Functional Foods and Chronic Disease: Role of Sensory, Chemistry and Nutrition

By Michel Aliani and N.A. Michael Eskin

Functional Foods and Chronic Disease: Role of Sensory, Chemistry and Nutrition explores the range of functional foods that are effective against a wide range of chronic diseases and addresses the impact of functional food bioactive compounds on organoleptic properties. Beginning with an introduction that details the key sensory and advanced instrumental methods essential for addressing the common problems associated with designing functional foods, the book also addresses the impact of aging and chronic diseases on sensory acuity as well as the effectiveness of functional foods in treating a wide range of chronic diseases.

Sections highlight the need for acceptable functional foods for individuals suffering from a wide range of chronic diseases and contain practical recommendations for their development. Food scientists, nutritionists, dietitians, food product developers, food supplement producers, food ingredient developers, natural product scientists, herbalists, and pharmacists, as well as students studying related areas, will benefit from this important resource.

• Highlights the need for acceptable functional foods for individuals suffering from a wide range of chronic diseases
• Includes case studies, applications, literature reviews, and a summary of recent developments in the field
• Provides suggestions for improving the organoleptic properties of functional foods

• Language: English
• Publisher: Academic Press
• Release date: Mar 20, 2024
• ISBN: 9780323972666

Book preview

Preface

The current state of health of the world's population, particularly in developed countries, is at a perilous level. The COVID-19 pandemic not only pointed out the high obesity levels among adults but also the alarming level of childhood obesity. Such obesity, particularly in adults, leads to a variety of chronic diseases, while diabetes type 2 is predominant among obese children.

Chapter 1 of this book covers functional foods and the major chronic diseases prevalent in North America and globally. Chapter 2 presents the protocols, including sensory methods, to ensure the acceptability and efficacy of functional foods when designing human clinical studies. Chapter 3 covers the impact that aging and chronic diseases have on sensory acuity. Chapter 4 compares the effectiveness of hempseed and flaxseed diets in preventing cardiovascular disease. Chapter 5 is a systematic review and meta-analysis of functional foods and their ability to treat patients with diabetes. Chapter 6 is a detailed review of the effectiveness of functional foods and their nutraceuticals against cancer. Chapter 7 highlights those bioactives in foods that can delay the progression and complications associated with chronic kidney disease. The ability of functional foods to alleviate symptoms, improve stool consistency, and gut microbiota in adult celiacs is covered in Chapter 8. The growing interest in nutraceuticals and functional foods in treating fatty liver disease is discussed in Chapter 9. The role of diet, functional foods, and the microbiome in treating gout is the subject of Chapter 10. Chapter 11 examines the effect of omega-3 fatty acids on Parkinson's disease behavioral and neuropathological abnormalities. The beneficial effect of the Mediterranean diet in reducing the progression of Alzheimer's and related diseases is discussed in Chapter 12. The last Chapter 13, discusses the beneficial effects of an anti-inflammatory functional food diet in reducing the severity and progression of autism spectrum disorder and schizophrenia.

We hope this book provides important information to food scientists, nutritionists, and medical researchers studying the efficacy of functional foods and their nutraceuticals. There is an urgent need to reduce obesity and its associated chronic diseases and find more effective and safe ways to treat these conditions worldwide. We are grateful to the experts from around the world for their important contributions and acknowledge the excellent editorial assistance by the staff of Elsevier/Academic Press.

Michel Aliani and Michael N.A. Eskin

Chapter 1

Functional foods and chronic diseases prevalent in North America and globally

Erin Goldberga, Donna Rylanda, Michael N.A. Eskina, and Michel Aliania,b

a Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada

b Albrechtsen Research Center, St. Boniface Hospital, Winnipeg, MB, Canada

1.1 Introduction

A chronic disease, as defined by the Center for Disease Control and Prevention (CDC), is one that is persistent and affects individuals over a long period of time. It can be hereditary or caused by inferior living conditions such as poor nutrition, a sedentary lifestyle, as well as from the extensive use of tobacco or other harmful substances including alcohol. According to the CDC, 60% of adults in the United States suffer from one chronic disease while 40% have two or more (Buttorff et al., 2017). Such chronic diseases require continued medical attention and impair the daily lives of many millions of citizens. The leading cause of death and disability in Canada and the United States is heart disease, diabetes, and cancer, which together with other chronic diseases are responsible for the astronomical annual health costs of just under four trillion dollars annually. Such health costs beset the economies of the other developed and less developed countries around the world. Consequently, efforts to ameliorate the impact of chronic diseases will help to reduce the financial burden as well as the suffering of billions of people around the globe.

