China has an extensive history of understanding the links between food and well-being. The Chinese have long believed that foodstuffs and drugs come from the same source, and the importance of balanced food was discussed in The Yellow Emperor's Classic of Internal Medicine (West Han dynasty, 206208 B.C.). That food could be used instead of drugs to treat diseases was discussed in a book entitled Effective Emergency Treatments (Tang dynasty, a.d. 618-907). For the Chinese, food was not only to be enjoyed for the taste, but also to be appreciated for its medicinal values. The most comprehensive work describing basic information about the functionality of food was carried out by Li in 1578. He devoted 27 years to study materia medica, and collected information on 1,892 different kinds of medicinal materials in a book of 25 volumes.
In Chinese medicine, foodstuffs having highly active healing effects are categorized as drugs, and those having milder effects are categorized as foods. The Chinese health authorities have listed those food materials in a special category called ''Items with both food and drug properties." These would be called functional food materials in Western semantics. The Chinese health authorities have regulated the use of drugs in food since 1987, and established a list of traditional Chinese foods with medicinal effects that can be treated as food and not regulated by drug standards. This list has been updated four times to date (1988,1991,1998, and 2002) and consists currently of more than 87 materials, mostly of plant origin (flowers, fruits, peels, seeds, leaves, whole plant, roots). We refer to these foods as Chinese functional ingredients (CFI) because many of them are from China itself, or have been used by the Chinese in foods for a long period of time. Some of these CFI are used in China for treating digestive disorders such as diarrhea, constipation, and colitis, or to promote digestion.
In this chapter, we will discuss only the CFI that have been approved by the Chinese authorities and are food grade. We will not discuss green tea as there are already many reviews on this subject. The areas of gut health that we have considered are carcinogenesis, indigestion, constipation, vomiting, diarrhea, appetite, and promotion of digestion and bile secretion. The quality and quantity of data vary widely on each of these topics, and whereas anticarcinogenesis has been extensively studied in the scientific literature for some individual compounds, other areas of ''gut comfort'' have generally been studied on the unfractionated CFI itself. The information in this review is not complete and the area is changing fast, but we have tried to present an overview of CFI on gut function, and then have considered the biological activities of selected components of the CFI that may be responsible for the observed activity. Table 1 summarizes the effects of CFI on gut disorders and digestion, and some of the CFI for which scientific evidence exists for the activities are discussed below. CFI that appear in Table 1 but are not listed below are considered in China to have an effect, but we have been unable to find suitable scientific corroboration of these activities. The structures of components discussed in Section 4 are shown in Figure 1.
It should be appreciated that the dosage and frequency of CFI are part of Chinese culture and that these benefits may not directly and readily
Table 1 List of CFI Used in Traditional Disorders and to Promote Digestion
Agastache (Agastache rugosa) Aloe (Aloe vera)
Amomum fruit (Amomum xanthiodes)
Apricot seed (Prunus armeniaca) Bamboo leaf (Lophatherum gracile) Bitter orange flower (Citrus aurantium)
Cassia tora seed (Cassia tora) Chinese angelica (Angelica anomala) Chinese yam (Dioscorea opposita) Cinnamon (Cinnamomum cassia)
Clove (Eugenia caryophyllata)
Euryale seed (Euryale ferox) Fennel seed (Foeniculum vulgare)
Ginger (Zingiber officinale) Hawthorn (Crataegus cuneata) Hemp seed (Cannabis sativa) Honeysuckle (Lonicera japonica) Job's tears (Coix lachryma-jobi) Kudzu root (Pueraria lobota) Lesser galangal (Alpinia officinarum)
Licorice (Glycyrrhiza uralensis)
Lotus seed (Nelumbo nucifera) Mandarine orange peel (Citrus reticulata) Nutmeg (Myristica fragrans)
Pepper (Piper nigrum) Perilla leaf (Perilla frutescens) Purslane (Portulaca oleracea) Safflower (Carthamus tinctorius) Smoked plum (Prunus mume)
Star anise (Illiicum verum) Sword bean (Canavalia gladiata) Winter radish seed (Raphanus sativus)
Chinese Medicine to Treat Gut
Diarrhea, promote digestion, excite smooth muscle Constipation Relieve vomiting Diarrhea, against poor appetite, bile secretion, constipation Constipation, laxative Constipation
Diarrhea, chronic enteritis Diarrhea, promote digestion, control smooth muscle Promote digestion, relieve vomiting, excite smooth muscle Diarrhea
Promote digestion, control smooth muscle Diarrhea
Diarrhea, promote digestion
Diarrhea, enhance appetite Diarrhea, promote digestion, control smooth muscle Diarrhea, smooth muscle control, mucosa protection Diarrhea
Diarrhea, promote digestion Chronic diarrhea, promote digestion, control smooth muscle Diarrhea, promote digestion Diarrhea, excite smooth muscle Diarrhea, bile secretion Enhance appetite
Chronic diarrhea, enhance appetite, control smooth muscle, bile secretion Bile secretion Relieve vomiting Diarrhea, excite smooth muscle, constipation
Source: Ref. 142.
Figure 1 Structures of some CFI.
Chlorogenic acid o7
Figure 1 Structures of some CFI.
translate into Western-style administration. This chapter makes no claims about safety of usage of any of these ingredients, since maximum doses are not always known. Furthermore, doses have been derived from traditional practices and '' trial and error.'' There is also the possibility of contamination and variability within extracts and plant sources, and these factors need to be fully clarified before adoption into regular consumption in the West. Quality control and specification are key issues in potential systemic use of CFI to limit risk and ensure maximum benefits.
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