Digestive Functional Foods 2

Nella seconda installazione mi concentro su due dati interessanti: l’importanza dei disturbi gastrointestinali nelle farmacopee tradizionali, e la predominanza di alcuni taxa nelle piante medicinali ad attività gastrointestinale: Asteraceae, Lamiaceae ed Apiaceae.
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Plants used for gastrointestinal complaints in the folk traditions
In analyzing the literature on traditional remedies, it is quite evident that there is a prevalence of plant remedies used for gastrointestinal complaints. In a comparison between indigenous and biomedical pharmacopoeias cited by Balick and Cox, and summarized data referring to 15 different geographical areas, it was shown that “indigenous plant remedies are focused more on gastrointestinal disorders then western Pharmacopoeas”. In fact, the main indication for plant-based remedies was gastrointestinal disturbances (accounting for 15% of the total), equal only to dermatological complaints.[1]

These data are confirmed by more recent research.
In the now famous paper by Etkin and Ross on Hausa folk medicinal knowledge, of the 781 recipes registered, 184 (23.5%) were used for gastrointestinal complaints. Limiting the analysis to the naturalistic maladies, the percentage rises to 32%.[2]
Amongst the most cited uses of the remedies of the Masai in Kenya, gastrointestinal indications play a major role: stomachache is cited 100% of the time, loss of appetite 92% and indigestion 45%.[3] In more recent study on Kenyan ethnobotany, plant remedies for stomach problems were cited 20% of the times.[4]
Very similar percentages are found in other African areas. The proportion of remedies used for treatment of gastrointestinal related disease are for instance high in most studies conducted in Ethiopia, going from 23%[5] to 35%.[6]

In a comparison of Mediterranean folk pharmacopoeias, the percentage of plants used for gastrointestinal complaints went from 31.2 in Uzbekistan, to 21.68 in Turkey, to 16.93 in Greece, to 10.6 in Italy.[7]
In an ethnobotanical survey of the western Pyrenees the plants were used primarily for gastrointestinal or RT disorders,[8] and a survey done in a Peruvian clinic showed that gastrointestinal problems were the second most important reason for patients to use plants.[9]
In the ethnobotany of the South West of the US, around 23.6% of the remedies are used for gastrointestinal disorders.[10]

According to two papers on Brazilian ethnomedicine, 22 to 30% of the medicinal plants were used for digestive disorders, the second most frequent use of all.⁠[11]
A very similar percentage is apparent in a study on Mexican ethnobotany, where roughly 30% of all plants were used to treat colics and stomachaches.[12]
According to Volpato and coworkers, almost 50% of the remedies used by Haitian immigrant to Cuba are intended to treat general gastrointestinal disorders, and about 20% are used as digestive and carminative.[13]
In Perù, 20.3% of the 402 medicinal plant species were used to treat gastrointestinal disturbances, the second most important indication of all,[14] and 6,68% of all plant mixtures (the highest percentage of all uses) was used to treat colic and intestinal problems.[15]
The use of medicinal plants for the treatment of gastrointestinal disorders has a high prevalence in other Andean societies as well.[16]

Many papers have recorded the very high percentage of plants used for gastrointestinal disorders in India, usually the most frequent use af all. The data vary between 25,3% for indigestion,[17] to 30% for stomach related disorders,[18] to 51,2% for generic gastrointestinal disorders.[19] Even when the indications are not the most important, the percentages are still very relevant, as in two recent studies reporting percentages of 9 and 18% for gastrointestional uses.[20]
In a review of remedies used in Pakistan, 16% of the plants were used for gastric problems.[21]
In a recent paper on Nepali remedies, 14,3% of plant species were taken for indigestion, and 10,7% were used as appetite stimulants.[22]
In East Timor the digestive uses were 4th by frequency, adding uo to 6,7%.[23]
⁠In an ethnobotanical study based in China, 40,52% of plants were used to treat gastrointestinal disorders.[24]

These data refer to medicinal plants but, even when selecting only those remedies that can be ascribed to the food-medicine continuum, this trend remains evident.[25] In a study in Mediterranean Spain, the functional or medicinal foods were used in great prevalence for gastrointestinal disorders (up to 20.4%),[26] and the same was true in a study in northwest Patagonia, where a great number of edible medicinal plants were used for gastrointestinal disorders.[27]

