Developments in Nutraceuticals

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H. DUREJA et al.

Indian Journal of Pharmacology 2003; 35: 363-372 EDUCATIONAL FORUM

Correspondence: H. DurejaE-mail: [email protected]

ABSTRACT

KEY WORDS

DEVELOPMENTS IN NUTRACEUTICALS

H. DUREJA, D. KAUSHIK, V. KUMAR

Department of Pharmaceutical Sciences, M. D. University, Rohtak-124 001.

Manuscript Received: 28.4.2003 Revised: 19.7.2003 Accepted: 31.8.2003

In recent years there is a growing interest in nutraceuticals which provide health benefits and are alternativeto modern medicine. Nutrients, herbals and dietary supplements are major constituents of nutraceuticalswhich make them instrumental in maintaining health, act against various disease conditions and thuspromote the quality of life. The explosive growth, research developments, lack of standards, marketingzeal, quality assurance and regulation will play a vital role in its success or failure.

Dietary supplements herbals nutrients

Introduction

Consumers are deeply concerned about how their

health care is managed, administered and priced.

They are frustrated with the expensive, high-tech,

disease-treatment approach predominant in modern

medicine; the consumer is seeking complementary

or alternative beneficial products and the red tape ofmanaged care makes nutraceuticals particularly

appealing. Nutraceuticals (often referred to as

phytochemicals or functional foods) are natural

bioactive, chemical compounds that have health

promoting, disease preventing or medicinal

properties. Nutraceuticals are found in a mosaic of

products emerging from (a) the food industry, (b) the

herbal and dietary supplement market, (c)

pharmaceutical industry, and (d) the newly merged

pharmaceutical/ agribusiness/ nutrition conglo-

merates. The present article reviews the general

concept, categories, research developments, areas

of concern and regulatory aspects of nutraceuticals.The term nutraceutical was coined in 1979 by

Stephen DeFelice, founder and chairman of the

Foundation for Innovation in Medicine located in

Cranford, New Jersey. It was defined as a food or

part of food, that provides medical or health benefits,

including the prevention and treatment of disease1.

Nutraceuticals may range from isolated nutrients,

herbal products, dietary supplements and diets to

genetically engineered ''designer'' foods and

processed products such as cereals, soups and

beverages. Doubtlessly, many of these products

possess pertinent physiological functions and

valuable biological activities2. With the passage of

the Dietary Supplement Health and Education Act of1994, the definition of nutraceuticals has been

expanded to include vitamins, minerals, herbs and

other botanicals, amino acids and any dietary

substance for use by humans to supplement the diet

by increasing total dietary intake and subsequently

increased the use of nutraceuticals dramatically3,4.

However, functional food concept is different from

nutraceuticals and can be defined as food products

to be taken as part of the usual diet in order to have

beneficial effects that go beyond what are known as

traditional nutritional effects5. The goal of achieving

an optimal or maximal state of nutrition and health is

becoming an increasing challenge with theintroduction of many nutraceuticals6. The ascribed

health benefits of nutraceuticals are legion. Various

products are claimed not only to reduce the risk of

cancer and heart disease but also to prevent or

treat hypertension, high cholesterol, excessive

weight, osteoporosis, diabetes, arthritis, macular


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degeneration (leading to irreversible blindness),

cataracts, menopausal symptoms, insomnia,

diminished memory and concentration, digestive

upsets and constipation and not to mention

headaches4. Nutraceuticals are marketed in concen-trated forms as pills, capsules, powders and tinctures

either as a single substance or as combination

preparations7.

Categories of nutraceuticals

Nutraceuticals are non-specific biological therapies

used to promote wellness, prevent malignant

processes and control symptoms. These can be

grouped into the following three broad categories 8:

1. substances wi th estab li shed nut ri ti onal

functions, such as vitamins, minerals, amino

acids and fatty acids - Nutrients

2. herbs or botanical products as concentrates

and extracts - Herbals

3. reagents derived from other sources (e.g.

pyruvate, chondroitin sulphate, steroid

hormone precursors) serving specific

functions, such as sports nutrition, weight-loss

supplements and meal replacements Dietary

supplements.

