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Review

An update on the safety of nutraceuticals and effects on lipid parameters

ORCID Icon &
Pages 303-313 | Received 16 Nov 2017, Accepted 16 Jan 2018, Published online: 29 Jan 2018

References

  • Bloom DE, Cafiero ET, Jané-Llopis E, et al. The global economic burden of noncommunicable diseases. Geneva: World Economic Forum; 2011 Sep. Report No.: 080911.
  • Organisation WH. Cardiovascular diseases (CVDs) 2015. [cited 2016 Aug 28]. Available from: http://www.who.int/mediacentre/factsheets/fs317/en/.
  • Hobbs FD, Banach M, Mikhailidis DP, et al. Is statin-modified reduction in lipids the most important preventive therapy for cardiovascular disease? A pro/con debate. BMC Med. 2016;14:4.
  • Baigent C, Keech A, Kearney PM, et al. Cholesterol Treatment Trialists’ (CTT) Collaborators. Efficacy and safety of cholesterol-lowering treatment: prospective metaanalysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005;366:1267–1278.
  • Baigent C, Blackwell L, Emberson J, et al.; Cholesterol Treatment Trialists’ (CTT) Collaboration. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010;376:1670–1681.
  • Ward N, Sahebkar A, Banach M, et al. Recent perspectives on the role of nutraceuticals as cholesterol-lowering agents. Curr Opin Lipidol. 2017;28(6):495–501.
  • Booth JN 3rd, Colantonio LD, Howard G, et al. Healthy lifestyle factors and incident heart disease and mortality in candidates for primary prevention with statin therapy. Int J Cardiol. 2016;207:196–202.
  • Appel LJ, Sacks FM, Carey VJ, et al.; OmniHeart Collaborative Research Group. Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart randomized trial. Jama 2005;294:2455–2464.
  • Brown MS, Goldstein JL. Biomedicine. Lowering LDL – not only how low, but how long? Science. 2006;311:1721–1731.
  • Brinton EA. Management of hypertriglyceridemia for prevention of atherosclerotic cardiovascular disease. Endocrinol Metab Clin North Am. 2016;45:185–204.
  • Patti AM, Toth PP, Giglio RV, et al. Nutraceuticals as an important part of combination therapy in dyslipidaemia. Curr Pharm Des. 2017 Mar 17;23. doi:10.2174/1381612823666170317145851
  • Houston M. The role of nutraceutical supplements in the treatment of dyslipidemia. J Clin Hypertens. 2012;14:121–132.
  • Cicero AF, Fogacci F, Colletti A. Food and plant bioactives for reducing cardiometabolic disease risk: an evidence based approach. Food Funct. 2017;8:2076–2088.
  • Reiner Ž. Resistance and intolerance to statins. Nutr Metab Cardiovasc Dis. 2014;24:1057–1066.
  • Stroes ES, Thompson PD, Corsini A, et al.; European Atherosclerosis Society Consensus Panel. Statin-associated muscle symptoms: impact on statin therapy – European Atherosclerosis Society Consensus Panel Statement on Assessment, Aetiology and Management. Eur Heart J. 2015;36:1012–1022.
  • Devaraj S, Jialal I. The role of dietary supplementation with plant sterols and stanols in the prevention of cardiovascular disease. Nutr Rev. 2006;64:348–354.
  • Wang P, Chen Y-M, He L-P, et al. Association of natural intake of dietary plant sterols with carotid intima-media thickness and blood lipids in Chinese adults: a cross-section study. PLoS One. 2012;7:e32736.
  • Andersson SW, Skinner J, Ellegård L, et al. Intake of dietary plant sterols is inversely related to serum cholesterol concentration in men and women in the EPIC Norfolk population: a cross-sectional study. Eur J Clin Nutr. 2004;58:1378–1385.
  • Mannarino E, Pirro M, Cortese C, et al. Effects of a phytosterol-enriched dairy product on lipids, sterols and 8-isoprostane in hypercholesterolemic patients: a multicenter Italian study. Nutr Metab Cardiovasc Dis. 2009;19:84–90.
