Forschende
Komplementärmedizin
Wissenschaft | Praxis | Perspektiven
Characteristics and Health Benefits of Phytochemicals
Claus Leitzmann
Institute of Nutrition Science, University of Giessen, Giessen, Germany
Keywords
Phytocemicals · Plants · Nutrition · Food Science
Summary
In food science the term ‘phytochemicals’ includes a va-
riety of plant ingredients with different structures that
are capable of health-promoting effects. Phytonutrients
are natural substances but are not called nutrients in the
traditional sense, since they are synthesized by plants
neither in energy metabolism nor in anabolic or cata-
bolic metabolism, but only in specific cell types. They
differ from primary plant compounds in that they are not
essential to the plant. Phytonutrients perform important
tasks in the secondary metabolism of plants as repel-
lents to pests and sunlight as well as growth regulators.
They occur only in low concentrations and usually have
a pharmacological effect. Since antiquity, these effects
have been used in naturopathy in the form of medicinal
herbs, spices, teas, and foods. With the development of
highly sensitive analytical methods, a variety of these
substances could be identified. These phytochemicals
may have health benefits or adverse health effects, de-
pending on the dosage. In the past, these effects were
studied in cell and tissue cultures as well as in animal
models. Meanwhile there are numerous epidemiological
data that point to the extensive health potential of phyto-
chemicals in humans. A high dietary intake of phyto-
chemicals with vegetables, fruits, nuts, legumes, and
whole grain is associated with a reduced risk for cardio-
vascular and other diseases.
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Review Article · Übersichtsarbeit
Forsch Komplementmed 2016;23:69–74 Published online: February 4, 2016
DOI: 10.1159/000444063
Schlüsselwörter
Sekundäre Pflanzenstoffe · Pflanzen · Ernährung ·
Ernährungswissenschaft
Zusammenfassung
Unter dem Begriff «sekundäre Pflanzenstoffe» wird in
der Ernährungswissenschaft eine Vielzahl pflanzlicher
Inhaltsstoffe mit unterschiedlichen Strukturen zusam-
mengefasst, die gesundheitsfördernde Effekte entfalten
können. Sekundäre Pflanzenstoffe zählen zu den Natur-
stoffen, sind aber im klassischen Sinne keine Nährstoffe,
denn sie werden von Pflanzen weder im Energiestoff-
wechsel noch im anabolen oder im katabolen Stoffwech-
sel synthetisiert, sondern nur in speziellen Zelltypen. Sie
grenzen sich von primären Pflanzenstoffen dadurch ab,
dass sie für die Pflanze nicht lebensnotwendig sind. Se-
kundäre Pflanzenstoffe erfüllen wichtige Aufgaben im
sekundären Stoffwechsel der Pflanzen als Abwehrstoffe
gegenüber Schädlingen und Sonnenlicht sowie als
Wachstumsregulatoren. Sie kommen nur in geringen
Konzentrationen vor und haben üblicherweise eine phar-
makologische Wirkung. Seit der Antike werden diese
Wirkungen in der Naturheilkunde mittels Heilpflanzen,
Gewürzen, Tees und Lebensmitteln genutzt. Mit der Ent-
wicklung hochempfindlicher Analysemethoden konnte
eine Vielzahl dieser Substanzen identifiziert werden.
Diese Pflanzenstoffe können je nach Dosierung gesund-
heitsfördernde oder gesundheitsschädigende Wirkungen
haben. Zunächst wurden diese Wirkungen in Zell- und
Gewebekulturen sowie in Tiermodellen untersucht. In-
zwischen liegen zahlreiche epidemiologische Daten vor,
die auf das umfangreiche Gesundheitspotenzial der se-
kundären Pflanzenstoffe beim Menschen hinweisen. Eine
hohe Aufnahme von sekundären Pflanzenstoffen mit
Gemüse, Obst, Nüssen, Hülsenfrüchten und Vollkorn-
produkten ist mit einem reduzierten Risiko für Herz-
Kreislauf- und andere Erkrankungen verbunden.
