Functional foods and nutraceuticals

in the management of diseases

Speaker : Arvind,
Assistant Professor (Biochemistry & Nutrition)
CFST, I. Ag. Sc., BHU, Varanasi
 Functional foods
❑ Foods that contain some health promoting ingredients beyond
basic nutrients

❑ Functional foods are either enriched or fortified - Nutrification

 Nutraceuticals
Nutrition + Pharmaceuticals
Coined by Dr. Stephen L. DeFelice, 1989
A product isolated or purified from foods and generally sold in
medicinal forms not usually associated with food and demonstrated to
have a physiological benefits or provide protection against diseases.

Dietary Supplements
A product that contains nutrients derived from food products that are
concentrated in liquid or capsule form
Dietary Supplement Health and Education Act (DSHEA) , 1994- a
product taken by mouth that contains a “ dietary ingredients” intended to
supplement the diet.
Dietary ingredients may be vitamins, minerals, herbs, Amino Acids,
Enzymes & other metabolites
 Cold/
Ginger Cough/Antiinflammatory/

Antiseptic/Antibacterial/
Curcumin Antioxidant/
Anticarcinogenic
Respiratory disorders/
Tulsi Cold/ Cough/ Skin
care/Antioxidant
Reduction in
CVD/Reduction in
Garlic Diabetes/Blood
purifier/Prevents prostrate
cancer
Antioxidant
Amla
 Example of functional
components
Components Sources Potential benefits

CLA Milk / Meat Immunomodulatory/Antic

arcinogenic/Antiatherogen
ic
Anthocyanidin Fruits/Cranberry Juice Reduce risk of
cancer/Antioxidant
Catechins/Gallic Acid Tea/Rape seed/ Grapes Antioxidant

Flavones Fruits/Beans/Vegetables Reduce cancer risk

Proanthocyanidine Cocoa/ Chocolate Reduce CVD

Insoluble dietary fibres Wheat Bran Reduce colon cancer risk

Soluble dietary fibres Oat bran Reduce Cholesterol

Components Sources Potential benefits

Diadzein/Zenistein Soyabean/Flex seed Reduce menopause

symptoms/Bone health

Lycopene Tomatoes Antioxidant/Reduce

prostate Cancer
Luteine Vegetables Healthy vision

Glucosinolates Cruciferous Activators of Liver

detoxification enzymes
Resveratol Red Grapes Antioxidant

Sulphorphame Broccoli Cancer prevention

Omega -3 fatty acids Fish/ Flax seeds Reduction in

cardiovascular disease
Nutraceuticals available in the market

Brand name Components Functions

Betatene Carotenoids Immune function

Xangold Lutein esters Eye health

Lipoec α- lipoic acid Potent antioxidant

Generol Phytosterol CHD reduction

Premium probiotics Probiotics Intestinal disorders

soylife Soyabean phytoestrogen Bone health

Z-trim Wheat Zero calorie fat replacer

Linumlife Lignan extract Prostate health

Nutraceuticals available in the market

Brand name Components Functions

Fenulife Fenugreek Control blood sugar

galactomannon

Teamax Green tea extract Potent antioxidant

Marinol ω- 3 fatty acid, DHA, CVD protection

EPA

Clarinol CLA Weight loss ingredient

Cholestaid Saponin Reduce cholesterol

Commonly used herbs
 Some other commonly used herbs
❑Shatavari

❑Arjuna

❑Ashwagandha

❑Brahmi

❑Vidarikand

❑Triphla (Amla + Harad+ Behda)

❑Aloe Vera
 Functional foods &
Nutraceuticals for
cardiovascular diseases

Cardiovascular diseases (CVDs) are the group of disorders

of the heart and blood vessels and are responsible for the
highest mortality, worldwide.
 Hawthorn Plant (Crataegus oxycantha)
❑Medicinal part of hawthorn are the leaves, flowers and berries
used singly or in combination
❑Useful in angina, hypertension, arrhythmia and congestive
heart failure
❑160 to 900 mg/day of an aqueous-alcoholic extract effective
❑The active compounds are flavones, flavanols , oligomeric
procyanidins (Catechins and epicatechins), triterpene
saponins, phenolics, and few cardioactive amines which causes
direct vasodilation of the coronary vascular smooth muscles.
❑The antioxidant & antithrombotic activities are likely to be
responsible for cardiovascular improvements
 Hawthorn Plant (Crataegus oxycantha)

