Spotlight on Dietary Supplements and Functional Foods

1. Spotlight on Dietary Supplements and Functional Foods

2. Dietary Supplements: Vitamins and Minerals • Various forms • Vitamins, minerals, amino acids, herbs, glandular extracts, enzymes, etc. • Moderate Supplementation • In the range of the Daily Values (DVs) • Megadoses • High levels; multiples of the DVs

3. Dietary Supplements: Vitamins and Minerals Moderate supplementation Increased nutrient needs and/or poor intake Women of childbearing age who may become pregnant Pregnant and breastfeeding women Women with heavy menstrual losses Children

4. Dietary Supplements: Vitamins and Minerals • Moderate supplementation • Increased nutrient needs and/or poor intake • Infants • People with severe food restrictions • Strict vegetarians who abstain from animal foods and dairy products • Older adults • Others

6. Dietary Supplements: Vitamins and Minerals • Moderate supplementation • Look for brands that contain at least 20 vitamins and minerals • No more than 100% of its DV

7. Dietary Supplements: Vitamins and Minerals Megadoses in conventional medical management Conventional medicine Drug interactions Malabsorption syndromes Treatment of deficiencies Druglike effects

8. Dietary Supplements: Vitamins and Minerals • Megadosing beyond conventional medicine: orthomolecular nutrition • Achieving the optimal nutrition levels in the body • Drawbacks of megadoses • Can act as a drug • Can create deficits of other nutrients • Can interfere with absorption of others

10. Dietary Supplements: Natural Health Products Natural health products Herbal therapy (phytotherapy) Traditional medical practices Little scientific evidence of efficacy, safety

11. Dietary Supplements: Natural Health Products Helpful herbs, harmful herbs St. John’s wort Milk thistle Ginkgo biloba Saw palmetto extract Cranberry juice

12. Dietary Supplements: Natural Health Products Helpful herbs, harmful herbs Strong enough to help, strong enough to hurt Can interfere with standard medicines DANGER: Examples of products with toxic side effects St. John’s Wort Yohimbe Ephedra Chaparral Comfrey

13. Dietary Supplements:Natural Health Products • Quality control issues • Contaminants • Poorly standardized strength or potency • Regulations • Current good manufacturing practices • Other dietary supplements • Hundreds of products

14. Dietary Supplements in the Marketplace • Freedom of speech and press • The FTC and supplement advertising • Federal Trade Commission • The FDA and supplement regulation • Dietary Supplement Health and Education Act • Dietary supplements are not drugs • Dietary supplements are not food additives • Approval by FDA is not required

15. Dietary Supplements in the Marketplace • Supplement labels • Ingredient information • Supplement fact panel

17. Dietary Supplements in the Marketplace Supplement labels Claims allowed Health claims (approved by FDA), structure/function claims, and nutrient content claims Examples Calcium and osteoporosis Folate and neural tube defects

18. Dietary Supplements in the Marketplace Structure/function claims Must have “disclaimer” statement on label

19. Dietary Supplements in the Marketplace • Nutrient content claims • Consistent with definitions approved for foods • Canadian regulations • Natural health products regulations

20. Dietary Supplements in the Marketplace Choosing dietary supplements Is the quantity enough to have an effect? Is the product new to you? What is its bioavailability? Can it interact with any prescription or other medications you are taking? Does the product promise too much? Who is selling the product? U.S. Pharmacopeia verification

21. Dietary Supplements in the Marketplace • Fraudulent products • Potential warning signs (examples) • Claim to be alternatives to FDA-approved drugs • Claim to be a legal alternative to steroids • Marketed primarily in a foreign language/mass emails

22. Dietary Supplements in the Marketplace Fraudulent products Secret cure (“breakthrough”) Pseudomedical jargon (e.g., “detoxify”) Cures a wide range of diseases No side effects, only benefits Backed by “scientific research” you can’t find Remember, if it sounds too good to be true…

23. Functional Foods Provide health benefits beyond nutrition Phytochemicals Antioxidants Neutralize free radicals Reduce heart disease, cancer risk Found in fruits, vegetables, whole grains, legumes, and wine

24. Functional Foods • Phytochemicals make food functional • Substances in plants • Promote health • Are not essential for life • Are a benefit to the plant itself

25. Phytochemicals Make Food Functional • Benefits of phytochemicals • Associated with a decreased risk of chronic diseases • Cancer • Cardiovascular diseases • Prevent chronic disease • Phytoestrogens • Neutralize free radicals

26. Phytochemicals Make Food Functional • Adding phytochemicals to your diet • Include more functional foods and fewer empty calories • More fruit • More vegetables • Make half of your grains whole

27. Phytochemicals Make Food Functional • Foods enhanced with functional ingredients • Adding health promoting properties during processing

28. Phytochemicals Make Food Functional • Regulatory issues for functional foods • Food • Drugs • Dietary supplements • Additives in functional foods • Herbs and other novel ingredients • GRAS guidelines apply

29. Food Additives Direct additives Added to foods for specific reason Indirect additives Unintentionally become part of a food

30. Food Additives Purpose of direct additives Maintain product consistency Improve or maintain nutritional value Keep food appetizing and wholesome Provide leavening or control acidity and alkalinity Enhance flavor or color

31. Food Additives Regulation by FDA Food additives: FDA approval; manufacturer must prove safety Color additives: FDA approval; manufacturer and FDA tests batches for purity Example: any dye that impacts color

32. Food Additives Regulation by FDA Generally Recognized as Safe (GRAS) Example: salt, sugar, spices Prior-sanctioned substance Example: sodium nitrite and potassium nitrite

33. Food Additives • Delaney Clause • Apply to food additives • Apply to color additives • No approval if additive causes cancer • Human • Animals • Controversy associated with amount tested in animals vs. actual human consumption

34. Claims for Functional Foods Structure/function claims for functional foods Based on nutritive value of foods Not as stringently regulated as health claims

35. Strategies for Functional Food Use • Stick with the science • Eat fruit and vegetables • Eat nutrition-fortified products as needed • Read, read, read (scientific articles) • Be critical of advertising and hype • If it sounds too good to be true, it probably is!

36. Complementary and Alternative Medicine (CAM) Complementary Practices used in addition to conventional medicine Alternative Practices used in place of conventional medicine

37. Complementary and Alternative Medicine (CAM) Nutrition in CAM Vegetarian diets Macrobiotic diet Food restrictions and prescriptions Need for scientific evaluation