Nutraceuticals: What are they & Why are they Important?

Introduction

Nutraceutical is a portmanteau of 2 words “Nutrition” and “Pharmaceutical”, coined by Dr.Stephen DeFelice (1,2). Our Indian food regulatory authority FSSAI (Food safety and standards authority of India) defines Nutraceutical as any food formulated to fulfill dietary requirement arising out of a physiological condition or specific disease or disorder, whose composition should significantly differ from ordinary food of comparable nature (3). It may contain either or all the following – Single or combination of Plant /botanical or its part in the form of powder, concentrate, extract in water, ethyl alcohol or hydro-alcoholic extract. Minerals, vitamins, proteins, amino acids or metals within the Recommended daily allowance (RDA) or enzymes, substance from animal origin, pre and probiotics. It is also important to standardize the active ingredient in the nutraceutical and produce it under good manufacturing practices. Therefore, ensuring purity, safety and potency of food ingredients is paramount to provide a reliable nutraceutical to the consumers. While products which includes drugs, ayurvedic, siddha or unani drugs, narcotic or psychotropic substance or claims to cure or mitigate any specific disease, disorder or condition, they do not fall under the ambit of nutraceutical.

Is Supplementation necessary?

Supplementation is not a substitute for a healthy diet. Plenty of fruits, vegetables, whole grains, adequate protein and healthy fat should be able to provide all the nutrients required for an optimal health. However due to modern lifestyle, not everyone is able to fulfill their daily requirements of nutrients. New age non-communicable lifestyle related conditions such as metabolic syndrome (Diabetes, hypertension, Obesity), cardiovascular, neurological, increased susceptibility to infections, musculoskeletal, gastrointestinal and renal issues (4) among the others, are predominantly due to poor lifestyle choices which includes consumption of high sugar, salt, and fat-laden junk foods, sedentary routine with no or minimal physical activity, compromised sleep and smoking/alcohol abuse. All these conditions are accompanied by alteration in redox state (5), one of the critical among the various changes, leading to chronic sub-clinical inflammation and oxidative stress. In such conditions, the demand for nutrients in the body is increased. Among the array of benefits offered by Nutraceuticals, they have high antioxidant and anti-inflammatory activity assisting in countering these adverse effects (6). With emerging scientific evidence on botanicals or plant derived nutrients also termed as “Phytonutrients” rich in a plethora of complex yet beneficial components, are gaining importance.

Role of Nutrients in Optimal health

Citing some of the examples of Nutraceuticals, Dietary fiber from Oats, barley, beans, fruits classified as insoluble (cellulose, hemicellulose, lignins) or soluble fibers (pectins, gums, β-glucans) have been shown to regulate digestion by either acting as bulking agents or modulating gut microbiota. Higher intake of fibers has been shown to provide satiety, enhance gastrointestinal functioning, improve glucose tolerance, lower LDL cholesterol and in turn lower the risk of various lifestyle disorders (9).

High intake of fruits and vegetables which are rich sources of vitamins, minerals and phytonutrients has been associated with lower risk of CVD (Cardiovascular diseases) (5). Antioxidant vitamins like A, C and E and minerals such as selenium, & zinc act individually or in synergy to counter oxidative stress by scavenging the free radicals, the underlying cause of most of the lifestyle disorders (8).  A recent study with multivitamin supplementation to subjects aged 65 years and above demonstrated improved brain function, memory, and executive function (tasks involving planning ahead or remembering instructions) indicating multivitamin can slow down the age-related decline in brain function by up to 60% (10).

Omega-3 fatty acids are the long-chain Polyunsaturated fatty acids (PUFAs) which are also termed as “essential fatty acids” critical for performance of normal physiological function. Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA) are the major omega-3s primarily obtained by fatty fish such as mackerel, salmon, herring etc but also found in nuts and seeds such as Flax seed, Chia seeds and walnuts. These are important nutrients necessary all through the life from proper fetal development especially retina and brain function, entire gestation period to supporting in managing various lifestyle conditions such as CVDs and neurological conditions attributed to its anti-inflammatory action (9, 20, 21).

Polyphenols are basically secondary metabolites of plants, also called phytochemicals, which plants make to protect them from various stressors. In humans, studies demonstrate a plethora of benefits of polyphenols such as to have positive effect on inflammatory markers (11,13), improve endothelial function and vasodilation (12,13), helps manage hypertension by modulating angiotensin converting enzyme (ACE) (13), manage serum glucose and lipid levels (13,14), regulate bone formation (15) to mention a few.

A healthy digestive system is associated to brain/mental health (16), hormonal harmony, mood and immune system therefore it is necessary to maintain a well-functioning digestive system. Probiotics are those beneficial bacteria such as Bifidobacterium and Lactobacillus which colonize in the intestine, modulating and enhancing host mucosal immune health and thereby maintaining intestinal homeostasis (17). Prebiotics such a galacto-oligosaccarides and inulin, are those which serve as food to probiotics, non-digestible by gastrointestinal juices, but are degraded only by the intestinal bacterial enzymes, while having negative impact on pathogenic bacteria, therefore helps to prevent gut dysbiosis (6).

