CAMS

CAMS and the consumer

“Do you believe that the company that makes the product has to give proof of this claim? … I would like to believe it.”

CAMs, or Complementary and Alternative Medicines are an interesting grey area for the average consumer – somewhere between a medicine and a food. The shelves are full of them, so obviously we are buying them! But what does the man on the street think about the health claims made by these products?

We’ll be examining exactly what is regulated and how a little later in the newsletter – but for now let’s take a look into the mind of the average consumer. Do we believe that solid science and thorough testing back up every health claim that appears on marketed products?

I asked a few people in the medicine aisle of a few local grocery stores three questions:

1. When you see a health claim on a product such as “reduces blood pressure” “assists the immune system”, “aids in weight loss” or “lowers cholesterol” etc – do you believe it?

2. Do you feel that enough information is given on health claims as to how the product does this? Or don’t you feel this information needs to be included?

3. Do you believe that the company that makes the product has to give proof of this claim in order to be allowed to print the claim?

My first telling observation was that for the most part, people seemed surprised by the questions. This would lead me to think that many people hadn’t thought to question these claims – but perhaps I was wrong. Once presented with the questions, they came up with a few surprising answers. While overwhelmingly they seemed to believe that these claims should be strictly governed – many said that you had to employ ‘common sense’ when faced with a health claim on any product. These were often the same people who replied that they didn’t think enough information about how the product accomplished its health claim was given.

So it seems that while we obviously have a lot of consumers who do believe that health claims are strictly governed and can be trusted there is definitely a group which feels you can’t take a claim at face value. One participant mentioned something interesting – that they felt a claim like ‘reduces blood pressure’ should be backed up with proof, while a claim like ‘assists in weight loss’ was “more marketing than a real health claim”.

Some remarked that they rely on brand name when it comes to whether or not they trust a claim. If it is a well-known brand they are more likely to trust the claim, whereas one participant said you need to be more careful with a “dodgy” brand. Most participants said they felt the product should give more information about how it achieves what it claims – but one participant’s honest answer: “It would be too hard for me to understand” might give an indication as to why many products do not. Would a product that stated “Reduces blood pressure through the action of angiotensin- converting enzyme inhibitors” really give the average consumer any more useful information? Unlikely.

What did pleasantly surprise me was that many respondents felt it was important to do their own research before purchasing a complementary medicine, vitamin supplement or herbal remedy. In the Information Age, it seems the customer is starting to become more aware of their own power in making informed purchases – what they do want however is a guarantee that an authority is still looking out for us too. As one respondent replied to the question: ‘Do you believe that the company that makes the product has to give proof of this claim in order to be allowed to print the claim?’ “I would like to believe it.”

For a look into the mind of a more educated consumer, I asked my local pharmacist about these types of products – mainly herbal remedies – and why they stocked them. She confirmed that customer demand is one of the main factors in the pharmacy’s decision to stock them, but that they felt the products definitely benefited their customers too. What she was concerned about was how little information pharmacists have access to with regards to how these medicines could potentially interact with their patient’s prescription medications, but overall she felt the potential benefits of these types of medicines were often overlooked and warranted further study. When questioned about these products not being controlled by the MCC (Medicines Control Council) she made a good point – that she doesn’t need MCC approval to tell pharmacy visitors that increasing their fruit and vegetable consumption is good for them, so why should she discourage them from taking a herbal immune booster? That said, it would be hard to overdose on fruits and vegetables, which do not have written health claims attached to their packaging.

My opinion? My own journey has led me to believe that our lifestyle and dietary choices need to be addressed together with any other therapy – be it an alternative medicine or a prescription drug. And when it comes to health claims, I’m the kind of consumer who emailed a major supplement brand to find out whether their Vitamin B12 supplement contained methylcobalamin or cyanocobalamin – so let me place myself on the pernickety side of the consumer scale!

It’s also very important to mention of course that while there are many manufacturers selling products on the market that have blatantly misleading claims, there are also many manufacturers doing their best to comply to government requirements, ensure the customer’s safety and back up the effectiveness of their product with genuine health claims.

While I can’t quite shake the feeling that society needs to be more aware that every product they see on the shelf is there strictly for the purpose of getting you to buy it – perhaps times are changing. I still feel that we need to become more responsible consumers, that there’s no excuse in today’s world for simply taking a health claim at face value without doing our own research. And I think it’s just as important to Google “why XYZ supplements don’t work” in addition to why they do.

