Research on adults has shown that when certain energy dense foods (EDF) are marketed as ‘healthy’, consumption of these foods increases during a single eating occasion. However, the effect health claims can have on consumption and taste in pre-adolescent children is largely unknown. The main objective of this thesis was to examine how health claims influence energy intake (EI) and liking in pre-adolescent children. A between-subject experimental design was used, whereby 66 participants (34 girls and 32 boys, mean ± SD age: 10.5 ± 1.4 years), consumed a chocolate milkshake while watching specific videos on YouTube ® for 20 minutes. The participants were randomly assigned in equal numbers split into one of two groups. For one group (control), no label was added and nothing was said about the milkshake. In the experimental (health claim) group, the milkshakes were labeled and presented as “high in calcium, and healthy”. The primary outcomes were EI and liking of the milkshake, while appetite sensations were also assessed using visual analogue scales (VAS). Results from Analysis of Covariance (ANCOVA) indicate that compared to the same shake without a health claim, a chocolate milkshake that was advertised as healthy was perceived as healthier, although there was no effect on EI or taste. When sex was investigated, boys consumed significantly more calories than girls when the milkshake was advertised as healthy. The higher EI from boys in the ‘healthy’ condition suggests a health claim may elicit different food consumption behaviors between sexes. In addition, the participants from the experimental (healthy) group who rated the milkshake as highly healthy consumed significantly more calories than those from the same group who only rated the milkshake moderately healthy. Further research is needed to better determine the effects of different health claims on children’s taste and EI, and to corroborate these initial findings and examine the underlying reasons for the observed sex differences.

Introdução. A epidemia global de obesidade e suas consequências ocorrem simultaneamente a uma maior consciência quanto às escolhas que promovem a saúde, padrões estéticos cada vez mais magros e oferta crescente de alimentos industrializados de alta densidade calórica, saborosos e práticos. Este cenário estimula a indústria de alimentos a utilizar apelos de saúde como estratégia de concorrência. Objetivo. Analisar a utilização de apelos de saúde e outras estratégias de incentivo ao consumo presentes na rotulagem de alimentos industrializados, sua coerência com os teores de calorias, gorduras, açúcares e sal presentes nesses alimentos e sua convergência com a legislação pertinente. Metodologia. A definição de teores elevados de calorias, gorduras, açúcares e sódio e dos quesitos que nortearam a análise foi feita a partir da legislação pertinente e da literatura. Um formulário foi criado e a análise baseou-se nas informações declaradas na rotulagem pelo fabricante. A categoria estudada foi Biscoitos e Salgadinhos. Os produtos foram escolhidos pela análise do gasto das famílias paulistanas com alimentação a partir da base de micro dados da Pesquisa de Orçamento Familiar (POF), da Fundação Instituto de Pesquisas Econômicas (FIPE). Foram identificadas 64 marcas e adquiridos 209 produtos em supermercados da cidade de São Paulo. Foram avaliados densidade calórica, teores de açúcar, gorduras saturada e trans, e sódio. Quatro dos quesitos tratam de diversas formas de estímulo ao consumo (apelos de saúde, selos de certificação, brindes e prêmios e apresentação do produto); o último trata da obrigatoriedade de informar os teores de gorduras, açúcar e sódio em destaque. Produtos com um ou mais teores elevados não deveriam apresentar nenhuma ação relativa aos quatro primeiros quesitos, e todos deveriam atender ao último, por ser exigência legal. Resultados. A totalidade dos produtos apresentou densidade calórica elevada e para 99% a quantidade de Kcal/100g foi maior que o dobro do limite; 48% não informaram os teores de açúcar separadamente; 22% declararam quantidades elevadas de açúcar; 64% apresentaram teores elevados de gordura saturada. Mais