Medically reviewed on Dec 18, 2017
Scientific Name(s): Pectin
Common Name(s): Pectin
Pectin has been used in antidiarrheal products and to lower blood lipoprotein levels. Pectin also has been investigated for its ability to reduce the consequence of exposure to radiation and to inhibit prostate cancer growth, but more study is needed.
Pectin and/or modified pectin have been used in clinical studies in doses of 10 to 20 g daily.
Contraindications have not yet been identified.
Information regarding safety and efficacy in pregnancy and lactation is lacking.
Coadministration of pectin with beta-carotene–containing foods or supplements can reduce beta-carotene blood levels by more than 50%. Concomitant use of pectin and lovastatin, and other HMG-CoA reductase inhibitors may decrease absorption of the HMG-CoA reductase inhibitor.
Pectin is generally well tolerated when ingested. Occupational asthma has been associated with the inhalation of pectin dust, along with cross-sensitivity to cashew and pistachio nuts.
No major toxicities have been reported with the use of pectin.
Pectin is found in the cell walls of all plant tissue where it acts as an intercellular cement, giving the plant rigidity. The compound is found at concentrations of 15% to 30% in the fiber of fruits, vegetables, legumes, and nuts. 1 Lemon and orange rinds are among the richest sources of pectin, containing up to 30% of this polysaccharide. 2 Pectin is also found in the roots of most plants. 3
Pectin has been used in the food industry to add body and texture to jellies, jams, puddings, and other gelatinous products. It has also been added to antidiarrheal products and has been particularly effective when combined with adsorbing clays, such as kaolin.
Pectin is a polysaccharide with a variable molecular weight ranging from 20,000 to 400,000, depending on the number of carbohydrate monomers. 2 The core of the molecule is formed by linked D-polygalacturonate and L-rhamnose residues. The neutral sugars D-galactose, L-arabinose, D-xylose, and L-fucose form the side chains on the pectin molecule. Once extracted, pectin occurs as a coarse or fine yellowish powder that is highly water soluble and forms thick colloidal solutions. In the presence of calcium ions, pectin forms a gel that is more resistant to disruption in the gut than alginate gel. 3 The parent compound, protopectin, is insoluble but is readily converted by hydrolysis into pectinic acids (also known generically as pectins). 4
Pectin that has been pH-modified into smaller, less complex molecules is called modified citrus pectin. This modification allows better dissolution in water and more complete absorption by the body. 5
Uses and Pharmacology
The widespread usage of pectin preparations by humans makes animal experiments largely irrelevant, except in cancer studies.Cancer
Dietary fiber has been associated with a reduction in the risk of colon cancer; however, this association has been questioned in a pooled analysis of prospective cohort studies. 6 After accounting for other dietary risk factors, no association was found with risk of colorectal cancer, and analysis by specific food sources also found no association. 6
Modified pectin has been evaluated for efficacy in cancer treatment. The mechanism by which pectins may exert their effect is suggested to be the ability to bind to cancer cell surface galectins (galactose-binding lectins) and cause mitochondrial disruption. 7 , 8 , 9 , 10 , 11 Consequent interference with cell-cell or cell-matrix adhesion and induction of apoptosis has been described. 8 Pectin-derived galectin-3 receptor binding agents (GBC-590 and GCS-100) have entered phase 2 trials. 7 , 10Animal data
Modified citrus pectin was studied in a rat prostate cancer model for its effectiveness against prostate cancer metastasis. Although primary tumor growth was not affected, metastasis was reduced when compared with control. 12 In vitro experiments have demonstrated efficacy of modified pectin on human prostate cell lines in inducing apoptosis 8 ; and skin, colon, lung, and melanoma lines in inhibiting cell proliferation. 13Clinical data
A nonrandomized intervention study using modified citrus pectin demonstrated a statistically significant increase in prostate-specific antigen (PSA)-doubling time in 7 out of 10 patients with refractory prostate cancer. 5 , 9 Survival times were not measured in this study, but a slowing of disease progression was postulated based on the increase in PSA–doubling time. Phase 2 trials have evaluated the effect of pectin-derived galectin-3 receptor binding agents in refractory or relapsed colorectal and pancreatic cancer and have reported tumor stabilization and reduction of tumor growth in some patients. 7 , 10Cardiovascular
