II. CONCLUSIONS AND RECOMMENDATIONS FROM THE PAPERS PRESENTED AND DISCUSSED

13.

Tee E Siong, resource person for the Consultation, presented an overview of the status of functional foods in Europe, North America, Australia and Codex Alimentarius. A major part of the overview dealt with the status in ten countries in Asia and a summary of efforts made in recent years to harmonize approaches to functional foods in the region.

14.

There was no official or legal definition of functional foods or specific regulations for these foods in Europe, North America, Latin America and Australia. Nevertheless, there was a great deal of interest in these countries and a number of food products with functional or health properties have appeared in the market.

15.

The subject of functional foods had been discussed in various meetings of the Codex Alimentarius, including the Executive Committee, the Codex Committee on Nutrition and Foods for Special Dietary Uses and the Codex Coordinating Committee of Asia (CCAsia) in 2002 and 2004. CCAsia had proposed the conduct of a global expert consultation on the subject.

16.

The specific physiological properties of functional foods are expected to be communicated to consumers through nutrition and health claims. Codex Alimentarius had adopted guidelines on nutrition and health claims in mid-2004 and commenced deliberations on developing scientific guidelines of the health claims. Europe had embarked on an extensive project called Process for the Assessment of Scientific Support for Claims on Foods (PASSCLAIM). The United States Food and Drug Administration (USFDA) allows health claims to be made on a food or dietary supplement based on three main processes: claims that meet significant scientific agreement, claims based on authoritative statements and qualified health claims.

17.

Findings of a survey of the status of functional foods conducted in 2002 in ten countries in Asia were summarized, namely China, (including Taiwan Province) Indonesia, Japan, Malaysia, Myanmar, Philippines, Singapore, South Korea, Thailand and Viet Nam. The survey showed that the definition or usage of the term functional foods varied greatly amongst these countries. Only Japan and China had products that fall wholly or partially within the scope of functional foods as defined in the survey. However, the term "functional foods" was not used in the regulations pertaining to these foods. In each of these three countries, a specific regulation was enacted and a pre-marketing approval system was in place to review each health product based on scientific substantiation. In South Korea and the Philippines, the term "functional foods" was used to include dietary supplements in pharmaceutical dosage forms. In the remaining countries (Indonesia, Malaysia, Myanmar, Singapore, Thailand and Viet Nam)^[1], there were no regulations on functional foods. There was, nevertheless, a great deal of interest in functional foods in these countries.

18.

The survey results clearly showed that functional foods were at very different stages and even directions of development in the region. Some degree of harmonization and common understanding on functional foods would help promote their development and bring about greater consumer confidence. The International Life Sciences Institute (ILSI) Southeast Asia Region therefore organized the first Asian Regional Workshop on Functional Foods in Kuala Lumpur in October 2003. Representatives from regulatory agencies, research organizations and the academia from ten countries in Asia participated in the workshop. A wide variety of topics was discussed and there was general agreement on the following topics: essential attributes or characteristics; regulatory and marketing aspects; and opportunities for collaboration and harmonization.

19.

ILSI organized the second Asian Regional Workshop on Functional Foods in Bangkok in October 2004. A total of 30 regulators and scientists from selected Asian countries participated in the meeting which focused on continued efforts in harmonization, especially in the areas of scientific substantiation and safety evaluation. Workshop participants reiterated that there is great potential for the development of functional foods in the region. A large number of products and biologically active ingredients are native to the region. Development in this subject had been hampered by differences in the understanding and usage of the term "functional foods". It was felt that a harmonized approach would enhance regional development.

20.

The term "functional food" is not familiar among the Bangladeshi population, not even among food and nutrition scientists or policy-makers at large. Some foods are, however, known to deliver health benefits and therefore regarded as "health" or "healthful" foods and have been regarded as functional foods.

21.

Bangladeshi food is principally plant based, with plant products contributing around 90 percent of total food mass and about 96 percent of total dietary energy. Varying from plant to plant, thousands of bioactive compounds, pigments and natural antioxidants, many of which are implicated with health effects like protective action against heart disease, hypertension, cancer, diabetes and other diseases, have been known to occur in the plants. They are therefore termed as phytoprotectants. These include: (a) organosulphur compounds, commonly found in Alliums (e.g. garlic, onions) and Brassica species (e.g. cabbage, cauliflower), (b) products of the isoprenoid pathway found universally in vascular plants (e.g. coloured vegetables), and products of the phenylpropanoid pathway found in fruits, vegetables, coffee, tea and alcoholic beverages.

22.

Two food items have recently gained increased attention due to their special attributes and benefits for leading a healthy life. One of these is of plant origin, namely the mushroom; the other is an animal food, marine fish. Until recently, mushrooms were not a welcome food item in the daily diet of the Bangladeshi population, principally because of the fear of toxicity of the wild types. However, people are now turning towards mushrooms as the cultivation of safe, edible varieties started in the country owing to a government initiative. Sea fish are becoming increasingly popular among the public due to constant preaching from nutritionists about their role in maintaining sound cardiac health.

23.

Foods with functional attributes are available in the market in fresh, natural form. Those who know about them buy these foods from the market just as they would buy other food. The government is trying to popularize mushrooms as a functional food among the public through attractive posters claiming their manifold positive health and nutritional benefits. Bangladesh is still following the East Pakistan Pure Food Ordinance, 1967 for national regulations, standards, guidelines and codes of practice to control the quality of foods marketed in the country and ensure consumers protection. No specific mention was made of functional foods in this Ordinance.

24.

The people of Bangladesh are becoming more and more health conscious these days. There is ample scope to make functional foods popular among the people through mass campaign. However, these foods have to be safe, tasty, nutritious and healthful. For this, research and development efforts should be strengthened to offer really effective existing or new functional foods.

25.

In China, the definition of functional foods (health foods) is food that has special health functions. These foods are suitable for consumption by special groups of people and have the function of regulating human body functions; they are, however, not meant for therapeutic purposes. These kinds of food products should obtain prior approval from the government before being allowed to be sold.

