Letter from the Editors

With the emergence of the Internet has come

online availability of numerous products and

different information sources about herbal

medicinal agents. Seville orange - also called

Bitter orange (Citrus aurantium subsp. au-

rantium) – is among the “supplements” ad-

vertised widely in recent years for the promo-

tion of rapid weight loss. The current situation

concerning its safety as a dietary supplement

is critically analyzed inside this issue of the

Newsletter.

Fruits are a very important dietary source of

vitamins, anti-oxidants and other health bene-

fits. Included of course are other Citrus spe-

cies such as Sweet orange (Citrus sinensis)

and Grapefruit (Citrus paradisi). Healthcare

professionals should be aware that drinking

grapefruit juice may interact with the statins

and other classes of medication when they are

taken, thereby causing elevated concentration

levels of these drugs in the blood. Adverse

drug interactions are a serious public health

issue.

Let’s look next at Carambola (Averrhoa ca-

rambola), which is also known as Five finger

or Star fruit, and which belongs to the Oxali-

daceae family. It is noteworthy that consum-

ing large quantities of this fruit juice alone

can be a health risk. Like grapefruit, when

Carambola fruit is taken in combination with

certain medications it has been shown to

cause significant increases in the dosage of

the medication within the body. Clinicians

and poison information centres have been

alerted to the growing evidence of serious

adverse effects ensuing when individuals with

kidney troubles consume the Star fruit/

Carambola/ Five finger. (See D.J.

Wagstaff. “International Poisonous

Plants Checklist. An Evidence-

based Reference”. 2008. CRC

Press, U.S.A.).

Reading the Internet shows that an

increasing number of rigorous in-

tervention studies and clinical tri-

als are also being conducted on

food supplements to assess their

potential therapeutic value. Only last year

scientific findings were published to demon-

strate that blood pressure can be lowered by

taking extracts either of Chili/Hot pepper

(Capsicum species) (See D. Yang et al.

2010), or of Tea (Camellia sinensis) (See I.A.

Persson et al. 2010).

“When it comes to chocolate, resistance is

futile.” Much is written about the health-

promoting virtues of Cocoa (Theobroma ca-

cao) and chocolate products, so a critical

comment concerning their potential in lower-

ing blood pressure is presented in the next

article below.

Inside this issue:

June, 2011 Volume 3, Issue:2

C A R I B B E A N H E R B A L M E D I C I N E R E S E A R C H I N S T I T U T E

CaHMRI News

LETTER FROM THE EDITORS 1

COCOA PRODUCTS AS HERBAL DRUGS

2

SEVILLE ORANGE PRODUCTS ARE SAFE

3

Averrhoa carambola

http://agriculturesource.com

The effect of cocoa products on blood pressure

was the subject of a systematic review and

meta-analysis published by S. Desch and col-

laborators inside a 2010 issue of the American

Journal of Hypertension. These scientists

confirmed that the blood pressure lowering

capacity of flavanol-rich cocoa products was

indeed demonstrated in a large set of clinical

trials.

“When it comes to chocolate, resistance is

futile”. In the particular case of chocolate stud-

ies, there seems to be a severe shortage of high

-quality clinical trials which can support the

use of chocolate for any health condition. The

obstacle has been that in many clinical trials

the chocolate intake involved varying flavanol

contents, which were dependent on the sources

of these products. Differences in the fermenta-

tion, roasting and other manufacturing process-

es may lead to different yields of flavanol

components in the chocolate product. Since the

commercial producers tend to guard their co-

coa processing techniques as trade secrets, the

challenge is for precise characterization of the

chocolate samples to be used in the clinical

trials. In order to be able to demonstrate any

adequate relationships between therapeutic

efficacy and flavonoid content, clearly still

more clinical trials ought to be conducted us-

ing strictly characterized chocolate products as

test materials.”

Analyses of the various cocoa products of

trade will show that the polyphenol (flavanoid)

content is highest in cocoa powder (“cocoa

solids”), followed by dark chocolates, and then

milk chocolate, with negligible amounts in

white chocolate. In fact white chocolate is

manufactured from cocoa butter and milk sol-

ids - without any cocoa powder.

At present the neurological basis of choco-

late’s appeal remains elusive.

A neat summary of the present situation was

described in the following way by C. Heiss

and M. Kelm (in 2010. European Heart

Journal (July), 31 (13),1554- 1556). “While

Chocolate and cocoa are products derived from

the beans (seeds) found in the fruits of the Ca-

cao (or Cocoa) tree (Theobroma cacao). Un-

like Tea and Coffee, Cocoa has considerable

food value, because the cocoa bean contains

approximately 25% fat, 15% protein and 10%

carbohydrates. The cocoa bean is also the

source of caffeine and other physiologically-

reactive compounds.

