The history of food supplements in the UK

Published on: 30th April 2019

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The use of food as medicine has deep historical roots. Ancient medical texts from Egypt, Greece, Rome, China and India describe medical applications for garlic[1]; chocolate was viewed as medicinal by 18th century European doctors[2] and the adage “an apple a day keeps the doctor away”[3] remains a commonly held view today.

TC Callis

The idea that certain components of food are necessary to support health and prevent disease has equal longevity. Old wives tales advised pregnant women to put an iron nail into an apple overnight and then eat the apple the next day; what was not understood at the time was the action of acids within the apple which transformed iron from the nail into a bioavailable form which would be consumed with the apple[4]. In 1754 James Lind, working as a ship’s surgeon in the Royal Navy started what was effectively a clinical trial to determine if a component in food could prevent scurvy, a widespread disease among sailors on long voyages. His work led, in 1795, to fresh lemon juice being given to all Royal Navy Sailors[5]. Again, what was not known then was that scurvy was a deficiency disease caused by a lack of vitamin C, a substance contained within lemons.

In the early 20th century the Polish biochemist Kazimierz Funk isolated several substances from foods that he realised were needed to help maintain health. Funk coined the term “vitamine” because he believed the substances were amine compounds that were vital to life; the name stuck, although the final “e” was dropped[6]. At the same time there was growing recognition of the importance of minerals in the diet. As more vitamin compounds were isolated and more minerals were acknowledge as being vital to health, some of these isolated substances began to be used as fortification in certain foods[7], as well as in the creation of what were, essentially the first food supplements.

In 1941 the UK Government’s Ministry of Food introduced a Welfare Food Scheme to help to ensure that children, expectant and nursing mothers and elderly people were provided with additional nutrition to supplement wartime food rationing[8]. The welfare foods included cod liver oil, blackcurrant syrup (which was subsequently substituted for concentrated orange juice) and vitamin A and D tablets for expectant mothers[9].

Although there was recognition that vitamins, minerals and cod liver oil were food derived, their use was generally viewed as preventative or curative. Because of this, products containing nutrients to supplement the diet were considered medicinal. There were a number of cod liver oil products on sale to the public, however the products were only stocked in chemists which reinforced the view that these products were medicines.

Following the implementation of the 1968 Medicines Act, food supplements were officially classified as medicines and could only claim to prevent deficiency diseases. However, in 1988 the NHS delisted supplements and ceased reimbursing against prescriptions for these products. In response, the industry approached the Medicines Control Agency (MCA), (which was the former MHRA) seeking to clarify which category of food supplement products might fall under. The MCA and industry reached an agreement that all vitamin, mineral and cod liver oil products would be reclassified as foods and would therefore be regulated by the Ministry for Agriculture, Fisheries and Food (MAFF). Because the products would no longer be classified as medicines they would not be permitted to claim or imply that they could treat, prevent or cure any disease. This then raised the question, what, if anything, could be said about them in marketing communications?

Further discussions between the MCA, MAFF and industry reached agreement that these products would be called food supplements, as they were intended to supplement the diet, and they could claim to “help maintain” in relation to general health. Thus, was born the health claim!

In the 30 years since food supplements entered the marketplace as standalone products which could claim to support health the UK market has matured into a multimillion-pound industry which continues to innovate and grow.

 

References:
[1] Rivlin, R. (2001). Historical Perspective on the Use of Garlic. The Journal of Nutrition, [online] 131(3), pp.951S-954S. Available at: https://doi.org/10.1093/jn/131.3.951S [Accessed 24 Apr. 2019].
[2] Lippi, D. (2019). Chocolate in History: Food, Medicine, Medi-Food. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3708337/ [Accessed 24 Apr. 2019].
[3] https://www.medicalnewstoday.com/articles/291683.php
[4] ROSANOFF, A. and KENNEDY, B. (2019). Bioavailability of Iron Produced by the Corrosion of Steel in Apples. [online] Available at: https://doi.org/10.1111/j.1365-2621.1982.tb10134.x [Accessed 24 Apr. 2019].
[5] http://www.jameslindlibrary.org/articles/james-lind-and-scurvy-1747-to-1795/
[6] Semba, R. (2012). The Discovery of the Vitamins. International Journal for Vitamin and Nutrition Research, 82(5), pp.310-315. [online] Available at https://doi.org/10.1024/0300-9831/a000124 [Accessed 24 April 2019].
[7] http://ffinetwork.org/about/Food_fortification_history.pdf
[8] https://discovery.nationalarchives.gov.uk/details/r/C10953
[9] https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/549165/The_Urban_Working_-_Class_Household_Diet_1940-1949.pdf

 

By TC Callis, Food Supplements Regulatory Manager, PAGB

 

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