Affiliation(s)
- Stephanie Jew
- School of Dietetics and Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Quebec H9X 3V9, Canada
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24
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Abstract
Epidemiological investigations suggest that soy consumption may be associated with a lower incidence of certain chronic diseases. Clinical studies also show that ingestion of soy proteins reduces the risk factors for cardiovascular disease. This led to the approval of the food-labeling health claim for soy proteins in the prevention of coronary heart disease by the U.S. FDA in 1999. Similar health petitions for soy proteins have also been approved thereafter in the United Kingdom, Brazil, South Africa, the Philippines, Indonesia, Korea, and Malaysia. However, the purported health benefits are quite variable in different studies. The Nutrition Committee of the American Heart Association has assessed 22 randomized trials conducted since 1999 and found that isolated soy protein with isoflavones (ISF) slightly decreased LDL cholesterol but had no effect on HDL cholesterol, triglycerides, lipoprotein(a), or blood pressure. The other effects of soy consumption were not evident. Although the contributing factors to these discrepancies are not fully understood, the source of soybeans and processing procedures of the protein or ISF are believed to be important because of their effects on the content and intactness of certain bioactive protein subunits. Some studies have documented potential safety concerns on increased consumption of soy products. Impacts of soy products on thyroid and reproductive functions as well as on certain types of carcinogenesis require further study in this context. Overall, existing data are inconsistent or inadequate in supporting most of the suggested health benefits of consuming soy protein or ISF.
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Affiliation(s)
- Chao Wu Xiao
- Nutrition Research Division, Food Directorate, Health Products and Food Branch, Health Canada, 2203E Banting Research Centre, Ottawa, Canada.
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25
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Abstract
Government-approved health claims support dietary intervention as a safe and practical approach to improving consumer health and provide industry with regulatory guidelines for food product labels. Claims already allowed in the United States, United Kingdom, Sweden, and The Netherlands for reducing cholesterol through consumption of oat or barley soluble fiber provide a basis for review, but each country may have different criteria for assessing clinical evidence for a physiological effect. For example, the FDA-approved barley health claim was based on a petition that included 39 animal model studies and 11 human clinical trials. Since then, more studies have been published, but with few exceptions, clinical data continue to demonstrate that the consumption of barley products is effective for lowering total and LDL cholesterol. More research is needed to fully understand the mechanism of cholesterol reduction and the role of beta-glucan molecular weight, viscosity, and solubility. In an assessment of the physiological efficacy of a dietary intervention, consideration should also be given to the potential impact of physical and thermal food-processing treatments and genotypic variation in the barley source. New barley cultivars have been generated specifically for food use, possessing increased beta-glucan, desirable starch composition profiles, and improved milling/processing traits. These advances in barley production, coupled with the establishment of a government-regulated health claim for barley beta-glucan, will stimulate new processing opportunities for barley foods and provide consumers with reliable, healthy food choices.
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Affiliation(s)
- Nancy P Ames
- Cereal Research Centre, Agriculture and Agri-Food Canada, Winnipeg, Manitoba R3T 2M9, Canada.
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26
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Proceedings of a symposium held at the Canadian Nutrition Congress. June 21, 2007. Winnipeg, Canada. J Nutr 2008; 138:1189S-260S. [PMID: 18561371 DOI: 10.1093/jn/138.6.1189s] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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27
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Asp NG, Bryngelsson S. Health claims in Europe: new legislation and PASSCLAIM for substantiation. J Nutr 2008; 138:1210S-5S. [PMID: 18492859 DOI: 10.1093/jn/138.6.1210s] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A regulation on nutrition and health claims made on foods was introduced in the European Union in 2007. This Regulation provides opportunities for the use of health claims on foods in Europe, including reduction of disease risk claims. The Regulation will be fully implemented by January 2010. A community list of permitted and rejected claims will be established and made available to the public. Some European countries have applied voluntary codes of practice on health claims for foods, awaiting the Regulation. Experience with scientific evaluation and use of health claims has been gained using these codes with regard to both generic claims that are closely related to official nutrition recommendations and to product-specific claims based on human intervention studies with the product. The European Commission supported a concerted action project, "Process for the Assessment of Scientific Support for Claims on Foods" (PASSCLAIM). This project reviewed the scientific state of the art in diet and health areas regarded most likely for health claims. The main purpose of the PASSCLAIM project was to define a set of generally applicable criteria for the scientific substantiation of health claims. These criteria were considered to be a scientifically robust tool for evaluating the quality of the data submitted in support of health claims on foods. PASSCLAIM is useful in assisting applicants for a health claim to prepare their supporting dossiers as well as in aiding agencies responsible for evaluating the scientific evidence for the claim.