In Cuba viandas (starchy roots and tuber crops) and fruits, typical foods used also as medicinal resources, are particularly important for gastrointestinal distress. Viandas are usually boiled in water or milk and eaten as mashed vegetables (Xanthosoma spp., given as a stomachic, for gastritis and stomach ulcers), or grated and sun dried and eaten with milk (Maranta arundinacea, given to kids as a digestive).[28] Fruits are used as simple remedies to improve digestion (Carica papaya, Mangifera indica, Citrus sinensis for example), to prevent colic and “stomach congestion” in kids.[29]

Various reasons have been proposed to explain the prevalence of use for gastrointestinal disorders. Balick and Cox put forward reasons of saliency and of danger perception: the gastrointestinal ailments were, according to the authors, easily identifiable, contrariwise to, for example, tumors; and in traditional societies or in ancient periods of our history the main risks for people were infective diarrheas, gastrointestinal parasitic diseases, alimentary intoxications, etc., much more than cardiovascular diseases, CNS disturbances or neoplastic diseases.[30] Traditional pharmacopoeias are also probably quite conservative and tend to favor gastrointestinal remedies even when the prevalence of diseases has changed.[31]

This prevalence would also be partly explained by the ancient, pre-cultural link between plants and humans. Herbal remedies were (and still are) mainly used per os, thus human beings have “explored” the secondary metabolites sphere mainly through the gastrointestinal tract, which then has a pivotal role as a first diaphragm between the external world and its dangers (xenobiotics) and the internal physiology, and had to “measure itself” against plant constituents: those constituents that represented at the same time a health risk and a pharmacological opportunity.

If the thesis that man had to live in a world rich in alimentary toxins, and at times had to adapt and “learn” to use the same toxins to his own advantage; it is possible that he developed systems of detection, management and defense and that these systems are mainly present in the same gastrointestinal tract.[32]

In fact, according to Johns, the effects of wild foods on the gastrointestinal tract has probably been one of the primary factors in the evolution of medicine and of the use of medicinal foods. Because taste has always been the messenger of many chemical messages, it has been interpreted in many contextualized manners, so that even bitter and pungent tastes could be accepted or even desired.[33]

