The current review considers satiety-based approaches to weight management in the context of health claims. Health benefits, defined as beneficial physiological effects, are what the European Food Safety Authority bases their recommendations on for claim approval. The literature demonstrates that foods that target within-meal satiation and post-meal satiety provide a plausible approach to weight management. However, few ingredient types tested produce the sustainable and enduring effects on appetite accompanied by the necessary reductions in energy intake required to claim satiety/reduction in hunger as a health benefit. Proteins, fibre types, novel oils and carbohydrates resistant to digestion all have the potential to produce beneficial short-term changes in appetite (proof-of-concept). The challenge remains to demonstrate their enduring effects on appetite and energy intake, as well as the health and consumer benefits such effects provide in terms of optimising successful weight management. Currently, the benefits of satiety-enhancing ingredients to both consumers and their health are under researched. It is possible that such ingredients help consumers gain control over their eating behaviour and may also help reduce the negative psychological impact of dieting and the physiological consequences of energy restriction that ultimately undermine weight management. In conclusion, industry needs to demonstrate that a satiety-based approach to weight management, based on single-manipulated food items, is sufficient to help consumers resist the situational and personal factors that drive overconsumption. Nonetheless, we possess the methodological tools, which when employed in appropriate designs, are sufficient to support health claims.

While the health benefit of a functional food may be a metabolic response that lowers risk for disease, the actual target for the food or food component may be on the functioning of the gastrointestinal tract (GIT). For example, slowing absorption from the intestine, as measured by examining the appearance of the nutrient or food component in the blood, the hormone response associated with absorption of the compound or excretion of the compound, may provide a health benefit. However, the food component may slow absorption by delaying gastric emptying, altering the mixing within the intestinal contents or decreasing the availability of digestive enzymes in the intestine. These measures of GIT function provide validation of the mechanisms by which the functional food or food components affect metabolism. Bioavailability of physiologically active compounds from foods will be determined by the digestibility of foods that contain these compounds, their subsequent absorption and utilization by tissues. The physical structure of foods contributes to the functional effects of foods as well as to the availability of compounds from foods. For example, recent studies have demonstrated that changing the viscosity of the gut contents alters absorption and GIT response. Additionally, food structures such as the plant cell wall change the availability of absorbable compounds along the gastrointestinal contents. The areas of probiotics and prebiotics have highlighted the potential importance of gut microflora in health. While evidence suggests biological activity relevant to disease risk reduction, the long-term implications of the microbial activity have yet to be established.

Objectives: Inappropriate hospital admissions are commonly believed torepresent a potential for significant cost reductions. However, thispresumes that these patients can be identified before the hospitalstay. The present study aimed to investigate to what extent this ispossible.

Methods: Consecutive admissions to a department of internalmedicine were assessed by two expert panels. One panel predicted theappropriateness of the stays from the information available atadmission, while final judgments of appropriateness were made afterdischarge by the other.

Results: The panels correctly classified 88% of the appropriate and27% of the inappropriate admissions. If the elective admissionspredicted to be inappropriate had been excluded, 9% of the costswould have been saved, and 5% of the gain in quality-adjusted life-years lost. The corresponding results for emergency admissions were14% and 18%.

Conclusions: The savings obtained by excluding admissions predicted tobe inappropriate were small relative to the health losses. Programsfor reducing inappropriate health care should not be implementedwithout investigating their effects on both health outcomes and costs.