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Revision as of 07:21, 13 February 2007 by Rhode Island Red (talk | contribs) (→Adverse Effects: hopefully this will be less objectionable (see discussion))(diff) ← Previous revision | Latest revision (diff) | Newer revision → (diff)Juice Plus is a branded line of dietary supplements containing concentrated fruit and vegetable extracts fortified with added vitamins and nutrients. Juice Plus is manufactured by Natural Alternatives International (NAI; San Marcos, CA) and is distributed by National Safety Associates (NSA; Collierville, TN) through direct or multi-level marketing. Several Juice Plus products are marketed including Orchard Blend and Garden Blend capsules (NSA's main product), Vineyard Blend capsules, chewable and gummy supplements for children, and a version for dogs and cats.
Product Contents
Orchard Blend/Garden Blend
The Juice Plus Garden Blend U.S. bottle label contains the following information. The recommended daily serving size is 2 capsules (750 mg each), which contain the following nutrients (as percentages of the Reference Daily Intake): vitamin A (as beta-carotene) 140%, calcium 4%, vitamin E 80%, vitamin C 70%, iron 2%, and folate 70%. A 2-capsule serving contains no fat or cholesterol, 10 mg sodium, 1 g carbohydrate, and less than 1 g each of dietary fiber and protein. The ingredients listed in descending order of amount (exact amounts not listed) are: vegetable juice powder and pulp from carrots, parsley, beets, kale, broccoli, cabbage, spinach, and tomato; gelatin, lipase, amylase, protease, cellulase, beet fiber, barley bran, oat bran, cabbage fiber, glucomannan, plant cellulose, dried plant fiber, Lactobacillus acidophilus, vegetable-derived magnesium stearate, anthocyanins, allicin, lycopene, polyphenol catechins, Dunaliella salina (algae), and indole carbinols.
The Juice Plus Orchard Blend U.S. bottle label contains the following information. The recommended daily serving size is 2 capsules (750 mg each), which contain the following nutrients (as percentages of the Reference Daily Intake): vitamin A (as beta-carotene) 110%, calcium 2%, vitamin E 70%, vitamin C 320%, iron 2%, and folate 35%. A 2-capsule serving contains no fat or cholesterol, 5 mg sodium, 1 g carbohydrate (less than 1 g each of dietary fiber and sugars), and less than 1 g protein. The ingredients listed in descending order of amount (exact amounts not listed) are: fruit juice powder and pulp from apple, orange, pineapple, cranberry, peach, acerola cherry, and papaya; gelatin, bromelain, papain, lipase, amylase, protease, and cellulase; apple pectin, citrus pectin, date fiber, prune powder, glucomannan, citrus bioflavenoids, dried plant fiber, Lactobacillus acidophilus, vegetable-derived magnesium stearate, anthocyanins, polyphenol catechins, Dunaliella salina (algae), and indole carbinols.
Orchard Blend and Garden Blend are sold only in 4-month supplies of 8 bottles (4 of each). Two capsules per day of each of these products (4 capsules in total) constitute the usual daily regimen. Juice Plus products do not contain certified organic ingredients. In accordance with the Dietary Supplement Health and Education Act of 1994, Juice Plus is not intended to prevent, treat, cure, or mitigate any disease.
Several nutrients, including folate, beta-carotene, vitamin C, and vitamin E, are added to the product’s refined plant powders to compensate for nutrient loss during processing. Allicin and other undisclosed phytochemicals are also added. Other additives listed on European bottle labels include thickening and anticaking agents (excipients), calcium carbonate, magnesium carbonate, niacin, vitamin B6, coenzyme Q10, vitamin B1, and vitamin B2.
According to the product label, the suggested daily 4-capsule Juice Plus regimen provides (in % Reference Daily Intake with corresponding amounts in parentheses): folate 105% (420 µg), vitamin C 390% (234 mg), vitamin E 150% (45 IU), beta-carotene 250% (7.5 mg), calcium 6% (61 mg), and iron 4% (0.72 mg). Four studies which included chemical analyses of Juice Plus have indicated nutrient amounts that differ from the amounts listed on the label. The weight of individual Juice Plus capsules has been variably reported as 1 g, 850 mg, and 750 mg (current U.S. bottle label), and according to National Safety Associates, the product’s composition has undergone changes since it was first introduced.
Juice Plus Orchard Blend capsules contain 24.1% concentrated fruit juice powder by weight, and Garden Blend capsules contain 26.3% vegetable juice powder, as listed on UK/Switzerland bottle labels.