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Notes
[1] Balick, M., Cox, L. (1996) Plants, people, and culture: the science of ethnobotany. New York: Scientific American Library
[2] Etkin NL, e Ross PJ (1994) “Pharmacological implications of “wild” plants in Hausa diet”. In NL Etkin (ed.) Eating on the wild side: The pharmacological, ecological, and social implications of using noncultigens. Arizona University Press
[3] Kiringe, John Warui (2006) “A Survey of Traditional Health Remedies Used by the Maasai of Southern Kaijiado District, Kenya”. Ethnobotany Research & Applications; 4:061-073
[4] Bussmann, R. W. (2006) “Ethnobotany of the Samburu of Mt. Nyiru, South Turkana, Kenya”. Journal of ethnobiology and ethnomedicine, 2, 35. doi: 10.1186/1746-4269-2-35.
[5] Teklehaymanot, T., & Giday, M. (2007) “Ethnobotanical study of medicinal plants used by people in Zegie Peninsula, Northwestern Ethiopia.” Journal of ethnobiology and ethnomedicine, 3, 12. doi: 10.1186/1746-4269-3-12.
[6] Tessema T, Giday M, Aklilu N (2001) “Stacking and information on the medicinal plants of Ethiopia”. In National Biodiversity strategy and action plan project Medicinal plant Team, Addis Ababa: IBDA; 2001.
[7] Everest, A and Ozturk, E (2005) “Focusing on the ethnobotanical uses of plants in Mersin and Adana provinces (Turkey)”. Journal of Ethnobiology and Ethnomedicine, 1:6
[8] Akerreta, S, Cavero, RY, Calvo, MI (2007) “First comprehensive contribution to medical ethnobotany of Western Pyrenees” Journal of Ethnobiology and Ethnomedicine; 3:26
[9] Bussmann, RW, Sharon D, Lopez A (2007) “Blending traditional and western medicine: medicinal plant use among patients at the Clinica Anticona in El Porvenir, Peru”. Ethnobotany Research and Applications; 5:185-199
[10] Curtin, L.S.M. (1997) Healing herbs of the upper rio grande: Traditional Medicine of the South West. Revised and edited by Michael Moore. Western Edge Press
[11] Almeida, C. D. F. C. B. R., Amorim, E. L. C. de, Albuquerque, U. P. de, & Maia, M. B. S. (2006). “Medicinal plants popularly used in the Xingó region – a semi-arid location in Northeastern Brazil”. Journal of ethnobiology and ethnomedicine, 2, 15. doi: 10.1186/1746-4269-2-15; Albuquerque, U. P. de. (2006) “Re-examining hypotheses concerning the use and knowledge of medicinal plants: a study in the Caatinga vegetation of NE Brazil”. Journal of ethnobiology and ethnomedicine, 2, 30. doi: 10.1186/1746-4269-2-30.
[12] Estrada, E., Villarreal, J. a, Cantú, C., Cabral, I., Scott, L., & Yen, C. (2007) “Ethnobotany in the Cumbres de Monterrey National Park, Nuevo León, México”. Journal of ethnobiology and ethnomedicine, 3, 8. doi: 10.1186/1746-4269-3-8
[13] Volpato, G., Godínez, D., Beyra, A., & Barreto, A. (2009) “Uses of medicinal plants by Haitian immigrants and their descendants in the Province of Camagüey, Cuba”. Journal of ethnobiology and ethnomedicine, 5, 16. doi: 10.1186/1746-4269-5-16.
[14] Luziatelli, G., Sørensen, M., Theilade, I., & Mølgaard, P. (2010) “Asháninka medicinal plants: a case study from the native community of Bajo Quimiriki, Junín, Peru”. Journal of ethnobiology and ethnomedicine, 6(1), 21. doi: 10.1186/1746-4269-6-21.
[15] Bussmann, R. W., Glenn, A., Meyer, K., Kuhlman, A., & Townesmith, A. (2010) “Herbal mixtures in traditional medicine in Northern Peru”. Journal of ethnobiology and ethnomedicine, 6, 10. doi: 10.1186/1746-4269-6-10.
[16] Bussmann, R. W., & Sharon, D. (2006) “Traditional medicinal plant use in Loja province, Southern Ecuador”. Journal of ethnobiology and ethnomedicine, 2, 44. doi: 10.1186/1746-4269-2-44; Alexiades MN, Lacaze D. (1996) “FENAMADs program in traditional medicine: an integrated approach to health care in the Peru- vian Amazon”. In Balick MJ, Elisabetsky E, Laird SA (eds.) Medicinal Resources of the Tropical Forest Columbia University Press, New York:341-365; Arrázola S, Atahuachi M, Saravia E, Lopez A. (2002) “Diversidad floristica medicinal y potencial etnofarmacólogico de las plantas de los valles secos de Cochabamba Bolivia”. Revista Boliviana de Ecología y Conservación Ambiental; 12:53-85; Bastien J (1987) Healers of the Andes: Kallawaya Herbalists and Their Medicinal Plants University of Utah Press, Salt Lake City; Bastien J (1992) Drum and Stethoscope: Integrating Ethnomedicine and Biomedicine in Bolivia University of Utah Press, Salt Lake City
