Medication Guide App

Jujube

Scientific Name(s): Ziziphus zizyphus (L.) Karst. Family: Rhamnaceae (Buckthorn)

Common Name(s): annab , ber , Chinese date , daechu , hei zao , hongzao , jujube , natume , red date , Semen Ziziphi Spinosae , sour date , suanzaoren

Uses

The seeds, fruit, and bark of jujube have been used in traditional medicine for anxiety and insomnia, and as an appetite stimulant or digestive aid. Experiments in animals support the presence of anxiolytic and sedative properties. However, clinical trials are lacking.

Dosing

Information is lacking.

Contraindications

Information is lacking.

Pregnancy/Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking. Avoid use of jujube bark preparations.

Interactions

An interaction with venlafaxine has been reported.

Adverse Reactions

Information is lacking.

Toxicology

Information is lacking.

Botany

Z. zizyphus is a small deciduous tree or shrub with thorny branches that grows 5 to 10 m tall. It is native to many parts of Asia, requiring hot summers and sufficient water for fruiting; however, the plant can tolerate colder temperatures and can survive in desert habitats. It has 2 to 7 cm long shiny, green, ovate leaves with 3 conspicuous veins at the base of the leaves. The flowers are small with yellow-green petals. The edible oval fruits are green when immature, turn dark red to purple-black and wrinkle when ripe, and contain a single hard seed. 1 , 2

History

Traditional use of jujube dates back 2,500 years in original Chinese materia medica records. The fruit, seed, and bark are described in Korean, Indian, and Japanese traditional writings, as well. They are used to alleviate stress and insomnia and as appetite stimulants, digestive aids, antiarrhythmics, and contraceptives. The sweet smell of the fruit is said to make teenagers fall in love. The fruit is eaten fresh or dried and made into candy; tea, syrup, and wine are also made from the berries. 2 , 3 , 4

Chemistry

Composition of the plant parts varies geographically, as well as on the processing technique used. 5 The fruit is high in carbohydrates, especially fructose and glucose, which accounts for about 77% of the weight. Vitamins C, B complex, and A, as well as calcium, potassium, and other mineral elements, have been identified. 5 , 6

Glycoside saponins, including jujuboside A and B, have been identified, as well as flavonoids, triterpenes, and short-medium chain fatty acids (eg, stearic, oleic, palmitic, linoleic). 6 , 7 , 8 , 9 , 10 , 11 , 12

Uses and Pharmacology

Clinical trials are lacking.

CNS

Jujube is used traditionally as an anxiolytic and sedative. Animal experiments using the saponin jujuboside and flavonoids from the fruits, as well as the seed extract, showed reductions in anxiety, impaired coordination and responses, and enhanced barbiturate-induced hypnotic effects. 9 , 13 , 14

In a plant screening exercise, oleamide from a jujube extract given for 3 weeks attenuated scopolamine-induced amnesia in mice. A role in cognitive impairment disorders, such as that seen in Alzheimer disease, was suggested, as the jujube extract appeared to increase the activation of choline acetyltransferase. 15

Cancer

Studies using specific saponins, as well as ethyl acetate and water extracts of the fruit and bark, have explored the potential cytotoxicity of jujube. Apoptosis and differential cell cycle arrest are suggested to be responsible for the dose-dependent reduction in cell viability. Activity against certain human cancer cell lines has been demonstrated in vitro. 2 , 11 , 16

Gastrointestinal

Jujube fruit has traditionally been used as a paste, puree, or soup to enhance digestion. In animal experiments, jujube extract decreased GI transit time and increased fecal moisture content. Increased fatty acid concentration in the cecum and decreased fecal ammonia and bacterial enzyme activity in the feces were also measured. 6

In a small (N = 50) clinical trial, the symptoms of patients with chronic idiopathic constipation improved with daily consumption of jujube extract (average, 20 drops per day) versus placebo. Because of practical issues, GI transit times were not measured in the study. 17 Jujube extract may offer a safe natural laxative option.

Other
Contraceptive

An ethylacetate extract of the plant bark arrested the normal estrus cycle of adult female mice and reduced the weight of the ovaries. The antisteroid action was reversed upon cessation of extract supplementation. 4

Immunoregulatory

In vitro experiments in sheep and human blood suggest anticomplementary action of the tripenoids of ethylacetate fruit extracts. 11 , 18

Dosage

Information on dosages for clinical applications is lacking. Bacterial contamination of imported jujube products remains an issue for the Food and Drug Administration (FDA). 19

In a clinical trial, up to 40 drops of extract per day were used in chronic idiopathic constipation. 17 For traditional GI uses, up to 50 g of dried fruit per day (equivalent to 4 g of extract) have been used. 6

Pregnancy/Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking. A contraceptive action of a bark extract has been demonstrated in mice. 4

Interactions

There has been a case report of a severe, acute serotonin reaction of venlafaxine with coadministration of jujube. Jujube 0.5 g/day was consumed regularly, and the reaction occurred after a single dose of venlafaxine 37.5 mg. 19

