Do The Math
Why functional foods may add up to better health

By Todd Runestad

Walk the aisles of your local natural foods store, and you're sure to notice tempting little words and phrases popping up on boxes, bottles, and cartons everywhere. "May help reduce the risk of heart disease," promises a box of cereal. "As much bone-building calcium as milk," touts an OJ container. "Nine grams of soy protein," says a nutrition bar, the words suggestively encircled by the shape of a heart.

Such tag lines announce the $76 billion global market for a new breed of nutritionally pumped-up products called functional foods. Since a tsunami of research in the 1990s thrust functional foods into the marketplace, the Food and Drug Administration (FDA) has authorized more than a dozen health claims that link certain nutrients with a reduced risk of various chronic conditions and diseases, showing that functional foods go beyond basic nutrition. "What has occurred over the last ten years is a refocusing of foods," says Clare M. Hasler, PhD, founding director of the Functional Foods for Health program at the University of Illinois at Urbana-Champaign. "We've gone from looking at foods as items that provide essential nutrients to items that prevent chronic disease."

But some nutritionists believe the functional-food concept makes it easier for manufacturers to make junk food sound healthier. (Maybe you've seen the cheese doodles bag proudly proclaiming 100 percent of the RDA of calcium?) "Functional foods reinforce the misleading idea that health benefits depend on single ingredients, and they divert attention from the need to promote healthful dietary patterns," says Marion Nestle, author of Food Politics (University of California Press, 2002) and former nutrition policy advisor to the Department of Health and Human Services.

The reality, however, is that most Americans aren't eating the recommended five daily servings of fruits and vegetables. The result? With convenience and concerns about public health trumping nutritional idealism, the FDA is allowing a limited—but growing—number of health and nutrient-content claims on food labels. Some added nutrients were previously available only in supplement form—and some labels make implied claims that merit close scrutiny. How can you best navigate the food-store aisles, now that they're flooded with souped-up promises and products? Let's investigate the three largest categories of functional foods to help you select the best foods for your health.

Fortified Drinks
Calcium-fortified orange juice is probably the best-known example of a fortified food. And its popularity is well deserved. After all, who wouldn't want a dose of bone-building calcium in their a.m. OJ?

This year, juice titan Minute Maid has begun marketing orange juice with as much calcium and vitamin D as milk. Tropicana offers OJ with twice the RDA of vitamin C and 100 percent of the RDA for vitamin E in each serving. Just be sure the OJ brand you choose contains one of the more soluble forms of calcium. "Tropicana does a good job" of enriching its orange juice, says Hasler. "The calcium form they use, calcium citrate malate, is better absorbed than the form generally used in a multivitamin, which is calcium carbonate." Also make sure these extra vitamins—in conjunction with supplements—don't interfere with any medications you may be taking.

Water and sports drinks form another category that's gone functional. A new wave of potables promises everything from a boost in stamina to a jolt of energy to a quick recovery. Of course, the first functional drink, Gatorade, is still around (in fact, it's number one in the sports-drink category because, well, it works).

One of the biggest new names in the genre is Red Bull, which contains enough B vitamins and amino acids (OK, and caffeine) to get your blood flowing. Drink a can and you feel a rush. "Red Bull defined the energy-drink category by combining caffeine, taurine [an amino acid], B vitamins, and glucuronolactone [a human metabolite formed from glucose] and simultaneously creating youth appeal," says Marilyn Schorin, PhD, founder of Focus Nutrition and onetime senior manager for scientific and regulatory affairs for the Pepsi-Cola Company. "Caffeine levels [in Red Bull] are higher than is allowed in soft drinks in the U.S., and the amino acid taurine and B vitamins can enhance energy."

So if energy is what you're after, here's a product that performs. Just beware: A serving of Red Bull contains about the same amount of caffeine (80 mg) as 1 cup of filtered coffee; if taken regularly, it can leave you dehydrated and craving that caffeine rush.

Enhanced waters packed with vitamins and minerals are also flooding the market. But do they work—or are you better off taking a multi in the morning? The answer is unclear, though some think the multi is better. "None of these New Age [water] drinks have a quantifiable benefit," says Randolph Horner, director of New World Nutrition, a product developer in New City, New York. "If you need to drink enough to be therapeutic, you're not a consumer, you're a guzzler."

The future of fortified drinks. Innovative changes and even more additions are on the horizon. Incongruous as it may sound, you'll soon be able to sip drinks containing heart-healthy soluble fiber and plant sterols.

Probiotic drinks, such as yogurt, kefir, and acidophilus milks already well-known in lactose-intolerant circles, are huge sellers in Japan and Europe and are just now gaining prominence on American grocery store shelves. Actimel, a single-serving probiotic drink from Dannon, for example, increases the numbers of "friendly" bacteria in the gastrointestinal tract, with demonstrated benefits for gut health and immunity.

