The best remedy

From the medicine cabinet to the kitchen cupboard. NGF’s Stacey Sheppard talks to Professor Jeya Henry about the benefits of functional foods, their potential for the future and the challenges they must overcome.

“What we are saying is that we want to change the way in which health prevention is emerging”
-Jeya Henry

As consumers become increasingly health-conscious, demanding foods with added nutritional value and which promote health benefits, a modern craze is sweeping through the food and drink industry with many multi-national food giants investing in so-called functional foods. From eggs enriched with Omega 3 fatty acids to reduce the risk of heart disease to the addition of chemicals called phytosterols to margarines to impede the absorption of cholesterol, the functional foods industry is experiencing rapid growth across the globe. Consultancy PricewaterhouseCoopers has estimated the global market for functional foods to be worth €85 billion in 2013.

Although the idea of functional foods is nothing particularly new – vitamin B has long been added to flour to fight pellagra and vitamin D to milk to combat rickets – the recent trend has only been around for 25 years or so. It started in Japan in 1984, when the Japanese government promoted the enhancement of foodstuffs on the grounds of public health.

Jeya Henry, Professor of Human Nutrition and Director of the Functional Food Centre at Oxford Brookes University – the UK's first centre dedicated to researching functional foods – explains the origins of the functional foods concept: "Japan has the largest ageing population in the world. The ministry of health and agriculture in Japan recognised the fact that the ageing population would require considerable health interventions and if one could prevent disease rather than treat it, it would be a very effective strategy.

"Therefore they launched a whole conceptual framework on using diet and food as a way to reduce the risks of various health degenerative diseases like heart disease, hypertension, diabetes, weight gain, etc. Since then it has slowly percolated through the system and it reached the North American and European shores round about 1995," says Professor Henry.

The Functional Food Centre opened at the beginning of 2009 and its main aims include the identification of functional food ingredients that may help prevent disease. "What we are saying is that we want to change the way in which health prevention is emerging. We want to move from the medicine cabinet to the kitchen cupboard and that means moving from pharmacological intervention to dietary intervention. I think it is a very powerful argument to use diet as a platform for health attributes. I think it is a fantastically intellectual challenge," he says fervently.

 His team have taken up this challenge and are currently working on four particular areas. The first is that of low Glycaemic Index (GI) foods which can help to lower blood glucose through the slower release of glucose into the blood. This is an area that is quite important for managing and treating type 2 diabetes and he says that there is increasing evidence that eating a low GI diet can help to reduce the risk of becoming a diabetic.

The second area of great interest is the effect of the ageing process. He explains that there are two main things that occur when we get old: "One is that we have what is called a cognitive decline. The other thing is that you also have a decline in taste and taste perception. So the question that we are posing is can we provide some dietary interventions to enhance taste equity and therefore make it more pleasurable to taste and eat food, but also can we make some dietary interventions to retard the progression of cognitive decline." This is something that he believes will be vitally important for Britain since 20 percent of the population will be over 60 years old by 2025.

Satiety is the third issue that the Functional Food Centre will be addressing in its research. As Professor Henry points out, humans are creatures of habit and no matter how many times they are told to cut down their food intake to prevent weight gain they rarely act upon this advice. "If we can find certain types of food that will increase our sense of satiety then unconsciously we will not eat excess amounts of food," he says. "We are trying to find out what kinds of foods actually increase stomach distension or enhance hormone receptors or neurotransmitters to increase satiety."

The final area of research is one that Professor Henry believes is somewhat neglected - the nutritional needs of women. "People tend to forget that women represent 50 percent of the population, but if you look at the global research on the nutrition of women it is abysmally poor. So we are trying to redress that balance by asking the simple question of is it true that during the menstrual cycle women show particular taste preferences? It has been anecdotally documented that women show changes in food preference and diet during the menstrual cycle. Is that true? And if so, what are the implications for their health outcome?

"Does it have any implications on defining the nutrient requirements for women? Can we provide foods that are of particular biological need during the pre-menstrual cycle and during the menstrual cycle? This is an area that I think will have very rich rewards. It will not only make women feel better during their cycle, but above all could be of importance when trying to regulate their body weight," he explains.

 Aside from these areas of research, he believes that functional foods have an even greater potential. In the future, he hopes to explore the possible benefits that functional foods could offer to those suffering from depression. "Depression is something that people talk about in quiet whispers, but it is a very big problem. One in five of us in our nation are going to have some degree of depression in the broad spectrum of diagnosis and that is serious. People are given prescription drugs to ameliorate depression, and what I'm saying is what about diet. What can diet do?

"This is an area that I believe holds enormous potential, looking at how we can manage and articulate the role that diet can play, not in preventing depression, but in reducing its pathology and its outcome and I think that this will be wonderful," he says enthusiastically.

