Acerola
Scientific Name(s): Malpighia emarginata, Malpighia glabra L.
Common Name(s): Acerola, Antilles cherry, Barbados cherry, Cereso, Cereza, Cerisier, Puerto Rican cherry, Semeruco, West Indian cherry
Medically reviewed by Drugs.com. Last updated on Sep 21, 2023.
Clinical Overview
Use
Acerola provides natural vitamin C and other vitamins and minerals. It has been investigated, primarily in vitro and in animal studies, for potential antioxidant, antifungal/antimicrobial, hypoglycemic, hepatic, dermatologic, and CNS effects. Traditional uses include as an astringent and for treatment of diarrhea, dysentery, hepatitis, and fever. However, clinical trial data are lacking to recommend use for any indication.
Dosing
Clinical data are lacking to guide dosing of acerola.
Contraindications
Contraindications have not been identified.
Pregnancy/Lactation
Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking.
Interactions
None well documented.
Adverse Reactions
Large doses may produce GI distress. Prolonged use of large doses of ascorbic acid (a component of acerola) may predispose to the development of renal calculi.
Toxicology
No data.
Scientific Family
- Malpighiaceae (Barbados cherry)
Botany
Acerola (previously Malpighia punicifolia L.) is native to the West Indies but is also found in northern South America, Central America, Texas, and Florida. It is a small shrub or tree that grows from 5 to 15 m in height. The branches are brittle, and the leaves are glossy and dark to light green. The 5-petaled flowers range in color from pink to white. Acerola fruit is cherry-like, 3-lobed, bright red (when ripe), and 1 to 2 cm in diameter, containing several small seeds. Some of the fruits are sweet; however, most are tart and acidic. Mature fruits are soft and contain 80% juice. The fruits deteriorate rapidly once removed from the tree and are too perishable for sale at standard markets. Acerola should not be confused with the related plants Banisteriopsis caapi (known as ayahuasca) and Galphimia glauca, which belong to the Malpighiaceae family and appear to have activity on the CNS.(Delva 2013, Leung 1996, Praskash 2018, USDA 2021)
History
Traditionally, acerola fruits have been used to treat dysentery, diarrhea, and liver disorders. Both M. glabra and M. emarginata have been reported to be excellent sources of vitamin C. Acerola is used as a source of food and juice, and it is also sold as a natural health supplement because of its high vitamin C concentration. Acerola's high ascorbic acid content was first noted in 1946 by Asenjo and de Guzman of Puerto Rico.(Delva 2013, Leung 1996, Prakash 2018)
Chemistry
Acerola contains vitamin C 1% to 4.5% (1,000 to 4,500 mg per 100 g) as ascorbic and dehydroascorbic acids in the edible portion of the fruit, an amount 50 to 100 times that of ascorbic acid found in an orange or lemon. The content of vitamin C in acerola varies with ripeness (highest in green and lowest in fully ripened fruit), season, and climate, and exceeds the vitamin C content of peeled oranges (about 0.05% or 50 mg per 100 g).(Delva 2013, Leung 1996, Prakash 2018)
In an analysis of vitamin C from Barbados cherry pulp submitted to processing and different forms of storage, freezing (−18°C) the fruits preserved a greater percentage of vitamin C compared with room temperature storage or refrigeration.(Visentainer 1998)
Acerola contains vitamin A (4,300 to 12,500 units per 100 g) at about the same level as in carrots. Other constituents include thiamine; riboflavin; niacin; calcium; iron; bioflavonoids; phosphorus; malic acid; pantothenic acid; potassium; magnesium; and the sugars dextrose, fructose, and sucrose. Protein, fiber, lipids, fatty acids, zinc, and other mineral content have also been described. Due to its high ascorbic acid content, along with other phytonutrients such as phenolic acids, flavonoids, anthocyanins, and carotenoids, acerola has been called a "super fruit."(Delva 2013, Leung 1996, Prakash 2018, Visentainer 1997)
Uses and Pharmacology
Anti-allergic properties
Clinical data
Acerola, in combination with Cinnamomum zeylanicum and Bidens pilosa, was evaluated in a pilot study of patients with seasonal allergic rhinitis.(Corren 2008)
Antifatigue activity
Animal data
An animal study demonstrated antifatigue effects of acerola.(Klosterhoff 2018)
Antimicrobial effects
In vitro data
