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    Therapeutic Foods
    Therapeutic Foods
    Therapeutic Foods
    Ebook1,173 pages20 hours

    Therapeutic Foods

    By Alexandru Mihai Grumezescu and Alina Maria Holban

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    About this ebook

    Therapeutic Foods, Volume 8 in the Handbook of Food Bioengineering series, is an essential resource for anyone investigating foods that may be utilized as therapeutic agents. Plants and animal products have been utilized since ancient times as medicine to treat diseases, and the properties within foods and ingredients are still investigated for food therapy and prophylaxis. The book is a comprehensive resource for researchers and scientists already in the field or those just entering. It covers many spices, plant extracts, essential oils and vegetal mixtures that have immune-stimulatory effects and can be efficiently utilized in the treatment of infections and cancer.

    • Presents introductory chapters for background and practical examples of therapeutic foods used in different diseases to aid in research
    • Provides scientific methods to help eliminate food spoilage and bacterial contamination in food packaging
    • Includes benefits of the applications of functional properties of food and food ingredients to benefit health and well-being
    LanguageEnglish
    PublisherAcademic Press
    Release dateSep 23, 2017
    ISBN9780128112670
    Therapeutic Foods

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      Book preview

      Therapeutic Foods - Alexandru Mihai Grumezescu

      Therapeutic Foods

      Handbook of Food Bioengineering, Volume 8

      Edited by

      Alina Maria Holban

      Alexandru Mihai Grumezescu

      Table of Contents

      Cover

      Title page

      Copyright

      List of Contributors

      Foreword

      Series Preface

      Preface for Volume 8: Therapeutic Foods

      Section I: State of the Art and Applications

      Chapter 1: Nutraceuticals: Myths Versus Realities

      Abstract

      1. Nutraceuticals

      2. Natural, Nutraceuticals, and Pharmaceuticals

      3. Nutraceuticals: Myths Versus Realities

      4. Health Claims of Nutraceuticals

      5. Labeling Requirements

      6. Safety and Quality Issues

      7. Global Regulations and Compliance

      8. Role of Nutraceuticals in Human Health

      9. Conclusions

      Chapter 2: The Impact of Functional Food and Nutraceuticals in Health

      Abstract

      1. Introduction

      2. Disease Patterns Arising From a 21st-Century Lifestyle

      3. Food as Medicine

      4. Challenges With Natural Nutrient Supplement

      5. Allopathic Drugs and Challenges

      6. Nutrients as Adjunct for Chemical Drugs

      7. Nutrient Adjuncts for Cancer Therapy

      8. Advancement in Food Processing for Nutrients

      9. Conclusions

      Acknowledgments

      Section II: Nutrition

      Chapter 3: Lipids as Nutraceuticals: A Shift in Paradigm

      Abstract

      1. Introduction

      2. Classification of Lipids

      3. Biological Functions of Lipids

      4. Lipid Transport

      5. Lipids in Pathogenesis of Diseases

      6. Lipids as Nutraceuticals

      Chapter 4: Plant Nutrition and Agronomic Management to Obtain Crops With Better Nutritional and Nutraceutical Quality

      Abstract

      1. Introduction

      2. The Nutritional and Nutraceutical Quality of Crops

      3. Nutraceutical Value of Plant Crops and Human Health

      4. Regulation of the Synthesis and Accumulation of Compounds That Enhance the Nutraceutical Quality of Plant Foods

      5. Agricultural Practices for Improving the Nutraceutical Quality of Crops

      6. Results of Applying Agricultural Practices on Nutraceutical Quality

      7. Conclusions

      Chapter 5: Mushrooms as Sources of Therapeutic Foods

      Abstract

      1. Introduction to Mushrooms as Therapeutic Foods

      2. Cultivation Technologies for Edible and Medicinal Mushrooms

      3. Mushrooms Uses in Traditional Medicine Versus Scientific Confirmation for the Uses

      4. Agaricus spp.

      5. Antrodia spp.

      6. Boletus spp.

      7. Cordyceps spp.

      8. Ganoderma spp.

      9. Hericium spp.

      10. Laetiporus spp.

      11. Lentinula spp.

      12. Phellinus spp.

      13. Trametes spp.

      14. Miscellaneous Mushrooms

      15. Conclusions

      Acknowledgments

      Chapter 6: Oregano: A Feed Additive With Functional Properties

      Abstract

      1. Introduction

      2. Antimicrobial Growth Promoters

      3. Oregano Essential Oil

      4. Modes of Action of Oregano

      5. Use of Oregano in Animal Nutrition

      6. Conclusions

      Chapter 7: Potential of Chokeberry (Aronia Melanocarpa L.) as a Therapeutic Food

      Abstract

      1. Introduction

      2. Chokeberry (Aronia melanocarpa)

      3. Bioavailability and Metabolism of Polyphenols Present in Chokeberry

      4. Chokeberry Products-Extracts

      5. New Technologies in Chokeberry Products

      6. Conclusions

      Acknowledgments

      Chapter 8: Beta Glucan as Therapeutic Food

      Abstract

      1. History

      2. New Discoveries

      3. Nutrition and Immunity

      4. Why the Immune Responses are Dependent on Nutrition

      5. Beta Glucans

      6. Transport Through the Gastrointestinal Tract

      7. Beta Glucan and Immunity

      8. Beta Glucan as Food Additive

      9. Conclusions

      Acknowledgment

      Chapter 9: Nutritionally Enhanced Foods Incorporating Chía Seed

      Abstract

      1. Introduction

      2. Therapeutic Foods

      3. History and Ethnobotanical Aspects of Chia

      4. Some Reports on Use of Chia Seed as Food Ingredient

      5. Conclusions

      Section III: Medical Impact

      Chapter 10: Perspective Therapeutic Effects of Immunomodulating Acidic Herbal Heteropolysaccharides and Their Complexes in Functional and Dietary Nutrition

      Abstract

      Abbreviations

      1. Introduction

      2. Chemical Diversity of Herbal Acidic Heteropolysaccharides and Relation to Immunogenicity

      3. Perspective Therapeutic Effects of Acidic Heteropolysaccharides

      4. Preparation of Immunomodulating Acidic Heteropolysaccharides and Their Complexes

      5. Concluding Remarks

      Acknowledgments

      Chapter 11: Soybeans, Flaxseeds, and Fish Oil in the Treatment of Renal Disease

      Abstract

      1. Introduction

      2. Sources, Dietary, and Supplement Intake

      3. Clinical Association of Soybeans, Flaxseed, and Fish Oil Treatments in CKD

      4. Conclusions

      Acknowledgments

      Chapter 12: Maca, A Nutraceutical From the Andean Highlands

      Abstract

      1. Introduction

      2. A Crop Native From the Peruvian Highlands

      3. The Tradition Behind Maca

      4. The Science Behind Maca

      5. The Future of Maca

      6. Concluding Remarks

      Acknowledgments

      Chapter 13: Phytochemical and Pharmacological Properties of Secondary Metabolites in Berries

      Abstract

      1. Introduction

      2. Taxonomic Problems

      3. Berry Fruits, Bioactives, and Bioavailability

      4. Metabolic Syndrome

      5. Clinical Efficacy and Mechanism of Action Berries

      6. Cancer and Oxidative Species

      7. Types of Cancer With Potential to be Treated by Medicinal Plants

      8. Epidemiological Studies of Cancer

      9. Conclusions

      Section IV: Cancer Therapy

      Chapter 14: Functional Foods and Chemoprevention in Cancer

      Abstract

      1. Functional Foods and Bioactive Compounds

      2. Bioactive Compounds With Anticancer Activity

      3. Conclusions

      Chapter 15: Epigenetic Nutraceuticals in Cancer Treatment

      Abstract

      1. Introduction

      2. Diet and Transgenerational Epigenetic Changes

      3. Epigenetic Nutraceuticals in Cancer Treatment

      4. Essential Micronutrients–Folate, Selenium, Vitamin D

      5. Flavonoids

      6. Polyphenol Catechins

      7. Conclusions, Future Perspectives, and Challenges

      Index

      Copyright

      Academic Press is an imprint of Elsevier

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      Copyright © 2018 Elsevier Inc. All rights reserved.