Nutrients:

The most commonly known nutrients are antioxidant,water and fat-soluble vitamins. Many potential

benefits have been attributed to antioxidant use in

the form of dietary intake or supplementation9-13.

Antioxidants, in general, may be useful in the

prevention of cancer and cerebrovascular disease9.

High dietary intake of vitamin E may prevent

Parkinsons disease10. Agus et al., determined that

the oxidized form of vitamin C, dehydroascorbic acid,

readily crosses the blood brain barrier11. These

findings have implications for increasing the uptake

of antioxidants in the central nervous system; thus,

some feel that this has the potential for improving

the treatment of Alzheimers disease. Jialal and Fullerfound that the combination of vitamin E, C and beta

carotene has been useful in reducing low density

lipoprotein oxidation and subsequent athero-

sclerosis12.

Vitamin supplement is associated with increased

antibody titre response to both hepatitis B and tetanus

vaccines as a result of macrophage and T cell

stimulation13. Those genetically predisposed to

pancreatic cancer have low serum levels of selenium;

thus, it is assumed that supplementation with

selenium may help to prevent this condition14,15. Thosesuffering from asthma and skin cancer have also been

evaluated with selenium for its potential use, although

results have been inconclusive16. Zinc is an essential

component of more than hundred enzymes involving

digestion, metabolism and wound healing. L-arginine

is a semi-essential amino acid that is a substrate for

nitric oxide production. Ceremuzynski et al.,

demonstrated that supplementation of L-arginine

improved exercise capacity in patients, who had

angina17. A list of common nutrients with their health

benefits is given in Table 1.

Herbals:

Herbals are as old as human civilization and they

have provided a complete storehouse of remedies

to cure acute and chronic diseases. The knowledge

of herbals has accumulated over thousands of years

so that today we possess many effective means of

ensuring health care. Numerous nutraceuticals are

present in medicinal herbs as key components. A list

of commonly known herbal and phytochemical

products with their therapeutic activity is shown in

Table 2.

Herbal extracts, including -sitosterols (found in Saw

Palmetto berry), cernilton (pollen extract), and

pygeum africum (African plum) have been clinically

evaluated for use in the treatment of benign prostatic

hyperplasia20. It has been found that common herbal

treatment is in the use of Echinacea for the prevention

and treatment of colds and flu. A series of five placebo

controlled studies evaluating the use of Echinacea

produced mixed results, which the authors attribute

to either the use of healthy volunteers, rather than

patients, or the use of extracts that were not

standardized or chemically defined mono-

preparations21. Ernst suggested that St Johns wort

is efficacious for mild to moderate depression, butserious concern exists about its interactions with

several conventional drugs22.

Echinacea may be helpful in the treatment or

prevention of upper respiratory tract infections, but

trial data are not fully convincing. Saw Palmetto has

been shown in short term trials to be efficacious in

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Table 1. Common nutrients and their associated health benefits 18.

Nutrients Health benefits

Fat Soluble Vitamins

Vitamin A Antioxidant, essential, for growth and development, maintains healthy vision, skin and mucousmembranes, may aid in the prevention and treatment of certain cancers and in the treatmentof certain skin disorders.

Vitamin D Essential for formation of bones and teeth, helps the body absorb and use calcium

Vitamin E Antioxidant, helps form blood cells, muscles, lung and nerve tissue, boosts the immune system

Vitamin K Essential for blood clotting

Water Soluble Vitamins

Vitamin C Antioxidant, necessary for healthy bones, gums, teeth and skin, helps in wound healing, mayprevent common cold and attenuate its symptoms

Vitamin B1

Helps to convert food in to energy, essential in neurologic functions

Vitamin B2

Helps in energy production and other chemical processes in the body, helps maintain healthyeyes, skin and nerve function

Vitamin B3

Helps to convert food in to energy and maintain proper brain function

Vitamin B6

Helps to produce essential proteins and convert protein in to energy

Vitamin B12 Helps to produce the genetic material of cells, helps with formation of red blood cells,maintenance of central nervous system and synthesize amino acids and is involved inmetabolism of fats, protein and carbohydrates