Despite many large trials evaluating the effect of dietary fiber on cardiovascular outcomes, few trials specifically investigate the role of pectin, and controversy remains regarding its efficacy in affecting the lipid profile. 14 , 15 , 16 , 17 Most studies have evaluated pectin in combination with other gums. Varying results have been found in these trials, with some showing decreases in total cholesterol level and triglycerides (although high-density lipoprotein [HDL] cholesterol levels remained unaffected) and others failing to lower cholesterol in hypercholesterolemic patients. 18 , 19 , 20 , 21 , 22 Trials evaluating the effect of pectin alone on serum lipids have also found varying results. 15 , 23 , 24 , 25 , 26 A meta-analysis of cholesterol-lowering effects of dietary fiber (comparison of pectin, oat bran, guar gum, and psyllium) showed that increasing soluble fiber may make only a small contribution to dietary therapy to lower cholesterol. 17 Mechanisms of action have been investigated and include an ability to protect against low-density lipoprotein (LDL) peroxidation, 27 , 28 upregulation of HDL metabolism, 16 and the higher water-holding capacity of pectin compared with cereals or bran. 16 Systolic blood pressure was decreased in pectin-treated adults versus placebo in a double-blind, randomized clinical trial, 23 while hypertension remained unaltered in another study. 29Chelating effects
Modified citrus pectin 15 g/day significantly increased the urinary excretion of arsenic, cadmium, and lead in healthy adults (normal metal load) after 6 days of administration. 30 This chelating effect has been attributed to the presence of rhamnogalacturonan in pectin. In children from Belarus with moderate and high cesium loads, the administration of apple-derived pectin ( Vitapect ) 10 g/day reduced the level of cesium. 29 , 31 Beneficial effects on the antioxidant level of hematologic systems have also been demonstrated. 32Diabetes
Meals high in soluble fiber have been shown to reduce the rise in postprandial blood glucose and insulin concentrations. 15 However, a few trials specifically evaluating the effect of pectin on markers of diabetes have been less convincing. No change in fasting plasma glucose levels and no effect on postprandial glucose response were noted for pectin in healthy adults or adults with dietary-controlled type 2 diabetes, 23 , 33 while hypoglycemic actions were noted in nondiabetic patients with hyperlipidemia. 26GI
Pectin has been used in the management of diarrhea for many years. Pectin supplementation was as effective as green bananas in the management of persistent diarrhea in children. Both pectin and banana reduced the volume of stool, improved stool quality, decreased the amount of oral replacement solutions and intravenous fluids for hydration needed, and shortened the duration of illness. 34 , 35 In a study of 44 critically ill, tube-fed adults receiving antibiotics, there was a trend toward decreased diarrhea in those receiving fiber and pectin. Pectin stimulates epithelial growth in the colon, thus reducing diarrhea. 36 Additional suggested mechanisms of action in the GI tract include the effect of peptic oligosaccharides on the intestinal microflora. 37 , 38 , 39Gastroesophageal reflux
A pectin-based, raft-forming, antireflux agent available in Europe has been studied for use in patients with heartburn. This product reduces the amount of food and acid concentration reaching the esophagus, thus reducing heartburn. 40 , 41 , 42 The pectin-based agent also has been shown to delay the recurrence of moderate or severe heartburn and erosive esophagitis when used as maintenance treatment. 43 However, in a study of patients with an ileal pouch-anal anastomosis, neither pectin nor fiber had any effect on stool frequency. 44 Gastric emptying rate was increased with coadministration of pectin in an experiment in healthy adults. 45Other
Drug delivery systems
A combination of alginate-pectin-polylysine particulates shows promise as a vehicle for controlled-release medications. The presence of a rigid pectin gel inside the particulates imparts a stronger and more stable vehicle in acidic and alkaline solutions, which could prolong drug release. This particulate system may have potential use as a carrier for drugs that are poorly absorbed after oral administration. 3 , 46Immunomodulation
Pectic polysaccharides, including arabinogalactin, rhamnogalacturonan, and comaruman originating in various plants used in traditional medicine, have been evaluated for their effect on the immune system. There also have been reports describing the evaluation of plants such as Comarum palustre , Glinus oppositifolus , Vernonia kotschyana , and Bergenia crassifola . 47 , 48 , 49 , 50 , 51 , 52 Various actions have been described from in vitro experiments, including interference with neutrophil adhesion, complement-fixing actions, and upregulation of cytokine secretion.Allergy
Galacto-oligosaccharides have been evaluated for their preventive effect on food sensitization in infants. Insufficient data exist to support or refute a use for prebiotic supplementation to prevent food allergy. 53 A physical influence by pectin on the digestion of food proteins as allergens has been suggested. 54 However, allergy to pectin itself has been reported. 55
Information regarding safety and efficacy in pregnancy and lactation is lacking.
