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International Journal of Clinical Case Reports 2024, Vol.14, No.6 http://medscipublisher.com/index.php/ijccr © 2024 MedSci Publisher, registered at the publishing platform that is operated by Sophia Publishing Group, founded in British Columbia of Canada. All Rights Reserved. MedSci Publisher is an international Open Access publisher specializing in clinical case, clinical medicine, new variations in disease processesregistered at the publishing platform that is operated by Sophia Publishing Group (SPG), founded in British Columbia of Canada. Publisher MedSci Publisher Editedby Editorial Team of International Journal of Clinical Case Reports Email: edit@ijccr.medscipublisher.com Website: http://medscipublisher.com/index.php/ijccr Address: 11388 Stevenston Hwy, PO Box 96016, Richmond, V7A 5J5, British Columbia Canada International Journal of Clinical Case Reports (ISSN 1927-579X) is an open access, peer reviewed journal published online by MedSci Publisher. The journal is considering all the latest and outstanding research articles, letters and reviews in all aspects of clinical case, containing clinical medicine which advance general medical knowledge; the event in the course of observing or treating a patient; new variations in disease processes; as well as the expands the field of clinical relating to case reports. All the articles published in International Journal of Clinical Case Reports are Open Access, and are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. MedSci Publisher uses CrossCheck service to identify academic plagiarism through the world’s leading plagiarism prevention tool, iParadigms, and to protect the original authors’ copyrights.
International Journal of Clinical Case Reports (online), 2024, Vol. 14, No.6 ISSN 1927-579X http://medscipublisher.com/index.php/ijccr © 2024 MedSci Publisher, registered at the publishing platform that is operated by Sophia Publishing Group, founded in British Columbia of Canada. All Rights Reserved. Latest Content Research Progress on the Development and Clinical Application of Functional Foods Based on Food-Medicine Homology Zhenyuan Zhang, Lingjuan Wang, Xiangqian Fan International Journal of Clinical Case Reports, 2024, Vol. 14, No. 6, 299-311 Genetic Mechanisms and Clinical Significance of HPV16/18 Specific Variants in Cervical Cancer Haiyan Chen, Lei Yuan, Jia Zhou, Ailing Jia, Yuchen Zheng, Ke Li, Ye Qiu, Zhidong Qiu International Journal of Clinical Case Reports, 2024, Vol. 14, No. 6, 312-326 Antidiabetic Potential of Phytochemicals fromEucommia ulmoides Zongyue Chen, Yichen Zhao, Degang Zhao International Journal of Clinical Case Reports, 2024, Vol. 14, No. 6, 327-338 Study on the Application and Impact of Smart Health Devices in Community Care Mingzi Huang, Li Zhu, Yeli Huang International Journal of Clinical Case Reports, 2024, Vol. 14, No. 6, 339-350 The Current Status and Development Trends of Integrating Traditional Chinese Medicine (TCM) Constitution Identification with Modern Personalized Dietary Therapy Guangman Xu International Journal of Clinical Case Reports, 2024, Vol. 14, No. 6, 351-361
International Journal of Clinical Case Reports 2024, Vol.14, No.6, 299-311 http://medscipublisher.com/index.php/ijccr 299 Review Article Open Access Research Progress on the Development and Clinical Application of Functional Foods Based on Food-Medicine Homology Zhenyuan Zhang, Lingjuan Wang , Xiangqian Fan Yiwu Senyu Agricultural Technology Co., Ltd., Yiwu, 322000, Zhejiang, China Corresponding author: 18657909933@163.com International Journal of Clinical Case Reports 2024, Vol.14, No.6 doi: 10.5376/ijccr.2024.14.0030 Received: 03 Sep., 2024 Accepted: 06 Oct., 2024 Published: 02 Nov., 2024 Copyright © 2024 Zhang et al., This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Preferred citation for this article: Zhang Z.Y., Wang L.J., and Fan X.Q., 2024, Research progress on the development and clinical application of functional foods based on food-medicine homology, International Journal of Clinical Case Reports, 14(6): 299-311 (doi: 10.5376/ijccr.2024.14.0030) Abstract The concept of "food-medicine homology" (FMH) aligns with the modern demand for natural and health-promoting dietary options. This research article reviews the development and clinical application of functional foods based on FMH. The origin and evolution of FMH are explored, highlighting its integration into both traditional Chinese medicine and modern dietary practices. The study discusses the regulatory challenges and technological advancements in the development of functional foods, emphasizing the importance of bioactive ingredients such as probiotics, antioxidants, and polyunsaturated fatty acids. Clinical trials and efficacy testing are also examined, underscoring the unique challenges and potential of functional foods in preventive medicine, concludes with a call for accelerated research and innovation to fully realize the potential of FMH in modern functional foods. Keywords Food-medicine homology; Functional foods; Bioactive ingredients; Preventive medicine; Clinical application 1 Introduction The concept of "medicine food homology" (MFH) has its roots in traditional Chinese medicine (TCM), where certain foods are recognized for their dual role in providing nutrition and therapeutic benefits. This principle aligns with the modern demand for natural and health-promoting dietary options, reflecting a growing consumer interest in functional foods that support overall well-being (Hou and Jiang, 2013). The integration of MFH into contemporary functional food development represents a significant advancement in both food science and medicine, offering innovative solutions to enhance health through diet (Marotta et al., 2012). The increasing prevalence of chronic diseases and the limitations of conventional pharmaceuticals have further underscored the importance of functional foods, which can potentially reduce