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Kiwi Fruit

Scientific Name(s): Actinidia chinensis Planchon.
Common Name(s): China gooseberry, Chinese gooseberry, Kiwi fruit, kiwi fruit extract, Tara fig, Tengligen

Clinical Overview

Use

Kiwi fruit is a useful nutritional source of vitamin C and carotenoids. Limited small clinical studies have examined the role of kiwi fruit in relieving constipation. Effects on the immune and cardiovascular systems are being investigated.

Dosing

One kiwi fruit contains about 100 mg vitamin C, approximately the recommended US daily intake, and considerable quantities of the carotenoids lutein and xanthine.

Contraindications

Contraindications have not yet been identified.

Pregnancy/Lactation

Generally recognized as safe (GRAS) when used as food.

Interactions

None well documented.

Adverse Reactions

Allergic reactions may occur in sensitive individuals. Cross-sensitivity with various pollens, latex, banana, and avocado is possible. Diarrhea has been reported following consumption of large quantities of the kiwi fruit.

Toxicology

Information is lacking.

Botany

A. chinensis, the plant source of kiwi fruit, is native to China and Taiwan, but cultivation is widespread throughout the world. Major producers include New Zealand, the United States (California), and Italy, but a considerable harvest is obtained from several other countries, including France, Israel, and Spain. The Hayward variety is the most commonly grown commercial cultivar because of its superior hardiness and long shelf life, but several other varieties, including one bearing a yellow-fleshed fruit, are cultivated. The plant is a vigorous, deciduous climber that grows to about 9 m in height, tolerating full sun or semishade. The scented flowers are pollinated by insects and appear in summer. Individual flowers are dioecious, with male or female flowers on separate plants. The egg-shaped fruit has a furry, brown skin, and firm, translucent, emerald-green flesh with numerous small, edible, black seeds at the center. When ripe, the fruit is very juicy with an acidic flavor, often described as a mixture of strawberry and pineapple. "Tara fig" (Actinidia arguta) is a related American species grown domestically.1, 2, 3, 4

History

The fruit was originally known as the Chinese gooseberry, but after aggressive marketing by New Zealand fruit growers, it became known as the kiwi fruit, partly because of its resemblance to the small, brown, flightless bird. It has been used in China as the basis for flavorful wine and has a long tradition of use as a beverage. Kiwi juice has been used in some cultures as a traditional meat tenderizer. Other reported traditional uses include treatment of urinary calculi and use as a diuretic, febrifuge, and sedative.2, 3, 4

Chemistry

The main protein component of kiwi fruit is actinidin, a thiol-protease. It accounts for about 50% of the soluble protein content of the fruit and is also its major allergen. The gene for actinidin has been sequenced. The proteolytic activity of actinidin is similar, but not identical, to that of papain. A glycoprotein inhibitor specific for pectin methylesterase has been isolated from the fruit; it is ineffective against other polysaccharide-degrading enzymes, such as polygalacturonase and amylase.5, 6, 7, 8, 9, 10

The aroma profile and the aroma-active components of kiwi fruit have been extensively investigated.8 More than 80 compounds have been identified in the volatile fraction of kiwi fruit; about 35 components appear to contribute to the aroma of kiwi fruit puree. The composition of the volatile fraction changes rapidly as the fruit matures from fresh, mature, to overripe, with a decrease in C6 compounds such as hexanal, hexenol, and ethyl butyrate, and an increase in terpene esters. The major compounds isolated from fresh puree include 3-methyl-2-butanone, 3-hydroxy-2-butanone, (E)-2-hexenal, ethyl 3-hydroxybutyrate, phenylethyl alcohol, alpha-terpineol, and geraniol. None of the flavor compounds are unique to kiwi fruit.11, 12

Several antimicrobial compounds have been isolated from kiwi fruit. Seven phytoalexins were isolated from a methanol extract of the unripe fruit previously wounded and inoculated with fungus. The isolated antimicrobial agents included a novel triterpene phytoalexin named actinidic acid, as well as arjunolic acid, asiatic acid, and 23-hydroxytormentic acid. A single-chain, antifungal, thaumatin-like protein, thought to be the only defense protein present in kiwi fruit, also has been identified. Kiwi fruit has high concentrations of ascorbic acid, carotenoids, folate, potassium, magnesium, and copper.4, 13, 14 Isoflavones and vitamin E are also present.4, 15

Kiwi seed oil has a high content of omega-3-fatty acids. The roots, which are used in traditional Chinese medicine, contain tripenoids that are weakly cytotoxic.16, 17

Uses and Pharmacology

Antimicrobial

A thaumatin-like antifungal protein isolated from kiwi fruit showed modest activity against Botrytis cinerea and weaker inhibitory activity against Mycosphaerella arachidicola, Coprinus comatus, and Physalospora piricola.14

