Recent Advances in Marine-Based Nutraceuticals and Their Health Benefits.

The oceans have been the Earth's most valuable source of food. They have now also become a valuable and versatile source of bioactive compounds. The significance of marine organisms as a natural source of new substances that may contribute to the food sector and the overall health of humans are expanding. This review is an update on the recent studies of functional seafood compounds (chitin and chitosan, pigments from algae, fish lipids and omega-3 fatty acids, essential amino acids and bioactive proteins/peptides, polysaccharides, phenolic compounds, and minerals) focusing on their potential use as nutraceuticals and health benefits.

Nutraceuticals and Nutrition Supplements: Challenges and Opportunities.

The term "nutraceuticals" is derived from "nutrition" and "pharmaceuticals" and is used fornutrition products that are also used as medicine [1] [...].

Nutraceuticals: A Comparative Analysis of Regulatory Framework in Different Countries of the World.

BACKGROUND: Nutraceutical is a term that is a combination of nutrition and pharmaceutical. They are believed to improve physical and mental health and provide therapeutic benefit in disease conditions. Nutraceuticals are claimed to be beneficial in several disease conditions which include cardiovascular disorder, neurodegenerative disorders, metabolic disorders and cancer prevention. OBJECTIVE: In the current review, we will study the current regulatory framework in some of the major countries of the world by comparing different parameters of these regulations. FINDINGS: Global nutraceutical market is currently expanding at a rapid pace but there are some restraints to the market growth which include poor quality manufacturing and unharmonized regulations leading to trade barriers across the globe. Although there are laws and regulations in place which govern nutraceutical products in different countries, these regulations lack harmonization and differ from country to country. Some of the countries follow stringent regulations, whereas, in some of the countries, well-structured and stern regulations for nutraceuticals are lacking. CONCLUSION: The development of a well regulated, harmonized and research-driven approach can help boost the confidence of consumers in nutraceutical products in the world thereby driving the nutraceutical market.

[Consulting Pharmacists Who Have Advisory Staff License Regarding the Use of Medicines and Health Foods].

The widespread use of health foods, including supplements, is now common among patients. This is because many health foods are being claimed to be beneficial. If patients use medicines and health foods concurrently, the interaction between the two might lead to adverse events. Additionally, it is reported that pharmacists do not generally care about health food use in their patients, because they also lack sufficient knowledge about health foods. On the contrary, there are some licenses to be a health food advisor in Japan, and the generic name of these licenses is "advisory staff". Pharmacists who have this license are specialists in both medicines and health foods, and thus, they might pay more attention to the concurrent use of medicines and health foods compared to those who do not have the advisory staff license. To address this issue, we conducted a study with an online questionnaire about health food consultation, and 87 pharmacists with advisory staff license participated. Only 36.8% of participants were found to always ask their patients about health food use. However, 92.0% of them had experience of consultation about the simultaneous use of medicines and health foods, and 17.2% of them recognized adverse events by knowing about the concurrent use. Patients who experienced adverse events have used either eicosapentaenoic acid/docosahexaenoic acid supplement with epadel or Ginkgo biloba extract with warfarin. Therefore, an active interview with pharmacists is important to avoid such adverse events in patients.

An evaluation of the genotoxicity and subchronic toxicity of the peel extract of Ponkan cultivar 'Ohta ponkan' (Citrus reticulata Blanco) that is rich in nobiletin and tangeretin with anti-dementia activity.

Nobiletin and tangeretin are major components of polymethoxylated flavones in the peels of citrus fruits such as Citrus reticulata. Because nobiletin and tangeretin have attracted attention due to their beneficial health properties, citrus peel extracts, in which they are concentrated, have the potential to serve as a functional food ingredient to prevent diseases. In this study, a series of toxicological studies on the peel extract of Ponkan cultivar 'Ohta ponkan' (Citrus reticulata Blanco), was conducted. No mutagenic activity was observed in a bacterial reverse mutation test, whereas chromosomal aberrations were induced in an in vitro mammalian chromosomal aberration test. No genotoxicity was observed in an in vivo mammalian micronucleus test. In a 90-day study at daily doses of 54, 180, or 540 mg/kg body weight (bw)/day, hyaline droplet nephropathy, which specifically occurs in adult male rats, was observed in males of 540 mg/kg bw/day group. No other adverse effects were observed in the 90-day study. The no adverse effect level in the 90-day study was considered to be 540 mg/kg bw/day for female rats and less than 540 mg/kg bw/day for male rats.