da metade dos produtos continha gordura vegetal, mas declarou 0% de gordura trans na porção; 35% eram alimentos livres de gordura vegetal; 53% apresentaram teores de sódio elevados sendo 17% entre 50% e 100% acima e 20%, mais que o dobro do limite. Noventa e quatro por cento dos produtos apresentaram teores concomitantemente elevados; 27%, calorias, gordura saturada e sódio; 20%, calorias e sódio e 17%, calorias e gordura saturada. Setenta e um por cento dos produtos com um ou mais dos teores elevados utilizaram apelos de saúde na sua rotulagem; 4%, selos de certificação de sociedades médicas; 6% bonificações, prêmios ou brindes e 16%, embalagens especiais; 66% dos produtos não apresentaram teores de gorduras, açúcar e sódio em destaque apesar de esta ser exigência legal. Conclusão. Os produtos estudados apresentaram um ou mais dos teores avaliados acima dos parâmetros estabelecidos; apelos de saúde e outras estratégias de marketing nutricional foram identificados em produtos que não deveriam ser associados a uma alimentação saudável ou ter seu consumo incentivado. / Introduction. The global epidemic of obesity and its consequences occur simultaneously to a greater awareness of the choices that promote health, aesthetic standards increasingly thin and an increasing availability of foods of high caloric density, tasty and practical. This scenario encourages the food industry to use health claims as competitive strategy. Objective. To analyze the use of health claims and other strategies to boost consumption present in food labeling, the consistency with the levels of calories, fat, sugar and salt in these products and its convergence with relevant legislation. Methodology. The definition of high levels of calories, fats, sugars and sodium and the questions that guided the analysis were based was based on the relevant legislation and the literature. A form was created and the analysis was based on the information declared on the label by the manufacturer. The category studied was Cookies and Snacks. Products were chosen by the analysis of the household spending from Sao Paulo city with food from the Household Budget Survey (POF) database, run by Economic Research Institute Foundation (FIPE). Sixty four brands were identified and 209 products were purchased in supermarkets in the city of São Paulo. Energy density, sugar content, saturated and trans fats, and sodium were evaluated. Four of the questions dealt with various forms of promotion (health claims, certification, gifts and prizes and product presentation) and one with the obligation to highlight the levels of fat, sugar and sodium. Products with high levels of one or more of these contents should not present any elements relating to the first four questions, and all of them should serve the latter, because it is a legal requirement. Results. All the products showed high caloric density and for 99% of them the amount of Kcal/100g was higher than twice the threshold; 48% did not report sugar levels separately; 22% informed high amounts of sugar; 64% had elevated levels of saturated fat. More than half of the products contained vegetable fat, but stated 0% trans-fat per portion; 35% were vegetable fat free products; 53% of the sample showed elevated levels of sodium; 17% informed sodium levels between 50% and 100% above while 20% report more than double the limit . Ninety-four percent of the products showed high levels simultaneously; 27%, calories, sodium and saturated fat; 20%, calories and sodium and 17%, saturated fat and calories. Seventy-one percent of the products with one or more elevated levels used health claims in its labeling; 4% presented medical societies seal certification, 16% used special packaging and 6% offered bonuses, prizes or giveaways; 66% of the products did not show the levels of fat, sugar and sodium highlighted despite it being a legal requirement. Conclusion. The products included in this study had one or more of the assessed levels above established parameters; health claims and other marketing strategies were identified in nutritional products that should not be associated with healthy eating or have their consumption encouraged.

