Search

Leila Arfaoui,1 Areej Alkhaldy,1 Ahad Alareeshi,1 Ghadeer AlSaadi,1 Shaima Alhendi,1 Afnan Alghanmi,1 Wejdan Alghafari,1 Mourad Assidi2,3 1Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, 21589, Saudi Arabia; 2Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, 21589, Saudi Arabia; 3Medical Laboratory Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, 21589, Saudi ArabiaCorrespondence: Leila Arfaoui Tel +966 126401000 (ext. 41612)Email leila.arfaoui@gmail.comBackground: Few studies have investigated the knowledge and attitudes towards the nutrition facts label, the nutrient content and health claims (NHCs) among consumers from different countries/cultures.Methods: This cross-sectional study assessed the knowledge and self-reported use of the nutrition facts label and NHCs among Saudi adults. A total of 722 participants were recruited using an online questionnaire.Results: Total knowledge score was 5.8 ± 2.5/13 points (45%). Approximately, 18%, 77%, and 5% of the participants had low, medium, and high levels of knowledge, respectively. Participants were more knowledgeable on the nutrition facts label (2.6 ± 1.6/5 points) and health claims (2.7 ± 1.2/4 points) versus nutrient content claims (0.5 ± 0.7/4 points). The total use score was 20.1 ± 5.7/30 points (67%); approximately, 2%, 61%, and 37% of the participants were classified as low, medium, and high use level, respectively. Participants’ use of the nutrition facts label, nutrient content claims, and health claims was 10.0 ± 3.1/15, 6.5 ± 2.2/9, and 3.6 ± 1.8/6 points, respectively.Conclusion: This study highlights the need for more education and public awareness programs to enhance consumer knowledge and use of the nutrition facts label and NHCs, and consequently lead to healthy dietary choices.Keywords: health claims, knowledge, nutrition facts label, nutrient claims, nutritional information

To develop algorithms to identify metastatic castration-sensitive prostate cancer (mCSPC) patients and castration-resistant prostate cancer (mCRPC) patients, using health claims data and laboratory test results.A targeted literature review summarized mCSPC and mCRPC patient selection criteria previously used in real-world retrospective studies. Novel algorithms to identify mCSPC and mCRPC were developed based on diagnosis codes indicating hormone sensitivity/resistance, prostate-specific antigen (PSA) test results, and claims for castration and mCRPC-specific treatments. These algorithms were applied to claims data from Optum Clinformatics Extended DataMart (Date of Death) Databases (commercial insurance/Medicare Advantage [COM/MA]; 01 January 2014-31 July 2019) and Medicare Fee-for-Service (Medicare-FFS; 01 January 2014-31 December 2017).Previous real-world studies identified mCSPC primarily based on metastasis diagnosis codes, and mCRPC based on mCRPC-specific drugs. Using the current study's algorithms, 7034 COM/MA and 19,981 Medicare-FFS patients were identified as having mCSPC, and 2578 COM/MA and 11,554 Medicare-FFS as having mCRPC. Most mCSPC patients were identified based on evidence of being hormone/castration-naive. Patients were identified as having mCRPC most commonly based on rising PSA (COM/MA), or at the metastasis diagnosis date if it occurred after castration (Medicare-FFS). Among patients with mCSPC, 14-17% had evidence of progression to castration resistance during a median 1-year follow-up period, mostly based on use of mCRPC-specific drugs.Comprehensive algorithms based on claims and laboratory data were developed to identify and distinguish patients with mCSPC and mCRPC. This will facilitate appropriate identification of mCSPC and mCRPC patients based on health claims data and better understanding of patient unmet needs in real-world settings.

This paper presents an analysis of the underlying assumptions and choices of the European regulatory process for health claims. The latter are scientifically substantiated statements, usually in th...