  • Malhotra A, Shafiq N, Arora A, et al. Dietary interventions (plant sterols, stanols, omega-3 fatty acids, soy protein and dietary fibers) for familial hypercholesterolaemia. Cochrane Database Syst Rev. 2014;6:CD001918.
  • Baker WL, Baker EL, Coleman CI. The effect of plant sterols or stanols on lipid parameters in patients with type 2 diabetes: a meta-analysis. Diabetes Res Clin Pract. 2009;84:e33–e37.
  • Talati R, Sobieraj DM, Makanji SS, et al. The comparative efficacy of plant sterols and stanols on serum lipids: a systematic review and meta-analysis. J Am Diet Assoc. 2010;110:719–726.
  • Brown JM, Yu L. Protein mediators of sterol transport across intestinal brush border membrane. Subcell Biochem. 2010;51:337–380.
  • Merkens LS, Myrie SB, Steiner RD, et al. Sitosterolemia. 2013 Apr 4. In: Adam MP, Ardinger HH, Pagon RA, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993–2017. [Last accessed 2017 Nov 12]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK131810/.
  • Gylling H, Radhakrishnan R, Miettinen TA. Reduction of serum cholesterol in postmenopausal women with previous myocardial infarction and cholesterol malabsorption induced by dietary sitostanol ester margarine. Circulation. 1997;96:4226–4231.
  • Pirro M, Vetrani C, Bianchi C, et al. Joint position statement on “Nutraceuticals for the treatment of hypercholesterolemia” of the Italian Society of Diabetology (SID) and of the Italian Society for the Study of Arteriosclerosis (SISA). Nutr Metab Cardiovasc Dis. 2017;27(1):2–17.
  • Brown L, Rosner B, Willett WW, et al. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr. 1999;69:30–42.
  • Marlett JA. Sites and Mechanisms for the Hypocholesterolemic Actions of Soluble Dietary Fiber Sources. In: Kritchevsky D., Bonfield C. (eds) Dietary Fiber in Health and Disease. Advances in Experimental Medicine and Biology, Boston, MA;Springer. 1997;427:109–121.
  • Wei Z-H, Wang H, Chen X-Y, et al. Time- and dose-dependent effect of psyllium on serum lipids in mild-to-moderate hypercholesterolemia: a meta-analysis of controlled clinical trials. Eur J Clin Nutr. 2009;63(7):821–827.
  • Ribas SA, Cunha DB, Sichieri R, et al. Effects of psyllium on LDL-cholesterol concentrations in Brazilian children and adolescents: a randomised, placebo-controlled, parallel clinical trial. Br J Nutr. 2015;113:134–141.
  • Onakpoya I, Posadzki P, Ernst E. The efficacy of glucomannan supplementation in overweight and obesity: a systematic review and meta-analysis of randomized clinical trials. J Am Coll Nutr. 2014;33(1):70–78.
  • Guardamagna O, Abello F, Cagliero P, et al. Could dyslipidemic children benefit from glucomannan intake? Nutrition. 2013;29:1060–1065.
  • Sood N, Baker WL, Coleman CI. Effect of glucomannan on plasma lipid and glucose concentrations, body weight, and blood pressure: systematic review and meta-analysis. Am J Clin Nutr. 2008;88:1167–1175.
  • Sahebkar A, Serban M-C, Gluba-Brzózka A, et al. Lipid-modifying effects of nutraceuticals: an evidence-based approach. Nutrition. 2016;32:1179–1192.
  • Zhu X, Sun X, Wang M, et al. Quantitative assessment of the effects of beta-glucan consumption on serum lipid profile and glucose level in hypercholesterolemic subjects. Nutr Metab Cardiovasc Dis. 2015;25:714–723. 54.
  • Reiner Z, Catapano A, De Backer G, et al. The task force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). ESC/EAS guidelines for the management of dyslipidaemias. Eur Heart J. 2011;32:1769–1818.
  • EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA). Scientific opinion on the substantiation of a health claim related to oat beta-glucan and lowering blood cholesterol and reduced risk of (coronary) heart disease pursuant to Article 14 of Regulation (EC) No 1924/2006. EFSA J. 2010;8:188.
