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Functional Foods

Article  in  European journal of clinical nutrition · July 2010

DOI: 10.1038/ejcn.2010.101 · Source: PubMed

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 European Journal of Clinical Nutrition (2010) 64, 657–659
& 2010 Macmillan Publishers Limited All rights reserved 0954-3007/10
www.nature.com/ejcn

EDITORIAL
Functional foods
European Journal of Clinical Nutrition (2010) 64, 657–659; state of health and well-being and/or reduction of risk of disease’
doi:10.1038/ejcn.2010.101 (Consensus document, 1999).
Today, Japan is the only country that recognizes functional
foods as a distinct category, and the Japanese functional food
Humankind has always been interested in food. This, market is now one of the most advanced in the world.
although a platitude, is worth remembering. The science of Known as foods for specified health use (FOSHU), these are
functional foods is the convergence of two major events in foods composed of functional ingredients that affect the
our lives—diet and health. The association between food and structure and/or function of the body and are used to
disease is widely recognized as the bedrock of preventive maintain or regulate specific health conditions, such as
nutrition. The concept of ‘functional foods’ is often cited as a gastrointestinal health, blood pressure and blood cholesterol
newly emerging field. However, this idea was first described levels (Hosoya, 1998). As of July 2008, nearly 500 food
in the ancient Vedic texts from India, and in Chinese products had been granted FOSHU status in Japan.
traditional medicine. The vision to develop functional foods In 1912, Casimir Funk presented a seminal paper propos-
reflects the oriental philosophy that: ‘Medicine and food ing the ‘Vitamine’ theory (McCollum, 1957). He proposed
have a common origin’. that the absence of certain minute substances in foods rather
The conviction to develop functional foods first emerged than the presence of germs caused disease. The theory and
in Japan in the 1980s when faced with escalating health-care concept that he developed has had a direct bearing on the
costs. The Ministry of Health and Welfare initiated a development of functional foods. The concept of functional
regulatory system to approve certain foods with documented foods has now been extended to include food constituents
health benefits (Arai, 1996). Its primary objective was to that reduce the risk of chronic disease (Plat and Mensink,
improve the health of the nation’s ageing population. 2001). Today we are at a new frontier in nutritional science.
In 1984, the Ministry of Education, Science and Culture, The transition from ‘adequate’ to ‘optimal’ nutrition. It is
an ad hoc group in Japan commenced a national project to here that functional foods will have a pivotal role in
explore the link between food and medical sciences (Ohama reducing diet-related chronic diseases.
et al., 2006). The term ‘functional food’ first appeared Functional foods may be broadly grouped into the
in 1993 in the Nature news magazine under the heading following:
‘Japan explores the boundary between food and medicine’  Conventional food containing naturally occurring bioac-
(Swinbanks and O’Brien, 1993). tive substance. An example could be b-glucan in oat bran
Functional food is essentially a marketing term and to lower blood cholesterol;
globally, it is not recognized by law. Several definitions for  Foods that have been modified, by enrichment or other
functional foods exist. These include, that given by Health means, with bioactive substances. An example could be
Canada: ‘Similar in appearance to conventional food, consumed margarine that contains added phytosterol that is known
as part of the usual diet, with demonstrated physiological benefits, to lower serum cholesterol;
and/or to reduce the risk of chronic disease beyond basic  Synthesized food ingredients, such as some specialized
nutritional functions’ (Health Canada, 2000). Other defini- carbohydrates intended to have probiotic effects.
tions include that from the International Food Information
Council (IFIC), that is functional foods are, ‘foods or dietary A functional food can be (1) a natural food, (2) a food to
components that may provide a health benefit beyond basic which a component has been added, (3) a food from which
nutrition’ (Bagchi, 2008). The International Life Sciences a component has been removed, (4) a food where one or
Institute of North America (ILSI) has defined functional more components has been modified, (5) a food in which
foods as, ‘foods that by virtue of physiologically active food the bioavailability has been modified or (6) any combination
components provide health benefits beyond basic nutrition’ of these. Examples of these are shown in Table 1.
(Bagchi, 2008). The European Commission Concerted Action A food product can be made functional by using any of
on Functional Food Science in Europe regards a food as the five approaches listed below:
functional, ‘if it is satisfactorily demonstrated to affect benefi- (1) Eliminating a component known to cause or identified
cially one or more target functions in the body, beyond adequate as causing a deleterious effect when consumed (for
nutritional effects, in a way that is relevant to either an improved example, an allergenic protein).
 Editorial
658
Table 1 Categories of functional foods

Category Example

Basic food Carrots (containing the anti-oxidant b-carotene)

Processed foods Oat bran cereal
Processed foods with added ingredients Calcium-enriched fruit juice
Food enhanced to have more of a functional component Tomatoes with a higher levels of lycopene
Isolated, purified preparations of active food ingredients (dosage form) Isoflavones from soy
b-Glucan from oat bran

Adapted from Arvanitoyannis and Van Houwelingen-Koukaliaroglou (2005).

