nutraceuticals in CVD prevention

1. NUTRACEUTICALS IN
CARDIOVASCULAR DISEASE
PREVENTION
Presented by
AMTUL FATIMA
16451S0302
M pharmacy 1yr .2nd -sem
Dept. pharmaceutics
Guided by
Ms. Farsiya Fatima
(M.pharm)

2. Nutraceutical is a combination of 2 words
 Nutrition and
 Pharmaceutical
 The term “Nutraceutical” was first coined by Dr.
Stephen

3. Defination
Nutraceutical can be defined as
A food or part of food or nutrient, that provides
health benefits, including the prevention and
treatment of a disease.”

4. NEED FOR NUTRACEUTICALS
 Allopathic cure is available for most of the disorders but it comes at a price.
 Cost of medicine is increasing day by day as like other commodities.
 Allopathic medicines are associated with a variety of side effects.
 Therefore, more and more people are inclining towards lifestyle
modification and use of herbal products only.

5. CONCEPT OF NUTRACEUTICALS
Nutrition
required for
health
Pharmaceutical
Remedy for
sickness/injury
Nutraceuticals
preventative
medical approach

6. CLASSIFICATION OF NUTRACEUTICALS
BASED ON FOOD SOURCES

7. 1. Dietary fibres
• Plant origin substances present in food which are not digested
and add bulk to the intestinal contents.
Examples : Fruits, barley, oats, lignin, cellulose, pectin etc
• Generous intake of these fibers in diet is associated
with low risk of CVD, hypertension, diabetes,
obesity, colon cancer and gastrointestinal disorders.

8.  These are live microbial feed supplements which when be administered
in adequate dose, help in improving the intestinal microbial balance of
the host.
E.g Lactobacilli, bifidobacteria, sacromyces cervicea etc.
 Their administration is reported to be associated with a decreased risk
of allergy, asthma, cancer, infection of ear and urinary tract infection.
2. Probiotics

9. 3.prebiotics
 These are the dietary ingredients that benefit the host by selectively altering the
composition or metabolism of gut microbial flora.
• These are generally fructose based oligosaccharides existing naturally or
supplemented in the food and are not digested by human beings.
• Examples : chicory roots, banana, tomato and beans etc. These are found to be
beneficial in dyslipidemia, relief from constipation and in certain tumors.

10. 4. Polyunsaturated fatty acids
These may be omega 3 fatty acids e.g. α-linolenic acid,
eicosapentaenoic acid and docosahexaenoic acid.
• Found in fatty fishes, flaxseed, soybean etc.
omega 6 fatty acids eg arachidonic acid found in corn, safflower,
sunflower and soybean etc.

11. 5. Antioxidant vitamins
These include vitamin C, vitamin E and carotenoids.
These vitamins are abundant in many fruits and
vegetables and possess singlet oxygen quenching and
lipid peroxidation preventing properties.
• Regular intake of these helps in prevention of a number
of diseases.

12. CLASSIFICATION OF
NUTRACEUTICALS BASED ON
CHEMICAL NATURE

14. Areas covered by nutraceuticals
 Sleep disorder.
 Rheumatoid arthritis.
 Digistion problems.
 Prevention of cancers.
 Maintaining blood pressure.
 Lowering cholestrol.
 Diabetic problems .
 Osteoporosis.

15. SAFETY AND EFFICACY
15
Dietary supplements are not regulated as drugs by the FDA- Manufacturers are not
required to prove that supplements are safe and effective (although they must have a
history of safety).
Few supplements have been studied rigorously for safety and effectiveness (although
some may eventually be shown to be safe and effective).
Safety of nutraceuticals product is often easier to
establish than efficacy. Studies that test doses of
nutraceuticals several folds greater than the intended
dose help to establish toxicity data

16. MARKET SCENARIO OF NUTRACEUTICALS
• There is a growing demand for plants based medicines, health products, pharmaceuticals,
food supplements, cosmetics etc. in the national and international market.
Indian Market
• Nutraceuticals is one huge business opportunity awaiting the Indian Pharmaceutical
Industry in the coming years.
• Indian nutraceuticals market is expected to reach US$ 6.1 billion by 2020 as compared to
US$ 2.8 billion at present, driven by consumers becoming more conscious towards health
and fitness, according to report titled 'Emerging Indian Nutraceutical' Market.
16

17. ADVANTAGES OF NUTRACEUTICALS
• Nutraceutical have the potential to play a role in healthy eating and to
contribute to the prevention and treatment of diseases.
• Since new molecule is difficult to discover and more expensive and
risky then ever before, many pharmaceutical companies are now trying
to manufacture nutraceutical so that there is undoubtedly a very huge
and growing market.
• The belief among consumers that these “food like substances” are
either harmless or least toxic as compared to conventional
pharmaceuticals.
17

18. ADVANTAGES OF NUTRACEUTICALS
• The role of nutraceutical in treating inappropriate dietary habits are seen as
contributing to the leading cause of deaths due to coronary heart disease, certain
type of cancers etc.
• Nutraceutical are gaining popularity as people are relying on them for
safeguarding their health and avoiding side effects associated with drugs as well
long history of use and better patient tolerance as well as public acceptance.
• Plants constitute to be a major source of new lead generation of nutraceutical.
18