Introdução. A epidemia global de obesidade e suas consequências ocorrem simultaneamente a uma maior consciência quanto às escolhas que promovem a saúde, padrões estéticos cada vez mais magros e oferta crescente de alimentos industrializados de alta densidade calórica, saborosos e práticos. Este cenário estimula a indústria de alimentos a utilizar apelos de saúde como estratégia de concorrência. Objetivo. Analisar a utilização de apelos de saúde e outras estratégias de incentivo ao consumo presentes na rotulagem de alimentos industrializados, sua coerência com os teores de calorias, gorduras, açúcares e sal presentes nesses alimentos e sua convergência com a legislação pertinente. Metodologia. A definição de teores elevados de calorias, gorduras, açúcares e sódio e dos quesitos que nortearam a análise foi feita a partir da legislação pertinente e da literatura. Um formulário foi criado e a análise baseou-se nas informações declaradas na rotulagem pelo fabricante. A categoria estudada foi Biscoitos e Salgadinhos. Os produtos foram escolhidos pela análise do gasto das famílias paulistanas com alimentação a partir da base de micro dados da Pesquisa de Orçamento Familiar (POF), da Fundação Instituto de Pesquisas Econômicas (FIPE). Foram identificadas 64 marcas e adquiridos 209 produtos em supermercados da cidade de São Paulo. Foram avaliados densidade calórica, teores de açúcar, gorduras saturada e trans, e sódio. Quatro dos quesitos tratam de diversas formas de estímulo ao consumo (apelos de saúde, selos de certificação, brindes e prêmios e apresentação do produto); o último trata da obrigatoriedade de informar os teores de gorduras, açúcar e sódio em destaque. Produtos com um ou mais teores elevados não deveriam apresentar nenhuma ação relativa aos quatro primeiros quesitos, e todos deveriam atender ao último, por ser exigência legal. Resultados. A totalidade dos produtos apresentou densidade calórica elevada e para 99% a quantidade de Kcal/100g foi maior que o dobro do limite; 48% não informaram os teores de açúcar separadamente; 22% declararam quantidades elevadas de açúcar; 64% apresentaram teores elevados de gordura saturada. Mais da metade dos produtos continha gordura vegetal, mas declarou 0% de gordura trans na porção; 35% eram alimentos livres de gordura vegetal; 53% apresentaram teores de sódio elevados sendo 17% entre 50% e 100% acima e 20%, mais que o dobro do limite. Noventa e quatro por cento dos produtos apresentaram teores concomitantemente elevados; 27%, calorias, gordura saturada e sódio; 20%, calorias e sódio e 17%, calorias e gordura saturada. Setenta e um por cento dos produtos com um ou mais dos teores elevados utilizaram apelos de saúde na sua rotulagem; 4%, selos de certificação de sociedades médicas; 6% bonificações, prêmios ou brindes e 16%, embalagens especiais; 66% dos produtos não apresentaram teores de gorduras, açúcar e sódio em destaque apesar de esta ser exigência legal. Conclusão. Os produtos estudados apresentaram um ou mais dos teores avaliados acima dos parâmetros estabelecidos; apelos de saúde e outras estratégias de marketing nutricional foram identificados em produtos que não deveriam ser associados a uma alimentação saudável ou ter seu consumo incentivado. / Introduction. The global epidemic of obesity and its consequences occur simultaneously to a greater awareness of the choices that promote health, aesthetic standards increasingly thin and an increasing availability of foods of high caloric density, tasty and practical. This scenario encourages the food industry to use health claims as competitive strategy. Objective. To analyze the use of health claims and other strategies to boost consumption present in food labeling, the consistency with the levels of calories, fat, sugar and salt in these products and its convergence with relevant legislation. Methodology. The definition of high levels of calories, fats, sugars and sodium and the questions that guided the analysis were based was based on the relevant legislation and the literature. A form was created and the analysis was based on the information declared on the label by the manufacturer. The category studied was Cookies and Snacks. Products were chosen by the analysis of the household spending from Sao Paulo city with food from the Household Budget Survey (POF) database, run by Economic Research Institute Foundation (FIPE). Sixty four brands were identified and 209 products were purchased in supermarkets in the city of São Paulo. Energy density, sugar content, saturated and trans fats, and sodium were evaluated. Four of the questions dealt with various forms of promotion (health claims, certification, gifts and prizes and product presentation) and one with the obligation to highlight the levels of fat, sugar and sodium. Products with high levels of one or more of these contents should not present any elements relating to the first four questions, and all of them should serve the latter, because it is a legal requirement. Results. All the products showed high caloric density and for 99% of them the amount of Kcal/100g was higher than twice the threshold; 48% did not report sugar levels separately; 22% informed high amounts of sugar; 64% had elevated levels of saturated fat. More than half of the products contained vegetable fat, but stated 0% trans-fat per portion; 35% were vegetable fat free products; 53% of the sample showed elevated levels of sodium; 17% informed sodium levels between 50% and 100% above while 20% report more than double the limit . Ninety-four percent of the products showed high levels simultaneously; 27%, calories, sodium and saturated fat; 20%, calories and sodium and 17%, saturated fat and calories. Seventy-one percent of the products with one or more elevated levels used health claims in its labeling; 4% presented medical societies seal certification, 16% used special packaging and 6% offered bonuses, prizes or giveaways; 66% of the products did not show the levels of fat, sugar and sodium highlighted despite it being a legal requirement. Conclusion. The products included in this study had one or more of the assessed levels above established parameters; health claims and other marketing strategies were identified in nutritional products that should not be associated with healthy eating or have their consumption encouraged.