• This herb also has some inotropic and

chronotropic effects with potential to irritate
the mycocytes.
 Terminalia arjuna
• Terminalia arjuna is a deciduous tree
• large tree; attaining 60-80 ft.
• Leaves are subopposite, usually 4-6 in. in length,
• Flowers are small, sessile, white and occur all round white or yellow stalk.
• Flowering stage of Arjuna is in summer whereas fruiting stage is in winter.
• Bears fruits 2.3-3.5 cm long, which are fibrous woody, globrous with 5 hard
wings, straighted with numerous curved veins.
• Flowers in april-july.
• Arjuna seeds are hard germinating, usually takes 50-76 days (Oudhia, 2002).

Kingdom : Plantae
Division : Magnolipophyta
Class : Magnoliopsida
Order : Myrtales
Family : Combretaceae
Genus : Terminalia
Species : arjuna
 Arjuna bark Arjuna bark (Powder)

Arjuna bark is smooth pinkish grey, flanking off in large flat pieces. The bark is astringent,
sweet, acrid, cooling, aphrodisiac, cardiotonic, urinary astringent, expectorant, alexiteric
and is useful in fractures, ulcers, cirrhosis of the liver, hyperhidrosis, otalgia and
hypertension.
 Arjuna’s active constituents

Tannins, triterpinoids, saponnins (arjunic acid, arjunolic

acid, arjungenin, arjunglycosides), flavonoids (arjunon,
arjunolone and leteilin), Arjunetosides I, Arjunetosides II,
Arjunetosides III, Arjunetosides IV, Arjunine, arjunetein,
gallic acid, ellagic acid, oligomeric proanthocyanidins
(OPCs), phytosterols (β-sitosterol), calcium, magnesium,
zinc and copper. Miller (1998)
 Health beneficial effects of Arjuna
➢ Cardiovascular protection
➢ Antioxidant
➢ Anticarcinogenesis
➢ Anti ulcer activity
➢ Anti diabetic activity
➢ Antibacterial and antimutagenic activity
➢ Curing of Respiratory system disorders
➢ Curing of Reproductive disorders
 Terminalia arjuna
❑ The bark of Terminalia arjuna has been widely used in Ayurvedic system of
medicine for cardiac disorders since ancient times
❑ Terminalia Arjuna described as cardiac tonic – reduces workload on heart
lowers blood pressure and improve cholesterol profile.
❑ It regularizes the heartbeat, strengthens the heart muscles, constricts the fine
blood vessels, activates the heart, reduces bleeding and reduces
inflammation.
❑ Arjuna bark is rich in saponins, flavanoids and tannins. The bark is
astringent, sweet, acrid, cooling, aphrodisiac, cardiotonic, expectorant,
alexiteric
❑ Arjuna decreases the level of triglycerides and cholesterol and recovers the
level of HDL, act as an anti-ischemic agent, act as good as the drug isosorbide
mononitrate in chronic stable angina, relieves myocardial necrosis in rats,
modulates platelet aggregation
(Balasubramaninas (2003)
 Arjuna in Cardiovascular Health
• Terminalia Arjuna described as cardiac tonic – reduces workload on heart, lowers blood
pressure and improve cholesterol profile.

• It regularizes the heartbeat, strengthens the heart muscles, constricts the fine blood
vessels, activates the heart, reduces bleeding and reduces inflammation.

• Arjuna decreases the level of triglycerides and cholesterol and recovers the level of HDL,
act as an anti-ischemic agent, act as good as the drug isosorbide mononitrate in chronic
stable angina, relieves myocardial necrosis in rats, modulates platelet aggregation, act as
an effective antioxidant and contains folic acid. Balasubramaninas (2003)

• Arjuna has found to be the most potent hypolipidemic agent and induced partial
inhibition of atheroma in rabbits, when the rabbits were administered drugs (T. arjuna, T.
chebula and T. Belerica) along with cholesterol. (Shaila et al., 1998)

• Cholesterol lowering effects of vitamin E (400 IU) and finely pulverized bark powder (500
mg) was compared on 105 patients. After one month, in the tree bark group, total and LDL
cholesterol were significantly lowered as compared to placebo or vitamin E groups.
 Various forms of Arjuna