disease incidence and improve quality of life (Birch and Bonwick, 2019). This study employs a multidisciplinary approach, integrating insights from food chemistry, biology, nutrition, pharmacology, and statistics to explore the development and clinical application of MFH-based functional foods (Granato et al., 2017). The methodology includes a comprehensive review of existing literature, analysis of clinical trials, and evaluation of bioactive components in MFH materials. The study is structured to first provide an overview of the MFH concept and its historical context, followed by a detailed examination of the bioactive ingredients and their health benefits. The study discusses the technological advancements in functional food development, the challenges faced in clinical trials, and the future prospects of MFH-based functional foods (Hou and Jiang, 2013; Brown et al., 2018; Yuanyuan et al., 2023). This study elucidates the potential of MFH materials in the development of functional foods that can be integrated into daily diets to promote health and prevent diseases. This includes identifying and characterizing the bioactive compounds in MFH materials, understanding their mechanisms of action, and evaluating their efficacy through clinical trials. Additionally, the research aims to address the technical and regulatory challenges in the functional food industry, proposing strategies to enhance the bioavailability and consumer acceptance of these products. By bridging the gap between traditional knowledge and modern science, this study seeks to contribute to the advancement of functional foods and their role in public health.
International Journal of Clinical Case Reports 2024, Vol.14, No.6, 299-311 http://medscipublisher.com/index.php/ijccr 300 2 Concepts and Theoretical Foundation of Food-Medicine Homology Functional Foods 2.1 The formation and evolution of the "Food-Medicine Homology" concept The concept of "Food-Medicine Homology" (FMH) has its roots in traditional Chinese medicine (TCM), where the boundary between food and medicine is often blurred. Historically, many foods have been recognized for their medicinal properties, and this dual role has been documented in ancient texts. The idea is that certain foods can provide both nutritional benefits and therapeutic effects, thus promoting health and preventing disease. Over time, the FMH concept has evolved, integrating modern scientific research and technological advancements. This evolution has led to a more systematic understanding of how specific food components can influence physiological processes and contribute to disease prevention and management. For instance, recent studies have highlighted the role of FMH ingredients in regulating macrophage polarization, which is crucial in managing conditions like atherosclerosis (Huang et al., 2023). Similarly, the anti-inflammatory properties of walnut protein peptides in treating ulcerative colitis have been explored, demonstrating the potential of FMH foods in clinical applications (Hong et al., 2023). 2.2 Theoretical foundation of food-medicine homology functional foods The theoretical foundation of FMH functional foods is built on the principles of TCM, which emphasize the balance and harmony of the body's internal environment. This holistic approach considers the synergistic effects of various food components, rather than focusing on isolated nutrients or compounds. The FMH theory posits that foods with medicinal properties can modulate biological pathways and improve health outcomes. Modern research supports this theory by elucidating the mechanisms through which FMH ingredients exert their effects. For example, the regulation of macrophage polarization by FMH substances involves complex interactions with cellular signaling pathways, which can alter the microenvironment and reduce the progression of diseases like atherosclerosis (Huang et al., 2023). Additionally, the anti-inflammatory effects of walnut protein peptides in ulcerative colitis are mediated through the inhibition of the TLR4-MAPK pathway and the restoration of intestinal microbial balance (Hong et al., 2023). These findings underscore the potential of FMH functional foods to serve as both preventive and therapeutic agents, bridging the gap between nutrition and medicine. By integrating traditional knowledge with contemporary scientific research, the FMH concept provides a robust framework for developing functional foods that can enhance health and well-being. This approach not only aligns with the principles of TCM but also offers a promising avenue for addressing modern health challenges through dietary interventions. 3 Classification and Representative Ingredients of Food-Medicine Homology Functional Foods 3.1 Classification based on functions Functional foods can be classified based on their health benefits and the specific functions they serve in the human body. These classifications often include categories such as probiotics, prebiotics, and biogenics. Probiotics are viable microorganisms, such as lactobacilli and bifidobacteria, that improve the intestinal bacterial balance and overall gut health. Prebiotics, on the other hand, are nondigestible food ingredients like oligosaccharides and dietary fiber that selectively stimulate the growth of beneficial intestinal bacteria. Biogenics include biologically active peptides and plant flavonoids that modulate intestinal microbiota and enhance health through various mechanisms (Mitsuoka, 2014). Functional foods are also categorized based on their ability to enhance bioregulation, biodefense, disease prevention, and anti-aging properties. For instance, they can help manage stress, appetite, and nutrient absorption, boost immunity, and suppress allergies. They also play a role in preventing diseases such as diarrhea, constipation, cancer, and diabetes, and in slowing down aging processes by stimulating the immune system and reducing oxidative stress (Mitsuoka, 2014).
