What defines a healthful diet? If the answer could be faithfully expressed in one breath, we would not exist. So many have tried. In the ever-changing, mottled habitats and predicaments entangled in human history, and trailing every sidestep across continents, oceans and hemispheres of flickering fauna and flora, our bodies know nothing other than to assume, require and cherish variety.
Although perpetuated by intuition more than controlled scientific evidence, the specter of nutritional diversification remains an irrevocable cornerstone of preventive medicine. No discovery, however factually illustrious and statistically omnipotent, will ever challenge that. And amidst the poorly tangible, intransigently chaotic variegation of food, a common thread flashes before my eyes every day.
At the logical, cultural, sensory and hedonic levels, wine, tea, coffee, fruit, cocoa, almonds and olive oil bear no common thread. Those who follow nutrition research will point out their overlapping set of health benefits—antiatherogenic, antidiabetic and neuroprotective properties being most representative of the evidence-based botanical therapeutic forefront. At the level of chemical composition, however, the picture becomes more clear. While these foods contain hundreds of different phytochemicals in a pageant of variable and changing concentrations, one class, known as polyphenols, prevails in rich quantities. If the foregoing are unfamiliar to you, ask yourself if you drank a cup of coffee this morning. If so, you consumed approximately 1,000 mg of chlorogenic acids and related phenolics. In other words, you are a member of this club.
So, welcome. This discussion is pertinent to anyone who eats food. Polyphenols are eligible for a designation as a “mark” of a healthy diet. Tell me if these 5 statements sounds familiar:
(1) Refined diets contain low levels.
(2) Many are unstable during processing.
(3) Many are destroyed by cooking.
(4) Low intake is associated with poor health.
(5) Supplementation is associated with health benefits.
We know from the history of nutrition that whenever these 5 statements converge—regardless of what the compound is—we are talking about an important, and possibly essential, nutrient. And parallel with this discourse, the question that inevitably follows is simple—Should we supplement?
Polyphenol supplements have been in widespread use for over 30 years, with much success across numerous medical applications. Examples include resveratrol, quercetin, green tea, curcumin, cranberry, grape seed, pine bark, cocoa, pterostilbene, bilberry, hawthorn, magnolia, elderberry and pomegranate extracts.
While the collective body of evidence supports the value of supplementation in many clinical settings, the practical question persists—How should we supplement? From the standpoint of both the consumer and manufacturer, to understand polyphenol supplementation, two variables must be clearly understood. Polyphenol ”intake” subsumes two main variables – (1) what types are being consumed, and (2) what are the doses? These questions often go unanswered in research because of the extraordinary heterogeneity of polyphenols in food, both qualitatively and quantitatively, coupled with the fact that these parameters fluctuate. For example, the composition and concentration of anthocyanins, a large, diverse sub-class of polyphenols in a bottle of pinot noir depends on the dampness of the vineyard, time of harvesting, whether oak barrels were used, among other agrarian and production variables. A plethora of these dynamic factors exist for cocoa, tea, fruits and vegetables. This complexity, however intimidating, is best navigated by the manufacturer through strategic sourcing, formulation, research and testing.
I have navigated all of these processes in some capacity, and witnessed success only when two pieces of information could be delineated: (1) maximum knowledge of composition and (2) confidence in potency. Contrary to pinot noir, a supplement can deliver resveratrol, the prototype, with considerable certainty with respect to both variables. Accordingly, clinical researchers are choosing products based on (1) and (2). Their academic livelihoods depend on reproducible outcomes, so circumventing much of the inter- and intra-study variation that typifies whole foods brings them to the manufacturer who can provide the highest level of compositional and quantitative certainty and consistency.
Clinical researchers typically ask the following questions of the manufacturer:
1. Does the product provide the clinically researched potency of polyphenols?
2. How are the polyphenols measured?
3. What is known regarding its bioavailability?
4. Is the potency and purity tested?
Consistency is critical not only in research, but in the clinic, where reliability matters most. Medical practitioners are selecting the products based on the quality of the research and confidence in what they see on the label. Within a supplement, a given plant extract may contain hundreds of these compounds, which cannot be determined for every lot, and they would never fit on the label.
Conversely, it may contain only one compound, like resveratrol. For general wellness and disease prevention in healthy individuals, diversifying diet and using low doses of multiple polyphenol formulas makes immaculate theoretical sense. For treatment of a specific, existing condition, single agents at precise doses are often appropriate.
Polyphenols represent diversity, yet they are unified by many common signatures of health benefits. More than 4,000 different polyphenols exist in plant foods, and a growing number of them will appear in supplement form. Since polyphenol research, formulation, manufacturing and testing require expertise in pharmacology, nutrition and chemistry, identifying a manufacturer qualified on all levels is essential. Only then can the highest level of certainty be expected.
The world of polyphenols has its chaos, its uncertainty and its variation. Yet, in a diet replete with them, it runs like a chariot, on 4,000 moving parts.
Integrative Pharmacology 