  • Cicero AFG, Colletti A, Bajraktari G, et al. Lipid-lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel. Arch Med Sci. 2017;13(5):965–1005.
  • Fu J, Bonder MJ, Cenit MC, et al. The gut microbiome contributes to a substantial proportion of the variation in blood lipids. Circ Res. 2015;117(9):817–824.
  • Garcia-Rios A, Torres-Peña JD, Perez-Jimenez F, et al. Gut microbiota: a new marker of cardiovascular disease. Curr Pharm Des. 2017;23(22):3233–3238.
  • Shimizu M, Hashiguchi M, Shiga T, et al. Meta-analysis: effects of probiotic supplementation on lipid profiles in normal to mildly hypercholesterolemic individuals. PLoS One. 2015;10:e0139795.
  • Wu Y, Zhang Q, Ren Y, et al. Effect of probiotic Lactobacillus on lipid profile: A systematic review and meta-analysis of randomized, controlled trials. PLoS One. 2017;12(6):e0178868.
  • Mistry P. Natural cholesterol-lowering products: focus on probiotics. Br J Community Nurs. 2014;19(Suppl 11):S14–S18.
  • Guarner F, Schaafsma GJ. Probiotics. Int J Food Microbiol. 1998;39:237–238.
  • Cho YA, Kim J. Effect of probiotics on blood lipid concentrations: a meta-analysis of randomized controlled trials. Medicine. 2015;94:e1714.
  • Doron S, Snydman DR. Risk and safety of probiotics. Clin Infect Dis (Review). 2015;60 Suppl 2:S129–S134.
  • Gordon RY, Cooperman T, Obermeyer W, et al. Marked variability of monacolin levels in commercial red yeast rice products: buyer beware! Arch Intern Med. 2010;170:1722–1727.
  • Ma J, Li Y, Ye Q, et al. Constituents of red yeast rice, a traditional Chinese food and medicine. J Agric Food Chem. 2000;48:5220–5225.
  • Gerards MC, Terlou RJ, Yu H, et al. Traditional Chinese lipid-lowering agent red yeast rice results in significant LDL reduction but safety is uncertain – a systematic review and meta-analysis. Atherosclerosis. 2015;240:415–423.
  • Guardamagna O, Abello F, Baracco V, et al. The treatment of hypercholesterolemic children: efficacy and safety of a combination of red yeast rice extract and policosanols. Nutr Metab Cardiovasc Dis. 2011 Jun;21(6):424–429.
  • Cicero AF, Morbini M, Rosticci M, et al. Middle-term dietary supplementation with red yeast rice plus coenzyme Q10 improves lipid pattern, endothelial reactivity and arterial stiffness in moderately hypercholesterolemic subjects. Ann Nutr Metab. 2016;68(3):213–219.
  • Mazzanti G, Moro PA, Raschi E, et al. Adverse reactions to dietary supplements containing red yeast rice: assessment of cases from the Italian surveillance system. Br J Clin Pharmacol. 2017 Jan 17;83:894–908. [Epub ahead of print]. doi:10.1111/bcp.13171
  • DFG Permanent Senate Commission on Food Safety. Toxicological evaluation of red mould rice: an update. 2012;1–24.
  • Chan W-H, Shiao N-H. Effect of citrinin on mouse embryonic development in vitro and in vivo. Reprod Toxicol. 2007;24:120–125.
  • Rangboo V, Noroozi M, Zavoshy R, et al. The effect of artichoke leaf extract on alanine aminotransferase and aspartate aminotransferase in the patients with nonalcoholic steatohepatitis. Int J Hepatol. 2016;2016:1–6.
  • Capasso F, Gaginella TS, Grandolini G, et al. Phytotherapy: a quick reference to herbal medicine. Berlin: Springer; 2003.
  • Sahebkar A, Pirro M, Banach M, et al. Lipid-lowering activity of artichoke extracts: A systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2017 Jun 13:1–8. [Epub ahead of print]. doi:10.1080/10408398.2017.1332572
  • Giglio RV, Patti AM, Nikolic D, et al. The effect of bergamot on dyslipidemia. Phytomedicine. 2016;23:1175–1181.
