I would like to submit my comments on an article titled ‘Advertisement of
food products for children’ [1].
The industry producing food and nutrition supplements
indulges sometimes in misleading the medical fraternity and public by
giving exaggerated health claims in advertisements, product literature,
and product labels. This is done to increase sales and make more profits.
Many countries have laws to regulate marketing and
advertising of these products. In the United States, the Food and Drug
Administration (FDA) have regulatory responsibility for dietary
supplements. Under the Dietary Supplement Health and Education Act of 1994
(DSHEA), the dietary supplement manufacturer is responsible for ensuring
that a dietary supplement is safe before it is marketed [2]. Also, the
Federal Trade Commission (FTC) of US regulates advertising of dietary
supplements in national or regional newspapers and magazines; in radio and
TV commercials, including infomercials; through direct mail to consumers;
or on the Internet. The FTC requires that all information about
supplements be truthful and not misleading. Before disseminating an
advertisement, advertisers must have adequate substantiation for all
objective product claims. Similarly in European Union, article 16 of the
general food law says "Without prejudice to more specific provisions of
food law, the labeling, advertising and presentation of food or feed,
including their shape, appearance or packaging, the packaging materials
used, the manner in which they are arranged and the setting in which they
are displayed, and the information which is made available about them
through whatever medium, shall not mislead consumers." [3]. In India, the
Food Safety and Standards Authority of India lays down science based
standards for articles of food and to regulate their manufacture, storage,
distribution, sale and import, to ensure availability of safe and
wholesome food for human consumption. Article 24 of the FSS act 2006 deals
with ‘restrictions of advertisement and prohibition as to unfair trade
practices’[4]. It says: (i) No advertisement shall be made of any
food which is misleading or deceiving or contravenes the provisions of
this Act, the rules and regulations made there under; (ii) No
person shall engage himself in any unfair trade practice for purpose of
promoting the sale, supply, use and consumption of articles of food or
adopt any unfair or deceptive practice including the practice of making
any statement, whether orally or in writing or by visible representation
which (a) falsely represents that the foods are of a particular
standard, quality, quantity or grade-composition; (b) makes a false
or misleading representation concerning the need for, or the usefulness.
Provided that where a defence is raised to the effect
that such guarantee is based on adequate or scientific justification, the
burden of proof of such defence shall lie on the person raising such
defence.
Similarly, the article 23 (1) of the FSS Act regulates
the advertising of food products and says- "No person shall manufacture,
distribute, sell or expose for sale or dispatch or deliver to any agent or
broker for the purpose of sale, any packaged food products which are not
marked and labelled in the manner as may be specified by regulations:
Provided that the labels shall not contain any statement, claim, design or
device which is false or misleading in any particular concerning the food
products contained in the package or concerning the quantity or the
nutritive value implying medicinal or therapeutic claims or in relation to
the place of origin of the said food products."
As regard the advertisement of the product Pediasure in
the print and electronic media [5,6], the information brochure provided to
the medical practitioners, and the labelling information on the product
tin, the manufacturer (Abbott nutrition) makes following health claims
about the product: scientifically formulated to provide complete and
balanced nutrition; clinically proven to provide catch-up growth;
clinically proven to reduce sick days; supports brain development; and,
enhances height, weight and immunity.
The manufacturer quotes some studies in support of
these claims. An analysis of these studies reveals that out of the four
quoted studies:
• Three studies, apart from having sub-optimum study
designs, involved an explicit conflict of interest as Abbott or Ross
company employees are investigators in these studies [7-9] (the
manufacturer has not disclosed this fact in the advertisements, product
information for medical professionals and product labels).
• The fourth one [10] dealt with the relative
contribution of growth deficiency and psychosocial factors to cognitive
development in toddlers with infantile anorexia and has no reference to
the product – direct or indirect. Still quoted as "supports brain
development".
Thus, it is amply clear that in spite of a regulatory
mechanism in place to look into the issue of health claims in our country,
multinational nutrition companies are openly flouting the rules. This is
high time that regulatory bodies should take appropriate actions to stop
misleading health claims. Indian Academy of Pediatrics should take a lead
in highlighting such issues as its constitution mandates it to act as an
advocate of the children of this country.
References
1. Vashishtha VM. Advertisement of food products for
children: a tale of legality, ethics and indifference. Indian Pediatr.
2010;47:857-9.
2. US food and drug administration. Dietary
supplements. Available at: http://www.fda.gov/Food/Dietary Supplements/default.htm.
Accessed on 20 February, 2011.
3. European Commission. General food law – Regulation
(EC) no. 178/ 2002. Available at: http://eur-lex.europa.eu/pri/en/oj/dat/2002/l_031/l_03120020201en00010024.pdf
4. Food safety and standards authority of India. Food
safety and standards Act, 2006. Available at: http://fssai.org/Portals/0/Pdf/FOOD-ACT.pdf.
Accessed on February 20, 2011
5. Pediasure TV advertisement. Available at: http://www.youtube.com/watch?v=feezABoE3dM.
Accessed on 20 February, 2011.
6. Times of India. Pediasure advertisement. Available
at: http://epaper.timesofindia.com/Default/Scripting/ArchiveView.asp?skin=pastissues2&enter=LowLevel&A
W=1298276113687&AppName=2&G Z=T&BaseHref=TOIA%2F2010%2F11%2F14&Page= 11.
Accessed on 20 February, 2011.
7. Alarcon PA, Lin LH, Noche M Jr, Hernandez VC,
Cimafranca L, Lam W, et al. Effect of oral supplementation on
catch-up growth in picky eaters. Clin Pediatr. (Phila) 2003;42:209-17.
8. Morales E, Craig LD, MacLean WC Jr. Dietary
management of malnourished children with a new enteral feeding. J Am Diet
Assoc. 1991;91:1233-8.
9. Fisberg M, et al. Effect of oral nutritional
supplementation with or without synbiotics and sickness and catch-up
growth in preschool children. Int Pediatr. 2002;17:216-22.
10. Chatoor I, Surles J, Ganiban J, Beker L, Paez LM,
Kerzner B. Failure to thrive and cognitive development in toddlers with
infantile anorexia. Pediatrics. 2004;113:e440-7.