Dietary supplement sales have surpassed $30 billion per year with their use becoming and remaining extremely popular amongst the general public. There are numerous bioactive components, both nutritive and non-nutritiv...Dietary supplement sales have surpassed $30 billion per year with their use becoming and remaining extremely popular amongst the general public. There are numerous bioactive components, both nutritive and non-nutritive, in dietary supplements with considerable efficacy in promoting health. However, there are many ways disallowed ingredients may enter the supplement pipeline with potentially toxic effects. Dietary supplements can be regulated (either pre- or post-market) as a drug, dietary supplement, a nutraceutical, new dietary ingredient (NDI), generally recognized as safe (GRAS) food ingredient, a food additive, or a food. A pharmaceutical drug (medication) is used to treat, cure, prevent, or diagnose a disease and is regulated by the FDA pre-market only and allowed by medical prescription, whereas the other labeling designations are largely regulated post-market. One such molecule with a labeling problem is tianeptine, which has global use as an efficacious, prescribed drug, while at the same time being considered a non-drug and potentially dangerous adulterant often referred to as gas station heroin. In this paper, we critically evaluate the use and labeling of this compound and attempt to clarify the conundrum surrounding its legal or illegal use. Tianeptine is effective and efficacious as an antidepressant in those responding poorly to selective serotonin reuptake inhibitors (SSRIs) and exhibits many medicinal characteristics of tricyclic antidepressants with fewer opioid-like side effects. As a result, sixty-six countries permit use of tianeptine as a prescription drug. At higher doses, tianeptine has recently been shown to exhibit significant potential for abuse and dependency along with toxicity. As such, the US does not recognize tianeptine as an FDA-approved drug or as a dietary supplement, nutraceutical, new dietary ingredient (NDI), GRAS ingredient, or a food. Instead, tianeptine is a synthetic adulterant of a dietary supplement and considered technically an unapproved food additive. In conclusion, tianeptine, although viewed as a safe dietary supplement by many, is illegal in the US despite benefits to many but toxicity to others that make it vital that consumers and healthcare providers learn to critically evaluate and navigate the often confusing nomenclature of a purported dietary supplement to convey to the public whether it is efficacious, safe, and legal.展开更多
Although whole food nutrition will likely influence physical health more than any other lifestyle component besides exercise, the use of dietary supplements among men and women continues to be high. Due to this fact, ...Although whole food nutrition will likely influence physical health more than any other lifestyle component besides exercise, the use of dietary supplements among men and women continues to be high. Due to this fact, it is imperative that healthcare professionals understand how supplements may impact overall health and wellness of their patients. With the majority of adults taking some form of dietary supplements and many concomitantly taking prescription medications, healthcare providers should be conscientious of adverse effects and interactions that may occur between dietary supplements and prescription drugs. As many consumers are misled by false marketing, healthcare providers should encourage them to be wary of exaggerated claims and direct them to products that are scientifically supported and safe. Continuing education for healthcare providers on dietary supplements is crucial, with new dietary supplement products constantly reaching the markets, in addition to new findings being made through clinical research and case studies. While some dietary supplements provide no meaningful benefit, many dietary supplements have been identified that can be used to ameliorate nutritional deficiencies and reduce the risk of some common health conditions. Others can serve to improve mental and physical performance, while truly enhancing health. This article presents relevant information on dietary supplements that will be useful to the healthcare professional.展开更多
Dietary polyphenols, or phenolic compounds, are numerous, diverse, and ubiquitous phytochemicals occurring throughout the plant kingdom. They are important components of the human diet because of their capacity to red...Dietary polyphenols, or phenolic compounds, are numerous, diverse, and ubiquitous phytochemicals occurring throughout the plant kingdom. They are important components of the human diet because of their capacity to reduce the risk of chronic diseases such as cardiovascular disease and cancer. In plants, polyphenols contribute to resistance to pathogens due to their potent astringency and function as phytoalexins. As a result, organic grapevines grown with reduced pesticides may be more stressed by pathogens than conventionally grown grapevines and presumably produce more polyphenols. Since polyphenols also play an important role in the sensory qualities of fruits and wines particularly involving astringency and bitterness, there may be differences that affect sensory perceptions of wine. This establishes a conundrum where dietary polyphenols are healthful but potentially unpalatable.We recruited and randomized 18 female participants (21 - 50 y) to one of five groups (3 - 4 per group). Each group evaluated the sensory qualities of a geographically paired organic (OW) and conventional wine (CW) and an artificially colored white wine placebo (PW) with significantly differing total polyphenol concentrations (TP). Participants reported for three visits (one wine per visit) where they consumed 5 ounces (150 mL) of wine over 15 minutes while completing the sensory survey. Sensory evaluations based on a Likert-type scale included visual, aroma, and taste perceptions and overall impressions (scale 0 - 10). In two wine pairs, the OW contained significantly more TP (3.49 and 5.86 g/L) than the respective CW (2.63 and 4.63 g/L). In two other wine pairs both produced by sustainable viticulture, the CW (5.23 and 8.38 g/L) contained sig- nificantly more TP than OW (4.55 and 3.70 g/L) and in one set the amounts were equivalent (4.10 and 4.17 g/L). The five PW averaged 1.26 ± 0.20 g/L. Although there were significant differences in TP content of test wines, the results indicated that no significant differences in either intensity or quality for any of the sensory qualities were detected be- tween paired OW and CW wines but both scored significantly higher than the PW, with significantly lower TP. We conclude in this pilot study that a subset of OW from the Southwestern US is perceived similarly to CW produced by the same vineyard even with significantly differing TP concentrations.展开更多