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Claus Leitzmann, PhD
Institute of Nutrition Science
University of Giessen
Universiteit Gent
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Wilhelmstraße 20, 35392 Giessen, Germany
Claus@Leitzmann-Giessen.de
 Introduction
Phytochemicals are secondary metabolites of low-molecular
weight that occur naturally in plants. These biologically active mol-
ecules have evolved in the interaction between the plant and its en-
vironment. For many years phytochemicals were mainly consid-
ered as natural toxicants that were potentially harmful. During re-
cent years the health benefits of consuming diets rich in plant
foods has been increasingly recognized. Due to the growing epide-
miological evidence showing a protective effect of vegetable and
fruit intake against a number of chronic diseases, a revival of inter-
est in secondary plant metabolites has developed. Phytochemicals
are not nutrients in the classical sense. However, in view of the cur-
rent comprehensive understanding of food, phytochemicals as well
as dietary fibers could be considered as nutrients [1].
The difference between primary and secondary plant metabo-
lites is their divergent function. The primary plant substances pro-
teins, fats, and carbohydrates including dietary fiber contribute to
energy metabolism and to the structure of the plant cell. Secondary
plant metabolites are non-nutritive dietary components that are es-
sential for the interactions of the plant with its environment. They
serve as defense against insects, fungi, and other microorganisms;
as growth regulators, pigments, and flavors. Secondary plant me-
tabolites are quite diverse chemical compounds that are present
only in very small amounts. Since they have potential pharmaco-
logical effects on humans, scientists are systematically investigating
the health-promoting effects of phytochemicals.
In addition to beneficial health effects, phytochemicals can be
harmful. For this reason they were primarily seen as toxic and con-
sidered as ‘anti-nutritive’ metabolites in the past. It is well estab-
lished that phytochemicals can restrict the availability of nutrients
and increase the permeability of the intestinal wall. Meanwhile it is
known that with the usual amounts of food consumed, nearly all
natural components are harmless. On the contrary, most phyto-
chemicals that were formerly regarded as harmful have a variety of
health-promoting effects [2].
At present the total number of phytochemicals is not known, the
estimations go beyond 100,000 substances. With a mixed Western
Table 1. Classification of phytochemicals and
their main effects
Phytochemical
Carotenoids
Phytosterols
Saponins
Glucosinolates
Polyphenols
Protease inhibitor
Monoterpenes
Phytoestrogens
Sulfides
A = anticarcinogenic; B = antimicrobial; C = antioxidative; D = antithrombotic; E = immunomodulatory
properties; F = anti-inflammatory; G = influence on blood pressure; H = cholesterol-lowering effect;
I = modulate blood glucose levels.
70 Forsch Komplementmed 2016;23:69–74
diet, about 1.5 g of phytochemicals are ingested daily. Vegetarians
and vegans can have a much higher intake of secondary plant me-
tabolites. Currently there are no recommended levels of intake for
phytochemicals. An appropriate framework is still needed for estab-
lishing their recommended intakes, because their recognized health
benefits may not be readily defined in the context of nutritional es-
sentiality [3]. It would be helpful to establish this framework for
these nonessential food components that would take into consider-
ation intermediary biomarkers indicative of optimal health [4].
The classification of phytochemicals is based on their chemical
structure and their functional characteristics. The main groups of
phytochemicals are listed in table 1 [1].
Characteristics of Phytochemicals
In the following, the most important phytochemicals are briefly
characterized [2].
Carotenoids are common in vegetables and fruits, which are de-
pendent on the red and yellow carotenoid pigments essential for
photosynthesis. Carotenoids are either oxygen-free or contain oxy-
gen (xanthophylls). Approximately 50 of the about 700 natural ca-
rotenoids are important in human nutrition. Depending on the ca-
rotenoid structure, some carotenoids possess provitamin A activity.
