Scientific Name(s): Ziziphus jujuba Mill.
Common Name(s): Annab, Ber, Chinese date, Daechu, Hei zao, Hongzao, Jujube, Natume, Red date, Semen Ziziphi Spinosae, Sour date, SuanzaorenClinical Overview
Use
The seeds, fruit, and bark of jujube have been used in traditional medicine for anxiety and insomnia, and as an appetite stimulant or digestive aid. Experiments in humans and animals support the presence of anxiolytic and sedative properties. However, robust evidence from epidemiologic and clinical studies is lacking.
Dosing
Information is lacking.
Contraindications
Information is lacking.
Pregnancy/Lactation
Information regarding safety and efficacy in pregnancy and lactation is lacking. Avoid use of jujube bark preparations.
Interactions
An interaction with venlafaxine has been reported.
Adverse Reactions
Information is lacking.
Toxicology
Information is lacking.
Scientific Family
- Rhamnaceae (Buckthorn)
Botany
Z. jujuba is a small deciduous tree or shrub with thorny branches that grows 5 to 10 m tall. It is native to many parts of Asia, requiring hot summers and sufficient water for fruiting; however, the plant can tolerate colder temperatures and can survive in desert habitats. It has 2 to 7 cm long shiny, green, ovate leaves with 3 conspicuous veins at the base of the leaves. The flowers are small with yellow-green petals. The edible oval fruits are green when immature, turn dark red to purple-black and wrinkle when ripe, and contain a single hard seed.
History
Traditional use of jujube dates back 2,500 years in original Chinese materia medica records. The fruit, seed, and bark are described in Korean, Indian, and Japanese traditional writings, as well. They are used to alleviate stress and insomnia and as appetite stimulants, digestive aids, antiarrhythmics, and contraceptives. The sweet smell of the fruit is said to make teenagers fall in love. The fruit is eaten fresh or dried and made into candy; tea, syrup, and wine are also made from the berries. This traditional Chinese medicine has been used to treat many diseases such as insomnia, forgetfulness, headaches, and dizziness.
Chemistry
Over 150 compounds have been identified in this plant, including terpenoids, alkaloids, flavonoids, fatty acids, volatile oils, polysaccharides, and others.The polysaccharides are one of the major biologically active components of the jujube fruit and have various biological effects, including immunomodulatory, antioxidant, antitumor, hepatoprotective, and hypoglycemic activities, and GI-protective effects.
Composition of the plant parts varies geographically, as well as on the processing technique used. The fruit is high in carbohydrates, especially fructose and glucose, which accounts for about 77% of the weight. Vitamins C, B complex, and A, as well as calcium, potassium, and other mineral elements, have been identified.
Glycoside saponins, including jujuboside A and B, have been identified, as well as flavonoids, triterpenes, and short-medium chain fatty acids (eg, stearic, oleic, palmitic, linoleic).
Uses and Pharmacology
Both extracts and purified compounds have excellent biological activities, especially sedative and hypnotic effects. Other effects include ameliorating or improving learning and memory, anti-inflammation, antioxidation, blood pressure and lipid lowering, antiaging, and antitumor effects.
Anemia
Evidence for the development of jujube fruit as a supplementary product for prevention and/or treatment of anemia has been proposed. In addition, further investigation, production, and application of jujube polysaccharides in functional foods and therapeutic agents is foreseen.
CNS
Animal data
Jujube is used traditionally as an anxiolytic and sedative. Animal experiments using the saponin jujuboside and flavonoids from the fruits, as well as the seed extract, showed reductions in anxiety, impaired coordination and responses, and enhanced barbiturate-induced hypnotic effects.
In a plant screening exercise, oleamide from a jujube extract given for 3 weeks attenuated scopolamine-induced amnesia in mice. A role in cognitive impairment disorders, such as that seen in Alzheimer disease, was suggested, as the jujube extract appeared to increase the activation of choline acetyltransferase.
A hydroalcoholic extract of Z. jujube has been shown to possess antiepileptic effects against induced seizures in rodents.
