Angry Doctor

Monday, January 29, 2007

How NOT to argue for Alternative Medicine 7

Half-a-billion Chinese mothers can't be wrong?

Allow health product vendors to plug benefits

THE Straits Times reported that the Government will introduce new controls for health products ('New controls for health products'; ST, Jan 23). This is surely welcomed by consumers as the new law will extend better protection. On the other hand, I hope the new law will give health product vendors a clear direction in allowing them to state health benefits on product labels and in advertisements.

In the Chinese diet, medicine-powered food is often used in treatment or as a booster for overall well-being. In Chinese families that have the custom of drinking soup, gouqi (wolfberries or Lycium chinense) is often used to enhance the soup's tonic effects. Chinese medicine has long used it to improve the immune system, improve eyesight, protect the liver and boost male reproductive ability.

With the current food control regulations, you break the law if you sell gouqi and make any such claims on your product label or in an advertisement. Yet the claims are the very reason mothers use gouqi in their cooking.

In the United States, the Food and Drug Administration allows certain health claims for food high in nutrients proven to support health. For example, it allows food high in potassium to claim that 'diets containing foods that are good sources of potassium and low in sodium may reduce the risk of high blood pressure and stroke'. Such permission is given based on sufficient medical evidence and strong authoritative recommendation.

In China, the health authorities publish a list of herbs which are both food and medicine, as well as herbs prohibited in food.

Most legal systems today are designed to regulate on a 'treatment-centric' basis. One is not allowed to make claims about nutrition and food, even when everyone knows their medicinal effects. Hence, the healing power of nutrition and food is not given enough weight in the health-care system. This paradigm does not match reality, especially in Asian societies.

The authorities will prosecute anyone who sells tongkat ali labelled as 'enhancing sexuality' even though this is widely recognised in South-east Asia. Once in Melbourne, I saw an advertisement that said, 'Stronga; Longa; Tongka', a humorous way to bypass restrictions. But most health promoting foods are not as lucky as tongkat ali.

Devising a health products law in Singapore is probably more challenging than in the West as we have a long history of using food as medicine. However, I am confident the Government will come up with a practical and forward-looking law that not only protects consumer interests but also nurtures the local health food business for the global market.

Chen Bin

'This paradigm does not match reality, especially in Asian societies.'

How ironic.

Anyway, while Mr Chen is arguing for vendors of traditional herbal medicine to be exempted from having to prove their claims, scientific studies are already being conducted on herbal medicines to test these claims.

In fact, compounds extracted from the fruits and root bark of Lycium chinense have been shown to have antimicrobial and hepato-protective properties in animal studies. However, that is not to say that it does 'improve the immune system, improve eyesight, protect the liver and boost male reproductive ability' in humans, or that the effective (and safe) dosage and method of preparation had been established in human subjects.

Certainly if Lycium chinense is proven to confer all the health benefits stated by Mr Chen, vendors would be allowed to state so when selling it. Until then, angry doc doesn't see what's wrong with not allowing health products with unproven efficacy to claim otherwise just because of its customary use.

After all, one wouldn't allow cow dung to be touted as a healthy product to be used on umbilical stumps just because people in Africa have been using it for centuries.

While an absence of evidence is not evidence of absence, an absence of evidence is still an absence of evidence.

Added: the reply from AVA

Food products: Health claims not permitted

I REFER to the letter by Mr Chen Bin, 'Allow health product vendors to plug benefits' (ST, Jan 29).
The use of claims for food, including food containing approved herbal ingredients, is regulated under the Sale of Food Act and the Food Regulations administered by the Agri-Food & Veterinary Authority (AVA). A list of Chinese medicinal ingredients commonly used in food can be downloaded from AVA's website at

In Singapore, food products may carry nutrition claims as long as they comply with the nutrient-claim guidelines established by the Health Promotion Board and have an acceptable nutrition information panel incorporated in their labels. The nutrition information panel should declare the amounts of calories, protein, carbohydrate, fat and the nutrients claimed.

Claims that describe the role of a nutrient in growth, development and normal functions of the body may be allowed if they are supported by well-established scientific evidence.

However, the use of health-improvement claims on food products is not permitted as there is currently no scientific evidence to prove that consumption of any food alone, with or without the addition of approved herbal ingredients, can bring about health improvement. At present, there are also no international guidelines on the use of health-improvement claims or claims relating to the efficacy of traditional herbs when used in food.

Nevertheless, AVA would like to assure the public that it will closely monitor international developments on the use of health claims, to ensure that Singapore's regulatory requirements continue to be in line with international guidelines.

We thank Mr Chen for sharing his views on this subject.

Goh Shih Yong
Assistant Director
Corporate Communications
for Chief Executive Officer
Agri-Food & Veterinary Authority
Ministry of National Development

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