Coadministration of pectin with beta-carotene–containing foods or supplements can reduce beta-carotene blood levels by more than 50%. 56 There is some evidence that concomitant ingestion of pectin with high-energy diets may reduce the nutritional benefits of these diets, as demonstrated in a controlled trial of undernourished children; urea production also was shown to be lower in children who ingested pectin with their caloric supplement. 57
In 3 patients with hypercholesterolemia, concomitant use of pectin 15 g and lovastatin 80 mg daily produced an increase in LDL cholesterol compared with taking lovastatin alone. 58 When pectin was stopped, the LDL cholesterol decreased. Pectin may decrease the GI absorption of lovastatin. Based on pharmacologic and pharmacokinetic considerations, a similar interaction may be expected to occur with concurrent use of pectin and other HMG-CoA reductase inhibitors (eg, atorvastatin).
Pectin is a fermentable fiber that results in the production of short-chain fatty acids and methane. 59
Occupational asthma associated with the inhalation of pectin dust is a well-recognized hazard. 60 , 61 , 62 , 63 Positive skin test results for pectin indicate that an immunoglobulin E (IgE)–mediated hypersensitivity reaction is probably involved. 63 Case reports exist of allergy (anaphylaxis) to pectin and cross-reactivity to cashews and pistachios. 55 , 64
Doses of pectin 50 to 100 mg/kg increased the number of gastric mucosal lesions produced by ethanol or aspirin when studied in rats. No increase was produced by application of pectin 25 mg/kg. 65 Whether these pectin-induced physicochemical changes are reproducible in humans has yet to be studied.
No major toxicities have been reported with the use of pectin.
Bibliography1. Marlett JA. Content and composition of dietary fiber in 117 frequently consumed foods. J Am Diet Assoc . 1992;92(2):175-186.
2. Windholz M, ed. The Merck Index , 10th ed. Rahway, NJ: Merck & Co; 1983.
3. Liu P, Krishnan TR. Alginate-pectin-poly-L-lysine particulate as a potential controlled release formulation. J Pharm Pharmacol . 1999;51(2):141-149.
4. Evans WC. Trease and Evans' Pharmacognosy , 13th ed. London, England: Balliére Tindall; 1989.
5. Strum SB, Scholz M, McDermed J, McCulloch M, Eliaz I. Modified citrus pectin slows PSA doubling time: a pilot clinical trial. Paper presented at: International Conference on Diet and Prevention of Cancer; May 28-June 2, 1999; Tampere, Finland.
6. Park Y, Hunter DJ, Spiegelman D, et al. Dietary fiber intake and risk of colorectal cancer: a pooled analysis of prospective cohort studies. JAMA . 2005;294(22):2849-2857.
7. Cotter FE. Unraveling biologic therapy for Bcl-2-expressing malignancies. Semin Oncol . 2004;31(6 suppl 16):18-21; discussion 33.
8. Jackson CL, Dreaden TM, Theobald LK, et al. Pectin induces apoptosis in human prostate cancer cells: correlation of apoptotic function with pectin structure. Glycobiology . 2007;17(8):805-819.
9. Guess BW, Scholz MC, Strum SB, Lam RY, Johnson HJ, Jennrich RI. Modified citrus pectin (MCP) increases the prostate-specific antigen doubling time in men with prostate cancer: a phase II pilot study. Prostate Cancer Prostatic Dis . 2003;6(4):301-304.
10. Günzburg WH, Salmons B. Use of cell therapy as a means of targeting chemotherapy to inoperable pancreatic cancer. Acta Biochim Pol . 2005;52(3):601-607.
