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Complementary and Alternative Medicine: Fair and Balanced

The proof is in the orange juice 

Tropicana's strategy for presenting its orange juice as a functional food exemplifies the type of scientific support needed for all such products.

By John Russo Jr./Vicus.com
 

VICUS.COM (20 July 2000) -- A number of food and drink manufacturing companies are beginning to test the waters of the potentially lucrative functional foods industry, many by fortification of existing food and drink brands with proven ingredients. However, to earn the public's trust, clinical science needs to back up the claims made on labels (currently, these products are not regulated by the Food and Drug Administration; Ross, 2000).

 

What are some factors driving the demand for
 functional foods?

* Advances in nutritional science, agricultural technologies and processing techniques (e.g., biotechnology, genetic engineering). 
 * Ready access to nutrition and medical information through widespread media coverage, the Internet and other avenues. 
 * Emphasis on disease prevention, in response to escalating health-care costs.
 * Recent legislative events such as government regulations, which have changed how foods are marketed and labeled. 
 * The aging of the population, which is increasing the demand for healthier foods or food ingredients to improve health. By 2030, an estimated one-third of the U.S. population will be older than 65 years of age. 
 * The growing self-care movement. Consumers are becoming more interested in being responsible for their own health and are taking an active role in improving their health through foods.

   Source:  National Dairy Council

During the Nutracon 2000 conference in Las Vegas, Nev., held July 17-19, Nancy Green, vice president of Nutritional Products for Tropicana, outlined that company's strategy to establish the value of Tropicana orange juice as a functional food, which is defined as food that may provide health benefits in addition to its accepted nutritional value.

Tropicana, which is owned by food-and-beverage giant PepsiCo, has been successful in its approach, which bears a striking resemblance to the marketing plans followed by major pharmaceutical companies. Importantly, from the perspective of health-care professionals and consumers, it provides guidelines for what we should be looking for in the development of scientific support for functional food marketing claims.

Its strategy incorporates four elements that are essential to establishing functional food credibility, according to Green:

  • Identify a component of a product that provides a health benefit.        
  • Affiliate with a university to design and conduct a clinically relevant study to document that benefit.        
  • Present the results at a scientific meeting and/or in a reputable journal.        
  • Institute a program to ensure that consumers and health-care professionals learn of the results. 
The presence of third-party credibility distinguishes this strategy from a simple advertising campaign. A company needs to partner with independent experts at a university level who are contracted by the sponsoring company (Tropicana in this case) to conduct a study that will determine the impact of the product in a health condition.

Once the study is completed, the results are submitted for review to another group of independent experts, who examine the results and judge their worthiness for presentation during a scientific meeting or publication in a peer-reviewed scientific journal. Furthermore, the study is carried out in a population that is similar to those who will consume functional food. 

Tropicana's approach has been successful. A recently completed survey of consumers by the International Food Information Council found that oranges and orange juice were among the most often identified foods having health benefits (IFIC, 2000). 

 

Functional food claims

When confronted with health claims for functional foods, ask the following questions before you accept the claims:

First, distinguish between the "active" substance in the research referred to in the advertisement and the product being sold.
 * Does the advertised product contain the actual substance(s) being promoted as having health benefits?
* Have the benefits of this substance been proven to occur in the product being advertised?
*Were the benefits actually found to occur in people like you?

Second, look for confirmation of claims by an independent third party.
* Was the proof obtained as part of an independent effort by a third party?
*Have the results been presented and reviewed by experts in the field through a scientific meeting or publication?

Source: Nancy Green, vice president of Nutritional Products for Tropicana

Case histories

Two case histories presented by Green provide a standard for judging other functional food claims.

Case 1: Homocysteine as a risk factor for heart disease

Homocysteine is associated with an increased risk of coronary heart disease, stroke and peripheral vascular disease. However, folic acid has been shown to lower homocysteine levels in the blood and may reduce the risks posed by this amino acid (American Heart Association, 2000). Tropicana wanted to promote the value of its orange juice, which contains folic acid, in preventing heart disease. To do this, they contracted with the Medical College of Wisconsin (Milwaukee) to conduct a clinical study. The researchers found that daily consumption of orange juice was associated with an increase in folate blood levels and a decrease in homocysteine. The results were presented at the American College of Nutrition meeting in 1998 and then used to provide scientific support for the Tropicana advertising campaign.

 

Case 2: Blood lipid levels and the consumption of orange juice

In 1999, Tropicana wanted to promote the value of its orange juice to raise high-density lipoproteins (HDL; good cholesterol). It contracted with the University of Western Ontario (Canada) to do a study that would address this issue. The researchers found that consumption of this brand of orange juice raised HDL cholesterol by 21%. The findings were then presented during the annual American Heart Association meeting. Tropicana subsequently used these data as scientific support for its orange juice advertising campaign.

Comment

The process followed by Tropicana was complex, costly and time-consuming. It required submitting its product to clinical research to prove that an ingredient in its product actually accomplished in humans what was suggested by earlier research.

It also required it to work with several independent organizations that were not motivated by the need to sell orange juice.

The results offer consumers and health-care professionals information that is more reliable and applicable to their health needs. 

John Russo Jr., Pharm.D., is senior vice president of medical communications at Vicus.com. He is a pharmacist and medical writer with more than 20 years of experience in medical education.

References:

American Heart Association: Homocysteine, folic acid and cardiovascular disease
http://www.americanheart.org/
Heart_and_Stroke_A_Z_Guide/homocys.html.