Functional Foods Leo Galland Director, Foundation for Integrated Medicine President, Applied Nutrition, Inc. DEFINITION The concept of functional foods
derives from the observation that certain foods and beverages exert beneficial
effects on human health that are not explained by their nutritional content (i.e.,
macronutrients, vitamins and minerals). The definition of functional
foods varies among countries for reasons that are historical, cultural and
regulatory. In
its broadest use, functional foods are food-derived products that, in addition
to their nutritional value, enhance normal physiological or cognitive functions
or prevent the abnormal function that underlies disease. A hierarchy of
restrictions narrows the definition. In most
countries, a functional food must take the form of a food or beverage, not a
medication, and should be consumed the way a conventional food or beverage is
consumed. If the ingredients are incorporated into pills, sachets or other
dosage forms, they are considered dietary supplements or nutraceuticals,
not functional foods. In HISTORY If the broadest, least restrictive definition is employed,
the use of functional foods for promoting health and relieving symptoms is as
old as the practice of medicine. Specific dietary recommendations for treating
or preventing various types of illness have been documented in Hippocratic and
Vedic texts and the canons of traditional Chinese medicine. Traditional Chinese
remedies frequently contain recipes for combining specific foods with culinary
and non-culinary herbs to produce healing mixtures. Folk medicine, East and
West, has always depended upon functional foods. Peppermint (Mentha piperita) tea
has a long history of use for digestive complaints. Peppermint oil contains spasmolytic components that block calcium channels in
smooth muscle. Cranberry (Vaccinium macrocarpon) juice contains proanthocyanidins
that inhibit the attachment of E .coli to the epithelium of the urinary
bladder, explaining its efficacy in prevention of bacterial cystitis and its
traditional use for treatment of urinary infection. Herbs and spices are added to food to enhance flavor and
initially were used to inhibit spoilage. Many of these have documented
medicinal uses that render them functional foods, broadly defined. Thyme (Lamiaceae spp) was
used as a vermifuge in ancient Fermentation is a form of food modification initially
developed for preservation. The health-enhancing effects of fermented foods
have a place in folk medicine. Several fermented foods have health benefits
that exceed those of their parent foods and can be considered functional foods,
broadly defined. These include red wine, yogurt and tempeh.
Red wine is a whole fruit alcohol extract that concentrates polyphenols
found primarily in the seed and skin of the grape. Its consumption is
associated with protection against heart disease, perhaps because red wine polyphenols inhibit the production of free radicals and
lipid peroxides that result from the simultaneous ingestion of cooked meat.
Fresh yogurt contains live cultures of lactic acid-producing bacteria that can
prevent the development of traveler's diarrhea, antibiotic-induced diarrhea,
rotavirus infection, and vaginal yeast infection, decrease the incidence of
post-operative wound infection following abdominal surgery and restore the
integrity of the intestinal mucosa of patients who have received radiation
therapy. Tempeh is made from dehulled,
cooked soybeans fermented by the fungus, Rhizopus
oligosporus. Not only is its protein content
higher than the parent soybean, it has antibiotic activity in vitro and
the ability to shorten childhood diarrhea in vivo. Modification of a food to make it less harmful by removing
potential toxins or allergens may create a functional food. Using this
criterion, infant formula, protein hydrolysates, low
sodium salt substitutes, low fat dairy products and low erucic
acid rapeseed oil (canola oil) might be considered functional foods. If the most restrictive definition of functional foods is
employed, the functional food movement began in Interest in the development of functional foods quickly
spread to North America and In EDIBLE PLANTS AND PHYTOCHEMICALS Because their
consumption is known to enhance health, vegetables, fruits, cereal grains, nuts