11. Sathisha UV, Jayaram S, Harish Nayaka MA, Dharmesh SM. Inhibition of galectin-3 mediated cellular interactions by pectic polysaccharides from dietary sources. Glycoconj J . 2007;24(8):497-507.
12. Pienta KJ, Naik H, Akhtar A, et al. Inhibition of spontaneous metastasis in a rat prostate cancer model by oral administration of modified citrus pectin. J Natl Cancer Inst . 1995;87(5):348-353.
13. Kang HJ, Jo C, Kwon JH, Son JH, An BJ, Byun MW. Antioxidant and cancer cell proliferation inhibition effect of citrus pectin-oligosaccharide prepared by irradiation. J Med Food . 2006;9(3):313-320.
14. Liu S, Buring JE, Sesso HD, Rimm EB, Willett WC, Manson JE. A prospective study of dietary fiber intake and risk of cardiovascular disease among women. J Am Coll Cardiol . 2002;39(1):49-56.
15. Zhang C, Liu S, Solomon CG, Hu FB. Dietary fiber intake, dietary glycemic load, and the risk for gestational diabetes mellitus. Diabetes Care . 2006;29(10):2223-2230.
16. Wu H, Dwyer KM, Fan Z, Shircore A, Fan J, Dwyer JH. Dietary fiber and progression of atherosclerosis: the Los Angeles Atherosclerosis Study. Am J Clin Nutr . 2003;78(6):1085-1091.
17. Brown L, Rosner B, Willett WW, Sacks FM. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr . 1999;69(1):30-42.
18. Biesenbach G, Grafinger P, Janko P, Kaiser W, Stuby U, Moser E. The lipid lowering effect of a new guar-pectin fiber mixture in type II diabetic patients with hypercholesterolemia [in German]. Leber Magen Darm . 1993;23(5):204, 207-209.
19. Knopp RH, Superko HR, Davidson M, et al. Long-term blood cholesterol-lowering effects of a dietary fiber supplement. Am J Prev Med . 1999;17(1):18-23.
20. Hosobuchi C, Rutanassee L, Bassin SL, Wong ND. Efficacy of acacia, pectin, and guar gum-based fiber supplementation in the control of hypercholesterolemia. Nutr Res . 1999;19(5):643-649.
21. Jensen CD, Haskell W, Whittam JH. Long-term effects of water-soluble dietary fiber in the management of hypercholesterolemia in healthy men and women. Am J Cardiol . 1997;79(1):34-37.
22. Davidson MH, Dugan LD, Stocki J, et al. A low-viscosity soluble-fiber fruit juice supplement fails to lower cholesterol in hypercholesterolemic men and women. J Nutr . 1998;128(11):1927-1932.
23. Schwab U, Louheranta A, Törrönen A, Uusitupa M. Impact of sugar beet pectin and polydextrose on fasting and postprandial glycemia and fasting concentrations of serum total and lipoprotein lipids in middle-aged subjects with abnormal glucose metabolism. Eur J Clin Nutr . 2006;60(9):1073-1080.
24. Sheehan JP, Wei IW, Ulchaker M, Tserng KY. Effect of high fiber intake in fish oil-treated patients with non-insulin-dependent diabetes mellitus. Am J Clin Nutr . 1997;66(5):1183-1187.
25. Veldman FJ, Nair CH, Vorster HH, et al. Dietary pectin influences fibrin network structure in hypercholesterolaemic subjects. Thromb Res . 1997;86(3):183-196.
26. Wolfram RM, Kritz H, Efthimiou Y, Stomatopoulos J, Sinzinger H. Effect of prickly pear ( Opuntia robusta ) on glucose- and lipid-metabolism in non-diabetics with hyperlipidemia—a pilot study. Wien Klin Wochenschr . 2002;114(19-20):840-846.
27. Yang SS, Cheng KT, Lin YS, Liu YW, Hou WC. Pectin hydroxamic acids exhibit antioxidant activities in vitro. J Agric Food Chem . 2004;52(13):4270-4273.
28. Lewińska D, Rosiński S, Piatkiewicz W. A new pectin-based material for selective LDL-cholesterol removal. Artif Organs . 1994;18(3):217-222.
