Should botanical health claims be substantiated with evidence on traditional use? Reviewing the stakeholders’ arguments

Background: The evaluation of botanical health claims was put on hold to determine whether traditional use evidence is sufficient to substantiate these health claims. To gain a deeper understanding of the discussion on the substantiation of botanical health claims, a critical review of the stakeholders' arguments was conducted. Methods: The relationships of stakeholders were analysed with a social network analysis and the stakeholders' arguments were critically reviewed with scientific literature. Results: The social network analysis showed that the majority of stakeholders were in favour of using traditional use evidence for botanical health claim substantiation. These stakeholders were however highly interrelated which may explain their similar viewpoints. The arguments put forward by the stakeholders cover a wide array of subjects indicating the discussion's complexity. Various arguments could furthermore not be assessed with scientific literature as these were focused on the unpredictable impact of a decision on the substantiation of botanical health claims. The review also shows that stakeholders interpret various underlying concepts such as consumer misleading differently. Conclusions: This study shows that the discussion is scattered. A political decision on various unclear concepts is required to eventually make a decision upon using traditional use evidence to substantiate botanical health claims