      No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.

      This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).

      Notices

      Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary.

      Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility.

      To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.

      Library of Congress Cataloging-in-Publication Data

      A catalog record for this book is available from the Library of Congress

      British Library Cataloguing-in-Publication Data

      A catalogue record for this book is available from the British Library

      ISBN: 978-0-12-811517-6

      For information on all Academic Press publications visit our website at https://www.elsevier.com/books-and-journals

      Publisher: Andre Gerhard Wolff

      Acquisition Editor: Nina Bandeira

      Editorial Project Manager: Jaclyn Truesdell

      Production Project Manager: Punithavathy Govindaradjane

      Designer: Matthew Limbert

      Typeset by Thomson Digital

      List of Contributors

      Navneet Agnihotri,     Panjab University, Chandigarh, India

      Dulce E. Alarcón-Yaquetto

      Universidad Peruana Cayetano Heredia

      Research Circle of Plants with Effects on Health, Lima, Peru

      Tania V. Altamirano,     Universidad Latino, Mérida, Yucatán, México

      Pathan S. Begum,     KVR Government Degree College for Women, Kurnool, Andhra Pradesh, India

      Adalberto Benavides-Mendoza,     Autonomous Agrarian University Antonio Narro, Saltillo, Coahuila, Mexico

      Priyanka Bhadwal,     Panjab University, Chandigarh, India

      Eleftherios Bonos,     Research Institute of Animal Science, Pella, Greece

      Marcelino Cabrera-De la Fuente,     Autonomous Agrarian University Antonio Narro, Saltillo, Coahuila, Mexico

      Efterpi Christaki,     Aristotle University of Thessaloniki, Thessaloniki, Greece

      Ana Ćirić,     University of Belgrade, Belgrade, Serbia

      Luis M. Contreras-Medina,     Universidad Autónoma de Querétaro, Santiago de Querétaro, Querétaro, México

      Nada Ćujić,     Institute for Medicinal Plants Research, Belgrade, Serbia

      Petko N. Denev

      Institute of Organic Chemistry with Centre of Phytochemistry, Bulgarian Academy of Sciences

      Innovative-Technological Center Ltd., Plovdiv, Bulgaria

      Ana A. Feregrino-Perez,     Universidad Autónoma de Querétaro, Santiago de Querétaro, Querétaro, México

      Emmanuel Flores-Huicochea,     National Polytechnic Institute, Biotic Product Development Center, Yautepec, Morelos, Mexico

      Panagiota Florou-Paneri,     Aristotle University of Thessaloniki, Thessaloniki, Greece

      Lina Garcia-Mier,     Universidad del Valle de México, Campus Querétaro, Santiago de Querétaro, Querétaro, México

      Juan F. Garcia-Trejo,     Universidad Autónoma de Querétaro, Santiago de Querétaro, Querétaro, México

      Yordan N. Georgiev

      Institute of Organic Chemistry with Centre of Phytochemistry, Bulgarian Academy of Sciences

      Innovative-Technological Center Ltd., Plovdiv, Bulgaria

      Ilias Giannenas,     Aristotle University of Thessaloniki, Thessaloniki, Greece

      Jasmina Glamočlija,     University of Belgrade, Belgrade, Serbia

      Susana González-Morales,     Autonomous Agrarian University Antonio Narro, Saltillo, Coahuila, Mexico

      Gustavo F. Gonzales

      Universidad Peruana Cayetano Heredia

      Research Circle of Plants with Effects on Health, Lima, Peru

      Ramon G. Guevara-González,     Universidad Autónoma de Querétaro, Santiago de Querétaro, Querétaro, México

      Teodora Janković,     Institute for Medicinal Plants Research, Belgrade, Serbia

      Sandra N. Jimenez-Garcia,     Universidad de Guanajuato, Campus Celaya-Salvatierra, Celaya, Guanajuato, México

      Antonio Juárez-Maldonado,     Autonomous Agrarian University Antonio Narro, Saltillo, Coahuila, Mexico

      Nevena Kardum,     University of Belgrade, Belgrade, Serbia

      Rabia Khalid,     University of Agriculture, Faisalabad, Punjab, Pakistan

      Maria G. Kratchanova

      Institute of Organic Chemistry with Centre of Phytochemistry, Bulgarian Academy of Sciences

      Innovative-Technological Center Ltd., Plovdiv, Bulgaria

      Sandeep Kumar,     Panjab University, Chandigarh, India

      Paola Leija-Martínez,     Autonomous Agrarian University Antonio Narro, Saltillo, Coahuila, Mexico

      Vannucci Luca,     Institute of Microbiology, Prague, Czech Republic

      Zvonko Magic

      Military Medical Academy, University of Defense

      Institute for Medical Research, Military Medical Academy, Belgrade, Serbia

      Edwin E. Martínez Leo

      Universidad Latino

      Universidad Autónoma de Yucatán, Mérida, Yucatán, México

      Nebojša Menković,     Institute for Medicinal Plants Research, Belgrade, Serbia

      Manol H. Ognyanov

      Institute of Organic Chemistry with Centre of Phytochemistry, Bulgarian Academy of Sciences

      Innovative-Technological Center Ltd., Plovdiv, Bulgaria

      Amanda Ortíz-Sánchez,     Autonomous University of Morelos, Biodiversity and Conservation Research Center, Cuernavaca, Morelos, Mexico

      Sima Petr,     Institute of Microbiology, Prague, Czech Republic

      Jovana Petrović,     University of Belgrade, Belgrade, Serbia

      Slavica Radjen,     Military Medical Academy, University of Defence, Belgrade, Serbia

      Senthilkumar Rajagopal,     Rayalaseema University, Kurnool, Andhra Pradesh, India

      Meerza A. Razak,     Rayalaseema University, Kurnool, Andhra Pradesh, India

      J. Rodolfo Rendón-Villalobos,     National Polytechnic Institute. Biotic Product Development Center, Yautepec, Morelos, Mexico

      Danijela Ristić-Medić,     Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade, Serbia

      Supraj R. Sangam,     Jawaharlal Nehru Technological University (JNTU), Hyderabad, Telangana, India

      Katarina Šavikin,     Institute for Medicinal Plants Research, Belgrade, Serbia

      Bhoomika Sharma,     Panjab University, Chandigarh, India

      Prerna Sharma,     Panjab University, Chandigarh, India

      Maira R. Segura Campos,     Universidad Autónoma de Yucatán, Mérida, Yucatán, México

      Mian K. Sharif,     University of Agriculture, Faisalabad, Punjab, Pakistan

      Shubham Singh,     Nizam College, Hyderabad, Telangana, India

      Marina Soković,     University of Belgrade, Belgrade, Serbia

      Dejan Stojković,     University of Belgrade, Belgrade, Serbia

      Gordana Supic

      Military Medical Academy, University of Defense

      Institute for Medical Research, Military Medical Academy, Belgrade, Serbia

      Marija Takić,     Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade, Serbia

