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					Q1. To what extent should the food regulatory system be used to meet broader
    public health objectives?

Food should be a fundamental part of good health but health claims related to food
are generally non-robust and not evidence based. Food regulations need to take into
account consumer protection in terms of labelling –this is in regards to consumers
being able to make an informed choice about avoiding certain products, which they
may either have a known allergy/intolerance to, or wish to avoid, due to short and
long term health concerns, such as soy or corn products. This also applies to food
with GM ingredients. Consumers should be able to avoid these products but this is
not possible unless labelling is rigorous.

Manufacturers should not be able to make misleading health claims on their products
as this is confusing for consumers. Unsupported non-research based claims are
regularly made about infant formula products in particular. This practice which is
related to a monopolistic market system means that manufacturers attempt to
compete on what is termed „quality‟ or on amounts of certain novel ingredients
included in products, when in reality there is no evidence to back up the claims and
the benefits of these novel ingredients is unclear at best.

A good example of this are the long chain polyunsaturated fatty acids (LCPUFAs)
DHA & ARA which are added to the majority of infant formula products despite a
Cochrane Systematic Review conducted in 2008 which examined the research and
found no benefit to either full term or preterm babies from the addition of these
products.

Simmer, Patole & Rao stated, “… feeding term infants with milk formula enriched
with LCPUFA had no proven benefit regarding vision, cognition or physical growth”.

Simmer, Schulzke, & Patole stated, “… the evidence does not support the claim that
preterm infants have improved visual and intellectual development if their formula is
supplemented with LCPUFA. LCPUFA supplementation does not significantly
influence the long term growth of preterm infants”

Research continues to be inconsistent and inconclusive but this has not prevented
extensive marketing campaigns claiming visual, immune system and brain benefits
which have resulted in parents mistakenly believing that these products are
somehow closer to breastmilk. This is a link to a revealing report from England which
demonstrates the confusion about infant formula products and how these misleading
health benefit claims confuse parents.
http://www.cwt.org.uk/pdfs/Formula_PTBReport.pdf

It is not appropriate in this submission to relate the multitude of differences between
the living synergistic fluid that is breastmilk and an inert infant formula product but
while on the subject of LCPUFAs it is well worth pointing out that breastmilk has
approximately 150 LCPUFAs.

One further issue related to these novel LCPUFAs produced for infant formula
products, is concerning the use of the toxic chemical Hexane as an agent for
extraction. Hexane is a petroleum by-product of gasoline refining. The DHA and ARA
products are also structurally different to those found in human milk and are derived
mostly from algae and soil fungus.

For an in depth report about these novel oils and the extraction processes please
see the Cornucopia Institute report at
http://cornucopia.org/DHA/DHA_FullReport.pdf

Please see also the adverse reactions to these infant formula products with novel oil
additives here http://cornucopia.org/DHA/AdverseReactionReports.pdf

Some infants experience a range of symptoms including watery, explosive diarrhea,
severe vomiting, and gastrointestinal distress. Parents have no way of knowing that
these products may have these effects without effective warning labels. Health
claims could be considered the least appropriate ones to make for these products
given the lack of evidence of benefit and the evidence of adverse reactions.

Recently there has been a dispute in the USA regarding the addition of these oils to
organic products. Parents buying organic products may trust the organic label and
be unaware of the source of the ingredients or the processing procedures.

Another „optional‟ ingredient that originally looked „promising‟ (according to industry
dieticians) is nucleotides – it is my understanding that the initial „excitement‟ about
this additive was not borne out. This outcome does not appear, however, to have
reduced the industry health claims about this ingredient.

In summary – the food regulatory system should specifically act to protect all
consumers, but particularly the most vulnerable consumers; infants, toddlers and
young children. Protection in this case would take the form of eliminating misleading
marketing and removing health claims from infant formula products and all baby
foods up until at least the age of two years.


Q2. What is adequate information and to what extent does such information
    need to be physically present on the label or be provided through other
    means (eg education or website)?