[17] Kala, C. P. (2005) “Ethnomedicinal botany of the Apatani in the Eastern Himalayan region of India”. Journal of ethnobiology and ethnomedicine, 1, 11. doi: 10.1186/1746-4269-1-11.
[18] Pradhan, B. K., & Badola, H. K. (2008) “Ethnomedicinal plant use by Lepcha tribe of Dzongu valley, bordering Khangchendzonga Biosphere Reserve, in North Sikkim, India”. Journal of ethnobiology and ethnomedicine, 4, 22. doi: 10.1186/1746-4269-4-22.
[19] Sajem, A. L., & Gosai, K. (2006) “Traditional use of medicinal plants by the Jaintia tribes in North Cachar Hills district of Assam, northeast India”. Journal of ethnobiology and ethnomedicine, 2, 33. doi: 10.1186/1746-4269-2-33.
[20] Ragupathy, S., & Newmaster, S. G. (2009) “Valorizing the “Irulas” traditional knowledge of medicinal plants in the Kodiakkarai Reserve Forest, India”. Journal of ethnobiology and ethnomedicine, 5, 10. doi: 10.1186/1746-4269-5-10; Ragupathy, S., Steven, N. G., Maruthakkutti, M., Velusamy, B., & Ul-Huda, M. M. (2008) “Consensus of the “Malasars” traditional aboriginal knowledge of medicinal plants in the Velliangiri holy hills, India”. Journal of ethnobiology and ethnomedicine, 4, 8. doi: 10.1186/1746-4269-4-8.
[21] Hayat, M. Q., Khan, M. A., Ahmad, M., Shaheen, N., Yasmin, G., & Akhter, S. (2008) “Ethnotaxonomical approach in the identification of useful medicinal flora of tehsil Pindigheb (District Attock) Pakistan”. Ethnobotany Research & Applications, 6, 035-062
[22] Kunwar, R. M., Nepal, B. K., Kshhetri, H. B., Rai, S. K., & Bussmann, R. W. (2006) “Ethnomedicine in Himalaya: a case study from Dolpa, Humla, Jumla and Mustang districts of Nepal”. Journal of ethnobiology and ethnomedicine, 2, 27. doi: 10.1186/1746-4269-2-27.
[23] Collins, S. W. M., Martins, X., Mitchell, A., Teshome, A., & Arnason, J. T. (2007) “Fataluku medicinal ethnobotany and the East Timorese military resistance”. Journal of ethnobiology and ethnomedicine, 3, 5. doi: 10.1186/1746-4269-3-5.
[24] Long, C., Li, S., Long, B., Shi, Y., & Liu, B. (2009) “Medicinal plants used by the Yi ethnic group: a case study in central Yunnan”. Journal of ethnobiology and ethnomedicine, 5, 13. doi: 10.1186/1746-4269-5-13.
[25] Ruffo, C.K., Birnie, A., Tengnas, B. (2002) Edible wild plants of Tanzania. RELMA, Kenya; Williamson, G.; Yongping Bao; Chen, K.; Bucheli, P. (2004) “Effects of Phytochemicals in Chinese Functional Ingredients on Gut Health” In Choon Nam Ong and B. Halliwell (eds.) Herbal and Traditional Medicine Molecular Aspects of Health. Lester Packer
[26] Rivera-Nunez D., Obion-de-Castro C (1993) “Plant food as medicine in Medittìerranean Spain” In Actes du 2e Colloque Européen d’Ethnophannacologie et de la 1 le Conference internationale d’Ethnomédecine, Heidelberg, 24-27 mars 1993;
[27] Ladio AH (2006) “Gathering of wild plant foods with medicinal use in a Mapuche community of Northwest Patagonia” in Pieroni A, & Price LL Eating and Healing: Traditional Food As Medicine, The Haworth Press.
[28] Volpato G, Godìnez D “Medicinal foods in Cuba: Promoting health in the household”, in Pieroni and Price 2006 Op. Cit.
[29] Volpato, Godinez 2006 Op. Cit.
[30] Balick and Cox 1996 Op. Cit.
[31] Rivera-Nunez, Obon-de-castro, 1993 Op. Cit.
[32] Johns 1990, Op. Cit.
[33] Johns, T (1994) “Ambivalence to the palatability factor in wild food plants”. In NL Etkin (ed.) Eating on the wild side: The pharmacological, ecological, and social implications of using noncultigens. Arizona University Press

