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European Journal of Clinical Nutrition is a high quality, peer-reviewed journal that covers all aspects of human nutrition.
EDITORIAL
Functional foods
European Journal of Clinical Nutrition (2010) 64, 657–659;
doi:10.1038/ejcn.2010.101
Humankind has always been interested in food. This,
although a platitude, is worth remembering. The science of
functional foods is the convergence of two major events in
our lives—diet and health. The association between food and
disease is widely recognized as the bedrock of preventive
nutrition. The concept of ‘functional foods’ is often cited as a
newly emerging field. However, this idea was first described
in the ancient Vedic texts from India, and in Chinese
traditional medicine. The vision to develop functional foods
reflects the oriental philosophy that: ‘Medicine and food
have a common origin’.
The conviction to develop functional foods first emerged
in Japan in the 1980s when faced with escalating health-care
costs. The Ministry of Health and Welfare initiated a
regulatory system to approve certain foods with documented
health benefits (Arai, 1996). Its primary objective was to
improve the health of the nation’s ageing population.
In 1984, the Ministry of Education, Science and Culture,
an ad hoc group in Japan commenced a national project to
explore the link between food and medical sciences (Ohama
et al., 2006). The term ‘functional food’ first appeared
in 1993 in the Nature news magazine under the heading
‘Japan explores the boundary between food and medicine’
(Swinbanks and O’Brien, 1993).
Functional food is essentially a marketing term and
globally, it is not recognized by law. Several definitions for
functional foods exist. These include, that given by Health
Canada: ‘Similar in appearance to conventional food, consumed
as part of the usual diet, with demonstrated physiological benefits,
and/or to reduce the risk of chronic disease beyond basic
nutritional functions’ (Health Canada, 2000). Other defini-
tions include that from the International Food Information
Council (IFIC), that is functional foods are, ‘foods or dietary
components that may provide a health benefit beyond basic
nutrition’ (Bagchi, 2008). The International Life Sciences
Institute of North America (ILSI) has defined functional
foods as, ‘foods that by virtue of physiologically active food
components provide health benefits beyond basic nutrition’
(Bagchi, 2008). The European Commission Concerted Action
on Functional Food Science in Europe regards a food as
functional, ‘if it is satisfactorily demonstrated to affect benefi-
cially one or more target functions in the body, beyond adequate
nutritional effects, in a way that is relevant to either an improved
state of health and well-being and/or reduction of risk of disease’
(Consensus document, 1999).
Today, Japan is the only country that recognizes functional
foods as a distinct category, and the Japanese functional food
market is now one of the most advanced in the world.
Known as foods for specified health use (FOSHU), these are
foods composed of functional ingredients that affect the
structure and/or function of the body and are used to
maintain or regulate specific health conditions, such as
gastrointestinal health, blood pressure and blood cholesterol
levels (Hosoya, 1998). As of July 2008, nearly 500 food
products had been granted FOSHU status in Japan.
In 1912, Casimir Funk presented a seminal paper propos-
ing the ‘Vitamine’ theory (McCollum, 1957). He proposed
that the absence of certain minute substances in foods rather
than the presence of germs caused disease. The theory and
concept that he developed has had a direct bearing on the
development of functional foods. The concept of functional
foods has now been extended to include food constituents
that reduce the risk of chronic disease (Plat and Mensink,
2001). Today we are at a new frontier in nutritional science.
The transition from ‘adequate’ to ‘optimal’ nutrition. It is
here that functional foods will have a pivotal role in
reducing diet-related chronic diseases.
Functional foods may be broadly grouped into the
following:
Conventional food containing naturally occurring bioac-
tive substance. An example could be b-glucan in oat bran
to lower blood cholesterol;
Foods that have been modified, by enrichment or other
means, with bioactive substances. An example could be
margarine that contains added phytosterol that is known
to lower serum cholesterol;
Synthesized food ingredients, such as some specialized
carbohydrates intended to have probiotic effects.
A functional food can be (1) a natural food, (2) a food to
which a component has been added, (3) a food from which
a component has been removed, (4) a food where one or
more components has been modified, (5) a food in which
the bioavailability has been modified or (6) any combination
of these. Examples of these are shown in Table 1.
A food product can be made functional by using any of
the five approaches listed below:
(1) Eliminating a component known to cause or identified
as causing a deleterious effect when consumed (for
example, an allergenic protein).
European Journal of Clinical Nutrition (2010) 64, 657–659
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(2) Increasing the concentration of a component naturally
present in food to a point at which it will induce
predicted effects (for example, fortification with a
micronutrient to reach a daily intake higher than the
recommended daily intake).