International Journal of Clinical Case Reports 2024, Vol.14, No.6, 299-311 http://medscipublisher.com/index.php/ijccr 301 3.2 Classification based on active ingredients Functional foods can also be classified based on their active ingredients, which are the bioactive compounds responsible for their health benefits. Common active ingredients include polyunsaturated fatty acids (PUFAs), probiotics, prebiotics, synbiotics, and antioxidants. These ingredients are incorporated into food products through various technological means to ensure their stability and efficacy (Granato et al., 2020; Xu et al., 2024). Polyphenols, terpenoids, flavonoids, alkaloids, sterols, pigments, and unsaturated fatty acids are some of the key active ingredients found in functional foods. These compounds are known for their antioxidant, anti-inflammatory, and cholesterol-lowering properties, which are particularly beneficial for managing chronic diseases like type 2 diabetes mellitus (T2DM) (Alkhatib et al., 2017). The Mediterranean diet, rich in fruits, vegetables, oily fish, olive oil, and tree nuts, serves as a model for functional foods due to its high content of these nutraceuticals (Alkhatib et al., 2017). 3.3 Detailed analysis of representative raw materials The concept of "medicine food homology" (MFH) aligns with the modern trend of returning to natural and green healthy living. MFH materials are a treasure trove of functional factors that can be utilized in the development of functional foods. More than 80 MFH materials have been approved by China's Ministry of Health, and their effective ingredients have been summarized in detail. These materials include a variety of herbs, fruits, and vegetables that have been traditionally used in Chinese medicine for their therapeutic properties. For example, ginseng is a well-known MFH material that has been extensively studied for its adaptogenic properties, which help the body resist stress and improve overall vitality. Ginseng contains active compounds called ginsenosides, which have been shown to enhance immune function, reduce inflammation, and improve cognitive performance (Hou and Jiang, 2013). Another representative MFH material is goji berries, which are rich in antioxidants, vitamins, and minerals. Goji berries have been used in traditional Chinese medicine to improve vision, boost immune function, and promote longevity. The active ingredients in goji berries, such as polysaccharides and carotenoids, contribute to their health benefits. Turmeric, a spice commonly used in Indian cuisine, is another example of an MFH material with significant health benefits. The active ingredient in turmeric, curcumin, has potent anti-inflammatory and antioxidant properties. Curcumin has been studied for its potential to prevent and manage chronic diseases such as cancer, cardiovascular diseases, and neurodegenerative disorders (Hou and Jiang, 2013). In addition to these traditional MFH materials, modern research has identified new resources that can be developed into functional foods. For instance, the utilization of vegetable and fruit by-products as functional ingredients is gaining attention. These by-products, such as seed coats, hulls, husks, peels, seeds, and pomace, are often discarded as waste but are rich in nutrients and bioactive compounds. Incorporating these by-products into functional foods can enhance their nutritional value and contribute to food sustainability. For example, the peels of fruits like apples and oranges are rich in dietary fiber, vitamins, and antioxidants. These peels can be processed and incorporated into bakery products, dairy products, and beverages to enhance their nutritional profile and provide additional health benefits. Similarly, the seeds of fruits like grapes and pomegranates are rich in polyphenols and can be used to develop functional foods with antioxidant and anti-inflammatory properties (Lau et al., 2021). The development and clinical application of functional foods based on food-medicine homology involve a comprehensive understanding of their classification based on functions and active ingredients. Representative raw materials, both traditional and modern, offer a wealth of bioactive compounds that can be harnessed to promote health and well-being. The integration of these materials into functional foods not only provides health benefits but also supports sustainable food production practices.
