functional foods: phytochemicals – hidden nutrition gems · 2019-04-16 · phytochemicals –...

January 15, 2015

Presenter:

Sylvia Escott-Stump, MA, RD, LDNDirector, Dietetic Internship

Department of Nutrition Science – East Carolina UniversityModerator:

James M. Rippe, MD – Leading cardiologist, Founder and Director, Rippe Lifestyle Institute

Approved for 1 CPE (Level 2) by the Commission on Dietetic Registration, credentialing agency for the Academy of Nutrition and Dietetics.

NUTRI-BITES®

Webinar Series

Functional Foods: Phytochemicals – Hidden Nutrition

Gems

ConAgra Foods Science Institute With a mission of:

Promoting dietary and related choices affecting wellness

by linking evidence-based understanding

with practice

Webinar logistics CEUs – a link to obtain your Continuing Education Credit

certificate will be emailed and available on this webinar’s page at www.ConAgraFoodsScienceInstitute.com within 2 days.

A recording of today’s webinar, slides, and summary PowerPoint will be available to download as a PDF within 2 days at: www.ConAgraFoodsScienceInstitute.com

The presenter will answer questions at the end of this webinar. Please submit questions by using the ‘Chat’ dialogue box on your computer screen.

http://www.conagrafoodsscienceinstitute.com/


Today’s Faculty

Sylvia Escott-Stump, MA, RD, LDNDirector, Dietetic InternshipDepartment of Nutrition Science East Carolina University

Moderator:James M. Rippe, MD – Leading cardiologist, Founder and Director, Rippe Lifestyle Institute

Learning Objectives

After the webinar the participant will be able to: Review current knowledge and identify future research

questions regarding phytochemicals Offer practical dietary strategies for clients to include more

phytochemicals into their diets

NUTRI-BITES®

Webinar Series

Phytochemicals – Hidden Nutrition Gems

FUNCTIONAL FOODS –

PHYTOCHEMICALS: HIDDEN NUTRITION GEMSSylvia Escott-Stump, MA, RD, LDN East Carolina University, Greenville [email protected]

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mailto:[email protected]

Life Span

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Presenter

Presentation Notes

Ideally, if environmental and genetic factors were properly aligned, humans could live 120 years. The DNA damage theory proposes that aging is a consequence of unrepaired accumulation of naturally occurring damage to the mitochondrial and nuclear DNA in our cells. Unrepaired cell damage is more detrimental in slowly replicating cells, such as those in the brain, bones and heart.

LIFE EXPECTANCY• Bronze & iron ages:

26 years

• In the US: 78.74 years

• In Japan: 83.10 years

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Presenter

Presentation Notes

Life expectancy is calculated at birth and is the average length of time a person can be expected to live. Life expectancy has risen over the years. Back in the bronze and iron ages, people only lived to be 26 years old. Now we can expect to live well into our 70s and 80s. In Japan, the philosophy of “eating until you are 80% full” seems to have merit as they have the highest life expectancy at 83 years!

What are the Keys to Longevity?S Escott-Stump 10

Presenter

Presentation Notes

So what are the keys to a long life? Good nutrition of course, along with immunizations and regular medical care. A healthy weight and physical activity also play a role.

What are “functional foods?”“Whole foods and fortified, enriched, or enhanced foods have a potentially beneficial effect on health when consumed as part of a varied diet on a regular basis, at effective levels….”

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2013 Academy position paper on functional foods http://www.eatright.org/About/Content.aspx?id=8354

Presenter

Presentation Notes

You might ask—what are Functional foods? They can be whole foods, or fortified, enriched, or enhanced foods that give us a beneficial effect if we eat them in adequate amounts. The Academy of Nutrition and Dietetics position paper is a reliable reference to use.

http://www.eatright.org/About/Content.aspx?id=8354

Figure

Kapsak WR et al. Functional Foods: Consumer Attitudes, Perceptions, and Behaviors in a Growing Market. JADA 111:804, 2011.

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Presenter

Presentation Notes

This slide shows a summary of consumer attitudes, perceptions and behaviors. In general, the public does believe there are health benefits from functional food and beverage ingredients. And they often do choose foods in the grocery store or away from home accordingly.

Our Professional Goal?

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Presenter

Presentation Notes

As health professionals, we want to work with key groups to assure that the public receives accurate information. There is so much confusion… but we want to be sure that OUR voices are reliable AND HEARD.

