These days, only those skilled in the art and science of nutrition seem to realize how many positive studies on dietary supplements and nutraceuticals have been published in recent years. There has been a veritable avalanche citing nutritional benefits of certain foods, nutrients and herbs. This stands in contrast to the negative information that frequently emanates from the mainstream press. What puzzles many in the nutrition industry is the speed with which public opinion can be turned by the findings of just one study.
One of the most recent and shocking of these studies told of increased prostate cancer rates related to heavy multivitamin use1. Although the authors pointed out several biases of the research, the press ignored these caveats and printed sweeping headlines stating that multivitamin use caused cancer. An ensuing study claimed that people who ate a diet rich in B vitamins could cut their risk of pancreatic cancerâ€”except for those people who got their B vitamins from supplements; it was suggested the latter group has a 139% increased risk of developing the disease2. The researchers in the second study did state it was preliminary, but suggested that, in combination with other results, there was the possibility of an increased risk of cancer associated with supplement use. They stated this because “if a person did not take in enough of these nutrients consistently through diet and then suddenly started taking multivitamins in an effort to become healthy” that it might “fuel pancreatic cancer growth.” Again, the bias that participants in these studies might be at a greater risk of developing the disease because of their previous diets (and, consequently, were at a greater risk of mortality) was absent from the headlines.
The recent treatment of supplements as potential dangers is quite different from the time when the media was quick to tout them as a cure for all sorts of illnesses, without the support of strong scientific research. The recent wave of suspicion against supplements coincided with the first large epidemiological studies that linked beta-carotene to reduced cancer risk if taken in food form and to increased risk if taken in supplement form. Although a few studies confirmed that supplemental purified beta-carotene was to blame, there was little effort made to distinguish these effects from other mixed carotenoid supplemental sources of beta-carotene. Another carotenoid that has received much positive attention, especially for reducing the risk of prostate and cervical cancers, is lycopene. Yet again, after several studies showing positive benefits for preventing prostate cancer, a study released this year concluded that blood lycopene levels were found to have no effect on prostate cancers, and this has received widespread media attention3.
This negative trend in the popular media and in some scientific reports also impacts trade statistics. The market for nutritional supplements totaled $4.7 billion in 2006, up only 1% over previous years’ sales, according to Packaged Facts, a publishing division of MarketResearch.com, in its report titled “Nutritional Supplements” (November 2006). According to the report, “The main reason for this lackluster performance is the recent spate of negative media reports regarding nutritional supplements, which have dampened consumer confidence in the products even as functional foods continue to attract a wider following.” The report identified a new focus on condition-specific supplements as an area that can help the nutritional supplement market rebound and predicted that the market for supplements will improve through 2011. Much growth will be due to targeting specific conditions of concern to Baby Boomers. Likewise, they see the use of more functional food ingredients (like cranberry and pomegranate) and food-like delivery systems pushing supplement sales. Packaged Facts predicts that consumer confidence will return as positive reports emerge to contradict negative claims.
Recent research suggests some opportunity with such condition-specific areas as:
Diabetes and Insulin SensitivityChocolate lovers rejoice! There has been more good news about chocolate this year, including the claim that cacao liquor proanthocyanidins may prevent elevation of blood glucose in diabetic, obese mice. The researchers suggested that dietary intake of food or drinks made from cacao beans might help prevent the onset of type 2 diabetes4. Additionally, the consumption of magnesium-rich products, especially whole grains, was found to cut the risk of type 2 diabetes by 35% in African-American women5.
Weight ControlChocolate fanatics are not the only ones getting good news. Red wine drinkers also have something to sing about, as one finding on the benefits of resveratrol, the phenolic derivative found in red wine and some plants, was described as “the breakthrough of the year.” Resveratrol fed to mice on high-calorie diets was found to protect the mice from the negative effects of their debaucherous behavior. A month later, another group of researchers found that mice fed resveratrol were found to be protected against diabetes and obesity6,7.
Findings that show that small nutritional compounds could have such an effect on the outcomes of obesity are important at a time when more pressure is being put on the food industry to cope with this growing epidemic. Although the correlation between obesity and certain types of cancer had already been known, in 2006 it was found that obesity was linked to more aggressive tumor types in people with ovarian cancer (as well as a bleaker prognosis)8.
