NONI JUICE
Noni juice is derived from the fruit of the Morinda citrifolia tree indigenous to Southeast Asia and Australasia. It has been promoted, illegally in several cases, as a cure for a number of human diseases. However, there is no evidence to support any claims of therapeutic benefit.[1]
NONI JUICE
On August 26, 1998, the Attorneys General of Arizona, California, New Jersey, and Texas announced a multi-state settlement with Morinda, Inc. following charges that the company had made "unsubstantiated claims in consumer testimonials and other promotional material indicating that its Tahitian Noni juice could treat, cure or prevent numerous diseases such as diabetes, clinical depression, hemorrhoids and arthritis."[2] Such claims rendered the beverage an unapproved new drug under state and federal food and drug laws and should not have been sold until it received approval. Under the terms of the agreement, Morinda agreed to:
In August 2004, the US Food and Drug Administration issued a Warning Letter to Flora, Inc. for violating section 201(g)(1) of the Federal Food, Drug, and Cosmetic Act (the Act) [21 U.S.C. 321(g)(1)]. Flora made twelve unfounded health claims about the purported benefits of noni juice as a medical product, in effect causing the juice to be evaluated as a drug. Under the Act, this necessitates all safety and clinical trial evidence for the juice providing such effects in humans.[3]
The FDA letter also cited 1) absent scientific evidence for health benefits of the noni phytochemicals scopoletin and damnacanthal, neither of which has been confirmed with biological activity in humans, and 2) lack of scientific foundation for health claims made by two proponents of noni juice, Dr. Isabella Abbot and Dr. Ralph Heinicke.[3] Two other FDA letters have been issued for the same types of violations.[4]
Research has pointed to anthraquinones found in noni roots, leaves and fruit[5][6] as potentially toxic to the liver and other organs.[7] In 2005, two published clinical case reports described incidents of acute hepatitis caused by ingesting Tahitian Noni juice. These case reports were reviewed in 2006 by the European Food Safety Authority (EFSA),[8] which initially reported that data available at the time of the case reports were not sufficient to establish a causal relationship between consumption of the juice and hepatotoxicity; however, an increasing number of subsequent case reports suggested that some individuals may be particularly sensitive to hepatotoxic effects of noni fruit products.[9] The U.S. National Center for Complementary and Integrative Health advised against consumption of noni products if one has a history of liver disorders.[10]
The potential for toxicity caused by noni juices remained under surveillance by EFSA, individual food safety authorities in France,[11] Finland[12] and Ireland,[13] and medical investigators in Germany.[14]
Although noni plants and juices have been promoted by practitioners of alternative medicine as a cure for a number of human maladies including HIV, heart disease and cancer, the American Cancer Society concluded that "there is no reliable clinical evidence that noni juice is effective in preventing or treating cancer or any other disease in humans".[1]
In one study, heavy tobacco smokers were given 4 ounces (118 ml) of noni juice per day. After 1 month, they experienced a 30% reduction of two common free radicals compared to their baseline levels (19).
Noni juice may reduce levels of these cancer-causing chemicals. Two clinical trials found that drinking 4 ounces (118 ml) of noni juice daily for 1 month reduced the levels of cancer-causing chemicals in tobacco smokers by about 45% (13, 20).
One study found that drinking up to 6.4 ounces (188 ml) of noni juice per day for 1 month significantly reduced total cholesterol, LDL (bad) cholesterol levels, and the inflammatory blood marker C-reactive protein (24).
For example, one 3-week study gave long-distance runners 3.4 ounces (100 ml) of noni juice or a placebo twice daily. The group that drank noni juice experienced a 21% increase in average time to fatigue, which suggests improved endurance (26).
In a similar study, people with osteoarthritis took 3 ounces (89 ml) of noni juice daily. After 90 days, they experienced a significant decrease in the frequency and severity of arthritis pain, as well as an improved quality of life (29).
Arthritis pain is often associated with increased inflammation and oxidative stress. Therefore, noni juice may provide natural pain relief by reducing inflammation and combatting free radicals (30, 31).
Noni juice has numerous potential benefits, including boosting endurance, relieving pain, supporting your immune system, reducing cellular damage caused by tobacco smoke, and aiding heart health in smokers.
However, in 2005, a few cases of liver toxicity were reported in people consuming noni juice. The European Food Safety Authority (EFSA) then re-evaluated the fruit, concluding that noni juice alone did not cause these effects (34, 35, 36).
In 2009, EFSA issued another statement confirming the safety of noni juice for the general population. However, EFSA experts did report that some individuals may have a particular sensitivity for liver toxicity effects (37).
