Juice Plus

Common Names

How It Works
Juice Plus has not been shown to treat or prevent cancer.
Juice Plus is a dietary supplement that contains dried concentrates of fruits and vegetables. It has been studied for its antioxidant and cardiovascular effects, but more studies are needed. Consumption of juice plus is thought to reduce oxidative stress and DNA damage, and has been associated with a reduction in the symptoms of common cold. In a study of head and neck cancer patients, JP affected an increase in serum micronutrient levels, but no clinical benefit.
Although there are ongoing clinical studies of Juice Plus in cancer patients, it has not been proven to treat or prevent cancer. Cancer patients should discuss the use of supplements with their physicians. Juice Plus is not a substitute for fresh fruits and vegetables.
Purported Uses
- To prevent and treat cancer
  Evidence is lacking to support this claim.
- To prevent and manage heart disease
  Small studies showed mixed results. Well-designed clinical trials are needed.
- To reduce cold symptoms
  One study shows that taking capsules consisting of a juice powder concentrate of fruits and vegetables can reduce common cold symptoms and duration.
Do Not Take If
You are undergoing chemotherapy or radiation therapy: Supplements with antioxidant properties may decrease the effectiveness of these treatments.
Side Effects
Some patients reported gastrointestinal distress and hive-like rash in clinical studies.
Brand Name
Juice Plus+®
Clinical Summary
Juice Plus (JP) is a formulation derived from a variety of fruits and vegetables and contains additional vitamins. It is marketed to complement daily diet based on the notion that people do not consume enough fruits and vegetables. Studies on bioavailability suggest that consumption of JP can increase serum levels of alpha-carotene, vitamin C, and folate ⁽¹⁾ ⁽²⁾ but studies with other markers, such as lutein and alpha-tocopherol yielded mixed results. JP was comparable to standard vitamin C and E supplements, ⁽³⁾ but it remains unclear if this product is nutritionally superior to fresh produce. In addition, JP was shown to decrease plasma homocysteine levels, a risk factor for cardiovascular disease ⁽⁹⁾ ⁽¹⁾, but the results were not reproducible ⁽⁴⁾. Studies on cardiovascular effects, such as changes in blood pressure and cholesterol levels are inconclusive ⁽⁵⁾ ⁽⁴⁾. JP consumption is thought to reduce oxidative stress and DNA damage ⁽¹⁰⁾ ⁽⁶⁾ ⁽²⁾, and has been associated with a reduction in the symptoms of common cold ⁽¹²⁾. Gastrointestinal distress ⁽⁵⁾ and hive-like rash ⁽¹¹⁾ have been associated with intake of JP in clinical trials.
In a study of head and neck cancer patients, JP affected an increase in serum micronutrient levels, but no clinical benefit ⁽¹⁵⁾.
While there is ongoing research using JP in cancer patients, it has not been proven to prevent or treat cancers. Due to its antioxidant effects, JP may interfere with the actions of some chemotherapy drugs. Cancer patients should discuss the use of supplements with their physicians. JP is not a substitute for fresh fruits and vegetables.
Purported Uses
- Cancer prevention
- Cardiovascular disease
- Weight loss
Mechanism of Action
JP is thought to have antioxidant and immunomodulating properties. It reduces some biomarkers of oxidative stress but not others ⁽⁶⁾ ⁽³⁾ ⁽²⁾. Inflammatory cytokine TNF alpha production increased up to 8 weeks following consumption of JP but decreased thereafter. It had no effect on other markers including IL-4, IL-6, superoxide dismutase or glutathione ⁽⁶⁾ ⁽⁷⁾ ⁽⁸⁾. JP decreased levels of plasma homocysteine, a risk factor for cardiovascular diseases ⁽¹⁾ ⁽⁹⁾, but failed to show similar effects in another study ⁽⁴⁾. Intake of phytochemical antioxidants may have protective effect on endothelial function by preserving the bioactivity of nitric oxide ⁽⁴⁾. JP’s effects on regulating blood pressure are mixed. Consumption of fresh fruits and vegetables can lower cholesterol levels due to their high fiber content, whereas JP extract did not appreciably alter cholesterol levels ⁽⁴⁾ ⁽⁵⁾.
Adverse Reactions
Gastrointestinal distress ⁽⁵⁾ and hive-like rash ⁽¹¹⁾ were reported in clinical studies.