and seeds are the most widely researched functional foods. The health
benefits of a plant-based diet are usually attributed to the content of fiber
and of a variety of plant-derived substances (phytonutrients
and phytochemicals) with antioxidant, enzyme inducing
and enzyme inhibiting effects. Some phytochemicals
may also exert their health effects by modifying gene expression. Carotenoids, for example, enhance expression of the gene
responsible for production of Connexin 43, a protein
that regulates intercellular communication. The protective effect of carotenoid consumption against the development of cancer is
more strongly related to the ability of individual carotenoids
to upregulate Connexin 43
expression than their antioxidant effects or conversion to retinol. Dietary
supplementation with beta-carotene reduces the blood levels of other carotenoids, some of which are more potent inducers of Connexin 43 than is beta-carotene. The unexpected and
highly publicized increase in incidence of lung cancer among smokers taking
beta-carotene supplements may be explained by this mechanism. Phytochemicals associated with
health promotion and disease prevention are described in Table 2. The most
studied food sources of these phytonutrients are soy
beans (Glycine max) and tea (Camellia
sinensis leaves), but tomatoes (Lycopersicon esculentum),
broccoli (Brassica oleracea),
garlic (Allium sativum),
turmeric (Curcuma longa), tart cherries (Prunus cerasus) and
various types of berries are also receiving considerable attention as
functional food candidates. An overview
of the soy and tea research illustrates some of the clinical issues encountered
in the development of functional foods from edible plants. Soy protein extracts have been found to lower cholesterol in
humans, an effect that appears to be related to amino acid composition. Soy
protein extracts frequently contain non-protein isoflavones,
which have received considerable attention because of their structural
similarity to estrogen. Soy isoflavones are weak
estrogen agonists and partial estrogen antagonists. Epidemiologic and
experimental data indicate that isoflavone exposure
during adolescence may diminish the incidence of adult breast cancer. In
vitro studies show conflicting effects. On the one hand, soy isoflavones induce apoptosis of many types of cancer cells;
on the other hand, estrogen receptor-bearing human breast cancer cells
proliferate in tissue culture when exposed to isoflavones.
Although the widespread use of soy in Asia is cited in support of the safety of
soy foods, the intake of isoflavones among Asian
women consuming soy regularly is in the range of 15 to 25 mg per day,
significantly less than the isoflavone content of a
serving of soy milk as consumed in the Regular
consumption of tea, green or black, is associated with
a decreased risk of heart disease and several kinds of cancer. These benefits
are attributed to tea's high content of catechin
polymers, especially epigallocatechin gallate (ECGC), which has potent antioxidant and antiinflammatory effects, may lower cholesterol in hyperlipidemic individuals and alter the activity of
several enzymes involved in carcinogenesis. Catechin
content is highest in young leaves. Aging and the fermentation used to produce
black tea oxidize tea catechins, which polymerize
further to form the tannins, theaflavin and thearubigen. Although ECGC is a more potent antioxidant
than theaflavin, theaflavin
is far more potent an antioxidant than most of the commonly used antioxidants,
like glutathione, vitamin E, vitamin C and butylated hydroxytoluene (BHT). Both ECGC and theaflavin
are partially absorbed after oral consumption, but a clear dose-response
relationship has not been established. Tea-derived catechins
and polymers are being intensively studied as components of functional foods,
because the results of epidemiologic, in vitro and animal research
indicate little toxicity and great potential benefit in preventing cancer or
treating inflammation-associated disorders. Clinical trials have shown a mild
cholesterol-lowering effect and perhaps some benefit for enhancing weight loss.
PROBIOTICS AND PREBIOTICS Probiotics are live
microbes that exert health benefits when ingested in sufficient quantities.
