Functional Foods Presentation

FUNCTIONAL FOODS Britt MacArthur, Katherine Mykytka, Rebecca Dover, Kerri Kimzey, & Jessica Oakley

What is a functional food?

Functional Foods •

Functional foods are foods that contain additional benefits which exceed their basic nutritional value

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A functional food should be nutritious before additional supplements are added.

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Today they include a wide range of items including whole grains, fruits, fatty fish, and foods or beverages that have been fortified or enhanced

History •

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Over two thousand years ago Hippocrates said, "Let food be thy medicine." Although the concept of functional foods is not entirely new, it has evolved considerably over the years. The basis for the progression of interest in functional foods can be found all the back in the 1920s when iodine began being added to salt to prevent goiters.

History •

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Other twentieth-century examples include vitamin A and D fortification of milk and niacin and folic acid fortification of grains. These early fortification examples focused on reducing the risk of diseases of deficiency. In the latter part of the twentieth century, consumers began to focus on wellness and the reduction of chronic disease. Research now focuses frequently on the promotion of health through many lifestyle factors, including the consumption of an optimal diet. As of 2002, researchers have identified hundreds of food components with functional qualities, and they continue to make new discoveries surrounding the complex benefits of phytochemicals in foods.

Credibility •

American Dietetic Association position statement -The American Dietetic Association made a statement earlier this year about their position on the issue. They gave their support for the usage of functional foods and for research into advancing the field and furthering the benefits of their incorporation into a balanced, varied diet for all individuals.

Rationale and Regulation •

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Consumer demand has increased development of functional foods, due in part to: -Increased health care costs, an awareness and desire to enhance personal health, advancing scientific evidence that diet can alter disease prevalence and progression, aging population, and changes in food regulation The Food and Drug Administration- regulation

Categories •

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Conventional/Unmodified whole foods such as fruits and vegetables: represent the simplest form of a functional food Ex. Carrots are considered to be functional foods because they are rich in such physiologically active components such as beta carotene Modified foods (fortified and enhanced foods) are also considered to be functional

FRUITS & VEGETABLES

Fruits & Vegetables •

the simplest form of functional foods

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A natural form

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One of best sources for antioxidants and phytochemicals

Why are fruits & vegetables necessary? • •

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oxidation= the loss of an electron Produces reactive substances known as free radicals that cause damage to cells Caused by: normally during metabolism, body’s immune system purposefully creates them to neutralize viruses and bacteria, & environmental factors such as pollution, radiation, cigarette smoke and herbicides Natural process in the body Causes degenerative diseases associated with aging and cancer

WHAT ARE ANTIOXIDANTS?

Antioxidants •

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Natural components present in fruits and vegetables Stabilizes free radicals before they cause harm Present in vitamins, minerals, carotenoids, and polyphenols Due to the naturally occurring process of oxidation, we must have a balance of antioxidants to maintain health

Phytochemicals • •

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One type of antioxidants Promote optimal health by lowering risk for chronic diseases Only found in plant foods Fruits and vegetables are best sources

EXAMPLES OF FUNCTIONAL COMPONENTS

Carotenoids •

Beta-carotene – –

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Lutein & Zeaxanthin – –

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Sources: carrots, various fruits, sweet potatoes, leafy green vegetables, red peppers, & pumpkin Specifically reduces risk for lung cancer Sources: kale, collards, spinach, corn, & citrus Reduces risk of cancer & promotes eye health (specifically macular degeneration)

Lycopene – –

Sources: tomatoes Reduces risk of prostate cancer

Flavonoids •

Anthocyanidins – –

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Flavanols – –

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Sources: berries, cherries, red grapes Contributes to maintenance of brain function Sources: apples, grapes Contributes to maintenance of heart health

Flavanones – –

Sources: citrus foods Reduces risk of cancer

More flavonoids •

Flavonols • •

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Sources: onions, apples, broccoli Reduces risk of cancer

Proanthocyanidins •

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Sources: cranberries, apples, strawberries, grapes Promotes urinary tract health and heart health

