Ask the Nutritionist: What are Phoods?

Q:
I’ve been hearing a lot about “functional foods” recently but I don’t really know what they are. Can you explain?

A:
All whole foods have functional health components—carrots contain beta-carotene, grains have fiber—but some products have been manipulated to become “phoods”: a combination of foods and pharmaceuticals. They are ordinary foods with a healthy extra. Definitions vary, but most dietitians use the term functional foods or phoods for items spiked with a nutrient that has specific health properties.

Iodized salt is one of the earliest examples of a functional food. In the 1920s, iodine was added to salt to help prevent goiter (an enlarged thyroid gland). In recent years, food manufacturers have added “extras” to other foods. Take orange juice. By itself, OJ is a healthy beverage loaded with vitamin C and folate. But when calcium is added, the juice is transformed into a liquid delivery system for the bone-strengthening mineral. Could you get the same benefit from a supplement? Sure. But many people prefer to get nutrients from a single source. There are plenty of other places to find functional foods; for more examples, see our chart. (below)

FOODS & BRANDS	ADDED COMPONENT	POSSIBLE BENEFIT
Eggs Organic Valley	Omega-3 fatty acids (produced by feeding hens omega-rich flaxseed)	Lowers blood cholesterol levels; can boost joint health and ease arthritis
Yogurt Activia from Dannon	Probiotics such as lactobacilli and bifidobacteria	Improves gastrointestinal health
Margarine Benecol	Plant sterol and stanol esters	Lowers LDL and total blood cholesterol levels
Orange juice Tropicana, Minute Maid, Organic Valley	Calcium	Contributes to bone health
Vitamin water Multi-V Lemonade from Glaceau	Vitamins A, C and E and calcium	Protects cells from damage and keeps bones strong
Prune juice Sunsweet	Lutein (a vitamin found in green vegetables and egg yolks)	May help strengthen vision
Cereal Smart Start from Kellogg’s	Soy protein	Promotes heart health
Sports drinks Gatorade	Sodium and potassium	Replenishes electrolytes lost during exercise
Teas Traditional Medicinals	Echinacea	Can provide relief from colds

Q:
Do we need all of our foods to be functional? And are there any drawbacks to eating these foods?

A:
No, we don’t have to eat only fortified foods. Their value depends on each particular product and on the strength of the scientific evidence for supplemental benefits.

It’s important to note that the science backing functional foods may be less than rock solid. In 2003, the Food and Drug Administration relaxed standards for health claims. Previous regulations called for “significant scientific agreement” on benefits. Now, labels tout benefits if the “weight of scientific evidence” supports the statement. It may sound like a small word change, but that opened the door for dubious claims and products that can list benefits that wouldn’t have passed muster before. For example, drinks containing lutein may claim they help maintain eye health, even though the research behind this statement is inconclusive.

Lower federal standards plus an exploding demand by consumers for functional foods mean you may pay more for products that have an “extra” but provide no added health benefit. It costs companies pennies to add an ingredient or two to foods—much less than the 10 to 20 cents more they can then charge for the fortified version.

The worst-case scenario of functional foods would be consuming too much of questionable ingredients. Take St. John’s wort, which is found in certain herbal teas. The herb accumulates in the body and can cause allergic reactions, upset stomachs and sensitivity to light (both for skin and eyes).

Another concern is that consumers will veer away from a well-balanced diet to one that relies too heavily on additives for nutrition.

But a lot of fortified products are good for you. There’s solid proof that breads, cereals and pasta with added iron, fiber and folic acid (also known as folate, a vitamin that helps protect against neural tube defects in infants) are beneficial, as many of us don’t get enough of these nutrients.

When shopping, the key is to be realistic, and remember that if a functional food seems too good to be true, it probably is. Don’t over-eat a food just because it claims a health benefit. Eggs loaded with omega-3 fatty acids are still high in cholesterol. Cookies with soy protein provide no advantage if they’re high in sugars, sodium and fats. The best bet for all-around nutrition is still to make sure your diet is rich in fruits, vegetables, legumes and whole grains—which are naturally functional and chock-full of essential vitamins and minerals.

Suzanne Havala Hobbs, PhD, is director of the doctoral program in health leadership in the School of Public Health at the University of North Carolina at Chapel Hill.