In a study that screened plants for antifungal activity, M. glabra was among the most active species exhibiting antimicrobial effects.(Caceres 1993, Delva 2013)
Antioxidant properties
In vitro data
Antioxidant properties have been described, and are related to the vitamin C, phenolic compounds, and carotenoid content of the fruit.(Delva 2013, Hwang 2001)
Chemotherapeutic properties
Animal and in vitro data
Acerola extracts have been investigated for cytotoxic effects. Some extracts showed tumor-specific cytotoxic activity against tumor cell lines such as human oral squamous cell carcinoma. In an animal experiment, acerola extract reduced the number of NNK-initiated cells at the initiation stage.(Delva 2013)
CNS effects
Animal data
A study in mice found that acerola juice was able to offset some detrimental brain effects of an obesity-associated diet, at least in part by reducing oxidative stress and reversing inhibition of energy metabolism.(Leffa 2017)
Glycemic/Lipid profile effects
Animal data
In a murine study, offspring of diabetic rats (streptozotocin induced) treated with M. emarginata juice showed reductions in glucose, cholesterol, and triglyceride levels, as well as an increase in high-density lipoprotein cholesterol levels.(Barbalho 2011)
Hepatic effects
Animal data
Animal data suggest that acerola polysaccharides may ameliorate nonalcoholic fatty liver disease by regulating lipogenesis, decreasing inflammatory responses and oxidative stress, and improving mitochondrial functioning.(Hu 2020)
Skin protective effects
Animal data
Acerola juice suppressed ultraviolet B–induced skin pigmentation in a murine model.(Sato 2017)
Vitamin supplementation
There is debate regarding differences in physiological functions of vitamin C derived from "natural" sources compared with that produced synthetically or semisynthetically (as ascorbic acid). There is no clear evidence that naturally derived vitamin C is superior in efficacy to synthetic ascorbic acid. Because vitamin C from acerola is better absorbed in humans than synthetic ascorbic acid and the fruit provides several other vitamins and minerals, supplements and concentrates from acerola present attractive alternatives for individuals with vitamin C deficiency.(Prakash 2018) However, superiority over a multivitamin preparation is unclear.
In vitro data
An in vitro study noted increased expression of sodium-dependent vitamin C transporter 1 in intestinal cells caused by other polyphenols present in acerola juice. The authors concluded that acerola may be better absorbed by humans than synthetic ascorbic acid.(Takino 2020)
Clinical data
In a bioavailability and pharmacokinetic study conducted in an undefined number of young healthy Japanese males, the net 6-hour urinary excretion of ascorbic acid was lower after ingestion of acerola juice than after ingestion of commercial ascorbic acid alone.(Uchida 2011) Other data also suggest that acerola is better absorbed by humans than synthetic ascorbic acid.(Prakash 2018)
Dosing
Clinical data are lacking to guide dosing of acerola.
Pregnancy / Lactation
Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking.
Interactions
None well documented. Absorption and excretion of ascorbic acid were favorably altered with concomitant consumption of acerola juice.(Uchida 2011)
Warfarin absorption may be reduced by acerola. This interaction is theoretical and based on an association between reduced warfarin absorption and high vitamin C content.(Nutescu 2006)
Adverse Reactions
No specific adverse effects have been associated with ingestion of acerola. However, the ingestion of large doses may induce GI side effects, including diarrhea. Prolonged use of large doses of ascorbic acid may predispose to the development of renal calculi.(Leung 1996) Intake of large amounts of acerola seeds has been associated with development of rectal bezoars.(Denadai 2013)
A study has demonstrated an increase in dentin permeability due to acerola fruit juice.(Batitucci 2012)
Toxicology
Information on whole plant extracts is limited. Because vitamin C is a water soluble compound, it is readily excreted by the body and is not typically associated with toxicity.
References
Disclaimer
This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.
This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.
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