Species of Lactobacilli and Bifidobacteria, sometimes combined with Streptococcus thermophilus are the main bacteria used as probiotics in fermented dairy products. Most probiotic research has been done with nutraceutical
preparations, but yogurt has been shown to alleviate lactose intolerance,
prevent vaginal candidosis in women with recurrent vaginitis and reduce the incidence or severity of
gastrointestinal infections. Prebiotics are
non-digestible food ingredients that stimulate the growth or modify the
metabolic activity of intestinal bacterial species that have the potential to
improve the health of their human host. Criteria associated with the notion
that a food ingredient should be classified as a prebiotic
are that it remains undigested and unabsorbed as it passes through the upper
part of the gastrointestinal tract and is a selective substrate for the growth
of specific strains of beneficial bacteria (usually Lactobacilli or Bifidobacteria), rather than for all colonic
bacteria, inducing intestinal or systemic effects through bacterial
fermentation products that are beneficial to host health. Prebiotic
food ingredients include bran, psyllium husk,
resistant (high amylose) starch, inulin
(a polymer of fructofuranose), lactulose,
and various natural or synthetic oligosaccharides, which consist of short chain
complexes of sucrose, galactose, fructose, Several prebiotics have documented
effects that are probably independent of their effects on gastrointestinal
flora. Whereas the high phytic acid content of bran
inhibits the absorption of minerals, FOS have been
shown to increase absorption of calcium and magnesium. Short chain
FOS are sweet enough to be used as sugar substitutes. Because they are
not hydrolyzed in the mouth or upper GI tract, they are non-cariogenic
and non-insulogenic. Bran contains immunostimulating polysaccharides, especially beta-glucans and inositol
phosphates, which have been shown to stimulate macrophage and natural killer
cell activity in vitro and in rodent experiments. The poor solubility
and absorption of beta-glucans and inositol phosphates are significant barriers to clinical
effects in humans. IMMUNE MODULATORS Several substances produced by animals and fungi have been investigated for immune modulating effects. Fish oils are the most studied. As a source of omega-3 fatty acids, fish oil consumption by humans has been shown to influence the synthesis of inflammatory signaling molecules like prostaglandins, leukotrienes and cytokines. In addition to direct effects on prostanoid synthesis, omega-3 fats have also been shown to directly alter the intracellular availability of free calcium ions, the function of ion channels and the activity of protein kinases. Generally administered as nutraceuticals rather than as functional foods, fish oil supplements have demonstrated anti-inflammatory and immune suppressive effects in human adults. A high intake of the omega-3 fatty acids, eicosapentaenoic (EPA) and docosahexaenoic (DHA), from seafood or fish oil supplements has also been associated with prevention of several types of cancer, myocardial infarction, ventricular arrhythmias, migraine headaches, and premature births, and with improved control of type 2 diabetes mellitus, inflammatory bowel disease, rheumatoid arthritis, cystic fibrosis, multiple sclerosis, bipolar disorder and schizophrenia. EPA but not DHA is effective for schizophrenia and depression; DHA but not EPA improves control of blood sugar in diabetics. The benefits of fish oil supplements have prompted efforts at increasing the omega-3 content of common foods by adding fish oil or flax oil extracts. Consumption of these has been associated with decreased levels of some inflammatory biomarkers, including thromboxane B2, prostaglandin E2 and interleukin 1-beta. Feeding
flax seed meal or fish meal to hens enriches the omega-3 content of the yolks
of the eggs they lay. Consumption of these omega-3 eggs increases the omega-3
content of plasma and cellular phospholipids and produces an improved blood
lipid profile when compared with consumption of standard eggs. Egg yolk is not
only a source of fatty acids, but also of carotenoids
and immunoglobulins. The xanthophyll
carotenoids zeaxanthin
and its stereoisomer lutein are readily absorbed from
egg yolk. Their consumption is associated with a decreased incidence of macular
degeneration and cataract. Immunizing hens to specific pathogens and extracting
the antibodies present in their egg yolks yields a functional food that has
been shown to prevent enteric bacterial or viral infection in experimental