International Journal of Clinical Case Reports 2024, Vol.14, No.6, 299-311 http://medscipublisher.com/index.php/ijccr 302 4 Development Technologies and Processing Techniques of Food-Medicine Homology Functional Foods 4.1 Major development technologies The development of functional foods, particularly those based on the concept of food-medicine homology (FMH), involves a variety of advanced and traditional technologies. Traditional techniques have been the cornerstone of functional food development, focusing on the extraction and incorporation of bioactive compounds from natural sources. These methods include solvent extraction, fermentation, and enzymatic hydrolysis, which are widely used to isolate and enhance the functional properties of food ingredients (Betoret et al., 2011). Emerging technologies have significantly expanded the toolkit available for developing FMH functional foods. Nanotechnology, for instance, has revolutionized the field by improving the bioavailability, stability, and controlled release of bioactive compounds. Nanomaterials can enhance the delivery of nutrients and bioactives, ensuring that they remain effective throughout the food processing and storage stages (Nile et al., 2020). Additionally, network pharmacology has been proposed as a novel approach to study the complex interactions between food components and their health benefits. This method leverages multi-omics data to understand the multi-component and multi-target nature of FMH foods, providing a more comprehensive understanding of their therapeutic potential (Yuanyuan et al., 2023). 4.2 Novel formulation and product design The formulation and design of FMH functional foods require a multidisciplinary approach that integrates food science, nutrition, and pharmacology. One of the key challenges in this area is ensuring that the bioactive compounds retain their efficacy throughout the food processing and storage stages. This involves the careful selection of food matrices that can protect and stabilize these compounds. For example, the use of encapsulation techniques can help in protecting sensitive bioactives from degradation due to environmental factors such as light, heat, and oxygen (Sun-Waterhouse, 2011). Innovative product design also focuses on consumer acceptance, which is crucial for the success of functional foods. Factors such as taste, texture, and appearance play a significant role in consumer preferences. Therefore, the development process often includes sensory evaluation and consumer testing to ensure that the final product meets consumer expectations (Baker et al., 2021). Additionally, the concept of personalized nutrition is gaining traction, where functional foods are tailored to meet the specific health needs of different consumer groups. This approach not only enhances the efficacy of the functional foods but also increases their market appeal. 4.3 Stability and preservation of active ingredients The stability and preservation of active ingredients in FMH functional foods are critical for maintaining their health benefits. Various strategies are employed to enhance the stability of bioactive compounds during processing and storage. One such strategy is the use of natural antioxidants, which can protect bioactives from oxidative degradation. Additionally, the application of nanotechnology can improve the stability of these compounds by reducing their particle size and increasing their surface area, thereby enhancing their interaction with other food components (Nile et al., 2020; Pu and Cai, 2024). Packaging technologies also play a vital role in preserving the quality and efficacy of FMH functional foods. Advanced packaging solutions, such as active and intelligent packaging, can extend the shelf life of these products by controlling the internal environment and monitoring the quality of the stored foods. For instance, the use of nanosensors in smart packaging can provide real-time information about the freshness and safety of the food, thereby ensuring that the bioactive compounds remain effective until consumption (Nile et al., 2020). The development and processing of FMH functional foods involve a combination of traditional and advanced technologies aimed at enhancing the efficacy, stability, and consumer acceptance of these products. By leveraging these technologies, it is possible to create functional foods that not only meet the nutritional
International Journal of Clinical Case Reports 2024, Vol.14, No.6, 299-311 http://medscipublisher.com/index.php/ijccr 303 needs of consumers but also provide additional health benefits, thereby contributing to the overall well-being of the population. 5 Clinical Research Progress on Food-Medicine Homology Functional Foods 5.1 Review of existing clinical research outcomes The concept of "medicine food homology" (MFH) has gained significant traction in recent years, aligning with the modern demand for natural and health-promoting dietary options. MFH materials, which are recognized for their dual role as both food and medicine, have been extensively studied for their potential to contribute to functional foods. These materials are rich in bioactive compounds that offer therapeutic benefits, making them a valuable resource for developing functional foods aimed at improving health and preventing diseases (Hou and Jiang, 2013). Research has shown that functional foods, including those based on MFH principles, can play a crucial role in genomic medicine. For instance, fermented papaya preparation has been highlighted for its antioxidant properties and potential benefits in genomic medicine, suggesting its role in reducing disease incidence and supporting pharmacological treatments (Marotta et al., 2012). However, despite the promising potential, the development of MFH functional foods is still in its early stages, and there is a need for more comprehensive clinical trials to validate their efficacy and safety (Hou and Jiang, 2013; Birch and Bonwick, 2019). 