      Vetvicka Vaclav,     University of Louisville, Louisville, KY, United States

      Moises A. Vazquez-Cruz,     Universidad del Valle de México, Campus Querétaro, Santiago de Querétaro, Querétaro, México

      Buddolla Viswanath,     Gachon University, Seongnam, Gyeonggi, South Korea

      Gordana Zdunić,     Institute for Medicinal Plants Research, Belgrade, Serbia

      Katarina Zeljic,     University of Belgrade, Belgrade, Serbia

      Foreword

      In the last 50 years an increasing number of modified and alternative foods have been developed using various tools of science, engineering, and biotechnology. The result is that today most of the available commercial food is somehow modified and improved, and made to look better, taste different, and be commercially attractive. These food products have entered in the domestic first and then the international markets, currently representing a great industry in most countries. Sometimes these products are considered as life-supporting alternatives, neither good nor bad, and sometimes they are just seen as luxury foods. In the context of a permanently growing population, changing climate, and strong anthropological influence, food resources became limited in large parts of the Earth. Obtaining a better and more resistant crop quickly and with improved nutritional value would represent the Holy Grail for the food industry. However, such a crop could pose negative effects on the environment and consumer health, as most of the current approaches involve the use of powerful and broad-spectrum pesticides, genetic engineered plants and animals, or bioelements with unknown and difficult-to-predict effects. Numerous questions have emerged with the introduction of engineered foods, many of them pertaining to their safe use for human consumption and ecosystems, long-term expectations, benefits, challenges associated with their use, and most important, their economic impact.

      The progress made in the food industry by the development of applicative engineering and biotechnologies is impressive and many of the advances are oriented to solve the world food crisis in a constantly increasing population: from genetic engineering to improved preservatives and advanced materials for innovative food quality control and packaging. In the present era, innovative technologies and state-of-the-art research progress has allowed the development of a new and rapidly changing food industry, able to bottom-up all known and accepted facts in the traditional food management. The huge amount of available information, many times is difficult to validate, and the variety of approaches, which could seem overwhelming and lead to misunderstandings, is yet a valuable resource of manipulation for the population as a whole.

      The series entitled Handbook of Food Bioengineering brings together a comprehensive collection of volumes to reveal the most current progress and perspectives in the field of food engineering. The editors have selected the most interesting and intriguing topics, and have dissected them in 20 thematic volumes, allowing readers to find the description of basic processes and also the up-to-date innovations in the field. Although the series is mainly dedicated to the engineering, research, and biotechnological sectors, a wide audience could benefit from this impressive and updated information on the food industry. This is because of the overall style of the book, outstanding authors of the chapters, numerous illustrations, images, and well-structured chapters, which are easy to understand. Nonetheless, the most novel approaches and technologies could be of a great relevance for researchers and engineers working in the field of bioengineering.

      Current approaches, regulations, safety issues, and the perspective of innovative applications are highlighted and thoroughly dissected in this series. This work comes as a useful tool to understand where we are and where we are heading to in the food industry, while being amazed by the great variety of approaches and innovations, which constantly changes the idea of the food of the future.

      Anton Ficai, PhD (Eng)

      Department Science and Engineering of Oxide Materials and Nanomaterials,

      Faculty of Applied Chemistry and Materials Science, Politehnica University of Bucharest,

      Bucharest, Romania

      Series Preface

      The food sector represents one of the most important industries in terms of extent, investment, and diversity. In a permanently changing society, dietary needs and preferences are widely variable. Along with offering a great technological support for innovative and appreciated products, the current food industry should also cover the basic needs of an ever-increasing population. In this context, engineering, research, and technology have been combined to offer sustainable solutions in the food industry for a healthy and satisfied population.

      Massive progress is constantly being made in this dynamic field, but most of the recent information remains poorly revealed to the large population. This series emerged out of our need, and that of many others, to bring together the most relevant and innovative available approaches in the intriguing field of food bioengineering. In this work we present relevant aspects in a pertinent and easy-to-understand sequence, beginning with the basic aspects of food production and concluding with the most novel technologies and approaches for processing, preservation, and packaging. Hot topics, such as genetically modified foods, food additives, and foodborne diseases, are thoroughly dissected in dedicated volumes, which reveal the newest trends, current products, and applicable regulations.

      While health and well-being are key drivers of the food industry, market forces strive for innovation throughout the complete food chain, including raw material/ingredient sourcing, food processing, quality control of finished products, and packaging. Scientists and industry stakeholders have already identified potential uses of new and highly investigated concepts, such as nanotechnology, in virtually every segment of the food industry, from agriculture (i.e., pesticide production and processing, fertilizer or vaccine delivery, animal and plant pathogen detection, and targeted genetic engineering) to food production and processing (i.e., encapsulation of flavor or odor enhancers, food textural or quality improvement, and new gelation- or viscosity-enhancing agents), food packaging (i.e., pathogen, physicochemical, and mechanical agents sensors; anticounterfeiting devices; UV protection; and the design of stronger, more impermeable polymer films), and nutrient supplements (i.e., nutraceuticals, higher stability and bioavailability of food bioactives, etc.).

      The series entitled Handbook of Food Bioengineering comprises 20 thematic volumes; each volume presenting focused information on a particular topic discussed in 15 chapters each. The volumes and approached topics of this multivolume series are:

