Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
  • A61K36/18—Magnoliophyta (angiosperms)
  • A61K36/185—Magnoliopsida (dicotyledons)
  • A61K36/75—Rutaceae (Rue family)
  • A61K36/752—Citrus, e.g. lime, orange or lemon
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
  • A61K31/19—Carboxylic acids, e.g. valproic acid
  • A61K31/194—Carboxylic acids, e.g. valproic acid having two or more carboxyl groups, e.g. succinic, maleic or phthalic acid
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
  • A61K36/18—Magnoliophyta (angiosperms)
  • A61K36/185—Magnoliopsida (dicotyledons)
  • A61K36/45—Ericaceae or Vacciniaceae (Heath or Blueberry family), e.g. blueberry, cranberry or bilberry
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
  • A61K36/18—Magnoliophyta (angiosperms)
  • A61K36/185—Magnoliopsida (dicotyledons)
  • A61K36/73—Rosaceae (Rose family), e.g. strawberry, chokeberry, blackberry, pear or firethorn
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
  • A61K36/18—Magnoliophyta (angiosperms)
  • A61K36/185—Magnoliopsida (dicotyledons)
  • A61K36/87—Vitaceae or Ampelidaceae (Vine or Grape family), e.g. wine grapes, muscadine or peppervine
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
  • A61K36/18—Magnoliophyta (angiosperms)
  • A61K36/88—Liliopsida (monocotyledons)
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
  • A61K47/26—Carbohydrates, e.g. sugar alcohols, amino sugars, nucleic acids, mono-, di- or oligo-saccharides; Derivatives thereof, e.g. polysorbates, sorbitan fatty acid esters or glycyrrhizin
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0087—Galenical forms not covered by A61K9/02 - A61K9/7023
  • A61K9/0095—Drinks; Beverages; Syrups; Compositions for reconstitution thereof, e.g. powders or tablets to be dispersed in a glass of water; Veterinary drenches
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P13/00—Drugs for disorders of the urinary system
  • A61P13/02—Drugs for disorders of the urinary system of urine or of the urinary tract, e.g. urine acidifiers
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P13/00—Drugs for disorders of the urinary system
  • A61P13/04—Drugs for disorders of the urinary system for urolithiasis

