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In recent times, plums have been described as foods with health-promoting properties. Research on the health effects of plum continue to show promising results on its antiinflammatory, antioxidant and memory-improving characteristics. The increased interest in plum research has been attributed to its high phenolic content, mostly the anthocyanins, which are known to be natural antioxidants. A systematic review of literature was carried out to summarize the available evidence on the impact of plums (Prunus species; domestica and salicina) on disease risk factors and health outcomes. A number of databases were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for relevant studies on plum health effects in vitro, animal studies and clinical trials. A total of 73 relevant peer-reviewed journal articles were included in this review. The level of evidence remains low. Of the 25 human studies, 6 were confirmatory studies of moderate quality, while 19 were exploratory. Plums have been shown to possess antioxidant and antiallergic properties, and consumption is associated with improved cognitive function, bone health parameters and cardiovascular risk factors. Most of the human trials used the dried version of plums rather than fresh fruit, thus limiting translation to dietary messages of the positioning of plums in a healthy diet. Evidence on the health effect of plums has not been extensively studied, and the available evidence needs further confirmation. Copyright © 2016 John Wiley & Sons, Ltd.
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REVIEW
A Systematic Review on the Health Effects of
Plums (Prunus domestica and Prunus salicina)
Ezinne O. Igwe*and Karen E. Charlton
School of Medicine, University of Wollongong, Northfields Avenue, Wollongong, New South Wales 2522, Australia
In recent times, plums have been described as foods with health-promoting properties. Research on the health
effects of plum continue to show promising results on its antiinflammatory, antioxidant and memory-
improving characteristics. The increased interest in plum research has been attributed to its high phenolic
content, mostly the anthocyanins, which are known to be natural antioxidants.
A systematic review of literature was carried out to summarize the available evidence on the impact of plums
(Prunus species; domestica and salicina) on disease risk factors and health outcomes.
A number of databases were searched according to the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses guidelines for relevant studies on plum health effects in vitro, animal studies and clinical trials.
A total of 73 relevant peer-reviewed journal articles were included in this review. The level of evidence re-
mains low. Of the 25 human studies, 6 were confirmatory studies of moderate quality, while 19 were exploratory.
Plums have been shown to possess antioxidant and antiallergic properties, and consumption is associated with
improved cognitive function, bone health parameters and cardiovascular risk factors. Most of the human trials
used the dried version of plums rather than fresh fruit, thus limiting translation to dietary messages of the
positioning of plums in a healthy diet.
Evidence on the health effect of plums has not been extensively studied, and the available evidence needs
further confirmation. Copyright © 2016 John Wiley & Sons, Ltd.
Keywords: plums; Prunus domestica;Prunus salcina; health effects; systematic review.
INTRODUCTION
The plum is a drupe fruit which belongs to the subgenus
Prunus (Family Rosaceae). The subgenus can be differ-
entiated from other subgenera (peaches, cherries, etc.)
as the shoots have a terminal bud and unclustered single
side buds, the flowers combine in groups of one to five
on short stems, and the fruit have a crease running down
one side and a smooth seed. Between 19 and 40 differ-
ent species of plum exist. Of these, only 2, the hexaploid
European plum (Prunus domestica) and the diploid
Japanese plum (Prunus salicina and hybrids), are of
commercial significance across the globe (Topp et al.,
2012). The nutritional composition of the two species
is considered similar (Table 1).
The European plum is believed to have been discov-
ered about 2000 years ago, with its origin somewhere
near the Caspian Sea. The fruit was introduced into
the USA in the 17th century by pilgrims, while the
Japanese plum has its origin in China but derived its
name from the country where it was mostly cultivated
and developed, Japan. The Japanese plum was intro-
duced into the USA in the late 19th century. Today,
the main producers of commercially grown plums are
the United States, Serbia, China and Romania. (UN
Food and Agriculture Organization, 2011).
Prunes are the dried version of plums and are known
for their laxative effect, which is commonly attributed to
its high fibre content (Tinker et al., 1991). Earlier studies
attributed the laxative effect of prunes to the presence
of phenolics (chlorogenic acid) (Chok and Lang, 1961)
and sorbitol (Reele and Chodos, 1985) that are in the
fruit, together with its high fibre content (Stacewicz-
Sapuntzakis et al., 2001). In the USA, prunes are re-
ferred to as dried plums. This name change was effected
in a bid to promote prunes as a health food instead of
being associated with old age (Zasky, 2008). Prunes
are produced industrially by drying plums at 8590°C
for 18 h. This process is believed to have originated
thousands of years ago also near the Caspian Sea, the
same region where the European plums were discov-
ered. With migration and civilization, prunes spread
throughout Europe. Today, California, USA is the
leading producer of prunes (dried plums) worldwide
(Norton, 2009).
In classifying whole and natural foods based on their
unique nutritional composition, flavonoid content is
one of the most important methods of classification
(Stadlmayr et al., 2011). The high levels of phenolic com-
pounds, including flavonoids and particularly the sub-
class of anthocyanins observed in the plum, have
resulted in a dramatically increased interest in plum-
based research since the 1990s (Nakatani et al., 2000;
Walle et al., 2003). A number of health benefits have
been associated to the plum fruit and these include im-
proved bone health, cognition and memory, antioxidant
anti-inflammatory effects and easement of constipation.
* Correspondence to: Ezinne Oyidia Igwe, School of Medicine, Univer-
sity of Wollongong, Northfields Avenue, Wollongong, New South Wales
2522, Australia.
E-mail: eok167@uowmail.edu.au
PHYTOTHERAPY RESEARCH
Phytother. Res. (2016)
Published online in Wiley Online Library
(wileyonlinelibrary.com) DOI: 10.1002/ptr.5581
Copyright © 2016 John Wiley & Sons, Ltd.
Received 23 July 2015
Revised 30 November 2015
Accepted 09 January 2016
These health-promoting properties have been attrib-
uted to the plums antioxidant capacity as a result of
the high phenolic content (Yu et al., 2009a; Noratto
et al., 2009; Franklin et al., 2006; Pawlowski et al., 2014;
Shukitt-Hale et al., 2009).
These observed health effects have been reported
from studies that have used different research designs
(in vitro, animal studies and clinical studies) and have in-
vestigated both plums, and related products and extracts
(Stacewicz-Sapuntzakis, 2013).
The aim of this systematic literature review is to de-
termine the level of current evidence on the beneficial
health effects of plum and its associated products.
MATERIALS AND METHODS
A number of electronic databases were searched:
Scopus, Web of Science, Cochrane library, CINAHL,
MedLine and ScienceDirect up to June 2015 with a com-
bination of search terms, including plum or prunes or
Prunus domestica or Prunus salicina and health effects
used as keywords (see Appendix 1 for Medline search
strategy).
Inclusion criteria for journal articles include
1. Studies carried out in vitro, on animal and clinical
studies.
2. Studies that utilized the fresh, dried, juice version or
extracts of the plum species P. domestica or P.
salicina.
3. All studies assessing any health outcome associated
with plum consumption.
4. Studies reported in English. Only studies reported in
English were included due to language barrier, rea-
sons of time efficiency and cost of translation not be-
ing feasible.
Exclusion criteria for journal articles include
1. Studies on the quantification of the nutritional com-
position and antioxidant properties of plums.
2. Studies that utilize different species of plums, for
example, the Japanese apricot, also known as
Japanese plums in the Prunus mume specie.
3. Studies assessing properties related to plum cultiva-
tion, harvest and the commercial aspects of the plum
fruit.
Articles were assessed for peer-reviewed status using
Ulrichs Web (available at: http://ulrichsweb.
serialssolutions.com.ezproxy.uow.edu.au/). A hand
search yielded one additional article, which was relevant
to this review.
For the clinical trials, all the relevant studies retrieved
were classified as either confirmatory or exploratory
studies. They were rated for their quality using relevant
criteria from the Delphi list, Cochrane Back Review
Group and the CONSORT Statement (Table 9), and
strength of evidence of study design assessed using the
Australian National Health and Medical Research
Council hierarchy levels of evidence with rankings from
level IIV.
The National Health and Medical Research Council ev-
idence hierarchy has six levels according to type of
research question with systematic review of level II studies
classified as levels I, randomized controlled trials, classified
as level II. Studies ranging from a pseudorandomised
Table 1. Major nutritional composition of European (Prunus
domestica) and Japanese (Prunus salicina) plums, per 100 g
weight (data from (USDA, 2014); data are a mix of Japanese
and European plums)
Component
European plum (P. domestica) and
Japanese plums (P. salicina)
Fresh
plums
Dried
prunes
Plum
juice
Water/moisture (g) 87.23 30.92 84.02
Energy (kj) 192 1006 243
Carbohydrate (g) 11.42 63.88 15.15
Protein (g) 0.70 2.18 0.51
Fat (g) 0.28 0.38 0.02
Sugars, total 14.22
Glucose (g) 5.07 25.46 23.3
a
Fructose (g) 3.07 12.45 11.8
a
Sucrose (g) 1.57 0.15 3.7
a
Total dietary fibre 1.4 7.1 0.9
Minerals
Calcium (mg) 6 43 10
Iron (mg) 0.17 0.93 0.34
Magnesium (mg) 7 41 8
Phosphorus (mg) 16 69 15
Potassium (mg) 157 732 154
Sodium (mg) 0 2 1
Zinc (mg) 0.10 0.44 0.11
Copper (mg) 0.057 0.281 0.054
Manganese (mg) 0.052 0.299 0.033
Fluoride (μg) 2.0 4.0
Vitamins
Ascorbic acid (C) (mg) 9.5 0.6 2.8
Thiamine (B
1
) (mg) 0.028 0.051 0.023
Riboflavin (B
2
) (mg) 0.026 0.186 0.059
Niacin (B
3
) (mg) 0.417 1.882 0.473
Pantothenic acid (B
5
) (mg) 0.135 0.422 0.072
Pyridoxine (B
6
) (mg) 0.029 0.205 0.027
Total Folate (μg) 5 4 3
Vitamin A, RAE (μg) 17 39 50
Vitamin E (mg) 0.26 0.43 0.18
Vitamin K
1
(μg) 6.4 59.5 4.3
Carotenoids
Carotene, beta (μg) 190 394 554
Carotene, alpha (μg) 0 57 0
Cryptoxanthin, beta (μg) 35 93 102
Lutein + zeaxanthin (μg) 73 148 49
Phenolic compounds
b
Total (mg) 111 184 121
c
Neochlorogenic acid (mg) 81 131 198.5
a
Chlorogenic acid (mg) 14.4 44 46.5
a
Anthocyanins (mg) 7.6
0.172
c
Catechins (mg) 5.4
Table adapted from (Stacewicz-Sapuntzakis, 2013) and (Netzel
et al., 2012)
a
(Stacewicz-Sapuntzakis, 2013) (plum juice concentrate)
b
(Mangels et al., 1993)
c
(Shukitt-Hale et al., 2009)
No available data.
E. O. IGWE AND K. CHARLTON
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
controlled trial to a comparative study without concurrent
controls classified as levels III-1 to III-3 and case series with
either post-test or pre-test/post-test outcomes classified as
level IV (NHMRC, 2000).
RESULTS
A total of 73 studies were eligible for inclusion in this
review (Fig.1). Of these, 18 investigated bone health
(2 in vitro, 12 animal studies and 4 clinical trials), and
20 investigated its anticancer and antiinflammatory
properties (13 in vitro studies, 6 animal studies and 1 clin-
ical trial). Eleven studies reported on plumsantioxidant
properties and their effect on cognition (2 in vitro
studies, 5 animal studies and 4 clinical trials) while nine
studies investigated the effect of plums on different com-
ponents of the metabolic syndrome (cholesterol, high
blood pressure and anti-thrombosis; 3 animal studies
and 6 clinical trials). For its commonly known laxative ef-
fect and satiety, 8 clinical studies were carried out. Five
studies examined its anti-allergic, anti-microbial and
immune-enhancing properties (2 in vitro studies and 3
animal studies), and 2 clinical studies examined its ef-
fects on liver function and risk factors for kidney stone
formation. Some of the findings reported from the
in vitro studies like improved bone health and anti-
inflammatory properties have also been confirmed in an-
imal and human studies. Tables 28 summarize the ex-
perimental and clinical studies, and Table 9 summarizes
the quality of the clinical studies included in this review.
Figure 1. PRISMA flow diagram for study selection process.
HEALTH EFFECTS OF PLUMS (Prunus domestica AND Prunus salicina)
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 2. Evidence on the effect of plums and its associated products on bone health
Reference Location Plum product investigated Sample/method Level of evidence* Effects observed
In vitro studies
(Bu et al., 2008) USA Dried plum extract
(Prunus domestica)
RAW 264.7 murine macrophage cells Inhibition of osteoclastogenesis under
inflammatory and oxidative stress
conditions possibly by polyphenol content
(Bu et al., 2009) USA Polyphenols extracted from
dried plum (P. domestica)
MC3T3-E1 cells pre-treated with dried plum
polyphenols (0, 2.5, 5, 10 and 20 μg/mL) and
24 h later stimulated with TNF-α(0 or 1.0 ng/mL).
