Miracle fruit improves sweetness of a low-calorie dessert without promoting subsequent energy compensation

Miracle Fruit, a Potential Taste-modifier to Improve Food Preferences: A Review

PURPOSE OF REVIEW

The miracle fruit contains the glycoprotein miraculin which can modify the taste perception of food and beverages at low pH conditions, altering the consumers' food preferences. This review aims to critically evaluate all available evidence on miracle fruit/ miraculin and taste modification and its potential role in improving food preferences.

RECENT FINDINGS

Miracle fruit suppresses sourness and induces sweetness in acidic food/ beverages. At low pH conditions, miracle fruit enhances the sweet taste and decreases the perceived intensities of salty and bitter tastes in solutions. However, the role of miracle fruit in sweet, salty, and bitter food is not adequately studied. The above effects alter the food-liking scores in individual foods and mixed diets. Miracle fruit is a pH-dependent taste modifier with the potential to be used in food applications to improve consumer food preferences. Future research on the changes in food preferences with the optimum miraculin dose, food type, and intrapersonal variations in taste sensitivity is warranted.

Efficacy and Safety of Habitual Consumption of a Food Supplement Containing Miraculin in Malnourished Cancer Patients: The CLINMIR Pilot Study

Taste disorders (TDs) are common among systemically treated cancer patients and negatively impact their nutritional status and quality of life. The novel food approved by the European Commission (EFSA), dried miracle berries (DMB), contains the natural taste-modifying protein miraculin. DMB, also available as a supplement, has emerged as a possible alternative treatment for TDs. The present study aimed to evaluate the efficacy and safety of habitual DMB consumption in malnourished cancer patients undergoing active treatment. An exploratory clinical trial was carried out in which 31 cancer patients were randomized into three arms [standard dose of DMB (150 mg DMB/tablet), high dose of DMB (300 mg DMB/tablet) or placebo (300 mg freeze-dried strawberry)] for three months. Patients consumed a DMB tablet or placebo daily before each main meal (breakfast, lunch, and dinner). Throughout the five main visits, electrochemical taste perception, nutritional status, dietary intake, quality of life and the fatty acid profile of erythrocytes were evaluated. Patients consuming a standard dose of DMB exhibited improved taste acuity over time (% change right/left side: -52.8 ± 38.5/-58.7 ± 69.2%) and salty taste perception (2.29 ± 1.25 vs. high dose: 2.17 ± 1.84 vs. placebo: 1.57 ± 1.51 points, p < 0.05). They also had higher energy intake (p = 0.075) and covered better energy expenditure (107 ± 19%). The quality of life evaluated by symptom scales improved in patients receiving the standard dose of DMB (constipation, p = 0.048). The levels of arachidonic (13.1 ± 1.8; 14.0 ± 2.8, 12.0 ± 2.0%; p = 0.004) and docosahexaenoic (4.4 ± 1.7; 4.1 ± 1.0; 3.9 ± 1.6%; p = 0.014) acids in erythrocytes increased over time after DMB intake. The standard dose of DMB increased fat-free mass vs. placebo (47.4 ± 9.3 vs. 44.1 ± 4.7 kg, p = 0.007). Importantly, habitual patients with DMB did not experience any adverse events, and metabolic parameters remained stable and within normal ranges. In conclusion, habitual consumption of a standard 150 mg dose of DMB improves electrochemical food perception, nutritional status (energy intake, fat quantity and quality, fat-free mass), and quality of life in malnourished cancer patients receiving antineoplastic treatment. Additionally, DMB consumption appears to be safe, with no changes in major biochemical parameters associated with health status. Clinical trial registered (NCT05486260).

