Health claim evidence requirements in Japan

Sprouts as probiotic carriers: A new trend to improve consumer nutrition

Over the past few decades, efforts to eradicate hunger in the world have led to the generation of sustainable development goals to reduce poverty and inequality. It is estimated that the current coronavirus pandemic could add between 83 and 132 million to the total number of undernourished people in the world by 2021. Food insecurity is a contributing factor to the increase in malnutrition, overweight and obesity due to the quality of diets to which people have access. It is therefore necessary to develop functional foods that meet the needs of the population, such as the incorporation of sprouts in their formulation to enhance nutritional quality. Germination of grains and seeds can be used as a low-cost bioprocessing technique that provides higher nutritional value and better bioavailability of nutrients. Consequently, the manuscript describes relevant information about the germination process in different seeds, the changes caused in their nutritional value and the use of techniques within the imbibition phase to modify the metabolic profiles within the sprouts such as inoculation with lactic acid bacteria and yeasts, to generate a functional symbiotic food.

Factors governing consumers buying behavior concerning nutraceutical product

In recent years, consumers are increasingly attracted to nutraceuticals, an important part of food considered propitious for human health. Therefore, consumers are willingly switching to nutraceuticals and are ready to pay the premium price. This review aims to identify various factors that govern consumer purchasing of nutraceutical products. The outcomes presented in the review provide a closer understanding of consumer attitudes toward buying behavior and their impact on the growth of the global nutraceutical market. The nutraceutical market has been identified depending on the type of nutraceuticals, forms, and regions governing the nutraceutical market. Factors such as health consciousness, knowledge about a product, product availability, price, marketing strategies, and social factors influence consumers' actual buying behavior toward nutraceutical products. A mini survey in Mumbai city of India was conducted to add practical data to the review, and factors affecting consumers' willingness to buy nutraceutical products were identified. It was observed that the decision-making toward buying nutraceutical products was affected by gender, age, education level, and acculturation. It was also identified that the legislation governing nutraceuticals needs to be harmonized throughout many parts of the world, which restricts the growth of this sector to some extent. The findings elucidate that nutraceutical industries should overcome the regulatory barriers and focus on developing innovative products, which will keep current consumers intact and help increase the consumer base and thus expand the nutraceutical market globally.

A model of health-related quality of life during COVID-19 pandemic: the role of food customer loyalty and affordability

Purpose

This research aims to test the simultaneous effects of the perceived threat of COVID-19, e-health literacy, e-health access barrier, loyalty toward healthy foods in general, loyalty toward functional foods, the affordability of healthy foods in general and the affordability of functional foods on health-related quality of life (HrQoL) during the COVID-19 pandemic.

Design/methodology/approach

A survey with 400 respondents in Banten, Indonesia, was performed. The data were analyzed using multiple regression analysis.

Findings

The results of the research showed that HrQoL during the COVID-19 pandemic was positively affected by e-health literacy and the affordability of healthy foods in general while negatively affected by the e-health access barrier, the perceived threat of COVID-19 and loyalty toward healthy foods in general. Furthermore, HrQoL was not influenced by loyalty toward and affordability of functional foods.

Research limitations/implications

This research was conducted in Banten. Due to the operational limitations during the COVID-19 pandemic, this research used a purposive sampling technique. Therefore, the next research should retest the model in different contexts and locations.

Practical implications

To improve HrQoL during the COVID-19 pandemic, citizens need to be educated on finding and utilizing credible online health information during the COVID-19 pandemic. Governments and health service providers should also strive to offer ease of access to credible online health information. Furthermore, the affordability of healthy foods, in general, should be managed well.

Originality/value

A few studies on HrQoL during COVID-19 pandemic were performed. However, there is a lack of paper that examines the role of food customer loyalty and affordability in a model of HrQoL during the COVID-19 pandemic. To the best of the authors’ knowledge, this paper is the first that involved and tested the role of food customer loyalty and affordability in a model of HrQoL during the COVID-19 pandemic.

Pharmaceutical Food Science: Search for Bio-Functional Molecules Obtained from Natural Resources to Prevent and Ameliorate Lifestyle Diseases

In this review, our resent pharmaceutical food science research for bio-functional molecules obtained from natural resources that contribute to i) suppression of postprandial blood glucose elevation and/or improvement of glucose tolerance and ii) reduction of visceral fat accumulation and improvement of lipid metabolism were summarized. Based on studies using MONOTORI science, salacinol (1), neokotalanol (4), and trans-tiliroside (20) have been approved or notified by the Consumer Affairs Agency in Japan as functional substances in food with health claims, Food for Specified Health Use and Food with Functional Claims.

Nature of the evidence base and strengths, challenges and recommendations in the area of nutrition and health claims: a position paper from the Academy of Nutrition Sciences

The regulation of health claims for foods by the Nutrition and Health Claims Regulation is intended, primarily, to protect consumers from unscrupulous claims by ensuring claims are accurate and substantiated with high quality scientific evidence. In this position paper, the Academy of Nutrition Sciences uniquely recognises the strengths of the transparent, rigorous scientific assessment by independent scientists of the evidence underpinning claims in Europe, an approach now independently adopted in UK. Further strengths are the separation of risk assessment from risk management, and the extensive guidance for those submitting claims. Nevertheless, four main challenges in assessing the scientific evidence and context remain: (i) defining a healthy population, (ii) undertaking efficacy trials for foods, (iii) developing clearly defined biomarkers for some trial outcomes and (iv) ensuring the composition of a food bearing a health claim is consistent with generally accepted nutrition principles. Although the Regulation aims to protect the consumer from harm, we identify some challenges from consumer research: (i) making the wording of some health claims more easily understood and (ii) understanding the implications of the misperceptions around products bearing nutrition or health claims. Recommendations are made to overcome these challenges. Further, the Academy recommends that a dialogue is developed with the relevant national bodies about Article 12(c) in the Regulation. This should further clarify the GB Guidance to avoid the current non-level playing field between health professionals and untrained ‘influencers’ who are not covered by this Article about the communication of authorised claims within commercial communications.