Contingent upon the individual diet, human serum largely contains
varying proportions of the oxygen-free carotenoids alpha- and
beta-carotene, lycopene and the xanthophylls lutein, zeaxanthin
and beta-cryptoxanthin. Beta-carotene accounts for up to 30% of
the total serum carotenoids. Oxygen-free and oxygen-containing
carotenoids differ mainly in their thermal stability. Beta-carotene in
carrots and lycopene in tomatoes are heat-stable, xanthophylls,
found mainly in green vegetables, are heat-sensitive. The total daily
intake of carotenoids amounts to about 6 mg in a Western diet.
Phytosterols are chemically very closely related to cholesterol.
They are mainly found in nuts, plant seeds, and oils with a daily
intake of 100–500 mg [5]. The phytosterol absorption of up to 10%
is low compared to over 40% for cholesterol. The low bioavailabil-
ity of phytosterols is due to the fact that absorbed phytosterols in
Evidence for the following effects
A B C D E F G H I
× × × ×
× ×
× × × ×
× × ×
× × × × × × × ×
× × ×
× × ×
× × ×
× × × × × × × ×
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the enterocytes are actively transported back to the intestinal
lumen. Phytosterols have a cholesterol-lowering effect partially due
to its capacity to inhibit the absorption of cholesterol which led to
the first functional food. Margarines enriched with phytosterol or
phytostanol have been marketed since the year 2001.
Saponins are surface-active compounds that form complexes
with proteins and lipids. They are bitter-tasting and are particu-
larly abundant in legumes. The daily average intake of saponins is
around 15 mg, but depending on the dietary habits may be as high
as 200 mg/d. Since saponins have a low absorption rate, they are
primarily active in the intestinal tract. In the past, saponins were
considered to be harmful to health due to their hemolytic proper-
ties. Since this could not be confirmed, some saponins were ap-
proved as a foam stabilizer in beer and for soft drinks in Europe
and North America.
Glucosinolates are present in members of the cabbage genus
(Brassica), that includes many important crop plants. The enzyme
myrosinase degrades glucosinolates to the three active metabolites
isothiocyanates, thiocyanates, and indoles. These substances con-
tribute to the typical flavor of horseradish, mustard, and broccoli.
Cutting or chewing of the plant eliminates the binding between the
enzyme and its substrates. Heating of cabbage reduces its glucosi-
nolate content to about 50% and inactivates its myrosinase activity.
The daily intake of glucosinolates is in the range of 10–50 mg. With
vegetarian or vegan diets, the intake can be as high as 100 mg/d.
Isothiocyanates are completely absorbed in the small intestine [6].
Polyphenols primarily include phenolic acids and flavonoids, in-
cluding flavonols, flavones, flavanols, flavanones, and anthocya-
nins. Polyphenols usually are bound to sugars and occur in red
wine, dark chocolate, tea, and apples. Flavonoids increase in the
ripening process and are located almost exclusively in the outer
layer of vegetables and fruits. Vegetables grown in the field have
higher flavonoid contents than greenhouse vegetables. Quercetin is
the most commonly found flavonoid with an intake of about 25
mg/d. It can be absorbed in health-relevant quantities, while other
flavonoids, such as the anthocyanins, are barely absorbed.
Protease inhibitors are found mainly in legumes and grains. In
the gut they hinder the activity of endogenous proteases, such as
trypsin, which causes an increased synthesis of digestive enzymes.
A specific trypsin form, which is resistant to protease inhibitors, is
synthesized by humans. Heating considerably reduces the activity
of protease inhibitors. The protease inhibitor intake averages about
300 mg/d. With diets high in grains and legumes, the intake can
increase substantially.
Monoterpenes such as menthol (peppermint), carvone (caraway
seeds) and limonene (citrus oil) are active substances in herbs and
spices. The average daily intake is up to 200 mg. Monoterpenes show
a high degree of bioavailability in humans due to their fat solubility.
