Health food has become a part of life in mainstream Taiwanese society. According to estimates, more than 70% of the population has eaten health food. But what exactly is it? Will eating it preserve health, build up immunity, or even prevent diseases?

The Lingzhi Revolution; Cure a Hundred Illnesses with Garlic; Wheat Grass, the Miracle Treatment. . . just reading the titles of these books arouses one's curiosity. And word often gets passed from person to person-eating lecithin can strengthen your memory and prevent senility; DHA and melatonin have the ability to prevent aging. . . . Whether it's flower pollen, lingzhi (Ganoderma lucidum, a kind of fungus), shark cartilage, immunity-enhancing milk powder, algae, fish oil or herbal tea, as long as one waves the "health food" banner, there are people who are willing to try it. From puling babes to senior citizens, from damsels craving beauty to students cramming for exams, everyone has a health food product specially made for them to digest.

Condensing nutrition

Who does not hope to be healthy? In the past, people were afraid of going hungry, of not having enough nutrition. They believed people should eat more, and add more "tonic supplements" to their diet. Now, because the economic environment has improved, everyone is eating too well; in fact, they hope that their food can help them "shed their extra burdens." And as the number of people who eat out increases, it becomes increasingly difficult to balance one's diet. Pressure in life is intense, and pollution omnipresent. Under these circumstances, if someone recommended that you try a certain special food product which can build up your immunity or even prevent disease, wouldn't you be happy to give it a try? And with chronic high blood pressure, circulatory diseases and cancer all on the rise, more than a few sufferers have taken traditional folk remedies or health foods as a new path of hope for fighting their diseases.

This line of thought is actually not unique to Taiwan. The island's recent fascination with health food has washed in on a wave of fashion from the United States and Japan. And the reason it has gained such great acceptance in Taiwan is not only because of the increased prosperity of recent years, but also because Chinese people have originally had the concept of nourishing the body with both healthful food and medicine. The two factors play off each other, to make the fad hotter than ever before.

"'Medicine and food come from the same source'-this is the special viewpoint of traditional Chinese medical theory. It places an emphasis upon using natural foodstuffs to undertake the work of fortifying the body," says Yang Ling-ling, director of the Taipei Medical College Graduate Institute of Herbal Medicine. But the most ideal paradigm is "preventing disease before it happens." For the ancient Chinese, such things as scallions, ginger, papaya and mutton were food, but they could also serve as medicine. For example, ginger tea can expel cold from the body, and papayas can relieve the body of heat.

In order to adjust to the frantic pace of modern people's lives, many manufacturers have extracted the nutrients from foods and concentrated them in the tablets and capsules of health food products, or placed them in bottles or cans, "for the convenience of the consumer," as many industry professionals emphasize.

Even if the price of your average health food product is hardly cheap, many consumers embrace the perspective that "expensive equals good," and they consider the purchase worthwhile. For this reason, more than a few businessmen see these products as a gold mine. Many cable TV operators sell these products on specialty sales channels. Drug stores serve as sales agencies. Even doctors and nurses moonlight as salespersons. The principal channel in Taiwan is multi-level marketing. In 1995, NT$19.4 billion was generated through direct sales alone.

The line between food and medicine

Nonetheless, what does that phrase "health food," which is rolling off every-one's lips, actually refer to? What categories does it include? Are they food products or medicines? There is actually no agreement. Many experts believe that the term "health food" is simply not valid. "If this refers to foods that can make you healthy if you eat them, then aren't green vegetables, fruit and rice all health foods?" ponders Chen Chao-tzu, director of pharmacognosy science at the Sun Yat-sen Cancer Center.

Looking at the question from the perspective of a pharmacist, health foods should refer to food products with supplemental tonic attributes. Those who have an insufficient nutritional supply after absorbing an ordinary intake of food can replenish themselves with these edibles. And do substances with vitamins and minerals count as health foods? "That depends on the dosage. If the dosage is low, they count as food; if the dosage is high, they count as medicine," says Chen.

Currently the Department of Health divides things that can be orally ingested into the two categories of foodstuffs and medicines. Research and development for medicines, as well as their approval for sale in the marketplace, must go through rigorous testing, with an emphasis placed upon "efficacy." For food products, however, the primary considerations are "safety" and "cleanliness." Health foods fall under the category of foodstuffs, and do not need to undergo strict testing before they are sold. Nevertheless, they are often produced in capsule or tablet form, and appear to be no different from medicine. Manufacturers also frequently insinuate that they possess powers to treat various kinds of ailments. This has created a gray area in terms of regulation.