❖ Choorna (Powder)
❖ Arist (Decoction)
❖ Capsules
❖ Syrups
❖ Avleha (paste)
❖ Tea
❖ Arjuna saar (juice)
❖ Ghrit (Ghee)
 Role of Phytosterols in Chloesterol
regulation
Phytosterol effects on cholesterol absorption
❑ Inhibition of cholesterol absorption resulting from the higher
affinity of phytosterols than of cholesterol for micelles
❑ Phytosterols appear to decrease the solubility of cholesterol in
the oil and micellar phases, thereby displacing cholesterol from
bile salt micelles and interfering with its absorption
❑ A cholesterol molecule with a methyl or ethyl group
(phytosterols) results in poor intestinal absorption of
phytosterols in humans
❑ About 5% or less of phytosterol is absorbed from the human
intestine compared with 30 to 60% for dietary cholesterol
Phytosterol effects in the intestinal lumen

❑ The small intestine is believed to be the major

site for cholesterol absorption.

❑ Cocrystallization of phytosterols and

cholesterol in the gastrointestinal tract could
lead to the reduction of intestinal cholesterol
uptake.
 Phytosterols in combination with
cholesterol lowering medications
The two most important pharmaceutical
approaches used to lower circulating cholesterol
levels are
(1) The bile-sequestering polymeric resins,
cholestyramine and colestipol
(2) 3-hydroxy-3-methylglutaryl coenzyme A
reductase inhibitors or statins
Combination therapy using statins with
phytosterols has proved efficacious for patients
with hypercholesterolemia
Role of Fibre in Reducing Serum Cholesterol

Soluble fibres, in particular, are thought to

exert a preventative role against heart disease as
they appear to have the ability to lower serum
cholesterol levels

Soluble fibre sources from pectin, oat bran,

guar gum, and psyllium reported a small but
significant reduction in serum cholesterol levels
 Mechanisms for lowering of
serum cholesterol by fiber
Ability of soluble fibers to form viscous gels in the intestinal
tract
Increased excretion of bile acids
Possible influences of short-chain fatty-acid production by
intestinal flora upon cholesterol synthesis
Bacterial fermentation of soluble fiber from oats results in the
production of short-chain fatty acids, specifically propionate,
that are absorbed in the colon and travel to the liver via the
portal vein.
Data from in vitro studies demonstrate an inhibition of hepatic
cholesterol and fatty-acid synthesis under the influence of
propionate
 Garlic
• Garlic has been shown to lower lipid and blood pressure,
reduce atherosclerosis, decrease coagulation and platelet
aggregation
• Garlic is made up of two active ingredients: allicin and alliin
• Alliin is converted to allicin after crushing and have role in
cardiovascular health
• Garlic is thought to lower the blood pressure by opening
calcium ion channel in the vascular smooth muscle,
resulting in vasodilation.
• HMG-CoA reductase activity which increase the catabolism
of fatty acids such as triglycerides and retardation of the
absorption of cholesterol from the intestine
 Side effects of garlic
• Odour and taste
• Other side effect include Flatulence, halitosis
and GI upset
• Some time anaphylaxis and bleeding
• Garlic powder 900 mg/day
 Commiphora mukul (guggulu)
• Guggulsterones compound known for
antihyperlipoproteinemic effect
• Exert their effect by antagonizing the farnesoid
receptor, which is activated by bile acid.
• This also thought to increase LDL receptor reuptake
and increase receptor binding sites
• This also thought to inhibit platelet and have anti
inflammatory properties
• Possible side effects: diarrhea, loose stool and rashes
• Guggulu may contain heavy metals
 Digitalis
• Digitalis also known as Digitalis purpurea and
lanata. Digitoxin is the active components.
• The dry leaves of the plant are thought to
contain the pharmacologic action.
• This herb is thought to work through positive
ionotropic effect
 Ginkgo biloba
• Concentrated acetone-water extract of dried
leaves; potency of 24 % flavone glycosides and
6 % terpenes
• The effect include reduction of capillary
fragility and free radical scavangers.
• This agent is also thought to work through
inhibition of platelet activating factor from
gingolides
• Dose ; 40 mg/tab three times a day
 Horse Chestnut seed
• It is a complex mixture of triterpenoid saponin
glycosides (Aescin) with the flavanoids
quercetin and kempferol
• Aescin can reduce lysosomal activity by 30 %
and restrict edema
• Adverse effect; GI tract disturbance.
 Others
Probiotic Products
CLA rich products
Garlic
Guggulu
Digitalis
Ginkgo
Horse Chestnut Seed
Bithcher’s Broom
Ginseng
 Functional foods and
nutraceuticals for Diabetes
management
 Diabetes
Diabetes mellitus - A group of metabolic diseases in which a
person has high blood sugar, either because the body does not
produce enough insulin, or because cells do not respond to the
insulin that is produced. This high blood sugar produces the
classical symptoms of polyuria (frequent
urination), polydipsia (increased thirst) and polyphagia (increased
hunger)