Seung Heon Lee,1 So-Youn Park,2 Jeong-Yeon Seon,3 Woo-Hwi Jeon,3 Sung-Il Nam,4 Jong-Hak Park,5 Jae Seok Park,6 Hae-Young Kim,7 Niket Thakkar,8 Prashanth Selvaraj,8 Anna Bershteyn,7 In-Hwan Oh3 1Division of Pulmonary, Sleep, and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea; 2Department of Medical Education and Humanities, School of Medicine, Kyung Hee University, Seoul, Republic of Korea; 3Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea; 4Department of Otolaryngology-Head & Neck Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea; 5Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea; 6Division of Pulmonology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea; 7Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA; 8Institute for Disease Modeling, Seattle, WA, USACorrespondence: In-Hwan Oh Department of Preventive MedicineSchool of Medicine, Kyung Hee University, Seoul, Republic of KoreaFax +82-2-969-0792Email ihoh@khu.ac.krObjective: To identify risk factors for intensive care unit (ICU) admission and mechanical ventilator usage among confirmed coronavirus disease (COVID-19) patients and estimate the effects of mitigation efforts on ICU capacity in Korea.Patients and Methods: Data on profiles and medical history of all confirmed COVID-19 patients in the past 1 year were extracted from the Korean National Health Insurance System’s claims database to assess risk factors for ICU admission and ventilator use. We used a time-series epidemic model to estimate the ICU census in Daegu from the reported hospital data.Findings: Multivariate regression analysis revealed male sex, old age, and residing in Daegu city as significant risk factors for ICU admission. The number of patients requiring ICU admission exceeded the bed capacity across all Daegu hospitals before March 9, 2020, and therefore, critically ill patients were transferred to nearby hospitals outside Daegu. This finding was consistent with our prediction that the ICU census in Daegu would peak on March 16, 2020, at 160 through mitigation efforts, without which it would have reached 300 by late March 2020.Conclusion: Older age and male sex were risk factors for ICU admission. In addition, the geographic location of the hospital seems to contribute to the severity of the COVID-19 patients admitted to the ICU and to the ICU capacity.Keywords: COVID-19 pandemic, ICU admission, Korea, risk factors

Obesity and type 2 diabetes are major health problems affecting hundreds of millions of people. Caloric overfeeding with calorie-dense food ingredients like sugars may contribute to these chronic diseases. Sugar research has also identified mechanisms via which conventional sugars like sucrose and fructose can adversely influence metabolic health. To replace these sugars, numerous sugar replacers including artificial sweeteners and sugar alcohols have been developed. Rare sugars became new candidates to replace conventional sugars and their health effects are already reported in individual studies, but overviews and critical appraisals of their health effects are missing. This is the first paper to provide a detailed review of the metabolic health effects of rare sugars as a group. Especially allulose has a wide range of health effects. Tagatose and isomaltulose have several health effects as well, while other rare sugars mainly provide health benefits in mechanistic studies. Hardly any health claims have been approved for rare sugars due to a lack of evidence from human trials. Human trials with direct measures for disease risk factors are needed to allow a final appraisal of promising rare sugars. Mechanistic cell culture studies and animal models are required to enlarge our knowledge on understudied rare sugars.

Childhood obesity is a health epidemic. While we know that food advertising is impacting dietary perceptions of youth, we do not know all of the contributing factors. Health claims are used...

There has been little research about which combinations of health claims, food product categories, and nutrient enrichment labellings are most appealing to consumers. This paper tests whether speci...

The beneficial effect of fresh tomatoes or processed tomato products on platelet aggregation depends on the presence of bioactive compounds in these products, in sufficient quantities, to produce a relevant physiological effect, when consumed as part of a normal diet. This work is focused on reviewing the development on tomato products bioactive compounds, particularly with reference to its potential biological activity with beneficial effect on the prevention of platelet aggregation.The most relevant studies found show that all bioactive compounds found in Water-soluble tomato concentrate are in tomato fruit and other tomato products, and there is enough evidence of their beneficial effects. According to the European Food Safety Authority requirements, further intervention studies (human clinical trials) using valid markers should be performed in order to demonstrate the beneficial effects of tomato products as consumer products (paste, puree, sauce or juice) on platelet aggregation. Our PubMed review results support the development of promising nutritional strategies involving tomatoes and tomato products to tackle cardiovascular disease as antiplatelet aggregation.

International audience; Research question: Debates about dietary health promotion at sports events are becoming more prominent and are making food and drink sport sponsorship arrangements increasingly problematic. This study uses choice architecture as a guiding framework to examine how ideas about ‘healthy choices’ for customer food and drink were operationalised at the Rio 2016 Olympic and Paralympic Games in Brazil.

This study investigated the impact of food claims, food cues, and objective health characteristics on health categorization speed and accuracy, believability of claims and perceptions of health, and taste for food items. One hundred twenty-four young adults were exposed to counterbalanced food item images, which varied by directness of visual food cues, type of food claims (health-related vs. taste-related), and objective healthfulness in a fully crossed design across three different food items. Participants categorized the foods as healthy or unhealthy in a speeded task and evaluated the perception of claim believability and perceptions of health and taste after exposure to images of the food items. Direct visual cues, especially when used with health claims, improved health and taste perception ratings and aided believability of health claims even for objectively unhealthy food products.

Over time, the quality of data on food purchases and label information has improved such that hedonic analyses to determine the implicit prices of product attributes can be conducted using more det...

