In Pursuit of Health Claims (PCN Fall 2013) OCT 21 2013 | Consumers and Producers | Pulse Crop News
This article appeared in the Fall 2013 issue of Pulse Crop News.
Beans and Cholesterol Lowering
Decades have research have shown that pulses can help lower cholesterol, but how many consumers think of eating more pulses when they find out they have high cholesterol levels? They may think of eating Cheerios, or oatmeal, or even flax for its omega-3 fats. The Mayo Clinic lists the following top 5 foods that can lower your blood cholesterol:
- Oatmeal, oat bran and high-fiber foods
- Fish and omega-3 fatty acids
- Walnuts, almonds and other nuts
- Olive oil
- Foods with added plant sterols or stanols
So where are pulses on this list? And how does the evidence we have compare to the evidence for these other foods?
Pulse Canada brought together a group of experts earlier this summer to examine the existing evidence we have in relation to beans and cholesterol lowering to determine whether we could pursue a health claim. Based on a systematic review of 93 publications related to beans and cholesterol reduction, only 8 studies could be used for health claim substantiation. Of these studies, 62.5% of studies saw a significant reduction in total cholesterol, while 50% saw a significant reduction in LDL-cholesterol, indicating a moderate and low strength of association, respectively (by Health Canada’s standards). A high strength of association, as supported by ≥75% of clinical studies reviewed, is a pivotal component of a health claim submission.
Based on this, the experts at the workshop concluded that further studies are needed before a beans and cholesterol-lowering health claim application could be submitted to Health Canada or the U.S. FDA. However, they unanimously agreed that the evidence supported the relationship between beans and cholesterol lowering. Since 2010, Health Canada has approved cholesterol-lowering claims for plant sterols, oat products, psyllium products, mono- and poly-unsaturated fatty acids, and barley. In comparison to the 8 included studies for the beans and cholesterol lowering review, the number of publications used to substantiate these other recently approved claims has ranged from 13 to 84.
The magnitude of the effect of these foods/ food constituents on LDL-cholesterol levels as shown in the included studies ranged from a reduction of 0.04% to 8.8%. In comparison, the magnitude of the effect of beans on LDL-cholesterol levels in the 8 included studies is equal or even greater than effects seen from these other foods/food constituents that have approved health claims in Canada. Beans produced 7 to 11% reductions in LDL-cholesterol levels in the included studies.
Although we may not have enough “high-quality” studies to submit a health claim application for beans and cholesterol-lowering right now, pulses are still getting recognized for the heart healthy benefits by some key influencers. The American Heart Association report published in 2010 on setting goals for health promotion and disease reduction for 2020 included whole grains, nuts, and legumes/pulses as dietary measures to lower risk of cardiovascular disease (CVD) or CVD risk factors such as blood cholesterol.
Pulses and Blood Sugar Control
Pulses are well established as a low glycemic index food, are often cited by diabetes health organizations as a good food choice because of their carbohydrate composition, and decades of research have shown pulses can help to maintain healthy blood sugar levels after a meal, but is this message getting out to consumers? A quick google search of “foods for blood sugar control” found the following list of six foods on WebMD that may help control blood sugar:
- Broccoli, Spinach and Green Beans
- Salmon and Lean Meats
- Sparkling Water
So why aren’t pulses on this list? Studies confirm that consumers are looking for foods with health benefits. Adding health claims to packaging allows manufacturers to communicate the health benefits of their products to consumers, and allows consumers to make informed purchasing decisions. Despite the prevalence of people with impaired glucose tolerance (pre-diabetes) or diagnosed diabetes, there are no health claims related to short term blood sugar control being made in Canada and a limited number if any being made in the United States.
There is a tremendous opportunity for the pulse industry to move forward with claims related to blood sugar control since this type of claim does not require pre-market approval in Canada or the US. In addition to already having a large body of evidence for pulses in this area, dietary intervention is often the preferred first choice for people with impaired glucose tolerance or diabetes which is of high prevalence globally.
In August, Pulse Canada brought together a group of experts in Toronto to examine the existing evidence in relation to lentils and short term blood sugar control to determine whether there is enough strong quality evidence to back a health claim that would be deemed “truthful and not misleading”.
Of all the publications available related to lentils and post-prandial glycemia, there were 10 clinical publications (12 intervention studies) that met the inclusion criteria based on Health Canada’s standards for evidence to substantiate a claim. Nine of the 10 publications were considered to be “high quality”. Overall, a highly consistent beneficial effect of lentil consumption on measurements related to short term blood sugar control was supported by 100% of the high-quality studies. Although this review focused on lentils specifically, there are also a large number of published studies investigating the effect of beans on short term glycemic control that could potentially be examined for a similar type of health claim.
Based on the review of lentils and short term blood sugar control research, the consensus at the workshop was that the industry could make a health claim in the US for whole lentils without any further research required. Pulse Canada will be meeting with the US pulse groups and FDA representatives to discuss this in more detail. Some of the claim wordings that have been proposed are:
- Lentils are a low glycemic index food, which contributes to healthy blood sugar levels.
- Eating lentils can contribute to healthy blood sugar levels.
- A serving of x grams of whole lentils results in a lower blood sugar response.
- Incorporation of whole/split lentils into your diet will help keep your blood glucose at healthier levels.
- Lentils contribute to a reduction in the blood sugar rise after eating. (A serving of 1/2 cup of boiled or canned lentils can produce this effect)
- Lentils result in a low blood sugar rise. (A serving of 1/2 cup of boiled or canned lentils can produce this effect)
The benefits of achieving a health claim include increased consumer awareness and media attention of that food or food component, as well as added incentive for food industry to include that particular food/ingredient within product formulations so they can carry the claim on their label. For example, according to a 2011 Mintel report, 170 plant sterol enriched products (e.g. margarine, yogurt, drinkable yogurt, fruit juice) were launched in the U.S. since the claim was approved in 2000.
There is a significant opportunity to accelerate the pace of innovation and commercialization of lentil containing food products by focusing future research to substantiate this health claim beyond whole lentils to include lentil flours and fractions.