A Study is Needed to Investigate the Influence of Health Functional Foods on Reducing National Medical Expenses

Based on the 2022 statistics from the OECD, it has been found that the national medical expenses of OECD countries are continuously increasing due to low birth rates and aging populations.1 In Korea, the national medical expenses were 4.5%, 7%, and 8.4% of the GDP in 2000, 2010, and 2020, respectively. While this is still lower than the OECD average of 8.8%, the US at 18.8%, Japan at 11.1%, and Germany at 12.8%, the rate of increase in Korea is the fastest among OECD members.2

Additionally, data from the National Statistical Office in Korea in 2022 shows that the life expectancy of Koreans is 83.5 years, indicating that Korea is becoming an aging society. The elderly population aged 65 or older exceeded 14% in 2017, which is the standard of an aging society, and is expected to increase to 20.6% in 2025. This suggests that Korea is on track to become the country with the largest number of elderly people in the world.

In an aging society, the most significant social issue that arises is the exponential rise in national medical expenses caused by chronic degenerative diseases such as hypertension, obesity, cardiovascular disease, and diabetes, which put a strain on the national economy.

To tackle this problem, developed nations like Japan and the US have implemented measures to improve national health and reduce healthcare costs by utilizing health functional foods (health supplements), which have been scientifically proven to aid in preventing these chronic degenerative diseases.3 These nations have introduced legislation such as the special act on health functional foods, established health functional food policies, and actively supported research on health functional foods at the national level.

To promote public health and reduce healthcare expenses by widely publicizing the efficacy of food, the US enacted the Nutritional Labeling and Education Act (NLEA) in 1990, which was the most proactive measure taken among OECD member countries. This law permits the labeling of the efficacy of a nutrient for a specific disease (health claim) so that the public can be informed of the disease prevention functions of nutrients. Prior to the enactment of this law, health claims on food were prohibited. As such, the permission of disease prevention labeling on food is the first measure of its kind in the world. Under this law, the FDA allowed the indication of efficacy for 12 nutrients, including the efficacy of calcium for osteoporosis, dietary fat for cancer, and plant sterol for coronary artery diseases. However, such indications were only allowed based on the Significant Scientific Agreement.

Aside from the Nutritional Labeling and Education Act (NLEA), the US also passed the Dietary Supplement Health and Education Act (DSHEA) in 1994 to broaden the range of application for health claims by including vitamins, minerals, herbs, amino acids, and other extracts and mixtures. In 1997, which was three years after the passage of this act, the so-called DSHEA effect was observed, leading to a three-fold growth in the global food market, as well as swift commercialization and research development of various medicinal plants.

Like the US, Japan established Food for Specialized Health Uses (FOSHU) as part of the Foods for Special Dietary Uses (FSDU) based on the Nutrition Improvement Act in 1991 (now the Health Promotion Act). FOSHU is defined as foods that contain constituents that have science-based specific health benefits on physiological functions or biological activities of the body, and therefore, contribute to preserving or improving health. The Ministry of Health and Welfare allows labeling of FOSHU ingredients, function, stability, and preventive diseases such as blood pressure, blood sugar, and osteoporosis. In 2001, the Food with Health Claims was established to expand the scope of function claim foods and categorize tablet- or capsule-type foods as food, which had previously been treated as medicine. In this manner, Japan has been endeavoring to promote national health by disseminating information about the functions of health foods and increasing the consumption of these foods.

In 2004, Korea followed the footsteps of the US DSHEA and Japan's Foods with Health Claims by enacting the Health Functional Foods Act. The Act aims to ensure the safety of health functional foods, enhance their quality, and promote their proper distribution and sale, thereby contributing to the improvement of public health and the protection of consumers. Health functional foods refer to foods that contain ingredients that act as nutrients or have beneficial effects on the structure or physiological function of the human body. These foods must be produced according to the Codes of Health Functional Foods and GMP (Good Manufacturing Practice) standards and be approved by the Minister of Food and Drug Safety.

As previously discussed, the US, Japan, and Korea are prioritizing the prevention of diseases to promote national health. To achieve this goal, they have implemented various measures such as enacting laws, establishing systems, disseminating information about the beneficial functions of functional foods to the public, and encouraging their consumption.

Efforts to promote the consumption of functional foods have been ongoing for several decades, and it is now time to assess their effectiveness. The US has taken a leading role in this evaluation, with the US Council for Responsible Nutrition (CRN) publishing a report titled "Smart Prevention-Health Care Cost Savings Resulting from the Targeted Use of Dietary Supplements, 2030," which examines how the consumption of health foods can reduce medical costs. According to the report, the intake of omega-3, lutein, calcium, and vitamin D saved 3.88 billion dollars for coronary heart disease treatment, 9.7 billion dollars for vision impairment treatment, and 1.52 billion dollars for osteoporosis treatment for one year, respectively. 4

Evaluation has also begun in the EU, with Food Supplements Europe reporting that the consumption of omega-3, Ca+Vit-D, and phytosterol for one year saved 7.3 billion, 2.82 billion, and 4.09 billion dollars, respectively, for the treatment of coronary heart disease, osteoporosis, and heart disease. These results demonstrate that functional foods significantly contribute to reducing medical expenses.5

As of 2022, the market size of health functional foods in Korea has surpassed 5 trillion won, and the Ministry of Food and Drug Safety continues to approve new health functional foods. Given that Korea is experiencing the fastest aging rate, the demand for health functional foods is expected to rise. Therefore, it is imperative to evaluate the effects of health functional foods on public health promotion and medical cost reduction. Unfortunately, no such studies or efforts have been made thus far.

It is now time for Korea to follow the lead of the US and EU in evaluating the effectiveness of health functional foods. The results of such evaluations are expected to prevent the misuse of health functional foods, encourage the use of necessary health functional foods, and contribute to the development and competitiveness of science and industry of Korea's health functional foods. Hence, it is hoped that the government and companies will take an interest in these efforts and invest grants for the evaluation research.

Over the past three decades, developed countries such as the US, EU, and Japan have been promoting the use of dietary supplements under strict laws and regulations. Korea enacted the Health Functional Food Law 20 years ago and has been following a similar path. Recently, the US and EU have made efforts to evaluate the effectiveness of such measures and have reported that health functional foods contribute to the promotion of public health and medical cost savings. However, Korea has yet to undertake any similar evaluation studies. It is imperative for Korea to conduct such studies to effectively contribute health functional foods to public health.