Professor Jane Mills, pro vice-chancellor of Massey University’s College of Health, explains how the future for rural health in NZ is positive.
One doctor in Italy is already prescribing kiwifruit and, once an important item of science relating to the health attributes of kiwifruit is approved by the EU, the kiwifruit solution will become a clinically accepted option for people with gastro problems.
Dr Juliet Ansell, Zespri's health and innovation leader, says health is one of three main drivers for consumption of kiwifruit; the others are taste and convenience.
The more people know about the health attributes, the more kiwifruit people buy, Ansell says. The fruit is important for digestive health, providing vitamin C and a range of sundry nutritional benefits.Digestive health has been a core research area for Zespri, "because the attributes of kiwifruit lend themselves to digestive health benefits, namely fibre and actinidin and other components as well. People have known for a long time how kiwifruit can affect laxation, but it goes beyond that [into] digestive comfort."
Ansell says as result of this knowledge Zespri has embarked on a major project in health research, undertaking a multi-centre clinical trial on laxation and comfort in Japan, Italy and New Zealand. The trial, on green kiwifruit, involves international researchers to ensure the research protocols meet international standards.
The NZ arm of the trial is finished, the Italian trial is about 75% finished and the Japanese trial is just starting.
"The goal of this is to [stake] a European health claim – the gold standard of health claims internationally. Then we will be able to say we have done 'clinically proven' research 'to help with your digestive comfort and laxation'," she explains.
"The EU has a very formal process which is highly regulated and involves external scientific peer review. Once the science officials make their decision it goes to the EU Commission for final approval, so it's very stringent."
The key to all Zespri's health communication is evidence-based science. Ansell says Zespri wants to have the data to back up these claims and not say things that aren't true, hence it spends a lot of money and places a lot of value on health research.
The time it takes to get approval from the EU is a "depends", Ansell says. "If they don't raise questions and [the research is seen to be] well designed and executed and the results are conclusive, it could be approved quickly. We've got a couple of EU regulatory consultants working with us, so we are thinking ahead and making sure we have everything covered before we submit it.
"Obviously, Europe is a big market for us. But the EU health claim regulations are gold standard and are recognised in a lot of other countries that don't have their own regulations so we will definitely be able to use the claims elsewhere."
Ansell says while the EU acceptance of the clinical trials is critical for communicating directly with consumers, Zespri has always made a point of talking to health professionals about the attributes of kiwifruit.
She is now talking about the results of the NZ trial at science conferences and believes health professionals are well aware of the benefits of kiwifruit.
A kiwifruit a day; keeps the doctor away
Dr Juliet Ansell recently presented the findings of the NZ kiwifruit trial at a conference of 600 gastroenterologists in Italy.
After her presentation a keynote speaker asked her where in the US he could buy kiwifruit to give to patients with gastro problems.
"An Italian doctor took me aside and showed me a sheet recommending that a patient try two kiwifruit a day to solve gastro problems. So in Italy they are already prescribing it," Ansell says.
"And I heard the comment 'it is refreshing to hear someone talk about food as a medicine'. One person said his patients were crying out for the solution I was offering. They don't want to take medicine, they want to use food."
Ansell says kiwifruit is a whole food – not a supplement, not a nutraceutical. It simply looks like food your mother would tell you to eat. She is proposing that "a kiwifruit a day keeps the doctor away".
"We did another study in digestive health comparing apples to kiwifruit in respect of bloating. Apples ferment quickly, produce a lot of gas and can be a problem for many people sensitive to gas retention. Comparing an apple a day with a kiwifruit a day, I have chosen to have a kiwifruit."