Ron Bailey10.01.04
Diabetes Prevention In Japan: An Update
The rising rates of diabetes and pre-diabetes Japan has created a surge of new product activity.
By Ron Bailey
It has only been one year since the last status report on diabetes in Japan, which was summarized in the October 2003 issue of Nutraceuticals World. There have been several interesting developments in the past year, however, so an update is in order.
The overall diabetes numbers have not changed significantly from projections reported a year ago. The World Health Organization (WHO) is continuing to report that there are over 175 million “people with diabetes” in the world, and that number is expected to increase to well over 350 million people by the year 2025. Official Ministry of Health, Labor, and Welfare (MHLW) sources in Japan are indicating that there are over 16 million Japanese people who are either “probable” cases or “suspected” cases, somewhat analogous to the diabetes and pre-diabetes incidence here in the U.S.
There is a growing awareness in Japan of the connection between obesity and type II diabetes, and the Japanese are becoming more familiar with terms such as “metabolic syndrome” and “Syndrome X,” which are used to define the risk factors related to pre-diabetes and diabetes. The most recent national nutrition survey in Japan, “The National Nutrition Survey in Japan, 2001” conducted by the National Institute of Health and Nutrition, is a useful source of information on the prevalence of obesity (defined as a Body Mass Index of greater than 25) in Japan. In that survey, over 30% of males over 30 years old and 25% of females over 50 years old were considered obese by the Japanese BMI standard.
This is a major concern in Japan, even though only 3% of the survey population had a BMI of 30 or greater, which is the obesity standard in the U.S. It is not possible in this brief summary to address the considerable activity in Japan in the weight loss and slimming categories, however, even though many of the products in the categories target, at least indirectly, people with diabetes and pre-diabetic conditions.
FOSHU (Food for Specified Health Uses) Developments
Although direct diabetes prevention and treatment claims in Japan would be considered drug claims and therefore not allowed for foods, the MHLW is continuing to support the FOSHU products that claim to be able to reduce or control blood sugar levels.
The Japan Health Food and Nutrition Food Association (JHNFA) recently published a detailed summary of the FOSHU category as of the end of 2003. This summary was translated and reported in the May 2004 issue of Japanscan Food Industry Bulletin, and represents the official status of the FOSHU category. It is interesting to note that FOSHU products targeting reduced blood sugar levels had retail sales of nearly $275 million in 2003, up from just over $160 million only two years earlier, a 70% gain. The number of approved FOSHU products targeting reduced blood sugar increased from 19 to 49 during the same two-year period. For perspective, there were 398 approved FOSHU products in all claim areas at the end of 2003, with retail sales of over $5 billion.
Nearly all of the new FOSHU reduced blood sugar product approvals during the past year have used indigestible dextrin fiber as the functional component to allow on-label claims that the product will “…moderate the absorption of sugar” and “…is suitable for people beginning to be concerned about blood sugar levels.” Since all FOSHU products are allowed to use the official FOSHU logo, which indicates the product has been either “approved” or is “permitted” for sale by MHLW, it is clear that the blood sugar claim has the full backing of the Japanese government. This is an indication of the level of official government concern for pre-diabetes and diabetes in Japan.
Non-FOSHU Market Activities
There have also been many interesting developments in Japan outside the formal FOSHU category during the past year. It is helpful to follow the development and marketing of new ingredients targeted at some of the pre-diabetes and diabetes conditions.
Examples from recent issues of Japanscan Food Industry Bulletin include:
• L-arabinose to “suppress absorption of sugar”
• L-carnitine “for people with diabetes”
• Banaba (Lagerstroemia speciosa) extract powder to “suppress a rise in blood sugar and prevent diabetes”
• Hanabiratake (Sparassis crispal) fungus “effective in suppressing blood sugar levels”
A review of the Health Ingredients Japan 2003 tradeshow directory provides additional examples, citing only those ingredients for which a specific reference to diabetes conditions was made in the directory abstracts:
• “Para Azul” herb from Paraguay with “efficacy on diabetes”
• Anti-Syndrome X mushroom extract (name not provided)
• Nitobe extract “for diabetes and pre-diabetes”
• “Catenorin” green tea extract for “blood glucose control”
• Maitake mushroom fraction “to ameliorate insulin resistance and prevent or treat Syndrome X or type II diabetes”
A similar review of the Guidebook from the May 2004 ifia 2004 International Food Ingredients and Additives show revealed the following additional examples:
• L-arabinose to “suppress increase of blood sugar”
• Guar fiber for the “regulation of blood sugar levels”
In general, the ingredient claims made in the trade show guidebook abstracts are quite conservative, particularly for the larger Japanese ingredient suppliers. It is possible, however, to obtain extensive laboratory and even clinical data in support of the new ingredients from the exhibitors. Some of the ingredients will eventually become formal functional components in FOSHU products, but only after extensive safety and efficacy data are generated in support of both the ingredient and the FOSHU product. Some of the ingredients will eventually be sold in the U.S. as well, typically targeting the New Dietary Ingredient market for dietary supplements, followed later by GRAS status for food applications when appropriate.
Final Thoughts
Although this summary has focused primarily on the status of blood sugar control products related to diabetes, a separate summary could have been written covering the rapidly growing “neutral fats, body fat” FOSHU category related to blood lipids and weight control and its relationship to diabetes and pre-diabetes. The FOSHU products in this category had retail sales in 2003 more than double the blood sugar control category, and are growing even more rapidly in terms of retail sales value.
The message from Japan is quite clear and consistent related to FOSHU products in particular. MHLW will continue to support the development and marketing of functional foods with demonstrated safety and efficacy, and will continue to use the results of the annual nutrition survey to guide its thinking. MHLW is particularly concerned with those health conditions, which continue to grow such as diabetes, and are constantly looking for reasonable cost, non-drug approaches to help solve such health issues.NW
***
Note: Important sources of information for this summary are the Ministry of Health, Labor, and Welfare (MHLW) websites from Japan, the National Institute of Health and Nutrition in Tokyo, Japanscan Food Industry BulletinITAL published in the U.K., the Health Ingredients Japan 2003 Directory, the ifia 2004 International Food Ingredients and Additives Guidebook and the Japan Health Food and Nutrition Food Association in Tokyo.