      Volume 1: Food Biosynthesis

      Volume 2: Food Bioconversion

      Volume 3: Soft Chemistry and Food Fermentation

      Volume 4: Ingredient Extraction by Physicochemical Methods in Food

      Volume 5: Microbial Production of Food Ingredients and Additives

      Volume 6: Genetically Engineered Foods

      Volume 7: Natural and Artificial Flavoring Agents and Food Dyes

      Volume 8: Therapeutic Foods

      Volume 9: Food Packaging and Preservation

      Volume 10: Microbial Contamination and Food Degradation

      Volume 11: Diet, Microbiome, and Health

      Volume 12: Impacts of Nanoscience on the Food Industry

      Volume 13: Food Quality: Balancing Health and Disease

      Volume 14: Advances in Biotechnology in the Food Industry

      Volume 15: Foodborne Diseases

      Volume 16: Food Control and Biosecurity

      Volume 17: Alternative and Replacement Foods

      Volume 18: Food Processing for Increased Quality and Consumption

      Volume 19: Role of Material Science in Food Bioengineering

      Volume 20: Biopolymers for Food Design

      The series begins with a volume on Food Biosynthesis, which reveals the concept of food production through biological processes and also the main bioelements that could be involved in food production and processing. The second volume, Food Bioconversion, highlights aspects related to food modification in a biological manner. A key aspect of this volume is represented by waste bioconversion as a supportive approach in the current waste crisis and massive pollution of the planet Earth. In the third volume, Soft Chemistry and Food Fermentation, we aim to discuss several aspects regarding not only to the varieties and impacts of fermentative processes, but also the range of chemical processes that mimic some biological processes in the context of the current and future biofood industry. Volume 4, Ingredient Extraction by Physicochemical Methods in Food, brings the readers into the world of ingredients and the methods that can be applied for their extraction and purification. Both traditional and most of the modern techniques can be found in dedicated chapters of this volume. On the other hand, in volume 5, Microbial Production of Food Ingredients and Additives, biological methods of ingredient production, emphasizing microbial processes, are revealed and discussed. In volume 6, Genetically Engineered Foods, the delicate subject of genetically engineered plants and animals to develop modified foods is thoroughly dissected. Further, in volume 7, Natural and Artificial Flavoring Agents and Food Dyes, another hot topic in food industry—flavoring and dyes—is scientifically commented and valuable examples of natural and artificial compounds are generously offered. Volume 8, Therapeutic Foods, reveals the most utilized and investigated foods with therapeutic values. Moreover, basic and future approaches for traditional and alternative medicine, utilizing medicinal foods, are presented here. In volume 9, Food Packaging and Preservation, the most recent, innovative, and interesting technologies and advances in food packaging, novel preservatives, and preservation methods are presented. On the other hand, important aspects in the field of Microbial Contamination and Food Degradation are shown in volume 10. Highly debated topics in modern society: Diet, Microbiome, and Health are significantly discussed in volume 11. Volume 12 highlights the Impacts of Nanoscience on the Food Industry, presenting the most recent advances in the field of applicative nanotechnology with great impacts on the food industry. Additionally, volume 13 entitled Food Quality: Balancing Health and Disease reveals the current knowledge and concerns regarding the influence of food quality on the overall health of population and potential food-related diseases. In volume 14, Advances in Biotechnology in the Food Industry, up-to-date information regarding the progress of biotechnology in the construction of the future food industry is revealed. Improved technologies, new concepts, and perspectives are highlighted in this work. The topic of Foodborne Diseases is also well documented within this series in volume 15. Moreover, Food Control and Biosecurity aspects, as well as current regulations and food safety concerns are discussed in the volume 16. In volume 17, Alternative and Replacement Foods, another broad-interest concept is reviewed. The use and research of traditional food alternatives currently gain increasing terrain and this quick emerging trend has a significant impact on the food industry. Another related hot topic, Food Processing for Increased Quality and Consumption, is considered in volume 18. The final two volumes rely on the massive progress made in material science and the great applicative impacts of this progress on the food industry. Volume 19, Role of Material Science in Food Bioengineering, offers a perspective and a scientific introduction in the science of engineered materials, with important applications in food research and technology. Finally, in volume 20, Biopolymers for Food Design, we discuss the advantages and challenges related to the development of improved and smart biopolymers for the food industry.

      All 20 volumes of this comprehensive collection were carefully composed not only to offer basic knowledge for facilitating understanding of nonspecialist readers, but also to offer valuable information regarding the newest trends and advances in food engineering, which is useful for researchers and specialized readers. Each volume could be treated individually as a useful source of knowledge for a particular topic in the extensive field of food engineering or as a dedicated and explicit part of the whole series.

      This series is primarily dedicated to scientists, academicians, engineers, industrial representatives, innovative technology representatives, medical doctors, and also to any nonspecialist reader willing to learn about the recent innovations and future perspectives in the dynamic field of food bioengineering.

      Alina M. Holban

      University of Bucharest, Bucharest, Romania

      Alexandru M. Grumezescu

      Politehnica University of Bucharest, Bucharest, Romania

      Preface for Volume 8: Therapeutic Foods

      In the modern society, the concept of therapeutic foods has gained new insights among researchers, medical representatives, industry, and consumers.

      Traditional uses of therapeutic foods were related to nutritional and therapeutic purposes in the form of dietary supplements. They were used for emergency feeding of malnourished children or to supplement the diets of patients having special nutritional needs. In recent years, the progress made in research and technology enabled the development of a true therapeutic food revolution. The concept of therapeutic foods was currently expanded to new avenues in medicine, that is, to prevent and even cure metabolic disorders or to promote a healthy lifestyle; and also in industry, that is, the development of green food industry. The concept of nutraceuticals and functional foods emerged in the last 20 years and the intense research made on this field has led to the development of numerous dietary supplements and food additives with health-benefiting properties.

      This book aimed to bring together the most investigated and innovative approaches regarding the development of therapeutic foods to obtain valuable products with improved quality, ensuring health promotion and environment protection in the context of a sustainable food industry.

      The volume contains 15 chapters prepared by outstanding authors from Serbia, USA, Pakistan, Greece, India, Czech Republic, Mexico, Bulgaria, and Peru.

      The selected manuscripts are clearly illustrated and contain accessible information for a wide audience, especially food scientists, engineers, biotechnologists, biochemists, industrial companies and also for any reader interested in learning about the most interesting and recent advances in the field of therapeutic foods.

      This volume includes an introduction into nutraceuticals (Chapter 1), Nutraceuticals: Myths Versus Realities, prepared by Sharif and Khalid. The chapter discusses the myths and realities about the use of nutraceuticals widely clearing prevalent ambiguities about their health benefits and the safe use before starting a new dietary regimen. A comprehensive deliberation regarding global market, trends, commonly used nutraceuticals, scientific evidence of reported health claims, mechanisms of action, nutraceuticals as diet replacement, comparison between drug and nutraceutical, safety and quality indicators, labeling requirements, and regulatory bodies are debated in this work.

      Chapter 2, entitled The Impact of Functional Food and Nutraceuticals in Health, prepared by Singh et al., explores the health benefits of the easily available nutraceuticals, which could act as adjunct lifesaving molecules for patients with chronic diseases, in a context of an established epidemiological relation between disease, lifestyle, and diet.

      In Chapter 3, Lipids as Nutraceuticals: A Shift in Paradigm, Kumar et al. reveals potential advantages of the incorporation of lipid compounds into human diet as functional foods. This study comes as an explanation over the fact that dietary intake of some lipids has been shown to suppress inflammation, hypercholesterolemia, and dyslipidemia and are implicated in cellular signaling pathways, including programmed cell death and malignant transformation.

      In Chapter 4, entitled Plant Nutrition and Agronomic Management to Obtain Crops With Better Nutritional and Nutraceutical Quality, Cabrera-De la Fuente et al. describe different growing systems, fertilizer management, the use of natural or synthetic elicitors, and the soil and climate conditions that lead to the production of crops with better nutritional and nutraceutical qualities.

      In Chapter 5, Mushrooms as Sources of Therapeutic Foods, Soković et al. focus on recent literature regarding antioxidant, antimicrobial, antitumor, and antidiabetic properties of edible mushrooms. Molecular mechanisms involved in the health-beneficial effects of mushroom extracts and purified compounds are discussed.

      Chapter 6, Oregano: A Feed Additive With Functional Properties, prepared by Giannenas et al., focuses on recent advances in the dietary use of oregano, which demonstrated notable beneficial effects on animal growth performance, feed efficiency, production traits, and product quality, as well as on modulation of immune system, intestinal architecture, and microbiota. Oregano could be regarded as a promising functional ingredient for an extensive use in animal nutrition.

      In Chapter 7, Potential of Chokeberry (Aronia Melanocarpa L.) as a Therapeutic Food, Ćujić et al. reveal the health-beneficial effects of chokeberry, highlighting impact on decreasing oxidative damage markers, improvement in prooxidant–antioxidant balance after polyphenol-rich chokeberry juice consumption, and increase in polyunsaturated fatty acids and decrease in monounsaturated fatty acids in erythrocytes, suggesting a role in cell protection against oxidative stress.

      In Chapter 8, Beta Glucan as Therapeutic Food, Vaclav et al. offer an up-to-date comprehensive review of the possible use of beta-glucan as a food additive, because beta-glucan has not only a prebiotic quality, but also immunostimulatory effects regardless of the route of administration, making it an ideal food additive.