Total Diet Approach• …communicate healthy eating

messages that emphasize a balance of food and beverages within energy needs, rather than any one food or meal.• 2013 Academy Position Paper: Total Diet

Approach to Healthy Eating

INFOGRAPHIC• http://www.eatright.org/Public/content.aspx?id=6442

480412

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Presenter

Presentation Notes

The Academy’s Total Diet Approach position paper is an excellent resource. Here, the emphasis is on a variety of foods rather than reliance on a single food or meal. The Infographic shown here is available for you to print for your office, or to share with your clients. While the news about how Americans are NOT meeting the Dietary Guidelines isn’t ideal, it can lead to a healthy conversation about setting realistic goals.

http://www.eatright.org/Public/content.aspx?id=6442480412

Bioactive Compounds

Animal foods (zoochemicals)

Marine foods (fish, shellfish, sea vegetables)

Plant foods (phytochemicals)

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Presenter

Presentation Notes

Bioactive compounds are natural chemicals that give use a desired health or wellness benefit. They might come from an animal (such as milk or meat,) from the sea (such as fish), or from plants (the phytochemicals.) Fortunately, humans have been able to adapt to diets where they can consume foods from all three groups…so we are biologically “omnivorous”.

Spices and Herbs

SPICES HERBS

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Presenter

Presentation Notes

Truly some of the greatest benefits come from our tiniest bioactive compounds: the spices and herbs. Spices represent the seeds, root, bark and flowers of the plant; and herbs are the green leafy parts grown for culinary or medicinal purposes. The early interest in functional foods was based on the medicinal use of herbal products.

What could a Nutrition Diagnosis be?Inadequate intake of bioactive substances

Excessive intake of bioactive substances

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Presenter

Presentation Notes

In the dietetics profession, a person might be diagnosed with an “inadequate intake” of a bioactive substance (perhaps liminoids). Or maybe it would be “excessive intake” of a bioactive substance, such as alcohol.

Phytochemical Chart

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Liu RH. Health-promoting components of fruits and vegetables in the diet. Adv Nutr. 2013 ;4:384S-92S.

Presenter

Presentation Notes

Just like the Periodic Table, the phytochemical family tree is quite complex. Luckily, today we will be focusing on just a few of these remarkable chemicals!

http://www.ncbi.nlm.nih.gov/pubmed/23674808

Polling Question• Have you taken any academic courses or intense workshops about phytochemicals?

• Yes• No

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Presenter

Presentation Notes

Here is your first polling question. Have you taken any academic courses or intense workshops about phytochemicals?

Various forms of indicators.

Ellwood K et al. Adv Nutr 2014;5:693-701

©2014 by American Society for Nutrition

Presenter

Presentation Notes

It is difficult to measure actual indicators of adequacy or excess. Scientists are working on finding biomarkers that can predict clinical outcomes. There are currently no dietary reference intakes (DRIs) for bioactive food components, such as lycopene or ginger. In China, these levels will be called “Specific Proposed Levels” or SPLs when they publish their next recommended dietary allowances.

Nutritional Genomics

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AlteredSNP

Bioactive Product

Absorbed Dose

Biologic Effect

+ or –Health Effect

Presenter

Presentation Notes

Our genes are affected by many bioactive compounds. Single nucleotide polymorphisms (SNPs) in our genes can alter how we absorb and metabolize food. In addition, the nutritional variability of the foods we eat and the amount of bioactive ingredients actually eaten will affect our health, beginning at birth and progressing throughout our lives.

Role of Bioactive Dietary Components

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“BIG FIVE ”• Curcumin (turmeric)

• EGCG (green tea)

• Genistein (soybean)

• Resveratrol (grapes)

• Sulforaphane (cruciferous vegetables)

Presenter

Presentation Notes

Epigenetic changes can be made by the effects of bioactive dietary compounds on gene expression. These specific components alter the DNA methylation and histone modifications required for gene activation or silencing. I call these THE BIG FIVE because of their importance: curcumin, EGCG, genistein, resveratrol, and sulforaphane. We will talk about each of these later.

Nuclear factor-κB (NF-kB)

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Presenter

Presentation Notes

Nuclear factor kappa-B represents a family of proteins. NF-κB and Signal transducers and activators of transcription 3 (STAT3) are the factors which activate >500 gene products affiliated with inflammation, cell transformation, angiogenesis, and metastasis. Most chemopreventive blockers act by inhibition of NF-κB and STAT3 pathways. These blockers have numerous side effects whereas plant-derived polyphenols do not. �

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Presenter

Presentation Notes

We know that cytokines and inflammatory factors (such as alcohol, red meat, and high fat foods) can promote certain cancers. We now understand the connections between inflammation and diabetes, HIV infection, intestinal disorders and obesity.

Interesting comment on modern diet…

“Antibiotics, disinfectants, and low use of plant foods may have forever altered our ancient gut microbiome….Dietary modulation to manipulate specific gut microbial species may offer therapeutic approaches.”

--Greiner AK et al. Chemoprevention in gastrointestinal physiology and disease. Natural products and microbiome. Am J Physiol Gastrointest Liver Physiol. 307:1-15, 2014.