5.2 Typical clinical research cases One notable clinical research case involves the use of fermented papaya preparation as a functional food. Clinical studies have demonstrated its significant antioxidant properties, which are attributed to its rich content of vitamins A and C, as well as certain amino acids. These properties have been linked to potential benefits in reducing oxidative stress and supporting healthy aging (Marotta et al., 2012). The integration of nutrigenomics in these studies has further highlighted the role of fermented papaya in modulating genetic and epigenetic interactions, leading to beneficial phenotypic changes. Another example is the application of network pharmacology in studying MFH materials. This approach has been used to explore the complex mechanisms of food bioactivity, drawing parallels with traditional Chinese medicine (TCM). Network pharmacology has provided insights into the multi-component and multi-target properties of MFH materials, demonstrating their potential in both nutritional and therapeutic contexts (Yuanyuan et al., 2023). 5.3 Application in chronic disease prevention and management The application of MFH functional foods in chronic disease prevention and management is a growing area of interest. Chronic diseases, such as diabetes, cardiovascular diseases, and neurodegenerative disorders, are major health concerns globally. Functional foods developed from MFH materials offer a promising strategy to mitigate these conditions through their bioactive components. For instance, the antioxidant properties of fermented papaya preparation have been shown to reduce oxidative stress, which is a common underlying factor in many chronic diseases. By modulating oxidative stress, these functional foods can potentially slow down the progression of diseases like Alzheimer's and cardiovascular diseases (Marotta et al., 2012). Additionally, the integration of functional foods into daily diets can help manage blood glucose levels, thereby aiding in the prevention and management of diabetes (Granato et al., 2017). The development of functional foods requires a multidisciplinary approach, integrating food chemistry, biology, nutrition, pharmacology, and statistics. This holistic strategy ensures that the health-promoting properties of MFH materials are thoroughly investigated and validated through rigorous clinical trials. Such an approach not only enhances the understanding of the therapeutic potential of these foods but also ensures their safety and efficacy for consumer use (Granato et al., 2017; Brown et al., 2018). The clinical research progress on MFH functional foods underscores their potential in promoting health and preventing chronic diseases. While significant strides have been made, there is a need for continued research and
International Journal of Clinical Case Reports 2024, Vol.14, No.6, 299-311 http://medscipublisher.com/index.php/ijccr 304 innovation to fully realize the benefits of these functional foods. Future studies should focus on comprehensive clinical trials, bioavailability assessments, and the development of new technologies to enhance the efficacy and consumer acceptance of MFH functional foods (Marotta et al., 2012; Hou and Jiang, 2013; Granato et al., 2017; Brown et al., 2018; Birch and Bonwick, 2019). 6 Safety and Standardization of Food-Medicine Homology Functional Foods 6.1 Safety evaluation of food-medicine homology products The safety evaluation of food-medicine homology (FMH) products is a critical step in ensuring that these functional foods are safe for consumer use. Given the dual nature of FMH products, which combine both nutritional and medicinal properties, rigorous safety assessments are necessary. These evaluations typically involve both preclinical and clinical testing phases. Preclinical testing often includes in vitro and in vivo studies to assess the potential toxicity, bioavailability, and pharmacokinetics of the active ingredients (Jones and Jew, 2007; Granato et al., 2020). Clinical trials are then conducted to confirm the safety and efficacy of these products in human subjects. Moreover, the safety of FMH products is also evaluated through the lens of traditional Chinese medicine (TCM) and modern pharmacology. TCM provides a historical context for the use of these products, while modern pharmacology offers a more detailed understanding of their mechanisms of action and potential side effects(Hou and Jiang, 2013; Yuanyuan et al., 2023). This dual approach ensures a comprehensive safety profile for FMH products, addressing both traditional and contemporary safety concerns. 6.2 Standardized production and quality control Standardized production and quality control are essential for the consistent efficacy and safety of FMH functional foods. The production process must adhere to stringent guidelines to ensure that the final product meets the required standards. This involves the use of high-quality raw materials, standardized extraction processes, and rigorous quality control measures (Jones and Jew, 2007; Granato et al., 2020). Quality control is particularly important in the context of FMH products, as the active ingredients can vary significantly depending on the source and processing methods. Advanced analytical techniques, such as high-performance liquid chromatography (HPLC) and mass spectrometry, are often employed to ensure the consistency and purity of the active ingredients (Figure 1) (Hou and Jiang, 2013; Alongi and Anese, 2021). Additionally, the development of a comprehensive database for FMH varieties can aid in the standardization process by providing a reference for the identification and quantification of active ingredients (Hou and Jiang, 2013). 6.3 Regulatory compliance and market entry Regulatory compliance is a significant hurdle for the market entry of FMH functional foods. Different countries have varying regulations regarding the approval and labeling of functional foods, which can complicate the market entry process. For instance, the European Union, the United States, and Japan each have distinct regulatory frameworks for functional foods, which include specific requirements for health claims and safety assessments (Kwak and Jukes, 2001; Bech-Larsen and Scholderer, 2007; Díaz et al., 2020). In the European Union, the regulatory framework is particularly stringent, requiring substantial evidence to support health claims. This often involves comprehensive clinical trials and detailed documentation of the product's safety and efficacy (Bech-Larsen and Scholderer, 2007; Birch and Bonwick, 2019). In contrast, the regulatory frameworks in the United States and Japan are somewhat more flexible but still require rigorous safety and efficacy data (Kwak and Jukes, 2001; Díaz et al., 2020). To navigate these regulatory landscapes, FMH product developers must engage in thorough documentation and compliance efforts. This includes compiling detailed dossiers that provide evidence of the product's safety, efficacy, and quality. Additionally, effective communication strategies are essential to educate both regulators and consumers about the benefits and safety of FMH products (Alongi and Anese, 2021; Baker et al., 2021). The
