Development and implementation of the guiding stars nutrition guidance program.

PURPOSE . To describe the collaborative process between a grocery retailer and a panel of nutrition experts used to develop a nutrition guidance system (Guiding Stars) that evaluates the nutrient profile of all edible products in the supermarket, and to report the results of the food and beverage ratings. DESIGN . A collaboration between a private retailer and members of the scientific community that led to the development of a scoring algorithm used to evaluate the nutritional quality of foods and beverages. SETTING/SUBJECTS . Northeast supermarkets (n  =  160). MEASURES . Food and beverage nutrition ratings and distribution of stars across different grocery categories. ANALYSIS . Descriptive statistics for rating distributions were computed. T-tests were conducted to assess differences in mean nutrient values between foods with zero versus three stars or a dichotomized variable representing all foods with one to three stars. RESULTS . All edible grocery items (n  =  27,466) were evaluated, with 23.6% earning at least one star. Items receiving at least one star had lower mean levels of sodium, saturated fat, and sugars and higher amounts of fiber than products not earning stars. CONCLUSION . The Guiding Stars system rates edible products without regard to brand or manufacturer, and provides consumers with a simple tool to quickly identify more nutritious choices while shopping. The low percentage of products qualifying for stars reflects poorly on the food choices available to Americans.

Position of the American Dietetic Association: functional foods.

All foods are functional at some physiological level, but it is the position of the American Dietetic Association (ADA) that functional foods that include whole foods and fortified, enriched, or enhanced foods have a potentially beneficial effect on health when consumed as part of a varied diet on a regular basis, at effective levels. ADA supports research to further define the health benefits and risks of individual functional foods and their physiologically active components. Health claims on food products, including functional foods, should be based on the significant scientific agreement standard of evidence and ADA supports label claims based on such strong scientific substantiation. Food and nutrition professionals will continue to work with the food industry, allied health professionals, the government, the scientific community, and the media to ensure that the public has accurate information regarding functional foods and thus should continue to educate themselves on this emerging area of food and nutrition science. Knowledge of the role of physiologically active food components, from plant, animal, and microbial food sources, has changed the role of diet in health. Functional foods have evolved as food and nutrition science has advanced beyond the treatment of deficiency syndromes to reduction of disease risk and health promotion. This position paper reviews the definition of functional foods, their regulation, and the scientific evidence supporting this evolving area of food and nutrition. Foods can no longer be evaluated only in terms of macronutrient and micronutrient content alone. Analyzing the content of other physiologically active components and evaluating their role in health promotion will be necessary. The availability of health-promoting functional foods in the US diet has the potential to help ensure a healthier population. However, each functional food should be evaluated on the basis of scientific evidence to ensure appropriate integration into a varied diet.

Health claims in the United States: an aid to the public or a source of confusion?

Health claims in the United States have been a topic of intense controversy since the mid-1980s. Three categories of claims can currently be used on food and dietary supplement labels in the United States: 1) health claims, 2) nutrient content claims, and 3) structure/function claims. Structure/function claims were authorized under the Dietary Supplement Health and Education Act and describe the effect of a dietary supplement on the structure or function of the body. Nutrient content claims are used to describe the percentage of a nutrient in a product relative to the daily value. Health claims describe a relation between a food, food component, or dietary supplement ingredient and reducing risk of a disease or health-related condition. Health claims are based on a very high standard of scientific evidence and significant scientific agreement. Are U.S. health claims really benefitting public health? Recent evidence suggests that this mode of communication has had limited success and in fact may be misleading to consumers.

Position of the American Dietetic Association: Functional foods.

It is the position of the American Dietetic Association that functional foods, including whole foods and fortified, enriched, or enhanced foods, have a potentially beneficial effect on health when consumed as part of a varied diet on a regular basis, at effective levels. The Association supports research to define further the health benefits and risks of individual functional foods and their physiologically active components. Dietetics professionals will continue to work with the food industry, the government, the scientific community, and the media to ensure that the public has accurate information regarding this emerging area of food and nutrition science. Knowledge of the role of physiologically active food components, from both phytochemicals and zoochemicals, has changed the role of diet in health. Functional foods have evolved as food and nutrition science has advanced beyond the treatment of deficiency syndromes to reduction of disease risk. This position reviews the definition of functional foods, their regulation, and the scientific evidence supporting this emerging area of food and nutrition. Foods can no longer be evaluated only in terms of macronutrient and micronutrient content alone. Analyzing the content of other physiologically active components and evaluating their role in health promotion will be necessary. The availability of health-promoting functional foods in the US diet has the potential to help ensure a healthier population. However, each functional food should be evaluated on the basis of scientific evidence to ensure appropriate integration into a varied diet.

Applying the theory of planned behavior to women's behavioral attitudes on and consumption of soy products.