Lecithin Inclusion by α-Cyclodextrin Activates SREBP2 Signaling in the Gut and Ameliorates Postprandial Hyperglycemia

BACKGROUND

α-cyclodextrin (α-CD) is one of the dietary fibers that may have a beneficial effect on cholesterol and/or glucose metabolism, but its efficacy and mode of action remain unclear.

METHODS

In the present study, we examined the anti-hyperglycemic effect of α-CD after oral loading of glucose and liquid meal in mice.

RESULTS

Administration of 2 g/kg α-CD suppressed hyperglycemia after glucose loading, which was associated with increased glucagon-like peptide 1 (GLP-1) secretion and enhanced hepatic glucose sequestration. By contrast, 1 g/kg α-CD similarly suppressed hyperglycemia, but without increasing secretions of GLP-1 and insulin. Furthermore, oral α-CD administration disrupts lipid micelle formation through its inclusion of lecithin in the gut luminal fluid. Importantly, prior inclusion of α-CD with lecithin in vitro nullified the anti-hyperglycemic effect of α-CD in vivo, which was associated with increased intestinal mRNA expressions of SREBP2-target genes (Ldlr, Hmgcr, Pcsk9, and Srebp2).

CONCLUSIONS

α-CD elicits its anti-hyperglycemic effect after glucose loading by inducing lecithin inclusion in the gut lumen and activating SREBP2, which is known to induce cholecystokinin secretion to suppress hepatic glucose production via a gut/brain/liver axis.

Intake of Koji Amazake Improves Defecation Frequency in Healthy Adults

Reportedly, the intake of koji amazake, a beverage made from steamed rice fermented by Aspergillus oryzae, improves defecation frequency. However, its functional ingredients and mechanism of action remain unclear. To compare the effects of koji amazake and a placebo beverage on defecation frequency and to identify the functional ingredients and mechanism of action, a randomized, placebo-controlled, double-blind parallel-group comparative trial was performed on two groups. The koji amazake had 302 ± 15.5 mg/118 g of A. oryzae cells, which was not in the placebo. Compared with the placebo group, the koji amazake group showed a significant increase in weekly defecation frequency at 2 weeks (5.09 days vs. 4.14 days), 3 weeks (5.41 days vs. 4.18 days), and 4 weeks (5.09 days vs. 3.95 days), along with an increase in the weekly fecal weight at 4 weeks (724 g vs. 501 g). The intake of koji amazake did not induce significant intergroup differences in the fecal SCFA concentration, whereas it significantly decreased the relative abundance of Blautia and significantly increased that of Bacteroides at 3 weeks. Therefore, koji amazake intake improved defecation frequency, and A. oryzae cells played potentially important roles as functional ingredients.

Development of Decontamination Treatment Techniques for Dry Powder Foods by Atmospheric-Pressure Nonequilibrium DC Pulse Discharge Plasma Jet

Dry powder food ingredients imported to Japan contain large amounts of viable bacteria and coliform bacteria, and we need a simple, low-cost, dry nonthermal decontamination method without spoiling nutrients, color, fragrance, and flavor. In this study, it is shown that the decontamination performance against viable bacteria and coliform bacteria is proportional to the plasma irradiation time when OH and O3 radicals are incident on the dry powder food ingredients placed in an atmospheric-pressure nonequilibrium DC pulse discharge Ar + O2 mixture gas plasma jet. Our study revealed that there is a correlation between the plasma irradiation time and DC pulse frequency increase and the decontamination effect on the general bacterial count.

A review of antidiabetic active thiosugar sulfoniums, salacinol and neokotalanol, from plants of the genus Salacia

During our studies characterizing functional substances from food resources for the prevention and treatment of lifestyle-related diseases, we isolated the active constituents, salacinol (1) and neokotalanol (4), and related thiosugar sulfoniums, from the roots and stems of the genus Salacia plants [Celastraceae (Hippocrateaceae)] such as Salacia reticulata Wight, S. oblonga Wall., and S. chinensis L., and observed their antidiabetic effects. These plant materials have been used traditionally in Ayurvedic medicine as a specific remedy at the early stage of diabetes, and have been extensively consumed in Japan, the United States, and other countries as a food supplement for the prevention of obesity and diabetes. Here, we review our studies on the antidiabetic effects of plants from the genus Salacia, from basic chemical and pharmacological research to their application and development as new functional food ingredients.

The possibility of improving meat quality by using peas and faba beans in feed for broiler chickens

The price-to-quality ratio of broiler chicken meat is one of the reasons why consumers use these products in their daily diet. The quality of poultry products such as meat is closely associated with the nutritional value and quality of feed fed to broilers. In composing broiler diets, the main focus is turned on crude protein (CP). Because of the trend for the poultry industry to reduce its dependence on soybean meal as a source of protein, the role of pulses in the supply of protein and energy, which could partly replace the soybean meal in poultry diets, increases. Due to considerable progress in plant breeding, the present research study used peas (Pisum sativum) of the var. ‘Bruno’ and var. ‘Pinochio’ as well as faba beans (Vicia faba minora) of the var. ‘Lielplatone’ was developed in Latvia. Higher protein diets induce a higher meat protein content, accordingly, feed proteins are hydrolyzed in the digestive system into amino acids (AA) that, after absorption, are used to form proteins and to build different body tissues. The most important AA was twofold lower in peas and faba beans than in soybean meal. Although the amount of AA in feed is not directly proportional to the content of AA in broiler chicken meat, the amount of AA in poultry feed can significantly affect an important meat quality criterion for consumers – the nutritional value of protein. Therefore, the research aimed to identify changes in AA composition and chemical composition – a qualitative property of poultry meat – as a result of adding pulses (peas and beans) to poultry diets. The research results showed that the diets with an addition of faba beans and peas had a positive effect on the level of essential amino acids (EAA) and non-essential amino acids (NEAA) in broiler meat, decreased cholesterol concentration in meat, and increased energy value of meat.

