A health claim found on a food labels and in food marketing is a claim by a food manufacturer that their product will reduce the risk of developing a disease or condition.
Health claims for food in Canada are overseen by Health Canada, the Government of Canada department responsible for national health. Health Canada has allowed 5 scientifically verified disease risk reduction claims to be used on food labels and on food advertising. Other countries, including the United States and Great Britain, have approved similar health claims on food labels.
Regulations The Food Directorate of Health Canada is responsible for the development of policies, regulations and standards that relate to the use of health claims on foods. They assess whether health claims are truthful and not misleading by reviewing mandatory and voluntary pre-market submissions. Health Claims are regulated under the Food and Drugs Act and the Food and Drug Regulations. The Section 5(1) of the Food and Drugs Act requires that all health claims be truthful and not misleading or deceptive. The regulatory requirements permitting the use of claims vary significantly depending on the nature and type of the claim. Some claims may be made without pre-market approval provided they are truthful and not misleading or deceptive, whereas other claims, such as disease risk reduction or therapeutic claims are only allowed once a regulatory amendment specifying the conditions for their use has been completed Health Canada (2009). "Food and Nutrition: Questions and Answers on Health Claims" URL: http://www.hc-sc.gc.ca/fn-an/label-etiquet/claims-reclam/qa-qr_claims-allegations-eng.php
Manufacturers are responsible for the accuracy of all information on the labels and advertisements for food and for compliance with all relevant food legislation and policies, including those pertaining to health claims. The Canadian Food Inspection Agency is responsible for ensuring that industry complies with these requirements
Types of approved claims Food claims express the composition, quality, quantity or origin of a food product. Examples of food claims are "Made in Canada", "Home-style Chilli", and "Fresh Pasta".
Nutrition (nutrient content) claims characterize the energy value of the food or the amount of a nutrient contained in a food. It provides a quick and easy way to identify foods with specific nutritional features of interest. Examples of nutrition claims are "low in sodium", "sodium free", and "100 Calories per serving".
Health claims are any representation in labeling or advertising that states, suggests, or implies that a relationship exists between consumption of a food or an ingredient in the food and a person's health.
There are two categories of health claims: General Health Claims and Specific Health Claims.
General health claims are broad, general claims that promote health through healthy eating or that provide dietary guidance. These claims do not refer to a specific or general health effect, disease, or health condition. For example, the claim "Include low fat product "x" as part of healthy eating" "healthy for you" or "healthy choice"
Specific health claims
Disease risk reduction and therapeutic claims Since 2003, Health Canada has allowed certain disease risk reduction claims to be used on food labels or in advertisements. These claims are used to describe the link between the characteristics of a diet, a food or food constituent and the risk reduction of a disease or the therapeutic effect of a food or food constituent or diet, (including restoring, correcting, or modifying body functions). Example: The claim "(naming the diet characteristics, food or food constituent) reduces the risk of heart disease" or "lowers blood cholesterol" can be used when the food carrying the claim meets conditions for use set out in the food regulations.# ^ Health Canada (2009). "Food and Nutrition: Questions and Answers on Health Claims" URL: http://www.hc-sc.gc.ca/fn-an/label-etiquet/claims-reclam/qa-qr_claims-allegations-eng.php
Function claims These claims are used to describe the specific physiological effects of foods and food constituents associated with health or performance. Example: The claim "(naming the food or food constituent) promotes regularity or laxation" can be used for coarse wheat bran providing a minimum of 7 grams of dietary fibre in a reasonable daily intake of the food.
Nutrient function claims (formerly known as biological role claims), are a type of function claim that describe the well-established functions of nutrients or energy necessary for the maintenance of good health, normal growth and development Example: The claim "Calcium aids in the formation and maintenance of bones and teeth" may be used for foods providing a minimum of 5% of the Recommended Daily Intake of the nutrient per serving of stated size and reference amount of the food.
Approved claims
"A healthy diet low in sodium and high in potassium can reduce the risk of high blood pressure"
Measurements of dietary sodium Dietary sodium can be measured in two ways. Total dietary sodium measures the amount (in grams or milligrams) of sodium in the food. Sodium ratio refers to the amount of sodium per amount of food eaten, usually in grams per kilocalorie, or milligrams per kilocalorie.
Dietary potassium can be measured as the total amount of potassium in the diet (usually in milligrams). It can also be measured in relation to sodium intake as the potassium-sodium ratio, in mg K/mg Na, or mg K/g Na. Only this last measurement shows the effect of dietary potassium as part of the equation; the rest measure only sodium intake, which is less important overall than the combined effects of potassium and sodium.
