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FEATURE: Food as medicine

John begins his day with a glass of fortified orange juice and a nourishing bowl of oatmeal. As the 56-year-old heart attack survivor plans his morning run and other activities for the next few days, he impresses his fingerprint on a personal electronic device and gets an instantaneous assessment of his nutritional needs -- including which foods and beverages will best nurture his body.

The technology may sound a little ahead of its time, but this futuristic vision, as described by a certified nutrition specialist, certainly seems feasible when you consider the potential for food as medicine in today's health-obsessed society. As Americans continue to focus on the prevention of obesity, diabetes, high cholesterol, and other medical conditions, the idea of eating for one's health as opposed to merely popping pills shows greater promise than ever.

"The obesity issue, which will continue to be top of mind, will be creating long-term opportunities for functional foods," says Nancy Childs, professor of food marketing at St. Joseph's University in Philadelphia. "It will help consumers reapproach food for nutritional value. Not every consumer will respond, but a large number will."

"Functional foods" is the term typically given to foods that provide specific health benefits besides nutrition. One of the earliest examples comes from the 1930s, when dairies began fortifying milk with vitamin D to combat rickets. Modern examples include enriched cereals, breads, sports drinks, and sports bars; vitamin-enhanced snack foods; and baby foods. Among their beneficial ingredients are antioxidants, calcium, soy, dietary fiber, and heart-healthy and cholesterol-lowering elements.

The Nutrition Business Journal estimates that the U.S. functional foods market, which includes beverages, generated about $20.6 billion in 2002 -- almost a 10 percent increase from the prior year. By 2006 the sector could realistically reach $33 billion, according to the Natural Marketing Institute in Harleysville, Pa.

"In Europe we're seeing that the growth of supplements has flattened, but the functional food growth has continued to increase dramatically," Childs observes. This suggests that people are much more receptive to food than to supplements, she adds.

"People are taking more responsibility for their own health care," notes Paul Kirby, v.p. of Hodgson Mill, Inc., an Effingham, Ill.-based manufacturer of functional foods. "There is a trend, both on the patient/consumer level and health care professional level, to avoid taking and dispensing drugs so casually."

A big incentive for the development of functional foods in the United States came last summer, when the U.S. Food and Drug Administration announced it would begin allowing manufacturers to submit petitions to make health claims based on a wide range of scientific evidence. Previously, food manufacturers had to prove that there was significant scientific agreement on the benefits of a product before they could place claims on labels. Nuts are the first products to benefit from the relaxed rules, as the FDA has approved labels that link eating such items as hazelnuts, pecans, pistachios, walnuts, and peanuts to a reduced risk of heart disease.

The new label claims will help manufacturers more easily communicate their products' potential benefits to consumers, observers note. "To me, functional foods are foods that choose to talk about their health benefits on their food labels. They use that as part of their positioning. We can say oatmeal is oatmeal, or we can say it's functional if we talk about how the [dietary fiber] beta-glucan helps reduce heart disease," Childs says.

The new health claims are terrific -- but only as long as companies are as truthful as possible in their descriptions, Kirby warns. "We definitely need more integrity in the claims being made, so consumers aren't being misled. For instance, companies can claim to have a 'whole wheat' product, when in fact it's only a bit more than 50 percent whole grain. The rest is processed, bleached white flour, so consumers aren't getting the functional benefits of a true whole-grain food like they might think," he says.

Hodgson Mill manufactures functional products such as a multigrain buttermilk pancake mix with milled flaxseed and soy, a wild blueberry muffin mix with flax, and even a brownie mix with flax. Milled flaxseed provides the mixes with heart-healthy omega-3 oils.

All those ingredients sound healthy, but as anyone in the food industry would agree, most consumers won't continue to buy even the healthiest food if it doesn't taste good. Tastiness is, of course, a key goal of manufacturers.

Yet coming up with palatable products isn't the greatest obstacle, Kirby says. "I think the biggest challenge may lie in the fact that many category managers in the food industry want to see movement reports. With newly created functional foods, we don't have that data to show them most of the time," he says.

Research's role

Accelerated research made possible by new technology has been a huge driver of functional foods development, according to Roger S. Clemens, a certified nutrition specialist and director of the Laboratory for Research and Services in Contemporary Therapeutics at the University of Southern California School of Pharmacy in Los Angeles. "Technology is changing our approach to nutrition. We're no longer looking at how to prevent scurvy. We're asking if ingredients are anti-inflammatory, if they help maintain mental alertness, if they help the immune system. We're also looking at doses now that probably have some type of effect, which we weren't able to measure before."

Still, the food industry is relatively new to what has been typically considered the pharmaceutical industry's territory, he says. "Some in the food industry have jumped on it, some haven't done it at all. It's a big investment -- it costs money to do the clinical studies and scientific investigations."

Not surprisingly, therefore, larger companies have been more willing -- and able -- to invest in functional foods development. They often do so gradually and with brands that are already familiar to consumers, according to Childs. "The growth of functional foods has been pervasive on a fortification level. I think it really has impacted a number of food products, but it hasn't represented a lot of brand-new products and brands that didn't pre-exist. I think that's good, because where consumers have really embraced this has been where there's a sense of familiarity to them."

One of the best examples is Tropicana Products, which began adding calcium to its orange juice several years ago. "At first the product didn't sell, but today there are few orange juices that don't have calcium in them," Clemens says. Tropicana hopes to build on its success with a new wellness line called Tropicana Pure Premium Essentials, which includes Healthy Kids, Immunity Defense, Low Acid, and Healthy Heart versions of its orange juice.

Late last year Minute Maid introduced Premium Heart Wise orange juice, which contains plant sterols that inhibit the absorption of cholesterol.

Some food makers are partnering with ingredient developers to gain an edge in new product expertise. The Hain Celestial Group announced last August that it's collaborating with Cargill Health & Food Technologies to jointly develop new food and beverage solutions for consumers, to address a broad range of health concerns. Specifically Hain plans extensions to its Rice Dream, Soy Dream, and WestSoy nondairy beverages.

Much of the action in the functional foods industry takes place on the ingredient supplier level, Childs notes. Some of the up-and-coming ingredients that show the most promise include antioxidants; omega-3s, which consumers typically had to get in the past by eating fish; and milk and milk byproducts, such as those found in Yoplait's drinkable yogurt, Nouriche, and Stonyfield Farm's various yogurt products.

"We're seeing wonderful things coming from the wine industry, with the various antioxidants in grapes, grape seeds, and grape skins," Clemens says.

If the excitement being generated today is any indication, the future of functional foods could be even bigger than current estimates suggest. "I can look back and say that things are happening today because of an investment attitude toward research five years ago," Childs says. "There's that lag before you see the results."
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