Case Report
Hepatotoxicity linked to JP use: A 51-year-old woman with endometrial cancer experienced elevated liver function tests and interference with allopathic therapies. The patient discontinued using the product and liver function tests normalized over 4 weeks ⁽¹⁴⁾.
Herb-Drug Interactions
Chemotherapy drugs: Theoretically, antioxidants can decrease the efficacy of certain chemotherapy drugs that rely on the generation of free radicals for their cytotoxic effects. Supplements with antioxidant properties are therefore not recommended during chemotherapy.
Herb Lab Interactions
May elevate serum level of some vitamins.
References
1. Samman S, Sivarajah G, Man JC, Ahmad ZI, Petocz P, Caterson ID. A mixed fruit and vegetable concentrate increases plasma antioxidant vitamins and folate and lowers plasma homocysteine in men. J Nutr. Jul 2003;133(7):2188-2193.
2. Kawashima A, Madarame T, Koike H, et al. Four week supplementation with mixed fruit and vegetable juice concentrates increased protective serum antioxidants and folate and decreased plasma homocysteine in Japanese subjects. Asia Pac J Clin Nutr. 2007;16(3):411-421.
3. Bloomer RJ, Goldfarb AH, McKenzie MJ. Oxidative stress response to aerobic exercise: comparison of antioxidant supplements. Med Sci Sports Exerc. Jun 2006;38(6):1098-1105.
4. Plotnick GD, Corretti MC, Vogel RA, et al. Effect of supplemental phytonutrients on impairment of the flow-mediated brachial artery vasoactivity after a single high-fat meal. J Am Coll Cardiol. May 21 2003;41(10):1744-1749.
5. Houston MC, Cooil B, Olafsson BJ, Raggi P. Juice Powder Concentrate and Systemic Blood Pressure, Progression of Coronary Artery Calcium and Antioxidant Status in Hypertensive Subjects: A Pilot Study. Evid Based Complement Alternat Med. 2007;4(4):455-462.
6. Lamprecht M, Oettl K, Schwaberger G, et al. Several indicators of oxidative stress, immunity, and illness improved in trained men consuming an encapsulated juice powder concentrate for 28 weeks. J Nutr. 2007;137(12):2737-2741.
7. Nantz MP, Rowe CA, Nieves C, Jr., Pervical SS. Immunity and antioxidant capacity in humans is enhanced by consumption of a dried, encapsulated fruit and vegetable juice concentrate. J Nutr. 2006;136(10):2606-2610.
8. Kiefer I, Prock P, Lawrence C, et al. Supplementation with mixed fruit and vegetable juice concentrates increased serum antioxidants and folate in healthy adults. J Am Coll Nutr. Jun 2004;23(3):205-211.
9. Panunzio MF, Pisano A, Antonicielloa A, et al. Supplementation with fruit and vegetable concentrate decreases plasma homocysteine levels in a dietary controlled trial. Nutr Res. 2003;23(9):1221-1228.
10. Smith MJ, et al. Supplementation with fruit and vegetable extracts may decrease DNA damage in the peripheral lymphocytes on an elderly population. Nutr Res. 1999;19:1507-18.
11. Inserra PF, et al. Immune function in elderly smokers and nonsmokers improves during supplementation with fruit and vegetable extracts. Integr Med. 1999;2:3-10.
12. Roll S, Nocon M, Willich SN. Reduction of common cold symptoms by encapsulated juice powder concentrate of fruits and vegetables: a randomised, double-blind, placebo-controlled trial. Br J Nutr. 2011 Jan;105(1):118-22.
13. Goldfarb AH, Garten RS, Cho C, et al. Effects of a fruit/berry/vegetable supplement on muscle function and oxidative stress. Med Sci Sports Exerc. Mar 2011;43(3):501-508.
14. Naing A, Aaron J, Kurzrock R. Juice plus or toxicity plus. Am J Med. Jan 2010;123(1):e1-2.
15. Datta M, Shaw EG, Lesser GJ, et al. A Randomized Double-Blind Placebo-Controlled Trial of Fruit and Vegetable Concentrates on Intermediate Biomarkers in Head and Neck Cancer. Integr Cancer Ther. 2018 Mar;17(1):115-123.