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Safety of Noni and Mangosteen Juice

Multilevel marketing companies accused of using exaggeration and pseudoscience to promote potentially dangerous products such as Metabolife and Hydroxycut by designing studies that appear to purposely mislead consumers.

August 2, 2013 |
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Supplementary Info

Sources Cited

T.-L. Fong, K. C. Klontz, A. Canas-Coto, S. J. Casper, F. A. Durazo, T. J. Davern II, P. Hayashi, W. M. Lee, L. B. Seeff. Hepatotoxicity due to hydroxycut: A case series. Am. J. Gastroenterol. 2010 105(7):1561 - 1566

E. L. Yu, M. Sivagnanam, L. Ellis, J. S. Huang. Acute hepatotoxicity after ingestion of Morinda citrifolia (Noni Berry) juice in a 14-year-old boy. J. Pediatr. Gastroenterol. Nutr. 2011 52(2):222 - 224

H. N. Yang, D. J. Kim, Y. M. Kim, B. H. Kim, K. M. Sohn, M. J. Choi, Y. H. Choi. Aloe-induced toxic hepatitis. J. Korean Med. Sci. 2010 25(3):492 - 495

R. Francavilla, E. Lionetti, S. Castellaneta, L. Cavallo. Helicobacter pylori eradication: Can't we do better? J. Pediatr. Gastroenterol. Nutr. 2011 53(4):468 - 469

F. Goodyear-Smith. Noni (Morinda citrifolia L.) Also known as great morinda, Indian mulberry, nunaakai, dog dumpling, mengkudu, beach mulberry, vomit fruit and cheese fruit. J Prim Health Care. 2(3):254-255.

A. L. Lobb. Science in liquid dietary supplement promotion: The misleading case of mangosteen juice. Hawaii J Med Public Health 2012 71(2):46 - 48

C. N. Boozer, J. A. Nasser, S. B. Heymsfield, V. Wang, G. Chen, J. L. Solomon. An herbal supplement containing Ma Huang-Guarana for weight loss: A randomized, double-blind trial. Int. J. Obes. Relat. Metab. Disord. 2001 25(3):316 - 324

U.S. Government Accountability Office. 2003. Dietary Supplements Containing Ephedra: Health Risks and FDA's Oversight.

A. Lobb. Science of weight loss supplements: Compromised by conflicts of interest? World J. Gastroenterol. 2010 16(38):4880 - 4882

H. G. Preuss, D. Bagchi, M. Bagchi, C. V. S. Rao, D. K. Dey, S. Satyanarayana. Effects of a natural extract of (-)-hydroxycitric acid (HCA-SX) and a combination of HCA-SX plus niacin-bound chromium and Gymnema sylvestre extract on weight loss. Diabetes Obes Metab 2004 6(3):171 - 180

Acknowledgements

Image thanks to Tijuana Brass via Wikimedia Commons. Thanks to Stephane Lahaye and Ellen Reid for their keynote help!

Transcript

Another case report of acute toxicity linked to noni juice ingestion, this time in a 14-year-old. At least his liver didn't fail more completely like in two of the earlier cases. What do you expect from a product also known as vomit fruit. The multi-level marketing company that sells noni products blamed aloe vera juice the boy had also consumed, which is indeed something else I'd encourage folks not to drink, but what about all the scientific studies promoting these types of products bandied about on their websites?

Recently, a public health researcher took the time to review the "Science in liquid dietary supplement promotion,” evidently a $23 billion dollar market. "Central to the marketing of many such products is the citation of ’scientific studies’ supporting the product’s health claims. While these studies seem deliberately created for marketing purposes, their findings and quality are generally presented in a manner that appears designed to mislead potential consumers.”

Here they use the case of mangosteen juice—another product I've warned about in the past—as an example of how widely marketed and consumed liquid dietary supplements use exaggeration and pseudoscience to bolster their web promotions of product effectiveness and safety.

