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Nutraceuticals – Essence of Life
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Monday, 21 December, 2015, 08 : 00 AM [IST]
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Dr Sanjay Agrawal
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fiogf49gjkf0d Nutraceuticals is a broad umbrella term that is used to describe any product derived from food sources with extra health benefits in addition to the basic nutritional value found in foods. They can be considered non-specific biological therapies used to promote general well-being, control symptoms and prevent malignant processes. The term “nutraceuticals” combines two words – “nutrient” (a nourishing food component) and “pharmaceuticals” (a medical drug). The name was coined in 1989 by Stephen DeFelice, founder and chairman of the Foundation for Innovation in Medicine, an American organisation located in Cranford, New Jersey.
The philosophy behind nutraceuticals is to focus on prevention, according to the saying by a Greek physician Hippocrates (known as the father of medicine) who said, “let food be your medicine.” Their role in human nutrition is one of the most important areas of investigation, with wide-raging implications for consumers, healthcare providers, regulators, food producers and distributors. The definition of nutraceuticals and related products generally depends on the source. They can be classified on the basis of their natural sources, pharmacological conditions, as well as chemical constitution of the products. Most often they are grouped in the following categories: dietary supplements, functional food, and medicinal food. Medical food is formulated to be consumed or administered internally, under the supervision of a qualified physician. Its intended use is a specific dietary management of a disease or condition for which distinctive nutritional requirements are established by the medical evaluation (on the basis of recognised scientific principle).
There is a fixed dose combination approved by Indian government (Metformin and vitamin B12) for treatment of diabetes mellitus type II. Metformin mainly causes reduction in sugar level in diabetes. Diabetes being a chronic disorder, metformin needs to require for a prolonged period of time. By doing this it induces deficiency of vitamin B12 which leads to neurological manifestations in patients. So requirement of vitamin is necessary for prevention and treatment of vitamin B12 deficiency.
Another important combination highly marketed in Indian market is (Pregabalin and vitamin B12) and (Gabapentin and vitamin B12) for an indication of diabetic neuropathy in diabetes patients. Long-term diabetes causes nerve degeneration in patients, which leads to significant burning pain at nerve site. Gabapentin and Pregabalin act as a neuronal analgesic which cause reduction in burning sensation while vitamin B12 induces regeneration of nerve growth so this combination having nutraceuticals is very much essential for treatment of diabetic neuropathy.
Vitamin B12 supplements alone or in combination with other vitamin preparation are useful for varied conditions like neurodegenerative disorders, anaemia, cardiovascular disorders, energy boost up and so on. The antioxidant function of beta carotene is due to its ability to quench singlet oxygen, scavenge free radicals and protect the cell membrane lipids from the harmful effects of oxidative degradation.
Another important nutraceutical product Lovaza is Omega-3 acid ethyl esters (90%) comprising (Eicosapentaenoic acid (EPA) ethyl ester + Docosahexaenoic acid (DHA) ethyl ester) capsule is indicated as an adjuvant treatment in secondary prevention after myocardial infarction, in addition to other standard therapy (e.g. statins, antiplatelet medicinal products, betablockers, ACE inhibitors). In addition it is also useful in endogenous hypertriglyceridemia as a supplement to diet when dietary measures alone are insufficient to produce an adequate response in type IV as monotherapy and in type IIb/III in combination with statins, when control of triglycerides is insufficient. Lovaza reduces the synthesis of triglycerides in the liver because EPA and DHA are poor substrates for the enzymes responsible for TG synthesis, and EPA and DHA inhibit esterification of other fatty acids.
Another widely used product is probiotics and prebiotics. Probiotics are ‘living micro-organisms, which upon ingestion in certain numbers exert health benefits beyond inherent basic nutrition.’ Alternatively probiotics are loosely known as live microorganisms belonging to natural biota with low or no pathogenicity, but with functions of importance to the health and wellbeing of the host. Probiotics may act by modulating the host's immune system, affecting other microorganisms directly or acting on microbial products, host products or food components. Probiotics have been shown to have applications in alleviating symptoms of allergies, cancer, AIDS, respiratory and urinary tract infections. Furthermore, various findings suggest that probiotics have beneficial effects in alleviating symptoms associated with ageing, fatigue, autism, and in reducing the risks of osteoporosis, obesity and possibly type II diabetes.
There are two gynaecological conditions, PMS (premenstrual syndrome) is a disorder having symptoms like breast pain, emotional labiality, depression, lethargy which mainly seen in second phase of menstrual cycle before ovulation and morning sickness (pregnancy induced nausea and vomiting) which is mainly due to increased level of progesterone in pregnancy. Pyridoxine (vitamin B6) plays a prime role in treatment of these two conditions. Since last decade different medications have been used in treatment of PMS like contraceptive pills, NSAIDs, antidepressant. Pyridoxine usage in this condition has been increasing from last few years and it has been giving satisfactory result in treatment of this condition. It improves symptoms of PMS such as mastalgia (breast pain or tenderness) and PMS-related depression or anxiety in some patients.
Role of nutraceuticals is also proven in few neurodegenerative conditions like Parkinson’s syndrome, Alzheimer’s disease and ALS (Amyotropiclateral sclerosis). This disorder, mainly due to generation of free oxidative radicals, damages central nervous system. Vitamin E, Coenzyme Q10 and a-lipoic acid are very useful in regeneration of antioxidant and prevention of neuro degeneration.
In old age groups or postmenopausal women there is increased risk of developing bone loss due less activity and estrogen hormone deficiency. Vitamin D and calcium supplement in this age group is utmost requirement to prevent bone loss and regain mineralisation.
Source of folic acid is green leafy vegetables and vitamin B12 is meat products. Indian population being vegetarian, there is increased chance of vitamin B12 deficiency. So supplement of vitamin B12 is extremely needed for this population.
Role of nutraceuticals has been increasing in various clinical aspects. A decade back it had been used as a placebo because the reason for its use was controversial and clinical studies with scientific evidences was not established. Still in the Indian market and in physicians, rationality of using nutraceuticals has not penetrated so use of these products is really a prime step in improvising people’s life.
(The author is medical consultant and editor-in-chief, IJMToday. For details, visit www.drsanjayagrawal.com)
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