Botanicals and Natural Bioactives: Prevention and Treatment of Diseases E-Book
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- Herausgeber: Bentham Science Publishers
- Kategorie: Lebensstil
- Serie: Bentham Briefs in Biomedicine and Pharmacotherapy
- Sprache: Englisch
- Veröffentlichungsjahr: 2024
Bentham Briefs in Biomedicine and Pharmacotherapy showcases the latest developments and techniques in the fields of pharmacology and healthcare, presenting them in distinctive volumes. Each volume offers a concise, focused overview of subjects, authored by experts in the field. The book series serves as an anthology for graduate students and researchers in pharmacology and life sciences, as well as medical professionals seeking specialization for research-related projects.
The second volume, Botanicals and Natural Bioactives: Prevention and Treatment of Diseases, discusses the medicinal applications of natural bioactives in the treatment of a variety of physiological disorders, including cardiovascular diseases, neurological dysfunctions, infectious diseases, age-related diseases, and cancer. The volume has eight chapters on disease treatment and preventative measures, with contributions from more than twenty experts. Readers will comprehend the niche utilization of botanicals and natural bioactives as medicinal agents for a variety of ailments. Overall, the chapters dwell on the chemosensory features of nutritious foods to avoid non-communicable diseases and the role of immunomodulating natural products and botanicals in the prevention and treatment of skin diseases, aging, inflammation, cancer, parasitic infections in the bloodstream, neurodegenerative diseases, osteoporosis, coronary heart disease, and autoimmune disorders. The variety of topics covered in this book makes it an excellent resource for a wide audience interested in phytomedicine.
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Students, researchers, pharmacologists, medicinal chemists, healthcare professionals and clinicians.
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FOREWORD
I am pleased to write this foreword for the e-book ‘Botanicals and Natural Bioactives: Prevention and Treatment of Diseases’. This outstanding endeavour by the editors represents a multi-disciplinary coverage of research in preventing and treating many diseases. This book embodies a compelling compilation of chapters on therapeutic aspects of natural bioactives against various physiological disorders. The authors deserve credit for their time and efforts to contribute excellent chapters relevant to their expertise. These chapters include timely discussions on ageing, infectious diseases, neurodegenerative diseases, osteoporosis, coronary heart diseases, and autoimmune disorders. I am confident this book will be a valuable addition to the bookshelves of teaching faculty, recognized investigators, and young graduate students. I wish you all the success for the launch of this book.
PREFACE
Scientific research in the diverse domains of biomedicine and pharmacotherapy has contributed much to the recent advancements in enhancing global health. Researchers have shown a great interest in exploring and enhancing the therapeutic assistance for a variety of diseases via vital understanding in areas of molecular diagnostics, immunobiology, regenerative medicine, drug development and discovery, cancer biology, functional genomics, pharmaceutics, chemical biology, human biology, and primary or scientific research. Following these, the book series Bentham Briefs in Biomedicine and Pharmacotherapy seeks to cover recent developments in various domains via various volumes.
The second volume “Botanicals and Natural Bioactives: Prevention and Treatment of Diseases” offers immense knowledge of the current research in the prevention and treatment of many diseases. This book volume provides recent and future trends in therapeutic aspects of natural bioactives against various physiological disorders. The pathogenic intervention of chronic ailments like cardiovascular diseases, neurodegenerative diseases, infectious diseases, age-associated diseases, and many cancers involves oxidative damage. The intensified pro-oxidant factors cause structural and functional defects at enzymatic and DNA levels. This leads to mutations and aberrations at the genetic level. The book chapters will captivate interest in the researchers for investigation and augmentation of the use of botanicals and natural bioactives in the remedial assistance against various ailments.
List of Contributors
Food Color, Taste, Smell, Culinary Plate, Flavor, Locale, and their Impact on Nutrition: Present and Future Multisensory Food Augmentation and Non-communicable Disease Prevention: An Overview
Douglas W. Wilson1,Fabien De Meester2,Toru Takahashi3,Ram B. Singh4,Harpal S. Buttar5,*Abstract
Cognizant that ‘the world is one family’, this overview describes chemosensory characteristics of food and related issues that may enable global inequalities in healthy food consumption to be improved with a reduction in non-communicable diseases (NCDs), preventatively. Past and modern aspects of food tradition are briefly described followed by titular chemosensory characteristics and their potential application to improving health in nutrition in the sense intended, including the culinary plate. Human-computer interface and food augmentation reality and commensal dining, in association with chemosensory properties, including sound concerning oral food processing, are described. Future research on arresting trends in the prevalence of NCD is suggested based on the literature. Visual cues for in-store food choice are discussed that potentially allow the consumer, through psychological processes and behavior outcomes, to be more discerning. Advertisements and store architecture per se are not discussed. The relatively high prevalence of anosmia caused by COVID-19 infection relative to non-infected subjects may alter taste and flavor perception and lead to changed dietary habits and metabolism. Most global consumers can practice the ‘how’ and ‘when’ to beneficially eat but food insecurity poses a global problem.