  • Di Donna L, De Luca G, Mazzotti F, et al. Statin-like principles of bergamot fruit (Citrus bergamia): isolation of 3-hydroxymethylglutaryl flavonoid glycosides. J Nat Prod. 2009;72:1352–1354.
  • Miceli N, Mondello MR, Monforte MT, et al. Hypolipidemic effects of Citrus bergamia Risso et Poiteau juice in rats fed a hypercholesterolemic diet. J Agric Food Chem. 2007;55:10671–10677.
  • Gliozzi M, Walker R, Muscoli S, et al. Bergamot polyphenolic fraction enhances rosuvastatin-induced effect on LDL-cholesterol, LOX-1 expression and protein kinase B phosphorylation in patients with hyperlipidemia. Int J Cardiol. 2013;170:140–145.
  • Gliozzi M, Carresi C, Musolino V, et al. The effect of Bergamot-derived polyphenolic fraction on LDL small dense particles and non alcoholic fatty liver disease in patients with metabolic syndrome. Adv Biol Chem. 2014;4:129–137.
  • Athyros VG, Tziomalos K, Katsiki N, et al. Cardiovascular risk across the histological spectrum and the clinical manifestations of non-alcoholic fatty liver disease: an update. World J Gastroenterol. 2015;21:6820–6834.
  • Mollace V, Sacco I, Janda E, et al. Hypolipemic and hypoglycaemic activity of bergamot polyphenols: from animal models to human studies. Fitoterapia. 2011;82:309–316.
  • Ried K, Toben C, Fakler P. Effect on garlic on serum lipids: an updated meta-analysis. Nutr Rev. 2013;71(5):282–299.
  • Steiner M, Lin RS. Changes in platelet function and susceptibility of lipoproteins to oxidation associated with administration of aged garlic extract. J Cardiovasc Pharmacol. 1998;31(6):904–908.
  • Liu C-S, Zheng Y-R, Zhang Y-F, et al. Research progress on berberine with a special focus on its oral bioavailability. Fitoterapia. 2016;109:274–282.
  • Abidi P, Zhou Y, Jiang J-D, et al. Extracellular signal-regulated kinase-dependent stabilization of hepatic low-density lipoprotein receptor mRNA by herbal medicine berberine. Arterioscler Thromb Vasc Biol. 2005;25(10):2170–2176.
  • Li H, Dong B, Park SW, et al. Hepatocyte nuclear factor 1α plays a critical role in PCSK9 gene transcription and regulation by the natural hypocholesterolemic compound Berberine. J Biol Chem. 2009;284(42):28885–28895.
  • Li XY, Zhao ZX, Huang M, et al. Effect of Berberine on promoting the excretion of cholesterol in high-fat diet-induced hyperlipidemic hamsters. J Transl Med. 2015;13:278.
  • Lan J, Zhao Y, Dong F, et al. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. 2015;161:69–81.
  • Meng S, Wang L-S, Huang Z-Q, et al. Berberine ameliorates inflammation in patients with acute coronary syndrome following percutaneous coronary intervention. Clin Exp Pharmacol Physiol. 2012;39(5):406–411.
  • Derosa G, Maffioli P, Cicero AF. Berberine on metabolic and cardiovascular risk factors: an analysis from preclinical evidences to clinical trials. Expert Opin Biol Ther. 2012;12:1113–1124.
  • Xin H-W, Wu X-C, Li Q, et al. The effects of berberine on the pharmacokinetics of ciclosporin A in healthy volunteers. Methods Findings Exp Clin Pharmacol. 2006;28:25–29.
  • Chan E. Displacement of bilirubin from albumin by berberine. Biol Neonate. 1993;63:201–208.
  • Affuso F, Mercurio V, Fazio V, et al. Cardiovascular and metabolic effects of Berberine. World J Cardiol. 2010;2:71–77.
  • Eng QY, Thanikachalam PV, Ramamurthy S. Molecular understanding of Epigallocatechin gallate (EGCG) in cardiovascular and metabolic diseases. J Ethnopharmacol. 2018;210:296–310.
