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July 2003
But do consumers recognize that such a distinction in
their food supply exists? IFIC has been tracking consumer awareness
through quantitative data collected in surveys since 1998. It finds
that 94% of consumers agree that certain foods have health benefits
beyond basic nutrition, and 85% of Americans have some level of interest
in learning more about functional foods. At least 79% of consumers are
aware of the connection between calcium and osteoporosis, 54% are aware
of the connection between antioxidants and cancer, and 35% are aware
of the connection between soy proteins and heart health. Consumers range of knowledge, however, does not
go very far beyond the awareness level, so the potential
for an improvement in nutritional education is very high. Media coverage
of nutritional issues has greatly improved over the last five years,
but much remains to be done to improve consumer nutrition. The benefits
to consumer well-being, as well as to the future of companies engaged
in research on functional ingredients are enormous. IFIC believes that
improved education is possible: It cites the success of media coverage
regarding the relationship of increased calcium intake and a reduced
chance of osteoporosis as a success story, stating that 91% of consumers
believe in the efficacy of this interrelationship. How can the food industry build on this type of faith?
IFIC says: When communicating about functional foods, it is important
to translate quality science into understandable and usable messages
that meet consumer needs. The following are specific communication strategies. This is definitely food for thought, and a good starting point for a discussion on where the industry is today and some of the potential claims for the future. This article will look at how regulations have progressed over the last 10 to 15 years, then discuss functional ingredients, both old and new, and how they have progressed toward established health claims.
Claims approved by FDA through the Nutritional Labeling
and Education Act of 1990 (NLEA) must be based on significant scientific
agreement among experts regarding the relationship between the substance
and a health condition. Accordingly, only 12 claims have currently met
these stringent requirements. FDA later enacted the Dietary Supplement Health and Education Act of 1994 (DSHEA), which exempted dietary supplements from the rules applied to food-additive approval and allowed the use of structure/function claims without prior FDA approval. With this, a company can make a statement such as: Helps support cartilage and joint function. This claim does not link a products functionality to a specific disease if it did, FDA would regulate the product as a drug.
Health claim. This category defines a claim that characterizes
the relationship between a food substance and a disease or health-related
condition. Nutrient-content claim. This relates to a claim that characterizes
the level of a nutrient in a food. Structure/function claim. This designation relates to any claim that characterizes the effect of a food on the structure or function of the body.
Calcium and osteoporosis. Regular exercise and a
healthy diet with enough calcium helps teen and young adult white and
Asian women maintain good bone health and may reduce their high risk
of osteoporosis later in life. Sodium and hypertension. Diets low in sodium may
reduce the risk of high blood pressure, a disease associated with many
factors. Dietary fat and cancer. Development of cancer depends
on many factors. A diet low in total fat may reduce the risk of some
cancers. Dietary saturated fat and cholesterol and risk of coronary
heart disease (CHD). While many factors affect heart disease,
diets low in saturated fat and cholesterol may reduce the risk of this
disease. Fruits, vegetables, and grain products that contain fiber,
and cancer. Low-fat diets rich in fiber-containing grain products,
fruits and vegetables may reduce the risk of some types of cancer, a
disease associated with many factors. Fruits, vegetables, and grain products that contain fiber,
particularly soluble fiber, and risk of CHD. Diets low in saturated
fat and cholesterol and rich in fruits, vegetables, and grain products
that contain some types of dietary fiber, particularly soluble fiber,
may reduce the risk of heart disease, a disease associated with many
factors. Fruits and vegetables and cancer. Low-fat diets
rich in fruits and vegetables (foods that are low in fat and may contain
dietary fiber, vitamin A or vitamin C) may reduce the risks of some
types of cancer, a disease associated with many factors. Broccoli is
high in vitamins A and C, and it is a good source of dietary fiber. Folate and neural-tube birth defects. Healthful
diets with adequate folate may reduce a womans risk of having
a child with a brain or spinal-cord birth defect. Dietary sugar alcohol and dental caries (cavities). Frequent
between-meal consumption of foods high in sugars and starches promotes
tooth decay. The sugar alcohols in this food do not promote tooth decay.
