Functional Foods Q & As

By Les Willis - Nutrition Consultant

Why and how were functional foods developed?
Historically speaking, the idea of a functional food, as in a food that conveys a particular health benefit, has its roots in the fortification of food with vitamins. However, functional foods as we know them today as specifically developed and manufactured items designed with a particular health benefit as their goal started in Japan in the 1980s. Japan also led the way with its regulatory body FOSHU (Foods for Specified Health Uses) to help consumers make informed choices.

The idea and development of functional foods has come a long way from the benevolent public health goals of food fortification and is now a bona fide commercial concern with the market dominated by PepsiCo, Coca-Cola, General Mills, Nestlé, Danone, Unilever and Yakult. These days, with a change in public attitudes to health, the promotion of individual responsibility and control over health, the major players, quite rightly, see a large and growing market for foods that provide health benefits.

Which types of functional foods provide the most health benefit, and why?
It is always difficult to conclusively prove a health benefit, especially one such as reduced risk, because there are so many factors involved. However, with functional foods we can definitely identify product groups that do convey a benefit.

Unsurprisingly, pro- and prebiotics are seen as effective for many people. In a clinical setting, the Actimel trial was widely reported because it appeared that a simple drink could reduce rates of hospital acquired infections and length of stay. Although the media certainly got a bit over excited, the data remains promising; it could just be the Hawthorne effect at work. People with IBS have reported these products help control their symptoms although, again clinically, results are much more mixed.

The overall picture for pre and probiotics is one of a large body of individual reports of definite benefits, but a less conclusive body of evidence from scientific studies. For me, even if a large proportion of the benefit of these products is actually placebo effect, they are cheap enough that the simple result of people feeling better is a good outcome.

If you are looking for a functional food product with proven clinical effectiveness then plant stanols and sterols lead the way because they 'work'. These products reduce LDL cholesterol when used in the recommended amounts. Personally, I would add a third food group not usually included as a functional food, and that is food products, such as smoothies, that provide one or more servings of fruit. As a simple effective way of being 'more healthy', eating fruit and vegetables is massively effective.

Are there any foods that have been touted as having functional food benefits, but don't?
It would be wrong to say anything that isn't a stanol, sterol, prebiotic, probiotic or that provides a serving of fruit and vegetables is useless, but this is not far from the truth either.

The problem is that claims are not based on what will sell and not what happens. One big class of products uses anti-oxidant ingredients to make a variety of claims from anti-aging and longevity to vitality. Anti-oxidants are beneficial, the thing is we know they are beneficial in food as part of a diet; so we know that eating a diet rich in fruit and vegetables is associated with better health, but we have no evidence that taking any isolated nutrient on its own would be linked to better health. And in reality we are still unable to establish a causal link. People who eat more fruit and vegetables also exercise more and drink less alcohol than average – it could be that its only when you put these three things together that you get any benefit.

The other problem is that many functional foods, and those containing omega-3 are a perfect example of this; is that the benefit only exists where there is a deficiency in the first place. With omega-3, you see improvements in people who do not get enough, but you see no effect in those who do. The improvement is seen when omega-3 is added to a deficient diet consistently over a period of months, and is not some sort of instant fix. Plus, take the omega-3 out and you are right back where you started.

There is a lot of customer confusion about functional foods, how can customers cut through the hype?
The biggest rule of thumb is to stop and apply the “is this too good to be true?” test. If something sounds too good to be true, it usually is, and in the field of food this is certainly the case. A lot of products make claims that if true, would not only make it a medical miracle, but also would require the manufacture to licence it as a drug because of its potency.

It is a very seductive proposition that appeals to us all, eat a food and feel better, live longer, be happier and more productive. We want it to be that easy and we do not like the fact that staying healthy requires effort and attention. People want quick fixes, functional food marketing, and snake oil products play on that desire.

Secondly, knowledge is power, if you take the time to understand the basics of how food works, and understand the difference between association and cause you can cut through the hype with ease. Food does not have drug like effects unless it has a drug in it, e.g. magic mushrooms. If the food has no drug, it will not work like one; instead any benefit will be derived slowly over time, and require consistent intake to be maintained – any product that claims otherwise is telling lies. You can also spot snake-oil claims by watching for associations being passed off as causes, with nutrition and health we can find associations but it is very difficult to find direct links. We find that certain groups have better health outcomes, and that their diets are richer in certain foods, not so long ago tomatoes (or lycopene) were touted an anti-cancer food because it was found that people with higher than average tomato intakes had lower rates of some cancers; but what the hype did not report is all the other things these people did that also promoted health, such as exercise, moderate alcohol intakes, not being working class, etc. It is true that the two bits of data change together, but we do not know if they are linked, after all if Alaskan coal production rose and fell alongside the Sidney birth rate you could say they were associated in a mathematical way, but you would be hard pressed to say they were linked. In the field of health data can be similarly disparate.

Are there any dangers in functional foods (e.g. people target then specifically instead of choosing a well-balanced diet, etc.)?
There are definitely dangers: and you identified a big one. For example, stanols and sterols are effective in lowering LDL cholesterol, but to get an effective dose they need to be used multiple times a day. This can get expensive very quickly, and also mean a change in dietary pattern that can easily lead to a lack of balance. If people are spending money on functional foods for a perceived benefit, then that money is not going on wholesome foods.

The other danger is that people think that functional foods will cancel out the effect of bad diets: it's the 'Diet Coke and a Big Mac syndrome'. Having a beneficial food in a sea of junk is really akin to the band playing on the Titanic!

We need to look at benefits and cost: if you want to be healthy no single food or pill or short term measure is the answer; there are no magic bullets. People see functional foods as magic bullets, and they are often sold in a way that plays to this desire. This is a bad picture of how health works and gives people an illusion of a reality that does not exist. If you want to be healthy, then you have to be healthy in what you do, not just stick 150ml of gloop down every morning.

What do you see as the future of functional foods in the UK and globally?
This is a massive market, so the food manufacturers are working hard to develop new products. Hopefully tightening regulations of food claims will mean that these products actually do what they claim to do. We will definitely see products becoming single dose because of the problems with consistency when people have to do something more than once a day. Increasingly there will be moves to make products more palatable too, and I can only applaud that. We have already seen dairy peptides being used to lower blood pressure with Flora's Ameal Peptide™ and again a single dose effective product has a big market potential.

Previously, functional food development has been more aimed at addressing medical needs and medical problems, whereas now I see the future being led by consumer demand. With an increasing number of people living longer, and an aging population, manufacturers are going to look to this market and the presently middle-aged consumer as growth areas. Elixir of youth products are already targeting these markets, so the big players will not be far behind.

One area the manufacturing companies see as lucrative is the weight loss market, and this is a big target for them. Worldwide it's worth billions, and already we can see food manufacturers have moved into touting their products to this market. Unfortunately, I do not see much research and development, so I think we will see products with the current array of dubiously effective, ineffective, and deceptive ingredients repackaged and relentlessly marketed to generate revenue.