Antioxidant activity

Kiwi fruit was found to have the highest concentration of ascorbic acid of a group of commonly eaten fruits and vegetables in an in vitro investigation of the antioxidant power.27 One kiwi fruit contains about 100 mg vitamin C, or equivalent to the recommended US daily intake. A study comparing the carotenoid content of a variety of food showed a higher proportion of lutein plus zeaxanthin (the major carotenoids in the human eye) in kiwi fruit than in spinach (54 and 47 mole%, respectively).28 In vitro and in vivo studies have been conducted to demonstrate the antioxidant activity of kiwi fruit.29, 30 In contrast to animal studies, human steady-state and pharmacokinetic bioavailability studies found no difference in bioavailability between vitamin C from a synthetic chewable tablet or eating skinless kiwi fruit.44, 45

Cancer

The plant roots are used in traditional Chinese medicine and contain tripenoids with demonstrated weak inhibitory effects in vitro against the growth of several human cancer cell lines.17

Cardiovascular

Animal data

Studies have been conducted in hypercholesterolemic mice fed preparations containing kiwi fruit and hawthorn, with positive results.18

Clinical data

Among healthy volunteers, platelet aggregation and plasma triglyceride levels were reduced after 28 days of fruit consumption. No effects on high-density lipoprotein or low-density lipoprotein cholesterol were observed.19, 20

Gastrointestinal

Animal data

There are no animal data supporting the use of kiwi fruit for improved GI function. Mice with inflammatory bowel disease fed kiwi fruit have been studied; however, effects on GI function were not reported.21

Clinical data

The fiber content of kiwi fruit is suggested to be about 3.5 g per 100 g of fruit.4, 22 A small, unblind clinical trial evaluated the effect of kiwi fruit on colon transit time and defecation frequency in healthy adults and in those with irritable bowel syndrome. Improved bowel function with kiwi fruit consumption compared with placebo was observed.23 Further small studies support anecdotal reports of laxative effects of kiwi fruit.22, 24

Immune function

Animal data

The effects of kiwi fruit extracts on immune function in mice has been studied.20, 21, 25

Clinical data

Limited preliminary clinical studies suggest consumption of kiwi fruit may assist in upregulating the immune system.20 A small study of elderly patients found kiwi fruit consumption reduced the severity and duration of symptoms associated with upper respiratory tract infections. Indicators of immune function (natural killer cell activity and phagocytosis) did not differ from those of the comparator banana group.26

Dosing

Clinical trials are lacking to inform therapeutic dosing.

One kiwi fruit contains about 100 mg vitamin C (approximately the recommended US daily intake) and considerable quantities of the carotenoids lutein and xanthine.27 In humans, bioavailability of vitamin C from consuming skinless kiwi fruit was found to be equal to that of a synthetic chewable vitamin C tablet.44, 45

Pregnancy / Lactation

GRAS when used as food. Safety and efficacy for dosages higher than those found in foods is unproven and should be avoided.

Interactions

None well documented.

The serotonin concentration of the fruit is approximately twice that of tomatoes and one-third that of bananas. Therefore, ingestion of kiwi fruit can increase urinary excretion of 5-hydroxyindoleacetic acid and may interfere with laboratory analyses for this serotonin by-product.31

Adverse Reactions

Allergy to kiwi fruit and the vine is well documented in the literature, and includes oral allergy syndrome, contact dermatitis, Kounis coronary syndrome, and anaphylaxis. Trace amounts of kiwi fruit have been responsible for some of these reactions.32, 33, 34, 35, 36, 37, 46 Although acute pancreatitis in the course of an allergic reaction to a food substance is rare, a case report describes a patient with repeated attacks of acute pancreatitis secondary to kiwi fruit ingestion.38

Cross-reactivity of kiwi fruit with several other allergens, including birch and meadow fescue grass pollens, latex, avocado, and banana has been reported.39, 40, 41, 42 The major allergen appears to be the proteolytic enzyme, actinidin. Industrial heating and homogenizing techniques appear to diminish the likelihood of allergic reactions.43

Consumption of relatively large quantities of kiwi fruit may result in diarrhea.20

Toxicology

Information is lacking.