26.

The regulation for the control of health food products was included in the Food Hygiene Law of the People’s Republic of China (1995). For foods which claimed to have specific health functions, the products and their descriptive material must be submitted to the administrative department of health under the State Council for review and approval. Hygienic standards and regulations for the control of manufacturing and marketing shall be formulated by the administrative department of health under the State Council.

27.

A regulation for the control of health foods was issued by the Ministry of Health on 15 March 1996. Under this regulation, the product must demonstrate by necessary animal and/or human functional tests that it has definite and stable health functions. All the raw materials and their products must meet the hygienic requirements of food. They must not cause any acute, sub-acute or chronic harmful effects to the human body. The Ministry of Health shall issue a Health Food Certificate for the qualified and approved health food with a code number. The product given the Health Food Certificate can be labeled with the special symbol for health foods stipulated by the Ministry of Health.

28.

Since October 2003, health food products were evaluated by the National Committee on the Assessment of Health Food Products and approved by the State Food and Drug Administration (SFDA). There are 27 health claim functions approved. These include enhancing the immune function, lowering blood cholesterol and sugar, lowering blood pressure, improving sleep and assisting in memory improvement.

29.

The specialty of Chinese health foods is their raw materials. Most of the materials are traditional Chinese foods and traditional Chinese medicines. Others include extracts of plants and animals, chemical compounds, prebiotics^[2] and probiotics^[3] and fungus. The total number of health food products approved is about 6 200 which comprise of 5 078 approved by MOH from 1996 to June 2003 and 1 200 approved by SFDA from July 2003 till July 2004.

30.

India has a rich history of having a variety of traditional and ethnic foods with functional attributes. The health properties of various condiments, spices, herbs, whole foods, seasonal fruits and vegetables have been documented in the literature and even in ancient scriptures of India. From an Indian context, functional foods include everything from herbal extracts to functional ingredients and from nutritionally improved common foods to even exotic ingredients added to it.

31.

Some of the functional foods which have been in use in India in the daily diet include turmeric, black pepper, cloves, cinnamon, asafoetida, cumin seeds, omum, mint, tulsi (holy basil) leaves, various green leafy vegetables, other vegetables and fruits, whole wheat and millets. These foods are used in daily food preparations and are also used in special dishes. Each of these foods has special health properties that are commonly known. Common ailments are treated with the help of these functional foods. The Traditional Knowledge Digital Library at the Central Food Technological Research Institute, Mysore is documenting this information digitally. This would help in the understanding of the functional attributes of these foods and also in the protection of intellectual property rights.

32.

Food to food fortification, sprouting, malting and fermentation are processes that enhance the functional properties of food and are widely used in the daily diet of indians. Fortification of foods with nutrients has also been undertaken. These include hydrogenated fats fortified with vitamins A and D, common salt with iodine, milk with vitamin A, flour with iron and folic acid and candies with iron, folic acid, and vitamin A.

33.

Research and development in the area of functional foods which also include nutraceuticals, pre- and probiotics and newer additives giving sufficient importance to preventive aspects has become more vital today. R&D institutions such as the Central Food Technological Research Institute, Mysore and other similar organizations are taking the lead.

34.

Various traditional foods having bioactive substances that provide additional health benefits over and above the physiological role of nutrients present in such foods need to be supported by science. Research on functional foods claims has assumed greater importance today due to its health-based approach and claims of prevention against diseases. The regulatory issue of functional foods requires special attention and should not only be based on a country approach but also occupy an important place in Codex, driven by the region. Discovering that a particular compound is beneficial to health is just the beginning of the development of marketable functional foods. This has a tremendous impact of reassurance to the consumer by proving the proven with adequate scientific support. The power of biotechnology and nutrigenomics^[4] also has a large amount of impact on functional foods. The emerging area of nutrigenomics is also very vital and ongoing projects and network projects in the country are continuing proactively.

35.

The overall outlook of food safety and functional foods is very important not only for the health claims of such foods but also to reassure the customer of the safety of such foods. Functional foods are expected to play a major role in terms of convenience and nutritional benefits. At the same time these should be available at affordable prices both in rural and urban areas.

36.

Recognizing that with increasing urbanization and globalization, the practice of consuming traditional foods and using special processes like sprouting, fermentation, malting, supplementation etc. for food preparation is on the decline, it is imperative to reinforce sound nutritional practices that enhance functional components in food through extensive awareness generation about functional foods with a view to promoting the nutrition and health of the people.

37.

Consumer awareness and interest in the association between diet or the components of diet and health has increased the demand for healthy food and functional foods. Preventing diseases and maintaining good health by means of functional foods and supplements have become a trend in urban Indonesia. Thus, the supply and demand for commercial functional food products have increased significantly.

38.

In line with these developments in the country, the government of Indonesia is making progress in the legal aspects of functional foods. A draft regulation on functional food control and a draft functional food guide are now being reviewed by the National Agency for Food and Drug Control. The drafts, which are expected to be legal documents in the near future, were formulated by an expert panel and stakeholders. According to the draft regulation, functional food is defined as natural or processed food containing one or more components which have been proven scientifically to have a certain physiological health benefit. The functional food should be prepared and consumed either as solid or liquid as part of one’s daily diet and have sensory characteristics accepted by consumers. The forthcoming regulation on functional food control consists of 27 articles, which cover definitions, coverage, criteria, standards, production, labelling and advertising, prohibition, supervision, inspection and sanctions.

39.

Most of the functional foods marketed are targeted at children and young men and women. The most popular components of functional foods promoted by food industries for young children’s foods are essential fatty acids, such as omega-3 (eicosapentaenoic acid & docosahexaenoic acid) and omega-6 fatty acids and calcium. Herbal components such as curcuma are also added to some drinks for children. The functional foods for young women and men are intended to promote stamina by the addition of iron, calcium and traditional herbal components such as ginseng, ginger and yohimbi. A herbal component of Saoropus androgynus leaves, a local green leafy vegetable (katuk) which has been proven to increase breast milk production of lactating women, has been added to special milk for lactating women.