INTRODUCTION
The subject matter of this overview topic is vast and only relevant scientific snippets and definitions have been embodied into a general framework of life on this planet. From a human perspective [1], sociological [2, 3], accessibility [4], environmental [5], locale [3], historiography [1], scientific [6-8], economic [9], feeding habits [10] and cultural [11] are among key factors/terms for food security [3, 12-14] and sustainability [5]; and even longevity [11]. From a philosophical/ religious point of view, food has a place in the concept that ‘the world is one family’ (‘Vashudayo Kutumbakam’ which comes from ancient Sanskrit in the Maha Upanishad (VI,71-73) [15]), a motivation for the authors to write this overview in this world of inequality [16, 17]; e.g. low-income countries’-CVD deaths [18]. The layout of this article concerning the reduction in global NCDs using food chemosensory properties is shown in Fig. (1).
Fig. (1)) Schema for reducing global NCDs using food chemosensory characteristics: health inequalities implicitly incorporate the ‘5WsH’ circumstances which refer to the who, what, where, when, why and ‘how’ of food consumption.Food
This is a source of chemical energy [19]. The human body requires food, and just as the entire universe has been reportedly made up of the five elements Viz. earth, water, fire, air, and space, which according to Hinduism [20] ((assumed to be traced back to the Veda) are Prithvi/Bhudevi (Sanskrit: Earth), Apas/Varuna/Jal (Sanskrit: Water), Agni (Sanskrit: Fire), Vayu (Sanskrit: Air), and Akasha/Dyaus (Sanskrit: Space/Atmosphere/Ether)) whereas a similar system of cosmic rather than natural substances, arose in East Asia [21]. In Ancient Mediterranean tradition, food utility could be construed to involve the four classical Greek elements [22] Viz. fire (energy), earth (chemicals), air (oxygen/carbon dioxide), and water (q.v. Empedocles (c450 BCE) ([23], pp 62,75)), later aether (space) (q.v. Aristotle [22, 19], 350 BCE). It has been said, “No animal can live without food….(which) is about the most important influence in determining the organization of the brain and the behavior that the brain organization dictates.” [24]. From birth, humans have different taste propensities [25], and presumably, this has developed throughout evolution [26, 27] and migration [28]: hence the subsection herein on ‘locale’. Today researchers think of food as being necessary for sustaining metabolic processes essential for life [29] including reproduction and fertility [30] in terms of thermodynamic properties associated with evolved anaerobic and aerobic pathways involving the metabolism of fats [31], carbohydrates, proteins, etc., and other essential ingredients. Descriptions of sensory and related characteristics are as follows.
Color
This does not exist in the external world but luminance along with wavelength (color) is extremely important in natural selection and behavior. Color, which arose in common ancestors in Cambrian times in the Metazoa, arises from the visual perception by the brain of the light-spectrum (390-700nm) in humans and other animals [32-34] emanating from absorption, emission, and reflection from objects interacting with different retinal cells [35]. In humans “Color is the general name for all sensations arising from the activity of the retina of the eye and its attached nervous mechanisms, this activity being, in nearly every case in the normal individual, a specific response to radiant energy of certain wavelengths and intensities [36]”. As a sensory property, this sense can affect food choice [37, 38]. Though in animals ‘one cap does not fit all’ there is an interplay between luminance and wavelength processing [32] e.g., identifying brown [39], which drives behavior. Luminance and wavelength color/contrast are important in the co-evolution in plants and animals [40, 41]. Also, visual pictures of high-calorific food with contrasts were shown to women with binge-eating disorder or bulimia nervosa (with controls) and differential brain activation was found using functional magnetic imaging [42]. Of practical value in marketing (FDM), is the CIELAB 3-dimensional color space tool [43] which represents the gamut of human photopic vision that allows the detection of small numerical differences in color and has utility in the wine [44] and food [45, 46] industries. It has been reported, for example, that blue light reduces the hedonic impression of food appearance but not the willingness to eat: men consumed less breakfast (omelets and mini-pancakes) than women under conditions of blue light unlike yellow or white light [47]. Taste and smell may affect our visual choice of food [48] which are now described.
