600
CLINICAL CORNER Translating knowledge into dietetic practice: a Functional Foods for Healthy Aging Toolkit Alison M. Duncan, Hilary A. Dunn, Laura M. Stratton, and Meagan N. Vella
Abstract: The advance of functional foods has evolved because of research linking functional foods to health, a regulatory environment that allows health claims on foods, and consumer demand for health-promoting food products. Among consumers, the rapidly growing older adult segment is poised to benefit from functional foods because of age-related health issues that are linked to food and health. Registered Dietitians (RDs) are recognized as food and nutrition experts and are well positioned to communicate the benefits of functional foods. The Functional Foods for Healthy Aging Toolkit was developed to provide guidance and resource materials to assist RDs in communicating with older adults about functional foods. The toolkit provides background on functional foods, including definitions, regulations, and case studies of functional food product labels. The role of functional foods in Canada’s aging demographic is examined and the relevance to disease risk is discussed. The toolkit is appended with educational resource sheets on common functional food bioactives, including antioxidants, dietary fibre, omega-3 fatty acids, plant sterols, prebiotics, and probiotics. This publicly available toolkit can help RDs and other healthcare professionals in their interactions with older adults to maximize the value and health benefits that dietary inclusion of functional foods can offer. Key words: toolkit, functional foods, older adults, healthy aging, Registered Dietitians. Résumé : Les produits alimentaires fonctionnels se sont développés grâce aux études établissant un lien entre ces aliments et la santé, a` un milieu de règlementation autorisant les allégations de santé sur les étiquettes des produits et a` la demande des consommateurs pour des produits santé. Parmi ces consommateurs, la population rapidement croissante des personnes âgées s’apprête a` profiter des bénéfices des aliments fonctionnels compte tenu des implications sanitaires entre l’âge, l’alimentation et la santé. Les diététistes professionnels sont reconnus a` titre d’experts en alimentation et sont bien placés pour communiquer les bénéfices provenant des aliments fonctionnels. La trousse d’alimentation fonctionnelle pour un vieillissement en santé (Functional Foods for Healthy Aging Toolkit) a été développée pour aider les diététistes et leur fournir des ressources documentaires afin de mieux renseigner les personnes âgées en matière d’alimentation fonctionnelle. Cette trousse contient des informations au sujet des aliments fonctionnels : définitions, règlementations et études de cas concernant les étiquettes des produits alimentaires fonctionnels. Cet article analyse le rôle des aliments fonctionnels chez les personnes âgées dans la population canadienne et leur pertinence a` l’égard du risque de maladie. La trousse présente en annexe des fiches au sujet des substances bioactives courantes telles que les antioxydants, les fibres alimentaires, les acides gras oméga-3, les stérols végétaux, les prébiotiques et les probiotiques. Cette trousse accessible au public peut aider les diététistes et autres professionnels de la santé a` faire valoir auprès des personnes âgées les vertus et les avantages sanitaires des aliments fonctionnels. [Traduit par la Rédaction] Mots-clés : trousse, aliments fonctionnels, personnes âgées, vieillissement en santé, diététistes professionnels.
Background The scientific focus relating nutrition to health has evolved in the past century from the ability of nutrients to prevent deficiencies to the role of nutrients in the prevention of chronic disease (Hasler 2002). This focus shift has been largely due to the identification and understanding of bioactive compounds in plants and animals that have potential to improve health. Functional foods that contain bioactive compounds are a core example of this focus shift and Health Canada’s working definition of functional foods supports this by noting that they are foods demonstrated to have physiological benefits and (or) reduce the risk of chronic disease beyond basic nutritional functions (Health Canada 1998). The advance of functional foods is due to numerous factors, including research linking functional foods to health and the development of a regulatory environment that allows the commu-
nication of research knowledge to consumers through health claims on foods. Canadian innovation and economic growth related to functional foods is evident (Cinnamon 2009; Tebbens 2005) and there is increasing consumer demand for functional food products. Among consumers, the rapidly growing older adult segment is poised to benefit from functional foods, particularly since risk of chronic disease increases with age (Turcotte and Schellenberg 2007). An analysis of Canadians’ demand for food products for health concluded that a key driver is perception of disease threat, which increases with age (Herath et al. 2008). Older adults are motivated to maintain and improve their health (Turcotte and Schellenberg 2007) and food choice is a strategy within their daily control. Older adults also frequently engage with their healthcare providers (Turcotte and Schellenberg 2007) of which Registered Dietitians (RDs) are recognized as experts on food and nutrition.
