The world today is facing a continuous increase in non-communicable diseases (NCDs). A critical reason lies in modern lifestyles, particularly unhealthy dietary patterns. As a result, the concept of ‘Food as Medicine’ has gained increasing attention in healthcare, emphasizing the use of food to prevent disease and support long-term health, rather than merely to satisfy hunger.

Research has examined in detail the bioactive compounds found in various foods, including their mechanisms in reducing inflammation and slowing physical decline. This has made food an important component of preventive healthcare.

The concept has led to the development of ‘functional foods,’ which are natural or processed foods that contain bioactive compounds supported by scientific evidence. Their effects have been evaluated using specific biomarkers. In addition, appropriate and safe intake levels can be clearly defined, enabling their health benefits to be realized effectively in both health promotion and NCD risk reduction. Functional food research has continued to expand and has contributed to transforming the role of foods from a basic necessity of life into an important component of healthcare.

Functional foods can be categorized into three groups:

1. Naturally Functional Foods

Naturally functional foods refer to whole foods that are not or minimally processed and naturally contain bioactive compounds. Key examples include:

Fruits and vegetables are rich in antioxidants, such as polyphenols, flavonoids, and various phytochemicals, which play an important role in reducing inflammation and protecting cells from damage caused by free radicals. A study in older adults revealed that increasing fruit and vegetable intake from 2.2 to 4.2 servings per day for 16 weeks can reduce several inflammatory biomarkers. Additionally, fruits and vegetables are sources of dietary fiber that support a balanced gut microbiome, which is associated with immune function.

Another interesting group is cruciferous vegetables, such as broccoli. These vegetables contain bioactive compounds, such as sulforaphane and isothiocyanates, which help activate enzymes involved in removing toxins and carcinogens from the body and also reduce the risk of DNA mutations, which is an important mechanism in cancer prevention.

2. Intentionally Modified Functional Foods

Intentionally modified functional foods refer to foods that naturally contain bioactive compounds but are further modified or fortified through industrial processes to enhance their health-promoting properties while preserving the characteristics of the original food. Key examples include:

Omega-3-fortified food products, such as omega-3-fortified milk and salad dressings. Studies have found that consuming 3 grams/day of omega-3 fatty acids increases the levels of EPA and DHA in plasma and red blood cell membranes. It also helps reduce triglyceride levels, increase HDL (good cholesterol) levels, and improve fatty acid balance in the body. These changes are reflected in biomarkers, such as a lower arachidonic acid/eicosapentaenoic acid (AA/EPA) ratio, which is associated with reduced cellular inflammation. Moreover, it helps reduce lipid peroxidation biomarkers, such as 9-HETE and 13-HODE, which are associated with vascular damage. These mechanisms may therefore help mitigate risk factors for cardiovascular diseases, especially in older adults.

Foods fortified with prebiotics, such as prebiotic-fortified yogurt or inulin-fortified pasta, are gaining increasing attention. Inulin is a dietary fiber with prebiotic properties that promotes gut health. Studies have found that inulin-fortified pasta can significantly reduce intestinal permeability by strengthening intestinal walls and making it more difficult for harmful substances or microorganisms to enter the bloodstream. This has been observed in studies showing decreased lactulose-mannitol ratio and zonulin levels, along with increased GLP-2 levels, indicating improved intestinal lining integrity, which may contribute to a lower risk of inflammatory bowel disease (IBD).

Moreover, vitamin-, mineral- or antioxidant-fortified food products can also help promote health, especially in individuals with malnutrition or inadequate nutrient intake.

3. Functionalized Foods

Functionalized foods refer to food products that are designed or developed to have health-promoting properties beyond those naturally found in the original food. This is achieved by adding bioactive compounds during the production process. Examples include polyphenol-enriched bakery products, pasta enriched with carrot and olive leaf flours to enhance antioxidant properties, and yogurt enriched with mango peel powder to provide prebiotic benefits. These reflect advances in food innovation that integrate nutrition and food technology to enhance the role of food in health promotion.

The expansion of the functional food industry reflects a shift in consumer attitudes toward nutrition and health, from viewing food solely as a source of energy and macronutrients to recognizing its role as a source of bioactive compounds that help promote health and prevent NCDs. This trend highlights the importance of preventive healthcare and the concept of food as medicine in promoting healthy longevity.

By the medical team of BDMS Wellness Clinic Institute and the Bangkok Association for the Study of Obesity and Health Rehabilitation (BARSO).

References

• Martirosyan D. Functional Food Science and Bioactive Compounds. Bioact Compd Health. 2025 Jul 1;8(6):218–29.
• Fekete M, Lehoczki A, Kryczyk-Poprawa A, Zábó V, Varga JT, Bálint M, et al. Functional Foods in Modern Nutrition Science: Mechanisms, Evidence, and Public Health Implications. Nutrients. 2025;17(13):2153.
• Christodoulou E, Laoutari S, Athanasiou F, Poutli E, Andreou D, Kourkoutas Y, et al. Bridging Science and Lifestyle: A Feasibility Study for Developing a Novel Functional Food to Support Well-Being. Nutraceuticals. 2025 Apr 15;5(2):10.
• Mozaffarian D, Manson JE. Food as medicine: translating the evidence. Nat Med. 2023 Apr 1;29(4):753–4.

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