(3) Adding a component that is not normally present in
most foods and is not necessarily a macronutrient or
a micronutrient, but for which beneficial effects have
been shown (for example, non-vitamin antioxidant or
prebiotic fructans).
(4) Replacing a component, usually a macronutrient
(for example, fats), intake of which is usually exces-
sive and replacing it with a component for which
beneficial effects have been shown (for example,
modified starch).
(5) Increasing bioavailability or stability of a component
known to produce a functional effect or to reduce the
disease-risk potential of the food.
One of the examples often quoted within the functional food
sector is the introduction of margarine spreads fortified with
plant sterols in the UK. Although there is limited information
related to the impact of diet-based intervention on disease
prevention and health-care cost reduction, a few case studies
are available to support the use of functional foods to improve
the health of the populations. A reduction of low-density
lipoprotein cholesterol by 10–15% was observed through the
consumption of plant stanol esters at levels of 2–3 g per day
(Nguyun, 1999). If this risk reduction is achieved in practice,
heart disease patient numbers in the UK would reduce by
250 0000 and save the UK health-care system d433 million.
The National Health Service in the UK estimated that these
products have the potential to lower the health-care costs for
cardiovascular disease by d100 million per year.
Despite the emerging interest and global consumption of
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
and food manufacturers alike (Hughes, 2009). Of the 416
claims evaluated, fewer than 2% were approved, a rejection
rate that calls into question the process itself. Claims related to
antioxidants, bowel function, neurological function and
glycaemic index were rejected. The rejection of carbohydrates
and their glycaemic indices appears to be at variance with
other international bodies. The World Health Organization,
for example, not only recognizes the concept of glycaemic
index, it advocates its wide usage (FAO/WHO, 1998). Yet EFSA
states that ‘carbohydrates that induce a low/reduced glycae-
mic response and carbohydrates with a low glycaemic index
(o55), which are the subject of the health claims are not
sufficiently characterised’. This is hard to reconcile as the
carbohydrate content of several foods has not only been
carefully characterized but also recognized as being metabo-
lized and absorbed differently. Even more curious is the
approval of b-glucan for lowering cholesterol but not for
lowering blood glucose. These anomalies highlight the
challenges ahead. EFSA urgently needs to balance scientific
judgement and consumer protection with the promotion and
nurturing of food innovation within Europe. There is an
urgent need for EFSA and the food industry to recalibrate each
other’s expectations. If not, EFSA will be perceived as a
harbinger of doom for the industry and scientists alike, stifling
creativity and ultimately the consumer will be the loser.
As the head of the Functional Food Centre in Oxford
whose primary goal is to evaluate and assess functional
benefits of foods and ingredients and to provide evidence-
based science to substantiate health claims, I welcome the
importance given to functional foods by the European Journal
of Clinical Nutrition by publishing this special issue on
functional foods based on peer-reviewed reviews and articles
accepted by the Journal. EJCN should be commended as
it has continued to support this growing new area of
nutritional science by consistently promoting the publica-
tion of evidence-based studies in this important field.
CJ Henry
Human Nutrition, Functional Food Centre,
Oxford Brookes University, Oxford, UK
E-mail: jhenry@brookes.ac.uk
References
Arai S (1996). Studies on functional foods in Japan. Bioscience
Biotechnol Biochem 60, 9–15.
Arvanitoyannis IS, Van Houwelingen-Koukaliaroglou M (2005).
Functional foods: a survey of health claims, pros and
cons, and current legislation. Crit Rev Food Sci Nutr 45,
385–404.
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).
Editorial
658
European Journal of Clinical Nutrition
Bagchi D (ed). (2008). Neutraceutical and Functional Food Regulations.
Elsevier: New York.
Consensus Document (1999). Scientific concepts of func-
tional foods in Europe consensus document. Br J Nutr 81,
S1–S27.
Food and Agriculture Organisation/World Health Organisation
(1998). Carbohydrates in human nutrition: report of a joint
FAO/WHO expert consultation, FAO Food and Nutrition paper 66,
Rome.
Health Canada (2000). Standards of evidence for evaluating foods
with health claims. Fact sheet 1. November 2000.
Hosoya N (1998). Health claims in Japan—foods for specified health
uses and functional foods. J Nutr Food 1, 1–11.
Hughes N (2009). Health claims thrown into disarray by EFSA
rejections. The Grocer, 10 October: 12–13.
