The use of dietary supplements by patients with cancer has risen significantly over the past 2 decades despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and the Internet, often receiving misleading information.
To facilitate the availability of evidence-based information on alternative and complementary therapies commonly used by patients with cancer, The ASCO Post launches this series on Integrative Oncology, guest edited by Barrie R. Cassileth, PhD. Our first installment addresses the popular supplement Acai Berry.
Acai Berry
Scientific Name: Euterpe oleraceae
Common Names: Acai palm, cabbage palm, palm berry
Overview
A small berry that grows on a palm tree, acai is native to Central and South America, particularly the Amazon region. It is consumed as food, raw or in the form of a juice. Acai is also used in traditional medicine to treat heart problems, infections, urinary ailments, and schistosomiasis, a disease transmitted by snails.
In Brazil, the largest producer of acai berries, they are referred to as “superfruits” or “purple gold” and consumed as an ice cream flavor or a juice. In the 1990s, acai was promoted as “superfood for age-defying beauty,” thus turning it into a global phenomenon. It is also marketed to treat heart disease, flu, and arthritis, to lower high cholesterol, for weight loss, to reverse aging, and as an anticancer agent.
Acai is sold in the form of juice, energy drinks, tablets, and as an ingredient in cosmetics. However, quality control is a major concern, as many products contain preservatives, added sugar, and hidden chemicals.1 Acai has also been the subject of many Internet scams in recent years. In 2009, a lawsuit was filed against 50 companies for using famous television personalities without their permission to endorse products containing acai.
Ingesting acai fruits that were contaminated with insects carrying the protozoan Trypanosoma cruzii, a causative agent of Chagas disease, resulted in 178 cases of acute illness.2
The pulp and skin of acai fruit are rich in anthocyanins, proanthocyanidins, and other fatty acids.3 A few in vitro and in vivo studies show that acai has anti-inflammatory, apoptotic4-7 and antioxidant effects.8-10 It inhibits nitric oxide production11 and cyclooxygenases 1 and 2,9 and induces apoptosis in HL-60 leukemia cells via caspase 3 activation.4 Human studies have not yet been conducted.
Acai/Drug Interactions
Because of its antioxidant effects, acai may interfere with some chemotherapeutic agents and with radiotherapy.12 ■
Disclosure: Dr. Cassileth and Ms. Gubili reported no potential conflicts of interest.
References
1. U.S. Food and Drug Administration: Public notification: “Acai berry soft gel ABC” contains undeclared drug ingredient. October 18, 2011. Available at www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/MedicationHealthFraud/ucm276098.htm. Accessed May 2, 2012.
2. Nóbrega AA, Garcia MH, Tatto E, et al: Oral transmission of Chagas disease by consumption of açaí palm fruit, Brazil. Emerg Infect Dis 15:653-655, 2009.
3. Schauss AG, Wu X, Prior L, et al: Phytochemical and nutrient composition of the freeze-dried amazonian palm berry, Euterpe oleraceae mart (acai). J Agric Food Chem 54:8598-8603, 2006.
4. Del Pozo-Insfran D, Percival SS, Talcott ST: Acai (Euterpe oleracea Mart.) polyphenolics in their glycoside and aglycone forms induce apoptosis of HL-60 leukemia cells. J Agric Food Chem 54:1222-1229, 2006.
5. Pacheco-Palencia LA, Talcott ST, et al: Absorption and biological activity of phytochemical-rich extracts from açai (Euterpe oleracea Mart.) pulp and oil in vitro. J Agric Food Chem 56:3593-3600, 2008.
6. Mertens-Talcott SU, Rios J, Jilma-Stohlawetz P, et al: Pharmacokinetics of anthocyanins and antioxidant effects after the consumption of anthocyanin-rich acai juice and pulp (Euterpe oleracea Mart.) in human healthy volunteers. J Agric Food Chem 56:7796-7802, 2008.
7. Jensen GS, Wu X, Patterson KM, Barnes J, et al: In vitro and in vivo antioxidant and anti-inflammatory capacities of an antioxidant-rich fruit and berry juice blend. Results of a pilot and randomized, double-blinded, placebo-controlled, crossover study. J Agric Food Chem 56:8326-8333, 2008.
8. Rodrigues RB, Lichtenthaler R,Zimmermann BF, et al: Total oxidant scavenging capacity of Euterpe oleracea Mart. (acai) seeds and identification of their polyphenolic compounds. J Agric Food Chem 54:4162-4167, 2006.
9. Schauss AG, Wu X, Prior RL, et al: Antioxidant capacity and other bioactivities of the freeze-dried Amazonian palm berry, Euterpe oleraceae mart. (acai). J Agric Food Chem 54:8604-8610, 2006.
10. Hassimotto NM, Genovese MI, Lajolo FM: Antioxidant activity of dietary fruits, vegetables, and commercial frozen fruit pulps. J Agric Food Chem 53:2928-2935, 2005.
11. Matheus ME, de Oliveira Fernandes SB, Silvera CS, et al: Inhibitory effects of Euterpe oleracea Mart. on nitric oxide production and iNOS expression. J Ethnopharmacol 107:291-296, 2006.
12. D’Andrea GM: Use of antioxidants during chemotherapy and radiotherapy should be avoided. CA Cancer J Clin 55:319-321, 2005.
Compiled by Barrie R. Cassileth, PhD, and Jyothi Gubili, MS, Memorial Sloan-Kettering Cancer Center. The About Herbs website is managed by K. Simon Yeung, PharmD, MBA, Lac, Memorial Sloan-Kettering Cancer Center.