      In Chapter 9, Nutritionally Enhanced Foods Incorporating Chía Seed, Rendón-Villalobos et al. reveal the benefits of chía, one of the oldest crops cultivated for centuries for its high dietary fiber content, fatty acids, such as omega-3 and protein content. The seeds are considered energizing ingredients loaded with nutrients, and with a bland, neutral taste profile are suitable for both sweet and savory applications. Some attributes of the seeds refer, for example, to: low-glycemic index, help to maintain energy levels, and is also a great way to boost daily iron intake.

      Chapter 10, Perspective Therapeutic Effects of Immunomodulating Acidic Herbal Heteropolysaccharides and Their Complexes in Functional and Dietary Nutrition, prepared by Georgiev et al., compiles information about the perspective therapeutic effects of herbal acidic heteropolysaccharides and their complexes, and emphasize on their role in functional and dietary nutrition.

      In Chapter 11, Soybeans, Flaxseeds, and Fish Oil in the Treatment of Renal Disease, Ristić-Medić et al. reveal and discuss recent evidence regarding the impact of soybeans, flaxseeds, and fish oil supplementation in reducing the progression of chronic renal disease and even elimination of some clinical outcomes in hemodialysis patients.

      Chapter 12, entitled Maca, A Nutraceutical From the Andean Highlands, prepared by Gonzales and Alarcón-Yaquetto, discusses the nutritional value and health benefits of hypocotyls of Maca. It seems that the therapeutic effects of Maca range from increase in sperm count and motility, improvement in embryo quality, reverse testosterone-induced prostate hyperplasia, and ovariectomy-induced osteoporosis, to enhanced learning and memory, delayed fatigue, and increase in the interferon gamma production, while reducing glycemia.

      Chapter 13, Phytochemical and Pharmacological Properties of Secondary Metabolites in Berries, prepared by Jimenez-Garcia et al., summarizes the biological active compounds in berries in relation to the prevention and treatment of severe diseases, such as cancer. The study highlights the necessity to emphasize on the relation between plant crops and elicitors to increase their variety in bioactive compounds and synthesis capacity focused on nutrition and health.

      In Chapter 14, Functional Foods and Chemoprevention in Cancer, Martínez Leo et al. describe current evidence related to the chemopreventive activity of functional foods and give an idea on the proposed multiple dietetic possibilities for cancer patients. Also, the potential to establish particular alimentary strategies that prevent and treat cancer in a more effective and personalized way is highlighted.

      In Chapter 15, Epigenetic Nutraceuticals in Cancer Treatment, Supic et al. reveal new insights into the emerging field of nutritional epigenetics, which is a novel and complex scientific field focused on studying dietary bioactive components as epigenetic modulators in chemoprevention and therapy of complex diseases, particularly cancer. The field of nutritional epigenetics seems to have very promising future in chemoprevention and treatment of cancer.

      Alina M. Holban

      University of Bucharest, Bucharest, Romania

      Alexandru M. Grumezescu

      Politehnica University of Bucharest, Bucharest, Romania

      Section I

      State of the Art and Applications

      Chapter 1: Nutraceuticals: Myths Versus Realities

      Chapter 2: The Impact of Functional Food and Nutraceuticals in Health

      Chapter 1

      Nutraceuticals: Myths Versus Realities

      Mian K. Sharif

      Rabia Khalid    University of Agriculture, Faisalabad, Punjab, Pakistan

      Abstract

      A nutraceutical is any substance that is the component of food providing medical or health benefits, including prevention and treatment of diseases. The term was first coined from nutrition and pharmaceuticals" in 1989 by Stephen DeFelice, founder and chairman of the Foundation for Innovation in Medicines. Nutraceuticals are broadly classified based on their natural sources, pharmacological conditions, and chemical constituents. The most commonly used nutraceuticals are probiotics, prebiotics, dietary fiber, antioxidants, phytoestrogen, saponins, carotenoids, phytochemicals, fatty acids, phenolics, isoprenoids, lipids, proteins, and herbs. The annual growth in the global nutraceuticals market is about 8% and is expected to exceed US $262.9 billion by 2020. Currently, the scientific community is investigating the role of nutraceuticals in human nutrition with wide-ranging implications for consumers, healthcare providers, regulators, food producers, and distributors. The trend of using nutraceuticals without proper knowledge has increased in recent years, and these products are thought to be as good as a balanced diet and are replacing regular dietary products. However, lack of information about nutraceuticals creates much confusion, apathy, and frustration among consumers. Numerous companies produce nutraceuticals but at the same time are sabotaging the health of millions of unsuspecting buyers. Many brands are producing synthetic products made from oxide minerals and other chemical substances that contain harmful substances, including preservatives, fillers, binders, coal tar, bitumen, gelatin, and waste products. There is concern about the effective utilization and excretion of these products by the human body as they may get lodged in body tissues, causing disease or exacerbating existing ailments. This chapter will discuss the myths and realities about the use of nutraceuticals, clarifying widely prevalent ambiguities about their health benefits and safe use before starting a new dietary regimen. Efforts will be made to comprehensively deliberate the global market and trends, commonly used nutraceuticals, scientific evidence of reported health claims, mechanisms of action, nutraceuticals as diet replacements, comparisons between drugs and nutraceuticals, safety and quality indicators, and labeling requirements and regulatory bodies.

      Keywords

      nutraceuticals

      myths and realities

      health claims

      nutraceuticals vs. pharmaceuticals

      labeling requirements

      regulatory bodies

      1. Nutraceuticals

      1.1. Preamble

      The use of nutraceuticals and functional foods in daily life has increased many times over the last decade. Consequently, a wide variety of nutraceuticals claiming numerous health benefits are available in the global market. A huge number of these nutraceuticals are now used for self-medication purposes and are frequently available in pharmacies and supermarkets, fostered by extensive media advertising of their purported health benefits. There has been a boom in their sales as consumers increasingly seek to self-medicate, either with the hope that these products will treat ailments that were unsatisfactorily handled with prescribed drugs, or to avoid the adverse side effects of some prescribed drugs. Key factors for the expanding market of functional foods and nutraceuticals are increasing population, aging population, and consumer interest toward use of these products instead of medicines. With the global increase in life expectancy, the number of aged individuals is also escalating, and this population is typically prone to a large number of diseases. This will ultimately be a major factor promoting the use of nutraceuticals in future. For example, it has been predicted that arthritis will affect most of the population at some time during their lifetimes, triggering the demand for preventive and curative strategies.

      Furthermore, the interest in nutraceuticals and supplements is increasing, powered through revolutionary studies that establish properties of nutraceuticals linked with public curiosity and client demand. Obesity is the most important concern worldwide, and the obese population is increasing in most developed and developing countries. In the United States, about 62% of the adult population comes under the category of overweight (according to body mass index estimates) and up to 50% of these are obese. According to the International Obesity Task Force, the number of obese in the many European countries has increased by 10%–50% in the past 10 years. Likewise, cardiovascular diseases are responsible for about 32% of the total deaths in the United States. Additionally, osteoporosis, arthritis, and cancer are also widespread.

      Although genetics is the most important factor in the progression of these ailments, most of them are preventable or could be minimized by way of a complete food regimen and managing weight. Moreover, people can optimize their well being through nutrient supplements. Another drive for food-based approaches is public awareness and education about the implications of nutritional sciences toward health improvement. Each year more and more journal articles are published, highlighting the link between healthy eating and wellness. Additionally, numerous books and popular articles related to healthy approaches are getting space on bookstore shelves. Besides print media, talk shows and health programs are aired globally focusing on various diseases along with prevention and cure strategies. This trend has further been triggered by advancements in telecommunication and web technologies and their increasing accessibility to the consumers. The Internet is rapidly becoming a major source of information for understanding etiology and remedy of various health ailments. All these technologies are increasing consumer interest in self-medication through various ways instead of seeking consultation from doctors (Lockwood, 2007).

