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NUTRI-BITES® Webinar Series Functional Foods: Phytochemicals – Hidden Nutrition Gems January 15, 2015 Presenter: Sylvia Escott-Stump, MA, RD, LDN Director, Dietetic Internship Department of Nutrition Science – East Carolina University Moderator: 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. 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. Today’s Faculty Sylvia Escott-Stump, MA, RD, LDN Director, Dietetic Internship Department of Nutrition Science East Carolina University Moderator: James M. Rippe, MD – Leading cardiologist, Founder and Director, Rippe Lifestyle Institute NUTRI-BITES® Webinar Series Phytochemicals – Hidden Nutrition Gems 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 S Escott-Stump 7 FUNCTIONAL FOODS – PHYTOCHEMICALS: HIDDEN NUTRITION GEMS Sylvia Escott-Stump, MA, RD, LDN East Carolina University, Greenville NC [email protected] 252-328-1352 S Escott-Stump Life Span 8 S Escott-Stump 9 LIFE EXPECTANCY • Bronze & iron ages: 26 years • In the US: 78.74 years • In Japan: 83.10 years S Escott-Stump What are the Keys to Longevity? 10 S Escott-Stump 11 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….” 2013 Academy position paper on functional foods http://www.eatright.org/About/Content.aspx?id=8354 Figure S Escott-Stump 12 Kapsak WR et al. Functional Foods: Consumer Attitudes, Perceptions, and Behaviors in a Growing Market. JADA 111:804, 2011. S Escott-Stump Our Professional Goal? 13 S Escott-Stump 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 14 S Escott-Stump Bioactive Compounds Animal foods (zoochemicals) Marine foods (fish, shellfish, sea vegetables) Plant foods (phytochemicals) 15 16 S Escott-Stump Spices and Herbs SPICES HERBS S Escott-Stump 17 What could a Nutrition Diagnosis be? Inadequate intake of bioactive substances Excessive intake of bioactive substances S Escott-Stump 18 Phytochemical Chart Liu RH. Health-promoting components of fruits and vegetables in the diet. Adv Nutr. 2013 ;4:384S-92S. S Escott-Stump 19 Polling Question • Have you taken any academic courses or intense workshops about phytochemicals? • Yes • No Various forms of indicators. Ellwood K et al. Adv Nutr 2014;5:693-701 ©2014 by American Society for Nutrition 21 S Escott-Stump Nutritional Genomics Altered SNP + or – Health Effect Biologic Effect Bioactive Product Absorbed Dose S Escott-Stump 22 Role of Bioactive Dietary Components “BIG FIVE ” • Curcumin (turmeric) • EGCG (green tea) • Genistein (soybean) • Resveratrol (grapes) • Sulforaphane (cruciferous vegetables) S Escott-Stump Nuclear factor-κB (NF-kB) 23 S Escott-Stump 24 S Escott-Stump 25 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. S Escott-Stump 26 Mediterranean Diet Influences on the Gut* S Escott-Stump How Phytochemicals Protect Us 27 S Escott-Stump Sources of Phytochemicals • Fruits • Vegetables • Legumes • Whole grains • Nuts and Seeds • Herbs and Spices 28 S Escott-Stump 29 4 Major Classes of Phytochemicals 1-Terpenes: • Carotenoids (35%) • Terpenoids 3- Thiols & Organosulfur compounds: • Cruciferous vegetables • Onions, garlic 2-Phenols: • Ellagic, caffeic, ferulic acids • Flavonoids (65%) • Lignans and phytosterols 4- Allium Compounds: • Onions, garlic, leeks, shallots S Escott-Stump TERPENES: CAROTENOIDS • Yellow, orange, red lipophilic pigments • 600 known • 14 are found in human serum • 6 are common in the food supply 30 S Escott-Stump Beta-Cryptoxanthin Orange Fruits, Egg Yolk Possible dose: 1-2 Servings per day 31 S Escott-Stump 32 Inflammation and Cancer Tanaka T et al. Cancer chemoprevention by citrus pulp and juices containing high amounts of β-cryptoxanthin and hesperidin. J Biomed Biotechnol. 2012; 2012:516981. S Escott-Stump Lycopene Tomato Products, Watermelon Dose: 20 mg/day; ½ to 1 cup of tomato products per week 33 S Escott-Stump Lycopene Lowers DNA Damage 34 Limonoids Citrus Fruits Dose: 100 micrograms/day; 1 serving per day S Escott-Stump 35 S Escott-Stump PHENOLS • Phenols are the big guns in the phytochemical world! 36 S Escott-Stump 37 ANTHOCYANINS BLUEBERRIES, CHERRIES, GRAPES, BEETS Proposed dose: Blueberries 1/2 cup per day Bing cherries 45/day lowers elevated C-reactive protein (CRP) S Escott-Stump 38 ELLAGIC ACID Raspberries and Strawberries • Strawberries and strawberry powder Dose: 3 cups whole berries (500 mg/day) lower blood glucose and inflammatory markers in the obese S Escott-Stump PUNICALAGIN + ELLAGIC ACID Pomegranate Dose: 3.5 oz/day 39 S Escott-Stump Triterpenoids PHYTOSTEROLS Dose: 2 to 3 g plant sterols per day (lowers LDL levels 6-12%) 40 S Escott-Stump 41 Phytosterol – Campesterol, β-sitosterol AVOCADO, SEEDS • Avocado (Persea americana) Dose: ½ avocado/day S Escott-Stump 42 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 S Escott-Stump 43 FERULIC ACID, HYDROXYTYROSOL Extra Virgin Olive Oil (EVOO) Dose: 1-2 Tbsp of EVOO per day S Escott-Stump Catechins Tea 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 44 S Escott-Stump 45 Resveratrol Skin of Red Grapes, Peanuts, Berries Dose: 2 grams per day (5 oz red wine or 5-10 mg/kg) S Escott-Stump Capsaicin (substance P) Chili Peppers Dose for weight management: 2mg before meals to reduce appetite Dose for digestive problems: 30120 mg capsule, 3 x/day 46 S Escott-Stump 47 Soluble Fiber (Beta Glucan), Antioxidant (Ergothioneine) Mushrooms White button mushrooms (Agaricus bisporus) Dose: “one handful” per day S Escott-Stump Soluble Fiber – Prebiotics Fructo-Oligosaccharides (FOS) • Sunchoke (Jerusalem artichoke)- best. Jicama, leeks, bananas, onion, wheat, asparagus, blue agave extract. Dose: ¼ to ½ cup/day 48 S Escott-Stump Whole Grains Dose: 3-5 serving/d (48-80 g whole grain/day) 49 S Escott-Stump 50 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 S Escott-Stump 51 SPICES HERBS Kaefer CM, Milner JA. The role of herbs and spices in cancer prevention. J Nutr Biochem. 