The Toronto Star 
February 16th, 2003
By Peter Gorrie

High Cholesterol Head for Aisle 3

Picture grocery shopping on a February day, in say, 2013.

As now, you enter the supermarket, grab a cart, scan the list of specials. But you no longer head directly to the shelves.

Instead you detour to the diagnosis kiosk. There, someone- preferably someone with a little medical training –pricks your finger to take a blood sample.

In a couple of minutes, you have the test results: “Your cholesterol is high; go directly to Aisle 3: ‘Psyllium-enriched bread and cereal.’ Do not even think about the barbecues chicken display.”

Or, “your iron is low; make your first stop in Aisle 7: ‘Fortified canned vegetables.’”

Perhaps an instant bone-density test sends you to the refrigerated case of calcium-enhanced juices.

“I can see the day when I walk into a supermarket, turn left and there’s a health clinic to give results.” Says Bruce Holub, a nutrition professor at the University of Guelph.

The idea might sound farfetched but we’re inching toward it, food industry observers say. It’s the logical destination of a trend that’s taking health foods out of small chops and into giant supermarkets.

We’re witnessing the growth, and growing pains, of an industry loosely called functional foods. There’s no official definition, but it’s about foods that promise, with scientific backing, not only to nourish those who eat them, but also to prevent or cure illness; maybe even prolong life. It’s food as medicine.

Boomers shop for health, longevity

Health Canada took a hesitant step last month when it said it would let food companies claim on labels that the products may reduce risk of certain diseases.

Industry officials cheered, although not too enthusiastically,

The new rules don’t go nearly far enough, they complained. They cover just a handful of foods and permit only very general health statements. The U.S. allows far more.

“We haven’t gone out on a limb here,” notes Kelley Fitzpatrick, who this month opened a functional food research and lobbying center at the University of Manitoba in Winnipeg, with $25 million from the federal and Manitoba governments and some of the 380 or so companies in the Canadian industry.

Health Canada says it’s simply being prudent. Consumers need to know exactly what the benefits are, says Margaret Cheney, the agency’s chief of nutrition evaluation. “We feel it’s important to have well-validated claims…that stand the test of time.”

Food as medicine is old territory for health-shop aficionados or those who pop daily pills crammed with vitamins, minerals, herbs and proteins. It will have a familiar ring to anyone who remembers the miracle fads of the 1980s, when, one after another; oat bran, wheat grass, beta carotene, tofu, olive oil and any number of anti-oxidants strutted onto the stage as health saviours, only to get the hook when it became clear their benefits had been over-hyped.

But with the growing demand, and virtually no other substantial new food markets available, the big players-the likes of Pepsi Co, Kraft and General Mills- are jumping in.

They’re tapping in to the latest obsession of the baby boom generation, whose first members are well into the middle age and don’t like what they see a few years down the road.

In the 1960s,the postwar kids sang along with The Who: “I hope I die before I get old.” Now, already being offered seniors’ privileges by banks and insurance companies, they’re having revisionist thoughts about the British rockers’ 1964 ode to their generation.

They’ve decided that, all things considered, they’d prefer to live forever. If they must eventually exit life’s stage, they’d rather do it around, possibly, age 125, with faculties and libido intact.

The basic motivation is set out in The Baby Boomers’ Guide to Living Forever, by American nutritionist Terry Grossman. The book argues that the radical extensions of the human life span are only a few decades away. Boomers, it says, should live in a more healthy way now to increase their chances of being around when the amazing break- throughs come.

This generation is said to be the first in human history to be able to look forward to decades of healthy, enjoyable active life after retirement.

The Boomers are also, pollsters say, increasingly nervous about conventional medical care and cynical about institutions. They’d prefer to keep their fate in their own hands. They have access to more health information than ever and enough money to pay for their fixation on it. And they want to continue having it all – in this case, good health and the foods they’ve always enjoyed.

They’re being joined at the functional food buffet by a much younger generation, the computer-tethered youths who experts say, eat badly in the U.S., 25 per cent of their vegetable intake is chips and fries- and rarely exercise. They, or their parents, are finally worried that so many kids are overweight and have high cholesterol.

Functional foods make up 40 per cent of a natural nutrition industry that also covers organic foods, pills and other diet supplements, and personal care products. While they account for only 5 per cent of the North American food market, they’re expected to grow by about 7 per cent a year for the next decade, and to gain at the expense of supplements.

It’s not all going down as smoothly as a creamy milkshake. Some observers fear the government imprimatur won’t end problems and abuses. A few attempts to introduce functional foods have caused serious corporate indigestion, and the industry isn’t experiencing the massive boom predicted in the mid 1990s.

As well, those involved caution that while functional foods might promote better health, they wont perform miracles. Consumers still need a good basic diet and exercise, they say.

“There’s very little proof that any of this will let people live to 100.” Says Carol Culhane , president of International Food focus Ltd., a Toronto consulting company. “People are living to 100 not because of functional foods but because of cleaner water and better medicines.”

Companies have learned that success isn’t guaranteed.