29. Bandazhevskaya GS, Nesterenko VB, Babenko VI, Yerkovich TV, Bandazhevsky YI. Relationship between caesium (137Cs) load, cardiovascular symptoms, and source of food in 'Chernobyl' children—preliminary observations after intake of oral apple pectin. Swiss Med Wkly . 2004;134(49-50):725-729.
30. Eliaz I, Hotchkiss AT, Fishman ML, Rode D. The effect of modified citrus pectin on urinary excretion of toxic elements. Phytother Res . 2006;20(10):859-864.
31. Nesterenko VB, Nesterenko AV, Babenko VI, Yerkovich TV, Babenko IV. Reducing the 137Cs-load in the organism of “Chernobyl” children with apple-pectin. Swiss Med Wkly . 2004;134(1-2):24-27.
32. Bereza VIa, Chaialo PP, Iatsula GS, Shimelis IV, Protas AF. Pectin-containing products in the dietary nutrition of subjects exposed to ionizing radiation as a result of the accident at the Chernobyl Atomic Electric Power Station [in Russian]. Lik Sprava . 1993;(8):21-24.
33. Sanaka M, Yamamoto T, Anjiki H, Nagasawa K, Kuyama Y. Effects of agar and pectin on gastric emptying and post-prandial glycaemic profiles in healthy human volunteers. Clin Exp Pharmacol Physiol . 2007;34(11):1151-1155.
34. Rabbani GH, Teka T, Zaman B, Majid N, Khatun M, Fuchs GJ. Clinical studies in persistent diarrhea: dietary management with green banana or pectin in Bangladeshi children. Gastroenterology . 2001;121(3):554-560.
35. Rabbani GH, Teka T, Saha SK, et al. Green banana and pectin improve small intestinal permeability and reduce fluid loss in Bangladeshi children with persistent diarrhea. Dig Dis Sci . 2004;49(3):475-484.
36. Schultz AA, Ashby-Hughes B, Taylor R, Gillis DE, Wilkins M. Effects of pectin on diarrhea in critically ill tube-fed patients receiving antibiotics. Am J Crit Care . 2000;9(6):403-411.
37. Fanaro S, Jelinek J, Stahl B, Boehm G, Kock R, Vigi V. Acidic oligosaccharides from pectin hydrolysate as new component for infant formulae: effect on intestinal flora, stool characteristics, and pH. J Pediatr Gastroenterol Nutr . 2005;41(2):186-190.
38. Olano-Martin E, Gibson GR, Rastell RA. Comparison of the in vitro bifidogenic properties of pectins and pectic-oligosaccharides. J Appl Microbiol . 2002;93(3):505-511.
39. Olano-Martin E, Williams MR, Gibson GR, Rastall RA. Pectins and pectic-oligosaccharides inhibit Escherichia coli O157:H7 Shiga toxin as directed towards the human colonic cell line HT29. FEMS Microbiol Lett . 2003;218(1):101-105.
40. Waterhouse ET, Washington C, Washington N. An investigation into the efficacy of the pectin based anti-reflux formulation-Aflurax. Int J Pharm . 2000;209(1-2):79-85.
41. Havelund T, Aalykke C. The efficacy of a pectin-based raft-forming anti-reflux agent in endoscopy-negative reflux disease. Scand J Gastroenterol . 1997;32(8):773-777.
42. Kapadia CJ, Mane VB. Raft-forming agents: antireflux formulations. Drug Dev Ind Pharm . 2007;33(12):1350-1361.
43. Havelund T, Aalykke C, Rasmussen L. Efficacy of a pectin-based anti-reflux agent on acid reflux and recurrence of symptoms and oesophagitis in gastro-oesophageal reflux disease. Eur J Gastroenterol Hepatol . 1997;9(5):509-514.
44. Thirlby RC, Kelly R. Pectin and methyl cellulose do not affect intestinal function in patients after ileal pouch-anal anastomosis. Am J Gastroenterol . 1997;92(1):99-102.
45. Shimoyama Y, Kusano M, Kawamura O, et al. High-viscosity liquid meal accelerates gastric emptying. Neurogastroenterol Motil . 2007;19(11):879-886.
