Is acai effective in the treatment of inflammatory disorders?
Abstract
Acai berry is a supplement that has recently gained popularity in North America and European
countries. This supplement boasts many health benefits, including weight loss, skincare,
cardiovascular health, and more.2 One benefit is anti-inflammatory properties. Thus, in this poster,
we plan to address the question of “Is acai effective in the treatment of inflammatory disorders?”
Studies had shown evidence that acai was useful for anti-inflammatory properties in a variety of
ways. Components of acai pulp include anthocyanins, proanthocyanidins, other flavonoids, and
lignans. These components have been shown to have anti-inflammatory activity in proliferative and
exudative phases of inflammation.6 Additionally, it appeared to inhibit COX-1 and -2 in vitro studies
indicative of its potential anti-inflammatory effect.9 Consumption of acai berries has no reports of
adverse effects and known drug-drug interactions.3 Consequently, there is immense interest in using
acai berries to treat and supplement therapy of inflammatory diseases and conditions.
One example of an inflammatory disorder that was treated with acai is metabolic syndrome. One
study had shown that in patients with metabolic syndrome, drinking an acai beverage reduced key
markers of inflammation, such as interferon-gamma and 8-isoprostane.4 Another study reinforces
the benefit of acai in patients with type 2 diabetes. The polyphenolics from acai decrease damage to
the vascular endothelial cells in humans via lipopolysaccharide-induced inflammation.1 Another
inflammatory condition that was improved by acai consumption is wound healing.7 The reduction of
COX enzyme activity promotes anti-inflammation and helps heal wounds.
In another study, acai pulp in a juice mixture was given to study the pain, antioxidant, and
anti-inflammatory effect. The result of the study showed a correlation between pain levels and
antioxidant status, but no statistical significance for decreasing inflammatory marker, C-reactive
protein (CRP), despite a reduction.5 Larger clinical studies will be needed to confirm findings and the
use of acai berry in these areas of treatment.
The “Anti-inflammatory activity of polyphenolics from acai in intestinal myofibroblasts CCD-18Co
cells” study indicates the potential of acai polyphenolics in preventing intestinal inflammation by
partially reversing the effect of LPS-induced in a dose-dependent manner. Acai extracts could
potentially down-regulated LPS-induced mRNA-expression of tumor necrosis factor-alpha, TNF-α,
cyclooxygenase 2, COX-2, toll-like receptor-4, TLR-4, 12 TNF receptor-associated factor 6, TRAF-6,
NF-κB, VCAM-1, intercellular 14 adhesion molecule 1, and ICAM-1.8 However, the study concluded
that future in vivo studies should be performed to verify the potential of polyphenols from acai in
preventing intestinal inflammation.
In conclusion, compounds from the acai berry can reduce key inflammatory markers in the human
body. This opens up the potential for acai berry extracts to be used to care for patients with
inflammatory disorders and conditions. However, there still needs to be more
randomized-controlled trials in humans to establish efficacy.
References
1. Noratto, G.D., Angel-Morales, G., Talcott, S.T., Mertens-Talcott, S.U., 2011. Polyphenolics
from Açaí (Euterpe oleracea Mart.) and Red Muscadine Grape (Vitis rotundifolia) Protect
Human Umbilical Vascular Endothelial Cells (HUVEC) from Glucose- and Lipopolysaccharide
(LPS)-Induced Inflammation and Target MicroRNA-126. Journal of Agricultural and Food
Chemistry 59, 7999–8012.. doi:10.1021/jf201056x
2. Acai. National Center for Complementary and Integrative Health.
https://nccih.nih.gov/health/acai/ataglance.htm. Accessed August 2, 2021
3. Natural Medicines. (2021, August 2)). Acai [monograph].
http://naturalmedicines.therapeuticresearch.com
4. Kim H , Simbo SY , Fang C , et al. Açaí (Euterpe oleracea Mart.) beverage consumption
improves biomarkers for inflammation but not glucose- or lipid-metabolism in individuals
with metabolic syndrome in a randomized, double-blinded, placebo-controlled clinical trial.