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Presenter

Presentation Notes

Antibiotics, disinfectants, and low use of plant foods may have forever altered our ancient gut microbiome….Thus, we may need Dietary manipulation to reintroduce specific gut microbial species.” – Certainly, phytochemicals can play a part!


Mediterranean Diet Influences on the Gut*

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Presenter

Presentation Notes

The Mediterranean diet has many phytochemical ingredients that affect the gut microbiome. It lowers the risk for multiple chronic disorders, including allergies. Note that the superstars are Extra virgin olive oil and nuts. � ��

How Phytochemicals Protect Us

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Presenter

Presentation Notes

Plants have a natural defense system. There are over 2000 plant pigments (flavonoids, carotenoids, and anthocyanins) that provide color and flavor as well as protection from infections and microbial invasions. They reduce oxidation, modulate hormones, detoxify enzymes and block carcinogens. Phytochemicals can also reduce inflammation and age-related chronic diseases in humans.

Sources of Phytochemicals

• Fruits • Vegetables

• Legumes• Whole grains

• Nuts and Seeds• Herbs and Spices

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Presenter

Presentation Notes

When dietitians encourage plant-based diets, they focus on these phytochemical compounds in fruits, vegetables, legumes, whole grains, nuts, seeds, herbs and spices.

4 Major Classes of Phytochemicals

1-Terpenes: • Carotenoids (35%)• Terpenoids

2-Phenols: • Ellagic, caffeic, ferulic acids• Flavonoids (65%)• Lignans and phytosterols

3- Thiols & Organosulfurcompounds:

• Cruciferous vegetables• Onions, garlic

4- Allium Compounds: • Onions, garlic, leeks, shallots

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Presenter

Presentation Notes

We will discuss 4 major classes of phytochemicals. Of the plant pigments with antioxidant properties, 35% come from carotenoids and 65% come from flavonoids.

TERPENES: CAROTENOIDS

• Yellow, orange, red lipophilic pigments

• 600 known• 14 are found in human

serum • 6 are common in the food

supply

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Presenter

Presentation Notes

There are over 600 known carotenoids, but only 14 are found in human serum and only 6 are commonly found in the food supply. We are familiar with Alpha and Beta carotene, Cryptoxanthin, Lycopene, Lutein and Zeaxanthin.

Beta-CryptoxanthinOrange Fruits, Egg Yolk

Possible dose: 1-2 Servings per day

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Presentation Notes

Orange fruits are the best sources of beta-Cryptoxanthin, which may help protect against lung cancer. Mango may help modulate body fat and serum glucose. 1-2 Servings per day are recommended.

Inflammation and Cancer

Tanaka T et al. Cancer chemoprevention by citrus pulp and juices containing high amounts of β-cryptoxanthinand hesperidin. J Biomed Biotechnol. 2012; 2012:516981.

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Presenter

Presentation Notes

This chart shows how chemoprevention works. Obviously, one single food is not the answer--but a cumulative diet eaten over a lifetime can either protect or promote these inflammatory processes.

LycopeneTomato Products, Watermelon

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Dose: 20 mg/day; ½ to 1 cup of tomato products per week

Presenter

Presentation Notes

Lycopene seems to protect against several forms of cancer. Crushing tomatoes for catsup, salsa or tomato paste makes lycopene more available, as does using it with oil. Because it needs fat for absorption, Lycopene-enriched virgin olive oil is a great new way to buy it!

Lycopene Lowers DNA Damage

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Presenter

Presentation Notes

We know that lycopene reduces DNA damage. Blending phytochemicals yields even greater benefits: mixing pasta with tomato sauce and broccoli gives us lycopene AND sulforophane.

LimonoidsCitrus Fruits

Dose: 100 micrograms/day; 1 serving per day

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Presenter

Presentation Notes

The limonoids in citrus fruits are potent regulators of cell-to-cell signaling, with special defense against viruses and bacteria. Theey reduce damage caused by free radicals during oxidation. Try to eat one serving per day!

PHENOLS

• Phenols are the big guns in the phytochemical world!

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Presenter

Presentation Notes

Now we move to Phenols, the big guns in the phytochemical world, with over 4000 chemicals available to protect plants from oxidative damage! They have anti-inflammatory properties and may help us increase HDL levels.

ANTHOCYANINSBLUEBERRIES, CHERRIES, GRAPES, BEETSProposed dose: Blueberries 1/2 cup per day

Bing cherries 45/day lowers elevated C-reactive protein (CRP)

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Presentation Notes

There are > 635 anthocyanins identified in nature, protecting the body from free radical damage, especially the brain. These blue and red Anti-inflammatory beauties reduce the effects of aging. While it might be easy to eat ½ cup of blueberries, it would be more of a challenge to eat 45 bing cherries a day…but it is a natural way to reduce inflammation!