In light of the COVID-19 pandemic, it has become even more apparent that these underlying conditions put individuals with chronic diseases at a higher risk of complications and poorer outcomes. Therefore, minimizing these underlying conditions through functional food use has the potential to provide protective effects. While the COVID-19 pandemic has impacted countries globally, it is anticipated that the increased awareness of the ability of nutrients to enhance the immune system will further expand the functional food market once the pandemic is over. For example, during the pandemic, clinical records showed the beneficial effects of vitamin D on patients suffering from COVID-19 (Grant et al., 2020). Based on the number of studies relating the infectivity and severity of COVID-19 with vitamin D status, the potential of vitamin D supplementation for primary prevention or as an adjunctive treatment of COVID-19 appeared promising (Charoenngam et al., 2021). Dror et al. (2022) recently reported that patients with a vitamin D deficiency (<20 ng/mL) were 14 times more likely to suffer severely or critically from COVID-19 compared to patients with higher levels of vitamin D (>40 ng/mL). The current recommendation for vitamin D in the USA and Canada established by the Standing Committee on Dietary Intake in 1977 suggested that adults over 50 years of age should consume 400 IU/day. A similar level was also recommended in the UK. Based on the latest evidence, however, this level is clearly inadequate and Griffin et al. (2020) proposed a new level of 800–1000 IU/day for the general population. Bae and Kim (2020) recommended that nutrition therapy such as boosting the immune system with vitamin D, vitamin C, and selenium should be part of patient care for those suffering from COVID-19.

1.1.1 Functional foods

The concept of functional foods originated in Japan. Following World War II, the Japanese diet became Westernized resulting in increased deaths from heart disease that mirrored the deaths reported in Europe and North America. Such increases in heart disease, high blood pressure, hypertension, osteoporosis, diabetes, and cancer in Japan were attributed to dramatic changes in both lifestyle and dietary habits (Japanese Ministry of Health and Welfare, 1985). In an effort to reduce and prevent the development of such lifestyle-related diseases and mitigate future escalating healthcare costs, the Japanese Ministry of Health introduced The Food for Specified Health Use (FOSHU) system. The foods included in this category all had documented health benefits, particularly important for Japan's aging population (Hasler, 2002). Such foods bore a special seal because of their health properties and were identified as functional foods. These foods, by definition, promoted well-being and reduced the risk of chronic diseases. Shahidi (2012) defined functional foods as products resembling traditional foods that had clearly demonstrated physiological benefits. The foods in this category include a wide range of plant and fish products as well as fermented foods (Hasler, 2002; Mitsuoka, 2014; Birch and Bonwick, 2019).

To optimize health, consumers are actively pursuing holistic solutions to mitigate chronic diseases (Khan et al., 2013), which are defined as conditions that persist for a minimum of 1 year, requiring ongoing medical attention and/or limiting activities of daily living. As a result, the market segment in functional food products has grown at an annual rate of 10%. In 2020, prior to the pandemic, the global functional food market was worth $192 billion US dollars (Euromonitor, 2016). Diet is now considered to be closely linked to a variety of diseases, particularly age-related chronic diseases (Manach et al., 2017; Padayachee et al., 2017; Shlisky et al., 2017). As a result, functional food research has expanded significantly since 2006 with the number of peer-reviewed publications on functional foods increasing by over 350% (Fig. 1.1). The prominence of this area of research is further evident by the number of journals and academic books on functional foods and nutraceuticals. The global impact of the pandemic has been made worse by the declining health of the world's population. Cava et al. (2021) described it as a confluence between two pandemics, obesity, and COVID-19. Estimates by the National Health and Nutrition Examination Survey in 2017–2018 indicated that 42.5% of US adults aged 20 are obese with 9% severely obese. Such individuals have a 46% higher risk for COVID-19 infection and twice the risk for hospitalization (Popkin et al., 2020). The majority of these individuals generally suffer from one or more chronic diseases, which greatly increases the severity and complications of COVID-19 (Dietz and Santos-Burgoa, 2020).

