thanks to bob phelps for this discussion of the medicalisation of food - an issue of great relevance given the biotech industry's desperate quest for GE products with "consumer benefits".
The twilight zone: Medicalising the food supply
Drugs or Dinner: Marketing Functional Foods
Produced by Stan Correy
ABC Radio National Sunday 30/09/01
Stan Correy: Think about it: fish oil in ice cream; it increases your memory. Broc-o-bites, that's broccoli in a pill; wood chips or cholesterol lowering plant phytosterols in margarine; all part of the wonderful 'healthy' world of functional food and nutraceuticals.
Man: My father died young, and when I found out I had a cholesterol problem I just thought, Well, I'm not waiting around for it to happen to me. So I started using Flora Proactiv which actually reduced my cholesterol absorption. With Flora Proactiv I'm down from 6.5 to 4.5 in just three weeks. Now I can do anything I've been wanting to do for years.
Woman: Flora Proactiv, actively reduced cholesterol absorption.
Stan Correy: Hullo, I'm Stan Correy and you're with Background Briefing on ABC Radio National. And no, the ABC isn't accepting sponsorship from food companies.
But in today's program you'll be hearing more ads like the one from Flora Proactiv margarine from Unilever. It's a functional food because it claims you'll get a specific health benefit if you eat it. It contains cholesterol lowering phytosterols, or plant sterols.
That ad is aimed at people like me, health conscious baby boomers worried about their lifestyle diseases. High levels of bad cholesterol has become one of the biggest health issues in the Western world in the last few decades, and at the same time we're eating more and more processed and refined foods.
When food companies see baby boomers, they see dollars. But the companies have a big problem: baby boomers are a sceptical bunch and won't succumb to just any old hype.
Editor of the English magazine, New Nutrition Business, Julian Mellentin.
Julian Mellentin: Functional foods are an absolutely revolutionary concept. What's happened is over the past 20 years there have been very well accepted guidelines that your local dietitian, your doctors, practice nurse could tell you about, that constitute what is healthy eating. So eating fruit and vegetables and whole grains, reducing your consumption of saturated fats. What the food industry has done is it's moved on from that, and it's used science to develop foods which are basically magic bullets. Whereas advice from the past has been if you have a healthy diet and healthy lifestyle, that contributes to managing your health overall, the message now is Consume this food, this cholesterol lowering food, and that will lower your cholesterol and reduce your risk of heart disease. So that's a big difference from advice about consuming a range of foods.
Stan Correy: What's happening now in the food industry, says Julian Mellentin is food is being 'medicalised'.
Julian Mellentin: It's just very similar in effect, to suggesting to people that they take a drug, and what's very interesting is that a number of the companies who are selling cholesterol lowering table spreads for example, like Unilever with Flora Proactiv, are actually doing scientific work to show that people who have elevated cholesterol who are taking drugs, statin drugs to reduce their cholesterol, if they also eat cholesterol lowering margarine at the same time, that actually works in support of the drug. So you have this interesting situation where you have a food which has a drug-like effect, but is actually sold in your regular supermarket alongside regular margarines, and it's sold outside any kind of pharmaceutical regulation. And that's obviously a concern for the pharmaceutical industry who I think are keeping a wary eye on this area, and we see a number of pharmaceutical companies trying to enter the field of functional foods.
Stan Correy: So the days of an apple a day to keep the doctor away are over, because the food companies have to move on from apples to make new profits. To give credibility to their new products, they use scientists, doctors and people from the legal professions to spruik for them.
This is ex-magistrate Barbara Holbrow in an ad for cholesterol lowering margarine.
Barbara Holbrow: In law, you study the evidence carefully and stick to the facts. Before I agreed to speak about Logicol spread and cholesterol, I did the same. Just three to four serves of Logical a day will reduce the cholesterol you absorb from everything you eat. It's proven beyond reasonable doubt, which makes your decision easy.
Voiceover: Reduce your cholesterol absorption the Logicol way.
Stan Correy: Logicol is made by Australia's biggest food company, Goodman Fielder, one of the many reinventing itself as a health conscious company.
They started with Logicol margarine, but then decided that what was good for margarine must also be good in muesli bars, yoghurt and salad dressing. The trouble was they had good evidence to support their margarine product, but had relied on what's called 'post market approval' for the others. In June, all those other products were ordered off the supermarket shelves.
ANZFA, the Australian and New Zealand Food Authority, is the government authority that regulates food safety. It decided Goodman Fielder had failed to meet the safety requirements of the recently introduced Novel Food Standards.
