By David Brown
Washington Post Staff Writer
Tuesday, April 21, 2009
What exactly does it mean when a bottle of fruit juice wearing a cape declares, "I'm off to save prostates!"? What are we to think when we see the same bottle with a hangman's noose cut from its neck and are told it can "cheat death"? And what about when it's lying on a psychoanalyst's couch and is declared to be in "heart therapy"?
Well, for starters don't take those things seriously, says the maker of Pom Wonderful pomegranate juice.
" 'Cheat death' is simply the use of puffery, tongue in cheek. It's a voice that is frankly designed to cut through the clutter," Matt Tupper, president of Los Angeles-based Pom Wonderful, said recently.
But puffery aside, please do believe that pomegranate juice has all sorts of benefits in preventing -- or is it treating? -- conditions as disparate as coronary heart disease, impotence, diabetes and prostate cancer. That seems to be the main message of the company's advertising campaign in the Washington Metro and other high-profile venues around the region.
Pom Wonderful is in the midst of an effort to transform the deep-red and difficult-to-eat pomegranate from a novelty fruit to a drinkable Fountain of Youth. Its strategy employs science, humor and rhetoric that obscures as much as it reveals.
The juice is the latest project of marketing genius Lynda Resnick, who with her husband, Stewart, owns Fiji Water and Teleflora (and, until a few years ago, the Franklin Mint), as well as Pom Wonderful and a huge California fruit-and-nut-growing operation called Paramount Farms. She just published a book, "Rubies in the Orchard," that contains, according to its cover, "the Pom Queen's Secrets to Marketing Just About Anything." But for Resnick, pomegranates are far from anything.
Since 1990, she and her husband have spent about $30 million underwriting laboratory and clinical research on pomegranate juice. The studies have convinced her that the fruit's mystique and reputation for healthfulness (which goes back to the time of the pharaohs) is well deserved. She makes her father drink pomegranate extract every day, and he's still working at age 90. Last year she sent 18,000 pomegranate trees to Rwanda as part of a project to plant sustainable gardens for AIDS patients.
"I do believe from the bottom of my heart that pomegranate is the healthiest food in the world," she said in an interview while visiting Washington two weeks ago.
Resnick also believes "the medicine chest of the 21st century is in the produce case of the supermarket." Accordingly, her advertising campaign stresses pomegranate juice's biological effects and not its taste or general nutritiousness. It's the antioxidants -- and in particular the polyphenolic ones, which are also found in red wine, green tea and blueberry juice -- that are the big selling point.
What can or can't be said about a food or its components is a complicated issue governed by two agencies -- the Food and Drug Administration, which regulates food labeling, and the Federal Trade Commission, which regulates advertising.
The FDA allows three types of claims on food labels: a "health claim," a "structure/function claim" and a "nutrient content claim," each with specific requirements or guidelines. Pom Wonderful has not sought permission to make any of them.
"We have elected not to pursue an FDA health claim because [such claims] are not specific to individual products, but are used generically. . . . All pomegranate juices would be able to make the health claim," said Rob Six, a vice president of Roll Corp. International, the Resnicks' privately held company that owns Pom Wonderful and their other businesses.
Pom Wonderful says it grows all its own fruit and presses it in a proprietary way that, it says, maximally preserves the antioxidant compounds. Further, all the scientific research has been done on its juice, not other brands.
"Because so many consumers drink pomegranate juice for its promising health benefits, we would not want these other brands making FDA-certified health claims on inferior or adulterated pomegranate juice," Six said.
Currently, the FDA recognizes 17 specific health claims, each linking a food or dietary ingredient to a disease or "health-related condition." Twelve were authorized through a process in which the agency evaluates the evidence for a food's reputed health effects. The other five came into play as part of the FDA Modernization Act of 1997, which permits claims "based on an authoritative statement of a scientific body of the U.S. government or the National Academy of Sciences."
What a company can say under a health claim is rigidly demarcated, and it doesn't include such Madison Avenue flourishes as "Cheat death."
For example, if a company wants to promote a calcium-containing food as being useful in preventing osteoporosis, the FDA allows this specific claim language: "Adequate calcium as part of a healthful diet, along with physical activity, may reduce the risk of osteoporosis in later life."
