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Quest Vitamins LTD,
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Issue # 62 : Therapeutic uses of Bromelain

The Therapeutic uses of Bromelain
Bromelain, which is a phytonutrient derived from the pineapple plant, has been the subject of many recent scientific studies regarding its possible therapeutic uses. It has been shown to perform many functions and is widely known to possess enzymatic properties and, as a result, has been incorporated into many supplements designed to aid digestion. Bromelain is a protease, which essentially means it helps to breakdown dietary protein, but it has also been shown to possess anti-inflammatory and pain killing properties.

The discovery that bromelain could be used for reducing the symptoms of inflammatory diseases, such as arthritis, received much attention particularly among the vegan proportion of the population. This is because bromelain, as mentioned, is found in pineapple which therefore renders it suitable for use by vegans. Glucosamine sulphate, which can also be used to treat arthritis, is derived from shellfish which means that vegans who suffer from arthritis would not be able to use it.

A recent study investigated the possible therapeutic use of bromelain to alleviate knee pain. The study was open, dose-ranging postal study in volunteers which had been recruited through newspaper and magazine articles.

In total, seventy seven subjects were used who were randomly allocated to receive either 200mg or 400mg bromelain. Both treatment groups showed improvements in knee pain and these results were obtained using two validated questionnaires which were the WOMAC knee health index and the Psychological Well-Being Index. Those receiving the high dose (400mg bromelain) showed greater improvements with a reduction in symptoms such as knee stiffness and physical function being observed.

The results from the psychological test also showed improvements in both groups and, again, a dose dependant relationship was observed as those receiving the higher dose showed a greater improvement.

The conclusion of the study stated that bromelain may be an effective alternative treatment for reducing the physical symptoms associated with mild knee pain and also for improving the general well-being of the patients. The most effective dose appeared to be 400mg.

Phytomedicine 2002 Dec;9(8):681-6

Can bioflavonoids reduce heart disease risk?
A recent study analyzed the results from over 100,000 individuals in seven previously published studies to investigate if there was a link between consumption of flavonoids with the incidence of heart disease.
It was discovered that those consuming the most flavonoids had a statistically significant 20 percent reduction in risk of heart disease, which may be due to the antioxidant activity associated with these plant compounds. The richest sources of flavonoids were tea (mostly black), onions, apples and broccoli. Red wine is also thought to be another rich source.

European Journal of Clinical Nutrition. August 2003
Can Omega-3 improve lean body mass?
Omega-3 supplementation may help alleviate cancer-related weight loss, as well as help increase lean body mass, according to recent research. The study used 200 patients with advanced pancreatic cancer in their double blind, multi-centre trial.

The investigation lasted for eight weeks and subjects were randomly assigned to receive either a protein- and energy-dense supplement enriched with omega-3 fatty acids and antioxidants or a control supplement.

The conclusion of the study stated that while omega-3 fatty acids did not provide a therapeutic advantage over the control supplement, omega-3 supplementation caused a dose-dependant gain in weight and lean body mass.

Gut 52, 10:1479-1486, Oct 2003

Calcium + Exercise = Reduced osteoporosis risk?
Researchers conducted by the University of Arizona, Tucson USA, concluded that by adding exercise to calcium supplementation with or without hormone replacement therapy (HRT), those at risk of low bone mineral status, including post menopausal women, can improve bone mineral density, thereby reducing the risk of osteoporosis.

Exercise is thought to increase the efficiency of calcium uptake by the bone as an adaptive response to help maintain strength, which in turn reduces the risk of fracture.
Osteoporosis International 14, 8:637-643, Aug 2003

B vitamins may help maintain mental health
B vitamins have long been associated with the efficient functioning of the central nervous system, via their ability to help reduce homocysteine levels which has been linked to mental decline in the elderly.  

A recent study investigated the role of homocysteine and cognitive function in older Latinos in the Sacramento area. The researchers evaluated cognition, homocysteine status, and nutrient levels of vitamin B12 and folate. In addition, other variables were measured such as age, sex, and education. After analyzing the results, age and education did not show a strong association in mental status. Higher homocysteine levels have been linked to a decline in mental functioning. In conclusion, the results showed that vitamin B12 and folate may reduce homocysteine levels, which may therefore have the potential to protect against cognitive decline in the elderly.

Am J Clin Nutr. Sep 2003;78(3):441-447.

Dietary fibre reduces coronary heart disease
A recently published study of 9,776 adults investigated the relationship between coronary heart disease (CHD) and dietary fibre intake. All participants were cardiovascular disease (CVD) free at the initiation of this study.

After 19 years of follow-up, there were 1,843 cases of CHD and 3,762 cases of CVD. Those with a lower intake of dietary fibre (average 5.9 g daily) had a higher risk of CVD and CHD when compared to those who consumed and average of 20.7 g a day. After further investigation, the researchers found that water-soluble fibre was particularly associated with a decreased risk of these diseases.
Arch Int Med. Sept 8 2003;163(16):1897-1904.

