Chicory
Scientific Name(s): Cichorium intybus L.
Common Name(s): Blue sailor's succory, Chicory, Coffeeweed, Sugarloaf, Wild succory, Witloof
Medically reviewed by Drugs.com. Last updated on Sep 22, 2022.
Clinical Overview
Use
Roasted chicory roots are ground and brewed as a hot beverage. Chicory has traditionally been used to treat various GI disorders. Use of chicory for dyspepsia and as an appetite stimulant is recognized by the Expanded Commission E Monographs. Chicory-derived inulin has been investigated for its potential prebiotic, laxative, and antidiabetic effects, and for potential beneficial effects on mood and cognition. However, robust clinical studies are lacking to support use for any indication.
Dosing
Robust clinical trial data are lacking to provide dosing guidance. Chicory dosages, plant parts, and products used in clinical studies have varied. See specific indications in Uses and Pharmacology section.
Contraindications
Contraindications have not been identified.
Pregnancy/Lactation
Avoid use. Emmenagogue and abortifacient effects have been documented.
Interactions
None well documented.
Adverse Reactions
Contact dermatitis, occupational allergy, asthma, and anaphylaxis have been reported.
Toxicology
Information is limited; however, chicory is regarded as relatively safe, and inulin (a bioactive compound in chicory) has US Food and Drug Administration (FDA) generally recognized as safe (GRAS) status when consumed in foods.
Scientific Family
- Asteraceae (daisy)
Botany
C. intybus is a perennial plant indigenous to Europe, India, and Egypt. It grows as a weed in temperate climates and is widely cultivated in northern Europe. It was introduced to the United States in the late 19th century. Chicory has bright blue iridescent flowers that bloom from July to September. The dried root is the primary part used. When flowering, chicory has a tough, grooved, slightly hairy stem and stands 30 to 100 cm (10 to 40 in) in height. A milky exudate is found in the stems and leaves as well as in the root. C. intybus L. var. foliosum is grown primarily for its leaves, and var. sativum is used for its roots. Cichorium endivia is a closely related species of the genus.(Blumenthal 2000, Pirson 2009, USDA 2022)
History
In cultivation, chicory roots are "forced" during the fall and winter to produce 2 types of leaves used as greens: Barbe de capucin and witloof (or French endive). The leaves of young plants are used as potherbs, which are cooked like spinach. Leaves of older plants, when blanched, are used like celery. Chicory roots are boiled and eaten with butter; they are also roasted and used to add a bitter, mellow taste to coffee and tea or used as a substitute for coffee. According to Indian texts, whole plant chicory is used as a heart, digestive, stomach, and liver tonic, as well as a diuretic and anti-inflammatory agent. Use of chicory for dyspepsia and as an appetite stimulant is recognized by the Expanded Commission E Monographs. Inulin from chicory is used as a replacement for sugar and fat in snack bars and cakes.(Blumenthal 2000, Kumari 2012, Tsatsaragkou 2021)
Chemistry
Common chicory (C. intybus L.) is a source of biologically relevant elements (potassium, iron, calcium), vitamins (A, B1, B2, C), as well as bioactive compounds (inulin, sesquiterpene lactones, coumarin derivatives, cichoric acid, phenolic acids), which exert potent prohealth effects.(Janda 2021) Fresh chicory contains inulin (68%), sucrose (14%), protein (6%), cellulose (5%), ash (4%), and other compounds (3%) in contrast to dried chicory, which contains inulin (98%) and other compounds (2%).(Kaur 2021)
The roots contain large amounts of the polysaccharide fructan inulin, a bitter principle consisting of 1 part protocatechuic aldehyde to 3 parts inulin, as well as lactucin and lactucopicrin. In addition, the root contains a large number of steam-distillable aromatic compounds. Cichoriosides, ixerisoside, magnolialide, eudesmanolides, sesquiterpene lactones, caffeic acid derivatives, flavonoids, coumarins, polyphenols, and other compounds have been identified.
Acetophenone provides the characteristic chicory aroma. Upon roasting, inulin is converted to oxymethylfurfural, a compound with a coffee-like smell.
Constituents of the greens include chicoric acid (dicaffeoyl tartaric acid), flavonoids, catechol tannins, glycosides, carbohydrates, unsaturated sterols and triterpenoids, sesquiterpene lactones, and tartaric acid.
