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Nutraceuticals Inspiring the Current Therapy for Lifestyle Diseases

The nutraceutical industry is a combination of ‘Nutrition’ & ‘Pharmaceuticals’. Nutraceuticals are actually used to produce optimal clinical benefits with minimal side effects. ‘Let food be your medicine and medicine be your food’ was stressed by Hippocrates around 2000 years ago. Nutraceuticals are used as food or part of food that can have medicinal or health benefits, including disease prevention or treatment. Herbal nutraceuticals are effective tools to preserve health and function against acute and acute nutritionally induced activities. By supporting optimum fitness, longevity and quality of life, chronic diseases. Nutraceuticals are now part of the dietary landscape, Nutraceuticals are currently the industry’s fastest growing segments and the global nutraceutical market is valued at USD 117 billion.

Nutraceutical Categories:

There are various categories in nutraceutical vertical which are used for treatment of various lifestyle diseases which are as follows:

1) Dietary supplements:

• Vitamins, co-enzymes, minerals, carnitine
• Ginko bilba, Ginseng, Saint John’s wort

2) Functional foods:

• Oats, bran, psyllium & lignin’s for heart disease & colon disease
• Prebiotics- Oligofructose for control of intestinal flora
• Omega-3 milk in prevention of heart disease
• For cholesterol reduction, canola oil with reduced triglycerides
• Stanols (Benecol) in Cholesterol Adsorption Reduction

3) Medicinal foods:

• For immune enhancement, lactoferrin is quite helpful
• Transgenic oral vaccine plants against infectious diseases
• Health bars with drugs attached

4) Area covered by Nutraceutical products:

• Nutraceuticals have reached all clinical fields, such as anti-arthritis, pain killers, cold and cough, sleep disorders, digestion and prevention of some cancers, osteoporosis, blood pressure, cholesterol, depression and diabetes, etc.

Uses of Nutraceuticals in Different Therapeutic Areas: 

Nutritional therapy uses nutritional therapeutics as a healing system. This therapy is based on the conviction that foods can not only provide nutrients and energy, but can also provide medicinal benefits. There are following examples that will help to understand:

1. For cardiovascular diseases & eye sight:

Rice bran lowers the serum cholesterol levels in the blood, lowers the level of (LDL) and increases the level (HDL) in cardiovascular health. Higher the ratio more will be the risk of coronary heart diseases. Rice bran contains both Lutein and Zeaxanthin, which improves eyesight and reduces the chance of cataracts. The essential fatty acids, omega-3, omega-6, omega-9 and folic acid in rice bran are also promoting eye health.

2. For diabetes:

There has been growing evidence in recent years that plant-food products Polyphenols may be special nutraceuticals and supplemental therapies for different aspects of type 2 diabetes mellitus due to their biological properties. The occurrence of long-term diabetes complications such as cardiovascular disease, neuropathy, nephropathy and retinopathy can also be avoided by polyphenolic compounds.

3. Obesity & constipation:

In obesity and constipation, buckwheat seed proteins play a beneficial function, acting close to natural fibres found in foods. Weight loss can be promoted by 5-hydroxytryptophan and green tea extract.

4. Treatment of arthritis:

A common condition in which the end-point outcome in joint replacement surgery is arthritis. An alternative therapy for the pathological symptoms of arthritic disease is the use of nutraceuticals. Several clinical trials, animal feeding studies, and in vitro models that imitate cartilage degradation in arthritic disease have shown the effectiveness of fish oils (e.g. cod liver oil) in the diet. There is some evidence of other nutraceuticals other than that, such as green tea, herbal extracts, chondroitin sulphate and glucosamine.

5. Treatment for gastro-intestinal:

The prevalence of diet-related diseases is increasingly growing in Western societies. Increased because of greater hypercaloric food supply and a sedentary lifestyle. Main diet-related pathologies that share a common pathogenic denominator of low-grade inflammation are obesity, diabetes, atherosclerosis and neurodegeneration. In view of their capacity to exert anti-inflammatory responses, functional foods and nutraceuticals may represent a novel therapeutic approach to preventing or attenuating diet-related diseases. In particular, activation of regulatory intestinal T cells and homeostatic control of the gut microbiota have the potential to minimise low-grade inflammation in diet-related diseases.