ELLAGIC ACIDRaspberries and Strawberries

Dose: 3 cups whole berries (500 mg/day)

• Strawberries and strawberry powder lower blood glucose and inflammatory markers in the obese

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Presentation Notes

Ellagic acid is another good guy, protecting the skin against damaging ultraviolet rays. It also protects against aflatoxins in nuts or grains, and nitrosamines in overcooked meats, pickled vegetables and certain alcoholic beverages. Strawberries and strawberry powder can lower blood glucose and inflammatory markers in the obese as well! A dose would be 3 cups of whole strawberries or raspberries.

PUNICALAGIN + ELLAGIC ACIDPomegranate

Dose: 3.5 oz/day

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Presenter

Presentation Notes

Pomegranate reduces oxidative stress and may protect the brain against Alzheimer’s and Parkinson’s. It may help reduce the risk for type 2 diabetes and dental plaque formation, and might even help with male infertility. Who knew!

TriterpenoidsPHYTOSTEROLS

Dose: 2 to 3 g plant sterols per day (lowers LDL levels 6-12%)

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Presentation Notes

Plant sterols and stanols protect the heart and help to lower serum cholesterol levels if taken as 2-3 grams per day. There are over 200 found naturally in nuts, grains, seeds, fruits, vegetables in small amounts. We can purchase them now in fortified juice, margarine and such.

Phytosterol – Campesterol, β-sitosterolAVOCADO, SEEDS

• Avocado (Persea americana)

Dose: ½ avocado/day

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Presentation Notes

The avocado has taken the spotlight lately for its anti-inflammatory, cardioprotective and antimicrobial properties. It also may help prevent obesity or metabolic syndrome by increasing satiety! ½ avocaco is the dose.

Polling Question• How frequently do you edit or share recipes for patient or

clients to include more phytochemical-rich foods in their diets?

• All of the time• Some of the time• Rarely• Never

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Presentation Notes

Poll: How frequently do you edit or share recipes for patient or clients to include more phytochemical-rich foods in their diets?

FERULIC ACID, HYDROXYTYROSOLExtra Virgin Olive Oil (EVOO)

Dose: 1-2 Tbsp of EVOO per day

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Presentation Notes

Superstar: Extra Virgin Olive Oil prevents h. pylori peptic ulcer disease and stomach cancer, may protect against cognitive decline, and reduces heart disease risks. Recommend 1-2 tablespoons EVOO every day!

CatechinsTea

Epigallocatechin (EGCG) =major polyphenol

Dose: 3 cups green tea a day (50 mg/kg EGCG)

Or 100 - 750 mg per day of standardized green tea extract

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Presenter

Presentation Notes

Tea comes from the Camellia sinensis plant, with 4000 polyphenols. Green tea from unfermented leaves reportedly contains the highest concentration of superstar epigallocatechin, EGCG. Just 3 cups a day of green tea protects against many types of cancer.

ResveratrolSkin of Red Grapes, Peanuts, Berries

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Dose: 2 grams per day (5 oz red wine or 5-10 mg/kg)

Presenter

Presentation Notes

Superstar Resveratrol protects the heart and kidney. It is a powerful scavenger of reactive oxygen species and a promoter of the molecule called SIRT1. Through calorie restriction, SIRT1 can help to extend the lifespan, delay age-related disease, regulate inflammation, alter glucose and lipid metabolism, and support adaptation to cellular stress. Resveratrol + grape seed proanthocyanidins, EGCG and lycopene can reduce melanoma. Dose: 2 grams per day (5 oz red wine or 5-10 mg/kg)

Capsaicin (substance P)Chili Peppers

Dose for weight management: 2mg before meals to reduce appetite

Dose for digestive problems: 30-120 mg capsule, 3 x/day

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Presentation Notes

Capsaicin is an antioxidant that can lower blood glucose and increase levels of brown fat (taken as 2 mg before meals.) It is being used as a gastroprotective agent for chemical or H. pylori-induced mucosal damage (30-120 mg capsules before meals.) High-dose topical creams can reduce neurological pain from HIV or shingles.

Soluble Fiber (Beta Glucan), Antioxidant (Ergothioneine)Mushrooms

White button mushrooms(Agaricus bisporus)

Dose: “one handful” per day

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Presenter

Presentation Notes

White button mushrooms contain beta-glucan and conjugated linoleic acid (CLA) that minimize the effects of the enzyme aromatase; this reduces risks posed by high estrogen levels and helps reduce the risk of hormonal cancers (breast and prostate.) Ergosterol converts by UV radiation to vitamin D2, making mushrooms are also a good source! A handful a day is recommended!��

Soluble Fiber – PrebioticsFructo-Oligosaccharides (FOS)

• Sunchoke (Jerusalem artichoke)-best. Jicama, leeks, bananas, onion, wheat, asparagus, blue agave extract.