Summary & Conclusion

Growing consumer awareness towards the nutritional benefits, safe history of use and optimal health by foods and its components has been the driving force behind Nutraceutical boom. Government of several developed and developing countries realizing its importance in improving health, thereby reducing healthcare burden, and supporting rural economy, have been funding and promoting research and innovation (7). However, there is a need to further build scientific understanding of the individual and combined effect of the components on physiological functions and side effects or toxicity, cross reactivity to drugs or other food components, contamination with undesired toxic compounds such as heavy metals, toxins or microorganisms affecting the quality of the nutraceutical. Although, at the population level, nutraceuticals have been largely considered to be beneficial, there has been contradictory research outcomes. This variability in response to the nutrients by individuals may possibly be explored through Nutrigenomics and Nutrigenetics. The effect of genetic variation on dietary response comprises of Nutrigenetics while Nutrigenomics is the science of bioactives in food on genetic expression (18). A deeper understanding of these areas might pave way to personalized nutrition which will possibly tailor make the nutraceuticals to help benefit each individual.

At present, addressing some of the key challenges in Nutraceutical market which is a diverse regulatory framework across countries and a lack of universally accepted definition of Nutraceutical, will further aid in expansion, growth and segmentation in Nutraceutical applications (19). At the same time ensuring affordability, availability, establishing safety and efficacy are the key to the success of Nutraceuticals in the future.

References

1. Brower, V. Nutraceuticals: poised for a healthy slice of the healthcare market? Nat. Biotechnol. 1998, 16, 728-731
2. Cencic A and Chingwaru W. The Role of Functional Foods, Nutraceuticals, and Food Supplements in Intestinal Health. Nutrients 2010, 2, 611-625; doi:10.3390/nu2060611

3. Food safety and standard act 2006, No. 34 of 2006

4. https://www.nhp.gov.in/lifestyle-disorder_mtl#:~:text=The%20most%20common%20lifestyle%20disorders,is%20yet%20another%20lifestyle%20problem.

5. Nasri H, Baradaran A, Shirzad H, and Rafieian-Kopaei New Concepts in Nutraceuticals as Alternative for Pharmaceuticals. Int J Prev Med.2014 Dec; 5(12): 1487–1499

6. Anand S and Bharadvaja Potential Benefits of Nutraceuticals for Oxidative Stress management. Rev Bras Farmacogn.2022; 32(2): 211–220.

7. Daliri E B, Lee B H. Current Trends and Future Perspectives on Functional Foods and Nutraceuticals. Beneficial Microorganisms in Food and Nutraceuticals, 2015, Volume 27. ISBN : 978-3-319-23176-1 https://link.springer.com/chapter/10.1007/978-3-319-23177-8_10

8. Anderson JW, Baird P, Davis RH, Jr, Ferreri S, Knutdson M, Koraym A, Waters V, Williams CL. Health benefits of dietary fibre. Nutr Rev. 2009;67:188–205. doi: 10.1111/j.1753-4887.2009.00189.x

9. Das L, Bhaumik E, Raychaudhuri U, and Chakraborty Role of nutraceuticals in human health. J Food Sci Technol.2012 Apr; 49(2): 173–183

10. Flighting inflammation – How to stop the damage before it compromises your health. Special health report. Harvard Medical school. 2020

11. Christenson J, Whitby SJ, Mellor D, et al. The effects of resveratrol supplementation in overweight and obese humans: a systematic review of randomized trials. Metab Syndr Relat Disord. 2016;14:323–33

12. Duffy SJ, Keaney JF, Jr, Holbrook M, et al. Short- and long-term black tea consumption reverses endothelial dysfunction in patients with coronary artery disease. Circulation. 2001;104:151–6.

13. Patti M A, Al-Rasadi K, Giglio R V, Nikolic D, Mannina C,  Castellino G,  Chianetta R, Banach M, Cicero A F G,  Lippi G, Montalto G, Rizzo M and Toth P P. Natural approaches in metabolic syndrome management. Arch Med Sci.2018 Mar; 14(2): 422–441

14. Chacko SM, Thambi PT, Kuttan R, et al. Beneficial effects of green tea: a literature review. Chin Med. 2010;5:13

15. LinY, Kazlova V, Ramakrishnan S, Murray M A, Fast D, Chandra A, Gellenbeck K W. Bone health nutraceuticals alter microarray mRNA gene expression: A randomized, parallel, open-label clinical study. Phytomedicine.2016 Jan 15;23(1):18-26.

16. Eloisa Salvo-Romero, Patricia Stokes, and Mélanie G. Gareau Microbiota-immune interactions: from gut to brain. LymphoSign Journal. 2020; 7(1)

17. Yana F and Polk D B. Probiotics and immune health. Curr Opin Gastroenterol. 2011 October ; 27(6): 496–501

18.  Farhud DD, M Zarif Yeganeh,2 and M Zarif Yeganeh. Nutrigenomics and Nutrigenetics. Iran J Public Health. 2010; 39(4): 1–14

19.  Chopra A S, Lordan R, Horbańczuk O K, Atanasov A G, Chopra I, Horbańczuk O J, Jóźwik A, Huang L,Pirgozliev V, Banach M, Battino M, Arkells N. The current use and evolving landscape of nutraceuticals. Pharmacological Research. 2022; 175: 106001

20. Swanson D, Block R and Mousa S A. Omega-3 Fatty Acids EPA and DHA: Health Benefits Throughout Life. Adv. Nutr. 3: 1–7, 2012

21. Simopoulos AP. Importance of the Omega- 6/Omega- 3 Balance in Health and Disease: Evolutionary Aspects of Diet. World Rev Nutr Diet. Basel, Karger, 2011, vol 102, pp 10–21