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Proposal P293 – Nutrition, Health and Related Claims – Consultation Paper

1 February 2008

Dear Sir/Madam

Thank you for the opportunity to comment on this consultation paper. The New Zealand Food Safety Authority has consulted at length with the Ministry of Health in the development of our positions in this submission and we have the following comments to make.

General comments

Without a draft standard it is not possible to ascertain if the intent of the consultation paper has been carried through into the drafting of Standard 1.2.7

Detailed Response

1. Claimable food criteria or nutrient profiling scoring criteria for claims about vitamins and minerals

NZFSA supports an amended Option 3: Amend claimable food approach (remove claimable food criteria):

(a) foods carrying nutrition content claims must meet the Nutrient Profiling Scoring Criteria (NPSC);

(b) foods carrying general level health claims must meet the Nutrient Profile Scoring Criteria (NPSC)

We support the removal of the claimable foods criteria for nutrition content claims (as per option 3) and therefore having the same criteria applied to vitamins and minerals as to other properties of the food. ‘Claimable food’ is an outdated classification method and is empirical, not science based.

However we agree with the Ministry of Health’s view that option 3 as proposed by FSANZ will allow content claims to be made on energy dense-nutrient-poor foods without any disqualifying criteria. As such, this approach alone is inconsistent with national guidelines for healthy eating and is not in the best interests of public health.

Therefore we would strongly support, in addition to removing the claimable food criteria, the addition of a requirement that foods carrying any nutrient content claims (including vitamins and minerals) meet the nutrient profiling scoring criteria (NPSC) in line with the requirements for products carrying health claims.

Reviews of published and unpublished research clearly show that consumers associate content claims with health benefits, which indicates that consumers do not understand the distinction between nutrient content and health claims (Ni Mhurchu and Gorton 2007, Williams 2005). Of greater concern is the recent, soon to be published, research by Auckland University that suggests the majority of New Zealanders misinterpret nutrition content claims, with low income groups more likely to inappropriately believe that content claims imply the food is healthy.

2. Criteria for nutrition content claims about ‘saturated fatty acids as a low proportion of the total fatty acid content’ and about ‘trans fat free’

2.1 Criteria for nutrition content claims about saturated fatty acids as a low proportion of the total fatty acids content.

NZFSA supports an amended Option 4: New category of claim to the effect that the food has a low proportion of saturated fatty acids of total fatty acid content, limited to foods that meet the nutrient profiling scoring criteria (NPSC).

Foods can make a claim to the effect of a ‘low proportion of saturated fatty acids’ if:

• The food contains, as a proportion of the total fatty acid content no more than 28% saturated fatty acids and trans fatty acids; and

• the food contains no more  than 1% trans fatty of total fat; and

• The food meets the NPSC.

We believe that in this proposed proportional claim the 28% saturated fatty acids and trans fatty acids potentially allows provision for manufacturers to include higher levels of trans fatty acids into food products. The suggested amendment is an attempt to ensure manufacturing practice continues to maintain a very low level of trans fatty acid in food products. However the more fundamental issue is whether consumers will understand the resulting claim. There is a concern that consumers could interpret the claim as a low saturated fatty acid claim. If the Code was to remain silent in this area (as per option 1), the low proportion of saturated fatty acid claims currently available could continue to be made with no parameters around them regarding saturated fat content. This would create an inconsistency in the treatment of claims.

2.2 Criteria for ‘free of trans fatty acids’ nutrition content claims

NZFSA supports an amended Option 2: Trans fatty acid ‘free’ claims permitted on foods that are free of trans fatty acids and that contain:

• no more saturated fatty acids than 0.75g per 100mL of liquid food and 1.5g per 100g of solid food, or

• no more than 28% saturated fatty acids as a proportion of the total fatty acid content.

• The food meets the NPSC.

NZFSA proposes the addition of “the food meets the NPSC” for consistency. Inclusion of the provision “no more than 28% saturated fatty acids as a proportion of the total fatty acid content” is in line with National Heart Foundation guidance.

3. Substantiation of food-health relationships for use as a basis of general level health claims

NZFSA supports methods 1 and 2 (with minor modifications as outlined below) for substantiating general level health claims.

