Gary C. Smith, Colorado State University
Japanese academics were among the first to promote the concept of “Functional Foods”. In the 1980s, they defined them as having nutrition, sensory satisfaction, and physiological functions.1 Food has long been used to improve health, such as oranges and chicken soup to fight colds or the proverbial “apple a day to keep the doctor away.”2
IFT’s “Functional Foods: Opportunities and Challenges” notes, “Research has proven that food can reduce the risk of disease, from the effect of vitamin A from eggs on blindness, to the effect of zinc from high-protein foods on the immune system. Functional foods fit into a continuum that ranges from health maintenance and promotion, to disease treatment.”3
What is “Functional Food”?
FDA is in charge of all food labeling but has no statutory or legal definition for “Functional Foods” and, thus, does not regulate them.1 Three industry groups (Academy of Nutrition and Dietetics, Institute of Food Technologists, International Life Sciences) have separate, but very similar, definitions.
An amalgam of these would be, “Whole foods and fortified, enriched, or enhanced foods that improve health beyond basic nutrition.”1
Marketers have pounced on the concept, with one caveat: fortified foods and enhanced foods (which contain added nutrients or ingredients) are considered “Functional Foods,” whereas enriched foods (which only add back original ingredients removed during processing) are not considered “Functional Foods.”1
U.S. Consumers Prioritize Functional Foods
There is no doubt that diet influences human health, and National Institutes of Health confirms that the rise in obesity, diabetes, chronic lung disease, and cardiovascular disease in the U.S. is related to what and how we eat.2
Marketers were quick to seize on this opportunity when Pharmaceutical Market Europe magazine reported that, “Functional Foods command an average 25% profit margin, which is well beyond the single-digit percentages that food companies make on many of their consumer products.”2
And demand heated up during the COVID-19 pandemic. A survey of “U.S. Behaviors That Are Higher Priority Since January 2020” showed that 52% of adults answered Strengthening Immunity, 47% said Eating Healthy, and 41% said Managing Weight.4 Five Key Behavior Shifts identified by Archer Daniels Midland™ emphasized interest in tailored nutrition and a proactive perspective on immunity.5
People Increasingly Value Foods that Promote Immunity
Functional Foods gained prominence during the pandemic; 63% of shoppers now regularly buy foods for specific health benefits.6 Consumers are particularly interested in the following:
- Vitamins and minerals
- Immunity-boosting products
- Pediatric health
- Support for individuals at higher risk for getting more severe COVID-19, such as those with hypertension, obesity, or diabetes.6
In 2019, immunity ranked 18th among health issues of greatest concern, but now it ranks third.6 Consumers are now more concerned about immunity and wellness as they now seek Functional Food.7
Almost half (48%) of parents cite “immune health” as the reason they give children vitamins, minerals, and supplements, but less than 1% of global launches of new foods made immune-system claims during the two years prior to February 2020 (the start of the pandemic).7 There is a connection of gut health to immunity, since 70% of the immune system is in the gastro-intestinal gut microbiome, and it contains 10 times more health-determining bacteria than the rest of the body.8
Functional Foods are Trending Higher
Whole Foods Market™ identified “Ten Trends To Watch For in 2022”; 7 of the 10 trends had a health component.9 More than half of U.S. consumers say they are eating “more healthily” than they did prior to the pandemic.6
A survey found that 49% of global shoppers and 46% of those in the USA believe that health and wellness have become much more important over the past year.10 In the 1980s through the early 2000s (Healthy 101), consumer diet choices were about weight management – what was not in foods, such as fat and calories.11
Next came Healthy 201 from 2004 to 2020, when consumers were driven more about feeling good about what they eat, such as Organic, Natural, and Sustainably Raised.11
Now we are looking at Healthy 301 (Functional Foods, what foods can do for me – does it supply me with protein; does it support my health) and Healthy 401 (nutrition tailored to the unique individual).11
Consumers Want Food that Supports Mental Health in Addition to Physical Health
Health and wellness are being redefined as more than just nutrition and fitness. It now also means mental and emotional health; shoppers are turning to their grocery stores for answers to their quest for health.12 Nutrition ingredients can sharpen the mind and retain cognitive health through the person’s lifespan, according to research by King’s College London.13
Consumers have become more interested in the way that food can…
- Boost the body’s resilience.
- Lessen the emotional aspects of mental health.