  • Way T-D, Lin H-Y, Kuo D-H, et al. Pu-erh tea attenuates hyperlipogenesis and induces hepatoma cells growth arrest through activating AMP-activated protein kinase (AMPK) in human HepG2 cells. J Agric Food Chem. 2009;57:5257–5264.
  • Shishikura Y, Khokhar S, Murray BS. Effects of tea polyphenols on emulsification of olive oil in a small intestine model system. J Agric Food Chem. 2006;54:1906–1913.
  • Yuan F, Dong H, Fang K, et al. Effects of green tea on lipid metabolism in overweight or obese people: A meta-analysis of randomized controlled trials. Mol Nutr Food Res. 2018 Jan;62(1). doi: 10.1002/mnfr.201601122.7 Jun 21. [Epub ahead of print].
  • Serban C, Sahebkar A, Antal D, et al. Effects of supplementation with green tea catechins on plasma C-reactive protein concentrations: a systematic review and meta-analysis of randomized controlled trials. Nutrition. 2015;31:1061–1071.
  • Park CS, Kim W, Woo JS, et al. Green tea consumption improves endothelial function but not circulating endothelial progenitor cells in patients with chronic renal failure. Int J Cardiol. 2010;145:261–262.
  • Zhang C, Qin -Y-Y, Wei X, et al. Tea consumption and risk of cardiovascular outcomes and total mortality: a systematic review and meta-analysis of prospective observational studies. Eur J Epidemiol. 2015;30:103–113.
  • Cicero AF, Fogacci F, Colletti A. Potential role of bioactive peptides in prevention and treatment of chronic diseases: a narrative review. Br J Pharmacol. 2017;174:1378–1394.
  • Weggemans RM, Trautwein EA. Relation between soy-associated isoflavones and LDL and HDL cholesterol concentrations in humans: a meta-analysis. Eur J Clin Nutr. 2003;57:940–946.
  • Tokede OA, Onabanjo TA, Yansane A, et al. Soya products and serum lipids: a meta-analysis of randomised controlled trials. Br J Nutr. 2015;114:831–843.
  • Beavers DP, Beavers KM, Miller M, et al. Exposure to isoflavone-containing soy products and endothelial function: a Bayesian meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis. 2012;22:182–191.
  • Hazim S, Curtis PJ, Schär MY, et al. Acute benefits of the microbial-derived isoflavone metabolite equol on arterial stiffness in men prospectively recruited according to equol producer phenotype: a double-blind randomized controlled trial. Am J Clin Nutr. 2016;103:694–702.
  • EFSA Panel on Dietetic Products NaAN Scientific Opinion on the substantiation of health claims related to eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), docosapentaenoic acid (DPA) and maintenance of normal cardiac function (ID 504, 506, 516, 527, 538, 703, 1128, 1317, 1324, 1325), maintenance of normal blood glucose concentrations (ID 566), maintenance of normal blood pressure (ID 506, 516, 703, 1317, 1324), maintenance of normal blood HDL-cholesterol concentrations (ID 506), maintenance of normal (fasting) blood concentrations of triglycerides (ID 506, 527, 538, 1317, 1324, 1325), maintenance of normal blood LDL-cholesterol concentrations (ID 527, 538, 1317, 1325, 4689), protection of the skin from photo-oxidative (UV-induced) damage (ID 530), improved absorption of EPA and DHA (ID 522, 523), contribution to the normal function of the immune system by decreasing the levels of eicosanoids, arachidonic acid-derived mediators and pro-inflammatory cytokines (ID 520, 2914), and “immunomodulating agent” (4690) pursuant to Article 13 (1)of Regulation (EC) No 1924/20061. EFSA J. 2010;8:1796–1828. 163.
  • Howe P, Mori T, Buckley J. Long chain omega-3 fatty acids and cardiovascular disease – FSANZ consideration of a commissioned review. FSANZ. 2013. [cited 2017 Mar 31]. Available from: http://www.foodstandards.gov.au/consumer/labelling/nutrition/documents/FSANZ%20consideration%20of%20omega-3%20review1.pdf.
  • Harris WS, Bulchandani D. Why do omega-3 fatty acids lower serum triglycerides? Curr Opin Lipidol. 2006;17:387–393.
