presentation on nutraceuticals in health care

nutraceuticals

1. Nutraceuticals in health care Presenter-Dr Rajesh Nandi Moderator-Dr Mamta Facilitator-Dr Subham

2. Plan of presentation Introduction Classification Functional foods Dietary supplements Nutraceuticals in different disease Indian scenario Market cap Regulations

3. The term “Nutraceutical” was coined in 1989 by Dr. Stephen De Felice , MD, Founder and Chairman of the Foundation for Innovation in Medicine (FIM). Nonprofit organization established in 1976,also a medical research community Source:FIM is the leading advocate for encouraging natural substance medical research. [Internet]. fimdefelice.org. Available from: https://fimdefelice.org/ ‌

4. Introduction Nutraceutical”- combination of “nutrition” + “pharmaceutical” Definition - A food or part of food , that provides health benefits, including the prevention and treatment of a disease. By Dr. Stephen De Felice Source :-Singh J, Sinha S. Classification, regulatory acts and applications of nutraceuticals for health. International Journal of Pharma and Bio Sciences. 2012;2(1):177-87.

5. According to the Food Safety and Standards Authority of India (FSSAI), “a nutraceutical is a food product that provides physiological benefit and helps maintain good health”. ( FSSAI guidance and notification on nutraceuticals -An insight [Internet]. Available from: https://fssai.gov.in/upload/media/FSSAI_News_Guidance_FNB_09_06_2020.pdf) Example-Spirulina, omega-3 fatty acid

6. Why to study nutraceutical? Emerging science Healthful impact in our lives(Aid in improving health and prevention of multiple diseases) Combines the knowledge of nutrition and pharmacy

7. Nutraceuticals contribute to maintain a healthy life Food which Provides health benefits to reduce the risk of various diseases Food derivatives containing extracts from food stuff which have proven medicinal or nutritional benefits Presumably safe

8. Classification Traditional Chemical constituents- Nutrients Herbals Phytochemicals Nutraceutical enzymes Probiotics and pre-biotics Non Traditional – Fortified nutraceutical Recombinant nutraceutical Singh J, Sinha S. Classification, regulatory acts and applications of nutraceuticals for health. International Journal of Pharma and Bio Sciences. 2012;2(1):177-87.

9. Traditional Traditional nutraceuticals are simply natural compounds. Food contains several natural compounds that deliver benefits beyond basic nutrition. Such as lycopene in tomatoes, omega-3 fatty acids in salmon

10. I. Chemical Constituents Nutrients : They include substances such as vitamins, minerals, amino acids and fatty acids with established nutritional functions. Example: Most vegetables, wholegrain cereals, dairy products, fruits and animal products such as egg contains vitamins and minerals which helps to cure many diseases. Ex- Vit D and calcium osteoporosis, omega-3 in cholesterol reduction . Herbals : Herbal nutraceutical contain some bio active compounds in addition to vitamins and minerals . Ex- peppermint contains menthol as an active component helps to cure cold and flu .

11. Herbs Bio active compounds Health benefits Ginger Gingerols Antibacterial & anti inflammatory Garlic Alliin and allicin Antibacterial ,anti inflammatory & antihyperlipidemic Onion Alliin and allicin Antibacterial ,anti inflammatory, antihyperlipidemic Aloe vera Aloins and aloesin Anti inflammatory, emollient

12. Herbs Bio active compounds Health benefits Turmeric Curcumin Anti septic, Anti cancer & anti inflammatory Ginseng(ashwagandha) Ginsenosides Immunomodulatory, Anti inflammatory, Blood sugar control Ginkgo biloba Ginkgolide and bilobalide Anti oxidant & memory enhancer

13. c) Phytochemicals - Phytochemicals are naturally occurring plant based chemicals which are rich in biologically active compounds that provide health benefits. They have antioxidant ,anti-estrogenic ,anti-inflammatory immunomodulatory and anticarcinogenic characteristics. Majority of our foods such as whole grains beans fruits vegetables and herbs content phytochemicals.

