Nutraceutical and diseases

This presentation speaks about nutraceutical and their use in disease management

1. Nutraceutical and diseases By, Ayeeshya Kolhar PH.D. (Hort.) Post harvest technology 1

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8. It increase the health value of our diet. • It help us live longer. • It help us to avoid particular medical conditions. • It has a psychological benefit from doing something for oneself. • It is perceived to be more "natural" than traditional medicine and less likely to produce unpleasant side-effects. • May present food for populations with special needs (e.g. nutrient-dense foods for the elderly) Benefits 8

9. Fig.1 Therapeutic areas covered by nutraceutical products 9

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14. 14 Classification based on their use in disease control Sl.no Condition Nutraceuticals 1. Allergy relief Ginkgo Biloba 2. Arthritis support Glucosamine 3. Cancer prevention Flax Seeds ,Green Tea 4 Cholesterol lowering Garlic 5 Digestive support Digestive Enzymes 6 Diabetic support Garlic,monordica 7 Immunomodulator Ginseng 8 Prostate support Tomato Lycopenes

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32. Persons consuming generous amounts of dietary fibre , compared to those who have minimal fibre intake, are having low risk of CHR stroke hypertension diabetes obesity and certain gastrointestinal disorders. Increase in the intake of high fibre food improves serum lipoprotein values ,lowers blood pressure level, improves blood glucose control for diabetes, aids weight loss and promotes regularity. 32

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34. Nutraceuticals in cancer treatment The leading cause for death of adult is cancer. Treatment of cancer involves expensive and traumatic use of drugs, surgery and irradiation. Nutraceuticals have the ability to control and regulate the DNA damaging factors in cancer cells and DNA transcription in tumours . They possess numerous therapeutic benefits like anti-obesity, immunity enhancement, natural antioxidant, cardiovascular, Antidiabetic , and anti-inflammatory effects. The herbal-based dietary supplements (or Nutraceuticals) known to antagonize therapy. The research says that phytochemical are proven to be the potential to interfere even with the late-stage cancer and altering the metastatic spread of cancer 34

35. There has been vast growth in the Nutraceutical industries to yield large number of phytochemicals containing Nutraceuticals with diverse composition and health claim due to increased application of phytochemicals in cancer care. Numerous Nutraceuticals have shown to regulate specific tumour suppressor genes and cancer driving genes. By utilizing a daily diet of Nutraceuticals specific to the entire possible gene combinations found in your particular form of cancer we can inhibit the over-expressed oncogenes unique to that form of cancer. There are many cellular mediators involved to be manipulated from initial development of a single cell, to invasion, angiogenesis, proliferation and metastasis. 35

36. 1) Pleiotropic activity 2) Target Classical signaling Pathways (NF-kappa B, EGFR, AKT, etc .) 3 ) Sensitize tumour cells to chemo/radio- therapy 4 ) Generally well tolerated 5 ) Parent structure usable for design of novel synthetic analogues for improving efficacy Challenges of Nutraceuticals in cancer research: 1) Bioavailability: metabolized effectively, high systemic concentrations difficult to achieve 2) Insufficient pre-clinical data to advance combinational multi-agent therapy in clinical setting 3) Lower priority by pharmaceutical industry as they may not be patented Promises of Nutraceuticals in cancer research: 36

37. Table 1. Nutraceuticals which as widely used in cancer therapy Bioactive compound Source Mechanism Eugenol Cloves Inhibition of cell proliferation Inhibition of cell proliferation Diosgenin Fenugreek Supresses proliferation of cancerous cells and inhibits NFκβ activity Piperine Pepper Inhibition of cell proliferation Allicin Garlic Induces apoptosis Beta-carotene, lycopene Tomatoes Induces apoptosis Quercetin Black tea Induces apoptosis 6-gingerol Ginger Acts as anti-inflammatory and as 5-HT3 receptor antagonist Limonene Citrus oils from orange, lemon, mandarin, lime, and Grapefruit Has inhibitory effect on cell migration on cancerous cell 37

38. Nutraceuticals as antioxidants Antioxidants are the substances that act on free radicals or their actions. It has been proven that higher intake of foods/ compounds with antioxidant can reduce various human mortalities. Some compounds that possess antioxidant activities are onion, garlic, turmeric, basil, etc. Antioxidants (nutraceuticals) play a major role in neurodegenerative diseases like Parkinson’s disease, Alzheimer’s disease , etc. Major components that possess antioxidant activities are flavonoid polyphenols - green tea, apples, non- flavonoid polyphenols - turmeric, grapes, phenolic acids or phenolic diterpenes - rosemary, organ sulfur compounds- broccoli, garlic, etc. They act by directly scavenging free radicals or increasing endogenous cellular antioxidant defenses. They act on ROS and RNS. It also prevents the formation of oxidized LDL. Newer approaches include gene therapy that will produce more antioxidant in body and use of functional foods and novel biomolecules . 38

39. In current scenario, there are increased cases of age related degenerative diseases and people are keener to shift towards better quality of life. Hence, the combination of cosmetics and food supplements is a new approach used to provide skin care treatment. It was assumed by Denham Harman in 1950s that aging is a consequence of excessive production of free radicals. This results to cause damage to human body and even oxidative damage to DNA. Nutraceuticals useful as anti-aging acts similar as antioxidants. They also affect the processes that stimulate the production of reactive species; ROS, RON, etc. Right selection of nutrients plays a vital role in the treatment of various diseases which can be achieved by proper diet containing intake of food supplements rich in vitamin E, folic acid, vitamin B12, iron, etc. main food sources includes egg yolk, green leafed vegetables, beans, nuts, etc Nutraceuticals as anti-aging 39

