Dietary Supplements of Plant Origin © 2003 Taylor & Francis Ltd Dietary Supplements of Plant Origin A nutrition and health approach Edited by Massimo Maffei © 2003 Taylor & Francis Ltd First published 2003 by Taylor & Francis 11 New Fetter Lane, London EC4P 4EE Simultaneously published in the USA and Canada by Taylor & Francis Inc, 29 West 35th Street, New York, NY 10001 Taylor & Francis is an imprint of the Taylor & Francis Group This edition published in the Taylor & Francis e-Library, 2003. © 2003 Taylor & Francis Ltd All rights reserved. No part of this book may be reprinted or reproduced or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Every effort has been made to ensure that the advice and information in this book is true and accurate at the time of going to press. However, neither the publisher nor the authors can accept any legal responsibility or liability for any errors or omissions that may be made. In the case of drug administration, any medical procedure or the use of technical equipment mentioned within this book, you are strongly advised to consult the manufacturer’s guidelines. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalog record for this book has been requested ISBN 0-203-02709-4 Master e-book ISBN ISBN 0-203-34158-9 (Adobe eReader Format) ISBN 0–415–30835–6 (Print edition) © 2003 Taylor & Francis Ltd Contents List of Contributors vii Foreword viii 1 An introduction to dietary supplements of plant origin: definitions, background and an overview of this volume 1 BERNADETTE M. MARRIOTT 2 Herbal dietary supplements in the European market 18 VALERIO BOMBARDELLI 3 ESCOP, the European Commission, consumer policy and health protection 25 FRANCO VINCIERI AND ANTONELLA RIVA 4 Industrial plants as sources of dietary supplements 31 K. HÜSNÜ CAN BASER 5 Drug-like compounds from food plants and spices 43 GIOVANNI APPENDINO AND ORAZIO TAGLIALATELA-SCAFATI 6 Biotechnology of plant-derived dietary supplements 75 MARCO MUCCIARELLI 7 Biochemistry, physiology and bioengineering of bioactive compounds from plants used as dietary supplements 105 MASSIMO MAFFEI 8 Interaction of herbs with other medicines: the example of St John’s wort 171 JERRY COTT © 2003 Taylor & Francis Ltd vi Contents 9 Official and scientific information resources for botanical dietary supplements 187 GAIL B. MAHADY Appendix 203 Dietary supplments of plant origin: plants, diet and cancer prevention © 2003 Taylor & Francis Ltd Contributors Giovanni Appendino – DiSCAFF, Università del Piemonte Orientale, Viale Ferrucci 33, 28100 Novara, Italy. Valerio Bombardelli – INDENA S.p.A., Regulatory Affairs Department, Viale Ortles, 12 20139 Milan, Italy. K. Hüsnü Can Baser – Anadolu University, Medicinal and Aromatic Plant and Drug Research Centre (TBAM), 26470 Eskisehir, Turkey. Jerry Cott – 9002 Acredale Court, College Park, Maryland 20740-4001, USA. Massimo Maffei – Department of Plant Biology, University of Turin, Viale Mattioli 25, 10125 Turin, Italy. Gail B. Mahady – Department of Pharmacy Practice and UIC/NIH Center for Botan- ical Dietary Supplements Research, Program for Collaborative Research in the Pharmaceutical Sciences, College of Pharmacy, PAHO/WHO Collaborating Center for Traditional Medicine, University of Illinois at Chicago, Chicago, Illinois. Bernadette M. Marriott – The Burroughs Wellcome Fund, Research Triangle Park, North Carolina 27709-3901 and Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina 27599-7400, USA. Marco Mucciarelli – Department of Veterinary Morphophysiology, University of Turin, Via Leonardo da Vinci 44, 10095 Grugliasco, Turin, Italy. Antonella Riva – INDENA SpA, Viale Ortles, 12 20139 Milan, Italy. Orazio Taglialatela-Scafati – Dipartimento di Chimica delle Sostanze Naturali, Via Montesano, 49, 80131 Naples, Italy. Franco F. Vincieri – Dipartimento di Scienze Farmaceutiche, Università di Firenze, Via Gino Capponi, 9 50121, Florence, Italy. © 2003 Taylor & Francis Ltd Foreword The field of dietary supplement research has not kept pace with the burgeoning inter- est by consumers in the use of these products, particularly those of plant origin. Con- sumers and patients increasingly are demanding better evidence to support the claims that are made for effectiveness, safety and quality of these ingredients. Such scientific evidence exists, of course, but it is of widely variable quality. The abundance of information to support reasonable claims for some ingredients is easily matched by the enormous gaps in knowledge about others. Part of the reason for that exists in the way that herbal use has been translated to modern society. Many