Improvement of osteoblast activity and
function by up-regulating Runx2, Osterix and
IGF-I and increasing lysyl oxidase expression,
and reduction in osteoclastogenesis signalling
Animal studies
(Smith et al., 2014a) USA Dried plum (P. domestica) Six weeks dietary supplementation of dried plum
(5%, 15% or 25%) in adult, osteopenic
ovariectomized rats
Restoration of bone mineral density by two
higher doses and bone turnover suppression
(Deyhim et al., 2005) USA Dried plum (P. domestica) Dietary supplementation of dried plum (5%, 15%
and 25%) in adult, osteopenic ovariectomized rats
for 40 days
Bone quality improvement (restoring bone
density) with all doses
(Franklin et al., 2006) USA Dried plum (P. domestica) Dietary supplementation of dried plum (5%, 15%
and 25%) in orchidectomized rats for 90 days
Prevention of osteopenia in androgen deficient
male rats
(Bu et al., 2007) USA Dried plum (P. domestica) Dietary supplementation of dried plum (25%) in
osteopenic orchidectomized rats for 90 days
Reversion of bone loss due to orchidectomy
(Smith et al., 2014b) USA Dried plum (P. domestica) Dietary supplementation of dried plum (25%) in
adult mice for 4 or 12 weeks
Improvement in bone mass and structure
(Rendina et al., 2013) USA Dried plum (P. domestica) Eight weeks dietary supplementation of dried plum
(25%) in adult, osteopenic ovariectomized mice
Bone loss prevention with anabolic effect
(Halloran et al., 2010) USA Dried plum (P. domestica) Dietary supplementation of dried plum (15% or
25%) in adult and aged (old) male mice for 6 months
Restoration of lost bone and increase in bone
volume
(Rendina et al., 2012) USA Dried plum (P. domestica) Dietary supplementation of dried plum (5%, 15% or
25%) in ovariectomized adult mice for 4 weeks
Improvement of bone structure and
biomechanical properties and suppression of
lymphocyte TNF-αproduction by higher doses
(Pawlowski et al., 2014) USA Dried plum powder extract
(P. domestica)
Dietary supplementation of plum extract (9% or
20%) in ovariectomized rats for six intervention
(10 days) and washout (10 days) cycles
Improvement in bone calcium retention
(Monsefi et al., 2013) Iran Plum extract (P. domestica) Oral administration of plum extract (1.6 g/kg) in
distilled water in pregnant mice for 30 days
Increased osteogenesis index in fetuses of
mice treated with plum extract
(Arjmandi et al., 2010) USA Dried plum (P. domestica) One hundred eighty 3-month-old female
SpragueDawley rats assigned to 15 groups (n= 12)
and either ovariectomized (14 groups) or
sham-operated (Sham, one group) then placed on
different dietary treatments including one
supplemented with 5% fructooligosaccharides and
7.5% dried plum for 60 days.
Diets supplemented with 5%
fructooligosaccharides and 7.5% dried plum
was most effective in reversing both right
femur and fourth lumbar bone mineral density
and fourth lumbar calcium loss while significantly
decreasing trabecular separation.
(Continues)
E. O. IGWE AND K. CHARLTON
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 2. (Continued)
Reference Location Plum product investigated Sample/method Level of evidence* Effects observed
(Johnson et al., 2011) USA Dried plum
(P. domestica)
Seventy two 3-month-old female SpragueDawley
rats assigned to six groups (n= 12/group) and either
ovariectomized (five groups) or sham-operated
(Sham, one group) then placed on a semi purified,
powdered casein-based diet for 45 days to induce
bone loss. Thereafter, the groups were placed on
different dietary treatments, including one
supplemented with 5% fructooligosaccharides and
7.5% dried plum for 60 days.
In combination with soy protein, dried plum and
fructooligosaccharides had the most pronounced
effect in increasing lumbar bone mineral density.
Clinical trials
(Hooshmand et al., 2011) USA Dried plum
(P. domestica)
Hypothesis: dried plums reverses bone loss in
osteopenic postmenopausal women.
n= 160 osteopenic postmenopausal women
Study design/methods: randomized controlled
trial. Postmenopausal women randomly assigned
to treatment groups of dried plum (100 g/d) or
dried apple (75 g) daily for 1 year. Blood and urine
samples collected.
Sample size power: not stated
Dose: 100 g/day.
Duration: 1 year.
II Confirmatory Statistically significant increase in bone mineral
density of ulna and spine with decreased serum
levels in bone turnover markers (bone-specific
alkaline phosphatase and tartrate-resistant acid
phosphatase-5b) observed
(Arjmandi et al., 2002) USA Dried plum
(P. domestica)
Hypothesis: addition of dried plums to the diets
of postmenopausal women would positively
influence markers of bone turnover.
n= 58 postmenopausal women
Study design/methods: randomized controlled
trial. Postmenopausal women randomly assigned
to treatment groups of dried plum (100 g/d) or
dried apple (75 g) daily for 3 months. Blood and
urine samples collected.
Sample size power: not stated
Dose: 100 g/day.
Duration: 3 months.
II Exploratory Statistically significant increase in serum levels
of insulin-like growth factor-1 and bone-specific
alkaline phosphatase associated with increased
rates of bone formation
(Hooshmand et al., 2014) USA Dried plum
(P. domestica)
Hypothesis: dried plum has an effect on circulating
levels of sclerostin and bone metabolism measured
in serum levels of receptor activator of NF-
k
B ligand
and osteopotegerin.
n= 160 women with mild bone loss.
Study design/methods: randomised controlled trial.
Subjects randomly assigned to one of two groups
of dried plum or dried apple and provided with
II Exploratory Increase in bone mineral density of the ulna and
spine and also the receptor activator of NF-
k
B
ligand and osteopotegerin levels. A reduction in
serum sclerostin was also observed.
(Continues)
HEALTH EFFECTS OF PLUMS (Prunus domestica AND Prunus salicina)
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 2. (Continued)
Reference Location Plum product investigated Sample/method Level of evidence* Effects observed
500 mg Caplus 400 IU (10 μg) vitamin D.
Sample size power: not stated Dose: 100 g
dried plum per day Duration: 1 year
(Simonavice et al., 2014) USA Dried plum
(P. domestica)
Hypothesis: 6-month intervention with resistance
training and a combination of resistance training
and dried plum would improve total and regional
(lumbar spine, femur and forearm) BMD. Increase
lean body mass, skeletal muscular strength and
decrease fat body mass. Additionally, it was
hypothesized that the biochemical analyses for
both groups would reveal increased levels of bone
formation markers, decreased levels of bone
resorption markers, and decreased levels of
inflammation markers, with the RT + DP group
having the most improvements in these areas in
breast cancer survivors.
n= 23 female breast cancer survivors.
Study design/methods: casecontrol. Subjects
stratified into 1(RT) or 2(RT + DP) treatment groups.
Sample size power: not stated
Dose: 90 g dried plum per day
Duration: 6 months
II Exploratory No difference between groups or any
group-by-time interaction observed for any of
the variables.
RT, resistance training; DP, dried plum.
*Clinical trials ranked using (NHMRC, 2000) Levels of Evidence Hierarchy where I is a systematic review (highest rating) and IV is a case series or cross-sectional study (lowest rating) and also classified
as exploratory or confirmatory studies.
E. O. IGWE AND K. CHARLTON
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 3. Evidence on the anti-cancerous and antiinflammatory properties of plums and its associated products
Reference Location Plum product investigated Sample/method
Level of
evidence* Effects observed
In vitro studies
(Yu et al., 2009a) Korea Immature plum extract
(IPE)
(Prunus salicina)
Human hepatocellular carcinoma HepG2 cells,
Kato III gastric cancer cells, HeLa human
cervical carcinoma cells, U937 leukaemia
cells and MCF 7 hormone-dependent breast
cancer cells
Cell growth inhibition by IPE, that is, induction of
cancerous cell apoptosis
(Noratto et al., 2009) USA Mature red-fleshed plum
extract
(Prunus domestica)
MCF-7; the oestrogen-positive human breast
cancer cell line, MDA-MB-453; the oestrogen
negative human breast cancer cell line, and
MCF-10A; the breast epithelial cells
Inhibition of breast cancer cell proliferation and
significantly reduced toxicity on the normal cells
(Lee et al., 2009) USA Plum extract
(P. salicina)
Chicken spleen, RP9 tumour cells and HD11
macrophages
Stimulation of spleen lymphocyte proliferation
and NO production by cultured macrophages and
inhibition of tumour cell growth
(Fujii et al., 2006) Japan Prune extract
(P. domestica)
Caco-2 human colon carcinoma cell line,
KATO III human stomach carcinoma cell line
and CCD-18Co normal human colon fibroblast
cell line
Induction of cell apoptosis of cancer cells but not
normal cells
(Lea et al., 2008) USA Plum extract
(P. domestica)
SW1116, HT29, Caco-2 human colon cancer
cells and NCM460 human colon cells.
Growth inhibition and induction of differentiation
on colon cancer cells
(Hooshmand et al., 2015) USA Dried plum polyphenol
extract
(P. domestica)
Stimulation of macrophage RAW 264.7 cells
with either 1 μgmL
1
(for measurement of NO
production) or 1 ng mL
1
(for measurement of
COX-2 expression) of lipopolysaccharide to
induce inflammation and treated with different
doses of dried plum polyphenols.
Reduction in Nitric oxide and malondialdehyde
production with highest dose treatment
(1000 μgmL
1
). Reduction in lipopolysaccharide-
induced expression of COX-2 by the 100 and
1000 μgmL
1
dose.
(Kim et al., 2003) USA Plum polyphenol extract
(P. domestica)
Treatment of two cancer cell lines (HepG2
human liver cancer cells and DLD1 human
colon cancer cells) with polyphenol extract
of plum.
Antiproliferative activities on both cancer cell
lines in a dose dependent manner.
(Nishida et al., 2014) Japan Plum pectin extract
(P. domestica)
Incubation of heparan sulfate in differentiated
Caco-2 cells with pectin extracted from plums.
There was an obvious change in the sulphated
structures of HS following pectin
administration. Also, pectin upregulated human
HS 6-O-endosulfatase-2 (HSulf-2) expression
and inhibited HSulf-1 expression.
(Nishida et al., 2015) Japan Plum pectin extract
(P. domestica)
Incubation of differentiated Caco-2 cells
(cultured in 6-well plates at a cell density of
1.0 × 10
5
cells/well), with pectin, extracted
from plums.
Pectin-treated differentiated Caco-2 cells
promoted growth of IEC-6 cells and also an
upregulation of relative mRNA and protein
expression levels of Wnt3a protein.
(Continues)
HEALTH EFFECTS OF PLUMS (Prunus domestica AND Prunus salicina)
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 3. (Continued)
Reference Location Plum product investigated Sample/method
Level of
evidence* Effects observed
(Popov et al., 2014) Russia Plum pectic polysaccharide
extract
(P. domestica)
0.05 mL of plum pectic polysaccharide added
to peritoneal cell suspension and incubated in
a 96-well
flat-bottom tissue culture plate in the absence
or presence of phorbol-12-myristate-13-acetate
at 37°C for 15 mins.
Reduction in the adhesion of peritoneal
leukocytes. Inhibition of the production of
superoxide anion radicals by reducing xanthine
oxidase activity.
(Vizzotto et al., 2014) USA Plum polyphenol extract
(P. domestica)
Oestrogen independent MDA-MB-435,
oestrogen dependent MCF-7 breast cancer
cell lines and one non-cancerous breast line
MCF-10A exposed to varying concentrations
of plum extracts for 24 h.
Dose-dependent cytotoxic effect against MDA-
MB-435, weak activity against MCF-7 and small
or no activity against MCF-10A observed.
(Yu et al., 2007) Korea Immature, mid-mature and
mature plum extract
(P. salicina)
Six human cell cancer lines (Hep G2 human
hepatocellular carcinoma cells and Kato 111
human gastric carcinoma cells, Hela human
cervical carcinoma cells, U937 human
leukaemia cells, MCF 7 hormone-dependent
human breast cancer cells, and MDA-MB-231
hormone-independent human breast cancer
cells) incubated with varying concentration of
plum extract.
Cytotoxic effects observed and apoptosis
observed in MDA-MB-231 cells mediated by the
immature plum extract.
(Yu et al., 2009b) Korea Immature plum extract
(P. salicina)
Incubation of PMA-induced HepG2 human
hepatocellular carcinoma cells with Immature
plum extract.
Antimigrative property in (phorbol 12-myristate
13-acetate) PMA-induced HepG2 cells observed.
A strong inhibitory effect on the PMA-induced
MMP-9 secretion through suppression of the
transcriptional activity of the MMP-9 gene
independently of the TIMP gene in HepG2 cells
was also observed.
Animal studies
(Kim et al., 2008) Korea Immature plum extract IPE
(P. salicina)
Intraperitoneal injection of IPE (2.5 or 5 g/kg
bw/day) dissolved in phosphate buffered
saline for 5 days in male mice with
benzo(α)pyrene induced liver toxicity
Chemopreventive efficacy by inhibiting the
induction of CYP1A1 expression and reducing
the activity of glutathione peroxidase, superoxide
dismutase and catalase
(Cantu-Jungles et al., 2014) Brazil Polysaccharides from prunes
(P. domestica)
Inducement of acute gastric ulcer in rats using
intragastric administration of ethanol P.A. after
four different oral treatments including
polysaccharides from prunes fraction (3 and
10 mg/kg).
Reduction and inhibition of gastric lesion area
by prune polysaccharides fractions.
(Noratto et al., 2015) USA Plum juice
(P. salicina)
Administration of plum juice in drinking water
to obese Zucker rats ad libitum for 11 weeks
Antiadipogenic and anti-inflammatory effects.