14. Phytochemicals Function Sources Allyl sulfides Stimulate enzymes that help eliminate toxic compounds Onions ,spring onions Isothiocyanates Increase activity of Enzymes that help to detoxify carcinogens Cruciferous vegetables, broccoli cauliflower, cabbage Etc. Indoles Interfere with estrogen metabolism and therefore could reduce risk of estrogen related cancer Cruciferous vegetables, broccoli cauliflower, cabbage Etc. Isoflavones Anti inflammatory antineoplastic properties Soy foods ( soyabeans, tofu, soya milk, soya oil)

15. Phytochemicals Function Sources Flavonoids Antioxidant , anti-cancerous, anti inflammatory properties , anti atherosclerotic properties Citrus fruits, Green tea, grapefruit cruciferous vegetables ,red wine apples ,cherries, berries, tomato Carotenoids Beta carotene Lycopene Lutein Anti oxidant, anti carcinogenic Anti oxidant, anti carcinogenic Anti oxidant ( specifically prevents macular degeneration), anti carcinogenic Carrot, mango, pumpkin, green leafy vegetables etc. Tomato, papaya , peach, cranberries Carrots, bell pepper, corn, spinach

16. II Probiotic microorganisms Living microorganisms which provide health benefit in the host Promote healthy digestion and absorption of some nutrients Destroy other pathogenic bacteria and viruses Nutraceutical benefits include enhancing bowel function, prevention of colon cancer, reducing gut inflammation , Probiotics can cure lactose intolerance by the production of the specific enzyme (ß-galactosidase) that can hydrolyze the offending lactose into its component sugars Ex- Bifidobacterium lactis, Bifidobacterium longum, Bifidobacterium infantis , Lactobacilli, Lactococcus , streptococcus thermophilis etc.

17. III Nutraceutical enzymes Medical conditions such as digestive problems and Inflammatory disorders have their symptoms relieved by enzyme supplements in the diet. These enzymes are derived from microbial , plant and animal sources. Enzymes Source Function Bromelein Biodiastase Pineapple Soyabean Anti inflammatory Anti inflammatory Alpha amylase Beta galactosidase Saliva Bacteria Aid in digestion Lactose intolerance

18. Nontraditional nutraceuticals These are artificial foods developed via biotechnology. The bioactive compounds in foods are engineered to produce products for human wellness. Fortified nutraceuticals Food products that are obtained by adding nutrients or ingredients e.g. orange juice fortified with calcium, cereals with added vitamins or minerals and flour with added folic acid.

19. b)Recombinant nutraceuticals Produced with the help of biotechnology. Energy-providing foods, such as bread, alcohol, fermented starch, yogurt, cheese. Enzyme Product Saccharomyces cerevisae ( yeast) Alcohol P. Roqueforti (fungus) Roquefort cheese

20. Functional Foods Functional foods are foods that exerts health properties beyond the traditional nutrition value. Contain bio active compounds that have positive health benefit If the functional food helps in the prevention of a disease or its treatment it can be called ‘nutraceutical’. Types of Functional foods Foods that naturally contain biologically active, non-nutrient compounds known as phytochemicals that provide health benefits. All plant foods are rich in phytochemicals. Food products specifically formulated to have higher amounts of nutrients than would naturally occur in that food. These are also called “designer foods or techno foods”.

21. Example : Cereals and bread with added isoflavones. Margarine with added phytosterols, which help to reduce cholesterol Advantages: Some functional foods make it easier to meet requirements for nutrients that are often deficient in the diets . e.g. addition of calcium to orange juice ,addition of Vitamin D to milk . Some manufactured functional foods make it possible to achieve higher intakes of nutrients than with natural food sources of these compounds.(iron fortified cereals)

22. Disadvantages Functional foods can be confusing sometimes because people have to plan helpful diet according to the ingredients present in the functional food . They don’t offer any extra benefits over well planned diet based on whole grains fruits and vegetables . Manufactured functional foods cost more than naturally occurring ones. Therefore , the best approach to dietary planning is to use functional foods in moderation in addition to a healthful diet.

23. Dietary supplement Dietary supplement is a product that contains nutrient derived from food products that are concentrated in a liquid or a capsule form intended to provide nutrients that are missing or not sufficient in quantity in a person’s diet. It generally contains vitamins, minerals, amino acids. For example in vegetarian their diet lacks vitamin B-12 so supplement is useful for vegetarians. Dietary supplements are also used to increase the performance of athletes and sports players.( creatine, caffeine, fish oil)

24. Nutraceuticals in CVD Compounds Functions Allin and allicin Anti hyperlipidemic (↓cholesterol synthesis and ↑excretion in faeces)& Anti hypertensive property Omega 3 fatty acids Anti atherogenic and increase electrical stability of heart Iso flavones Anti hyperlipidemic (inhibit cholesterol absorption upregulation of LDL receptor), anti oxidant Proteins Natural ACE inhibitors are found in casein and whey protein Vitamins Anti hyperlipidemic ( by decreasing oxidation of LDL) Phytosterols Anti hyperlipidemic (increased VLDL uptake by liver and reduce cholesterol absorption)