The harvested cocoa fruit contains seeds (the

beans) embedded in a sticky pulp. When the

fruits are fermented for a few days in boxes,

oxidation takes place and aroma compounds

are released in the beans. The pulp may be

washed away, leaving behind the processed

beans which are dried and packed. On roasting

at high temperature the beans can be pulver-

ized to form a liquid mass called cocoa liquor.

Hydraulic pressing of this liquor separates out

the cocoa butter (about 55%), leaving behind

the cocoa cake. This cake is dried and ground

to yield a fine powder called cocoa powder (or

“cocoa solids”) with a fat content of about

22%.

The important flavor components in cocoa

beans include aliphatic esters, pyrazines,

diketopiperazines and theobromine. The char-

acteristic bitter taste of cocoa products may be

the consequence of roasting the bean, when the

diketopiperazines react chemically with theo-

bromine.

Cocoa powder comprises a mixture of various

amines and alkaloids (such as theobromine and

caffeine), and polyphenols (such as the fla-

vanols, as monomers, oligomers and as poly-

meric procyanidins).

Chocolate is manufactured from a mixture of

cocoa powder (“cocoa solids”) with milk pow-

der, sugar and various additives.

A wide variety of cocoa formulations has been

subjected to scientific study as potential thera-

peutic treatment for hypercholesterolaemia and

coronary disease and even for some skin con-

ditions.

Cocoa products as herbal drugs

Page 2

CaHMRI News

….SCIENTISTS

CONFIRMED THAT THE

BLOOD PRESSURE

LOWERING CAPACITY

OF FLAVANOL-RICH

COCOA PRODUCTS

WAS INDEED

DEMONSTRATED IN A

LARGE SET OF

CLINICAL TRIALS.

Theobroma cacao

http://treehugger.com

Seville orange -- also called Bitter orange

(Citrus aurantium) – fruit has long been used

in food, and it is the primary ingredient in

orange marmalade. The fruit juice is sweet-

ened and taken as a traditional folk remedy

for coughs and fever in some parts of Trini-

dad.

Extracts of the fruit are used in some modern-

day herbal dietary supplements taken in

weight management as well as in sports per-

formance products. The popularity for these

supplements containing Bitter orange grew

around 2004, after the US Food and Drug

Administration banned the controversial me-

dicinal herb called Ephedra or Ma huang

(Ephedra sinica).

Because Bitter orange contains a chemical

known as p-synephrine, many writers, jour-

nalists and regulators incorrectly assumed that

it was potentially unsafe. They assumed in-

correctly that the related chemical known as

m-synephrine was involved; although m-

synephrine is NOT found as a constituent of

Bitter orange. (In fact m-synephrine is the

synthetic drug known also as phenylephrine

or neosynephrine, which is used in nasal de-

congestants).

Confusion ensued over the years which led to

the statement -- made inside the September

2010 issue of “Consumer Reports” maga-

zine -- that Bitter orange (Seville orange) was

“linked by clinical research or case reports to

serious side-effects”.

A scientific response appeared earlier this

year in the form of a comprehensive review

produced by world experts on Bitter orange

and synephrine (See S.J. Stohs and H.G.

Preuss. 2011. “The Safety of Bitter Orange

(Citrus aurantium) and p-synephrine” in

HerbalGram, 89: 34- 39). They

found these items both to be safe in

normal use as foods and also as in-

gredients in dietary supplements.

“In summary”, they write, “Based on

current research as well as the exten-

sive ingestion of bitter orange and p-

synephrine in the form of dietary

supplements as well as fruit, juices,

and other citrus food products, the

data demonstrate that bitter orange

extract is safe for human consumption. No

credible adverse events have been directly

attributed to bitter orange, or its primary pro-

toalkaloid, p-synephrine, in association with

oral ingestion.”

Harmful herbs

Page 3

Volume 3, Issue:2

… DATA DEMONSTRATE

THAT BITTER ORANGE

EXTRACT IS SAFE FOR

HUMAN CONSUMPTION.

FUTURE ISSUES will include:

*Antidiabetic plants * Legendary herbal aphrodisiacs

* The modern herbal drug industry

To send us your comments

about this newsletter,

please contact;- The Herbal Institute at UTT at Tel: 1 (868) 673 0029 / 673 2654 compton.seaforth@utt.edu.tt or jennifer.paul@utt.edu.tt

Citrus aurantium

http://en.wikipedia.org

cont’d from page 2

chocolate represents a wonderfully delicious

treat that can doubtlessly be a healthy part of

a balanced diet, cardiologists need to consider

how best to communicate such findings and

ask the important question as to whether or

not they should directly or indirectly recom-

mend to their patients an increased consump-

tion of chocolate, a food relatively high in

saturated fat, sugar and calories.”.