Plant phenolics as functional food ingredients

Phenolic compounds have attracted much attention in recent times as their dietary intake has been associated with the prevention of some chronic and degenerative diseases that constitute major causes of death and incapacity in developed countries, such as cardiovascular diseases, type II diabetes, some types of cancers or neurodegenerative disorders like Alzheimer's and Parkinson's diseases. Nowadays it is considered that these compounds contribute, at least in part, for the protective effects of fruit and vegetable-rich diets, so that the study of their role in human nutrition has become a central issue in food research. This chapter reviews the current knowledge on the phenolic compounds as food components, namely their occurrence in the diet, bioavailability and metabolism, biological activities and mechanisms of action. Besides, the approaches for their extraction from plant matrices and technological improvements regarding their preparation, stability and bioavailability in order to be used as functional food ingredients are also reviewed, as well as their legal situation regarding the possibility of making "health claims" based on their presence in food and beverages.

Nutraceuticals: opening the debate for a regulatory framework

Currently, nutraceuticals do not have a specific definition distinct from those of other food-derived categories, such as food supplements, herbal products, pre- and probiotics, functional foods, and fortified foods. Many studies have led to an understanding of the potential mechanisms of action of pharmaceutically active components contained in food that may improve health and reduce the risk of pathological conditions while enhancing overall well-being. Nevertheless, there is a lack of clear information and, often, the claimed health benefits may not be properly substantiated by safety and efficacy information or in vitro and in vivo data, which can induce false expectations and miss the target for a product to be effective, as claimed. An officially shared and accepted definition of nutraceuticals is still missing, as nutraceuticals are mostly referred to as pharma-foods, a powerful toolbox to be used beyond the diet but before the drugs to prevent and treat pathological conditions, such as in subjects who may not yet be eligible for conventional pharmaceutical therapy. Hence, it is of utmost importance to have a proper and unequivocal definition of nutraceuticals and shared regulations. It also seems wise to assess the safety, mechanism of action and efficacy of nutraceuticals with clinical data. A growing demand exists for nutraceuticals, which seem to reside in the grey area between pharmaceuticals and food. Nonetheless, given specific legislation from different countries, nutraceuticals are experiencing challenges with safety and health claim substantiation.

Effects of resistant maltodextrin on bowel movements: a systematic review and meta-analysis

It is well known that dietary fiber helps to relieve and prevent constipation, and there are a number of scientific papers, including systematic reviews and meta-analyses on the effects of naturally derived dietary fiber on bowel movements. In recent years, there has been an increase in the manufacture of dietary fiber ingredients obtained from food raw materials, and these are now commonly available in the market. Resistant maltodextrin (RMD), a soluble dietary fiber, is manufactured from starch, and industrially produced soluble dietary fiber is used worldwide. While there are many reports on the effects of RMD on bowel movements, no systematic review or meta-analysis has been reported. We conducted a systematic review and meta-analysis to clarify the effect of RMD on bowel movements based on stool frequency and stool volume. We also investigated the subjective evaluation of RMD effects on bowel movements. Of a total of 314 potentially relevant articles, 28 articles met the eligibility criteria, and 29 randomized controlled trials were identified. As a result of integration analyses, we found that the intake of RMD significantly increased stool volume and stool frequency compared with placebo intake. Furthermore, RMD intake tended to improve sensation of complete/incomplete evacuation. In conclusion, the evidence suggests that RMD has a positive effect on bowel movements, contributing to normal bowel function. This finding will help in the development of new criteria for choice of dietary fiber in the process of developing food products.

Low-density lipoprotein oxidation biomarkers in human health and disease and effects of bioactive compounds

Based on the significance of oxidized low-density lipoprotein (LDL) in health and disease, this review focuses on human studies addressing oxidation of LDL, including three lines of biomarkers, (i) ex vivo LDL resistance to oxidation, a "challenge test" model, (ii) circulating oxidized LDL, indicating the "current in vivo status", and (iii) autoantibodies against oxidized LDL as fingerprints of an immune response to oxidized LDL, along with circulating oxysterols and 4-hydroxynonenal as biomarkers of lipid peroxidation. Lipid peroxidation and oxidized LDL are hallmarks in the development of various metabolic, cardiovascular and other diseases. Changes further occur across life stages from infancy to older age as well as in athletes and smokers. Given their responsiveness to targeted nutritional interventions, markers of LDL oxidation have been employed in a rapidly growing number of human studies for more than 2 decades. There is growing interest in foods, which, besides providing energy and nutrients, exert beneficial effects on human health, such as protection of DNA, proteins and lipids from oxidative damage. Any health claim, however, needs to be substantiated by supportive evidence derived from human studies, using reliable biomarkers to demonstrate such beneficial effects. A large body of evidence has accumulated, demonstrating protection of LDL from oxidation by bioactive food compounds, including vitamins, other micronutrients and secondary plant ingredients, which will facilitate the selection of oxidation biomarkers for future human intervention studies and health claim support.

Health claims on food products in Southeast Asia: regulatory frameworks, barriers, and opportunities

The Association of Southeast Asian Nations aims to act as a single market and allow free movement of goods, services, and manpower. The purpose of this article is to present an overview of the current regulatory framework for health claims in Southeast Asia and to highlight the current barriers and opportunities in the regulatory frameworks in the Association of Southeast Asian Nations. To date, 5 countries in Southeast Asia, i.e., Indonesia, Malaysia, the Philippines, Singapore, and Thailand, have regulations and guidelines to permit the use of health claims on food products. There are inconsistencies in the regulations and the types of evidence required for health claim applications in these countries. A clear understanding of the regulatory frameworks in these countries may help to increase trade in this fast-growing region and to provide direction for the food industry and the regulatory community to develop and market food products with better nutritional quality tailored to the needs of Southeast Asian consumers.