40.

Strengthening research and regulations, sharing information, establishment of databases and regional collaboration on functional food development are the main strategies that should be undertaken to protect both consumers and producers in the global market.

41.

The term "functional foods" is generally understood as foods that contain substances other than nutrients that may have beneficial effects on health beyond their nutritional properties. The concept of functional food is not new as the traditional diets of ethnic groups are known to recognize and highly regard the health and medicinal values of certain local foods, which are part of the daily diet. Recent studies and technology however have gone beyond these beliefs and have scientifically identified biologically and chemically active components associated with functional properties of the foods. The appropriate use of "functional foods" may improve variety and contribute to a balanced diet as well as offer potential health benefits.

42.

Areas of concern for functional foods identified are namely, the need for a global definition, a common understanding and standards and classification system, safety evaluation, scientific validation of the health benefits and dietary recommendations to be based on standards and guidelines as established for nutrients. Knowledge and understanding, product development in particular, product information as well as consumer demand and marketing of these foods need to be coordinated and regulated so as to reduce confusion and misinformation.

43.

Although there is no specific regulation or standard for functional foods or an official definition under the current food laws, Malaysia is actively proposing an international guidance to provide better regulatory control of these foods. Working Groups have been established to view recent developments. The control of ‘functional‘ claims on these foods is provided for under the Food Regulations 1985 in the nutrition labelling and claims provision gazetted in 2003. These regulations cover requirements for food declaration, nutrient content claims and nutrition function claims. While there are currently 27 permitted nutrient function claims, health claims are prohibited.

44.

The market has a wide range of ‘functional’ foods and products that are manufactured locally or abroad available in conventional food forms or beverages. Consumer groups have voiced concern for the safety, effectiveness and quality of the foods as well as the need for complete information on the products.

45.

Participation in scientific meetings and conferences by Malaysia country representatives keeps the country up-to-date with recent developments. Research is conducted in several institutions and public universities on food product development, properties and characteristics of the identified functional components of local plants.

46.

While functional foods potentially offer a new dimension on the role of foods to support well-being and health and to reduce risk of diseases, which are diet-related, many issues need to be resolved by the stakeholders. The challenge is to ensure the scientific validation of claims of the potential health benefits and safety of these foods and products before dietary recommendations on these foods can be developed. The prospect for nutrition education and communication is daunting as information may come from several sources and stakeholders in the development of these foods.

47.

The term functional food is very new in the country and has not been officially defined. Even among food scientists and nutritionists, there is no general agreement on the term. Some of these professionals interpret nutritious foods as functional foods, while others feel that they are herbs or medicinal plants that prevent or reduce the risk of diseases. There is no move to initiate a regulation on functional foods since it is felt that several basic issues need to be resolved at the first instance, including its definition, identification and acceptance by the consumers.

48.

Nepalese people have some perceptions as well as beliefs that some particular foods are able to improve one’s state of health and well being, or may be able to reduce the risk of or prevent diseases. Some examples of such foods available in the country are bitter gourd, turmeric, garlic, honey, fenugreek seed, ginger, sesame and Indian plum. Whether such foods can be categorized as functional foods or not needs to be further discussed. The real functions of such foods are still to be scientifically proven and for which R&D play an important role. Even commonly available fruits and vegetables can be considered as functional foods and people here generally have positive attitudes towards such foods.

49.

Food does not only contain nutrients; it is a composite package of nutrients, antinutrients, allergens and health significant components. Some foods may even contain toxins. So, we need to identify more and more foods with health significant components which prevent the increasing trend of non-communicable diseases as well as reduce other risks.

50.

Thus, all the related professionals, including food scientists, food technologists, biotechnologists, biochemists, nutritionists, dieticians, home economists and medical doctors need to discuss, in a common forum, the development of strategies as well as future plans of action in the area of functional foods.

51.

The Philippines is endowed with natural products that are potential ingredients for functional foods. At least 10 000 plants have been documented and 2 000 species are being subjected to research. Without being labeled as functional foods, our ancestors have recognized that some foods may have medicinal functions or health benefits beyond nutrition, which have been passed on from one generation to the next.

52.

The Philippines does not have a policy or a set of regulations for functional foods. A draft Administrative Order on "Rules and Regulations Governing Nutrition and Health Claims of Prepackaged Food Products Distributed in the Philippines" was presented by the Bureau of Foods and Drugs, Department of Health in February, 2004. Functional food can be defined as a food that satisfactorily demonstrates that it beneficially affects one or more target functions in the body beyond adequate nutritional effects, in a way which is relevant to either an improved state of health and well-being or reduction of risk to disease. Functional food is different from that of drugs aimed at preventing or curing diseases.

53.

An in-depth investigation on consumers’ concepts, attitudes, beliefs, values and behavior toward functional foods was conducted in Metro Manila. Functional foods were generally associated with foods in natural and processed forms that provided specific health and physiological effects beyond nutritive functions. The problems concerning the potential acceptance of functional foods in the market was the non-acceptability to consumers due to apprehensions about its product attributes (cost, taste/flavor, appearance and others). Respondents recognized the need to gear R&D efforts towards the development of foods with functional substances into more acceptable forms like juice drinks, cereals/cereal products, milk and milk products, candies or pasta/noodles.

54.

The public has to be aware and conscious of the "limitations" of functional foods, that is, they are not cures or medicines but risk-reducing foods; and that the potential benefits of consuming functional foods could be realized within the context of "eating a variety of foods every day". There should also be a conscious look-out for the ability of the poorer segments to access the wide range of functional foods.

55.

Several studies are being conducted by the Food and Nutrition Research Institute, Department of Science and Technology to determine the effectiveness of dietary fiber present in coconut flour as a functional food in terms of its fermentability, its effect on mineral availability, glycemic index and cholesterol lowering. The University of the Philippines had conducted studies on the effect of incorporating carageenan into various local foods to improve their functional properties. The National Integrated Research Program on Medicinal Plants has devised methodologies in the selection and scientific validation of medicinal plants for primary health care. The research was comprised of agriculture, basic pharmacology and toxicology/mutagenicity, mutagenicity research, clinical pharmacology, dosage formulation and manufacturing research and phytochemistry.