What happens in Australia is closely watched elsewhere in the world
Julian Mellentin: Well Australia makes a great test market for lots of companies, because it's a fairly Westernised country with a Westernised diet, but it is physically isolated, and therefore you can try out a product there, you can work perhaps just in two or three big cities, and not have any risk of overspill into your main markets back home in Europe or the United States. And Australians are also very innovative when it comes to food, and like to try new tastes and new ideas, and are prepared to experiment with new brands. Which is a harder thing to do in other countries, parts of Europe like Italy or Spain for example, where people have more conservative food culture.
Stan Correy: Enter the world of food science and food marketing and you find yourself behind the supermarket shelves in a drama of high passions. At one end it's about money. Governments have largely pulled out of funding independent scientific research and expect industry to do it. And regulators, they're under-resourced and have too many hot issues to handle. At another end, it's a very important public health issue, and it's not only about cholesterol. Obesity, for example, is now causing liver problems in children as young as four, and in older people it is not only linked to heart disease, but to several other serious illnesses.
Public health nutritionists say it would be much better to promote an all-round healthy diet, with people eating more fruit and vegetables, than to medicalise processed foods. If we did that, levels of obesity would go down, along with cholesterol levels, but there's no new money to be made out of people eating fresh foods.
The move to medicalise foods is compromising independence in science, and it's confusing consumers.
At Deakin University, nutrition scientist, Mark Lawrence.
Mark Lawrence: Historically we saw a relationship where the messages from nutritionists were around concepts such as a balanced diet, you know, enjoy a variety of foods, those sort of messages, and now increasingly we're seeing the messages of specific nutrients, look for specific foods for specific health effects. Or for reducing specific risk factors. Some people talk about this as being a medicalisation of the nutrition message, and so the nature of the relationship and the messages that are being communicated has changed quite substantially.
Stan Correy: And does that medicalisation therefore lead into if there's a specific nutrient that we know is in a carrot or in an orange, that can be kind of medicalised into a particular product? Is that what you mean?
Mark Lawrence: The approach is to say 'We will isolate that particular nutrient or active ingredient and then we'll concentrate it down into a form, and then we will add it into a novel food, a food that has no traditional use, and because we have isolated it and concentrated it, it might have some extra physiological capacity in the body', or what have you. And this is central to the whole concept of functional foods. And there is a great concern that we are distorting the sort of messages that are now getting out there. One of the implications that I personally am concerned about is it's almost as if the average consumer now needs a nutrition degree just to shop in the supermarket.
Stan Correy: Mark Lawrence is so concerned about conflicts of interest and bias in the regulation of food standards, that when interviewed just over a week ago, he said he had just stepped down from the Food Standards Committee at the Dietitians' Association of Australia.
Mark Lawrence: Basically I resigned today, because I found the situation untenable. Myself and the other public health nutritionists, we couldn't feel confident that the public health was going to take precedence over other dimensions.
Stan Correy: Mark Lawrence says the Standards Committee is not able to be vigilant enough because it is dominated by food industry representatives.
Mark Lawrence: I think there's a potential for a conflict of interests. I mean the particular committee I'm referring to is a Dietitians' Committee and dietitians are perhaps the best experts to advise people on food and health, yet this one particular committee, this Food Standards Advisory Committee, eight of the ten positions on it, the people are linked to food companies, and so you have to wonder about does a situation become untenable, and the two public health people who were involved on that committee find that constantly when there's an issue of controversy, they simply get outvoted.
Stan Correy: The President of the Dietitians' Association, Peter Williams, rejects the criticism. He says the very committee that Lawrence was on approved of ANZFA's decision to withdraw Goodman Fielder's functional food products in June. But he does agree with Mark Lawrence that there is increased pressure on nutritionists and dietitians because of the trend to medicalise food.
Peter Williams: I accept that. I mean I think our advice once upon a time was fairly straightforward when you look at the Dietary Guidelines, it was to have a varied diet, and to have lots of cereals and fruits and vegetables. And many people want to keep giving that advice, and that's obviously important advice for the general public. But the food supply is changing, and there's no doubt as science changes and technology changes, we're getting more and more modified foods in the diet, and we need to be able to give advice to consumers who are seeking professional opinion about those foods as well.
Stan Correy: As the public sector has dried up, more and more nutritionists now work for private industry. And so they too get caught up in the corp-speak jargon as they do the work of finding, and then getting clinical trials of ingredients that are added to foods. And then getting those ingredients certified safe. The international stamp of approval for a new food ingredient is GRAS, or G, R, A, S: Generally Regarded As Safe, much like potatoes or oranges, or rice. But functional or novel foods have pressured regulators to make special new standards to assess the safety of ingredients. Once they get past these, then the real fun starts. Now it's all about health claims.