2008;19:347-61. S Escott-Stump Carnosol 52 Rosemary, Sage, Oregano, Basil, Parsley DOSE: Carnosol 100-400 mg/kg increases GST activity S Escott-Stump Curcuminoids Turmeric, Curcumin Proposed Dose: 400 mg turmeric/curcumin 53 ORGANOSULFUR COMPOUNDS and THIOLS Cruciferous Vegetables Broccoli, Brussels sprouts, Cabbage, Cauliflower, Kale, Rutabaga, Horseradish Sulfur-containing phytonutrients Subclasses: • Indoles • Dithiolethiones • Isothiocyanates S Escott-Stump 54 S Escott-Stump 55 Liver Detoxification Pathways Phase 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 2 Metabolites 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 S Escott-Stump 56 Sulforaphane (Isothiocyanate) Broccoli Sulforaphane: Antioxidant Pancreatic ductal cancer stem cells: sulforaphane + EGCG + quercetin Inhibits H pylori infections; blocks gastric tumor formation ↑ production of the detoxification enzyme, Glutathione-S-Transferase (GST) • Appari M et al. Sulforaphane, quercetin and catechins complement each other in elimination of advanced pancreatic cancer by miR-let-7 induction and K-ras inhibition. Int J Oncol. 2014;45:1391-400. Dose: 100-200 g/day S Escott-Stump Allicin (Allium sativum L.) 57 GARLIC, CHIVES, LEEKS, ONIONS, SCALLIONS, SHALLOTS 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 S Escott-Stump 58 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 S Escott-Stump 59 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. S Escott-Stump 60 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 selfhealing • 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 • Respect the diversity of all health traditions and Alternative Medicine S Escott-Stump 61 Overall: Balanced Diet Approach • Even natural, whole foods could be troublesome if overconsumed • More is NOT ALWAYS BETTER Advice to the Registered Dietitians S Escott-Stump 62 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… S Escott-Stump 63 Overall: Choose Where You Stand • Guiding • Make suggestions? • Promoting • Back a product, food or supplement? • Help client to reach own conclusion? • Encourage use? © S. Escott-Stump 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 64 S Escott-Stump 65 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 S Escott-Stump 66 REMEMBER Our Professional Goal! Let’s ensure that the public has not only great nutrition tips but accurate information! S Escott-Stump 67 References and Further Information Academy of Nutrition and Dietetics. Position Paper on Functional Foods. J Acad Nutr Diet. 2013; 113:10961103. 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/claims http://www.fda.gov/food/ingredientspackaginglabeling/labelingnutrition/default.htm National Center for Complementary and Alternative Medicine http://nccam.nih.gov/health/antioxidants/introduction.htm Nutrition.gov http://www.nutrition.gov/whats-food/antioxidants-phytonutrients University of Maryland – Complementary and Alternative Medicine Guide http://umm.edu/health/medical/altmed US Food and Drug Administration, Center for Food Safety and Applied Nutrition http://www.cfsan.fda.gov/~dms/guidance US Department of Agriculture USDA Flavanol Database http://www.nal.usda.gov/fnic/foodcomp/Data/Flav/flav.html S Escott-Stump 68 Specific References Nutritional 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. S Escott-Stump 69 Specific References Lycopene 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. • S Escott-Stump 70 Specific References Punicalagin (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 metaanalysis 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 metaanalysis. 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 S Escott-Stump 71 Specific References Extra 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 metaanalysis of energy intake data. Appetite. 2014;73:183-8 Mushrooms Feeney MJ et al. Mushrooms and Health Summit proceedings. J Nutr. 2014 Jul;144(7):1128S-36S. S Escott-Stump 72 Specific References Whole 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;405:14651. • 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. S Escott-Stump 73 What Questions Do You Have? NUTRI-BITES® Webinar Series Phytochemicals – Hidden Nutrition Gems 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 ConAgra Foods Science Institute Nutri-Bites® Webinar details A link to obtain your Continuing Education Credit certificate will be emailed within 2 days Today’s webinar, including certificate link, will be available to download within 2 days at: www.ConAgraFoodsScienceInstitute.com For CPE information: [email protected] 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 Next ConAgra Foods Science Institute Nutri-Bites® Webinar In the Eye of the Beholder: Critical Evaluation of Nutrition Research Andrew W. Brown, PhD Post-doctoral Fellow, Office of Energetics Nutrition Obesity Research Center University of Alabama at Birmingham Date: March 12, 2015 2-3 pm EDT/1-2 pm CDT www.ConAgraFoodsScienceInstitute.com How are we doing? Stay on the line for a brief survey about today’s ConAgra Foods Science Institute Nutri-Bites® webinar: Phytochemicals: Hidden Nutrition Gems Thank you!