25. Nutraceuticals in Cancer and chemotherapy Compounds Functions Curcumin Suppress angiogenesis, metastasis and proliferation Silibinin Suppress cell proliferation, induce apoptosis and chemo sensitization Iso flavones Inhibit cell proliferation and promote apoptosis ,Up regulation of Bax

26. Target cancer Compounds /Food sources Functions Breast Resveratrol (grapes) Soy foods Vitamin A Garlic Apoptosis Anti angiogenic & apoptosis Anti proliferative & apoptosis Apoptosis Lung Flavonoids Soy foods Grape seeds Anti proliferative Apoptosis & Anti angiogenic Apoptosis Prostrate Luteolin ( fruits and vegetables) Berberine( secondary metabolite in plants) Gallic acid(secondary metabolite in plants) Apoptosis Anti proliferative and apoptosis Anti proliferative and apoptosis

27. Nutraceuticals in Diabetes Compounds Functions Insoluble dietary fibers(whole grains , legumes, nuts, spinach, apple , okra, radish) Soluble dietary fibers(psyllium husk, fruits like apple ,peach, vegetable- cabbage, potato) ↓ Risk of diabetes ↑ Insulin sensitivity , ↓ rise of post prandial glucose Isoflavones ↓ Insulin resistance Alpha lipoic acid ↑ Insulin sensitivity Minerals – Chromium and magnesium ↑ Insulin sensitivity Vitamin D ↓ Risk of type of type-I Diabetes ↓ Insulin resistance in type II diabetes ↑ Insulin secretion in type II diabetes

28. Nutraceuticals in osteoarthritis Compounds Functions Anthocyanins ↓Pain and stiffness of joints Isoflavones ↓ Pain and stiffness of joints and ↓ dependency on NSAIDS for long term Collagen and chondroitin ↓stiffness of joints and ↑ function of joints Gingerols ↓Pain Omega 3 and hyaluronic acid ↓Pain and morning stiffness of joints , ↑ function of joints, ↓ analgesic use

29. Nutraceuticals in gut health Compounds Functions Anthocyanins Anti oxidant, immune modulation, stimulate beneficial bacteria Isoflavones Anti oxidant, immune modulation, stimulate beneficial bacteria Phytochemicals in Olive oil Anti proliferative and anti inflammatory(Prevent colon cancer, intestinal polyps) PUFA Anti oxidant and anti proliferative (Prevent colon cancer, intestinal polyps) Probiotics and pre biotics ↑ growth of beneficial bacteria ↓ pathogenic bacteria

30. India and nutraceuticals India is now one of the leading consumers of nutraceutical products after USA, Europe ,China and Japan Due to increase in life style related diseases ,preference of organic products , unhealthy food practices-leading to nutritional deficiencies Support from the ayurvedic community( promoted use of herbal products since ancient times) Indian population have started accepting nutraceutical products in large numbers Also Post covid awareness and increase in preventive prioritization has added to the consumption of nutraceutical products

31. Market cap of nutraceuticals Global market size in 2023 USD 317.22 billion in 2023 CAGR( compound annual growth rate) of 9.6%  USA, Japan and Europe hold 90% of the global market share Indian market stood at 11 billion USD in 2023 with 3.5% of market share Source https://www.foodprocessingindia.gov.in/newsletter/emailer/two

32. https://www.maximizemarketresearch.com/wp-content/uploads/2019/10/Nutraceutical-Market2.webp

33. Companies in Indian market with their products Product name Ingredient Category Company name Chyawanprash Amla ,ashwagandha Immune booster Dabur India ltd Calciriol D-3 Calcium and vitamins Calcium supplement Cadila healthcare GRD Protein vitamins minerals carbohydrates Nutritional supplement Zydus cadila Ltd Protein-x Predigestable proteins when vitamins minerals and carbohydrates Protein supplement Pfizer ltd

34. Regulated under The Prevention of food adulteration Act 1954 Regulatory authority FSSAI Under Chapter IV article 22 Regulates manufacturing ,labelling , packing, selling , importing and distribution of these products Graded punishment depending upon the severity of violation

35. Benefits of regulation Alignment with international regulations Science based standards Clarity and uniformity on noble food areas Help to curb corruption Minimize adverse effects Prevent adulteration Prevent overdosage

36. Key requirements for manufacturing of nutraceuticals FSSAI has standardized nutraceutical so they may contain only any of the ingredients as specified in schedule 1 to schedule 8 of the nutraceutical regulations. According to the Food Safety and Standards Authority of India (FSSAI), “a nutraceutical is a food product that provides physiological benefit and helps maintain good health”.