Healthcare big data are a growing source of real-world data with which to identify and validate medications with repurposing potential. Previously, we developed a claims-based workflow to evaluate medications with potential to treat stimulant use disorders. In order to test the workflow, the framework was applied in the context of opioid use disorders (OUDs), for which there are medications with known efficacy. Using the Truven Marketscan Commercial Claims Database, a nested case-control analysis was conducted to determine the association between OUD medications (buprenorphine, naltrexone) and remission. Cases were defined as enrollees with a remission diagnosis and matched (1:4) to controls (individuals without remission) using incidence density sampling, with age group, sex, region, and index year as additional matching variables. After adjusting for behavioral health visits, polysubstance use disorders, and psychiatric disorders using conditional logistic regression, the odds of OUD medication exposure were 3.8 (99% confidence interval: 3.0 – 4.9) times higher in cases than controls. Evaluation of angiotensin converting enzyme inhibitors (e.g. lisinopril) as a negative control revealed no significant association between the medication and remission. This work demonstrates the feasibility of using administrative health claims data to evaluate the effectiveness of medications to treat substance use disorders.

The growing interest among consumers in the link between diet and health makes functional food one of the fastest growing sectors in the global food industry, especially functional dairy products. Understanding consumer choices with respect to functional food is an important and relatively new research area. Given the credence nature of functional food attributes, labelling plays a key role in allowing consumers to make informed choices about foods with enhanced health attributes. In 2007, Canada launched a review of the regulatory system for health claims on functional foods, which included rules concerning the approval, labelling and verification of health claims. In 2010 two new health claims related to oat products and plant sterols were approved by Health Canada. An analysis of how consumers respond to health claim information is therefore timely. This thesis focuses on examining the effects of different types of labelling and verification of health claims on consumers stated preferences for a specific functional food product, Omega-3 milk. The analysis incorporates reference-dependent effects. This study improves the knowledge of Canadian consumer understanding of health claims and the impact of health claims on consumer choice. This research is one of the first studies to simultaneously examine the effects of different types of health claims (e.g. function claims, risk reduction claims and disease prevention claims) and other ways of signalling or implying health benefits (e.g. symbols) on Canadian consumers' functional food choices. This study contributes to the knowledge in this domain by providing a comparative analysis of different types of labelling strategies. The extant knowledge of labelling effects in the formats of risk reduction claims, disease prevention claims and symbols or imagery on functional foods is limited. One of the primary contributions of this study is addressing this gap in the literature. The theoretical framework of this thesis is based on random utility theory. A stated preference choice experiment is designed to examine consumers' response to Omega-3 milk under different labelling scenarios. Using data from an online survey of 740 Canadians conducted in summer 2009, discrete choice models, including Conditional Logit, Random Parameter Logit and Latent Class models, and Willingness-To-Pay (WTP) values are estimated. The results suggest that full labelling (function claims, risk reduction claims and disease prevention claims) is preferred over partial labelling (e.g. the use of a heart symbol to imply a health claim), but primarily for risk reduction claims. There is no significant difference between a function claim, such as "good for your heart" and partial labelling in the form of a red heart symbol. The results also suggest that consumers on average respond positively to verification of health claims by government and the third party agencies, however, the Latent Class models reveal considerable heterogeneity in consumer attitudes toward the source of verification. The influences of key-socio-demographic (e.g. income, education and health status) and attitudinal factors (e.g. attitude, trust and knowledge) provide further insights into consumer responses in the choice experiment to identify different consumer segments. Moreover, the results reveal reference-dependent effects where perceived losses of ingredient or price attributes have a greater influence on consumer choice than perceived gains. In terms of industry and public policy implications, this study suggests that food manufacturers in Canada would benefit from the ability to make more precise health claims. The implications derived from the Latent Class Models could help the Canadian functional food industry to identify target consumer segments with different characteristics for the purpose of developing marketing strategies. Furthermore, the results of this study suggest that Canadian consumers are receptive to both full labelling and partial labelling. It indicates that public policy makers need to pay attention to effectively regulating health claims for functional foods so as to balance the need for credible health claims to facilitate the development of the functional food sector with the imperative of protecting consumers from misleading health claims. Public policy makers should also be aware that the verification of health claims plays an important role in reducing consumers' uncertainty and making health claims more credible.