Received 20 September 2013. Accepted 27 November 2013. A.M. Duncan, H.A. Dunn, L.M. Stratton, and M.N. Vella. Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada. Corresponding author: Alison M. Duncan (e-mail: [email protected]). Appl. Physiol. Nutr. Metab. 39: 600–603 (2014) dx.doi.org/10.1139/apnm-2013-0432
Published at www.nrcresearchpress.com/apnm on 16 December 2013.
Duncan et al.
601
Table 1. Content summary of The Functional Foods for Healthy Aging Toolkit. Section title
Section contents
1. Understanding Functional Foods
• •
•
•
2. Relevance of Functional Foods for Healthy Aging
• •
Definitions of functional foods as proposed by national and international organizations. Summary of the Canadian regulatory framework in regards to functional foods, including regulations relating to specific consumer information guidance tools that appear on functional food packaging (e.g., Nutrition Facts table, health claims). Case study examples that identify consumer information guidance tools on functional food products and highlight the purpose of the tool, Canadian regulatory notes, and opportunities for health professionals to utilize this tool in interactions with older adult consumers. Overview of the current Canadian marketplace with respect to functional foods and the opportunity for market growth. Description of the current demographic landscape in Canada, and the opportunity to utilize functional foods as a preventative strategy to reduce chronic disease in an aging population. Exploration of the important role Registered Dietitians play in educating older adult consumers about functional foods, and their need for reliable, evidence-based information relating to functional foods.
3. Summary and Results of University of Guelph Research Study on Functional Food Consumption by Older Adults
•
Highlights of the key findings of a CFDR-funded research project that explored the consumption and perceptions of functional foods among older adults.
Appendices
•
Educational resource sheets used in the CFDR-funded study on the definition of functional foods, functional food bioactives, functional food forms, and food health claims. One-page educational resource sheets for 6 common bioactives, including antioxidants, dietary fibre, omega-3 fatty acids, plant sterols, prebiotics, and probiotics.
•
Note: CFDR, Canadian Foundation for Dietetic Research.
There is a need and an opportunity to educate RDs and other health professionals about functional foods by creating tools to enable them to effectively interact with their clients about the benefits of incorporating functional foods into their diets. The purpose of this report is to briefly summarize the development process, and describe the content and implementation of a toolkit designed to facilitate the interaction of RDs with their older adult clients about functional foods.
Toolkit development The Functional Foods for Healthy Aging Toolkit (http://www. cfdr.ca/Downloads/Presentations/Functional-Foods-For-Healthy-AgingTOOLKIT-January.aspx) was developed as a knowledge translation and transfer (KTT) strategy of a Canadian Foundation for Dietetic Research (CFDR)-funded study aimed at exploring the consumption and perceptions of functional foods among older adults (Vella et al. 2013). The purpose of the toolkit is to address knowledge gaps in dietetic practice relating to functional foods and healthy aging by translating knowledge into a practice-relevant, userfriendly resource. The toolkit’s content and main messages were determined following a review of the literature pertaining to functional foods, aging and disease, and the Canadian food regulations. The toolkit went through several revisions until a draft version was established for feedback. The feedback process involved presentations to stakeholder groups, including scientists and health professionals in industry, government, academics, and clinical and community practice. Feedback from these presentations further supported the need for this resource, and informed additional toolkit revisions to its final form.
