Nutraceuticals. The use of active ingredients contained in foods, plants and microbial sources (e.g., probiotics) to prevent and help treat diseases is lost in the mists of time. Already in ancient Egypt, Greek and Roman civilizations, plants and herbs-such as garlic, thyme, cumin, juniper and cinnamon-were also widely used for these purposes. (1)
Among one, none and a hundred thousand, it is worthwhile to dwell on the broad concept of nutraceuticals, classifications proposed by science, possible benefits and critical issues. A brief scientific review to follow.
Nutraceuticals and nutraceuticals, concepts
Nutraceutics (from the intersection of nutrition and pharmaceuticals) studies the properties of foods and herbs in the prevention and treatment of disease. Analyzing the relationship between the intake of their specific constituents-understood as ‘nutraceuticals’-and health. (2)
They can be confused with fortified foods, which maintain or promote health due to elements added in them (vitamins, minerals, etc.), while nutraceuticals have the specific ability to prevent or treat diseases, except anemia, without additions in the food formulation. (3)
Nutraceuticals and health
The potential health effects of nutraceuticals are many and varied, in terms of efficacy and in the level of scientific evidence. Favorable interactions of some substances have been observed with inflammation and some forms of cancer, hypertension and cardiovascular disease, atherosclerosis, obesity, diabetes, and hepatic steatosis. (4). Most importantly, it has been shown to be effective in antioxidant, anti-aging, and cognitive function enhancing actions. (5)
Fig. 1. Schematization of different forms of nutraceuticals (Padmavathi, 2018)
Traditional Nutraceuticals
Traditional nutraceuticals are not subjected to interventions that change their composition. (6) They can be classified into three subcategories:
– chemical constituents. Nutrients and micronutrients, phytocompounds (e.g., polyphenols), (7)
– prebiotics and probiotics, which are able to interact favorably with the composition of intestinal flora, thus regulating the immune system and other functions that enable the maintenance of good health. (8)
– enzymes. These regulate bodily functions and are involved in reducing problems related to obesity, digestion, and blood sugar, and without their presence, functions in the body cannot be carried out properly.(9)
Non-traditional nutraceuticals
Non-traditional, on the other hand, are nutraceuticals obtained through additions or modifications (e.g., fermentations). They are distinguished into ‘fortified’ and ‘recombinant’. The former were historically used to make up for nutritional deficiencies in populations, with a focus on vitamins and minerals. And they have found development in products with specific declinations. (10)
Recombinants are used for targeted therapeutic interventions, primarily in pharmaceuticals. Although genetic engineering still presents uncertainties that should not be overlooked. (11)
Special techniques-such as nanoencapsulation, inclusion in nanoparticles or nanospheres-allow some of the limitations inherent in certain nutraceuticals to be overcome. (12) Such as low bioavailability, permeability and retention. Their goal is to precisely reach the area to be treated. In turn, however, they nevertheless deserve attention from risk analysis authorities about possible toxicity profiles. (13)
Fig. 2. Classification of traditional and non-traditional nutraceuticals (Padmavathi, 2018)
Possible health benefits
The use of nutraceuticals has an appreciable level of scientific evidence on some possible health benefits associated with their use. These include:
– The treatment of dyslipidemia, metabolic disorder, type 2 diabetes, obesity, osteoporosis, and endocrine system imbalances, (14)
– The significant reduction of ‘bad’ (LDL) cholesterol levels in the blood, including through the administration of vitamin and mineral mixes, (15),
– The reduction of osteopenia in post-pregnancy women with soy isoflavones (16),
– decreasing fat levels in obese children by prebiotics, which stimulated the growth of Bifidobacterium-friendly gut flora (17),
– The lowering of blood pressure in cardiac patients by magnesium administration. (18)
Possible critical issues
The nutraceuticals market has seen extraordinary development over the past decades. Due to increasing consumer attention to wellness and possible health improvement through dietary supplements. European legislation (dir. 2002/46/EC as amended) is indeed strict. And it is scrupulously applied especially in Italy, where it boasts top-notch production and an objectively unparalleled central control system at the Ministry of Health.