Functional Foods: Product Development, Technological Trends, Efficacy Testing, and Safety.

Functional foods is a very popular term in the social and scientific media; consequently, food producers have invested resources in the development of processed foods that may provide added functional benefits to consumers' well-being. Because of intrinsic regulation and end-of-use purposes in different countries, worldwide meanings and definitions of this term are still unclear. Hence, here we standardize this definition and propose a guideline to attest that some ingredients or foods truly deserve this special designation. Furthermore, focus is directed at the most recent studies and practical guidelines that can be used to develop and test the efficacy of potentially functional foods and ingredients. The most widespread functional ingredients, such as polyunsaturated fatty acids (PUFAs), probiotics/prebiotics/synbiotics, and antioxidants, and their technological means of delivery in food products are described. The review discusses the steps that food companies should take to ensure that their developed food product is truly functional.

[Attitude Survey Data on Interaction between Dietary Supplements and Medicines].

Since "Foods with Function Claims" system was established in 2015, the percentage of people taking health foods and supplements is gradually increasing. The number of people taking both dietary supplements and medicines is also increasing. Therefore, providing information on interaction between dietary supplements and medicines has become increasingly important. We have conducted a study for understanding the awareness of the consumers on the interaction of health foods and supplements with medicines. The ratio of those who do not consult with an informed opinion on the interaction between health foods and supplements with medicines was 76% and 55.2% admitted that they did not experience any side effects as a result of this interaction. In conclusion, the understanding of the interaction between health foods and medication among consumers is still limited and most of them do not consult with specialized physicians. It has been revealed that efforts to expanding the consumers understanding on the risk of interaction between supplements and medicines are necessary. It was suggested that the "Database for guiding the interaction between medicines and health foods" could be a useful tool for providing this type of information.

[Systematic Review of Case Reports on the Adverse Events Due to Health Food Intake by Cancer Patients].

Cancer patients use health foods (HFs) as complementary and alternative medicine, although the details of their adverse events (AEs) are unclear. We searched three databases [PubMed, "Igaku Chuo Zasshi", and Information System on Safety and Effectiveness for Health Foods website (https://hfnet.nibiohn.go.jp/)] for case reports on AEs related to HF intake in cancer patients published before October 2018. Of the matched reports, 76 studies and 92 patients (31 in Japan, 61 overseas) that met the selection criteria were included in this review. Thus, the severity of AEs and outcomes were not related to either the concomitant use of HF with cancer chemotherapy or cancer stages of patients. AEs caused by HF intake itself accounted for 87%, while drug-HF interaction accounted for 11%. According to the Common Terminology Criteria for Adverse Events (CTCAE) classification, 70% of patients whose grades were identified had severe cases (grades 3 to 5). In Japanese patients, hepatic and respiratory disorders accounted for 52% of the severe cases. Cases were predominantly developed as a result of an allergic mechanism, and mushroom products were mostly used. Overseas, serious cases were induced by products that were already indicated for safety problems. Moreover, notable AEs were recognized, such as hypercalcemia, which were caused by intake of HF containing calcium, vitamin D, and shark cartilage, and bacterial infection caused by probiotic products. Analyzing the details of AEs related to HF intake can help health professionals and cancer patients prevent health hazards.

Microalgal Derivatives as Potential Nutraceutical and Food Supplements for Human Health: A Focus on Cancer Prevention and Interception.

Epidemiological studies are providing strong evidence on beneficial health effects from dietary measures, leading scientists to actively investigate which foods and which specific agents in the diet can prevent diseases. Public health officers and medical experts should collaborate toward the design of disease prevention diets for nutritional intervention. Functional foods are emerging as an instrument for dietary intervention in disease prevention. Functional food products are technologically developed ingredients with specific health benefits. Among promising sources of functional foods and chemopreventive diets of interest, microalgae are gaining worldwide attention, based on their richness in high-value products, including carotenoids, proteins, vitamins, essential amino acids, omega-rich oils and, in general, anti-inflammatory and antioxidant compounds. Beneficial effects of microalgae on human health and/or wellness could in the future be useful in preventing or delaying the onset of cancer and cardiovascular diseases. During the past decades, microalgal biomass was predominately used in the health food market, with more than 75% of the annual microalgal biomass production being employed for the manufacture of powders, tablets, capsules or pastilles. In this review, we report and discuss the present and future role of microalgae as marine sources of functional foods/beverages for human wellbeing, focusing on perspectives in chemoprevention. We dissected this topic by analyzing the different classes of microalgal compounds with health outputs (based on their potential chemoprevention activities), the biodiversity of microalgal species and how to improve their cultivation, exploring the perspective of sustainable food from the sea.