(2) Increasing the concentration of a component naturally other international bodies. The World Health Organization,
present in food to a point at which it will induce for example, not only recognizes the concept of glycaemic
predicted effects (for example, fortification with a index, it advocates its wide usage (FAO/WHO, 1998). Yet EFSA
micronutrient to reach a daily intake higher than the states that ‘carbohydrates that induce a low/reduced glycae-
recommended daily intake). mic response and carbohydrates with a low glycaemic index
(3) Adding a component that is not normally present in (o55), which are the subject of the health claims are not
most foods and is not necessarily a macronutrient or sufficiently characterised’. This is hard to reconcile as the
a micronutrient, but for which beneficial effects have carbohydrate content of several foods has not only been
been shown (for example, non-vitamin antioxidant or carefully characterized but also recognized as being metabo-
prebiotic fructans). lized and absorbed differently. Even more curious is the
(4) Replacing a component, usually a macronutrient approval of b-glucan for lowering cholesterol but not for
(for example, fats), intake of which is usually exces- lowering blood glucose. These anomalies highlight the
sive and replacing it with a component for which challenges ahead. EFSA urgently needs to balance scientific
beneficial effects have been shown (for example, judgement and consumer protection with the promotion and
modified starch). nurturing of food innovation within Europe. There is an
(5) Increasing bioavailability or stability of a component urgent need for EFSA and the food industry to recalibrate each
known to produce a functional effect or to reduce the other’s expectations. If not, EFSA will be perceived as a
disease-risk potential of the food. harbinger of doom for the industry and scientists alike, stifling
creativity and ultimately the consumer will be the loser.
One of the examples often quoted within the functional food As the head of the Functional Food Centre in Oxford
sector is the introduction of margarine spreads fortified with whose primary goal is to evaluate and assess functional
plant sterols in the UK. Although there is limited information benefits of foods and ingredients and to provide evidence-
related to the impact of diet-based intervention on disease based science to substantiate health claims, I welcome the
prevention and health-care cost reduction, a few case studies importance given to functional foods by the European Journal
are available to support the use of functional foods to improve of Clinical Nutrition by publishing this special issue on
the health of the populations. A reduction of low-density functional foods based on peer-reviewed reviews and articles
lipoprotein cholesterol by 10–15% was observed through the accepted by the Journal. EJCN should be commended as
consumption of plant stanol esters at levels of 2–3 g per day it has continued to support this growing new area of
(Nguyun, 1999). If this risk reduction is achieved in practice, nutritional science by consistently promoting the publica-
heart disease patient numbers in the UK would reduce by tion of evidence-based studies in this important field.
250 0000 and save the UK health-care system d433 million.
The National Health Service in the UK estimated that these CJ Henry
products have the potential to lower the health-care costs for Human Nutrition, Functional Food Centre,
cardiovascular disease by d100 million per year. Oxford Brookes University, Oxford, UK
Despite the emerging interest and global consumption of E-mail: [email protected]
functional foods, the recent opinion of European Food Safety
Authority (EFSA) on article 13.1 for health claims has caused
considerable concern and consternation among nutritionists References
and food manufacturers alike (Hughes, 2009). Of the 416
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Arvanitoyannis IS, Van Houwelingen-Koukaliaroglou M (2005).
antioxidants, bowel function, neurological function and
Functional foods: a survey of health claims, pros and
glycaemic index were rejected. The rejection of carbohydrates cons, and current legislation. Crit Rev Food Sci Nutr 45,
and their glycaemic indices appears to be at variance with 385–404.

European Journal of Clinical Nutrition

 Editorial
659
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FAO/WHO expert consultation, FAO Food and Nutrition paper 66, esters. J Nutr 129, 2109–2112.
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with health claims. Fact sheet 1. November 2000. Plat J, Mensink RP (2001). Effects of plant sterols ands stanols on
Hosoya N (1998). Health claims in Japan—foods for specified health lipid metabolism and cardiovascular risk. Nutr Metab Cardiovasc
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