Feasibility and acceptability of miracle fruit application prior to the consumption of sour-tasting foods as a weight-loss strategy in adults with diabetes or prediabetes: A randomized crossover trial

Miracle fruit (MF) has emerged as a promising option for healthy noncaloric sweeteners due to its sour-to-sweet taste-modifying effects and high antioxidant activity. We aimed to examine the feasibility and acceptability of using MF as a weight-loss strategy for individuals with diabetes or prediabetes. Fifty Korean-American men and women (25 participants each) aged 45-75 years with diabetes or prediabetes were recruited in this study. They participated in a randomized placebo-controlled crossover trial where they took the assigned tablet (either an MF tablet or a placebo-sugar candy) 10 min before consuming food. Using a 9-point hedonic scale, participants assessed the likings of overall, flavor, texture, and aftertaste for green apples, goat cheese, lemonade, pickles, and plain fat-free yogurt before and 10 min after taking the assigned tablet. Additionally, overall liking for meals and calorie intake were assessed during subsequent ad libitum meal sessions. An ANOVA for a crossover design, and independent and paired t-tests were used to compare the outcomes. The results revealed that all postintervention liking values for sour-tasting foods were higher than the respective preintervention liking values for both interventions. However, the MF intervention showed significantly higher pre-post differences in liking for all sour-tasting foods and the overall liking values for breakfast and dinner compared to the placebo intervention (P < 0.001). Furthermore, the MF intervention resulted in a significantly lower calorie intake for each meal than the placebo (P < 0.001). These findings suggest that MF intervention can be considered a viable weight-loss strategy for individuals with diabetes.

Individual Differences in Chemosensory Perception Amongst Cancer Patients Undergoing Chemotherapy: A Narrative Review

Chemotherapy is an aggressive form of treatment for cancer and its toxicity directly affects the eating behavior of many patients, usually by adversely affecting their sense of smell and/or taste. These sensory alterations often lead to serious nutritional deficiencies that can jeopardize the patient's recovery, and even continue to affect their lives once treatment has terminated. Importantly, however, not all patients suffer from such alterations to their chemical senses; and those who do, do not necessarily describe the side effects in quite the same way, nor suffer from them with equal intensity. The origin of these individual differences between cancer patients undergoing chemotherapy treatment has not, as yet, been studied in detail. This review is therefore designed to encourage future research that can help to address the perceptual/sensory problems (and the consequent malnutrition) identified amongst this group of patients in a more customized/personalized manner. In particular, by providing an overview of the possible causes of these large individual differences that have been reported in the literature. For this reason, in addition to the narrative bibliographic review, several possible strategies that could help to improve the chemosensory perception of food are proposed.

Safety of dried fruits of Synsepalum dulcificum as a novel food pursuant to Regulation (EU) 2015/2283

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on dried fruits of Synsepalum dulcificum as a novel food (NF) pursuant to Regulation (EU) 2015/2283. The NF is pitted and dried (by lyophilisation) fruits of S. dulcificum. The NF contains the glycoprotein miraculin (≤ 2.5%) which causes sour and acidic foods to taste sweet. The fruits have a documented history of consumption in Africa and products thereof can be found in different markets worldwide. Information on the production process and the composition of the NF is sufficient and does not raise safety concerns. The applicant proposes to use the NF as or in food supplements for the adult population, excluding pregnant and lactating women, at a maximum daily amount of 0.9 g. Taking into account these conditions of use, the Panel considers that the consumption of the NF is not nutritionally disadvantageous. The provided genotoxicity studies do not raise concerns for genotoxicity of the NF. The Panel concludes that the only dose tested in a 90-day oral toxicity study of 2,000 mg/kg body weight (bw) per day was not associated with adverse effects. By applying an uncertainty factor of 200, the Panel concludes that the NF is safe at an intake level of 10 mg/kg bw per day, corresponding to a maximum daily intake of 0.7 g of the NF for the target population, rather than 0.9 g/day as proposed by the applicant.

Miracle Berry as a Potential Supplement in the Control of Metabolic Risk Factors in Cancer