Reduction in blood glucose, triglycerides and HDL
cholesterol levels
(Continues)
E. O. IGWE AND K. CHARLTON
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 3. (Continued)
Reference Location Plum product investigated Sample/method
Level of
evidence* Effects observed
(Mishra et al., 2012) India Plum extract
(P. domestica)
Inducement of peptic ulcer by pyloric ligation
in Wistar albino rats after administration of
plum extract (100, 150 or 200 mg kg
1
) for
7 days
Antioxidant and anti-ulcerogenic activity
(Yang and Gallaher, 2005) USA Dried plum
(P. domestica)
Dietary supplementation of dried plum (4.75 or
9.5%) in male Wistar rats for 10 days followed
by administration of two doses (1 week apart)
of azoxymethane and dietary supplementation
for 9 more weeks
Inhibition of risk factors associated with colon
carcinogenesis (reduction in faecal total and
secondary bile acids concentration, reduction in
colonic β-glucuronidase and 7α-dehydroxylase
activities and increased antioxidant activity)
(Gallaher and Gallaher, 2009) USA Dried plum
(P. domestica)
Dietary supplementation of dried plum (4.75 or
9.5%) and cholesterol in apolipoprotein
E-deficient mice for 5 months.
Development of atherosclerosis Impeded
Clinical trial
(Kasim-Karakas et al., 2002) USA Dried plum
(P. domestica)
Hypothesis: prune intake may alter the
metabolism of estrogens because prunes are a
rich source of both soluble and insoluble fibre
and cinnamates and decrease intestinal transit
time.
III-2 Exploratory Decrease in the independent excretion of 2OHE1
and 16αOHE1 observed but no statistically
significant change in the 2OHE1 - 16αOHE1
ratio following prune supplementation
n= 19 healthy premenopausal women
Study design/methods: crossover study.
After consuming habitual diets for three
menstrual cycles (control
run-in period), participants replaced dietary
simple sugars with prunes for another three
menstrual cycles (intervention period).
Sample size power: not stated
Dose: 100 g dried plum per day
Duration: 6 months.
*Clinical trials ranked using (NHMRC, 2000) Levels of Evidence Hierarchy where I is a systematic review (highest rating) and IV is a case series or cross-sectional study (lowest rating) and also classified
as exploratory or confirmatory studies.
HEALTH EFFECTS OF PLUMS (Prunus domestica AND Prunus salicina)
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 4. Evidence on the antioxidant property and effect on cognition of plums and its associated products
Reference Location
Plum product
investigated Sample/method
Level of
evidence Effects observed
In vitro studies
(Bouayed et al., 2009) France Phenolics from
plums
(P. domestica)
Polyphenolics extracted from seven varieties of
plum and quantified. Their antiradical activities
and protection against oxidative stress
evaluated in peripheral blood granulocytes.
Antioxidant activity and protection of blood
granulocytes from H
2
O
2
-induced oxidative
stress by preventing granulocytes from
intracellular ROS accumulation.
(Donovan et al., 1998) USA Prune/prune
juice extract
(P domestica)
Human LDL from plasma prepared from blood
collected from healthy volunteers.
Inhibition of LDL oxidation.
Animal studies
(Shukitt-Hale et al.,
2009)
USA Plum juice/dried
plum powder
(P. domestica)
Two groups of aged rats with either
consumption of a mixture of water and plum
juice (100%) (Group 1) or dietary
supplementation with dried plum powder (2%)
(group 2) for 8 weeks
Improved cognitive function assessed by
Morris Water Maze
(Shahidi et al., 2013) Iran Plum extract
(P. domestica)
Plum extracts (75, 100, 150 mg/kg)
administration by oral gavage to male mice
once a day for 7 days
Improvement in learning and memory in
mice assessed by the passive avoidance
test
(Kao-Ting et al., 2013) Taiwan Dried plum
powder (Prunus
salicina)
Dietary supplementation of dried plum powder
(2%) in nicotinamide/streptozotocin-induced
diabetic rats for 2 months
Improvement in cognitive performance,
antioxidant activity and improvement in
insulin sensitivity
(Sharma and Sisodia,
2013)
India Plum extract
(P. domestica)
Administration of optimum dose of plum
extract in distilled water to mice for 15 days
pre/post whole body exposure to 10 Gy
gamma-radiations
Antioxidant capabilities and improved
spatial learning
(Bouayed et al., 2007) France Chlorogenic
acid from P.
domestica
Administration of chlorogenic acid (20 mg/kg)
to mice and antioxidant effect on peripheral
blood granulocytes.
Decrease in anxiety related behaviours
(anxiolytic-like effect) and protection of
granulocytes from oxidative stress by
chlorogenic acid in vitro.
Clinical trials
(Prior et al., 2007) USA Dried plum/
dried plum
juice
(P. domestica)
Hypothesis: changes in antioxidant capacity
following consumption of plum juice may be
used to assess its potential to alter in vivo
antioxidant status and provide estimates of
dietary antioxidants necessary to prevent
postprandial oxidative stress.
II Exploratory No effect on plasma hydrophilic (H-) or
lipophilic (L-) antioxidant capacity measured
as Oxygen Radical Absorbance Capacity
(ORAC
FL
)
n= 6 healthy volunteers.
Study design/methods: randomized cross-over
study. Fasting blood sample collected and
participants fed test juices and blood samples
(Continues)
E. O. IGWE AND K. CHARLTON
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 4. (Continued)
Reference Location
Plum product
investigated Sample/method
Level of
evidence Effects observed
collected at 1, 2 and 4 h post juice
consumption.
Sample size power: not stated
Dose: 315 mL of dried plum juice; or dried
plums (131 g blended in 315 mL water
Duration: 2 weeks (with 2 weeks washout
period)
(Ko et al., 2005) Korea Plum juice
(P. salicina)
Hypothesis: Consumption of fruit juices
could scavenge ROS generated in
human plasma.
IV Exploratory Improved antioxidant activity in human
plasma measured by dichlorofluorescein
fluorescence
n= 10 healthy men.
Study design/methods: cross-over study.
Consumption of single dose of 150 mL of
plum juice. Blood samples collected at 0,
30, 60, 90 and 120 min after consumption
Sample size power: not stated
Dose: a single dose of 150 mL
Duration: 1 day (with 1 day washout period)
(González-Flores et al.,
2011)
Spain Plum
(P. salicina)
Hypothesis: there is a possible antioxidant
effect associated with diets enriched with
Japanese plums (P. salicina Lindl. cv.
Crimson Globe) in young, middle-aged and
elderly individuals.
IV Exploratory Statistically significant increase in
antioxidant capacity and urinary
6-sulfatoxymelatonin (aMT6-s)
n= 18 (6 per young, middle aged and older
group).
Study design/methods: Consumption of 390 g
plums without seeds per day divided into two
portions: 195 g as the lunch dessert and
195 g as the dinner dessert for 5 days. First-
void morning urines were collected before
treatment (basal values), the immediate day
after the last ingestion of plums (assay) and
1 day afterwards (post-assay).
Sample size power: not stated
Dose: 2 portions 390 g (195 g each) daily.
Duration: 5 days.
(Continues)
HEALTH EFFECTS OF PLUMS (Prunus domestica AND Prunus salicina)
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 4. (Continued)
Reference Location
Plum product
investigated Sample/method
Level of
evidence Effects observed
(Netzel et al., 2012) Australia Plum juice
(P. salicina)
Hypothesis: there is a possible antioxidant
effect associated with Queen Garnet Plum
Juice ingestion on the urinary antioxidant
capacity and the concentration of
malondialdehyde, a biomarker for oxidative
stress.
IV Exploratory Increase in urinary antioxidant capacity
and decrease in malondialdehyde
excretion (biomarker for oxidative
stress)
n=2 healthy male subjects
Study design/methods: crossover study.
Consumption of 400 mL of Queen Garnet
Plum Juice or 400 mL of water as an
antioxidant-free control beverage separated
by a 1-week washout phase.
Sample size power: not stated
Dose: single dose of 400 mL.
LDL, low-density lipoprotein; ROS, reactive oxygen species.
E. O. IGWE AND K. CHARLTON
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 5. Evidence on the effect of plums and its associated products on the different components of metabolic syndrome
Reference Location Plum product investigated Sample/method
Level of
evidence* Effects observed/conclusion
Animal studies
(Negishi et al., 2007) Japan Prune extract
(Prunus domestica)
Dietary supplementation of prune extract
(25%) in stroke-prone spontaneously
hypertensive rats for 5 weeks
Suppression of high (systolic) blood pressure
(Kuo et al., 2015) Taiwan Plum powder
(Prunus salicina)
Dietary supplementation of plum powder
(2% or 5%) in high cholesterol diet in mice
for 5 months
Amelioration of some symptoms of neurodegenerative
conditions like increased cholesterol and β-amyloid
(Aβ) concentration in the brain by both doses
(Lucas et al., 2000) USA Dried plums
(P. domestica)
Dietary supplementation (5% or 25% dried
plum) with dried plum in 48 ovariectomized
(ovx) 90-day old female SpragueDawley
rats for 45 days.
With elevated serum total cholesterol brought about by
ovariectomy, 25% prune diet prevented this increase
without affecting HDL cholesterol concentration and also
reduction in liver total lipids was observed.
Clinical trials
(Tinker et al., 1991) USA Dried plums
(P. domestica)
Hypothesis: (a) prunes as a source of fibre can
lower plasma cholesterol in men with mild to
moderate hypercholesterolemia (5.27.5 mmol
cholesterol/L). (b) faecal bile acid excretion is
increased in response to the ingestion of prunes
as a source of fibre, which may help explain the
cholesterol lowering effect of fibre.
II Confirmatory Plasma LDL cholesterol was statistically significantly
reduced after the prune period than the control, faecal
bile acid conc. of lithocholic acid was also statistically
significantly lower with prune consumption and both
faecal wet and dry weights were statistically
significantly higher with prune consumption.
n=41 free living men with mild
hypercholesterolemia.
Study design/methods: crossover study. 8 weeks
period split into two experimental diet periods,
each lasting 4 weeks. Subjects randomly
assigned a diet sequence, starting with either
consumption of a grape juice-control
supplement (GJ control) or a prune supplement.
Sample size power: not stated
Dose: 12 prunes (~100 g/d)
Duration: 8 weeks.
(Chai et al., 2012) USA Dried plums
(P. domestica)
Hypothesis: regular intake of apple favourably
improves lipid profiles, reduces atherogenic
risk ratios, lowers C-reactive protein levels,
and decreases levels of oxidative stress
marker in postmenopausal women
II Exploratory No statistically significant difference between treatment
groups in altering serum levels of atherogenic cholesterols
observed. For the dried apple group, total cholesterol was
statistically significantly reduced at 6 months.
n= 160 postmenopausal women
Study design/methods: casecontrol study.
Subjects randomly assigned to treatment
groups of dried apple (75 g) or dried plum
(100 g/d)
(Continues)
HEALTH EFFECTS OF PLUMS (Prunus domestica AND Prunus salicina)
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 5. (Continued)
Reference Location Plum product investigated Sample/method
Level of
evidence* Effects observed/conclusion
Sample size power: 95%
Dose: 100 g/day
Duration: 1 year.
(Afaghi et al., 2009) Iran Prunes Hypothesis: 8 fruits (Golab apples, green
apples, fresh apricots, prunes, cherries,
blueberries, golden no-seed grapes, and red
sultanas) are low glycemic index and
recommendable for diabetics and weight loss.
II Exploratory Serving size of prunes was low glycemic load fruit. Prunes
among other tested fruits were low glycemic index and can
be recommended for diabetics and weight loss management.
n=8
Study design/methods: crossover study. Eight
subjects (healthy, young men aged 2028,
normal weight with body mass index: 2025
kg/m
2
) randomly assigned to one of eight
fruits and blood glucose measured at 0, 15,
30, 45,60, 90 and 120 mins after consumption.
Sample size power: 95%
Dose: 143 g
Duration: not stated different occasions
after overnight fasting.
(Ahmed et al., 2010a) Pakistan Prunes
(P. domestica)
Hypothesis: use of prunes is useful in
cardiovascular disorders to bring about changes
in blood pressure or prevention of atherosclerosis.
II Confirmatory Reduction of blood pressure by single dose of prunes daily
group and the controls with the double dose of prunes
showing a reduction in just systolic blood pressure. There was
an increase in serum HDL of the control group whereas test
groups had significantly reduced serum cholesterol and LDL.
The data predicts cardiovascular protective effects of prunes.
n= 259 pre-hypertensive patients (systolic
BP = 120139 mmHg, diastolic BP = 8089 mmHg)
Study design/methods: randomised controlled trial.
Patients randomly assigned to three groups of
A-single dose, B-double dose or C-control group.
Blood pressure was recorded fortnightly, and
blood samples were taken at 0 and 8 weeks.
Sample size power: not stated.
Dose: group A-11.5 gm. Group B-23 gm.
Control-glass of water.
Duration: 8 weeks.
(Santhakumar et al.,
2015a)
Australia Plum juice
(P. salicina)
Hypothesis: anthocyanin-rich Queen Garnet
Plum Juice may ameliorate platelet activation-
related thrombogenesis and maintain
haemostatic function by (1) reducing platelet
aggregation and activation through blocking/
inhibiting various platelet activation pathways;
(2) prolonging clotting time and reducing
II Exploratory Queen Garnet Plum Juice supplementation inhibited platelet
aggregation induced by adenosine diphosphate, collagen and
arachidonic acid. There was reduction in platelet activation-
dependent surface-marker P-selectin expression
of activated de-granulated platelets. Increase in activated
partial thromboplastin clotting time and reduction in plasma-
(Continues)
E. O. IGWE AND K. CHARLTON
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 5. (Continued)
Reference Location Plum product investigated Sample/method
Level of
evidence* Effects observed/conclusion
fibrinogen concentration; and (3) exhibiting
favourable effects on lipid profile and
inflammation.
fibrinogen and malondialdehyde levels, a plasma biomarker
of oxidative stress.
n=21
Study design/methods: randomized, double
blind, placebo crossover trial. Healthy
volunteers randomly assigned to three
supplement groups of A-Queen Garnet
plum juice, B-prune juice or C-colour
matched placebo. Blood samples were
collected at least 8 h pre-prandial and mid-
stream fasting urine samples collected.