Figure 1.1 The bibliometric data were obtained using the Scopus database from 2006 to 2018 (to date), the index search terms were functional food AND " in vitro AND clinical studies": Exclusion criteria were theses, book chapters and conference proceedings. From Birch and Bonwick (2019)

While functional foods have no regulatory identification in the United States, the National Academy of Science's Food and Nutrition Board in the United States defined them as "any modified food or food ingredient that may provide health benefits beyond the traditional nutrients it contains" (Committee on Opportunities in the Nutrition and Food Sciences, Food and Nutrition Board, Institute of Medicine, 1994). Another definition by the International Life Sciences Institute in the United States proposed them as foods that, by virtue of the presence of physiological-active components, provide a health benefit beyond basic nutrition (International Life Sciences Institute, 1999). In 1989, the term nutraceutical was introduced by the Foundation of Innovation in Medicine as "the specific bioactive component in the particular functional food that contributes the specific health benefit" (DeFelice, 1992). An early review of nutraceuticals, their history and status were presented by Andlauer and Furst (2002). In a more recent review by Santini et al. (2018) they emphasized the need for a proper and unequivocal definition of nutraceuticals as they fall in the grey area between pharmaceuticals and foods. Consequently, legislation was needed to ensure their safety and health claim substantiation.

The Bureau of Nutritional Sciences of the Food Directorate of Health Canada proposed the following definition for functional foods in the late 1990s as "foods similar in appearance to, or maybe, a conventional food, consumed as part of a usual diet, and is demonstrated to have physiological benefits and/or reduce the risk of chronic disease beyond basic nutrition functions".

In Europe, functional foods were described by the following statement "a food product can only be considered functional if together with basic nutritional impact it has beneficial effects on one or more functions of the human organism either improving the general and physical conditions or/and decreasing the risk of the evolution of diseases" (Diplock et al., 1999; Siro et al., 2008). Other definitions for functional foods were also proposed by the Institute of Food Technologists (Clydesdale, 2004) and the American Dietetic Association (ADA) (American Dietetic Association, 1999; Hasler, 2002; Hasler and Brown, 2009).

In recognition of the need for a formal definition of functional foods, the 17th International Conference of the Functional Foods Centre organized jointly by the United States Department of Agriculture (USDA) and the Agricultural Research Service (ARS) developed the following definition, "natural or processed foods that contain known or unknown biologically active compounds, which, in defined effective non-toxic amounts, provide a clinically proven and documented health benefit for the prevention, management, or treatment of chronic disease" (Martirosyan and Singh, 2015). This definition highlighted, for the first time, that functional foods can be natural or processed. Secondly, functional foods contain bioactive compounds, that may act synergistically to improve health. Thirdly, certain, and nontoxic amounts of these bioactive compounds must be consumed for the functional food to be effective.

Whichever definition is chosen, functional foods are vastly different from both pharmaceuticals and nutraceuticals, which deliver therapeutic doses of active ingredients in the form of pills or capsules. The terminology and definition of functional foods are inconsistent worldwide, due to the lack of international standards for regulating functional foods to serve as baselines. Moreover, there are no regulations dealing specifically with functional foods. In Canada, all foods and drugs fall under the provisions of the Food and Drugs Act and regulations. Functional foods are clearly foods, not drugs, and cannot cure a chronic disease.

1.2 Chronic diseases

1.2.1 Cardiovascular disease

Cardiovascular diseases (CVDs), primarily ischemic heart disease (IHD) and stroke, are the major cause of global mortality and disability. They are responsible for approximately one-third of all reported deaths worldwide (Mozaffarian et al., 2016). The number of CVD cases doubled since 1990 reaching 523 million worldwide in 2019 with CVD deaths accounting for 18.6 million (Roth et al., 2020). Ischemic heart disease (IHD), also referred to as coronary heart disease (CHD) remains the leading cause of death globally (Khan et al., 2020). Over the past half a century, significant progress has been made in the US to decrease the burden of premature heart disease deaths. However, an increase in such risk factors as hypertension, obesity, and diabetes, have stalled this trend and may reverse any of the gains made so far (Ritchey et al., 2020). Consequently, cost-effective policies and interventions are urgently needed to achieve a 30% reduction.