New Nutrition Business Magazine has a list of new products each month, and the variety of foods and beverages and what they promise is mind-boggling. Here's a reading of a small selection from the magazine.
Orange flavoured powdered drink mix has been added to the heart bar line. If you have heart disease, take two servings of heart bar orange flavoured drink per day to feel a difference within two weeks. Use under the supervision of a physician. Listed ingredients include l-arginine, citric acid, soy isoflavins extract, betacarotine and Vitamin B12.
Nutra loops is specifically designed for children 12 months and older. Sweetened with real fruit juice, Nutra loops is an excellent source of 12 essential vitamins and minerals, including Vitamin C, iron, B vitamins, Vitamin E, zinc, folic acid and niacin, all essential vitamins and minerals for a child's growth and development. A no-mess snack, Nutra loops encourages hand to mouth co-ordination.
Simply Nutritious is a new range of functional drinks comprising mega green and mega antioxidant, which offer a combination of nutrients in a convenient drink format.
New Vita ball vitamin gum balls are promoted as a whole new way to take your vitamins. Targeted towards kids, the gum balls are distributed in a 36-count plastic tub. Literature for the product states, 'Vita ball, the vitamin gum ball uses patented gum ball technology to deliver 100% RDA of 11 essential vitamins in a fun and great tasting gum ball you'll love as a kid, a teen and beyond. Just five minutes of chewing provides the vitamins needed each day.'
Stan Correy: So even soft drinks and biscuits and sweets are being medicalised. Julian Mellentin calls it Death Marketing, and says this mixing of food and drugs is altering the market strategy of food companies all over the world.
Julian Mellentin: The single biggest risk that functional foods face is consumer cynicism, brought about by an excess of unsubstantiated health claims, and it's interestingly, although a lot of products are backed by very sound science, what you find is once that science gets from the R&D department to the marketing department, the marketing department is interested only in trying to leverage that science as much as possible to maximise sales, and that's the point at which the risk arises. I think what we might see for the next few years is food marketers continuing to rush down the route of what we call Death Marketing, using heavy claims, very aggressive scientific promotion, and finding as many of them such as Nestle and Kellogg have already found with their products, that consumers are cynical, it doesn't always work and then the fashion will pass by, and hopefully we'll settle down to a much more calm and rational way of communicating health benefits to consumers.
Stan Correy: Consumers are confused, and the messages nutritionists are trying to get out are compromised by these new campaigns. Australian nutritionist, Dr Rosemary Stanton, isn't enthusiastic about the health claims of functional foods. She calls it 'disease shopping'.
Rosemary Stanton: So you have the breakfast cereal that was good for your heart and the one that was good for your bowels, and the one that was good for your bones. Now if you care about your bones, you heart and your bowels, then what on earth do you buy? You'd be in a quandary, and I think that this sort of disease shopping is really making a lot of people confused. Yes, they're interested in health, but every survey says people are getting more confused, and I see the issue of functional foods confusing them even more. We really know that what people need to do for a healthy diet, is to eat more fruit and vegetables or to eat more whole grain products and to eat less of almost everything that comes in a packet.
Stan Correy: So is that one of the issues for the nutritional community that the functional foods area is perhaps getting in the way of the whole diet message?
Rosemary Stanton: I think it may backfire, in that people are certainly interested in nutrition, but they are confused, and when they start getting all these different products for different bits of the body, I think that they might say 'Look, it's all too complicated, I'm just going to go off and have a hamburger.'
Stan Correy: One of the hottest functional or novel food ingredients on the market at the moment is fish oil. You'll have seen it mentioned everywhere. The magic ingredient is the Omega 3 long chain polyunsaturated fatty acids. One of these acids, DHA is said to cure everything from depression, blood pressure, heart disease and autism. Our food regulator is currently looking at an application to put DHA from marine algae into infant formula.
It's true that numerous scientific studies over many years have proved Ted Egan: health benefits of eating more fish, but now they're going to put the goodness in fish into ice cream. An American firm, Arthur D. Little, has in fact done that.
But Radio National's Background Briefing team has done its research, and found that fish in dairy products happened first in Australia, 25 years ago.
The founding father of functional foods in the world was Aunty Jack.
Gary McDonald as Terry Dutton (1974)
Steady on, steady on... The ladies from the canteen have asked me to make an announcement... Hey, give us a go, give us a go. Why don't you try the new taste sensation plucked from King Neptune's depths and brimming with bovine goodness? When you wake up in the morning feeling RS, come on down to the canteen and try the marine flavoured dairy product, Captain Curd's Fish Milkshakes. - Oh geez, that sounds alright. Remember Curd's rhymes with Birds.