Taste
In humans/primates taste [49] (disambiguate sentiment and judgment in society [50, 51]), which comprises sensory afferents from intra- and extra-taste buds (epiglottis, soft palate, and esophagus) from food in the mouth and tongue [52, 53] arising from texture [54, 55] (and temperature and mechanical stress/ pain in the trigeminal system [56] in the taste cortex (anterior insula) [49], and inputs from the neurons of the orbitofrontal cortex (taste and smell of food) and amygdala. In humans, there is a learning curve in infants for taste and food preferences [57] and a genetic sensitivity to taste [58]. In the evolution of animals, particularly in herbivory, it is necessary for mutual survival to recognize categories of taste (e.g., sweet, sour, salty bitter, pungent, astringent [59], and smell). Singh et al. [60] have devised a 10-point hedonic scale for the perception of taste among Asians with some possible reservations for adjustment/expansion for a locale, vide infra e.g., Middle East and South Asia. Before the advent of bioelectronic tongues [61], understanding mechanisms of neuronal action that are satiety-specific e.g., fats, and calcium that may lead to designer foods [54, 62] to aid nutrition and combat eating disorders, it is preferable that taste, akin to other senses remains a ‘window onto the world’ with its evolutionary focus on specificity and sensitivity. It seems that taste can influence GLP-1 (Glucagon-like peptide) levels [63], which is important for insulin secretion and sensitivity, therefore in the prevention of metabolic syndrome which is an NCD. Methods have been developed to simulate human taste, but these are in their infancy and may be used to monitor food adulteration [64].
Smell
The olfactory system in human pregnant mothers develops in utero, possibly from conception (certainly in the first trimester) when the olfactory bulb differentiates from the forebrain [65-67]: and odor learning begins before birth in response to maternal consumption of volatile foods and may be important in ‘latching on’ as breast milk from natural mother or wet nurse has a characteristic odor (Jocelyn Baber-midwife-personal communication). Associative learning in odor perception of infants, based on food volatiles consumed by the mother [68] may be important for next-generation food consumption and nutrition, preconditioning in maternal diet through perspiration and lactation. In some animals, smell is more sensitive than humans due to anatomy and inhalation e.g., canines [69], and detailed descriptions of animal food-searching and nutrition are beyond the remit of this overview. Smell and food have relevance in the marketing of perfume [65]. Perhaps supermarkets may prime customers with fragrances, in a non-attentive way that influences food choice [70] and consequently nutrition. In a subtle/insidious way, perfumes could be used to promote food products e.g., ‘eau de stilton’ for Stilton cheese or ‘flame’ for red meat [65] marketed by the Stilton Cheese Company and Burger King, respectively. Odors also have ‘colors’ as adjudged by tasters of white wine adulterated with odorless dye assessed to be red; thus, olfactory information was probably ignored at the verbalization phase of this perceptual illusion [71].
‘Smell’ in insects is complex and mediated through receptor genes for chemical cues acting as signals for a range of non-social to eusocial cuticular hydrocarbons important in the evolution of communication in social insects, particularly concerning foraging and fertility [72]. Therefore, smell has evolved and is used in conjunction with other senses, as an important agent in safe food consumption in planetary life. The development of odor measurements can provide ‘fingerprint’ patterns of chemical species revealed from gas chromatographic/mass spectrographic [73] or specific devices e.g [74]. measurements obtained from odor-sample space analysis under control conditions. Given the role of vision, taste, and smell in food choice, and the appearance [75] and content of food on the plate [76], these being important factors in food consumption are now described as follows.
Culinary Plate
The factors that influence the safety (e.g. microfluidic technologies [77]) and nature of food consumption on the plate include hygiene standards [78], farming/fishery/aquaculture practices [79-81], food processing [82, 83], storage technologies (potential improvements [84]) and transport to point-of-sale (e.g. refrigeration [85] (functional food could reduce food waste, and added antioxidant dietary fiber, e.g. by-products of plant processing, can bring added health value [86]), psychological cognitive-affective aspects of food choice [87], plate size and food amount/spacing/calorific value [88-91], communal and shared eating [92], printing [6, 93, 94], labeling information/in color/size [95], gustatory competence in animal evolution [96], etc.). Cooking and cooking skills of chosen foods also relate to cultural, environmental, and socioeconomic factors leading to health inequalities [97] which are beyond the remit of this paper.