1.2.2 Diabetes

Wild et al. (2004) estimated the prevalence of diabetes by age and sex from data obtained from a limited number of countries and extrapolated it to the 191 WHO member states. They estimated that 2.8% of all age groups in 2000 will be living with diabetes with a global projection of 4.4% by 2030. However, these levels were far too low, as the global prevalence of diabetes in 2019 was estimated by Saeedi et al. (2019) to be 9.3% (463 million) of the world's population rising to 10.2% (578 million) by 2030 and 10.9% (700 million) by 2045. Type 2 diabetes is the predominant form of the disease and accounts for approximately 90% of the total. Saeedi et al. (2019) also pointed out that one out of two people are unaware that they even have the disease. It is obvious that the incidence of diabetes must be significantly reduced, otherwise health care systems around the world will be overwhelmed.

1.2.3 Cancer

Cancer remains a leading cause of death worldwide and is responsible for more than three-quarters of 20.4 million premature deaths of individuals between 30 to 70 years of age (Bray et al., 2021). Global statistics on the incidence and mortality from 36 cancers in 185 countries were published by Sung et al. (2021). Of the approximate 19.3 million new cancer cases recorded in 2020 over half the deaths (58.3%) occurred in Asia where 59.3% of the global population resides, while Europe and America accounted for 19% and 14.2% of cancer-related deaths, respectively. Female breast cancer was reported to be the most commonly diagnosed cancer followed by lung (11.4%), colorectal (10.0%), prostate (7.3%), and stomach (5.3%) cancers. Recent trends suggest that cancer may surpass CVD as the leading cause of premature deaths in most countries over the next century (Levi et al., 1999; Non-Communicable Disease (NCD) Countdown, 2020).

1.2.4 Chronic kidney disease

Chronic kidney disease (CKD), an age-related decline in renal function, is accelerated by hypertension, diabetes, obesity, and primary renal disorders (Gansevoort et al., 2013). A systematic review and meta-analysis by Hill et al. (2016) revealed that a high global prevalence of the disease was between 11% and 13% with the majority at stage 3. CKD, a global burden, was responsible for 1.2 million deaths in 2017 with the rate of mortality increasing by 41.5% between 1990 and 2017 (Vos and Bikbov, 2020). The number of people undergoing renal replacement therapy exceeded 2.5 million and is projected to double to 5.4 million by 2030. Slowing down the progression of CKD at an early stage not only has economic benefits but also prevents progression to end stage kidney disease (ESKD) and cardiovascular complications (Kidney Disease: Improving Global Outcomes (KDIGO), 2012; Trivedi et al., 2002).

1.2.5 Celiac disease

Celiac disease (CD) is an autoimmune disease found in genetically susceptible individuals exposed to dietary gluten (Lionetti and Catassi, 2011). While it was relatively uncommon several decades ago, CD has become a major health problem, particularly among Caucasians. The incidence of CD, however, has also been reported in the Middle East and India. The global prevalence of CD was considered to be around 1%, and a systematic review and meta-analysis by Singh et al. (2018) found the worldwide prevalence of CD was 1.4% and 0.7%, based on serological test and biopsy results, respectively.

1.2.6 Fatty liver disease

Chronic liver disease (CLD), a major cause of mortality and morbidity, increased worldwide by 40% from 1980 to 2010 (Marcellin and Kutala, 2018). Nonalcoholic fatty liver disease (NAFLD) is strongly associated with obesity as its prevalence is approximately the same rate as obesity. Around 13% of the world's adult population is obese with the largest number in the United States followed by China (Sayiner et al., 2016). NAFLD, in particular, has become a major problem in mainland China due to the unhealthy lifestyle of its aging and growing population. A combination of physical inactivity and consumption of calorie-dense foods has led to a rapid increase in metabolic diseases such as NAFLD (Sarin et al., 2020). The overall prevalence of NAFLD in mainland China was 20% or over 240 million of its citizens (Li et al., 2019). This number suggests that globally, one-fifth of those suffering from NAFLD reside in Asia (Li et al., 2019). As a result, China surpasses both Europe and the United States with the largest number of people suffering from NAFLD (Nan et al., 2021). Because of the prevalence of NAFLD in China, an international consensus recommended a change in its name from NAFLD to metabolic (dysfunction)-associated fatty acid liver disease (MAFLD) (Nan et al., 2021). MAFLD is now the official term for describing fatty liver disease because of its association with metabolic dysfunction. A subtype of NAFLD (or MAFLD) is nonalcoholic steatohepatitis (NASH) which can lead to cirrhosis, carcinoma, liver transplantation and death (Younossi, 2019). Patients with NASH are at a high risk for liver-related mortality and are candidates for liver transplantation worldwide (Sayiner and Younossi, 2019).

