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Pistachio

Scientific Name(s): Pistacia vera L.
Common Name(s): Pistachio

Clinical Overview

Use

Pistachio nuts have been clinically evaluated for use in hypercholesterolemia. Limited antiviral, antifungal, and antiprotozoal activity has been demonstrated in in vitro experiments, and anti-inflammatory actions have been reported.

Dosing

Hypercholesterolemia: unroasted pistachio nuts 65 to 75 g/day (equivalent to 20% of total daily calorie intake).

Contraindications

None identified.

Pregnancy/Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

None well documented.

Adverse Reactions

Most adverse reactions are associated with hypersensitivity to the plant or with allergic reactions.

Toxicology

Studies are lacking.

Botany

P. vera is a native of Central and West Asia, and also is distributed throughout the Mediterranean basin. It is grown in California and Arizona and other countries where it has been introduced.PLANTS 2008, Alma 2004 A related species is Pistacia lentiscus, commonly known as mastic.PLANTS 2008

It is a spreading tree and partially deciduous and grows up to 10 m high. Leaves occur in 1 to 5 pairs of thick, oval leaflets. Tiny, brown-green flowers give way to clusters of the oblong pistachio kernel.Alma 2004, Gentil 2007 The exudate of the plant forms a gum that is traditionally used for medicinal purposes.Alma 2004

History

Records of the consumption of pistachios as a food date to 7000 BC.Tsokou 2007 Pistachio is commonly used for flavoring candy and cakes, and in toothpaste and dentistry.Alma 2004, Tsoukou 2007

Traditional uses include treatment of toothache and other periodontal ailments, blood clotting, dyspepsia, asthma, jaundice, diarrhea, renal stones, and as an anti-inflammatory, antibacterial, and antiviral agent.Alma 2004, Tsokou 2007, Bozorgi 2013

The gum has been used for respiratory (anti-infective) and stomach diseases and as a lip balm. It is also used as a protectant for glass, porcelain, bone, wood, and metal objects.Alma 2004

Chemistry

The fruits of the pistachio are high in protein, oil, and vitamin E, compared with hazelnuts. Unsalted, they are high in potassium and low in sodium. The kernels are rich in linoleic and linolenic fatty acids.Ozcelik 2005

The essential oil of the leaves contains alpha-pinene (30%), terpinolene (18%), and bornyl acetate (11%), while the essential oil of the fruits contains alpha-pinene (55%), terpinolene (approximately 30%), limonene, 3-carene, and beta-pinene (approximately 1% each), which is similar to mastic gum oil. Alpha-pinene and terpinolene have shown antibacterial and antifungal activity, while terpinolene has some antioxidant activity.Tsokou 2007 Reviews of the chemical composition are available.Bozorgi 2013, Rauf 2017

Vitamin E alpha- and gamma-tocopherol, vitamin C, proanthocyanidins, transresveratrol, isoflavones, daidzein, and genistein have been identified in the edible nut.Gentile 2007, Tsokou 2007 The antioxidant activity is substantially affected by toasting.Gentile 2007

The essential oil of the gum contains mostly monoterpene hydrocarbons, oxygenated monoterpenes, and diterpenes, including alpha-pinene (75%), beta-pinene (9%), transverbenol (3%), camphene, limonene, and pinocarveol (approximately 1% each).Alma 2004

Uses and Pharmacology

Efficacy may be affected by the geographical source of the nuts and degree of processing.Alma 2004, Orhan 2006

Anti-inflammatory effect

Pistachio gum has been traditionally used for its anti-inflammatory effect in stomach conditions, hemorrhoids, and asthma. In an experiment in mice, the extracts from the fruit, leaves, and branch parts, as well as the exudates, were evaluated for anti-inflammatory and antinociceptive effect. The plant part extracts were ineffective, but an extract of the gum showed a dose-dependent effect on induced abdominal contractions and induced paw edema.Orhan 2006, Borzorgi 2013

Topical application from pistachio skin and seeds reduced ultraviolet-B–induced skin erythema in human volunteers. An additional antioxidant effect was also suggested based on the phenolic content of the seed.Martorana 2013

Antimicrobial

Animal data

In vitro studies show little action against human bacterial pathogens, but antifungal activity comparable with nystatin has been demonstrated by plant extracts and the essential oil of the gum.Alma 2004, Ozcelik 2005

The skin of the woody shell, fresh kernels, and unripe seeds of Turkish origin showed antiviral action against herpes simplex virus when compared with acyclovir.Ozcelik 2005 Extracts of the branches of the plant showed activity against Leishmania donovani, while an extract from the leaves was active against Plasmodium falciparum.Orhan 2006

Clinical data

Clinical trials are lacking.

Chemical composition

Reviews of the phytochemical studies have been published, with multiple medicinal applications suggested on the basis of chemical composition.Bozorgi 2013, Rauf 2017

Hypercholesterolemia

Animal data

gAnimal and in vitro experiments suggest an antioxidant action may be responsible for the effects observed in clinical trials.Gentile 2007, Aksoy 2007 A 60% loss in antioxidant action by roasting is suggested to be due to a loss in total phenol content, with isoflavones being affected by heat.Gentile 2007

Clinical data

Studies among healthy volunteersKocyigit 2006 and in humans with moderate hypercholesterolemiaEdwards 1999, Sheridan 2007, Gebauer 2008 have shown that inclusion of unroasted pistachio nuts in the diet affects the lipid profile.