Dose: ¼ to ½ cup/day

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Presentation Notes

Human milk provides our first prebiotic oligosaccharides which may help protect against allergy, atopic dermatitis, and asthma. Otherwise, prebiotic Fructo-Oligosaccharides (FOS) are produced by degradation of inulin. These short-chain low-digestible carbohydrates (LDCs) stimulate growth of Bifidobacteria that decrease gut dysbiosis from antibiotic treatments.

Whole Grains

Dose: 3-5 serving/d (48-80 g whole grain/day)

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Presentation Notes

The phytochemical content varies within and among the major cereal types: wheat, rye, rice, barley, and oats. Phenolic and flavanoid compounds are tightly bound to the cell wall matrix and bioavailability may be limited. In general, however, eating a variety of whole grains reduces systemic inflammation when consumed as 3-5 servings a day…and may even reduce the risk of type 2 diabetes. � �

Polling Question

• How often do you offer specific advice to patients, clients or students regarding the polyphenol phytochemicals?

• All of the time• Some of the time• Rarely• Never

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Presenter

Presentation Notes

Poll: How often do you offer specific advice to patients, clients or students regarding the polyphenol phytochemicals?

SPICES -HERBS

Kaefer CM, Milner JA. The role of herbs and spices in cancer prevention. J Nutr Biochem. 2008;19:347-61.

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Presentation Notes

Now let’s take a quick look at a few spices and herbs!

CarnosolRosemary, Sage, Oregano, Basil, Parsley

DOSE: Carnosol100-400 mg/kg increases GST activity

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Presentation Notes

Carnosol blocks the expression of the COX-2 gene. It is a diterpene with antioxidant, antimicrobial, antiangiogenic, antiinflammatory, and antiproliferative properties. Many scientists think that inhibiting COX-2 could help protect against colon, breast and prostate cancers. �

CurcuminoidsTurmeric, Curcumin

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Proposed Dose: 400 mg turmeric/curcumin

Presenter

Presentation Notes

Superstar curcuminoids (turmeric and curcumin) really help to reduce oxidative stress and lower neuronal cell death. These spices add the yellow coloring and distinctive flavors to Indian foods.

ORGANOSULFUR COMPOUNDS and THIOLS

Sulfur-containing phytonutrients

Subclasses:• Indoles• Dithiolethiones• Isothiocyanates

Cruciferous VegetablesBroccoli, Brussels sprouts, Cabbage, Cauliflower, Kale, Rutabaga, Horseradish

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Presenter

Presentation Notes

Now let’s look at the Sulfur-containing phytonutrients, and the cruciferous vegetable group.

Liver Detoxification PathwaysPhase I

Cytochrome P450 or mixed function oxidase system (MFOS) activates enzymes

Hormones, prostaglandins and xenobiotics (toxins) are broken down, become more water soluble and ready for elimination.

Phase 2Metabolites from phase I are conjugated in a series of reactions controlled by Glutathione-S-Transferase (GST)and NADPH quinone reductase, then excreted in the urine or feces (in bile).

Glutathione: modulates cell death; blocks carcinogens from damaging cell DNA; makes carcinogens easier to excrete

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Presentation Notes

The liver plays the biggest role in breaking down products for excretion. In Phase 1, Cytochrome P450 gene polymorphisms have been noted – some people cannot metabolize or excrete toxins (such as the tuberculosis bacterium) as well as others. In Phase 2, glutathione-S-transferase (GST) plays a big part in getting rid of carcinogens.

Sulforaphane (Isothiocyanate)Broccoli

Sulforaphane: Antioxidant

Inhibits H pylori infections; blocks gastric tumor formation

↑ production of the detoxification enzyme, Glutathione-S-Transferase(GST)

Dose: 100-200 g/day

Pancreatic ductal cancer stem cells: sulforaphane + EGCG + quercetin

• Appari M et al. Sulforaphane, quercetin and catechinscomplement each other in elimination of advanced pancreatic cancer by miR-let-7 induction and K-ras inhibition. Int J Oncol. 2014;45:1391-400.

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Presentation Notes

Superstar Sulforaphane is a huge Antioxidant factor. It is especially protective for stomach cancer, and is important when taken with EGCG and quercetin for pancreatic cancer! Older women and men experience greater oxidative stress and a loss of glutathione production, so they should increase their intake of cruciferous vegetables to 100-200 grams per day. �


Allicin (Allium sativum L.)GARLIC, CHIVES, LEEKS, ONIONS, SCALLIONS, SHALLOTS

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Dosage: 1/2 to 1 clove of garlic per day (0.25-l g of garlic per Kg)

Caution: Dried preparation may not be effective; heartburn, gas, and GI tract disturbances

Presenter

Presentation Notes

Allicin increases production of Glutathione-S-Transferase in liver detoxification, helping reduce carcinogen activation. It stimulates the immune system and may lower cholesterol and blood pressure. ½ to 1 clove of fresh garlic or equivalent per day is best; dried preparations are not as effective.