19. DISADVANTAGES OF NUTRACEUTICALS
 Not subjected to same testing and regulations as
pharmaceuticals
 Majority not regulated by FDA in USA
 Companies creating unregulated products to create
a wide profit margin
 Bioavailability of nutrients is lower
 No regulatory definition.
19

20. 20

21. NUTRACEUTICALS IN CARDIOVASCULAR DISEASE
PREVENTION
 GREEN TEA
 Turmaric
 GINGER
21

22. 22

23. 23

24. 24

25. Green Tea
 Source: Camellia sinensis
 Family : Theaceae
 CHEMICAL CONSTITUENTS:
Epigallocatechin
Epigallocatechingallate (EGCG)
Catechin
Epicatechingallate

26. Mechanism

27. Nutritional information:
 Black and green tea both show equal activity in total plasma
antioxidant. But some study show green tea to be more
effective than black.
 Tea polyphenols have anti-inflammatory, antithrombotic and
antiplatelet properties and effective in lowering risk of
developing CHD and MI.

28. Side Effects and Drug Interactions:
 Green tea is high in caffeine. Drinking too much green
tea will have the same effects on the body as those of
coffee and highly caffeinated soda.
over-consumption could lead to
 insomnia,
 irregular heart palpitation
 dizziness.
 You can also overdose on the caffeine in green tea
which may result in nausea, vomiting and stomach
cramps.

29. Health benefits
Antioxidant Effect: Antioxidants play an important role in vascular damage
and progression of various vascular disease, including atherosclerosis, ischemic
heart disease, hypertension, cardiomyopathies, cardiac hypertrophy and
congestive heart failure.
 Tea catechins have been largely studied for their antioxidant capacities and
are considered as important antioxidants. The antioxidant effects of catechins
are presumed to play a major role in mediating the cardio protective role of tea.

30. Effect on Lipid Profile:
 Hyperlipidemia, resulting from the abnormalities of lipid
metabolism, is one of the major risk factors for the
development of CVD. The elevated levels of plasma lipids such
as fatty acids, cholesterol, phospholipids and triglycerides can
lead to the development of atherosclerotic plaques.
 Green tea catechins affect lipid metabolism by various
mechanisms: Enhancement of antioxidant and phase II
enzymes .

31. MARKETED PRODUCT :

32. TURMERIC
 SOURCE: Curcuma longa
 FAMILY: :Zingiberaceae
 CHEMICAL CONSTITUENTS :
 Curcumin, desmethoxy curcumin,
bisdesmethoxy curcumin
32
enol form keto form

33. Nutritional Profile:
 Turmeric is an excellent source of both iron and
manganese. It is also a good source of vitamin B6,
dietary fiber, copper, and potassium.
Phytonutrients in turmeric include curcumin,
demethoxycurcumin, tumerones, and tumenorols.
33

34. Cardiovascular Benefits:
 main benefit of curcumin when it comes to heart disease,
is improving the function of the endothelium, which is
the lining of the blood vessels.
 It is well known that endothelial dysfunction is a major
driver of heart disease and involves an inability of the
endothelium to regulate blood pressure, blood clotting
and various other factors
 The curcumin group had a 65% decreased risk of
experiencing a heart attack in the hospital.

35. 35

36. Turmeric Dramatically Increases The Antioxidant Capacity of
The Body:
 Oxidative damage one of the mechanisms behind aging and
many diseases
36
free radicals formation
Free radicals tend to react with important organic
substances, such as fatty acids, proteins or DNA.
antioxidant that can neutralize free radicals

37. Anti-tumour activity :
 Anti-tumour activity Researchers have been studying curcumin as a
beneficial herb in cancer treatment. It can affect cancer growth,
development and spread at the molecular level. Studies have shown that it
can reduce angiogenesis (growth of new blood vessels in tumors),
metastasis (spread of cancer), as well as contributing to the death of
cancerous cells.
Preventing and Treating Alzheimer’s Disease:
 Alzheimer’s disease is the most common neurodegenerative disease in the
world and a leading cause of dementia. Unfortunately, no good treatment is
available for Alzheimer’s yet. Alzheimer’s disease is a buildup of protein
tangles called Amyloid plaques. Studies show that curcumin can help clear
these plaques.
37

38. DOSE:
 Powdered turmeric root has traditionally been
used as a stimulant and carminative at dosages of
0.5 to 3 g/day.
 Dosages of 3 to 6 g/day have been investigated to
protect against ulcers.
 Daily oral doses of curcumin 3.6 g have been
typically used in clinical trials, but dosages of
curcumin up to 8 g/day have been used. Higher
doses are associated with adverse GI effects.
38

39. MARKETED PRODUCTS
39

40. GINGER
 Source: Zingiber officinale
 family: Zingiberaceae.
40

41. CHEMICAL
CONSTITUENTS:
41

42. Active compound of ginger Biological activities
Gingerol antioxidant activity
Gingerol related compound Anti-tumour activity, Anti-inflammatory
and anti-analgesic activity.
Paradol Anti-oxidant and anti-cancerous
activity.
Shogoal Anti-oxidant and anti-inflammatory
activity. [6]-shogaol showed anticancer
activities through the inhibition of cell
invasion reduction of matrix
metalloproteinase-9 expression, anti-
proliferation activity
Zingerone Antioxidant activity.
Anti-inflammatory action.
Anti-bacterial activity.
Zerumbone Anti-tumour activity.
Anti-microbial activity.