46. Madziva H, Kailasapathy K, Phillips M. Alginate-pectin microcapsules as a potential for folic acid delivery in foods. J Microencapsul . 2005;22(4):343-351.
47. Popov SV, Ovodova RG, Popova GY, Nikitina IR, Ovodov YS. Adhesion of human neutrophils to fibronectin is inhibited by comaruman, pectin of marsh cinquefoil Comarum palustre L., and by its fragments. Biochemistry (Mosc) . 2005;70(1):108-112.
48. Popov SV, Popova GY, Nikolaeva SY, Golovchenko VV, Ovodova RG. Immunostimulating activity of pectic polysaccharide from Bergenia crassifolia (L.) Fritsch. Phytother Res . 2005;19(12):1052-1056.
49. Inngjerdingen KT, Patel TR, Chen X, et al. Immunological and structural properties of a pectic polymer from Glinus oppositifolius . Glycobiology . 2007;17(12):1299-1310.
50. Nergard CS, Matsumoto T, Inngjerdingen M, et al. Structural and immunological studies of a pectin and a pectic arabinogalactan from Vernonia kotschyana Sch. Bip. ex Walp. ( Asteraceae ). Carbohydr Res . 2005;340(1):115-130.
51. Szu SC, Bystricky S. Physical, chemical, antigenic, and immunologic characterization of polygalacturonan, its derivatives, and Vi antigen from Salmonella typhi . Methods Enzymol . 2003;363:552-567.
52. Kiyohara H, Matsumoto T, Nagai T, Kim SJ, Yamada H. The presence of natural human antibodies reactive against pharmacologically active pectic polysaccharides from herbal medicines. Phytomedicine . 2006;13(7):494-500.
53. Osborn DA, Sinn JK. Probiotics in infants for prevention of allergic disease and food hypersensitivity. Cochrane Database Syst Rev . 2007;(4):CD006475.
54. Polovic N, Blanusa M, Gavrovic-Jankulovic M, et al. A matrix effect in pectin-rich fruits hampers digestion of allergen by pepsin in vivo and in vitro. Clin Exp Allergy . 2007;37(5):764-771.
55. Ferdman RM, Ong PY, Church JA. Pectin anaphylaxis and possible association with cashew allergy. Ann Allergy Asthma Immunol . 2006;97(6):759-760.
56. Rock CL, Swendseid ME. Plasma beta-carotene response in humans after meals supplemented with dietary pectin. Am J Clin Nutr . 1992;55(1):96-99.
57. Doherty J, Jackson AA. The effect of dietary pectin on rapid catch-up weight gain and urea kinetics in children recovering from severe undernutrition. Acta Paediatr . 1992;81(6-7):514-517.
58. Richter WO, Jacob BG, Schwandt P. Interaction between fibre and lovastatin. Lancet . 1991;338(8768):706.
59. Mortensen PB, Nordgaard-Andersen I. The dependence of the in vitro fermentation of dietary fibre to short-chain fatty acids on the contents of soluble non-starch polysaccharides. Scand J Gastroenterol . 1993;28(5):418-422.
60. Baldwin JL, Shah AC. Pectin-induced occupational asthma. Chest . 1993;104(6):1936-1937.
61. Cohen AJ, Forse MS, Tarlo SM. Occupational asthma caused by pectin inhalation during the manufacture of jam. Chest . 1993;103(1):309-311.
62. Kraut A, Peng Z, Becker AB, Warren CP. Christmas candy maker's asthma. IgG4-mediated pectin allergy. Chest . 1992;102(5):1605-1607.
63. Jaakkola MS, Tammivaara R, Tuppurainen M, Lahdenne L, Tupasela O, Keskinen H. Asthma caused by occupational exposure to pectin. J Allergy Clin Immunol . 1997;100(4):575-576.
64. Räsänen L, Mäkinen-Kiljunen S, Harvima RJ. Pectin and cashew nut allergy: cross-reacting allergens? Allergy . 1998;53(6):626-628.
65. Figler M, Mozsik G. Effect of pectin application on gastric mucosal lesions induced by ethanol or aspirin in rats. Dig Dis Sci . 1998;43[abstract A13]:2342.
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