Isothiocyanates •

Sulforaphane •

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Sources: cauliflower, broccoli, Brussels sprouts, cabbage, kale, horseradish, turnips Reduces risk of cancer

Phenols •

Caffeic acid/ Ferulic acid • Sources: apples, pears, citrus fruits, some vegetables • Promotes healthy vision and heart health

Plant Stanols/Sterols •

Free stanols/sterols • Sources: corn • May reduce risk of Coronary Heart Disease

Prebiotic/Probiotics •

Inulin, Fructo-oligosaccharides, Polydextrose • Sources: onions, some fruits, garlic, leeks • Improves gastrointestinal health and calcium absorption

Phytoestrogens •

Lignans • Sources: some vegetables • Promotes heart health and healthy immune function • Reduces risk of breast cancer

Sulfides/Thiols •

Diallyl sulfide, allyl methyl trisulfide – –

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Sources: garlic, onions, leeks, scallions Promotes heart health and healthy immune function

Dithiolthiones –

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Sources: broccoli, cauliflower, Brussels sprouts, cabbage, turnips Promotes healthy immune function Detoxifies carcinogens

WHAT % OF AMERICANS DO NOT EAT VEGETABLES AT ALL?

50%

Statistics •

Less than 10% of Americans eat 2 servings of fruit and 3 servings of vegetables each day

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Over 70% eat no fruits or vegetables rich in Vitamin C per day

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80% eat no fruits or vegetables rich in carotenoids per day

Recommendations •

3-5 servings of vegetables everyday

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2-4 servings of fruits everyday

PLANT STEROLS AND STANOLS, OMEGA-3 FATTY ACIDS AND SOY PROTEIN

Functional foods and drinks are products that have been enriched with added nutrients or other substances that are considered to have a positive influence on health. Examples include cholesterol lowering spreads and foods with added nutrients, such as plant sterols and stanols, omega-3 fatty acids, and soy proteins. Lets take a look at the more popular functional foods currently on the market, and see how they may benefit our health and the evidence behind some of the claims being made about them.

Plant stanols and sterols •

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Plant stanols and sterols are plant-derived lipids which are of particular interest because of their potential health benefits, particularly in relation to cardiovascular disease (CVD). Sterols are essential components of plant cell membranes and play a key role in controlling membrane fluidity and permeability. Stanols are saturated sterols and occur naturally in small amounts in plant products such as nuts, seeds and legumes.

Plant stanols and sterols •

Both plant stanols and sterols have a structure that is very similar to cholesterol.

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They have been incorporated into many food products, most notably fat spreads, otherwise known as ‘cholesterol-lowering spreads’.

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Studies have found that consuming approximately 2g of plant stanols or sterols each day leads to a significant reduction in cholesterol concentrations in people with elevated cholesterol levels.

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Found to lower total and low density lipoprotein (LDL) cholesterol, without affecting high density lipoprotein (HDL); therefore thought to be effective in reducing the risk of heart disease

Plant stanols and sterols •

It is not possible to acquire their benefits by consuming plant foods alone. Products with added plant stanols and sterols need to be consumed in order to obtain their benefits.

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Studies have shown that these products also have the potential to significantly reduce both total and LDL cholesterol when consumed regularly with meals.

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Studies have also shown that the cholesterol lowering benefits of plant stanols and sterols are independent of diet, and greater cholesterol reductions can be achieved by following an overall healthy diet, exercising, and reducing saturated fat intake, while in addition to consuming products containing plant stanols and sterols (Andersson et al, 1999).

Plant stanols and sterols •

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Although plant stanols and sterols have been shown to effectively reduce cholesterol concentrations at an intake of 2g per day. There is currently no direct evidence that they actually reduce the incidence of CVD events (i.e. heart disease and stroke) More trials are required to determine the effectiveness of plant stanols and sterols and their affect on CVD events. The use of foods with added plant stanols and sterols is also of questionable benefit in individuals who do not suffer from elevated cholesterol. •

However, the consumption of such products (including cholesterollowering spreads, yogurts and other drinks) as part of an otherwise healthy diet, has been shown to be a promising addition, as intervention, for heart disease prevention.