      1.2. Definitions

      The term nutraceuticals is a blend of two words: nutrition and pharmaceutical. It was first used in 1989 by Stephen DeFelice, the founder of the Foundation for Innovation in Medicine. Nutraceutical substances fall in functional foods that provide medical benefits for disease prevention and treatment. These products ranges from supplements to genetically engineered and processed foods, such as soups, cereals, and beverages, to herbal products. Although currently there is no well-accepted definition for nutraceuticals, some common links exist among the definitions stated by various health practitioners and associations. According to the International Food Information Council, functional foods are diet based substances that can offer a benefit for better health and also provide basic nutrition. The International Life Sciences Institute of North America has defined functional foods as foods having bioactive dietary substances that provide benefits for human health beyond the provision of nutrition. Health Canada defines functional foods as foods similar in physical structure to common foods, consumed as a part of regular diet and have various health benefits and also reduce the incidence of diseases (Pathak, 2009). The Nutrition Business Journal classifies functional food as foods which are fortified with isolates that reaches to functional levels, recovering performance and improving health, include enriched cereals, cereals bars, sport drinks, fortified foods, snacks, prepared meals, baby foods, and more. The American Dietetic Association in a position paper has defined functional foods by emphasizing that the term functional indicates those foods that have health value leading to certain health benefits for the consumer, for example, reduced risk of diseases. However, Wellness Canada states that nutraceuticals are products that are made from foods and then converted into capsules, tablets, powders, or in different medicinal forms that are no longer related with meals. Overall, a nutraceutical is proven to have physiological improvement and provide health benefits beyond basic nutrition (Wildman et al., 2016).

      1.3. Classification

      Nutraceuticals are nonspecified natural therapies that are used to enhance wellness, prevent malignant processes, and control symptoms of various diseases (Radhika et al., 2011). These can be classified depending upon their origin, (Table 1.1) chemical nature (isoprenoid derivatives, phenolic substances, fatty acids and structural lipids, carbohydrates and derivatives), as well as sources. Furthermore, these can be grouped into the following categories.

      Table 1.1

      Classification of nutraceuticals on the basis of origin.

      Adapted from Wildman, R.E., Wildman, R., Wallace, T.C., 2016. Handbook of Nutraceuticals and Functional Foods, CRC Press, NY, USA.

      1.3.1. Dietary supplements

      A dietary supplement is a substance taken orally that contains a dietary ingredient meant to supplement the normal diet of an individual. The dietary material in these products could be minerals, vitamins, nutrients, herbs or different botanicals, bioactive agents, amino acids, or other resources related to enzymes and metabolites. These supplements could be isolates or concentrates present in capsules, smooth gels, tablets, pills, liquids, or powders and can include pro- and prebiotics, dietary fiber, omega-3 fatty acids, and antioxidants (Wildman et al., 2016).

      1.3.2. Functional foods

      Functional foods are designed to encourage the consumer to shift toward whole diet sources in their natural forms, instead of taking pills or capsules formed through a series of biochemical processes involving a large number of chemical agents that could harm the body. Functional foods can be fortified and enriched through a process called nutrification, which restores nutrients in a food to optimal levels or adds complementary nutrients such as calcium and vitamin D in milk and milk-based products. Common examples include cereals and grains such as oat and barley bran (known to prevent cardiovascular diseases and colon cancer), yogurts and other probiotics (to control intestinal flora), canola and other edible oils with low triglyceride levels (known to reduce cholesterol), omega-3 fatty acid–rich products like salmon (known to prevent heart diseases), and the plant stanols found in a variety of fruits, vegetables, and nuts (known to reduce cholesterol adsorption).

      1.3.3. Medicinal foods

      These include transgenic plants and other food products that may be loaded with medicines to prevent various health ailments (Ratnaparkhi et al., 2015).

      1.4. Global Market

      The worldwide market for dietary supplements and nutraceuticals has increased from US $117.3 billion in 2007 to US $176.7 billion in 2013 with a compound annual growth rate of 7.4%. The annual growth in the global market of nutraceuticals is about 8% and is expected to cross US $262.9 billion by 2020. According to a current report, the total market of dietary supplements and nutraceuticals in India is mounting at 21% per annum. It is presently valued at Indian Rs. 44 billion, but it could be worth more than Rs. 95 billion in 4 years. Although the nutraceuticals industry is at an initial stage in India, tremendous growth has been observed during recent years driven by the functional food and dietary supplement categories. The swift annual growth has been noted in dietary supplements (19.5%) and herbal products (11.6%). Nearly 66% of Americans and 47% of Japanese consume at least one type of nutraceutical annually, spending US $86 and 60 billion, respectively (Lockwood, 2007).

      1.5. Commonly Used Nutraceuticals

      Commonly used nutraceuticals along with dietary sources, extraction and manufacturing procedures, and analytical techniques used for their isolation are given in Table 1.2.

      Table 1.2

      Commonly used nutraceuticals, their sources, and possible extraction techniques.

      Adapted from Lockwood, B., 2007. Nutraceuticals: A Guide for Healthcare Professionals, second ed. Pharmaceutical Press, London, UK.

      1.6. Mechanism of Action

      Nutraceuticals follow the same mechanism of action as pharmaceuticals. These are available in forms, such as pills, capsules, and powders. After ingestion, active components are released in the body to perform their actions (Fig. 1.1).

      Figure 1.1   The Mechanism of Action for Nutraceuticals.

      The way by which nutraceuticals downregulate or upregulate any process in the body—by effecting certain enzymes, receptors, hormones, or genes—varies by the type, dose, and need for the nutraceutical in the body.

      2. Natural, Nutraceuticals, and Pharmaceuticals

      The common concept of the medical and pharmaceutical approaches to health involves looking for something that is required by the body to function properly. If the body is unable to produce something required for proper functioning, the normal metabolic process will be adversely affected. This something that is lacking in the body can be mimicked by certain chemicals manufactured in the laboratory and given to the patient. The chemical pathway previously disturbed due to lack of that specific component restores its function, and symptoms of deficiency and insufficiency of that particular component disappear. Drugs work by mimicking the action of natural substances normally present in the body. Sometimes these chemicals can also cause undesirable effects that are called side effects. Many of these foreign chemicals cannot be broken down and metabolized in a proper way and recycled, so these disturb biochemical pathways and cause toxic side effects.

      The process used for the manufacturing of nutraceuticals is somewhat similar to that of pharmaceuticals, in a laboratory and factory setting. Additionally, their mode of delivery and ingestion is also the same as both are taken orally in form of pills and tablets. The main difference is that most nutraceuticals are prepared to fulfill the requirement of a particular chemical by extracting it from the already existing natural substances or dietary sources, while drugs can be synthetic. The aim behind the use of these dietary supplements and nutraceuticals is to produce the same effect as drugs without any undesirable side effects. Major examples of nutraceuticals include melatonin, pregnenalone, lutein, hyaluronic acid, l-cartinine, coenzyme Q10, and creatine. If a high dose of only a single chemical is taken, after utilization in the biological pathways, this can cause deficiency of other chemicals in the body. Sometimes nutraceuticals are also synthesized in laboratories and are not the same as those present in natural sources. In many cases, people have reported no or negligible improvements in their health status after taking synthetic vitamins even with the same dose level as natural or food-based supplements. Furthermore, some studies have shown further deteriorations in health due to side effects associated with the consumption of synthetic supplements.