Folic acid Necessary to produce the genetic materials of cells, essential in first three months of pregnancyfor preventing birth defects, helps in red blood cell formation, protects against heart disease

Pantothenic acid Aids in synthesis of cholesterol, steroids and fatty acids, crucial for intraneuronal synthesis ofacetylcholine

Minerals

Calcium Essential for building bones and teeth and maintaining bone strength, important in nerve,muscle and glanddular functions

Iron Helps in energy production, helps to carry and transfer oxygen to tissues

Magnesium Essential for healthy nerve and muscle function and bone formation, may help preventpremenstrual syndrome (PMS)

Phosphorous Essential for bui lding strong bones and teeth, helps in formation of genetic material, energyproduction and storage

Trace elements

Chromium With insulin helps t o convert carbohydrates and fats into energy

Cobalt Essential component of vitamin B12, but ingested cobalt is metabolized in vivoto form the B

12

coenzymes

Copper Essential for hemoglobin and collagen production, healthy functioning of the heart, energyproduction, absorption of iron from digestive tract

Iodine Essential for proper functioning of the thyroid

Selenium Antioxidant, essential for healthy functioning of the heart muscle

Zinc Essential for cell reproduction, normal growth and development in children, wound healing,production of sperm and testosterone

Vitamin like compounds

Biotin Required for various metabolic functions

L- Carnitine Oxidation of fatty acids, promotion of certain organic acid excretion and enhancement of therate of oxidative phosphorylation

Choline Lipotropic agent used to treat fatty liver and disturbed fat metabolism

Vitamin F Involved in proper development of various membranes and synthesis of prostaglandins,leukotrienes and various hydroxy fatty acids

Inositol Lipotropic agent necessary for amino acid transport and movement of potassium and sodium

Taurine Aids in retinal photoreceptor activity, bile acid conjugation, white blood cell antioxidant activity,CNS neuromodulation, platelet aggregation, cardiac contractility, sperm motility, growth andinsulin activity

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Table 2. Common herbal and phytochemical products19.

Compound Therapeutic activity

Aloe vera gel Dilates capillaries, anti-inflammatory, emollient, wound healing properties(Aloe veraL. N.L. Burm.)

Chamomile Antiinflammatory, spasmolytic, antimicrobial, wound healing(Matricaria recutitaL.)

Echinacea Immunostimulant, treatment of cold and flu symptoms(Echinacea purpureaL.)

Eleuthera Adaptogen(Eleutherococcus senticosus

Rupr. & Maxim., Maxim)

Ephedra Bronchodilator, vasoconstrictor, reduces bronchial edema, appetite suppressant(Ephedra sinicaStapf.,Ephedra intermediaSchrank.,Ephedra equisetinaBunge.)

Evening primrose oil Dietary supplement of linoleic acid, treatment of atopic eczema(Oenothera biennisL.)

Feverfew Treatment of headache, fever and menstrual problems, prophylactic to reduce frequency,(Tanacetum partheniumL.) severity and duration of migraine headaches

Garlic Antibacterial, antifungal, antithrombotic, hypotensive, fibrinolytic, antihyperlipidemic,(Allium sativumL.) antiinflammatory

Ginger Carminative, antiemetic, cholagogue, positive inotropic, treatment of dizziness(Zingiber officinale Rosc.)

Ginseng Adaptogen(Panax ginseng ,Panax quinquefoliusL.)

Ginkgo (Ginkgo bilobaL.) Vasodilation, increased peripheral blood flow, treatment of post-thrombotic syndrome, chroniccerebral vascular insufficiency, short term memory loss, cognitive disorders secondary todepression, dementia, tinnitus, vertigo

Goldenseal Antimicrobial, astringent, antihemorrhagic, treatment of mucosal inflammation,(Hydrastis canadensisL.) dyspepsia, gastritis

Horehound Expectorant, antitussive, choleretic(Marrubium vulgareL.)

