An aging population, rising health care costs, and rapid advances in science and technology are fueling a revolution in food from its traditional role for survival and enjoyment to a new status: food as medicine.
The food industry is pouring millions of dollars into this transformation. Whether consumers will snap up these functional foods or "nutraceuticals" is unclear. But if the health claims prove true and the food is tasty, the likelihood is that they will.
Clare Hasler, Ph.D., executive director of the Functional Food for Health Program at the University of Illinois, Urbana, believes that over the next few years "there will be a glut of foods designed to optimize health," and that supermarkets of the future will have entire sections set aside for the prevention of chronic illnesses.
Functional foods represent an exploding market an estimated $29 billion a year in the United States alone, according to a recent report by Decision Resources, a Waltham, Mass., healthcare consultant. And several companies are now in the race, including Monsanto Co., St. Louis, Zeneca Pharmaceuticals, Wilmington, Del., and Hoffmann-La Roche Inc., Nutley, N.J.
Rather than eliminating unhealthy ingredients, such as fat, cholesterol, sugar, and salt, the strategy is to create foods that have an extra amount of a compound already associated with increased health.
Some nutraceuticals are already in the nation's supermarkets eggs with fish-derived fatty acids to lower the risk of heart disease; orange juice fortified with calcium to fight osteoporosis; herbal teas with anti-oxidants that may lower cancer risks; and margarine laced with a wood pulp ingredient that lowers cholesterol by 10%.
In March, the Kellogg Co., Battle Creek, Mich., introduced a new line of functional foods
under the brand name Ensemble. The 21 Ensemble products, including frozen entrees, bread,
baked potato crisps, cereal, and cookies, contain a fiber called psyllium from grain husks, which
in clinical trials lowered cholesterol.
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Soy Soup to Nuts
For several years, one company, Protein Technologies International, recently bought by DuPont Co., Wilmington, Del., has made soy protein isolates that are used in many foods from candy bars, salad dressings, and soups to infant formulas. But if another PTI soy product an isoflavone extract shows health benefit, it may qualify as a drug, not simply a food additive.
That requires testing in clinical trials. E. C. Henley, Ph.D., Vice President, Nutritional Sciences, at PTI/DuPont, said that her company over the years has patented several processes to extract particular isoflavones from soy. In collaboration with the National Cancer Institute, one of these extracts is being used in phase I prevention trials for breast and prostate cancer that began a few months ago.
(Several levels of evidence point to the health benefits of soy products. Epidemiologic studies show that Asians with high-soy diets have lower rates of prostate and breast cancer. And compounds extracted from soybean retard the growth of tumor cell lines and tumors in rats.)
Once the cancer trials are complete, as well as the heart disease and osteoporosis studies for which PTI is supplying its soy extract, soy may show up in more food products. Already it is used as protein filler in about 40% of all processed foods.
Prevention trials are also under way to test compounds found in cruciferous vegetables (broccoli, Brussels sprouts, mustard, radish, horseradish) for their ability to lower the risk of cancer. Several studies show that people with diets high in cruciferous foods have lower cancer rates. In fact, Elizabeth Jeffery, Ph.D., associate professor of nutritional toxicology at the University of Illinois at Urbana, said that a recent study found that as little as 10 grams (a dime weighs about 1 gram) of cruciferous vegetable per day is sufficient to significantly lower cancer risk. Two candidates from crucifers, indole-3-carbinol and phenethyl isothiocyanate, are being evaluated in phase I clinical trials. Because of its potential in reducing estrogen levels, indole-3-carbinol is being studied in women at risk for breast cancer, and PEITC, which inhibits the activation of nitrosamine carcinogens found in tobacco smoke, is being evaluated in chronic smokers.
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Sweeter Carrots
Another plant geneticist, Phil Simon, Ph.D., from the U.S. Department of Agriculture at the University of Wisconsin, Madison, has used classical plant breeding methods for over 20 years to improve the flavor and nutritional qualities of carrots. Carrots account for 30% of U.S. consumption of vitamin A, which has well-documented health benefits.
Simon said he began by selecting for carrots that were sweeter, and then focused on carotene, a precursor to vitamin A that so far has shown little health benefit when administered as a pill in several large clinical trials. Initially, his carrots had small levels of carotene; now the levels are up to 130 to 160 parts per million.