Digestibility of new dietary fibre materials, resistant glucan and hydrogenated resistant glucan in rats and humans, and the physical effects in rats

Resistant glucan (RG) and hydrogenated resistant glucan (HRG) are newly developed non-digestible carbohydrate materials that decrease lifestyle-related diseases. The bioavailability of RG and HRG was investigated by in vitro experiments using human and rat small intestinal enzymes and by in vivo experiments using rats in the present study. Oligosaccharides, which are minor components of RG and HRG, were hydrolysed slightly by small intestinal enzymes of humans and rats, and the hydrolysing activity was slightly higher in rats than in humans. The amount of glucose released from HRG was greater than that from RG. However, the high-molecular-weight carbohydrates of the main components were hardly hydrolysed. Furthermore, neither RG nor HRG inhibited disaccharidase activity. When rats were raised on a diet containing 5 % of RG, HRG, resistant maltodextrin or fructo-oligosaccharide (FOS) for 4 weeks, all rats developed loose stools and did not recover during the experiment, except for the FOS group. Body weight gain was normal in all groups and was not significantly different compared with the control group. Caecal tissue and content weights were significantly increased by feeding RG or HRG, although other organ and tissue weights were not significantly different among the groups. In conclusion, RG and HRG consist of small amounts of glucose and digestible and non-digestible oligosaccharides, and large amounts of glucose polymers, which were hardly hydrolysed by α-amylase and small intestinal enzymes. RG and HRG, which were developed newly as dietary fibre materials, had no harmful effects on the growth and development of rats.

Evaluation of the relative available energy of several dietary fiber preparations using breath hydrogen evolution in healthy humans

A standardized simple, indirect method for assessing the relative energy of dietary fiber carbohydrates is not yet established. There is a need for a standardized in vivo assay. The objective of the present study was to evaluate the relative available energy (RAE) for 9 major dietary fiber materials (DFMs) based on fermentability from breath hydrogen excretion (BHE) in subjects. Fructooligosaccharide (FOS) was used as a reference. The study was conducted using a within-subject, repeated measures design and approved by the Ethical Committee of University of Nagasaki. After DFM ingestion, end-expiratory gas (750-mL) was collected at 1-h intervals for 8 h, as well as at 2-h intervals between 8 h and 14 h, and 30 min after waking up and 24 h after DFM ingestion. Breath hydrogen concentration was assessed with a gas chromatograph. The RAE of DFMs tested was evaluated based on the area under the curve (AUC) of BHE of FOS. Based on the ratio of AUC for 8 h, the RAE of polydextrose, partially hydrolysed guar gum, resistant maltodextrin and partially hydrolysed alginate was 1 kcal/g, and that of glucomannan, heat-moisture treatment and high-amylose cornstarch and cellulose was 0 kcal/g, while the RAE of all tested DEMs including cellulose and glucomannan was 1 kcal/g in the calculation based on AUCs for 14 h and 24 h in subjects. We suggest that a breath hydrogen collection period of 14 h or more could be used to measure RAE for a range of fiber preparations in vivo.

Concomitant use of dietary supplements and medicines in patients due to miscommunication with physicians in Japan

We previously reported that some patients used dietary supplements with their medication without consulting with physicians. Dietary supplements and medicines may interact with each other when used concomitantly, resulting in health problems. An Internet survey was conducted on 2109 people who concomitantly took dietary supplements and medicines in order to address dietary supplement usage in people who regularly take medicines in Japan. A total of 1508 patients (two admitted patients and 1506 ambulatory patients) and 601 non-patients, who were not consulting with physicians, participated in this study. Purpose for dietary supplement use was different among ages. Dietary supplements were used to treat diseases in 4.0% of non-patients and 11.9% of patients, while 10.8% of patients used dietary supplements to treat the same diseases as their medication. However, 70.3% of patients did not declare dietary supplement use to their physicians or pharmacists because they considered the concomitant use of dietary supplements and medicines to be safe. A total of 8.4% of all subjects realized the potential for adverse effects associated with dietary supplements. The incidence of adverse events was higher in patients who used dietary supplements to treat their disease. Communication between patients and physicians is important for avoiding the adverse effects associated with the concomitant use of dietary supplements and medicines.

Inhibitory effect of black tea and its combination with acarbose on small intestinal α-glucosidase activity

ETHNOPHARMACOLOGICAL RELEVANCE

It is said that black tea is effective against type 2 diabetes mellitus because it can help modulate postprandial hyperglycemia. However, the mechanism underlying its therapeutic and preventive effects on type 2 diabetes mellitus is unclear. In this study, we focused on the effect of black tea on the carbohydrate digestion and absorption process in the gastrointestinal tract. We examined whether black tea can modulate postprandial hyperglycemia.

MATERIALS AND METHODS

The freeze-dried powder of the aqueous extract of black tea leaves (JAT) was used for in vitro studies of α-amylase activity, α-glucosidase activity, and glucose uptake by glucose transporters in Caco-2 cells; ex vivo studies of small intestinal α-glucosidase activity; and in vivo studies of oral sugar tolerance in GK rats, an animal model of nonobese type 2 diabetes mellitus.

RESULTS

Half maximal inhibitory concentration values indicated that JAT significantly reduced α-glucosidase activity, but weakly reduced α-amylase activity. Kinetic studies of rat small intestinal α-glucosidase activity revealed that the combination of JAT and the α-glucosidase inhibitor, acarbose, showed a mixed-type inhibition. JAT had no effect on the uptake of 2'-deoxy-d-glucose by glucose transporter 2 (GLUT2) and the uptake of α-methyl-d-glucose by sodium-dependent glucose transporter 1 (SGLT1). In the oral sucrose tolerance test in GK rats, JAT reduced plasma glucose levels in a dose-dependent manner compared with the control group. The hypoglycemic action of JAT was also confirmed: JAT, in combination with acarbose, produced a synergistic inhibitory effect on plasma glucose levels in vivo. In contrast to the oral sucrose tolerance test, JAT showed no effect in the oral glucose tolerance test.