56.

The growing concern for functional foods and related research and development could help in the attainment of food security either through a value-adding dimension that would encourage people to eat certain foods, vegetables for example, or through additional income that may be realized as food technology attempts to extract some of the physiologically active components for use in other food products.

57.

It has been observed that people consuming traditional diets over a long period of time live a healthy life free from any chronic illness. The additional benefits attributed to such diets over and above their nutritional significance is not always scientifically proven. Ayurveda, the traditional system of medicine practiced in Sri Lanka, recommends certain dietary items based on the traditional wisdom of their ancestors as treatment for certain illness.

58.

Though there is no established definition for functional foods, the general consensus of the scientific community is that functional foods are consumed as a part of a regular diet that demonstrates additional health benefits beyond its basic nutritional functions.

59.

There are an increasing number of dietary supplements, nutraceuticals and functional foods that have become available in the market for self medication. The growing scientific knowledge of the potential health benefits of both traditional and novel food ingredients is extremely encouraging. But they are presented and sold to the consumer with dubious claims which are not subject to any control by the Drug Regulatory Authority (DRA) or Food Administration Unit. There is no safeguard or guarantee under the current law and potentially hazardous products are freely available in the market. In recognition of these problems, the Director General of Health Services appointed a committee in April 2002 to serve as the scientific advisory committee to monitor dietary supplements and nutraceuticals.

60.

There is no systematic approach to address the issue and inadequate research is being done. Nevertheless, the Industrial Technology Institute (ITI) has taken some initiative to strengthen its capacity to undertake research and development in the area of food science to fill the gaps in knowledge and also to study the traditional claims linked to any particular food. This includes upgrading of the laboratory and training of research officers in various products including tea, coconut, medicinal herbs, etc. In addition, they are in the process of remapping the available data from different sources and promoting consumer awareness.

61.

It has been evidenced that improper food consumption is a cause of many chronic diseases, such as cardiovascular diseases and cancers; consumers are therefore now becoming more aware of their food consumption. Whereas healthy diet consumption is presently among one of the major concerns of consumers, functional foods and the dietary supplement business has been rapidly growing. As in other developing countries, there are a variety of imported and domestically-produced functional foods and dietary supplements available in Thailand. In addition, health claims on disease prevention that come along with functional foods also attract consumer attention, and have a great influence on the purchasing of functional foods.

62.

Functional foods are not a new concept in Thailand. It has been a firm belief among the people that food and medicine are from the same source and have the same purpose, i.e. to remain healthy. The strong points regarding functional foods in the country are that they are an integral part of the culture with a long history of use. Most of these foods, however, lack scientific evidence to substantiate the functional properties they are supposed to possess. Research on these foods is scattered among various academic and research institutions. Most of this work is focused on developing functional food products and identifying the bioactive compounds in these foods while in vitro and in vivo studies on the effectiveness of the bioactive components are still very limited.

63.

However, the problem Thailand is currently facing is how to regulate these functional foods. Based on the Thai FDA's perception, functional foods are grouped under the notification for food for special dietary uses and defined as foods which are similar in appearance to conventional food, consumed as part of a normal diet and exhibit physiological benefits including possibly reducing the risk of chronic diseases.

64.

According to the food regulations of Thailand, functional foods sometimes cannot be classified as either foods or drugs. Since Thailand does not have a specific regulation for functional foods, most of these foods are now falling in the grey zone between drugs and foods. However, clear cut identification is necessary in the pre-marketing process in order to classify whether a product is under the Drug Act or the Food Act. To classify a functional food as a drug or a food depends mainly on the type and concentration of active ingredients in the product and the claims made. If a product is classified as a food, three aspects need to be considered together, namely safety, quality and efficacy.

65.

For better consumer health protection, it is necessary to ensure that these health claims are based on scientific data and do not mislead consumers. As the food authority in Thailand, the Thai Food and Drug Administration has realized the problems regarding the control of functional foods, and is now developing a functional food and health claim regulation in order to avoid any negative impact arising from the growth of this food business.

66.

The general concept of functional foods in Viet Nam is that these are "foods that support the function of the organs in the body, and provide benefits beyond the meaning of nutrition, such as giving a feeling of satisfaction and well-being, increasing resistance and reducing the risk of diseases". Many foods are believed to have certain factors for preventing disease and strengthening the body. For example, Toi (Allium savtivum) is believed to help against bacterial or viral infection, and in many regions of Viet Nam, Toi is used regularly even in the ordinary diet of the people. However, in general, there is a lack of clinical trials to demonstrate the positive effects of these foods.

67.

Based on a classification suggested by the Ministry of Health concerning its utilization and concentration of micronutrients or other nutrients, the following are considered as functional foods: foods fortified with minerals and micronutrients; food supplements (nutrients, etc); food for health protection (products that support the functions of the body such as increasing resistance, reducing the risk to diseases); and foods that act as medicinal-nutrient products.

68.

There are already many kinds of functional foods being sold in the local market and this situation seems to be difficult to control. Along with socio-economic development and a free market economy, the protection of consumer’s interest and health has become an urgent need. In 1999, the Department of Food Hygiene and Food Safety (Ministry of Health) was established and, following that, some regulations have been established in which functional food is referred to as a part of these regulations in terms of its safety aspect.

69.

Presently, consumer understanding about functioning foods is still limited. Many people believe that some foods have some specific functions for health but are not quite sure about the concept, while expecting these foods to perform a lot of wonders. It should be emphasized that functional foods may have beneficial effects on our health, but they are not a replacement for a healthy, balanced diet and lifestyle. As functional foods will become an important area of food and nutrition, they should receive greater attention in Viet Nam in all aspects, including regulations, research and development as well as public awareness.

