The term "nutraceutical" was coined from "nutrition" and "pharmaceutical"
in 1989 by Stephen DeFelice, MD, founder and chairman of the Foundation for
Innovation in Medicine (FIM), Cranford, NJ.1 According to DeFelice, nutraceutical
can be defined as, "a food (or part of a food) that provides medical or health
benefits, including the prevention and/or treatment of a disease."1 However, the term nutraceutical as commonly used in marketing has no regulatory
definition.2 I propose to redefine functional foods and nutraceuticals. When food is
being cooked or prepared using "scientific intelligence" with or without knowledge
of how or why it is being used, the food is called "functional food." Thus,
functional food provides the body with the required amount of vitamins, fats,
proteins, carbohydrates, etc, needed for its healthy survival. When functional
food aids in the prevention and/or treatment of disease(s) and/or disorder(s) other
than anemia, it is called a nutraceutical. (Since most of the functional foods
act in some way or the other as antianemic, the exception to anemia is considered
so as to have a clear distinction between the two terms, functional food and
nutraceutical.) Thus, a functional food for one consumer can act as a nutraceutical
for another consumer. Examples of nutraceuticals include fortified dairy products
(eg, milk) and citrus fruits (eg, orange juice). The DSHEA formally defined "dietary supplement" using several criteria.
A dietary supplement3: - is a product (other than tobacco) that is intended to
supplement the diet that bears or contains one or more of the
following dietary ingredients: a vitamin, a mineral, an herb or
other botanical, an amino acid, a dietary substance for use
by man to supplement the diet by increasing the total daily
intake, or a concentrate, metabolite, constituent, extract, or
combinations of these ingredients.
- is intended for ingestion in pill, capsule, tablet,
or liquid form.
- is not represented for use as a conventional food or as
the sole item of a meal or diet.
- is labeled as a "dietary supplement."
- includes products such as an approved new drug, certified
antibiotic, or licensed biologic that was marketed as a dietary
supplement or food before approval, certification, or license
(unless the Secretary of Health and Human Services waives this
provision).
Thus, nutraceuticals (as per the proposed definition) differ from dietary
supplements in the following aspects: - Nutraceuticals must not only supplement the diet but should
also aid in the prevention and/or treatment of disease and/or
disorder.
- Nutraceuticals are represented for use as a conventional food or as the sole item
of meal or diet.
A ray of "cure preference" in the mind of common patients revolves around
nutraceuticals because of their false perception that "all natural medicines are
good." Also, the high cost of prescription pharmaceuticals and reluctance of
some insurance companies to cover the costs of drugs helps nutraceuticals
solidify their presence in the global market of therapies and therapeutic
agents. The use of nutraceuticals, as an attempt to accomplish desirable therapeutic
outcomes with reduced side effects, as compared with other therapeutic agents
has met with great monetary success.4,5 The preference for the discovery
and production of nutraceuticals over pharmaceuticals is well seen in pharmaceutical
and biotechnology companies. Some of the pharmaceutical and biotechnology
companies, which commit major resources to the discovery of nutraceuticals
include Monsanto (St Louis, MO), American Home Products (Madison, NJ), DuPont
(Wilmington, DE), Abbott Laboratories (Abbott Park, IL), Warner-Lambert
(Morris Plains, NJ), Johnson & Johnson (New Brunswick, NJ), Novartis (Basel,
Switzerland), Metabolex (Hayward, CA), Genzyme Transgenic, PPL Therapeutics,
Interneuron (Lexington, KY). However, with all of the aforementioned positive points, nutraceuticals still
need support of an extensive scientific study to prove "their effects with reduced
side effects." 6,7 This can be achieved by the enactment of FIM proposed
Nutraceutical Research and Education Act (NREA).8 The NREA includes the creation
of a Nutraceutical Commission (NUCOM) specifically for the review and approval of
nutraceuticals and the creation of a nutraceutical research grants program specifically
for clinical research. As per FIM, the key elements of NREA should include a
mechanism to create the exclusive rights to claims necessary for private investment
in research and development, and the creation of appropriate channels for the review,
approval, and regulation of new products and claims. We believe that in so doing the
NREA should keep in check the cost of nutraceuticals and thereby assure access for
everyone.
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1.
Brower V. Nutraceuticals: poised for a healthy slice of the healthcare
market? Nat Biotechnol. 1998;16:728-731.
2.
Zeisel SH. Regulation of "Nutraceuticals." Science. 1999;285:185-186.
3.
FDA/CFSAN resources page. Food and Drug Administration Web site. Dietary
Supplement Health and Education Act of 1994. Available at:
http://vm.cfsan.fda.gov/~dms/dietsupp.html.
4.
Nelson NJ. Purple carrots, margarine laced with wood pulp? Nutraceuticals
move into the supermarket. J Natl Cancer Inst. 1999;91:755-757.
5.
Whitman M. Understanding the perceived need for complementary and alternative
nutraceuticals: lifestyle issues. Clin J Oncol Nurs. 2001;5:190-194.
6.
Heyland DK. In search of the magic nutraceuticals: problems with current
approaches. J Nutr. 2001;131(9):2591S-2595S.
7.
Elizabeth AC. Over-the-counter products: nonprescription medications,
nutraceuticals, and herbal agents. Clin Obstet Gynecol. 2002;45(1):89-98.
8.
DeFelice SL. FIM Rationale and Proposed Guidelines for the Nutraceutical
Research & Education Act - NREA, November 10, 2002. Foundation for
Innovation in Medicine. Available at:
http://www.fimdefelice.org/archives/arc.researchact.html.

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