On small packages only, manufacturers can claim, Does not promote
tooth decay. Dietary soluble fiber, such as that found in whole oats
and psyllium seed husk, and CHD. Diets low in saturated fat and
cholesterol that include 3 grams of soluble fiber from whole oats per
day may reduce the risk of heart disease. One serving of this whole-oats
product provides __ grams of this soluble fiber. Plant sterol/plant stanol esters and CHD. For plant sterol
esters: Foods containing at least 0.65 gram per serving of plant
sterol esters, eaten twice a day with meals for a daily total intake
of at least 1.3 grams, as part of a diet low in saturated fat and cholesterol,
may reduce the risk of heart disease. A serving of (name of food) supplies
__ grams of plant sterol esters. For plant stanol esters, a claim
might read: Diets low in saturated fat and cholesterol that include
two servings of foods that provide a daily total of at least 3.4 grams
of plant stanol esters in two meals may reduce the risk of heart disease.
A serving of (name of food) supplies __ grams of plant stanol esters. Soy protein and CHD. Diets low in saturated fat
and cholesterol that include 25 grams of soy protein a day may reduce
the risk of heart disease. One serving of (name of food) provides __
grams of soy protein. All of these claims have certain restrictions regarding other components of the food, as well as the amount per serving in some cases. FDA allows three claims that are stated as qualified that is, FDA allows a claim, but the claim also states that FDA does not endorse it. This applies to the use of higher levels of folic acid than initially recommended by FDA to reduce the risk of neural-tube birth defects, the effect of B vitamins on risk of CHD and the effect of omega-3 fatty acids on risk of CHD.
In 1997, the Food and Drug Administration Modernization
Act (FDAMA) was approved, allowing a different route to a health claim.
With this act, a health claim can be based on an authoritative statement
of a scientific body of the U.S. government or the National Academy
of Sciences (NAS). This process is significantly faster a claim
notification must be submitted at least 120 days before the first introduction
of the food and its label. Under FDAMA, the following three additional
health claims were approved. Whole-grain foods. This claim reads, Diets rich
in whole-grain foods and other plant foods and low in total fat, saturated
fat, and cholesterol, may help reduce the risk of heart disease and
certain cancers, and is based on a statement in the NAS report
Diet and Health: Implications for Reducing Chronic Disease. Potassium. This says, Diets containing foods that
are good sources of potassium and low in sodium may reduce the risk
of high blood pressure and stroke, and is based on two statements
in the above NAS report. Choline. A label can state good source of choline;
contains choline; provides choline; excellent
source of choline; rich in choline; and high
in choline, provided the label also says Contains X% of
the Daily Value for choline per serving. The Daily Value for choline
is 550 mg. This is based on Dietary Reference Intakes for
Thiamine, Riboflavin, Niacin, vitamin B6, Folate, vitamin B12, Pantothenic
Acid, Biotin, and Choline, authored by the Food and Nutrition
Board, Institutes of Medicine (IOM) and NAS. Why choline? Choline is an essential nutrient also known as vitamin B4, with reported benefits linked to memory, heart function, liver function and brain development. Choline deficiency, on the other hand, has been linked to CHD, cirrhosis, hypertension and fatty degeneration of the liver. Choline is found naturally in significant concentrations only in eggs, red meats, liver and soy lecithin. Central Soya Co., Inc., Ft. Wayne, IN, which filed the petition for the new claim, promotes fortifying foods with lecithin to increase their choline content, with primary applications in baked goods. However, manufacturers could fortify a wider variety of foods with lecithin, including chocolate.
In its position statement on functional foods, the Chicago-based American Dietetic Association noted that this regulatory environment led to a proliferation of claims on a variety of products, creating an environment of confusion and distrust among health professionals and consumers. On Dec. 18, 2002, FDA commissioner Mark B. McClellan, M.D., Ph.D., announced The Consumer Health Information for Better Nutrition Initiative, which related to FDAs desire for a marketplace of ideas relating to health information of foods. According to McClellan, the problem is that right
now, theres not much of a path to enable such health claims to
be made. So there have been only limited incentives for the food industry
to develop better health-promoting foods
right now, consumers
turn to unproven and potentially dangerous remedies for weight loss,
such as dietary supplements and even smoking. FDA stated the objectives of the Initiative were to encourage
marketers of conventional foods and dietary supplements to make accurate
claims about the health benefits of their products and create
strong disincentives for dietary-supplement marketers to make false
and misleading health claims. A statement from The Grocery Manufacturers of America, Inc. (GMA), Washington, D.C., says: This FDA policy shift brings the agencys food claim evaluation in line with the FTCs 20 years of oversight experience using this same standard for advertising claims. Additionally, the FDA will allow food companies to include appropriate health claims on foods that may provide well-recognized nutritional or health benefits, as is common practice for manufacturers of dietary supplements.