Clinical data
A role in the management of insomnia has been suggested in a review of pharmacological effects of the jujube seed, based on 2 small clinical studies.The chemistry and psychopharmacology of the seeds of the Z. jujuba plant, Ziziphus spinosa, has been reported. Whole extracts and constituent compounds have been evaluated in preclinical and clinical studies. Z. spinosa secondary metabolites have shown to modulate GABAergic activity and the serotonergic system. The actual therapeutic agents require further confirmation/identification so that new insomnia phytomedicines can be discovered.(Shergis 2017)
A systematic review and meta-analysis of traditional herbal medicine (with Z. jujuba as the most frequently used herb) concluded that traditional herbal medicine may be an effective therapeutic option for insomnia in patients with cancer. However, considering the limited methodological qualities and inconsistent results of the included trials, further rigorous randomized controlled trials are required.
Cancer
Animal and in vitro data
Ursonic acid (UNA) is a naturally occurring pentacyclic triterpenoid extracted from certain medicinal herbs such as Z. jujuba. UNA has promising potential to be developed into cancer- and protozoan-fighting pharmaceuticals.
Studies using specific saponins, as well as ethyl acetate and water extracts of the fruit and bark, have explored the potential cytotoxicity of jujube. Apoptosis and differential cell cycle arrest are suggested to be responsible for the dose-dependent reduction in cell viability. Activity against certain human cancer cell lines has been demonstrated in vitro.
Contraceptive
An ethyl acetate extract of the plant bark had a contraceptive effect, as it arrested the normal estrus cycle of adult female mice and reduced the weight of the ovaries. The antisteroid action was reversed upon cessation of the extract supplementation.
Drug-induced hepatotoxicity
A small pilot, randomized, double-blind, placebo-controlled, clinical trial investigated the efficacy of Jujube syrup on the prevention of drug-induced hepatotoxicity in pulmonary tuberculosis (TB) patients. This study suggested that jujube syrup could prevent anti-TB drug-induced hepatotoxicity and that it could also improve the severity of the patient’s cough as well as the quality of life in pulmonary TB patients.
Gastrointestinal/Dyslipidemia
Animal data
Jujube fruit has traditionally been used as a paste, puree, or soup to enhance digestion. In animal experiments, jujube extract decreased GI transit time and increased fecal moisture content. Increased fatty acid concentration in the cecum and decreased fecal ammonia and bacterial enzyme activity in the feces were also measured.
Clinical data
In a small (N = 50) clinical trial, the symptoms of patients with chronic idiopathic constipation improved with daily consumption of jujube extract (average, 20 drops per day) versus placebo. Because of practical issues, GI transit times were not measured in the study. Jujube extract may offer a safe natural laxative option.
A clinical study evaluated consumption of jujube fruit as a powder (5 g taken 3 times a day for 1 month) among 86 obese adolescents (12 to 18 years of age) with dyslipidemia. Decreased serum total cholesterol and LDL cholesterol were reported, with no effect on other lipid indices, blood glucose, or BMI.
Immunoregulatory
In vitro experiments in sheep and human blood suggest anticomplementary action of the tripenoids of ethylacetate fruit extracts.(Lee 2004, Chan 2005)
Z. jujube (3.9%) is an ingredient in the Chinese multi-preparation CKBM-A01 studied for immunological effect.
Dosing
Information on dosages for clinical applications is lacking. Bacterial contamination of imported jujube products remains an issue for the Food and Drug Administration (FDA).
In a clinical trial, up to 40 drops/day of extract were used in chronic idiopathic constipation. For traditional GI uses, up to 50 g/day of dried fruit (equivalent to 4 g of extract) has been used.) A clinical study evaluated consumption of 5 g powdered jujube fruit taken 3 times/day for 1 month in adolescents with dyslipidemia. Doses of 10 mL/day of jujube syrup have also been used in a study evaluating drug-induced hepatotoxicity.(Maddahi 2022)
Pregnancy / Lactation
Information regarding safety and efficacy in pregnancy and lactation is lacking. A contraceptive action of a bark extract has been demonstrated in mice.
Interactions
There has been a case report of a severe, acute serotonin reaction of venlafaxine with coadministration of jujube. Jujube 0.5 g/day was consumed regularly, and the reaction occurred after a single dose of venlafaxine 37.5 mg.
Potentiation of effect of phenytoin and phenobarbitone in rodents has been reported. No effect on carbamazepine was noted
Adverse Reactions
Information is lacking. A clinical trial using extract of jujube reported no adverse effects and no changes to liver or kidney laboratory indices. Immunoglobulin E–mediated allergy with angioedema, generalized urticaria, asthma, and hypotension has been reported. A cross-reactivity with latex is also suggested.
