Scientific Name(s): Ziziphus zizyphus (L.) Karst.
Common Name(s): Annab, Ber, Chinese date, Daechu, Hei zao, Hongzao, Jujube, Natume, Red date, Semen Ziziphi Spinosae, Sour date, Suanzaoren
Clinical 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 animals support the presence of anxiolytic and sedative properties. However, evidence from epidemiologic and clinical studies is largely 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. zizyphus 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.
Chemistry
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).Reviews of the chemical constituents have been published.
Uses and Pharmacology
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.
Cancer
Animal data
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.
Clinical data
Research reveals no clinical studies evaluating the effect of jujube in cancer.
Contraceptive
An ethylacetate extract of the plant bark arrested the normal estrus cycle of adult female mice and reduced the weight of the ovaries. The antisteroid action was reversed upon cessation of extract supplementation.
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.
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 of extract per day were used in chronic idiopathic constipation. For traditional GI uses, up to 50 g of dried fruit per day (equivalent to 4 g of extract) have been used. A clinical study evaluated consumption of 5 grams jujube fruit as a powder taken three times a day for one month in adolescents with dyslipidemia.
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.
A hepatoprotective effect (reduction of serum bilirubin levels) has been reported in a review of pharmacological effects.
Toxicology
Information is lacking. In mice, the suggested median lethal dose for the fruit is 14 g/kg body weight intraperitoneally; for the bark extract, the dose is 2.5 g/kg.