37. Schedule list Schedules Content Schedule I List of vitamins and minerals Schedule II List of amino acid and other nutrients Schedule III The values of vitamins and minerals that are allowed to be used Schedule IV List of plants or botanical ingredients

38. Schedule list Schedules Content Schedule V List of food additives for health supplements, nutraceuticals and food with added probiotics and prebiotics Schedules VI Ingredients as nutraceuticals Schedule VII list of strains as probiotics Schedule VIII list of prebiotic compounds

39. Labelling Labels should include the following information:- The Word “nutraceutical” The common name of the nutraceutical The amount of each nutraceutical ingredient An advisory warning for recommended usage An advisory warning NOT FOR MEDICINAL use prominently written An advisory warning in case where a danger may exist with excess consumption An advisory warning for known side effect or any contradictions or any product related drug interactions as and if applicable A statement that product is required to be stored out of reach of children

40. Prohibition on labeling claims must mentions nutraceutical products cure for disease claims for example- “Prevent bone fragility in postmenopausal women” which implies cure for disease claims through any pictures or symbols.

41. Penalty for non-compliance Particulars Penalty Penalty for substandard food Up to 5,00,000 INR Penalty for misbranded food Up to 3,00,000 INR Penalty for misleading advertisement 10,00,000 INR Penalty for food containing extraneous matter 1,00,000 INR Food quality not in compliance with the act 2,00,000 INR Compensation in case of injury 1,00,000 INR

42. References Saini A, Malik A, Kumar M, Bhatt S. Nutraceuticals are for healthy life. International Journal of Scientific & Technology Research. 2020;9(2):150-62. Gul K, Singh AK, Jabeen R. Nutraceuticals and functional foods: the foods for the future world. Critical reviews in food science and nutrition. 2016 Dec 9;56(16):2617-27. Singh J, Sinha S. Classification, regulatory acts and applications of nutraceuticals for health. International Journal of Pharma and Bio Sciences. 2012;2(1):177-87. Nwosu OK, Ubaoji KI. Nutraceuticals: history, classification and market demand. Functional Foods and Nutraceuticals: Bioactive Components, Formulations and Innovations. 2020:13-22. Association of American Feed Control Officials (AAFCO) (1996) The AAFCO official publication. Davì G, Santilli F, Patrono C. Nutraceuticals in diabetes and metabolic syndrome. Cardiovascular therapeutics. 2010 Aug;28(4):216-26.

43. FSSAI guidance and notification on nutraceuticals -An insight [Internet]. Available from: https://fssai.gov.in/upload/media/FSSAI_News_Guidance_FNB_09_06_2020.pdf Yashwant Vishnupant Pathak. Handbook of Nutraceuticals Volume I. CRC Press; 2009. ‌ Kumar K, Kumar S. Role of nutraceuticals in health and disease prevention: a review. South Asian J Food Technol Environ. 2015;1(2):116-21. Colletti A, Cicero AF. Nutraceutical approach to chronic osteoarthritis: from molecular research to clinical evidence. International journal of molecular sciences. 2021 Nov 29;22(23):12920. ‌ Oppedisano F, Bulotta RM, Maiuolo J, Gliozzi M, Musolino V, Carresi C, Ilari S, Serra M, Muscoli C, Gratteri S, Palma E. The Role of Nutraceuticals in Osteoarthritis Prevention and Treatment: Focus on n‐3 PUFAs. Oxidative Medicine and Cellular Longevity. 2021;2021(1):4878562. DeFelice SL. The nutraceutical revolution: its impact on food industry R&D. Trends in Food Science & Technology. 1995 Feb;6(2):59–61. Pandey P, Pal R, Koli M, Raj Kumar Malakar, Verma S, Kumar N, et al. A Traditional Review: The Utilization of Nutraceutical as a Traditional Cure for the Modern World at Current Prospectus for Multiple Health Conditions. Journal of drug delivery and therapeutics. 2024 Mar 15;14(3):154–63