43. Nutritional information:
 Raw ginger is composed of 79% water, 18% carbohydrates,
2% protein, and 1% fat .
 In 100 grams (a standard amount used to compare with
other foods), raw ginger supplies 80 Calories and contains
moderate amounts of vitamin B6 (12% of the Daily Value,
DV) and the dietary minerals, magnesium (12% DV) and
manganese (11% DV).
43

44. Side Effects
 The most common side effects are
 heartburn,
 stomach upset and diarrhea.
Drug Interactions
if you're on blood thinners, diabetes medications or
medications for high blood pressure.
using ginger could lower your blood sugar levels or blood
pressure to potentially dangerous levels
44

45. Dose :
•For morning sickness: 500 to 2500 mg of ginger daily in
two to four divided doses for 3 days to 3 weeks has been
used.
• Inhaled as aromatherapy: For nausea and vomiting
after surgery: A solution of ginger essential oil has been
used. Aromatherapy with ginger alone, or in
combination with spearmint, peppermint, and
cardamom, has been inhaled through the nose and
exhaled through the mouth three times after surgery.
45

46. Cardiovascular Benefits:
 Cardiovascular Benefits: The University of Maryland Medical Center
done several preliminary studies that suggest ginger may lower
cholesterol and prevent blood from clotting.
 Stopping your blood from clotting can help people with heart disease,
where blood vessels become clogged and lead to heart attack or stroke.
High cholesterol can also lead to clogged arteries when the cholesterol
builds up on the artery walls.
 Ginger may also help to lower blood pressure, another indicator of
heart disease.
46

47. Anti-tumour activity:
Ginger and its constituents show a vital effect in the control
of tumour development through up
 regulation of tumour suppressor gene,
 induction of apoptosis.
6-gingerol has role in the suppression of the transformation,
hyper proliferation, and inflammatory processes that involve
in various steps of carcinogenesis, angiogenesis .
 6-gingerol, constituents of ginger play a role in the
induction of apoptosis in the prostate cancer.
47

48. Nausea:
 Cancer patients undergoing chemotherapy often experience
nausea and vomiting as a side effect of treatment. In some
cases, ginger may help reduce nausea in chemotherapy
patients.
 a 2009 study published in "Supportive Care in Cancer"
found that patients who received ginger with aprepitant,
48

49. Reducing Inflammation:
 Ginger extracts may help reduce inflammation, leading to less pain for
osteoarthritis patients.
 A 2001 study published in "Arthritis and Rheumatism" found that patients
with knee pain resulting from osteoarthritis experienced less pain after
taking a ginger extract twice daily for six weeks.
Ginger and Migraine Pain:
help reduce migraine pain in patients who experience a mild headache as a
precursor to a migraine
49

50. MARKETED PRODUCTS
 Ginger Travel Capsules traditional herbal
product available for motion sickness.
50

51. EXAMPLES OF NUTRACEUTICALS
CURRENTLY AVAILABLE IN MARKET

52. 52

53. 53
Nutraceutical may be beneficial to our health but we are still learning about
their benefits and possible harmful effects.
Government regulatory bodies also face challenges in this new category of
health products, which lies between foods and drugs.
Health professional , Nutritionists and regulatory toxicologist should
strategically work together to plan appropriate regulation to provide ultimate
health and therapeutic benefit to mankind
CONCLUSION

54. • Nutraceuticals are present in most of the food ingredients
with varying concentration
• Concentration, time and duration of supply of nutraceuticals
influence human health
• Manipulating the foods, the concentration of active
ingredients can be increased
• Diet rich in nutraceuticals along with regular exercise, stress
reduction and maintenance of healthy body weight will
maximise health and reduce disease risk

55.  References
1. Roth GA, Huffman MD, Moran AE, et al. Global and regional patterns
in cardiovascular mortality from 1990 to 2013. Circulation 2015; 132-
1667.
2. Voelter-Mahlknecht S. Epigenetic associations in relation to
cardiovascular prevention and therapeutics. Clin Epigenetics 2016; 8-4.
3. Piepoli MF, Hoes AW, Agewall S, et al. 2016 European Guidelines on
cardiovascular disease prevention in clinical practice. Eur Heart J. 2016;
37(29): 2315-81.
4. O’Keeffe C, Kabir Z, O’Flaherty M, et al. Modelling the impact of
specific food policy options on coronary heart disease and stroke deaths
in Ireland. BMJ Open 2013; 3: e002837.
5. Alissa EM, Ferns GA. Functional foods and nutraceuticals in the primary
of cardiovascular diseases. J Nutr Metab. 2012; 2012:569486

56. 56