      Sometimes diet-based approaches are adopted for improved health and wellness. If anything in the body is not working properly or there is something within the body that is not produced properly, this might be corrected through a food regimen or supplied through dietary supplements. The natural way is to make a diet plan that can provide nutrition on one hand and the extra nutrients to fulfill the deficiency on the other. Pharmaceutical and nutraceutical approaches are not really appreciated by health professionals because these strategies are oriented to remove symptoms instead of correcting the reason for the malfunction. Sometimes sufferers take complete meals and supplements with a pharmaceutical- or nutraceutical-based approach. The proper way to optimum health is the use of whole foods as a first strategy to meet the needs of missing elements, followed by the use of food supplements and nutraceuticals, whereas pharmaceuticals should be used as a last alternative (Murdock, 2010).

      3. Nutraceuticals: Myths Versus Realities

      Currently, the scientific community is investigating the role of nutraceuticals in human nutrition, mainly focusing on functions that have a lot of scope and wide range of applications among consumers, health-care practitioners, food law regulators, food producers, and distributors. Presently nutraceuticals are known to be necessary for optimal health, and the trend of using them without proper knowledge has increased in recent years. These products are thought to be as good as a balanced diet and even are replacing regular dietary products. However, lack of information about nutraceuticals creates a lot of uncertainty, apathy, and confusion among users. Numerous companies are producing nutraceuticals and playing with the health of millions of people who blindly believe in them. Many brands are producing synthetic products made from oxide minerals and other chemical substances that also accompany harmful substances, including preservatives, fillers, binders, coal tar, bitumen, gelatin, and waste products. There is concern about the effective utilization of these products by the human body as they may get lodged in body tissues, causing diseases or exacerbating existing ailments. In this context, commonly spread myths about the use of nutraceuticals and the facts based on scientific research are discussed below.

      3.1. Role of Nutraceuticals in the Prevention and Treatment of Health Disorders

      Nutraceuticals and dietary bioactive components are actually not medications, however, these are used to fill a nutritional gap in a balanced diet. These are helpful to fulfill daily nutritional needs that are difficult to meet with food alone, as in some physiological conditions the need for certain nutrients increases beyond normal limits. For example, before conceiving and during pregnancy the need for folate is increased to a great extent that cannot be met with diet alone, so it is supplied in the form of supplements. Likewise, Vitamin D supplements are used to meet the daily needs of individuals. In old age, calcium intake is suggested to prevent bone weakness and antioxidants to prevent aging marks on the skin. Supplements may have a role in preventing disease and promoting good health, but these don’t have any role in the treatment of diseases. Therefore, the claim that supplements and nutraceuticals can treat such health disorders is completely false. There is a need to create awareness and educate the public about the proper use of supplements for real purposes. This can be achieved through awareness campaigns, public seminars, and print and electronic media without the influence of marketing agencies and manufacturing companies (Isidoro et al., 2016; Nikolić and Marković, 2015).

      3.2. Supplements Can Correct Flaws in Diet

      There is always an ambiguity in the minds of consumers that if they fail to maintain a balanced diet, then supplements and nutraceutical extracts can help them. Supplements are not the alternative to a healthy, well-balanced diet. If someone is dieting, or avoiding animal or milk products or any other food group, it will become challenging to get all desired nutrients. Globally a massive number of individuals are taking vitamin supplements as insurance for better nutrition to balance their diets. According to researchers, multivitamins don’t have the same role in the human body as claimed by the manufacturers. Dietary supplements may contain some micronutrients in higher amounts than recommended in dietary guidelines. In some cases, these high levels may result in risky intakes. The results of a research trial conducted involving 161,808 postmenopausal women under the Women’s Health Initiative in 2009 were quite astonishing. The results showed that there was no reduction in death rate of women who were taking supplements as compared to control group. Furthermore, women taking the supplement were more prone to cardiovascular diseases or cancers of the lungs, breast, colon, endometrium, and rectum. The use of vitamin C, E, B6, B12, and folic acid did not seem to have any protective effect against cardiovascular diseases or cancer. In 2006, the US National Institutes of Health made a statement about lack of evidence for the recommended doses of multivitamins. In 2008, a Cochrane Collaboration review found that people in clinical trials who took supplementation of vitamin E, vitamin A, and beta-carotene had a higher death rate (Harvard Health Publication, 2009).

      Supplements can be taken as an addition to a regular diet. When healthy adults who are getting most of their nutrients from a regular diet also start taking supplements, the risks of toxicity may increase. For example, too much vitamin A intake can increase the risk of osteoporosis; too much vitamin E can raise the risk of suffering from a stroke, and excessive iron can elevate risks of heart diseases. Excess amounts of some nutrients are stored in body fat and are not excreted, and these may become toxic after accumulating in the body. There is no need for multivitamins or individual supplements if the consumer is already taking plenty of fruits and vegetables and also consuming fortified cereal, juice, and yogurt or milk, which are essential components of a balanced diet. Even if the supplements are taken properly, these cannot provide all the benefits of normal healthy eating because consumption of fruits and vegetables also delivers many phytonutrients that have potential health benefits. According to researchers, about a million phytonutrients cannot be obtained merely using supplements rather than consuming natural foods and a balanced diet. These nutrients are available in antioxidant-rich foods, which not only support the immune system but also improve coordination between the cells.

      3.3. All the Supplements Labeled All Natural are all Good

      All natural does not mean that the supplement is 100% free from synthetic chemicals used during extraction and processing of nutraceuticals. These components can become part of the extracted substance. Likewise, the process of tablet or capsule manufacturing further contributes harmful substances in the final formulations. If a dietary supplement is made synthetically or has a mixture of natural and synthetic constituents, it will give some relief when consumed for the first time, but this relief will subsequently disappear and symptoms will reappear. The body recognized these vitamins as foreign agents (toxins) and the immune system starts to work in order to remove them from the body. The removal in most of the cases is via urinary excretion as the human system attempts to get rid of the major quantity of these foreign chemicals. Research has shown that vitamin B1, as synthetic thiamine (thiamine HCl) reduced fatigue initially but after the use of few days caused fatigue in the body by building up pyruvic acid. This can lead to a vicious cycle of belief that the body needs more thiamine that increases fatigue instead of reducing it. Vitamins present in natural dietary sources are enzymatically alive while synthetic ones are actually dead chemicals. According to a scientific study conducted on 30,000 Finnish subjects, consumption of synthetic vitamin A did not exhibit any antioxidant activity. A true antioxidant has a protective effect for the muscles of heart, the lungs, and internal arterial surfaces. In this experiment, the human subjects given synthetic beta-carotene had 8% higher numbers of fatal heart attacks, strokes, and lung cancer than those who received the placebo (sugar pills). It was noted that synthetic vitamin A did not impart any biological activity in tissues. Instead the synthetic vitamin further stressed the immune system in efforts to rid it from the body through the liver and kidneys. Hence synthetic supplements and vitamins are considered bad due to following reasons:

      • These are made from oxide minerals and other harmful substances.

      • These also include preservatives, binders, fillers, and other waste products that are considered harmful, as well as toxic.

      • These are not easily digested by the body and so cannot be used appropriately.