- Enable improvements in mood and happiness by reducing stress and fatigue, as well as optimizing relaxation and sleep patterns.14
A brain health expert recommends starting your day with the right foods (i.e., the Big Three brain-boosting nutrients – protein, fat, and fiber) to help maintain heart health, provide steady energy, and optimize cognitive functioning.15 Concepts involving “Holistic Health” and “Functional Nutrition” both claim that taking a holistic approach to health, focusing on immunity-supporting foods, can help boost the body’s resilience and improve physical, mental, and emotional well-being.16, 17
“Food-As-Medicine”: Some Value Medicinal Benefits Over Taste
Mention of the term “Food–As–Medicine” (some call it “Kitchen Medicine”) helped it gain traction in January 2018 when a Congressional Food–As-Medicine Work Group convened with Jim McGovern (D–MA) as Leader, and Dariush Mozaffarian (Tufts University) as Scientific Panel Leader.18
John Stanton (a food marketing expert) said, “Food today is more about medicine than about taste; almost everything that tastes good has been labeled ‘bad for your heart’ or ‘causes cancer’. It’s amazing that people still pay attention to all the news about food, given that nutritionists have changed their opinions on virtually every bit of eating advice they have given us over the years – look at what’s happened to advice about cholesterol, and fats, and sodium.”19
Yet we have made food a medical product; it’s happened because of the opinions of friends and relatives or the reading of articles online from fringe groups advocating all sorts of unfounded beliefs.20
Viewing Food as Medicine Dates to at Least 400 BC
The “Meals that Heal” concept dates back to ancient Greece, when Hippocrates (the father of modern medicine), in 400 BC, declared, “Let food be thy medicine, and medicine be thy food.”21
Mehmet Oz (Columbia University) says, “A growing body of research evidence suggests that foods may be as good as – or better than – drugs; eating the right foods – and avoiding the wrong ones – can help boost the immune system and combat cancer, heart disease, diabetes, and Alzheimer’s disease.”21
What Does “Food-As-Medicine” Mean to Consumers?
What Food–As–Medicine means for consumers is a moving target – impacted by a multitude of factors such as individual-need states, age, and socioeconomic status.22 The ambiguity of the concept has allowed marketers to create products for specific medical purposes rather than using “Kitchen Medicine” to improve general health.22, 23
HealthFocus International looked at Food–As–Medicine across 22 countries and found that:
- 70% of people strongly believe in medicinal benefits from foods;
- and 49% have increased their belief in Food–As–Medicine over the past two years.24
In November 2020, 43% of U.S. adults said that staying healthy and living longer were the top goals they wanted to achieve with their food choices; if a food manufacturer can demonstrate that its products have medicinal properties, it could be a boon to its marketing strategies.25
Is Modern Healthcare a Barrier to Food-As-Medicine?
The concept of Food–As–Medicine has been around for ages; consumers eat certain foods (e.g., elderberry, moringa, turmeric, kombucha) because they believe those foods help them build immunity, prevent inflammation, aid their digestive health, and relieve stress and anxiety.25
Some say healthcare may be a barrier to adoption of Food–As–Medicine; it might be better if we gave everybody free vegetables instead.26 A documentary blames meat for “The End of Medicine”, saying, if everyone around the world went Vegan, both individuals and the planet would be healthier.27
Some say, “Now is the time to get on the ‘Food–As–Medicine’ train; now is the time to improve the health and wellness of the nation by having fruits/vegetables take a bigger piece of the consumer’s plate.28 Others say, “People have finally figured out that we cannot medicate our way out of diseases and ailments; it has become clear that the solution to our health challenges is not found in the ‘pharm’ but on the ‘farm’.”29
Consumers are Still Confused About Food-As-Medicine
Even though 80% of shoppers believe that “fresh” food is healthier for them than “processed food marketed as healthy,” there’s an information gap:
- 62% of consumers cite conflicting information and confusion about the healthfulness of specific foods.
- 40% do not clearly understand which fresh foods can act like medicine.