Products with added omega-3 •

Omega-3 fatty acids are a type of polyunsaturated fatty acid.

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Certain omega-3 fatty acids are termed ‘essential’ because they cannot be made in the body and therefore have to be provided by the diet.

Omega-3 Fatty Acids •

There has been considerable interest in the long-chain omega-3 fatty acids, eicosapentaenoic acid (EPA)

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Docosahexaenoic acid (DHA) =

Omega-3 Fatty Acids Which are derived from alpha-linolenic acid (ALA) However, the conversion of ALA to the longer-chain omega-3 fatty acids-EPA and DHA- is considered to be very limited in humans, so additional dietary sources are needed.

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Omega-3 Fatty Acids •

The interest steamed from a study done in the late 1970s on the Greenland Inuits. The study showed a low occurrence of coronary heart disease (CHD) in this Eskimo population which was attributed to their traditional diet of marine plants and animals particularly oily, fatty fish.

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All sources rich in omega-3 fatty acids EPA and DHA.

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The best dietary source of EPA and DHA is oily, fatty fish, but now there are increasing numbers of products on the market that have been fortified with EPA and DHA, such as eggs, bread, milk, and dairy products.

Health Effects of Omega-3 FA •

The cardiovascular benefits from long chain omega-3 fatty acid consumption have been attributed to their anti-inflammatory and anti-clotting effects.

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Consumption of fish, particularly fatty fish, offers significant health benefits in terms of a reduction in the risk of CVD. •

Moderate fish consumption and fish oil supplementation raised blood levels of DHA and slowed down the progression of abnormal thickening of artery walls due to fatty deposits (a condition that restricts blood flow to the heart, called atherosclerosis).

Omega-3 and Cognitive Function 

There has recently been a lot of speculation, particularly in the media, that omega-3 fatty acids may influence cognitive function and behavior, particularly in children. However, research in this area is still in its early stages, and so far there is little evidence that supplementation with omega-3 fatty acids, in the form of fish oils, leads to improvements in cognitive function (Lunn and Theobald, 2006).

Omega-3 Fatty Acids •

While the benefits of including fish, particularly oily fish, in the diet are well recognized, many people do not eat oily fish regularly and, therefore, it is important to eat other dietary sources of omega-3 fats.

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There are a wide range of products with added omega-3 currently on the market but it is important to consider their efficacy. •

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For example, it is important to take into account whether products actually provide the long-chain omega-3 fatty acids (EPA and DHA) or simply the shorter-chain omega-3 fatty acid, ALA.

The amount of omega-3 provided is also an important factor: as a benchmark, an intake of two portions of fish per week, including one oily, is equivalent to 450mg per day of omega-3 fatty acids.

Soy Protein •

Another major interest for atherosclerosis prevention has been addressed to vegetable proteins, particularly soy proteins whose consumption has been shown to successfully reduce cholesterolemia in experimental animals, as well as in humans with cholesterol elevations of genetic or non genetic origin.

Soy Protein One study addresses the potential of soy protein to increase low-density lipoproteins receptors (LDL-R) expression in human beings. Procedure: Compared two groups Group One: Patients were treated with animal protein Group Two: Patients were treated with textured soy protein (with the addition of cholesterol to balance the two diets) Results: Group One: •

After the animal protein diet there were minimal changes in lowdensity lipoprotein cholesterol (LDL-C) levels or LDL-R activity,

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The soy protein diet, in addition to a LDL-C reduction, showed an ↑ of around eightfold in total LDL degradation. This study, clearly suggests that some soy protein components are able to up-regulate LDL-R, decrease LDL-C, resulting in total LDL degradation.

Soy Protein •

A full understanding of the mechanism of action of soy protein has become vital for the selection of the most appropriate forms of soy for treating hypercholesterolemia (high blood cholesterol and triglycerides) .