CONCLUSIONS

JAT was demonstrated to inhibit the degradation of disaccharides into monosaccharides by α-glucosidase in the small intestine. Thereby indirectly preventing the absorption of the dietary source of glucose mediated by SGLT1 and GLUT2 transporters localized at the apical side of enterocytes in the small intestine. The results indicate that black tea could be useful as a functional food in the dietary therapy for borderline type 2 diabetes mellitus that could modulate postprandial hyperglycemia.

Effects of Bacillus subtilis var. natto products on symptoms caused by blood flow disturbance in female patients with lifestyle diseases

The fermented soybean product natto is a popular traditional food in Japan and is considered a health supplement. NKCP(®), a natto-derived dietary food supplement whose main component is bacillopeptidase F, has antithrombotic, fibrinolytic, and blood pressure-lowering effects. We examined whether daily intake of NKCP(®) effectively improves subjective symptoms in patients with lifestyle diseases in this cross-over, double-blind study. Fermented soya extract with subtilisin NAT (nattokinase) as the main component was used as an active placebo. A 4-week course of NKCP(®) significantly decreased the visual analog scale (VAS) score for shoulder stiffness from 42.3 to 32.4 (P=0.009), the VAS score for low back pain from 25.5 to 18.8 (P=0.02), and the VAS score for coldness of the extremities from 33.1 to 25.7 (P=0.002). However, no significant difference was found in the VAS score for headache. After a 4-week course of active placebo, no significant changes in the VAS score were found for any symptoms. The significant improvement in the symptoms secondary to blood flow disturbance was caused by the improvement in blood flow by NKCP(®). The use of dietary supplements based on the Japanese traditional food natto helps to relieve subjective symptoms for patients with lifestyle diseases receiving medical care.

Effects of acute and chronic boysenberry intake on blood pressure and endothelial function in spontaneous hypertensive rats

The effects of acute or chronic intake of boysenberry juice or artificial vinegar on blood pressure (BP) and endothelial function were investigated in spontaneous hypertensive rats (SHR). A single administration of boysenberry juice (BJ, equivalent to 0.5 mL/kg body weight) or artificial boysenberry juice vinegar (BJV, equivalent to 0.5 mL BJ and 0.10 g acetic acid/kg body weight) decreased both systolic blood pressure (SBP) and diastolic blood pressure (DBP) significantly. Reductions in SBP of the control group compared with the BJ and BJV groups reached maxima of -16.8±4.3 and -28.4±7.3 mmHg 8 h after administration, respectively. Chronic SBP- and DBP-lowering effects were also observed upon daily feedings of both BJ and BJV at 4 wk. No significant differences were found in SBP or DBP between respective acute and chronic intake of BJ and BJV, except for the decrease in DBP after 4 wk of BJV intake. This suggests that the polyphenol constituents in BJ and BJV likely play a major role in lowering SBP and DBP under these conditions and that acetic acid added to BJ exerts a DBP-lowering effect after 4 wk of BJV intake. The polyphenolic constituents of these beverages might elevate plasma NO concentration via aortic endothelial nitric oxide synthase activation, but the effects of chronic intake on blood pressure might also be at least partly mediated by the renin-angiotensin system. These results may help explain the beneficial effects of boysenberry intake on cardiovascular health, such as reduced blood pressure and improved endothelial function.

Inappropriate usage of dietary supplements in patients by miscommunication with physicians in Japan

Recently, people have used dietary supplements not only for nutritional supplementation, but also for treatment of their diseases. However, use of dietary supplements to treat diseases, especially with medications, may cause health problems in patients. In this study, we investigated use of dietary supplements in patients in Japan. This survey was conducted from January to December 2012, and was completed by 2732 people, including 599 admitted patients, 1154 ambulatory patients, and 979 healthy subjects who attended a seminar about dietary supplements. At the time of the questionnaire, 20.4% of admitted patients, 39.1% of ambulatory patients, and 30.7% of healthy subjects were using dietary supplements, which including vitamin/mineral supplements, herbal extracts, its ingredients, or food for specified health uses. The primary purpose for use in all groups was health maintenance, whereas 3.7% of healthy subjects, 10.0% of ambulatory patients, and 13.2% of admitted patients used dietary supplements to treat diseases. In addition, 17.7% of admitted patients and 36.8% of ambulatory patients were using dietary supplements concomitantly with their medications. However, among both admitted patients and ambulatory patients, almost 70% did not mention dietary supplement use to their physicians. Overall, 3.3% of all subjects realized adverse effects associated with dietary supplements. Communication between patients and physicians is important to avoid health problems associated with the use of dietary supplements.

Gazing into the crystal ball: future considerations for ensuring sustained growth of the functional food and nutraceutical marketplace

Over the last decade the concept of functional foods and nutraceuticals (FFN) has gained support from various stakeholders including the food industry, scientific and academic community, government institutions or regulators, producers and consumers. However, as one begins to evaluate the global FFN industry, several issues emerge including (i) a lack of consensus across jurisdictions for acknowledging safe and efficacious FFN, (ii) challenges regarding the classification of novel food-derived bioactives as FFN or drugs, and (iii) a disconnect between nutrient requirements and dosages of FFN required to facilitate health benefits. The objectives of the present review are to discuss the role of existing stakeholders within the FFN marketplace and identify performance indicators for growth within the FFN sector. In addition, the following report provides feasible resolutions to present and future challenges facing the global FFN industry to ensure sustained long-term growth.