Other Forms of Nutritional Dosing --Nano-medicine

Almonds 60 grams per day

Dark chocolate 100 g

EPA 3 g + DHA 2 g

Ginger juice or extract 2-4 g for analgesia

Oat bran 60 g

Soy Isofavones 25-50 mg/day

Tree Nuts 2-3 servings/day

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Presenter

Presentation Notes

Nano-medicine is the new term being used for this nutritional dosing. Examples would be recommending 100 grams of dark chocolate, or 60 grams of oat bran per day. This new aspect of medical science is still under development, so the evidence is not yet perfected. We have to use caution when we make these suggestions.

Example: Nutraceutical approach to cardiovascular risk reduction

• Armolipid Plus • 8 wks versus Pravastatin

• Red yeast rice extract• Berberine• Policosanol• Astaxanthin• CoQ10• Folic Acid

Ruscica M et al Nutraceutical approach to moderate cardiometabolic risk: results of a randomized, double-blind and crossover study with Armolipid Plus. J Clin Lipidol. 2014;8:61-8.

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Presentation Notes

We will see more studies where nutraceutical products are combined to determine if they can have similar but safer results (with fewer side effects) than current medical treatments. One study showed beneficial effects from multiple phytochemicals and vitamins (Armolipid Plus) for reducing cholesterol safely. We need more long-term studies to prove efficacy.


Guiding Principles for Counseling• Apply a “wholeness orientation” in health care delivery: mind, body, spirit, and environment

• Support and promote the natural capacity of recovery and self-healing

• Respect the diversity of all health traditions

• Disseminate comprehensive, quality and timely information

• Recognize the patient’s right to choose freely among safe and effective care or approaches

• White House Commission on Complementary and Alternative Medicine

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Presentation Notes

The White House Commission on Complementary and Alternative Medicine has provided several Guiding Principles for Counseling, including supporting a wholeness of health orientation and a respect for diversity of all health traditions. Patients have the right to choose freely among safe and effective approaches. Enhancement of foods and meals should be done first to fortify with essential nutrients, and second, to add health-promoting, beneficial phytochemical ingredients. We can certainly be the individuals who teach others how to do this!

Overall: Balanced Diet Approach

• Even natural, whole foods could be troublesome if over-consumed

• More is NOT ALWAYS BETTER

Advice to the Registered Dietitians

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Presentation Notes

Remember: Overall, we must promote the Balanced Diet Approach. More is not always better. SOME ADVICE to the dietitians: Be familiar with the medications that clients are taking. Be familiar with unintended consequences of overconsumption of any food. For example, Kale contains vitamin K –while it is helpful in blood clotting, significant changes in vitamin K intake will alter warfarin activity.

Overall: Safety

Botanical supplements are not regulated by the Food and Drug Administration

• Any biologically active ingredient, consumed in excess, can be harmful.

“Natural” does not guarantee safety --SNAKE VENOM is natural…

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Presentation Notes

Botanical supplements are not regulated by the Food and Drug Administration. There are no federal standards to ensure dose, safety and purity. Look for health-related statement on supplements. Natural does not guarantee safety!

Overall: Choose Where You Stand

• Guiding• Make suggestions?

• Help client to reach own conclusion?

• Promoting• Back a product, food or supplement?

• Encourage use?

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Presentation Notes

You must decide, based on current evidence, where you stand. Are you guiding or promoting? Are you merely suggesting a product, or are you going to promote a specific food?

Overall: Be a Client Advocate

• Identify and document use of herbs and botanicals • Discuss with physician.

• Advocate for better regulation of herbs and botanicals as drugs, not foods

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Presentation Notes

Overall: Be a Client Advocate! Note the use of herbs and botanicals; document and discuss them with the physician.

Polling Question• After this webinar, how likely are you to discuss specific

phytochemicals for improving health?

• Very likely• Likely• Somewhat likely• Plan to review the literature again

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Presentation Notes

Poll: After this webinar, how likely are you to discuss specific phytochemicals for improving health?

REMEMBER Our Professional Goal!

Let’s ensure that the public has not only great nutrition tips but accurate information!

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Presentation Notes

REMEMBER Our Professional Goal – we want the public to have not only great nutrition information, but ACCURATE nutrition information. Let us continue to review and produce the evidence-based research that will allow us to ensure that the public has the best, most accurate information. Sustainable diets of the future will include phytochemicals that support the environment, nutrition and affordability. I want to thank Dr. Rippe and ConAgra for this opportunity and thank each of you as participants for joining in today.

References and Further InformationAcademy of Nutrition and Dietetics. Position Paper on Functional Foods. J Acad Nutr Diet. 2013; 113:1096-

1103. http://www.eatright.org/About/Content.aspx?id=8354

Aggarwal BB et al. Identification of novel anti-inflammatory agents from Ayurvedic medicine for prevention of chronic disease. Curr Drug Targets 2011; 12(11):1595-1653.