Definitions

• urolithiasis The incidence of urolithiasis is increasing worldwide. Established risk factors for urolithiasis include dehydration, family history, obesity, bowel disease, and diets high in sodium and animal protein. Additional approaches to preventing or treating urolithiasis are needed. While compositions that are high in citrate have been utilized in the prevention of urolithiasis, the inconvenience and taste of such preparations have resulted in poor patient compliance. While there have been attempts to produce citrate rich beverages that delivers clinically significant citrate to individuals such that the occurrence of kidney stones is prevented or reduced, as shown in US Patent No. 9,278, 112 ( ⁇ 12 patent), these compositions are believed to be tasteless beverages that are problematic resulting in poor patient compliance. Additionally, the beverage envisioned by the 112 patent requires significant volumes to achieve clinical benefit.
• beverage that are citrate rich products - including beverages (liquids, powders, liquid concentrates) that not only prevents the onset of kidney stones but treats all forms of urolithiasis. Additionally, such a beverage to improve patient compliance should be comprised of naturally occurring sources (eg. citrus juices) that are be fortified with naturally occurring source(s), of added citrate or in the alternative added citrates that are synthesized citrate supplements. It is also desirable to consumption of such a beverage in consumer friendly volumes results in higher urinary citrate levels and alkalization of urine such as to produce urine pH at about 6 to 7.1.
• beverages liquids, powders, liquid concentrates
• a beverage is further needed in that about 8 ounces of (one serving) is sufficient to produce desired therapeutic effect with continued use every day having a citrate level that is about 4500mg (2000-6500mg) per serving.
• a beverage having fortified citrate levels is further need that may optionally contain Ca, K, Mg, Zinc, mineral supplements, vitamin supplements and soluble fiber is also needed. It is also desirable that such a beverage will also contain lower potassium levels, lower acidity levels and lower glycemic index. Additionally, for ease of use and patient safety, it is desirable that such a beverage has a shelf life that is extended by various methods of pasteurization process.
• edible, citrate-rich compositions also referred to as edible, citrate- rich products
• methods of making edible, citrate-rich compositions including citrate- rich beverages (citrate-rich liquid compositions), powders and liquid concentrates
• methods in which such edible, citrate-rich compositions, including citrate-rich beverages (citrate-rich liquid compositions), powders and liquid concentrates are consumed (methods of therapy), which include (a) methods of preventing the onset of urolithiasis, (b) methods of reducing (partially or completely) the extent to which urolithiasis occurs and (c) methods of treating urolithiasis, by administering citrate-rich products.
• citrate-rich products or citrate-rich beverages may be a combination of naturally occurring citrate products or that naturally occurring citrate products fortified with synthesized citrate supplements.
• the preceding are referred to as methods of therapy /therapeutic methods.
• Urolithiasis encompasses conditions in which stones are formed or reside in the urinary system and includes nephrolithiasis (stones in the kidneys), ureterolithiasis (stones in the ureter) and cystolithiasis (stones in the bladder).
• the most common component of urinary calculi is calcium, which is a major constituent of nearly 75% of stones.
• Calcium oxalate makes up about 60% of all stones; mixed calcium oxalate and hydroxyapatite, 20%; and brushite stones, 2Va.
• Uric acid stones occur in another 10% of individuals.
• the citrate-rich compositions described herein are particularly useful for individuals in whom calcium and/or uric acid based stones are likely to form or have formed. It may also be used in patients who form cystine based stones.
• Edible, citrate-rich compositions such as edible, citrate-rich liquids (e.g., beverages, concentrates) and powders, can comprise naturally-occurring source(s) of citrate (such as citrus juices), can be fortified naturally-occurring source(s) of citrate (which contain a (one or more, at least one) added citrate/ citrate source and have higher citrate concentration than the corresponding product that is not fortified/ includes no added citrate) or can be a combination of naturally-occurring citrate-containing source(s) and fortified citrate-rich products, such as a combination of naturally-occurring citrate-rich beverage(s) and fortified citrate-rich beverage(s).
• naturally-occurring source(s) of citrate such as citrus juices
• fortified naturally-occurring source(s) of citrate which contain a (one or more, at least one) added citrate/ citrate source and have higher citrate concentration than the corresponding product that is not fortified/ includes no
• Naturally-occurring and/or fortified citrate-rich beverages include, but are not limited to, juice, juice-water, carbonated, and non-carbonated beverages, shakes, smoothies, drinkable yogurt- type, milk products and k-cups.
• Citrate-rich beverages may be in a ready-to drink form or available as a concentrate, retort pouch, freeze-dried beverage, or a powder mix to be reconstituted with water or other ingestible liquid(s).
• a sufficient volume of a citrate-rich composition such as a beverage described herein, results in higher urinary citrate levels and alkalization of urine (such as to produce urine with pH of from about 6 to about 7.1, including pH of about 6.0, about 6.1, about 6.2, about 6.3, about 6.4, about 6.5, about 6.6, about 6.7, about 6.8, about 6.9, about 7.0, about 7.1).
• a sufficient volume is consumed to have a therapeutic effect (with continued use), which can be solubilization of developing or existing stones and/or reduction (partially or completely) of future stone development.
• a citrate-rich beverage one serving
• 8 ounces of a citrate-rich beverage (one serving) described herein is sufficient to produce the desired therapeutic effect with continued use.
• Continued use can be over several days (e.g., two days or more, two to five days or more, a week or more, a month or more, several months, a year or more or over many weeks, months or years, including essentially every day for an individual's life.
• the time over which use must continue can be determined on an individual basis.
• a citrate-rich composition such as a citrate- rich beverage
• a period of time e.g., a month
• consumption ends, consumption begins again (e.g., symptoms reoccur or life status/circumstances change) and continues for a period of time, followed by one or more additional periods during which the citrate-rich composition, such as the citrate-rich beverage is consumed daily for a period of time and consumption and one or more additional periods during which it is not consumed.
