Generic and product-specific health claim processes for functional foods across global jurisdictions

The Impact of Time on Nutrition and Health Claims on the Irish Marketplace

Since the implementation of Regulation (EC) No 1924/2006 on nutrition and health claims (NHCR) made on food, only 261 health claims have been authorised, suggesting that the regulation creates challenges for the food industry. This study looks at the prevalence of nutrition and health claims labelled on food on the Irish market. Specifically, we compared their prevalence in 2009 with those present on the marketplace in 2022. Food labels of defined food categories were examined in three nationwide supermarkets in Ireland, and data of claims made on these labels were collected. A series of statistical analyses was conducted to compare the results from 2021 with those of 2009. In 2021, around half of the examined products (52.8%) displayed at least one nutrition claim, showing no significant difference with the data collected in 2009 (53.5%). Individual categories, however, did exhibit changes between the two time points. The prevalence of health claims on food has decreased from 21.6% in 2009 to 10.5% in 2021. There will always be a time lag between when a regulation is enacted and what its true impact can be measured. This study provides these data for the impact of time on EU Regulation 1924/2006 on the Irish market.

Pharma-Nutritional Properties of Olive Oil Phenols. Transfer of New Findings to Human Nutrition

The Mediterranean diet has been long associated with improved cardiovascular prognosis, chemoprevention, and lower incidence of neurodegeneration. Of the multiple components of this diet, olive oil stands out because its use has historically been limited to the Mediterranean basin. The health benefits of olive oil and some of its components are being rapidly decoded. In this paper we review the most recent pharma-nutritional investigations on olive oil biophenols and their health effects, chiefly focusing on recent findings that elucidate their molecular mechanisms of action.

Reviewing the Nutrition and Health Claims Regulation (EC) No. 1924/2006: What do we know about its challenges and potential impact on innovation?

Health claims potentially represent an opportunity for firms to engage in product differentiation and thereby induce investment into R&D and innovation in the food sector. The Nutrition and Health Claims Regulation (EC) No. 1924/2006 (NHCR) aims at protecting and promoting innovation as one of its objectives. However, existing studies indicate that this regulation may create several challenges for innovation in the food sector. To this end, we review the challenges related to the NHCR (Article 13.1) and its impact on innovation. Extant literature suggests that companies face challenges related to changing list of ingredients, missing transparency, wording of claims, limited financial resources, limited R&D resources, switching product categories and abandoning the functional foods sector. Moreover, current studies imply that so far the NHCR (in specific Article 13.1) does not seem to encourage innovation in the EU food sector.

Cholesterol-lowering properties of oat β-glucan and the promotion of cardiovascular health: did Health Canada make the right call?

In 2010, Health Canada approved a heath claim acknowledging the link between increased oats (Avena sativa)-soluble fibre consumption and a reduction in total serum cholesterol levels. The approval also recognized the relationship between decreased total blood cholesterol concentration and a reduced risk of coronary heart disease. The functional food ingredient believed to be responsible for the hypocholesterolemic property of oats is β-glucan, a highly viscous, soluble fibre composed of d-glucose monomers linked by a combination of β-(1→4) and β-(1→3) glycosidic bonds. Found mainly in the endosperm cell wall of oats, β-glucan is thought to reduce total serum and low-density lipoprotein cholesterol by forming a viscous mass in the small intestine thus limiting intestinal absorption of dietary cholesterol as well as the re-absorption of bile acids. Given the evolution of research information with time as a result of the continual, rapid generation of new research data by laboratories around the world, it became imperative to examine the compatibility of the conclusion reached by Health Canada on the basis of the body of evidence contained in the initial petition submitted in January 2007, with newer post-2006 data. After careful evaluation, this work concludes on the basis of new research information that a dose of 3 g/day oat β-glucan consumed as part of a diet “free of saturated fatty acids” or “low in saturated fatty acids” could help to promote cardiovascular health.

Design considerations on the proof of efficacy of functional foods

Functional food research encompasses several types of study designs, including observational studies and randomized clinical trials (RCTs). Markers that can predict potential benefits or risks relating to certain health conditions are often the primary endpoints of such studies since a direct measurement of the effect of food on health and well-being and/or reduction of disease risk is often not possible. Whether RCT should be at the top of the pyramid also in nutritional research remains a controversial issue. Undoubtedly, further research is needed to redesign RCT methodology that would adequately serve the need to demonstrate the health effects of foods. We address this functional food research question by assuming that there is a known relationship between the surrogate and the true endpoint explored during the surrogacy assessment. Statistical inference on the true (unobserved) endpoint is derived on the basis of its predicted values. We illustrate this approach through a motivating example from the literature on coronary heart disease, integrated with simulated scenarios.

Scientific substantiation of health claims in the EU

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.

Effect of mulberry leaf extract with enriched 1-deoxynojirimycin content on postprandial glycemic control in subjects with impaired glucose metabolism

Aims/Introduction:  The glucose analogue, 1-deoxynojirimycin (DNJ), found in mulberry (Morus alba) leaves, is a promising α-glucosidase inhibitor. We evaluated the effect of the ingestion of mulberry leaf extract with enriched DNJ content on postprandial hyperglycemia in subjects with impaired glucose metabolism.