herbal ingredients have been used in traditional healing systems (e.g. traditional Chinese medicine, Ayurveda, and many others) for centuries, some- times millennia. This should offer comfort and security for their incorporation into conventional Western models of healthcare, health promotion, disease prevention, and even disease treatment. However, given the patterns of use of these ingredients – espe- cially when available as dietary supplements – there are now circumstances in which they are used chronically when their traditional use called for acute symptom manage- ment, or when their application is completely different from anything that com- mended their use in traditional healing. Coupled with this are the other challenges that exist in this field: the lack of information about mechanism of action for many herbal products; the array of regula- tory authorities that govern the marketing of herbal products around the world; the variability in manufacture of products; and the paucity of validated analytical methods, reference materials and standards. A book that attempts to address these issues should be celebrated, not only because of the challenges that it confronts, but also because of the promise that some herbal products can offer, e.g. in health promotion, disease prevention and disease manage- ment. This book represents collaboration between many specialists from very different disciplines. In addition, it offers the reader a comprehensive look at many aspects of the roles that these ingredients can play in human health. From legislative mandates to biochemistry, from functional foods to industrial applications, this book covers many topics crucial to understanding both the promise and the challenge associated with dietary supplements of plant origin. Paul M. Coates, Ph.D. Director, Office of Dietary Supplements National Institutes of Health Bethesda, Maryland 20892-2086, USA © 2003 Taylor & Francis Ltd 1 An introduction to dietary supplements of plant origin Definitions, background and an overview of this volume Bernadette M. Marriott Introduction Dietary supplements are in widespread use in the United States (Eisenberg et al., 1993, 1998; Kessler et al., 2001). This use continues to grow as more people, particu- larly the baby-boomers, become concerned about their access to health care, and the quality of that care, and seek complementary and alternative medical practices (Eisen- berg et al., 1998; Foster et al., 2000; Kessler et al., 2001; Rainey and Cason, 2001). With the increasing advent of food that is heavily synthetic and influenced by techno- logy, a significant segment of the US population is turning towards foods and medi- cines, including dietary supplements of plant origin, that they see as more natural (Kaptchuk and Eisenberg, 1998; Greger, 2001). Information on supplement use comes from many sources but there are limited data that incorporate the reasons for supplement selection and employ sampling techniques that are representative of the breadth and diversity of the United States’ population. At present, the best data on use of supplements of plant origin in the US is based on emerging data from the ongoing National Health and Nutrition Examination Survey (Radimer et al., 2000) and specific populations such as cancer survivors (cf. Richardson et al., 2000; Boon et al., 2000). The number of meta-analyses, clinical studies and trials of the health outcomes of botanical supplements has grown exponen- tially in the last six years. These data have not only underlined the potential health value of supplements of plant origin, as, for example, the dramatic expansion of research on phytotherapeutic agents in the treatment of benign prostatic hyperplasia (cf. Lowe and Fagelman, 1999), but identified that the choice and dose of supplements can directly interact with prescription drugs (Miller, 1998; Fugh-Berman, 2000), and impact nutrient bioavailability from food as well as other treatment regimes (Drew and Myers, 1997; Marriott, 1997; Ernst, 1998; Miller, 1998; Barone et al., 2001; and see Cott in this volume). In addition, reports continue to emerge that demonstrate inconsistency in supplement content, labelling and quality (cf. Shibata and Asetai, 1996; Hahm et al., 1999; Harkey et al., 2001), as well as incidents of toxicity (Brent, 1999; Ritter and Dembicki, 2000). While data on why individuals chose to use botan- ical supplements, the demographics of their use, and related health behaviours are still developing, it is critically important to build a strong basic scientific understanding of the chemistry, biology and biotechnology