The Pharmaceutical Journal
Vol 270 No 7232 p92
18 January 2003

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A timely and well set out text on nutraceuticals — but more detail needed

'Nutraceuticals', by Lisa Rapport and Brian Lockwood. Pp xvii+163. Price £29.95. London: Pharmaceutical Press; 2002. ISBN 0 85369 503 2

Since Hippocrates advised to "Let food be thy medicine and medicine be thy food", medicines and foods have been defined according to contemporary knowledge. According to the American Nutraceutical Association, nutraceuticals are functional food products whose nutritional value is enhanced by the addition of natural ingredients with potentially disease-preventing and health-promoting properties. The authors choose to widen this definition to include food supplements in general, probiotics, fortified breakfast cereals, vitamins, herbal remedies and even genetically modified foods, although few of these items are included in the book. In particular vitamins, minerals and amino acids are excluded, leaving a list of just eight supplements usually obtained from a food source but sold as isolated purified components in pharmacological doses for specific ailments. This comparatively slim volume seeks to "evaluate the literature that exists for these nutraceuticals and to assess the medical and scientific evidence available". It is an expanded compilation of articles previously published in The Pharmaceutical Journal. In addition there is a useful introductory chapter to the subject.

Much of the evidence for the use of nutraceuticals is conflicting and of poor quality. In some cases the trials are unblinded; in others placebo control is absent. Some studies have been carried out using only animal models. In the case of glucosamine evidence is difficult to assess because different salts and different routes of administration are commonly used. Despite pointing out these methodological flaws Rapport and Brown are quite upbeat about the potential efficacy of their chosen products in specified conditions but they do counsel vigilance for long-term use and indicate where interactions with prescribed drugs are possible.

This book comes as a timely addition to the Pharmaceutical Press portfolio because the growing field of nutraceuticals and functional foods is likely to impact on the practice of pharmacy over the next decade. Although clearly written and well set out, the subject is covered rather superficially. The casual reader will find the book useful, however, something more comprehensive would be required by pharmacists wishing to pursue their studies in greater detail.

Steven Kayne