✓ Type 1 diabetes (IDDM)

✓ Type 2 diabetes (NIDDM)
✓ Gestational diabetes

Diabetes insipidus
 Management of diabetes
• ALA and its reduced derivative, dihydrolipoic acid, improve insulin
sensitivity, glucose tolerance in type II DM, and diabetic
neuropathy. However, in clinical trials, it did not show any
significant alteration in the fasting glucose and insulin
concentration. This poses a question as to its reliability as a
therapeutic agent that would provide significant improvement of
glycemic control in DM
• Biotin increases glucokinase activity, thereby improving glucose
tolerance and insulin sensitivity. The recommended dose is 16
mg/day in type II DM.
• Carnitine improves glucose metabolism and disposal. The
recommended dose is 1–2 g twice daily.
• CoQ10 reduces fasting glucose, postprandial glucose, and
hemoglobin A1C. The recommended dose is 100 mg twice daily.
• Flavonoids enhance insulin secretion, improve insulin sensitivity,
reduce serum glucose, and inhibit sorbitol accumulation in the lens
of the eye and nerves.
 Management of diabetes
• Chromium is an essential micronutrient acting as a cofactor in
numerous insulin regulatory steps. It reduces fasting glucose,
postprandial glucose, hemoglobin A1C, C-peptides, fasting insulin,
and insulin resistance. Conversely, it increases cellular insulin
binding, the number and activation of insulin receptors, and
insulin growth factor-I receptor. The recommended dose is 8
mcg/kg/day.
• Gamma linoleic acid improves glucose tolerance, improves insulin
resistance, and protects, as well as improves, diabetic neuropathy.
The recommended dose is 500–1,000 mg/day.
• Magnesium improves insulin sensitivity and secretion. The
recommended dose for those with normal kidney function is 500
mg twice a day with 50–100 mg of vitamin B6.
• Manganese is an important cofactor in many glycolytic enzymes; it
improves insulin synthesis and insulin sensitivity and serves as
“insulin.” An intact pancreatic beta cell is required for manganese
to be effective. The optimal dose is 5–10 mg/day.
 Management of diabetes
• Omega 3 fatty acids improve insulin sensitivity and insulin secretion and reduce serum

glucose. The recommended dose is 900 mg of EPA and 600 mg of DHA with a total daily

dose of EPA plus DHA lower than 3 g.

• Pycnogenol has been found to lower plasma glucose and hemoglobin A1C, improve

glutathione levels, and reduce oxidative stress. The recommended dose is 100 mg/day.

• Selenium is an important antioxidant; it serves as an “insulin-mimetic,” reduces fasting

glucose, and protects against diabetic retinopathy. The recommended dose is 200 mcg/day.

• Taurine improves glucose tolerance and insulin sensitivity, reduces glycosylation of proteins

and hemoglobin, and improves symptoms of diabetic neuropathy. The recommended dose

is 1.5–3 g twice daily.

• Zinc improves insulin binding and insulin sensitivity; increases insulin synthesis, secretion,

and utilization; protects beta cells; reduces glucose; and improves diabetic retinopathy. The

recommended dose is 30–50 mg daily.

 Management of diabetes
Bitter Melon (Momordica charantia)

Blood sugar lowering action of fresh juice or extract (also known as plant
insulin) of unripe fruit has been established
Charatin – extracted by alcohol, is a hypoglycemic agent and more potent
than the drug tolbutamide.
It also contain insulin like polypeptide, polypeptide –P, which lowers the
blood sugar level in type -1 diabetic patients

Bitter gourd

50 ml raw karela juice daily improves the blood glucose tolerence in Type II
Diabetes
Gymnea sysvestre (Gurmar, Meshasringi, Cherukurinja)

Assist the pancreas in the production of insulin.