6. Treatment for Cancer:

The primary source of vitamin A is beta-carotene, and it has anti-oxidant properties that help prevent cancer and other diseases. The most active antioxidants are beta-carotene, among other carotenes. Alpha and beta carotenes tend to provide defence against lung, colorectal, breast, uterine and prostate cancers, along with gamma carotene and the carotenes lycopene and lutein68, which do not convert to vitamin A. The most popular form is B-Carotene and can be found in fruits and vegetables with yellow, orange, and green leaves. These may include cabbage, spinach, lettuce, tomatoes, broccoli, sweet potatoes, cantaloupe, oranges, and squash throughout the winter.

Conclusion:

Nutraceuticals have shown their health benefits and the potential to avoid diseases, which should be consumed according to their recommended appropriate intake. Nutraceuticals and functional foods have become a multi-billion dollar sector in the global economy. Nutraceuticals play a significant role in clinical growth in the present self-medication scenario. But their effectiveness depends on their efficiency, purity, protection and efficacy being sustained.

Therapeutic Food to Fight Malnutrition

The developed and underdeveloped countries such as Asia, Africa, and South America face the leading challenges related to Food and Nutrition Insecurity and nutritionally related diseases. Food storage & Poor access to adequate health facilities have taken center stage among the global challenges, especially in the most developing and underdeveloped countries mentioned above. Malnutrition and Undernourishment are the two significant health-related growing issues in the world.

Malnutrition Prevalence in India: 

The significant public health problem in India is malnutrition among under-five children. This is reflected by the fact that underweight children’s prevalence is among the highest in the world in India. It is also observed that the bulk of malnutrition in India is a concentrated phenomenon that is, a relatively small number of districts, states, and villages comprise a large share of the malnutrition burden- only five states and 50% of towns account for about 80% of the malnutrition burden. Also, In India, the prevalence of Severe acute malnutrition (SAM) is 7.5%.

How COVID-19 has worsened the condition of malnutrition?

The pandemic outbreak has only worsened India’s problem of malnutrition. During the coronavirus pandemic in India, Tens of thousands of children slept on an empty stomach. India has taken small steps over the last few years to fight against malnutrition, resulting in a significant decline in the child mortality rate. If this progress were continued, India would have met its ‘sustainable Goal’ of reducing the mortality rate of under-five by 25% by 2030. However, the little progress too came to a halt as the lockdown forced millions of children to stay out of school. Anganwadis were also closed, which meant that thousands of children in rural areas could not get food under the Mid-Day meal program. This led to UNICEF’s conclusion that India is likely to witness an increase in malnutrition by at least 10%.

Ready-to-Use-Therapeutic Food (RUTF) as the Solution to Malnutrition:

Foods designed for specific health-related issues, usually to meet the nutritional requirement, are therapeutic food. The RUTF is a mixture of milk powder, powdered vitamins, minerals, vegetable oil, and peanut butter with the proper nutrients needed by an individual. This medicinal food’s primary purpose is to use it for emergency feeding of malnourished children or to supplement a person’s diet with special nutrition requirements, such as the elderly. RUTF does not require any special preparation before consumption, making it practical and ideal for cooking facilities and fuel limiting constraints.

Case Study: 

Severe acute malnutrition is reported to account for more than one million preventable child deaths. The reported mortality was as high as 20-30%. As per the WHO Diagnostic criteria for diagnosis, a cure rate of 75% with <10% mortality has been set as the minimum goal. Ready to use therapeutic food (RUTF) is used as a solution for managing SAM cases. The case study was carried out in Kerala, among 67 children with SAM admitted in SAT Hospital, Govt. Medical College showed that 33 (51.6%) achieved cure, 18 (28.1%) were not cured, 12 (14.1%) lost to follow up, and 4(6.25%) died, which concludes that the cure rate was less than the goal of 75%, but the mortality was <10%. 

