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Consumer Issues
Chapter 9
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Consumer Issues
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Proliferation of cyberspace information—and misinformation
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Ever-evolving science of nutrition has progressed from three square meals a day and a wellrounded diet to MyPyramid
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Baby boomers
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Information and Misinformation
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Consumers are often confused by nutrition messages
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Sources of consumer confusion include the media, the internet, and the food industry
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Information and Misinformation (cont’d)
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The media
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A significant source of nutrition information as well as misinformation
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Consumers may fail to make the distinction between correlation and causation and may
draw inappropriate conclusions from study results
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Other types of media inaccuracy
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Generalizing a study to a broader population
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Overstating the size of the effect
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Information and Misinformation (cont’d)
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The Internet
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Vast and ever-growing source of nutrition and health information
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49% of those seeking information are looking at diet, nutrition, vitamins, or nutritional
supplements
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No regulatory safeguards in place to ensure that the information is accurate
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Junk science coexists with legitimate data
Information and Misinformation (cont’d)
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The food and supplement industry
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Ingredient listings and Nutrition Facts labels are reliable and accurate by law
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Advertising can blur the line between false advertising and freedom of speech
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Ads can fall short of the expectations of truthful, substantiated, and not misleading
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Information and Misinformation (cont’d)
Judging reliability
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Test the validity and reliability of nutrition “news” by asking who, what, when, where,
and why
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Who is promoting the message?
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What is the message?
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When was the study conducted, the results published, the web site updated?
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Where was the study conducted?
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Why was the article written?
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Information and Misinformation (cont’d)
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Combating nutrition misinformation
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Determining if information is valid and reliable may be easier than persuading a client
that he or she has been a victim of hype
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If clients’ beliefs are unsupported but harmless, you may risk alienating them for no
reason by waging a war to convince them they are misinformed
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Clients may reject you as a credible reference
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Question
Is the following statement true or false?
Ingredient listings and Nutrition Facts labels are reliable and accurate by law.
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True.
Answer
Rationale: Although ingredient listings and Nutrition Facts labels are reliable and accurate by
law, advertising made to resemble newsworthy articles or featuring celebrity endorsements can blur the
line between false advertising and freedom of speech.
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Food Labels
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Nutrition facts
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Nutrition Facts label
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Intended to:
 Provide consumers with reliable and useful information
 Help avoid nutritional excesses
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Food Labels (cont’d)
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Everything hinges on portion size
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All information that appears on the Nutrition Facts label is specific for the size portion
listed
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There may be slight differences in the serving size among different manufacturers
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Food label serving sizes may also differ from size equivalents used in MyPyramid
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Food Labels (cont’d)
Percent daily value may not be accurate for an individual
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It may underestimate or overestimate the contribution to an individual’s diet,
depending on how many calories the individual actually needs
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The Percent Daily Value listed on food labels for fat, saturated fat, carbohydrate, and
dietary fiber is based on a 2,000-calorie diet
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Food Labels (cont’d)
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Percent daily value may not be accurate for an individual (cont’d)
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Ingredient list
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Nutrient amounts used to calculate the %DV are not all based on current dietary
reference intakes (DRIs)
Listed in descending order by weight
Food Labels (cont’d)
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Nutrient content claims
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Terms such as “Low,” “Free,” and “High” describe the level of a nutrient or substance in
a food
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Legally defined
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Reliable and valid
“More,” “reduced,” or “light”
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Food Labels (cont’d)
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Health claims
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Health claims on food labels are legally defined, such as “calcium may help prevent
osteoporosis” and “low sodium may help prevent high blood pressure”
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In contrast, structure/function claims, such as “improves mood,” “relieves stress,” and
“for hot flashes,” can be used without FDA approval and do not have to carry a
disclaimer
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Food Labels (cont’d)
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Health claims (cont’d)
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Items that make one of these claims also meet other requirements:
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They do not exceed specific levels for total fat, saturated fat, cholesterol, and
sodium
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They contain at least 10% of the Daily Value (before supplementation) for any
one or all of the following: protein, dietary fiber, vitamin A, vitamin C, calcium,
and iron
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Food Labels (cont’d)
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Health claims (cont’d)
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Additional health claim criteria are specific for the claim made
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Specific FDA-approved labeling language must be used for qualified health claims
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Companies must petition the FDA for prior written permission to make a qualified
health claim
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Food Labels (cont’d)
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Structure/function claims
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Offer the possibility that a food may improve or support body function
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Examples:
 An example of a disease claim needing approval is “suppresses appetite
to treat obesity”
 A function claim that does not need approval is “suppresses appetite to
aid weight loss”
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Food Labels (cont’d)
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Structure/function claims (cont’d)
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Previously used primarily by supplement manufacturers
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Disclaimer: “These statements have not been evaluated by the FDA. This product is not
intended to diagnose, treat, cure, or prevent any disease.”