References

1. Actinidia chinensis. USDA, NRCS. 2012. The PLANTS Database (http://plants.usda.gov, 11 September 2012). National Plant Data Team, Grensboro, NC 27401-4901 USA. Accessed October 31, 2012.
2. Akinnifesi FK, Leakey RR, Ajayi OC, et al. Indigenous Fruit Trees in the Tropics: Domestication, Utilization and Commercialization. UK: CABI Publishing; 2007.
3. Choudhary D, Mehta A. Fruit Crops. Jaipur, India: Oxford Book Co; 2010.
4. Duke JA. Handbook of Medicinal Herbs. 2nd ed. CRC Press; 2002.
5. Pastorello EA, Conti A, Pravettoni V, et al. Identification of actinidin as the major allergen of kiwi fruit. J Allergy Clin Immunol. 1998;101(4 Pt 1):531-537.9564807
6. Pastorello EA, Pravettoni V, Ispano M, et al. Identification of the allergenic components of kiwi fruit and evaluation of their cross-reactivity with timothy and birch pollens. J Allergy Clin Immunol. 1996;98(3):601-610.8828538
7. Varughese KI, Su Y, Cromwell D, Hasnain S, Xuong NH. Crystal structure of an actinidin-E-64 complex. Biochem. 1992;31(22):5172-5176.1606141
8. Naylor S, Ang SG, Williams DH, Moore CH, Walsh K. Rapid determination of sequence variations in actinidin isolated from Actinidia chinesis (var. Hayward) using fast atom bombardment mapping mass spectrometry and gas phase microsequencing. Biomed Environ Mass Spectrom. 1989;18(6):424-428.2765702
9. Podivinsky E, Forster R, Gardner RC. Nucleotide sequence of actinidin, a kiwi fruit protease. Nucleic Acids Res. 1989;17(20):8363.2813065
10. Balestrieri C, Castaldo D, Giovane A, Quagliuolo L, Servillo L. A glycoprotein inhibitor of pectin methylesterase in kiwi fruit (Actinidia chinesis). Eur J Biochem. 1990;193(1):183-187.2226435
11. Jordán MJ, Margaría CA, Shaw PE, Goodner KL. Aroma active components in aqueous kiwi fruit essence and kiwi fruit puree by GC-MS and multidimensional GC/CG-O. J Agric Food Chem. 2002;50(19):5386-5390.12207479
12. Santoni F, Barboni T, Paolini J, Costa J. Influence of cultivation parameters on the composition of volatile compounds and physico-chemical characteristics of kiwi fruit. J Sci Food Agric. 2012 Aug 30.2293662110.1002/jsfa.5850
13. Lahlou EH, Hirai N, Kamo T, Tsuda M, Ohigashi H. Actinidic acid, a new triterpene phytoalexin from unripe kiwi fruit. Biosci Biotechnol Biochem. 2001;65(2):480-483.11302196
14. Wang H, Ng TB. Isolation of an antifungal thaumatin-like protein from kiwi fruits. Phytochemistry. 2002;61(1):1-6.12165295
15. Fu L, Xu H. A preliminary study of the effectiveness of Chinese therapeutic food on regulating female reproductive hormones. Integr Med Insights. 2011;6:7-12.21614163
16. Cravotto G, Bicchi C, Mantegna S, et al. Extraction of kiwi seed oil: Soxhlet versus four different non-conventional techniques. Nat Prod Res. 2011;25(10):974-981.21644177
17. Xu YX, Xiang ZB, Jin YS, Shen Y, Chen HS. Two new triterpenoids from the roots of Actinidia chinensis. Fitoterapia. 2010 Oct;81(7):920-924.20550955
18. Xu H, Xu HE, Ryan D. A study of the comparative effects of hawthorn fruit compound and simvastatin on lowering blood lipid levels. Am J Chin Med. 2009;37(5):903-908.19885950
19. Duttaroy AK, Jørgensen A. Effects of kiwi fruit consumption on platelet aggregation and plasma lipids in healthy human volunteers. Platelets. 2004;15(5):287-292.15370099
20. Skinner MA, Loh JM, Hunter DC, Zhang J. Gold kiwifruit (Actinidia chinensis 'Hort16A') for immune support. Proc Nutr Soc. 2011;70(2):276-280.21349229
21. Lin HM, Edmunds SJ, Zhu S, Helsby NA, Ferguson LR, Rowan DD. Metabolomic analysis reveals differences in urinary excretion of kiwifruit-derived metabolites in a mouse model of inflammatory bowel disease. Mol Nutr Food Res. 2011;55(12):1900-1904.21957058
22. Chan AO, Leung G, Tong T, Wong NY. Increasing dietary fiber intake in terms of kiwifruit improves constipation in Chinese patients. World J Gastroenterol. 2007;13(35):4771-4775.17729399
23. Chang CC, Lin YT, Lu YT, et al. Kiwifruit improves bowel function in patients with irritable bowel syndrome with constipation. Asia Pac J Clin Nutr. 2010;19(4):451-457.21147704