OBJECTIVE: To identify variables that significantly predict the intention and behavior concerning soy consumption applying the Theory of Planned Behavior and to determine the role of race on women's perspectives and consumption behaviors concerning soy. DESIGN: Cross-sectional survey, with self-administered questionnaires. SETTING: City park service programs, community organizations, black cultural classes, and university offices. PARTICIPANTS: A convenience sample of 205 black (n = 103) and white (n = 102) women. VARIABLES MEASURED: Women's behavioral attitudes, subjective norms, perceived behavioral control, intention, and behavior related to soy consumption. ANALYSIS: Correlation and stepwise regression analysis. RESULTS: All variables in the Theory of Planned Behavior showed significant correlations with behavioral intention, with behavioral attitudes exhibiting the strongest correlation (r = .57, P < .01). Stepwise multiple regression analyses revealed that behavioral attitude toward taste and subjective norms accounted for 47.7% of the variance in behavioral intention. Behavioral attitude toward taste explained 48.6% of the variability in behavior. There was no difference between races for consumption or Theory of Planned Behavior variables. CONCLUSIONS AND IMPLICATIONS: A negative attitude toward the taste of soy was the major predictor for low soy consumption. However, future studies should be undertaken to verify this relationship once more women become aware of and have tasted soy.

Effects of a functional foods nutrition education program with cardiac rehabilitation patients.

PURPOSE: This study educated cardiac rehabilitation patients about the potential health benefits obtained from specific "heart healthy" functional foods and evaluated whether a targeted education program about these foods leads to their increased consumption or positive attitude changes. METHODS: The targeted audience was 69 cardiac rehabilitation patients (phases 2 and 3). Four foods (soy, oats, sterol/stanol ester-enhanced margarine, and nuts) were discussed in two 90-minute education sessions conducted 2 months apart. These sessions provided scientific information about each food, allowed participants to sample products, and collected data using both preeducation and follow-up surveys. RESULTS: The findings showed a significant increase in the reported consumption of all four functional foods (soy in particular), and several positive attitude changes concerning the relation between diet and heart health. Most of the participants (88%) either agreed or strongly agreed that they intended to continue incorporating functional foods into their diet to improve heart health. CONCLUSION: According to the reported attitudinal and behavioral intentions, the education of cardiac rehabilitation patients may lead to beneficial dietary changes conducive to the reduction of cardiovascular disease risk.

Functional foods: benefits, concerns and challenges-a position paper from the american council on science and health.

Functional foods can be considered to be those whole, fortified, enriched or enhanced foods that provide health benefits beyond the provision of essential nutrients (e.g., vitamins and minerals), when they are consumed at efficacious levels as part of a varied diet on a regular basis. Linking the consumption of functional foods or food ingredients with health claims should be based on sound scientific evidence, with the "gold standard" being replicated, randomized, placebo-controlled, intervention trials in human subjects. However, not all foods on the market today that are claimed to be functional foods are supported by enough solid data to merit such claims. This review categorizes a variety of functional foods according to the type of evidence supporting their functionality, the strength of that evidence and the recommended intakes. Functional foods represent one of the most intensively investigated and widely promoted areas in the food and nutrition sciences today. However, it must be emphasized that these foods and ingredients are not magic bullets or panaceas for poor health habits. Diet is only one aspect of a comprehensive approach to good health.

The cardiovascular effects of soy products.

In human clinical intervention trials, soy product consumption reduced levels of total cholesterol and low-density lipoprotein cholesterol (LDL-C). In October 1999, the US Food and Drug Administration approved a health claim for the relationship between consumption of soy protein and reduced risk of coronary heart disease. This article provides an overview of the cardiovascular effects of various soy products, including their effects on blood lipids, LDL-C oxidation, blood pressure, and vascular reactivity. Potential mechanisms of effect are discussed, emphasizing human clinical intervention trials. Soy consumption improves plasma lipids, although this effect appears to be more pronounced in individuals with elevated cholesterol. Soy and its associated isoflavones also reduce LDL oxidation and improve vascular reactivity.

Effects of an educational program on intent to consume functional foods.

As consumers seek alternate ways to enhance health and prevent disease, incorporating functional foods into nutrition counseling and educational programs will become increasingly important. The Functional Foods for Health Program at the University of Illinois created and distributed 142 functional food educational kits to Illinois registered dietitians (RDs). Twenty-seven RDs presented the kits to consumer groups and returned 530 utilizable program evaluation/consumption questionnaires (370 females, 160 males). The food the highest percentage of participants ate daily was tomato products (18.8%), followed by garlic, broccoli, oats, yogurt, fish, grapes, tea, and soy. The foods the highest percentage of subjects consumed less than monthly were: soy (68.9%), tea (57.8%), grape (44.8%), and yogurt (25.9%). Following the education, at least 74.9% intended to eat more tomatoes, grapes, oats, and broccoli. Our study demonstrates that age, gender, and awareness of health benefits dramatically influence intent to change dietary habits.