While we acknowledge the efforts and significant progress made in developing the scientific substantiation framework to date, we have reservations with methods 3 and 4 as proposed in this consultation document.

Method 1 – List of nutrient function statements

We would like to suggest that the words’ food-health relationships’ in 1.1 and 1.2 are replaced with ‘nutrient function statements’ and the words ‘based on’ are changed to ‘consistent with’. The subclauses would then read:

1.1 The nutrient function statements mentioned in Table 1 may be used as the basis of a general level health claim.

1.2 The wording of the statement is not prescribed for the purpose of making a claim, however, the general level health claim must be consistent with the scientific intent of the nutrient function statement.

For consistency with the rest of the Food Standards Code (FSC) the entry in Table 1 for Vitamin B₁ should be listed as Thiamin i.e spelt without an ‘e’.

FSANZ has removed the nutrient function statement for docosahexaenoic (DHA) from Table 1 as there are no criteria for claims about DHA in the Code on which to base a general level health claim. We are unable to locate where within the Draft Standard it stipulates that there needs to be criteria in the Code before a nutrient function statement is permitted. If the nutrient function statement for DHA that has been removed (DHA, an omega-3 fatty acid, supports the normal development of the brain, eyes and nerves) was to be evaluated under Method 4 of the scientific substantiation framework and found to be substantiated could the claim then be made? If the logic used by FSANZ to remove the DHA claim was to be extended to all nutrient function claims it would limit such claims to vitamins and minerals, protein and dietary fibre. This could be an unintended consequence of proceeding with the removal of DHA claims.

Method 3 – Prescribed list of scientific source documents

Table 3

While we support the majority of sources listed in Table 3, NZFSA does not support the use of textbooks to substantiate health claims. Textbooks can vary in quality and the scientific rigour applied to them e.g. they can vary from single author through to a large number of authors with editors of sections and overall editors. Our view is that source documents be on a prescribed list rather than textbooks which are an individual’s interpretation of source documents. A new edition of a textbook could be issued as a result of an update of certain parts of the text, while the relevant chapter remains unchanged. Thus the textbook itself could fulfil the 10 year rule, as stated in Table 3 (p33 of the Consultation Paper) as regards publication but the information itself may be out of date.

The scientific reviews carried out by the UK Joint Health Claims Initiative (JHCI) are unlikely to be updated because the JHCI ceased operation on 31 March 07. However the information on their website is scheduled to remain active until 2010. We suggest that FSANZ needs to further consider how to address the issue of outdated information.

We strongly suggest a requirement be added to method 3 to ensure the sources of information used as substantiation for a claim cannot be solely from one author.

Method 4 - Systematic Review

This method describes the standard methods for carrying out a systematic review. From a medical perspective the process of conducting systematic reviews has been accepted and applied for more than 10 years. In method 4 however, there is no requirement for systematic reviews to be published in an international peer reviewed journal or report. We therefore share the Ministry of Health’s concern that despite guidelines for conducting systematic reviews, not all systematic reviews are reliable (Moher 2007) particularly if reputable peer review and publication is not a feature. Findings of systematic reviews can be manipulated by varying the criteria for identifying and including (or excluding) research studies. We recognize that publication could mean access to substantiation data by competitors and while this would not be desirable, some peer review mechanism to address unreliability could significantly reduce the enforcement burden. Therefore, we support the use of systematic reviews that are funded and undertaken by independent organizations and individuals such as the JHCI and the Cochrane database of scientific reviews as listed for method 3.

We suggest that if method 4 is to be included in the substantiation framework, a model example of a general level health claim dossier prepared by means of method 4 - Systematic Review be included in the User Guide being developed for Standard 1.2.7.

Yours sincerely

References

Ni Mhurchu C, Gorton D. 2007. Nutrition labels and claims in New Zealand and Australia: a review of use and understanding. Australian and New Zealand Journal of Public Health 31(2): 105-12.

Williams P. 2005. Consumer understanding and use of health claims for foods. Nutrition Reviews 63(7): 256-64.

Moher D, Tetzlaff J, Tricco AC, et al. 2007. Epidemiology and reporting characteristics of systematic reviews. PLoS Medicine 4(3): e78.