Positive Health Online

New research in the field of food science (Nutriceutical), has potentially opened up a natural way to help us manage some of the most debilitating conditions of this century - anxiety, insomnia and depression. This research supports the general view that diet and nutrition can have a significant impact on mental as well as physical health. ‘Nutraceutical' is the term used to describe food based products that use modern agricultural and manufacturing technologies to develop highly effective products for specific health conditions. It is part of the growing trend to use nutritional approaches to support conventional medicines. New research in this field is also helping support the nutritional imbalances or deficiencies are the core drivers in many diseases. In this article we are also exploring the principle that mind and body are not separate i.e. nutritional imbalances in the body increase the risk of illness of the mind and vice versa.

As a pharmacist, I have worked with herbal medicines for over 25 years. However, the acceleration in learning and innovation in the area of nutraceuticals, (food as medicine), over the last decade has impressed most. I have seen how specific, highly concentrated foods can offer new and effective natural ways to help improve health. It is after all, the founder of modern medicine, Hippocrates who said, “Let your food be your medicine”, nearly 2500 years ago!

As pharmacists, we set the bar high when it comes to accepting research as fact. The latest studies on Saffron use modern double - blinded trials with placebo controls and human subjects in statistically significant numbers. The results show clear clinical benefits that are statistically significant for anxiety, sleep and mood. The double-blind and placebo controls mean that the results are not distorted by either the test subjects or the practitioners involved. In addition, there are a number of controlled studies which support this data demonstrating that saffron can be a useful support for these conditions without  significant side effects.

So how could we have missed these health benefits after centuries of traditional saffron use? Very easily actually! Firstly the studies show that you need a very high daily intake of the highest quality Saffron - 28-30mg a day. Recent studies have also demonstrated that the clinical benefits are optimised when the saffron extract contains 3.5% Lepticrosalides (collective term for the three most important carotenoids crocin, picrocrocin and safranal). If you look at the amounts purchased from the supermarkets at astronomical prices, these are a tiny fraction of this level. These intakes need to be repeated every day to achieve the required health benefits. In addition, the saffron has to be grown in a region where the active carotenoids are naturally high in concentration. They then need further concentration using a special filtration system to reach the optimum level of 3.5% Lepticrosalides. Lower levels of these specific carotenoids will reduce the effectiveness of saffron extracts significantly.

Saffron Flower

The best Saffron to achieve these levels are grown in the more drier soils of northern Spain, southern Italy, and specific areas within the main cultivating regions of Iran (where 90% of the world’s Saffron is grown). The importance of the growing conditions, batch to batch testing for the actives and the quality of the manufacturing processes should never be underestimated for saffron or any other natural food supplement or medicine.

The German poet and scientist Goethe stated that we must observe both the physical and factual alongside the subjective, each having an importance when assessing a plant for its medical and health benefits. When you look at the history of Saffron, there are many traditional uses for the spice, hand-picked from the stamen of the crocus flower. The fact that it flowers and is harvested while approaching the darkest and coldest time of the year, provide clues to its health benefits. Somehow, the unique carotenoids peak at this time of year, produced as a stress reaction by the plant to protect itself from the lack of light and colder weather. These are subjective observations, but interesting, significant and relevant all the same.

Our ancestors were very keen observers of these characteristics and instinctive in the way they saw foods and used them in traditional medicines. This is probably why Saffron spice has such an extensive history of use within traditional health systems for a wide variety of conditions.

As modern scientists we must respect and learn from these traditions, but also apply modern science to assess the effectiveness of these approaches. We often see many traditional herbal references provide long lists of indications which have not been fully tested in controlled conditions. The same applies to the long list of potential uses for Saffron extracts, where only the use for mood, sleep and anxiety are clinically proven benefits to date.

We are only just starting on the journey to discover the full potential of food as medicine - both for treatment and prevention. It is truly fascinating and empowering to witness how modern science is helping traditional foods help improve health and well-being  making a real difference in people’s lives.

A scientific review of Saffron published by Journal of Dietary Supplements in 2011 (8(1):58–114, 2011) gave the following assessments of the quality/level of clinical evidence for the main listed indications for which Saffron could be of potential benefit:

Scientific Evidence for Common/Studied Uses

• Depression - B;
• Alzheimer’s disease - C;
• Asthma - C;
• Dysmenorrhea – C;
• Erectile dysfunction – C;
• Exercise performance enhancement - C;
• Infertility (male) - C;
• Premenstrual syndrome - C;
• Psoriasis - C.

Level of Evidence Grade

• A (strong scientific evidence);
• B  (good scientific evidence);
• C  (unclear or conflicting scientific evidence);
• D  (fair negative scientific evidence);
• F (strong negative scientific evidence).

Since this review of evidence was carried out, a significant number of new clinical trials have been published supporting and strengthening the claims of efficacy for mild to moderate depression. A selection of these references are as follows. A significant new Randomized Controlled Trial (RCT) study currently undergoing peer review will be reported in this journal later this year.

References

1. Khazdair MR, et al. The effects of Crocus sativus (saffron) and its constituents on nervous system: A review. Avicenna J Phytomed; 5(5):376-91. Review. Sep-Oct 2015.

2. Christodoulou E, et al.  Saffron: a natural product with potential pharmaceutical applications. J Pharm Pharmacol.;67(12):1634-49. Dec 2015. doi: 10.1111/jphp.12456. Epub Aug 14 2015.

3. Hausenblas HA, et al. A systematic review of randomized controlled trials examining the effectiveness of saffron (Crocus sativus L.) on psychological and behavioral outcomes.  J Integr Med.;13(4):231-40. Jul 2015. doi: 10.1016/S2095-4964(15)60176-5.

4. Talaei A, et al. Crocin, the main active saffron constituent, as an adjunctive treatment in major depressive disorder: a randomized, double-blind, placebo-controlled, pilot clinical trial.  J Affect Disord;174:51-6. Mar 15 2015. doi: 10.1016/j.jad.2014.11.035. Epub Nov 26 2014.

5. Lopresti AL, Drummond PD. Saffron (Crocus sativus) for depression: a systematic review of clinical studies and examination of underlying antidepressant mechanisms of action. Hum Psychopharmacol;29(6): 517-27. Nov 2014. doi: 10.1002/hup.2434. Epub Sep 22 2014.

6. Hausenblas HA, Saha D, Dubyak PJ, Anton SD. Saffron (Crocus sativus L.) and major depressive disorder: a meta-analysis of randomized clinical trials. J Integr Med; 11(6):377-83. Nov 2013. doi: 10.3736/jintegrmed2013056.

7. Shahmansouri N, et al. A randomized, double-blind, clinical trial comparing the efficacy and safety of Crocus sativus L. with fluoxetine for improving mild to moderate depression in post percutaneous coronary intervention patients.  J Affect Disord:155: 216-22. Feb 2014. doi: 10.1016/j.jad.2013.11.003. Epub Nov 16 2013.

8. Kashani L, Raisi F, Saroukhani S, et al. Saffron for treatment of fluoxetine-induced sexual dysfunction in women: randomized double-blind placebo-controlled study.  Hum Psychopharmacol; 28(1):54-60. Jan 2013. doi: 10.1002/hup.2282. Epub Dec 20 2012.

9. Modabbernia A, Sohrabi H,et al.  Effect of saffron on fluoxetine-induced sexual impairment in men: randomized double-blind placebo-controlled trial. Psychopharmacology (Berl): 223(4):381-8. Oct 2012 Epub May 3 2012.