Functional Foods in Macedonia: Consumers’ Perspective and Public Health Policy


  • Igor Spiroski Institute of Public Health of the Republic of Macedonia, Skopje
  • Dragan Gjorgjev Institute of Public Health of the Republic of Macedonia, Skopje
  • Jasna Milosevic IPSOS Strategic Marketing, Belgrade
  • Vladimir Kendrovski WHO Regional Office for Europe, European Centre for Environment and Health, Bonn
  • Daniela Naunova-Spiroska Avicena Diagnostica, Skopje
  • Dominique Barjolle Institute for Environmental Decisions IED, ETH Zürich, Zürich



functional foods, attitudes, consumers, Macedonia, public health.


Background: The objective of our study was to explore the knowledge, attitudes and practices of Macedonian consumers towards functional foods, to predict future trends and to assess the national public health policies encompassing the functional foods market.

Methods: Total of 518 respondents aged 18+, from all regions in the country participated in the study. They were sampled through three-staged national representative sampling procedures. The questionnaire comprised questions regarding the level of information about functional foods, trust in health claims, frequency of consumption and knowledge and attitudes related to those foods. Statistical significance was determined at p<0.05.

Results: Respondents aged 18-34 were more informed compared to the total population (22 and 16 % respectively, p<0.05). Most of the consumers consume these products once a day. Employed consumers were willing to increase daily consumption from 3 to 18 % (p<0.05). On average 65.1% of the statements assessing knowledge were answered correctly. On a scale from -3 to +3 functional foods were considered as very healthy (mean=2.03, SD=1.42).

Conclusion: On average, Macedonian consumers have a positive attitude and high expectations of functional foods. Public health policies still lag when compared to comprehensive approach of the food industry in market placement of these products.


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Diplock AT, Aggett PJ, Ashwell M, Bornet F, Fern EB, Roberfroid MB. Scientific concepts of functional foods in Europe. Consensus document. Brit J Nutr. 1999; 81(Suppl 1):S1–S27.

Kapsak WR, Rahavi EB, Childs NM, White C. Functional foods: Consumer attitudes, perceptions and behaviors in a growing market. J Am Diet Assoc. 2011; 111(6):804-10.

van Abeelen AF, Elias SG, Bossuyt PM, Grobbee DE, van der Schouw YT, Roseboom TJ, Uiterwaal CS. Cardiovascular consequences of famine in the young. Eur Heart J. 2012; 33(4):538-45.

Hu FB. Do functional foods have a role in the prevention of cardiovascular disease? Circulation. 2011; 124(5):538-40.

Jones B. Prepared Foods Exclusive: No Functional Fad. Accessed September 6, 2010.

Binns N, Howlett J. Functional foods in Europe – international developments in science and health claims. Brussels: ILSI, 2008.

Korzen-Bohr S, O'Doherty Jensen K. Heart disease among post-menopausal women: acceptability of functional foods as a preventive measure. Appetite. 2006; 46(2):152-63.

Siró I, Kápolna E, Kápolna B, Lugasi A. Functional food. Product development, marketing and consumer acceptance - a review. Appetite. 2008; 51(3):456-67.

International Food Information Council. 2009 Functional Foods/Foods for Health Consumer Trending Survey. Washington, DC: IFIC, 2009.

Landström E. To Choose or not to Choose Functional Foods, that is the Question. Master thesis. Uppsala: Uppsala University, 2008.

European Parliament and the Council of the European Union. Regulation (EC) No 1924/2006 of the European Parliament and of the Council of 20 December 2006 on nutrition and health claims made on foods. Brussels: Official Journal of the European Union L 12, 2007.

Verhagen H, Vos E, Francl S, Heinonen M, van Loveren H. Status of nutrition and health claims in Europe. Arch Biochem Biophys. 2010; 501(1):6-15.

Christidis N, Tsoulfa G, Varagunam M, Babatzimopoulou M. A cross sectional study of consumer awareness of functional foods in Thessaloniki, Greece. Nutr Food Sci. 2011; 41(3):165-74.

State Statistical Office of the Republic of Macedonia. Census of population, households and dwellings in the Republic of Macedonia 2002. Skopje: SSA, 2005.

Niva M. Can we predict who adopts health-promoting foods? Users of functional foods in Finland. Scand J Food Nutr. 2006; 50(1):13-24.

Pothoulaki M, Chryssochoidis G. Health claims: Consumers’ matters. J Funct Foods. 2009; 1(2):222-8.

Spiroski I, Kendrovski V, Dimitrovska M, Dimitrovska Z. Products with nutritional and health claims – consumers’ attitudes and market expectations in the Republic of Macedonia. In: Proceedings of the International Symposium on Health Benefits of Foods – From Emerging Science to Innovative Products; 2011 October 5-7; Prague, Czech Republic; 2011.

Landström E, Hursti UK, Magnusson M. "Functional foods compensate for an unhealthy lifestyle". Some Swedish consumers' impressions and perceived need of functional foods. Appetite. 2009; 53(1):34-43.

Verbeke W. Functional foods: Consumer willingness to compromise on taste for health?. Food Qual Prefer. 2006; 17(1-2):126-31.

Annunziata A, Vecchio R. Functional foods development in the European market: A consumer perspective. J Funct Foods. 2011; 3(3):223-8.

Siegrist M, Stampfli N, Kastenholz H. Consumers' willingness to buy functional foods. The influence of carrier, benefit and trust. Appetite. 2008; 51(3):526-9.

Williams PG. Can Health Claims for Foods Help Consumers Choose Better Diets?. Curr Med Lit Clin Nutr. 2006; 15(2):25-30.

Zezelj I, Milosevic J, Stojanovic Z, Ognjanov G. The motivational and informational basis of attitudes toward foods with health claims. Appetite. 2012; 59 (3):960-7.

European Commission. Commission Regulation (EU) No 432/2012 of 16 May 2012 on establishing a list of permitted health claims made on foods, other than those referring to the reduction of disease risk and to children’s development and health. Brussels: Official Journal of the European Union L 136, 2012.

World Health Organization Regional Office for Europe. European health for all database. Accessed December 30, 2012.

World Health Organization. WHO Global Health Observatory Data Repository. Accessed December 30, 2012.

Hasler CM, Brown AC. Position of the American Dietetic Association: functional foods. J Am Diet Assoc. 2009; 109(4): 735-46.




How to Cite

Spiroski I, Gjorgjev D, Milosevic J, Kendrovski V, Naunova-Spiroska D, Barjolle D. Functional Foods in Macedonia: Consumers’ Perspective and Public Health Policy. Open Access Maced J Med Sci [Internet]. 2013 Dec. 15 [cited 2021 Apr. 12];1(1):102-7. Available from:



E - Public Health