The multilevel marketing company that sells mangosteen cited a study they paid for to support its assertion that their product is "shown to be safe at all dosages tested" and indeed "safe for everyone." The study involved exposing just 30 people to their product, though, with another 10 given placebo. As the researcher notes here, with that few people exposed, the stuff could kill 1 or 2% of people and you'd never even know.

This study of the multi-level marketing supplement Metabolife had 35 on the stuff and they seemed to do just fine until… it was withdrawn from the market after being linked to 18 heart attacks, 26 strokes, 43 seizures and 5 deaths. Oops.

Hydroxycut was studied on 40 people. No serious adverse effects, and same story: withdrawn after dozens of cases of organ damage including massive hepatic necrosis requiring liver transplants, and death.

And oftentimes the multilevel marketing study researchers don't disclose their funding sources, pretending to be objective scientists, but a little detective work exposed a whole web of financial conflicts of interest, "at best reducing the face-validity of findings, and at worst [they] represent deception.”

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Ariel Levitsky.

To help out on the site please email volunteer@nutritionfacts.org

Dr. Michael Greger
  • Plantstrongdoc M.D.

    If I rember correctly, you need 125,000 “patient-years” with a conventional drug, to exclude rare sideeffects, so a trial with 30 or 40 people followed for a short period of time, is an embarrassment, if you talk safety

    • Darryl

      The U.S. FDA has no fixed requirement for phase II and phase III trial “patient exposure years” or “patient years of exposure” prior to drug approval, but from the first few hundred search results they seem run between 130 and 20,000.

      • Plantstrongdoc M.D.

        Darryl,
        Yes, and that is why very rare sideeffects emerge several years after approval. That is one reason not to want “the newest” prescription drug from your doctor. Somtimes it is better to get an older drug, that has been on the market for several years (or go plantstrong!)

        • http://nutritionfacts.org/ Michael Greger M.D.

          I’m with you PSD!

      • Veganrunner

        Darryl,

        Change in topic. I am trying to find the b12 supplements (methylcobalamin) you mentioned and I can’t find it. The ones I find have a lot of preservatives.

        Thanks for posting again.

        • Darryl

          The liquid methylcobalamin I take has little in the way of preservatives. 4 oz. represents a 54 year supply at the U.S. RDA, but I stick it in the refrigerator to ensure it might last a significant fraction of that.

          • Veganrunner

            You are the best! Thanks.

  • basskills

    Dr. Greger, what are your thoughts on bottled coconut water? good or bad?

  • aloha

    What do you think of noni juice from fresh noni? I live in Hawaii and many friends drink fermented and fresh noni juice from fruit off trees in their yard. I would assume it would be equally toxic?

  • kathi richards

    I will stick to whole foods thank you.

  • Thea

    These type of videos leave me feeling disgusted. I keep hearing government officials proclaim on TV that our food supply is safe, but they seem to do nothing to actually make that statement true. This is another one of Dr. Greger’s videos that should be on the 6:00 news.

  • pres68y

    Gad, they are doing about the same thing Monsanto and many pharmaceutical companies routinely do!

  • Geoffrey Levens

    The outer “latex” of aloe leaves is a very harsh laxative. What is wrong w/ the inner get only which is a mild, anti-inflammatory, tissue healing nutritive? Any specific negative research on the inner gel alone?

  • Geoffrey Levens

    Re: Metabolife- I do think “weight loss” products are pretty misguide if not outright stupid. That said, “active ingredients” were guarana and ma huang, both of which are central nervous system stimulants; guarana weighs in at an average of 5% caffeine if I remember correctly. Is this product somehow different than other stimulant herbals that have been seriously misused and abused by idiots seeking either performance enhancement (generally illegal) or seeking magical rapid weight loss without any change in lifestyle and eating habits who then blame the herb for their troubles?

  • Stefan

    Morinda Noni Juice IS approved as a safe food

    “Hepatotoxicity and subchronic toxicity tests of Morinda citrifolia (noni) fruit.