Licorice Expectorant, secretolytic, treatment of peptic ulcer(Glycyrrhiza glabraL.,G. uralensisFisch.)

Melissa Topical antibacterial and antiviral(Melissa officinalisL.)

Plantago seed Cathartic(Plantago arenariaWaldst.,Plantago arenariaKit.Plantago ovata)

Slippery elm Mucilaginous demulcent, emollient and nutrient, used to sooth irritated mucous membranes,(Ulmus rubraMuhl.) ulcerations of the digestive tract

St. Johns wort Anxiolytic, antiinflammatory, antidepressant, monoamine oxidase inhibitor

(Hypericum perforatumL.)Valerian Spasmolytic, mild sedative, sleep aid

(Valeriana officinalisL.)

Willow bark Antiinflammatory, analgesic, antipyretic, astringent, treatment of rheumatic and arthritic(Salix albaL., conditions, headache and goutS. daphnoidesVillars,S. pentandraL.)

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reducing the symptoms of benign prostate

hyperplasia. Kava is an efficacious short term

treatment for anxiety. None of these herbal medicines

is free of adverse effects22. St. Johns wort, for

instance, interacts with prescription drugs leading topotentially serious consequences23. It is a mild

monoaminoxidase inhibitor and cannot be used with

high tyramine foods and antidepressants. A case

describes a kidney transplant patient whose

cyclosporin level dropped dramatically and

dangerously after self-medicating St. Johns wort

extract at only one-third of the recommended dose24.

It was suggested that gingko is of questionable use

for memory loss and tinnitus but has some effect on

dementia and intermittent claudication22. The increase

in microcirculation observed with ginkgo may be a

mechanism of the improvement of cognitive functionseen in healthy individuals and those with

dementia25,26. A positive effect of Ginkgo biloba on

cognitive function is not proven by data from rigorous

clinical trials. The use of Ginkgo bilobaas a "smart"

drug cannot be recommended on the basis of the

evidence available to date and there is a particular

need for further long term trials with healthy subjects27.

Vegetables, fruits, whole grains, herbs, nuts and

seeds contain an abundance of phenolic compounds,

terpenoids, sulfur compounds, pigments, and other

natural antioxidants that have been associated with

protection from and/or treatment of conditions suchas cardiovascular disease and cancer. The foods and

herbs with the highest anticancer activity include

garlic, soybean, cabbage, ginger, licorice root and

the umbelliferous vegetables. Citrus, in addition to

providing an ample supply of vitamin C, folic acid,

potassium, and soluble fibre, contains a host of active

phytochemicals. Clinical trials have not yet been able

to demonstrate the claimed protective effects from

taking supplements28. Epidemiological and experi-

mental studies suggest that dietary phytosterols may

offer protection from the most common cancers in

Western societies, such as colon, breast and prostate

cancer. The possible mechanisms by whichphytosterols offer this protection include the effect

on membrane structure and function of tumor and

host tissue, signal transduction pathways that

regulate tumor growth and apoptosis, immune

function of the host and cholesterol metabolism

by the host29.

Silagy and Neil suggested that garlic powder

preparation might be of some clinical use in subjects

with mild hypertension. However, there is still

insufficient evidence to recommend it as a routine

clinical therapy for the treatment of hypertensivesubjects30. Garlic is superior to placebo in reducing

total cholesterol levels. However, the size of the effect

is modest and the robustness of the effect is

debatable. The use of garlic for hypercholesterolemia

is therefore of questionable value31. The possible

protective effect of aqueous garlic extract against

oxidative organ damage distant from the original burn

wound was determined. Burn injury caused a

significant decrease in glutathione level and

significant increases in malondialdehyde and protein

oxidation levels and myeloperoxidase activity at post-

burn 2 and 24 h. Since garlic extract reversed these

oxidant responses it seems likely that garlic extractprotects tissues against oxidative damage32.

The infusion of pig growth factor-mobilized peripheral

blood leukocytes (containing 1 to 2% progenitor cells)

(pPBPC) into baboons is associated with a thrombotic

microangiopathy which results from a direct effect of

these pig cells on platelet aggregation. Ajoene is a

synthetic derivative of garlic that inhibits aggregation

of human platelets induced by all known agents.

