A press ad for the health supplements supplier FutureYou, seen on 28 March 2017, promoted the food supplement Turmeric+. The ad featured the claim "Support Healthy Joints with TURMERIC+" alongside an image of the product which included the claims "supports healthy joints" and "helps maintain flexible joints".
Two complainants challenged the claims "support healthy joints” and “helps maintain flexible joints”, which were required to comply with the requirements of Regulation (EC) 1924/2006 on nutrition and health claims made on foods (the Regulation), as reflected in the CAP Code.
Cambridge Nutraceuticals Ltd t/a FutureYou said that their product Turmeric+ was an effective means of supporting joint health, and was based on a highly bioavailable patented Meriva formulation. They believed that the totality of the evidence available was such that they could make the claims that Turmeric+ could “support healthy joints” and “help maintain flexible joints”. They understood that those claims were permissible as “on hold” claims subject to the transition measures in Article 28 (5) of the Regulation, which required them to comply with existing national provisions applicable to them.
FutureYou provide ten studies which they said showed the product’s effectiveness in supporting joint health. The reviews included randomised controlled trials, in vitro studies and a systematic review concerning the effects of turmeric on patients with osteoarthritis. They said those papers showed that turmeric was effective in treating osteoarthritis, and also in delaying and preventing the disease. They said that to make a health maintenance claim, it was necessary to demonstrate a delay or preventative effect. They pointed out that the effects of turmeric in preventing cartilage degradation and in inhibiting pro-inflammatory mediators were also referenced in those studies. Another paper addressed the effects of turmeric on delayed onset muscle soreness in healthy volunteers subjected to moderate exercise. Another paper examined the relative absorption of different formulations of curcumin (turmeric). They said that in reducing inflammation and pain, and by improving mobility for those with the chronic condition of mild to moderate osteoarthritis, bioavailable curcumin was shown to be effective.
According to the Regulation, health claims were defined as those that stated, suggested or implied that a relationship existed between a food category, a food or one of its constituents and health. We understood that a proposed health claim had been submitted to the European Food Safety Authority (EFSA) for curcumin with the wording "Cell protection / Helps to protect joints / Helps to maintain joints flexibility / Contributes to Joints health", and that those claims were currently listed as 'on hold' in a list of botanical substances. Such claims were still under consideration by EFSA and may or may not be approved in future. On-hold claims were allowed to be used in marketing, provided that they were used in compliance with applicable existing national provisions (in this case the CAP Code), which meant that the claims needed to be substantiated by evidence.
We assessed the evidence provided by FutureYou in support of the on-hold claims. We noted that EFSA had published a negative scientific opinion on the on-hold claims in question. The EFSA Panel had concluded that a cause and effect relationship had not been established between the consumption of Curcuma longa (turmeric) and the maintenance of normal joints, on the basis of the evidence provided to EFSA. FutureYou had provided us with evidence which had not been considered by the EFSA Panel, and we therefore considered whether the body of evidence was sufficient to substantiate the claims, taking into account the EFSA Panel’s view on the evidence they had seen.
Eight of the papers, which included a systematic review, randomised controlled trials and in vitro studies, addressed the effects of turmeric on treating osteoarthritis (joint arthritis). We disagreed with FutureYou’s view that the studies provided evidence beyond treating osteoarthritis such as delaying and preventing the disease because all of the studies specifically addressed treating osteoarthritis, with all of the clinical trials using patients with osteoarthritis. While none of the papers had been considered by the EFSA Panel, we noted that EFSA had considered human intervention studies on the treatment of arthritis in their negative scientific opinion. EFSA ruled that such evidence did not establish that patients with arthritis were representative of the general population, or that the treatment of symptoms of arthritis could be extrapolated to the maintenance of normal joints in the general population. We agreed with EFSA that the effects of turmeric in treating people with arthritis (or in delaying or preventing it) was not sufficient evidence that turmeric would have the same effect in supporting and maintaining healthy joints of the general healthy population not suffering from arthritis. We therefore considered that the papers provided by FutureYou in relation to the effects of turmeric on those with osteoarthritis were not relevant evidence to support the claims that their product could "support healthy joints” and “help … maintain flexible joints”.
One of the papers submitted contained a study on healthy patients in an assessment of the potential of curcumin to prevent delayed onset muscle soreness after muscle activity.
However, while the sample in that case was healthy normal patients, the effects of curcumin on the muscles were examined after eccentric muscle injury was induced on the patients through exercise. We therefore considered that the effects of curcumin on a population with eccentric muscle injury were not sufficient evidence to prove that it would have the same effect when consumed by a general healthy population. Furthermore, we considered that the effect of curcumin on the muscle was not directly relevant to its effect on the joints, and therefore it was not appropriate evidence in support of the claims "support healthy joints” and “helps maintain flexible joints”.
The final paper submitted was a randomised controlled study on the relative absorption of different formulations of curcumin. The paper did not, however, address efficacy claims for contributing to, and helping to maintain, healthy joints. Therefore, we considered it was not appropriate evidence in support of the claims.
Because the claims "support healthy joints” and “helps maintain flexible joints” had not been substantiated, we concluded that the ad breached the Code.
The ad breached CAP Code (Edition 12) rules
Marketing communications must not materially mislead or be likely to do so.
Before distributing or submitting a marketing communication for publication, marketers must hold documentary evidence to prove claims that consumers are likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation.
Marketing communications that contain nutrition or health claims must be supported by documentary evidence to show they meet the conditions of use associated with the relevant claim, as specified in the EU Register. Claims must be presented clearly and without exaggeration.
Only nutrition claims listed in the updated Annex of the EU Regulation (as reproduced in the EU Register) may be used in marketing communications.
Only health claims listed as authorised in the EU Register, or claims that would have the same meaning to the consumer may be used in marketing communications.
http://www.ec.europa.eu/food/food/labellingnutrition/claims/community_register/authorised_health_claims_en.htm. (Food, food supplements and associated health or nutrition claims), and 15.7 15.7 Nutrition and health claims for food supplements must be permitted or authorised as provided for at rule 15.1.1 above. Marketing communications that contain nutrition or health claims must be supported by documentary evidence to show they meet the conditions of use associated with the relevant claim as specified in the EU Register. (Food supplements and other vitamins and minerals).
The ad must not appear again in its current form. We told FutureYou not to use on-hold claims in their marketing unless they held evidence that substantiated the claims.