McCollum EV (1957). A History of Nutrition. The Riverside Press:
Cambridge, MA.
Swinbanks D, O’Brien J (1993). Japan explores the boundary between
food and medicine. Nature 364, 180.
Nguyun TT (1999). The cholesterol-lowering action of plant stanol
esters. JNutr129, 2109–2112.
Ohama H, Ikeda H, Moriyama H (2006). Health foods and foods with
health claims. Toxicology 221, 95–111.
Plat J, Mensink RP (2001). Effects of plant sterols ands stanols on
lipid metabolism and cardiovascular risk. Nutr Metab Cardiovasc
Dis 11, 31–40.
Editorial
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European Journal of Clinical Nutrition
Chapter
Functional foods have undergone significant changes over time, with their historical importance rooted in different cultures and their definition expanding to include various products. These foods play a vital role in addressing nutritional deficiencies and enhancing overall health. The presence of bioactive compounds like antioxidants, polyphenols, and probiotics contributes to their health benefits, including antioxidant effects and improvement of gut health. A primary area of interest in current research involves investigating the effects of functional foods on chronic diseases, with a particular emphasis on their potential health benefits. Ongoing clinical trials and proposed research directions play a pivotal role in advancing this field of study. Technological advancements have also played a role in the development of functional foods, allowing for the inclusion of new bioactive ingredients and responding to market trends and consumer preferences. The sector has witnessed advancements through the integration of new bioactive substances, as well. But, the implementation of stringent regulatory measures is crucial to guarantee the safety and effectiveness of these developments. Despite these achievements, the industry encounters obstacles in terms of scientific investigation, consumer awareness, and adherence to regulations. However, there are substantial prospects for expansion through international cooperation and the creation of inventive functional food items that cater to various consumer demands. This offers a promising avenue for tackling public health issues and enhancing overall wellness.
Chapter
Functional foods, understanding their origins, exploring their current status, and envisioning the promising trends will shape their future. This book chapter begins with the history of functional foods, where ancient cultures recognized the healing potential of certain foods. However, today functional foods have evolved beyond tradition, becoming an important ingredient of modern nutrition. In the current scenario, these foods extend beyond basic sustenance, offering a number of health benefits. Probiotics, antioxidants, and omega-3-fatty acids are being most commonly utilized ingredients, promising not just satiety but a holistic approach to well-being. Functional foods undergo various processing technologies like 3D food printing, encapsulation; ultra-sound treatment, spray drying, extrusion etc. not only enhances their nutritional content, but also their bioavailability, and overall health benefits. As the global emphasis on health and wellness intensifies, the future of functional foods unfolds as a dynamic frontier in nutrition science. The future of functional foods is characterized by innovation in ingredients, processing technologies, and personalized nutrition. As science, technology, and consumer preferences converge, the horizon is rich with possibilities, paving the way for a new era where functional foods not only nourish the body but also contribute to a healthier, more sustainable world.
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1. The Functional Food Science in Europe (FUFOSE) project was introduced, evaluated and accepted by the EU DG XII FAIR Programme as a Concerted Action. Its aim was to develop and establish a science-based approach for the emerging concepts in functional food development. Over the last three years of this EU Concerted Action co-ordinated by ILSI Europe, scientific data have been evaluated and new concepts have been elaborated. This Consensus Document is the culmination of the EU Concerted Action and its key points and recommendations are summarized here. It is by no means the end of the process, but, rather, an important starting point and the stimulus for functional food development. 2. Considerable progress has been made in scientific knowledge leading to the identification of functional food components which might eventually lead to an improved state of health and well-being and/or reduction of risk of disease. Consumers are becoming more aware of this development as they seek a better-quality, as well as a longer, life. The food industry has an opportunity to provide products that are not only safe and tasty, but also functional. The originality of the approach in this EU Concerted Action is that it is function-based, rather than product-based. The latter approach would have to be influenced by local considerations of different cultural as well as dietary traditions, whereas the function-based approach starts from the biologically based science that is universal. Furthermore, and most importantly, the function-based approach in this EU Concerted Action has allowed the development of ideas that suggest a unique way in which to link this scientific basis of functional foods with the communication about their possible benefits to consumers. 3. This EU Concerted Action has adopted the following working definition, rather than a firm definition, for functional foods: A food can be regarded as 'functional' if it is satisfactorily demonstrated to affect beneficially one or more target functions in the body, beyond adequate nutritional effects in a way that is relevant to either an improved state of health and well-being and/or reduction of risk of disease. 