Phytoestrogens have effects similar to those of endogenous es-
trogens. They bind to mammalian estrogen receptors but have only
about 0.1% of the efficacy of human estrogens. However, their con-
centration in body fluids and tissues may be up to 10,000-fold
higher. The two major groups of phytoestrogens are isoflavones
and lignans. Depending on the amount and concentration of en-
Phytochemicals
dogenous estrogens, phytoestrogens can act both as estrogens and
antiestrogens. Isoflavones are almost exclusively found in soybeans
and soybean products. Lignans are present in higher concentra-
tions in flax seeds and whole grain products. The major isoflavones
in soy are the glycosides of genistein and daidzein. Western diets
provide less than 2 mg/d, Asian and vegetarian diets can reach an
intake of up to 15–40 mg/d [7].
Sulfides include all organosulfur compounds of bulbous plants
like garlic. The main active substance of garlic is allicin. Injury to
the tissue of the garlic wedge leads to the release of the enzyme al-
liinase which produces allicin from the basic compound alliin [8].
In addition to the phytochemicals discussed so far, there are
further phytochemicals that do not fit in the classification above.
Some of these are lectins, glucarates, phthalides, chlorophyll, toco-
trienols, and phytic acid.
Health Benefits of Phytochemicals
Information on the health-promoting potential of vegetables and
fruits as well as on isolated phytochemicals has been obtained from
different experimental systems (cell and tissue cultures, animal ex-
periments, human studies). Of particular relevance are human stud-
ies, especially epidemiological and intervention studies, and bio-
marker-related studies. There is mutual agreement among experts
that only part of the potential effects of phytochemicals has been
sufficiently investigated to come to final recommendations [9]. In
the following, the results of some of the more recent publications
concerning wide-spread non-communicable diseases are presented.
Cardiovascular Diseases (CVD)
Cardiovascular diseases are the leading cause of death globally.
It is estimated that 90% of CVD is preventable by healthy eating,
physical exercise, avoidance of tobacco smoke, and limiting alcohol
intake. Treating high blood pressure and diabetes is also beneficial.
Most CVD affects older adults. The average age of death from cor-
onary artery disease in the developed world is around 80 years
while it is around 68 years in the developing world. Disease onset is
typically seven to ten years earlier in men as compared to women.
In a systematic review the association between dietary flavonoid
intake and CVD risk was evaluated. The intakes of several flavo-
noids were inversely associated with the risk of CVD when com-
paring the highest and lowest categories of intake. A similar asso-
ciation was observed for flavonol intake and CVD risk. Every 10
mg/d increment in flavonol intake was associated with a 5% de-
crease in the risk for developing CVD. The data suggests that the
dietary intakes of six classes of flavonoids, namely flavonols, antho-
cyanidins, proanthocyanidins, flavones, flavanones and flavan-
3-ols, significantly decrease the risk of CVD [10].
In a study including 1,063 randomly selected women aged >75
years all-cause, cancer, and cardiovascular mortalities were assessed.
During the 5-year follow-up period, 129 (12%) deaths were docu-
mented. Participants with high total flavonoid intake were at lower
risk of 5-year all-cause mortality than those with low total flavonoid
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consumption. Similar beneficial relations were observed for both
CVD mortality and cancer mortality. A high consumption of flavo-
noid-rich foods (tea, chocolate, red wine, fruits, and vegetables) is as-
sociated with a reduced risk of mortality in older women. The bene-
fits of flavonoids may extend to the etiology of cancer and CVD [11].
In a meta-analysis involving 452,564 participants with 7,233
coronary heart disease (CHD) cases, pooled results suggested that
highest flavonoids intake versus lowest intake was significantly as-
sociated with the risk of CHD. Linear dose-response relationship
was found between flavonoids intake and CHD risk. The results
suggest that elevated flavonoids intake might have a protective ef-
fect on CHD [12].
In another meta-analysis including eight studies with 5,228
stroke cases among 280,174 participants, the summary RR indi-
cated a significant association between highest flavonol intake and
reduced risk for stroke. An increase in flavonol intake of 20 mg/d
was associated with a 14% decrease in the risk for developing stroke.