Gummies
Juice Plus gummies consist of 85% corn syrup and 10% beef gelatin. Chemical analysis during a research study gave the following nutrient amounts based on the recommended daily regimen of 6 gummies (approximate percentage of the adult Reference Daily Intake in parentheses): vitamin C 107.1 mg (179%); vitamin E 82.6 IU (275%); vitamin A 14.8 mg (494%); thiamin 1.39 mg (93%); riboflavin 0.05 mg (3%); niacin 2.51 mg (13%); pyridoxine 0.64 mg (32%); zinc 0.62 mg (4%); magnesium 13.65 mg (3%), calcium 94.5 mg (9%); potassium 58.4 mg (2%); and copper 0.32 mg (16%).
Consumer complaints regarding Juice Plus were received by the Better Business Bureau's National Advertising Division. The complainants said that in April 2005 the National Safety Associates advertising featuring Dr. William Sears misleadingly implied that Juice Plus Gummies are low in sugar and are a nutritional alternative to fruits and vegetables. NSA promised to modify its ads and stop calling Gummies “the next best thing to fruits and vegetables”. As of October 2006, the Juice Plus homepage features the claim that Juice Plus is “the next best thing to fruits and vegetables”, but not specifically in reference to the Gummies form of the product.
Product Research
Of the published peer-reviewed studies on Juice Plus products, seven were funded and authored by the manufacturer, NAI, three were funded by the main distributor, NSA, two were funded by individual Juice Plus distributors, and two studies were conducted independently. The products examined in the majority of the studies were Garden Blend and Orchard Blend; one study was performed on Vineyard Blend taken in combination with Garden and Orchard Blend, and one study was on Juice Plus Gummies.
Nutrient Absorption
Three studies focusing on the uptake of nutrients in the blood of subjects taking Juice Plus found high absorption of folate and beta-carotene and inconsistent absorption of vitamin E and vitamin C. Other studies found that Juice Plus does not raise the blood levels of other key phytonutrients from fresh fruits and vegetables, such as lycopene, lutein, zeaxanthin, and beta-cryptoxanthin.
Antioxidant Activity
Based on an in vitro test of antioxidant activity, a study found that 1 g of Juice Plus Garden Blend/Orchard Blend powder had the corresponding antioxidant capacity to approximately 10 g (fresh weight) of fruit or vegetable, amounting to 30 g (roughly one-third of a serving) per 4 capsules.
Three studies, which were not blinded or placebo-controlled, found that Juice Plus capsules reduced parameters of oxidative stress. One of these studies, authored and sponsored by the manufacturer, reported a 75% reduction in serum lipid peroxides, an oxidative stress marker, after 7 to 28 days. This study, which has been quoted by NSA in support of the product’s antioxidant efficacy, has been criticized on the basis that it was poorly designed, included only 15 subjects, and failed to include monitoring or control of the participants’ food intake. The results of the study have also been contradicted by three randomized, double-blind, placebo-controlled studies, longer in duration and with more subjects, which found no significant reductions in lipid peroxidation, or other markers of oxidative stress in test subjects. The specific oxidation of DNA in subjects taking Juice Plus has been examined in 4 studies. A non-controlled, non-randomized study published in 1999 found a 67% decrease in DNA oxidation;. However, these results were contradicted by three randomized, double-blind, placebo-controlled trials, which found that Juice Plus had no significant effect on DNA oxidation.
A placebo-controlled study conducted in 2002 found that Juice Plus Gummie candies did not significantly improve the antioxidant status of children, as indicated by negative results from 6 different antioxidant tests. The authors said it was possible that the supplement did not contain enough of the proper antioxidants to make a significant difference or that the antioxidants extracted in the fruit/vegetable extract were not bioavailable.
Cardiovascular Effects
Several studies have examined the effects of Juice Plus on biochemical parameters associated with cardiovascular function. A non-controlled study found a 37% decrease in homocysteine levels,. Other studies, including two that were randomized, double-blind, placebo-controlled trials, found that homocysteine levels were not reduced or were reduced only marginally (7%). Two randomized, double-blind placebo controlled studies have examined the effect of Juice Plus on serum cholesterol and LDL levels. One study found that Juice Plus had no significant effects; the other found slight decreases in cholesterol (6%) and LDL (9%) in subjects that took Orchard/Garden Blend, but no reductions among subjects who took Juice Plus Vineyard blend in addition. One study found that Juice Plus had no effect on blood pressure in healthy subjects.