Dairy products are associated with numerous health benefits. These are a good source of nutrients such as carbohydrates, protein (bioactive peptides), lipids, minerals, and vitamins, which are essential for growth, development, and maintenance of the human body. Accordingly, dairy bioactive peptides are one of the targeted compounds present in different dairy products. Dairy bioactive compounds can be classified as antihypertensive, anti-oxidative, immmunomodulant, anti-mutagenic, antimicrobial, opoid, anti-thrombotic, anti-obesity, and mineral-binding agents, depending upon biological functions. These bioactive peptides can easily be produced by enzymatic hydrolysis, and during fermentation and gastrointestinal digestion. For this reason, fermented dairy products, such as yogurt, cheese, and sour milk, are gaining popularity worldwide, and are considered excellent source of dairy peptides. Furthermore, fermented and non-fermented dairy products are associated with lower risks of hypertension, coagulopathy, stroke, and cancer insurgences. The current review article is an attempt to disseminate general information about dairy peptides and their health claims to scientists, allied stakeholders, and, certainly, readers.

Little is known about food advertising in the print media in South Africa or other developing countries. We investigated the extent to which different ethnic population groups of South Africa are exposed to magazine advertising for food and beverages. Five different magazines (n = 162 issues) with the most adult readers were assessed. We identified 959 food-related advertisements. These were for food and beverages (80.9%), dietary supplements (10.4%), and slimming products (8.7%). Of the 658 advertisements for specific food and beverages, most (59.3%) were for unhealthy foods. Numerous cases of misleading health/nutrition claims were seen. Government interventions are required to reduce the advertising of unhealthy food-related products and to curb misleading advertising.

This study examined impacts of different types of fiber labels (i.e., a regular label; fiber-labeled; fiber-labeled with a health claim) on consumers’ perceptions, purchase intentions, and willingness to pay. Consumers’ taste- and health-consciousness and degree of food neophobia were considered as moderators. Results reveal that different types of labels significantly influenced consumers’ perceptions toward the product. Consumers with higher overall perceptions had higher purchase intentions. Fiber labeling with a health claim made consumers willing to pay more. The analysis found a direct impact on the purchase intentions of consumers’ health-consciousness and their overall perceptions.

Barley (Hordeum vulgare L.) is a nutritious cereal but very little (only about 2%) of this grain is used as human food. However, it has attracted the attention of researchers and food processors in the last 15 years for its potential health benefits. It is also recognized as a functional grain because it contains high levels of β-glucan and phytochemicals. Therefore, a number of barley processing research and animal/clinical trials have been performed over the last 15–20 years. Also, health claims have been approved by a number of government agencies including the Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA) about consumption of β-glucan, an important component of barley. Barley must undergo various processing steps before human consumption, which greatly affect their composition and physicochemical properties. These properties play an important role in the development of new products. Therefore, the present article reviews the literature on the effect of proces...

An experimental auction and the eye-tracking technology are used to detect the relationship between consumers’ understanding of the nutrition information and their willingness to pay for food items. Additional attention is given to health-conscious individuals. Salad mix and apple juice are selected for the experiment. A Tobit model is used for the analysis. The results show that nutrition information has some effect on consumers’ purchasing decision. Shoppers are willing to pay less for fat and mineral information, but more for ingredient, protein, sodium, and carbohydrate information of salad mix. As for apple juice, shoppers care only for energy and other nutrient information, as well as the health claim “vitamin C naturally high.” Further, health-conscious individuals are more responsive to the nutrition claims, such as “high in fiber” (salad mix) and “vitamin C naturally high” (orange juice). A possible limitation of the conclusion exists due to the small sample size.

This paper presents an analysis of the concept of scientific substantiation in European health claims regulation. It focuses on the controversies about the demand for the establishment of cause-and-effect relationships between food consumption and health outcomes in claim substantiation. Our analysis, on the basis of regulatory and scientific documents, identifies two opposing views about the aims of health claims regulation. Each of these two stances links certain regulatory objectives with specific epistemic policies, that is particular sets of scientific methodology, criteria, and procedure. The regulators, in selecting a demanding evidentiary approach based on a hierarchy of methodologies that requires causal data for substantiation of claims, give priority to preventing the authorization of false claims. The opposing view, espoused by the critics of this approach, opts for less demanding requirements for substantiation, implying the market availability of a wider range of products with health claims ...

Considering the difference between hedonic and utilitarian products, this article presents how the choice of color in food packaging, along with the nutrition content claim (NCC) labeling, can influence the consumer’s perception of food healthiness and purchase intention. The responses of 120 non-color-blind and non-obese college students from two within-subject experiments were analyzed by adopting a mixed model for repeated measurement. The results suggest that utilitarian, but not hedonic, food products in blue-colored packages were perceived to be healthier than those in red-colored packages. The perception of food healthiness, which was sensitive to the package color, also influenced the purchase intention of packaged foods. Moreover, when the NCC label was presented, food in a blue package with health claims in the NCC (e.g., “light” label) was perceived healthier than food in a red package with regular labels. This article also discusses the managerial implications of the findings for packa...