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This selection can only be made once the active component/s and their mechanism of action have been fully revealed So what’s in Soy Protein or rather soybeans? The major storage proteins in soybeans are 7S and 11S globulins: from early studies the 7S globlin appear to be primarily responsible for the hypocholesterolemic effects of soy protein, whereas the 11S component appeared essentially inactive.

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Soy Protein An interesting activity on hypercholesterolemia and body weight was conducted Procedure: Gave a daily administration of four candies containing 5 g of 7S globulin to moderately overweight Japanese individuals with hypercholesterolemia Results: ↓ TGs by 14% ↑raised HDL-C by 5% Exerted a remarkable 6% reduction in the mean visceral fat area. Proving: The remarkable effectiveness of this very simple regimen thus reinforces the recommendation to increase the intake of soy proteins for cardiovascular protection.

CARBOHYDRATES

Dietary Fibers •

Dietary fibers refer to the remains of plant cells that are resistant to hydrolysis by human enzymes

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Positive influence on constipation, hyperlipidemias, diabetes, obesity, and diverticular disease

Dietary Fibers •

Many different kinds: –

General dietary fibers •

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Insoluble fiber •

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Cholesterol lowering

Intermediate fibers •

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Protective benefits

Viscous polysaccharides •

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Aid to digestion, promote regularity, prevent constipation

Soluble fiber •

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Carbohydrate and lipid metabolism modulation, antioxidants, phytonutrients

Prebiotic effect, cholesterol lowering

Resistant starch •

Bowel function

Which Carbohydrate offers more dietary fiber? 1 slice whole wheat bread OR 1 slice white bread?

Which Carbohydrate offers more dietary fiber? ⅓ cup bran flakes OR ⅓ cup corn flakes?

Which Carbohydrate offers more dietary fiber? 1 cup white rice OR 1 cup brown rice?

Which Carbohydrate offers more dietary fiber? ½ cup strawberries OR ½ cup grapes?

Which Carbohydrate offers more dietary fiber? 1 baked potato with skin OR ½ cup mashed potatoes without skin?

Which Carbohydrate offers more dietary fiber? 1 tbsp. wheat germ OR 1 tbsp. wheat bran?

Dietary Fibers •

Drawbacks: – –

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Difficult to incorporate “pure” polysaccharide fractions in food products May cause gas

Food Sources: – – – – – –

Whole grains – wheat, corn, oats, rice Legumes Cereals Broccoli Oatmeal Beans

Non-digestible Oligosaccharides (NDOs) • • • •

Extracted from natural sources Synthesized by transferases Resistant to human intestinal enzymes Three categories of nutritional properties • • •

Strong Promising Preliminary

Non-digestible Oligosaccharides (NDOs) • •

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2 main NDOs: Inulin and fructo-oligosaccharides (FOS) Modify bowel habits • • •

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Fecal bulking Normalization of stool frequency Prebiotic effect

Help manage diabetes Improved bone health

Non-digestible Oligosaccharides (NDOs) •

Modulation of lipid metabolism

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Prevention against colon cancer

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More promising than dietary fibers and resistant starches

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Main benefit: bifidobacteria

Non-digestible Oligosaccharides (NDOs) •

Food sources: • • • •

beans wheat rye barley

Sugar Alcohols •

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Derived from starch, sucrose, and glucose Provide energy but low in calories Commonly combined with sweeteners or as additives in gum, candies, beverages, and snack foods Absorbed slowly and incompletely May prevent/reduce dental carries

Sugar Alcohols • • • •

Sorbitol Mannitol Xylitol Isomalt

Sugar Alcohols •

Drawbacks • • •

Bloating and diarrhea Weight gain when overeaten Laxative effect

DAIRY

Dairy •

2 Main Types •

Vitamin D Fortification

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Probiotic Addition

Vitamin D •

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Fortified foods provide most of the vitamin D in the American diet. Milk fortification plan was first implemented in the 1930s. Recent studies have reported a possible resurgence of childhood rickets, as well as hypovitaminosis D in schoolchildren and the elderly. Approximately 30 to 40% of the U.S. population is estimated to be deficient in Vitamin D.