Improves the ability of insulin to lower blood glucose in both diabetes
Decrease the carving of sweet
Recommended dose – 500 mg
 Management of diabetes
Onion & Garlic

Blood lowering action – Allyl propyldisulphide (APDS; 125 mg) and Diallyl Dislphide oxide
(allicin; 100 mg), Flavonoids

Onion extract – 25-200 gram

Fenugreek (Trigonella foenum)

Defatted portion of the seed – Alkaloid (Trogonelline, Nicotinic acid and Coumarin)

Blueberry leaves (Vaccinium myrtillus)

Decoction of leaves have long history of antidiabetic action

Myrtillin (an anthocyanoside) is most active ingredients

Blueberry anthocyanoside increase capillary integrity, inhibit free radical damage and
improve the tone of vascular syastem

Helpful in the treatment of eye diseases including diabetic retinopathy

 Management of diabetes
Asian Ginseng

Enhance the release of insulin from pancreas and increase the no. of insulin receptor
Recommended dose – 200 mg/day

Bilberry

Lower the risk of some diabetic complications, such as diabetic cataract & retinopathy

Cinnamon (Cinnamomum aromaticum)

Grapes

Resveratrol – protect against cellular damage to blood vessels caused by the high
production of glucose in diabetes
Oligomeric proanthocyanidins, Pycnogenols- Present in red grapes

Green tea

Epigallocatechin-3- gallate – Reduce the fasting and postprandial glucose

Protect the β cells destruction by inhibiting the iNOS gene expression
 Others
✓ Probiotic Products

✓ Prebiotics

✓ Dietary fibres

✓ Jambal fruit

✓ Sajina

✓ Ginkgo biloba
Functional foods and nutraceuticals
for cancer management
 Anticarcinogenic potential of milk fat
Conjugated Linoleic acid, sphingomylein, butyric acid and other ether lipids
present in milk fat shows anticarcinogenic effects. (Parodi, 1997)
Conjugated linoleic acid inhibited proliferation of human malignant
melanoma, colorectal, breast and lung cancer cell lines.
(Shultz et al. 1992; Schonberg and Krokan 1995)
In vitro studies showed that the milk phospholipid, sphingomyelin, through
its biologically active metabolites ceramide and sphingosine, participates in
three major antiproliferative pathways influencing oncogenesis, namely,
inhibition of cell growth, and induction of differentiation and apoptosis.
(Parodi, 1997)
Feeding of ghee to rats showed the anticarcinogenic potential against colon
and breast cancer. (Bhatia, 2005; Ip et al., 1991)
Feeding of CLA enriched ghee showed the anticarcinogenic potential
against breast cancer in rats.
(Kathirvelan, 2007)
 Anticarcinogenic properties of
Lactobacilli
❖ Inhibition of tumour cells
(Reddy et al.,1973)
❖ Suppression of bacteria which are
responsible for release of carcinogen
(Goldin and Gorbach.,1977)
❖ Destruction of carcinogen
(Rowland and Grasso,1975)
Mechanism of anticarcinogenecity

Binding of carcinogens and anti-genotoxic

effects

Stimulation of protective enzymes

Stimulation of immune response

Modulation of the intestinal microflora

 Dietary Fibres and intestinal Cancer
Dietary fibres:- enhance the stool bulk and decrease
the exposure to carcinogens
Fermentation products:- short chain fatty acids, H2O,
CO2, CH4, H2
Butyrate is effective against colon carcinogenesis
Wheat bran is a insoluble dietary fibre
Fermented slowly, resulting in greater concentration
of butyrate in distal colon
The presence of butyrate lowers the intestinal pH
which in turn inhibit the conversion of primary bile
acids to secondary bile acids
(Mc Intyre et al ., 1993)
 Role of Lycopene

Proposed mechanisms for the role of lycopene in preventing chronic diseases. Dietary lycopene may increase the lycopene status in the
body and, acting as an antioxidant, may trap reactive oxygen species, increase the overall antioxidant potential or reduce the oxidative
damage to lipid (lipoproteins, membrane lipids), proteins (important enzymes) and DNA (genetic material), thereby lowering oxidative
stress. This reduced oxidative stress may lead to reduced risk for cancer and cardiovascular disease. Alternatively, the increased lycopene
status in the body may regulate gene functions, improve intercell communication, modulate hormone and immune response, or regulate
metabolism, thus lowering the risk for chronic disease. These mechanisms may also be interrelated and may operate simultaneously to
provide health benefits.,
 Mechanism of Action of SIT on Tumor
Development

Effect of SIT on membrane structure

➢ Because SIT has a structure similar to

cholesterol, an integral lipid component of
biological membranes, its incorporation into
membranes has been investigated.