Website focus relies on consumers being able to access the information easily. As
some consumers do not have access to computers and may not be computer literate
this method will not be adequate to meet all needs. Education is also reliant on ease
of access for consumers and sufficient ongoing dedicated funding to enable a
comprehensive programme. Issues such as who will deliver the education, what form
this will take, where and how it will be delivered, and how it will be monitored and
updated are crucial components. It is necessary for a multi-pronged approach to be
taken or the risk of not meeting the information needs of population groups is a real
concern. Suggest diverse consumer focus group work prior to any decision.
Adequate information would consist of country of origin labelling, disclosure of
genetically modified ingredients and disclosure of any of the major potentially
allergenic ingredients such as dairy, soy, legumes, fish, wheat/gluten as well as a full
list of ingredients. Corn derived ingredients also require disclosure as do products
containing palm oil.
Colour coding could be utilised particularly for GM ingredients – a traffic light colour
system for example.

Allergenic ingredients require naming clearly on labels

Country of origin labelling- this is obviously complex as there may be multiple
countries involved. Potentially a globe design would be useful with pinpoints on the
relevant countries.

Animal welfare issues – consumers should be able to buy with confidence knowing
that animals have not been mistreated. Battery eggs/chickens and pork from crated
pigs should be able to be avoided for example. This would hopefully represent
further work towards reduction in animal cruelty. Many consumers wish to shop as
ethically as possible and labels should make this easier.

Also warnings need to be added about potential adverse reactions to infant formulas
containing DHA & ARA. Currently the products only suggest that babies may
become ill due to inappropriate preparation of the product by a parent or carer. There
is nothing to suggest that the product itself may cause some gastrointestinal
problems.

If a suggestion is made that „benefits‟ occur only if a product is used „correctly‟ or
harm occurs only if a product is made up incorrectly this is misleading. This implies
that when a product is used in a „real-life‟ setting by parents, such as during
preparation of the breast-milk substitute and/or the feeding of the infant the claimed
„benefits‟ are somehow compromised only for this reason. Powdered infant formulas
are also non-sterile and have the potential to be contaminated by bacteria such as
Enterobacter Sakazakii or Salmonella. The label should also inform parents that the
powdered product is not sterile. Correct usage is crucial once the powder is
reconstituted and correct preparation of the feed is also a significant issue.

Adequate information related to infant formula products is complex. There are many
issues with these products, including the misleading health claims previously
mentioned. Parents have limited access to sufficient information even related to
something as basic as whey casein ratios and what this means. Currently there are
80% casein products available on supermarket shelves and these are problematic in
terms of negative gut effects particularly in younger babies. There is currently a
product that is cheaper than others on the shelves in NZ supermarkets which is 80%
casein and labelled for use „from birth‟. Parents are attracted to this product due to
the price. It is relevant to note that human milk has a ratio of 10% casein to 90%
whey initially (human, not bovine of course) and then it transforms over a period to
60% whey and 40% casein. At no point does human milk ever reach 80% casein
levels. High bovine casein protein levels cause constipation and gut problems in
infants. Ideally these products should not be on the market at all but if they are
permitted to be on sale perhaps a warning about adverse gut reactions such as
constipation could be considered.

One other claim on some infant formula products that requires consideration is the
one related to what are termed „Good Night Milks‟ in the UK. These products are to
be found under different names in New Zealand and Australia. The drawcard that
appeals to tired parents is the claim that babies will sleep for longer. Please see the
Scientific Advisory Committee on Nutrition‟s report 2008 in regards to the concerns
about these products and their claims
http://www.sacn.gov.uk/pdfs/final_sacn_statement_on_good_night_milks.pdf

Q3. How can accurate and consistent labelling be ensured?

Strict government regulation, monitoring and meaningful sanctions for breaches
      and violations. Adequate funding to enable monitoring agencies to function
      effectively. Education programmes.