 

REFERENCES: –

1. https://nijp.org/amp/use-of-indigenous-ready-to-use-therapeutic-food-rutf-and-outcome-of-under-five-children-with-severe-acute-malnutrition/
2. https://www.businessinsider.in/india/news/the-covid-19-pandemic-has-only-worsened-indias-problem-of-malnutrition/articleshow/78683367.cms
3. https://www.researchgate.net/publication/338388445_Ready-to-Use_Therapeutic_Foods_RUTFs_for_Remedying_Malnutrition_and_Preventable_Nutritional_Diseases

 

New Food Labelling Regulations Related to Packaged Food Products

On August 23, 2006, India’s government passed the Food Safety and Standard Act or the FSS Act. The FSSAI, i.e., Food Safety and Standard Authority of India, was entrenched under this act. This act is meant to cover or carry out operations related to setting the standard of food articles. This crucial step changed the businesses way involved in food articles in India. The FSSAI standards are based on scientific research. They help regulate the storage, manufacture, sale, import-export, distribution and making all types of other food articles available to the general population.

The FSSAI published new food labelling regulations related to packaged food products, based on the recommendations of the expert group. 

What it is about?

The following provisions are described in the scientific document: 

• Chapter 1: – Prescribes pre-packaged foods labelling requirements and displays essential information on-premises where food is processed, served, manufactured, and stored. Several definitions have been listed under the context otherwise requires.
• Chapter 2: – covers the general requirement of labelling pre-packaged foods such as food name, list of ingredients, calculation of nutrients, and nutritional information. Declaration of name and complete address, lot/code/batch identification, Date marking, a declaration regarding food additives, retail sale price, FSSAI logo, and license no., Net quantity and consumer care details. Etc.
• Chapter 3: – contains a display of information in the food service establishment of the Regulation.
• Chapter 4: – has the non-retail container labelling requirements.
• Chapter 5:- Of Regulation indicates the labelling of packaged food additives for retail sale. Mandatory labelling declaration for various food products has been set out in schedule 2.

When is it going to be implemented?

India’s Food safety standards Authority published a “Food Safety and Standards (labelling and display), Regulation 2020 gazette notification on December 14. 2020. The Regulation shall come into force from the date of their disclosure in the Official Gazette. All the Regulation provisions should comply with all the Food Business Operator after one year from their disclosure date except chapter-3 of this Regulation. Food Business Operator shall comply with this by January 1, 2022.

What are the concerns related to this?

Industry concerns: –

• There has been a concern by the food industry giants regarding the bigger size fonts to be used in the principal display panels.
• The industrial bodies have complained that it is not feasible for them to use expiration date similar to that of the pharmaceutical industry. They would like to stick to the ‘Best before date.’ for this purpose.
• The guidelines dictate the menu cards calorific value to the cafe chains and restaurants with more than ten outlets.
• Further, the guidelines mention that all the E-platform food and beverage sales should communicate the essential requirement to the consumers before the deal, which includes (batch date, best before date, expiry date, and packaging date).

 

Source: 

1. https://fssaifoodlicense.in/food-safety-and-standards-act/
2. https://resources.selerant.com/food-regulatory-news/fssai-publishes-food-safety-and-standards-labelling-and-display-regulations-2020
3. https://packagingsouthasia.com/she-safety-health-and-environment/regulation-compliances/fssai-reworks-norms/

 

The recent outbreak of COVID has changed people’s behaviour in many ways, which has even affected the growth of the various market in the right way; being the largest exporter, consumer, and producer of spices, India accounts for half of the global trading in this sector.

Industries such as pharmaceuticals, indigenous alternative medicine, cosmetics, resin, and natural colour use spices in a considerable amount. Any interference in the domestic and global supply chain throws an adverse impact on the supply and production of vital industries and workers involved in spices’ processing and output.

