Nutritional Outlook

Nutritional Outlook, May 2018

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■ NUTRITIONAL OUTLOOK 56 Men's Health MAY 2018 "Beta-sitosterol is gaining in popularity right now," she adds. "More research is need- ed, which is dif cult with natural products because funds are limited. But over time, I see the men's health supplement market be- coming more comprehensive. Prorox looks at prostate enlargement, but also androgens, nutrition, and other factors. We need to move the public toward a more comprehen- sive understanding of health issues. Exercise helps to raise testosterone in men, which wards of certain health problems." Probiotics Now Entering the Prostate Health Space For many years, "prostate supplements" typi- cally meant "herbal supplements." But now, other kinds of ingredients are gaining noto- riety in combination with other longstand- ing prostate health ingredients. Dan Souza, health and nutrition category manager for Naturex (Avignon, France), says that pro- biotics are now entering the men's health category and being used in interesting com- binations with existing prostate-health in- gredients. For instance, Souza says, Naturex recently launched a version of its patented Flowens full-spectrum cranberry powder "that is optimized for use in combination with probiotics." "T e low-water-activity formulation re- sults in better shelf stability for the probiot- ics, and when consumed, the microbiome- accessible phytochemicals in combination with targeted probiotics may deliver syner- gistic benef ts," he says. He adds that ingre- dients like these also avoid the supply chain challenges facing some more traditional prostate health ingredients like saw palmet- to. He notes that maintaining an adequate supply of saw palmetto continues to be an issue for the prostate health industry, and that saw palmetto faces both cost challenges and a growing risk of adulteration as supply- management struggles continue. T is is why, he says, the industry is now sourcing dif er- ent botanicals, like cranberry. Naturex's Flowens, made from cranberry fruit powder, has been shown in clinical tri- als to reduce LUTS symptoms in men, mak- ing cranberries a good candidate for men's health and prostate health formulations. One randomized, double-blind, placebo- controlled clinical trial followed 124 men be- tween the ages of 45 and 70 for six months. All participants were assessed using the In- ternational Prostate Symptom Score (IPSS) at zero, three, and six months. At the outset of the study, all participants scored between 8 and 19 on the IPSS, indicating that they all had moderate prostate symptoms. During the study, participants took a once-daily dose of Flowens at either a con- centration of 250 mg or 500 mg, or a placebo. After six months, all groups saw reductions in their IPSS rating, but the 250-mg and 500- mg Flowens groups saw reductions in their IPSS ratings of 3.1 and 4.1 points, respective- ly, while the placebo group saw a reduction of only 1.5 points. 5 "In their report, the study authors noted that this level of reduction is considered to be clinically relevant under guidelines produced by the American Urological Association," Souza notes. Flowens has also been awarded six health claims from Health Canada, he adds. Saw Palmetto Extract as Bioactive as Drug? Research on saw palmetto has historically been mixed. While saw palmetto's ef cacy has been called into question by reviews and studies published in The Journal of the American Medical Association 6 , among other journals, a recent study was much more pos- itively in favor of saw palmetto. T is study demonstrated that saw palmetto was as ef- fective as the prescription drug f nasteride at relieving the symptoms of enlarged prostate. T e in vitro study examined the ef cacy of both Euromed's (Presto, PA) branded saw palmetto extract supplement Prosterol and of generic drug f nasteride at inhibiting 5-alpha-reductase. Finasteride's therapeutic ef ects for enlarged prostate are partly due to the drug's ability to inhibit 5-alpha-reduc- tase. T e study found that a 10 microgram per milliliter dose of the saw palmetto extract resulted in a 91% mean inhibition of 5-alpha- reductase expression. A similar 8-nanometer dose of f nasteride resulted in only an 82% mean inhibition, the researchers said. 7 T e study also found that Euromed's saw palmetto extract acted through the same mechanisms as f nasteride and was as ef ec- tive as other industry-leading saw palmetto extracts at inhibiting 5-alpha-reductase, but without involving the harsh solvent hexane. In a press release, Euromed said that its saw palmetto ingredient also of ers sev- eral benef ts due to its roots as a supple- ment ingredient. "No doctor's prescription is necessary to obtain a proven bioactive prostate health dietary supplement; it spares the expense of the medical prac- titioner's fees; it spares the high costs of prescription drugs; and, most importantly for health, it eliminates exposure to drug- related side ef ects." Euromed's Director of U.S. Sales, Guy Woodman, says that Euromed recently completed construction of a new laboratory facility in Barcelona. New analytical equip- ment will improve quality-control measures related to Euromed's saw palmetto extract, an important step that Woodman says is necessary on the heels of 2016's saw palmet- to shortage. DRUG-SUPPLEMENT INTERACTIONS: CONSUMER SAFETY REMAINS A PRIORITY Prostate health supplements are a popular remedy for men who are facing age-related prostate diffi culties. But the jury is still out on whether it is safe for men who are taking certain prescription medications to also take prostate supplements. According to Harvard Medical School's health publishing division, herbal remedies like saw palmetto may interact with drugs like naproxen or anticoagulants to increase the risk of bleeding in men with benign prostatic hyperplasia. 10 However, many of the con- cerns around saw palmetto and its interactions with prescription drugs stem from isolated case reports and experimental studies of unknown clinical relevance. 11 Further research is needed to clarify the mechanisms of interaction, if they exist, and to determine whether or not saw palmetto causes interactions with antiplatelets, anticoagulants, or NSAIDs.

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