The growing interest among consumers in the link between diet and health makes functional food one of the fastest growing sectors in the global food industry, especially functional dairy products. Understanding consumer choices with respect to functional food is an important and relatively new research area. Given the credence nature of functional food attributes, labelling plays a key role in allowing consumers to make informed choices about foods with enhanced health attributes. In 2007, Canada launched a review of the regulatory system for health claims on functional foods, which included rules concerning the approval, labelling and verification of health claims. In 2010 two new health claims related to oat products and plant sterols were approved by Health Canada. An analysis of how consumers respond to health claim information is therefore timely. This thesis focuses on examining the effects of different types of labelling and verification of health claims on consumers stated preferences for a specific functional food product, Omega-3 milk. The analysis incorporates reference-dependent effects. This study improves the knowledge of Canadian consumer understanding of health claims and the impact of health claims on consumer choice. This research is one of the first studies to simultaneously examine the effects of different types of health claims (e.g. function claims, risk reduction claims and disease prevention claims) and other ways of signalling or implying health benefits (e.g. symbols) on Canadian consumers' functional food choices. This study contributes to the knowledge in this domain by providing a comparative analysis of different types of labelling strategies. The extant knowledge of labelling effects in the formats of risk reduction claims, disease prevention claims and symbols or imagery on functional foods is limited. One of the primary contributions of this study is addressing this gap in the literature. The theoretical framework of this thesis is based on random utility theory. A stated preference choice experiment is designed to examine consumers' response to Omega-3 milk under different labelling scenarios. Using data from an online survey of 740 Canadians conducted in summer 2009, discrete choice models, including Conditional Logit, Random Parameter Logit and Latent Class models, and Willingness-To-Pay (WTP) values are estimated. The results suggest that full labelling (function claims, risk reduction claims and disease prevention claims) is preferred over partial labelling (e.g. the use of a heart symbol to imply a health claim), but primarily for risk reduction claims. There is no significant difference between a function claim, such as "good for your heart" and partial labelling in the form of a red heart symbol. The results also suggest that consumers on average respond positively to verification of health claims by government and the third party agencies, however, the Latent Class models reveal considerable heterogeneity in consumer attitudes toward the source of verification. The influences of key-socio-demographic (e.g. income, education and health status) and attitudinal factors (e.g. attitude, trust and knowledge) provide further insights into consumer responses in the choice experiment to identify different consumer segments. Moreover, the results reveal reference-dependent effects where perceived losses of ingredient or price attributes have a greater influence on consumer choice than perceived gains. In terms of industry and public policy implications, this study suggests that food manufacturers in Canada would benefit from the ability to make more precise health claims. The implications derived from the Latent Class Models could help the Canadian functional food industry to identify target consumer segments with different characteristics for the purpose of developing marketing strategies. Furthermore, the results of this study suggest that Canadian consumers are receptive to both full labelling and partial labelling. It indicates that public policy makers need to pay attention to effectively regulating health claims for functional foods so as to balance the need for credible health claims to facilitate the development of the functional food sector with the imperative of protecting consumers from misleading health claims. Public policy makers should also be aware that the verification of health claims plays an important role in reducing consumers' uncertainty and making health claims more credible.