• Citrate-rich beverages can be consumed by individuals (humans) known to form stones (who have previously formed stones, such as kidney stones, stones in the ureter or bladder); individuals (humans) at risk for forming kidney stones (e.g., those with a family history of kidney stone formation; men, such as men between 20 and 50 years of age); individuals (humans) in occupations predisposing to heat exposure and dehydration; individuals (humans) with bowel disease that leads to enteric hyperoxaluria; pregnant women and individuals (humans) who are non-stone formers, but who consume citrate-rich beverages described herein, such as as part of a preventative regimen (e.g., for preventing development of urolithiasis). They find use, for example, in conditions that include, but are not limited to, hypercalciuria, hyperuricosuria, hyperoxaluria, hypomagnesuria, hypocitraturia, cystinuria and gouty diathesis.
• the methods include methods of preventing the onset of at least one of the conditions, methods of reducing (partially or completely) the extent to which at least one of the condition occurs and methods of treating at least one of the conditions once it has occurred.
• the method is carried out by administering a citrate-rich product.
• the edible, citrate-rich compositions can be used in military, athletic, and outer space programs in the global market. Particular advantages of the citrate-rich beverages described herein are their ease of preparation and their enjoyable taste, which will contribute to compliance by those who need or would benefit from their consumption. Liquid preparations of citrate permit longer intestinal transit time.
• FIGs 1 and 2 are schematic representations of methods (processes) by which citrate- rich beverages can be produced.
• Edible, citrate-rich compositions including edible, citrate-rich beverages, powders and liquid concentrates, described comprise one or more sources of citrate, such as one or more citrate-containing juice(s) and/or one or more juice concentrate(s); or one or more citrate- containing juice(s) and/or one or more juice concentrate(s) and one or more additional source(s) of citrate that is not a citrate-containing juice (referred to as a non-juice citrate source).
• Citrate- containing juices include, but are not limited to, orange juice, lemon juice, lemonade, tangerine juice, pineapple juice, grape juice, cranberry juice, lime juice and grapefruit juice. Concentrates of one or more of these juices can be used.
• Non-juice citrate sources include potassium citrate, sodium citrate, calcium citrate, zinc citrate, magnesium citrate, citric acid or any combination of two, three, four, five or six of potassium citrate, sodium citrate, calcium citrate, zinc citrate, magnesium citrate, and citric acid.
• Non-juice citrate sources are, for example, powders (e.g., fine or crystalline powder), pills or tablets.
• the citrate level of an edible citrate-rich composition is about 4500mg (range about 2000mg-about 6500mg) per serving, which equates to the typical range of oral potassium citrate given in tablets 20-60Meq per day. It is contemplated within the scope of this disclosure that a serving would be approximately 8 ounces. On a daily (24 hour) basis, citrate intake contributed by an edible citrate-rich composition, such as a citrate-rich beverage, does not exceed about 6500mg.
• the citrate level to be included in a specific citrate-rich beverage can be determined using known methods and the amount included will varyfte determined for a particular citrate-rich composition based on such considerations as the severity of the condition for which the citrate-rich beverage will be consumed, the age of the consumer and the ability to prepare a beverage acceptable to consumers.
• the citrate level ranges from about 2100mg-about 6400mg per serving; about 2500mg-about 6400mg per serving; about 3000mg-about 6400mg per serving; about 3500mg- about 6400mg per serving; about 4000mg- about 6400mg per serving; about 4500mg-about 6400mg per serving; about 5000mg-about 6400mg per serving; or about 6000mg- about 6400mg per serving.
• the citrate level is any citrate level from at least about 2100mg per serving up to and including about 6400m g per serving, such as at least about 2000mg per serving; at least about 2100 mg per serving; at least about 2200mg.
• a serving is approximately 8 fluid ounces, which can be consumed in one or more portions.
• an 8-ounce serving can be consumed at one time or in more than one portion, such as several smaller amounts in a day, the total of which is an 8-ounce serving.
• an 8 ounce serving of a citrate-rich beverage can be diluted (to produce a beverage with a lower citrate concentration).
• Citrate can be provided as potassium citrate, sodium citrate, calcium citrate, zinc citrate, magnesium citrate, citric acid, other form of citrate appropriate for consumption by humans, or any combination (e.g., any combination of two, three, four, five or six of potassium citrate, sodium citrate, calcium citrate, zinc citrate, magnesium citrate, and citric acid).
• Sources of citrate that are not citrate-containing juices are referred to as non-juice citrate sources.
• Such edible, citrate-rich compositions may further comprise one or more (a, at least one) of the following: soluble calcium, soluble potassium, soluble magnesium, soluble zinc, mineral supplements, vitamin supplements, and soluble fiber.
• the edible, citrate-rich compositions may also comprise added sugar (e.g., sucrose, fructose, glucose, honey, galactose, maltose, lactose) and/or sugar alternative(s).
• Sugar content may be reduced (partially or completely) through the use of sugar alternatives, such as all natural sugar alternatives, such as but not limited to, honey, coconut or date sugar, Stevia or sugar alcohols (e.g., erythritol, xylitol, sorbitol).
• Such citrate-rich beverages may comprise additional ingredients including, but not limited to, any combination of juice blends of fruits and/or vegetables (e.g., for flavor), coloring, flavor, natural and artificial sweeteners, preservatives, caffeine, protein, tea and coffee.
• Juice blends of fruits and/or vegetables included, for example, for flavor might not be citrate-containing, but could also include some citrate.
• Edible, citrate-rich compositions such as edible, citrate-rich beverages
• Such compositions can also be in the form of a concentrate (liquid or powder, for example), which is combined with a liquid, such as milk, water, additional juice (e.g., a juice that is not a citrate-containing juice described herein, such as apple juice or pear juice), soy-based beverage, before the composition is consumed.
• the citrate-rich beverages are formulated to contain lower potassium levels, have reduced acidity and have lower glycemic index or any combination ofthe three (e.g., lower potassium levels and reduced acidity; lower potassium levels and lower glycemic index; reduced acidity and lower glycemic index; all three).
• citrate sources can be used in making edible, citrate-rich compositions.
• Sources of citrate include juices that contain citrate (e.g., orange juice, lemon juice, lemonade, tangerine juice, pineapple juice, grape juice, cranberry juice, lime juice and grapefruit juice and other sources of citrate suitable/appropriate for consumption, such as citrate in tablet or powder form.
• the juice or juices used to produce a citrate-rich beverage can be in the form of a juice concentrate or juice in ready -to-consume form (not a juice concentrate).