MATERIALS AND METHODS

  In study 1, we carried out a randomized, double-blind, crossover trial to assess the effects of single ingestion of mulberry leaf extract (3, 6 or 9 mg DNJ) or placebo on blood glucose and insulin concentrations during 2 h after a carbohydrate (200 g boiled white rice) challenge in 12 subjects with fasting plasma glucose (FPG) in the range of 100-140 mg/dL. Study 2 was a randomized, double-blind, placebo-controlled trial to assess the efficacy of 12-week extract supplementation (6 mg DNJ, t.i.d.) for long-term glycemic control in 76 subjects with FPG in the range of 110-140 mg/dL.

RESULTS

  In study 1, ingestion of the mulberry leaf extract led to attenuated postchallenge acute glycemia in a dose-dependent manner (P = 0.006, group × time interaction, two-way anova). In study 2, the serum 1,5-anhydroglucitol concentration, a sensitive indicator of postprandial glycemic control, in the extract group increased and was higher than that in the placebo group over the 12-week treatment period (P < 0.001, group × time interaction, two-way anova); no differences in FPG, glycated hemoglobin and glycated albumin concentrations were observed between the groups.

CONCLUSIONS

  Long-term ingestion of mulberry leaf extract with enriched DNJ content could result in improved postprandial glycemic control in individuals with impaired glucose metabolism. These trials were registered with UMIN (no. UMIN000003154 and UMIN000003155). (J Diabetes Invest, doi: 10.1111/j.2040-1124.2011.00101.x, 2011).

Potential pitfalls of health claims from a public health nutrition perspective

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.

Evidence-based criteria in the nutritional context

During the last decade, approaches to evidence-based medicine, with its heavy reliance on the randomized clinical trial (RCT), have been adapted to nutrition science and policy. However, there are distinct differences between the evidence that can be obtained for the testing of drugs using RCTs and those needed for the development of nutrient requirements or dietary guidelines. Although RCTs present one approach toward understanding the efficacy of nutrient interventions, the innate complexities of nutrient actions and interactions cannot always be adequately addressed through any single research design. Because of the limitations inherent in RCTs, particularly of nutrients, it is suggested that nutrient policy decisions will have to be made using the totality of the available evidence. This may mean action at a level of certainty that is different from what would be needed in the evaluation of drug efficacy. Similarly, it is judged that the level of confidence needed in defining nutrient requirements or dietary recommendations to prevent disease can be different from that needed to make recommendations to treat disease. In brief, advancing evidence-based nutrition will depend upon research approaches that include RCTs but go beyond them. Also necessary to this advance is the assessing, in future human studies, of covariates such as biomarkers of exposure and response, and the archiving of samples for future evaluation by emerging technologies.

A study of nutrition and health claims--a snapshot of what's on the Irish market

OBJECTIVE

To examine the use of nutrition and health claims on packaged foods commonly eaten in Ireland.

DESIGN

An assessment of the labels of packaged food products that are commonly eaten in Ireland to determine the level of use of nutrition and health claims. Where present, the exact text of the claims as observed was recorded for seventeen different food categories and the claims categorised in accordance with EU Regulation 1924/2006 on nutrition and health claims made on foods.

SETTING

Four retailers in Dublin, Ireland.

RESULTS

Of the foods surveyed, 47.3 % carried a nutrition claim and 17.8 % carried a health claim. Frozen fruit & vegetables and Breakfast cereals were the food categories with the highest proportion of nutrition claims. The most widespread nutrition claim was that referring to 'fat' and, within this group, the most commonly used text was 'low fat'. The largest category of health claims observed in the present survey was general health claims. Claims referring to the digestive system were the most common followed by claims that a product will 'lower/reduce/regulate your cholesterol'. Yoghurt & yoghurt drinks was the food category with the highest proportion of health claims, of which improving or boosting the digestive system was the most common.

CONCLUSIONS

The use of nutrition and health claims on the Irish market is widespread. EU Regulation 1924/2006 requires monitoring of the market for these types of claims. The current study could provide baseline data for the food industry and regulators to monitor the development of this market in the future.

The evidence to support health claims for probiotics

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.

Health claims on foods in Canada

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.

Health effects of soy protein and isoflavones in humans

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.

Evidence for health claims: a perspective from the Australia-New Zealand region

Establishing the evidence for health claims involves reviewing the available body of scientific knowledge and linking this to statements meaningful to consumers. This requires an understanding of scientific merit as well as consumer perceptions of health messages. Food Standards Australia New Zealand sets standards for current nutrient content claims and is close to approving a proposed new framework for all forms of nutrition and health claims on foods. This article discusses this proposed health claims standard in light of the challenges health claims pose to nutrition science. It critically describes the framework for the standard, reviews issues related to substantiation of claims, and provides commentary on the proposed assessment of evidence. This spectrum of permission reflects the use of food in health promotion, disease prevention, and early disease management when therapeutic agents may not be required. The position is consistent with an understanding that food delivers nutrients and bioactive substances at levels that support the improved health of the human organism in the early stages of the health-disease spectrum. Increasing knowledge of the role of food components and its intelligent application in dietary modification can result in this strategy playing a major role in disease prevention and early disease management. The amount of evidence required to enable health claim labeling should be based on a reasonable judgment and clear understanding of the role of nutrition in health and disease.

Issues surrounding health claims for barley

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.

Health claims in Europe: new legislation and PASSCLAIM for substantiation

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.

Scientific substantiation of functional food health claims in China

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.

Health claims in the United States: an aid to the public or a source of confusion?

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.

Health claim evidence requirements in Japan

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."