The aim of the current study was to generate information related to functional food consumption among a sample of 200 older adults using a researcher-administered questionnaire. To date, there has been minimal investigation into the perception of information related to functional foods among older adults, a consumer segment that is poised to benefit from the incorporation of functional foods in their diets due to age-related health issues . Hence, the current study advances this area of knowledge to provide information that can be utilized by stakeholders including health care professionals and the food industry to improve functional food acceptance among older adults.
Reflective of the rapidly aging population in Canada [13, 14], all participants in the current study were 60 years of age or older (mean age of 70.8 ± 7.17 years old). Previous investigations into consumer attitudes, knowledge and perceptions of functional foods and their associated health claims have not focused on older adults and rather explored a broader age demographic [16, 31, 33, 40–43] and have primarily been geographically limited to Europe [16, 24, 31, 33, 40–42] and Australia [21, 25, 43]. Participants in the current study were predominately female (70.0%) and Caucasian (95.0%) which reflects the higher proportion of women and those of Caucasian ethnicity within the Canadian older adult population . However, participants had a higher level of education and a greater annual household income relative to the overall Canadian population of older adults , which limits generalizability of the study results.
Knowledge and information about functional foods
An increased awareness and knowledge about functional foods was the most frequently identified factor (85.5% of participants) that would increase functional food consumption. This is consistent with results of a Portuguese study in which knowledge and familiarity with the functional food product were among the top factors influencing choices of functional foods . Other questionnaire studies have also shown that knowledge, particularly with respect to the nutritional attributes and potential health benefits of functional foods, can increase consumers’ perceived healthiness of functional foods  and willingness to consume functional foods [19, 45]. Participants in the current study also frequently reported (71.0% of participants) that the influence of a health professional would increase their consumption of functional foods, suggesting that the advice of health professionals has the potential to influence functional food consumption among older adults. This is in line with previous research that has shown that consumers perceive health professionals to be credible and trustworthy sources of information regarding functional foods [21, 23–25, 46].
Related to information, the majority (56.5%) of participants in the current study indicated that they actively seek out information about functional foods. The most common sources of information about functional foods utilized by participants were food labels (74.3%), newspapers, magazines and/or books (71.7%) and family and/or friends (54.9%). These results are comparable to those of a Swedish questionnaire study in which the most common sources of information for functional foods were identified as television, advertisements in newspapers or magazines and food packaging. Furthermore, a 2008 Canadian population study investigating nutrition knowledge, attitudes and behaviours found that Canadian consumers obtain food and nutrition information from easily accessible sources and that the most common sources utilized were food labels, the internet and magazines, newspapers and books . Also consistent with the current study, focus group research has identified family and/or friends as key sources of information pertaining to functional foods [22, 23, 25]. While some studies have suggested that consumers distrust the information on food labels [22, 25], the results of the current study demonstrate that the older adult consumers primarily utilize food labels as a source of information about functional foods. Noteworthy is that although participants in the current study predominately reported that the influence of a health professional would increase their functional food consumption, health professionals were not among the common sources of information for functional foods. Hence, there is great potential for health professionals to promote increased functional food acceptance and consumption among older adults by serving as a source of credible information pertaining to functional foods.
Participants in the current study predominately (63.5%) indicated that they need more information about functional foods and would prefer to receive this information from newspapers, magazines and/or books (68.5%), food labels (66.1%) and the internet (48.8%). As increased awareness and knowledge was the primary factor that would increase functional food consumption among this sample of older adults, functional food information coming from these sources is likely to influence awareness and consumption. The type of information participants would like to receive about functional foods largely pertained to the health benefits of functional foods (26.8%), the bioactive ingredients in functional foods (15.8%) and the risks/adverse effects related to functional foods (14.2%). Similarly, participants of a focus group study conducted in Sweden expressed a lack of knowledge regarding which ingredients in functional foods have an effect on the body and how these ingredients impact health . Previous questionnaire studies conducted in Uruguayan  and American  adults have also suggested that the most influential information with respect to consumer acceptance of functional foods is that which communicates the relationship between the functional ingredient and health. While a relatively low percentage (14.2%) of participants in the current study perceived the need for information pertaining to the risk of adverse/negative effects of functional foods, previous focus group studies have highlighted consumer concerns regarding the safety of functional foods, particularly with regards to the potential long-term effects on health , the possibility of overconsumption of bioactive ingredients [24, 25] and negative interactions between functional foods or between ingredients within a functional food product [24, 48]. Overall, it is evident that older adults in this sample are motivated to seek out information about functional foods and more information, particularly with respect to the health benefits of functional foods, has the potential to increase functional food consumption among this consumer segment.