This article examines how consumer familiarity with product-concepts and functional ingredients as well as inferences about an advertiser’s manipulative intent affect ratings about the level of scientific support of health claims on food. Three claim conditions reflecting the sufficient levels of support within the WHO framework (“possible,” “probable,” and “convincing”) have been tested in a survey conducted in the German language. Though consumers do not completely disregard the level of claim support as respondents rated “convincing”-level claims slightly higher than “probable”-and “possible”-level claims, consumers’ misevaluations of health claims in terms of their scientific substantiation were found to be high. Knowledge structures are more indicative of consumer inferences about claim support. Product-concept familiarity positively affects claim substantiation ratings. No effect of ingredient familiarity has been observed. Inferences of manipulative intent negatively affect claim support ratings. T...

Objective: To assess clinical and economic benefits of radiofrequency ablation (RFA) compared to hysterectomy when treating patients suffering from menorrhagia. Methods: Based on German health claims data, a retrospective, longitudinal, observational analysis was performed. Patients having continuously statutory health insurance coverage during the study and being coded for menorrhagia and a relevant treatment option were included in the analysis. The control group was created using propensity score matching. Results: We discovered that using RFA generates cost savings of €1844 during the quarter of performance. As direct costs during a 2-year follow-up show similar levels in both groups, these initial savings can be preserved. This is partly because even if more patients in the RFA group were re-coded for menorrhagia after initial therapy, just a small proportion of these patients required another surgical intervention. Conclusion: RFA should more often be considered a relevant treatment option both from...

The growing presence of products on the market with added value in terms of health makes essential their regulation and harmonization in critical aspects such as safety. The toxicology applied to the bioactive compounds should demonstrate the absence of toxic effects at doses advised for consumption, as well as evaluate the potential toxic effects in the assumption that the products are used in quantities superior to those recommended. The specific strategy should be defined case by case; therefore, prior to any toxicological development, it is essential to study all the information regarding the bioactive compounds (BACs) characterization, nutridynamics and nutrikinetics, that is available. In this guideline, a general strategy to be applied in the development of BACs is proposed. It includes a first in vitro phase to discard genotoxicity and endocrine effects and a second in vivo phase with different possibilities regarding the duration and the extension of the studies.

The characterization and stability evaluation of food and food constituents (chemical active ingredient/microorganism) for which nutrition or health claims want to be requested are essential for the success of an application to EFSA. This work reviews the requirements that must be fulfilled for a full characterization of the active substance, comprising origin, elaboration, or extraction method, and chemical/microbiological composition, using validated analytical methods. The review focuses not only on establishing the specifications of the final active ingredient or food but also on ensuring homogeneity between batches. In addition, the article discusses the methodologies and conditions of the stability studies that need to be performed on food and food constituents to verify that the relevant compounds--chemical and microbiological active ingredients--will get to the consumer in the intended state and concentration to accomplish the claimed health effect over shelf life.

The seeds of the plants of the Fabaceae, commonly known as “grain legumes” or “pulses,” are major foodstuffs in most countries. In addition, these seeds may also provide some health benefits, in particular in the area of hypercholesterolemia and hypertension prevention. Whereas the hypocholesterolemic activity of soy protein has been well known for decades and was finally supported by the health claim by the U.S. Food and Drug Administration in 1999, similar information on non-soy legumes is scarce. This paper reviews all such available data from animal models and human trials as well as information on the mechanism of action provided by in vitro studies, mainly on cell cultures or assays on specific enzymes. This body of data indicates that a regular consumption of grain legumes may be useful both for the prevention of hypercholesterolemia and hypertension. More investigations are needed, however, for elucidating the mechanism of action and the actual effective components in legumes.

During the college years, young adults develop eating habits and concerns that follow them throughout their lives. Understanding college students’ menu selections in dining-out situations can provide insight into their eating habits. This study aimed to investigate college students’ preferences for types of nutrition information (such as macronutrients and total calories, specific nutrients, and health claims) on restaurant menus, and the impact of nutrition information on purchase intention. The presence of caloric and macronutrient information on restaurant menus was found to significantly affect purchase intention. The findings provide a foundation for future hospitality studies investigating dining-out menus as a persuasive tool for better health, and suggest strategies for industry professionals.

During the past years there is a rising demand for improving the quality and nutritional value of foods that has encouraged the research and development of new food ingredients and products. Nevertheless, to date, many of the health claim applications evaluating EFSA have been rejected. Hence, it is critical for companies involved in the development of functional foods to be aware of the full flowchart needed for the scientific support of a health claim from the very beginning. This series of articles summarize the conclusions presented in July 2014 during the workshop INCOMES devoted to clarify methodologies for scientific support of health claims in foods/ingredients, in the framework of the XVI Reunión de la Sociedad Española de Nutrición, and are intended to be a practical tool, outlining the sections that an application for authorization of a health claim should contain.

