title: Health claims assessment in the field of joint and cartilage: a consensus viewpoint of the Group for the Respect of Ethics and Excellence in Science.
abstract: BACKGROUND
  In 2006, the European Parliament and Council issued a regulation (No. 1924/2006) for the nutrition and health claims made on foods, including food supplements. According to the regulation, the use of nutrition and health claims shall only be permitted if the substance in respect of which the claim is made has been shown to have a beneficial nutritional or physiological effect. In the field of joint and cartilage health, there is no clear scientific-based definition of the nature of such a beneficial nutritional or physiological effect. The objective of this paper is to scientifically define the possible content of health claims related to joint and cartilage health and to provide scientific guidelines for the design of clinical studies which need to be adopted to substantiate such health claims.
  
  
  METHODS
  Literature review up to September 2011 followed by a consensus expert discussion organized by the Group for the Respect of Ethics and Excellence in Science (GREES).
  
  
  RESULTS
  In line with the general principles of the PASSCLAIM and the Codex recommendations, the GREES identified four acceptable health claims related to joint and cartilage health based on the effects on discomfort, joint and cartilage structural integrity or risk factors for joint and cartilage diseases. The GREES considers that randomized controlled trials on a relevant outcome is the best design to assess health claims. Moreover, animal studies could also be of interest to substantiate some health claims, to assess the clinical relevance of endpoints used in human studies or to extrapolate data obtained in patients to the target (apparently) healthy population.
  
  
  CONCLUSIONS
  According to the methodology and biomarkers used in the study and whether or not additional animal studies are provided to support the claim, various health claims can be acceptable in the field of joint and cartilage health.
authors.affiliation: Department of Public Health, Epidemiology and Health Economics, University of Liège, Belgium. olivier.bruyere@ulg.ac.be
authors.forename: O
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authors.lastname: Bruyère
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authors.lastname: Avouac
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authors.lastname: Richette
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authors.lastname: Maheu
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authors.lastname: Bruel
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authors.lastname: Pauquai
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authors.lastname: Ythier-Moury
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authors.lastname: Tsouderos
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authors.lastname: Urban
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authors.lastname: Rovati
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mesh_terms: D000818:Animals; D001675:Bioethics; D002356:Cartilage; D019587:Dietary Supplements; D005062:European Union; D006801:Humans; D007596:Joints