Carotenoids, such as alpha- and beta-carotene,
lutein, lycopene, or zeaxanthin, provide associated potential benefits.
For example, studies show that tomatoes and tomato products, sources
of lycopene, may reduce the risk of prostate cancer. Green vegetables,
which supply lutein, help maintain healthy vision. Gelatin, via its collagen-hydrolysate content,
may help improve some symptoms associated with osteoarthritis. Various cereal grains provide dietary fiber, a
functional element that in its various forms and in recommended
daily amounts can help reduce the risk of colon or breast cancer,
or reduce the risk of cardiovascular disease (CVD). Oats, psyllium and
other whole grains can sport an FDA-approved claim in this regard. Omega-3 fatty acids are commonly found in tuna,
and certain fish and marine oils. They may reduce the risk of CVD, and
improve mental and visual functions. Another member of the fatty-acid
group, conjugated linoleic acids (CLA) common in certain cheese
and meat products may improve body composition or decrease the
risk of contracting certain types of cancer. Various flavonoids, such as anthocyanidins, catechins,
flavanones and flavones, are found in citrus and other fruits, vegetables,
and some types of tea. These flavonoids can neutralize free radicals
and may reduce the risk of certain cancers. Cruciferous vegetables, such as broccoli and kale,
and horseradish supply sulphoraphane, which also neutralizes free radicals
and may help reduce the risk of certain cancers. Phenols, which include caffeic and ferulic acid,
are found in various fruits, vegetables and citrus products, and supply
antioxidant-like activities to help reduce the risk of degenerative
diseases that affect the heart or eyes. Ingredients such as corn, soy, wheat and wood oils
supply plant stanols and sterol esters that help lower blood cholesterol
levels and thereby help reduce the risk of CHD. Research has found pre- and probiotics help improve
gastrointestinal (GI) health. Prebiotics, commonly based on fructooligosaccharides
(FOS), are found naturally in Jerusalem artichokes, shallots and onion
powder, while probiotics, such as lactobacillus, can be found in yogurt
and other dairy products. Soy products, ranging from whole soybeans to foods
containing soy proteins, contain saponnins, which may lower LDL cholesterol
and contain anti-cancer enzymes. In addition, FDA has approved a health
claim for soy proteins, allowing a label to state: 25 grams of
soy protein per day may reduce the risk of heart disease. Soybeans and soy-based foods contain phytoestrogens
the isoflavones daidzein and genistein that may reduce
menopausal symptoms, such as hot flashes. Flax, rye and certain vegetables
also contain phytoestrogens in the form of lignans. These may offer
protection against heart disease and certain cancers, and could possibly
lower LDL cholesterol levels, total cholesterol or triglyceride levels. Sulfides or thiols may lower LDL cholesterol levels
and help maintain a healthy immune system. Onions, garlic, leeks, scallions
and certain cruciferous vegetables are some foods that may provide these
functional components. Tannins such as the proanthocyanidins found
in cranberries and cranberry products, cocoa and chocolate may
improve urinary-tract health or reduce the risk of CVD. This long list is not all-inclusive. Some ingredients have approved health claims; many others do not. But in each case, studies continue to build that substantiate their benefits. Many of the original claims favored consumption of whole foods, leaving many novel-food-ingredient manufacturers to seek qualified health claims (as in the case of omega-3 fatty acids) or to settle for structure/function claims. Will the new system favor research into novel food ingredients?
Several companies, such as RFI Ingredients, Blauvelt,
NY, have come halfway to establishing claims for combinations by blending
fruit, vegetable and spice extracts toward an ORAC (oxygen radical absorbance
capacity) value. ORAC, measured in mmoles Trolox equivalents (TE) per
gram, compares a sample to Trolox (a noncommercial, water-soluble derivative
of tocopherol) to state the ability of a substance to disarm oxygen
free radicals. According to RFI, single servings of fresh or freshly
cooked fruits and vegetables supply an average of 600 to 800 ORAC units.
