Use of Natural Products Including
Omega-3 Fatty Acids for
Preventive Health Care and for
Lowering Health Care Costs
Conference on Seal Oil, Collagen, and Protein Products
June 7-8th, 2004 - DFAIT, Ottawa
Prof. Bruce J. Holub
Department of Human Biology & Nutritional Sciences
University of Guelph
Guelph, ON, Canada
‘Nutraceuticals’ and ‘functional foods’ can be defined
as follows by Health Canada:
A ‘nutraceutical’ is a product isolated or purified from
foods that is generally sold in medicinal forms not
usually associated with food. A nutraceutical is
demonstrated to have a physiological benefit or provide
protection against chronic disease (Health Canada).
A ‘functional food’ is similar in appearance to, or may
be, a conventional food, is consumed as part of a usual
diet, and is demonstrated to have physiological benefits
and/or reduce the risk of chronic disease beyond basic
nutritional functions (Health Canada).
The above definitions for nutraceuticals and
functional foods, while helpful, fail to appreciate and
allow for the important roles that these can also play
in retarding disease progression, enhancing disease
management, and offering effective risk factor
modification in those with existing disease (as most
Canadians have by their fifties).
‘Nutraceuticals’
‘Functional Foods’
‘Wellness Foods’
‘Medicinal Foods’
‘Pharma Foods’
Estimated Prevalence of Cardiovascular Disease in
Americans by Age and Sex
90
80
70
60
Males
50
Females
40
30
20
10
0
20-24
25-34
Source:http://www.americanheart.org
35-44
45-54
Age (yr)
55-64
65-74
75+
Partial Listing of Lifestyle-related and other
Disorders/Diseases where Nutraceuticals/Functional
Foods can play a Major Role in Prevention/Management
1. Cardiovascular Diseases (CVD) and risk factors (blood
lipids, b.p., etc.)
2. Type 2 Diabetes
3. Cancers (colon, prostate, breast, others)
4. Osteoporosis
5. Kidney Disorders
6. Inflammatory conditions (arthritis, bowel, etc.)
7. ‘Psychiatric disorders’
8. Others
Health Care Expenditure in Canada
Parameter
Cardiovascular
Cancer
Type 2 Diabetes
Arthritis
Drugs
Diet-related Disorders
Total
$ billion/yr
13
20
10
10
15
30
> 100
Selected Rationale for Introduction of Functional
Foods into Marketplace and Health-Care System
1. Current Canadian health policy of medical treatment
(pharmaceuticals, etc.) with or without dietary advice denies
public the benefit offered by nutraceuticals/functional foods.
2. Most Canadians refuse to follow Health Canada’s Guidelines for
Healthy Eating (reluctance to change from ‘Western-style’ diet).
3. Current dietary patterns/foods in Canada don’t provide
sufficient intakes of natural nutraceutical components needed for
optimal health promotion or disease prevention/management.
4. Lifestyle (diet)–related chronic diseases/disorders in
Canada are major burden on health care costs
(particularly with ageing population).
5. Offers low-cost and early control of risk factors for
subsequent disease (e.g., heart disease).
6. Offers a ‘preventive’ model for disease prevention rather
than the current ‘medical’ model.
7. Dietary advice often proven to be ineffective on longerterm (e.g., blood cholesterol-lowering by dietary advice).
8. Offers control of ‘moderately’ elevated risk factors (e.g.,
blood cholesterol, triglyceride, etc.) which current healthcare system fails to control.
9. High ‘quit’ rate on pharmaceutical agents.
10. Functional foods can serve as optional or complementary
approaches for risk factor control and disease management
(not offered to Canadians today despite clinical/scientific
evidence).
11. Other countries (physicians, etc.) routinely use
nutraceutical/functional foods for health care.
12. Dramatic reduction in health care costs.
13. Boom to Canadian economy/production of products, job
creation, reduced dependency on imported/costly
pharmaceutical products, etc.