1.2.7 Gout

Gout, the most common form of inflammatory arthritis, is characterized by elevated levels of serum uric acid (SUA). When the level of uric acid surpasses the saturation point, monosodium urate (MSU) crystals form which are deposited predominantly in peripheral joints and surrounding tissue (Kuo et al., 2015). The long-term effects are joint damage and disfiguring subcutaneous tophi, the latter a pathogenic feature of chronic gout. Gout affects both longevity and well-being and is becoming recognized as an independent risk factor for cardiovascular disease (So, 2010). In their review of gout, Kuo et al. (2015) commented on its substantial global burden which has been increasing globally over the past 50 years. A recent review by Dehlin et al. (2020) noted that the prevalence and incidence of gout varied widely with the populations studied and ranged from <1% to 6.6% affecting 0.58–2.89/1000 persons per year. More men than women suffer from gout, which increases with age and in some ethnic groups. Treatment is somewhat variable with only a third to a half of patients suffering from gout taking urate-lowering medications with less than half adhering to the treatment. Obesity, diet, and comorbid conditions are among the many risk factors for gout, which increases the risk for cardiovascular and chronic kidney diseases.

1.2.8 Parkinson's disease

Parkinson's disease is the second most common neurodegenerative disease that affects 1%–3% of the adult (65+) population (Beitz, 2014). It is a progressive degeneration disease that cannot be stopped or slowed down. It was first described in the 1800s and today nearly 60,000 new cases are diagnosed every year (Sherer et al., 2012). It is 1.5 times more likely to occur in men compared to women with 7–10 million people affected worldwide. The most effective medication is L-DOPA and related dopamine agonists that can compensate for dopaminergic neuron loss. There is no cure or disease-modifying treatment available for Parkinson's disease, however, supplementation with omega-3 fatty acids, vitamin D, B vitamins and coenzyme Q may play a role in the management of this disease (Lange et al., 2019).

1.2.9 Alzheimer's disease and dementia

Alzheimer's disease (AD) and dementia are becoming major global health challenges. Dementia, in particular, is expected to quadruple over the next 40 years with 1 out of 85 people worldwide affected by this disease (Brookmeyer et al., 2007). Using meta-analysis, Gao et al. (2019) reviewed 38 articles with 53 cohorts on the incidence of dementia and 35 articles with 35 cohorts on the incidence of AD. A significant association was observed between later birth dates and the decreased incidence of dementia for age groups 65–74, 75–85, and >85 while no significant associations were observed for AD in any of the different age groups. The AD rates in non-Western countries, however, only showed a significant increase in the 65–74 age group. The specific etiology and risk factors associated with AD are urgently needed in order to mitigate the devastating impact of this disease (Jack et al., 2018).

1.2.10 Autism and schizophrenia

Autism spectrum disorder (ASD) is a complex developmental disorder in which social interaction and communication are impaired by restrictive and repetitive behavior (Catala-Lopez et al., 2019). While detected in early childhood, it is generally not diagnosed until much later. According to WHO (2020), the global incidence of ASD is 1 out of 160 children. An estimated 62 million cases of ASD were recorded worldwide in 2016 with a prevalence of 0.83% (Gialloreti et al., 2019). Schizophrenia is a complex mental disorder that develops in late adolescence or early adulthood. Charlson et al. (2018) estimated that 21 million people live with schizophrenia worldwide and this number is expected to increase as the population ages. A greater understanding of the destructive and overlapping features of ASD and schizophrenia is required to mitigate their clinical, cognitive, and neurobiological effects (Pina-Camacho et al., 2022).

1.2.11 Functional food study workflow

The workflow in Table 1.1 serves as a guide for completing an effective functional food study. Several critical steps have been outlined for a step-by-step and progressive guide to a successful functional food study. The different stages of functional food development need to be carefully monitored to ensure a final acceptable product. Methodologies used for sensory evaluation of functional foods are similar to other types of foods. However, the addition of some functional ingredients such as peptides might have a sensory impact. This topic is explored in more detail in Chapter 2. Some additional instrumental analysis using an electronic nose and electronic tongue is of particular interest if performed alongside human panels. The correlation between human-generated results and any other instrumental counterpart might facilitate the exclusion of repetitive tasks and provide an easier tool to monitor key volatile and/or taste compounds of interest.