International Journal of Clinical Case Reports 2024, Vol.14, No.6, 299-311 http://medscipublisher.com/index.php/ijccr 305 safety and standardization of FMH functional foods involve a multi-faceted approach that includes rigorous safety evaluations, standardized production processes, and stringent regulatory compliance. By adhering to these guidelines, FMH products can achieve market success while ensuring consumer safety and trust. Figure 1 Insight into the integrated approach to the key technological steps, i.e., design and evaluation, of the Functional Food Development Cycle (Adopted from Alongi and Anese, 2021) 7 Market Status and Consumer Perception Analysis 7.1 Market overview of food-medicine homology functional foods The market for food-medicine homology (FMH) functional foods has seen significant growth in recent years, driven by increasing consumer awareness of the health benefits associated with these products. Functional foods, which include FMH products, are designed to provide additional health benefits beyond basic nutrition. This market segment has expanded rapidly, particularly in regions such as the USA, Japan, and Europe, where consumers are increasingly seeking foods that promote well-being and reduce the risk of chronic diseases (Siró et al., 2008). The development and commercialization of FMH functional foods are complex and require addressing technological, legislative, and consumer demand challenges. Despite these challenges, the market potential for FMH functional foods remains high, with ongoing innovations and product developments aimed at meeting consumer needs and preferences (Siró et al., 2008; Hou and Jiang, 2013). In Europe, for instance, the functional foods market has been growing steadily, with consumers showing a preference for products that are perceived as naturally healthy, such as yogurt, cereals, and juices. These products are often seen as credible carriers of functional ingredients, which enhances their market acceptance (Annunziata and Vecchio, 2011). The concept of FMH aligns well with the current consumer trend towards natural and green healthy living, further driving the market growth. However, the market is still in its early stages, and there is a need for more knowledge dissemination and technological innovations to fully realize the potential of FMH functional foods (Hou and Jiang, 2013). 7.2 Consumer perception and acceptance of food-medicine homology Consumer perception and acceptance of FMH functional foods are influenced by a variety of factors, including socio-demographic characteristics, cognitive and attitudinal factors, and the perceived health benefits of the
International Journal of Clinical Case Reports 2024, Vol.14, No.6, 299-311 http://medscipublisher.com/index.php/ijccr 306 products. Studies have shown that older consumers and women are more likely to accept functional foods due to their stronger belief in the health benefits and willingness to compromise on taste for health properties (Bimbo et al., 2017; Topolska et al., 2021). Additionally, consumers with higher nutritional knowledge and those who are more health-conscious are more likely to accept and prefer FMH functional foods (Bimbo et al., 2017; Baker et al., 2022). However, consumer acceptance is not uniform across all demographics. For instance, younger consumers and those with lower nutritional knowledge may be less familiar with the concept of functional foods and, therefore, less likely to accept them (Figure 2) (Baker et al., 2022). Moreover, the presence of an ill family member can increase the likelihood of acceptance, as consumers are more motivated to seek out health-promoting foods (Verbeke, 2005). Effective communication and education about the benefits of FMH functional foods are crucial in increasing consumer acceptance and driving market growth. Clear and evidence-based health claims can also enhance consumer trust and acceptance of these products (Birch and Bonwick, 2019; Topolska et al., 2021). 8 Future Development Trends and Challenges 8.1 Integration of technology and new techniques The integration of advanced technologies and innovative techniques is pivotal for the future development of functional foods based on food-medicine homology (FMH). Emerging technologies such as machine learning, artificial intelligence, and network pharmacology are being increasingly utilized to enhance the development and efficacy of functional foods. For instance, machine learning algorithms have shown promise in precision nutrition by developing predictive models that can tailor nutritional advice to individual needs, thereby improving the effectiveness of dietary interventions (Kirk et al., 2021). Similarly, network pharmacology, which has been extensively used in traditional Chinese medicine (TCM), is now being applied to study the complex mechanisms of food, offering a more microscopic understanding of food bioactivity and nutrition (Yuanyuan et al., 2023). Moreover, the development of targeted delivery systems for food functional ingredients is another significant technological advancement. These systems enhance the bioavailability and controlled release of functional ingredients, thereby improving their efficacy in nutritional interventions. Recent studies have demonstrated the potential of emulsion-based and polymer-based delivery systems in addressing chronic diseases such as inflammatory bowel disease, liver disease, obesity, and cancer (Wang et al., 2023). These technological innovations are crucial for the modernization and effectiveness of FMH functional foods. 