Explaining Neutraceuticals

By Chuck Dinerstein, MD, MBA — May 18, 2021
Neutraceuticals is a portmanteau, the combination of the words "nutrition" and "pharmaceuticals." It refers to “a food containing health-giving additives and having medicinal benefit,” and which seeks to combine the halos of good nutrition and medicine. It seems too good to be true. And as you know, often that promise is more sizzle than steak.
Image by NatureFriend from Pixabay

 

 

 

“Let food be thy medicine, and medicine be thy food.” - Hippocrates

 

Neutraceutical is a relatively recent term, as this Ngram from Google demonstrates. It has a lot of cache in the marketing world, certainly compared to “food as medicine.” A neutraceutical is a constituent or component of food that has both nutritional and medicinal benefits – it is the basis for claiming that some foods, and they vary from year to year, are superfoods which 

“have gained attention as an alternative therapeutic and preventive approach alongside the advantages of being more affordable and available.”

Neutraceuticals are “bioactive derivatives” that accumulate within foods, including amino acids, fatty acids, phytochemicals, and everyone’s favorites antioxidants and probiotics. These components, in isolation, have a scientific foundation in supporting or improving our health. Though they sound suspiciously like supplements, when wrapped, literally, as a food, neutraceuticals seem so much more natural. Unless supplied by Big Agriculture, in which case they will be artificial and therefore evil. 

We certainly can’t label these bioactive derivatives as medicine, which would require FDA approval. From a marketing perspective, it is better to leave neutraceuticals in that grey area, part food, part medicine, below the regulatory radar.

Good, and good for you

There are a variety of ways to think about or classify these special foods. Beginning with most traditional, “functional foods.” Rice and wheat are the number one and two global staples, but other functional foods include:

  • Carrots with carotenoids, the source of carrots' color, having anti-inflammatory and antioxidant activity
  • Tomatoes contain lycopene, a phytochemical that helps maintain "chemical balance in the brain, thus providing neuroprotective activity.”
  • Plants with fiber that both increase transit of the rest of the meal through your GI tract, reducing constipation, and decrease transit to allow less of a sugar spike – a twofer health benefit
  • Herbs, especially the aromatics, are antioxidants, unless, of course, they are dried, and those properties are lessened
  • Fatty acids found in animal fats, fish oil, seeds, olive oil, and coconuts are anti-inflammatory and immune modulators
  • Biotics – including probiotics, beneficial bacteria found in fermented foods, especially milk and cheese. And prebiotics, the “fertilizing agent for probiotics,” promoting the probiotics, found in fruits and vegetables.

You can see that by breaking down any whole food into its constituents, you may find one element in sufficient quantities to have uncovered a neutraceutical!

Supplements are taken to “maintain and improve health and not to cure diseases.” That hurts the “ceutical” side of neutraceuticals, but you could make a case that a supplement is a medication when a nutritional deficiency does exist. Many of our foods have inadequate amounts of the necessary “ingredient,” or have had it stripped away in processing. Food can be “fortified” with the missing micronutrient, say calcium in orange juice, to reduce sugar spikes, but that is artificial and, by definition, bad. Bad neutraceutical! 

Even worse are neutraceuticals resulting from “genetic recombination and biotechnology.” Golden Rice, designed to provide Vitamin A, has been the poster child for shame and blame. But that is in part due to the technology being newish. There are other nutraceuticals, the products of biotechnology, that are not treated as poorly; cheese is one. It requires fermentation, biotechnology, albeit older, to create that product. I am not sure where to put plant-based “meat;” I’m leaning towards calling it a neutraceutical because it comes from plants, but the orthodox among us nix it because genetically modified yeast provides the “bloody” look and taste. 

Neutraceuticals as Medicine

No one will tell you outright to eat food as medicine, but it is frequently suggested to help. Neutraceuticals have been shown, in beakers and flasks, to inhibit cancer cells, to attenuate cancer signals, to promote bacteria, then, in turn, reduce colon tumors, to alter cell signaling to enhance chemo or radiation therapy. Their antioxidant and anti-inflammatory abilities go without mention. But all of this is in the laboratory. None of this has been shown to be causal in the real world you and I inhabit. For example, plants do exert effects on our digestion and will reduce lipid profiles and sugar spikes. Whether those changes will, in turn, reduce heart disease and diabetes remains unsolved.

They can’t hurt, can they?

The answer is that we don’t know. We do know that foods are safe, but neutraceuticals as supplements are untested, especially regarding their interactions with medicines that we might take. There is no regulation of the actual amounts of neutraceutical you are taking or what comes with it. Yes, beet extract seems on the face of it safe, but for those interested in its neutraceutical benefits, isn’t there a bit of concern that pesticides or fertilizers may have been part of the extract too?

“Let food be thy medicine, and medicine be thy food.” Hippocrates

I began with that quote. It is often found in articles discussing the medicinal value of food. It captures the essence of neutraceuticals. Not because of its words, but because Hippocrates never said them. First of all, everything we know about Hippocrates comes from those after him; he left few records. Second, for the Greek culture at the time, “food was considered as a material that could be assimilated after digestion (e.g., the air was also food) and converted into the substance of the body.” Medicine was “a product which was able to change the body’s own nature (in terms of humor quality or quantity) but not be converted into the body’s own substance.” They did not have marketers that would deliberately confuse the two. 

Just as marketers try to wrap nutritional and health halos, they try to create past wisdom that smooths the comparison of reducing food into nutritional elements rather than cuisine. 

“Hippocrates is the enemy of Big Pharma and its commodification of drugs, and the supporter of the pure and the natural; yet, of course, the holistic devotees of Hippocrates themselves have something to sell.” Hippocrates Now

Source: Nutraceuticals: Transformation of Conventional Foods into Health Promoters/Disease Preventers and Safety Considerations Molecules DOI: 10.3390/molecules26092540

 

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Chuck Dinerstein, MD, MBA

Director of Medicine

Dr. Charles Dinerstein, M.D., MBA, FACS is Director of Medicine at the American Council on Science and Health. He has over 25 years of experience as a vascular surgeon.

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