Flavor
Flavor may be described as a perception drawn from multisensory inputs which can be core intrinsic (smell, some elements of touch, taste) or extrinsic (shape, color, sound,) [98, 99]. Cowart [100] has divided flavor into two parts: sensitivity to chemical stimuli (threshold, sensitivity, adaption, etc.); hedonism (preferences, pleasantness, etc.); and the chemoaesthetic sensations described by Lawless and Heyman [101]. A review of flavor preferences of children and adults found that children had preferences for sweet and salty flavors cf. to adults [102] and possibly Vice versa for children and adolescents for sour and bitter flavor preferences, which may have a bearing on NCD risk depending on their flavor preference and dietary consumption in childhood and adolescence and later.
Locale
As men and women have developed differentially in anatomy, physiology, and morphology, over evolutionary time, in different parts of the world with multifarious food preparations that have been developed, they have evolved different dietary and nutritional needs. In isolation, cautious causal interpretation of sensory data is the watchword because ethnicity, gender, age, diet, alcohol consumption, social class, occupation, exercise (inactivity), shift work, smoking, environment, etc., and sensory measurement may influence erroneous conclusions about causation, but correlations indicate the strength and direction of association e.g., factors associated with non-communicable diseases such as cardiovascular disease. The experiment design and analysis are paramount for national studies e.g., cross-section design with sufficient participants for prescribed statistically significant differences. Singh et al. [60] cite the work of the University of Nottingham’s Sensory Science Centre which studied 223 volunteers who were pheno- (PTS (6-n-propylthiouracil (PROP) Taster Status [103]; SLS (Sweet Liking Status); TTS (Thermal Taster Status)) and genotyped for TAS2R38 –rs713598 (encoding a bitter taste receptor) and the salivary trophic factor Gustin –rs2274333; single nucleotide polymorphism is indicated. The taste phenotypes were found to be independent, but differences between Asians and Caucasians existed, the former being more likely to be PROP supertasters, as well as more likely to be thermal tasters or Low Sweet Likers, than the latter. Gender was also significantly associated with SLS, where males were more likely to be High Sweet Likers. For perceived taste intensity, traditional ANOVA analysis proved to be challenging. The alternative approach, using regression trees, was shown to be an effective tool to provide a visualized framework to demonstrate the multiple interactions in this dataset. For example, ethnicity was the most influencing factor for perceived sour and metallic taste intensity, where Asians had a heightened response compared to Caucasians. The regression tree analysis also highlighted that the PTS effect was dependent on ethnicity for sour taste, and PTS and TTS effects were dependent on ethnicity for metallic taste. The quest now is to determine if all these food-choice sensory and related factors are possibly associated with nutritional outcomes and the future prevalence of NCDs.
Impact on Nutrition and Non-communicable Disease Prevention
Non-communicable diseases included herein are cancer, cardiovascular disease (CVD), diabetes, and obesity [104] (these also include dementias, bone and joint diseases, liver and GI diseases, etc.) and evidence-based counter-high-risk dietary constituents include nuts, fruit, vegetable oils, non-starchy vegetables, legumes, and fish whereas increased risk is associated with red meat, trans fat, sugar, refined grains, starch, etc. and a recent notable reviewed 51-chapter publication by Singh and colleagues is relevant [3, 105-113] which includes a chapter on Ancient Chinese medicine [109]. It would seem logical to assume that when chemo-senses are impaired the choice of dietary constituents is changed, possibly increasing adverse factors for NCDs [114]. Liu et al. [115], as part of the National Health and Nutrition Examination Survey of the USA for self-reporting adults ≥40y, building on a previous study of smell and taste dysfunction by Hoffman et al. [116], found that ethnicity (non-Hispanic Blacks), a CVD history, and high alcohol consumption was associated with a higher prevalence of taste impairment. The prevalence of smell impairment was independently associated with cancer, age, gender ethnicity, family income and educational attainment. The scale of the smell and taste impairment was estimated overall to be approximately 21 (14%) and 26(17%) million Americans for smell and taste, respectively; there were also significant differences, in univariate analysis, for diabetes as per hypertension and cancer for smell impairment [115]. It follows that prospective and objective measures of smell and taste are needed to progress towards more definitive outcomes of association of non-communicable disease and chemo-senses.