Food Funct. 2018 Jun 20;9(6):3097-3103. doi: 10.1039/c8fo00595h. PMID: 29850709.
5. Jensen GS, Ager DM, Redman KA, Mitzner MA, Benson KF, Schauss AG. Pain reduction and
improvement in range of motion after daily consumption of an açai (Euterpe oleracea Mart.)
pulp-fortified polyphenolic-rich fruit and berry juice blend. J Med Food.
2011;14(7-8):702-711. doi:10.1089/jmf.2010.0150
6. Kang, J., Xie, C., Li, Z., et al. (2011). Flavonoids from acai (euterpe OLERACEA MART.) pulp
and their antioxidant and Anti-inflammatory activities. Food Chemistry, 128(1), 152–157.
https://doi.org/10.1016/j.foodchem.2011.03.011
7. Xiong J , Matta FV , Grace M , Lila MA , Ward NI , Felipe-Sotelo M , et al. Phenolic content,
anti-inflammatory properties, and dermal wound repair properties of industrially processed
and non-processed acai from the Brazilian Amazon. Food Funct. 2020;11(6):4903–14.
8. Dias MM, Martino HS, Noratto G, Roque-Andrade A, Stringheta PC, Talcott S, Ramos AM,
Mertens-Talcott SU. Anti-inflammatory activity of polyphenolics from açai (Euterpe oleracea
Martius) in intestinal myofibroblasts CCD-18Co cells. Food Funct. 2015 Oct;6(10):3249-56.
doi: 10.1039/c5fo00278h. PMID: 26243669.
Responses
Hello Iris, Emi, and Loan – what are the two main things you learned from preparing and developing this topic?
Hi Dr. Shane-McWhorter, one thing I learned as I prepared for this poster topic is how foods or supplements are often promoted to have all these extra benefits despite no clinical evidence so it’s important to be educated on it especially since patients could ask us. Another thing I learned is there is in lack of understanding and randomized trials regarding the efficacy of supplements available to the public, as one study we looked at had many limitation and require additional study to confirm efficacy
Hi Dr. Shane-McWhorter,
I agreed with Iris that patients and consumers potentially use acai berry to prevent anti-inflammation. But there is a lack of understanding and available information to the public in its clinical use. In addition, there are no clinical studies that we found proving the benefit of acai berry in reducing anti-inflammatory biomarkers. Also, I thought it was interesting that we couldn’t find much information about the drug interaction and adverse effects of acai berry.
Hello Dr. Shane-McWhorter!! Two main things I learned from preparing and developing this topic is that acai can come in a variety of dosage forms, such as freeze-dried pulp and beverages, rather than just capsules or tablets like I have seen in other supplements. I also learned that the polyphenolic structure of acai that gives it its purple color is also present in other compounds and is the active component that affects inflammatory markers.
Loved reading your poster! Would you recommend that patients taking acai stop taking it prior to an MRI? If larger studies were to be conducted, do you hypothesize that there may be more or less of a chance for clinical and statistical significance of benefits observed in patients taking acai?
Thanks Britney! That’s a great question, from my understanding of the study the consumption of acai increases the contrast but does not affect the overall result. And the specification of the amount consumed was not provided by the study thus it would be something that I recommend the patient speak to the radiologist about.
Hi Brittney! Thank you for your question!! I think if larger studies were to be conducted, it is hard to give a concrete answer as to whether or not it would be statistically/clinically significant in reducing inflammation. However, I do think that current evidence in the in vivo and in vitro studies is promising, so I think there is a high likelihood that in larger cohorts in a randomized, controlled trial that the results would be statistically significant.
Thanks Iris and Emi!
Interesting topic. What types of patients were involved in the first study – osteoarthritis or rheumatoid arthritis? Are there any other potential uses of acai? What would you say to a person who wants to use this product? Any potential problems with someone who is taking other anti-inflammatory products?