Decreases were observed for mean plasma total cholesterol, total cholesterol/high-density lipoprotein (HDL), and low-density lipoprotein (LDL)/HDL ratios; increased HDL levels were reported. No changes were found for triglycerides or LDL levels. No change in blood pressure or body weight was found with these regimens.Kocyigit 2006, Edwards 1999, Sheridan 2007, Gebauer 2008 One trial evaluated changes in apolipoproteins and reported a decrease in apolipoprotein B.Gebauer 2008

The effect on the lipid profile was demonstrated after 2 doses in one trialGebauer 2008 and other studies evaluated effects after 3 weeks of supplementation.Kocyigit 2006, Edwards 1999, Sheridan 2007

Dosing

Studies evaluating the dietary effect of unroasted pistachio nuts on lipid profiles have used doses equivalent to 20% of the total daily calorie intake. This approximates 65 to 75 g/day in most adultsEdwards 1999, Sheridan 2007 but up to 125 g/day has been used.Gebauer 2008

Pregnancy / Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

None well documented.

Adverse Reactions

Most adverse reactions are associated with hypersensitivity to the plant species or allergic reactions. Anaphylaxis is reported to be uncommon despite widespread use in foodstuffs.Fernandez 1995 Cross-sensitivity with other tree nuts has been reported.Liccardi 1999, Goetz 2005, Parra 1993

Toxicology

Studies are lacking. One study found no cytotoxicity of plant extracts against mammalian cells.Orhan 2006

References

Aksoy N, Aksoy M, Bagci C, et al. Pistachio intake increases high density lipoprotein levels and inhibits low-density lipoprotein oxidation in rats. Tohoku J Exp Med. 2007;212(1):43-48.
Alma MH, Nitz S, Kollmannsberger H, Digrak M, Efe FT, Yilmaz N. Chemical composition and antimicrobial activity of the essential oils from the gum of Turkish pistachio (Pistacia vera L.). J Agric Food Chem. 2004;52(12):3911-3914.15186116
Bozorgi M, Memariani Z, Mobli M, et al. Five Pistacia species (P. vera, P. atlantica, P. terebinthus, P. khinjuk, and P. lentiscus): a review of their traditional uses, phytochemistry, and pharmacology. ScientificWorldJournal. 2013;2013:219815.24453812
Edwards K, Kwaw I, Matud J, Kurtz I. Effect of pistachio nuts on serum lipid levels in patients with moderate hypercholesterolemia. J Am Coll Nutr. 1999;18(3):229-232.10376778
Fernández C, Fiandor A, Martinez-Garate A, Martinez Quesada J. Allergy to pistachio: crossreactivity between pistachio nut and other Anacardiaceae. Clin Exp Allergy. 1995;25(12):1254-1259.8821307
Gebauer SK, West SG, Kay CD, Alaupovic P, Bagshaw D, Kris-Etherton PM. Effects of pistachios on cardiovascular disease risk factors and potential mechanisms of action: a dose-response study. Am J Clin Nutr. 2008;88(3):651-659.18779280
Gentile C, Tesoriere L, Butera D, et al. Antioxidant activity of Sicilian pistachio (Pistacia vera L. var. Bronte) nut extract and its bioactive components. J Agric Food Chem. 2007;55(3):643-648.17263455
Goetz DW, Whisman BA, Goetz AD. Cross-reactivity among edible nuts: double immunodiffusion, crossed imunoelectrophoresis, and human specific igE serologic surveys. Ann Allergy Asthma Immunol. 2005;95(1):45-52.16095141
Kocyigit A, Koylu AA, Keles H. Effects of pistachio nuts consumption on plasma lipid profile and oxidative status in healthy volunteers. Nutr Metab Cardiovasc Dis. 2006;16(3):202-209.16580587
Liccardi G, Russo M, Mistrello G, Falagiani P, D'Amato M, D'Amato G. Sensitization to pistachio is common in Parietaria allergy. Allergy. 1999;54(6):643-645.10435484
Martorana M, Arcoraci T, Rizza L, etal. In vitro antioxidant and in vivo photoprotective effect of pistachio (Pistacia vera L., variety Bronte) seed and skin extracts. Fitoterapia. 2013;85:41-48.23313777
Orhan I, Aslan M, Sener B, Kaiser M, Tasdemir D. In vitro antiprotozoal activity of the lipophilic extracts of different parts of Turkish Pistacia vera L. Phytomedicine. 2006;13(9-10):735-739.17085297
Orhan I, Küpeli E, Aslan M, Kartal M, Yesilada E. Bioassay-guided evaluation of anti-inflammatory and antinociceptive activities of pistachio, Pistacia vera L. J Ethnopharmacol. 2006;105(1-2):235-240.16337351
Ozcelik B, Aslan M, Orhan I, Karaoglu T. Antibacterial, antifungal, and antiviral activities of the lipophylic extracts of Pistacia vera. Microbiol Res. 2005;160(2):159-164.15881833
Parra FM, Cuevas M, Lezaun A, Alonso MD, Beristain AM, Losada E. Pistachio nut hypersensitivity: identification of pistachio nut allergens. Clin Exp Allergy. 1993;23(12):996-1001.10779292
Pistacia vera L. USDA, NRCS. 2007. The PLANTS Database (http://plants.usda.gov, November 2008). National Plant Data Center, Baton Rouge, LA 70874-4490 USA.
Rauf A, Patel S, Uddin G, et al. Phytochemical, ethnomedicinal uses and pharmacological profile of genus Pistacia. Biomed Pharmacother. 2017;86:393-404.28012394
Sheridan MJ, Cooper JN, Erario M, Cheifetz CE. Pistachio nut consumption and serum lipid levels. J Am Coll Nutr. 2007;26(2):141-148.
Tsokou A, Georgopoulou K, Melliou E, Magiatis P, Tsitsa E. Composition and enantiomeric analysis of the essential oil of the fruits and the leaves of Pistacia vera from Greece. Molecules. 2007;12(6):1233-1239.17876292

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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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