Despite this enormous potential though, functional foods have recently faced a number of stumbling blocks. It would appear that producers of everything from yoghurt to energy drinks and bread to breakfast foods are rushing to add miracle ingredients into their products in the hope of attracting health-conscious consumers with their supposed benefits. But as Professor Henry points out, it pays to be a little cautious when faced with foods that claim to be functional.

"You need to be very careful how you define functional foods, because the term has been slightly prostituted," he says. "We need to be very clear about how we pitch and represent functional foods, because like everything else it also attracts a lot of Charlatans. I always say we need to distinguish between fish oil and snake oil. We know that fish oil has a lot of good attributes that offer health benefits, but there are also a lot of people who are trading snake oil. We need the consumer to be much more aware and much more savvy in trying to understand how to discriminate."

Consumers are faced with a multitude of food products all claiming to offer certain health benefits so it is no wonder that this can often lead to confusion. This is not necessarily due to a lack of awareness on the part of consumers. He believes that the government regulation goes a long way to protect the consumer and also explain the potential health benefits of consuming functional foods.

 "The European Food Safety Authority (EFSA) has now made a very clear decree that we can't make any health claims without substantiation. So we are now on a clear path where functional foods are going to be evolving, but there are also going to be very clear checks and boundaries," says Professor Henry.

However, as he points out, it is extremely important to ensure that stricter regulation does not end up stifling innovation. "What you need to ensure is academic and intellectual freedoms, which will allow these creative things to emerge. You also need checks to make sure these things don't go out of kilt.  What you don't want is overregulation, which will decimate the functional food industry in Britain and Europe at the expense of other countries such as Japan, Asia and North America."

Since EFSA made its recent decree, many food and beverage products that make such health claims have come under strict scrutiny and have been asked to provide evidence to support their assertions. How will this strict regulatory environment impact the functional food industry?

"The regulatory environment has, in my view been a little draconian at the beginning.  That is not necessarily a bad start. What you really want is to get rid of the Charlatans in one fell swoop. The bright and the more persistent will then rise up from the ashes. You clearly don't want to be too flexible, as this will allow every Tom, Dick and Harry into the trade. So what you must do is regulate quite rigorously and then see who is emerging from that castigation, and those will be the ones to triumph in the long term," he says.

The stricter regulations do indeed throw up innumerable challenges for those involved in the production and manufacture of functional foods. There is not only the need to provide documentary evidence of efficacy, but a new challenge is to convince consumers that the products they are buying are tasty, but also have health attributes over and above the nutritional element. As many companies are finding their health claims rejected by EFSA, consumers are losing confidence and this is something that needs to be addressed.

However, Professor Henry doesn't necessarily believe that EFSA's rigorous investigations of health claims will only serve to damage consumer confidence. He says it may help increase their confidence in the system as they become aware that nobody is above the law. "I don't want to be too specific, but there have been some quite embarrassing stories concerning big multi-national companies that have been brought to book and to be honest I am surprised that such large companies are getting their sums wrong.

"But it also tells us something useful, which is that the British society in general and the scientists in particular have a responsibility. If you make an error of judgement, we will be seeking accountability and that is fantastic. This is only something that can be done in a system like we have in Britain."

Jeya Henry is a Professor in Human Nutrition at Oxford Brookes University in the UK and Director of the Functional Food Centre, Oxford. He is a consultant to the World Health Organisation, UNICEF and the Food and Agriculture Organisation of the United Nations on all aspects relating to nutrition assessment, food safety and nutrient requirements. He is also Editor-in-Chief of the International Journal of Food Sciences and Nutrition.

A bad time for good bacteria

No area of the functional food market has been more dogged by scepticism and controversy than the probiotics sector, which, in 2008, represented 18 percent of the functional food market and was worth €10.5 billion.

In recent months, probiotics have suffered blow after blow as changes have been made to the regulatory environment. In October, a TV ad for Danone's Actimel yoghurt was banned by the UK's advertising watchdog because the evidence provided by Danone could not prove their claims that the product could help protect "normal, healthy school-aged" children against common childhood illnesses.

This ruling followed September's settlement of a 2008 lawsuit against Dannon, Danone's US subsidiary. The company was accused of falsely advertising its Activia and DanActive yoghurts and overstating the health attributes of the products. Dannon agreed to reimburse consumers to a sum of US$35m and change the labelling and marketing of both products.

Also in October, probiotic ingredients came under fire from the European Food Safety Authority in the first phase of the review it is conducting under EU regulation 1924/2006 on nutrition and food health claims. Of the 523 opinions issued by EFSA, 180 related specifically to probiotics and the result was less than disappointing. Nine were rejected while a further 105 were judged to have provided insufficient evidence of their effects.

Both Danone and Yakult withdrew their claims before the EFSA evaluation took place and have since resubmitted them but the results will not be available until 2010.