Burgess COMMENTARY

Peter Burgess

FOOD ... Forget the Supplements: Focus on a Healthy Diet Instead ... The food industry says nutraceuticals are the key to transforming our health – but the truth is far murkier.

There’s no evidence that the father of modern medicine Hippocrates ever said, “Let food be thy medicine and medicine be thy food.” Some debate whether he’d even have agreed with the sentiment. Nevertheless that Facebook-friendly quote has become the motto for a whole industry of what’s become known as “functional foods” or “nutraceuticals”.

By now most people are aware of the cholesterol-fighting stanols and sterols that are added to margarines and yoghurts, plus the omega-3, the “friendly bacteria” that, according to their manufacturers, can do everything from make us cleverer to boost our immune system. In the last five years, though, two seemingly contradictory movements have swept through the functional food industry. One is that ever more nutraceuticals have emerged. Everything from beer laced with collagen (it’s supposed to be good for your skin) to burritos with added probiotics. Yet, at the same time, European food authorities have restricted the claims that manufacturers are allowed to make. Do any of these so-called miracle foods, then, actually work?

“Nutraceuticals is a marketing term but there are undoubtedly foods with active effects,” says the British Dietetics Association’s Duane Mellor. “You only have to look at coffee, with caffeine, which has a very obvious effect. There’s good evidence that stanols reduce cholesterol and you can get far more of it when it’s added to margarine than you would from food.”

Japan, where the probiotic drink Yakult was invented in 1935, is regarded as the homeland of nutraceuticals. Thanks to a lighter legislative touch than in Europe it’s also relatively easy for food manufacturers to claim special powers for their products. It’s in Japan that you can buy a beer called “Precious”, which is laced with two grammes of collagen and marketed to women as a beauty treatment with the slogan: “Guys can tell if a girl is taking collagen.”

“I don’t think collagen beer would meet the standards required by the FSA (Food Standards Agency)!” says Dr Mellor. “The trouble is it’s a long way from your gut to your skin. Collagen is a protein and the enzymes in your gut are going to break it down.” Nutritional therapist Lucy Patterson is equally dubious about the idea of drinking yourself beautiful. “I use collagen mostly for gut health,” she says, “but you’re better off adding it to smoothies and shakes rather than alcohol. Alcohol is dehydrating and a toxin in other ways so it’s not the best thing for your skin.”

In Japan you can also buy a fizzy drink, Mets Cola, which contains added indigestible dextrin which is supposed to stop you absorbing fat. Mellor argues that many of these products, even if they do what they say, merely have a “health halo”. Selling an unhealthy product such as cola for its supposed health-benefits might do more harm than good.

Patterson, though, thinks there is something to be said for products such as the burrito with probiotics. “Probiotics often have a tangy, pickly flavour,” she says, “which can be strange if you’re not used to it. Anything that encourages people to eat it is a good thing.” But only if probiotics actually work. In 2010 probiotic market leader Danone withdrew its claims that Actimel and Activia boost the immune system and aid digestive health, after EU scientists disputed the claims. The NHS in the UK accepts that probiotics might have benefits for treating diarrhoea and digestive problems but not much more.

Proponents, meanwhile, continue to claim much more impressive effects. Most recently a study suggested that consumption of fermented foods, such as sauerkraut and pickles, can reduce social anxiety in young people. “It is likely that the probiotics in the fermented foods are favourably changing the environment in the gut, and changes in the gut in turn influence social anxiety,” said the author of the study, Professor Matthew Hilimire. The standard of proof required in the EU, however, is higher than that provided by individual research papers. “To be accepted, the product has to contain a molecule that’s been proven to work, proof of cause and effect and success in clinical trials,” says Dr Mellor. But he says that his own research into the alleged mood-boosting effects of chocolate is a good example of why it’s hard to make definitive claims about specific, targeted health-benefits of food. “There is some evidence that polyphenols, which can be found in chocolate, may improve mood,” he says. “but it didn’t work in my study. When I gave people chocolate their anxiety levels went down, but that was because I was giving them bags of chocolate, which is a nice thing to do.”

Clearly “nutraceuticals” can work, in some circumstances, for some people. Explaining why they work, though, is extremely difficult. Even omega-3, although generally accepted to be an important nutrient, has its limitations according to Dr Mellor. The much publicised research into its effects on children’s concentration is still heavily debated.

“There have been some successful trials but is it the omega-3 itself that has the effect?” he says. “There’s evidence that sitting down for a social meal and having a healthy diet works better.”

One reason that food is not really like medicine, then, is because there’s more to eating than just its chemical effects. “We need to go back to a traditional family meal,” says Dr Mellor. “It might not sound very exciting but we’ve lost the social aspect of food. That’s just as important. We’ve pinned too much on functional foods.”