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Structure/function claims now appear on food labels and do not require a disclaimer
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Food Labels (cont’d)
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Structure/function claims (cont’d)
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Can appear on “junk” foods
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Do not require FDA approval
Future directions
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Some food manufacturers and retailers have begun adding symbols to food packages
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Some food companies in Britain have adopted a traffic light label system that shows by
red, yellow, or green lights if a food is low, medium, or high in fat, sodium, and sugar
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FDA is considering amending labeling laws
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Question
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What do structure/function claims do?
a. Offer the possibility that a food may improve body function
b. Show FDA approval of the claim
c. Cannot appear on junk food
d. Include symbols in their claim
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Answer
a. Offer the possibility that a food may improve body function
Rationale: Structure/function claims offer the possibility that a food may improve or support
body function, which is a subtle distinction from the approved health claims that relate a food or
nutrient to a disease.
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Dietary Supplements
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A group name for products that contain one or more dietary ingredients including vitamins,
minerals, herbs or other botanicals, amino acids, and other substances.
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Dietary Supplements (cont’d)
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Intended to add to (supplement) the diets of some people, not to replace a healthy diet
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Taken by mouth as a capsule, tablet, lozenges, liquid, or “tea”
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FDA estimates there are more than 29,000 supplements on the market with more added daily
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Majority of supplements used are multivitamin/ multimineral supplements
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Scientific research is lacking for many herbal products
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Dietary Supplements (cont’d)
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Good manufacturing practice requirements (CGMPs)
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For the first time, identity, purity, quality, and composition of dietary supplements are
required to be accurately reflected on the label
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Dietary Supplements (cont’d)
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Significant step in protecting consumers is ensuring that supplements:
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Are free of contaminants or impurities, such as natural toxins, bacteria, pesticides, glass,
lead, or other substances
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Contain the stated amount of a dietary ingredient
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Are properly packaged
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Are made from ingredients that were properly handled
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Dietary Supplements (cont’d)
Manufacturers must report all serious dietary supplement adverse events to the FDA
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There are major differences between how supplements and drugs are regulated and marketed
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Dietary Supplements (cont’d)
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Supplement regulation
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In their medicinal sense, herbs are technically unapproved drugs
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Regulated by the FDA as foods
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Do not have to meet the same standards as drugs and over-the-counter medications
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Supplements differ greatly from conventional drugs
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Dietary Supplements (cont’d)
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Supplement regulation (cont’d)
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Safety and effectiveness are not proven
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Before a drug can be marketed, the FDA must authorize its use based on the
results of clinical studies
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The regulations regarding dietary supplements are lax
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Do not require FDA review for safety before they are marketed
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Dietary Supplements (cont’d)
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Supplement regulation (cont’d)
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Manufacturers that want to market a new dietary ingredient must submit information
to the FDA that supports their conclusion that reasonable evidence exists that the
product is safe for human consumption
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Once a product is marketed, the responsibility lies with the FDA to prove danger rather
than with the manufacturer to prove safety
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If a new product is found to be unsafe, the FDA issues a consumer advisory discouraging
its use
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Dietary Supplements (cont’d)
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Supplement regulation (cont’d)
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Strength is not standardized
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No legal definition of standardization as it applies to supplements
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Difference in concentration may be related to several factors
Dosages are not standardized
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Recommended dosages vary among manufacturers because there is no
premarket testing to determine optimum dosage or maximum safe dosage
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Dietary Supplements (cont’d)
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Supplement regulation (cont’d)