Dark Chocolate: To Eat or Not to Eat? A Review.

Dark chocolate is not the most popular chocolate; the higher concentration in antioxidants pays tribute to the increment in bitterness. The caloric density of dark chocolate is potentially lower but has a large variability according to recipes and ingredients. Nevertheless, in the last decade, the interest in dark chocolate as a potential functional food has constantly increased. In this review, we present the nutritional composition, factors influencing the bioavailability, and health outcomes of dark chocolate intake. We have extracted pro- and counter-arguments to illustrate these effects from both experimental and clinical studies in an attempt to solve the dilemma. The antioxidative and anti-inflammatory abilities, the cardiovascular and metabolic effects, and influences on central neural functions were selected to substantiate the main positive consequences. Beside the caloric density, we have included reports placing responsibility on chocolate as a migraine trigger or as an inducer of the gastroesophagial reflux in the negative effects section. Despite an extensive literature review, there are not large enough studies specifically dedicated to dark chocolate that took into consideration possible confounders on the health-related effects. Therefore, a definite answer on our initial question is, currently, not available.

[The experimental evaluation in vivo of hypoglycemic properties of functional food ingredient - polyphenolic food matrix].

The aim of this study was the evaluation of hypoglycemic action of functional food ingredient (FFI) - a polyphenol food matrix in 3-month in vivo experiment with the use of fat male mice C57BL/6. The food matrix was produced by means of incubation of bilberry leaves extract (2% solution, pH 3.6) with buckwheat flour in ratio 1:50 during 45 min at 25 °C. The polyphenol content in experimental batch of matrix was 26.6±0.5 mg-equivalent of gallic acid per 1 g of flour. The experiment was conducted with the use of 46 male mice C57Bl/6c. Blood glucose level was estimated before starting the feeding experiment. An oral fasting glucose tolerance test (GTT) was also conducted, the area under the curve (AUC) was calculated. The animals were randomly divided into 4 groups (according to the body weight, glucose level and AUC): control group K1, fed with standard semisynthetic diet, control group K2 (n=10) and experimental groups G3 and G4 (n=13). The symptoms of type 2 diabetes in groups K2, G3 and G4 were modeled with the use of high-fat high-carbohydrate diet (HFHC diet, 30% fat, 20% sucrose). FFI was included into the diet of animals of experimental groups G3 and G4 in doses 2.5 and 5 g per 100 g of ration, respectively. The GTT test was repeated on the 40th and 82nd days of experiment. On the 15th, 54th and 91st days the insulin resistance test (IRT) was conducted. The consumption of HFHC diet by K2 group animals resulted in development of obesity in these animals to the week 11, which was characterized by increase in the body weight gain (37.1±4.9%) in comparison with control group K1 animals (23.4±2.2%). The introduction of FFI into animal's diet decreased significantly body weight gain of these animals in comparison with K2 group. On the week 8, the significant increase in blood glucose level of animals fed with HFHC diet was found (K2 - 8.2±0.3, G3 - 8.1±0.3, G4 - 8.5±0.3 mmol/L), in comparison with control group K1 (7.1±0.3 mmol/L). On the 91st day of experiment this difference remained significant only for group K2 (9.3±0.6 against K1 group - 7.7±0.3 mmol/L), what shows the beneficial hypoglycemic action of the FFI in both doses (for G3 group - 8.5±0.2, for G4 - 8.4±0.3 mmol/L). On the week 8 the disorder in glucose tolerance was found in animals of group K2, what is one of type 2 diabetes symptoms. The introduction of FFI in a dose 2.5 g/100 g into group G3 diet inhibited the development of these disease symptoms. The introduction of FFI in a higher dose (5 g/100 g of a diet) to a certain extent inhibited the development of insulin resistance. There was no effect of FFI, introduced into animal's diet, on cognitive functions and short-term and long-term memory.

[Current Status of Health Foods Including Their Interactions with Drugs and Adverse Events].