40. Obesity is a common chronic disease and a major underline reason for metabolic syndrome which arises when there is an imbalance between energy intake and energy expenditure. Some components widely used as nutraceuticals in obesity are curcumin , bottle guard, black gram, green tea, etc. They secrete leptin and other cytokines like IL-1, IL-6 that are critically involved in obesity and chronic inflammation. They also help in reducing LDL and total cholesterol. Some act by limiting overall food daily intake. Nutraceuticals have ability to affect weight loss and have huge potential to reverse the development of overweight and obesity-related comorbidities . Nutraceuticals as anti-obesity 40

41. Diabetes is a metabolic syndrome where a person suffers from high blood glucose. It is caused due to lack of insulin production or the body cells do not respond properly to insulin or both. Some nutraceuticals used to treat and prevent diabetes are Emblica officinalis , fenugreek, green tea, etc. It also includes anti-oxidant vitamins like vitamin C and E and minerals like magnesium and chromium. They generally act by affecting insulin sensitivity and also prevent insulin resistance. Some act by increasing hepatic glycogen concentration and decreasing the concentration of glycogen phosphorylase and glyconeogenic enzymes Nutraceuticals as anti-diabetic 41

42. Cardiovascular diseases The incidence of chronic diseases like cardiovascular diseases, cancers, diabetes and obesity is rapidly increasing. Cardiovascular diseases (CVD) refers to group of disorders of the heart and blood vessels and include hypertension (high blood pressure), coronary heart disease (heart attack), cerebro vascular disease (stroke), heart failure, peripheral vascular disease , etc. Majority of the CVD are preventable and controllable. It was reported that low intake of fruits and vegetables is associated with a high mortality in cardiovascular disease. Diet rich in fruits and vegetables prevents CVD. 42

43. Nutraceuticals in the form of antioxidants, dietary fibers, omega-3 polyunsaturated fatty acids, vitamins, and minerals are recommended together with physical exercise for prevention and treatment of CVD. The polyphenols present in grapes and in wine alter cellular metabolism and signalling , which is consistent with reducing arterial disease . Flavonoids are widely distributed in onion, endives, cruciferous vegetables, black grapes, red wine, grapefruits, apples, cherries and berries. Flavanoids in plants available as flavones (containing the flavonoid apigenin found in chamomile); flavanones (hesperidins - citrus fruits; silybin - milk thistle flavonols ( tea:quercetin , kaempferol and rutin grapefruit; rutin buckwheat; ginkgo flavon glycosides -ginkgo) play a major role in curing the cardiovascular diseases . 43

44. Flavonoids block the angiotensin -converting enzyme (ACE) that raises blood pressure; by blocking the "suicide" enzyme cyclo oxygenase that breaks down prosta glandins , they prevent platelet stickiness and hence platelet aggregation. Flavonoids also protect the vascular system and strengthen the tiny capillaries that carry oxygen and essential nutrients to all cells. Flavonoids block the enzymes that produce estrogens, thus reducing the risk of estrogens induced cancers. 44

45. Parkinson's disease Parkinson’s disease is a brain disorder that results from nerve damage in certain regions of the brain causing muscle rigidity, shaking, and difficult walking usually occurring in mid to late adult life. Creatine appeared to modify Parkinson’s disease features as measured by a decline in the clinical signs. Glutathione to determine its effect on nerve and its power as an antioxidant. Nutritional supplements have shown some promising results in preliminary studies, it is important to remember that there is not sufficient scientific data to recommend them for Parkinson's disease at present. 45

46. Diabetes Diabetes mellitus is characterized by abnormally high levels of blood glucose, either due to insufficient insulin production, or due to its ineffectiveness. The most common forms of diabetes are type 1diabetes (5%), an autoimmune disorder, and type 2 diabetes (95%), which is associated with obesity. Lipoic acid is a universal antioxidant, for the treatment of diabetic neuropathy. It is possible that lipoic acid may be more effective as a long-term dietary supplement aimed at the prophylactic protection of diabetics from complications. Dietary fibers from psyllium have been used extensively both as pharmacological supplements, food ingredients, in processed food to aid weight reduction, for glucose control in diabetic patients and to reduce lipid levels in hyperlipidemia extracts of bitter melon and of cinnamon have the potential to treat and possibly prevent diabetes. However it has been suggested that Nutraceuticals with meaningful doses of combinations may substantially prevent and presumably could be marketed legally 46

47. Osteoarthritis (OA), a debilitating joint disorder . Joint discomfort from OA and other joint disorders may reduce physical activity in individuals experiencing this condition, resulting in energy imbalance and weight gain. Increased weight can exacerbate existing problems, through additional stress on joints. Glucosamine (GLN) and chondroitin sulfate (CS) are widely used to alleviate symptoms of OA. These nutraceuticals have both nutrient and pharmaceutical properties and seem to regulate gene expression thus providing a plausible explanation for their anti inflammatory activities. Osteoarthritis 47

48. Table 2. Various nutraceuticals used against different diseases. 48

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50. 50 Not subjected to same testing and regulations as pharmaceuticals Majority not regulated by FDA in USA Companies creating unregulated products to create a wide profit margin Bioavailability of nutrients is lower No regulatory definition Disadvantages

51. CONCLUSION Nutraceuticals have been emerged as an alternative to modern medicines and have proven health benefits. Most dietary supplements are derived from plants and some from animals. Nutraceuticals has disease prevention capability with good nutritional value and food ingredients with additional health benefits. They are widely accepted by all age groups due to their higher quality, purity, safety and efficacy, promoting health and help to cure diseases. The latest trend is moved towards nutragenomics and nutraceuticals has led to new era of medicine and health. 51