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Claims on packaging do not require FDA approval
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Cannot claim to be used for the diagnosis, treatment, cure, or prevention of
disease; they can be labeled with statements explaining their purported effect
on the structure or function of the human body (e.g., “alleviates fatigue”) or
their role in promoting well-being (e.g., “improves mood”)
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Statements do not require FDA approval
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Dietary Supplements (cont’d)
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Supplement regulation (cont’d)
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Warnings are not required
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Supplements are not required to carry warning labels
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No advisories about who should not use the product
Supplements are self-prescribed
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Consumers may misdiagnose their condition
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Clients may not inform their physicians about their use of herbs
Dietary Supplements (cont’d)
Supplement regulation (cont’d)
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Advice for supplement users
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Consumers who choose to use supplements should ask critical questions
beforehand
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Consumers should check with the FDA web site for consumer advisories on
supplements
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Only single-supplement products should be used and the dose should be small
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Dietary Supplements (cont’d)
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Supplement regulation (cont’d)
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Advice for supplement users (cont’d)
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Should be taken at different times from prescribed medications
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Should be discontinued immediately if adverse side effects or supplement–drug
interactions occur
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Pregnant or lactating women and children under the age of 6 should not use
herbs and other botanical supplements
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Question
Is the following statement true or false?
Dietary supplements are required to carry warning labels approved by the FDA.
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Answer
False.
Rationale: Unlike drugs, supplements are not required to carry warning labels about potential
side effects, adverse effects, or supplement–drug interactions. Nor are there advisories about who
should not use the product.
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Food Quality Concerns
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Retaining the nutrient content of food
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An eating plan may not provide optimal amounts of all nutrients if the food has been
improperly stored or overly processed
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The more that is done to a food before it is eaten, the greater the loss of naturally
present nutrients
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Vitamins, minerals, and fiber are particularly vulnerable to the effects of food processing
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Food Quality Concerns (cont’d)
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Functional foods
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One of the fastest growing segments of the food industry
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Generally applies to foods that provide health benefits beyond basic nutrition
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Manufactured functional foods
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A blend of food and pharmacy (“phoods”)
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Food has one or more functional ingredients added
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Food Quality Concerns (cont’d)
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Functional foods (cont’d)
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New functional foods with unique combinations of ingredients are being introduced in
the marketplace faster than science can provide information on their safety
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Adverse effects are brought to light only if consumers alert the FDA to suspected
problems
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It is likely that more foods will be considered functional and that the supply of
manufactured functional foods will expand exponentially
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Food Quality Concerns (cont’d)
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Functional foods (cont’d)
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Position of the American Dietetic Association is that functional foods have a potentially
beneficial effect on health when consumed as part of a varied diet on a regular basis
(ADA, 2004)
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Should be viewed as an option in the continuum of good nutrition, not as a “magic
bullet”
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Food Quality Concerns (cont’d)
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Organically grown foods
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Demand for organic foods has soared over the last decade
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Organic farming uses “natural” products
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Regulations are also in place for raising organically grown livestock
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Organically grown foods are comparable to conventionally grown foods in taste and nutritional
value
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Because of production costs, higher losses, and lower yields, they are more expensive than
other foods
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Food Quality Concerns (cont’d)
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Organically grown foods (cont’d)
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The USDA ensures that the production, processing, and certification of
organically grown foods adhere to strict national standards and that organic
labeling meet criteria that define the 4 official organic categories
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Organic food is usually more expensive
Food Quality Concerns (cont’d)