4. Functional foods must remain foods and they must demonstrate their effects in amounts that can normally be expected to be consumed in the diet. They are not pills or capsules, but part of a normal food pattern. A functional food can be a natural food, a food to which a component has been added, or a food from which a component has been removed by technological or biotechnological means. It can also be a food where the nature of one or more components has been modified, or a food in which the bioavailability of one or more components has been modified; or any combination of these possibilities. A functional food might be functional for all members of a population or for particular groups of the population, which might be defined, for example, by age or by genetic constitution. 5. The development of functional foods must rely on basic scientific knowledge of target functions in the body that are relevant to an improved state of health and well-being and/or the reduction of risk of diseases, the identification of validated markers for these target functions and the evaluation of sound scientific data from human studies for their possible modulation by foods and food components. This EU Concerted Action has proposed that markers can be classified according to whether they are markers of exposure to the functional food component whether they are markers that relate to target function or biological response or whether they are intermediate markers of the actual disease endpoint or health outcome. 6. Consumers must be made aware of the scientific benefits of functional foods and this requires clear and informative communication through messages (claims) on products and in accompanying materials. This EU Concerted Action has identified two types of claims that are vital to functional food development and has provided a scientific basis for them to help those who have to formulate and regulate the claims. Claims for 'Enhanced Function Claims' (Type A) should require that evidence for the effects of the functional food is based on establishment and acceptance of validated markers of Improved Target Function or Biological Response, while claims for the Reduced Risk Of A Disease (Type B) should require that evidence is based on the establishment and acceptance of Markers of Intermediate Endpoints of Disease. These markers must be shown to be significantly and consistently modulated by the functional food or the functional food component for either type of claim to be made. This EU Concerted Action has therefore proposed a scheme whereby the scientific basis of functional food development can be linked to the communication of their benefits to the public. If the principles of such a scheme can be universally adopted then this should ultimately improve communication to consumers and minimize their confusion. 7. Functional foods must be safe according to all standards of assessing food risk and new approaches to safety might need to be established. This EU Concerted Action proposes that the development of validated markers as described above should, if possible, be used and integrated in the safety assessment with particular attention being paid to long-term consequences and interactions between components. 8. The development of functional foods, with their accompanying claims, will proceed hand in hand with progress in food regulation, which is the means to guarantee the validity of the claims as well as the safety of the food. Science in itself cannot be regulated and functional food science provides only the scientific basis for these regulations. 9. The Individual Theme Group papers, which are the science base for this Concerted Action, represent the critical assessment of the literature by European experts.
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Nature is the international weekly journal of science: a magazine style journal that publishes full-length research papers in all disciplines of science, as well as News and Views, reviews, news, features, commentaries, web focuses and more, covering all branches of science and how science impacts upon all aspects of society and life.
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This paper pinpoints the "tertiary" function of foods which, different from the conventional "primary" and "secondary" functions that are related to nutrition and preference, respectively, is understood to be directly involved in the modulation of our physiological systems such as the immune, endocrine, nerve, circulatory, and digestive systems. Insights into this newly defined function are particularly important in that the intake of some physiologically functional constituents of foods could be effective in preventing diseases that may be caused by disorders in these physiological systems. Technologically, it has become feasible to design and produce physiologically functional foods (simply, functional foods) that are expected to satisfy in whole or in part a today's demand for disease prevention by eating. Such public expectations are reflected in the activation and development of systematic, large-scale studies on foods as seen in "Grant-in-Aid" research sponsored by the Ministry of Education, Science, and Culture. Meanwhile, the Ministry of Health and Welfare has initiated a policy of officially approving functional foods in terms of "foods for specified health uses" as defined by new legislation. Up to now (October 1995), 58 items have thus been approved. The first was a hypoallergenic rice product approved as of June 1, 1993. Here I discuss details of studies on rice-based functional foods. Other basic and applied studies directed toward the tertiary function, with future perspectives for functional foods, are also discussed.
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Plant sterols and stanols derived from wood pulp and vegetable oils lower total and LDL cholesterol by inhibiting cholesterol absorption from the intestine in humans. Plant stanols are virtually unabsorbable, which makes them more ideal hypocholesterolemic agents than plant sterols. The esterification of plant stanols has allowed their incorporation into various foods such as margarine without changing the taste and texture of those foods. Plant stanol esters at a level of 2-3 g/d have been shown to reduce LDL cholesterol by 10-15% without side effects. Plant stanol esters appear to be a helpful dietary adjunct to a prudent diet to lower cholesterol.