As the public interest in health information has increased globally, the use of health benefits in food advertisements is becoming more essential for food marketing strategy. Consumers view a food product as healthy if it carries a health claim, whereas there has been an ongoing debate about the value of health claims as a strategy to help consumers’ healthier food consumption. The present study attempted to examine the food commercials broadcast on Korean network television in terms of claim types and executional elements. Results indicate that television food advertising has made a wide number of implied “soft” health claims (e.g., “good for health”) without substantial information and call into question whether consumers are misled or deceived by the executional elements used for presenting health messages. The findings of the study raise regulatory concerns about the provision of potentially confusing or misleading health messages in food advertising nationally as well as internationally and suggest f...

Food manufacturers have an incentive to include nutrient content claims, health claims, or other types of labeling statements on foods if they believe that consumers will be willing to pay more for products with specific attributes. We estimated semi-log hedonic price regressions for five breakfast bar and cereal product categories using Nielsen Scantrack scanner data for 2004 and found that labeling statements for these foods are often associated with substantially higher prices, reflecting higher implicit value to consumers. The largest effects were associated with “carb-conscious” carbohydrate labeling (reflecting the time period of the data), followed by fat and sugar content labeling statements.

Herbs, herbal extracts, or phytochemicals are broadly used as foods, drugs, and as traditional medicines. These are well regulated in Europe, with thorough controls on both safety and efficacy or validity of health claims. However, the distinction between medicines and foods with health claims is not always clear. In addition, there are several cases of herbal products that claim benefits that are not scientifically demonstrated. This review details the European Union (EU) legislative framework that regulates the approval and marketing of herbal products bearing health claims as well as the scientific evidence that is needed to support such claims. To illustrate the latter, we focus on phytoecdysteroid (PE)-containing preparations, generally sold to sportsmen and bodybuilders. We review the limited published scientific evidence that supports claims for these products in humans. In addition, we model the in silico binding between different PEs and human nuclear receptors and discuss the implications of these putative bindings in terms of the mechanism of action of this family of compounds. We call for additional research to validate the safety and health-promoting properties of PEs and other herbal compounds, for the benefit of all consumers.

The significant association between diet and human health broadens the consumer concept to look at food not only for its basic nutrition but also for allied health benefits. Nevertheless, a large segment of the population is still reluctant to buy functional foods due to ambiguities related to their health claims. This review highlighted the role of functional foods against various physiological threats, like cardiovascular disorders, diabetes, oxidative stress, cancer insurgence, and immune dysfunction. Recent developments in dietary supplements are also the limelight of the article. The discussion also encapsulated the role and responsibilities of regulatory agencies, such as the Food and Agriculture Organization, the Codex Alimentarius Commission, and the International Alliance of Dietary Food Supplement Association, in harmonizing the legislations regarding the risk assessment and health claims of functional foods.

Objective: Nutritional supplements are inadequately regulated in South Africa. These types of products are increasingly advertised and the advertisements frequently contain health claims. Because advertisements play a considerable role in informing potential consumers, it is crucial that information about supplements in advertisements is accurate. A survey was carried out to determine the extent to which health claims are made in nutritional supplement advertisements and to describe the appropriateness of the research cited within the advertisements in support of the health claims.Design: The design was a descriptive survey.Method: The five women’s magazines with the highest circulation figures in South Africa in July 2010 were identified by the Audit Bureau of Circulations of South Africa as Cosmopolitan, Finesse, Move!, Rooi Rose and Sarie. Issues of these magazines were obtained during the period from September 2010 to August 2011. Pre-specified eligibility criteria were used to identify suitable advertisements and to determine the percentage of nutritional supplements about which health claims were made. The percentage of these supplements for which research was cited in support of the claims was also determined, and the level and appropriateness of the cited research, described.Results: In total, 486 eligible advertisements were identified which referred to 158 nutritional supplements. Of these, 137 (86.7%) made health claims and 9 of the 137 (6.6%) cited research to support their claims. The cited research was judged to be largely inappropriate based on study design and/or the characteristics of the study.Conclusion: South Africans should be wary of advertisements that make claims about the health benefits and safety of nutritional supplements. Regulation of the advertising of nutritional supplements is urgently needed.Keywords: dietary supplements, health claims, regulation, advertising, evidence based health care

