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Nutraceutical, a term combining the words “nutrition” and “pharmaceutical,” was originally defined by Dr. Stephen L. DeFelice to describe a nutritional product that claims to provide medicinal benefits in addition to their regular nutritional value.[1] Nutraceuticals can refer to foods, dietary supplements, medical foods, and functional foods that may provide prevention and treatment of illness or disease [2]. Nutraceutical foods are not subject to the same testing and regulations as pharmaceutical drugs.[1]

Contents

Food as medicine

 A sculpture of the father of Western medicine, Hippocrates.Hippocrates.
Considered a father of Western medicine, Hippocrates advocated the healing effects of food.

The Egyptians, Chinese, and Sumerians are just a few civilizations that have provided evidence suggesting that foods can be effectively used as medicine to treat and prevent disease. Documents hint that the medicinal benefits of food have been explored for thousands of years [3]. Hippocrates, considered by some to be the father of Western medicine, said that people should “Let food be thy medicine.”

The modern nutraceutical market began to develop in Japan during the 1980s. In contrast to the natural herbs and spices used as folk medicine for centuries throughout Asia, the nutraceutical industry has grown alongside the expansion and exploration of modern technology.[4]

New research conducted among food scientists show that there is more to food science than what was understood just a couple decades ago.[4] Until just recently, analysis of food was limited to the flavor of food (sensory taste and texture) and its nutritional value (composition of carbohydrates, fats, proteins, water, vitamins and minerals). However, there is growing evidence that other components of food may play an integral role in the link between food and health.

These chemical components are derived from plant, food, and microbial sources, and provide medicinal benefits valuable to long-term health. Examples of these nutraceutical chemicals include probiotics, antioxidants, and phytochemicals.

Nutraceutical products were considered alternative medicine for many years. Nutraceuticals have become a more mainstream supplement to the diet, now that research has begun to show evidence that these chemicals found in food are often effective when processed effectively and marketed correctly.

Classification of nutraceuticals

Nutraceuticals is a broad umbrella term used to describe any product derived from food sources that provides extra health benefits in addition to the basic nutritional value found in foods. Products typically claim to prevent chronic diseases, improve health, delay the aging process, and increase life expectancy.[5]

Health Canada, a website operated by the Canadian government, defines nutraceuticals as “a product isolated or purified from food that is generally sold in medicinal forms not usually associated with food. A nutraceutical has been demonstrated to have a physiological benefit or provide protection against chronic disease.” [6]

There is minimal regulation over which products are allowed to display the nutraceutical term on their labels. Because of this, the term is often used to market products with varying uses and effectiveness. The definition of nutraceuticals and related products often depend on the source. Members of the medical community desire that the nutraceutical term be more clearly established in order to distinguish between the wide varieties of products out there.[7] There are multiple different types of products that fall under the category of nutraceuticals.

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Dietary supplements

A vitamin B supplment
Dietary supplements, such as the vitamin B supplement show above, are typically sold in pill form.

A dietary supplement is a product that contains nutrients derived from food products that are concentrated in liquid or capsule form. The Dietary Supplement Health and Education Act (DSHEA) of 1994 defined generally what constitutes a dietary supplement. “A dietary supplement is a product taken by mouth that contains a "dietary ingredient" intended to supplement the diet. The "dietary ingredients" in these products may include: vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissues, glandulars, and metabolites. Dietary supplements can also be extracts or concentrates, and may be found in many forms such as tablets, capsules, softgels, gelcaps, liquids, or powders.” [8]

Dietary supplements do not have to be approved by the U.S. Food and Drug Administration (FDA) before marketing. Although supplements claim to provide health benefits, products usually include a label that says: “These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.”

Functional foods

Functional foods are designed to allow consumers to eat enriched foods close to their natural state, rather than by taking dietary supplements manufactured in liquid or capsule form. Functional foods have been either enriched or fortified, a process called nutrification. This practice restores the nutrient content in a food back to similar levels from before the food was processed. Sometimes, additional complementary nutrients are added, such as vitamin D to milk.

Health Canada defines functional foods as “ordinary food that has components or ingredients added to give it a specific medical or physiological benefit, other than a purely nutritional effect.” [6] In Japan, all functional foods must meet three established requirements: foods should be (1) present in their naturally-occurring form, rather than a capsule, tablet, or powder; (2) consumed in the diet as often as daily; and (3) should regulate a biological process in hopes of preventing or controlling disease.[9]

Medical foods

medical food
A photo of medical food on an IV pole.

Medical foods aren’t available as an over-the-counter product to consumers.[10] The FDA considers medical foods to be “formulated to be consumed or administered enterally under the supervision of a physician, and which is intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements, on the basis of recognized scientific principles, are established by medical evaluation.” [9] Medical foods can be ingested through the mouth or through tube feeding. These foods are often designed to meet certain nutritional requirements for people diagnosed with specific illnesses. Medical foods are closely monitored by medical supervision.