Although many people (and patients) in Japan currently consume health foods such as supplements, few have proper knowledge of their usefulness and safety. In December 2015, the Food Safety Commission of Japan issued a report and 19 messages mainly on the safety of health foods to disseminate appropriate knowledge to consumers. The report divided health food risks into three categories: 1) risks as food (e.g., increased lung cancer risk in smokers consuming excess ß-carotenoid); 2) risks as health foods (e.g., short consumption history, drug contamination, poor quality of active ingredients, and interactions with drugs); and 3) risks due to a lack of adequate scientific information on health foods. The risk of insulin autoimmune syndrome caused by α-lipoic acid is relatively high among Japanese individuals because its onset is associated with HLA-DRB1*04:06, an HLA allele occurring frequently in East Asian populations. As for health food-drug interactions, an important pharmacokinetic interaction between drugs and St. John's Wort was described from several viewpoints: different effects on drugs within the same class (depending on the metabolic pathway); interindividual differences in its effects; importance of considering active metabolite involvement; and time course of interaction. An example of an interaction affecting drug efficacy was also introduced. Because the Japanese government now promotes a health-supportive pharmacy program in which pharmacies have a role in supporting the health of local patients/consumers, pharmacists are expected to acquire more scientific information on health foods, evaluate their evidence levels, and provide that information in plain language to patients/consumers.

[Information System on the Safety and Effectiveness of Health Foods and Recent Topics].

Along with an increase in self-care and self-medication practices, the use of health foods as primary and secondary methods of disease prevention has increased. Consumers are aware only of the health benefits of dietary ingredients, although the potential risks associated with most ingredients are unknown. Adverse events associated with the use of health foods have been reported, and in some cases they were due to inappropriate use such as the concomitant use of several health foods or health foods and drugs. It is important that healthcare professionals, especially pharmacists, provide reliable, evidence-based information to ensure the safe and appropriate use of dietary supplements by their patients. Thus, we constructed an online database, the "Health Foods Network (HFNet)" that compiles reports on the safety and effectiveness of health foods and their ingredients. It serves to disseminate information based on scientific research not only in Japan but also worldwide. This article provides an overview of the HFNet. Additionally, findings from our recent survey and educational interventions among college students are discussed. We hope that this article will be helpful for pharmacists and other healthcare professionals who provide consultations on the use of health foods.

[Problems with Advertisements for Health Foods].

We have been studying the way advertisements for medicines have been monitored by the Health, Labour and Welfare Sciences Research Grants. In the last fiscal year, we identified products that were being advertised to general consumers, such as OTC drugs and designated quasi-drugs, and made recommendations to the Ministry of Health, Labour and Welfare on the methods of advertisement. Members of our research group, including physicians, pharmacists, and consumers, pointed out that advertisements for so-called health foods and foods with functional claims were much more unregulated than those for drugs, including OTC drugs. Thus, this fiscal year, we decided to focus on health foods. Advertisements for health foods are regulated by the Health Promotion Act and the Act against Unjustifiable Premiums and Misleading Representations; moreover, in many cases, cautions are issued by the Consumer Affairs Agency or prefectures. Several studies also reported health damage in patients who, because of their belief in advertisements, intentionally discontinued treatment or missed the opportunity to receive appropriate medical treatment. Here, we report inappropriate advertisements for health foods that may cause health hazards.

[Current Problems Associated with Overseas Health Products].

In recent years, consumer interest in health and health foods (e.g., dietary supplements) has increased, and the types of and market for health foods have also expanded rapidly. The safety of health foods is a significant concern in many countries. Numerous adverse events associated with the consumption of health foods have been reported. There are cases that have resulted in serious liver failure, renal failure, and death in other countries. These products may contain undeclared medical ingredients and toxic chemical compounds that are illegally and intentionally added or contain natural plant toxins. Products containing high levels of heavy metals have also been reported to cause such adverse events. Some products remain on the market, even after regulatory agencies alert consumers and issue warnings to their sellers. Moreover, because people can buy health foods from sources overseas via the Internet, adverse effects associated with the use of such products remain a concern. Two cases of adverse events were reported in Japanese individuals who purchased "OxyElite Pro" products imported privately. They are advertised as weight-loss and muscle-building products and have been associated with many cases of liver failure and hepatitis in the USA. In this paper, regulatory systems and adverse events associated with the use of health foods in other countries are discussed.

Nutraceuticals and functional foods for the control of plasma cholesterol levels. An intersociety position paper.

