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Jujube

Scientific Name(s): Ziziphus jujuba Mill.
Common Name(s): Annab, Ber, Chinese date, Daechu, Hei zao, Hongzao, Jujube, Natume, Red date, Semen Ziziphi Spinosae, Sour date, Suanzaoren

Medically reviewed by Drugs.com. Last updated on Apr 14, 2022.

Clinical Overview

Use

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 humans and animals support the presence of anxiolytic and sedative properties. However, robust evidence from epidemiologic and clinical studies is 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.

Scientific Family

Botany

Z. jujuba 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.(PLANTS 2009, Vahedi 2008)

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.(Gupta 2004, Jiang 2007, Vahedi 2008) This traditional Chinese medicine has been used to treat many diseases such as insomnia, forgetfulness, headaches, and dizziness.(He 2020)

Chemistry

Over 150 compounds have been identified in this plant, including terpenoids, alkaloids, flavonoids, fatty acids, volatile oils, polysaccharides, and others.(He 2020) The polysaccharides are one of the major biologically active components of the jujube fruit and have various biological effects, including immunomodulatory, antioxidant, antitumor, hepatoprotective, and hypoglycemic activities, and GI-protective effects.(Ji 2017)

Composition of the plant parts varies geographically, as well as on the processing technique used.(Guil-Guerrero 2004) 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.(Guil-Guerrero 2004, Huang 2008)

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).(Huang 2008, Jiang 2007, Lee 2003, Lee 2004, Singh 2008, Zhang 2003, Zhao 2006) Reviews of the chemical constituents have been published.(Gao 2013, Rodríguez Villanueva 2017)

Uses and Pharmacology

Both extracts and purified compounds have excellent biological activities, especially sedative and hypnotic effects. Other effects include ameliorating or improving learning and memory, anti-inflammation, antioxidation, blood pressure and lipid lowering, antiaging, and antitumor effects.(He 2020)

Anemia

Evidence for the development of jujube fruit as a supplementary product for prevention and/or treatment of anemia has been proposed.(Chen 2020) In addition, further investigation, production, and application of jujube polysaccharides in functional foods and therapeutic agents is foreseen.(Ji 2017)

CNS

Animal data

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.(Jiang 2007, Peng 2000, Shou 2002)

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.(Heo 2003)

A hydroalcoholic extract of Z. jujube has been shown to possess antiepileptic effects against induced seizures in rodents.(Pahuja 2012)

Clinical data

A role in the management of insomnia has been suggested in a review of pharmacological effects of the jujube seed, based on 2 small clinical studies.(Rodríguez Villanueva 2017) The chemistry and psychopharmacology of the seeds of the Z. jujuba plant, Ziziphus spinosa, has been reported. Whole extracts and constituent compounds have been evaluated in preclinical and clinical studies. Z. spinosa secondary metabolites have shown to modulate GABAergic activity and the serotonergic system. The actual therapeutic agents require further confirmation/identification so that new insomnia phytomedicines can be discovered.(Shergis 2017)

A systematic review and meta-analysis of traditional herbal medicine (with Z. jujuba as the most frequently used herb) concluded that traditional herbal medicine may be an effective therapeutic option for insomnia in patients with cancer. However, considering the limited methodological qualities and inconsistent results of the included trials, further rigorous randomized controlled trials are required.(Yoon 2021)

Cancer

Animal and in vitro data

Ursonic acid (UNA) is a naturally occurring pentacyclic triterpenoid extracted from certain medicinal herbs such as Z. jujuba. UNA has promising potential to be developed into cancer- and protozoan-fighting pharmaceuticals.(Son 2020)

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.(Huang 2007, Lee 2004, Tahergorabi 2015, Vahedi 2008)

Contraceptive

An ethyl acetate extract of the plant bark had a contraceptive effect, as it arrested the normal estrus cycle of adult female mice and reduced the weight of the ovaries. The antisteroid action was reversed upon cessation of the extract supplementation.(Gupta 2004)

Drug-induced hepatotoxicity

A small pilot, randomized, double-blind, placebo-controlled, clinical trial investigated the efficacy of Jujube syrup on the prevention of drug-induced hepatotoxicity in pulmonary tuberculosis (TB) patients. This study suggested that jujube syrup could prevent anti-TB drug-induced hepatotoxicity and that it could also improve the severity of the patient's cough as well as the quality of life in pulmonary TB patients.(Maddahi 2022)

Gastrointestinal/Dyslipidemia

Animal data

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.(Huang 2008)

Clinical data

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.(Naftali 2008) Jujube extract may offer a safe natural laxative option.

A clinical study evaluated consumption of jujube fruit as a powder (5 g taken 3 times a day for 1 month) among 86 obese adolescents (12 to 18 years of age) with dyslipidemia. Decreased serum total cholesterol and LDL cholesterol were reported, with no effect on other lipid indices, blood glucose, or BMI.(Sabzghabaee 2013)

Immunoregulatory

In vitro experiments in sheep and human blood suggest anticomplementary action of the tripenoids of ethylacetate fruit extracts.(Lee 2004, Chan 2005)

Z. jujube (3.9%) is an ingredient in the Chinese multi-preparation CKBM-A01 studied for immunological effect.(Maek-a-nantawat 2009)

Dosing

Information on dosages for clinical applications is lacking. Bacterial contamination of imported jujube products remains an issue for the Food and Drug Administration (FDA).(Stewart 2004)

In a clinical trial, up to 40 drops/day of extract were used in chronic idiopathic constipation.(Naftali 2008) For traditional GI uses, up to 50 g/day of dried fruit (equivalent to 4 g of extract) has been used.(Huang 2008) A clinical study evaluated consumption of 5 g powdered jujube fruit taken 3 times/day for 1 month in adolescents with dyslipidemia.(Sabzghabaee 2013) Doses of 10 mL/day of jujube syrup have also been used in a study evaluating drug-induced hepatotoxicity.(Maddahi 2022)

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.Gupta 2004

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.Stewart 2004

Potentiation of effect of phenytoin and phenobarbitone in rodents has been reported. No effect on carbamazepine was noted.Pahuja 2012

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.Stewart 2004 Immunoglobulin E–mediated allergy with angioedema, generalized urticaria, asthma, and hypotension has been reported. A cross-reactivity with latex is also suggested.Lombardi 2005

A hepatoprotective effect (reduction of serum bilirubin levels) has been reported in a review of pharmacological effects.Rodríguez Villanueva 2017

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.Gupta 2004, Naftali 2008

References

Disclaimer

This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.

This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.

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