Toolkit content The 84-page toolkit, which is summarized in Table 1, is divided into 3 sections, and includes an executive summary and appended educational resources. Section 1 provides background about functional foods, starting with a summary table of functional food definitions from organizations around the world. Although the term “functional food” is not a regulatory term and has no universal definition, there are common themes that are identified and described. Section 1 continues with an expanded discussion of functional foods with summaries on consumer awareness, bioactive ingredi-
ents in functional foods, food forms, and relationship between functional foods and natural health products. There is also a comprehensive table that inventories all sources of consumer guidance information that is found on functional food labels. These consumer guidance information tools include the list of ingredients, the Nutrition Facts table, nutrient content claims, additional food-related claims (e.g., “Fresh”, “Natural”, “Product of Canada”), all types of health claims (disease risk reduction, therapeutic, nutrient function, probiotic), and front-of-package labelling. The table provides extensive notes regarding the Canadian regulations relating to each guidance information tool, including the criteria that must be met before the information can be included on food packaging and the relevance of this information to dietetic practice and older adult consumers. The consumer guidance information summarized in the table is exemplified with case-study illustrations of 5 functional food products (cereal, juice, margarine, milk, yogurt) for which the consumer guidance information is highlighted, defined, and described, and made relevant to dietetic practice for all product views (top, bottom, front, back, sides). Figure 1 provides an example of one of the side views of a yogurt product with text boxes explaining the dietetic practice points relating to the nutrient function and nutrient content claims on the package. Section 1 concludes with an examination of the evolution of functional foods in the Canadian marketplace. Section 2 of the toolkit explores the relevance of functional foods for healthy aging. Canada’s aging demographic and its relationship with disease risk is examined with a focus on the increased incidence of major age-related chronic diseases, specifically cancer, cardiovascular disease, and type 2 diabetes. The impact of aging Canadians on health care expenditure and the potential for functional foods to contribute to healthy aging is discussed. Finally, the role of the RD in communicating the benefits of functional foods is examined. RDs are well positioned to educate older adult consumers about functional foods, and are recognized as the connection between evidence relating to nutrition and health and consumers (Canadian Council of Food and Nutrition 2008; Hasler et al. 2009). However, it has been noted in the literature that RDs require evidence-based information about functional foods (Sheeshka and Lacroix 2008), and the toolkit provides an opportunity to translate and transfer relevant information about functional foods for use in dietetic practice. Published by NRC Research Press
602
Appl. Physiol. Nutr. Metab. Vol. 39, 2014
Fig. 1. Case-study product example from the Functional Foods for Healthy Aging Toolkit. (From The Functional Food for Healthy Aging Toolkit, reproduced with permission of Alison M. Duncan © Alison M. Duncan, Hilary A. Dunn, Meagan N. Vella, Laura M. Stratton, 2012.)
Section 3 of the toolkit provides a summary and core results of the CFDR-funded study for which the toolkit serves as a KTT strategy. A summary of the research rationale and methods is provided as are the abstracts from the annual meetings for the Canadian Nutrition Society and Dietitians of Canada (DC). The toolkit is appended with information handouts that were used in the CFDR-funded research study on the definition of functional foods, functional food bioactives, functional food forms and food health claims. Appendices are also included for educational resource sheets that can be used by RDs to discuss common functional food bioactives with their clients, including antioxidants, dietary fibre, omega-3 fatty acids, plant sterols, prebiotics, and probiotics. The resource sheets for each of the 6 identified bioactives are concise, single-page summaries of the bioactive and how it affects health. They also include key review article references for additional information.
The Functional Foods for Healthy Aging Toolkit is designed to provide guidance and materials to assist RDs and other health professionals in their communications and interactions with older adults about functional foods for healthy aging. The toolkit was developed in response to the advance of functional foods in Canada (Agriculture and Agri-Food Canada 2009), Canada’s aging population, and the potential for functional foods to benefit older adults. This resource will allow RDs and other health care professionals to better navigate their interactions with older adults to maximize the value that inclusion of functional foods in the diet can offer toward improving nutrition and health.
Toolkit dissemination
Acknowledgements
The toolkit was publicly launched in January 2013 through a CFDR-hosted Webinar that had 480 participants, the majority of which were RDs. Following the Webinar, the toolkit was made available in PDF format on the Web sites of CFDR, DC, and Agrifood for Healthy Aging (A-HA). The toolkit has been promoted through e-mail campaigns and various social media outlets of CFDR, DC, and A-HA, and oral presentations of the toolkit have also been made to stakeholder groups. The toolkit includes a link to a brief online anonymous survey, which seeks to gather information about the utility and relevance of the information provided in the toolkit in relation to dietetic practice. In addition, an
opportunity is provided to share brief anecdotes about how the toolkit has been used in practice. The survey results will be used to inform future KTT initiatives.
Summary
The authors would like to acknowledge funding support from the CFDR and the Agri-Food and Rural Link program, a partnership between the Ontario Ministries of Agriculture and Food, and Rural Affairs, and the University of Guelph. CFDR and A-HA are acknowledged in their contributions to the wide dissemination of the toolkit to stakeholders. The authors would also like to acknowledge the contributions of B.Sc. students Sarah Dainty and Brittney Kay during the toolkit development process.