Growth of Immune Boosting Spices during the Pandemic:

Customers across the globe are showing a massive interest in building their immunity and safeguarding their health. India, known as the king of spices, has a vast history of trading with China and Rome’s ancient civilization. The people in large amount has started using the zest with anti-viral and anti-inflammatory properties like never to prevent the infection. Some spices double in rate, and many of the herbs have gone out of stock. Since the virus outbreak, there is an increase in the sale of black pepper, garlic, dry ginger, and turmeric.

Export Trend Moves Up:

The observation of Prime Minister Shri Narendra Modi has shown that there is increasing use of spice in the world after the outbreak of a pandemic, which gave a massive rise in exports of Indian spices, by 23 % in dollar terms and 34% in rupee terms in June this year 2020, report by ASSOCHAM. It was found that chilies were the most exported zest from India in the fiscal year, 2020. With an anticipated volume of over 484 thousand metric tonnes. Cumin followed while turmeric ranked third.

Since May 2020, there is a surge in export and the resumption of cardamom e-auction, which has facilitated better price realization by the cardamom growers. The growing trend in exports in the auction prices rose by Rs 600, Touching an average of Rs 1615 per Kg. Around 100 tonnes of cardamom valued at Rs 25 crore have been exported to Saudi since May, the largest customer of Indian cardamom.

Some of the Immune Boosting Spices:

For building immunity, it is necessary to have a balanced diet with the inclination towards immunity boosters.

Garlic:

The bioactive ingredient of garlic, i.e., allicin, is released when the garlic is cut or chopped into pieces. Research has shown that allicin helps in reducing the common cold by 63%. Garlic is used as traditional medicine by major civilizations such as Egyptians, Chinese, and Babylonians since ancient times.

Turmeric:

The bioactive agent of turmeric, i.e., curcumin, acts as an anti-inflammatory agent. AYUSH recommends that turmeric powder, basil, and grated ginger are the best immune boosters when consumed daily.

Ginger:

The bioactive compound of ginger, i.e., Gingerol, traditional medicine, is extensively used to cure asthma, coughs and colds, and gastrointestinal complaints. It can be taken either in juice or in tea, or in the form of a dried powder.

Black Pepper:

Pepper acts as a remarkable natural remedy for nasal congestion and sinuses, providing immediate relief. It has been found by research that including black pepper, powdered, or crushed daily, can strengthen the body’s defence, and can improve overall health.

 

Source:-

1. www.newindianexpress.com/cities/hyderabad/2020/aug/12/covid-19-spice-it-up-urge-experts-to-boost-immunity
2. www.fnbnews.com/Ingredients-and-Flavours/growth-of-immune-boosting-spices-during-the-pandemic

In providing a promising new route in engaging and delivering successful nutrition intervention in young adults and adolescents, digital technologies such as social media, gamification, health tracking, education, social support and others play a vital role.

Increasing use of social media and smartphones by these age groups is making technology-based interventions specifically pertinent to help this age group and teach positive habits that can be carried further into adult life.

According to a recent review, a technology-based intervention can also help treat mental health, diet modification, physical inactivity and substance abuse.  Robotics and Artificial intelligence also help researchers learn more about the connections between technology and humans.

Emerging Technologies in R&D as a Nutritional Intervention: 

Microarray and nanotechnology, these new emerging technologies can advance the science of nutrition by developing, discovering, and delivering several intervention strategies to improve health and reduce the complication and risk of various diseases.

Food grade nanotechnology and microarray are being increasingly used to improve efficient encapsulation, increasing bioavailability and digestibility.

Supply Chain (Food Blockchain Revolution): 

Blockchain technology is becoming a new level of sharing information and transparency for the farmers to processors to packer to distributor to packaged goods maker to retailer to foodservice operator to the exporter to the consumer, blockchain technology is taking off as a novel for the agri-food business to disclose and record transactions in an open virtual space across the entire chain.