The increased incidence of chronic diseases related to altered metabolism has become a social and medical concern worldwide. Cancer is a chronic and multifactorial disease for which, together with genetic factors, environmental factors are crucial. According to the World Health Organization (WHO), up to one third of cancer-related deaths could be prevented by modifying risk factors associated with lifestyle, including diet and exercise. Obesity increases the risk of cancer due to the promotion of low-grade chronic inflammation and systemic metabolic oxidative stress. The effective control of metabolic parameters, for example, controlling glucose, lipid levels, and blood pressure, and maintaining a low grade of chronic inflammation and oxidative stress might represent a specific and mechanistic approach against cancer initiation and progression. Miracle berry (MB) (Synsepalum dulcificum) is an indigenous fruit whose small, ellipsoid, and bright red berries have been described to transform a sour taste into a sweet one. MB is rich in terpenoids, phenolic compounds, and flavonoids, which are responsible for their described antioxidant activities. Moreover, MB has been reported to ameliorate insulin resistance and inhibit cancer cell proliferation and malignant transformation in vitro. Herein, we briefly summarize the current knowledge of MB to provide a scientific basis for its potential use as a supplement in the management of chronic diseases related to altered metabolism, including obesity and insulin resistance, which are well-known risk factors in cancer. First, we introduce cancer as a metabolic disease, highlighting the impact of systemic metabolic alterations, such as obesity and insulin resistance, in cancer initiation and progression. Next, as oxidative stress is closely associated with metabolic stress, we also evaluate the effect of phytochemicals in managing oxidative stress and its relationship with cancer. Finally, we summarize the main biological activities described for MB-derived extracts with a special focus on the ability of miraculin to transform a sour taste into a sweet one through its interaction with the sweet taste receptors. The identification of sweet taste receptors at the gastrointestinal level, with effects on the secretion of enterohormones, may provide an additional tool for managing chronic diseases, including cancer.

Antihyperglycemic and hepatoprotective properties of miracle fruit (Synsepalum dulcificum) compared to aspartame in alloxan-induced diabetic mice

OBJECTIVE

This study was undertaken to investigate the antihyperglycemic potential of miracle fruit (MF) as well as its hepatic safety as compared to aspartame in alloxan-induced diabetic mice.

METHODS

MF extracts were prepared and screened for their phytochemical composition using high-performance liquid chromatography (HPLC). Total phenolic, flavonoid and tannin contents and antioxidant potential were also determined. Additionally, MF was evaluated for its sensory attributes. For in vivo work, MF ethanol extract at high (MFH: 500 mg/kg body weight [BW]) and low (MFL: 250 mg/kg BW) doses as well as aspartame were injected intraperitoneally into alloxan-induced diabetic mice. Blood glucose levels were determined following acute and subchronic treatment. At the end of the study, animals were sacrificed, serum was collected for biochemical analysis and liver tissues were obtained for histopathological examination.

RESULTS

MF ethanol extract contained more flavonoids and tannins, and had higher 1,1-diphenyl-1-picrylhydrazyl radical-scavenging activity (79.61%) compared to MF aqueous extract (P < 0.05). HPLC analysis of MF ethanol extract also revealed the presence of 10 antioxidants with quercetin comprising the major polyphenol. Additionally, sensory analysis of MF showed that its intake is effective in masking undesirable sourness. Subchronic administration of MFH proved amelioration of hyperglycemia in mice as compared to aspartame. Moreover, aspartame treatment significantly elevated (P < 0.05) the level of alanine aminotransferase and had destructive effects on the liver histopathology; however, hepatic architecture was restored by low and high doses of MF.

CONCLUSION

MF is an effective antihyperglycemic with hepatoprotective properties that can be used as a healthier alternative sweetening agent in place of aspartame for sour beverages.

Taste and smell disturbances in cancer patients: a scoping review of available treatments

PURPOSE

Taste and smell disturbances in patients affected by cancer are very common, but often under-recognized symptoms. If not addressed properly, they may impact nutritional status, food enjoyment, and quality of life. Treatment tools available for clinicians to manage chemosensory alterations are limited and are often based on personal clinical experiences. The aim of this study was to assess current oncological and palliative care literature through a scoping review, in order to identify available treatments for taste and smell alterations in cancer patients.

METHODS

Medline, Embase, CINAHL, ProQuest Dissertations and Theses, and Google Scholar were searched from inception until January 2020, with subject headings relevant to the domains of chemosensory alterations, palliative, and cancer care. A total of 10,718 English and French language publications were reviewed, yielding 43 articles on the researched topic.

