Micronutrients, nutraceuticals, and functional foods from cells to humans

Bioactive Ingredients Food Group

Cardiovascular disease (CVD) is the major cause of mortality and morbidity in the Western world (Micha et al., 2012). Preventive, i.e. public health measures are being implemented worldwide and include campaigns aimed at smoking cessation, reduction of salt consumption, increased physical activity, and, in general, education to proper lifestyle (Micha et al., 2012). Pharmacological treatment of CVD has also improved greatly over the past decades and several effective drugs, e.g. statins, beta-blockers, ACE inhibitors/AIIRAs, anti-platelets are now available. However, side effects and limited adherence to treatment often limit pharmacological effectiveness.

In addition to prescription drugs, nutraceuticals/functional foods/medical foods are being increasingly added as adjunct treatment of CVD or to prevent it is high-risk (real or perceived) subjects, even though there are no published high-quality human trials comparing drug vs. drug + nutraceuticals (Dutta et al., 2014; Mahabir, 2014). Notable examples include phytosterols, soluble fiber, or soy protein to lower blood cholesterol concentrations and fish oil for hypertriglyceridemia, for which clinical evidence is solid enough to recommend their use. Because of the strong epidemiological correlation between plant-based diets and lower CVD incidence (Visioli et al., 2005), much research is being devoted to clarify the biological activities of phytochemicals, namely of (poly)phenols. Indeed, (poly)phenols are endowed with very interesting healthful properties, most of which – alas – have only been demonstrated in vitro (Visioli and Dávalos, 2011).

Yet, the nutraceutical industry is rapidly cashing in on basic research and many (poly)phenol-based products are now available on the market to target CVOf note, several (poly) phenol-based products are currently being labeled as antioxidants (in a quixotic search for the most potent one), even though - due to bioavailability and kinetic constraints issues - modern research is disproving direct antioxidant activities (Chiva-Blanch and Visioli, 2012; Visioli, 2015). In recent years, many human dietary interventions aimed at investigating the potential cardiovascular health effects of (poly)phenol-derived preparations on cardiovascular risk markers have been carried out to back their often unrealistic health claims. We carry out studies that range from cell culture mechanistic investigations (Visioli and Dávalos, 2011) to human trials (Crespo et al., 2015), in order to validate (or not) health claims associate with nutraceuticals and functional foods (Tome-Carneiro and Visioli, 2015).

Population aging is a worldwide demographic trend. Consequently, the prevalence of chronic age-related conditions such as clinically diagnosed neurological diseases, cognitive decline, and dementia will significantly increase in the near future. The important role of diets and healthy lifestyle as preventative of neurodegenerative diseases is widely accepted nowadays, and it may provide preventive strategies in very early, non-symptomatic phases of dementia well, especially because there are still no effective treatments for it. Another area of investigation we are actively exploring is that of effects of selected micronutrients on the aging brain, to propose evidence-based strategies for dietary improvements of cognitive decline (Visioli and Burgos-Ramos, 2015).

References

1. Crespo, M.C., Tome-Carneiro, J., Burgos-Ramos, E., Loria Kohen, V., Espinosa, M.I., Herranz, J., Visioli, F., 2015. One-week administration of hydroxytyrosol to humans does not activate Phase II enzymes. Pharmacol. Res. 95-96, 132-137.

2. Chiva-Blanch, G., Visioli, F., 2012. Polyphenols and health: moving beyond antioxidants. J Berry Res 2, 63-71.

3. Dutta, D., Mahabir, S., Pathak, Y.V., 2014. Background to nutraceuticals and human health, in: Mahabir, S., Pathak, V.S. (Eds.), Nutraceuticals and health. Review of human evidence. CRC Press, Boca Raton, pp. 3-12.

4. Mahabir, S., 2014. Methodological challenges conducting epidemiological research on nutraceuticals in health and disease. PharmaNutrition 2, 120-125.

5. Micha, R., Kalantarian, S., Wirojratana, P., Byers, T., Danaei, G., Elmadfa, I., Ding, E., Giovannucci, E., Powles, J., Smith-Warner, S., Ezzati, M., Mozaffarian, D., 2012. Estimating the global and regional burden of suboptimal nutrition on chronic disease: methods and inputs to the analysis. Eur. J. Clin. Nutr. 66, 119-129.

6. Tome-Carneiro, J., Visioli, F., 2015. Polyphenol-based nutraceuticals for the prevention and treatment of cardiovascular disease: Review of human evidence. Phytomedicine.

7. Visioli, F., 2015. Xenobiotics and human health: A new view of their pharma-nutritional role. PharmaNutrition 3, 60-64.

8. Visioli, F., Bogani, P., Grande, S., Galli, C., 2005. Mediterranean food and health: building human evidence. J. Physiol. Pharmacol. 56 Suppl 1, 37-49.

9. Visioli, F., Burgos-Ramos, E., 2015. Selected Micronutrients in Cognitive Decline Prevention and Therapy. Mol. Neurobiol. 10. Visioli, F., Dávalos, A., 2011. Polyp