  • Eslick GD, Howe PR, Smith C, et al. Benefits of fish oil supplementation in hyperlipidemia: a systematic review and meta-analysis. Int J Cardiol. 2009;136:4–16.
  • Leslie MA, Cohen DJ, Liddle DM, et al. A review of the effect of omega-3 polyunsaturated fatty acids on blood triacylglycerol levels in normolipidemic and borderline hyperlipidemic individuals. Lipids Health Dis. 2015;14:53.
  • Cicero AF, Reggi A, Parini A, et al. Application of polyunsaturated fatty acids in internal medicine: beyond the established cardiovascular effects. Arch Med Sci. 2012;8:784–793.
  • Cicero AF, Colletti A. Krill oil: evidence of a new source of polyunsaturated fatty acids with high bioavailability. Clin Lipidol. 2015;10:1–4.
  • Ursoniu S, Sahebkar A, Serban M-C, et al.; Lipid and Blood Pressure Meta-analysis Collaboration Group. Lipid-modifying effects of krill oil in humans: systematic review and meta-analysis of randomized controlled trials. Nutr Rev. 2017;75:361–373.
  • Wachira JK, Larson MK, Harris WS. n-3 Fatty acids affect haemostasis but do not increase the risk of bleeding: clinical observations and mechanistic insights. Br J Nutr. 2014 May;111(9):1652–1662.
  • Serban M-C, Sahebkar A, Mikhailidis DP, et al. Impact of L-carnitine on plasma lipoprotein(a) concentrations: a systematic review and meta-analysis of randomized controlled trials. Sci Rep. 2016;6:19188.
  • Pooyandjoo M, Nouhi M, Shab-Bidar S, et al. The effect of (L-) carnitine on weight loss in adults: a systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2016;17:970–976. 207.
  • Mazidi M, Rezaie P, Banach M Impact of L-carnitine on C-reactive protein: a systematic review and meta-analysis of 10 randomized control trials with 925 patients. Presentation at 2nd CPPEI Congress in Vienna, July 2017 (data unpublished).
  • Serban M-C, Sahebkar A, Dragan S, et al. A systematic review and meta-analysis of the impact of Spirulina supplementation on plasma lipid concentrations. Clin Nutr. 2016;35:842–851.
  • Neyrinck AM, Taminiau B, Walgrave H, et al. Spirulina protects against hepatic inflammation in aging: an effect related to the modulation of the gut microbiota? Nutrients. 2017;9(6):633.
  • Johnston TP, Korolenko TA, Pirro M, et al. Preventing cardiovascular heart disease: promising nutraceutical and non-nutraceutical treatments for cholesterol management. Pharmacol Res. 2017;120:219–225.
  • Cicero AF, Parini A, Rosticci M, et al. Nutraceuticals and cholesterol-lowering action. Int J Cardiol Met Endocr. 2015;6:1–4.
  • Gonnelli S, Caffarelli C, Stolakis K, et al. Efficacy and tolerability of a nutraceutical combination (Red Yeast Rice, Policosanols, and Berberine) in patients with low-moderate risk hypercholesterolemia: a double-blind, placebo-controlled study. Curr Ther Res Clin Exp. 2014 Nov;15(77):1–6.
  • Cicero AF, Colletti A. Combinations of phytomedicines with different lipid lowering activity for dyslipidemia management: the available clinical data. Phytomedicine. 2016;23(11):1113–1118.
  • Cicero AF, Colletti A. Statins and nutraceuticals/functional food: could they be combined?. In: Banach M, editor. Combination therapy in dyslipidemia. Springer Verlag; 2015. p. 127–142.
  • Hunter PM, Hegele RA. Functional foods and dietary supplements for the management of dyslipidaemia. Nat Rev Endocrinol. 2017 May;13(5):278–288.
  • Somdat M, Yashwant VP. Nutraceuticals and health: review of human evidence. Nutraceut Basic Res Clin Appl. 2016.
  • Dutta D, Pathak Y. Background to Nutraceuticals and Human Health. In: Mahabir  S, Pathak YV (Eds). Nutraceuticals and Health: Review of Human Evidence. CRC Press. 2016;3–18.

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