    Abstract

    Morinda citrifolia (noni) fruit juice has been approved as a safe food in many nations. A few cases of hepatitis in people who had been drinking noni juice have been reported, even though no causal link could be established between the liver injury and ingestion of the juice. To more fully evaluate the hepatotoxic potential of noni fruit juice, in vitro hepatotoxicity tests were conducted in human liver cells, HepG2 cell line. A subchronic oral toxicity test of noni fruit was also performed in Sprague-Dawley (SD) rats to provide benchmark data for understanding the safety of noni juice, without the potential confounding variables associated with many commercial noni juice products. Freeze-dried filtered noni fruit puree did not decrease HepG2 cell viability or induce neutral lipid accumulation and phospholipidosis. There were no histopathological changes or evidence of dose-responses in hematological and clinical chemistry measurements, including liver function tests. The no-observed-adverse-effect level (NOAEL) for freeze-dried noni fruit puree is greater than 6.86 g/kg body weight, equivalent to approximately 90 ml of noni fruit juice/kg. These findings corroborate previous conclusions that consumption of noni fruit juice is unlikely to induce adverse liver effects..”

    http://www.ncbi.nlm.nih.gov/pubmed/19797868

  • colonyofcells delacruz

    Mangosteen is a pretty common fruit in asia so I won’t worry too much about the dangers of mangosteen. I don’t know if noni is commonly consumed in its place of origin. Aloe vera is a very effective laxative and there is probably some danger from using any laxative for a long period. Most of the commercial aloe juice are required to be filtered to remove the laxative so the laxative free aloe juice might be safer. Aloe juice is good as a mouthwash and does kill bacteria in the mouth.

  • colonyofcells delacruz

    In tradition, the inner gel of aloe vera was used as a burn treatment so the safety of ingesting the inner gel is something we might not be so sure about. The laxative free (filtered) aloe vera juice is sold in many stores and there are no newspaper reports of people being harmed by it. Some commercial mouthwash has aloe vera as the main ingredient. In tradition, the yellow bitter laxative from the latex of aloe vera has been used as a laxative for ages and was never intended for long term use as with any laxative.

  • Cassandra

    Does the danger lie in the fruit itself (whole fruit, dried, powder,
    etc), or is the danger simply in the supplement, which may have a host
    of other unwanted items?This wasn’t clear to me in the video.

    I put the inner portion of aloe in a smoothie, is that safe? I saw that filtered aloe juice drinks have the laxative properties filtered out, but I try to go whole food instead of processed, when possible. Do you find raw aloe to be dangerous?

  • Thinkabouddit

    Natural News just printed that noni stimulates the immune system to reject tumor cells: http://www.naturalnews.com/041

  • Lillis

    Again, read this about Noni from Morinda, a safe tested Novel food in Europe

    http://www.ncbi.nlm.nih.gov/pubmed/19797868

  • NIROJ

    I came to know that 1 USA based company FOREVER LIVING PRODUCT is providing stabilised Aloe vera Gel, Bee honey based supplements which are very beneficial to humans for optimal health. And also the products correct prescription and consumption cures many diseases, I saw in my home town. What is your view?

  • http://www.naturallifeenergy.com/ Aqiyl Aniys

    My aunt has a noni tree on her property in Jamaica and she drinks noni juice all the time without any ill effects. She has lost a lot of weight and her energy is sky high.

  • Clover

    Not sure that I agree with just about anything you have posted…but especially Mangosteen….with the Mayo Clinics double blind study and all the independent research being done all over the world…you are either bought out and believe everything Big Pharma tells you, or you represent another company. People must do their own research and check their own findings. For me…will never be without…and my liver enzymes improved ( no more fatty liver) and my CRP dropped a bit over 3 pts. to .069 ! Please do your own independent research.

    • Thea

      Clover: Dr. Greger donates his time for this website. He makes no money off of it, and he is quite conscientious in his research. The only people Dr. Greger represents are everyday people like you and me.

      You are entitled to your opinion. Alternate opinions, especially personal experiences, are quite welcome on this site. However, false accusations are immature and unwelcome. We all make mistakes; you might consider fixing your post…