14. Others
Paradigm Shift in Health Care is Needed in Canada
Current: ‘Medical Model’ (later in life)
Medical Management with or without Dietary
Advice of Chronic Disorders/Diseases (no
Functional Foods/Nutraceuticals
Future: ‘Preventive Model’ (early in life)
Wide introduction and use of Functional
Foods/Nutraceuticals for Prevention of Chronic
Disorders/Diseases
(drug therapy)
6
Blood Cholesterol (mmol/L)
(~50% eligible
for drug therapy)
(~ 40% have
CVD)
5
(current)
4
(< 10% eligible
for drug therapy)
(<5% have
CVD)
(future if FFoods)
3
20
30
40
Ages
50
Blood Plasma Triglyceride Levels (mmol/L) in the Population (45-54 yr)
Percentage of Population
50
<1.1
25
1.1-2.2
=>2.3
0
No-Low Risk
Moderate-High Risk:
No Clinical
Management
High Risk:
Candidates for
Clinical Management
Effects of Selenium Supplementation for
Cancer Prevention in Patients with
Carcinoma of the Skin
A Randomized Controlled Trial
(Clark et al. JAMA. 1996;276:1957-1963)
% Reduction in Cancer*
Total cancer incidence
37
Total cancer mortality
50
Prostate cancer incidence
65
Colorectal cancer incidence
61
* 200 ug Selenium/day as nutraceutical supplementation
Some Examples of Natural Blood Triglyceride-Lowering
Nutraceutical Ingredients and their Potential to Reduce
Subsequent Heart Disease Treatment Costs if Initiated as
Preventive Foods in Healthy Individuals
Nutraceutical
Ingredient
Wholesale Cost of
Daily Ingredient
to Lower
Triglyceride (by
8%)
Expected %
Decrease in
Disease Risk
Omega-3 Fatty
Acids
(EPA/DHA)
13 cents/day
20% (in women)
(yearly cost = $47) 7.5% (in men)
Reduced
Expenditure
for Heart
Disease per
year*
$2.70 billion
(both genders)
* Includes both reduced dependency on costly triglyceride-lowering drugs later life and the reduced
risk for later disease development needing costly medical treatment. Expected decrease (%) in
disease risk based on published literature giving blood lipid changes in relation to disease risk.
Higher intakes of nutraceutical ingredients in functional foods will give a corresponding lower
decrease in later disease and greater cost savings.
Potential Savings with
Nutraceuticals/Functional Foods
a) Via Disease Prevention = $20 billion/yr
b) Via Disease Management = $10 billion/yr
c) Total
= $30 billion/yr
Barriers to Functional Foods Contributing to Human
Health and Chronic Disease Prevention in Canada
1. Health Canada does not currently allow any ‘health claims’
on functional foods (labels, etc.) regardless of proof of
efficacy, safety, published human/clinical trials, etc.
Therapeutic claims are generally restricted to patented,
costly, imported pharmaceutical (not natural)
agents/chemicals.
2. Functional Food/Nutraceutical use in health care (health,
disease prevention/management) not generally known by
health care professionals (e.g., not taught in medical school
curricula).
3. Medical Research Council (CIHR) spends <1% of its
research budget on Functional Food – human research
(incl. product development, other). This is a fraction of
what is spent on research directed at evaluating
imported pharmaceuticals (drugs).
4. Health coverage (insurance, OHIP, private plans, etc.)
will not cover nutraceuticals/functional foods as
therapeutic agents (only drugs) in contrast to other
countries.
5. Numerous others
1. Diet-related chronic diseases and disorders (cardiovascular diseases,
type 2 diabetes, many cancers, other) are of major and increasing
prevalence in our population. These contribute to our present and
accelerating health care expenditures with this trend continuing as
our population ages.
2. Canadians have been denied access to functional foods with natural
nutraceutical components for the prevention, delay of onset,
retardation of disease, and disease management (including risk factor
modification) despite overwhelming evidence-based published human
studies showing their dramatic ability to be highly effective in these
regards and to dramatically reduce health care costs.
3. The public have indicated their general unwillingness to significantly
change the ‘western-style’ diet as now consumed. Functional foods
and nutraceuticals can dramatically reduce disease incidence,
severity, progression, etc. with or without any significant changes in
overall dietary consumption patterns.
•
Health care costs in Canada can be reduced by a minimum of
$20 billion/yr by early risk factor management and the
accompanying disease prevention /retardation along with an
additional minimal
$10 billion savings for disease management applications.
•
The agri-food industry/sector needs extensive government
support if it intends to be an international participant at the
forefront of producing functional foods for disease prevention
and management (along with the economic benefits to Canada
that can be derived from such a prioritizing of resources,
research, job creation, marketing opportunities, use of our
natural agricultural resources, etc.). The gross under-funding
of research in the area of functional foods for disease
prevention in this country is in striking contrast to the past and
previous research allocations given to drug-related research
(usually on patented pharmaceuticals from non-Canadian
sources). Canada is lagging well behind other countries in this
important area.
6.
A ‘preventive model’ using functional foods and not the regular ‘medical
model’ needs to be established as soon as possible using a new breed of
‘preventive health specialists’ from our vast pool of eager, young, and
underemployed B.Sc. graduates in life sciences from across Canada. The
preventive model should focus on early detection and functional food-based
control of ‘moderate’ risk factors in our younger population using the
‘preventive’ specialists without a dependency on physicians.
7.
Education and training of various health specialists and professionals as well
as the public in functional foods and natural nutraceuticals for the prevention
and management of disease is also needed.
8.
The public, food industry, academic plus government scientists, and various
health specialists/professionals have indicated their enthusiastic interest and
support for the early and broad-based entry of functional foods with
appropriate health claims into the Canadian marketplace. Functional foods
need to become the ‘pharmacy’ for disease prevention as well as management.
9.
Government leadership in launching functional foods with natural
nutraceutical components is desperately needed in Canada as soon as possible.
Functional Foods
Can Become the
Pharmacy for
Disease Prevention