February 24, 2020
Dr. Gwen Y. Reyes-Amurao, M.D.
Nutrition has always been a basic concern when it comes to health and wellness. Diet, among other things, is one of the greatest determinants of health and can either have beneficial or deleterious effects on one’s body. With the saying you are what you eat, individuals all over the world are now becoming more conscious of what they ingest and introduce into their bodies.
Through the latest advancements in science and nutrition, additional sources of essential nutrients have now emerged. Manufacturers of these nutrients are providing more alternatives in the food and supplement industry, with nutraceuticals topping the list. But what are they really? Are they vital to one’s health and are they as effective as they claim to be? Let us find out.
Definition of Nutraceuticals
The term nutraceutical has been around since the 1980s. It was a term coined by Stephen De Felice, founder and chairman of an organization that focuses on medical research called Foundation for Innovation in Medicine. He defines nutraceuticals as food or parts of food that provide medical or health benefits, including the prevention and treatment of disease.
According to the International Journal of Preventive Medicine, nutraceuticals is a term derived from nutrition and pharmaceuticals. It specifically defines nutraceuticals as a product isolated from food that is sold in medicinal forms such as pills, powders, or liquid forms in vials and are not usually associated with food or have benefits that are not purely nutritional.
In another definition by the Journal of Phytochemistry, nutraceuticals were defined as pharmaceutical forms containing food phytochemical as active principles. Although definitions may vary and clinical evidence may still be lacking in some areas, some studies show that it has indeed physiologic benefits and can provide protection against chronic disease, improvement of health, and an overall increase in the quality of
life and life expectancy.
Types and Classifications of Nutraceuticals
Nutraceuticals are further grouped into categories based on their chemical constitution and natural sources. They are classified into the following:
These supplements are known to contain nutrients from food that can be taken in addition to one’s diet or when one’s diet is lacking in essential nutrients. Vitamin, mineral, and herbal supplements are the most common examples of these and have specific and individual benefits to one’s health.
Medical food is formulated for enteric or internal administration. This is often advised or done under the supervision of a physician and is intended for the specific dietary management of a disease condition for which distinctive nutritional requirements are established after thorough medical evaluation. This is given to those who are unable to take in food normally who may need the help of a nasogastric tube or NGT in order to get the daily nutrients needed by the body.
The Institute of Medicine’s Food and Nutrition Board defines functional food as any food or food ingredient that may provide a health benefit beyond the traditional nutrients it contains. They are considered to have enhanced nutritional benefits and are taken like normal food. Some examples of functional food include fermented food such as yogurt, and fortified food like cereals and milk.
These are supplements or remedies prepared from plants or plant derivatives. Research claims that herbs have been the foundation of current medications available in the market and have the same effective ingredient used in medications all over the world.
These are derived from the farm and are considered as pharmaceuticals as the name implies. They are manufactured mostly from agricultural crops and animal products and are advanced in terms of biotechnology and genetically reformed to be more nutritious.
Nutraceuticals vs. Pharmaceuticals
Both nutraceuticals and pharmaceuticals play an important role in treating and preventing illness. Although many may be skeptical about nutraceutical claims, some have already been backed up by clinical evidence and studies. Technically speaking, nutraceuticals are substances which have no patent protection, which is why only pharmaceutical compounds may be sanctioned by the health department and food and drug administration once they have claims that cannot be proven. This is also the reason why the label ‘no approved therapeutic claims’ are found on such preparations.
When it comes to content or constitution, nutraceuticals have an advantage over pharmaceutical drugs since they are derived from natural sources. According to the Journal of Food, Science and Technology, development of nutraceuticals begins with identification of substances in the nature that are useful to the human body and are extracted from their very source. The good thing about them is they can have a positive effect on one’s health, with very few harmful side effects reported.
Pharmaceuticals on the other hand, are manufactured in laboratories and are entirely synthetic or artificial. Sadly, most of these drugs do have harmful side effects despite their ability to help cure disease and illness.
Role of Nutraceuticals in Health
Nutraceuticals that have been studied over the past few years can now address most of the medical conditions present in our society, some of which include arthritis, respiratory tract infections, sleep disorders, digestion, osteoporosis, high blood pressure and cholesterol levels, high blood sugar. They can even help prevent something as complicated as cancer or depression and address something as simple as deficiency in essential nutrients.
In a study published in the International Journal of Preventive Medicine, recent data revealed promising results in the role of nutraceuticals in different areas of health including diabetes, cardiovascular diseases, neurologic disorders, and cancer. There have been a lot of claims when it comes to how nutraceuticals address these conditions. However, it is mainly due to the antioxidative properties found in these products that benefits to one’s health can actually be possible.
Nutraceuticals and Disease
Alzheimer disease is a medical condition that has affected millions all over the world. Nutraceuticals containing curcumin, lutein, lycopene, turmeric, and beta-carotene have been found to delay development of dementia due to their ability to combat oxidative stress.