Chicory flowers contain cichoriin, esculin, esculetin, scopoletin, and umbelliferone.(Balbaa 1973, Cankar 2011, Duke 2002, Hussain 2011, Hussain 2012, Kumari 2012)
Uses and Pharmacology
C. intybus displays choleretic and digestion-promoting, as well as appetite-increasing, anti-inflammatory, and antibacterial actions, due to its varied phytochemical composition. Therefore, chicory is used most often to treat GI disorders.(Janda 2021)
Anti-inflammatory effects
Animal data
Anti-inflammatory effects have been observed in animal wound models, with wound healing observed following administration of a methanol root extract ointment in rats.(Suntar 2012)
Clinical data
In a pilot study of 40 individuals older than 50 years, limited efficacy (assessed using Western Ontario and McMaster Universities Osteoarthritis Index scale) in osteoarthritis of the knee and hip was observed at the highest of 3 chicory doses tested (600 to 1,800 mg/day in divided doses for 1 month). Further trials are necessary.(Olsen 2010)
Antihelmintic effects
Animal and in vitro data
Chicory has demonstrated antihelmintic action in cattle and other animals. A study using bioassay fractionization determined that SL 8-deoxylactucin is the chicory component with the strongest antihelmintic activity.(Valente 2021) A study of several chicory products demonstrated that the industrial byproduct of root pulp left over after inulin extraction had the greatest activity against Caenorhditis elegans and Ascaris suum.(Pena-Espinoza 2020)
Antimutagenic effects
In vitro data
Studies have demonstrated antimutagenic properties for chicory and its chemical constituents.(Conforti 2008, Edenharder 1994, Reddy 1997, Reddy 1998, Tang 1997)
Antioxidant activity
In vitro data
Radical scavenging activity and antioxidant effects have been demonstrated and may be due to the phenolic content of the roots or to the beta-sitosterol constituent.(Lante 2011, Suntar 2012) This antioxidant activity may be responsible for observed hepatoprotective effects.(Abd El-Mageed 2011, Atta 2010, Minaiyan 2012, Nassirian 2008, Zafar 1998)
Bone health
Clinical data
In a double-blind, randomized, crossover trial, 15 women who were at least 10 years postmenopausal received a commercially available product of chicory oligofructose plus long-chain inulin enriched with oligofructose or placebo for 6 weeks. Effects of calcium and magnesium absorption as well as bone turnover were measured. Compared with placebo and baseline, the chicory product resulted in a significant increase in calcium and magnesium absorption (P<0.05 each); however, no significant differences were observed in markers of bone turnover. A strong correlation was noted between baseline bone turnover and treatment-induced magnesium absorption (r=0.777; P<0.001). Additionally, bone mineral density of the lumbar spine was associated with responders versus nonresponders.(Holloway 2007)
Cardiovascular conditions
Animal and in vitro data
Experiments using an isolated toad heart suggest chicory extracts possess cardiodepressant effects.(Balbaa 1973, Duke 2002) Chicory coffee is rich in phenolics, including caffeic acid, which has demonstrated inhibition of platelet aggregation in vitro.(Schumacher 2011) In a rat study, alcoholic chicory extract at a low dose of 50 mg/kg significantly decreased systolic, diastolic, and median arterial blood pressure, whereas a high dose of 200 mg/kg demonstrated no effect.(Sedighi 2021)
Clinical data
A study in 27 healthy adults demonstrated decreased whole blood and plasma viscosity following daily consumption of chicory coffee 300 mL (caffeine free) for 1 week. Effects on platelet aggregation were mixed.(Schumacher 2011) In a double-blind, randomized, placebo-controlled trial conducted in 54 adults with type 2 diabetes, significant improvements were observed in systolic blood pressure (P=0.01) and diastolic blood pressure (P=0.03) after 2 months of oligofructose-enriched chicory inulin 10 g/day.(Farhangi 2016)
Cytotoxic effects
Animal and in vitro data
Cytotoxic studies evaluating C. intybus extracts have shown antitumor potential and have identified metabolite constituents including guaianolides, 6‑methoxyflavone, eudesmanolides, germacranolides, polyacetylene, sterol, anthocyanin, delphinidin, 3,4‑dihydroxyphenethyl, and other novel compounds. Many of these phytometabolites have shown positive cytotoxic activities in vitro, and antitumor action in vivo and in clinical trials, demonstrating the potential of C. intybus metabolites as antitumor drugs.(Imam 2019)
Dermatologic effects
Clinical data
