Eye Health Issues In Japan

Examining potential eye health ingredients in Japan.

By Ron Bailey

There is no question that there is an increasing interest in eye health in Japan. This is related in part to the expected concerns of an aging population, but it is also related to the concerns amongst people of all ages who are computer and television screen (over)users subject to potential eye strain. The focus of the nutraceutical and functional food markets in Japan has been on eye fatigue, however, rather than the age-related eye diseases such as cataracts and age-related macular degeneration (AMD). In the minds of the Japanese consumers, eye strain is considered a short term issue, as compared with the longer term nature of more serious eye diseases.

Japanese Dietary Considerations

The annual nutrition survey conducted by the National Institute of Health and Nutrition (published in Japanese only) clearly shows that the daily consumption of yellow and green vegetables has been increasing in recent years, nearly doubling since the 1975 base reporting period. In addition, the intakes of the primary vitamins (A, B1, B2 and C), which are measured annually in the survey, consistently are well above the Japanese RDA’s for those vitamins across all age groups and for both males and females. To the extent that a healthy daily diet is of value in maintaining eye health, there is no question that the average Japanese diet is adequate.

The Japanese are also becoming more interested in the potential health benefits of antioxidants from various food sources, not just related to prevention of age-related health conditions such as cancer and heart disease. Consumption of anthocyanin-rich berries, for example, has grown significantly in Japan as the awareness of the potential health benefits of these foods increases, and as they become more readily available in Japan at reasonable prices and with acceptable quality.

The Wild Blueberry Association of North America has been extremely successful in marketing North American (from the U.S. and Canada) wild blueberries in Japan over the past few years. Consequently, they have be­come one of the most popular ingredients (and flavor) for ice cream and yogurt, for example, and they are now being added to a wide range of other foods in Japan. On-label claims cannot be made for the blueberry-containing products, but the quantitative on-label anthocyanin content can be included in the nutritional information. Japanese consumers have been convinced that the blueberry anthocyanins help to relieve the eye fatigue associated with too much computer and television screen viewing, with the added advantage that the blueberry taste is very acceptable.

Other less well-known anthocyanin-rich berry products being sold in Japan include Aronia (chokeberry) and bilberry (often in dietary supplement form and imported from Europe). Total imports of all fresh berries, primarily blueberries, were valued at nearly $60 million in 1999 according to the July-August, 2000 issue of Focus Japan published by the Japan External Trade Organization (JETRO). This was a nearly six-fold increase in just a five-year period, which is a clear indication of the Japanese consumer interest.

Japanese Eye Health Data Background

At the present time, there is less public official eye health information available to consumers in Japan than in the U.S. The National Institute of Health and Nutrition, for example, did not include any questions regarding eye health in a recent annual report of consumer health concerns in Japan (diabetes, cerebral apoplexy and nutrition were the major issues). From the consumer perspective, it is believed by many Japanese that typically brown-eyed Japanese may be less susceptible to the cataracts and AMD that often occur with aging, and therefore are less concerned about these health conditions, which are growing concerns in the West. Data from other Asian locations, however, including findings published by the Singapore National Eye Centre and their affiliated re­searchers, suggest the incidence of cataracts and AMD are serious and growing concerns in Asia.

There is no Japanese equivalent of the AREDS (Age-Related Eye Disease Study) project, which is being coordinated by the National Institute of Health (NIH) here in the U.S., and apparently no long term nationwide study on eye health specifically (at least no public information is readily available). With the publication of positive diet-related findings here in the U.S., however, this may well ­change in the ­­­­future as the Japanese consumers become more interested in the need for longer term eye health maintenance. It is also expected that the eye doctors in Japan will be more interested in western scientific information, particularly if it can be shown that the Asian trends in Singapore and other countries are relevant to the Japanese population.

Japanese Market Nutraceutical and Functional Food Opportunities

To the extent that the North American blueberry exporting associations are able to demonstrate actual eye health benefits as a result of consumption of blueberries and blueberry anthocyanins, the market in Japan should increase. While "relief of eye fatigue" may not prove to be a health claim suitable for FOSHU (Food for Specified Health Use) status, a well-designed clinical study showing such benefits could be used in Japan in print advertising and other promotional materials. This same logic would likely apply to other anthocyanin-rich ingredients, although clearly blueberries already have an established credibility amongst Japanese consumers for this purpose.

Regarding the longer term disease prevention opportunities, it can be expected that relatively new nutra­ceutical ingredients such as lutein from marigold flowers for AMD will also be of increasing interest in Japan. Lutein is already being sold in Japan, but so far on a limited basis, with relatively low consumer awareness. The scientific support is ex­panding, however, and it can be as­sumed that as the Japanese become more aware of the longer term health risk of AMD amongst Asian populations, they will become more interested in lutein (with its accompanying zeaxanthin) for prevention. Spinach is an excellent source of lutein as well, and is a popular green vegetable in Japan, so there could be additional marketing opportunities for spinach as a food ingredient as the market awareness develops.

The recent trend in Japan toward increased levels of user payments for medical services (and less government insurance support) is also expected to increase consumer interest in "self-health management." Natural ingredients such as blueberries, spinach, and even flower-derived ingredients such as lutein, will become increasingly popular in ­­­­­­­Japan for health maintenance applications. There is an added incentive for the medical community to support such efforts, as prescription drug prices continue to decline and prevention becomes more of a focus for day-to-day health. This is in fact a stated government health priority in Japan. NW
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Note: Important sources of information for this article are the National Institute of Health and Nutrition in Tokyo, JETRO’s Focus Japan, and Singapore National Eye Centre publica­­­­tions.