Current evidence shows that cholesterol management either reduces the likelihood of cardiovascular disease (CVD) or slows down its progression. Hence, it is important that all health professionals make appropriate use of all the available intervention strategies to control risk factors: from dietary improvement and positive lifestyle changes to the use of functional foods, food supplements, and drugs. This review examines the effect of the most frequently occurring cholesterol-lowering substances in functional foods or in supplements across Europe, namely plant sterols and stanols, monacolin K found in red yeast rice, berberine and beta-glucans. We conclude that currently available supplements and functional foods can effectively reduce plasma LDL cholesterol levels by about 5 to 25%, either alone or in combination. Suitable candidates for these products are mainly individuals at low absolute cardiovascular risk at a young age or according to classic algorithms. Of note, despite being freely available for purchase, these products should be used following shared agreement between the physician and the patient ("concordance").

The inhibitory effect of Manuka honey on human colon cancer HCT-116 and LoVo cell growth. Part 2: Induction of oxidative stress, alteration of mitochondrial respiration and glycolysis, and suppression of metastatic ability.

Despite its high content of phenolic compounds, the chemopreventive activity of Manuka honey (MH) is still elusive. The aim of the present work was to evaluate the effects of MH on oxidative stress, antioxidant enzymes, cellular metabolism and the metastatic ability in HCT-116 and LoVo cells, paying particular attention to the molecular mechanisms involved. We observed a strong induction of oxidative stress after MH treatment since it augmented the accumulation of reactive oxygen species and increased the damage to proteins, lipids and DNA. Furthermore, MH suppressed the Nrf2-dependent antioxidant enzyme expression (superoxide dismutase (SOD), catalase and heme oxygenase-1) and the activity of SOD, catalase, glutathione peroxidase and glutathione reductase. Cell metabolisms were markedly disrupted after MH treatment. It decreased maximal oxygen consumption and spare respiratory capacity, which could reduce the mitochondrial function that is correlated with cell survival potential. Simultaneously, MH decreased the extracellular acidification rate (glycolysis) of HCT-116 and LoVo cells. Furthermore, MH suppressed the p-AMPK/AMPK, PGC1α and SIRT1 activation, involved in the survival of HCT-116 and LoVo cells under metabolic stress conditions. Dose-dependently, MH reduced the migration and invasion (MMP-2 and MMP-9) ability, and concurrently regulated EMT-related markers (E cadherin, N cadherin, and ß-catenin) in both cell types. The above findings indicate that MH induces HCT-116 and LoVo cell death partly by enhancing oxidative stress, as well as by regulating the energy metabolism in both aerobic and anaerobic pathways and suppressing the metastatic ability.

The inhibitory effect of Manuka honey on human colon cancer HCT-116 and LoVo cell growth. Part 1: the suppression of cell proliferation, promotion of apoptosis and arrest of the cell cycle.

Numerous investigations have been made on plant phenolic compounds and cancer prevention in recent decades. Manuka honey (MH) represents a good source of phenolic compounds such as luteolin, kaempferol, quercetin, gallic acid and syringic acid. The aim of this work was to evaluate the chemopreventive effects of MH on human colon cancer HCT-116 and LoVo cells. Both cells were exposed to different concentrations of MH (0-20 mg mL-1 for HCT-116 cells and 0-50 mg mL-1 for LoVo cells) for 48 h to measure apoptosis and cell cycle arrest as well as apoptosis and cell cycle regulatory gene and protein expression. MH exhibited profound inhibitory effects on cellular growth by reducing the proliferation ability, inducing apoptosis and arresting the cell cycle in a dose-dependent manner. Interestingly, MH treatment in non-malignant cells did not exert any significant toxicity at similar concentrations. The apoptosis event was associated with the increasing expression of p53, cleaved-PARP and caspase-3 and with the activation of both intrinsic (caspase-9) and extrinsic (caspase-8) apoptotic pathways. MH induced cell cycle arrest in the S phase in HCT-116 cells, and simultaneously, in LoVo cells, it occurred in the G2/M phase through the modulation of cell cycle regulator genes (cyclin D1, cyclin E, CDK2, CDK4, p21, p27 and Rb). The expression of p-Akt was suppressed while the expression of p-p38MAPK, p-Erk1/2 and endoplasmic stress markers (ATF6 and XBP1) was increased for apoptosis induction. Overall, these findings indicate that MH could be a promising preventive or curative food therapy for colon cancer.

The Cardiovascular effects of chocolate.

The antioxidants as polyphenols, especially flavanols present in cocoa, exert a favorable effect on endothelium vasodilation, modulate inflammatory markers, and decrease platelet aggregation, lipid oxidation and insulin resistance. Recent nutritional intervention trials and molecular studies demonstrate that consumption of cocoa, particularly rich in flavanols, is beneficial to promote cardiovascular health. This review describes the cardiovascular effects of chocolate.