Improvement in skin barrier protection was observed with 28-day application of chicory root extract 3% gel cream in 50 healthy female volunteers 45 to 60 years of age. Prevention of transepidermal water loss and improvement in skin microrelief were significant with the chicory root extract plus ultraviolet filters compared with controls.(Maia Campos 2017)
Diabetes
Clinical data
No association between chicory consumption and diabetes risk was observed in a large prospective cohort of French women.(Sartorelli 2010) However, in a double-blind, randomized, placebo-controlled trial in 54 adults with type 2 diabetes, 2-month administration of oligofructose-enriched chicory inulin 10 g/day resulted in significant improvements in fasting serum glucose (P=0.029 vs placebo) and glycosolated hemoglobin (P=0.01). Additionally, significant improvements were observed in the treatment group versus placebo for calcium (P=0.02), alkaline phosphatase (P=0.001), systolic blood pressure (P=0.01), and diastolic blood pressure (P=0.03).(Farhangi 2016)
A systematic review of literature of 23 studies (3 of which were clinical) concluded that C. intybus might improve glycemic status, dyslipidemia, oxidative stress, and inflammation. Of the 19 studies that evaluated the effect of chicory on glycemic index, 15 showed that C. intybus improved blood glucose index (it had no effect in 2 clinical studies and 3 animal studies). Of the 13 studies evaluating the effect of C. intybus on lipid profiles, 10 showed improved dyslipidemia. Twelve studies showed that chicory significantly reduced oxidative stress and inflammation. Further clinical studies are needed to confirm these findings.(Nasimi 2021)
In a randomized, double-blind, placebo-controlled study (N=100) evaluating the effect of C. intybus aqueous seed extract supplementation (270.5 mg twice daily 30 minutes before a meal for 12 weeks) on markers of glycemic control, oxidative stress, inflammation, and lipid profile in type 2 diabetes mellitus, significant reductions in inflammation, oxidative stress, and hypertriglyceridemia were observed in the C. intybus seed group (P<0.05). Study results suggest that C. intybus seed supplementation ameliorates disease progression and is beneficial as a potential adjunct dietary supplement for the management of type 2 diabetes mellitus.(Chandra 2020)
Food and pharmaceutical applications
Inulin is widely used in the food and pharmaceutical industries. Inulin can be used as a thickener, fat replacer, sweetener and water-retaining agent in the food industry. Inulin can also be applied in pharmaceutics as a stabilizer, drug carrier, and auxiliary therapeutic agent for certain diseases (eg, constipation, diabetes).(Wan 2020)
Hepatic effects
Animal data
When chicory was added to the daily diet of rats, all parts (root seed, stem, and leaf) were associated with lower liver enzymes, especially chicory seed, which also demonstrated significant benefits for lipid profiles.(Hameed 2022)
In rats, chicory extract protected the liver from alcohol-induced damage and increased ADH and ALDH (alcoholysis enzymes) levels.(Kim 2021) In rats with nonalcoholic fatty liver disease (NAFLD), chicory polysaccharides showed benefit via multiple mechanisms, primarily adenosine monophosphate-activated protein kinase activation.(Wu 2018) Prophylactic administration of fresh chicory juice significantly reduced hepatic fibrosis and elevated liver enzymes in rats subsequent to carbon tetrachloride exposure. In contrast, changes were not significant when the juice was administered after exposure.(Algazeery 2021)
Clinical data
In a trial of patients with obesity and NAFLD (N=92), 9 g/day of chicory seed (4.5 g in 100 mL of water twice daily) for 12 weeks demonstrated small, but statistically significant decreases in weight, body mass index, and waist circumference, but not waist-to-hip ratio. No changes in lipid profiles were noted.(Ghaffari 2019) In another study in patients with NAFLD (N=60), brewed chicory leaf resulted in significant reductions in ALT, AST, and bilirubin; however, the study was stopped early (at 6 weeks rather than the planned 12 weeks) due to unexpected adverse effects with chicory compared with the placebo group, including significant increases in red blood cells, platelets, hemoglobin, LDL, total cholesterol, and fasting blood sugar, as well as GI adverse effects of nausea, diarrhea, heartburn, abdominal pain, and food intolerance with the inability to eat normal meals.(Faraji 2022)
Microbial oral disease
In vitro data
Chicory extracts have been shown to inhibit gingivitis-causing oral pathogens in vitro.(Daglia 2011, Spratt 2012)
Mood and cognition
Clinical data