文摘Dietary supplement sales have surpassed $30 billion per year with their use becoming and remaining extremely popular amongst the general public. There are numerous bioactive components, both nutritive and non-nutritive, in dietary supplements with considerable efficacy in promoting health. However, there are many ways disallowed ingredients may enter the supplement pipeline with potentially toxic effects. Dietary supplements can be regulated (either pre- or post-market) as a drug, dietary supplement, a nutraceutical, new dietary ingredient (NDI), generally recognized as safe (GRAS) food ingredient, a food additive, or a food. A pharmaceutical drug (medication) is used to treat, cure, prevent, or diagnose a disease and is regulated by the FDA pre-market only and allowed by medical prescription, whereas the other labeling designations are largely regulated post-market. One such molecule with a labeling problem is tianeptine, which has global use as an efficacious, prescribed drug, while at the same time being considered a non-drug and potentially dangerous adulterant often referred to as gas station heroin. In this paper, we critically evaluate the use and labeling of this compound and attempt to clarify the conundrum surrounding its legal or illegal use. Tianeptine is effective and efficacious as an antidepressant in those responding poorly to selective serotonin reuptake inhibitors (SSRIs) and exhibits many medicinal characteristics of tricyclic antidepressants with fewer opioid-like side effects. As a result, sixty-six countries permit use of tianeptine as a prescription drug. At higher doses, tianeptine has recently been shown to exhibit significant potential for abuse and dependency along with toxicity. As such, the US does not recognize tianeptine as an FDA-approved drug or as a dietary supplement, nutraceutical, new dietary ingredient (NDI), GRAS ingredient, or a food. Instead, tianeptine is a synthetic adulterant of a dietary supplement and considered technically an unapproved food additive. In conclusion, tianeptine, although viewed as a safe dietary supplement by many, is illegal in the US despite benefits to many but toxicity to others that make it vital that consumers and healthcare providers learn to critically evaluate and navigate the often confusing nomenclature of a purported dietary supplement to convey to the public whether it is efficacious, safe, and legal.
文摘Although whole food nutrition will likely influence physical health more than any other lifestyle component besides exercise, the use of dietary supplements among men and women continues to be high. Due to this fact, it is imperative that healthcare professionals understand how supplements may impact overall health and wellness of their patients. With the majority of adults taking some form of dietary supplements and many concomitantly taking prescription medications, healthcare providers should be conscientious of adverse effects and interactions that may occur between dietary supplements and prescription drugs. As many consumers are misled by false marketing, healthcare providers should encourage them to be wary of exaggerated claims and direct them to products that are scientifically supported and safe. Continuing education for healthcare providers on dietary supplements is crucial, with new dietary supplement products constantly reaching the markets, in addition to new findings being made through clinical research and case studies. While some dietary supplements provide no meaningful benefit, many dietary supplements have been identified that can be used to ameliorate nutritional deficiencies and reduce the risk of some common health conditions. Others can serve to improve mental and physical performance, while truly enhancing health. This article presents relevant information on dietary supplements that will be useful to the healthcare professional.
文摘Dietary polyphenols, or phenolic compounds, are numerous, diverse, and ubiquitous phytochemicals occurring throughout the plant kingdom. They are important components of the human diet because of their capacity to reduce the risk of chronic diseases such as cardiovascular disease and cancer. In plants, polyphenols contribute to resistance to pathogens due to their potent astringency and function as phytoalexins. As a result, organic grapevines grown with reduced pesticides may be more stressed by pathogens than conventionally grown grapevines and presumably produce more polyphenols. Since polyphenols also play an important role in the sensory qualities of fruits and wines particularly involving astringency and bitterness, there may be differences that affect sensory perceptions of wine. This establishes a conundrum where dietary polyphenols are healthful but potentially unpalatable.We recruited and randomized 18 female participants (21 - 50 y) to one of five groups (3 - 4 per group). Each group evaluated the sensory qualities of a geographically paired organic (OW) and conventional wine (CW) and an artificially colored white wine placebo (PW) with significantly differing total polyphenol concentrations (TP). Participants reported for three visits (one wine per visit) where they consumed 5 ounces (150 mL) of wine over 15 minutes while completing the sensory survey. Sensory evaluations based on a Likert-type scale included visual, aroma, and taste perceptions and overall impressions (scale 0 - 10). In two wine pairs, the OW contained significantly more TP (3.49 and 5.86 g/L) than the respective CW (2.63 and 4.63 g/L). In two other wine pairs both produced by sustainable viticulture, the CW (5.23 and 8.38 g/L) contained sig- nificantly more TP than OW (4.55 and 3.70 g/L) and in one set the amounts were equivalent (4.10 and 4.17 g/L). The five PW averaged 1.26 ± 0.20 g/L. Although there were significant differences in TP content of test wines, the results indicated that no significant differences in either intensity or quality for any of the sensory qualities were detected be- tween paired OW and CW wines but both scored significantly higher than the PW, with significantly lower TP. We conclude in this pilot study that a subset of OW from the Southwestern US is perceived similarly to CW produced by the same vineyard even with significantly differing TP concentrations.
