Survey of health claims for Australian foods made on Internet sites.

More and more information is becoming available via the Internet, with many people now choosing to use this source of information for everything from planning their family holiday to purchase of goods or investigating medical technologies. In the article by Dragicevich et al., (1) manufacturers of food are clearly tuned into this trend and are actively using the Internet to promote the health-related virtues of their products through the use of health claims. In doing so, many are breaking the current food laws that govern claims that can be made about foods.

The new food standards on nutrition, health and related claims will be finalised during this year (2) so it is timely to consider some of the implications for health and nutrition professionals. Monitoring and enforcement and public and professional education are two key areas identified as contributing to the effectiveness of regulation of food-related claims. (3)

Monitoring and enforcement of health claims will be an issue. In their article, Dragicevich et al. conclude that 'the Internet is an area of advertising that requires close monitoring' and that there are a high proportion of non-compliant claims that are appearing on Internet sites already. This raises the question, why are these claims not being monitored now? The research by Food Standards Australia New Zealand has identified that the people charged with monitoring and enforcing such claims, Environmental Health Officers, do not have adequate time or resources to enforce labelling regulations. (4) If health claims are not actively monitored, what will be the impact on the public's trust in the food regulation system and its capacity to ensure that the Food Standards Code has some meaning?

State and territory governments are charged with monitoring all aspects of the food standards and assign priority based on management of risks. Some food issues have both scientific and societal/media recognition for their risk to health, for example dioxins in foods such as the fish in Sydney Harbour. (5,6) A direct link can be established between the chemical in food and the seriousness of the risk to human health. The impact on human health of nutrition information can be harder to quantify. Declaration on a food label of the presence or absence of allergens in foods will have a direct impact on people who suffer from food allergies. A statement about a component of the food reducing the risk of a future illness or helping to manage a chronic health condition is much harder to quantify and therefore may be reduced in importance when it comes to enforcement priorities.

Without adequate enforcement, a range of claims may proliferate, from perhaps truthful but unlawful, to spurious or misleading. Dragicevich et al. identified a larger number of breaches of the current food legislation on Internet sites. Their finding supports the assertion that when an area is not actively monitored, adherence to the law is less likely to occur. Consequences can be significant. People may inappropriately manage their condition through the foods they consume, they may avoid seeking appropriate advice from a health professional or they may exacerbate their health problem or risk through poor food choices. Sophisticated modelling frameworks are required to enable such risks to be quantified and stronger arguments made regarding the priority that should be given to this area of the food legislation. In the meantime, caution needs to be taken and all claims need to be closely monitored to minimise the opportunity for such problems to occur.

Research has indicated that while people consider health claims another form of advertising, they also use claims on food products to influence their food choices, perhaps misguidedly. (7-9) There are at least three points at which action needs to be taken to support more health-enhancing food choices. Health professionals have a role to support people to interpret claims about foods appropriately, so that they can make use of them in their health decision making. Educating health professionals to incorporate how to interpret health-related information, from whatever source, into their client education sessions will be critically important. An approach that assists people to make their own food and health decisions and to make judgements about the quality of information sources is quite different to providing information about food, diet and health. This may require review of how health professionals approach their counselling and education sessions.

Food retailers also have a role in providing point of sale information on the products they sell. At a minimum they can act to ensure that all product information is provided in a manner consistent with the food standards. This would extend some present practices of imposing requirements on suppliers regarding a range of other factors relating to food standards and quality, such as the presence of food safety plans.

Thirdly, educators have an important role in educating the next generation in health decision-making skills and interpretation of health information. Governments appear eager to take high profile decisions about school factors that are nutrition-related, such as banning certain soft drinks from school premises. (10) Such a decision is relatively easy and cheap to make, is straightforward to enforce and, whereas some may not agree with it, can be argued to be 'a step in the right direction'. Mandatory curriculum requirements regarding food and nutrition skills education (including how to interpret and use information on food labels or on the Internet) would complement the proposed changes to the food regulation. Unfortunately such an education approach does not appear to be considered as a high priority and certainly would be more difficult to achieve.

The current action to change the Food Standards Code to permit a wider use of nutrition, health and related claims on foods culminates almost two decades of professional debate and investigation. This represents a major investment in terms of professional input and regulatory resources. This level of investment is not likely to diminish in the future. Let us learn from these discussions and reviews and ensure that the changes in the regulations are accompanied by adequate resources in monitoring, enforcement and education to maximise their effectiveness in positively influencing food choices to support public health outcomes.

Heather Yeatman, DPH 

Associate Professor in Public Health, Interim Head, School of Public Health

University of Wollongong 

Wollongong, New South Wales, Australia

REFERENCES

1 Dragicevich H, Williams P, Ridges L. Survey of health claims for Australian foods made on Internet sites. Nutr Diet 2006; 63: 139-47.

2 Food Standards Australia New Zealand (FSANZ). Nutrition, Health and Related Claims. 2006. (Cited 26 May 2006). Available from URL: http://www.foodstandards.gov.au/whatsinfood/healthnutritionandrelatedclaims/

3 Hodge W, Brooks M, Hart K. Process Evaluation of the Management Framework for the Folate-Neural Tube Defect Health Claims Pilot. Final Report. 1999. (Cited 26 May 2006.) Available from URL: http://www.foodstandards.gov.au/_srcfiles/Part_2_process_eval.pdf

4 Patterson D, Zappelli B, Chalmers BA. Report to ANZFA, Food Labeling Issues--Consumer Quality Research. Canberra, Australia: Food Standards Australia New Zealand (FSANZ), 2001.

5 United States Environmental Protection Agency. Fact Sheet: Polychlorinated Dibenzo-P-Dioxins and Related Compounds: Update: Impact on Fish Advisories. US EPA September 1999. EPA-823-F-99-015. 2006. (Cited 6 Jun 2006.) Available from URL: http://www.epa.gov/ost/fish/dioxin.pdf

6 Don't come the raw prawn. Fishing ban overdue (Editorial). Sydney Morning Herald 2006; Wednesday 25 Jan (p. 14, first edition).

7 Levy A, Derby BM, Roe B. Consumer Impact of Health Claims: An Experimental Study. Report to Food and Drug Administration Center for Food Safety and Applied Nutrition, Washington, DC, USA. 1997.

8 Wansink B, Cheney MM. Leveraging FDA health claims. J Consum Aff 2005; 39: 386-99.

9 Williams P. Consumer understanding and use of health claims for foods. Nutr Rev 2005; 63: 256-64.

10 Carr R. New recipe for healthy students (Media release). NSW Premiers Department 2004; Friday 30 April. (Cited 17 July 2006.) Available from URL: http://www.health.nsw.gov.au/obesity/adult/canteens/rel_hcanteens.pdf