Sample size power: not stated.
Dose: 200 mL/day of each juice.
Duration: 28 days with 2 weeks washout
period.
(Santhakumar et al.,
2015b)
Australia Plum juice
(P. salicina)
Hypothesis: anthocyanin-rich Queen Garnet
Plum Juice may impart anti-thrombotic
effects via (a) inhibition of platelet
aggregation by simultaneously targeting
different platelet activation pathways
(adenosine diphosphate: ADP-P2Y12/
P2Y1; collagen: GPVI/α2β1 and arachidonic
acid: cyclooxygenase-1COX-1), (b)
reducing platelet hyper-activation and de-
granulation by blocking surface receptors
responsible for activation, and (c) favourably
altering coagulation parameters and lipid profile.
II Exploratory Inhibition of adenosine diphosphate-induced platelet
aggregation both without and under exercise induced
oxidative stress, inhibition of arachidonic acid-induced
aggregation under oxidative stress. Also, there was
reduced platelet activation-dependant
P-selectin expression both without and under
oxidative stress. Favourable effects on
coagulation parameters both with and without
oxidative stress were also observed.
n=13
Study design/methods: randomized, double
blind, placebo crossover trial. Healthy
volunteers randomly assigned to two
supplement groups of A-Queen Garnet
plum juice or B-a flavoured and coloured
formulated cordial placebo. Oxidative
stress was induced by constant load
exercise bout for 1 h at 70% of their
VO
2PEAK
Blood samples were collected at
fasting state and at least 812 h pre-
prandial on day 1 and day 29.
(Continues)
HEALTH EFFECTS OF PLUMS (Prunus domestica AND Prunus salicina)
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
The quality of the clinical studies included is, at best,
of moderate quality. There were 6 confirmatory studies
of moderate quality (1 on bone health, 2 on different
components of metabolic syndrome, and 3 on satiety
and laxative effect) and 19 exploratory studies. Evi-
dence on the health effect of plums has not been exten-
sively studied, and the available evidence needs further
confirmation.
BONE HEALTH
Based on results from 18 studies (2 in vitro, 12 animal
studies and 4 clinical trials) reported in this review,
promising evidence exists on the effect of plum on bone
health. This body of evidence has mostly been in agree-
ment and also confirmed in human trials. Bu et al. (2008)
in their in vitro study involving two groups investigated
the effect of dried plum polyphenols on osteoclastogen-
esis in which one group was stimulated with lipopolysac-
charide (LPS) to induce inflammation and the other
group stimulated with hydrogen peroxide (H
2
O
2
)to
induce lipid peroxidation. It was observed that the
LPS-stimulated sample produced NO (nitric oxide)
detectable at 8 h, which further increased at 16 h, while
the H
2
O
2
stimulated cells did not produce NO. This in-
crease in NO associated with LPS was downregulated
by different doses (10, 20, 30 μg/mL) of plum polyphe-
nol at both 8 h and 16 h. The authors concluded
that dried plum polyphenols directly inhibit osteoclasto-
genesis, which leads to reduced osteoclast activity by
downregulation of Nuclear factor of activated T-cells,
cytoplasmic 1 (NFATc1) and inflammatory mediators.
The results from this in vitro experiment by Bu et al.
(2008) has also been confirmed in animal studies
(Deyhim et al., 2005; Franklin et al., 2006; Bu et al.,
2007; Smith et al., 2014a). Among these, the study by
Smith et al. (2014a) is slightly different in that unlike
the other studies that studied longer term effects of
dried plum on systemic biochemical markers of bone
metabolism and alteration in gene expression as the
main outcome measure, their main objective was to un-
derstand the mechanism of action by which dried plum
altered bone metabolism. Regulators of osteoblast and
osteoclast differentiation and osteoblast activity were
studied over a period of 6 weeks. Compared with the an-
abolic therapy using parathyroid hormone that signifi-
cantly increased systemic and local indicators of bone
formation with no effect on systemic marker of bone re-
sorption, dried plum supplementation suppressed bone
turnover with no effect on the indices of bone formation
at the endocortical surface. In another study by the
same research team, dried plum supplementation ini-
tially suppressed cancellous bone turnover but demon-
strated a biphasic response over time, exerting positive
effects on bone mass and bone structure (Smith et al.,
2014b). Plum extract has also been shown to be effective
in increasing bone calcium retention by 20%
(Pawlowski et al., 2014).
Rendina et al. (2013) compared the dried plum with
other dried fruits (apple, apricot, grape and mango)
and observed that only the dried plum had an anabolic
effect on trabecular bone in the vertebra and prevented
bone loss in the tibia. This demonstrates a potentially
unique effect of plum that was absent in the other fruits
Table 5. (Continued)
Reference Location Plum product investigated Sample/method
Level of
evidence* Effects observed/conclusion
Sample size power: not stated.
Dose: 200 mL/day of each juice.
Duration: 28 days with 2 weeks washout
period.
LDL, low-density lipoprotein; HDL, high-density lipoprotein.
*Clinical trials ranked using (NHMRC, 2000) Levels of Evidence Hierarchy where I is a systematic review (highest rating) and IV is a case series or cross-sectional study (lowest rating) and also classified
as exploratory or confirmatory studies.
E. O. IGWE AND K. CHARLTON
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 6. Evidence on the satiety and laxative effect of plums and its associated products
Reference Location
Plum product
investigated Sample/method
Level of
evidence* Effects observed
Clinical trials
(Piirainen et al.,
2007)
Finland Prune juice (prepared from
plum juice concentrate,
prune puree, water and
7% fructose)
(Prunus domestica)
Hypothesis: prune juice alone may have a
laxative effect on the bowel function of those
adults with certain gastrointestinal symptoms
but are otherwise healthy.
IV Confirmatory Laxative effect with increased flatulence.
n= 54 volunteers with mild GIT symptoms.
Study design/methods: 1 week baseline
period, 2 week prune juice (consumption)
period followed by 1 week follow-up period
with daily record of bowel habit
Sample size power: not stated.
Dose: 125 mL twice a day.
Duration: 4 weeks.
(Cheskin et al.,
2009)
USA Plum juice
(P. domestica)
Hypothesis: plum juice supplementation diet
would induce significant improvements in
bowel frequency, and consistency, and
possibly decrease appetite compared with
baseline as well as placebo and psyllium
treatments.
II Confirmatory Constipation relief and stool softening
evident with consumption of plum juice.
n= 36 adults with chronic constipation
symptoms.
Study design/methods: randomized
controlled crossover trial. Consumption of a
daily portion of plum juice in comparison with
psyllium and apple juice in adults with chronic
constipation symptoms.
Sample size power: not stated.
Dose: 8 oz (237 mL) per day.
Duration: 14 days.
(Attaluri et al.,
2011)
USA Dried plum
(P. domestica)
Hypothesis: dried plums are as effective as
psyllium in the treatment of adults with
chronic constipation.
II Confirmatory Effective treatment with dried plum on
mild to moderate constipation observed.
n= 40 patients with chronic constipation.
Study design/methods: single blind,
randomized cross-over study. Consumption of
a daily portion of dried plums or psyllium for a
treatment period of 3 weeks after which
participants continued on their usual remedies
for constipation for another 6 weeks. For the
(Continues)
HEALTH EFFECTS OF PLUMS (Prunus domestica AND Prunus salicina)
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 6. (Continued)
Reference Location
Plum product
investigated Sample/method
Level of
evidence* Effects observed
duration of the study, subjects maintained
daily symptom and stool diaries.
Sample size power: 80%.
Dose: 50 g twice a day with meals.
Duration: 14 weeks (with 1 week washout
period between treatments).
(Farajian et al.,
2010)
Greece Prunes
(P. domestica)
Hypothesis: a preload including dried prunes
consumed as a snack before a meal,
compared with an isoenergetic bread product
preload, would reduce (a) meal time energy intake,
(b) appetite for dessert offered after lunch and,
(c) energy intake for the next 24 h.
II Exploratory Reduced consumption of dessert with
lower energy intake observed. An increased
satiety at all time points between snack and
meal was also observed.
n= 45 normal weight subjects.
Study design/methods: randomized cross-
over study. Fasting participants offered a
standardized breakfast followed by a preload
of either dried prunes or bread product after
2 h. Three hours after the preload, a
standardized lunch and desert was provided.
Subjects also rated their hunger, thirst, desire
to eat, motivation to eat and satiety on 100 mm
line visual analogue scales just before and right
after the preload consumption, every 45 min up
till the 180th minute On completion of the test
day, detailed record of all foods and beverages
intake for the next 24 h was collected.
Sample size power: not stated.
Dose: five prunes (40 g) before meals on each
testing day.
Duration: 2 days (with 1 week washout period).
(Furchner-Evanson
et al., 2010)
USA Dried plum
(P. domestica)
Hypothesis: snack choices similar in fat,
protein, carbohydrate and sugar contents
while differing in fibre content have an effect
on satiety, subsequent food intake and plasma
glucose, insulin and ghrelin responses.
II Exploratory Satiety index area under the curve greater
for dried plum trial. Consumption of the dried
plum elicited lower plasma glucose and insulin
area under the curve and tended to promote
a greater plasma ghrelin antioxidant capacity.
n= 19 healthy female subjects
Study design/methods: randomized crossover
study with at least 1 day washout. Subjects
randomly assigned to receive four different test
foods including dried plums. Blood samples
(Continues)
E. O. IGWE AND K. CHARLTON
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 6. (Continued)
Reference Location
Plum product
investigated Sample/method
Level of
evidence* Effects observed
collected at baseline and every 15 mins in 1 h
then 90 and 120 mins.
Sample size power: not stated.
Dose: served in a 238 kcal (1000 kj) portion.
Duration: not stated.
(Howarth et al.,
2010)
USA Dried plum
(P. domestica)
Hypothesis: snack selection (dried plums vs
common carbohydrate-rich low-fat cookies)
influences daily energy consumption, nutrient
intake and metabolic responses.
II Exploratory No change observed with energy intake or
weight. In comparison with cookie, dried
plum promoted greater intake of fibre,
potassium, riboflavin, niacin and calcium.
There was an observed reduction in total fat
as well as cholesterol intake with dried plum
snacks. Dried plum did not alter plasma
triglyceride concentration but softer stool
consistency was observed with dried plum
consumption.
n= 26 healthy female subjects
Study design/methods: randomized crossover
study with 2 weeks washout. Subjects
randomly assigned to receive either dried
plums or low-fat cookies for two separate
2-week feeding. A 7 day bowel habit
questionnaire was completed.
Sample size power: 80%
Dose: served in a 100 kcal portion
twice a day.
Duration: 4 weeks.
(Lucas et al., 2004) USA Dried plum
(P. domestica)
Hypothesis: dradual incorporation of 100 g of
dried plum into the daily diet of healthy
postmenopausal women would not cause
significant changes in self-reported bowel
habits including frequency of defecation,
faecal bulk and stool consistency.
II Exploratory With both dried plum and apples, there was no
statistically significant differences observed
for any of the parameters used to assess
bowel function.
This indicates the absence of any negative side
effects associated with prune consumption.
n=58
Study design/methods: randomized
controlled trial. Postmenopausal women
randomly assigned to treatment groups of
dried plum (100 g/d) or dried apple (75 g)
daily for 3 months. A 7 day bowel habit
questionnaire was completed.
Sample size power: not stated
Dose: 100 g/day.
Duration: 3 months.
(Pasalar et al.,
2013)
Iran Prunes
(P. Domestica)
Hypothesis: prunes and flixweed are effective
in the prevention of constipation among
Iranian pilgrims who attended the Hajj
ceremony in 2010 in the kingdom of Saudi Arabia.
II Exploratory Using Rome III criteria to define constipation
(less than three times of defecation/week,
with straining, difficulty in defecation,
unproductive urges, feeling
(Continues)
HEALTH EFFECTS OF PLUMS (Prunus domestica AND Prunus salicina)
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 6. (Continued)
Reference Location
Plum product
investigated Sample/method
Level of
evidence* Effects observed
of anorectal obstruction, hand manoeuver to
facilitate stool extraction and feeling of
incomplete evacuation), a statistically
significant difference was observed
between the groups with the case group
less constipated.
Study design/methods: randomised controlled
trial. 170 Iranian Hajj pilgrims randomly assigned
to two groups of case and control. Case group
received measured doses of prunes and flixweed
daily before lunch and dinner and control group
had their meals with no intervention.
Sample size power: not stated
Dose: 4050 g/day with 1015 g of flixweed.
Duration: 3 weeks.
*Clinical trials ranked using (NHMRC, 2000) Levels of Evidence Hierarchy where I is a systematic review (highest rating) and IV is a case series or cross-sectional study (lowest rating) and also classified
as exploratory or confirmatory studies.
E. O. IGWE AND K. CHARLTON
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 7. Evidence on the anti-allergic, anti-microbial and immune-enhancing property of plums and its associated products
Reference Location
Plum product
investigated Sample/method
Level of
evidence* Effects observed
In vitro studies
(Cevallos-Casals et al.,
2006)
USA Plum extract
(Prunus salicina)
Plum extract placed in a well with diluted
bacteria inoculum.
Inhibitory effects against Escherichia coli
0157:H7 and Samonella enteritidis.