As director of a national program to develop new carrot strains, Simon gives them to seed companies once he's satisfied. After 5 to 10 years of field testing by the seed company, Simon's sweet, high carotene carrots are now in grocery stores.
Another plant geneticist interested in producing a healthier carrot is Leonard Pike, Ph.D., at Texas A & M University, College Station. His current strains are maroon. That's because his first foray into healthier carrots began by accident in 1988 when he found three carrots from Brazil that had purple blotches on their sides and decided as a novelty to breed them, selecting for carrots that were uniformly dark purple.
But when he began hearing reports that the compound responsible for the purple color (anthocyanins, a flavanoid, also present in other fruits such as grapes, blueberries, cranberries, and dark purple cherries) had anti-cancer properties in laboratory and animal experiments, he decided to cross the maroon carrots with the commercial ones resulting in a carrot high in both beta carotene and anthocyanin that also tastes good. "Well," philosophizes Pike, "sometimes you're smart and sometimes you're lucky."
Now, because of several reports linking lycopene to decreased cancer risks, he is trying to incorporate lycopene from slightly red Chinese carrots into his maroon carrots. (Lycopene gives the plant its red color.)
"We are in a highly focused, fast-forward mode, trying to put all three compounds in the same carrot and in a lot of other crops." said Pike, adding that about 42 companies are sponsoring the research.
"Fortunately, many fruits and vegetables have low amounts of all these compounds, so we really don't have to worry about gene transformation or biotechnology. We're just going through a massive laboratory, analytical screening saving those that are the highest in each compound, and crossing and intercrossing. We've found that most of these can be increased very quickly. Can you hear the blenders in the background?"
There is good epidemiologic evidence to support the association of foods high in antioxidants certain carotenoids (alpha-carotene, beta-carotene, and lycopene), vitamin E, vitamin C, and the trace element selenium with reduced cancer risk at several sites. This is reinforced by animal and in vitro studies.
One antioxidant, lycopene, received a lot of attention in December of 1995 when research from Harvard Medical School, Boston, suggested that foods such as tomatoes, pizza, and tomato sauce may help reduce prostate cancer risk. Tomatoes are the major dietary source of lycopene; those richest in lycopene are found in canning or processed foods.
Super Tomatoes
A Feb.16 article in the Journal of the National Cancer Institute reviewing 72 past studies on the link between various cancers and the consumption of tomatoes and tomato-based products found that the connection was statistically significant in 35 of these studies and most compelling for cancers of the prostate, lung, and stomach. But because tomatoes are a rich source of other carotenoids, lycopene's benefit as a supplement has not been proven.
Nevertheless, reports such as these have led Peter Bramley at the School of Biological Sciences at the University of London to manipulate some of the tomato's genes to increase both the lycopene and beta carotene content. So far he has created tomatoes with a twofold increase in lycopene and a four- to fivefold increase in beta carotene.
"A twofold increase for lycopene is not enough," said Bramley. "When we get a good product, Zeneca will market it . . . maybe in a few years. At the present time, public resistance to genetically-altered products is huge."
Researchers in private industry, like Monsanto, are also using genetic engineering techniques to create nutraceuticals. Scientists there are developing beta-carotene-enriched canola oil.
European researchers are also exploring functional foods, according to Bramley.
Swiss and German scientists, with funds from the Rockefeller Foundation and the European Union, for example, using genetic engineering are creating beta-carotene enriched rice. Both Monsanto and Rockefeller hope to market their oil and rice in countries whose populations are deficient in vitamin A.
But these products still pose considerable challenges. Consumers will have to sort through confusing health messages about what to eat, and food-makers must show the health benefit without compromising flavor.
No Guarantees
And proving health benefits doesn't guarantee success. Campbell Soup spent $50 million on a line of frozen foods proven in clinical trials to lower blood sugar, cholesterol, and blood pressure and discontinued it last year when sales were low.
So the dice are still rolling as to when or if the functional foods business will take off. The odds seem to depend in large part on whether consumers are willing to include high-lycopene tomatoes, isoflavone-enhanced candy bars, and maroon carrots in their diets.
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