8.2 Personalized nutrition and precision health management Personalized nutrition and precision health management represent a significant trend in the development of functional foods. Precision nutrition aims to provide tailored dietary recommendations based on individual genetic backgrounds, physiology, microbiome, and other personal factors. This approach is particularly promising for the prevention and management of metabolic syndrome, obesity, type 2 diabetes, and cardiovascular diseases (Toro-Martín et al., 2017). The integration of omics technologies, such as metabolomics, into nutrition science is paving the way for more personalized and clinically relevant nutritional interventions (Tebani and Bekri, 2019). The use of machine learning in precision nutrition is also gaining traction. By incorporating complex features and large datasets, machine learning models can provide high-performance nutritional recommendations that are more effective than generic advice (Kirk et al., 2021). However, the implementation of precision nutrition requires a concerted effort among basic and clinical scientists, health professionals, and policymakers to establish a comprehensive framework that can translate these findings into practical dietary advice (Toro-Martín et al., 2017). This multidisciplinary approach is essential for the successful adoption of personalized nutrition in clinical and public health settings.
International Journal of Clinical Case Reports 2024, Vol.14, No.6, 299-311 http://medscipublisher.com/index.php/ijccr 307 Figure 2 Categories and determinants of consumer acceptance toward functional foods and the number of articles that were investigated (Adopted from Baker et al., 2022) 8.3 Need for multidisciplinary research The development of functional foods based on FMH necessitates a multidisciplinary research approach. The complexity of food bioactivity and nutrition requires the collaboration of experts from various fields, including food science, nutrition, pharmacology, and technology. For instance, the holistic approach proposed for functional food development emphasizes the need for integrating technological and nutritional viewpoints to create effective functional foods (Alongi and Anese, 2021). This approach involves a continuous cycle of regulation, technological
International Journal of Clinical Case Reports 2024, Vol.14, No.6, 299-311 http://medscipublisher.com/index.php/ijccr 308 innovation, efficacy evaluation, and consumer feedback, which can drive the development of functional foods in a more systematic and effective manner. Furthermore, the concept of FMH itself is inherently multidisciplinary, as it combines principles from both traditional Chinese medicine and modern nutrition science. The development of FMH functional foods requires a deep understanding of the therapeutic mechanisms of FMH materials, which involves both TCM and Western medicine perspectives (Hou and Jiang, 2013). Therefore, fostering multidisciplinary research collaborations is crucial for advancing the field of FMH functional foods and addressing the complex challenges associated with their development and application. 8.4 Challenges and coping strategies Despite the promising trends, several challenges hinder the development and clinical application of FMH functional foods. One major challenge is the lack of a universally recognized definition and dedicated regulation for functional foods. This regulatory gap creates inconsistencies and barriers in the development and commercialization of functional foods (Alongi and Anese, 2021). To address this issue, there is a need for clear definitions and regulations that can guide the development and evaluation of functional foods, ensuring their safety, efficacy, and consumer acceptance. Another challenge is the variability in individual responses to dietary interventions, which complicates the implementation of precision nutrition. Factors such as genetic background, microbiome composition, environmental exposures, and social determinants of health can significantly influence the effectiveness of nutritional recommendations. To cope with this challenge, researchers must adopt systems approaches and new technologies that can account for these variables and provide more precise and personalized nutritional advice. Additionally, training and workforce development are essential to equip researchers and health professionals with the skills needed to implement precision nutrition and reduce health disparities (Lee et al., 2022). The future development of FMH functional foods hinges on the integration of advanced technologies, personalized nutrition approaches, multidisciplinary research, and effective coping strategies to address regulatory and individual variability challenges. By embracing these trends and overcoming the associated challenges, the field of FMH functional foods can make significant strides in improving public health and well-being. 9 Concluding Remarks The concept of "medicine food homology" (MFH) has gained significant traction in recent years, aligning with contemporary demands for natural and health-promoting food products. Research has extensively documented the origins and evolution of MFH, highlighting its potential in modern functional foods. Over 80 MFH materials approved by China's Ministry of Health have been identified, with their effective ingredients and treatment mechanisms summarized. The development of functional foods has also seen a notable increase, driven by consumer interest in health benefits and the potential to reduce chronic health disorders. Studies have shown that older adults and women are particularly receptive to functional foods due to their perceived health benefits. Additionally, the integration of fruits into functional foods has been explored, emphasizing the importance of bioactive ingredient stability and consumer-oriented product development. Future research should focus on enhancing the bioavailability and clinical efficacy of active ingredients in functional foods. This includes developing innovative methods to blend bioactive ingredients without compromising organoleptic properties. The application of network pharmacology in food science offers a promising avenue for understanding the complex mechanisms of food bioactivity, leveraging the multi-component and multi-target properties of both food and traditional Chinese medicine. Furthermore, there is a need for standardized guidelines to validate the functional claims of food products, ensuring that they meet regulatory requirements and consumer expectations. Research should also explore personalized nutrition, utilizing emerging technologies to cater to individual nutritional needs and preferences.