No description available.

Alimentos funcionais podem ser entendidos como aqueles que, em virtude de seus componentes fisiologicamente ativos, fornecem benefícios à saúde além da nutrição básica. Esta emergente categoria de alimentos surgiu no Japão, em meados da década de 1980. A partir de então, outros países desenvolveram o seu sistema regulatório acerca de Alimentos Funcionais. No Brasil, é possível alegar que determinados alimentos possuem propriedades funcionais e/ou de saúde. Em função disso, surge uma série de incongruências e interações importantes entre legislação de alimentos e de medicamentos. Uma análise nas publicações de registros deferidas pela ANVISA possibilita constatar que um mesmo produto poderá ser registrado nestas duas categorias. As reivindicações da saúde não devem ser evitadas, pois, podem ser um importante veículo de informação para os consumidores. Todavia, é preciso que regras claras sejam estabelecidas para que o consumidor tenha acesso ao real instrumento para o cuidado com a saúde. Agências regulatórias de qualquer país devem estar direcionadas para garantir aos consumidores segurança e qualidade dos alimentos. Serão necessárias regras mais claras para a indústria, para que ao fim do processo o consumidor não seja enganado por falsas promessas de cura. O aprofundamento do debate acerca da legislação de Alimentos funcionais traz a tona a suspeita da legitimação do processo de medicalização dos alimentos por parte das agências reguladoras, tanto no âmbito nacional quanto internacional. Este trabalho não objetivou discutir a funcionalidade dos alimentos. O foco da nossa atenção está em demonstrar os riscos sanitários relativos à ausência de definições claras acerca da regulamentação desta emergente categoria de alimentos e ainda discutir suas implicações para a Saúde Pública. / Functional Food can be understood as the ones that, because of their physiologically active components, provide health benefits besides the basic nutrition. That emergent food category appeared in Japan in the middle eighties. From then, other countries developed their regulatory system concerning Functional Food. In Brazil it is possible to allege that certain kinds of food have functional and/or health properties. Observing that situation, we can see many important incongruities and interactions between food and medicine legislation. An analysis at the conceding register published by ANVISA shows that the same product can be registered in both categories. Heal claims cant be avoided, since it can be an important vehicle of information to the consumers. However, it is necessary to establish clear rules so that the consumers can have access to a real instrument for their health care. Regulation agencies of any country must be directed to guarantee to the consumers food security and quality. Clear rules for industries are necessary so that at the end of the process the consumer is not deceived by fake promises of cure. Going deeper into the discussion about Functional Food legislation emerges the suspect of the legitimacy of the process of turning food into medicine by the regulation agencies, both on national and international scopes. The objective of this study is not to discuss food functionality. Our focus of attention was to demonstrate the sanitary risks related to absence of clear definitions about the regulation of that arising food category and, besides, discuss its implications to Public Health.

