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Nutraceuticals: A Guide for Healthcare Professionals

Nutraceuticals: A Guide for Healthcare Professionals, 2nd ed., by Brian Lockwood. Chicago, IL: Pharmaceutical Press; 2007. Hardcover; 426 pages. ISBN-13: 978-0853696599. $75.00. Available in ABC online store.

What a treat it was to review such a scholarly book on the very important science behind nutraceuticals! Finally, a nutraceuticals book on my shelf that is well-researched, timely, highly credible, and well written. The author, Brian Lockwood, PhD, a senior lecturer in pharmacy at the University of Manchester, dedicated this book to his father, also a pharmacist, who unfortunately died before the book was published. This book would have made him proud.

The aim of the book was to “explore, discuss, and possibly substantiate claims” for a great many natural dietary ingredients, frequently referred to as nutraceuticals. Hands down, Dr. Lockwood succeeded in doing that. If one were to attempt to create a new dietary supplement product and relied solely on this book as a guide, one would need little else. The book is intended for pharmacists, medical practitioners, nurses, and students of each discipline. Regrettably, the author does not mention dietitians, the category in which I belong, many of whom would also find it valuable.

The first 4 chapters are the least interesting to me. They provide a general overview of nutraceuticals and regulations. Unfortunately, some information is too out-dated to be meaningful. For example, data from the late 1990s were used to determine the percentage of the population using dietary supplements/nutraceuticals. Surely newer data are available. In this chapter and many others, the data presented were “Euro/ UK-centric.” Few statistics were germane to the markets or demographics in the United States. The second chapter felt very “pharmacist-like” to me—it had several drawings and discussions about structure and pharmacokinetics. Two dozen or so ingredients were reviewed and each had a corresponding “recommended dose range.” However, it was not clear how the references in that section led to these recommendations. It’s far better for the readers to go to the meat of the book (i.e., condition-specific chapters), where the actual recommendations of nutraceutical doses are supported by clinical studies. The third chapter deals with sources and manufacturing. Even though this was not of keen interest to me, the table included in this chapter was worth the price of the whole book. Dr. Lockwood listed commonly used nutraceuticals, their source (bovine, milk, conventional foods, etc.), manufacturing issues, their safety status (generally recognized as safe or GRAS), and analytical techniques. The “source” and GRAS columns were most valuable. The fourth chapter deals again with pharmacytype issues—more on bioavailability and pharmacokinetics. For me, the outcome of clinical studies reviewed in the remaining chapters is more important than these types of issues.

Now to the good stuff: chapters 5–18 address specific conditions. Topics include joint disease, heart-health, sleep, sports, bone health, and so forth. Each are superbly researched and well presented. Nearly every major study is cited for each nutraceutical ingredient. The only two I could not find were the age-related eye disease study (AREDS) for eye health and the GISSI-Prevenzione study for heart health. The only shortcoming is that each chapter does not end with a summary table of the clinical trials and the effective dose of the nutraceuticals reviewed. Busy clinicians may find it difficult to cull through the dense material in order to find the correct amount to recommend of a certain supplement.

Dr. Lockwood consistently updates information found in the previous edition and includes many more studies on tea (Camellia sinensis, Theaceae) and soy (Glycine max, Fabaceae), as publications on these 2 highly popular ingredients have increased the most since the first edition published in 2002. Unfortunately, many of the tearelated studies were conducted on subjects drinking tea rather than taking it as a capsule. In keeping with the scientific rigor of the book, it is difficult to match the dose of tea from cupfuls of liquid to a solid pill form.

Two chapters, on cancer and osteoporosis, were particularly thorough. The first included an excellent review of how commonly-known supplements (e.g., melatonin, conjugated linoleic acids [CLA]) affect cancer risk. For bone health, Dr. Lockwood presents the relevant science behind L-carnitine and CLA. The chapter on weight loss was the weakest of the condition-specific chapters. It included only a few of the plethora of nutraceuticals touted for weight loss. Reviewed are DHEA (dehydroepiandrosterone), green tea, carnitine and CLA. Surely others are available (e.g., hydroxycitric acid [HCA], chromium, Hoodia gordonii [Asclepiadaceae], etc.) and should have been included, even if data weren’t favorable to promote weight loss. Also missing was any substantial discussion of drug/supplement interactions. In my view, this important subject belongs in the chapter on synergies.

There was some overlap, though that is to be expected. Information on Omega-3s, soy, and tea appeared in many chapters, but the author was careful to review only the relevant studies that relate to the chapter theme. Similarly, a discussion of metaanalysis—a statistical review of pooled trials—has its own chapter devoted to it, but also such reviews appear elsewhere when relevant.

In summary, to anyone who has anything to do with nutraceuticals—be it healthcare provider, product developer, or regulator— this book is a must-have. I look forward to subsequent updates of this scholarly work. Reading such a fine book on the subject of nutraceuticals makes me proud to work in this field.

—Stacey J. Bell, DSc, RD Nutritional Consultant Belmont, MA