- 53% say it’s essential to get data about food origins, safety, and nutritional properties to confidently use Food–As–Medicine.30
The Deloitte Insights® survey found that most consumers see potential benefits from Food–As–Medicine; it revealed these percentages of consumers who “agree” or “strongly agree” with each statement:
(a) The right foods can help keep me healthy and prevent me from suffering certain health problems, 78%
(b) The right foods can be therapeutic and help alleviate certain health problems, 76%
(c) Eating the right food can be the best medicine, 75%31
U.S. Consumers Will Pay a Premium for Foods that Act as Medicine
Even though the price is influencing shopper purchase decisions at retail more during these inflammatory times, 55% of consumers say they are willing to pay a premium for the right foods if they can act as medicine – contributing to their health and welfare.31, 32
In the U.S., more than 48 million households have a member with a health condition that needs to be managed through diet; these families can benefit from foods that have preventive or therapeutic effects, but in no case should Food–As–Medicine detract from the importance of pharmaceuticals prescribed by a physician.33
Food-As-Medicine Gains Federal Foothold
As consumers have sought foods to boost immunity and overall wellness, the concept of Food–As–Medicine has begun to take hold. Some say “Food and medicine will converge in the next five years because of the pace of science and the powerful health benefits of produce (i.e., fruits and vegetables) as ‘accelerators’.”34
To reduce diet-related diseases (high blood pressure, obesity, diabetes, cancer, heart disease, and stroke) and hunger, President Biden announced he is creating a pathway to:
- Provide free school meals for all students;
- Expand the Supplemental Nutrition Assistance Program (SNAP);
- Develop front-of-package nutrition labels; and
- Implement a Medicare test of “Food–As–Medicine.”35
Some of the White House proposals will require Congressional action, while others can be undertaken by FDA (e.g., front-of-package nutrition labels; guidelines to reduce sodium and added sugars in food).35
FSNS offers a full range of analysis for nutritional labeling.
1 Valigra, Lori. 2021. Food Quality & Safety. May Edition.
2 Zacka, Michael. 2014. Food Processing. June Edition.
3 Institute of Food Technologists. Food Processing. June Edition.
4 Mintel®. 2021 Food Processing. August Edition.
5 Shroeder, Eric. 2021. Dairy Processing. August 30 Issue.
6 Sloan, Elizabeth. 2021. Food Quality & Safety. May Edition.
7 Accetta-Smith, Pamela. 2021. Diary Processing. April 20 Issue.
8 Bonham, Sara. 2021. Dairy Processing. April 21 Issue.
9 Nunes, Keith. 2021. Dairy Processing. October 18 Issue.
10 Bonham, Sara. 2021. Dairy Processing. June 28 Issue.
11 Ishmael, Wes.2021. CALF News. July Edition.
12 Nelson, Andy. 2021. Dairy Processing. July 20 Issue.
13 Hughes, Kerry. 2021. Prepared Foods. November 17 Issue.
14 Williams, Lu Ann. 2021. Prepared Foods. July 16 Issue.
15 Wicks, Lauren. 2022. Well + Good. October 24 Issue.
16 Innova Market Insights®. 2021. Prepared Foods. September 14 Issue.
17 Canning, Katie. 2021. Dairy Foods. October 3 Issue.
18 Teicholz, Nina. 2018. Nutrition Coalition. January 10 Issue.
19 Stanton, John. 2018. Food Processing. June Edition.
20 Stanton, John. 2019. Food Processing. March Edition.
21 Newsmax® 2022. Special Health Report. Summer Edition.
22 McHugh, Holly. 2020. Prepared Foods. March Edition.
23 Berry, Donna. 2020. Meat + Poultry. December 28 Issue.
24 HeathFocus International. 2020. Meat + Poultry. December Issue.
25 The NPD Group®. 2021. Prepared Foods. April 6 Issue.
26 Gregg, Jeff. 2021. Dairy Processing. July 26 Issue.
27 Thompson-Weeman, Hannah. 2022. Meatingplace. June 1 Issue.
28 Acosta, Gina. 2022. Progressive Grocer. August 2 Issue.
29 Burns, Cathy. 2022. The Packer. October 27 Issue.
30 Deloitte Insights®. 2022. July Edition.
31 Edsall, Daniel. 2022. The Packer. September 26 Issue.
32 Sowder, Amy. 2022. The Packer. September 27 Issue.
33 Academy of Nutrition and Diabetics Foundation. 2022. August Edition.
34 Strailey, Jennifer. 2022. The Packer, July 15 Issue. [1] Hoffman, J. and J. Wiesemeyer. 2022. Drovers. September 27 Issue.
35 Hoffman, J. and J. Wiesemeyer. 2022. Drovers. September 27 Issue.