International Journal of Clinical Case Reports 2024, Vol.14, No.6, 299-311 http://medscipublisher.com/index.php/ijccr 309 To support the growth of the functional foods industry, policymakers should consider implementing regulations that ensure the safety and efficacy of these products. This includes establishing clear definitions and guidelines for functional foods, as well as supporting scientific research to validate health claims. The industry should focus on developing products that not only meet consumer demands for health benefits but also maintain high standards of taste and quality. Collaboration between academic institutions, industry, and government agencies will be crucial in driving innovation and ensuring the successful commercialization of new functional food products. Additionally, effective communication strategies are needed to educate consumers about the benefits of functional foods, thereby increasing their acceptance and market penetration. By addressing these areas, the functional foods sector can continue to evolve, offering significant health benefits and meeting the growing consumer demand for natural and effective health-promoting products. Acknowledgments The authors extend sincere thanks to two anonymous peer reviewers for their feedback on the manuscript. Conflict of Interest Disclosure The authors affirm that this research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest. References Alkhatib A., Tsang C., Tiss A., Bahorun T., Arefanian H., Barake R., Khadir A., and Tuomilehto J., 2017, Functional foods and lifestyle approaches for diabetes prevention and management, Nutrients, 9(12): 1310. https://doi.org/10.3390/nu9121310 PMid:29194424 PMCid:PMC5748760 Alongi M., and Anese M., 2021, Re-thinking functional food development through a holistic approach, Journal of Functional Foods, 81: 104466. https://doi.org/10.1016/j.jff.2021.104466 Annunziata A., and Vecchio R., 2011, Functional foods development in the european market: a consumer perspective, Journal of Functional Foods, 3: 223-228. https://doi.org/10.1016/j.jff.2011.03.011 Baker M., Lu P., Parrella J., and Leggette H., 2021, Consumer acceptance toward functional foods: a scoping review, International Journal of Environmental Research and Public Health, 19(3): 1217. https://doi.org/10.3390/ijerph19031217 PMid:35162240 PMCid:PMC8835010 Baker M., Lu P., Parrella J., and Leggette H., 2022, Investigating the effect of consumers' knowledge on their acceptance of functional foods: a systematic review and meta-analysis, Foods, 11(8): 1135. https://doi.org/10.3390/foods11081135 PMid:35454722 PMCid:PMC9028956 Bech-Larsen T., and Scholderer J., 2007, Functional foods in Europe: consumer research, market experiences and regulatory aspects, Trends in Food Science and Technology, 18: 231-234. https://doi.org/10.1016/j.tifs.2006.12.006 Betoret E., Betoret N., Vidal D., and Fito P., 2011, Functional foods development: trends and technologies, Trends in Food Science and Technology, 22: 498-508. https://doi.org/10.1016/j.tifs.2011.05.004 Bimbo F., Bonanno A., Nocella G., Viscecchia R., Nardone G., Devitiis B., and Carlucci D., 2017, Consumers' acceptance and preferences for nutrition-modified and functional dairy products: a systematic review, Appetite, 113: 141-154. https://doi.org/10.1016/j.appet.2017.02.031 PMid:28235616 Birch C., and Bonwick G., 2019, Ensuring the future of functional foods, International Journal of Food Science and Technology, 54(5): 1467-1485. https://doi.org/10.1111/ijfs.14060 Brown L., Caligiuri S., Brown D., and Pierce G., 2018, Clinical trials using functional foods provide unique challenges, Journal of Functional Foods,45: 233-238. https://doi.org/10.1016/j.jff.2018.01.024 Díaz L., Fernández-Ruíz V., and Cámara M., 2020, An international regulatory review of food health-related claims in functional food products labeling, Journal of Functional Foods, 68: 103896. https://doi.org/10.1016/j.jff.2020.103896 Granato D., Barba F., Kovačević D., Lorenzo J., Cruz A., and Putnik P., 2020, Functional foods: product development, technological trends, efficacy testing, and safety, Annual Review of Food Science and Technology, 11: 93-118. https://doi.org/10.1146/annurev-food-032519-051708 PMid:31905019
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