Fish Milkshake jingle:
Walkin' with my baby got a thirst on my mind I love my little dish I just wish I could give my dish a Fish milk shake, get a fish milkshake Fish milk shake, get a fish milkshake Oooh ooh fish fish, ooh ooh shake shakeS etc etc
In 27 different flavours: Smoked eelS
Stan Correy: Failed functional food entrepreneur, Aunty Jack of Wollongong. It's ironic that the University of Wollongong has a very serious nutrition research institute called the Smart Foods Centre.
There's another market niche for these food companies, those people who don't have time to eat at all. Well, do they have a product for you: nutraceuticals.
Julian Mellentin: The term nutraceutical is often used interchangeably with functional foods. It's a slightly strange word, a combination of nutrition and pharmaceutical. That's used less and less to refer to foods, it's mostly used to talk about vitamin pills, supplements, that kind of thing, and you'll find that the food industry itself primarily uses the term functional foods.
Stan Correy: Editor of the English magazine, New Nutrition Business, Julian Mellentin.
In some ways, nutraceuticals is just the old vitamin and herbal supplements industry given a new name. It's gone so far the Japanese are impregnating clothes with vitamins. For about $160 you can get a T-shirt impregnated with Vitamin C. The claim is the vitamin will rub off on your skin and be absorbed into your body.
Till they come on the market here, we'll just have to take the pills. Australian pharmaceutical company, Herron, has recently launched itself into the nutraceutical market with products called Mydaily, so you have Mydaily fish in a capsule, Mydaily meat in a capsule, veggies, fruit in a capsule, and dairy in a capsule.
Man: And if there's a food I don't get enough of, I take Mydaily, to help make up for it.
Stan Correy: We need the vitamins and nutrients these real foods give, but with the Aussie bloke and his barbie, who has time for cooking vegetables?
Man: I don't get enough veggies.
Woman: Mydaily from Herron, the key nutrients from the foods you don't eat daily.
Stan Correy: It's the growth of this kind of nutraceutical industry that is forcing traditional food companies like Goodman Fielder into competing with more and more new functional foods.
Goodman Fielder last month announced the appointment of two high fliers in the food world: Dr Geoffrey Anisson, a former spokesman for the food industry lobby group, The Australian Food and Grocery Council, and Mark Barr, to their research innovation and marketing division.
Background Briefing contacted Goodman Fielder for an interview with Mr Annison or Mark Barr, the new boss of marketing. Goodman Fielder declined our request for an interview.
Traditional food processing companies like Goodman Fielder have to get involved in the new health conscious food trends, or be left behind. They have a problem, however. Functional foods position themselves somewhere between a food and a drug, and the companies have to invest a lot more time and money in R&D to protect themselves from the image of snake oil spruikers.
Industry economics consultant, David Michaels.
David Michaels: A major player like Goodman Fielder just simply has to get involved because just by definition they're going to lose market share in the food market if a key segment in it stars growing much faster than what they are in, so it's inevitable that they be in there. But I think it's going to also be more challenging in terms of developing greater focus with a greater technical knowledge about the actual underlying relationship between particular foods and the nutrients within them. So again you're starting to play at the edge of pharmaceutical-type research, the R&D at the bottom. I would anticipate this type of thing would push Goodman Fielder's R&D budgets up, they'd need a much higher commitment than what they probably have had in the past to R&D to be an effective, long-term
player in this area.
Stan Correy: What you mean by that is that if they're going to get into this food which has extra value by particular nutrients, then they're going to have to invest similar amounts of money in research, scientific research, to back those products.
David Michaels: Exactly, I think that because one of the areas that's still being played out in this, goes back to the snake oil thing, is just establishing the veracity of the research. You want to go back probably a bit further to substantiate that research, get hold of that knowledge, and then to pack it into products so you've got something very substantial to differentiate yourself from another product.
Stan Correy: The most significant functional food in Australia in the past 18 months has been cholesterol lowering margarine, produced by multinational companies like Unilever and Goodman Fielder.
The companies' consumer research indicated they were on a winner. People don't want to give up their delicious spreads, but they do want to lower cholesterol. These new margarines lets you have both.
It's interesting to survey functional food ads in general, with this consumer desire to eat the cake and stay slim too in mind. These foods carefully target the desired demographics, the baby boomers. Lots of ads say certain foods will help you stay slim. None say just eat less and exercise more, or if they do it's in very fine print on the package.
Ironies and double sided messages abound on TV; no wonder people are confused. After an ad for a luscious pizza, which was stacked with saturated fats in the cheese, and also very fattening, came this scene from The Simpsons
News Presenter: Tonight on Smart Line: I'm OK, you're too fat, here's your host Kent Brockman.