Scientists believe that increasing intake of foods that provide
2,000 to 5,000 units per day may be needed to increase serum and tissue
antioxidant activities sufficiently to improve health outcomes. Vitamin E was first used more than 60 years ago to treat
CHD, and many studies have established potential benefits in treating
or reducing risk of cataracts, diabetes and cancer. A number of studies
have shown vitamin C, which is often linked with vitamin E, to reduce
blood pressure. Research shows beta-carotene, the most abundant carotenoid
identified in plants, reacts with free radicals, lowering risk of degenerative
diseases such as cancer and CHD. Some studies have also shown a benefit
in asthma treatment. Carrots are a good source of both beta-carotene
and alpha-carotene, which is also an active antioxidant. Studies show lutein, a carotenoid found in broccoli, spinach
and kale, reduces the risk of macular degeneration by increasing the
thickness of macular pigments. A recent Harvard study suggested an inverse
relationship between lutein and zeaxanthin levels, and the development
of severe cataracts; other studies have suggested that both are necessary
to reduce risk of macular degeneration. Some studies have indicated
that lutein may also reduce the risk of certain cancers. More than 5,000 flavonoid compounds have been reported
in plants, cereals and tea. Green tea contains a high concentration
of catechins, shown to contribute to risk reduction of CHD, and of gastric,
colon and esophageal cancers. A number of studies have compared the
antioxidant activity of tea to that of fruits and vegetables. So why are there no direct antioxidant claims? According to IFIC, the problem is the inconsistency of clinical trials, although research does indicate overall health benefits. IFIC says that current recommendations by health professionals are to consume a varied diet with at least five servings of fruits and vegetables and six to 11 servings of grains per day.
According to Marianne OShea, Ph.D., manager of nutrition
and technical services, Loders Croklaan, Channahon, IL, While
a recommended dose has not been established, some studies suggest that
up to 1 gram per day of omega-3 fatty acids will positively impact health. Omega-3 fatty acids are an essential class of polyunsaturated fatty acids (PUFAs) found in fish oil. Studies have indicated that omega-3 fatty acids eicosapentoic acid (EPA) and docosahexanoic acid (DHA) help to reduce the risk of CHD, and are essential for membrane synthesis in the brain and retina, as well as neural development. In addition, research shows DHA improves visual functioning and cognitive development in preterm infants. The Dallas-based American Heart Association (AHA) recommends eating fatty fish, such as mackerel, lake trout, herring, sardines, albacore tuna and salmon, at least two times per week. AHA also recommends eating omega-3 fatty acids from other sources, such as soybeans, canola and flaxseed. According to AHA: People who have high triglycerides
(blood fats) may benefit from a supplement of 2 to 4 grams of EPA and
DHA per day. Even the 1 gram per day dose recommended for CHD patients
may be more than they can get from the diet alone. Flaxseed, mentioned by the AHA as a source of omega-3
fatty acids, is another plant source that may have high potential for
a future health claim. Flaxseed has been in the diet for thousands of
years Hippocrates used it to relieve intestinal discomfort
and it is a source of alpha-linoleic acid (an omega-3) as well as dietary
fiber (two-thirds insoluble fiber and one-third soluble fiber). Flaxseed
also contains 20 grams of protein per 100 grams dry weight and is rich
in potassium, which has an existing health claim related to risk reduction
of high blood pressure and stroke. Although the health claim for plant stanols and sterols is relatively recent, their cholesterol-lowering effects have been known for years. Found naturally in fruits, vegetables, nuts, cereals and vegetable oils, stanols and sterols resemble cholesterol structurally and are essential components of plant cell walls. FDA has indicated it will consider expanding the current health claim to include a wider range of food products consisting of free stanols and sterols.
These would include resistant starch, inulin, fructooligosaccharides,
polydextrose and beta-glucan. Previous articles (see Raising the
Sports Bar in the May 2003 issue of Food Product Design) have
reported on resistant starch, and previous reports have noted the benefits
of inulin, fructooligosaccharide and polydextrose. Developers have researched beta-glucan as an ingredient
for many years, and have isolated beta-glucan from yeast, oats and barley.