Flavonoids found in onions, endives, cruciferous vegetables, grapefruits, apples, berries, pomegranates, and grapes play a major role in prevention and treatment of cardiovascular diseases or CVD. Flavonoids have been shown to affect certain enzymes responsible for controlling blood pressure and prevent platelet aggregation. They can protect the vascular system that carries oxygen and nutrients to the rest of the body. They have also been associated with a reduction in the risk of coronary heart disease especially in the elderly.
Phytosterols, which are mainly found in plants, have the ability to compete with dietary cholesterol by blocking its uptake. This also leads to a reduction in risk of developing cardiovascular disease. Luckily, they are easily found in green and yellow vegetables. Ginger on the other hand, has long been studied because of its anti-inflammatory properties that help protect against high blood pressure, while fish rich in omega-3 fatty acids have been shown to protect against CVD by lowering bad cholesterol levels. When it comes to cancer prevention, a healthy diet plays an important role despite the presence of other predisposing factors. In general, carotenoids have antioxidant properties, specifically lycopene and beta-carotene that aid in combating cancer. Tomatoes, guava, grapefruit, watermelon, and papaya have been studied to decrease oxidative stress and help lessen the damage to DNA that eventually leads to cancer.
Phytochemicals, specifically phytoestrogens, are recommended for prevention of prostate and breast cancer while soy food, specifically soybeans seem to offer protection against breast, uterine, lung, colorectal, and breast cancers.
Saponins found in peas, soybeans, tomatoes, potatoes, alfalfa sprouts, spinach and clover are reported to possess anti-mutagenetic and anti-tumor activities which lower the risk of cancer and prevent cancer cells from growing.
Tannins found in grapes, lentils, tea, and berries have been shown to scavenge free radicals and detoxify carcinogens and thus been proven to be anti-carcinogenic. Pectin which is a soluble fiber found in apples has been shown to prevent prostate cancer metastasis by inhibiting cancer cells from adhering to other cells in the body.
In general, consumption of fruits and vegetables rich in cysteine, glutathione, selenium, vitamin E, vitamin C, and lycopene that contain phytochemicals elevate the levels of anti-oxidative capacity.
Pre-clinical studies have proven that nutraceuticals, specifically herbal supplements and remedies have beneficial effects in diabetic individuals. Omega-3 fatty acids have also been suggested to reduce glucose tolerance in those predisposed to diabetes. Dietary fibers like psyllium have been studied extensively as pharmacological supplements, and food ingredients in processed food to aid weight reduction and to control glucose levels in diabetic patients.
The carotenoid lutein found in orange fruits and vegetables such as sweet potatoes, carrots, squash, tomatoes, mangoes and corn and the zeaxanthin found in egg yolks, corn, green peas, lettuce, kiwi, spinach and collard greens have been studied to be beneficial in the treatment of visual disorders. High content in this type of flavonoids in nutraceuticals have been shown to possess antioxidant properties which has helped in delaying the progression of age-related macular degeneration, a condition of the eye which can eventually lead to blindness.
Glucosamine and chondroitin sulfate due to their anti-inflammatory properties are now widely used to alleviate symptoms of osteoarthritis, a joint disorder which has caused disabilities worldwide. When it comes to boosting the immune system, a variety of nutraceuticals have been shown to have important roles in immune status and susceptibility to certain diseases. Nutraceuticals containing Echinacea have been associated with such benefits. With the recent studies proving that intestinal epithelial cell function has a lot to do with the immune system, probiotics have now played a major role in the treatment and prevention of infectious diarrhea and strengthening the immune system, specifically the strains of Lactobacillus and Bifidobacterium. Sulfur compounds in garlic have also been found to help boost the immune system.
Side Effects of Nutraceuticals
Because of the wide range of benefits of nutraceuticals and their relatively safe natural sources, side effects or toxic levels are often set aside. Just like in any type of pharmaceutical, nutraceuticals may also have reactions in individuals, which may include allergies, change in bowel habits, and may also manifest kidney and liver effects when taken in large doses for a long period of time. Despite this, nutraceuticals generally have less side effects in comparison to pharmaceuticals.
A growing concern though is the reaction nutraceuticals may have when taken with conventional medication. According to the Journal of Current Drug Safety, for individuals with metabolic conditions on maintenance medications, nutraceuticals such as herbal and dietary supplements may decrease its therapeutic effects and efficacy when taken together.
In severe cases, concurrent intake of nutraceuticals and pharmaceuticals have been reported to lead to certain blood disorders. Because of this, it is important to consult a physician prior to taking any type of supplement, since most may inadvertently lead to drug-supplement interactions or reactions.
Nutraceuticals: Medicinal Food?
Since nutraceuticals are derived from food (i.e. plants, fruits) and have proven health benefits, they may technically be considered as both food and medicine. But just like pharmaceuticals, these products do undergo some form of processing that, in the end, may affect its efficacy and toxicity potential. Since these still fall under the classification of supplements, most of the essential vitamins, minerals and nutrients they claim to provide can be effectively derived from a healthy diet.
The good thing is, with the recent food and research developments, nutraceuticals do not just simply supplement but now also address and prevent certain medical conditions. Until further testing and studies are done, they will be classified as such but will still remain to have beneficial effects on one’s health.