Although ajoene is a powerful inhibitor of platelet

aggregation, the need for repeated administration and

its partial effect on pPBPC-induced platelet

aggregation would suggest that it may be of onlylimited value in preventing the thrombotic

microangiopathy that develops when pPBPC are

infused into baboons 33. Compounds like diallyl

sulfides, diallyl disulfides and quercetin which are

active components of garlic, have known anti-

inflammatory, antimutagenic activities. Similarly, active

components in tomato, such as kaempferol and

chlorogenic acid, have antimutagenic activities and

lycopene is the most active oxygen quencher with

potential chemo preventive activities. These results

suggest that tomato and garlic suspensions have a

protective effect on colon carcinogenesis which is

mediated by modulation of different biological

pathways during carcinogenesis34.

Honey has proven antimicrobial activity. Green tea

enhances humoral and cell mediated immunity while

decreasing the risk of certain cancers and the risk of

cardiovascular disease. Ginseng enhances

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production of macrophages, B and T cells, natural

killer cells and colony-forming activity of bone

marrow 13. Panax ginseng prevents irradiation-

induced programmed cell death in hair follicles,

suggesting important therapeutic implications.Nutraceuticals (dietary plants) like soya bean, garlic,

ginger and green tea which have been suggested, in

epidemiological studies, to reduce the incidence of

cancer may do so by inducing programmed cell death.

Soybean extract has been shown to prevent

development of disease like polycystic kidneys, while

Artemisia asiatica attenuates cerulein-induced

pancreatitis in rats. Interestingly enough, a number

of food items as well as herbal medicines have been

reported to produce toxic effects by inducing

programmed cell death35.

Four nutraceuticals, sugar beet roots, cucumberfruits, New Zealand spinach leaves and turmeric

rhizomes, were evaluated for their comparative

effectiveness against dimethylbenz (a)anthracene-

initiated and croton oil-promoted skin tumours and

found that turmeric is the most potent nutraceutical

against such tumours36. Scientific evaluation of herbal

products has been limited, yet herbal products are

the most commonly consumed health care products.

Because of known pharmacological effects and

potential interaction of many of these compounds with

therapeutic drugs, a history of herbal intake should

be considered as part of routine medical history and

should be evaluated before any change in prescriptiondrugs and before medical procedures37.

Dietary supplements:

Dietary supplements have also been developed to

manage a variety of diseases. For instance, pre-

packaged, nutritionally balanced meals that meet the

recommendations of national health organizations

influenzed multiple risk factors for patients with

cardiovascular disease and increased patient

compliance with dietary restrictions38. Ketogenic diets,

comprised of foods high in fat and low in protein and

carbohydrate content, have been reported to improve

seizure control. However, these diets are widely

acknowledged to be unpalatable, making sustained

compliance with dietary restrictions difficult39. Cereals

and grains is an area of nutraceuticals in which

calcium fortification is very strong. Kelloggs is a

leader with calcium fortified All-Bran plus and

Nutrigrain bars. Researchers have found that

minimally refined grains may reduce the incidence

of diabetes40 and may be beneficial in the prevention

of gastrointestinal cancers41.

Burgeon is bread containing soya flour and linseeds,which provide phytoestrogens, natural substances

that mimic the structure of hormone oestrogen.

Phytoestrogens have been documented to enhance

oestrogens levels when hormonal levels are low or

to weaken the effects of oestrogen when levels are

high. This action may prevent against both hot flushes

and breast cancer. Other common foods that may

have potential therapeutic value include edible

mushrooms. For example, several species of edible

mushrooms in order of decreasing cultivated tonnage,

Lentinus (shiitake), Pleurotus (oyster), Auricularia

(mu-er), Flammulina (enokitake), Tremella (yin-er),

Hericium, and Grifola (maitake) have varying degreesof immunomodulatory, lipid lowering, antitumor and

other beneficial or therapeutic health effects without

any significant toxicity42.

