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January 22, 2001
In the Mix
Are "functional foods" valuable and safe?

keep bumping into them on the shelves: Strange foods I've never seen before. Mixtures of cholesterol-lowering compounds in margarine. Concoctions of calcium in cereal or orange juice. A sprinkling of echinacea in soup. Drinks laced with kava kava or ginkgo.

Ounce of Prevention


By Elizabeth Smoots, M.D.

The American Dietetic Association (ADA) says they're all part of a promising new trend in the food industry called functional foods. Also termed designer foods or nutraceuticals, these products contain natural or added substances that purportedly provide health benefits beyond the ordinary level of nutrition.

Edibles that correct dietary deficiencies -- for example, iodized salt and vitamin-D-enriched milk -- have been around for generations. Functional foods take it one step further, asserts the ADA, and strive toward disease prevention, energy enhancement, and the nebulous goal of optimal health.


As for products spiked with herbal additives -- which may have drug-like properties -- it's anyone's guess how much you can safely consume or if they could interact with your medications.


Linking diet and disease

I suspect recent research advances are fueling growth of the $16-billion-a-year functional foods industry. And, according to a survey conducted by the International Food Information Council, 86 percent of Americans want to learn more about the nutritional benefits of these foods.

Sifting kernels of truth from the chaff, dietary experts have found solid evidence for the health-promoting qualities of some nutraceuticals. For example, studies have shown phytochemicals in fruits and vegetables can help prevent cancer. Folate-enriched cereals reduce the risk of birth defects. And isoflavones in soy products help lower cholesterol. Products containing ingredients with a strong scientific link to a particular disease may be labeled with a Food and Drug Administration (FDA) approved health claim.

But many so-called functional foods make dubious claims. For instance, there is no direct evidence that snack foods with added echinacea support your immune system or beverages containing antioxidants enhance normal heart function. Nevertheless, manufacturers are frequently allowed to make claims like these without any documented proof or prior FDA approval, as long as they print the following disclaimer: "This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, mitigate, cure, or prevent any disease."

A dearth of regulation

Worse yet, regulatory loopholes in food-supplement law may permit the sale of functional foods that are unhealthy for you, or even downright hazardous. Some nutraceuticals contain excess fat, sugar, or salt. And functional foods that are treated as supplements -- rather than as foods -- are mostly unregulated and therefore may be tainted with contaminants or toxic substances.

As for products spiked with herbal additives, which may have drug-like properties, it's anyone's guess how much you can safely consume or if the herbs could interact with your medications. Believe it or not, the FDA does not even require that listed ingredients must actually be present in some functional foods. So buyer beware -- what you see may not be what you get.

In response to these concerns, the Center for Science in the Public Interest (CSPI) has filed a complaint with the federal government citing many examples of potentially hazardous products. The CSPI is urging officials to stop manufacturers from making false claims and selling functional foods with unsafe ingredients.

Until these problems get sorted out, I recommend that you take a few precautions.

  • If you want to use functional foods, first try the active ingredients plain and simple -- like in a conventional food such as tofu, or as a vitamin pill or herbal supplement -- before consuming them in a mixture.
  • Carefully research each new nutraceutical product.
  • Buy only brands made by a reputable company.
  • Check with your doctor to make sure your choices are compatible with your medications and with any health conditions you have.

Lastly, I'd like to point out that many functional foods are essentially processed foods containing food additives. For optimum health, your diet should emphasize whole foods like fruits, vegetables, whole grains, and beans, which naturally contain nutrients that protect against disease. Try as we may, it's not easy to improve on Mother Nature's own blends.

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Elizabeth Smoots, M.D., F.A.A.F.P., is a board-certified family physician in Seattle, Washington. A fellow of the American Academy of Family Physicians, Dr. Smoots specializes in prevention and primary care medicine.