FDA food labeling/claimshttp://www.fda.gov/food/ingredientspackaginglabeling/labelingnutrition/default.htm

National Center for Complementary and Alternative Medicinehttp://nccam.nih.gov/health/antioxidants/introduction.htm

Nutrition.govhttp://www.nutrition.gov/whats-food/antioxidants-phytonutrients

University of Maryland – Complementary and Alternative Medicine Guidehttp://umm.edu/health/medical/altmed

US Food and Drug Administration, Center for Food Safety and Applied Nutritionhttp://www.cfsan.fda.gov/~dms/guidance

US Department of Agriculture USDA Flavanol Databasehttp://www.nal.usda.gov/fnic/foodcomp/Data/Flav/flav.html

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http://www.eatright.org/About/Content.aspx?id=8354

http://www.fda.gov/food/ingredientspackaginglabeling/labelingnutrition/default.htm

http://nccam.nih.gov/health/antioxidants/introduction.htm

http://www.nutrition.gov/whats-food/antioxidants-phytonutrients

http://umm.edu/health/medical/altmed

http://www.cfsan.fda.gov/%7Edms/guidance

http://www.nal.usda.gov/fnic/foodcomp/Data/Flav/flav.html

Specific ReferencesNutritional Genomics

• Academy, Position Paper on Nutritional Genomics. 2014,JAND 114: 299-312.• Barnes S. Nutritional Genomics, Polyphenols, Diets, and Their Impact on Dietetics.2008, JADA 108:1888-1895.

Bioactive Dietary Components• Meeran SM et al. Epigenetic targets of bioactive dietary components for cancer prevention and therapy. Clin Epigenetics.

2010 Dec 1;1:101-116.• Wang S et al. Novel insights of dietary polyphenols and obesity. J Nutr Biochem. 2014 Jan;25:1-18.

Mediterranean Diet and Microbiome• Del Chierico F et al. Mediterranean diet and health: food effects on gut microbiota and disease control. Int J Mol

Sci. 2014;15:11678-99. • Urpi-Sarda M et al. Virgin olive oil and nuts as key foods of the Mediterranean diet effects on inflammatory biomakers

related to atherosclerosis. Pharmacol Res. 2012;65:577-83.

Carotenoids• Ciccone Dietary intake of carotenoids and their antioxidant and anti-inflammatory effects in cardiovascular care.

Mediators Inflamm. 2013;2013:782137. • Jacob JK et al. Biochemical basis for functional ingredient design from fruits. Annu Rev Food Sci Technol.

2012;3:79-104.

Beta-Cryptoxanthin• Lucas EA et al. Mango modulates body fat and plasma glucose and lipids in mice fed a high-fat diet. Br J Nutr. 2011;

106 :1495-505. • Min KB, Min JY. Serum carotenoid levels and risk of lung cancer death in US adults. Cancer Sci. 2014;105:736-43.

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Specific ReferencesLycopene

• Garridio M et al. A lycopene-enriched virgin olive oil enhances antioxidant status in humans. J Sci Food Agric. 2013; 93:1820-6.

• Raiola A et al. Enhancing the health-promoting effects of tomato fruit for biofortified food. Mediators Inflamm. 2014; 2014:139873.

Phenols• Malireddy S et al. Phytochemical antioxidants modulate mammalian cellular epigenome: Implications in health and

disease. Antioxid Redox Signal. 2012;17:327-39. • Nicod N et al. Green tea, cocoa, and red wine polyphenols moderately modulate intestinal inflammation and do not

increase high-density lipoprotein (HDL) production. J Agric Food Chem. 2014;62:2228-32.

Anthocyanins• He J, Guisti MM. Anthocyanins: natural colorants with health-promoting properties. Annu Rev Food Sci Technol.

2010;1:163-87.• Kelley DS et al. Sweet bing cherries lower circulating concentrations of markers for chronic inflammatory diseases in

healthy humans. J Nutr. 2013;143:340-4.

Ellagic Acid• Alvarez-Suarez JM et al. One-month strawberry-rich anthocyanin supplementation ameliorates cardiovascular risk,

oxidative stress markers and platelet activation in humans. J Nutr Biochem. 2014; 25:289-94. • Basu A et al. Strawberry as a functional food: an evidence-based review. Crit Rev Food Sci Nutr. 2014;54:790-806. • Hseu YC et al. Ellagic acid protects human keratinocyte (HaCaT) cells against UVA-induced oxidative stress and

apoptosis through the upregulation of the HO-1 and Nrf-2 antioxidant genes. Food Chem Toxicol. 2012 50:1245-55. • Zunino et al. Effects of dietary strawberry powder on blood lipids and inflammatory markers in obese human

subjects. Br J Nutr. 2011, 9:1-10.