• any combination of orange juice, lemon juice, lemonade, tangerine juice, pineapple juice, grape juice, cranberry juice, lime juice, grapefruit juice, orange juice concentrate, lemon juice concentrate, lemonade concentrate, tangerine juice concentrate, pineapple juice concentrate, grape juice concentrate, cranberry juice concentrate; lime juice concentrate and grapefruit juice concentrate can be used to produce an edible, citrate-rich composition.
• juice is used here to refer to (encompasses) juice in ready-to-consume form and juice concentrate.
• the citrate-rich beverages are formulated such that their consumption in sufficient quantity to prevent the onset of urolithiasis, reduce (partially or completely) the extent to which urolithiasis occurs, or treat urolithiasis results in a daily intake of not more than about 4500mg potassium or the recommended daily intake; not more than about 1200mg calcium or the recommended daily intake; not more than about 320-420mg magnesium or the recommended daily intake; not more than about 40mg of zinc or the upper tolerance level; or any combination of the foregoing.
• citrate-rich beverages described herein typically contain, per 8 ounce serving, from about 60mg to about lOOOmg potassium, from about lOOmg to about410mg magnesium, from about lmg to about 20mg zinc. They may also contain per 8 ounce serving, from about 5mg to about 500mg calcium.
• the volume of citrate-rich compositions, such as a citrate-rich beverage, consumed daily is from about 200ml to about 1000ml; in these cases, the levels of the components (e.g., citrate) are adjusted accordingly (so that consumption of the volume from about 200ml to about 1000ml provides the same amount of citrate as in an 8 ounce serving described herein.
• the adjustment can be carried out by diluting an 8 ounce serving described herein with sufficient additional liquid that does not contain citrate to produce the desired volume.
• at least one 8 ounce serving is consumed each day.
• the volume consumed each day can be consumed in one or more doses or servings.
• the citrate-rich beverages can, optionally, also include (be supplemented with) sodium bicarbonate. Consumption of the citrate- rich beverage in the amounts described can result in increased urinary citrate excretion, alkalization of urine and increased urinary volume. Formulation of such beverages may be adjusted based on the consumer's health and dietary and lifestyle restrictions. Following is a description of several embodiments of citrate-rich beverages and how they are produced. These embodiments are provided as examples only and are not to be considered limiting in any way.
• Citrate-rich beverages can comprise any combination of citrate-containing edible ingredients or components available, including citrate-containing juice(s) and additional, different source(s) of citrate which are not citrate-containing juice(s) (also referred to as non- juice citrate sources).
• a citrate-rich beverage comprises a (at least one; one or more) citrate-containing juice and an additional source of citrate that is not a citrate-containing juice (non-juice citrate source), such as one or more of the following: potassium citrate, sodium citrate, calcium citrate, zinc citrate, magnesium citrate, and citric acid.
• the citrate-containing juice(s) can be, for example, at least one of the following: orange juice, lemon juice, lemonade, tangerine juice, pineapple juice, grape juice, cranberry juice, lime juice and grapefruit juice.
• the citrate-rich beverage includes a (at least one; one or more) citrate-containing juice and an additional source of citrate that is not a citrate-containing juice
• the citrate-rich juice is lemon juice, lime juice, orange juice, tangerine juice or grapefruit juice.
• the citrate-rich beverage comprises at least two (two or more) citrate-containing juices and may, optionally, also include an additional source of citrate that is not a citrate-containing juice.
• the citrate-rich beverage includes two or more citrate-containing juices, such as any combination of two or more of orange juice, lemon juice, lemonade, tangerine juice, pineapple juice, grape juice, cranberry juice, lime juice and grapefruit juice, and does not include an additional source of citrate that is not a citrate- containing juice.
• the two or more citrate-containing juices are any combination of two or more citrate-containing juices in amounts sufficient to produce a citrate- rich beverage that includes the desired amount of citrate, such as 4500mg (range 2000mg- 6400mg) per serving, which equates to the typical range of oral potassium citrate given in tablets 20-60Meq per day.
• a citrate rich beverage includes two or more citrate- containing juices and no additional source of citrate that is not a citrate-containing juice, the juices are any combination of two or more of lemon juice, lime juice, orange juice and grapefruit.
• Other citrate-containing juices can be included, such as to provide a source of citrate and to add to/alter the flavor of the citrate-rich beverage.
• the citrate-containing juices can be any combination of two or more of orange juice, lemon juice, lemonade, tangerine juice, pineapple juice, grape juice, cranberry juice, lime juice and grapefruit juice and the non-juice citrate source can be potassium citrate, sodium citrate, calcium citrate, zinc citrate, magnesium citrate, citric acid or any combination of two, three, four, five or six of theforegoing.
• the juices are at least two of the following: lemon juice, lime juice and orange juice.
• citrate-rich beverages typically provide, for example, 4500mg citrate (range 2000mg-6400mg) per 8 ounce serving. Additionally, they may further comprise one or more (at least one) of the following: soluble calcium, soluble potassium, soluble magnesium, soluble zinc, mineral supplements, vitamin supplements, soluble fiber, sugar or sugar alternative. Additional ingredients that may be in such citrate-rich beverages include, but are not limited to, any combination of juice blends of fruits and/or vegetables, coloring, flavor, preservatives, caffeine, protein, tea and coffee.
• citrate-rich beverages described here will be selected taking into consideration such factors as the level of citrate desired, flavor, texture, appearance and other characteristics that will contribute to effectiveness, compliance and marketability of the beverages. As shown in Table 1, 2 and 5, there are many juices that can be used as sources of citrate in producing citrate-rich beverages. Additionally, Penniston and co-workers report that lemon juice contains 1.44 gm per ounce of juice; lime juice contains 1.38 gm per ounce of juice; fresh orange juice or orange juice made from concentrate contains about 0.25 gm per ounce and grapefruit juice contains 0.0068 gm per ounce. See: Penniston, K.L. et al., J. Endourol, 2008 Mar 22(3). 567-70. Quantitative assessment of citric acid in lemon juice, lime juice and commercially-available fruit juice products.
• citric acid content of commercially prepared juice drinks varies, depending on the manufacturer, but can range from 0.03 grams per ounce to 0.22 grams per ounce.
• Some artificially flavored and sweetened juices that contain no fruit can have more citric acid than the naturally-occurring citrate in citrus fruit.
• a citrate-rich beverage such as a cranberry lemonade beverage
• contains water e.g., about 80-about 85%
