Functional Foods: The Lines Have Blurred

The line between food and medicine has blurred considerably in the last two decades. Today our grocery aisles are flooded with foods that promise health benefits beyond their basic nutritional value. These benefits range from memory lapses cured by herbs, to digestive disturbances cured by beneficial bacteria (probiotics), to heart attacks prevented by plant sterols. In between there are thousands of products that claim to promote health or prevent disease.

The market for these so-called "functional foods" has become one of the fastest growing industries in the US. Already a multi-billion dollar industry, experts predict annual growth rates of 7% or higher for the functional food market, but no one dares predict how far this new wave may carry us. The red wine "pill" has already been developed, and some researchers already foresee the day of edible vaccines.

While the trend is certainly good for the health of processed food manufacturers, environmentalists and health policy experts worry that as the clamor for functional additives provide a slippery slope for more genetically modified foods. Nutritionists and scientists also see hazards for the consumer that may outweigh the benefits. Chief among them is simple safety.

Regulatory authorities around the world tend to be years behind the companies introducing these products. Our own FDA requires nutrition facts only for those substances with FDA daily values, such as vitamin A or calcium. Amounts of ingredients such as omega-3 fatty acid and probiotics are not regulated, so consumers can't know how much they should be ingesting, but manufacturers are not required to disclose how much or little they are putting in their foods.

Another concern is the possibility of overdose, or hyper-vitaminosis. The combination of taking multivitamins and also consuming fortified nutrition bars, health drinks and cereals may be too much of a good thing. Vitamin A, for example, is required at low doses, but may be toxic at levels only 10 times those required to prevent deficiencies.

Studies have suggested that long-term intake of a diet high in vitamin A may promote the development of osteoporotic hip fractures in women.

(1) The Harvard School of Public Health (HSPH) has also warned about consuming too much folic acid from food. The HSPH doesn't suggest we give up our daily multivitamin-multimineral supplement, but that we avoid heavily fortified foods that deliver a full day's dose--or sometimes more--of folic acid.

(2) The most basic concern, however, is that these new prescription foods might encourage consumers to switch from a diverse, healthy diet to a basically unhealthy one - with an increasing reliance on functional: additives or modifications. The front package claim, "Fortified with essential vitamins and minerals," on products like breakfast cereal and drinks can be a powerful distraction from the fact that these products often contain high amounts of sugar. While enriched or fortified foods can make significant contribution to nutrient intakes, they do not have the same nutritional benefits as the whole foods for which they substitute. The whole food will always be superior.