For millennia, spices have been an integral part of human diets and commerce. Recently, the widespread recognition of diet-health linkages bolsters their dietary importance. The bioactive components present in them are of considerable significance owing to their therapeutic potential against various ailments. They provide physiological benefits or prevent chronic ailment in addition to the fundamental nutrition and often included in the category of functional foods. Black pepper (Piper Nigrum L.) is an important healthy food owing to its antioxidant, antimicrobial potential and gastro-protective modules. Black pepper, with piperine as an active ingredient, holds rich phytochemistry that also includes volatile oil, oleoresins, and alkaloids. More recently, cell-culture studies and animal modeling predicted the role of black pepper against number of maladies. The free-radical scavenging activity of black pepper and its active ingredients might be helpful in chemoprevention and controlling progression of tumor growth. Additionally, the key alkaloid components of Piper Nigrum, that is, piperine assist in cognitive brain functioning, boost nutrient's absorption and improve gastrointestinal functionality. In this comprehensive treatise, efforts are made to elucidate the antioxidant, antimicrobial, anti-inflammatory, gastro-protective, and antidepressant activities of black pepper. Moreover, the synergistic interaction of black pepper with different drugs and nutrients is the limelight of the manuscript. However, the aforementioned health-promoting benefits associated with black pepper are proven in animal modeling. Thus, there is a need to conduct controlled randomized trials in human subjects, cohort studies, and meta-analyses. Such future studies would be helpful in recommending its application in diet-based regimens to prevent various ailments.

A multi-method study was conducted to, first, establish the prevalence of types of health- and nutrition-related (HNR) claims (nutrient content, structure/function and health claims) with benefit-seeking and risk-avoidance appeals in food advertisements appearing in magazines with large female audiences and, second, determine the effects of the two HNR-paired appeal types on females’ evaluative judgements of food advertisements. Analysis of 633 food advertisements from eight women-orientated magazines found a substantial use of risk-avoidance appeals in food advertising, primarily in association with nutrient content claims. Risk-avoidance appeals were especially present in product categories considered relatively unhealthy and less nutritious. Two experiments conducted to examine appeal-type effects in association with nutrient content claims found that both benefit-seeking and riskavoidance appeals enhanced perceived healthiness of advertised food products among females; however, risk-avoidance appeals ...

Wheat bran is a concentrated source of insoluble fibre. Fibre intakes are generally lower than recommendations. This paper reviews the physiological effects of wheat bran and the health benefits it may provide in terms of the prevention of diseases such as colon and breast cancers, cardiovascular disease, obesity and gastrointestinal diseases. In recognition of the weight of evidence, the European Food Safety Authority has recently approved two health claims for wheat bran and gastrointestinal health.

This article reviews the landmark studies of advertising claims and analyzes the health claims for food products advertised on Korean TV. The present study examined 1,479 food commercials aired on three major television networks from 2005 to 2007. The commercials containing health claims accounted for 29.5% of the total. The health claims ranged from the nutrient content to the use of ambiguous expressions such as "healthy." Among the 5 types of health claims considered, specific nutrient claims ranked first (11.1%), followed by general health claims (9.4%). The regulatory policies of Korea concerning such advertising claims were compared with those of the United States. The results of this study are expected to have important implications for Korean policymakers who need better ways to regulate health claims for food products.

A total of 43 individuals were included in a study of genetic and environmental factors associated with cardiovascular disease; seven subjects (16%) were diagnosed with the metabolic syndrome. A statistically significant association was observed between the E2 allele of the apolipoprotein E (Apo E) polymorphism and an increasing number of metabolic syndrome features (p = 0.03). Clinical and biochemical abnormalities identified could be ascribed to the combined effects of unfavorable genotypes and environmental factors known to interact with the Apo E gene. Excessive alcohol intake, high-calorie diets and smoking should be restricted in individuals with the Apo E2 and/or E4 alleles, which are associated with a significantly increased risk of cardiovascular disease.

Despite the increased use of health claims in food advertising, few studies have investigated how specific nutrition claims have differential effects depending on how they are presented. In this context, the current study tests the anchoring hypothesis. Anchoring refers to a common human tendency to evaluate information differently depending on the presence or absence of a numerical "anchor" or reference point. Two (pilot and main) experimental studies explore anchoring effects on audience response to food advertising both directly and moderated by cognitive, motivational, and message factors. The pilot study finds that food product ads employing nutrition claims with an anchor rather than without an anchor generate two results: First, participants perceive the product to have lower fat/lower calorie contents (anchoring hypothesis); second, they prefer the messages with an anchor over those without an anchor. The main study reports that when anchoring is successfully evoked, it produces favorable attitudes toward the ad, favorable attitudes toward the brand, and purchase intention-but only when moderated by health orientation, claim believability, and nutrition knowledge. Practical implications are provided with respect to regulatory guidelines and effective communication strategies for promoting low-fat and low-calorie products in food advertising.

A series of studies involving 594 participants applies schema theory to explain the increasingly popular practice of using unmatched claims for food advertising. The findings are consistent with the schema congruity hypothesis that using health claims for vice products or taste claims for virtue products, each of which is perceived as moderately incongruent, leads to more favorable brand evaluations than using congruent or extremely incongruent claims. Findings suggest that advertisers take into consideration the goodness of food products regarding both long- and short-term benefits (i.e., virtue vs. vice) when designing advertising messages.