But I was impressed at the level of scepticism I encountered – while it’s very important that health claims are regulated where they can be to protect the consumer, an alert and educated public has the power to protect itself too.

Article by: Catherine Robinson

Claims

Food for thought

Food for Thought – How useful are Nutrition labels to the average South African?

With escalating rates of lifestyle-related health issues globally, it has never been more important that consumers are aware of the factors which are under their control when they make food choices. Understanding and correctly interpreting food labels can enable consumers to make informed decisions about the foods they choose to purchase and provide to their families.

In the 2011 study Consumers’ knowledge of food label information: an exploratory investigation in Potchefstroom, South Africa, some valuable insights were gained despite the limited scope.

The study was limited to a group of 299 participants, of which the largest component was Afrikaans-speaking females with a tertiary education and no children. However, 4% and 38% of respondents had below grade 12 or up to grade 12 levels of education respectively.

While information such as best before dates, storage instructions and identifying symbols such as Halaal or Heart Foundation endorsements were easily and accurately identified by the vast majority of respondents, only 53% of respondents were able to calculate how many serving sizes were included in a product. Since many food labels give nutritional information ‘per serving’ – this indicates a clear problem in correct application of the information, even if the values themselves are largely understood, and the participants are well educated. In addition, manufacturers are required to include nutritional values per 100g – however whether this will be of benefit to a consumer making an in-store decision under a time constraint is debatable.

While many consumers may be aware that is it recommended for them to cut back on saturated fat, only 3% of respondents could correctly identify a food as being low in saturated fat.

Under the current labelling regulations (R146/2010) the amount of saturated fat ‘per serving’ and ‘per 100 g’ are mandatory where nutritional information or claims are provided.

Even more importantly, as long as a food manufacturer does not make any nutritional claims about their product – it is not compulsory for them to publish these details at all. And this is not entirely negative – smaller manufacturers without the funds to have their product analysed by an accredited laboratory every 3 years should certainly not be prevented from entering the marketplace in the first place; and they will still be required to provide a list of ingredients, additives, allergens, storage information, etc.

But does reading and understanding food labels actually lead to improved choices?

According to Food and nutrition labelling: the past, present and the way forward (Koen et al., 2016), the short answer is yes. People who make use of food labels were found to be more likely to make informed food choices in practice – with their diets reflecting a reduced fat, cholesterol, sodium, and overall energy intake, and increased consumption of fibre, iron and vitamin C.

In light of this since the publication of the latest regulations relating to the labelling and advertising of foodstuffs, or R146/2010, we have certainly made some progress towards food labelling practices which are easier for the average consumer to understand, however there is still significant room for improvement.

Looking at the largest South African study to date conducted after the implementation of the new regulations, conducted by Bosman et al. with 1997 respondents across four ethnic groups – some general areas of interest were uncovered:

• Most consumers are able to locate the nutritional information on packaging, however some expressed uncertainty in their understanding of the information provided.

• Consumers who did not read labels on a frequent basis indicated lack of interest, habitual purchasing, price concerns and time constraints as the main reasons.

Furthermore, in 2008, 41% of women and 21% of men in South Africa were classified as obese, with 32% of females and 35% of males with high blood pressure, which are considered to be diseases of lifestyle. (WHO, 2014). Between 2010 and 2011, the Department of Health enacted laws governing Trans- Fat and saturated fat in foods and their labelling. Similarly, Sodium reduction laws, currently being revised, were published in 2013, for enforcement between 2016 and 2019.

In essence, many consumers still have difficulty putting their knowledge into action when making purchasing decisions, even with the current labelling systems. While there may be scope to improve the current R146 regulations and make them more accessible to the average consumer – a certain degree of accountability must be taken by individuals as well. Fine tuning the regulations and bringing them in line with global best practices is a goal we certainly need to strive towards, however the education of the public in making food choices is clearly just as vital.

Engagement invitation: What are your thoughts? Do you find nutritional labels hard to decipher? Let us know in the comments section below.

Article by: Catherine Robinson

References

1. van der Merwe D, Bosman M, Ellis S, de Beer H, Mielmann A. Consumers’ knowledge of food label information: an exploratory investigation in Potchefstroom, South Africa. Public Health Nutr 2012: 16(3) 403-408.
2. Koen N, Blaauw R, Wentzel-Viljoen E. Food and nutrition labelling: the past, present and the way forward. S Afr J Clin Nutr 2016: 29(1) 13-21.
3. World Health Organization. Noncommunicable Diseases (NCD). Country Profiles, 2014.