Higher dietary flavonol intake is associated with a reduced risk for
stroke, especially among men. The results support a recommenda-
tion for higher consumption of flavonol-rich foods such as vegeta-
bles, fruits, tea, chocolate, and red wine to prevent stroke [13].
Cancer
Cancer is the second most frequent cause of death in industrial-
ized countries. Nutrition is the major exogenous factor that modu-
lates cancer risk and contributes to about one-third of all types of
cancer. A higher intake of vegetables and fruits is associated with a
lower risk of various types of cancer. For all classes of phytochemi-
cals occurring in vegetables and fruits, anti-cancer effects have been
described. Based on the potential cancer-preventive activity of plant
foods, it has been recommended to increase the consumption of
vegetables and fruits to at least five servings per day. In addition to
eating plenty of vegetables, fruits and whole grains, not eating too
much processed and red meat [14] and not drinking too much alco-
hol, many cancers can be prevented by maintaining a healthy weight,
not smoking, and avoiding too much exposure to sunlight [15].
In a large prospective analysis with 20 years of follow-up, higher
concentrations of α-carotene, β-carotene, lycopene, and total carote-
noids were associated with 18–28% statistically significantly lower
risks of breast cancer. Associations were apparent for total carote-
noids measured ˰10 years before diagnosis. Carotenoid concentra-
tions were strongly inversely associated with breast cancer recurrence
and death compared with not recurrent and not lethal disease.
Women with high plasma carotenoids were at reduced breast cancer
risk particularly for more aggressive and ultimately fatal disease [16].
The association of prediagnostic plasma concentrations and di-
etary consumption of carotenoids and vitamins A, C, and E with
the risk of colon and rectal cancer was examined in the EPIC case
control study [17] with 898 colon cancer cases, 501 rectal cancer
cases, and 1,399 matched controls. An association was observed
between higher prediagnostic plasma retinol concentration and a
lower risk of colon cancer, most notably proximal colon cancer.
Dietary phytosterols appear to play an important role in the regula-
tion of serum cholesterol and do exhibit anticancer properties. Ad-
72 Forsch Komplementmed 2016;23:69–74
ditionally, inverse associations for dietary β-carotene and dietary
vitamins C and E with colon cancer were detected.
A systematic review and meta-analysis [18] of epidemiological
studies investigated whether the intake of specific carotenoids from
dietary sources as well as combined carotenoids is associated with
the risk of head and neck cancer. The risk reduction associated
with β-carotene equivalents intake was 46% for cancer of oral cav-
ity and 57% for laryngeal cancer. Lycopene, α-carotene, and
β-cryptoxanthin were associated with at least 26% reduction in the
rate of oral and pharyngeal cancer.
Diabetes
Worldwide an estimated 400 million people have diabetes, with
type 2 diabetes making up about 90% of the cases. This represents
8.3% of the adult population, with equal rates in both women and
men. Prevention and treatment of type 2 diabetes involve a healthy
diet, maintaining a normal body weight, physical exercise, and
avoiding use of tobacco. Control of blood pressure and maintain-
ing proper foot care are important for people with the disease.
Type 1 diabetes must be managed with insulin injections. Diabetes
at least doubles the risk of death.
In a meta-analysis of prospective cohort studies involving
284,806 participants, 18,146 diabetes cases were identified. The
relative risk of type 2 diabetes for the highest intake of total flavo-
noids compared with the lowest was 0.91. Furthermore, an increase
in the total flavonoids intake of 500mg/d was associated with a sig-
nificant risk reduction of 5% [19].