➢ The incorporation of SIT resulted in a significant

effect on the concentration of two phospholipids,
i.e., a 50% decrease in sphingomyelin and an 8%
increase in phosphatidylcholine.
Proposed mechanism by which β-sitosterol inhibits tumor growth and stimulates apoptosis.
Abbreviations: SIT, β -sitosterol; SPh, sphingomyelin; PP2A, protein phosphatase 2A;
SPh-ase, sphingomyelinase; SPh-synthase, sphingomyelin synthase
 Others
Lemon grass - A recent study by the Food and Nutrition
Research Institute of the Department of Science and
Technology ( DOST ) claims that every 100g of edible
tanglad when boiled can contain up to 24.205 micrograms of
β-carotene the anti-oxidant that scientists believe can help
prevent cancer.

Cow urine – it contains nitrogen, sulphur, phosphate, sodium,

manganese, carbolic acid, iron, silicon, chlorine, magnesium,
melci, citric, titric, succenic, calcium salts, Vitamin A, B, C,
D, E, minerals, lactose, enzymes, creatinine, hormones and
gold acids.

Terminalia arjuna

Inulin/Fuctooligosaccharides

Aloe Vera
Action of Aloe Vera as gastroprotective, it decreases TNF- α and Leukocyte
adhesion on P-selectin post capillary venule which lead to reduced
inflammation, helps epithelial cells proliferation and its emollient action as
forming layer on gastric epithelial cells.
Management of Osteoporosis
and osteoarthritis
• Bone and joint diseases can lead to disability, immobility, pain, and
a reduction in activities of daily living for many patients.
• Two of the most prevalent bone and joint conditions include
osteoporosis and osteoarthritis.
• Osteoporosis is a skeletal disorder characterized by compromised
bone strength predisposing to an increased risk for fractures. Bone
strength reflects the integration of two main features: bone density
and bone quality.
• Conventional therapies for treatment of osteoporosis, such as
bisphosphonates, raloxifene, and hormone replacement therapy
treatment. The drawback to these conventional therapies is that
they have documented negative side effects.
• Calcium and vitamin D are dietary supplements that are considered
standards of therapy for the prevention of osteoporosis and in
conjunction with other therapies for the treatment of osteoporosis
Calcium
 Vitamin D
• Vitamin D is a fat-soluble vitamin that is naturally
present in few foods but is often added to fortifi ed
food products, such as milk and cereal
• It is also produced endogenously through exposure of
the skin to ultraviolet rays from the sun.
• Vitamin D is needed for calcium absorption in the gut
and maintenance of adequate serum calcium and
phosphate concentrations to enable normal bone
mineralization. It is also necessary for bone growth and
remodeling by osteoblasts and osteoclasts.
 DEHYDROEPIANDROSTERONE
• Dehydroepiandrosterone (DHEA) is produced in the adrenal glands
and in the liver.
• Administration of DHEA has been proposed to prevent or treat
osteoporosis
• Dehydroepiandrosterone sulfate (DHEA-S) is the storage form of
DHEA. Peripheral tissues and target organs convert DHEA-S to
DHEA, which can then be metabolized to androstenedione, the
major human precursor to androgens and estrogens.
• DHEA can be synthesized from natural sources, such as soy and wild
yam, by the conversion of constituents such as diosgenin into DHEA
• DHEA orally at 50−100 mg/day has been studied to improve BMD in
older women and men with osteoporosis or osteopenia.
 PHYTOESTROGENS
• Also known as daidzein, genistein, isofl
avones, kudzu, red clover, and soy,
phytoestrogens are plant-derived compounds
that can have weak estrogenic effects.
• Isoflavones come from metabolized soy
products (such as tofu) and soybeans.
• Isoflavones, such as Promensil and Novogen,
at 40 mg/day have been used totreat
osteoporosis.
 VITAMIN K
• Two forms of vitamin K have been studied for the treatment of
osteoporosis: vitamin K1 (phytonadione or phylloquinone) and
vitamin K2 (menaquinone or menatetrenone).
• Food sources high in vitamin K1 include green leafy vegetables,
such as spinach, cabbage, and mustard and turnip greens. Food
source containing vitamin K2 are found in meat and fermented
food, and vitamin K2 is synthesized by bacteria in the colon.
• Vitamin K has been shown to promote bone mineralization via
osteocalcin.
• Vitamin K may also decrease bone resorption by decreasing
prostaglandin E2 synthesis in osteoclasts, and by effects on calcium
balance, and IL-6 production in bone”
• For osteoporosis, vitamin K1 (phytonadione) at 1 or 10 mg daily or
vitamin K2 (menaquinone) at 45 mg daily has been used in studies.
 Osteoarthritis
• Glucosamine
• S-adenosylmethionine
• Devil’s claw
• Antioxidant vitamins
 Management of Obesity
• Leptin and Ghrelin hormones
• Role of Green Tea
• Role of Dietary fibres in glucose metabolism
• Garcinia
• Chromium
• Conjugated linoleic acid
• Calcium
• Medium chain triglycerides
Leptin and Ghrelin hormones
 Green tea
• The caffeine present in green tea acts as a
stimulant that has been shown to aid fat
burning and
improve exercise performance in
various studies.
• The massive range of antioxidants known
as catechins helps burn fat and
boost metabolism that is key to lose
weight and reduction in BMI
• The consumption of green tea increase
postprandial thermo genesis and fat
oxidation and reduce the adipocyte
lipogenesis, fat absorption and supress
appetite
 Garcinia
• The antiobesity effects of garcinia is attributes
to Hydroxycitric acid (HCA). It suppress fatty
acid biosynthesis and appetite and increase
energy expenditure
• Decrease fat accumulation
• Increase fat oxidation
• Food intake suppression
• Downregulation of obesity associated gene
 Chromium
• Trivalent chromium is an essential nutrient, needed for
carbohydrate and fat metabolism, that is found in numerous food
sources, including beef, liver, eggs, chicken, brewer’s yeast, oysters,
wheat germ, green peppers, apples, bananas, and spinach.
• Chromium supplementation improves insulin function in diabetics
and has been investigated for reduction in body fat and for
retention of lean body mass. Novel chromium complexes,
chromium picolinate, and niacin bound chromium (NBC), have been
investigated for their effects on body weight and body fat
distribution.
• NBC has been shown to be efficacious in improving body
composition and weight status in overweight and obese subjects
when combined with a reduced calorie diet and exercise regimen.
• NBC was shown to improve body fat loss but retain lean body mass.
Additionally, NBC has been found to have the greatest
bioavailability compared with other novel chromium compounds.
 Conjugated Linoleic Acid
• CLA is a family of isomers of linoleic acid, each having different
functions. One has anticarcinogenic, antiobesity, and antidiabetic
effects; another has anticancer effects.