Farmaceuticals

According to a report written for the United States Congress entitled "Agriculture: A Glossary of Terms, Programs, and Laws", “(Farmaceuticals) is a melding of the words farm and pharmaceuticals. It refers to medically valuable compounds produced from modified agricultural crops or animals (usually through biotechnology). Proponents believe that using crops and possibly even animals as pharmaceutical factories could be much more cost effective than conventional methods (i.e., in enclosed manufacturing facilities) and also provide agricultural producers with higher earnings…

“At issue in the United States has been whether the current system for regulating biotechnology is adequate for ensuring the safety (to humans, animals and crops, and the environment) of newly emerging applications, such as farmaceuticals… The term farmaceuticals is more frequently associated, in agricultural circles, with medical applications of genetically engineered crops or animals.” [11]

Examples

broccoli
Studies show that broccoli may help in the prevention of cancer

The following is an incomplete list of foods with reported medicinal value:

In addition, many botanical and herbal extracts such as ginseng, garlic oil, etc. have been developed as nutraceuticals. Nutraceuticals are often used in nutrient premixes or nutrient systems in the food and pharmaceutical industries.

Market and demand

Nearly two-thirds of the American population takes at least one type of nutraceutical health product. The US health and wellness industry is approximated to be a $91 billion dollar market,[13] significantly less than a $250 billion estimate given by Stephen L. DeFelice.[10] The distinction between which products count as nutraceuticals makes it difficult to accurately quantify the size of the market. Even without specific financial figures, business reports continually suggest that the market is consistently growing.

One possible explanation for the growth of nutraceuticals in the United States is the aging baby-boomer population. As the average age of the citizens continues to rise, the population increases its focus on health and wellness. By halfway through the 21st century, there could be almost 142 million Americans over the age of 50, based on a projected population of nearly 400 million citizens.[3]

Although the price of some nutraceuticals may drop as generic products make their way into the market, people’s dependence on these products and their increasing availability suggests that the growth of the market shall remain stable.

Effectiveness and safety

Regulation

Unlike pharmaceutical drugs, nutraceutical products are widely available and minimally monitored. Companies are not obligated to back claims about the function and effectiveness of their product, but many companies attempt to provide scientific backing of their products to increase credibility.

International sources

In the global market, there are significant product quality issues[14] Nutraceuticals from the international market may claim to use organic or exotic ingredients, yet the lack of regulation may compromise the safety and effectiveness of products. Companies looking to create a wide profit margin may create unregulated products overseas with low-quality or ineffective ingredients.

Bioavailability

Bioavailability, which can be thought of as the the "absorption rate" of a supplement product, is one of the main challenges in finding effective nutraceutical products. The bioavailability of nutrients is higher in food eaten in its natural state. Even among unprocessed foods, not all foods are broken down and digested as effectively. Nutraceuticals with poor absorption rates results in nutrients being disposed from the body without providing any nutritional or medicinal benefit.

Impact of placebo effect

Similar to pharmaceuticals, part of the effectiveness of nutraceuticals may be attributed to the placebo effect. Consumers using nutraceuticals may inaccurately credit their use of nutraceuticals for healing illness, when the body is often able to recover on its own.

See also

References

  1. ^ a b http://www.fimdefelice.org/archives/arc.fueling.html
  2. ^ http://www.fimdefelice.org/archives/arc.researchact.html
  3. ^ a b Handbook of Nutraceuticals and Functional Foods (1ed). Edited by Robert E. C. Wildman. CRC Series in Modern Nutrition. 2001. 0-8493-8734-5.
  4. ^ a b Functional Food and Health. Edited by Takayuki Shibamoto, Kazuki Kanazawa, Fereidoon Shahidi, Chi-Tang Ho. ACS Symposium 993. 2008. 978-0-8412-6982-8.
  5. ^ http://www.hc-sc.gc.ca/fn-an/alt_formats/hpfb-dgpsa/pdf/label-etiquet/nutra-funct_foods-nutra-fonct_aliment-eng.pdf
  6. ^ a b http://www.hc-sc.gc.ca/sr-sr/biotech/about-apropos/gloss-eng.php
  7. ^ http://www.aapsj.org/view.asp?art=ps050325
  8. ^ http://www.fda.gov/Food/DietarySupplements/ConsumerInformation/ucm110417.htm
  9. ^ a b http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6TB0-40SFGPY-2N&_user=456938&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000021830&_version=1&_urlVersion=0&_userid=456938&md5=e13f1f8e198d9f868aa7831144a5c5d3
  10. ^ a b http://www.nature.com/nbt/journal/v16/n8/pdf/nbt0898-728.pdf
  11. ^ http://ncseonline.org/nle/crsreports/05jun/97-905.pdf
  12. ^ Weingärtner O. et al. Controversial role of plant sterol esters in the management of hypercholesterolaemia. Eur Heart J. 2009 Feb;30(4):404-9. Available online at : [1]
  13. ^ http://www.foodnavigator-usa.com/Financial-Industry/Consumers-look-to-heal-through-functional-foods
  14. ^ Regulation of Functional Foods and Nutraceuticals: A Global Perspective. Clare M. Hasler. IFT Press and Blackwell Publishing. 2005. 0-8138-1177-5.

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