70.

Functional foods are an area of considerable research focus worldwide and at AIT. A number of definitions for functional foods are available in food science and nutrition literature. A brief description of all functional foods is that "it is a food that provides a health benefit beyond inherent nutrition". This new category of food represents an increasingly diverse collection of products.

71.

The Asian Institute of Technology has conducted a number of studies into various functional foods. In the field of probiotics in yoghurt, Lactobacillus brevis isolated from traditionally Thai fermented cabbage (so called Pak-kard-dong) was used, in comparison with commercial probiotic lactic acid strains. Viability of the probiotic at the end of marked shelf life of probiotics product is essential. In general, the functionality of all bioactive components needs to be effective at the point of use after processing and at the end of its shelf life. Studies have been conducted to determine the antioxidative effectiveness of black cumin oil which is used as an ingredient in many Asian countries. Efforts are being made to develop a method by which g-oryzanol, an antioxidant in rice bran can be isolated and purified from refining soap stock as a valuable co-product which might be added back to rice bran oil or used in other products (used in cosmetics and skin care products).

72.

Sound substantiated proof is essential in order to pave the way for functional foods to be given the importance they deserve. When there is good evidence it will be possible to persuade consumers that the product and the claims are genuine. It is important, therefore, to look beyond short-term commercial prospects to consider long-term scientific studies. There needs to be general scientific guidelines for testing the safety and clinical efficacy of functional foods and ingredients in order to validate their benefits. A problem that is difficult to regularize is the amount of the bioactive component that needs to be consumed in order to derive benefits as this depends on lifestyles, genotype and phenotype of the consumer. Technically, the development of methods to detect bioactive components in food or synergistic properties need to be developed especially for herbs, spice ingredients and ethnic products.

73.

A number of the traditional foods consumed in Asia have many of the active ingredients which have come under detailed scrutiny. Retention of such foods as part of our life style can be an easy method of deriving the benefits expected. There is an urgent need to set a framework of regulations that allows the production and sale of legitimate functional foods. A unified and co-operative approach in its development will be beneficial to the region.

74.

Arising from the 13 presentations made, several common points or issues were apparent. In Asia, several foods with functional attributes have been in use for centuries especially with reference to traditional and ethnic foods and a wide variety of foods including fruits and vegetables, legumes, spices and condiments, and marine fish. Even though the concept existed, the term "functional foods" is not in use and there is no accepted formal definition. Food regulations only exist for general foods and there are no specific laws for a separate category of functional foods exist in most countries worldwide. In the meantime many commercialized products already exist in the market claiming to be functional foods and carry various nutrition and health claims.

75.

There was a general positive attitude towards functional foods. These foods should, however, be viewed to have a disease-risk reduction and health promotional role rather than a curative role. In line with food-based dietary guidelines, functional foods should be food-based rather supplements. The health benefits of functional foods emerge from a holistic approach from several bioactive components present in a food and its bioavailability.

76.

Two working groups were formed to discuss the following topics:

77.

Both working groups discussed at length the characteristics that would distinguish functional foods from general foods. Several characteristics which may ultimately evolve for a definition of functional foods were identified. Several attributes which may reflect the fine tuning of the characteristics were listed, thereby clearly defining the scope of functional foods.

78.

Group I discussed the diet implications and the positioning of these foods in the daily diet. The Consultation recognized that although potential health benefits may be derived from consumption of functional foods, these cannot replace a healthy, balanced diet and an active lifestyle. Whilst certain foods may have proven functional properties, it is important to educate consumers on the appropriate usage of these foods. Over emphasis of such foods should be discouraged. The Consultation noted this and other similar issues related to nutritional safety.

79.

The Consultation discussed various consumer concerns on functional foods. Safeguarding consumer interest was recognized to be of prime importance. A related topic deliberated by the Group was communications about functional foods to the public. Conveying of accurate information relating to the claimed health benefits of functional foods to the public was considered important so as not to misinform or confuse consumers.

80.

The importance of scientific substantiation of claims for functional foods was reiterated by Group II. For traditional foods or ethnic foods, scientific substantiation was seen as important if health claims were to be made, in order to reinforce its long history of use. The Consultation called for closer collaboration and networking in conducting these scientific studies. Public, private and academia partnerships in scientific substantiation of the claims was encouraged.

81.

The Consultation recognized that in order to safeguard the interest of consumers, a regulatory system for pre-marketing approval for functional foods was essential. At the same time, such a system should be sufficiently competent, transparent and not unnecessarily restrictive. It was emphasized that the proposed system for functional foods must be established within the framework of the existing food regulatory system.

82.

On the subject of R&D, the Consultation recognized the need to understand and appreciate the current status of functional foods in the region. The Consultation further noted the need to establish an inventory of existing traditional and ethnic foods with potential functional properties and the follow-up research activities that are required. Collaboration among institutions within a country and at the region was also emphasized.

83.

Functional foods should be in conventional food form and possess inherent or added bioactive/biologically active components that have characteristics of promoting health benefits beyond basic nutrition which can be substantiated scientifically.

84.

Functional foods should have the following attributes:

85.

The challenge is to mainstream functional foods into the daily diet. This would require promoting consumption of foods with functional properties through national food-based dietary guidelines and appropriate nutrition strategies.

86.

Augmenting functional components/properties of foods through traditional processes like germination, fermentation, malting, food-to-food enrichment, etc. deserves due consideration. In addition, correct methods of food preparation and processing, both at the household and commercial levels are essential to conserve and enhance functional properties.

87.

Optimum intake of the functional food should be determined through human clinical trial which would indicate the amount of effective levels of the bioactive component in order to make a health claim. Even though a functional food is considered to have specific health benefits, excessive consumption should not be encouraged as this may displace other foods in the diet. The emphasis should be on variety, moderation, balance and a combination of foods to promote health and nutritional wellbeing.

88.