24. Rush E, Patel M, Plank LD, Ferguson LR. Kiwifruit promotes laxation in the elderly. Asia Pac J Clin Nutr. 2002;11(2):164-168.12074182
25. Edmunds SJ, Roy NC, Davy M, et al. Effects of kiwifruit extracts on colonic gene and protein expression levels in IL-10 gene-deficient mice. Br J Nutr. 2012;108(1):113-129.22152591
26. Hunter DC, Skinner MA, Wolber FM, et al. Consumption of gold kiwifruit reduces severity and duration of selected upper respiratory tract infection symptoms and increases plasma vitamin C concentration in healthy older adults. Br J Nutr. 2012;108(7):1235-1245.
27. Szeto YT, Tomlinson B, Benzie IF. Total antioxidant and ascorbic acid content of fresh fruits and vegetables: implications for dietary planning and food preservation. Br J Nutr. 2002;87(1):55-59.11898770
28. Sommerburg O, Keunen JE, Bird AC, van Kuijk FJ. Fruits and vegetables that are sources for lutein and zeaxanthin: the macular pigment in human eyes. Br J Ophthalmol. 1998;82(8):907-910.9828775
29. Iwasawa H, Morita E, Yui S, Yamazaki M. Anti-oxidant effects of kiwi fruit in vitro and in vivo. Biol Pharm Bull. 2011;34(1):128-134.21212530
30. Karlsen A, Svendsen M, Seljeflot I, et al. Compliance, tolerability and safety of two antioxidant-rich diets: a randomised controlled trial in male smokers. Br J Nutr. 2011;106(4):557-571.21806852
31. Feldman JM, Lee EM. Serotonin content of foods: effect on urinary excretion of 5-hydroxyindoleacetic acid. Am J Clin Nutr. 1985;42(4):639-643.2413754
32. Shimizu T, Morikawa A. Anaphylaxis to kiwi fruit in a 12-year-old boy. J Asthma. 1995;32(2):159-160.7559267
33. Mempel M, Rakoski J, Ring J, Ollert M. Severe anaphylaxis to kiwi fruit: immunologic changes related to successful sublingual allergen immunotherapy. J Allergy Clin Immunol. 2003;111(6):1406-1409.12789247
34. Mancuso G, Berdondini RM. Oral allergy syndrome from kiwi fruit after a lover’s kiss. Contact Dermatitis. 2001;45(1):41.11422270
35. Rademaker M. Allergic contact dermatitis from kiwi fruit vine (Actinidia chinensis). Contact Dermatitis. 1996;34(3):221-222.8833473
36. Veraldi S, Schianchi-Veraldi R. Contact urticaria from kiwi fruit. Contact Dermatitis. 1990;22(4):244.2347180
37. Gázquez V, Dalmau G, Gaig P, Gómez C, Navarro S, Mercé J. Kounis syndrome: report of 5 cases. J Investig Allergol Clin Immunol. 2010;20(2):162-165.20461972
38. Gastaminza G, Bernaola G, Camino ME. Acute pancreatitis caused by allergy to kiwi fruit. Allergy. 1998;53(11):1104-1109.9860247
39. Voitenko V, Poulsen LK, Nielsen L, Norgaard A, Bindslev-Jensen C, Skov PS. Allergenic properties of kiwi-fruit extract: cross-reactivity between kiwi-fruit and birch-pollen allergens. Allergy. 1997;52(2):136-143.9105517
40. Gavrovic-Jankulovic M, Cirkovic T, Burazer L, Vuckovic O, Jankov RM. IgE cross-reactivity between meadow fescue pollen and kiwi fruit in patients' sera with sensitivity to both extracts. J Investig Allergol Clin Immunol. 2002;12(4):279-286.12926188
41. Möller M, Kayma M, Vieluf D, Paschke A, Steinhart H. Determination and characterization of cross-reacting allergens in latex, avocado, banana, and kiwi fruit. Allergy. 1998;53(3):289-296.9542609
42. Alemán A, Sastre J, Quirce S, et al. Allergy to kiwi: a double-blind, placebo-controlled food challenge study in patients from a birch-free area. J Allergy Clin Immunol. 2004;113(3):543-550.15007359
43. Fiocchi A, Restani P, Bernardo L, et al. Tolerance of heat-treated kiwi by children with kiwifruit allergy. Pediatr Allergy Immunol. 2004;15(5):454-458.15482522
44. Carr AC, Bozonet SM, Pullar JM, Simcock JW, Vissers MC. A randomized steady-state bioavailability study of synthetic versus natural (kiwifruit-derived) vitamin C. Nutrients. 2013;5(9):3684-3695.24067392
45. Carr AC, Bozonet SM, Vissers MC. A randomised cross-over pharmacokinetic bioavailability study of synthetic versus kiwifruit-derived vitamin C. Nutrients. 2013;5(11):4451-4461.24284610
46. Guler Y, Kalkan S, Esen AM. An extremely rare trigger of Kounis syndrome: Actinidia chinensis. Int J Cardiol. 2014;172(2):e324-e325.24456873

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