Kent Brockman: Good evening. Did you know that 34-million American adults are obese? Taken together that excess blubber could fill the Grand Canyon two-fifths of the way up. That may not sound impressive, but keep in mind it is a very big canyon.
Homer Simpson: This sucks. Where's that channel changer? (struggles, but is too obese to reach) We'll give it a chance.
Kent Brockman: Americans have grown up with the image of the jolly fat man: Dom De Louis, Alfred Hitchcock, and of course, Santa Claus. But in real life, Santa would be suffering from gallstones, hypertension, impotence and diabetes.
Stan Correy: And so Santa dies, after eating too much vitamin enhanced fruit cake. But someone, somewhere is working on a functional food that could have given him a few more years happily eating highly processed food.
A referee works hard to earn the trust of players, coaches and fans. They must never doubt that you stick to the facts and tell it straight. I agreed to say the following about Logicol and cholesterol because nutritional research has proven it to be true. Just two to three serves a day of any foods from the Logical range will reduce the cholesterol you absorb from everything you eat. Now with a fact like that, there's only one decision you can make. Reduce your cholesterol the Logicol way.
Stan Correy: Early this year was a time of high activity in the functional foods sector. Everyone was supposed to be getting ready for June 16, the day the Novel Food Standards code was to be implemented. All functional food products would have to pass these new standards.
The food regulator, ANZFA was also having its legislation rewritten and Senate Committees were discussing amendments. In February, our food regulator shocked the food industry by stating it wanted to ban the use of sterols in food products like margarine, muesli bars, milk, salad dressing and other products. Companies like Unilever and Goodman Fielder had been marketing them as cholesterol lowering products for over 12 months, expecting regulatory approval. Goodman Fielder started an intensive lobbying campaign in the media and among parliamentarians to stop ANZFA interfering.
At times like this rhetoric and accusations are thrown about with vigour. The food industry calls consumer groups 'tree hugging food police'. The consumer groups label the food industry 'junk food merchants'.
The debate about cholesterol lowering plant sterols got a good run in the general media, and the medical journals covered the technical side.
The conflict between Goodman Fielder and ANZFA was also closely watched in the global market.
Julian Mellentin: And at one point there were more products containing sterols, more products claiming that they could reduce your risk of heart disease, on sale in Australia than any other country that we were aware of. There were two milks, a cereal bar, two table spreads and those are just the things I can think of off the top of my head. Now what was interesting was that the companies behind the table spreads had demonstrated to the satisfaction of ANZFA, Australia New Zealand Food Authority, that the products were both safe and that they worked. So they'd done their correct safety and efficacy studies. What seems to have happened next is that sterols were added, as I've said, to a whole range of foods, and ANZFA turned round and questioned this and said, Can you show us the safety and efficacy studies you've done on all the other foods? Because of course for the science to be good, you actually have to show the effectiveness of the individual product, you can't create one product and then generalise the results to all other foods.
ANZFA gave them several months to actually come back with that, and it turned out that the big companies hadn't done their homework. They weren't able to demonstrate the safety and efficacy of plant sterols in a broader range of foods. Now there's no suggestion actually that they're not safe, and there's no suggestion that they don't work, but rather irresponsibly, they hadn't done the homework to show that that was the case. ANZFA very reasonably took the point of view that the products should be taken from the market until those studies were forthcoming, and that is effectively what happened in June of this year.
It's unlikely that, I suspect, that the safety and efficacy work will be complete for another 12 months, so until I think the middle of next year Australians are just going to see the table spreads, Logical and Flora Proactiv on the market, those have been proven to work and to be entirely safe. It'll be some time before the safety and efficacy of the other products is proven. But it's actually put up a red flag for the food industry, because the marketers, keen to capitalise on the science, will try to rush other products to market in other parts of the world, trying to build on the experience they had in Australia, and now they've all kind of slowed down and they've realised they're actually going to have to do the scientific homework to demonstrate the safety and efficacy of their products before they create the mega markets that they were hoping for.
Stan Correy: And multinational companies like Unilever did use the success of selling their novel margarine in Australia in their English advertising. Flora Proactiv they claimed was 'big news' in Australia. But it got them into trouble with the UK advertising standards authority. In a bitter dispute about whose margarine lowers the most cholesterol, Unilever and another multinational, Johnson & Johnson, complained about each other's advertising. The advertising standards authority ruled against both companies, stating they'd exaggerated how much the margarines could lower cholesterol.
Why functional or novel foods are causing so much angst for food regulators and food companies is that they have no long-term history of use in the community. The food companies armed with their scientific studies can't understand the caution of the regulators.
Ian Lindenmayer is Head of Australia's food regulator, ANZFA.