However, it is a Herculean task to design studies, using multisensory human-food information, to prevent non-communicable diseases: but we invoke Elpis, the spirit of hope [117], to make progress: by suggesting one alters people’s behavior on food choices through marketing (FDM) [118, 119], based on functional foods (in a predictable way) without causing adverse health effects, using human-computer interactive flavor augmentation (HCIFA) (enhancing, boosting, modifying flavor: perceived/imagined [99]) technologies/methodologies [99, 120]. The human visual experience of food (shape, color) in the UK, and elsewhere, may influence choice through logical semantics, concerned with presupposition and implication, e.g., round rosy red apples, ’wonky’/misshapen grubby vegetables/mushrooms but on a global basis, orthonasal olfaction is beyond the remit of this overview e.g. odor is not discernible in some packaged products, particularly in supermarkets. However, Velasco et al. [121] demonstrated a Stroop [122] like effect when searching for the product packaging which exhibited rapid searching by participants when congruent characteristics, e.g., color/flavor label, were present cf. non-congruent (e.g. red/tomato Vs. yellow/tomato) [121].
Elpis, the Spirit of Hope, will traverse the gap between HCIFA in a limited setting to one of the large-scale designs involving psychologists, computer experts, statisticians, social and behavioral scientists, regulatory and monitoring bodies, operating through expert practitioners, which will lead consumers/diners (food and beverages) towards a healthier lifestyle; including a reduction in non-communicable diseases [123] (NCD). Beginning with VATMA (Visual, Auditory, Tactic, Multisense, Augmentation) [99], visual perception in appetite science can be enhanced by pairing the main dish, comprising putative low-risk NCD constituents, with a garnish [124], or including the same with herbs and spices which may have cultural outcomes [125] or trends towards vegetarianism [126]. One can change the luminance of food on a plate to convey the mental imagery of freshness [127] or by the neatness of the plating of food [128]. All such augmentations may involve factors, vide supra, e.g., color, shape, and more, e.g., sound [129] (auditory flavor augmentation [130]; necklace device [131]; commensal dining robotics [132]; etc.).
The use of extended reality (XR) technology, comprises augmented reality (AR), mixed reality, and virtual reality and the former has used a pro-cam AR system to modify the shape and appearance of food on a plate (sponge-cake & chips) such that increased food chroma can increase the taste-sweetness of sponge-cake. Experiments have been conducted on the hedonics of taste and flavor wherein tableware (EducaTableware) has been introduced which emits sounds/music according to the electrical resistance of the food through fork (EaTheremin) or TeaTheremin (which is a cup-type device used for drinking) [133, 134] which can be linked to mealtime and used as possibly one tool for increasing cardiometabolic health [135], including NCDs, particularly if children are initiated through acoustic media e.g. nursery rhymes [136]. From a tactile perspective, the flavor may be influenced by the weight, and size of cutlery [137, 138]; prevention of NCD using the ‘gravitamine spice’ system [139] may potentially encourage people to eat less (of the correct food). Although future augmentation reality processes may be combined, they are not sufficiently developed to enhance any NCD prevention strategies and are not discussed further. However, experiment design will be critical and expensive as one progresses from a laboratory-style setting through to a pilot field experiment and thence to large-scale trials.
DISCUSSION
Global NCD: Future Research
An important question asked of food research for reducing global NCDs, especially in low- and middle-income countries [140] (where the burden of NCDs is the highest and rapidly growing [141]), is ‘its effectiveness’ given (the oft conflicting) research/activities undertaken by public health bodies and the food and beverage industry [142], and NGOs (Singh et al e.g [143].) and individual practices. Effectiveness is a questionable measurement for a variety of reasons including food insecurity [144, 145] and economic constraints (women) [146, 147]. Aware (authors) of the Katha Upanishad idiom (c5 century BCE) [148] on so-called personal ignorance, it is important to set the work in this overview from the perspective of health priorities on global ‘hidden hunger’ [149, 150], NCDs and the sustainability of feeding the world’s population [151]. According to FAO data [152] an acceleration of the ‘present’ reduction of hunger and malnutrition is needed (see Fig. (2) for future food research by global networks of centers of excellence). It has been reported that 800 million are chronically underfed from an energy perspective, 2 billion have micronutrient deficiency and 1.9 billion are overweight or obese [153, 154]. Importantly, 4.7 million premature deaths are linked to obesity, 13% of the adult population (39% overweight) and 1 in 5 children/adolescents are obese or overweight, respectively [155]. Reference [155] has an important interactive feature for providing information on children, women, men, and adult obesity over several recent decades.
