Pectin

• How It Works

  There is some evidence to support use of pectin for diarrhea and for lowering cholesterol. More studies are needed to determine pectin’s benefits for cancer.

  Pectin is a soluble fiber present in most plants but is concentrated in the peel and pulp of citrus fruits such as lemons, oranges, and grapefruits, as well as apples. Modified Citrus Pectin (MCP) is obtained by changing pectin so it is better absorbed by the body. Data from studies in cells and mice showed that pectin and MCP have anticancer properties. There is also some evidence from human studies that pectin and MCP are effective in treating diarrhea and in lowering cholesterol. Pectin causes side effects such as abdominal cramps and diarrhea and may interfere with the absorption of some types of supplements.

• Purported Uses
  • Diarrhea
    Pectin has been shown to be effective in treating diarrhea in children with persistent diarrhea.
  • Hypercholesterolemia
    Diets supplemented with fiber can benefit patients with high blood cholesterol.
  • Cancer prevention and treatment
    Laboratory and animal studies have shown that pectin has anticancer properties. Human studies are needed to verify these results.
• Do Not Take If
  • You are taking lovastatin for high cholesterol: Pectin may inhibit the action of lovastatin and may increase LDL cholesterol.
  • You are taking carotenoid and alpha-tocopherol supplements: Pectin interferes with their absorption.
• Side Effects
  • Abdominal cramps
  • Diarrhea
• Brand Name

  Modified Citrus Pectin Power

• Clinical Summary

  Pectin is a soluble fiber rich in galactoside residues. It is present in most plants but is concentrated in the peel and pulp of citrus fruits and in apples. Pectin is used as a gelling agent in food. It is also used as a remedy for diarrhea, to lower cholesterol, or to improve satiety. Modified Citrus Pectin (MCP) is an altered form of pectin that has shorter carbohydrate chains and is claimed to be better absorbed by the body.

  Preclinical studies suggest inhibitory effects with pectin in colon ^(1) (2), breast ⁽³⁾, liver ⁽¹³⁾, and lung ⁽¹⁶⁾ cancer cell lines. Preliminary clinical data suggest that pectin is beneficial in treating diarrhea ⁽⁴⁾ and in reducing levels of toxic heavy metals ⁽¹⁴⁾. Pectin is also effective against hypercholesterolemia ⁽⁵⁾, but a recent study showed that source and type of pectin influences its activity ⁽¹⁵⁾. Another study also demonstrated that different types pectin are varied in their properties and may affect appetite and energy intake differently ⁽¹⁷⁾.

  Pectin has been promoted for reducing colon cancer risk and damage from radiation therapy, but there is insufficient scientific evidence to support these uses. In a small non-randomized study, MCP was shown to increase the doubling time of prostate-specific antigen in patients with prostate cancer ⁽⁶⁾.

  Gastrointestinal side effects such as abdominal cramps and diarrhea have been reported with use of pectin ^(5) (6).

• Food Sources

  Apples and citrus fruits such as lemons, oranges, and grapefruits.

• Purported Uses
  • Cancer prevention
  • Cancer treatment
  • Diarrhea
  • High Cholesterol
• Mechanism of Action

  Modified Citrus Pectin (MCP) acts as a ligand for galectin-3, which plays a major role in tumor formation and progression ^(7) (8). Binding of MCP to galectin-3 was shown to inhibit tumor growth, angiogenesis, and metastasis in vivo. MCP is thought to render galectin-3 incapable of binding its receptors that would result in angiogenesis ⁽⁹⁾. Galectin-3 is also found in prostate cancer cells and prostate tissue. In another study, MCP was shown to increase doubling time of prostate-specific antigen (PSA), presumably by binding galectin-3 ⁽⁶⁾. Pectin induced apoptosis in adenocarcinoma cells in vitro via caspase-3 activity resulting in DNA degradation ⁽¹⁾.

• Adverse Reactions

  Mild abdominal cramps and diarrhea, which resolved after stopping MCP ⁽⁶⁾.

• Herb-Drug Interactions
  • Lovastatin: Pectin caused an increase in low-density lipoprotein in patients with hypercholesterolemia ⁽¹⁰⁾.
  • Carotenoid and alpha-tocopherol supplements: The absorption of these supplements is affected by pectin ⁽¹²⁾.
• References

  1. Olano-Martin E, Rimbach GH, Gibson GR, Rastall RA. Pectin and pectic-oligosaccharides induce apoptosis in in vitro human colonic adenocarcinoma cells. Anticancer Res 2003; 23(1A):341-346.

  2. Umar S, Morris AP, Kourouma F, Sellin JH. Dietary pectin and calcium inhibit colonic proliferation in vivo by differing mechanisms. Cell Prolif 2003; 36(6):361-375.

  3. Taper HS, Roberfroid M. Influence of inulin and oligofructose on breast cancer and tumor growth. J Nutr 1999; 129(7 Suppl):1488S-1491S.

  4. 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.

  5. 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.

  6. 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.

  7. Inufusa H, Nakamura M, Adachi T et al. Role of galectin-3 in adenocarcinoma liver metastasis. Int J Oncol 2001; 19(5):913-919.

  8. Nakamura M, Inufusa H, Adachi T et al. Involvement of galectin-3 expression in colorectal cancer progression and metastasis. Int J Oncol 1999; 15(1):143-148.

  9. Nangia-Makker P, Hogan V, Honjo Y et al. Inhibition of human cancer cell growth and metastasis in nude mice by oral intake of modified citrus pectin. J Natl Cancer Inst 2002; 94(24):1854-1862.

  10. Richter WO, Jacob BG, Schwandt P. Interaction between fibre and lovastatin. Lancet 1991; 338(8768):706.

  11. MICROMEDEX(R) Healthcare Series. 120. 2004. Thomson MICROMEDEX.

  12. Hoffmann J, Linseisen J, Riedl J, Wolfram G. Dietary fiber reduces the antioxidative effect of a carotenoid and alpha-tocopherol mixture on LDL oxidation ex vivo in humans. Eur J Nutr 1999; 38(6):278-285.

  13. Liu HY, Huang ZL, Yang GH, Lu WQ, Yu NR. Inhibitory effect of modified citrus pectin on liver metastases in a mouse colon cancer model. World J Gastroenterol. 2008 Dec 28;14(48):7386-91.

  14. Eliaz I, Weil E, Wilk B. Integrative medicine and the role of modified citrus pectin/alginates in heavy metal chelation and detoxification—five case reports. Forsch Komplementmed. 2007 Dec;14(6):358-64.

  15. Brouns F, Theuwissen E, Adam A, et al. Cholesterol-lowering properties of different pectin types in mildly hyper-cholesterolemic men and women. Eur J Clin Nutr. 2012 May;66(5):591-9.

  16. Leclere L, Fransolet M, Cote F, et al. Heat-modified citrus pectin induces apoptosis-like cell death and autophagy in HepG2 and A549 cancer cells. PLoS One. 2015;10(3):e0115831.

  17. Wanders AJ, Feskens EJ, Jonathan MC, et al. Pectin is not pectin: a randomized trial on the effect of different physicochemical properties of dietary fiber on appetite and energy intake. Physiol Behav. Apr 10 2014;128:212-219.