Super Breakfast
Breakfast is clearly one key to good health. According to Harvard University researchers, reporting at a March 2003 American Heart Association conference, if you eat breakfast, you're significantly less likely to be obese and diabetic. Eating whole-grain cereal instead of refined grains further protects you against cardiovascular disease, diabetes, and certain cancers. If you eat oats, your blood pressure is likely to be lower. And if you feed your children oats they're about half as likely to be obese as their Pop-Tart-eating friends. In 1998, the FDA concluded there was "significant scientific agreement" that soluble fiber promotes heart health; the FDA now allows heart-healthy claims on fiber-rich cereals.

"Functional fats" will soon replace unhealthy trans fats in bakery items, turning some muffins into healthy morning meals. And since 1998, whole new brands of cereal containing psyllium, oats, flax, and high concentrations of functional fibers have sprung up, with healthy-sounding names such as Heart to Heart and Take Heart, helping manufacturers take advantage of fiber's perceived health benefits. You can't miss the myriad heart logos that appear on the fronts of cereal boxes, pointing to the health benefits of the products within (manufacturers either borrow heart-health logos from the American Heart Association or create their own). Considering that the average American gets only 14 grams of fiber per day, compared with the new recommendations of 25 grams per day for women aged 19 to 50 and 38 grams for men of the same age, it makes good sense for many people to incorporate these cereals into their diets.

But before you buy, note that FDA health claims almost always contain qualifying language. Heart-healthy claims are usually followed by the phrase "as part of a diet low in cholesterol and fat." The message? Just because you eat Cheerios or Kashi in the morning, don't think you can eat cheeseburgers all afternoon and still have a healthy heart. "The health claim [on some cereal boxes] is misleading," cautions Nestle. "It suggests that if you eat this product, you're going to solve that disease problem. Wouldn't it be wonderful if it were true? But it can't possibly be true. Eating Cheerios isn't going to prevent a heart attack." Incorporating these cereals into a well-rounded diet, however, is a positive health move.

The future of breakfast foods. Radical changes in breakfast foods are just getting started. Believe it or not, bagels, bars, waffles, and muffins may soon upstage breakfast cereals as convenient and healthy foods with which to begin the day. How? "Functional fats" will soon replace un-healthy trans fats in bakery items, turning some muffins into healthy morning meals.

New ingredients in cereals will also capitalize on health claims. Look for omega-3 fatty acids, soy flakes, lycopene, lutein, and high-tech "resistant-starch" carbs, which are said to counteract spikes in blood sugar and help you lose weight.

Breakfast will also increasingly speak to individuals. Women's breakfast foods will contain extra B vitamins, essential for mothers; cereal for kids will boast extra calcium; and a heart-health cereal with extra fiber will be available for men.

The Energy-bar Scene
Only a few years ago, nutrition bars were liberated from the candy aisle. This billion-dollar niche now commands its own section of the store. The principle behind these energy bars is to provide both simple sugars for a quick energy jolt and complex carbohydrates, the body's best long-term fuel source. But do they really work—or might you just as well eat a Snickers bar? A 2001 study by the Human Performance Laboratory at St. Cloud State University in Minnesota demonstrated that Clif Bars really do deliver sustained energy. When study volunteers drank a glucose control beverage, their blood sugar levels rose rapidly and then dropped to 9 percent below baseline—the point at which a sugar crash, or hypoglycemic reaction, begins to occur. But when they ate Clif Bars, their blood sugar levels rose moderately, peaking at 30 to 40 minutes and never dropping below baseline during the two-hour test.

Of course, choosing just one nutrition bar from the masses can be bewildering. How can you tell by perusing labels which bar has the right stuff? One easy way, according to PowerBar's director of marketing, Christine Dahm, is to look at the sugar content as a percentage of total carbohydrates. Better bars contain upwards of 45 grams of carbs, with about half that amount being sugar. (So a quality bar that contains 45 grams of carbs should have only about 20 grams of sugar.) In crash-and-burn bars, maybe two-thirds of the total carbs are sugar. The most decadent candy bars are almost all sugar. Stay away! "Also, look at total fat because fat is the hardest thing for the body to digest," says Dahm. Nutritionists also counsel avoiding bars that contain hydrogenated oils, a source of trans fats. Look for a bar containing more than 2 grams of fiber and healthy ingredients such as soy protein, oats, brown rice, other whole grains, and flaxseed.

The future of energy bars. Last year, President Bush's personal physician in Texas, Kenneth Cooper, MD, encouraged manufacturers to formulate and market "heart bars" loaded with vitamins B6 and B12, folic acid, and the cardiotonic herb English hawthorn (Crataegus laevigata). These bars may make it to store shelves before the end of Bush's term, so be on the lookout.

In addition, expect to find bars capitalizing on new research that demonstrates the subtly different benefits of different protein sources, such as whey, soy, casein, and bovine colostrum.

Whether or not you choose to use functional foods is personal. But eating a diet rich in whole fruits and vegetables and supplementing with functional foods seems to be a sound strategy and a smart step toward leading a healthy life. "People are interested in optimizing their health, reducing obesity—all those things that can improve their quality of life," says Hasler. And functional foods may make accomplishing that goal a little bit easier to swallow.