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Nutraceuticals

by Dr Cedric Nazareth

 

The term “nutraceuticals” combines the word “nutrient” with “pharmaceuticals” to describe dietary supplements used for the treatment or prevention of disease. The term has not received official sanction from standard textbooks of pharmacology or medicine, nor is it recognised by regulatory bodies such as the US FDA. Nevertheless, it conveniently describes a host of preparations about which there is an increasing awareness. Nutraceuticals are derived from naturally-occurring substances that could be a part of the normal diet. But why bother consuming voluminous quantities of herbs and the like when you can simply pop in a few pills instead? For example, broccoli is a vegetable that is supposed to protect against cancer, but you need not consume a stalk; a 500 mg tablet of broccoli extract will probably do just as well. And if you would like the antioxidant properties of the flavonoids found in wine but don’t want the alcohol, you can have grape seed pills.

A popular nutraceutical is garlic, frequently taken to lower serum cholesterol levels. Several scientific studies support the benefits of garlic, but not all are convinced that garlic actually controls cholesterol levels. Broccoli contains sulforaphane that protects against cancer. Even as a supplement, sulforaphane appears to have anti-cancer properties. Tomatoes have been observed to confer some protection against prostate cancer and also perhaps against cancers of the pancreas, bladder, cervix, and digestive tract. The cancer-fighting properties of tomatoes could be due to lycopene - now available as a tablet. Grapes are rich in flavonoids which have antioxidant properties, affording cardiovascular protection. This may explain why regular wine-drinkers have a lower risk of heart attacks.

All sorts of of nutraceuticals are available. In one survey of Alzheimer’s patients, 35% were taking vitamin E, 25% were on anti-inflammatory drugs, 14% on ginkgo biloba and 9% on herbal medicines. For Alzheimer’s disease alone, nutraceuticals include ginkgo biloba, phosphatidylserine, acetyl L-carnitine and huperzine, among others. Ginkgo biloba produces memory enhancement by increasing blood flow to the brain. The requirements of phosphatidylserine, a phospholipid vital for brain cell function, increases with aging and supplementation is suggested. Acetyl L-carnitine has been evaluated in several studies for Alzheimer’s disease, and huperzine A is derived from the herb club moss (Huperzia serrata) found in China.

Nutraceuticals need not come only as tablets. They could be foods and beverages too. The beverage segment is one of the fastest growing of the nutraceuticals markets and also has the benefit of being convenient for the addition of nutraceutical ingredients. Beverages could include meal replacement beverages, lifestyle and wellness beverages, medicinal teas and isotonic beverages. In the U.S., the beverage market accounts for $1.17 billion of a nutraceuticals market valued at approximately $86 billion and growing at about 10% annually. It is estimated that more than 100 million people in the U.S. are using nutraceuticals. In Japan, about 47% of the population consume these products. The interest in nutraceuticals could be related to a perception that “natural is good”. They are particularly favoured for their supposed benefits in chronic diseases and in trying to ward off the effects of aging. Optimism regarding their roles in preventing disease may also contribute to their popularity.

With considerable data on their benefits, nutraceuticals could contribute significantly to the prevention of diseases. Older consumers in particular are more open to taking dietary supplements or eating certain foods to maintain their health, but nutraceuticals would need to gain ground with doctors, who generally speaking, do not prescribe them as freely as they prescribe conventional drugs. In fact, most nutraceuticals are simply not considered to be “drugs” in the conventional sense because they have not gone through the usual stringent drug approval process, and are not mentioned in standard textbooks. Currently the nutraceuticals lie in limbo, somewhere between foods and drugs.

Another issue is standardization. There may be many brands of St. John’s Wort, but which brand is better? Of course, standardisation of extracts can be difficult, and it may take a while before anything conclusive emerges on this front.

Finally, there is a key question - can the extract be better than the real thing? Furthermore, if the tomato extract comes at a price that is many times higher than the cost of a kilogram of tomatoes, that question could well be the most important of all.

 

October 2000 Pharma Marketing Page. http://pharmapage.tripod.com/1.html
This article appreared in Pharma Business, October 27, 2000.
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