(Yaqeen et al., 2013) Pakistan Prune extract
(Prunus domestica)
Ethanol extracts of prunes tested against nine
bacteria; five gram-positive bacteria
(Staphylococcus aureus,Streptococcuc
intermedias,Bacillus cereus, and Bacillus pumilus)
and four gram-negative bacteria (Eschrichia coli,
Proteus mirabilis,Shigella flexneri,Salmonella
typhi and Klebsiela pneumoniae).
Antibacterial activity observed.
Animal studies
(Karasawa et al., 2012) Japan Prune extract
(P. salicina)
Dietary supplementation with 25% ovalbumin
and 1% prune extract over 6 weeks in rats
injected 20 L of distilled water containing 20 g
of mite allergen between the 3rd to 6th week
Reduction in allergic response in comparison
with control group
(Lee et al., 2008) USA Plum powder
(P. salicina)
Dietary supplementation with 0.5% or 1.0%
plum in 1-day old chickens and oral
inoculation with 5000 sporulated oocysts of
Eimeria acervulina at day 12 post-hatch.
Increase in body weight gain, levels of
MRNAs for interferon-ϒand interleukin-15.
There was a reduction in faecal oocyst
shedding and chickens fed the plum
supplemented diets exhibited greater spleen
cell proliferation
(Noratto et al., 2014) USA Plum juice
(P. domestica)
Administration of plum juice in obese Zucker
rats for 11 weeks. Body weight recorded once
a week.
Several bacteria groups (e.g. Lactobacillus
and members of Ruminococcacea) were
found to be more abundant in the plum
group. There was also a distinct contrast
between the microbiota of control and
treatment groups.
*Clinical trials ranked using (NHMRC, 2000) Levels of Evidence Hierarchy where I is a systematic review (highest rating) and IV is a case series or cross-sectional study (lowest rating) and also classified
as exploratory or confirmatory studies.
HEALTH EFFECTS OF PLUMS (Prunus domestica AND Prunus salicina)
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 8. Evidence on the effect of plum and its associated products on liver function and kidney stone risk factors
Reference Location
Plum product
investigated Sample/method Level of evidence* Effects observed
Clinical trials
(Ahmed et al., 2010b) Pakistan Prune juice
(Prunus domestica)
Hypothesis: prune juice does not alter liver function. II Exploratory Liver function test showed significant
reduction of serum alanine transaminase
and serum alkaline phosphatase but no
effect on serum aspartate transaminase
and bilirubin
n=107 healthy volunteers
Study design/methods: casecontrol study.
Participants randomly assigned to three different
groups of A (single dose of 1 pack of prunes =
11.43 kg, i.e. three prunes), B (control; a glass of
water) and C (double dose of group A) consumed
daily. Blood samples were taken on week zero and
week 8 for liver function tests, that is, serum
alkaline phosphatase, bilirubin, aspartate
transaminase and alanine transaminase.
Sample size power: not stated
Dose: three prunes (~11.43 g) or a double dose
of six prunes (~22.86 g) per day.
Duration: 8 weeks.
(Keßler et al., 2002) Germany Plum juice
(P. domestica)
Hypothesis: plum, cranberry- and blackcurrant
juice may have an influence on the urinary
composition and therefore on multiple risk
factors of kidney stone formation.
II Exploratory No significant effect on urinary biochemical
or physiochemical parameters
n=12 healthy male subjects.
Study design/methods: Participants control-
fed a standardized diet daily with plum juice.
Twenty four-hour urine sample collected.
Sample size power: not stated
Dose: 330 mL of plum juice.
Duration: 5 days
*Clinical trials ranked using (NHMRC, 2000) Levels of Evidence Hierarchy where I is a systematic review (highest rating) and IV is a case series or cross-sectional study (lowest rating) and also classified
as exploratory or confirmatory studies.
E. O. IGWE AND K. CHARLTON
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 9. Quality rating of included clinical studies using relevant criteria from the Delphi List, Cochrane Back Review Group and the CONSORT Statement (Verhagen et al., 1998; Van Tulder et al.,
2003; Schulz et al., 2010)
J Nutr (2011) 106:
923930
J Wom Health
Gend-B (2002) 11:
6168
Br J Nutr (2014)
112: 5560
Appl Physiol Nutr
Metab (2014) 39:
730739
Am J Clin Nutr
(2002) 76:
14221427.
J Am Coll Nutr
(2007) 26:
170181.
J Med Food (2005)
8(1): 4146.
J Food Nutr Res
(2011) 50:
229236.
n= 160 dried plum
(Prunus domestica)
100 g/day versus
dried apple Parallel
12 months
n= 58 dried plum
(P. domestica)
100 g/day versus
dried apple Parallel
3 months
n= 160 dried plum
(P. domestica)
100 g/day versus
dried apple Parallel
1 year
n= 23 dried plum
(P. domestica)
90 g/day + resistance
training versus
resistance training
casecontrol 6 months
n= 19 dried plum
(P. domestica)
100 g/day versus
habitual dietary
simple sugars
Cross-over 6 months
n= 6 dried
plum/dried plum
juice (P. domestica)
131 g versus
selected fruits
Cross-over 2 weeks
n= 10 plum juice
(P. salicina) Single
dose of 150 mL
versus selected
fruit juices Cross-over
18 days
n= 18 dried plum
(P. salicina)
2 × 195 g/day Case
series 5 days
A Postmenopausal
women (Osteopenic)
Postmenopausal
women
Women with
mild bone loss
Female breast cancer
survivors
Postmenopausal
women (Healthy)
Healthy volunteers Healthy volunteers Healthy volunteers
B Yes Yes Yes Yes No Yes No Not applicable
C No (not feasible) No (not feasible) No (not feasible) No (not feasible) No (not feasible) No No Not applicable
D Yes Yes Yes Yes Yes Yes Yes Yes
E Yes Yes Yes Yes Yes Yes Yes Yes
F Yes Yes Yes Yes Do not know Yes Yes Not applicable
G Yes Yes Yes Yes Yes Yes Yes Yes
H Yes Yes Yes Yes Yes Yes Yes Yes
I Yes Yes Yes Yes Yes Probably no Probably no Probably no
JNo No No No No No No No
K Yes Yes Yes Yes Yes Yes Yes Yes
L Yes Yes Yes Yes Yes Yes Yes Yes
TS 10 10 10 9 8 9 8 7
J Food Biochem
(2012) 36: 159170.
Am J Clin Nutr
(1991) 53 (5):
12591265
J Acad Nutr Diet
(2012) 112:
11581168.
Curr Top Nutraceut
R (2009) 7:
157160
J Ayub Med Coll
Abbottabad (2010a)
22(1): 3831
J Funct Foods
(2015a) 12:
1122
J Funct Foods
(2015b) 14:
747757
Nutr Res
(2007) 27:
511513.
Internet J Nutr
Wellness (2009)
7: 1-1
n= 2 plum juice
(Prunus. salicina)
Single dose of
400 mL versus
400 mL water
Cross-over 1 week
n= 41 prunes
(P. domestica)
100 g/day versus
360 mL grape juice
Cross-over 8 weeks
n= 160 dried plum
(P. domestica)
100 g/day versus
dried apple Parallel
12 months
n= 8 prunes
143 g/day versus
eight different fruits
Cross-over
n= 259 prunes
(P. domestica)
11.5 g or 23 g/day
versus water Parallel
8 weeks
n= 21 plum juice
(P. salicina)
200 mL/day versus
prune juice/placebo
Cross-over 28 days
n= 13 plum juice
(P. salicina)
200 mL/day versus
placebo Cross-over
28 days
n= 54 prune juice
(P. domestica)
2 × 125mL/day
Case-series 4 weeks
n= 36 Plum juice
(p. dometica)
8 ounces/day vs
psyllium and apple
juice Cross-over
6 weeks
A Healthy volunteers Free living men
with mild
hypercholesterlemia
Postmenopausal
women
Healthy young men Pre-hypertensive
patients
Healthy volunteers Healthy volunteers Adults with mild
GIT symptoms
Adults with chronic
constipation
symptoms
B No Not stated Not stated No Not stated Yes Yes Not applicable Yes
C No (not feasible) No (not feasible) No (not feasible) No (not feasible) No (not feasible) Yes Yes Not applicable no (not feasible)
D Yes Yes Yes Yes Yes Yes Yes Yes Yes
(Continues)
HEALTH EFFECTS OF PLUMS (Prunus domestica AND Prunus salicina)
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
Table 9. (Continued)
E Yes Yes Yes Yes Yes Yes Yes Yes Yes
F Yes Yes Yes Yes Yes Yes Yes Not applicable Yes
G Yes Yes Yes Yes Yes Yes Yes Yes Yes
H Probably no Probably no Yes Yes Yes No No Yes Yes
I Yes Yes Yes Yes Yes Yes No Probably no Yes
JNo No No No No No No No No
K Yes Yes Yes Yes Yes Yes Yes Yes Yes
L Yes Yes Yes Yes Yes Yes Yes Yes Yes
TS 8 8 9 8 8 9 8 7 10
Aliment Pharm Ther
(2011) 33: 822828
Eat Behav (2010)
11(3): 201203
Appetite (2010)
3: 564569
J Am Diet Assoc
(2010) 9:
13221327
J Appl Res
(2004) 4: 3743
Res J Pharm Biol
Chem Sci (2013)
2: 11951204
J Pharm Sci
(2010b) 23:
463466.
n= 40 dried plum
(P. domestica)
2 × 50 g/day versus
psyllium Cross-over
14 weeks
n= 45 prunes
(P. domestica) 40 g
prune pre-load
versus bread
product Cross-over
over 1 week
n= 19 dried plum
(P. domestica)
238 kcal portion
versus baked foods
and water Cross-over
n= 26 Dried plum
(P. domestica)
100 kcal portion
versus low fat
cookies Cross-over
4 weeks
n= 58 dried plum
(P. domestica)
100 g/day versus
dried apple Parallel
3 months
n= 170 dried
plum and flixweed
(P. domestica)
4050 g/day Parallel
3 weeks
n= 107 prunes
(P. domestica) three
groups of either
single dose, double
dose or control
casecontrol 8 weeks
A Patients with
chronic constipation
Normal weight
individuals
Healthy female
subjects
Healthy female
subjects
Postmenopausal
women
Iranian Hajj pilgrims Healthy volunteers
B yes Yes Yes Yes Yes Yes Yes
C No (not feasible) No (not feasible) No (not feasible) No (not feasible) No (not feasible) No (not feasible) No (not feasible)
D Yes Yes Yes Yes Yes Yes Yes
E Yes Yes Yes Yes Yes Yes Yes
F Yes Yes Yes Yes Yes No Yes
G Yes Yes Yes Yes Yes Yes Yes
H Yes Yes No No Yes Yes Yes
I Probably no Probably no Yes Yes Yes Yes Yes
J no No No Yes No No No
K yes Yes Yes Yes Yes Yes Yes
L yes Yes Yes Yes Yes Yes Yes
TS 9 9 8 9 9 8 10
An eligibility criteria specified, B randomization appropriate, C treatment allocation concealed, D similarity at baseline, E outcome measures and control intervention explicitly described, F co-intervention
comparable, G outcome measures relevant, H adverse events and I drop-outs fully described, J sample size based on a priori power calculation, K point estimates and measures of variability presented for
the primary outcome measure, L appropriate timing giving a total score (TS) of 12.
E. O. IGWE AND K. CHARLTON
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
studied. This anabolic effect of dried plum supplementa-
tion has also been observed by others (Halloran et al.,
2010) in animal models. Prevention of age-associated
bone loss was evident because of this anabolic effect,
while bone volume increased and already lost bone
was restored.
Investigating further, Monsefi et al. (2013) observed
the effect of plum extract on bone parameters in the off-
spring of pregnant mice as well as in non-pregnant mice.
Plum extract was orally administered to the sample pop-
ulation, and results showed that in the non-pregnant
mice, there was an increase in the femoral and tibial
lengths and serum calcium content, while the foetuses
and new-borns of the pregnant mice had higher osteo-
genesis index, which was calculated by dividing the ossi-
fied length by the total length of each bone.
Ovarian hormone deficiency, which is evident in post-
menopausal women, is a known major risk factor for os-
teoporosis (Baron, 1993). For this reason, effect of plum
consumption on bone health in human trials has been
carried out mostly on postmenopausal women. A die-
tary supplementation trial compared the effects of con-
sumption of dried plum (100 g) with dried apple (75 g)
for 3 months on markers of bone turnover in postmeno-
pausal women (Arjmandi et al., 2002). The difference in
the amount of dried plum and dried apple compared
was related to comparable quantities of energy, carbo-
hydrates, fat and fibre, obtainable from 100 g of dried
plum. Baseline and post-treatment values of serum and
urinary biochemical markers of bone status showed that
only dried plums significantly increased serum levels of
insulin-like growth factor-1 and bone-specific alkaline
phosphatase activity.
A similar longer-term randomized controlled study
compared the effects of dried plum and dried apple
on osteopenic postmenopausal women for 1 year
(Hooshmand et al., 2011). In addition to similar results
of Arjmandi et al. (2002), the authors observed that
dried plum significantly increased bone mineral density
of the ulna and spine.
In a slightly different study, Simonavice et al. (2014)
examined the effects of resistance training and dried
plum consumption on strength, body composition,
blood markers of bone and inflammation in breast can-
cer survivors. They observed that even though the
breast cancer survivors increased upper and lower body
strength, no improvements were observed in their body
composition and bone mineral density.