Adverse Reactions

Information is lacking. A clinical trial using extract of jujube reported no adverse effects and no changes to liver or kidney laboratory indices. 19 Immunoglobulin E–mediated allergy with angioedema, generalized urticaria, asthma, and hypotension has been reported. 20 A cross-reactivity with latex is also suggested. 20

Toxicology

Information is lacking. In mice, the suggested median lethal dose for the fruit is 14 g/kg body weight intraperitoneally; for the bark extract, the dose is 2.5 g/kg. 4 , 17

Bibliography

1. Ziziphus zizyphus . USDA, NRCS. 2008. The PLANTS Database ( http://plants.usda.gov , March 2009). National Plant Data Center, Baton Rouge, LA 70874-4490.
2. Vahedi F, Fathi Najafi M, Bozari K. Evaluation of inhibitory effect and apoptosis induction of Zyzyphus jujube on tumor cell lines, an in vitro preliminary study. Cytotechnology . 2008;56(2):105-111.
3. Jiang JG, Huang XJ, Chen J, Lin QS. Comparison of the sedative and hypnotic effects of flavonoids, saponins, and polysaccharides extracted from Semen Ziziphus jujube . Nat Prod Res . 2007;21(4):310-320.
4. Gupta M, Mazumder UK, Vamsi ML, Sivakumar T, Kandar CC. Anti-steroidogenic activity of the two Indian medicinal plants in mice. J Ethnopharmacol . 2004;90(1):21-25.
5. Guil-Guerrero JL, Díaz Delgado A, Matallana González MC, Torija Isasa ME. Fatty acids and carotenes in some ber ( Ziziphus jujuba Mill) varieties. Plant Foods Hum Nutr . 2004;59(1):23-27.
6. Huang YL, Yen GC, Sheu F, Chau CF. Effects of water-soluble carbohydrate concentrate from Chinese jujube on different intestinal and fecal indices. J Agric Food Chem . 2008;56(5):1734-1739.
7. Zhang M, Ning G, Shou C, Lu Y, Hong D, Zheng X. Inhibitory effect of jujuboside A on glutamate-mediated excitatory signal pathway in hippocampus. Planta Med . 2003;69(8):692-695.
8. Zhao J, Li SP, Yang FQ, Li P, Wang YT. Simultaneous determination of saponins and fatty acids in Ziziphus jujube (Suanzaoren) by high performance liquid chromatography-evaporative light scattering detection and pressurized liquid extraction. J Chromatogr A . 2006;1108(2):188-194.
9. Jiang JG, Huang XJ, Chen J. Separation and purification of saponins from Semen Ziziphus jujuba and their sedative and hypnotic effects. J Pharm Pharmacol . 2007;59(8):1175-1180.
10. Lee SM, Min BS, Lee CG, Kim KS, Kho YH. Cytotoxic triterpenoids from the fruits of Zizyphus jujuba . Planta Med . 2003;69(11):1051-1054.
11. Lee SM, Park JG, Lee YH, et al. Anti-complementary activity of triterpenoides from fruits of Zizyphus jujuba . Biol Pharm Bull . 2004;27(11):1883-1886.
12. Singh AK, Pandey MB, Singh VP, Pandey VB. Xyloprine-C, a new cyclopeptide alkaloid from Zizyphus xylopyra . J Asian Nat Prod Res . 2008;10(8):725-728.
13. Shou C, Feng Z, Wang J, Zheng X. The inhibitory effects of jujuboside A on rat hippocampus in vivo and in vitro. Planta Med . 2002;68(9):799-803.
14. Peng WH, Hsieh MT, Lee YS, Lin YC, Liao J. Anxiolytic effect of seed of Ziziphus jujuba in mouse models of anxiety. J Ethnopharmacol . 2000;72(3):435-441.
15. Heo HJ, Park YJ, Suh YM, et al. Effects of oleamide on choline acetyltransferase and cognitive activities. Biosci Biotechnol Biochem . 2003;67(6):1284-1291.
16. Huang X, Kojima-Yuasa A, Norikura T, Kennedy DO, Hasuma T, Matsui-Yuasa I. Mechanism of the anti-cancer activity of Zizyphus jujuba in HepG2 cells. Am J Chin Med . 2007;35(3):517-532.
17. Naftali T, Feingelernt H, Lesin Y, Rauchwarger A, Konikoff FM. Ziziphus jujuba extract for the treatment of chronic idiopathic constipation: a controlled clinical trial. Digestion . 2008;78(4):224-228.
18. Chan AS, Yip EC, Yung LY, et al. Immuno-regulatory effects of CKBM on the activities of mitogen-activated protein kinases and the release of cytokines in THP-1 monocytic cells. Biol Pharm Bull . 2005;28(9):1645-1650.
19. Stewart DE. Venlafaxine and sour date nut. Am J Psychiatry . 2004;161(6):1129-1130.
20. Lombardi C, Mistrello G, Roncarolo D, Senna G, Passalacqua G. Latex-jujube cross-reactivity: case report and immunological study. Allergy . 2005;60(7):971-972.

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