Ian Lindenmayer: I think one needs to think about novel foods in the context of what's happening in the food industry worldwide. New technology is coming along at an unprecedented rate that's producing new techniques for making foods, and GM is perhaps the most topical one at the present time. It's also producing different sorts of foods, foods with ingredients that have either not been in the food supply before or which perhaps have been in the food supply at only very low levels before. And also we are seeing ever-increasing numbers of foods that have been traditional in other people's diets moving into our food supply.
The position we start from as the regulator, is that food must be safe for human consumption, and most of the foods in the food supply we regard as GRAS, that stands for Generally Regarded As Safe, because they've had hundreds of years, thousands of years of traditional use. Novel foods are foods that have not had that long period of traditional use in our environment.
Stan Correy: Consumer groups and some nutritionists welcome ANZFA's decision to take Goodman Fielder's products off the shelves in June. Others weren't so happy. Professor Paul Nestel, from the Baker Institute in Melbourne, and Dr Peter Clifton from the CSIRO had been doing research on plant sterols for Goodman Fielder. They say ANZFA over-reacted.
Peter Clifton: Most people assumed in fact the margarines had been withdrawn as well, and were quite worried about whether they should stop eating their margarine because of this concern. So the whole thing was handled rather poorly in the sense that it wasn't really made clear that these other foodstuffs were not allowed; it was because of the anxiety about very high levels of sterols. It's obviously very difficult under any circumstances to suddenly say a food that has been in the marketplace, people have been consuming, has now suddenly to be removed. So even if you say Look, it's not because there's anything wrong with this food, it's just because if you ate it along with everything else, we're worried. But then on the other hand, to say sterols are safe, and we've got no evidence to say they're unsafe. The two things don't fit together easily, so it's always going to be difficult to make that kind of decision.
Stan Correy: As mentioned, Radio National's Background Briefing asked Goodman Fielder for an interview about its new ventures in the functional food market. Goodman Fielder declined to talk to Background Briefing.
Earlier this year, the company complained of unfair treatment by ANZFA, in a submission to a Senate hearing. They claimed that ANZFA had not given them enough time last year to prepare their application in to meet the June 16 deadline this year. This is a reading from the Goodman Fielder submission.
Goodman Fielder is undertaking additional safety and efficacy studies and urging ministers to find a way around the impasse at their meeting in May. It has been both time consuming and expensive to have to resort to these measures when there would have been plenty of time to carry out whatever was necessary if ANZFA had not taken six months out of the process. This example shows that the current system is extremely inflexible and lacks basic mechanisms to cope with difficulties that should be simple to fix.
Stan Correy: ANZFA defends itself and says it wasn't unfair to Goodman Fielder.
Ian Lindenmayer: I don't believe that we need to change the approach we are now following, which is one which is very open to innovation, but which is not prepared to have companies innovating at the expense of the population. Our primary statutory duty is to protect public health and safety, and where a food doesn't have history of safe use, we owe it to the Australian population to ensure that due scientific testing has been done to confirm that safety.
Stan Correy: Again, what happened was highly significant, and was being watched by the food industry around the world.
Ian Lindenmayer: In my talking with heads of regulatory agencies overseas, there's a common theme that some companies will target one particular regulator on one particular product and another on another in the hope that there can then be some ratcheting off each other. Now that's not a bad thing at all, provided the regulators are robust in their safety assessment of products prior to their being permitted onto the market.
Stan Correy: And do you think then, looking at criticism you might get from consumer representatives that you're under pressure to be more responsive to the food industry because of the commercial pressures of developing Australian industry?
Ian Lindenmayer: Well we are certainly under those commercial pressures, that's true. But we have a statutory duty that we take very seriously, to put the protection of public health and safety at the very top of our priorities.
Stan Correy: To repeat, it's known that plant sterols in margarine are good for reducing bad cholesterol levels in middle-aged and elderly people. The clinical trials have been done for that. But the margarine still has to carry an advisory warning that these products are not appropriate for pregnant women, infants, or young children. Some nutritionists, like Dr Rosemary Stanton, says the whole concept of medicalising food is fraught with problems.
Rosemary Stanton: Because although these plant sterols reduce cholesterol, because they take the cholesterol out of the body and stop it being absorbed, they also take out some fat soluble vitamins and they take out compounds called carotinoids. Now the research is still pretty much in its infancy, but at this stage the data we have suggests that these carotinoids have very important anti-cancer properties. Now in public health terms, if you take something like plant sterols, you put it in the milk, the bread, the breakfast cereal, the salad dressings, biscuits, soups, a whole range of different products, and you then feed these products to somebody like a child who doesn't have a cholesterol problem anyway, but they are going to be deprived then of these valuable carotinoids which may protect them from cancer 25, 30 years down the track. So we'd have to know absolutely for sure that these things were entirely safe and we simply can't do those kind of studies. So I think we need to tread very carefully.