ANTIOXIDANT AND ANTIINFLAMMATORY
ACTIVITY
The antioxidant property of plums has mostly been at-
tributed to its high phenolic content (Ko et al., 2005;
Lea et al., 2008). Research on this health effect has
mostly been carried out with the ripe plum fruit or its
products. Yu et al. (2009a) on the other hand studied
the antioxidant effect of immature plum extract (IPE)
on selected cancer cells in vitro. The authors observed
that even though the IPE was effective in inhibiting
growth of the cancer cells (human hepatocellular carci-
noma HepG2 cells, Kato III gastric cancer cells, HeLa
human cervical carcinoma cells, U937 leukaemia cells
and MCF 7 hormone-dependent breast cancer cells),
this inhibitory effect was not observed in the hormone-
dependent breast cancer cells, and as the fruit ripened,
there was a reduction in its inhibitory effect. In a similar
study, Noratto et al. (2009) aimed to identify the pheno-
lic fraction responsible for the potential chemopreven-
tive and/or chemotherapeutic action in plum. They
observed that all extract fractions were effective in
exerting antioxidant effect on studied cancer cell lines
with the flavonols and procyanidins more effective than
the phenolic acids and anthocyanins. This result was
also confirmed by Lea et al. (2008) who, in addition,
observed that the synergic effect of the total phenolic
content of the plum extract significantly increased its an-
tioxidant activity.
Investigating this antioxidant effect on human colon
cancer cells, Fujii et al. (2006) and Lea et al. (2008), in
similar studies with prune and plum extract, respec-
tively, observed that the extracts did not reduce the via-
ble cell number of the human normal colon fibroblast
cells while inducing apoptosis of cancer cells. Noratto
et al. (2009), among other studies, also observed similar
results in their study with breast cancer cell lines.
These results have also been confirmed in animal
studies. Kim et al. (2008) observed that IPE inhibited
the growth of hepatoma HepG2 cells and had a protec-
tive effect against benzo(α)pyrene induced liver toxicity
by decreasing serum aminotransferase and hepatic con-
tents of lipid peroxide. In addition to studying the anti-
oxidant capabilities in animal studies, Mishra et al.
(2012) also observed an anti-ulcer effect after feeding
Wistar albino rats for 7days with 100, 150 or 200 mg
kg
1
of plum extract and inducing peptic ulcer by pylo-
ric ligation. Gastric ulcerative index was estimated,
which showed that the group pre-treated with plum
extract had a significantly reduced gastric volume and
a significantly lower ulcerative index. This anti-ulcer
effect was also observed by (Cantu-Jungles et al., 2014)
in which acute gastric ulcer was induced by administra-
tion of ethanol P.A. after different oral treatments,
including prune polysaccharides, which showed a reduc-
tion and inhibition of the gastric lesion area. Yang and
Gallaher (2005) further investigated the effect of plum
on colon cancer risk factors whereby they observed that
even though dietary supplementation with dried plum
showed no inhibitory effect on aberrant crypt foci for-
mation at the initiation stage of cancer and early pro-
gression, it was able to inhibit several risk factors
associated with colon carcinogenesis. These include
reduction in faecal total and secondary bile acid
concentration, decrease in colonic β-glucuronidase and
7α-dehydroxylase activities and increased antioxidant
activities.
Contrary to observing similar results with in vitro and
animal studies, results from human trials have not been
in agreement. A study that investigated the plasma anti-
oxidant capacity changes after a meal observed that con-
sumption of a meal containing dried plum or dried plum
juice did not alter plasma antioxidant capacity (hydro-
philic and lipophilic ORAC
FL
) (Prior et al., 2007). This
result was contradicted by the findings of Ko et al.
(2005) that demonstrated that nine different fruit juices,
including plum juice, exhibited significant antioxidant
effects in human plasma within 30 mins of consumption
by suppressing reactive oxygen species generation. Sim-
ilarly, González-Flores et al. (2011) confirmed the
HEALTH EFFECTS OF PLUMS (Prunus domestica AND Prunus salicina)
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
antioxidant capability of plums in young, middle-aged
and elderly adults. After consumption of 195 g of plum
twice a day for 5 days, there was a significant increase
from baseline in urinary 6-sulfatoxymelatonin (an anti-
oxidant) and total antioxidant capacity levels measured
by colorimetric assay. Similarly, Netzel et al. (2012) ob-
served that following consumption of the Queen Garnet
plum juice, there was a threefold increase in hippuric
acid excretion (a potential biomarker for total polyphe-
nols intake and metabolite), an increase in urinary anti-
oxidant capacity and a reduction in malondialdehyde
excretion, which is a biomarker for oxidative stress.
COGNITIVE IMPROVEMENT
Cognitive improvement associated with consumption of
plum has not been extensively studied in humans. Most
of the available evidence is from animal studies. This
effect on cognition has mainly been attributed to the an-
tioxidant property of plums as a result its high polyphe-
nolic content. In a study in which four groups of mice
were fed a high-cholesterol diet, with either 2% or 5%
plum powder supplementation, a significant difference
was observed in the time taken to complete the Morris
water maze task between the group fed just the high-
cholesterol diet and the control group, as well as the
5% and 2% plum powder supplementation group
(Kuo et al., 2015). In a similar study but slightly contra-
dictory results, Shukitt-Hale et al. (2009) compared the
effects of 100% plum juice and 2% dried plum powder
supplementation to modify age-related deficits in cogni-
tive function in aged rats. It was observed that there was
an improvement in cognition with the plum juice, but
not with the dried plum powder.
Using plum extract, Shahidi et al. (2013) supple-
mented the diets of three groups of mice with different
doses (75, 100, 150 mg/kg). There was a statistically sig-
nificant difference in the number of trials to acquisition
in the passive avoidance test that evaluates learning
and memory between the control group and the plum
extract treated groups. The retention test also showed
that the treated groups had increased step through
latency in the retention in comparison with the control
group. These results are in line with similar studies
(Sharma and Sisodia, 2013; Kao-Ting et al., 2013) that
demonstrate a beneficial health effect of plum on
cognition.
Bouayed et al. (2007) examined the effect of
chlorogenic acid from plums on anxiety-related behav-
iours in mice using the light/dark test, the elevated plus
maze and the free exploratory test. Results showed a
decrease in anxiety-related behaviours (anxiolytic-like ef-
fect) and protection of granulocytes from oxidative stress.
Plum consumption protected against oxidative stress
induced by radiation with special attention to spatial
learning. Sharma and Sisodia (2013) observed that plum
possesses prophylactic ability against radiation-induced
metabolic disorders and also improved spatial learning.
Exposed mice that had received plum performed better
by taking less time to reach the coloured platform in the
circular water tank apparatus (proxy for spatial learning
and memory). Similarly, Kao-Ting et al. (2013) studied
the effect of plum consumption for 2 months on
cognitive performance and expression of cerebral
neurodegeneration-related protein in streptozotocin-
induced diabetic rats. Cognitive performance, assessed
using the Morris water maze, showed that the plum sup-
plemented diet had a significant beneficial effect on spa-
tial memory and learning. There was also a significant
reduction in expression of cerebral beta-amyloid, which
is evident in Alzheimers disease. Significant decreases
in hyperglycaemia, insulin resistance and oxidative
stress in the sample of rats were also observed.
CARDIOVASCULAR DISEASE RISK FACTORS
Insulin resistance, a major risk factor for metabolic syn-
drome and selected cancers, presents a major public
health concern (Tsugane and Inoue, 2010). Studying
the beneficial health effects of plums on cardiovascular
disease risk factors, Noratto et al. (2015) compared the
effect of plum juice with peach juice and a placebo
group, which received the same amount of sugar in
either peach or plum juice in obese Zucker rats. Their
results showed that the plum juice group had the lowest
weight gain and also that plum polyphenols exerted the
highest anti-adipogenic and antiinflammatory effects in
fat tissues. This provides evidence of the reduction of
mRNA levels of peroxisome proliferator-activated
receptor associated with plum intake.
Negishi et al. (2007) studied the effect of prune extract
on blood pressure elevation in stroke-prone spontane-
ously hypertensive rats for 5 weeks. They observed that
prune extract supplementation in diet suppressed the el-
evation of systolic blood pressure but not diastolic blood
pressure. A study by Gallaher and Gallaher (2009) on
apoE-deficient mice, known to be susceptible to rapid
development of atherosclerotic lesions when fed choles-
terol, investigated the ability of dried plum supplemen-
tation to reduce atherosclerosis. The percentage
arterial tree atherosclerotic lesion area was significantly
lower in groups fed the dried plum supplemented diet
(4.75%), either with or without cholesterol, compared
with the group fed cholesterol without dried plum
supplementation.
In human trials, results have been inconclusive. Chai
et al. (2012) studied the effect of daily dried plum con-
sumption in comparison with dried apple on cardiovas-
cular disease risk factors in postmenopausal women
over a 1-year period. Results showed that serum total
cholesterol levels were significantly lower in the dried
apple group in comparison with the dried plum group
only at 6 months. There was also a cholesterol-lowering
effect for serum total and low-density lipoprotein cho-
lesterol at 12 months, but this was not significant.
Neither dried apple nor dried plum had a significant
effect on the serum levels of atherogenic cholesterol.
Contrary to this observation, Tinker et al. (1991) ob-
served that in adult men with mild hypercholesterol-
emia, supplementation with prunes significantly
lowered plasma low-density lipoprotein cholesterol
compared with a grape juice control group. A signifi-
cantly lower faecal bile acid concentration of lithocholic
acid was also reported.
Regarding the effect of prunes on high blood pres-
sure, Ahmed et al. (2010a) conducted a study with three
groups of pre-hypertensive patients who were random-
ized to receive on a daily basis, either a single dose of
E. O. IGWE AND K. CHARLTON
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
prunes (11.5g), a double dose (23 g) or a glass of water
(control) for 8 weeks. Participants who received either
the single dose or a glass of water on empty stomach
in the morning showed significant reduction in both sys-
tolic and diastolic blood pressure, while the double dose
was associated with only a reduction in systolic blood
pressure. The control (water) group also had significant
increase in serum high-density lipoprotein that was not
seen by prune-treated groups
Plum juice supplementation with the novel-bred Queen
Garnet plum that has higher anthocyanin concentrations
than the usual variant (Santhakumar et al., 2015a) ob-
served an inhibition of platelet aggregation induced by
adenosine diphosphate, collagen and arachidonic acid.
LAXATIVE EFFECT
Studies have also been carried out on the commonly
known laxative effect of prunes, which has been attrib-
uted to its high fibre content. Piirainen et al. (2007)
studied the effect of prunes on individuals with mild gas-
trointestinal symptoms. This study observed that con-
sumption of prune juice reduced the occurrence of
difficulty in defecation. Similarly, consumption of a daily
portion of plum juice before a meal in adults with chronic
constipation softened the stool, provided immediate re-
lief and participants showed more preference to prune
juice than apple juice (Cheskin et al., 2009). Similar re-
sults were also observed with dried plum in patients with
mild to moderate constipation by Attaluri et al. (2011) in
which the effect was attributed to a synergistic effect pro-
vided by sorbitol, dietary fibre and polyphenols.
ANTI-ALLERGY AND ANTIMICROBIAL
PROPERTY
On the anti-allergy capability of plum, Karasawa et al.
(2012) carried out a study with prune extract diet sup-
plementation and injection of mite allergen for 3 weeks.
It was observed that with the prune extract supplemen-
tation, number of sneezing events, total and mite
allergen-specific immunoglobulin E levels were signifi-
cantly lower even though they were unable to identify
any anti-allergic components in the prune extract.
Studying the antibacterial property of plums, Yaqeen
et al. (2013) observed that when tested on five different
gram-positive bacteria, ethanol extracts of prunes exhib-
ited an antibacterial property. This antibacterial prop-
erty was also observed by (Cevallos-Casals et al., 2006)
OTHER EFFECTS
Other reported beneficial health effects of plum include
its effect on liver function in healthy individuals. In a
clinical trial, Ahmed et al. (2010b) observed a significant
reduction in serum alanine transaminase and serum al-
kaline phosphatase (clinical biomarkers of liver health)
with no changes observed in serum aspartate transami-
nase and bilirubin.
Keßler et al. (2002) studied the effect of plum juice on
urinary stone risk factors and observed that plum juice
had no significant effect on urinary composition. How-
ever, a study that utilized the Australian Queen Garnet
plum reported an increase in urinary antioxidant capac-
ity (Netzel et al., 2012).
Farajian et al. (2010) studied the short-term effect of
prunes included as snacks prior to a meal on energy in-
take and satiety in normal-weight individuals. This
study demonstrated that a preload of prunes in com-
parison with a bread product before a meal resulted
in lower energy intake at later meals, including lunch
and the desert (910 Kcal ± 233 on prunes day vs
971 Kcal ± 249 on bread product day. Pvalue 0.010)
as well as increased satiety at all time points tested
between the snack and meal. Similar studies have also
observed similar results (Furchner-Evanson et al., 2010;
Howarth et al., 2010)
DISCUSSION
This systematic literature review identified 73 peer-
reviewed journal articles on the health effects of plum
and its associated products. Despite an increase in
plum-based research that has emerged over the past de-
cade, the level of evidence remains low. Of 25 clinical
studies, nine studies included randomization to a plum
supplementation group, but only one of these studies
adequately described the method of randomization
and blinding. Nonetheless, results from some of the
study outcomes are consistent. Considering bone health
as the main study outcome, the polyphenols present in
the plum appear to be responsible for the benefits.