Thank you Dr. Shane-Mcwhorter! The first study included patients with both osteoarthritis and rheumatoid arthritis but does lack confirmation of if they had a clinical diagnosis. Others also use acai as an antioxidant or for metabolic syndrome (glucose level and cholesterol levels), however, both of these uses are also lacking in evidence.
I would say there is no known harm in taking acai supplements or eating them. Additionally, there are also no known drug-drug interactions. I would suggest eating them normally should be harmless but they should speak with their doctor if they’re taking a supplemental amount regularly and are on anti-inflammatory therapy
If someone who wanted to use acai extract talked to me about wanting to use it, I would advise them to use it as a food rather than a supplement. The reason for this is that the supplement manufacturers are not always credible in the manufacturing of their products. Also, acai extract in foods is comparably minimal to the doses in supplements. However, if someone was totally set on taking acai supplements, I would advise them to take the lowest possible dose to start, to review potential drug-to-drug interactions, and to look for the GMP certification on the product bottle.
I do think there is a potential drug-to-drug interaction, despite no drug-to-drug interactions documented. This is with anti-inflammatories such as NSAIDs. Both acai and NSAIDs inhibit COX-1 and -2 enzymes. If taken together, it has the potential to potentiate bleeding adverse effects.
Hello Iris, Emi, and Loan!
Suppose a patient were to want to start to use acai for its anti-inflammatory processes. Is there a particular formulation you would recommend or that you found was most commonly used for this indication?
One particular formulation I would recommend is either the beverage or freeze-dried pulp. These are the formulations that have the most data about their clinical efficacy. I would also emphasize that the patient AVOID raw acai berries, as this formulation has the potential to distribute parasitic disease.
Hello Emi and Iris, along the same lines as Brittney’s questions asked earlier. Are you aware if MRI Centers take into consideration patients use of supplements such as Acai and counsel the patient on whether or not to continue taking the supplement before going through an MRI? Are they even aware of this kind of interaction with MRIs?
Hey James! Thanks for the great question! With every MRI, a medication reconciliation is performed to ensure that the patients are not taking anything that would interact with the contrast dye and/or decrease the accuracy of the MRI. Acai and other supplements are to be stopped prior to MRIs. In fact, acai is so potent in affecting oral contrast dye that it is being considered to be used as an alternative to regularly used contrast dye! https://pubmed.ncbi.nlm.nih.gov/15062934/
Hi James, great question! From my understanding, there is no special preparation or specific foods to avoid for MRI scans unless specified by the physician. I feel some might be aware of this effect. And I would definitely recommend patients to check with their doctor prior to their MRI if they are using acai products.
First off great poster! Secondly, I was curious what made you all decide to look into the anti-inflammatory effects of acai? I only know acai as a yummy treat!
Hi Clint!! Thank you so much!! It is a yummy treat that we all enjoy, but we also know it to be a superfood! We wanted to look further into its “superfood” effects and see what exactly made it super, and if those effects were analyzed in the setting of treating disease states.
Great job on this poster, it looks awesome! 🙂 Do you know of any other populations/disease states that could benefit from acai?
Hi Ali!! Thank you so much!! I think besides the metabolic syndrome and arthritis populations we analyzed, we also saw some studies that helped patients who were overweight with managing inflammation!
Did you happen upon any studies conducted in Brazil? When I lived there as a missionary, we ate açai almost every day! It would be interesting to see if any studies have been conducted there since it is a national staple consumed in huge amounts.
Hi Tyler! That is so cool that you saw acai used a lot in Brazil!! In the studies we analyzed, it looks like they took place in either the United States and China, particularly Texas A&M University! However, it looks like a lot of these studies had received acai products from Brazil, so it doesn’t surprise me to hear that there was a lot of acai use in Brazil!
Hi Tyler, the study that I found was conducted in Texas, but the frozen acai pulp was imported from Belém, PA, Brazil.
Thanks for the responses Emi and Loan!
Comments are closed.