    Self regulation has not been effective in other areas. It was suggested at
     the consultation meeting in Christchurch that the self regulatory codes
     developed by the infant formula industry are effective and could be used
     as a model for other food industry groups. In reality these self regulatory
     codes do not work. There has been no evidence of infant formula industry
     self regulatory codes having any effect on inappropriate marketing.
     Furthermore because these codes are voluntary they only apply to the
     companies who sign up and they do not cover companies selling products
     designed for the baby food market who are not infant formula
     manufacturers. The self regulatory codes in Australia and New Zealand
     are weak versions of the International Code and do not cover the range of
     products essential for consumer protection which include what are termed
     Follow-On Milks claimed to be necessary from around six months for
     infants. The World Health Organisation in1986 had this to say, “The
     practice being introduced in some countries of providing infants with
     specially formulated milks (so called follow up milks) is not necessary”.

The FSANZ Act requires linking to consumer protection laws within both Australia
and New Zealand. The Charter of Health Consumer Rights in Australia provides a
summary which is relevant also to food and labelling issues:

   •    The right to safety – protection against products, production processes and
        services which are hazardous to health or life
    • The right to be informed – given the facts needed to make an informed
        choice, and protected against dishonest or misleading advertising and
        labelling
    • The right to a healthy environment – to live and work in an environment
        which is non-threatening to the well being of present and future generations
Consumers Health Forum Australia
http://www.chf.org.au/public_resources/consumer_rights.asp

As one of the guiding principles of the Code for Advertising of Food states;

“ Advertisements should not by implication, omission, ambiguity or exaggerated
claim mislead or deceive, or be likely to mislead or deceive consumers, abuse the
trust or exploit the lack of knowledge of consumers, exploit the superstitious, or
without justifiable reason play on people‟s fear”.
Q4. What principles should guide decisions about government intervention on
    food labelling?

Ethical principles including consumer safety particularly related to health, rights
     to adequate information, prevention of deceptive and misleading conduct,
     and avoidance of harm, which means indirect as well as direct harm.
     Indirect harm can be caused by deception, breaking a promise as with a
     false claim, withholding of adequate information or provision of misleading
     information.

“Food companies are not health or social service agencies, and nutrition
becomes a factor in corporate thinking only when it can help sell food” Nestle, M.
(2002). Food Politics. Berkeley: University of California Press
Marion Nestle, academic nutritionist, clearly states the issues about where food
companies‟ priorities lie. Decisions about labelling should not take into account
any claims by industry of financial disadvantage but should focus on consumer
protection.

Q8. In what ways can food labelling be used to support health promotion
initiatives?

Health promotion initiatives may often represent methods by which industry can
     persuade consumers to buy products so caution is necessary. Food
     labelling regulations require tightening to prevent misleading health claims.
     Health promotion could be supported by having warning labels on foods
     that are unhealthy. Health claims should not be allowed on food items.
     Synthetic vitamins and other additives touted as beneficial on labels may be
     misleading for consumers. Synthetic additives should be declared.

A good example of how food labelling can be used to support health promotion is
    in the area of baby food. Both the New Zealand and Australian Health
    Departments have developed guidelines for healthy eating for infant and
    toddlers. Exclusive breastfeeding for six months is highly advised and
    recommended. This is also a World Health Organisation recommendation
    and it is in the Global Strategy for Infant and Young Child Feeding. These
    recommendations are seriously undermined by baby food companies in
    both Australia and New Zealand continuing to use the four to six months
    labels on their products which are obvious on supermarket shelves.
    Industry also produce parent guides for infant feeding using confusing
    terminology such as starting solid food „around six months‟ but „not before
    four months‟. Losing what may amount to eight weeks of baby food revenue
    is significant for industry but the health of infants should be the first priority
    and not revenue and profits for industry


Q9. In what ways can disclosure of ingredients be improved?

Government regulation, monitoring, easy process for reporting of violations,
    meaningful sanctions to encourage compliance. Testing of more products to
    encourage compliance
Q10. To what extent should health claims that can be objectively supported by
     evidence be permitted?

Health claims should be recognised as useful marketing strategies. Objectively
     supported evidence may only be achieved by independent research not
     funded by the industry. Certainly industry studies should be examined
     closely. Conflict of interest issues must be taken into account. Study design
     also requires rigorous analysis as do study questions.