References Agriculture and Agri-Food Canada. 2009. Market analysis report, consumer trends, functional foods. Available from http://www.gov.mb.ca/agriculture/ Published by NRC Research Press
Duncan et al.
statistics/pdf/marketanalysis%20report_functionalfoods-en.pdf. [Accessed 10 September 2013.] Canadian Council of Food and Nutrition. 2008. Tracking Nutrition Trends VII. Available from http://www.cfdr.ca/Sharing/CCFNLibrary/Tracking-NutritionTrends.aspx. [Accessed 7 November 2013.] Cinnamon, B. 2009. Results from the functional foods and natural health products survey – 2007. Available from http://www.statcan.gc.ca/pub/88f0006x/ 2009001/part-partie1-eng.htm. [Accesed 10 September 2013.] Hasler, C.M. 2002. Functional foods: Benefits, concerns and challenges – a position paper from the American council on science and health. J. Nutr. 132(12): 3772–3781. PMID:12468622. Hasler, C.M., Brown, A.C., and American Dietetic Association. 2009. Position of the American Dietetic Association: Functional Foods. J. Am. Diet. Assoc. 109(4): 735–746. doi:10.1016/j.jada.2009.02.023. PMID:19338113. Health Canada. 1998. Policy paper – Nutraceuticals/functional foods and health claims on foods. Available from http://www.hc-sc.gc.ca/fn-an/label-etiquet/ claims-reclam/nutra-funct_foods-nutra-fonct_aliment-eng.php. [Accesed 10 September 2013.]
603
Herath, D., Cranfield, J., and Henson, S. 2008. Who consumes functional foods and nutraceuticals in Canada? Results of cluster analysis of the 2006 survey of Canadians’ demand for food products supporting health and wellness. Appetite, 51(2): 256–265. doi:10.1016/j.appet.2008.02.018. PMID:18417254. Sheeshka, J., and Lacroix, B.J. 2008. Canadian dietitians’ attitudes toward functional foods and nutraceuticals. Can. J. Diet. Pract. Res. 69(3): 119–125. doi:10. 3148/69.3.2008.119. PMID:18783636. Tebbens, J. 2005. Functional foods and nutraceuticals: the development of valueadded food by Canadian firms. Available from http://www.statscan.gc.ca/pub/ 88f0006x/2005016/part-partie1-eng.pdf. [Accessed 12 September 2013.] Turcotte, M., and Schellenberg, G. 2007. A portrait of seniors in Canada. Statistics Canada, Ottawa. Available from http://www.statcan.gc.ca/pub/89-519-x/ 89-519-x2006001-eng.pdf. [Accesed 12 September 2013.] Vella, M.N., Stratton, L.M., Sheeshka, J., and Duncan, A.M. 2013. Exploration of functional food consumption in older adults in relation to food matrices, bioactive ingredients and health. J. Nutr. Gerontol. Geriatr. 32(2): 122–144. doi:10.1080/21551197.2013.781419. PMID:23663212.
Published by NRC Research Press
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CLINICAL CORNER Translating knowledge into dietetic practice: a Functional Foods for Healthy Aging Toolkit Alison M. Duncan, Hilary A. Dunn, Laura M. Stratton, and Meagan N. Vella
Abstract: The advance of functional foods has evolved because of research linking functional foods to health, a regulatory environment that allows health claims on foods, and consumer demand for health-promoting food products. Among consumers, the rapidly growing older adult segment is poised to benefit from functional foods because of age-related health issues that are linked to food and health. Registered Dietitians (RDs) are recognized as food and nutrition experts and are well positioned to communicate the benefits of functional foods. The Functional Foods for Healthy Aging Toolkit was developed to provide guidance and resource materials to assist RDs in communicating with older adults about functional foods. The toolkit provides background on functional foods, including definitions, regulations, and case studies of functional food product labels. The role of functional foods in Canada’s aging demographic is examined and the relevance to disease risk is discussed. The toolkit is appended with educational resource sheets on common functional food bioactives, including antioxidants, dietary fibre, omega-3 fatty acids, plant sterols, prebiotics, and probiotics. This publicly available toolkit can help RDs and other healthcare professionals in their interactions with older adults to maximize the value and health benefits that dietary inclusion of functional foods can offer. Key words: toolkit, functional foods, older adults, healthy aging, Registered Dietitians. Résumé : Les produits alimentaires fonctionnels se sont développés grâce aux études établissant un lien entre ces aliments et la santé, a` un milieu de règlementation autorisant les allégations de santé sur les étiquettes des produits et a` la demande des consommateurs pour des produits santé. Parmi ces consommateurs, la population rapidement croissante des personnes âgées s’apprête a` profiter des bénéfices des aliments fonctionnels compte tenu des implications sanitaires entre l’âge, l’alimentation et la santé. Les diététistes professionnels sont reconnus a` titre d’experts en