Zbar and NiteBite are two products in the form of

bars that contain sucrose, protein and uncooked

starch in order to provide continuous glucose release

to diabetics during the night. The sucrose is released

immediately while the protein is converted to glucose

approximately 2-5 hours after ingestion and the

uncooked starch is converted to glucose 6-8 h post

ingestion43,44. Stadelman found a novel and exciting

application of egg technology by using the eggantibodies to prevent or treat diseases45.

The two nutraceuticals namely glucosamine sulfate

and chondroitin sulfate are effective and safer to

alleviate symptoms of osteoarthritis46 whereas Deal

and Moskowitz emphasized that glucosamine sulfate

and chondroitin sulfate are not FDA-evaluated or

recommended for treatment of osteoarthritis 47.

Immune milk products are promising examples of

health promoting nutraceuticals48. Numerous casein

and whey protein derived angiotensin-I-converting

enzyme inhibitory peptides/hydrolysates have been

identified. These peptides/hydrolysates may be

classified as nutraceuticals due to their ability to

provide health benefits49. Buckwheat has been used

and will be better used as an important raw material

for functional food production. Buckwheat proteins

have unique amino acid composition with special

biological activities of cholesterol-lowering effects,

antihypertension effects and improving constipation

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and obesity by acting similar to dietary fiber and

interrupting the in vivo metabolism. The trypsin

inhibitor isolated from buckwheat seeds are heat

stable and can cause poor digestion if they are not

suitably cooked before consumption. The buckwheatseeds may also contain some allergenic proteins,

which induces allergy. Buckwheat flour can improve

diabetes, obesity, hypertension, hypercholesterolemia

and constipation50.

An emerging area of nutraceuticals is that of dairy

foods containing friendly or probiotic bacteria claimed

to promote gut health. Bio yoghurts containing

Lactobacillus acidophilusand Bifidobacteria lead the

sector; whilst specialist fermented products such as

yakut (providing L casei Shirota), nestles LC1

(providing Lactobacillus johnsonii) and the culturelle

(providing Lactobacillus GG) are also strongplayers 51. Drinks are a fast developing area of

functional foods. A new range of herb and vitamin

enhanced drinks called Phuse claims to help

overcome problems ranging from postmenstrual

syndrome to lack of energy52.

Recently, Mei et al. prepared calcium caseinate and

whey protein isolate films and found that these films

may be used for wrapping or coating to enhance the

nutritional value of foods53. Because of these findings,

nutraceuticals are becoming more widely accepted

as an adjunct to conventional therapies for enhancing

general well being. As a result of extensive research

on these nutraceuticals various products are availablein National and International market and some of

these are shown in Table 3.

Areas of concern

The lack of quality control is a major area of concern

for nutraceuticals56. The quality of plant material and

manufacturing processes used for nutraceuticals are

regulated by food laws, which lack the specificity

required for botanical drugs. This can have serious

consequences. Contamination, for instance, with

toxins after fungal infection of raw plant material or

with other ingredients has been repeatedly reported

and can have potential fatal consequences 57.Adulterations and numerous other types of impurity

of nutraceuticals conceivably remain undetected

simply because there is an almost total absence of

specific quality control. Absence of quality control not

only increases the risk to the consumer, it also results

in a total lack of impetus to conduct adequate

research that demonstrates the potential benefits of

nutraceuticals or ensures their safety58.

New clinical applications of nutraceuticals are

increasingly being reported, but there are fundamental

differences between formulation, production and the

evidence supporting clinical use. Nutraceuticals

generally fall within the novel foods and ingredients

regulations but their purity, dosage requirements and

clinical consequences exceed those of most

healthfoods. Replacement of one nutrient or

antioxidant is unlikely to correct the cascade of

interconnected metabolic abnormalities associated

with many diseases59. Cost is another factor that

receives scant attention. These products sell for

substantial amounts more than mainstream products,

in as much as botanicals are costly to produce.