However, Hooshmand and Arjmandi (2009) suggested
that even though dried plum polyphenols have some
bone modulating properties, the synergistic effect of
these polyphenols, together with potassium and vitamin
K, is required to produce potent effects on bone mass
and microarchitecture and to reverse ovariectomy-
induced bone loss in mature animals. Regardless,
compared with other dried fruits (apple, apricot, grape
and mango), only the dried plum exhibited an anabolic
effect on trabecular bone in the vertebra and prevented
bone loss (Rendina et al., 2013).
Some of the findings from the in vitro studies have
been confirmed in animal studies but remain to be
confirmed in human clinical trials. Most of the available
human trials used the dried version of plums rather than
fresh fruit, thus limiting translation to dietary messages
of the positioning of plums in a healthy diet. The drying
process significantly decreases anthocyanin and flavonol
content of plums (Piga et al., 2003). The effect of other
processing methods on the antioxidant properties of
plums has been studied by Valero et al. (2012).
Blanching decreased the tannins and antiradical effi-
ciency of the fruits but increased the total polyphenol
content, while osmotic dehydration had no effect on
the total polyphenol and ferric reducing power. Fresh
plums also have a higher free radical scavenging capac-
ity (superoxide and peroxy radicals) and antioxidant ac-
tivity than dried plums (Morabbi Najafabad and Jamei,
2014). Regardless, prunes are known to contain higher
levels of phenolic compounds than most fruits and also
possess higher radical scavenging activity, even possibly
HEALTH EFFECTS OF PLUMS (Prunus domestica AND Prunus salicina)
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
the highest in dried fruit and vegetable products present
in human diet (Shahidi, 2012). Further studies are re-
quired to compare the health effects of fresh plum, plum
juice and dried plum in human trials.
Extraction methodology is also an important factor in
plum-based research as different solvents have shown
some disparity in extracts. Estimating the antioxidant
capacity of the whole plum fruit, Dhingra et al. (2014)
observed that in extracting the bioactive compound in
plum, the ethyl acetate and butanol fraction showed
the most antioxidant potential in comparison with the
hexane and aqueous fraction.
Evidence included in this systematic review was gath-
ered from studies that differed in a number of ways, in-
cluding population studied, study design, outcome
measures and methods of randomization. This limits
comparison between studies. Limitations related to dif-
ferent study designs are particularly evident in the
animal studies that show inconsistent results. For exam-
ple, Kuo et al. (2015) observed significant outcomes on
cognition using the Morris water maze task on mice
fed a high-cholesterol diet with 2% dried plum supple-
mentation. Conversely, Shukitt-Hale et al. (2009)
showed that plum juice, but not a dried plum powder
(2% concentration), was effective in alleviating cogni-
tive deficits in aged rats. This may possibly be explained
by a difference in the dosage of nutrients provided in
the two studies, or the food matrix, or both
(Wesche-Ebeling et al., 1996) but remains to be
elucidated in dose-response studies.
There have been no reports on the side effects associ-
ated with daily consumption of plum and its associated
products. Studies have shown that consumption of dried
plum over a long period has no significant effect on the
levels of insulin and glucose or bowel function
(Hooshmand et al., 2013; Lucas et al., 2004). Regardless,
plums are known to contain considerable levels of oxa-
lates, which occur naturally and may increase the risk
of kidney stone formation (Ruan et al., 2013). High levels
of oxalate in the body inhibit the absorption of calcium,
thereby resulting in precipitation of calcium, which can
result in stone formation in the kidney and bladder
(Massey, 2003; Weaver et al., 1987). Keßler et al. (2002)
observed that plum consumption had no significant ef-
fect on the risk factors associated with kidney stone de-
velopment. These potential side effects have not been
reported with usual plum consumption; however, it is im-
portant to identify the upper level of safe intake.
The increased interest in plum-based research has
been attributed to the fruits high levels of polyphenols
and more recently its anthocyanin (a sub-class of flavo-
noids) content. Anthocyanins are water-soluble plant
pigments that are particularly conspicuous in fruits and
flower tissues where they are responsible for the diverse
range of red, blue and purple colours. Anthocyanins
are one of the most versatile subclasses of flavonoids
that are known to protect chloroplasts from
photodegradation by absorbing high-energy quanta,
while scavenging free radicals and reactive oxygen spe-
cies. The key characteristic that differentiates anthocya-
nin glycosides from other subclasses of flavonoid
glycosides is their ability to be absorbed after oral inges-
tion, although to a limited extent. In nature, about 17
different anthocyanins have been discovered, but only
six (cyanidin, delphinidin, petunidin, peonidin,
pelargonidin and malvidin) have been shown to be of
dietary importance and are ubiquitously distributed
(Jaganath and Crozier, 2010). The major anthocyanins
found in the plum are cyanidin (3-rutinoside,
3-glucoside and 3-xyloside) and peonidin (3-rutinoside
and 3-glucoside) (Usenik et al., 2009). Anthocyanins
are absorbed in the small intestine and colon and
transported in human serum and urine, mainly as me-
tabolites to reach target cells (Talavéra et al., 2004;
Kay, 2006). Anthocyanins are known to be natural anti-
oxidants and have generated a great amount of interest
among researchers in the last decade. This trend has
also been observed among plum breeders as different
varieties of plum are cultivated through hybridization.
One of these hybrids is the Australian Queen Garnet
plum, a hybrid of the Japanese plum developed through
a breeding programme funded by the Queensland Gov-
ernment in Australia. This novel-bred Queen Garnet
plum is known for its exceptionally high anthocyanin
levels, reaching up to 277 mg per 100 g fruit (Fanning
et al., 2013). Even though levels of anthocyanin content
in fruits progressively increase during fruit development
and ripening, this is more than two times higher than the
total anthocyanin content of regular plums that has been
reported to range from 5 to 173 mg per 100 g across
harvest years (Miletic et al., 2012). The beneficial health
effects of these levels of anthocyanin found in the Queen
Garnet plum are currently being researched. Preliminary
studies using this variant of plum have demonstrated anti-
thrombotic activity in humans (Santhakumar et al., 2015a)
and a beneficial effect on metabolic syndrome in rat
models, in vivo and in vitro bioactivity (Bhaswant et al.,
2015). It is important that similar studies be performed with
different hybrids of plum to confirm their beneficial health
effects in the fight against chronic diseases.
Other parts of the plum fruit that are usually
discarded or used in animal feed may also provide food
components that confer health benefits. The plum
pomace, a by-product (pulpy residue) from plum juice
has been reported to contain 38-49% dietary fibre and
have antioxidant and anti-inflammatory properties that
have been demonstrated in vitro (Milala et al., 2013).
CONCLUSION
In conclusion, this systematic review has identified an
emerging body of evidence that demonstrates the bene-
ficial health effects of plum consumption. The largest
amount of evidence to date relates to prevention and
management of osteoporosis, which shows promising
evidence as an adjunctive therapy. However, many of
the study designs were of low quality; therefore, it is im-
portant that well designed human trials are conducted to
confirm these observed effects. Consideration of the nu-
tritional composition of plums and prunes and the ef-
fects of processing on their bioactivity is also important
for future research. Elucidation of the mechanism of ac-
tion of plum polyphenols, identification of potential ad-
verse effects and the effects of dosage on outcomes is
necessary to inform dietary guidelines for chronic dis-
ease prevention and management.
Conflict of Interest
The authors of this manuscript have no conflict of interest to declare.
E. O. IGWE AND K. CHARLTON
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
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Appendix 1: Search Strategy: Medline (OVID)
Searches
1 "plum*1".m_titl.
2 limit 1 to English language
3 Prunes.m_titl.
4 limit 3 to English language
5 "prunus domestica".m_titl.
6 limit 5 to English language
7 "prunus salicina".m_titl.
8 limit 7 to English language
9 2 or 4 or 6 or 8
10 (9 not "plum blossom needle").m_titl.
11 limit 10 to English language
12 (9 not "plum pox").m_titl.
13 limit 12 to English language
14 (12 not "plum curculio").m_titl.
15 limit 14 to English language
16 (15 not "plume").m_titl.
17 limit 16 to English language
HEALTH EFFECTS OF PLUMS (Prunus domestica AND Prunus salicina)
Copyright © 2016 John Wiley & Sons, Ltd. Phytother. Res. (2016)
... Although the exact mechanism of chemotherapyinduced liver injury is unknown, it seems that it is a consequence of oxidative damages. 1 The recommended formulas in PM textbooks for managing liver hot dystemperament are simple edible sources of phytochemicals for ameliorating the hepatic toxicities. Antioxidant and hepatoprotective properties of P. domestica, [16][17][18] S. officinarum, 19,20 manna of Hedysarum, 21,22 and T. indica [23][24][25] have been shown in previous studies. ...
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Complications of chemotherapy including liver injury have always been an issue in the management of cancer-ous patients. A 5-year-old girl, known case of acute lymphocytic leukemia, presented with rise of liver enzymes diagnosed as chemotherapy drug-induced liver injury grade 1. A juice from soaked fruits (consisted of tamarind, prune, manna of Hedysarum, and brown sugar) followed by chicory distilled water with oxymel was used con-comitant with chemotherapy; it resulted in a significant decrease in liver enzymes. Such natural products recommended by Persian Medicine for the management of liver injury (liver dystemperament in this viewpoint) should be further evaluated in experimental studies.
... Japanese plum (Prunus salicina Lindl.) is an important stone fruit species cultivated worldwide, with a global production that reaches over 12 million tons [1]. Fresh plums are appreciated by consumers for their good taste related to a balance between soluble solids' content and acidity as well as for their health promoting potential due to high nutraceutical compounds' content' mainly phenolics, carotenoids, vitamin C and fiber [2][3][4]. The main challenge to the plum fruit industry is to maintain the nutritional value along the supply chain, avoiding huge economic losses due to poor postharvest management practices [5]. ...
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In this study, the influence of a chitosan-based coating was assessed on qualitative traits and non-enzymatic and enzymatic antioxidant systems in Prunus salicina, ‘Black Golden’ Japanese Plum, during 35 days of cold storage followed by 3 days at 24 °C to evaluate its shelf life. Chitosan coating delayed the physico-chemical traits such as the total soluble solids, titratable acidity, firmness and skin color associated with the plum ripening process during cold storage and shelf life. Furthermore, the highest bioactive compounds’ content and antioxidant activity in the coated plum were registered during the stored period. Chitosan-based coating enhanced the activities of superoxide dismutase and ascorbate peroxidase during cold storage and shelf-life. Moreover, this edible coating contributes to reducing membrane damages with lower lipoxygenase activity and, consequently, malondialdehyde accumulation. A multivariate statistical analysis approach identified the two key components, correlated to all analyzed traits, that influenced the changes within chitosan coated and uncoated Japanese plums during storage. Chitosan coating is a cheap and eco-friendly tool to delay ripening process and to improve the antioxidant systems and storability of the ‘Black Golden’ Japanese plum.
... In a previous systematic review [11], health effect of plums (P. domestica and P. salicina) for different pharmacological uses such as anti-inflammatory and increasing bone mineral density were reviewed. ...
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Plums is one of the most cultivated stone fruits due to its fast growing popularity. It has various traditionally recognized health benefits. There are two main commercial types of plums: the European plum (Prunus domestica) and the Japanese plum (Prunus salicina), each having many varieties. Researchers are gathering further evidence of pharmacological effects for plums by scientifically studying its anti-inflammatory, antioxidant properties. A systematic review analysing the literature related to the effects of plums on prevention and treatment of cancer is warranted. This is the first review examining the cancer-related effects of plums. Antioxidation properties of the active constituents of plum were also compared. Scopus, Google Scholar, PubMed, Medxriv and Cochrane Library databases, from their date of inception until July 2021 were utilized. The risk of bias was assessed using CONSORT checklist. A total of 6639 studies were screened and eventually only 54 studies were included. Full-text review of included studies revealed that plum extracts were rich in antioxidants. Overall, most of the studies that fulfilled the eligibility criteria were in vitro and a few clinical studies involving in vivo work. Therefore, it would be beneficial to perform more studies on animals or humans, to confirm that the result obtained from these in vitro studies are able to be extrapolated in a wider range of applications. Further clinical and in vivo studies are warranted to validate plums as a functional food for treatment and prevention of cancer.
... Stone fruits, such as plums, have also been important sources of an array of phytochemicals (e.g., flavonoids, flavanols, and flavonols) that may reduce the risk of cardiovascular diseases [7]. Plum products, among others, contribute to ease dejection, increase bone health, and improve cognition [8]. Plums and their products, in particular, have been recognized as functional foods as they contain a number of compounds that have beneficial health effects upon consumption [9]. ...
Article
Full-text available
Plums are one of the commercially important stone fruits that are available on the market in both fresh and processed form and the most sought-after products are prunes, cans, jams, and juices. Maturity, harvest, and post-harvest technologies fundamentally determine the relatively short shelf life of plums which is often threatened by Monilinia spp. Causing brown rot worldwide. The aim of the present research was to use advanced analytical techniques, such as hand-held near infrared spectroscopy (NIRS) and electronic tongue (e-tongue) to detect M. fructigena fungal infection on plums and quantify this fungal contamination in raw plum juices. For this purpose, plums were inoculated with fungal mycelia in different ways (control, intact, and through injury) and stored under different conditions (5 °C, and 24 °C) for eight days. The results obtained with the two instruments were analyzed with chemometric methods, such as linear discriminant analysis (LDA) and partial least squares regression (PLSR). The NIRS-based method proved successful when detectability before the appearance of visible signs of the infection was studied. E-tongue was able to detect and quantify the concentration of juice derived from plum developed with M. fructigena with RMSECV lower than 5% w/w. Overall, the two methods proved to be suitable for discriminating between the treatment groups, however, the classification accuracy was higher for samples stored at 24 °C. The research results show both NIRS and e-tongue are beneficial methods to reduce food waste by providing rapid determination of fruit quality.