alimentation et sont bien placés pour communiquer les bénéfices provenant des aliments fonctionnels. La trousse d’alimentation fonctionnelle pour un vieillissement en santé (Functional Foods for Healthy Aging Toolkit) a été développée pour aider les diététistes et leur fournir des ressources documentaires afin de mieux renseigner les personnes âgées en matière d’alimentation fonctionnelle. Cette trousse contient des informations au sujet des aliments fonctionnels : définitions, règlementations et études de cas concernant les étiquettes des produits alimentaires fonctionnels. Cet article analyse le rôle des aliments fonctionnels chez les personnes âgées dans la population canadienne et leur pertinence a` l’égard du risque de maladie. La trousse présente en annexe des fiches au sujet des substances bioactives courantes telles que les antioxydants, les fibres alimentaires, les acides gras oméga-3, les stérols végétaux, les prébiotiques et les probiotiques. Cette trousse accessible au public peut aider les diététistes et autres professionnels de la santé a` faire valoir auprès des personnes âgées les vertus et les avantages sanitaires des aliments fonctionnels. [Traduit par la Rédaction] Mots-clés : trousse, aliments fonctionnels, personnes âgées, vieillissement en santé, diététistes professionnels.
Background The scientific focus relating nutrition to health has evolved in the past century from the ability of nutrients to prevent deficiencies to the role of nutrients in the prevention of chronic disease (Hasler 2002). This focus shift has been largely due to the identification and understanding of bioactive compounds in plants and animals that have potential to improve health. Functional foods that contain bioactive compounds are a core example of this focus shift and Health Canada’s working definition of functional foods supports this by noting that they are foods demonstrated to have physiological benefits and (or) reduce the risk of chronic disease beyond basic nutritional functions (Health Canada 1998). The advance of functional foods is due to numerous factors, including research linking functional foods to health and the development of a regulatory environment that allows the commu-
nication of research knowledge to consumers through health claims on foods. Canadian innovation and economic growth related to functional foods is evident (Cinnamon 2009; Tebbens 2005) and there is increasing consumer demand for functional food products. Among consumers, the rapidly growing older adult segment is poised to benefit from functional foods, particularly since risk of chronic disease increases with age (Turcotte and Schellenberg 2007). An analysis of Canadians’ demand for food products for health concluded that a key driver is perception of disease threat, which increases with age (Herath et al. 2008). Older adults are motivated to maintain and improve their health (Turcotte and Schellenberg 2007) and food choice is a strategy within their daily control. Older adults also frequently engage with their healthcare providers (Turcotte and Schellenberg 2007) of which Registered Dietitians (RDs) are recognized as experts on food and nutrition.
Received 20 September 2013. Accepted 27 November 2013. A.M. Duncan, H.A. Dunn, L.M. Stratton, and M.N. Vella. Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada. Corresponding author: Alison M. Duncan (e-mail: [email protected]). Appl. Physiol. Nutr. Metab. 39: 600–603 (2014) dx.doi.org/10.1139/apnm-2013-0432
Published at www.nrcresearchpress.com/apnm on 16 December 2013.
Duncan et al.
601
Table 1. Content summary of The Functional Foods for Healthy Aging Toolkit. Section title
Section contents
1. Understanding Functional Foods
• •
•
•
2. Relevance of Functional Foods for Healthy Aging
• •
Definitions of functional foods as proposed by national and international organizations. Summary of the Canadian regulatory framework in regards to functional foods, including regulations relating to specific consumer information guidance tools that appear on functional food packaging (e.g., Nutrition Facts table, health claims). Case study examples that identify consumer information guidance tools on functional food products and highlight the purpose of the tool, Canadian regulatory notes, and opportunities for health professionals to utilize this tool in interactions with older adult consumers. Overview of the current Canadian marketplace with respect to functional foods and the opportunity for market growth. Description of the current demographic landscape in Canada, and the opportunity to utilize functional foods as a preventative strategy to reduce chronic disease in an aging population. Exploration of the important role Registered Dietitians play in educating older adult consumers about functional foods, and their need for reliable, evidence-based information relating to functional foods.