DASH diet Dietary Approaches to Stop Hypertension (DASH) is a dietary intervention designed to reduce blood pressure in patients with hypertension. It emphasizes fruits and vegetables, low-fat dairy products, whole grains, poultry, nuts and fish, and limits red meats, sweets and sweetened drinks. It has been found to reduce hypertension in patients even without weight loss or reduction of sodium intake. However, it is usually used in combination with a sodium-controlled diet.
Supporting research Most research has shown that reducing sodium intake reduces the risk of cardiovascular disease(CVD) and all-cause mortality rate.
A study by Langford in 1983 observed that populations that consume less sodium also tend to have relatively high potassium intake, and a lower rate of CVD. Within the USA, he also noticed racial and class differences in CVD, which he suggests may be due to sodium being cheaper to acquire in the diet than potassium, since many products contain added salt. Reddy and Katan recommend a salt intake below 5 g/day (5000 mg/day), and to increase potassium intake by 2 - 3 g/day. The study emphasizes that this should be done through dietary changes, rather than by taking a dietary supplement containing potassium.
He et al. observed in 1999 that increased salt consumption had a direct relationship to increased risk of CVD and all-cause mortality in overweight people.
Cook et al. observed patients 10–15 years after they had received treatments for prehypertension. They found that reducing sodium intake by 1.2 g/day reduced the number of people needing anti-hypertension treatment by 50%. Subjects who had no hypertension when they began the study 10 – 15 years earlier were also 50% less likely to require treatment for hypertension.
Their results suggest that increased sodium intake can cause CVD independently of hypertension - that is, even if the patient continues to have normal blood pressure. High sodium intake is associated with increased vascular reactivity and growth, and myocardial fibrosis, which is associated with myocardial disarray. They also noticed a direct relationship between sodium intake and ventricular hypertrophy, an increase in the mass of the left ventricle of the heart. In lay terms, this means an enlargement of the heart chamber that pumps blood to body tissues, including the cardiac muscle itself. In order to reduce blood pressure, and prevent hypertension and CVD, Cook et al. recommend reducing sodium intake by 25 - 30% from current levels.
Increasing dietary potassium intake has been shown to have a significant effect on blood pressure in populations with high sodium intake. It is not apparent from the study performed by Khaw et al. whether there is a difference for populations consuming low amounts of sodium; however, this is not particularly relevant in Canada, where people are more likely to consume excess sodium.
Dietary sources of sodium In 2007, Joffres et al. reported that in the typical Canadian diet, 11% of sodium occurs naturally, 12% is added during cooking and at the table, and 77% is added by industry during processing. Their study was to determine whether regulations to limit the amount of salt added by food manufacturers could reduce the prevalence of hypertension by 30%, which would substantially reduce Canadian health care costs.
Opposing research Some Studies do not recommend that the general healthy population should reduce their sodium intake because they feel that there is no conclusive evidence that this will guarantee a lower incidence of hypertension. A major study with this recommendation is the National Health and Nutrition Examination Survey (NHANES I). They did observe that people with a lower-sodium diet had a lower all-cause mortality and cardiovascular disease (CVD) -related mortality rate. However, because they could not be certain that reducing sodium intake could reduce hypertension and CVD, and it was not just one factor in the lifestyles of people who naturally ate a lower-sodium diet, they did not feel a need to recommend that the general population should reduce sodium intake.
The Developers of the DASH diet do not recommend reducing dietary sodium, because they found that the overall DASH diet is effective even without reducing sodium intake. That is, an overall healthy diet is more important than only reducing sodium intake, even in regulating hypertension. A 1996 study by Midgley et al. recommends a reduction in sodium intake for older patients with hypertension, but does not support recommendations for the general population to reduce their sodium intake.
As mentioned above, sodium intake can have cardiovascular effects without hypertension. It is therefore prudent to reduce sodium intake even if blood pressure is normal. It is important to consume an overall healthy diet that essentially follows the Canada Food Guide. Reducing sodium intake to recommended levels can reduce the risk of future hypertension and cardiovascular problems, and reduction of sodium intake carries no inherent risk. Because most of the sodium we consume is added during processing, preparing healthy meals at home and adding salt during cooking, rather than purchasing ready meals and snacks, is an easy way to reduce sodium intake without compromising the flavour and texture that salt provides in food.
Summary Most studies to date have shown that reducing sodium intake and increasing potassium intake, to levels recommended in Canadian nutritional guidelines such as RDA, can reduce the risk of hypertension, cardiovascular disease, and all-cause mortality. Most dietary sodium in Canada is added by food manufacturers during processing, and regulations controlling the amount of salt that can be added by food manufacturers may help reduce the prevalence of these illnesses in Canada.
"A healthy diet with adequate calcium and vitamin D may reduce the risk of osteoporosis" In order to make the health claim "A healthy diet adequate in calcium and vitamin D, and regular physical activity, help to achieve strong bones and may reduce the risk of osteoporosis, the food must be:
high or very high in calcium, may also be very high in Vitamin D,