Food and Nutritional Supplements

1 The Rise and Rise of Food and Nutritional Supplements an Overview of the Market.- 1.1 Introduction.- 1.2 The Products.- 1.3 What are People Taking?.- 1.3.1 Cod Liver on.- 1.3.2 Multivitamins.- 1.3.3 Single Vitamins.- 1.3.4 Evening Primrose Oil.- 1.3.5 Minerals.- 1.3.6 Garlic Products.- 1.3.7 Functional Foods.- 1.4 Growth Across Western Europe.- 1.5 Who Manufactures Vitamin, Mineral and Dietary Supplements?.- 1.6 Retail Distribution of Vitamins, Minerals and Dietary Supplements.- 1.7 What is Driving the Growth in this Market?.- 1.7.2 The Trend Towards Self-Medication.- 1.7.2.1 Concerns About Illness Drive Demand.- 1.7.2.2 Changes in the Pharmacy.- 1.7.2.3 Changes in Primary Health Care.- 1.8 Do Supplement Users Need to Take Supplements?.- 1.9 Regulating the Market.- 1.10 The Future for Vitamins, Minerals and Dietary Supplements.- 1.11 ConclusionM.- 1.12 References.- 2 Why do Health Professionals Need to Know More About Nutrition?.- 2.1 Introduction.- 2.1.1 The Implication of Diet in Disease.- 2.2 Our Hunger for Knowledge.- 2.3 Health Professionals: the Authorative Source of Nutrition Information?.- 2.4 Nutrition: the Orphan Discipline.- 2.5 What are the Obstacles to Giving Nutrition Advice?.- 2.6 The Updated Role of Health Professionals: a New Approach.- 2.6.1 Tailored Dietary Advice.- 2.6.2 Different People, Different Dietary Needs.- 2.6.3 Drug-Nutrient Interactions.- 2.6.4 The Impact of Diet in Health Economics.- 2.7 Conclusion.- 2.8 References.- 3 Nutrient Requirements in Health and Disease.- 3.1 Introduction.- 3.2 What Nutrients are Needed, and How Much?.- 3.3 Dietary Reference Values.- 3.4 Meeting the Targets.- 3.5 Pregnancy and Lactation — Life-Long Health Implications of Nutrition.- 3.6 The Weaning Process.- 3.7 Childhood.- 3.8 Younger Schoolchildren.- 3.9 Adolescence.- 3.10 Adulthood.- 3.11 Older Years.- 3.12 Conclusion.- 3.13 References.- 4 Placebo and Panacea: The Healing Effect of Nutritional Supplements.- 4.1 Why Do So Many People Feel Unwell.- 4.2 The Placebo or Healing Effect.- 4.3 Who Responds to Placebo Medication.- 4.4 Nutritional Supplements as Placebos.- 4.5 The Ethics of Prescribing or Marketing Placebos as Nutritional Supplements.- 4.6 References.- 5 Antioxidants Nutrition and Health.- 5.1 Introduction.- 5.2 Involvement of Free Radicals in Degenerative Disease and Modulation by Antioxidants.- 5.3 Cancer Aetiology.- 5.4 Cardiovascular Disease Aetiology.- 5.5 Reduction of Disease Risk by Antioxidant Nutrients.- 5.6 Cancer.- 5.7 Cardiovascular Disease.- 5.8 References.- 6 Nutritional and Non-Nutritional Uses of Vitamin B6.- 6.1 Introduction.- 6.2 Metabolism and Metabolie Functions of Vitamin B6.- 6.3 Requirements and Reference Nutrient Intakes.- 6.4 Potential Benefits of Higher Levels of Intake: Homocysteine Metabolism.- 6.5 Pharmacological Uses of Vitamin B6.- 6.5.1 Side-Effects of Oral Contraceptives.- 6.5.2 Impaired Glucose Tolerance and Diabetes Mellitus.- 6.5.3 Depression.- 6.5.4 The Premenstrual Syndrome.- 6.5.5 Morning Sickness.- 6.5.6 Carpal Tunnel Syndrome.- 6.5.7 Hypertension.- 6.6 Drug Interactions with Vitamin B6.- 6.7 Toxicity of Vitamin B6.- 6.8 References.- 7 Folic Acid and Disease Prevention:A Long Day’s Journey Into light.- 7.1 Introduction.- 7.2 Folate Prevention of Neural Tube Defects.