3. Summary and Results of University of Guelph Research Study on Functional Food Consumption by Older Adults
•
Highlights of the key findings of a CFDR-funded research project that explored the consumption and perceptions of functional foods among older adults.
Appendices
•
Educational resource sheets used in the CFDR-funded study on the definition of functional foods, functional food bioactives, functional food forms, and food health claims. One-page educational resource sheets for 6 common bioactives, including antioxidants, dietary fibre, omega-3 fatty acids, plant sterols, prebiotics, and probiotics.
•
Note: CFDR, Canadian Foundation for Dietetic Research.
There is a need and an opportunity to educate RDs and other health professionals about functional foods by creating tools to enable them to effectively interact with their clients about the benefits of incorporating functional foods into their diets. The purpose of this report is to briefly summarize the development process, and describe the content and implementation of a toolkit designed to facilitate the interaction of RDs with their older adult clients about functional foods.
Toolkit development The Functional Foods for Healthy Aging Toolkit (http://www. cfdr.ca/Downloads/Presentations/Functional-Foods-For-Healthy-AgingTOOLKIT-January.aspx) was developed as a knowledge translation and transfer (KTT) strategy of a Canadian Foundation for Dietetic Research (CFDR)-funded study aimed at exploring the consumption and perceptions of functional foods among older adults (Vella et al. 2013). The purpose of the toolkit is to address knowledge gaps in dietetic practice relating to functional foods and healthy aging by translating knowledge into a practice-relevant, userfriendly resource. The toolkit’s content and main messages were determined following a review of the literature pertaining to functional foods, aging and disease, and the Canadian food regulations. The toolkit went through several revisions until a draft version was established for feedback. The feedback process involved presentations to stakeholder groups, including scientists and health professionals in industry, government, academics, and clinical and community practice. Feedback from these presentations further supported the need for this resource, and informed additional toolkit revisions to its final form.
Toolkit content The 84-page toolkit, which is summarized in Table 1, is divided into 3 sections, and includes an executive summary and appended educational resources. Section 1 provides background about functional foods, starting with a summary table of functional food definitions from organizations around the world. Although the term “functional food” is not a regulatory term and has no universal definition, there are common themes that are identified and described. Section 1 continues with an expanded discussion of functional foods with summaries on consumer awareness, bioactive ingredi-
ents in functional foods, food forms, and relationship between functional foods and natural health products. There is also a comprehensive table that inventories all sources of consumer guidance information that is found on functional food labels. These consumer guidance information tools include the list of ingredients, the Nutrition Facts table, nutrient content claims, additional food-related claims (e.g., “Fresh”, “Natural”, “Product of Canada”), all types of health claims (disease risk reduction, therapeutic, nutrient function, probiotic), and front-of-package labelling. The table provides extensive notes regarding the Canadian regulations relating to each guidance information tool, including the criteria that must be met before the information can be included on food packaging and the relevance of this information to dietetic practice and older adult consumers. The consumer guidance information summarized in the table is exemplified with case-study illustrations of 5 functional food products (cereal, juice, margarine, milk, yogurt) for which the consumer guidance information is highlighted, defined, and described, and made relevant to dietetic practice for all product views (top, bottom, front, back, sides). Figure 1 provides an example of one of the side views of a yogurt product with text boxes explaining the dietetic practice points relating to the nutrient function and nutrient content claims on the package. Section 1 concludes with an examination of the evolution of functional foods in the Canadian marketplace. Section 2 of the toolkit explores the relevance of functional foods for healthy aging. Canada’s aging demographic and its relationship with disease risk is examined with a focus on the increased incidence of major age-related chronic diseases, specifically cancer, cardiovascular disease, and type 2 diabetes. The impact of aging Canadians on health care expenditure and the potential for functional foods to contribute to healthy aging is discussed. Finally, the role of the RD in communicating the benefits of functional foods is examined. RDs are well positioned to educate older adult consumers about functional foods, and are recognized as the connection between evidence relating to nutrition and health and consumers (Canadian Council of Food and Nutrition 2008; Hasler et al. 2009). However, it has been noted in the literature that RDs require evidence-based information about functional foods (Sheeshka and Lacroix 2008), and the toolkit provides an opportunity to translate and transfer relevant information about functional foods for use in dietetic practice. Published by NRC Research Press
602
Appl. Physiol. Nutr. Metab. Vol. 39, 2014
Fig. 1. Case-study product example from the Functional Foods for Healthy Aging Toolkit. (From The Functional Food for Healthy Aging Toolkit, reproduced with permission of Alison M. Duncan © Alison M. Duncan, Hilary A. Dunn, Meagan N. Vella, Laura M. Stratton, 2012.)