Adverse Effects
The investigators in a study on Garden/Orchard Blend in elderly subjects noted anecdotally that it was generally well tolerated; 2 out of 55 subjects discontinued treatment prematurely and withdrew from the study due to the development of a hive-like rash. Another study reported adverse effects (upper-respiratory tract, urinary, and musculoskeletal) in 5 of 16 subjects who took Juice Plus for 7 days. These events resolved spontaneously and were deemed by the researchers to be unrelated to treatment. Other adverse effects listed in the Juice Plus Franchise Owner's Manual and the Special Nutritional Adverse Event Monitoring System include gastrointestinal cramps, fever, nausea, bloating, diarrhea, and constipation. Heartburn, abdominal pain, diarrhea, gas with foul odor, and indigestion have been noted as very common risks associated with taking Juice Plus Orchard and Garden Blend, and nausea and vomiting as less common risks; in some cases these side effects may be serious and long lasting, persisting after use of the supplement has been stopped. According to document filed with the Institutional Review Board of Wake Forest University School of Medicine, subjects participating in a Juice Plus research study were informed that taking Orchard Blend and Garden Blend capsules presents unknown risks and has the potential to cause harm to the unborn fetus.
Juice Plus Children's Research Foundation
The Juice Plus Children's Research Foundation, founded in 1997, is a non-profit organization whose goal is to initiate and/or support programs that advance the principle that improved nutrition leads to healthier lifestyle and overall better health in children. The foundation is chaired by executives of National Safety Associates and operates from the company's head office in Memphis, TN. As of 2007, no research had been published by the Foundation. The Foundation conducts an ongoing survey which has found a general improvement in diet and lifestyle habits. The scientific value of the survey has been questioned by the University of California Berkeley Wellness Letter and by Stephen Barrett of MLMWatch, who say that the Foundation is used mainly as a marketing gimmick to get families to buy Juice Plus products.
Criticism and Controversy
Doubts about the benefits of Juice Plus raised by the Memorial Sloan-Kettering Cancer Center, the University of California Berkeley and other critics include: the product’s marketing being unsupported by research data, the product contains too little fruit and vegetable powder to offer significant clinical benefits, effects can be attributed to the inclusion of added exogenous vitamins and micronutrients, and the products are excessively priced relative to their potential benefits.Cite error: A <ref> tag is missing the closing </ref> (see the help page).
References
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- ^ Virtual Franchise Owner's Manual (December 2002). National Safety Associates.
{{cite book}}: Cite has empty unknown parameter:|coauthors=(help) - ^ Plotnick, Gary; Corretti MC, Vogel RA, Hesslink, Jr. R, Wise JA. (2003). "Effect of supplemental phytonutrients on impairment of the flow-mediated brachial artery vasoactivity after a single high-fat meal" (pdf). J Am Coll Cardiol 41 (10): 1744-9.
- "EN Squeezes the Raw Truth Out of Juice Plus Claims". Environmental Nutrition. March 2002.
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- "Are all antioxidants what they claim to be?" (pdf). GNLD International.
- ^ Chambers SJ; et al. (1996). "Evaluation of the antioxidant properties of a methanolic extract from 'Juice Plus fruit' and 'Juice Plus vegetable' (dietary supplements)". Food Chem. 57: 271–274.
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{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Leeds AR; et al. (2000). "Availability of micronutrients from dried, encapsulated fruit and vegetable preparations: a study in healthy volunteers". J Hum Nutr Diet. 13: 21–7.
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{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Smith MJ, Inserra PF, Watson RR, Wise JA, O'Neill KL (1999). "Supplementation with fruit and vegetable extracts may decrease DNA damage in the peripheral lymphocytes of an elderly population". Nutr Res. 19 (10): 1507–18.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Inserra PF, Jiang S, Solkoff D, Lee J, Zhang Z, Xu M, Hesslink R, Wise J, Watson RR (1999). "Immune function in elderly smokers and nonsmokers improves during supplementation with fruit and vegetable extracts". Integr Med. 2 (1): 3–10.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Stewart, R.J.; et al. (2002). "Antioxidant status of young children: Response to an antioxidant supplement". J Am Diet Association. 102 (11): 1652–7.
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{{cite web}}: Cite has empty unknown parameter:|coauthors=(help) - ^ Samman S.; et al. (2003). "A mixed fruit and vegetable concentrate increases plasma antioxidant vitamins and folate and lowers plasma homocysteine in men" (pdf). 133 (7): 2188–93.
{{cite journal}}: Cite journal requires|journal=(help); Explicit use of et al. in:|author=(help) - ^ Bloomer RJ; et al. (2006). "Oxidative stress response to aerobic exercise: comparison of antioxidant supplements". Med Sci Sports Exerc. 38: 1098–1105.
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{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Bamonti F; et al. (2006). "Increased free malondialdehyde concentrations in smokers normalise with a mixed fruit and vegetable juice concentrate: a pilot study". Clin Chem Lab Med. 44 (4): 391–6.
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{{cite web}}: Cite has empty unknown parameter:|coauthors=(help) - Barrett, Stephen. "Questionable Research by the Juice Plus Children's Research Foundation". MLM Watch. Retrieved 2007-02-05.
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