An oral preparation of Lactobacillus acidophilus for the treatment of uncomplicated acute watery diarrhoea in Vietnamese children: study protocol for a multicentre, randomised, placebo-controlled trial

BACKGROUND

Diarrhoeal disease is a major global health problem, particularly affecting children under the age of 5 years. Besides oral rehydration solution, probiotics are also commonly prescribed to children with acute watery diarrhoea in some settings. Results from randomised clinical trials (RCTs) in which investigators studied the effect of probiotics on diarrhoeal symptoms have largely shown a positive effect; yet, the overall quality of the data is limited. In Vietnam, probiotics are the most frequently prescribed treatment for children hospitalised with acute watery diarrhoea, but there is little justification for this treatment in this location. We have designed a RCT to test the hypothesis that an oral preparation of Lactobacillus acidophilus is superior to placebo in the treatment of acute watery diarrhoea in Vietnamese children.

METHODS

This RCT was designed to study the effect of treatment with L. acidophilus (4 × 109 colony-forming units/day) for 5 days for acute watery diarrhoea against a placebo in 300 children ages 9 to 60 months admitted to hospitals in Vietnam. Clinical and laboratory data plus samples will be collected on admission, daily during hospitalisation, at discharge, and at follow-up visits for a subset of participants. The primary end point will be defined as the time from the first dose of study medication to the start of the first 24-hour period without diarrhoea as assessed by the on-duty nurse. Secondary endpoints include the time to cessation of diarrhoea as recorded by parents or guardians in an hourly checklist, stool frequency over the first 3 days, treatment failure, rotavirus and norovirus viral loads, and adverse events.

DISCUSSION

The existing evidence for the use of probiotics in treating acute watery diarrhoea seems to favour their use. However, the size of the effect varies across publications. An array of different probiotic organisms, doses, treatment durations, study populations, designs, settings, and aetiologies have been described. In this trial, we will investigate whether probiotics are beneficial as an adjuvant treatment for children with acute watery diarrhoea in Vietnam, with the aim of guiding clinical practice through improved regional evidence.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN88101063.

An oral preparation of Lactobacillus acidophilus for the treatment of uncomplicated acute watery diarrhoea in Vietnamese children: study protocol for a multicentre, randomised, placebo-controlled trial

BACKGROUND

Diarrhoeal disease is a major global health problem, particularly affecting children under the age of 5 years. Besides oral rehydration solution, probiotics are also commonly prescribed to children with acute watery diarrhoea in some settings. Results from randomised clinical trials (RCTs) in which investigators studied the effect of probiotics on diarrhoeal symptoms have largely shown a positive effect; yet, the overall quality of the data is limited. In Vietnam, probiotics are the most frequently prescribed treatment for children hospitalised with acute watery diarrhoea, but there is little justification for this treatment in this location. We have designed a RCT to test the hypothesis that an oral preparation of Lactobacillus acidophilus is superior to placebo in the treatment of acute watery diarrhoea in Vietnamese children.

METHODS

This RCT was designed to study the effect of treatment with L. acidophilus (4 × 109 colony-forming units/day) for 5 days for acute watery diarrhoea against a placebo in 300 children ages 9 to 60 months admitted to hospitals in Vietnam. Clinical and laboratory data plus samples will be collected on admission, daily during hospitalisation, at discharge, and at follow-up visits for a subset of participants. The primary end point will be defined as the time from the first dose of study medication to the start of the first 24-hour period without diarrhoea as assessed by the on-duty nurse. Secondary endpoints include the time to cessation of diarrhoea as recorded by parents or guardians in an hourly checklist, stool frequency over the first 3 days, treatment failure, rotavirus and norovirus viral loads, and adverse events.

DISCUSSION

The existing evidence for the use of probiotics in treating acute watery diarrhoea seems to favour their use. However, the size of the effect varies across publications. An array of different probiotic organisms, doses, treatment durations, study populations, designs, settings, and aetiologies have been described. In this trial, we will investigate whether probiotics are beneficial as an adjuvant treatment for children with acute watery diarrhoea in Vietnam, with the aim of guiding clinical practice through improved regional evidence.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN88101063.

Effects of dietary fibre and tea catechin, ingredients of the Japanese diet, on equol production and bone mineral density in isoflavone-treated ovariectomised mice

Equol is a metabolite of the isoflavone daidzein (Dz) and is produced by the bacterial microflora in the distal intestine and colon. Some epidemiological studies have reported an association between increased equol production and intakes of green tea or dietary fibre, which are ingredients of the standard Japanese diet. We examined the effects of a diet supplemented with Dz and tea catechin or dietary fibre on equol production and bone mineral density in ovariectomised (OVX) mice. Female mice of the ddY strain were either sham operated or OVX. OVX mice were fed a control diet, a 0·1 % Dz-supplemented diet or a 0·1 % Dz diet supplemented with one of the food components commonly consumed in the Japanese diet. The mice were given 1 % tea catechin (w/w) as part of the diet in Expt 1 or 5 % polydextrose (PD) and 5 % raffinose (Raf) (w/w) as part of the diet in Expt 2. Catechin reduced serum equol levels and attenuated the beneficial effect of Dz on femoral bone loss. The soluble dietary fibres PD and Raf stimulated equol production, and enhanced the bone-protective effects of Dz on femoral bone. These results suggest that dietary fibre, in particular, PD, may alter the bioavailability of isoflavones and prevent osteopenia in OVX mice.

Use of supplements by young elite Japanese athletes participating in the 2010 youth Olympic games in Singapore

OBJECTIVE

To investigate the prevalence of supplement use among young elite Japanese athletes.

DESIGN

Survey study.

SETTING

2010 Youth Olympic Games, Singapore.

PARTICIPANTS

Data were collected from individual interviews during medical evaluations of 75 athletes selected for the Japanese national team.

