Food Therapy

Putting a new spin on "Eat it, it's good for you," cholesterol-reducing margarine and eggs infused with heart-healthy fatty acids have arrived in a new category called "functional foods." There are also corn puffs and snack bars containing Ginkgo biloba, an herb thought to boost memory, and vitamin-dusted gummy bears. "It worries me that they are trying to turn junk food into something masquerading as health food," says Marion Nestle, Ph.D., professor of nutrition at New York University.

Functional foods are broadly defined as those that claim, or at least hint broadly at, enhanced health benefits. Included are juice drinks fortified with herbs such as echinacea, said to augment immunity, and ginseng, believed to boost energy. Federal regulations for foods and supplements don't require clinical trials of products whose labels, like these, merely imply health benefits.

Foods that carry specific health assurances, such as disease prevention, are a different matter, requiring testing and approval from the U.S. Food and Drug Aministration (FDA). Quaker Oats, with its claim that it can lower risk of heart disease, was the first functional food to get the green light. Now nearly a dozen such claims have been approved. Some foods, with drug-like qualities, are dubbed "pharmafoods" or "nutraceuticals." They include Benecol, the margarine claiming to lower cholesterol.

Are These Claims for Real? Do We Need These Foods?

As functional foods appear on store shelves, what defines a food, supplement or drug becomes increasingly fuzzy. Where, for instance, should St. John's Wort-spiked juice fit? Classified as a supplement, the herb has been shown to be effective in countering depression. It appears safe for most people, but it has recently been found to reduce the efficacy of some drugs, including an HIV treatment and birth control pills.

While it's unlikely that functional foods and drinks contain enough of any supplement to produce a risk, some of the benefits may be exaggerated, according to Fergus Clydesdale, Ph.D., head of food science at the University of Massachusetts. "It's an open question whether the human body can absorb the active ingredient in the form in which it appears in the product or, if it is absorbed, whether the dose is large enough to be useful," he says.

Critics also ask whether functional foods represent good value for their often greatly increased cost. Benecol sells for $4.99 for 8 ounces as compared to $0.75 for 8 ounces of conventional margarine. If used as directed, it will lower serum cholesterol only by 10%, but add 240 calories of fat to the diet -- extra calories not needed in the U.S., where 22% of us are obese, and 54% are overweight. The drug Lipitor, with risk of side effects, can reduce cholesterol levels by 40% without adding any dietary fat. The least-intrusive remedy is plain old-fashioned dieting: "If you modify type and amount of fat and keep calorie intake down, changing your eating patterns can reduce cholesterol by an average of 10-15%. Eat more fruits, vegetables and grains, less fat," advises Gail Frank, Ph.D., R.D., professor of nutrition at California State University, Long Beach, and spokesperson for the American Dietetic Association.

Food technologists counter that their target market is consumers who already view food as potential medicine, such as those who use honey for a sore throat; in the new tech-food world, people will eat as therapy, and be glad to pay a "nutraceutical" premium. The biotech industry further argues that the poor in less developed countries, who have difficulty in obtaining sufficient vitamins, desperately need functional foods. Biotechnologists have already engineered "golden rice," rich in beta carotene, which can be converted into vitamin A within the human body, and a rapeseed (for canola oil) also high in beta carotene. Although he says biotechnology is one potential way to reduce world hunger, Gordon Conway, president of the Rockefeller Foundation, which is funding the development of golden rice, has also urged caution, warning that, "there are clear environmental risks associated with genetic engineering." And, while clinical trials of vaccines in GE potatoes, bananas and lettuce are underway, scientists are expressing concern about possible contamination of regular food crops via pollen drift and the effects on insects that ingest the drug-laden plants.

Human health concerns about GE foods include the potential for new food allergens, growing antibiotic resistance, and increased levels of Insulin-like Growth Factor-1, linked to some cancers, in rBGH-treated milk. An April 2000 report from the National Academy of Sciences' Institute of Medicine called for a reevaluation of FDA regulations governing the testing and monitoring of genetically engineered (GE) foods. Use of GE animals as "bioreactors" to produce antibiotic eggs or milk with an infection-fighting human protein raises concerns about food safety if these animals enter the food chain after their productive days end.

What's driving all this innovation is industry, not consumer demand, says Margaret Mellon, Ph.D., director of the agriculture and biotechnology program at the Union of Concerned Scientists. "With grocery sales and profits nearly flat, the food industry is hoping to develop a new niche and create demand for these products -- for which they will likely charge a premium price."

Dr. Nestle agrees: "It's not much to do with nutrition and a lot to do with marketing." But Bruce Watkins, Ph.D., Purdue University professor and director of the Center for Enhancing Foods to Protect Health, argues otherwise. Functional foods, he insists, can offer health protection, and hens given feed that enhances the level of desirable omega-3 fatty acids in eggs may provide a cheaper source of these beneficial fats than, say, salmon. Dr. Clydesdale envisions supermarkets with color-coded foods that "correspond with genetic dispositions for chronic diseases, such as cancer, diabetes, and heart disease," and how to calculate precisely the appropriate dose. In other words, shopping could get very complicated.

Impact of Consumer Choice

Functional foods sold $14.7 billion in 1998 in the U.S. and are projected to reach $17 billion by 2001. While annual organic food retail sales have soared from $1 billion in 1990 to the $8 billion projected for this year, consumers are spending more than twice as much on functional foods. Will that choice make sustainable, ecologically-produced food even more difficult to find? Demand drives the marketplace and consumer choices have absolutely everything to do with supply. What we buy today shapes tomorrow's supermarket shelf, so the future of both organic and functional foods ultimately rests in our hands.

Nicols Fox is the author of Spoiled (Penguin, 1998, $14.95) and It Was Probably Something You Ate (Penguin,1999, $13.95).