Section 3 of the toolkit provides a summary and core results of the CFDR-funded study for which the toolkit serves as a KTT strategy. A summary of the research rationale and methods is provided as are the abstracts from the annual meetings for the Canadian Nutrition Society and Dietitians of Canada (DC). The toolkit is appended with information handouts that were used in the CFDR-funded research study on the definition of functional foods, functional food bioactives, functional food forms and food health claims. Appendices are also included for educational resource sheets that can be used by RDs to discuss common functional food bioactives with their clients, including antioxidants, dietary fibre, omega-3 fatty acids, plant sterols, prebiotics, and probiotics. The resource sheets for each of the 6 identified bioactives are concise, single-page summaries of the bioactive and how it affects health. They also include key review article references for additional information.
The Functional Foods for Healthy Aging Toolkit is designed to provide guidance and materials to assist RDs and other health professionals in their communications and interactions with older adults about functional foods for healthy aging. The toolkit was developed in response to the advance of functional foods in Canada (Agriculture and Agri-Food Canada 2009), Canada’s aging population, and the potential for functional foods to benefit older adults. This resource will allow RDs and other health care professionals to better navigate their interactions with older adults to maximize the value that inclusion of functional foods in the diet can offer toward improving nutrition and health.
Toolkit dissemination
Acknowledgements
The toolkit was publicly launched in January 2013 through a CFDR-hosted Webinar that had 480 participants, the majority of which were RDs. Following the Webinar, the toolkit was made available in PDF format on the Web sites of CFDR, DC, and Agrifood for Healthy Aging (A-HA). The toolkit has been promoted through e-mail campaigns and various social media outlets of CFDR, DC, and A-HA, and oral presentations of the toolkit have also been made to stakeholder groups. The toolkit includes a link to a brief online anonymous survey, which seeks to gather information about the utility and relevance of the information provided in the toolkit in relation to dietetic practice. In addition, an
opportunity is provided to share brief anecdotes about how the toolkit has been used in practice. The survey results will be used to inform future KTT initiatives.
Summary
The authors would like to acknowledge funding support from the CFDR and the Agri-Food and Rural Link program, a partnership between the Ontario Ministries of Agriculture and Food, and Rural Affairs, and the University of Guelph. CFDR and A-HA are acknowledged in their contributions to the wide dissemination of the toolkit to stakeholders. The authors would also like to acknowledge the contributions of B.Sc. students Sarah Dainty and Brittney Kay during the toolkit development process.
References Agriculture and Agri-Food Canada. 2009. Market analysis report, consumer trends, functional foods. Available from http://www.gov.mb.ca/agriculture/ Published by NRC Research Press
Duncan et al.
statistics/pdf/marketanalysis%20report_functionalfoods-en.pdf. [Accessed 10 September 2013.] Canadian Council of Food and Nutrition. 2008. Tracking Nutrition Trends VII. Available from http://www.cfdr.ca/Sharing/CCFNLibrary/Tracking-NutritionTrends.aspx. [Accessed 7 November 2013.] Cinnamon, B. 2009. Results from the functional foods and natural health products survey – 2007. Available from http://www.statcan.gc.ca/pub/88f0006x/ 2009001/part-partie1-eng.htm. [Accesed 10 September 2013.] Hasler, C.M. 2002. Functional foods: Benefits, concerns and challenges – a position paper from the American council on science and health. J. Nutr. 132(12): 3772–3781. PMID:12468622. Hasler, C.M., Brown, A.C., and American Dietetic Association. 2009. Position of the American Dietetic Association: Functional Foods. J. Am. Diet. Assoc. 109(4): 735–746. doi:10.1016/j.jada.2009.02.023. PMID:19338113. Health Canada. 1998. Policy paper – Nutraceuticals/functional foods and health claims on foods. Available from http://www.hc-sc.gc.ca/fn-an/label-etiquet/ claims-reclam/nutra-funct_foods-nutra-fonct_aliment-eng.php. [Accesed 10 September 2013.]
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