• juice concentrate e.g., lemon juice concentrate; orange juice concentrate; lime juice concentrate or a combination of two or three of these
• sugar e.g., about 10- about 15%
• juice concentrate e.g., cranberry juice concentrate (e.g., about 1-about 4%
• citrate e.g., about 1-about 2.5%; e.g., zinc citrate, potassium citrate, magnesium citrate, monosodium citrate or any combination of two, three or four of these).
• a citrate-rich beverage contains water (e.g., about 80- about 83%); juice concentrate (e.g., lemon juice concentrate; orange juice concentrate; lime juice concentrate or a combination of two or three of these) (e.g., about 2-3%); sugar (e.g., about 12- about 13%); juice concentrate (e.g., cranberry juice concentrate (e.g., about 1-about 2%); citrate (e.g., total about 1.4-about 2.0%; e.g., zinc citrate, potassium citrate, magnesium citrate, monosodium citrate or any combination of two, three or four of these).
• juice concentrate e.g., lemon juice concentrate; orange juice concentrate; lime juice concentrate or a combination of two or three of these
• sugar e.g., about 12- about 13
• juice concentrate e.g., cranberry juice concentrate (e.g., about 1-about 2%)
• citrate e.g., total about 1.4-about 2.0%; e.g., zinc citrate
• a citrate-rich beverage contains water (e.g., about 80-about 83%); juice concentrate (e.g., lemon juice concentrate; e.g., about 2-3%, such as about any of 2.1, 2.22.3, 2.4, 2.5, 2.6, 2.7, 2.8, or 2.9%); sugar (e.g., about 12- about 13%); juice concentrate (e.g., cranberry juice concentrate (e.g., about 1-about 2%, such as about any one of 1.1, 1.2, 1.3, 1,4, 1.5, 1.6, 1.7, 1.8, 1.9% ); citrate (e.g., total about 1.4-about 2.0%; e.g., zinc citrate, potassium citrate, magnesium citrate, monosodium citrate or any combination of two, three or four of these).
• juice concentrate e.g., lemon juice concentrate; e.g., about 2-3%, such as about any of 2.1, 2.22.3, 2.4, 2.5, 2.6, 2.7, 2.8, or 2.9%
• sugar
• the citrate-rich beverage contains zinc citrate (about 0.02%, to about 0.1 %,), magnesium citrate anhydrous (about 0.4%, to about 0.9%) and monosodium citrate (e.g., 0.1%, about 0.2%, about 0.3% about 0.4%, about 0.5%, about 0.6%, about 0.7%, about 0.8°/ 0 , aboutO.9%).
• a citrate-rich beverage contains water (e.g., about 80-about 83%); juice concentrate (e.g., orange juice concentrate; e.g., about 2-3%, such as about any of 2.1, 2.2 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, or 2.9%); sugar (e.g., about 12- about 13%); juice concentrate (e.g., cranberry juice concentrate (e.g., about 1-about 2%, such as about any one of 1.1, 1.2, 1.3, 1,4, 1.5, 1.6, 1.7, 1.8, 1.9% ); citrate (e.g., total about 1.4-about 2.0%; e.g., zinccitrate, potassium citrate, magnesium citrate, monosodium citrate or any combination of two, three or four of these).
• juice concentrate e.g., orange juice concentrate; e.g., about 2-3%, such as about any of 2.1, 2.2 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, or 2.9%
• a citrate-rich beverage contains water (e.g., about 80-about 83%, such as about 81%, about 82%, about 83%) ); juice concentrate (e.g., lemon juice concentrate; e.g., about 2-3%, such as about any of 2.1, 2.2 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, or 2.9%); sugar (e.g., about 12- about 13%); juice concentrate (e.g., cranberry juice concentrate (e.g., about 1-about 2%, such as about any one of 1.1, 1.2, 1.3, 1,4, 1.5, 1.6, 1.7, 1.8, 1.9% ); and citrate (e.g., total about 1.4-about 2.0%; e.g., zinc citrate (about 0.02%-about 0.1%), magnesium citrate (about 0.7-about 0.9%), and monosodium citrate (about 0.1-0.2%).
• juice concentrate e.g., lemon juice concentrate; e.g., about 2-3%, such as about
• a citrate-rich beverage contains water (e.g., about 80-about 85%); juice concentrate (e.g., lemon juice concentrate; orange juice concentrate; lime juice concentrate or a combination of two or three of these) (e.g., about 5 - about 13%); sugar (e.g., about 4 - about 9%); citric acid (e.g., about 0.1-about 0.5%); citrate (e.g., total about 1-about 2.5%; e.g., zinc citrate, potassium citrate, magnesium citrate, monosodium citrate or any combination of two, three or four of these); flavor(s), such as natural flavor(s) (e.g., strawberry, orange, raspberry or a combination of two or three of these) (e.g., about 0.1-about 1.0%).
• juice concentrate e.g., lemon juice concentrate; orange juice concentrate; lime juice concentrate or a combination of two or three of these
• sugar e.g., about 4 - about 9%
• citric acid e.g.,
• a citrate-rich beverage contains water (e.g., about 80-about 83%); juice concentrate (e.g., lemon juice concentrate; orange juice concentrate; lime juice concentrate or a combination of two or three of these) (e.g., about 10 -12%); sugar (e.g., about 4- about 6%); citric acid (e.g., about 0.1-about 0.5%); citrate (e.g., total about 1-about 2.5%; e.g., zinc citrate, potassium citrate, magnesium citrate, or any combination of two or three of these); flavor(s), such as natural flavors) (e.g., strawberry, orange, raspberry or a combination of two or three of these) (e.g., about 0.001-about 1.0%).
• juice concentrate e.g., lemon juice concentrate; orange juice concentrate; lime juice concentrate or a combination of two or three of these
• sugar e.g., about 4- about 6%
• citric acid e.g., about 0.1-about 0.5%
• citrate e.g
• a citrate-rich beverage contains water (e.g., about 80%, about 81%, about 82% or about 83%); juice concentrate (e.g., orange juice concentrate or lime juice) (e.g., about 10 -12%); sugar (e.g., about 4- about 6%); citric acid (e.g., about 0.1, about 0.2%, about 0.3%, about 0.4%); citrate (e.g., total about 1- about 2.0%; e.g., zinc citrate (about 0.1%, about 0.2%; about 0.3%; about 0.4%), potassium citrate (about 0.2%, about 0.3%, about 0.4%; about 0.5%; about 0.6%), magnesium citrate (e.g., about 0.4%, about 0.5%, about 0.6%, about 0.7%), or any combination of two or three of these); fruit flavor(s), such as natural flavor(s) (e.g., strawberry, orange, raspberry or a combination of two or three of these) (e.g., about 0.001-about 1.0%).
• juice concentrate e
• a citrate-rich beverage such as a berry lemonade beverage, contains water (e.g., about 80-about 85%); juice concentrate (e.g., lemon juice concentrate; orange juice concentrate; lime juice concentrate or a combination of two or three of these) (e.g., about 2 -5%); sugar (e.g., about 10- about 15%); juice concentrate (e.g., cherry juice concentrate, cranberry juice concentrate (e.g., about 0.2-about 4%); citrate (e.g., about 1-about 2.5%; e.g., zinc citrate, potassium citrate, magnesium citrate, monosodium citrate or any combination of two, three or four of these); and fruit flavor, such as natural flavor (e.g., raspberry, orange, strawberry or a combination of two or three of these) (e.g., about 0.1% to about 0.6%).
• juice concentrate e.g., lemon juice concentrate; orange juice concentrate; lime juice concentrate or a combination of two or three of these
• sugar e.g.,
• a citrate-rich beverage contains water (e.g., about 80, about 81%, about 82%, about 83%, about 84%; about 85%); juice concentrate (e.g., lemon juice concentrate; e.g., about 2%, about 3%, about 4%); sugar (e.g., about 10%, about 11%, about 12%, about 13%, about 14%, about 15%); juice concentrate (e.g., cherry juice concentrate; e.g., about 0.2%, about 0.3%, about 0.4%, about 0.5?/ 0 ); citrate (e.g., total about 1%-about 2.5%; e.g., zinc citrate (e.g.