Health claims as they relate to functional foods
The majority of participants (93.5%) in the current study reported that they were aware of the health claims on food labels. Of those that were aware, 91.0% indicated that they read the health claims which is relatively higher than the prevalence of food label use identified in studies conducted in France , Uruguay , New Zealand  and the United Kingdom  which ranged from 27.0% to 82.0% of participants. This difference may be due to the fact that participants in the current study were asked specifically about their awareness and use of health claims on food labels, while the mentioned studies inquired about overall food label use among participants [11, 41, 49, 50]. It should also be noted that these investigations were conducted in countries with varying regulations regarding food labels and health claims, thus limiting comparisons to the current study. The relatively high prevalence of health claim use in the current study may also be due to over-reporting by participants; however, some studies have shown that older consumers tend to be more health-oriented and have a greater interest in healthy eating [41, 51] which may translate into greater use and interest in nutrition information [37, 52]. In the current study, participants with a higher education level were significantly more likely to report being aware of health claims compared to those with a lower education level, which is comparable to previous research that has demonstrated a greater use of nutrition labels among individuals with a higher level of education [37, 53]. Overall, these findings indicate that older adult consumers in this sample are cognisant of the health claims on functional food products and that level of education plays a role in consumer awareness of health claims.
The majority of older adult participants in the current study indicated that they found nutrient content claims, nutrient function claims, and disease risk reduction claims to be informative and that the presence of these health claims on a functional food label would increase their likelihood of consuming that functional food product. Similarly, results of a number of questionnaire [27, 31, 54], interview-based  and purchase simulation  studies have shown that the presence of a health claim on a functional food product has a positive effect on purchase intention and the likelihood of consumption of the product. The presence of health claims on functional food products has been shown to influence consumers’ perceptions of the healthiness and nutritional value of the products [26, 30, 31, 54, 55], which may rationalize consumers’ reported preference for products with health claims. In the present study, females were significantly more likely than males to report that the presence of a disease risk reduction claim on a functional food label would increase the likelihood that they would consume that product. Although a number of previous studies conducted in Belgian [10, 31, 35] and Finnish  adults have found weak associations between socio-demographic variables and attitudes towards functional foods and their health claims, some studies have demonstrated that women are more interested in nutrition information  and healthy eating [41, 57] than men. Ultimately, further research is needed in order to elucidate the relationship between socio-demographic variables and consumer perceptions of health claims on functional food products in order to develop targeted nutrition information that will appeal to specific consumer groups.
Participants in the current study were asked to indicate which nutrients, when mentioned in a nutrient content claim on a functional food product, would increase their consumption of the product. The most common responses were salt/sodium (78.0% of participants), dietary fibre (67.5%) and omega-3 fatty acids (61.0%) although responses were high for most of the nutrients listed, suggesting that older adults in this sample consider a number of food components when using nutrient content claims to make choices regarding functional food products. The frequent choice of a salt/sodium nutrient content claim in the current study is comparable to previous studies conducted in Australian  and English  adults in which participants most frequently searched for information on food labels regarding the content of fat, sugar, salt and calories. This finding may also be attributable to the current focus on reducing the sodium content in food products in Canada and the increased public awareness of health issues related to high sodium intake . Dietary fibre and omega-3 fatty acids were also frequently chosen by participants in the current study as nutrients that, when mentioned in a nutrient content claim on a functional food label, would increase consumption, suggesting that the content of these bioactive ingredients is of particular interest to older adults when choosing functional food products. This information is of value from a food industry perspective as further development of functional food products which are low in sodium and contain these bioactives may be well accepted among older adult consumers.
When participants in the current study were asked to select the primary functions or biological roles that, when mentioned in a nutrient function claim on a functional food product, would increase the likelihood that they would consume the product, their most common responses were “helps lower cholesterol” (60.5%) and “factor in the formation and maintenance of bones and teeth” (56.5%). These findings are similar to the results of questionnaire studies conducted in a broader consumer demographic in the Netherlands , Trinidad  and Uruguay  in which claims for functional foods related to lowering or maintaining healthy cholesterol levels were among the top preferred claims, although claims related to strengthening the immune system and providing the body with energy were also among the top preferred claims [11, 33, 59]. In the current study, participants reported heart disease (53.0%), osteoporosis/bone health (53.0%) and cancer (44.5%) as the top health areas that, when mentioned in a disease risk reduction claim on a functional food product, would increase their consumption of the product. Claims on functional foods pertaining to a reduced risk of cancer and heart disease were also among the top preferred claims reported by participants in previous questionnaire studies [11, 33] and it has been suggested that claims on functional food products relating to health areas that are of personal relevance to consumers are expected to be most successful in the marketplace [16, 33, 46]. The results of the current study suggest that the primary health concerns of older adults in this sample are heart health, maintenance of healthy cholesterol levels and osteoporosis/bone health. This information has the potential to drive the development of functional food products that bear claims relating to these health concerns, as they may be successful among older adult consumers.