In a study on dietary intake of carotenoids and its impact on the
risk of type 2 diabetes [20], data from 37,846 participants were ana-
lyzed using a validated food frequency questionnaire. During a
follow-up of 10 ± 2 years, 915 incident cases of type 2 diabetes were
ascertained. After the usual adjustments, higher β-carotene intakes
were associated inversely with diabetes risk. For α-carotene, a bor-
derline significant reduced risk was observed. β-cryptoxanthin, ly-
copene, lutein, zeaxanthin, and the sum of all carotenoids did not
associate with diabetes risk. This study shows that diets high in
β-carotene and α-carotene are associated with reduced type 2 dia-
betes, in generally healthy men and women [20].
Osteoporosis
In the developed world, depending on the method of diagnosis,
2–8% of males and 9–38% of females are affected by osteoporosis.
Osteoporosis becomes more common with age. About 15% of
white people in their 50s and 70% of those over 80 years are af-
fected. White and Asian people are at greater risk. Osteoporosis is
more common in women than men. Prevention of osteoporosis
includes a proper diet during childhood. Efforts to prevent broken
bones in those with osteoporosis include a good diet, exercise, and
fall prevention. Lifestyle changes, such as stopping smoking and
not drinking alcohol, can help.
A meta-analysis included random control trials to investigate the
association of soy isoflavones and osteoporosis [21]. Soy isoflavones
significantly increased the bone mineral density by 54% and de-
creased the bone resorption marker urinary deoxypyridinoline
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(DPD) by 23% compared to baseline in women. The effect of isofla-
vones on bone mineral density regarding menopausal status and
isoflavone dose revealed higher weighted mean difference changes
in postmenopausal women and isoflavone doses above 75 mg/d.
Soy isoflavone supplements significantly increase bone mineral
density and decrease the bone resorption marker urinary DPD [21].
A review aimed to clarify the effect of soy isoflavones on bone
mineral density (BMD) and turnover markers in menopausal
women [22]. Soy isoflavones significantly improved lumbar spine
BMD in a moderate manner, but did not affect total hip, femoral
neck, and trochanter BMD. Ingestion of soy isoflavones for six
months appeared to be enough to exert a beneficial effect on lumbar
spine BMD. Soy isoflavones may prevent postmenopausal
osteoporosis and improve bone strength thus decreasing risk of frac-
ture in menopausal women by increasing lumbar spine BMD and
decreasing bone resorption marker urine deoxypyridinoline [22].
Cataract
About 20 million people globally are blind due to cataracts. Cat-
aracts become more common with age. Prevention includes wear-
ing sunglasses and not smoking; foods containing lutein, such as
kale, spinach and egg yolk, can help.
A meta-analysis [23] showed significant inverse associations be-
tween nuclear cataract and blood lutein / zeaxanthin concentra-
tions, with pooled RRs ranging from 0.63 for zeaxanthin to 0.73 for
lutein. Blood lutein and zeaxanthin were also noted to lead towards
a decrease in the risk of cortical cataract and subcapsular cataract.
High blood lutein and zeaxanthin are significantly associated with
a decrease in the risk of nuclear cataract. However, no significant
associations were found for ARC in other regions of the lens [23].
Menopausal Conditions
Soy foods are uniquely rich sources of isoflavones which are
classified as both phytoestrogen and selective estrogen receptor
modulators. The phytoestrogenic effects of isoflavones have led
some to view soy foods and isoflavone supplements as alternatives
to conventional hormone therapy.
There is substantial evidence that soy foods have the potential to
address several conditions and diseases associated with the meno-
pausal transition. Amongst others, they have the potential to re-
duce ischemic heart disease by lowering blood low-density lipopro-
tein-cholesterol concentrations, improve endothelial function, and
possibly slow down the progression of subclinical atherosclerosis.
Isoflavone supplements also consistently alleviate menopausal hot
flashes, provided they contain sufficient amounts of the predomi-
nant soybean isoflavone genistein. Clinical and epidemiological
data indicate that adding soy foods to the diet can contribute to the
health of postmenopausal women [24].
Cognitive Functions
Cognition is the set of all mental abilities and processes related
to knowledge, attention, memory, judgment, evaluation, reasoning,
problem solving, decision making, comprehension, and produc-
tion of language.