One issue that requires consideration is related to control groups for any study
    on infant formula. All infant formula products need to be measured against
    the biological norm which is breastmilk and breastfeeding. Measuring one
    formula product against another formula product leads only to a competition
    to increase quantities of novel ingredients or to put further novel ingredients
    into the products. A breastfed control group is essential for comparison of
    outcomes and the breastfed group must also be defined further to establish
    the type of breastfeeding. Partial breastfeeding is not the same as exclusive
    breastfeeding and results can be skewed without a rigorous definition.

It is also insufficient to conduct short term trials on products designed for long term
use such as infant formula products. Short term effects do not necessarily last and
claims can be made which are non-robust.

Q12. Should specific health warnings (e.g., high level of sodium or saturated fat
     per serve) and related health consequences be required?

Yes


Q13. To what extent should the labelling requirements of the Food Standards
     Code address additional consumer-related concerns, with no immediate
     public health and safety impact?

Consumer related concerns should always be taken into account


Q17. Is there a need to establish agreed definitions of terms such as „natural‟,
     „lite‟, „organic‟, „free range‟, „virgin‟ (as regards olive oil), „kosher‟ or „halal‟?
     If so, should these definitions be included or referenced in the Food
     Standards Code?

Absolutely as „green and healthy‟ terminology can give false impressions to
consumers. Many consumers know now that free range can mean anything from a
larger space inside a shed, to a door opened to the outside a couple of times a day,
to chickens truly free ranging. Some other issues are not quite so clear or have not
received as much publicity and consumers should be given enough information to
make an informed choice.
Q26. What objectives should inform decisions relevant to the format of front-of-
     pack labelling?

No misleading health claims
Consumer protection
Health issues


Q28. To what degree should the Food Standards Code address food
     advertising?

Health claims on infant formula products should be removed. They are used as a
     marketing tool as described previously and this creates a market where the
     competition is to add more of some ingredients or create new novel
     ingredients with further health claims. If an ingredient really strengthened
     infant immune systems (which are of course particularly vulnerable for
     infants formula fed and without the immune protection provided via the
     maternal immune system and breastfeeding) then it would be blatantly
     unethical for this ingredient to be in some products and not in others. All
     infant formulas should have the safest possible nutritional composition
     without the addition of novel ingredients which can only be touted as „may‟
     improve eye, immune, brain, gut function. If they REALLY improved any
     function and there was robust research available they would not use the
     word „may‟.

If an ingredient is deemed to be necessary and useful for the nutritional aspects of
infant formula products then it should be a required addition to all products
considering the vulnerability of infants – there should be no possibility of certain
products becoming more „popular‟ as what we are interested in here is the health
and development of infants as the primary focus.

This should not be a competition to attract parent buyers but it should be
     concerned with looking after this vulnerable infant population by ensuring
     one good product is available that meets nutritional needs and high
     standards without misleading marketing. The aim should be to ensure that
     children achieve the best attainable standard of health - this can only be
     fulfilled through breastfeeding of course - but if the infant is not breastfed
     the breast-milk substitute needs to be safe and without non-essential novel
     ingredients. Industry profits from the failure of breastfeeding which means
     that statements concerning vulnerability and infant health and protecting
     markets become contradictory.

The International Code of Marketing of Breast-Milk Substitutes and subsequent,
     relevant World Health Assembly resolutions should be enforced by both
     Australia and New Zealand.

Q29. In what ways can consistency across Australia and New Zealand in the
     interpretation and administration of food labelling standards be improved?
One issue to consider – Using the definition of an infant from birth to one year in both
Australia and NZ to eliminate confusion with infant formula products and marketing
of these products. Currently Australia are using the accurate one year definition but
New Zealand is using the incorrect six months definition. Using a six month definition
gives infant formula companies more scope for misleading marketing of follow on
milks.


Q34. What are the advantages and disadvantages of retaining governments‟
     primary responsibility for administering food labelling regulations?

Increased compliance


Q35. If a move to either: self regulation by industry of labelling requirements; or
     co-regulation involving industry, government and consumers were to be
     considered, how would such an arrangement work and what issues would
     need to be addressed?

Industry self regulatory codes have not been effective so should be avoided.
Governments should regulate and have robust consumer representative
relationships

				
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