Fig. (2)) Avenues of future food research by global networks of centers of excellence.It is reasonable, amid the multifarious global risk factors for NCDs, that the salient feature of this overview enables future niche activities to reduce NCDs through the creation of centers or networks of excellence which translate properly statistically ‘significant and powered’ findings through paired or networked public health bodies within or between countries akin to those reported [141] and so enhancing global research platforms rather than being largely forgotten [156].
Visual Cues
In a global context, it is important to consider the visual design cues for food choice [157] affecting behavioral outcome or psychological processes [119, 158, 159]. A consumer’s interpretation of health claims on the packaging labels of functional food products [160] will motivate them to purchase or otherwise (q.v. health star rating rather than nutrition information [161]). More of the product, particularly if they have a perceived need, poses higher risks, e.g. an elevated NCD risk. There are 74 categories of future research items (e.g., FR 73 is a long-term choice needed for making unappealing products appealing) [157]: this is a complex situation to be unraveled in NCD reduction research programs because not all are related to in-store food marketing per se. Price and inflationary socioeconomic pressure may force consumers to choose cheaper and possibly foods that are less healthy [162]. Populations in nations that were formerly very adherent to the Mediterranean Diet (MD) are choosing not to do so, which may indicate less reduced CVD (e.g., among children or adolescents) [163-165]. Media information about food can be a target for public health policies such as NCD reduction, particularly from food corporations adjudged to be sometimes cautious in providing food-health information or who have alternative views or promotions that are often directed towards unhealthy food [166-168]. Adverti- sements [169] are not discussed further in this overview.
Olfaction
It remains to be seen how COVID-19 [170] in low-, medium- and high-income countries may change the prevalence of NCDs due to its high prevalence (though not exclusive and variable [171, 172] of anosmia (short term (or longer) effect [173]) compared to non-infected tested subjects (3:1 [174]) which alters taste and flavor perception [175], through possibly differential mechanisms [176] potentially leading to malnutrition, weight loss, fatigue, poorer mental health, etc [175]. Importantly, an infection may affect comorbidities including NCDs such as diabetes progression [177] which is not part of this overview.
Texture
Food texture may affect oral processing and if dietary management advice increases the number of masticatory cycles before bolus, this may reduce dietary intake, and increase satiety [178], and consequently ‘how to eat’ and ‘when to eat [179]’ may, given the appropriate low-ultra-processed food, reduce NCDs [180].
CONCLUSION
Cognizant that ‘the world is one family’, this overview describes chemosensory characteristics of food and related issues that may enable global inequalities in healthy food consumption to be improved with a reduction in non-communicable diseases (NCDs). Food color, taste, smell, culinary plate, flavor, locale, and the disposition of food on the culinary plate all have the potential to have a favorable impact on nutrition and non-communicable disease, particularly in concert with researchers around the world. Human-computer interface and food augmentation reality and commensal dining in association with chemosensory properties, including sound concerning oral food processing are described. Future research on arresting trends in the prevalence of NCD is suggested based on the literature. Visual cues for in-store food choice are discussed that potentially allow the consumer, through psychological processes and behavior outcomes, to be more discerning. The relatively high prevalence of anosmia caused by COVID-19 infection relative to non-infected subjects may alter taste and flavor perception and lead to changed dietary habits and metabolism. Food insecurity poses a global problem and the authors recognize the global plight of 800 million or so who are chronically underfed, the 2 billion who have micronutrient deficiency and 1.9 billion who are overweight or obese, and the 4.7 million premature deaths that are linked to obesity. For many, life is difficult, but alternative crops may yield promise subject to healthy nutrition [e.g., 181, 182] (Non-vivere bonum est, sed bene vivere [183] (To live is not a blessing, but to live well)); and Elpis with the relevant author-citations herein (and others in the past, present and future) will substantially overcome this scourge on humanity.
AUTHORSHIP ATTRIBUTION
DW mainly wrote the paper; FDM provided marketing advice; RBS was the expert on NCDs and nutrition; TT provided information on dietary fiber; and HSB reviewed the structure and edited content.