RESULTS

The heterogeneity of selected articles led to difficulties in interpretation and analysis of the available evidence. Included publications differed in study design, population sample, anticancer treatments, and measures of assessment for taste and smell disturbances. A broad variety of treatment options were described including zinc and polaprezinc, radio-protectors, vitamins and supplements, anti-xerostomia agents, active swallowing exercises, nutritional interventions, delta-9-tetrahydrocannabinol, and photobiomodulation.

CONCLUSION

This scoping review identifies the current state of knowledge regarding chemosensory alterations within supportive cancer care. Despite not reaching firm conclusions, this article offers therapeutic venues to further explore in larger and more methodologically sound studies.

Effects of different miracle fruit products on the sensory characteristics of different types of sour foods by descriptive analysis

Miracle fruit's potential benefit is encouraging as a powerful antioxidant and sweetness enhancer due to its novel ability to modify sour taste to sweet. However, further studies are needed to evaluate the practicality of different miracle fruit products. Thus, this study aimed to characterize the taste modification effects of different miracle fruit products on different sour foods. For this, 10 trained subjects (80% female, 50% white, Mean ± SE = 27.3 ± 3.9 years old) performed a Quantitative Descriptive Analysis using a Latin Square design with three replications. One session was composed of pre- and posttest for miracle fruit administration. Five food samples (green apple, goat cheese, lemonade, plain fat-free yogurt, and cucumber pickle) and four miracle fruit products (three different brands of miracle fruit pill-Y, G, M and one powder product-P) were used and data were analyzed using analysis of variance and principal component analysis. The typical effects of miracle fruit, sweetness increase and sourness suppression were observed for all food samples albeit to different degrees. Y and M pills were most impactful while powder product was least, and goat cheese and yogurt had the most pronounced impact at increasing sweetness. Prior Miracle Fruit administration significantly decreased bitterness and increased creaminess in yogurt. However, it increased off-flavor in lemonade and pickle. Results suggest that miracle fruit usage for increasing sweetness is effective but the degree of taste-modifying effect differs according to the types of miracle fruit product and food samples applied. PRACTICAL APPLICATION: This research confirms miracle fruit's unique taste-modifying abilities and demonstrates a high potential as a sweetness enhancer to benefit human health. The results can be used to optimize miracle fruit's application and can be applied by food industry and health care provider to develop clinical remedies or disease prevention strategies.

Shade and nutrient-mediated phenotypic plasticity in the miracle plant Synsepalum dulcificum (Schumach. & Thonn.) Daniell

Phenotypic plasticity as a change of genotype expression in response to environmental heterogeneity varies in magnitude among crop species and can induce a shift in a plant’s phenology. In Synsepalum dulcificum, a West African orphan fruit tree, such phenological plasticity is not well understood. Here, we hypothesize that light stimulation and changes in organic nutrient availability would induce an accelerated transition in S. dulcificum from its juvenile to its reproductive phase. We grew 14-month-old seedlings of S. dulcificum under a range of nutrient regimes, both in shade and in full sunlight, and measured their survival, vegetative growth, biomass allocation, and transition to reproductive maturity. The results reveal that S. dulcificum responds favourably to both shading and nutrient application, with the shading exhibiting a stronger influence on the measured variables. The species’ morphological plasticity, particularly in terms of plant height and stem diameter, was found to exceed both its fitness and allocational plasticities. Under the conditions examined, we observed an accelerated transition to fruiting, at an age of only 24 months. The observed plasticity suggests S. dulcificum to be an intermediate shade-tolerant species. This finding expands our knowledge on the appropriate environmental conditions for the breeding and cultivation of this species.

Protein calorie malnutrition, nutritional intervention and personalized cancer care

