Maryam Miraghajani, Anastasia Victoria Lazaridi, Sarvadaman Pathak, Priyanka Bhatt, and Yashwant Pathak
What Are Nutraceuticals?
About 2000 years ago, Hippocrates correctly stated: âLet food be your medicine and medicine be your foodâ (1). Currently, there is increased global interest due to the recognition that ânutraceuticalsâ play a major role in health enhancement. The term ânutraceuticalâ was coined by combining the terms ânutritionâ and âpharmaceuticalâ and was originally defined by Dr. Stephen L. De Felice, founder and chairperson of the Foundation of Innovation Medicine (2). Nutraceuticals have potential nutritional and therapeutic effects, and are easily accessed, cost-effective, and tolerable, with a wide margin of safety (3).
Nutraceuticals, which have also been called medical foods, designer foods, phytochemicals, functional foods, and nutritional supplements, include such everyday products as âbioâ yogurts and fortified breakfast cereals, as well as vitamins, herbal remedies, and even genetically modified foods and supplements (4). There is also a lot of confusion regarding the terminology, which differs between countries, but the usual definition is a product isolated from foods that is generally sold in medicinal forms not usually associated with food (5). Both in Canada and in Great Britain, a functional food is essentially a food, but a nutraceutical is an isolated or concentrated form of a nutrient (6, 7). In the United States, âmedical foodsâ and âdietary supplementsâ are regulatory terms; however ânutraceuticalsâ, âfunctional foodsâ, and related terms are determined by consultants and marketers, based on consumer trends (8).
There also seems to be a âthin dividing lineâ between the definitions of âpharmaceuticalsâ and ânutraceuticalsâ. âPharmaceuticalsâ may be considered as medication used to treat and improve outcomes of interventions provided to patients, while ânutraceuticalsâ are those that are intended to prevent diseases (9, 10). However, a nutraceutical for one consumer can act as a pharmaceutical for another (9). Examples of nutraceuticals include fortified dairy products (milk as such is a nutrient and its product, casein, is a pharmaceutical) and citrus fruits (orange juice is a nutrient and its constituent, ascorbic acid, is a pharmaceutical). So, in another definition, both pharmaceutical and nutraceutical compounds might be used to cure or prevent diseases, but only pharmaceutical compounds have governmental approval. Also, nutraceuticals, in contrast to pharmaceuticals, are substances that usually have no patent protection (9).
Overall, nutraceuticals should provide a health benefit to the consumer that is greater than that of a general food item. Indeed, they are non-specific biological therapies used to promote wellness, prevent malignant processes, delay the aging process, prevent chronic diseases, increase life expectancy, or support the structure or function of the body (5). However, nutraceuticals are claimed to provide protection against some chronic disorders including obesity, diabetes, degenerative and inflammatory diseases, cancer, and cardiovascular diseases (5). These conditions involve many physiological and metabolic changes, including increased oxidative stress and an imbalance between the oxidative and antioxidative systems leading to cellular dysfunction. This can cause compromised cell signaling and cell cycle control, cellular transport and overall decreased biological activity, immune activation, and inflammation. Most nutraceuticals have antioxidant, anti-inflammatory, anticarcinogenic, and neuroprotective effects with the ability to counteract these adverse conditions (5, 11, 12). Hence, they are considered as optimal sources of health promotion, especially for the prevention of life-threatening diseases.
Presently over 470 nutraceutical products are available with documented health benefits. Some popular nutraceuticals include polyphenols and vitamins (for dermatologic benefits), glucosamine (for arthritis), lutein (for macular degeneration), ginseng (for colds), echinacea (anti-immune properties), folic acid, minerals, essential fatty acids, amino acids, etc. (9, 13). Knowing the safety concerns related to nutraceuticals, it is necessary to ensure maximum potential benefits without adverse effects. From a large number of nutraceutical-related studies, they appear to be safe, although this can be compromised by contamination with toxic plants, metals, mycotoxins, pesticides, fertilizers, drugs, etc. (3). The assessment of claimed toxicity and the safety of nutraceuticals need appropriate pharmacokinetic/toxicokinetic studies.
Scope and Future Development of the Nutraceuticals
Currently, nutraceuticals, which provide various health benefits in the treatment and prevention of diseases, are receiving more attention. Many âWesternâ diseases derived from metabolic syndrome, which is a result of chronic inflammation, have been studied for years to identify their causes as well as prevention and treatment. These include:
- cardiovascular diseases (CVDs) including coronary artery diseases, stroke, and heart failure;
- cancer of any type, such as colorectal, brain, and breast cancers;
- Type II diabetes; and
- neurodegenerative diseases (such as Alzheimerâs and Parkinsonâs diseases).
This list is extensive. For this reason, companies have produced drugs to treat and regulate most of these diseases as well as tablets containing food substances that can prevent or regulate certain conditions. However, there are many challenges to overcome when developing nutraceuticals in a laboratory. One challenge is that, as nutraceuticals are made from food products, their formulation is limited. Another challenge is to determine the stability of the formula, because factors such as pH, temperature, and pressure might affect the desired effectiveness of the product (14). Additionally, complete tests of active uptake, the metabolic response, and the biological variability should be considered before introducing the final product onto the market (15).
Our current way of life includes high levels of stress, anxiety and bad eating habits, which add a significant burden to peopleâs health. Because nutraceuticals can potentially minimize factors that contribute to health deterioration, research on nutraceuticals should be emphasized. Thus, laboratories at nutraceutical companies are not restricted to the development of new âsuperfoodsâ to address human needs. The aim is to link nutrition and health and to create pioneering products that could significantly decrease the effects of some non-communicable diseases (NCDs), such as diabetes, cardiovascular disease, and cancer. Thus, the populationâs mortality rate, and consequently the public sectorâs health expenditures, could potentially be reduced. With this objective, both food and pharmaceutical companies have to combine their product strategies, technology, marketing, and supply chain management to obtain a competitive advantage for their products, which are based on innovation and creativity.
Recently, many people have developed the habit of taking nutraceuticals regularly to boost their health because, for example, they might not be able to eat a food product because of its smell, taste, and/or appearance, or it because it does not fit with their eating patterns. All nutraceuticals can be found on the market at a low cost or available to the public without any prescription, so they can be purchased with just a click of the mouse, without any further information or explanation about them from a pharmacist. Thus, regulatory models need to be expanded to performed research, examine emerging issues and hazards, and contribute to improvements in legislation. In the United States, dietary supplements are regulated by the Dietary Supplement Health and Education Act (DSHEA), and food additives a...