Regulatory aspects

In USA, watershed legislation was passed in 1994 to

regulate the manufacture and marketing of

nutraceuticals. This law, known as the Dietary

Supplement Health and Education Act, reversed 45

years of increasing FDA regulation of health related

products60. The FDA may establish good manu-

facturing practices for nutraceuticals as long as these

regulations are molded after the less stringent

regulations for foods as opposed to those for drugs.

A draft law reminiscent of the Dietary Supplement

Health and Education Act is in development in India

to regulate manufacturing, importing and marketingof health foods/dietary supplements and other

nutraceuticals. Also the country's central drug control

department has put some structures in place for

dietary supplements, but it is taking a long time for

states to cooperate and some states have rejected

the structures when their own rules and regulations

conflict. Also a new independent association has been

formed in India to address some of these issues.

The Indian Health and Dietary Supplement

Association was created to represent pharmaceutical,

nutraceutical, herbal, direct selling and other service

oriented industry companies and plans to affiliate withthe International Alliance of Dietary Supplement

Associations in the near future. The association is

planning a scientific conference to bring the industry

and government together to share information,

experience and perspectives on the use and

regulation of dietary supplements.

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Table 3. List of marketed nutraceutical products54-55.

Product Category Contents Manufacturer

Coral calcium Calcium supplement Calcium and trace minerals Natures answer, Hauppauge,

NY, USAWeight smartTM Nutritional supplement Vitamins and trace elements Bayer corporation, Morristown,

NL, USA

Omega woman Immune supplement Antioxidants, vitamins and Wassen, Surrey, U.K.phytochemicals (eg.Lycopene,and resveratrol)

Appetite InterceptTM Appetite suppressant Caffeine, tyrosine and Natrol, Chatsworth, CA, USAphenylalanine

ChaserTM Hangover supplement Activated calcium carbonate Living essentials, Walled lake,and vegetable carbon MI, USA

Rox Energy drink Taurine, caffeine and Rox America, Spartanburg, SA, USAglucuronolactone

Mushroom optimizerTM Immune supplement Mushrooms, polysaccharides Jarrow formulas, Los Angeles,

and Folic acid CA, USABiovincaTM Neurotonic Vinpocetine Cyvex nutrition, Irvine, CA, USA

Proplus Nutritional supplement Soy proteins Campbell soup company, Camden,NJ, USA

Snapple-a-dayTM Meal replacement beverage Vitamins and minerals Snapple beverage group, WhitePlains, NY, USA

WelLife Amino acid supplement Granulated-L-glutamine Daesang America Inc.,Hackensach, NJ, USA

PNer plusTM Neuropathic pain Vitamin and other natural NeuroHelp, San Antonio, Texas, USAsupplement supplement

OlivenolT M Dietary supplement Natural antioxidant, Cre Agri, Hayward, CA, USAhydroxytyrosol

Threptin Diskettes Protein supplements Proteins and vitamin B Raptakos, Brett & Co. Ltd.,

Mumbai, IndiaGRD Nutritional supplement Proteins, vitamins, minerals Zydus Cadila Ltd. Ahmedabad, India

and carbohydrates

Proteinex Protein supplement Predigested proteins, vitamins, Pfizer Ltd., Mumbai, Indiaminerals and carbohydrates

Calcirol D-3 Calcium supplement Calcium and vitamins Cadilla healthcare limited,Ahmedabad, India.

Conclusion

Nutraceuticals are destined to play an important role

in future therapeutic developments but their success

will be governed by control of purity, safety and

efficacy without inhibiting innovation. Nutraceuticals

will continue to appeal because they are convenient

for todays lifestyle. Some are also genuinely

researched and offer novel ingredients that can bring

about health benefits quicker than would normally

be the case through eating conventionally healthy

foods alone. The present accumulated knowledge

about nutraceuticals represents undoubtedly a great

challenge for nutrit ionists, physicians, food

technologists and food chemists. Public health

authorities consider prevention and treatment with

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nutraceuticals as a powerful instrument in maintaining

health and to act against nutritionally induced acute

and chronic diseases, thereby promoting optimal

health, longevity and quality of life. A place for

nutraceuticals in clinical practice is emerging, butimportant pharmaceutical and clinical issues need to

be addressed by further research.

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