Swiss pharmaceutical giant Novartis, Campbell Soup, Kellogg and British retailer Marks & Spencer all launched carefully formulated products that had less staying power than a sugar doughnut. Novartis , for instance launched a kind of nutrition bars, cereal and drinks, colour-coded to show the part of the body to be benefited. But poor sales killed the line in about a year.

High prices hurt. The main drawback though, is that “there are limits to how much people want in a product,” says Tom Clough, of Health Strategies Consulting, in Providence, RI. “A lot of companies misread the amount of science they want.”

Functional foods come in many forms.

Some are based on natural components of foods, like the cholesterol-fighting soluble fibre in oatmeal, or lycopene , a chemical in tomatoes that’s believed to keep our eyes from deteriorating and might reduce the risk of prostate cancer.

More often, ingredients are added or enhanced –calcium mixed into orange juice or cereal; hens fed flax meal so their eggs are enriched with heart helping Omega-3 fatty acid; tomatoes genetically engineered to boost their lycopene content.

Some functional foods provide a mega-dose of nutrients. Others simply move ingredients from one product to another. Omega-3 eggs are in the second category. They contain the same fatty acid found in fish and flax seed. But, says Holub, you’d need to eat fish three times a week to get a health benefit and, “many people aren’t eating fish three times a week.”

Several countries years ago ordered fortification of a few products to solve public health problems. Vitamin D is added to milk to prevent rickets in children. Iodine goes into table salt to combat goitre. Refined flour gets B vitamins and iron to replace what’s lost in processing. Margarine is enhanced with vitamins A and D.

Health Canada allows nutrients to be added to 27 other products; for example, vitamin C in fruit drinks and dried potatoes, and the eggs with an Omega-3 boost. A new infant formula incorporates a plant chemical called DHA, found in breast milk and considered vital to development of the brain and eyes. But while these might be considered functional foods, they can’t make health claims; their labels can’t state what the added ingredients are supposed to do.

On the other hand, not all enriched foods are functional foods. Some are refined to nothing but empty calories and packed with sugar, fat or salt.
Health claims are the industry’s Holy Grail. They’re what make a product burst on to the scene, says Clough. “When a company can say ‘oats help to reduce cholesterol,’ the gun goes off.”

The U.S. Food and Drug Administration pushed by court rulings and strong industry lobbying, has approved 14 claims, including some specific to certain products. Last December, it also permitted “Qualified” claims-they’ll have scientific backing but not universal agreement. Consumers, the FDA says, can decide for themselves.

The agency “cave in,” to industry pressure, says Jeff Cronin of the Washington-based center for Science in the Public Interest, or CSPI, an independent research and lobby group.

“Consumers won’t be a able to tell if a health claim had FDA approval or not. It’s unfair to expect them to evaluate a claim.”

Health Canada is in no rush to follow the U.S. lead, the four claims it just approved, which describe general effects of large classes if food, have been allowed in the U.S. for a decade. Ottawa offered a proposal for more- specific claims, but “nobody was very happy with it,” Cheney says.

Nutritionists worried it might lead people to see functional foods as “magic bullets that would fix you just like a pill,” undermining healthy eating, said Bill Jeffries, of CSPI’s Canadian office, in Ottawa.

Industry officials complained the plan was too restrictive. They wanted to be able to claim that a product might reduce the risk of cancer, heart disease or other ailments. Health Canada was only prepared to let them claim effects on the body-that a certain ingredient, for example, may lower cholesterol levels. “No single food I know of will decrease the risk of heart disease, “ Cheney says.

Health Canada pulled back, although it did introduce new nutrition labels, to appear over the next three years, and the four general health claims. At some point, it will resume work on more specific claims.

Among these issues:

Foods get health claims only if they’re low in harmful ingredients like saturated fats and sugar. But some junk products tout themselves as nutritious, notes Jeffries. “It’s awful from a public health perspective.”

It’s one thing to say an ingredient lowers cholesterol in the blood, then link that to reduced heart disease. It’s another to claim, for example, that anti-oxidants keep cells healthy and ward off cancer.
They don’t produce a body change that can be linked to the benefit. Still, the FDA is expected to approve a qualified claim that two anti-oxidants, vitamins C and E, reduce the risk of some cancers.
Products often contain too little of an ingredient to provide the benefit. Some U.S. claims aren’t tied to amounts that most people eat. Consumers might need to eat four bowls of cereal a day, Cheney says. The claim for soy protein is based on eating 25 grams a day. “That’s no single serving of soy.”

People could pay a premium for ingredients that don’t need, in most cases, as with vitamin C, an excess dose will be wasted. A few, including calcium or folic acid could be dangerous.

Processing and storage might destroy some ingredients.

Some produce mixed results. A couple of studies suggest selenium reduced the risk of prostate and colon cancer in men. But it could increase breast cancer in women.

Despite the concerns, a banquet of functional products is being unveiled: Most are breads, nutrition bars and beverages: Promising ingredients include tree pulp, powdered berries and fenugreek- a curry spice that, with the flavour removed is an excellent source of fibre.

Genetic engineering is still a small part of the business but it’s expected to expand. Fitzpatrick says. The industry “assumes die-hards will never go for (genetically modified) foods, but that’s not the mass market.”