Currently the field is regulated according to articles 19 and 20 of the Food Health Management Law, which stipulate that food products or additives may not place exaggerated claims about curative efficacy on their packaging or use the media to advertise in such a way as to lead people to misconstrue that they have medicinal functions. Violators may be fined a sum ranging from NT$9000 to NT$90,000. Nevertheless, Chen Lu-hung, deputy director of the Food Health Bureau frankly admits, "No matter how much you punish them, it's never enough." Such trifling sums mean nothing at all to an unlawful manufacturer that is constantly reaping huge profits.

The right cure to match the ailment

National Taiwan University Hospital clinical dietician Cheng Chin-pao believes that before consuming health foods, it is best to have a health examination and ascertain one's own physical condition. "You have to know what your body needs to have fortified for it to be useful." The nutrients health foods are claimed to contain are often derived from natural food sources, and the quantity they actually contain is often quite small. "If you want to eat a food product rich in DHA, which is derived from fish oil, you might as well eat a little extra deep-sea fish, like saury or salmon. And the cost is not enormous," she says.

Although currently there is little research being done either in Taiwan or abroad on the side effects of health food products, any clinical physician can provide a number of examples. For instance, vitamin E can keep blood platelets from clotting; during surgery, it may lead to an excessive flow of blood. Some people ingest excessive amounts of liquid lingzhi (Ganoderma lucidum) extract, absorbing too much of the heavy metal germanium, and thus causing their kidneys to fail. Others take lecithin and end up with diarrhea, or even heart palpitations or high blood pressure. "It's very important to find the right cure for your sickness. And you can't augment nutrition forever without any limits," Cheng Chin-pao cautions.

Some administrative precedents

Of course, not all health food products should be avoided, and it would not be entirely correct to say that food can only provide nutrition and has no efficacy in treating ailments. Chiang Wen-chang, professor at NTU's Graduate Institute of Food Science and Technology, believes that although "health-preserving food products" cannot immediately cure diseases, they are beneficial for modulating bodily functions and aiding recovery.

In 1984, research was done in Japan on the functionality of foods. It was discovered that besides providing nutrition and sensory enjoyment, food also modulates physiological functions, prevents diseases and aids recovery from illness. "Functional food products" are processed foods which have been modified from existing foods so that they can regulate bodily functions, as well as serving as ordinary victuals.

In 1991, Japan's Ministry of Health, which regulates food and drugs, promulgated the new term, "food for specified health use," designating 70 different categories, including refined rice, dietary fiber, and lactic acid drinks which contain oligosachharides that can stabilize the digestive system.

In the 1980s, the United States Food and Drug Administration (FDA) made a sharp delineation between food and medicine. Food products were not allowed to claim to have medical benefits, and so-called health foods were considered to have "no legal definition." Later on the FDA agreed that under certain conditions food products could claim to fulfill certain health requirements. In 1994 the United States Congress passed the Dietary Supplement Health and Education Act, listing vitamins, minerals, medicinal herbs and amino acids within the scope of this category. Ever since then, although the makers of these kinds of health foods have been required to provide the FDA with safety information, presale testing has not been mandated. The door has actually been opened wider than ever.

A new version of an old tune

In Taiwan, in view of the current lack of order in the health food market, legislator Hau Lung-pin has advocated drafting a "Health Food Product Act," which would establish the three separate categories of food, medicine, and health food, to be administered separately. The Department of Health is, however, making preparations to revise existing regulations, and a nutritional studies committee, commissioned last year, has already drawn up a rough draft. It is expected to be approved by the end of June. Chiang Wen-chang, who is in charge of formulating the draft legislation, states that the evaluation standards of these "Procedures for Administering Food for Health Use" will take into consideration existing regulations in Japan and mainland China.

Actually, all experts are of the opinion that the real secret for health lies in using a variety of different foodstuffs on a daily basis, and taking in a balanced supply of nutrients, as well as doing a proper amount of exercise and a normal balance of work and relaxation. In this way one will naturally increase the body's immunity and ability to resist the invasion of germs and viruses.

In addition, "to increase immunity, maintaining peaceful emotions is also very important," says Sun An-ti, doctor of immunology at NTU. So the next time you consider taking an appropriate health food product, don't go so far as to believe it is a magical elixir.

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Living in a modern metropolis, it is hard not to join the ranks of restaurant-goers. Going beyond filling one's tummy and satiating one's appetite to achieve balanced nutrition is far from easy for many people. (photo by Pu Hua-chih)

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The vast array of health food products may be beneficial for balancing nutrition, but don't lose sight of the forest for the trees, neglecting to absorb a sufficient amount of nutrition from fresh foods. (photo by Vincent Chang)

Through extraction, mixing, concentration, and packaging, every step of the production process must be rigorously monitored to insure quality.