Position of the Academy of Nutrition and Dietetics:

Functional Foods
Shelby Fitsch
NFS 4950
Prof. L. Kull
February 22, 2016

It is the position of the Academy of Nutrition and Dietetics to recognize that although all foods
provide some level of physiological function, the term functional foods is defined as whole foods
along with fortified, enriched, or enhanced foods that have a potentially beneficial effect on
health when consumed as part of a varied diet on a regular basis at effective levels based on
significant standards of evidence. The Academy supports Food and Drug Administrationapproved health claims on food labels when based on rigorous scientific substantiation. Effective
date: October 16, 1994 December 31, 2016. Authors: Kristi M. Crowe, PhD, RD, LD and Coni
Francis, PhD, RD.
For many individuals, eating serves a greater purpose than satisfying hunger. Overall
health and wellness seems to be the main goal in todays society, with an emphasis on disease
prevention. Over the last 20 years, research has shifted from nutrients that cure deficiency
diseases to disease prevention using nutritive and non-nutritive compounds. This shift is mostly
due to scientific advances, as well as an increased emphasis on self-treatment by the consumer.
There are many factors that drive the functional food market, which include: the rising cost of
health care, a growing trend to self-treat, increasing age in population, the obesity epidemic, and
the increasing number of lifestyle diseases in the United States. The functional foods movement
is beneficial all around. It can potentially minimize the cost of healthcare while simultaneously
improving the wellbeing of the consumer.
The term functional foods holds no legal value in the United States and has no globally
accepted definition; it is merely a marketing term. In a sense, all food is functional because it
provides nutrients and energy. However, the Academy of Nutrition and Dietetics; the
International Food Information Council; the Institute of Food Technologists; the International
Life Sciences Institute; the European Commission; Health Canada; and the Japanese Ministry of

Health, Labor, and Welfare have publicly defined the term functional foods in their own ways.
In summary, each organization focuses on the nutritive and non-nutritive substances of food, and
how those substances have a potentially positive effect on disease prevention. Functional foods
only refer to food substances. Medical foods and dietary supplements are considered
nutraceutical. Nutraceutical is a term that refers to nearly any bioactive component that
delivers a health benefit, commonly in supplement form 1
Functional foods are classified into three main categories: 1) Conventional foods that
contain natural bioactive food substances. These include vegetables, fruits, grains, dairy, fish,
and meats. An example of the functionality of these foods would be the probiotics in yogurt and
antioxidant vitamins in orange juice. 2) Modified foods that contain bioactive substances through
fortification. An example of this would be n-3 fatty acids in eggs. 3) Food ingredients that are
synthesized, which provide prebiotic benefits. An example of this would be a resistant starch,
which is an indigestible carbohydrate that provides prebiotic benefits.
In terms of regulation, Japan has been the main supervisor for functional foods. The
Japanese Ministry of Health, Labor, and Welfare was the first organization to recognize the
category of functional foods. The first program to permit health claims based on scientific
evidence was the Food for Specified Health Uses (FOSHU). Products approved as FOSHU are
allowed to use the FOSHU seal of approval on their product labels. 1 In the United States, food
is regulated under the Federal Food, Drug, and Cosmetic Act of 1938. This act has no definition
for the term functional foods. The claim is that there are already regulations concerning the
use of food ingredients that are adequate to cover functional food ingredients. 1 Currently, food
manufacturers can use four categories of health claims on food labels, which are: 1) nutrient
content claims; 2) structural/function claims; 3) health claims; and 4) qualified health claims.

The purpose of a health claim is to provide the consumer with information pertaining to dietdisease relationships when the scientific support has not reached the highest level of scientific
evidence. 1 After reviewing the scientific evidence submitted to the Food and Drug
Administration (FDA), a food product is permitted to contain a health claim as long as the
product meets the criteria outlined for each claim, according to the Nutritional Labeling and
Education Act. The FDA must authorize a health claim before it is added to a food label.
In order to ensure functional foods are working to its greatest potential, scientific research
much be conducted to verify the bioavailability and efficacy of bioactive food compounds
consumed in typical dietary patterns. Bioavailability is the rate in which the active substances are
absorbed and become available to use by the body at the intended site of action. While
bioavailability is a rather simple concept, it becomes complex when the composition of the diet
is taken into consideration, as well as differing rates of absorption and metabolism among
individuals. Once bioavailability is determined, research is conducted to evaluate the efficacy of
the bioactive compounds using the outcomes of interest in a target population.
The gold standard for research of functional foods is a double-blind, placebo-controlled
study. When a standard checklist is reported with each study, an individual can easily compare
multiple trials based on the checkpoints. These checkpoints include, but are not limited to:
subject, use of a control, frequency of intake, duration, etc. Including these checkpoints ensures
that comparison and duplication of results can easily be remodeled in another trail. Research has
shown that the bioavailability of nutrients depends on the food matrix. The food matrix is the
composition and microstructure of the food. 1 Also, research has shown that nutrient and nonnutrient interactions within the food matrix can be neutralizing, synergistic, or additive. For
example, vitamin C enhances the antioxidant effect of vitamin E. Taking these points into

consideration, it is apparent that the interaction of bioactive compounds within the food matrix
are extremely diverse. Advancement in research is needed in order to fully understand these
reactions and further develop functional foods to its greatest potential.
One of the biggest challenges with functional foods research is that the entire functional
food cannot be provided in a cell culture. Typically in functional foods research, the bioactive
compounds are isolated in vitro models and evaluated based on their functional properties.
However, the problem with in vitro models is that the concentration of the bioactive compound is
usually inconsistent with typical dietary doses. In the end, unrealistic results may arise. On the
other hand, there are also advantages to functional foods research. Some bioactive compounds
can reach a point of toxicity, which hinders its potential benefit. For example, bioactive
compounds such as antioxidants can shift the antioxidant-oxidant balance within the body. In
other words, antioxidants can produce oxidative stress when consumed in high amounts in the
diet. Further research of functional foods can recommend appropriate levels of intake for
beneficial bioactive compounds.
For the Registered Dietician (RD), food is no longer viewed as only macro- and micronutrients. In order to remain nutrition experts, it is the job of the RD to stay up-to-date on the
knowledge of functional foods. Some ways to stay informed are through the Journal of the
Academy of Nutrition and Dietetics research abstracts, joining the Academys Dietitians in
Integrative and Functional Medicine group, and the Academys Evidence Analysis Library. It is
the job of the RD to incorporate solid evidence-based research into their practice. If the RD is
familiar with the four categories of health claims, he/she can incorporate those foods into the diet
of a patient dealing with a certain medical condition. It is important to note that marketing

strategies often overshadow scientific evidence. It is essential that the RD educate the patient on
appropriate levels of intake in order to optimize health.
Unfortunately, I think functional foods are going to be the next fad in society. Functional
foods put the consumer in control. The consumer is able to self-treat and refrains from going to
the doctor. I do believe there is great validity in the bioactive compounds of functional foods,
however, without proper instruction from an RD, the consumer is unaware of the recommended
intake levels. Also, I think functional foods have potential to be great marketing strategies RDs.
Since RDs do not treat medical conditions, it leaves our niche rather small. However, with the
aid of functional foods, the RD is able to implement certain foods in the diets of individuals
dealing with certain diseases. Lastly, functional foods greatly support the goal of the RD, which
is disease prevention through the diet.

References
1. Crowe KM, Francis C. Position of the academy of nutrition and dietetics: functional foods. J
Am Diet Assoc. 2013;113:1096-110