Research that links certain healthy foods to lowering obesity has also been accumulating. For example, a handful of almonds rich in flavonoids, antioxidants, vitamin E and magnesium may be able to induce a feeling of satiety and help aid people in managing their weight9. Likewise, a new meta-analysis has revealed that conjugated linoleic acid (CLA), a dairy component, has a modest effect in reducing body fat (at the dose of 3.2g/day)10.
Cholesterol ControlAccording to a 2007 report by Frost & Sullivan entitled “New Excitement in the Natural Cholesterol Reducing Products Market,” a dietary supplement that is a proprietary combination of polymethoxylated flavones from orange peel and Phellodendron amurense extract is “set to storm the market.” When compared to other cholesterol-reducing products on the market, the new combination is said to have a different mechanism of action than statin drugs and might be a good complementary strategy for prescription drug users.
Enhanced Energy and/or Sports ProductsIn a double-blind, placebo-controlled, three-way crossover trial, apple extract was found for the first time to improve physical fatigue11. The branded apple extract (1,200mg/day) was given for eight days and found to improve physical performance on a bicycle ergometer with fatigue-inducing workload trials.
Eye HealthPeople who eat at least two servings of fish per week have been found to be less likely to develop age-related macular degeneration (AMD). Subjects with diets high in omega-3 fatty acids, coming predominantly from tuna, salmon or other oily fish, were close to 40% less likely to have AMD than those who ate little omega-312.
Digestive HealthLast year, at a research conference sponsored by an oligosaccharide supplier, the co-chair of the event was quoted as saying, “Prebiotics potentially may be more relevant [for health] than probiotics.” Key health benefits of prebiotics that have been studied are bone health and colorectal cancer prevention.
However, new research unveiled last year showed that natural resistant starch may be delivering health benefits through a previously overlooked mechanism. Although energy dilution and bulking were thought to be the main theories explaining fiber’s benefits, the new research shows fermentation has a greater impact on cellular metabolism and fat deposition than the other theories13.
Bone HealthResults of a recent study on the mounting effects of prebiotics on improved bone health found that supplementation of the diet with the soluble fibers inulin and oligofructose boosts calcium absorption in rats by 40%. Better calcium absorption was also shown in adolescent girls and postmenopausal women in a previous study14. It is thought that these studies will open up whole new areas of research15.
One of the areas that alternative medicine proponents have been talking about for literally decades is the acid/base balance of the diet and its implications upon wellness and bone health. Recent research demonstrated for the first time that by just partially reversing the acidity of the diet, bone mass increased to a degree previously found when induced by pharmaceuticals. This research may open up new avenues of research into the benefits of lowering the high acidity of the modern diet16.
Although accepted as an important nutrient in the prevention of osteoporosis, vitamin D’s role in these benefits has been largely unknown. However, a recent study found that orally administered vitamin D inhibited the production of a protein called c-Fos, a key factor in the development of the cells that degrade and reabsorb bone (thereby tipping the quotient to more bone formation)17. This study is one of several that has increased public awareness of the vitamin and spurred sales in the U.K. One of these studies reviewed the evidence of what constituted the best source of vitamin D. It was recommended that with the high rates of skin cancer, the U.K. researchers’ proposal to get vitamin D through 10 to15 minutes of unprotected sun exposure in the middle of the day was “highly irresponsible.” As a result, taking supplements and the diet were concluded as being more responsible and still effective18.
Mood and Cognitive HealthDaily fish oil supplementation has been found to reduce anger levels as well as balance other mood states, such as anxiety and the tendency towards aggressive behavior. A new study adds to the mounting clinical evidence that low levels of omega-3 oils, particularly EPA and DHA, contribute to anger and anxiety and depressive, suicidal and aggressive behaviors19. Omega-3 fatty acids, especially DHA, have also been found recently to potentially lower the risk of dementia and Alzheimer’s disease20.
According to a study on the benefits of the Mediterranean-style diet, the risk of Alzheimer’s disease may also be cut 68% though adherence to the diet21. The researchers theorized that the Mediterranean diet could be “capturing the composite effect of dietary antioxidants.” In another study, drinking three glasses of fruit or vegetable juice a week was found to potentially cut the risk of Alzheimer’s disease by 75%22. This research also points out that it is not the antioxidant vitamins (C, E and beta-carotene), but the antioxidant polyphenols that contribute the benefits. Another recent study showing similar results for the reduction of Alzheimer’s disease by antioxidant polyphenols showed pomegranate juice could halve the build-up of proteins in the brain that are linked to the development of Alzheimer’s23.