MAIN OUTCOME MEASURES

Main outcome measures included the use of supplements, products used, frequency of use, purpose of use, and relationships between supplement use and athlete attitudes toward a balanced diet.

RESULTS

All 75 athletes agreed to participate in this study, and individual interviews by pharmacists made it possible to collect complete answers from all athletes. Of these athletes, 47 (62.7%) used 1 or more supplement products (average number of products used, 1.1 ± 1.3). The most popular supplement was amino acids, which were used by 33 athletes (44.0%). Of the supplements used, 28 (32.6%) were taken every day, whereas 28 (32.6%) were used only on special occasions. Moreover, 34 of the supplement products (39.5%) were taken to enhance recovery from fatigue, whereas 19 (22.1%) were used to improve athletic performance. Statistical analysis suggested that there was no significant relationship between supplement use and attitudes toward a balanced diet.

CONCLUSIONS

The results revealed widespread supplement use among young elite athletes in the Japanese national team for the Singapore Youth Olympic Games in 2010. Moreover, these athletes apparently used supplements without considering the effects of their normal diets.

Lactobacillus paracasei and Lactobacillus plantarum strains downregulate proinflammatory genes in an ex vivo system of cultured human colonic mucosa

Significant health benefits have been demonstrated for certain probiotic strains through intervention studies; however, there is a shortage of experimental evidence relative to the mechanisms of action. Here, noninvasive experimental procedure based on a colon organ culture system has been used that, in contrast to most experimental in vitro models reported, can preserve natural immunohistochemical features of the human mucosa. This system has been used to test whether commensal lactobacilli (Lactobacillus paracasei BL23, Lactobacillus plantarum 299v and L. plantarum 299v (A(-))) were able to hinder inflammation-like signals induced by phorbol 12-myristate 13-acetate (PMA)/ionomycin (IO). Whole genome microarrays have been applied to analyze expression differences, from which mRNA markers could be inferred to monitor the effect of putative probiotic strains under such conditions. Regarding the gene expression, PMA/IO treatment induced not only interleukin (IL)-2 and interferon gamma (IFN-γ), as expected, but also other relevant genes related to immune response and inflammation, such as IL-17A, chemokine (C-X-C motif) ligand (CXCL) 9 and CXCL11. The ex vivo culturing did not modify the pattern of expression of those genes or others related to inflammation. Interestingly, this study demonstrated that lactobacilli downregulated those genes and triggered a global change of the transcriptional profile that indicated a clear homeostasis restoring effect and a decrease in signals produced by activated T cells.

An ultra performance liquid chromatographic method for determining phytosterol uptake by Caco-2 cells

A simple method for the determination of cellular uptake of phytosterols by Caco-2 cells has been developed by ultra performance liquid chromatography with ultraviolet detection (UPLC-UV). UPLC-UV was established using an ODS column, acetonitrile/H(2)O (9:1, v/v) as a mobile phase, and a detection wavelength at 210 nm. As analytes, β-sitosterol, campesterol, stigmasterol, and brassicasterol were selected based on the abundance in foods and the similarity of their structures. A linear relation was observed between the peak area and the amount of sterol injected from 50 to 2000 pmol (r>0.999) with a relative standard deviation (RSD) of less than 2.5% (n=6). This method was applied to the determination of cellular uptake of phytosterols by Caco-2 cells. Recovery tests showed that phytosterols were extracted from the cell lysates by chloroform and determined by UPLC-UV with a recovery rate of more than 80.2% and an RSD of less than 11.3% (n=3). When Caco-2 cells were incubated with phytosterols at 37°C, their uptake was increased with time in a concentration-dependent manner. This method will be useful for the simultaneous determination of cellular phytosterols in an in vitro intestine model.

Scientific substantiation of health claims in the EU

EU legislation on nutrition and health claims made on foods (Regulation (EC) No. 1924/2006) specifies that health claims should be only authorised for use in the Community after a scientific assessment of the highest possible standard is carried out by the European Food Safety Authority (EFSA). This paper focuses on the scientific substantiation of health claims within the context of the EU Regulation. The evaluation of the substantiation of health claims is carried out by the EFSA Scientific Panel on Dietetic Products, Nutrition and Allergies (NDA). The EFSA has published extensive guidance to assist applicants in the preparation of applications for authorisations of health claims. This guidance summarises the general principles applied by the NDA Panel in the evaluation of health claims, including the scientific criteria for substantiation, as well as the scientific requirements for the substantiation of specific health claims. To date, the EFSA NDA Panel has concluded that a wide range of health claims has been substantiated. These include claims for many well-established functions of nutrients, as well as beneficial effects of foods and food constituents on a range of body functions. In addition, claims have been substantiated on the role of nutrients in growth and development of children and on the effects of nutrients and food constituents on reduction of risk factors for disease. EFSA evaluations and guidance have made an important contribution to the understanding of the scientific substantiation of health claims which will help to set new directions for research and will guide future innovation.

Antihypertensive and vasorelaxant effects of water-soluble proanthocyanidins from persimmon leaf tea in spontaneously hypertensive rats

The antihypertensive and vasorelaxant effects of water-soluble proanthocyanidins, extracted in persimmon leaf tea, were investigated in spontaneously hypertensive rats, rat aortas, and human umbilical vein endothelial cells. Oral administration of proanthocyanidins significantly decreased the systolic blood pressure of the rats after 4 h, as compared with distilled water controls. A vasorelaxant effect on rat aortas was induced by proanthocyanidins, and it was abolished by removal of the endothelium and inhibition of endothelial nitric oxide synthase and soluble guanylyl cyclase activity. The phosphorylation levels of endothelial nitric oxide synthase (Ser-1177) and the upstream kinase Akt (Ser-473) in umbilical cells also increased in a time-dependent manner after the addition of a proanthocyanidin-rich fraction. These results suggest that the antihypertensive effect of proanthocyanidins in persimmon leaf tea is due to vasorelaxation via an endothelium-dependent nitric oxide/cGMP pathway, and that proanthocyanidins might be useful in dietary lowering of blood pressure.