animals. Bovine colostrum, the milk produced by cows during the first few days post-partum, has a long history of use as a functional food. Compared to mature milk, colostrum contains higher amounts of immunoglobulins, growth factors, cytokines, and various antimicrobial and immune-regulating factors. Consumption of bovine colostrum has been shown to reduce the incidence of diarrheal disease in infants and of symptoms of respiratory infection in adults. Specific hyperimmune bovine colostrums, produced by immunizing cows to pathogenic organisms like Cryptosporidium parvum, Helicobacter. pylori, rotavirus, and Shigella spp., may prevent or treat infection by these organisms. Human studies have also shown that consumption of bovine colostrum can improve anaerobic athletic performance and prevent the enteropathy induced by use of non-steroidal anti-inflammatory drugs. Mushrooms play a
major role in traditional Chinese medicine and as components of contemporary
Chinese health foods. Many Basidiomycetes
mushrooms contain biologically active polysaccharides in fruiting bodies,
cultured mycelium, or culture broth. Most belong to the group of beta-glucans that have both beta-(1-->3) and beta-(1-->6)
linkages. Although they stimulate macrophages and natural killer cells, the
anti-cancer effect of mushroom polysaccharide extracts appears to be mediated
by thymus-derived lymphocytes. In experimental animals, mushroom polysaccharides
prevent oncogenesis, show direct antitumor activity
against various cancers, and prevent tumor metastasis. Clinical trials in
humans have shown improvement in clinical outcome when chemotherapy was
combined with the use of commercial mushroom polysaccharides like lentinan (from Lentinus
edodes or shiitake), krestin
(from Coriolus versicolor)
or schizophyllan (from Schizophyllum
commune). Mushroom extracts may fulfill their potential more as medicines
than as functional foods. DESIGNER FOODS An important
direction in the development of functional foods is the combination of numerous
ingredients to achieve a specific set of goals, rather than efforts to uncover
the potential benefits of a single food source. Infant formula was probably the
first area for designer foods of this type, because of the profound influence
of nutrients on the developing brain and immune system. The addition of DHA to
infant formula for enhancing brain and visual development, the alteration of
allergenic components in food and the possible use of probiotics
and nucleotides to enhance immune response are important developments in this
area. Sports nutrition is another established arena for designer
foods. Specific nutritional measures and dietary interventions have been
devised to support athletic performance and recuperation. Oral rehydration
products for athletes were one of the first categories of functional foods for which
scientific evidence of benefit was obtained. Oral rehydration solutions must
permit rapid gastric emptying and enteral absorption,
improved fluid retention and thermal regulation, to enhance physical
performance and delay fatigue. Carbohydrates with relatively high glycemic index combined with whey protein concentrates or
other sources of branched chain amino acids have been shown to enhance recovery
of athletes. Caffeine, creatine, ribose, citrulline, L-carnitine and
branched chain amino acids have each been shown to improve exercise performance
or diminish post-exercise fatigue. Whether combinations of these ingredients,
blended into foods or beverages, will perform better than the individual
ingredients will help to determine the design of future sports foods. Optimal cardiovascular health involves prevention of
excessive levels of oxidant stress, circulating homocysteine,
cholesterol, triglycerides and fibrinogen, and protection of the vascular
endothelium. A mix of ingredients that may supply all of these effects could
consist of soy protein powder, oat beta-glucan, plant
sterols and stanols, folic acid, L-arginine, DHA, magnesium, and red wine or green tea polyphenols. Evidence suggests that addressing multiple
nutritional influences on cardiovascular health will be more beneficial than
addressing only one influence, but more definitive studies are needed. Genetic
factors may need to be incorporated for designer foods to achieve their full
potential. Polyunsaturated fatty acids, for example, raise the serum
concentration of HDL-cholesterol among individuals who carry the Apo A1-75A
gene polymorphism, but reduce HDL-cholesterol levels of individuals who carry
the more common Apo A1-75G polymorphism. RECOMMEDNED
Ashwell, M. (2001). Functional Foods: A Simple
Scheme for Establishing the Scientific Basis for all Claims. Public
Health Nutrition. CABI Publishing, Bellisle, F., Diplock,
A.T., Hornstra, G., Koletzko,
B., Roberfroid, M.B., et al., eds. (1998). Functional
Food Science in Publishing, Clydesdale, F. M., and Chan, S.
H., eds (1995), First International Conference on
east-West Persepctives on Functional Foods, Nutrition
Reviews, 54 (11, part II): S1-S202. Diplock, A.T., Aggett,
P.J., Ashwell, M, Bornet,
F., Fern, E.B., Roberfroid, M.B., eds. (1999). Scientific Concepts of Functional Foods
in British
Journal of Nutrition.