The population or the sub-population targeted by the product should be identified. The potential undesirable effects of population groups outside the intended target group consuming the functional food should be given due consideration and appropriate action taken to minimize this. The cumulative effect of consuming the active ingredients arising from different foods containing it should also be considered.

89.

The safety and quality of functional foods should be of prime concern. Other factors that need to be considered to ensure consumer acceptance include confidence in the health benefit, cost and affordability, availability, accessibility and convenience.

90.

Simple and accurate communication to the target populations should be emphasized. All efforts must be made to safeguard consumers from exaggerated health claims, misleading information on products and false advertising. Consumer information on preparation and storage of products must be clearly provided.

91.

Adequate data on consumers’ perception on functional foods are lacking in most countries and efforts must be made to obtain this information.

92.

Behavioural Change Communication (BCC) is important to create consumer awareness on functional foods, utilizing all available channels of communication. BCC to the public should cover all aspects of a wholesome diet and the potential role of functional foods in promoting optimal health. The existing sound practices of food preparation, processing and storage need to be reinforced. BCC should include information on the scientific evidence of the health benefits of functional foods.

93.

Scientific substantiation of functional properties should follow standard protocols and would include in vitro, epidemiological and in vivo (preferably in human) studies according to Codex guidelines. The difficulties of performing in vivo studies in humans, especially placebo-controlled trials on traditional foods, due to the presence of multiple ingredients need to be recognized. If no health claim is made for a food, in vivo studies on humans may not be necessary. If any health claim is to be made on a traditional and/or ethnic food it is not required to go through the standard protocol as described above since it has been consumed over generations.

94.

A regional network of scientists and researchers should be set up to undertake studies to substantiate the functional claims through sharing of databases and validation of results through multi-country approaches. Study protocols should be reviewed periodically and harmonized for the region. Research institutions, academia, industry and public-private partnerships must be encouraged for scientific substantiation of the claims.

95.

The treasure of traditional/ethnic foods of the Asia-Pacific region must be utilized as a basis for developing functional food. It is therefore necessary to carry out scientific substantiation of health claims for these foods through well-organized and suitably networked studies in the region in order to move this class of foods to functional foods. Digitization of documentation would greatly help to facilitate this effort.

96.

Functional foods must comply with national regulations on nutrition. All functional foods must meet the necessary requirements for food safety, labelling and claims as determined by national regulations or such guidelines as provided by Codex Alimentarius. For regulatory clearance of functional foods, an approval system consisting of expert committee members from different disciplines is encouraged to be in place in each country in the region within the framework of the existing regulatory system.

97.

False claims through advertising and promotion must be controlled through regulatory agencies. A minimum effective level of the bioactive component(s) must be established for the functional claim, and this level must be maintained throughout its shelf-life. The safety level of the claimed bioactive component(s) must be stipulated. Approved analytical methods must be available for testing the food, preferably carried out by accredited laboratories.

98.

Regulatory activities on functional foods should be established within the existing regulatory system and should also regularly keep abreast with Codex guidelines. Effective monitoring and evaluation of such activities should be central to such a regulatory system.

99.

Documentation of the existing information on traditional and ethnic foods and other foods that may have potential functional properties in each country is needed in order to create a database. Nodal institution(s) would need to be identified in each country to coordinate this activity.

100.

Studies should be conducted to identify the functional properties of these foods and substantiate their possible health benefits. The identified bioactive components in foods should be highlighted in food composition tables. Data obtained from these activities could be used in association with health and morbidity patterns in the country for formulation of policies and programmes.

101.

Development of new products using the traditional knowledge base of bioactive components as well as ethnic practices must be encouraged and should be based on scientific studies and evidence. The development of rapid, simple methods for testing bioactive components in foods should be given priority. The effect of processing on the bioavailability of bioactive components needs to be studied. Advanced basic research on bioactive components and novel molecules are also necessary. Reference materials and certified reference materials of bioactive components with a focus on validation in the region through networking should be developed. Countries are encouraged to be proactive in R&D activities, commencing with taking action on capacity building in human resources and infrastructure.

102.

Efforts can be made to identify foods common to the region with potential functional properties with a view towards establishing a regional standard for Codex consideration.

103.

Countries are encouraged to establish a database of traditional and ethnic foods with health benefits for the development of potential functional foods.

104.

Countries are encouraged to initiate follow-up activities on functional foods to bring about greater awareness to all stakeholders. Support from international agencies and donors could be sought if warranted. When these activities are organized, they are encouraged to invite the participation of all member countries in the region.

105.

National level advocacy and sensitization of policy-makers, orientation and training of programme managers and educators at all levels, including the food industry and consumer organizations are suggested.

106.

Countries are urged to promote foods with functional properties through national food-based dietary guidelines and appropriate nutrition strategies.

107.

Countries may consider identifying nodal institution(s) or focal points for coordination of all activities related to functional foods, including an information clearing house, liaison with other countries and international agencies and organizing activities on functional foods.

108.

Provide technical assistance for studies and activities on functional foods to be conducted by member countries.

109.

Strengthen regional advocacy and networking on functional foods in collaboration with other international agencies such as WHO and the United Nations University.

110.

As a follow up to the International Conference on Nutrition (ICN), the National Plan of Action for Nutrition (NPAN) was prepared and approved at the highest level involving the 13 ministries in the country. As per the NPAN, Food and Nutrition Policy, Agriculture Policy, Health Policy, Food Policy and Education Policy had been formulated and were being implemented.

111.

Health, Population and Nutrition Section Programmes (HPNSP) had been undertaken by the Ministry of Health and Family Welfare. Apart from this, multi-sectoral programmes - NNP had also been undertaken. Although the Ministry of Health and Family Welfare is the national focal point for nutrition activities, the closest and immediate partner is the Ministry of Agriculture. In consonance with ICN, nutrition considerations have been incorporated into all national programmes and projects. At the primary and secondary school levels, nutrition has been included in the course curriculum. Moreover, initiatives have been taken to incorporate nutrition in the course curriculum of Agriculture Training Institutes (ATIs). Besides, the vulnerable group development programme (VGDP), vulnerable group feeding programmes (VGFP), Food for Education (FFE) programmes, and Widows Allowance Programme have been introduced and are being expanded throughout the vulnerable areas of the country. As part of developing a nutrition situation databank, FIVIMS activities are also under implementation.