Additionally, noni juice may interact with certain medications, such as those used to treat high blood pressure or those used to slow blood clotting. For this reason, it is important to consult with your medical provider before drinking noni juice.
In fact, 3.5 ounces (100 ml) of noni juice contains roughly 8 grams of sugar. Studies show that sugar-sweetened beverages like noni juice may increase your risk of metabolic diseases, such as nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes (39, 40, 41).
We report the case of a man with chronic renal insufficiency who self-medicated with an alternative medicine product known as noni juice (Morinda citrifolia). The patient presented to the clinic with hyperkalemia despite claiming adherence to a low-potassium diet. The potassium concentration in noni juice samples was determined and found to be 56.3 mEq/L, similar to that in orange juice and tomato juice. Herbal remedies and alternative medicine products may be surreptitious sources of potassium in patients with renal disease.
A second similar trial was completed but with some modifications [42]. This trial equally divided 46 university athletes as well as 14 non-athlete controls into a TNJ group and a blackberry juice group. For 30 days, these athletes drank 100 mL TNJ or blackberry juice twice per day. This trial also included pre- and post-intervention time-to-fatigue treadmill tests, with accompanying blood analyses. The TNJ group experienced a significant decrease in mean serum creatine kinase (CK) concentration, while no such decline occurred in the blackberry juice group. This finding suggests that the improvement in endurance is a result of the ability of TNJ to mitigate exercise-induced muscle tissue damage. This protective effect likely involves the antioxidant properties of noni, as CK concentration increased along with oxidative stress markers in athletes undergoing intensive training [43]. Indeed, intense exercise causes increases in free radical production and inflammation [44] both of which are inhibited by TNJ.
The antiglycation potential of noni fruit juice was further demonstrated in an eight-week open-label intervention study and in a cross-sectional population study [66]. Both studies were conducted within the context of iridoid content, as iridoids are major phytochemicals in noni fruit and are well known for their anti-AGE biological activities [67,68]. Both studies utilized skin autofluorescence as a marker for AGE accumulation in the body [69]. The eight-week intervention study measured changes in the skin autofluorescence of 34 adults who daily consumed a mixed noni juice beverage similar to TNJ, TruAge Max (Morinda, Inc., American Fork, UT, USA). TruAge Max (MAX) is also composed of noni fruit puree but is mixed with cornelian cherry (Cornus officinalis and Cornus mas) juices, and olive (Olea europaea) leaf extract. Overweight or obese, prehypertensive, or grade 1 hypertensive males and females with impaired fasting glucose and who were not using prescription medication were included in the trial. Previously published population reference values revealed that the average initial skin autofluorescence of this group was typical of healthy 44-year-old adults even though their average actual age was 40. As such, their AGE-associated age (ASA) was four years older than their average actual age. But eight weeks of MAX supplementation reduced the ASA of this group to 39 years, demonstrating a significant antiglycative effect.
The cross-sectional population study included 3913 people from ten locations throughout Japan. During health education and promotion events, a questionnaire was used to collect demographic data and information on daily ingestion rates of mixed noni juice beverages (i.e., TNJ or MAX). Daily iridoid intake was calculated from the ingestion rates by applying the data obtained from chemical analyses of the beverages. As with the eight-week intervention study, skin autofluorescence was used as a marker for AGE burden in 2790 mixed noni juice consumers and 1123 controls (those who did not drink any noni juice beverages). Regression analysis revealed that mixed noni juice intake was associated with lower AGE levels with noni consumers having an average ASA that was 2.07 years less than the general population. Notably, for every mg of iridoids consumed, ASA decreased by 0.017 years. Among those who never smoked, the average ASA of mixed noni juice consumers was 3.52 years less than the general population. The significant anti-AGE activity of mixed noni juice was at least in part a result of its ability to induce antioxidant enzyme activity, specifically superoxide dismutase and catalase [70].
The second weight loss study included 90 grade 3 overweight (morbidly obese) adults who were divided into three treatment groups [80]. For six weeks, all participants followed a low calorie and low sodium diet. Participants in two separate mixed noni juice groups were assigned to drink either TNJ or MAX for the duration of the study. Those in the control group did not consume any noni juice beverages. Muscle mass loss was significantly lower in those drinking mixed noni juice beverages compared to the control group. Maintenance of weight loss throughout the study was greater in those drinking TNJ or MAX than in the control group as was reduction of waist circumference and body mass index. The preservation of active muscle cell mass seems to be a likely mechanism by which the improved weight loss was achieved by those in the TNJ and MAX groups. Protection of muscle tissue is also one mechanism responsible for improved endurance, as previously discussed. 041b061a72