CABI Publishing, Farnworth, E.R., Handbook of Fermented Functional Foods
(2003) CRC Goldberg, I., editor (1994) Functional Foods Designer
Food, Pharmafoods, Nutraceuticals,
Chapman and Hall, ILSI Knorr, D. (1999). Technology Aspects
Related to Microorganisms in Functional Food. Trends in
Food Science and Technology. Issue):295–306. Langseth, L. (1995). Oxidants,
Antioxidants and Disease Prevention. ILSI Langseth, L. (1996). Nutritional
Epidemiology: Possibilities and Limitations. ILSI Langseth, L. (1999). Nutrition
and Immunity in Meskin, M.S., Biidlack B.I., Davies,
A.J., Omaye, S.T., eds
(2002)Phytochemicals
in Nutrition and Healt, CRC Roberfroid, M.B. (2000). Defining
Functional Foods. In: Gibson, G. and Williams, C., eds. Functional
Foods. Woodhead Publishing Ltd., Truswell, A.S. (1995). Dietary Fat: Some
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Table
1. Some ingredients conferring FOSHU status on Japanese
functional foods Ingredient Physiological
function_________ Dietary
fiber Improve
gastrointestinal function psyllium seed husk wheat bran hydrolyzed
guar gum Oligosaccharides Improve
gastrointestinal function xylo-, fructo-,
isomalto- and
mineral absorption soy-derived polydextrose Bacterial
cultures Improve
gastrointestinal function Lactobacilli Bifidobacteria
Soy
protein isolates Reduce
cholesterol levels Diacylglycerols Reduce
triglyceride levels Sugar
alcohols Prevent
dental caries maltitol palatinose erythritol Green
tea polyphenols Prevent
dental caries Absorbable
calcium Improve
bone health calcium
citrate malate casein phosphopeptide Heme iron Correct iron deficiency Eucommiacea (tochu) leaf glycosides Reduce
blood pressure Lactosucrose, lactulose, Improve
gastrointestinal function indigestible
dextrin Table 2. Phytochemicals Associated with Health Promotion and Disease Prevention Group Typical
components Biological
activities _____Food sources Carotenoids alpha- and beta-carotene Quench singlet and Red, orange and cryptoxanthin,
lutein, triplet
oxygen, increase yellow fruits and lycopene,
zeaxanthin cell-cell
communication vegetables, egg yolk, butter fat, margarine Glucosinolates,
indole-3-carbinol Increase
xenobiotic Cruciferous Isothiocyanates
sulphoraphane metabolism,
alter vegetables, estrogen metabolism horseradish Inositol inositol hexaphosphate
Stimulate natural killer
Bran, soy foods phosphates (phytate) cell function, chelate divalent cations Isoflavones genistein, daidzein Estrogen agonist and
Soy foods, kudzu antagonist, induce apoptosis Lignans enterolactone, Estrogen
agonists and Flax seed, rye enterolactone antagonists, inhibit tyrosine kinase Phenolic gallic, ellagic, ferulic, Antioxidant,
enhance Diverse fruits, acids chlorogenic,
coumaric xenobiotic metabolism
vegetables Phytoallexins resveratrol Antioxidant,
platelet Red wine, grape inhibition, induce seed apoptosis Polyphenols
flavonoids, chalcones, Antioxidant, enhance Diverse fruits, catechins, anthocyanins, xenobiotic
metabolism, vegetables, red proanthocyanidins inhibit numerous enzymes wine, tea Saponins glycyrrhizin,
Antimicrobial,
immune Legumes, nuts, ginsenosides boosting, cytotoxic to herbs cancer cells Sterols beta-sistosterol, Bind cholesterol,
decrease Nuts, seeds, campestrol colonic cell proliferation, legumes, stimulate T-helper-1 cells
cereal grains Sulfides diallyl sulfides Antimicrobial, antioxidant Garlic, onions This article is provided for general educational purposes only and is not intended to constitute (i) medical advice or counseling, (ii) the practice of medicine or the provision of health care diagnosis or treatment, (iii) the creation of a physician--patient relationship, or (iv) an endorsement, recommendation or sponsorship of any third party product or service by the sender or the sender's affiliates, agents, employees, or service providers. If you have or suspect that you have a medical problem, contact your doctor promptly. |
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