Selected Food Sources of Vitamin D http://ods/od.nih.gov/factsheets/vitamind.asp

Food

IUs per serving

Percent DV

Milk, nonfat, reduced fat, and whole, vitamin Dfortified, 1 cup

98

25

Yogurt, fortified with 20% of the DV for vitamin, 6 ounces

80

20

Margarine, fortified, 1 tablespoon

60

15

Current Barriers to Adequate Vitamin D Intake • •

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Problems with the consumption of fluid milk The U.S. has experienced pronounced declines in the overall consumption of milk in the last decade. Studies conducted to examine the possibility of increasing the level of vitamin D fortification Data also demonstrated that vitamin D is equally bioavailable from fortified hard cheeses.

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What are Probiotics?

Probiotics •

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Living microorganisms, usually lactic acid bacteria Term first used in 1965 for describing substances secreted by one organism which stimulate the growth of another. Beneficial due to the effects on different intestinal functions Several different types are being introduced in a variety of dairy products around the world.

The Intestinal Microflora •

There are over 400 types of bacteria found in the gastrointestinal tract.

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The types and number of bacteria are influenced by several factors: • • • •

Stress Antibiotics Aging Diet

Health Claims for Probiotics • • • • •

Enhance the host’s immune system Improve intestinal tract health Reduce symptoms of lactose intolerance Reduce the risk of certain cancers Beneficial in a variety of diseases and metabolic problems • • • •

Crohn’s disease Irritable bowel syndrome Cholesterol metabolism Diverticulitis

Challenges Associated with Establishing Health Claims for Probiotics • • • • • •

Identification of microorganisms Enumeration of microorganisms Efficacy testing Clinical trials and active ingredients Dosage of probiotic bacteria Safety aspects

Mechanism of Action •

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Partial lactose digestion and stimulation of the intestinal mucosal lactase activity • Lactobilli used in the fermented milk industry have active beta-galactosidase Lactic acid bacteria produce several metabolites which prevent the growth of food borne pathogens in dairy products Can use enymatic mechanisms to modify toxin receptors and block toxin mediated pathology Prevent colonization of pathogens by competitive inhibition Lower intestinal pH Release of gut protective metabolites Regulation of intestinal motility and mucus production

Use of Probiotics: Study-based Evidence •

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Evidences of probiotic effectiveness in Necrotising Enterocolitis Diarrhea Inflammatory bowel disease Cancers Surgical infections

Other Benefits •

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Role in prevention of transmission of AIDS and STDs Antibacterial effects Probiotics in critical illness Probiotics in allergic diseases Possible effects on serum lipid levels

FAO/WHO Guidelines for the Evaluation of Probiotics in Food •

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ftp://ftp.fao.org/es/esn/food/wgreport2.pdf

Further Considerations • •

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Disturbing natural intestinal microflora Regulated and proper manufacturing practices Marketing tool for many companies Status of the microorganisms Possible lack of well-controlled studies in humans

Conclusion •

As long as they are substantially regulated and consumers take the time to discern the legitimacy of food claims, functional foods can be a great asset to the progression of the nutrition field.

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It is important to note that functional foods are not magic bullets — they can’t make up for a diet that is high in saturated fat or sugar.

Conclusion •

Functional foods are simply meant to be a complement to lifestyle change, as well as prevention. They are not meant as a sole source of treatment.

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Moderation is truly the key, as with everything in life.

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As Paracelsus said in the 15th century, “All substances are poisons... the right dose differentiates a poison from a remedy.”