Digestive Functional Foods 1

Necessitato a fare un po’ di lavoro di background per un articolo prossimo venturo su cibi funzionali con attività digestiva, pubblico qui parte del materiale raccolto, in alcuni pezzi. La versione in italiano? Speriamo in tempi brevi :-).

Inizio con un volo d’uccello sui termini del discorso: i cibi funzionali.

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Functional foods and nutraceuticals
During the 1980s the Japanese Health Authorities identified special foods with extra-nutritional values as an important object of discussion, and in 1984 the Japanese Ministry of Education Science and Culture used the term “physiologically functional foods” or “functional foods” for the first time. In 1991, a formal category for alimentary items that had extra-nutritional activities was introduced: that of the “Foods for Specified Health Uses” (FOSHU), defined as: “foods with documented evidence of aiding specific physiological functions beyond whatever conventional nutrient exist in the food”.[1]

Around the time when the FOSHU system was under discussion in Japan, the term “nutraceutical” was introduced in the U.S., which included “any substance that may be considered a food or a part of a food and demonstrates to have a physiological benefit, or to provide medical or health benefits, including the prevention and treatment of protection against chronic  disease”,[2]  and which, although “produced from foods”, is  “sold in pills, powders, (potions) and other medical forms not generally associated with food[3] “.

Functional foods have been defined in many ways, but recent definitions describe them as: “products that have physiologic benefits beyond nutritive qualities, and are offered in the form of foodstuffs, including those that have been fortified or have ingredients reduced or removed”;[4] or as items that are: “similar in appearance to conventional foods, (…) consumed as part of a usual diet, and have demonstrated physiological benefits and / or reduce the risk of chronic disease beyond basic nutritional functions.”

Since then, many other terms have been used to describe the complex and multifaceted gray area of food-and-medicine: pharmafood, phytoceutical, phytonutrient, medicinal food, designer food, etc. However, functional food and nutraceutical remain the two most commonly encountered terms, and are often used interchangeably in the generalist news media. In fact one is the subset of the other, since by definition nutraceuticals are those functional foods that are transformed and offered in a pill or otherwise concentrated form, different from normal, common foodstuff.

Traditional functional foods
Although these two term have perhaps been around for 20 years, foods which are “good for your health” (Traditional or Folk Functional Foods) have been around for much longer. Medical historians have stressed the fact that the distinction between medicines and food was blurred and at times non-existent in ancient and preliterate societies, and that it was the advent of modern medicine which artificially constructed a defined hiatus between diet and therapy, food and medicine.[5]  Quoting Albala: ”most complex societies codify their foods investing in them a significance beyond satisfying hunger. In the West, at least since the ancient Greeks, this significance has been medical.”[6] Galen, following the Hippocratic spirit of preventive medicine of the Regimen, codified the age old belief that a good doctor should also be a good cook.[7] Boorde and Cogan could, in the middle of the 16th century, still hotly debate in favor of this belief, the first saying that: ”A good coke is halfe a physycyon. For the chefe physycke (the counseyll of a physycyon excepte) doth come from the kytchyn”,[8] the second referring to: ”cunning Cookes, or to the learned Physitian, who is or ought to be a perfect Cooke in many points”.[9]

The same can be said of ancient Chinese Medicine,[10] where the term Wei meant “taste” but carried all the potency of astronomical, political, ritual and medical theory association with the five agents (wood, fire, earth, metal, water), and the five flavors were to extend a framework of knowledge that had existed since/been constructed in early imperial times.[11]

Examples of FF are also available in contemporary times, both in pre-industrial societies and, although vanishing, in industrialized societies.[12] In the introduction to the collection of essays dedicated to medicinal foods, Pieroni and Price present some memories that could well be our own: the chestnut-meal polenta cooked in red wine as a cough remedy recalled by Pieroni[13] and the chicken soup used for colds cited by Price;[14] and  since the 1970s ethnobotanical literature has made it clear that the blurring of  boundaries between food and medicine is present in contemporary traditional societies, and that, as many studies have shown, non-cultivated wild gathered plants play an important role in the health benefits attributed to the Mediterranean diets.[15]

Ethnobotanists have pointed out that it would be more appropriate to talk about a continuum linking the opposite poles of medicines and foods in folk knowledge,[16] and Pieroni and Quave have come up with an often-cited mapping of this continuum, describing three other categories beyond those of food and medicine:[17]

  • Functional Foods: consumed as foods but acting beyond their basic nutritional function as food by providing protection or reducing the risk of chronic disease.
  • Folk Functional Foods: weedy species or foods eaten because they are healthy but with a general rather than unique and specific health action. Besides their main nutritional or denjoyment purposes they have other effects on body functions.[18]
  • Food medicines/Medicinal foods are ingested in a food context but are assigned specific medicinal properties; or they are consumed in order to obtain a specific medicinal action.