• magnesium citrate e.g. 0.6%, about 0.7%, about 0.8%, about 0.9%, about 1.0%)
• monosodium citrate e.g., about 0.05%, about 0.06% about 0.07%, about 0.08%, about 0.09%, about 0.10%, about 0.11%, about 0.12%
• fruit flavor such as natural flavor (e.g., raspberry flavor; e.g., about 0.1%, about 0.4%, about 0.5%, about 0.6%).
• a specific embodiment is an edible citrate-rich composition in which citrate is present at (the composition comprises) a level of from about 2000mg citrate to about 6400mg citrate per 8 ounce serving.
• citrate is present at about 4500mg per 8 ounce serving and the source of citrate is at least one source selected from the group consisting of a citrate-containing juice, potassium citrate, sodium citrate, magnesium citrate, zinc citrate citric acid, and calcium citrate.
• the composition in one embodiment of the edible citrate-rich composition, is a beverage and, for example, the citrate-containing juice is at least one of the following: orange juice, lemon juice, lemonade, tangerine juice, lime juice, pineapple juice, grape juice, cranberry juice and grapefruit juice.
• citrate-rich compositions can further comprise one or more of the following: soluble calcium, soluble potassium, soluble magnesium, mineral supplements, vitamin supplements, soluble fiber in sugar-containing preparation and soluble fiber in sugar-free preparation.
• Any of these citrate-rich compositions can comprise/is constituted with at least one (a, one or more) of water, juice, milk, and yogurt and, in some embodiments, the composition is a liquid, frozen, or freeze-dried.
• the citrate-rich composition can further comprise sodium bicarbonate.
• a further embodiment is a method of reducing (partially or completely) the extent to which urolithiasis occurs in an individual or of treating urolithiasis in an individual, comprising administering a therapeutically effective amount of a citrate-rich composition of any one of the embodiments described herein to the individual, wherein the therapeutically effective amount of the citrate-rich composition is administered in at least one dose and can be administered in multiple doses over time.
• the therapeutically effective amount of the citrate-rich composition is administered in multiple daily doses or portions (multiple daily doses or portions per 24 hour period) .
• a further embodiment is a method of increasing urinary citrate levels and producing alkalization of urine in an individual in need thereof, comprising administering a citrate-rich composition of any one of the embodiments described herein to the individual in an amount sufficient to increase citrate levels in the individual's urine and produce urine of pH from about 6 to about 7.1, wherein the citrate-rich composition is administered in at least one dose per day (at least one dose per 24 hour period) and can be administered in multiple doses over time.
• the citrate-rich composition is administered in one daily dose (one dose in a 24-hour period).
• the citrate-rich composition is administered in more than one daily dose (more than one dose in a 24-hour period).
• the citrate-rich composition is administered for more than one day and can be administered over an extended period of time, which can be two or more days, a week or more, a month or more, many months, a year or more, many years or as needed throughout the individual's life.
• One embodiment is a method of reducing (partially or completely) the extent to which urolithiasis occurs in an individual or of treating urolithiasis in an individual, comprising administering a citrate-rich composition that comprises from about 2000mg citrate to about 6400mg citrate per 8 ounce serving to the individual, wherein the 8 ounce serving of the citrate- rich composition is administered in at least one dose or portion per day (24 hour period) and can be administered in multiple doses overtime.
• FIGs 1 and 2 are schematic representations of methods (processes) by which citrate- rich beverages can be produced.
• components one or more citrate-containing juice(s) (e.g., citrate- containing juice(s) in ready-to-drink/not concentrated form and/or citrate-containing juice concentrate ⁇ )) and, in some embodiments, one or more additional source(s) of citrate which is not a citrate-containing juice) are combined, using known methods, in sufficient amounts to produce a citrate-rich beverage in which the citrate content is as described in detail above.
• citrate-containing juice(s) e.g., citrate- containing juice(s) in ready-to-drink/not concentrated form and/or citrate-containing juice concentrate ⁇
• additional source(s) of citrate which is not a citrate-containing juice are combined, using known methods, in sufficient amounts to produce a citrate-rich beverage in which the citrate content is as described in detail above.
• the method comprises: (a) hydrating a citrate blend, by combining source(s) of citrate (e.g., non-juice sources of citrate) with water and producing a hydrated citrate blend (which includes the citrate source(s) in water); (b) optionally, adding or combining the hydrated citrate blend with sugar and/or sugar alternative, if desired (an optional addition/combination) and mixing the resulting combination as needed to dissolve the sugar and/or sugar alternative in the hydrated citrate blend; (c) combining the product of (a), if no sugar or sugar alternative is used or the product of (b), if sugar and/or sugar alternative is used, with juice concentrate ⁇ ) (concentrate ⁇ ) of the citrate-containing juices to be included in the citrate- rich beverage), flavoring(s) and additional components and blending/mixing the resulting combination to dissolve the components, thereby producing a blended product; (d) processing the blended product under conditions under which the blended product is pasteurized, thereby producing a pasteurized
• the method further comprises processing the citrate-rich beverage to produce a packaged citrate-rich beverage.
• the citrate blend of (a) comprises zinc citrate, magnesium citrate and monosodium citrate anhydrous. It is combined with sufficient water to hydrate the citrate blend (e.g., combined with 100°F water) and the combination is mixed, producing the citrate blend in water, referred to as a hydrated citrate blend. If sugar and/or a sugar alternative is included, it is combined with the hydrated citrate blend and the resulting combination is mixed until the sugar is dissolved. In some embodiments (e.g., when the quantity/volume of components is small), the resulting combination is mixed for about 1 minute.
• the resulting product is combined with juice concentrate(s) (concentrate(s) of the citrate-containing juices to be included in the citrate-rich beverage), flavoring(s) and additional components and the resulting combination is mixed or blended, thereby producing a blended product.
• the blended product is treated under conditions that result in its pasteurization, thereby producing a pasteurized blended product that is a pasteurized citrate-rich beverage.
• the blended product is pasteurized under process conditions such as bringing the product up to a temperature of about 185°F (e.g., for about 3 seconds, using a flow rate of about 13.5ml/minute).