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Organically grown foods (cont’d)
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USDA maintains that organic foods are not safer than conventional foods
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The journal Food Additives and Contaminants showed organically grown
produce consistently had only 1/3 as many pesticide residues as
produce grown conventionally and that organic produce was far less
likely to contain more than one residue
Food Quality Concerns (cont’d)
Organically grown foods (cont’d)
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Environmental Working Group created a ranking of produce from worst (most pesticide
residues) to best (least pesticide residues)
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Experts agree that thoroughly rinsing all fruits and vegetables under running water and
discarding the outer leaves, where appropriate, are vital to reduce exposure to natural
dangers such as bacteria and manmade risks such as chemical residues
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Food Safety Concerns
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Foodborne illness
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In the United States, as many as 76 million illnesses and 5,000 deaths per year are
attributed to consumption of contaminated food or water
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Transmitted to people from within the food
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Food Safety Concerns (cont’d)
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Foodborne illness (cont’d)
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The majority of foodborne illnesses are caused by bacteria
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Other causes include viruses, parasites, and molds
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Foods containing animal proteins are the most frequent vehicles
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Most common symptoms of foodborne illness may be mistaken for the flu
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Most cases are self-limiting and run their course within a few days
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Food Safety Concerns (cont’d)
Foodborne illness (cont’d)
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Symptoms that warrant medical attention include bloody diarrhea, a stiff neck with
severe headache and fever, excessive diarrhea or vomiting, and any symptoms that
persist for more than 3 days
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Infants, pregnant women, the elderly, and people with compromised immune systems
(people with acquired immunodeficiency syndrome [AIDS] or cancer, organ transplant
recipients, or people taking corticosteroids) are particularly vulnerable
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Food Safety Concerns (cont’d)
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Foodborne illness (cont’d)
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Major cause of foodborne illnesses is unsanitary food handling
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Steps must be taken to prevent cross-contamination between raw and cooked foods
and through food handlers
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Food Safety Concerns (cont’d)
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“Mad Cow Disease” (bovine spongiform encephalopathy [BSE])
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BSE is believed to be caused by prions, an infectious form of a type of protein
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Prions are resistant to heat and so are not destroyed by cooking
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Creutzfeldt-Jacob disease (vCJD), which is the human version of BSE
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Food Safety Concerns (cont’d)
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Food biotechnology
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Combines plant science with genetics to improve food
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Positive results are numerous and varied
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Healthier crops and greater yields
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Greater resistance to severe weather
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Longer shelf-life and increased freshness
Food Safety Concerns (cont’d)
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Food biotechnology (cont’d)
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Higher nutritional value
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Better flavor
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Improved characteristics
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New food varieties through crossbreeding
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Potential benefits to alleviate world hunger
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Food Safety Concerns (cont’d)
Food biotechnology (cont’d)
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The United States is the leader in biotech farming
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Biotechnology has created more than 200 new therapies and vaccines, beginning with
FDA approval of recombinant human insulin in 1982
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FDA asserts that genetically engineered foods do not pose a health or safety risk
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Genetically engineered foods do not require mandatory labeling unless the food
contains new allergens
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Food Safety Concerns (cont’d)
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Food irradiation
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Irradiation is used to reduce or eliminate pathogens that can cause foodborne illness
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Sometimes referred to as “cold pasteurization”
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Most extensively studied food processing technique available in the world
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Federal law requires irradiated food to be labeled
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Question
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What is one of the positive results of food biotechnology?
a. Blander flavor
b. Neutral freshness
c. Improved characteristics
d. Enhanced food varieties
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Answer
c. Improved characteristics
Rationale: The positive results are numerous and varied including improved characteristics such
as celery without strings.