Yeast beta-glucan was first sold as an ingredient many years ago, and
suppliers have marketed oat ingredients with 5% to 15% beta-glucan levels
for the past 10 to 15 years. In the past few years, reports have placed
beta-glucan levels from oats and barley at more than 70%. Beta-glucans
are polysaccharides that, like other fibers, can lower cholesterol,
absorb water in the GI tract to reduce appetite, act as antioxidants,
slow absorption of glucose into the bloodstream and act as prebiotics. Fenugreek, a fibrous herb with a high galactomannan content,
has similar effects. Fenugreek exhibits hypocholesterolemic, hypolipidemic
and hypoglycemic activity in healthy and diabetic animals and humans.
The mechanism is uncertain, but its activity is associated with the
defatted seed material, whose galactomannan fiber and saponin components
may be the active components. Future claims could potentially link a
wide range of high-fiber novel ingredients to their effects on well-being. On May 19, 2003, inulin was officially given GRAS status by FDA. Inulin and oligofructose are not digested, and so act as soluble fiber. They are reduced in calories compared to standard carbohydrates, stimulate the growth of beneficial bifidobacteria, and they do not lead to a rise in serum glucose or stimulate insulin secretion in diabetics. Studies have shown the benefits of inulin as a soluble fiber and prebiotic, as well as its improvement of calcium uptake.
A prebiotic is a nondigestible food ingredient that benefits
the consumer by selectively stimulating the growth and/or activity of
one bacterium, or a limited number of bacteria, in the intestine, benefiting
consumer health. A probiotic can be either a live microbial food supplement;
or a microbial preparation (or food) containing live and/or dead microorganisms,
and their metabolites. Examples of foods are yogurt, acidophilus milk
or buttermilk. Positive health benefits related to pre- and probiotics
include cholesterol reduction, protection from GI diseases (a healthy
gut), improved immunity, reduced cancer risk and improved calcium
absorption. According to a report in the June 2002 Canadian Medical Association Journal: Although traditional thinking has been that the presence of one form of bacteria rather than another in the gut is necessary to produce such actions, more recent evidence suggests that the secondary products produced by the flora are responsible for the bioactivity that leads to health benefits. These secondary products include short-chain fatty acids as well as short bioactive peptides resulting from milk or other proteins in the gut. This change in thinking will probably stimulate active research in exploring mechanisms that might explain the health benefits of probiotic and prebiotic materials. This, in turn, will lead to applications for new claims with a cleaner definition than simply a healthy gut.
As was noted earlier, a manufacturer can make a claim about soys heart benefits if the food contains at least 6.25 grams of soy protein per serving a quarter of the effective amount of 25.0 grams per day. FDA did not accept claims regarding the role of isoflavones from soy in cholesterol reduction. However, support for this claim continues to increase; expect to see activity toward a new claim for this in the near future. The United Soybean Board, Chesterfield, MO, states that soy is a unique source of isoflavones, which are active in risk reduction of heart disease, breast and prostate cancer, osteoporosis (by increasing bone density), and control of hot flashes (results were inconsistent, and benefits are perhaps modest). An intake of 30 to 100 mg per day of isoflavones is recommended.
To date, FDA has exercised caution in its assessment of potential health claims, leaning toward whole-food claims through much of the 90s. The next step has involved opening up dialogue on potential health claims to encourage the development of novel ingredients and to encourage responsible clinical studies. As stated earlier, clear consumer education is also key to this process. Before allowing a claim, careful consideration of the full body of scientific evidence considering all benefits, but also considering any potential toxicity or negative interactions with essential nutrients that may threaten certain medical conditions is necessary. Ronald C. Deis, Ph.D., is the vice president of applications development and technical service at SPI Polyols, Inc., New Castle, DE. Deis has 20 years of experience in the food industry, both in food ingredients (starches, polyols, high-potency sweeteners, bulking agents) and in consumer-product companies (cookies, crackers, soups, sauces). He has been a short-course speaker (polyols, fat replacers) and a freelance writer on a number of food-science-related subjects in food journals, and has contributed chapters on sweeteners and fat replacers for several books.
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