• the pasteurized citrate-rich beverage is further processed, using known methods, to prepare it for storage and sale.
• the citrate-rich beverage can be hot filled (e.g., at about 185°F) into containers (e.g., glass, plastic, juice box, carton, retort pouch, can), which are then further processed, as needed, to prepare them for storage and sale.
• the containers are closed (capped, sealed), inverted briefly, chilled (e.g., in an ice bath for about 10 minutes or more) and the final product is placed in cartons.
• aseptic packaging can be used.
• the method comprises combining two citrate-containing juices, such as lemon juice concentrate and cranberry juice concentrate; water; sugar and non-juice citrate sources (citrate blend), such as zinc citrate, potassium citrate, magnesium citrate (anhydrous) and monosodium citrate, under conditions that result in production of a citrate-rich beverage in which the citrate level is about 5600 mg/8 ounce serving.
• citrate-containing juices such as lemon juice concentrate and cranberry juice concentrate
• water sugar and non-juice citrate sources (citrate blend), such as zinc citrate, potassium citrate, magnesium citrate (anhydrous) and monosodium citrate
• the method comprises combining a citrate-containing juice, such as orange juice concentrate; sugar; and non- juice citrate sources (citrate blend), such as citric acid; zinc citrate and potassium citrate; and flavoring, such as fruit flavor (e.g., strawberry flavor and orange flavor), under conditions that result in production of a citrate-rich beverage in which the citrate level is about 5500 mg/8 ounce serving.
• a citrate-containing juice such as orange juice concentrate
• sugar and non- juice citrate sources (citrate blend)
• non- juice citrate sources such as citric acid; zinc citrate and potassium citrate
• flavoring such as fruit flavor (e.g., strawberry flavor and orange flavor)
• the method comprises combining two citrate-containing juices, such as lemon juice concentrate and cherry juice concentrate; sugar; non-juice citrate sources (citrate blend), such as zinc citrate, potassium citrate, magnesium citrate (anhydrous) and monosodium citrate; and flavoring, such as raspberry flavor, under conditions that result in production of a citrate-rich beverage which contains about 5300mg citrate/8 ounce serving.
• citrate-containing juices such as lemon juice concentrate and cherry juice concentrate
• sugar non-juice citrate sources (citrate blend), such as zinc citrate, potassium citrate, magnesium citrate (anhydrous) and monosodium citrate
• flavoring such as raspberry flavor
• the method comprises combining two or more citrate-containing juices, such as lemon juice concentrate and cranberry juice concentrate; water; sugar and non- juice citrate sources (citrate blend), such as zinc citrate, potassium citrate, magnesium citrate (anhydrous) and monosodium citrate, under conditions that result in production of a citrate-rich beverage in which the citrate level is from about 2000mg to about 6400mg /8 ounce serving.
• citrate-containing juices such as lemon juice concentrate and cranberry juice concentrate
• water sugar and non- juice citrate sources (citrate blend), such as zinc citrate, potassium citrate, magnesium citrate (anhydrous) and monosodium citrate
• two or more of the following citrate-containing juices are combined: orange juice, lemon juice, lemonade, tangerine juice, pineapple juice, grape juice, cranberry juice and grapefruit juice; sufficientwater is combined with the juice concentrate(s).
• the two or more citrate-containing juices are combined in varying concentrations that result in a citrate-rich beverage that comprises from about 2500mg to about 6400mg per 8 ounce serving, such as about 4500-5500mg per 8 ounce serving.
• lemon juice, lime juice, orange juice, grapefruit juice or any combination of two, three or four of lemon juice, lime juice, orange juice and grapefruit juice can be combined in appropriate quantities to produce a citrate-rich beverage.
• a citrate-rich beverage comprises two or more of the following citrate-containing juices: orange juice, lemon juice, tangerine juice, pineapple juice, grapejuice, cranberry juice and grapefruit juice and an additional source of citrate that is not a citrate- containing juice (non-juice citrate source), such as a source of one or more of the following: potassium citrate, sodium citrate, calcium citrate, zinc citrate, magnesium citrate, citric acid. They are combined in sufficient amounts to produce a citrate-rich beverage in which the citrate content is from about 2500mg to about 6400mg per 8 ounce serving, such as about at least 4500mg per 8 ounce serving.
• the amount of each type of citrate source (citrate-containing juice, other source of citrate that is not a citrate-containing juice) needed to produce a citrate-rich beverage in which the citrate content is the desired amount (e.g., from about 2000mg to about 6400mg per 8 ounce serving, such as about 4500mg per 8 ounce serving) can be determined empirically, if the citrate content of each component is known or is determined, if necessary, using known methods.
• the citrate content of juices such as orange juice, lemon juice, and grapefruit juice is shown in Table 1 and of additional juices in Table 5.
• citrate- rich beverages described herein which contain blends of natural juices, such as, but not limited to, citrus juices, increase urinary citrate excretion and hydration and will offer consumers at risk for stone formation an adjunct to medical therapy.
• a solid (powder mix) or a liquid form for reconstitution into a citrate-rich beverage There are many possible combinations of components described herein that can be used to produce citrate-rich beverages, as well as to produce the powder and liquid concentrates that can be used to produce citrate-rich beverages.
• the liquid formulations, both ready to use and concentrated may be sterilized by such methods as_heat treatment, to inhibit contamination and increase shelf-life.
• Flavor profiles were identified that can act as vehicle to deliver high citrate level beverage that cater to consumer flavor interest. Marketable flavor profiles against prominent citrate sources were identified. Formulations prototype development include lemonade, orange and/or pineapple.
• the target for magnesium was 350mg/serving. However, the daily value (DV) for Mg is 400mg/serving. Some prototypes were formulated slightly above the 350mg/serving target to minimize the use of potassium and sodium.
• Prototype processing assessment samples were prepared using a pilot scaled plate heat exchanger (Armfield FT43 A). In order to process a shelf stable, hot-fill process, product was processed above the minimal food safety recommendations (FDA Juice Guidance recommends heat processing at juice at 160°F for 3 seconds). Conservative hot fill processing conditions were used for pilot plant prototypes using a 185°F (for at least 3 seconds) and a flow rate of 13.5ml/min. This process condition could likely be reduced once a final process operation is considered. Hot filling at 185°F (with inversion) was done to ensure that spoilage organisms were not introduced during filling. FDA guidance for food safety juice processing was used as a reference for juice time/temperature conditions.

