Polyphenol-Rich Ginger (Zingiber officinale) for Iron Deficiency Anaemia and Other Clinical Entities Associated with Altered Iron Metabolism
Abstract
:1. Introduction
2. Ginger as a Functional Food
2.1. Nutritional Composition and Traditional Use
2.2. Phytochemistry and Health Benefits
2.3. The Growing Popularity of Ginger
2.4. Safety
2.5. Adverse Events
2.6. Drug Interactions
3. Pathophysiology of IDA and Its Treatment
3.1. Iron Homeostasis
3.2. IDA and Its Aetiology
3.3. Treatment of IDA
3.4. Adverse Effects of Oral Iron Therapy
4. Ginger and IDA
4.1. Iron Absorption Enhancement
4.2. Antioxidant Activity
4.3. Anti-Inflammatory Action
4.4. Gut Microbiota Modulation
4.5. Erythropoiesis Stimulation
4.6. Iron Overload Prevention
4.7. Ginger-Synthesised Iron Nanoparticles
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
AI | Anaemia of inflammation |
CAT | Catalase |
CI | Confidence interval |
CRP | C-reactive protein |
DcytB | Duodenal cytochrome B |
DMT-1 | Divalent metal transporter 1 |
FeNP | Iron nanoparticle |
FPN | Ferroportin |
Gata1 | GATA-binding factor 1 |
GR | Glutathione reductase |
GST | Glutathione-S-transferase |
HAMP | Hepcidin antimicrobial peptide |
Hb | Haemoglobin |
HSPC | Haematopoietic stem/progenitor cells |
IDA | Iron deficiency anaemia |
MDA | Malondialdehyde |
NF | Nuclear factor kappa B |
NO | Nitric oxide |
NOAEL | No observed adverse effect level |
RBC | Red blood cell |
RCT | Randomised controlled trial |
SF | Serum ferritin |
siRNA | Short interference RNA |
SOD | Superoxide dismutase |
TNF | Tumour necrotic factor |
WHO | World Health Organization |
Appendix A. International Patents
Publication No | Date | Classification Code | Title | Country |
---|---|---|---|---|
101243891 | 20 August 2008 | A23L 1/337 | Sea tangle vegetarian stuffing boiled dumplings and its processing method | China |
103947928 | 11 March 2014 | A23L 1/10 | Fleece-flower root nutrition eight-treasure porridge and its preparation method | China |
104026495 | 10 September 2014 | A23L 1/212 | Haw flake containing pig blood and coarse cereals, and preparation method thereof | China |
105495158 | 25 September 2014 | A23L 1/315 | Black-bone chicken sausage and preparation method thereof | China |
104095016 | 15 October 2014 | A61K 36/9068 | Infantile iron-deficiency anemia treating cookie and preparing method thereof | China |
104323303 | 4 November 2015 | A23L 1/314 | Method for making tomato beef stewed product | China |
104643216 | 27 May 2015 | A23L 2/02 | Blood-replenishing and beautifying calcium blended lotus root juice and preparation method thereof | China |
105664116 | 15 June 2016 | A61K 36/9068 | Traditional Chinese medicine for treating infant iron deficiency anemia as well as preparation method and application thereof | China |
106362108 | 1 February 2017 | A61K 36/9068 | Traditional Chinese medicinal pill used for hematogenesis | China |
106616937 | 10 May 2017 | A23L 31/00 | Stropharia rugosoannulata and black chicken can and preparation method thereof | China |
106889422 | 27 June 2017 | A61K 36/9068 | Edible flour for tonifying blood and warming the uterus and production method thereof | China |
107772293 | 9 March 2018 | A23L 13/50 | Body-nourishing black bone chicken | China |
107772373 | 9 March 2018 | A61K 36/9068 | Decoction preventing and curing osteoporosis | China |
108887607 | 27 November 2018 | A23L 13/70 | Spicy shredded pork with garlic sauce and making method thereof | China |
108433084 | 24 August 2018 | A23L 27/50 | Soy sauce | China |
113278488 | 20 August 2021 | A61K 36/9068 | Spartina alterniflora spleen-tonifying stomach-nourishing pericarpium citri reticulatae wine decocting pot and preparation process thereof | China |
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Nutrient | Amount | Unit |
---|---|---|
Carbohydrate | 39.70–58.21 | % |
Protein | 11.65–12.05 | % |
Crude fibre | 8.30–21.90 | % |
Fat | 9.89–17.11 | % |
Moisture | 3.95–4.63 | % |
Ash | 4.95–7.45 | % |
-carotene | 0.68–0.81 | mg/100 g |
Ascorbic acid | 2.2–3.8 | mg/100 g |
Polyphenols | 11.8–12.5 | mg/100 g |
Calcium | 64.4–69.2 | mg/100 g |
Iron | 1.5–1.8 | mg/100 g |
Copper | 0.46–0.75 | mg/100 g |
Beneficial Property | Study Type | Research Findings | Reference |
---|---|---|---|
Iron absorption enhancement | Ex vivo | Ginger was the most potent spice for enhancing iron absorption by increasing uptake by 28.5 ± 2.09% in the jejunum of rats compared to control. | [137] |
In vitro | Adding ginger to food enhanced the bioaccessibility of dietary iron by 2- to 3-fold depending on the formulations. | [138] | |
Human study | Ginger plus oral iron therapy improved haematological and iron parameters of anaemic patients better than oral iron therapy alone. | [139,140] | |