      • These are nonorganic in nature so are not digestible; any substance that is taken must be organic in nature so the body can break it down with higher efficiency in order to absorb its nutrients.

      • These are manufactured by pharmaceutical companies and then sold to subsidiary health companies.

      3.4. When a Nutrient is Introduced in Market, Stock it up

      Supplements are freely available over the counter, so the general public is not necessarily aware of the sensitivity of their use. They should be aware of how vitamins or nutrients are advertised. Before starting the use of bioactive components that have many health claims that attract attention, the consumer should consult a doctor or dietician about the authenticity of the product. Likewise, more care should be taken to start a supplement if someone is suffering from disease where a higher dose could have bad effect on health. For example, people who are taking blood thinners or aspirin should be careful about using vitamin E and omega-3 supplements as these could further limit the ability of blood to clot and increase risk of bleeding. Ingesting these nutrients in whole foods is not harmful, but care must be taken to use supplement because a supplement could lead to excess.

      It is also advised to know which nutrients are already present in the diet and which should be taken in supplemental forms. If a balanced diet is providing all the required nutrients in appropriate amounts, use of supplements may harm your body in the long run. In a study, high levels of serum retinol were associated with high risk of prostate cancer. Conversely, other reports on nutraceuticals give conflicting results showing the beneficial effect of nutraceuticals in certain cases, such as improvement of endothelial vasodilation and rheumatoid arthritis and in LDL reduction. These confronting results of different studies create ambiguity in the minds of consumers about the use, side effects, and limitations of nutraceuticals that highlight the need for more refined and accurate scientific evidence for the use of nutraceuticals. Various areas are understudied, such as bioavailability, bioactivity of metabolites, safe dosages, dose response and toxicity of various bioactive compounds, and interaction of nutraceuticals with pharmaceuticals or between different nutraceuticals when taken together. Substances used as ingredients in the production of nutraceuticals may have quality and safety issues related to toxicity. Moreover, many nutraceuticals are not patented and thus are easily produced and supplied to the market, and so legislation is necessary to control the production and marketing of these nutraceuticals to avoid adverse effects associated with their use (De Silva and Lanerolle, 2011).

      3.5. Nutraceuticals are as Good for Health as Diet

      Nutraceuticals that are marketed to consumers often hold many functional and health claims. Bioactive substances including leucopene, phytosterols, omega-3 fatty acids, and flavonoids are claimed to be linked with the reduction of risk factors of cardiac diseases by reducing hypercholesterolemia and hypertension and decreasing free radicals or platelet-dependent thrombotic activity. Some are claimed to be responsible for anticarcinogenic activity with augmentations of microsomal detoxification systems and antioxidant defense. Scientific studies support that ingestion of bioactive compounds in the form of whole foods has significant benefits, including the protective effects of the Mediterranean diet and fish consumption in relation to reduced risks of cardiovascular diseases. In contrast, health claims attributable to most isolated biologically active ingredients when ingested, as nutraceuticals have not been supported in studies. A balanced diet has some additional health benefits and is more preventive as compared to isolated supplements because it is not the single component that has a role but different components in combination. For example, iron deficiency can be due to lack of iron or may be due to lack of vitamin C that is required for iron absorption. A diet source may contain both vitamin C and iron at the same time, but a supplement is only a salt of iron; hence, in that case the dietary source definitely gives better results (Espín et al., 2007).

      3.6. In Vitro and In Vivo Studies are Enough to Believe Health Benefits of Certain Nutrients

      The bioavailability, mechanism of action of the isolated bioactive components, and health claims about nutraceuticals are most often not supported by scientific evidence. The most common claim about these products is the antioxidant activity of these compounds, which is mostly studied in in vitro trials without studying the antioxidant capacity of these products in human trials. Intake, metabolism, bioavailability, and distribution in various tissues of these polyphenols are important factors that must be established in connection to the biological effects of these nutraceuticals. Species like fish, yeast, mice, and flies have many genes that are identical to human genes, so these animals are considered model organisms and are generally used in research to study human genes and various human diseases. Research on rats has led to key advances in our ability to treat serious diseases and ailments prevalent in humans. For example, an experiment on mice resulted in successful treatments for acute promyelocyticleukaemia, or APL, which is a form of cancer that was previously largely not curable.

      Thus, as mostly animal and in vitro studies are done, the claims and expected results in humans from intake of these products may differ from expected outcomes. In this context, clinical trials are emphasized to get more accurate results. The bioactive compound resveratrol, derived from grapes, is a good example in this regard. Human trials failed to prove the chemopreventive properties of this compound reported in various animal trials. Even megadoses of resveratrol were unsatisfactory to elicit systemic levels sufficient for chemopreventive efficacy in cancer patients. Another example is corticosteroids that are teratogenic in animals but not in humans, or thalidomide, which is not a teratogen in various animal species but is teratogenic in humans. One reason why animal experiments mostly do not replicate in human trials is that the animal assays are poorly planned, conducted, and analyzed. Another viable reason for this failure to copy the outcome of animal research in humans is that reviews and summaries of proof from animal research are insufficient.

      Nutraceuticals are a very common example of innovation in biotechnological products with disproportionate and insufficient development of quality scientific evidence to back or counter their validity. But nutraceuticals may well have potential in the future if backed by solid verification and validation, especially for use under special conditions. Given the consumer market appeal of nutraceuticals, ample legislative safeguards are essential. Until further evidence can be found, health professionals must be alert to the possibility of opposed results of nutraceuticals, unsafe interactions with different medicines, and dietary imbalances because of overuse (Bracken, 2009; Vandamme, 2014). All these aforementioned myths are common among consumers, and we have discussed these examples to illustrate the nature of claims and the reality of the marketed products (Jafari, 2016).

      3.6.1. Anthocyanins

      Numerous scientific analyses have shown many health benefits associated with anthocyanins and anthocyanin-containing berries mainly due to their antioxidant capacity, monitored in in vitro studies and animal assays but not in human experimental studies. The isolated anthocyanin extracts or the berries have a large number of health benefits in relation to various medical conditions including improvement of visual capacity, reduction of obesity, improvement of brain and cognitive function, and cancer and cardiovascular risk prevention. Berries and anthocyanins derived from berries have a lot of health-protecting benefits that are used as attractive fantasy to grab the attention of consumer by exaggerating the benefits during marketing and advertisement. The information about the composition and health claims of these nutraceuticals are provided mostly through Internet sources. The main dietary origin of nutraceuticals of this type is single-berry extract such as bilberry and wild blueberry, or a blend of more than two berries, such as blueberry, wild bilberry, elderberry, cranberry, strawberry, and raspberry extracts. On the label of these nutraceuticals the total amount of a specific compound is present as a milligram or percent value. In these tablets some other compounds are also present in a large amount and sometimes even more than the active compound, which is somehow misleading for the customer about the composition of the product. For example, nonspecified polyphenols can comprise up to 70% of the total composition of final products, but in the rare cases that marketers include the amount of these nonspecified polyphenols on labels, this ultimately misleads the customer. Also the dosage mentioned on the label of a tablet is not standardized and experimentally established but suggested on the basis of general observations and human need of antioxidants. Antioxidant capacity, which is a very important property of any nutraceutical, is also mentioned on the label but its validity is far less than reality because it is estimated from animal assays and in vitro antioxidant capacity by ORAC assays, which is different from the antioxidant potential in human body. Additionally, wellness claims linked with berry nutraceuticals include maintaining healthy blood glucose stages and decreasing the chance of cancers. Labeling makes clear that none

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