Some other plants are used multifunctionally, simultaneously used as food and medicines without any relationship between the two uses.[19]

It is, therefore, clear that, when talking about traditional functional foods, we need to go beyond the marketing hype, which often puts together (without blending them) the themes of the “natural” hence “safe” traditional food, with the scientific authority of biomedicine bestowed on the term functional.
Any research on this subject needs to be done across fields of research, combining historical, ethnobotanical and biomedical knowledge and insights, to avoid the fallacy of seeing FF as a mere container/vessel for phytochemicals, discounting the cultural construction of the objects of research.  Not only would this be methodologically incorrect, it would also  lead to an important mistake: namely, ascribing functional potential to a material simply due to the presence of an identified compound with known experimental activity; or, conversely, of choosing one compound as the sole element responsible for  the “medicinal” dimension of a food.

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Note
[1] Etkin, N.L. Edible medicines: An ethnopharmacology of food. The University of Arizona Press. 2006. p. 207; Dai Y, Luo X., “Functional food in China”. Nutr Rev. 1996 Nov; 54 (11 Pt 2):S21-3.
[2] DeFelice, S.L. “Preface”. In S.L. DeFelice (ed.) Nutraceuticals: Developing, Claiming, and Marketing Medical Foods. Pp. V-viii. Marcel Dekker, New York
[3] Recommendations for Defining and Dealing with Functional Foods, Report of the Bureau of Nutritional Sciences Committee on Fuctional Foods, Health Canada, 1996
[4] Etkin, N.L. 2006 Op. Cit. Pp. 207-208
[5] Etkin, N.L. Chapter 2: “Food in the history of biomedicine”. In N.L. Etkin 2006 Op. Cit. p. 207
[6] Albala, Kenneth “Dietary regime in the Renaissance”, in Malloch Room Newsletter, Jan. 1994,7: 1–2.
[7] Grant, M Galen on food and diet, London, Routledge, 2000, p. 62.; Powell, O Galen: On the properties of foodstuffs, Cambridge University Press, 2003
[8] Boorde, A The first boke of the introduction of knowledge and a compendyous regyment, ed. F J Furnivall, Early English Text Society, Extra Series, 10 London, Early English Text Society, 1870, p. 277; from the edition of 1547. As quoted in Andrew Wear, Knowledge and practice in English medicine, 1500–1680, Cambridge University Press, 2000, p. 170
[9] Cogan, T The haven of health: chiefely gathered for the comfort of students, and consequently of all those that have a care of their health, amplified upon five words of Hippocrates, written Epid. 6, Labor, cibus, potio, somnus, Venus .. . Hereunto is added a preservation from the pestilence, with a short censure of the late sicknes at Oxford of Thomas Cogan, London, printed by Henrie Midleton, for William Norton, 1584, p. 98, as cited in Wear, op. cit., note 2 above, p. 170.
[10] Unschuld, Paul U. Medicine in China: A History of Ideas. University of California Press, 1985; Unschuld, Paul U. Medicine in China: a history of pharmaceutics. Berkeley: University of California Press; Lo, Vivienne, and Penelope Barrett. “Cooking up fine remedies: on the culinary aesthetic in a sixteenth-century Chinese Materia Medica.” Medical History 49, no. 4 (2005): 395-422..
[11] Graham, A Disputers of the Tao, La Salle, ILL, Open Court, 1989, pp. 314–70
[12] Rivera-Nunez D., Obion-de-Castro C “Plant food as medicine in Meditterranean Spain” Actes du 2e Colloque  Européen  d’Ethnophannacologie  et  de  la 1 le Conf6rence  internationale  d’Ethnomédecine, Heidelberg, 24-27 mars 1993; Sandhu DS, Heinrich M. “The use of health foods, spices and other botanicals in the Sikh community in London”. Phytother Res. Jul 2005;19(7):633-42