AI Revolutionizing Food Processing and Healthcare Business:

AI is impacting the food processing industry efficiently; it helps the industry both directly and indirectly. It allows farmers with weather predictions, which indirectly produces high-quality raw materials for food processing companies. It instantly soothes the food processing business by food safety compliance, maintaining cleanliness, developing products, and sorting packages and products. 

AI technology even plays a vital role in healthcare by forecasting potential high-risk conditions and improving diagnostic accuracy. With enhanced AI capabilities, robotics equipped with AI robust seems to play a substantial role as surgical assistants, delivery, and transportation aids.

Consumer Awareness through Apps: 

• Lesson From m-Nutrition:
  m-Nutrition is a global mobile-based advisory service, promotes behavioural change around farming practices and nutrition to boost adults and children’s nutritional health in low-cost countries. This m-Nutrition is a well-designed service that provides individually practical, tailored, and context-particular advice lacking in other information sources.

• E-Learning to Empower Front-Line Nutrition Workers in India:
  The department of child and women development and FaNS Project of Madhya Pradesh, India, implemented an interactive eLearning platform in February 2019 to provide counselling skills to 97 135 front line supervisors and workers, high-quality, standardized, and systematic training to boost nutrition knowledge. To analyse this digital tool’s effects on front line workers’ capacity-building, a study was conducted in December 2019, which showed that 25,000 have embarked on 40 hours training course and 7000 have completed it. The training benefited ninety-nine percent of participants, and they claimed that the training enhanced their nutrition knowledge and counselling skills. The practice was said to be systematic, comprehensive, and suited to participants’ roles and responsibilities.

 

The Nutraceutical industry is a booming field in India as the consumers are increasingly gaining exposure to various Dietary supplements and fortified products. Despite increasing awareness, nutrition remains an incompletely understood concept in India and a large portion of the population suffers from Malnutrition in one or the other form. As Nutraceuticals are presumed to be safe and are marketed without prescription in India, it is crucial to impose stringent guidelines and regulations over the active ingredients of nutraceuticals, identity, purity and bioavailability for the rationale use of nutraceuticals. Nutrivigilance is necessary to incorporate monitoring schemes to identify the adverse effects caused by nutraceuticals for the consumer safety.

Reporting by Healthcare providers:
Healthcare providers play a vital role as they are actively connected with patients and consumers. They are also aware of the health profile, history and current medication regimen of their patients. They can thus be tapped as influencers to educate the consumers about ensuring the right Nutrition.

Educating the consumer:
Providing Nutrivigilance guidance, awareness and updates as leaflets to consumers can improve awareness among them. Once again, healthcare providers can be instrumental in explaining potential side effects or inappropriate use and potentially risky combination of Nutraceuticals with other medicines.

Combating adverse effects of Nutraceuticals:

• Avoiding prolonged use of Nutraceuticals without guidance of healthcare professionals
• Not taking Nutraceuticals to treat self-diagnosed conditions
• Not consuming Nutraceuticals with, or instead of Prescription medications without
• consulting a Healthcare professional
• Consulting healthcare professionals about the supplements taken before a surgical procedure
• Abstaining use of Nutraceuticals sold through improper and untrustworthy channels
• Being cognizant of labels and information provided on Nutraceutical products

Regulatory perspective:
The Dietary Supplement Health and Education act as well as the Food Safety and Standards act have issued rules and regulations regarding registration and licensing of Nutraceuticals in India.
As per norms, the manufacturer:

• Is accountable for product analysis, development, authentication and safety of Nutraceuticals
• it makes and supplies
• Must not print any misleading information on the labels
• Must not claim that the product will diagnose, treat or prevent any disease
• Must guarantee purity, composition and identity of their Nutraceuticals

Path Ahead:
The domestic Nutraceutical market is currently experiencing growth. Existing as well as new players are providing nutraceuticals and dietary supplements both locally as well as globally.
With this background, the standardization of these products is one of the valiant challenges for regulators and the industry stakeholders. The need, scope and importance of Nutrivigilance have to be accepted with paramount importance.