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http://www.ncbi.nlm.nih.gov/pubmed/?term=Phytochemical+antioxidants+modulate+mammalian+cellular+epigenome





Specific ReferencesPunicalagin (Pomogranate)

• Banihani S et al. Pomegranate and type 2 diabetes. Nutr Res. 2013;33:341-8. • Fedder MD et al. An extract of pomegranate fruit and galangal rhizome increases the numbers of motile sperm: a

prospective, randomised, controlled, double-blinded trial. PLoS One. 2014;9:e108532

Phytosterols (sterols, stanols)• Ras RT et al. LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-

analysis of randomised controlled studies. Br J Nutr. 2014;112:214-9. • Talati et al. The comparative efficacy of plant sterols and stanols on serum lipids: a systematic review and meta-

analysis. J Am Diet Assoc. 2010; 110:719-26.

Campesterol (Avocado)• Fulgoni VL 3rd et al. Avocado consumption is associated with better diet quality and nutrient intake,

and lower metabolic syndrome risk in US adults: results from the National Health and Nutrition Examination Survey (NHANES) 2001-2008. Nutr J. 2013;12:1.

• Wien M et al. A randomized 3×3 crossover study to evaluate the effect of Hass avocado intake on post-ingestive satiety, glucose and insulin levels, and subsequent energy intake in overweight adults. Nutr J. 2013;12:155

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Specific ReferencesExtra Virgin Olive Oil

• Estruch R et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279-90.

EGCG/Catechins• Saleh F et al. Analysis of the effect of the active compound of green tea (EGCG) on the proliferation of peripheral

blood mononuclear cells. BMC Complement Altern Med. 2014;14:322.

Resveratrol• Tong LX, Young LC. Nutrition: the future of melanoma prevention? J Am Acad Dermatol 2014; 71:151-60.

Capsaicin• Leung FW. Capsaicin as an anti-obesity drug. Prog Drug Res. 2014;68:171-9. • Mozsik G. Capsaicin as new orally applicable gastroprotective and therapeutic drug alone or in combination

with nonsteroidal anti-inflammatory drugs in healthy human subjects and in patients. Prog Drug Res. 2014;68:209-58.

• Whiting S et al. Could capsaicinoids help to support weight management? A systematic review and meta-analysis of energy intake data. Appetite. 2014;73:183-8

MushroomsFeeney MJ et al. Mushrooms and Health Summit proceedings. J Nutr. 2014 Jul;144(7):1128S-36S.

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Specific ReferencesWhole Grains

• Belobrajdic DP, Bird AR. The potential role of phytochemicals in wholegrain cereals for the prevention of type-2 diabetes. Nutr J. 2013;12:62.

• Ye EQ et al. Greater whole-grain intake is associated with lower risk of type 2 diabetes, cardiovascular disease, and weight gain. J Nutr. 2012;142:1304-13.

Carnosol• Barni MV et al. Carnosic acid inhibits the proliferation and migration capacity of human colorectal cancer cells.

Oncol Rep. 2012; 27:1041-8. • Chun KS et al. Carnosol: a phenolic diterpene with cancer chemopreventive potential. J Cancer

Prev. 2014;19:103-10. • Wang T et al. Carnosic acid (CA) prevents lipid accumulation in hepatocytes through the EGFR/MAPK pathway.

J Gastroenterol. 2012; 47:805-13.

Sulforaphane• Rajendran P et al. Dietary phytochemicals, HDAC inhibition, and DNA damage/repair defects in cancer cells. Clin

Epigenetics. 2011;3:4. • Suganuma H et al. Stimulation of phagocytosis by sulforaphane. Biochem Biophys Res Commun. 2011;405:146-

51.

Allicin• Antony ML, Singh SV. Molecular mechanisms and targets of cancer chemoprevention by garlic-derived bioactive

compound diallyl trisulfide. Indian J Exp Biol. 2011;49:805-16.• Tsubura A et al. Anticancer effects of garlic and garlic-derived compounds for breast cancer control. Anticancer Agents

Med Chem. 2011;11:249-53.

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What Questions Do You Have?

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Based on this webinar the participant will be able to: Review current knowledge and identify future research

questions regarding phytochemicals Offer practical dietary strategies for clients to include more

phytochemicals into their diets

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Phytochemicals – Hidden Nutrition Gems

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Recent CEU webinars archived at the ConAgra Foods Science Institute website: Sodium: Too much, too little or just right? A Decade of Nutrigenomics: What Does it Mean for Dietetic Practice? Ethics for All: Applying Ethics Principles across the Dietetics Profession Sports Nutrition: The Power to Influence Exercise Performance Culinary Competency to Enhance Dietetic Practice Nutrition and Oral Health: What Dietitians Should Know


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In the Eye of the Beholder: Critical Evaluation of Nutrition Research

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Phytochemicals: Hidden Nutrition Gems

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