Now if there are people, if you've got somebody who's 65 and they've got high cholesterol and they're at high risk of having a heart attack, then the plant sterol products might be very good for them. In that case, why not put the plant sterol into a pill so that they can take it, rather than putting it in the whole food supply and possibly causing future health problems for everyone.
Stan Correy: And Stanton isn't convinced that just carrying out clinical trials on these new ingredients solves the problem of safety. To Rosemary Stanton some food additives, like the good bacteria, acidophilus in commercial yoghurt, probably doesn't do any harm. But adding sterols to several different kinds of food is a problem.
Rosemary Stanton: What we're going to see I think with these functional foods, is we'll have some little study done with 45 people given the product for three weeks, and someone says Look, no harm came to them, they seem to be all right, therefore it's all right. I think we'll have to judge those studies very, very carefully and many of them will be found wanting. We simply don't know the effects of adding some of these compounds. Some foods will be entirely safe, so that some of the yoghurt products for example, they may not do what they're claimed to do, but they probably won't do any harm. We've got a long history of eating yoghurt, so I wouldn't be worried about that. The plant sterols although vegetarians consume them, they consume them in a fraction of the amount that they were being added to various foods. Now these foods contained a label saying 'Don't have more than three serves a day'; that's very, very difficult to control that. I don't think a 10-year-old boy who's hungry and opens the fridge will think 'I'd better not have the sterol containing yoghurt because I've already had sterol containing milk and bread today.' It won't work that way. So we have to be extremely careful and I think this is a real case where some of these ingredients would be better added to a pill so that you could more carefully target them at the section of the population for whom they were beneficial and you could then tell those people as the Heart Foundation has done with the plant sterol products, 'You're going to have to eat some extra fruit and vegetables'.
Stan Correy: Now using Rosemary Stanton to comment on this issue is the food industry equivalent of using a red rag against the proverbial bull. Stanton is a popular TV personality, a nutritionist with a high profile. But the food industry would see her as scaremongering, or at least taking a too purist view of modern nutrition.
The CSIRO is an organisation that would say it's moved with the times in modern nutrition. In the process it's also being taunted with accusations that it's too close to the food industry for true independence. From the CSIRO, Dr Peter Clifton.
Stan Correy: In a recent Federal Parliamentary Library Paper on the issue of cholesterol levels, researcher Dr Rod Panter directly addressed the issue of the increasing industry influence within the CSIRO Division of Health Sciences and Nutrition. Here is a reading from that paper.
One suspects that most players in the food arena have either a direct commercial interest in what people eat, or else are beholden to industry for funding. A good example of increasing industry influence is within the CSIRO Division of Health Sciences and Nutrition. The Division has been forced to turn increasingly to industry in recent years for funding support. In one sense, this makes CSIRO less isolated from industry and prevents its research from becoming commercially irrelevant. However unless the Federal government spends more on nutrition research, there's likely to be tension between consumer interests and food industry interests within the division.
Stan Correy: These sorts of comments are becoming more common as nutrition and health sciences find themselves more and more dependent on corporate money.
Peter Clifton says the CSIRO is well aware of the criticism.
Peter Clifton: I think it's just something we have to wear. I mean I think most people who work in CSIRO are pretty fiercely independent and quite proud of their reputation, and have had that accusation levelled against us by many different people. But we are required by law, by government decree, to get 30% of our funding from industry. So to do that we have to actually do industry related research so that much of the research that we publish has been funded by industry. The same worldwide of course, that when you look at the bottom of any journal article you'll see it's been supported by a whole swag of companies. But that doesn't in any way diminish the status of the researchers.
Stan Correy: You don't think that issue's become more of a problem because of this new functional food sector emerging, with terms like medical food, nutraceuticals, there's a lot of pressure by industry to get a stake in this area, therefore pressure on the scientist to get the evidence.
Peter Clifton: I agree there is pressure, but I can't imagine a situation where the scientist would in any way fake the results or re-interpret a less than positive result to the advantage of the company. So everybody I know says it the way it is, and if it's not what the company wanted, then that's just bad luck. And often they go away very disappointed of course, and you don't see them again.
Stan Correy: No-one is suggesting that all science funded by company money is skewed or biased or lacking independence. But some of it is. And the fact also remains that corporations are not likely to fund science that is of no benefit to them. From Deakin University, Mark Lawrence.