112.

As a follow up to the ICN in 1992, the NPAN was developed in collaboration and consultation with government and non-government organizations. A policy for development of soy bean and its by-products and utilization of soybean resources and a Milk Action Plan was developed, along with the development of milk products and milk processing. Food-based dietary guidelines and a food guide were developed which was depicted as the Chinese Pagoda. The Chinese Food Composition Tables (FCT), established and published in 1991, were revised in 2002. Another revision is underway which will be completed in 2005. A few bioactive components will be included in this FCT. Training courses in nutrition for dietitians, setting up of Registration for Dietitians for Certification is another on-going programme.

113.

Presently, revision of the Recommended Dietary Allowance to the Recommended Nutrient Intake is being undertaken. The National Nutrition Survey was completed in 2003 and the data are being analyzed and will be published in 2005. The Chinese Nutrition Congress was held in October 2004 with the participation of over 500 participants from China. A Nutritional Sciences book for professionals and scientists featuring six volumes has been recently published and is being widely used. It includes sections on: Basic knowledge on Nutrition, Food Technology, Community Nutrition and Clinical Nutrition. Nutrition labelling for packaged foods is another national level initiative.

114.

The achievements under the National Nutrition Policy have been reviewed and the vision for the next decade has been proposed as part of the terms of reference of the National Nutrition Mission set up in July 2003 under the chairmanship of the Prime Minister. The Executive Committee of the National Nutrition Mission met on 3 September 2004 under the chairpersonship of the Minister of State for Women and Child Development. This was followed by a Core Group meeting on 6 October 2004 and the agenda for the meeting for the National Nutrition Mission is under finalization. National Guidelines on Infant and Young Child Feeding were released on 6 August 2004. Nutrition advocacy and awareness generation have been accelerated and media campaigns have been organized on national nutrition events in the country.

115.

The follow-up of World Food Summit: 5fyl had gained momentum. A National Food Security Summit was organized in February 2004 to deliberate on food and nutrition security issues. A Task Force on Food and Nutrition Security was set up in the Planning Commission to prepare a mid-term strategy. A Conference of State ministers and Secretaries of food and public distribution was organized on 7 September 2004. Inter-ministerial meetings were held to review the implementation of FIVIMS Projects in Orissa and Himachal Pradesh.

116.

Several efforts were undertaken towards reducing food insecurity and malnutrition in Indonesia during the last decade as a follow-up to the ICN and WFS and WFS: 5fyl meetings. Some of the efforts included the development and implementation of food based dietary guidelines; the Food Act of 1996 and its regulations; the Food and Nutrition Plan of Action of 2000; nutrition advocacy for sustainability of food security and nutrition programmes to political leaders, legislative members, governors and heads of districts; strengthening existing programmes (such as Surveillance/FIVIMS, promoting child care and dietary guidelines); several policy and coordinating meetings (such as National Conference of Food Security Board, National Workshop on Food and Nutrition etc); new programme strategies, such as wheat flour fortification, revolving fund for food security, policy studies, family nutrition awareness, and capacity building for the local government; and revised RDA for Indonesians.

117.

However, the economic crises and structural and policy reformation, including decentralization transition during the last six years, had slowed down the improvement made on improving people’s welfare, including food security and nutrition of the people. Although the food security and nutritional status of the people have improved during the last decade, both macro- and micro-nutrient deficiencies, such as protein energy malnutrition (PEM), iron deficiency anemia (IDA), vitamin A deficiency (VAD), and iodine deficiency disorders (IDD), are still prevalent among Indonesian children and women, particularly among the poor.

118.

In order to address the issues of reducing food insecurity and nutrition problems faced by Indonesia during the five year crisis period, the Government of Indonesia took a loan for a Social Safety Net (SSN) programme. This included programmes on food (rice for the poor and complementary food for poor children), nutritious supplements, basic health services for the poor, strengthening the capacity of the concerned institutions such as the local government on food and nutrition surveillance, women’s movement organization (PKK) and integrated Health Post (Posyandu). Since the last two years the Government of Indonesia continued the programmes of rice for the poor and complementary food for poor children with its own money. Currently, the Ministry of Health promotes a programme on Family Nutrition Awareness, as part of Healthy Indonesia 2015 and Nutrition Plan of Action, through public-private partnerships. The programme includes promoting regular body weighing, exclusive breast feeding up to 6 months, using iodised salt, eating a variety of foods, and managing family resources to maintain food security.

119.

As a follow-up of the International Conference on Nutrition in 1992, the National Plan of Action for Nutrition Malaysia (NPANM) were developed through collaboration and consultations with many government and non-government agencies. The Plan included the major ICN issues and consisted of nine thrust areas from which strategies and activities were undertaken by various sectors. The main objectives of the NPANM were to achieve and maintain the nutritional well being of all Malaysians through access by all to a nutritionally adequate diet, safe foods and healthy living conditions in a manner that is environmentally sound and socially sustainable. Implementation of the strategies and activities were monitored and coordinated through a national committee (National Coordinating Committee for Food and Nutrition), which is chaired by the Deputy Director General of Health (Public Health). Four Technical Working Groups were established for the following areas, namely policy, dietary guidelines, training and research.

120.

Under the NPANM, existing nutrition and nutrition-related activities were strengthened and new activities were identified and implemented. Some of the major achievements in this regard include the setting - up of the National Council of Food Safety and Nutrition in 2003, which is a high level policy-making body in the country. The Council, whose members consist of the Chief Secretaries and Director Generals of several agencies and NGO’s, is chaired by the Minister of Health. In addition, in 2003 the Government approved the National Nutrition Policy that was developed with input from many government and non-government agencies. The NPAN is now being revised in line with the National Nutrition Policy.

121.

