Health Claims on Your Food

Have you read your groceries lately? Many of them tout reasons why health-minded shoppers should buy them, such as to lower cholesterol, reduce risk of osteoporosis or prevent cancer. Some sport bright red hearts claiming the products are heart healthy. But can you trust such health claims? It depends. There are many different kinds of health and nutrition claims on food packages like cereal boxes, snack bars and soup cans. The merit of a health message depends on the kind of claim it actually is.

“It often can be confusing for consumers, no matter how well-educated they are, to distinguish among the different health-related statements that may appear on food packages,” says Diane McKay, PhD, an assistant professor at Tufts’ Friedman School and a scientist in the HNRCA Antioxidants Research Laboratory. “If it is indeed an FDA-approved health claim, consumers can be reassured that there is scientific evidence to warrant putting the claim on the package.” Such health claims have a standard format you can learn to identify.

TAKE CHARGE!

When you’re grocery shopping, follow these common-sense tips for evaluating food products with messages about disease prevention:

Consider, is it familiar? “If the message is consistent with nutrition information you’ve seen or heard from reliable sources, it’s more likely the claim is scientifically sound,” McKay says.

Put on your reading glasses. The details of health claims are typically in smaller print, so to truly evaluate them, read the entire message.

Comparison shop. Two similar foods that bear the same health claim aren’t necessarily equal. For example, two whole-grain cereals that each display a heart health claim may still differ in important aspects such as sugar, sodium or fiber. Alternatively, two cereals may be similar or one slightly better, but only one may choose to use the claim.

Keep it in perspective. Regardless of how strong a health claim is for a food, it’s just one of many you’ll eat over the course of a day. A single food will not save your health; it has to be eaten in the context of an overall healthy dietary pattern.

Remember that many foods without health claims are healthy, too. “Most foods you’ll see health claims on are packaged, processed foods,” McKay says. “Minimally processed and whole foods, such as vegetables, fruits, legumes and whole grains may not display a health claim, especially if sold loose or in bulk form, but clearly they are some of the most healthful foods you can eat.”

What Is a Health Claim? Although some people may call any type of health or nutrition message on a food package a “health claim,” this isn’t really consistent with the FDA’s definition. Packaged food and beverage labels may carry four general types of claims, which include health claims, qualified health claims, structure/function claims and nutrient content claims. This special report focuses on health claims and qualified health claims, but each type of claim is summarized in “Quick Guide to Claims,” right.

“A health claim is made of two parts: The first part identifies the food or food component about which the claim is made, and the second part is a statement about its relationship with a specific disease or health-related condition,” McKay says. “So, a sign that it’s likely a health claim is when it mentions a condition like heart disease or cancer.”

Although there are several different disease conditions supported by health claims that are pre-approved by the FDA, those related to heart disease are probably the ones you’ll see most often. For example, on oatmeal, you may see: “Smart for your heart! As part of a heart-healthy diet, the soluble fiber in oatmeal can help reduce cholesterol.” However, every product that contains oats cannot make such a claim related to heart health; the products have to meet specific nutritional requirements. “Oat products would be disqualified from making such a claim if they were high in other nutrients that might have a negative effect on heart health, including sodium and saturated fat,” McKay says. Also, the oat products must have at least 0.75 grams of beta-glucan soluble fiber per serving.

Sometimes heart-health claims are accompanied by the American Heart Association (AHA) Heart-Check Mark. Note that the mark itself isn’t regulated by the FDA. However, the AHA has specific, science-based requirements that a product must meet to include this mark and that must be consistent with FDA regulations for making a heart disease health claim. To use the AHA mark, food companies pay an administrative fee, which supports the cost of ensuring compliance, so some opt not to participate.

What’s Behind a Health Claim? Health claims have to be backed by “significant scientific agreement,” as determined by the FDA. The agency assesses the totality of the scientific evidence and may consider viewpoints of qualified experts outside the FDA, if publicly available. For example, this may include the opinion of a federal government scientific body, such as the National Institutes of Health, or an independent expert body, such as the AHA. So, FDA-authorized health claims are not based on emerging science, but rather, something that has been studied for quite a while and about which scientists have a great deal of confidence.

When you see a health claim on a food, you’ll often find a brief, bold statement on the front of the package, such as “Can help lower cholesterol,” with an asterisk linking it to a detailed footnote that’s in smaller print and that meets the FDA’s requirements for how the health claim must be worded. Here’s a closer look at a few health claims so you can get a better idea of how they’re typically phrased on food packages and what’s required to make such statements:

Sodium and Hypertension
Sample claim: Diets low in sodium may reduce the risk of high blood pressure, a disease associated with many factors.
Requirements: The product must be low in sodium (140 milligrams or less per serving or per 100 grams of the food if it’s a main dish/meal).

Calcium, Vitamin D and Osteoporosis
Sample claim: Adequate calcium and vitamin D, as part of a well-balanced diet, along with physical activity, may reduce risk of osteoporosis.
Requirements: The product must be high in calcium and vitamin D (at least 20% of the Daily Value) and
in forms readily absorbed by the body.

Soy Protein and Risk of Heart Disease
Sample claim: In a diet low in saturated fat and cholesterol, 25 grams of soy protein per day may reduce the risk of heart disease. A serving of this soy milk has 8 grams soy protein.
Requirements: The soy milk must be low in saturated fat and cholesterol and have at least 6.25 grams of soy protein per serving.

Spotting a Qualified Health Claim: While health claims are pretty straightforward, qualified health claims are a bit trickier. Although these also describe a relationship between a food or food component and a disease or health-related condition, the evidence does not have to be as strong for a qualified health claim. The science on which it’s based must be credible but may be emerging, incomplete or inconsistent. Because of this, such claims must be worded in a way that doesn’t mislead you about the strength of the evidence.

There are many qualified health claims that have been reviewed by the FDA and that can be included on foods and dietary supplements. These claims cover a range of health concerns, such as cancer, heart disease, cognitive function and type 2 diabetes. The FDA reviews the evidence for a qualified health claim when a company or organization petitions the government to do so.

One of the more common qualified health claims you’ll see is about nuts and heart disease. For example, on a jar of lightly salted peanuts you might find: “Scientific evidence suggests but does not prove that eating 1.5 ounces per day of most nuts as part of a diet low in saturated fat and cholesterol and not resulting in increased caloric intake may reduce risk of heart disease.” Did you notice the disclaimer, “but does not prove” in the first part of the claim? This “qualifier” tells you that while there’s some evidence for the claim, it’s limited and lacks the “significant scientific agreement” required for a regular health claim.

Although the disclaimer “but does not prove” may give you pause, some disclaimers required by the FDA are even stronger and hint that the claim is even weaker. For example, if you saw a disclaimer as part of a qualified health claim that said, “The FDA has concluded that there is very little scientific evidence for this claim,” you would rightly conclude that whether or not the food actually can decrease risk of the specified disease is really uncertain. So, don’t overlook these disclaimers—they give you important clues. Because of the uncertainty, wordiness and sometimes negative tone of the claims, some companies choose not to use them at all.

Although FDA-regulated health claims and other claims on your food can be informative and may help you make healthier choices, they do make your job as a savvy consumer more challenging since the level of scientific evidence that supports them varies. Being aware of this can help you better determine whether you should put the product in your grocery cart or leave it on the store shelf.

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