In a model that induced dementia in ratsâ€”by replicating the normal process of aging through radiation exposureâ€”both strawberry and blueberry extracts were found to provide protection from the effects of radiation (or aging) on brain function. The rats were fed berry extracts for eight weeks prior to the radiation exposure. The researchers noted that this was not the first evidence linking blueberries to protection from dementia and Alzheimer’s24.
Green tea extract (EGCG, specifically) has been found to potentially slow the progression of Huntington’s disease, a disease that is characterized by neurotoxicity, due to an accumulation of mutated proteins in people who have the genetic propensity to the disease. This research adds to the growing body of evidence on the health benefits for green tea, including lowering the risk of certain cancers, increasing weight loss and protecting against Alzheimer’s25.
This year, a large-scale clinical trial is being launched by the National Institute of Neurological Disorders and Stroke to assess if creatine can slow the progression of Parkinson’s disease. If the results are positive, this study could spell new formulation and marketing opportunities for creatine.
Looking ForwardAs can be seen even in the sampling of scientific and media reports about condition-specific news on supplements, the overlap between supplements and functional foods is increasing. Just as food companies are developing more products geared toward functional foods, supplement companies are expected to be developing more “food like” products such as powdered or extract versions of green tea and pomegranate. Consumers also will see additional food-based polyphenol antioxidant sources, such as berries, CLA, apple and citrus extracts, omega-3 fatty acid sources and even wine and chocolate.
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2 Schernhammer, E, et al. 2007. Plasma Folate, Vitamin B6, Vitamin B12, and Homocysteine and Pancreatic Cancer Risk in Four Large Cohorts Cancer Res. 67:5553-5560.
3 Peters, U, et al. 2007. Serum lycopene, other carotenoids, and prostate cancer risk: a nested case-control study in the prostate, lung, colorectal, and ovarian cancer screening trial. Cancer Epidemiol Biomarkers Prev. 16:962-8.
4 Tomaru, M, et al. 2007. Dietary supplementation with cacao liquor proanthocyanidins prevents elevation of blood glucose levels in diabetic obese mice. Nutrition. 23:351-5.
5 Qi, L, et al. 2006. Whole-grain, bran, and cereal fiber intakes and markers of systemic inflammation in diabetic women. Diabetes Care. 29:207-11.
6 Baur, JA, et al. 2006. Resveratrol improves health and survival of mice on a high-calorie diet. Nature. 444:337-42.
7 Lagouge, M, et al. 2006. Resveratrol improves mitochondrial function and protects against metabolic disease by activating SIRT1 and PGC-1alpha. Cell. 127:1109-22.
8 Pavelka, JC, et al. 2006. Effect of obesity on survival in epithelial ovarian cancer. Cancer. 107:1520-4.
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14 Abrams, SA, et al. 2005. A combination of prebiotic short- and long-chain inulin-type fructans enhances calcium absorption and bone mineralization in young adolescents. Am J Clin Nutr. 82:471-6.
15 Holloway, L, et al., 2007. Effects of oligofructose-enriched inulin on intestinal absorption of calcium and magnesium and bone turnover markers in postmenopausal women. Br J Nutr. 97:365-72.
16 Jehle, S, et al., 2006. Partial neutralization of the acidogenic Western diet with potassium citrate increases bone mass in postmenopausal women with osteopenia. J Am Soc Nephrol.17:3213-22.
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21 Scarmeas, N, et al. 2006. Mediterranean diet, Alzheimer’s disease, and vascular mediation. Arch Neurol. 63:1709-17.
22 Dai, Q, et al., 2006. Fruit and vegetable juices and Alzheimer’s disease: the Kame Project. Am J Med. 119:751-9.
23 Hartman, RE, et al., 2006. Pomegranate juice decreases amyloid load and improves behavior in a mouse model of Alzheimer’s disease. Neurobiol In a model that induced dementia in rats, both strawberry and blueberry extracts were found to provide protective effects.
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