Interactions between nutrition and medicine in effect and law
The research presented in the thesis concerns the use of nutritional science in the implementation of the European Nutrition and Health Claim Regulation as well as either the positive or negative effects resulting from combining the use of foods and pharmaceuticals.
Due to technological and economical changes, food and food products are not only being used to satisfy hunger but also to enhance health. With these health enhancing products as food supplements and functional foods becoming more popular, regulations around these products are developed as the nutrition and health claim regulation. This European regulation deals with all voluntary communications on food products about its nutritional content or health effect and requires these claims to be based on scientific evidence. The research presented in this thesis describes that the implementation of the regulation could be optimised by clarifying the methods which should be used in studying the health effects and by creating one EU-wide enforcement approach.
While food shifts towards being used as medicine, the use of food together with medicinal products can lead to both positive effects as well as negative adverse events. In this thesis both are exemplified: based on literature we show the potential of food components to reduce lung inflammation and increase lung function in patients suffering from chronic inflammatory lung diseases; the reports of adverse events due to interactions between prescribed medicine and food products show the potential negative results of combining food and medicine. When the active components of food products can be identified in more detail, these interactions can be predicted.
We advocate for specifying and characterising the functional ingredient based on these active components in health claims. Currently the bioactive is often connected to the food item it is delivered in, as is done with epicatechin from cocoa. In the approved health claim the term ‘cocoa flavonols’ is used, even though the amount of epicatechin in the cocoa is leading for using the claim on a product since this substance is responsible for the health effect. Still, the same amount of epicatechin in another product, as grapeseed extract, is not allowed to bare the same health claim. The effectiveness of the NHCR will be increased when defining and studying this bioactive substance is requested in the dossier substantiating the claim.
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