With respect to understanding of health claims on functional food products, the majority of participants in this study did not find nutrient content (63.5%), nutrient function (66.0%), or disease risk reduction (74.8%) claims to be confusing. Furthermore, participants with a higher level of education were significantly more likely to report that they did not find disease risk reduction claims confusing compared to those with a lower level of education, suggesting that education not only contributes to awareness of health claims among older adults in this sample, but also to understanding of the claims. However, as highlighted by a large-scale cross-national study conducted in Italy, Germany, the United Kingdom and the United Sates, numerous factors are likely to influence consumer understanding of health claims including knowledge pertaining to the claim or the food component mentioned in the claim, familiarity with the product and familiarity with the terminology used in the claim . Among participants in the current study, the main reason for confusion regarding nutrient content claims was that they did not contain enough information (37.1%), with 21.6% of participants stating that they would look to the rest of the label, including the nutrition facts table, for more information. This is contrary to an interview-based study conducted by the United States Food and Drug Administration which found that in the presence of a nutrient-health claim, consumers tend to truncate their information search to only the claim itself and do not typically investigate the nutrition information on the rest of the label . However, coinciding with the frequent use of the food label as a source of information for functional foods, it is evident that older adults in the present study utilize the nutrition information present on food labels to increase their knowledge and understanding of the health claims associated with functional food products.
Of the participants in the present study who found nutrient function and disease risk reduction claims to be confusing, the primary reason for confusion specified was that participants were skeptical and/or had a lack of trust in the claims (39.5% and 50.6%, respectively). A number of focus group studies examining consumer beliefs and attitudes towards functional foods and their associated health claims also found that participants exhibited skepticism towards health claims, which was related to a lack of trust in the information provided by food manufacturers [21, 22, 24, 25]. Participants sampled from Canadian , Australian  and Uruguayan  adults have communicated that they would be more trusting of claims that were substantiated by scientific evidence and verified by the government. These data highlight the importance of consumer trust in the information pertaining to functional foods, which is a key factor for functional food acceptance [18, 34]. While the minority of participants in the current study expressed skepticism towards the health claims on functional foods, the implementation of educational campaigns designed to inform consumers of the thorough regulatory process required to approve health claims for food products in Canada may improve consumers’ perceptions of the credibility of health claims.
In order to elucidate the type of health claim preferred by older adults in the present study, participants were asked whether they found nutrient content claims, nutrient function claims, or disease risk reduction claims to be most informative. Participants primarily reported that the claims were equally informative (34.5%) or that nutrient content claims were most informative (34.5%). Numerous previous studies have attempted to determine the type of health claim preferred by consumers [16, 20, 33, 35, 42], however the results have been inconsistent which may be related to differences in the consumer demographics examined. The preferred type of health claim for functional foods will differ depending on the consumer group examined and may change over time as consumers develop more knowledge pertaining to functional foods and health claims . Despite these inconsistencies, the results of studies conducted in the United States  and Finland  demonstrated that participants prefer shorter claims relating to the content of nutritional components such as fat or probiotics, which coincides with the preference for nutrient content claims observed in the current study. Ultimately, these results indicate that older adult consumers perceive health claims on functional food products to be informative and demonstrate some preference toward claims that indicate the presence of specific nutrients or food components.
Study limitations and strengths
While the current study thoroughly explored information sources for functional foods and the awareness and perceptions of health claims on functional food products among a sample of older adults, it is not without limitations. All data collected was self-reported and therefore there may be discrepancies between the reported information and participants’ actual understanding and perceptions related to functional foods and health claims. It is also limiting that participants were recruited from a specific geographic area and were predominately Caucasian and well-educated with a relatively high annual household income, all of which hinders generalizability of the results.
Despite these limitations, the current study had strength in that it utilized a researcher-administered questionnaire which allowed for researcher and participant interaction, ensuring understanding of the concepts examined and the completeness of the data. In addition, the study questionnaire consisted of a variety of open- and close-ended questions which enabled the collection of a wide breadth of data. This also allowed for the collection of quantitative data, yet participants were able to qualitatively describe their perceptions related to functional foods and health claims. To date, there has been limited investigation into the awareness and perceptions of health claims from a Canadian regulatory perspective and thus the current study greatly contributes to this area of knowledge. The present study also had broad inclusion criteria which allowed for the recruitment of a wide sample of older adults from which to gather data regarding functional foods, information sources and health claims.