Companies can also promote a food by saying what it does on a physiological level, without mentioning a specific disease. These so-called structure/function claims allow companies to make statements such as "calcium builds strong bones" or "fiber maintains bowel regularity." Structure/function claims don't need to be preapproved by the FDA, but companies "should be able to substantiate any claims made about the product," said Barbara Schneeman, director of the agency's office of nutrition, labeling and dietary supplements.
For food companies wishing to market healthfulness through nutrient content claims, there are strict rules about how, for example, a cereal can get a label of "high-fiber" or a soup the designation "low in sodium."
Exactly where the FDA's interest in "labeling" ends and the FTC's interest in "advertising" begins is somewhat fuzzy.
The FDA, for example, can look at a company's advertising, Web sites and printed materials -- and not just the label on the bottle or box -- to determine the "intended use" of a product. The FTC doesn't clear advertisements in advance, but, similar to the FDA, it requires that "any company that advertises a health benefit have science to back it up," said Heather Hippsley, assistant director of the FTC's division of advertising practices.
The dozens of studies funded by Pom Wonderful have been done in numerous laboratories in the United States and Israel. The most active researcher is Michael Aviram, a biochemist on the Technion Faculty of Medicine in Haifa, Israel, who has co-authored 31 pomegranate-related papers since 1999. In an e-mail exchange, he said that Pom Wonderful pays only for research, not for advocacy, and that he has no ownership interest in the company.
Here is a sample of the company-sponsored research that has been published in peer-reviewed journals:
-- A 2004 study of 19 people found that those who drank the juice for a year had carotid arteries with thinner walls -- often a sign of less atherosclerotic plaque -- as well as less damaging "oxidative activity" of their cholesterol than when they entered the study. Their systolic (or "top") blood pressure fell 21 percent.
-- A study in 2005 of 45 patients with heart disease found that those who drank pomegranate juice for three months performed somewhat better on stress tests than those who didn't.
-- A study in 2006 of 46 men who'd been treated for prostate cancer found that drinking pomegranate juice slowed the rise of prostate specific antigen (PSA), which is sometimes a sign of a recurrence of the tumor.
While Pom Wonderful's research has elucidated the juice's biological actions, the studies generally aren't the type that government agencies favor when evaluating evidence of a food's supposed health benefits.
The Pom Wonderful human studies tend to be small, with fewer than 100 participants (in some cases fewer than a dozen). In many, the people already have a disease. In some, the scientists measured variables such as "nitric oxide synthase activity" and "serum angiotensin converting enzyme activity," whose effect on disease is indirect and, in some cases, unclear.
In contrast, the FDA favors large studies that start with people who don't have the condition (such as hypertension or coronary heart disease) that a consumer is trying to avoid. The agency also prefers research that measures clear-cut events (such as heart attacks and strokes) or, if that isn't possible, then proven "surrogate markers" for disease.
While pomegranate juice is indisputably high in antioxidants, the health value of such compounds is also a matter of dispute.
For example, a randomized, placebo-controlled trial of the antioxidant vitamins E and C in 14,641 male physicians reported in November that after eight years neither of the tested supplements reduced a person's risk of heart attack and stroke.
Last spring, the Cochrane Collaboration, a noncommercial organization that evaluates the evidence for diagnostic and treatment strategies, examined 67 randomized trials of supplements containing vitamins E, C, A, beta carotene and selenium, all of which are antioxidants. The studies involved 232,550 people, both healthy and ill.
The reviewers found "no evidence to support antioxidant supplements to prevent mortality in healthy people or patients with various diseases." They noted that "vitamin A, beta carotene and vitamin E may increase mortality," and advised that "antioxidant supplements need to be considered medicinal products and should undergo sufficient evaluation before marketing."
However, the people at Pom Wonderful say their product is a world away from vitamins and minerals taken in pill form.
"When you are talking about pomegranates, you are talking about dozens of mostly phenolic molecules brought together in concert in the fruit," said Tupper, the company president.
So what's a consumer to think?
About all that can be said now is that pomegranate juice's promise should perhaps be taken with a grain of salt.