• As an antiobesity agent, CLA is believed to act by decreasing food

and energy intakes, decreasing lipogenesis, and increasing fat
oxidation, lipolysis, and energy expenditure.

• They are found in dairy products associated with the fat fraction
and in ruminant animals, such as beef and lamb

• CLA was found to be effective in reducing fat mass in the abdomen

and legs of overweight and obese women.
 Placebo study
• A placebo is an inactive drug or treatment used in
a clinical trial. It is sometimes referred to as a “sugar
pill.” A placebo-controlled trial compares a new
treatment with a placebo. The placebo is usually
combined with standard treatment in most
cancer clinical trials.
• A placebo is a pill, injection, or thing that appears to be
a medical treatment, but isn't. An example of a placebo
would be a sugar pill that's used in a control group
during a clinical trial. The placebo effect is when an
improvement of symptoms is observed, despite using a
nonactive treatment.
 Blinded study

• An experimental group, also known as a treatment group, receives

the treatment whose effect researchers wish to study, whereas
a control group does not. They should be identical in all other ways.
• A double-blind study is one in which neither the participants nor
the experimenters know who is receiving a particular treatment.
This procedure is utilized to prevent bias in research
results. Double-blind studies are particularly useful for preventing
bias due to demand characteristics or the placebo effect.
• In a single-blind study, only the participants are blinded. In a
double-blind study, both participants and experimenters
are blinded. In a triple-blind study, the assignment is hidden not
only from participants and experimenters, but also from the
researchers analyzing the data.
• A negative control is a control group in an experiment
that uses a treatment that isn't expected to produce
results. A positive control is a control group in an
experiment that uses a treatment that is known to
produce results.
• Water is commonly used as a negative control in
chemical tests, especially distilled water.
• Clinical trial randomization is the process of assigning
patients by chance to groups that receive different
treatments. In the simplest trial design, the
investigational group receives the new treatment and
the control group receives standard therapy.