Mark Lawrence: That issue has been raised within the nutrition community, and I understand there is a dilemma there. I'm sure the science that the CSIRO conducts is excellent science. Often it gets back to how the evidence is then interpreted and applied by others, as well as is the other more basic types of research being conducted, or are we only focusing on a very narrow type of nutrition agenda.
Stan Correy: What do you mean by a narrow nutrition agenda? You're saying it's not so much the science but it's the way that the research results could be then interpreted by the people who need to use them?
Mark Lawrence: Well if we only are conducting a certain type of research, if we're only looking for answers for certain questions, if we're only posing certain hypotheses, that'll be the evidence we collect. If we're not posing hypotheses for other types of issues or questions, well we will never know those answers.
Stan Correy: It can all get pretty tense as the leading nutritionists duck and weave to deal with the realities of needing corporate funding and yet seeing the dangers for science in both the perception and reality of the research. Last year a group called the Nutrition Advisory Council, chaired by another prominent Australian nutritionist, Professor Mark Wahlqvist, had made an announcement saying the best way to avoid cancer was to avoid eating meat. What was important was that the Nutrition Advisory Council is convened by the very vegetarian company, Sanitarium.
When that announcement was made, another prominent nutrition professor, Stewart Truswell of Sydney University responded that most nutrition announcements linking diet and disease were commercially driven and gave nutritionists a bad image. Professor Truswell says that wasn't exactly what he meant.
Stewart Truswell: No I didn't really talk about the image of nutritionists. What I think I said, I could look it up, it's in a newspaper, was that people might be surprised to discover that usually when there's a nutritional breakthrough appearing in the media, this has actually been paid for by some company, that there's been a commercial interest behind it. Whereas if a poor scientist, working in the university, has had a good piece of research result and it's published in a very good journal, that won't hit the media. That was the point I was trying to make.
Stan Correy: Right, well I've got the article here, and it says, 'If I have one message, it's that most statements about nutrition are commercially driven and this is bad. It is agreed amongst most nutritionists that this is a major reason for confusion and scepticism about nutrition in the community.' It seems to me from my story which is I suppose, using the context of this marketing of functional foods and nutraceuticals, considering that they are often fuzzy terms, what you described last year is still happening now because of the pressure in the food industry to get new markets?
Stewart Truswell: Yes, well if something comes out in all the radios and all the newspapers about some new piece of nutrition research, one is usually able to find which particular company paid for this research.
Stan Correy: Now a year later, he says he no longer has the same level of concern about nutritionists getting involved with the food industry in general. It's when the relationship is with a particular company that there's a problem, he says. It makes it very confusing for the public.
Stewart Truswell: The confusion is unfortunate, and one of the reasons why I made that statement last year is because I think it's very unfortunate that we no longer have an agreed umpire on matters of public health nutrition. For 50 years there was the Nutrition Standing Committee of the National Health & Medical Research Council at the Commonwealth Department of Health and this was terminated, not under the present government, but actually under the previous government, and the people like myself and one or two others have been jumping up and down for many years saying this should be reinstated. We need a group of experts who can look at issues that come up and can give a consensus of informed opinion about what the general public should do about it. But with the idea of small government then this is one of the things that can be dispensed with. Another consequence of small government is under-funding of both universities and CSIRO so that people that want to do research in nutrition have usually got to get part of their funding from industry. Whether this causes bias is for anyone to say. I'm not saying that it does, but it means at least that people can't necessarily go ahead on really creative research, they've got to work on more mundane research which are connected with particular food products.
Stan Correy: Government money is drying up. Scientists need money and work. The traditional food industry has hit the proverbial brick well. They simply can't make extra profits out of selling plain grains, veggies and fruit. The food industry has to find more and more new ways to tempt consumers to their products. It's no longer credible for the food to be just delicious, especially if it's full of fat and bad things. There's nowhere to go but to make it full of supposedly good things.
President of the Dietitians' Association of Australia, Peter Williams.
Peter Williams: I think there is a real danger that if we focus on food messages and just say 'This is a magic solution to a public health problem' that people don't understand that just changing one food is not the solution, it's the whole balance of their diet and their patterns of eating. And so yes, there's a problem when we start talking about a single food and not talking about the total balance of the diet, and there's very little support these days from government for that whole-of-diet message. And that's one of the roles I guess traditionally dietitians have tried to fulfil. We do that on an individual level when we're counselling people, but to get resources for large public health campaigns is really quite difficult these days.
Background Briefing theme
Stan Correy: Background Briefing's Co-ordinating Producer is Linda McGinnis; Technical Producer, Tom Hall; Research, Paul Bolger. Executive Producer is Kirsten Garrett; I'm Stan Correy, you're with Radio National.