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Affiliation(s)
- Nils-Georg Asp
- SNF Swedish Nutrition Foundation, Ideon Science Park, SE-22370 Lund, Sweden.
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28
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Abstract
This article provides an overview of the procedures involved in scientific substantiation of functional food health claims in China. The definition of a functional food is discussed, in addition to the factors that led to its modification in 2005. The framework of administration includes the regulation of functional foods, steps involved in submission of dossiers, the safety control system for raw materials and products, and technical procedures for testing and evaluation. Scientific evidence required for a claim includes evidence from product tests in addition to evidence resulting from complete scientific literature searches relative to the food material or component in question. Currently, the 4 main rules for functional food assessment in China include 1) functional assessment procedures; 2) standard toxicological assessment; 3) regulations on nutrient supplements; and 4) standard analytical methods for functional components. The current situation for functional foods in China is analyzed, including a discussion of the distribution of the 27 currently allowed functional food health claims. The effectiveness of functional foods and health claims for improving health relies largely on the motivation and education of the public to be able to make good choices.
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Affiliation(s)
- Yuexin Yang
- National Institute of Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
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29
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Hasler CM. Health claims in the United States: an aid to the public or a source of confusion? J Nutr 2008; 138:1216S-20S. [PMID: 18492860 DOI: 10.1093/jn/138.6.1216s] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Health claims in the United States have been a topic of intense controversy since the mid-1980s. Three categories of claims can currently be used on food and dietary supplement labels in the United States: 1) health claims, 2) nutrient content claims, and 3) structure/function claims. Structure/function claims were authorized under the Dietary Supplement Health and Education Act and describe the effect of a dietary supplement on the structure or function of the body. Nutrient content claims are used to describe the percentage of a nutrient in a product relative to the daily value. Health claims describe a relation between a food, food component, or dietary supplement ingredient and reducing risk of a disease or health-related condition. Health claims are based on a very high standard of scientific evidence and significant scientific agreement. Are U.S. health claims really benefitting public health? Recent evidence suggests that this mode of communication has had limited success and in fact may be misleading to consumers.
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Affiliation(s)
- Clare M Hasler
- Robert Mondavi Institute for Wine and Food Science, College of Agricultural and Environmental Sciences, University of California, Davis, CA 95616, USA.
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30
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Yamada K, Sato-Mito N, Nagata J, Umegaki K. Health claim evidence requirements in Japan. J Nutr 2008; 138:1192S-8S. [PMID: 18492856 DOI: 10.1093/jn/138.6.1192s] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In the early 1980s the Japanese scientific academy defined a functional food as a food having a tertiary or physiologically active function. The current Japanese "Food with Health Claims" include 2 categories. For the first category, "Food with Nutrient Function Claims," the label may be freely used if a product satisfies the standard for the minimum and maximum levels per daily portion usually consumed. The second category is defined as "Food for Specified Health Uses" (FOSHU). FOSHU foods are those that contain dietary ingredients that have beneficial effects on the physiological functions of the human body, maintain and promote health, and improve health-related conditions. Health claims on these foods correspond to the category of "other" function claims of the Codex Alimentarius. However, claims of disease-risk reduction are not currently allowed under FOSHU with an exception for calcium and folic acid. Manufacturers can emphasize the characteristics of their products and promote sales by labeling or claims. Therefore, the labeling should be clear and correct and avoid any chance of misinterpretation. The labeling of health claims on foods should always be based on scientific evidence. Any manufacturer who applies to the government for approval under the FOSHU code for its product must tabulate both published available publications and internal reports on the effectiveness of the product and/or its ingredients and provide a summary of each available publication or report. The tabulation must include in vitro metabolic and biochemical studies, in vivo studies, and randomized controlled trials on Japanese people. The overall philosophy of the Ministry is to maintain and improve the health status of people and to prevent chronic noncommunicable diseases through an approach that involves a well-balanced diet as well as through the use of "health foods" including "Food with Health Claims."
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Affiliation(s)
- Kazuhiko Yamada
- Food Function and Labeling Program and 4Information Center, National Institute of Health and Nutrition, Tokyo 162-8636, Japan
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