Landscapes

• Health & Medical Sciences (AREA)
• Natural Medicines & Medicinal Plants (AREA)
• Life Sciences & Earth Sciences (AREA)
• Chemical & Material Sciences (AREA)
• Pharmacology & Pharmacy (AREA)
• Veterinary Medicine (AREA)
• Public Health (AREA)
• General Health & Medical Sciences (AREA)
• Medicinal Chemistry (AREA)
• Animal Behavior & Ethology (AREA)
• Engineering & Computer Science (AREA)
• Epidemiology (AREA)
• Botany (AREA)
• Mycology (AREA)
• Microbiology (AREA)
• Medical Informatics (AREA)
• Biotechnology (AREA)
• Alternative & Traditional Medicine (AREA)
• General Chemical & Material Sciences (AREA)
• Chemical Kinetics & Catalysis (AREA)
• Urology & Nephrology (AREA)
• Bioinformatics & Cheminformatics (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Organic Chemistry (AREA)
• Biochemistry (AREA)
• Molecular Biology (AREA)
• Oil, Petroleum & Natural Gas (AREA)
• Coloring Foods And Improving Nutritive Qualities (AREA)
• Medicinal Preparation (AREA)
• Non-Alcoholic Beverages (AREA)
• Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)

Applications Claiming Priority (2)

Publications (2)

Family

ID=62025394

Family Applications (1)

Country Status (5)

Family Cites Families (11)

• 2017
  • 2017-10-23 CA CA3041861A patent/CA3041861A1/en active Pending
  • 2017-10-23 KR KR1020197014460A patent/KR20190073461A/ko not_active Application Discontinuation
  • 2017-10-23 WO PCT/US2017/057858 patent/WO2018080986A1/en unknown
  • 2017-10-23 CN CN201780066775.0A patent/CN109963575A/zh active Pending
  • 2017-10-23 EP EP17866350.6A patent/EP3532083A4/de active Pending

Also Published As

Similar Documents

Legal Events