Effect of mulberry leaf extract with enriched 1-deoxynojirimycin content on postprandial glycemic control in subjects with impaired glucose metabolism

Aims/Introduction:  The glucose analogue, 1-deoxynojirimycin (DNJ), found in mulberry (Morus alba) leaves, is a promising α-glucosidase inhibitor. We evaluated the effect of the ingestion of mulberry leaf extract with enriched DNJ content on postprandial hyperglycemia in subjects with impaired glucose metabolism.

MATERIALS AND METHODS

  In study 1, we carried out a randomized, double-blind, crossover trial to assess the effects of single ingestion of mulberry leaf extract (3, 6 or 9 mg DNJ) or placebo on blood glucose and insulin concentrations during 2 h after a carbohydrate (200 g boiled white rice) challenge in 12 subjects with fasting plasma glucose (FPG) in the range of 100-140 mg/dL. Study 2 was a randomized, double-blind, placebo-controlled trial to assess the efficacy of 12-week extract supplementation (6 mg DNJ, t.i.d.) for long-term glycemic control in 76 subjects with FPG in the range of 110-140 mg/dL.

RESULTS

  In study 1, ingestion of the mulberry leaf extract led to attenuated postchallenge acute glycemia in a dose-dependent manner (P = 0.006, group × time interaction, two-way anova). In study 2, the serum 1,5-anhydroglucitol concentration, a sensitive indicator of postprandial glycemic control, in the extract group increased and was higher than that in the placebo group over the 12-week treatment period (P < 0.001, group × time interaction, two-way anova); no differences in FPG, glycated hemoglobin and glycated albumin concentrations were observed between the groups.

CONCLUSIONS

  Long-term ingestion of mulberry leaf extract with enriched DNJ content could result in improved postprandial glycemic control in individuals with impaired glucose metabolism. These trials were registered with UMIN (no. UMIN000003154 and UMIN000003155). (J Diabetes Invest, doi: 10.1111/j.2040-1124.2011.00101.x, 2011).

Pharmacology in health foods:merits and demerits of food with health claims for the prevention of metabolic syndrome

The merits and demerits of food with health claims for the prevention of metabolic syndrome (MS) are reviewed. One major underlying cause of MS is obesity. Diet and lifestyle changes remain the cornerstones of therapy for obesity, but resulting weight loss is often small and long-term success is extremely uncommon and disappointing. Many anti-obesity drugs have been associated with unintended therapeutic outcomes. Currently, only one drug (mazindol) is approved in Japan for short-term treatment of individuals with a BMI over 35 kg/m(2). Treatment with orlistat with dietary modification, caffeine, or protein supplementation; consuming a low-fat diet; adherence to physical activity routines; prolonged contact with participants; problem-solving therapy; and the alternative treatment of acupressure are efficacious in reducing weight regain after weight loss treatment. Because obesity is highly stigmatized, any effective treatment should be made available to improve quality of life and self-image. Therefore, it is necessary to provide information to consumers through the media concerning 1) basic knowledge about health foods and laws concerning them, 2) scientifically based information on safety/effectiveness of health foods and food elements, and 3) reports on health disturbances associated with health foods around the world.

Functional food ingredients as adjunctive therapies to pharmacotherapy for treating disorders of metabolic syndrome

Abstract Information regarding the use of functional foods and nutraceuticals (FFN) in combating disease is rarely communicated to health care practitioners as medicinal strategies for patients. Metabolic syndrome (MetS) is an ideal paradigm for demonstrating the therapeutic properties of FFN. Encompassing multiple etiologies, including atherogenic dyslipidemia, insulin resistance, and hypertension, MetS affects over a third of American adults. However, as disease-related risk factors accumulate over time, guidelines for treating disorders of MetS progressively de-emphasize the use of FFN. Using marine omega-3 fatty acids, plant sterols, fiber, and tomato extract as examples, the purpose of this review is to endorse FFN as long-term adjunctive therapies to pharmaceutical treatment for disorders and risk factors for MetS. An additional goal is to compare physiological and molecular targets of FFN against corresponding prescription medications. Results reveal that FFN are viable treatment strategies for disorders of MetS, complementing pharmacological interventions by targeting and improving the biological processes that foster the development of disease. Thus, efficacious FFN therapies should be emphasized throughout all stages of treatment as adjuncts to pharmacotherapy for disorders of MetS. Accordingly, new developments in FFN research must be implemented into clinical guidelines with the prospect of improving disease prognoses as accessories to prescription medications.

Use of dietary supplements among preschool children in Japan

This study was conducted to examine the characteristics and use of dietary supplements by preschool children in Japan. A survey was conducted among 2,125 parents of preschool children to discover the status of dietary supplement use and their attitudes towards supplement use by their children. Logistic regression models were used to determine which characteristics predict supplement use in this population. For detailed characterization, child supplement users were also categorized as either the users of vitamins and minerals only or the users of other supplement components. For parents of non-user children, the parent's knowledge and attitudes toward supplements for children were investigated. Fifteen percent of children had used dietary supplements. Two parent-related factors were especially important, the frequency with which they referred to nutritional labels and their own supplement use, which had a significant encouraging effect on their children's supplement use. The parents of child supplement users showed limited awareness of the government system concerning diet and food, placed safety over efficacy, selected products with natural ingredients, and did not seek consultations with professionals. These parents, especially those who were aware of the specially designed supplements for children, exhibited positive responses to supplement use by their children. It is likely that parents' knowledge and attitudes toward dietary supplements and nutrition have a striking effect on their children's use of supplements. Unfortunately, their knowledge at present was less than satisfactory. More accurate information on nutrition, dietary intake and dietary supplements must be disseminated.