- 7.3 Other Congenital Malformations and Folate.- 7.4 Folate, Homocysteine and Occlusive Vascular Disease.- 7.5 Folate Requirements and Provision.- 7.6 Changed Diet.- 7.7 Supplements.- 7.8 Food Fortification.- 7.9 Conclusions.- 7.10 References.- 8 The Addition of Micronutrients to Food.- 8.1 Introduction.- 8.2 The Historical Background.- 8.3 Some Definitions.- 8.4 The Rationale for the Addition of Nutrients to Food.- 8.5 Policy Considerations.- 8.6 Legislative Aspects of Micronutrients Addition to Food.- 8.7 The Efficacy of the Addition of Micronutrients to Food.- 8.8 References.- 9 Probiotics and Prebiotics in Health.- 9.1 Introduction.- 9.2 Probiotic Bacteria in Human Health: An Overview Colette Shortt and Seppo Salminen.- 9.2.1 Introduction.- 9.2.2 Probiotics and Dietary Modulation.- 9.2.3 Concept of Probiotic Bacteria.- 9.2.4 Selection of Probiotic Strains.- 9.2.5 Conclusion.- 9.3 Prebiotics in Human Health: An Overview Marcel Roberfroid.- 9.3.1 Introduction.- 9.3.2 The Prebiotics.- 9.3.3 Malabsorption of the Non-Digestible Oligosaccharides.- 9.3.4 Fermentation in the Large Bowel: The Prebiotic Effect.- 9.3.5 Physiological Effects in the Gastro-Intestinal Tract.- 9.3.6 Prebiotics and the Risk of Colon Cancer.- 9.3.7 Conclusion: Prebiotics, What Benefit( s) for Human Health?.- 9.3.8 Conclusions.- 9.3.8 Conclusions.- 9.4 References.- 10 Phytoestrogens and Health.- 10.1 Introduction.- 10.1.1 Phytoestrogens — What are They and Where do we Find Them?.- 10.1.2 Isoflavones.- 10.1.3 Coumestans.- 10.1.4 Lignans.- 10.2 Dietary Intake.- 10.2.1 Baby Foods.- 10.2.2 Key Points.- 10.2.3 Effectsion Health.- 10.3 Heart Disease.- 10.3.1 Phytoestrogens May Reduce Blood Cholesterol Levels.- 10.3.2 Other Possible Effects of Phytoestrogens on CHD Risk.- 10.3.3 Key Points.- 10.4 Cancer.- 10.4.1 General Effects of Phytoestrogens.- 10.4.2 Breast Cancer.- 10.4.3 Prost ate Cancer.- 10.4.4 Other Cancers.- 10.4.5 Key Points.- 10.5 Osteoporosis.- 10.6 Key points.- 10.7 Menop ausal Symptoms.- 10.7.1 Key Points.- 10.8 Potential Adverse Effects.- 10.9 Conclusions and Recommendations.- 10.10 References.- 11 Dietary Supplements and their Role in the Prevention and Treatment of Coronary Heart Disease.- 11.1 Introduction.- 11.2 Evidence.- 11.3 Early Attempts at Dietary Modification to Prevent CHD.- 11.4 The Diet Trials.- 11.4.1 Fish.- 11.4.2 Nuts.- 11.4.3 Fibre.- 11.5 Homocysteine.- 11.6 Antioxidants.- 11.6.1 Vitamin C.- 11.6.2 ß-carotene.- 11.6.3 Vitamin E.- 11.7 Alcohol.- 11.8 Plant Sterols and Stanols.- 11.9 Conclusion.- 11.10 References.- 12 The Scientific Basis for Fish Oil Supplementation in Rheumatoid Arthritis.- 12.1 Introduction.- 12.2 Fatty Acids in the Human Diet.- 12.3 The Immune System.- 12.3.1 What is the Immune System and How Does it Work?.- 12.3.2 Communication Within the Immune System: Cytokines.- 12.3.3 Inflammation.- 12.3.4 Integration of the Immune Response.- 12.3.5 The Immune System in Health and Disease.- 12.4 Rheumatoid Arthritis.- 12.5 Eicosanoids: The Link Between FattyAcids and the Immune System.- 12.5.1 Eicosanoid Synthesis.- 12.5.2 Roles for Eicosanoids in Inflammation and Immunity.- 12.5.3 Eicosanoids and RA.- 12.5.4 Fish Oil and Eicosanoids.- 12.6 Effects of Fish Oil on Immune Function.- 12.7 Fish Oil Intervention in Rheumatoid Arthritis.- 12.8 Conclusions and Comments.- 12.9 References.