Cancer patients often experience weight loss caused by protein calorie malnutrition (PCM) during the course of the disease or treatment. PCM is expressed as severe if the patient has two or more of the following characteristics: obvious significant muscle wasting, loss of subcutaneous fat; nutritional intake of <50% of recommended intake for 2 weeks or more; bedridden or otherwise significantly reduced functional capacity; weight loss of >2% in 1 week, 5% in 1 month, or 7.5% in 3 months. Cancer anorexia-cachexia syndrome (CACS) is a multifactorial condition of advanced PCM associated with underlying illness (in this case cancer) and is characterized by loss of muscle with or without loss of fat mass. Cachexia is defined as weight loss of more than 5% of body weight in 12 months or less in the presence of chronic disease. Hence with a chronic illness on board even a small amount of weight loss can open the door to cachexia. These nutritional challenges can lead to severe morbidity and mortality in cancer patients. In the clinic, the application of personalized medicine and the ability to withstand the toxic effects of anti-cancer therapies can be optimized when the patient is in nutritional homeostasis and is free of anorexia and cachexia. Routine assessment of nutritional status and appropriate intervention are essential components of the effort to alleviate effects of malnutrition on quality of life and survival of patients.

Miracle Fruit (Synsepalum dulcificum) Exhibits as a Novel Anti-Hyperuricaemia Agent

Miracle fruit (Synsepalum dulcificum) belongs to the Sapotaceae family. It can change flavors on taste buds, transforming acidic tastes to sweet. We evaluated various miracle fruit extracts, including water, butanol, ethyl acetate (EA), and hexane fractions, to determine its antioxidant effects. These extracts isolated from miracle fruit exerted potential for reduction of uric acid and inhibited xanthine oxidase activity in vitro and in monosodiumurate (MSU)-treated RAW264.7 macrophages. Moreover, we also found that the butanol extracts of miracle fruit attenuated oxonic acid potassium salt-induced hyperuricaemia in ICR mice by lowering serum uric acid levels and activating hepatic xanthine oxidase. These effects were equal to those of allopurinol, suggesting that the butanol extract of miracle fruit could be developed as a novel anti-hyperuricaemia agent or health food.

Metallic taste in cancer patients treated with chemotherapy

BACKGROUND

Metallic taste is a taste alteration frequently reported by cancer patients treated with chemotherapy. Attention to this side effect of chemotherapy is limited. This review addresses the definition, assessment methods, prevalence, duration, etiology, and management strategies of metallic taste in chemotherapy treated cancer patients.

METHODS

Literature search for metallic taste and chemotherapy was performed in PubMed up to September 2014, resulting in 184 articles of which 13 articles fulfilled the inclusion criteria: English publications addressing metallic taste in cancer patients treated with FDA-approved chemotherapy. An additional search in Google Scholar, in related articles of both search engines, and subsequent in the reference lists, resulted in 13 additional articles included in this review. Cancer patient forums were visited to explore management strategies.

FINDINGS

Prevalence of metallic taste ranged from 9.7% to 78% among patients with various cancers, chemotherapy treatments, and treatment phases. No studies have been performed to investigate the influence of metallic taste on dietary intake, body weight, and quality of life. Several management strategies can be recommended for cancer patients: using plastic utensils, eating cold or frozen foods, adding strong herbs, spices, sweetener or acid to foods, eating sweet and sour foods, using 'miracle fruit' supplements, and rinsing with chelating agents.

INTERPRETATION

Although metallic taste is a frequent side effect of chemotherapy and a much discussed topic on cancer patient forums, literature regarding metallic taste among chemotherapy treated cancer patients is scarce. More awareness for this side effect can improve the support for these patients.

Antioxidant-rich phytochemicals in miracle berry (Synsepalum dulcificum) and antioxidant activity of its extracts

Miracle berry is known for its unique characteristic of modifying sour flavours to sweet. Twelve phenolics were identified and quantified in the miracle berry flesh at a level from 0.3 for kaempferol to 17.8 mg/100g FW for epicatechin. Lutein and α-tocopherol were also quantified at a level of 0.4 and 5.8 mg/100g FW, respectively. The TP and TF contents were 1448.3 GA and 9.9 QR mg Equiv/100g FW for the flesh, respectively, compared with 306.7 GA and 3.8 mg QR mg Equiv/100g FW of the seeds. The free radical scavenging and reducing percentage of the flesh extract was 96.3% and 32.5% in DPPH and ABTS assays, respectively. Additionally, the flesh extract had a high FRAP of 22.9 mmol/100g. It significantly inhibited the oxidation of PUFA in fish oil as well. Thus, miracle berry could also serve as an antioxidant-rich fruit to provide health promoting function.