... Shows antioxidant and antiinflammatory properties. (Lee et al., 2008;Ogunlana et al. 2008;Jaiswal et al., 2013;Igwe and Charlton, 2016;Muthamilselvan et al., 2016). ...
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Avian coccidiosis is a major parasitic disorder in chickens resulting from the intracellular apicomplexan protozoa that target the intestinal tract leading to a devastating disease. Eimeria life cycle is complex and consists of intra- and extra-cellular stages inducing a potent inflammatory response that results in tissue damage associated with oxidative stress and lipid peroxidation, diarrheal hemorrhage, poor growth, increased susceptibility to other disease agents, and in severe cases, mortality. Various anticoccidial drugs and vaccines have been used to prevent and control this disorder; however, many drawbacks have been reported. Drug residues concerning the consumers have directed research toward natural, safe, and effective alternative compounds. Phytochemical/herbal medicine is one of these natural alternatives to anticoccidial drugs, which is considered an attractive way to combat coccidiosis in compliance with the “anticoccidial chemical-free” regulations. The anticoccidial properties of several natural herbal products (or their extracts) have been reported. The effect of herbal additives on avian coccidiosis is based on diminishing the oocyst output through inhibition or impairment of the invasion, replication, and development of Eimeria species in the gut tissues of chickens; lowering oocyst counts due to the presence of phenolic compounds in herbal extracts which reacts with cytoplasmic membranes causing coccidial cell death; ameliorating the degree of intestinal lipid peroxidation; facilitating the repair of epithelial injuries; and decreasing the intestinal permeability induced by Eimeria species through the upregulation of epithelial turnover. This current review highlights the anticoccidial activity of several herbal products, and their other beneficial effects.
... Currently, Chile is the main exporter of plums in the world market, where a wide range of both European and Japanese varieties are grown. The fruits of the grown European varieties are mainly used for the production of prunes [3,4,5]. ...
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The results of studies 20 varieties of plum are presented. Highlighted the varieties with high quality indicators, grown in the south of Russia. The fractional composition of sugars, organic acids, aromatic substances, vitamins, polyphenols, amino acids and minerals has been studied. According to the results of the research, a prescription composition of canned food “Plum Jam” has been developed.
Article
Scope: Inflammatory bowel disease (IBD), including ulcerative colitis (UC), is a chronic recurrent inflammatory disease of the digestive tract and increases the risk of colon cancer. Method and results: In this study, we evaluated the effects of dietary intervention with freeze-dried plum (FDP), a natural antioxidant and anti-inflammatory fruit with no toxicity on dextran sulfate sodium (DSS)-induced acute and chronic experimental colitis in a mouse model and studied the molecular mechanisms of protection through the gut-liver axis. The results showed that FDP decreased the levels of inflammatory mediators and, which is a nitrative stress biomarker in both acute and chronic models. FDP markedly reduced DSS-induced injury to the colonic epithelium in both acute and chronic models. In addition, FDP significantly decreased the levels of pro-oxidant markers such as CYP2E1, iNOS, and nitrated proteins (detected by anti-3-NT antibody) in DSS-induced acute and chronic colonic injury models. Furthermore, FDP markedly reduced markers of liver injury such as serum ALT/AST, antioxidant markers, and inflammatory mediators in DSS-induced acute and chronic colonic injury. Conclusion: These results demonstrate that the FDP exhibits a protective effect on DSS-induced acute and chronic colonic and liver injury through the gut-liver axis via antioxidant and anti-inflammatory properties. This article is protected by copyright. All rights reserved.
Article
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Plums are a large group of closely related stone fruit species and hybrids of worldwide economic importance and diffusion. This review deals with the main aspects concerning plum agrobiodiversity and its relationship with current and potential contributions offered by breeding in enhancing plum varieties. The most recent breeding achievements are revised according to updated information proceeding from relevant scientific reports and official inventories of plum genetic resources. A special emphasis has been given to the potential sources of genetic traits of interest for breeding programs as well as to the need for efficient and coordinated efforts aimed at efficaciously preserving the rich and underexploited extant plum agrobiodiversity. The specific objective of this review was to: (i) analyze and possibly evaluate the degree of biodiversity existing in the cultivated plum germplasm, (ii) examine the set of traits of prominent agronomic and pomological interest currently targeted by the breeders, and (iii) determine how and to what extent this germplasm was appropriately exploited in breeding programs or could represent concrete prospects for the future.
Article
Full-text available
High consumption of fruit and vegetables has an inverse association with cardiometabolic risk factors. This study aimed to chemically characterize the hydroethanolic extract of P. domestica subsp. syriaca fruit pulp and evaluate its inhibitory activity against metabolic enzymes and production of proinflammatory mediators. Ultra-high-performance liquid chromatography high-resolution mass spectrometry(UHPLC-HRMS) analysis showed the presence of hydroxycinnamic acids, flavanols, and glycoside flavonols, while nuclear magnetic resonance(NMR) analysis showed, among saccharides, an abundant presence of glucose. P. domestica fruit extract inhibited α-amylase, α-glucosidase, pancreatic lipase, and HMG CoA reductase enzyme activities, with IC50 values of 7.01 mg/mL, 6.4 mg/mL, 6.0 mg/mL, and 2.5 mg/mL, respectively. P. domestica fruit extract inhibited lipopolysaccharide-induced production of nitrite, interleukin-1 β and PGE2 in activated J774 macrophages. The findings of the present study indicate that P. domestica fruit extracts positively modulate in vitro a series of molecular mechanisms involved in the pathophysiology of cardiometabolic diseases. Further research is necessary to better characterize these properties and their potential application for human health.
Article
Full-text available
The main objective of the present study is to investigate energy consumption, exergy and greenhouse gas (GHG) emissions from prune production in both the garden and plant sectors. Both energy and exergy analysis methods are used while some sustainability indicators such as the cumulative degree of perfection (CDP) and the renewability indicator (RI) as well environmental aspects are considered. The analysis is based on the actual operational data. The high energy consumption, exergy and GHG emissions are related to the post‐harvest and the factory operations. Natural gas is determined to be the most effective input to energy consumption, exergy and GHG emissions in the whole process of producing prunes. Based on the sustainability indicators used, the agricultural operation of the plum production process is partially renewable while the factory operation of the prune production process is highly non‐renewable. In cases where the production process of prunes includes the use of renewable energy and plum waste, CDP increases from 0.32 to 2.88 and RI from ‐2.16 to 0.65. The use of renewable sources in producing one ton of prune annually reduces GHG emissions by 362.55 tons and energy consumption by 7.45 TJ worldwide. The use of plum waste would also produce 402.8 TJ of energy per year. The present study investigates prunes production, showing how the high energy consumption, exergy, and greenhouse gas emissions relate to the post‐harvest and the factory operations. Natural gas is the most impactful input in the whole process of producing prunes. The use of biogas instead of natural gas in prune production reduces energy consumption to 0.01 of custom consumption.
Article
Full-text available
Objective: To determine the effect of daily consumption of 100 g of dried plum (Primus domestica L.) on the bowel habits of postmenopausal women. Method: Fifty-eight postmenopausal women not on hormone replacement therapy and free of any gastrointestinal problems or eating disorders were randomly assigned to receive either 100 g of dried plum or 75 g of dried apples daily for 3 months. During the first week of treatment and each month thereafter, the participants were asked to fill out a validated questionnaire regarding their weekly bowel habits. The parameters used to assess bowel habits included stool frequency, estimated fecal bulk, consistency of stool, strain and pain during bowel movement, and feeling of constipation. Results: In both treatment regimens, there were no significant differences between the 4 different time points for any of the parameters used to assess bowel function. Conclusion: Many postmenopausal women can take advantage of all the health benefits that accompany prune consumption, such as improving blood lipid profile and reducing bone loss, without negative gastrointestinal side effects.
Article
Full-text available
Increased consumption of dark-coloured fruits and vegetables may mitigate metabolic syndrome. This study has determined the changes in metabolic parameters, and in cardiovascular and liver structure and function, following chronic administration of either cyanidin 3-glucoside (CG) or Queen Garnet plum juice (QG) containing cyanidin glycosides to rats fed either a corn starch (C) or a high-carbohydrate, high-fat (H) diet. Eight to nine-week-old male Wistar rats were randomly divided into six groups for 16-week feeding with C, C with CG or QG, H or H with CG or QG. C or H were supplemented with CG or QG at a dose of ∼8mg/kg/day cyanidin glycosides from week 8 to 16. H rats developed signs of metabolic syndrome including visceral adiposity, impaired glucose tolerance, hypertension, cardiovascular remodelling, increased collagen depots in left ventricle, non-alcoholic fatty liver disease, increased plasma liver enzymes and increased inflammatory cell infiltration in the heart and liver. Both CG and QG reversed these cardiovascular, liver and metabolic signs. However, no intact anthocyanins or common methylated/conjugated metabolites could be detected in the plasma samples and plasma hippuric acid concentrations were unchanged. Our results suggest CG is the most likely mediator of the responses to QG but that further investigation of the pharmacokinetics of oral CG in rats is required.
Article
Polyphenolics in six plum cultivars extracted with 80% aqueous methanol were treated on two cancer cell lines, HepG2 human liver cancer cells and DLD1 human colon cancer cells. Plum polyphenolics showed the antiproliferative activities on both cancer cell lines in a dose-dependent manner. The effects on HepG2 cells were more apparent than on DLD1 cells. The relative antiproliferative activity of six plum cultivars on HepG2 cells was in the decreasing order: French Damson > Cacak Best > Beltsville Elite B70197 > Yugoslavian Elite T101 > Longjohn > Stanley. However, the relative antiproliferative activity on DLD1 cells was as follows: French Damson > Cacak Best > Beltsville Elite B70197 > Longjohn > Yugoslavian Elite T101 > Stanley. French Damson among six plum cultivars showed the highest growth inhibitory effects on two cancer cell lines, whereas Stanly exerted the lowest. There was a good correlation between total phenolics and IC50 values for DLD1 (r(2) = 0.666) and HepG2 cells (r(2) = 0.819).
Article
The test of the association between dietary intake of specific carotenoids and disease incidence requires the availability of accurate and current food composition data for individual carotenoids. To generate a carotenoid database, an artificial intelligence system was developed to evaluate data for carotenoid content of food in five general categories, namely, number of samples, analytic method, sample handling, sampling plan, and analytic quality control. Within these categories, criteria have been created to rate analytic data for beta-carotene, alpha-carotene, lutein, lycopene, and beta-cryptoxanthin in fruits and vegetables. These carotenoids are also found in human blood. Following the evaluation of data, acceptable values for each carotenoid in the foods were combined to generate a database of 120 foods. The database includes the food description; median, minimum, and maximum values for the specific carotenoids in each food; the number of acceptable values and their references; and a confidence code, which is an indicator of the reliability of a specific carotenoid value for a food. The carotenoid database can be used to estimate the intake of specific carotenoids in order to examine the association between dietary carotenoids and disease incidence.
Conference Paper
While plums are traditionally bred for fresh fruit traits such as size, sweetness, yield and disease resistance the Queensland Government breeding program for Japanese plum (Prunus salicina Lindl.) also selected for anthocyanin content to develop a new plum selection named 'Queen Garnet'. When ripe or overripe, it has a near black skin and deep red flesh colour, which when combined, result in exceptionally high anthocyanin content, reaching up to 277 mg/100 g fruit. The skin fraction contributes 36-66% of the total anthocyanin content of fruit. The plum is now being commercially grown to be processed into a range of functional products from food colourants to premium health products. These are sold on the basis of anthocyanin and antioxidant content. Protocols for increasing anthocyanin content have therefore been researched to maximise the total anthocyanin yield rather than fresh fruit weight and taste. The principal approach is through selective harvest of overripe plums high in colour, although post-harvest storage at 21°C results in further anthocyanin synthesis. Modified processing is also required to ensure recovery of anthocyanins from the skin fraction. The plum products have entered testing for assessing health properties beginning with an initial proof of in vivo bioavailability of the anthocyanins.
Article
Consuming fruits and vegetables as low glycemic index (GI) foods are recommended in the weight loss and also diabetic management. Recognition of GI of fruits in different regions enables us to develop and cultivate low GI fruits. To determine the GI of variety of fruits which are exportable in Iran, groups of 8 healthy nondiabetics male volunteers aged 20-28 within School of Medicine, randomly assigned to each of fruits including: apricots, prunes, cherries, bluberries, Golab apples, Green apples, Golden no-seed grapes and Red sultanas. GIs were calculated as the ratios of the incremental areas under these response curves to those for glucose ingestion. GIs of fruits were compared using repeated measure ANOVA and a test of withinsubjects contrast to compare the mean GI of certain tested fruits. Mean GI of variety of fruits were 39 ± 5, 41 ± 6, 50 ± 6, 34 ± 7, 29 ± 4, 28 ± 6, 48 ± 6, 49 ± 7 respectively for Golab apple, Green apple, apricots, prunes, cherries, blueberries, Golden no-seed grapes and Red sultanas. The GIs were significantly different between the 8 tested fruits (P > 0.002 for overall effect). Serving size of blueberries, cherries, Golab apples, Green apples, prunes, and apricots were low glycemic load (GL) fruits while golden no-seed grapes considered medium (GL= 13) and Red sultans with GL = 23 had the highest GL among tested fruits. All tested fruits were low GIs. The tested fruits can be recommended for diabetics and weight loss management. Consumption of one serving size sultanas will have high GL and is not suitable for diabetics.