Regulate Nutraceutical Market

People from different societies and cultures across the world have been using naturally occurring substances from food, plants and animals to prevent, treat, and alleviate different ailments since ancient times. A healthy and balanced diet helps us maintain normal body weight, thus enhance general wellbeing and in turn reduces the risk of a number of non-communicable diseases such as heart disease, stroke, diabetes, osteoporosis and cancer. 

Population is rapidly aging throughout the world. Therefore, people have shifted their interest to preventive health. At the same time, sales of functional foods, beverages, dietary supplements and personal care products have surged in recent times. A balanced diet, moderate exercise and essential supplements have been found providing respite from many of the preventable diseases, especially for aging population. 

Changing need 

In line with the changing need of the aging population, nowadays a term ‘nutraceuticals’ has been used to represent those substances obtained from plant, and animal sources and has physiological benefits in preventing chronic diseases. They are commonly promoted in the market having potential to improve overall general health, delay aging process, and prevent chronic diseases. They are also used to increase life expectancy and support the function of the body. Nutraceuticals usually have no patent protection in contrast to the pharmaceuticals, although both pharmaceutical and nutraceutical compounds might be used to cure or prevent diseases. 

Nutraceuticals’ market is divided into functional foods (cereal, bakery, confectionery, dairy, and snacks), functional beverages (energy drinks, sports drinks, fortified juice, dairy and dairy alternative beverages), dietary supplements (vitamins, minerals, botanicals, enzymes, fatty acids, proteins and amino acids) and personal care. Functional food shares the largest percentage of the market followed by functional beverages and dietary supplements.

Nowadays, nutraceuticals have received considerable attention owing to their nutritional, safety and therapeutic effects. By 2024, the global nutraceutical market is projected to have revenue of US$ 671.30 billion, growing at a compound annual growth rate (CAGR) of 7.5 per cent during the period from 2019 to 2024. Southeast Asia has the highest recent growth rates with estimated CAGR of 12 per cent. Thus, nutraceuticals are gaining recognition and are becoming important component of daily diet. The major reason for this paradigm shift is due to increase in the prevalence of non-communicable diseases and people's interest in preventing those lifestyle-related diseases besides addressing nutritional need of the aging population. Also people's focus, in recent times, has shifted from treatment to prevention due to rapid increase in the cost of treatment. 

Food supplements with essential micronutrients can be used to improve the health of individuals in need. However, many of the health benefit claims that are associated with food supplements may not have been supported by scientific data on their safety, efficacy and effect on health and pathological conditions. The rigorousness of studies on possible mechanism of action and beneficial health effects on specific pathological conditions are often lacking in case of nutraceuticals. 

The safety and efficacy issues of nutraceuticals are becoming a hot subject for debate among medical and scientific professionals. It is obvious that people consuming a balanced diet do not need food supplements, and there are chances of over supplementation that can cause adverse effects instead. Owing to lack of availability of proper nutrition, a large number of children in the developing countries still suffer from vitamin or mineral deficiencies. Therefore, micronutrients such as Vitamin A, iron, iodine and zinc are still given to children in the developing world in order to prevent those deficiencies. 

Despite their popularity, the health benefits of dietary supplements have always been remained questionable because of the fact that these products do not need to go through robust scientific processes for safety, efficacy and effects before marketing as pharmaceutical products. Lack of vitamins and minerals may cause deficiency diseases; however, a well-balanced diet is enough for preventing those diseases. 

There is substantial evidence that the use of vitamin and mineral supplements can be beneficial for a certain group of people. Vitamin D and calcium can increase bone density in postmenopausal women, multivitamin supplements may be beneficial for HIV/AIDS patients, multivitamins may reduce birth defects and use of folic acid by women of child-bearing age has definite benefit. However, a recent large-scale study has shown that there was no reduction in incidence of heart disease, stroke or premature death with the supplements of multivitamins, Vitamin D, Calcium and Vitamin C. This means there was no benefit from taking those supplements, but also causes no harm.

Legislation

There have been debates on either qualified medical professionals can prescribe those nutraceuticals or not. The controversy will remain for some time until government authorities address the issue with appropriate legislation. Many countries have banned its prescription and few have allowed in definite cases only.

The consumption of functional foods or food ingredients with positive health outcomes should have sound scientific evidence. Evaluating the current rate of sales and unsubstantiated claims made by nutraceuticals, appropriate legislations to safeguard the health of the population are urgently warranted in Nepal. Last but not the least, it is encouraged to eat more nutrient-rich whole foods both during normal health and diseased condition with plenty of fresh vegetables and fruits. This provides required amount of vitamins, minerals and nutrients necessary for good health. 

(Dr. Lohani is the clinical director at the Nepal Drug and Poison Information Centre. lohanis@gmail.com)