[13] Pieroni A, & Price LL “Introduction” in Eating and Healing: Traditional Food As Medicine, The Haworth Press, 2006
[14] Pieroni and Price 2006 Op. Cit.
[15] Pieroni A, Nebel S, Quave C, Munz H, Heinrich M. “Ethnopharmacology of liakra: traditional weedy vegetables of the Arbereshe of the Vulture area in southern Italy”. Journal of Ethnopharmacology 2002, 81:165-185.; Bonet, M.A. and J. Vallés. “Use of non-crop food vascular plants in Montseny biosphere reserve (Catalonia, Iberian Peninsula)”. International Journal of Food Science and Nutrition; 2002. 53:225– 248; Rivera, D., C. Obon, C. Inocencio, M. Heinrich, A. Verde, J. Fajardo, and R. llorach. “The ethnobotanical study of local mediterranean food Plants as Medicinal Resources in Southern Spain”. Journal of Physiology and Pharmacology. 2005. 56 (S):97–114; Tardío, J., H. Pascual, and R. Morales. “Wild food plants traditionally used in the province of Madrid, Central Spain”. Economic Botany. 2005;  59:122– 136; Tardío, J., M. Pardo de Santayana, and R. Morales. “Ethnobotanical review of edible plants in Spain” Botanical Journal of the Linnean Society, 2006, 152, 27–71; The Local Food-Nutraceuticals Consortium “Understanding local Mediterranean diets: A multidisciplinary pharmacological and ethnobotanical approach”. Pharmacological Research. 2005; 52 (2005) 353–366
[16] Etkin, N.L. and P.J. Ross “Food as medicine and medicine as food: An adaptive framework for the interpretation of plant utilisation among the Hausa of northern Nigeria”. Social Science and Medicine. 1982; 16: 1559-1573; Johns, T. With bitter herbs they shall eat it. Tucson: University of Arizona Press. 1990; Grivetti, L.E. and B.M. Ogle “Value of traditional foods in meeting macroand micronutrients needs: The wild plant connection”. Nutrition Research Review. 2000; 13: 31-46; Ogle, B.M. and L.E. Grivetti “Legacy of the chameleon: Edible wild plants in the kingdom of Swaziland, southern Africa. A cultural, ecological, nutritional study. Part I–Introduction, objectives, methods, Swazi culture, landscape and diet”. Ecology of Food and Nutrition. 1985a; 16: 193-208; Ogle, B.M. and L.E. Grivetti “Legacy of the chameleon: Edible wild plants in the kingdom of Swaziland, southern Africa. A cultural, ecological, nutritional study. Part II–Demographics, species, availability and dietary use, analysis by ecological zone”. Ecology of Food and Nutrition. 1985b; 17: 1-30; Ogle, B.M. and L.E. Grivetti “Legacy of the chameleon: Edible wild plants in the kingdom of Swaziland, southern Africa. A cultural, ecological, nutritional study. Part III–Cultural and ecological analysis”. Ecology of Food and Nutrition. 1985c; 17: 31-40; Ogle, B.M. and L.E. Grivetti “Legacy of the chameleon: Edible wild plants in the kingdom of Swaziland, southern Africa. A cultural, ecological, nutritional study. Part IV–Nutritional values and conclusions”. Ecology of Food and Nutrition. 1985d; 17: 41-64
[17] Pieroni, A. e Quave, C. “Functional foods or food medicines? On the consumption of wild plants among Albanians and Southern Italians in Lucania” in A., Pieroni e L., Leimar Price (eds.) Eating and Healing, Haworth Press,  2006, p. 110
[18] Preuss, A. “Characterisation of functional food”. Deutsche Lebensmittel-Rundschau, 1999. 95:468-472
[19] Ceuterick, Melissa, Ina Vandebroek, Bren Torry, Andrea Pieroni “The Use of Home Remedies for Health Care and Well-Being by Spanish-Speaking Latino Immigrants in London: A Reflection on Acculturation” in Andrea Pieroni & Ina Vandebroek (eds.) Traveling cultures and plants: The ethnobiology and ethnopharmacy of human migrations. Bergham Books, New York, 2007