The term 'functional foods' is not a standard nutritional term in nutrition textbooks. Regulatory agencies and professional associations of nutrition scientists and dieticians all use different definitions. ILSI Europe, an industry-sponsored forum in which representatives from industry, academia and government address nutrition issues, proposed a definition which in abbreviated form runs:
A food can be regarded as 'functional' if it is satisfactorily demonstrated to affect beneficially one or more target functions in the body, beyond adequate nutritional effects, in a way that is relevant to either an improved state of health and well-being and/or reduction of risk of disease.
More concise definitions are 'foods that provide a health benefit beyond basic nutrition' or 'foods that have health benefits beyond the traditional nutrients provided'. Examples are soy, garlic, and green tea. What these definitions do not include is the link with the food industry, which uses health claims to market functional foods. An alternative definition could therefore be 'a food which claims explicitly or implicitly to improve health or well-being'.8
Functional foods that are marketed with claims to reduce heart disease focus primarily on the risk factors of blood cholesterol, homocysteine and hypertension. This can be done by a reduced content of food components that are known to increase risk, such as saturated fat or sodium. More recently products have been designed that are enriched in components that are thought to reduce risk. The most common 'protective' ingredients include fibres, soya, omega-3 fatty acids, phytostanols and phytosterols, and (antioxidant) vitamins. These components have cholesterol or homocysteine-lowering abilities in metabolic studies. The added ingredients may be food components that are often deficient in Western diets, such as calcium and folate. Their recommended intake could, however, be achieved by 'normal' foods. The added ingredients may also be nutrients or phytochemicals that are normally not ingested in effective amounts because natural food sources of these ingredients are scarce or not part of out diet. Examples are phytosterols or probiotics. Examples of functional foods include soya drinks, eggs enriched with omega-3 fatty acids, margarines with plant sterols or stanols, and vitamin-enriched cereals.
In this chapter a distinction will be made between functional foods that help consumers adhere to dietary guidelines and functional foods that offer novel ingredients with claimed or suggested health effects.
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