Table 1.1

As stated in the second step of the workflow, the assessment of the functionality of the final developed food is essential to any functional food study. These assessments are needed in relevant cell cultures (Defries et al., 2022), proper animal models (Hanson et al., 2018), and finally, the assessment of these foods in human subjects (Edel et al., 2015) to guarantee the efficacy of the developed foods. Tests such as blood pressure measurements, electroretinography, and blood lipid profile may confirm the potential beneficial effects of functional foods.

Since it is rare that all these models are being used by the same research team, collaborative research is recommended to guarantee success. The choice of proper control food and control cells/animals and humans are extremely important for the final validation of the results. The low statistical power of human trials is usually a major weakness of these studies, an area that needs to be addressed.

Metabolomics is an ideal tool to investigate the effect of any known compound/bioactive/drug etc., on a set of metabolites and should be considered in functional food studies. In addition, the chemical structure of the bioactive compounds will likely be altered during metabolism by the liver (Edel et al., 2013) and therefore the identification of the modified bioactive compounds, destiny, and effects are also crucial to our understanding of how functional foods are effective to promote health and/or prevent chronic diseases.

The same way that different drugs can interact in the body, drugs can also interact with nutrients, and/or bioactive compounds. This drug–nutrient interaction should also be considered as these effects may have either detrimental or beneficial results/effects. In a recent study, the interaction between drugs such as metoprolol (antihypertensive) and metformin, and bean consumption in patients with peripheral artery disease has been demonstrated (Wang et al., 2022).

Once the functionality of the developed food is established (Step 2), it is critical that we understand how these bioactive compounds affect the rest of the metabolic pathways and identify other potential benefits and/or side effects (Step 3). Targeted analytical approaches are necessary to determine the effect of the studied functional food on potential target(s) (e.g., cholesterol, fatty acids, glucose, HbA1C, insulin, nitric oxide, bile acids) and potential biochemical pathways such as glycolysis and TCA cycle. These targeted analyses may be correlated to other physical and clinical measurements related to the chronic disease studied such as blood pressure, VO2 max test, vascular measurements, etc. In addition to a targeted analytical approach, which is commonly practiced in basic and medical research, nontargeted approaches are also recommended. The nontargeted approach is taking advantage of powerful existing technology in omics fields such as genomics, transcriptomics, proteomics, and metabolomics to screen thousands of known genes, RNA, proteins, and metabolites to provide a more complete picture of potential effects of the studied functional food on a vast array of targets. In most cases, these studies are considered to generate new hypotheses rather than testing any specific one. Metabolomics may be used to explore all compounds found in the studied food and to investigate their presence in physiological fluids in animal and clinical studies. Consistent with pharmacological studies, the dosages and kinetics of bioactive compounds should be investigated using these powerful techniques. For human trials, acceptability testing of the functional foods is strongly advised using the same approach outlined for consumers in Step 1 (similar questionnaire, scale, order of presentation, functional food products, etc.) (Ryland et al., 2018; Santiago et al., 2019; Fahmi et al., 2022). This enables a new dataset to be generated to understand statistical differences between different populations (consumer vs. clinical participants), and in different settings (sensory evaluation unit vs. clinic/hospital). Differences in motivations for participating in these two acceptability tests will be important for subsequent steps in the development workflow.

Functional food development should also consider the context of the regulatory environment which will vary in the country where the food is sold or marketed (Step 4).

1.3 Conclusion

The consumption of functional foods, unlike drugs, bears a minimal risk for potential side effects. However, they represent one management strategy for mitigating the impact that chronic diseases have on the healthcare system. This book provides a detailed discussion of the latest research on the efficacy of functional foods and nutraceuticals for the treatment of the world's major chronic diseases. The functional foods and bioactives covered in this book are listed in Table 1.2. While they are important in the fight against chronic disease development, they must be palatable enough to ingest on a regular basis. For this reason, sensory analysis including consumer acceptability (discussed in detail in Chapter 2) is critical for the successful development of any functional food. This book also examines the impact of aging and chronic diseases on sensory acuity (Chapter 3) as well as analytical and sensory methods for assessing the benefits provided by functional foods and nutraceuticals.

Table 1.2

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