Antioxidant activity | In vivo | Adding ginger to the diet significantly increased the activities of antioxidant enzymes () at the intestinal and gastric mucosa of rats, demonstrating enhanced protective effects against oxidative stress. | [141] |
In vitro | The polyphenols and diarylheptanoid derivatives of ginger contributed to both radical scavenging and inhibitory effects of autoxidation. | [142] | |
In vitro | Both red and white ginger variants possessed antioxidant capacities against free iron radicals in rat brains, but red ginger was superior at inhibiting Fe2-induced lipid peroxidation and chelating Fe2. | [143] | |
In vitro | Water-based extract of ginger showed relatively low antioxidant activities compared to other spices due to reduced phenolic contents produced from hydro-distillation extraction. | [144] | |
Anti-inflammatory action | Review | The bioactive compounds in ginger possessed broad anti-inflammatory properties that can block the activation of NF- by suppressing pro-inflammatory cytokines of IL-1, TNF- and IL-6, thus preventing hepcidin production. | [145] |
Human study | Ginger plus oral iron therapy significantly reduced the inflammatory marker TNF- () in anaemic patients better than oral iron therapy alone. | [139,140] | |
Gut microbiota modulation | In vitro | Undigested ginger polyphenols significantly increased the abundances of Bifidobacterium () and Enterococcus () after faecal inoculated fermentation, accompanied by elevated levels of SCFA and decreased pH value. | [146] |
In vivo | Ginger supplementation could mitigate the detrimental impact of a high-fat diet in mice by promoting the abundance of Bifidobacterium genus and SCFA-producing bacteria (Alloprevotella and Allobaculum). | [147] | |
In vivo | Ginger treatment significantly reduced antibiotic-associated diarrhoea symptoms () in rats with an associated increase in microbiota diversity and improved intestinal barrier integrity. | [148] | |
Human study | Ginger juice consumption in healthy adults decreased the Prevotella-to-Bacteroides ratio and pro-inflammatory Ruminococcus_1 and Ruminococcus_2 genus while increasing the Firmicutes-to-Bacteroidetes ratio, Proteobacteria and anti-inflammatory Faecalibacterium. | [149] | |
Erythropoiesis stimulation | In vivo | Ginger, with its bioactive compounds of 8-gingerol, 10-gingerol, 8-shogaol, and 10-shogaol, promoted the expression of Gata1 in erythroid cells of zebrafish embryos through the Bmp signalling pathway. | [150] |
In vivo | Ginger induced scl/runx1 expression through Bmp and Notch signalling pathways which up-regulated nitric oxide production for regeneration of haematopoietic stem/progenitor cells. | [151] | |
Iron overload prevention | In vivo | The bioactive lipids in ginger repressed some iron-related parameters, including reductions in 20% of 59Fe absorption, 65% of pancreatic non-haem iron, and 40% to 50% of serum ferritin levels, compared to controls. | [152] |
In vivo | Ginger extract demonstrated strong protective effects against iron toxicity through its free radical scavenging activities in iron-overloaded rats. | [153] | |
Case series | Ginger extract rich in 6-shogaol prevented iron overload in three patients with myelodysplastic syndrome. These patients had elevated serum ferritin (>300 g/L) at baseline but achieved >40% reductions after three months through upregulation of hepcidin. | [154] | |
Ginger-synthesised iron nanoparticles | In vitro | Ginger was used to bio-reduce the metallic ions to nanoparticles (Fe3+ ions to FeNPs). Transmission electron microscopy showed that the FeNPs in ginger were in the range of 14.08–21.57 nm with almost spherical forms and demonstrated considerable radical scavenging properties and antimicrobial activities against Gram-positive and Gram-negative bacteria and fungi. | [155] |
In vitro | Ginger can be a suitable green material for synthesising iron nanoparticles with high antioxidant and antibacterial properties. | [156,157] |
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Ooi, S.L.; Pak, S.C.; Campbell, R.; Manoharan, A. Polyphenol-Rich Ginger (Zingiber officinale) for Iron Deficiency Anaemia and Other Clinical Entities Associated with Altered Iron Metabolism. Molecules 2022, 27, 6417. https://doi.org/10.3390/molecules27196417
Ooi SL, Pak SC, Campbell R, Manoharan A. Polyphenol-Rich Ginger (Zingiber officinale) for Iron Deficiency Anaemia and Other Clinical Entities Associated with Altered Iron Metabolism. Molecules. 2022; 27(19):6417. https://doi.org/10.3390/molecules27196417
Chicago/Turabian StyleOoi, Soo Liang, Sok Cheon Pak, Ron Campbell, and Arumugam Manoharan. 2022. "Polyphenol-Rich Ginger (Zingiber officinale) for Iron Deficiency Anaemia and Other Clinical Entities Associated with Altered Iron Metabolism" Molecules 27, no. 19: 6417. https://doi.org/10.3390/molecules27196417