Vitamin D during winter
A recent study emphasized the need for vitamin D supplementation during the winter due to the decline in sunlight exposure. Usually, when sunlight hits the cells of the skin vitamin D is synthesised which reduces the need for dietary sources. Therefore, during the winter, vitamin D synthesis decreases exposing the subject to a risk of deficiency.

This study investigated whether the vitamin D generated during the summer would be enough to last through the winter. The results showed that healthy men could meet 80% of their daily requirement from summer stores alone which means that an additional supplement may be necessary to ensure optimum levels.

Am J Clin Nutr 2003;77:204-210

The effect of folic acid fortification
Folic acid is probably the most important nutrient to ensure the health of a new born baby?s central nervous system. Deficiencies of this nutrient during pregnancy can result in a nervous system disorder called spina bifida. It is currently recommended that women who are planning for a baby need to start supplementing with this nutrient at least 1 month before trying for a baby as folic acid is vital during the embryonic stages of life.

The government began to fortify flour in order to increase the folic acid content of one of our staple foods, bread. The results of this have been encouraging as the average intake of folic acid has increased throughout the population and in turn, this therefore, decrease the incidence of spina bifida.

J Nutr 2002; 132:2792-2798  

A to Z of Nutrients - Vitamin C
Vitamin C (ascorbic acid) is a ubiquitous compound, present in the physiologies of almost all plants and animals. Humans, other high primates, fruit bats and guinea pigs cannot produce their own bodily supply of vitamin C, and consequently require a regular dietary intake.

Vitamin C is an unstable water-soluble vitamin that is sensitive to heat, air, water (by leaching) and alkali (e.g. bicarbonate of soda). Certain metals, e.g. copper also speed the oxidative destruction of vitamin C.

What does it do?
Vitamin C has very many functions in the body - some still not completely understood. Below are listed some of the processes in which it is involved:
  • Formation of collagen - the body?s intracellular "cement"
  • Growth, tissue repair and wound healing
  • Formation of antibodies and stimulation of the white blood cells
  • Formation of corticosteroid hormones in the adrenal gland
  • Absorption of iron and its necessary accumulation in the bone marrow, spleen and liver.
  • As an antioxidant nutrient, it protects water-soluble substances from oxidation by allowing itself to be oxidised.
  • As an anti-histamine, vitamin C reduces the effect of histamine produced by the immune system. Histamine is responsible for many of the symptoms of allergies such as hay fever.
  • Carnitine formation in vegetarians, together with lysine
What are the deficiency signs?
The classic vitamin C deficiency disease is scurvy, early symptoms of which are usually bleeding of the gums and loosening of the teeth, together with lassitude, weakness, irritability and muscle ache.
A prolonged marginal deficiency of vitamin C may not lead to clinical symptoms, but may predispose towards heart disease and lowered immunity.

Is it toxic?
Vitamin C is on the whole extremely safe, with no toxic effects even at dosages of grams per day. Transient diarrhoea is the usual side-effect that is noted when excess levels are taken
The only other possibility of danger from high vitamin C intake occurs in people who have a family history of kidney stones, as oxalate can combine with calcium to form the stones. However, people who are not at high risk of kidney stones do not need to avoid vitamin C.

Taking very high doses of vitamin C - 5000 mg a day and up - and then suddenly stopping the supplementation has been thought to possibly cause "rebound scurvy". However a recent review has shown there is no real basis for this belief. Nevertheless it is perhaps advisable to come off high level vitamin C slowly.

Who should supplement?
The daily requirement of vitamin C should be obtained through diet if current dietary guidelines are followed. However, those who are wishing to boost the immune system during the winter months may benefit from an extra vitamin C supplement.

Intake levels: milligrams (mg)
Upper safe level for daily supplementation = 2000mg
Recommended Daily Allowance = 60mg
(Smokers requirements are increased by 80mg)

Which foods?
Food (mg/100g)
Blackcurrants 200
Pepper, green 100
Brussels sprouts 90
Mango 80
Cauliflower 60
Cabbage 55
Oranges 50
Grapefruit 40
Sweet Potato 25
Tomatoes 20
Potatoes: new 16; Oct-Dec 19; Jan-Feb 9; Mar-May 8
Lettuce 15
Bananas 10
The main sources of vitamin C in the diet are potatoes, fruit juices, citrus fruit and green vegetables. The vitamin C content of foods varies very widely depending upon season, variety and freshness.

1.    Vitamin and Mineral Safety, Council for Responsible Nutrition: 1997
2.    Health Essentials, Vitamin Guide: 1994
3.    Manual of Nutrition (MAFF): 1989
4.    The Vitamin Bible, Earl Mindell: 1988

Next Issue: Vitamin D

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