The acute effects of chicory inulin (enriched with oligofructose) on mood, well-being, and cognitive performance were investigated in 47 healthy young adult volunteers enrolled in a placebo-controlled, crossover study. Approximately 3 hours after administration of chicory inulin 5 mg, improvements in happiness, indigestion, and several memory tasks were noticed. However, it was unclear from the data if all measurements were correlated to baseline on the 2 test days.(Smith 2015)
Prebiotic/GI effects
Fructans are natural polymers found in different functional foods (eg, chicory roots). Fructans improve the gut physiology by enhancing the growth of Bifidobacteria and Lactobacilli while protecting from pathogenic microbes. In addition, consumption of fructans as prebiotics substantially improves glucose levels and regulates lipid metabolism, as well as decreases the level of lipopolysaccharides and diacylglycerol in the plasma membrane.(Kaur 2021)
Animal data
Chicory forage and roots added to the diet of pigs influenced GI microbacteria.(Liu 2012)
Clinical data
Inulin derived from chicory is a soluble dietary fiber that resists digestive hydrolysis; it is not absorbed in the small intestine but is fermented by colonic bacteria and is thus, by definition, a prebiotic. Clinical studies have shown daily inulin intake increases stool frequency and flatulence.(Micka 2017) Effects on GI bacteria largely include increases in Bifidobacteria, with some studies also demonstrating changes in Lactobacillus and Clostridium species in healthy volunteers.(Bonnema 2010, Kelly 2008, Kleesen 2007, Ripoll 2010, Rodríguez-García 2012, Slavin 2011) Inulin-rich soluble chicory extract was somewhat effective in relieving constipation in elderly patients(Marteau 2011) as well as in healthy adults.(Micka 2017) Doses of about 10 g/day appear to be well-tolerated, though nausea, bloating, and flatulence increase as the dosage increases.(Bonnema 2010, Marteau 2011, Ripoll 2010) Use of chicory for dyspepsia and as an appetite stimulant is recognized by the Expanded Commission E Monographs; however, robust clinical studies appear to be lacking to support this use.(Blumenthal 2000)
A small, placebo-controlled, parallel, randomized, double-blind trial (N=36) concluded that a daily dose of inulin promotes bifidobacterial growth and may improve gut function. It was also well tolerated in subjects with GI complaints. Subjects with abdominal symptoms and reduced tolerance of intestinal gas received either inulin (8 g/day; n=18) or maltodextrin as a placebo (8 g/day; n=18) for 4 weeks. Inulin decreased gas retention during a gas challenge test (by 22%; P=0.035 vs baseline), while placebo did not. In addition, inulin led to a higher relative abundance of bifidobacterial counts (P=0.01 vs placebo).(Azpiroz 2017)
In a randomized controlled trial of healthy adult participants with irregularity associated with low dietary fiber intake, daily supplementation with a short-chain inulin-type fructan derived from chicory roots (ie, oligofructose [Orafti P95]) provided a laxation effect without causing GI distress. Laxation benefits were especially pronounced for participants with more than 13 g/day habitual dietary fiber intake, with significant laxation occurring with Orafti P95 doses of 10 g/day and 15 g/day (P=0.04 and P=0.004, respectively).(Buddington 2017)
Dosing
Robust clinical trial data are lacking to provide dosing guidance. Chicory dosages, plant parts, and products used in clinical studies have varied. See specific indications in Uses and Pharmacology section. Native inulin up to 10 g/day was well tolerated in a study of healthy adults.(Bonnema 2010)
Pregnancy / Lactation
Avoid use. Emmenagogue and abortifacient effects have been documented.(Ernst 2002) Low levels of phytoestrogens have been identified in the milk of cows fed C. intybus.(Andersen 2009) In an older study, contraceptive activity was observed in female rats administered C. intybus extract postcoitum.(Keshri 1998)
Interactions
None well documented.
Adverse Reactions
Contact urticaria, occupational allergy, asthma, and anaphylaxis have been reported.(Pirson 2009, Willi 2009) A high intake of inulin has been reported to cause flatulence, bloating, and loose stools. Native inulin up to 10 g/day was well tolerated in a study of healthy adults.(Bonnema 2010) Case reports are lacking; however, traditional texts suggest caution in the presence of gallstones.(Blumenthal 2000)
Toxicology
Information is limited; however, chicory is regarded as relatively safe, and inulin has FDA GRAS status when consumed in foods.(Blumenthal 2000, FDA 2012)
Index Terms
- Cichorium endivia
References
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