Health Claims
Unraveling their Language on Food Labels
by Mary L. Klatt and Rosean B. Termini
‘oatmeal because it is made from whole grain oats, a
{good source of fiber, and helps lower cholesterol. We
cat fruit for antioxidants and drink milk because calcium is
good for our bones. We eat these foods each morning to main-
{ain healthy diets, We read the labels on these foods and trust
the health claims that appear on them, However, should we?
‘Avbealth claim isan expressed or implied daim on a label
that characterizes the relationship ofa substance toa disease or
health-related condition.’ A health claim has two components.
First, there must bea substance, such as food, food compo:
nent, ora dietary supplement. Second, there must bea disease
‘or health-related condition. “Calcium may reduce the risk af
“osteoporosis” provides an illustration ofa health claim
“Health claims garnered the spotlight inthe 1980s, when mar-
keting strategies began emphasizing the role nutrition played in
E ach morning we wake up ta healthy breakfasts, We eat
promoting health. For example, the Kellogg Company launched
an advertising campaign in 1984 for its All-Bran cereal urging
consumers to maintain a healthy weight and eat a well-
balanced diet consisting of low-fat, high-fiber foods, fresh rits
and vegetables, The National Cancer Institute contributed to
the advertisement. The health message stated thatthe National
Cancer Institute “believes eating the right foods may reduce
your risk ofsome kinds of cancer|" The public responded, as
evidenced by the 37 percent increase in sales of high-fiber cere-
alsin just one year?
“However the US. Food and Drug Administration (FDA) did
not recogoize health claims on food labels. Such labeling infcema
tion about disease was deemed a drug claim’ FDA’ relnetance
to allow health-related claims was rooted inthe Federal Food,
Drug, and Cosmetic Act (DCA). The FDCA charged FDA with
the duty to safeguard the public rom false and misleading health
Ms, Kliatt
is a 2007 graduate of the Widener
‘School of Law.
FDL
Ms. Termini
isa food and drug lawyer who
recently published Life Sciences
Law: Federal Regulation of Drugs,
Biologics, Medical Devices, Foods
and Dietary Supplements.
“oan va| Urata3
‘information, Essentially this consumer
protection stance resulted ina health-
‘elated claims ban’ Subsequent, FDA.
relaxed is position based on the emerg-
ing evidence linking diet and disease as
‘well as the public heightened interest in
health and nutrition. easoned thatthe
food label was an “appropriate vebicle” for
‘consumer education.?
Health Claims under NLEA
‘Congress passed the Nutrition Labeling
and Education Act (NLEA) in 1990.
Considered milestone legislation, NLEA
established a uniform system for labeling,
‘conventional foods and delegated to FDA
the duty to both evaluate the validity of
health claims and the regulation of their
use." NLEA health daims must moet the
significant scientific agreement (SSA)
standard, codified by statute:
‘The Secretary shall proml-
cate regulations authorizing
claims... only ifthe Secretary
determines, based on the total:
ity of publicly availabe scien-
tif evidence... that there is
significant scientific agreement,
‘among experts qualified by sci-
entific taining and experience
to evaluate such claims, thet
the claim is supported by such
evidence.
LEA required FDA to evaluate seven
initial substancetdisease relationships
under the SSA standard. In 1993, FDA
approved these claims: calcium and osteo
porosis; dietary lipids and cancer; sodium.
and hypertension; dietary saturated fat
and cholesterol and risk of coronary heart
disease; fiber-containing geain products,
fruits and vegetables and cancer; fruits,
‘vegetables and grain products that con-
tain fiber, particularly soluble fe, and
1k of coronary heart disease and fruits
and vegetables and cancer!
Few additional dims have mastered
the scientific credibility to meet the
‘SSA standard. The rigor ofthe standard
thas been a source of contention among,
‘manufacturers attempting to promote
thelr products through the use ofhealth
claims, Critics have found the standard
paternalistic shielding consumers from
valuable health information when the
‘evidence supporting a claim falls short
‘ofthe standerd." Marketers have also
attacked the standard for being imper-
rmissibly vague and stifling free speech,
In 1999, FDA was forced to clarify what
the SSA standard meant following the
landmark case of Pearson v Shalala In
Pearson, FDA rejected four health dims
for dietary supplements. FDA argued the
evidence supporting the claims was “in-
conelusve" and filed to give rise to “sig,
nificant scientific agreement.” Rejecting
DAsanalysis, the court stated that FDA
never explained how it measured “signif
cant” or otherwise defined the phrase" I
hold that FDA was required to give some
“definitional content to the phrase ‘ig-
nificant scientific agreement™
ing why the claims were rejected.”
Following Pearson, FDA issued
guidance on the meaning of “significant
scientific agreement FDA explained
thatthe standard represented the
agency’ best judgment in determining
‘whether qualified experts would likely
agree thatthe scientific evidence sup.
prs the proposed health claim. Wile
"unanimous agreement is not demanded,
in explain-
sno magical number exists for determin=
ing when the scientific community's
‘agreement becomes significant. "In the
process of scientific discovery, sgnificent
scientific agreement occurs well afer the
stage of emerging science, where data
and information permit an inference, but
before the point of unanimous agreement
within the relevant scientific community
that the reference is valid”
Subsequently, FDA approved afew ad
ditional claims under the SSA standard
folate and neural tube defects dietary
sugar aleohol and cavities dietary soluble
fiber, such as that found in whole oats
and paylium seed husk and coronary ar
tery diseases plant sterol estersand heart