Phytochemicals
In a cross-sectional study with 2,031 participants [25], those
who consumed chocolate, wine, or tea had significantly better
mean test scores and lower prevalence of poor cognitive perfor-
mance than those who did not. Participants who consumed all 3
studied items had the best test scores and the lowest risks for poor
test performance. The associations between intake of these food-
stuffs and cognition were dose-dependent, with maximum effect at
intakes of approximately 10 g/d for chocolate and approximately
75–100 ml/d for wine, but approximately linear for tea. The effect
was most pronounced for wine and modestly weaker for chocolate
intake. Thus, in the elderly, a diet high in some flavonoid-rich
foods is associated with better performance in several cognitive
abilities in a dose-dependent manner.
In a review of phytoestrogens on cognition [26] it was shown
that they reduce Alzheimer’s disease-related pathology, potentially
alleviating risk of progression. In addition to their antioxidant
properties, soy products also have the ability to affect cognition via
interaction with estrogen receptors. Limited data provide evidence
that effects of phytoestrogens on cognition may be modified by
dosage, duration of consumption, and cognitive test used. Phytoes-
trogen treatment interventions have also shown time-limited posi-
tive effects on cognition [26].
A greater proportion of lutein in the pediatric brain suggests a
need for lutein during neural development. In adults, higher lutein
status is related to better cognitive performance, and lutein supple-
mentation improves cognition [27].
Conclusions
Present knowledge of the effects of phytochemicals allows the
conclusion that these non-nutritive dietary compounds of plant
foods can have health-promoting effects. The most protective ef-
fect is observed when a high number of different phytochemicals is
consumed with plant foods, which presumably exerts cumulative
or synergistic effects. For many phytochemicals, detection methods
in foods and body fluids have been established. Although the deter-
mination of phytochemicals in terms of content, bioavailability,
and biokinetics is now possible, only key phytochemicals of the in-
dividual classes have been carefully studied. The toxic potential of
phytochemicals is negligible as long as consumption habits are re-
stricted to whole food and extracts or isolates are avoided. So far,
no adverse effects of phytochemicals as part of wholesome foods
have been reported, even in subjects on predominately vegetarian
diets. Most nutritional recommendations include an increase in the
consumption of plant-derived foods (5-a-day) based on the epide-
miological evidence that phytochemicals have beneficial effects on
health and wellbeing.
Disclosure Statement
The author declares that there is no conflict of interests concerning this
paper.
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References
1 Watzl B, Leitzmann C: Bioaktive Substanzen in Lebens-
mitteln. Stuttgart, Hippokrates, 2005.
2 Watzl B, Leitzmann C: Other biological active sub-
stances; in Mann J, Truswell S (eds): Essentials of
Human Nutrition. Oxford, Oxford University Press,
2012, pp. 207–215.
3 Wallace TC, Blumberg JB, Johnson EJ, Shao A: Dietary
bioactives: establishing a scientific framework for rec-
ommended intakes. Adv Nutr 2015; 15: 1–4.
4 Ellwood K, Balantine DA, Dwyer JT, et al.: Considera-
tions on an approach for establishing a framework for
bioactive food components. Adv Nutr 2014; 5: 693–701.
5 Phillips KM, Ruggio DM, Ashraf-Khorassani M: Phy-
tosterol composition of nuts and seeds commonly con-
sumed in the United States. J Agri Food Chem 2005; 53:
9436–9445.
6 Dinkova-Kostova AT, Kostov RV: Glucosinolates and
isothiocyanates in health and disease. Trends Molecu-
lar Med 2012; 18: 337–347.
7 Tetens I, Turrini A, Tapanainen H, Christensen T: Di-
etary intake and main sources of plant lignans in five
European countries. Food Nutr Res 2013; 11; 57.
8 Borlinghaus J, Albrecht F, Gruhlke MC, et al.: Allicin:
chemistry and biological properties. Molecules 2014;19:
12591–12618.