References 

Functional Foods Fact Sheet: Antioxidants (2009). International Food Information Council. Retrieved from http://www.ific.org/publications/factsheets/antioxidantfs.cfm? renderforprint=1

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Cochran, C. Fruit and Vegetable Whole Food Actives and their Benefits to Human Health. Retrieved from http://www.smokeysantillo.com/Fruit %20And%20Vegetable%20Whole%20Food%20Actives%20and%20Their %20Benefits%20To%20Human%20Health.htm

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Irene Nursing Home Pte Ltd. Functional Foods: What are Functional Foods . 2007. Retrieved from http://www.elderlynursing.com/functional_foods.htm

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Loo JL, Cummings J, Delzenne N. Functional food properties of nondigestible oligosaccharides: a consensus report from the ENDO project. British Journal of Nutrition. 1999; 81: 121-132.

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Brophy B & Schardt D. (1999). Functional Foods. Nutrition Action Health Letter: Center for Science in the Public Interest. Retrieved from http://www.cspinet.org/nah/4_99/functional_foods.htm

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Functional Foods. (2009). International Food Information Council Foundation. Retrieved from http://www.ific.org/nutrition/functional/upload/functionalfoodsbackgrounde

References 

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Functional Foods Fact Sheet: Antioxidants (2009). International Food Information Council. Retrieved from http://www.ific.org/publications/factsheets/antioxidantfs.cfm? renderforprint=1 Williamson C. Functional Foods: What are the Benefits? (2002). The British Nutrition Foundation. Functional Foods Fact Sheet: Plant Stanols and Sterols.(2009). International Food Information Council Foundation.  Retrievedfrom http://www.ific.org/publications/factsheets/sterolfs.cfm Functional Foods Fact Sheet: Omega-3 Fatty Acids. (2009).International Food Information Council Foundation. Retrieved from http://www.ific.org/publications/factsheets/omega3fs.cfm Cesare SR, Galli C, Anderson JW, Arnoldi A. Nutritional and Nutraceutial Approaches to Dyslipidemia and Atherosclerosis Prevention: Focus on Dietary Proteins. Elsevier Ireland Ltd. 2009; 203:8-17. German B, Schriffrin EJ, Reniero R. The development of functional foods: lessons from the gut. Tibtech. 1999; 17:492-499. Dayuff RL. American Dietetic Association complete food and nutrition guide. 3rd ed. Hoboken NJ: John Wiley and Sons; 2006: 126. Farnworth ER. The evidence to support health claims for probiotics. J Nutr. 2008; 138:1250S-1245S.

References 

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Dietary supplement fact sheet: vitamin D. Office of Dietary Supplements, National Institutes of Health. March 2008 (updated September 2009): http://ods.od.nih/gov/factsheets/vitamind.asp Calvo MS, Whiting SJ, Barton CN. Vitamin D fortification in the United States and Canada: current status and data needs. Am J Clin Nutr. 2004; 80(6):1710S-1716S. Hanson A, Metzger LE. Vitamin D fortification and stability in dairy products. Midwest Dairy Foods Research Center Department of Food Science and Nutrition, University of Minnesota. 2009: http://www.ndsu.edu/ndsu/hde/research/Vitamin_D_Fortification-A.Hansen.pdf Wagner D, Sidhom G, Whiting SJ, Rousseau D, Vieth R. The bioavailability of vitamin D from fortified cheeses and supplements is equivalent in adults. J Nutr. 2008; 138:1365-1371. The basics. Dannon Probiotics Center. Retrieved 8 October 2009: http://www.dannonprobioticscenter.com/basics Gupta V, Garg R. Probiotics. Indian Journal of Medical Microbiology. 2009; 27(3):202-209. Pareira DIA, Gibson GR. Effect of consumption of probiotics and prebiotics on serum lipid levels in humans. Critical Reviews in Biochemistry & Molecular Biology. 2002; 37(4):259-281. Guidelines for the Evaluation of Probiotics in Food. London Ontario, Canada: Food and Agriculture Organization of the United Nations/World Health Organization. Joint FAO/WHO Working Group Report on Drafting Guidelines for the Evaluation of Probiotics in Food. 2002. Van Hoffman C. Probiotics growth spurt continues in new categories. Brandweek. 2007; 48(24):7. Brown AC, Vallere A. Probiotics and medical nutrition therapy. Nutrition in Clinical Care. 2004; 7(2):56-68.