Legislation in other areas of the planet, conversely, is more permissive than in Europe. Regarding the composition of food supplements and also the information accompanying them. With the double risk of underestimating possible contraindications, related to the consumption of non-prescription products. And more generally, to less attention to the risk analysis on which food law in the EU (but not elsewhere) is based. (19)
Dietary supplements, due care
Moreover, dietary supplements from outside the EU are easy to find on the ecommerce channel, where the meshes of official public controls are unfortunately still weak. And it is therefore imperative for consumers to pay attention to the origin of products and their sellers. In the face of the possible presence of potentially harmful substances and/or active pharmaceutical ingredients, also of potential impact onanti-doping rules. As well as contaminants of various kinds (e.g., pesticides, heavy metals, fertilizers, toxic plants, mycotoxins, adulterations and various contaminations). (20)
Therefore, the possibility of purchasing these kinds of products in any physical store or online-without gathering prior advice from a competent physician about the actual needs and doses to be taken-requires a dutiful exercise of common sense. (21)
The potential of nutraceuticals is high, but their indiscriminate consumption deserves attention that should not be limited to the false prophets of the net, nor to the rarely disinterested stories of influencers on duty. With the goal of safeguarding, not compromising health. (22)
Dario Dongo and Andrea Adelmo Della Penna
Notes
(1) Ruchi (2017) Role of nutraceuticals in health care: A review. Int.J. Green Pharm 11(3), doi: http://dx.doi.org/10.22377/ijgp.v11i03.1146
(2) Dickinson (2011) History and review of DSHEA. Phytotherapy 82(1):5-10, doi: 10.1016/j.fitote.2010.09.001
(3) Kaira. (2003). Nutraceutical-definition and introduction. AAPS Pharm. Sci. 5(3), doi: 10.1208/ps050325
(4) Nasri et al. (2014). New concepts in nutraceuticals as alternatives for pharmaceuticals. Int. J. Prev. Med. 5(12):1487-99
(5) Liu et al. (2016). Fabrication of concentrated fish oil emulsions using dual-channel microfludization: Impact of droplet concentration on physical properties and lipid oxidation. J. Agric. Food Chem. 64(50):9532-41, doi: 10.1021/acs.jafc.6b04413
(6) Padmavathi. (2018). A general review on “Nutraceuticals”: Its golden health impact over human community. Int. J. Food Sci. Nut. 3(2):214-7
(7) Sapkale et al. (2012) Nutraceuticals-global status and applications: A review. Int. J. Pharm. Chem. Sci. 1(3):1166-81
(8) Kerry et al. (2018). Benefaction of probiotics for human health: A review. J. Food Drug Ana.26(3):927-39, doi: https://doi.org/10.1016/j.jfda.2018.01.002
(9) Nema et al. (2018). Importance of nutraceuticals in various diseases and human health: A literature review. World J. Pharm. Med. Res. 4(9):104-10
(10) Aronson. (2017). Defining “nutraceuticals”: Neither nutritious nor pharmaceutical. Br. J. Clin. Pharmacol. 83(1):8-19, doi: 10.1111/bcp.12935
(11) Bawa et al. (2013). Genetically modified foods: Safety, risks and public concerns – A review. J. Food Sci Tech. 50(6):1035-46, doi: 10.1007/s13197-012-0899-1
(12) Helal et al. (2019). Nutraceuticals’ novel formulations: The good, the bad, the unknown and patents involved. Recent Patents on Drug Delivery & Formulation 13(2):105-156, doi: 10.2174/1872211313666190503112040
(13) Asghar et al. (2018). Nutraceutical formulation strategies to enhance the bioavaibility and efficiency: An overview. Role of Material Science in food Bioengineering 329-352
(14) Berberich et al. (2017). Nutraceuticals in endocrine disorders. Nature Reviews, doi: 10.1038/nrendo.2017.169
(15) Marazzi et al. (2017). Comparison of low-dose statin versus low-dose statin + armolipid plus in high-intensity statin-intolerant patients with a previous coronary event and percutaneous coronary intervention (ADHERENCE trial). Am. J. Cardiol. 120:893-897, doi: 10.1016/j.amjcard.2017.06.015
(16) Lambert et al. (2017). Combined bioavailable isoflavones and probiotics improve bone status and estrogen metabolism in postmenopausal osteopenic women: a randomized controlled trial. Am. J. Clin. Nutr. 106:909-920, doi: 10.3945/ajcn.117.153353
(17) Nicolucci et al. (2017). Prebiotics reduce body fat and alter intestinal microbiota in children who are overweight or with obesity. Gastroenterology 153:711-722, doi: 10.1053/j.gastro.2017.05.055
(18) Dibaba et al. (2017). The effect of magnesium supplementation on blood pressure in individuals with insulin resistance, prediabetes, or noncommunicable chronic diseases: a meta-analyisis of randomized controlled trials. Am. J. Clin. Nutr. 106:921-929, doi: 10.3945/ajcn.117.155291
(19) Ekor (2014). The growing use of herbal medicines: Issues relating to adverse reactions and challenges in monitoring safety. Front. Pharmacol. 4:177, doi: 10.3389/fphar.2013.00177
(20) Gil et al. (2016). Toxic contamination of nutraceuticals and food ingredients. In Nutraceuticals Academic Press; p. 825-837, doi: 10.1016/B978-0-12-802147-7.00058-9 –
(21) Nounou et al. (2018). Adulteration and counterfeiting of online nutraceutical formulations in the United States: Time for intervention? J. Diet. Suppl. 15(5):789-804, doi: 10.1080/19390211.2017.1360976
(22) Durazzo et al. (2020). Nutraceuticals in human health. Foods 9:370, doi:10.3390/foods9030370
Dario Dongo, lawyer and journalist, PhD in international food law, founder of WIISE (FARE - GIFT - Food Times) and Égalité.
Graduated in Food Technologies and Biotechnologies, qualified food technologist, he follows the research and development area. With particular regard to European research projects (in Horizon 2020, PRIMA) where the FARE division of WIISE Srl, a benefit company, participates.