In the late nineteenth and early twentieth centuries, the profession of physical education was influenced by the ideas and research activities of physicians interested in understanding the role of physical training in health. Physicians Lilian Welsh and Clelia Mosher were among those physicians who contributed to both curricular developments in hygiene and physical education programmes in higher education and to scientific research that provided the basis for health claims from exercise, while employed by institutions of higher learning. In their decades of service to Goucher College (Welsh) and Stanford University (Mosher), these doctors also used science to diminish the claims of physiological inferiority of women thereby furthering the cause of higher education for women.

This article reports findings from an exploratory study about tropical fruit consumption in Belgium. The aim of this study is to identify motives and barriers for the consumption of fresh tropical ...

A content analysis and a quasi-experiment were performed to examine the current practices in food advertising, and the usage and the effectiveness of different advertising claims across two food categories (hedonic vs functional). The content analysis revealed that taste and specific nutrition claims are the two dominating types of advertising claims in recent food advertisements. Also, a greater proportion of advertisements for functional (vs hedonic) foods appeared to use such nutrition/health claims as general health and contains nutrient claims, whereas a greater proportion of advertisements for hedonic (vs functional) foods used taste claims. However, these current practices of food advertising were called into question by the results of the quasi-experiment, which showed that the nutrition/health claims were more effective when promoting hedonic (vs functional) foods, whereas taste claims were more effective when promoting functional (vs hedonic) foods in generating favourable attitudes and purchase...

The provision of nutrition and health information on food labels is increasing as an industry and regulation answer to the growing consumer concern with diet–health relationships. Prior research has shown that the presence of this information on food labels is valued by consumers; however, there is still no clear pattern on which labelling options are more valued and how different consumers value the different options. This paper analyses the results of a choice experiment conducted to identify the effect of multiple health and nutrition information sources on consumer food choice, taking into account preference heterogeneity using a latent class approach. Results show that different consumer groups can be identified with clearly distinguishable valuation and behavioural patterns. A minority of consumers attaches high willingness to pay (WTP) to the provision of additional information in the nutrition facts panel, however, this is not shown for a vast majority who value claims. Moreover, not taki...

This paper reviews recent consumer studies evaluating comprehension of a novel form of food labeling, qualified health claims, now permitted by FDA. The joint goals of qualified health claims are to encourage firms to make accurate, science-based claims about the health benefits of their products while helping consumers prevent disease and improve their health through sound dietary decisions using enhanced nutrition information. This paper examines whether consumers can differentiate between multiple levels of health claims and determines if a front label visual aid helps consumer understanding. Results of experimental consumer attitude studies are presented which suggest that people do not perceive significant differences between the three levels of qualified claims and traditional (unqualified or SSA) health claims. An additional experiment suggests that a visual aid (report card) may be an important device to help consumers distinguish between the levels of health claims. However, thought-listing data suggests that consumers use the report card to draw inferences about overall product quality rather than the strength of scientific evidence supporting the health claim. Implications of these findings for the future regulatory oversight and marketing of functional food products are discussed.

The area of health claims has been unregulated in Europe until recently. A new regulation on nutrition and health claims made on foods came into force on 19 January 2007. The Regulation has been eagerly awaited by all parties involved. The Regulation includes 37 whereas clauses, 29 Articles and an annex for nutrition claims and conditions applying to them. In practice, three main types of health claim are included in the Regulation, as referred to in Articles 13 and 14. The type of the scientific evidence is described slightly differently for Article 13.1 and Article 13.5: ‘‘generally accepted scientific evidence’’ and ‘‘newly developed scientific evidence’’, respectively, although the scientific status of evidence shall be the same for all kinds of claims. So far, there are four types of guidance for applying the Regulation. The wording of health claims is an essential issue in the Regulation, as well as the concept of nutrient profiles. In the Regulation there are three issues of special interest, when compared to the Swedish Food Sector’s Code of Practice, i.e. concerns about ‘‘other substances’’, ‘‘food supplements’’ and ‘‘the average consumer’’. The Regulation will be evaluated in 2013, reporting the impact of this Regulation on dietary choices and the potential impact on obesity and non-communicable diseases.

Based on principles specified in the Swedish Code on health claims and experiences from handling of claims within the Code, priorities that may be useful when establishing a positive list of generic health claims and for responsible use of claims are suggested. One key factor highlighted is that claims should be relevant and meaningful for the consumer. To be useful in choosing a healthy diet, claims should primarily aim to stimulate an intake in agreement with official nutrition recommendations. Claims may thus be considered as relevant primarily for nutrients of which a considerable part of the population has an intake deviating from the recommendations. For vitamins and minerals, commonly involved in many functions in the body, it would be useful to prioritize claims referring to effects considered more important than others. Functions true for all essential nutrients, and/or affected by a large number of dietary factors, would be less relevant to claim for single vitamins and minerals. The relative importance of a specific vitamin or mineral, in relation to other nutrients potentially exerting similar effects, should also be considered. Based on these priorities, and on claims permitted or suggested as examples in the Code, a list of generic claims on vitamins, minerals, fatty acids, carbohydrates, dietary fibre, energy and wholegrain is suggested. Additional issues considered within the Code are also discussed. Keywords: generic; glycaemic index; meaningful; relevant