Alimentos funcionais podem ser entendidos como aqueles que, em virtude de seus componentes fisiologicamente ativos, fornecem benefícios à saúde além da nutrição básica. Esta emergente categoria de alimentos surgiu no Japão, em meados da década de 1980. A partir de então, outros países desenvolveram o seu sistema regulatório acerca de Alimentos Funcionais. No Brasil, é possível alegar que determinados alimentos possuem propriedades funcionais e/ou de saúde. Em função disso, surge uma série de incongruências e interações importantes entre legislação de alimentos e de medicamentos. Uma análise nas publicações de registros deferidas pela ANVISA possibilita constatar que um mesmo produto poderá ser registrado nestas duas categorias. As reivindicações da saúde não devem ser evitadas, pois, podem ser um importante veículo de informação para os consumidores. Todavia, é preciso que regras claras sejam estabelecidas para que o consumidor tenha acesso ao real instrumento para o cuidado com a saúde. Agências regulatórias de qualquer país devem estar direcionadas para garantir aos consumidores segurança e qualidade dos alimentos. Serão necessárias regras mais claras para a indústria, para que ao fim do processo o consumidor não seja enganado por falsas promessas de cura. O aprofundamento do debate acerca da legislação de Alimentos funcionais traz a tona a suspeita da legitimação do processo de medicalização dos alimentos por parte das agências reguladoras, tanto no âmbito nacional quanto internacional. Este trabalho não objetivou discutir a funcionalidade dos alimentos. O foco da nossa atenção está em demonstrar os riscos sanitários relativos à ausência de definições claras acerca da regulamentação desta emergente categoria de alimentos e ainda discutir suas implicações para a Saúde Pública. / Functional Food can be understood as the ones that, because of their physiologically active components, provide health benefits besides the basic nutrition. That emergent food category appeared in Japan in the middle eighties. From then, other countries developed their regulatory system concerning Functional Food. In Brazil it is possible to allege that certain kinds of food have functional and/or health properties. Observing that situation, we can see many important incongruities and interactions between food and medicine legislation. An analysis at the conceding register published by ANVISA shows that the same product can be registered in both categories. Heal claims cant be avoided, since it can be an important vehicle of information to the consumers. However, it is necessary to establish clear rules so that the consumers can have access to a real instrument for their health care. Regulation agencies of any country must be directed to guarantee to the consumers food security and quality. Clear rules for industries are necessary so that at the end of the process the consumer is not deceived by fake promises of cure. Going deeper into the discussion about Functional Food legislation emerges the suspect of the legitimacy of the process of turning food into medicine by the regulation agencies, both on national and international scopes. The objective of this study is not to discuss food functionality. Our focus of attention was to demonstrate the sanitary risks related to absence of clear definitions about the regulation of that arising food category and, besides, discuss its implications to Public Health.

The World Wide Web has become a significant source of medical information for the public, but there is concern that much of the information is inaccurate, misleading, and unsupported by scientific evidence. This study analyzes the validity of health claims on the World Wide Web for the herbal Opuntia using an evidence-based approach, and supports the observation that individuals must critically assess health information in this relatively new medium of communication. A systematic search by means of nine search engines and online resources of Web sites relating to herbal remedies was conducted and specific sites providing information on the cactus herbal remedy from the genus Opuntia were retrieved. Validity of therapeutic health claims on the Web sites was checked by comparison with reports in the scientific literature subjected to two established quality assessment rating instruments. 184 Web sites from a variety of sources were retrieved and evaluated, and 98 distinct health claims were identified. 53 scientific reports were retrieved to validate claims. 25 involved human subjects, and 28 involved animal or laboratory models. Only 33 (34%) of the claims were addressed in the scientific literature. For 3% of the claims, evidence from the scientific reports was conflicting or contradictory. Of the scientific reports involving human subjects, none met the predefined criteria for high quality as determined by quality assessment rating instruments. Two-thirds of the claims were unsupported by scientific evidence and were based on folklore, or indirect evidence from related sources. Information on herbal remedies such as Opuntia is well represented on the World Wide Web. Health claims on Web sites were numerous and varied widely in subject matter. The determination of the validity of information about claims made for herbals on the Web would help individuals assess their value in medical treatment. However, the Web is conducive to dubious health information and individuals should exercise caution in accepting health claims unsupported by scientific evidence.