9 Bohn T, McDougall J, Alegria A, et al.: Mind the gap –
deficits in our knowledge of aspects impacting the bio-
availability of phytochemicals and their metabolites – a
position paper focusing on carotenoids and polyphe-
nols. Mol Nutr Food Res 2015; 59: 1307–1323.
10 Wang X, Ouyang YY, Liu J et al.: Flavonoid intake and
risk of CVD: a systematic review and meta-analysis of
prospective cohort studies. Brit J Nutr 2014; 111: 1–11.
74 Forsch Komplementmed 2016;23:69–74
11 Ivey KL, Hodgson JM, Croft KD, et al.: Flavonoid in-
take and all-cause mortality. Am J Clin Nutr 2015; 101:
1012–1020.
12 Jiang W, Wei H, He B: Dietary flavonoids intake and
the risk of coronary heart disease: a dose-response
meta-analysis of 15 prospective studies. Thromb Res
2015; 135: 459–463.
13 Wang ZM, Zhao D, Nie ZL, et al.: Flavonol intake and
stroke-risk: a meta-analysis of cohort studies. Nutrition
2015; 30: 518–523.
14 International Agency for Research on CancerI (ARC):
IARC Monographs, vol 114. Consumption of Red Meat
and Processed Meat. Lyon, IARC Working Group, 2015.
15 World Cancer Research Fund / American Institute for
Cancer Research (WCRF/AICR): Food, Nutrition,
Physical Activity, and the Prevention of Cancer: A
Global Perspective. Washington, AICR, 2007–2015.
16 Eliassen AH, Liao X, Rosner B, et al.: Plasma carote-
noids and risk of breast cancer over 20 y of follow-up.
Am J Clin Nutr 2015; 101: 1197–1205.
17 Leenders M, Leufkens AM, Siersema PD, et al.: Plasma
and dietary carotenoids and vitamins A, C and E and
risk of colon and rectal cancer in the European Pro-
spective Investigation into Cancer and Nutrition. Int J
Cancer 2014; 135: 2930–2939.
18 Leoncini E, Nedovic D, Panic N, et al.: Carotenoid in-
take from natural sources and head and neck cancer: a
systematic review and meta-analysis of epidemiological
studies. Cancer Epidemiol Biomarkers Prev 2015; 24:
1003–1011.
19 Liu YJ, Zhan J, Liu XL, et al.: Dietary flavonoids intake
and risk of type 2 diabetes: a meta-analysis of prospec-
tive cohort studies. Clin Nutr 2014; 33: 59–63.
20 Sluijs I, Cadier E, Beulens JW, et al.: Dietary intake of
carotenoids and the risk of type 2 diabetes. Nutr Metab
Cardiovasc Dis 2015; 25: 376–381.
21 Wei P, Liu M, Chen Y, et al.: Systematic review of soy
isoflavone supplements on osteoporosis in women.
Asian Pac J Trop Med 2012; 5: 243–248.
22 Taku K, Melby MK, Nishi N, et al.: Soy isoflavones for
osteoporosis: an evidence-based approach. Maturitas
2011; 70: 333–338.
23 Liu XH, Yu RB, Liu R, et al.: Association between lutein
and zeaxanthin status and the risk of cataract: a meta-
analysis. Nutrients 2014; 6: 452–465.
24 Messina M: Soy foods, isoflavones, and the health of
postmenopausal women. Am J Clin Nutr 2014;
100(suppl):423S–430S.
25 Nurk E, Refsum H, Drevon CA, et al.: Intake of flavo-
noid-rich wine, tea, and chocolate by elderly men and
women is associated with better cognitive test perfor-
mance. J Nutr 2009; 139: 120–127.
26 Soni M, Rahardjo TB, Soekardi R, et al.: Phytoestrogens
and cognitive function: a review. Maturitas 2014; 77:
209–230.
27 Johnson E: Role of lutein and zeaxanthin in visual and
cognitive function throughout lifespan. Nutr Rev 2014;
72: 605–612.
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