The NPAN is within the National Planning Commission of His Majesty’s Government of Nepal (NPC-HMG Nepal). The policy of NPAN had been incorporated in the 10^th Plan (2002 -2006) and accepted the status of nutrition as an indicator to improve the quality of life. The Ministry of Agriculture and Cooperatives and the Ministry of Health have separate units for nutrition, whereas in the Ministry of Education and Sport and in the Ministry of Local Development nutrition activities are included as part of primary education and rural development programme respectively. The Nutrition Coordination Committee of the National Planning Commission (NNCC/NPC) is responsible for coordinating the sectoral activities of NPAN.

122.

Some of the important and successful programmes are: universal salt iodization programme and distribution of iodized salt, feeding vitamin A capsules to children twice a year, nationwide implementation of the food act and food regulations. Another important aspect is the development of food-based dietary guidelines for Nepalese people in which traditional and festival foods have been included for promotion. A national policy and strategy for anemia control programme was also developed.

123.

However, the review meeting organized by NNCC/NPC on the status of NPAN’s achievements felt that further needs to be done to improve institutional mechanisms, human resources and institutional commitment for effective implementation and coordination for satisfactory implementation of NPAN activities. The National Nutrition Coordination Committee also felt the need to review/update NPAN.

124.

At the policy and programme level, nutrition considerations as embodied in the midterm PPAN 2005-2010 were incorporated in the medium-term Philippines Development Programme (MTPDP) 2005-2010. Household food security has improved through programmes such as food assistance, rolling stores, food for work, food for school programmes and the campaign for increased production/consumption of fruits, vegetables, eggs and milk products.

125.

To prevent and control specific micronutrient deficiencies, a universal supplementation programme for vitamin A was undertaken for 12-59 months with 86.8 percent and 91.2 percent coverage. Other programmes include food fortification of processed foods (Sangkap Pinoy) covering 66 products and staples (Diamond Seal) such as rice, wheat flour, sugar, cooking oil and salt.

126.

Food quality and safety has improved to protect consumers. Consultations with the food industry are ongoing for the adoption of RENI or Recommended Energy and Nutrient Intake, which used to be known as RDA.

127.

On FIVIMS, the manual of operations will be ready for distribution in December 2004. Continuing capacity-building activities have also been held throughout the year (2004).

128.

To prevent and manage infections, the Integrated Management of Childhood Illnesses (IMCI) has been adopted in 5 out of 15 regions in the country. Breastfeeding is promoted in the government bureaucracy through the establishment of lactation rooms and breast banks in workplaces. Anti-poverty programmes such as the CIDDS or Comprehensive Integrated Delivery of Social Services and KALAHI or "Kapitbisig Laban Sa Kahirapan" or "Joining Arms to Fight Against Poverty Programme" were being implemented to build capacities of families to meet their minimum basic needs. A Masterlist of nutritionally depressed municipalities (NDM) has also been distributed to agencies for consideration in the selection of development programme areas.

129.

Nutrition intervention programmes have been implemented targeting pregnant women infants and preschool children. There has been significant improvement in domestic food production with an increase in nutrient availability.

130.

The nutritional status of preschool and school age children and women has improved over the last decade. Programmes for strengthening food safety and control measures and implementation of FBDGs through multisectors (education, agriculture and health) are being implemented. A National Plan of Action for Children (2004-2008) for Sri Lanka has been developed to ensure universal access to health, nutrition and related services required for their growth and development.

131.

Besides A draft Food and Nutrition Policy of Sri Lanka (2004-2010) has also been formulated.

132.

In 2004, the food and nutrition plan was not directly incorporated in the 9^th National Economic and Social Development Plan. However, it is the aim of the government to ensure that all children aged 0-5 years are healthy both physically and mentally. In addition, exercise programmes, promoting appropriate sugar consumption in children and increasing consumption of vegetables and fruits are widely being promoted in order to prevent the rising problems of obesity and degenerative diseases. The routine nutrition activities are included in the Ministry of Public Health’s Strategic Plan. In this regard, it was noted that the problem of the quality of iodized salt needs to be urgently solved. The nutrient requirement for Thais (Thai Dietary Recommended Intake, DRI) is also currently under the process of revision.

133.

The government’s policy greatly emphasizes food safety, especially good manufacturing practices (GMP) for small and medium scale food producers. Certain food fortification programmes, i.e., double-fortified fish sauce and multiple fortifications of dried broken rice, etc., are planned for national level implementation and promotion in the market via the nutrition seal. Research on biofortification of iron in rice and a national survey on dietary consumption are also being conducted.

134.

In February 2001, the Prime Minister of Viet Nam ratified the National Nutrition Strategy which followed the National Plan of Action for Nutrition 1995-2000. The Government of Viet Nam is highly committed to continuing support for nutrition activities in Vietn Nam. Main activities included nutrition education, control of PEM, control of micronutrient malnutrition, food safety and hygiene, prevention of new emerging diet related chronic diseases, ensuring food security and multi-sectoral cooperation in nutrition activities. The government spent about US$3 million per year for nutrition programmes at the central level. In 2003, prevalence of under 5 malnutrition was 28.4 percent (underweight) and stunting was 32 percent. Viet Nam is still considered as having a high malnutrition rate in the region. Control of Vitamin A deficiency and IDD have been largely achieved with encouraging results, but sub-clinical vitamin A deficiency is still at about 15 percent amongst children under 5 years. Several activities on food hygiene and safety have also been carried out including mass education campaigns and food legislation development. The agricultural sector played an active role in ensuring food security, closely linking it with national poverty reduction programmes. This year, Viet Nam is carrying out a national nutrition survey (currently on-going) to provide mid-term data on evaluation of nutrition activities 2000-2005 in order to plan for the cycle of 2006-2010 of 2001-2010.

135.

The Consultation discussed in detail the draft report and adopted it unanimously after incorporating all amendments suggested. The Chair and Co-Chair of the Consultation expressed their appreciation to the participants for their active participation and cooperation.