This paper reports on an adaptation of the Skepticism toward Advertising framework (Obermiller and Spangenberg, 1998, Journal of Consumer Psychology, 7(2), 189–186) in examining Singapore consumers' skepticism toward health claims made by manufacturers. The study found that Singaporean consumers, like their Western counterparts, are skeptical about health claims. Age and consumer's self‐confidence in information acquisition, identification of product alternatives, and getting recognition from others about purchase decisions made, are important antecedents to Singaporeans' skepticism toward health claims. Cynicism is also found to be a distinct concept from skepticism. While motivation to process nutrition information positively influences Singaporeans' skepticism toward health claims, use of health claims is negated by skepticism toward such claims. Managerial implications arising from the findings are discussed and directions for future research suggested.

New research has shown that foods containing whole-grain barley or certain dry-milled ingredients from barley have cholesterol-lowering effects similar to those seen for certain oat foods. The US Food and Drug Administration therefore allows whole-grain barley and certain dry-milled barley fractions to claim a reduction in the risk of coronary heart disease. A new Swedish study has been performed with a specific boiled, flaked and milled barley product, Aktivated Barley®, mixed into cold drinks. This study showed a reduction in low-density lipoprotein-cholesterol levels in mildly hypercholesterolaemic subjects. There is therefore enough evidence for an extension of the generic health claim in the Swedish Code on health claims about certain types of dietary fibre, with regard to blood cholesterol levels and cardiovascular disease, to include barley fibres. The extension should also include foods with both oat and barley fibres, since there is no reason to believe that the mechanism(s) behind the cholesterol-lowering effect differ between the two cereal fibres. Keywords: Barley; cholesterol; dietary fibre; ?-glucan; health claim

The literature suggests that consumers are expecting additional healthy menu items from quick service restaurants due to the increasing rates at which people are becoming overweight and obese. The current exploratory study analyzes the menu items of ten quick service restaurant chains to determine how many new “healthy” items have been added to menus in 2004 in comparison to 2003. Further analysis, through the use of surveys, determined the types of new menu items, the nutrition/ health claim for each, and how these new healthy menu items have been promoted by five of the ten quick service restaurant chains. Based on the analysis, it was found that on average these chains added 5.3 new healthy menu items in 2004 when compared to 2003. It was also determined that the majority of the new menu items introduced were low calorie and low fat, and that internal promotional techniques were the primary method of marketing. Implications for practitioners and for future research are discussed.

"Functional" foods are branded foods, which claim, explicitly or implicitly, to improve health or well being. We review typical functional foods and their ingredients, efficacy, and safety. We also review regulations for health claims for foods worldwide. These regulations often allow manufacturers to imply that a food promotes health without providing proper scientific evidence. At the same time, regulations may ban claims that a food prevents disease, even when it does. We offer a plea for regulations that will permit all health claims that are supported by the totality of scientific evidence, and ban all claims that suggest an unproven benefit.

To provide evidence for or against allowing a health claim for calcium in Canada, we undertook a review of the current U.S. health claim for calcium and osteoporosis, and also reviewed the scientific literature published since that health claim was first proposed and reviewed by the U.S. Food and Drug Administration in 1991 and adopted in 1993. Our objectives were 1) to determine if the science behind the claim was still valid, and if so, 2) to recommend any new wording to the claim, if warranted, prior to implementation in Canada. Based on a review of the evidence (to May 2000) related to the various claim elements, the following health claim for calcium has been established in Canada: A healthy diet with adequate calcium and vitamin D, and regular physical activity, help to achieve strong bones and may reduce the risk of osteoporosis. The compositional criteria for foods bearing this claim are that the food must provide at least 200 mg calcium per serving and that the phosphorus content (excluding that provided by phytate) must be less than the calcium content.

This article addresses the subject matter of functional foods by analysing commercialization and marketing of a functional food product. Functional food is an evolving hybrid concept: certain substances in a food product are claimed to have health-promoting or disease-preventing qualities (e.g. Best, 1996). Consequently, functional food advertises a food product with medical qualities, which evokes various debates and difficulties in its definition from the point of view of the medical community, regulatory authorities, food industry and consumers. Globally, the approval of functional foods is a complex matter, as it depends on national criteria and practice. For instance, functional food is not a legal term in many countries, such as the USA, but the health claims of functional foods that are used in package labelling and marketing are strictly regulated. With respect to clinical evidence, the approval criteria of health claims may even resemble the approval criteria of drugs. Through the health claims, ...