The Pistachio Manifesto: Antioxidant, Metal Chelator, DNA Protector, Anti-Cancer Agent, Bug Killer (incl. H. Pylori & Herpes Simplex) & More. Have You Been Missing Out?

This is not exactly what I was talking about, when I said "going nuts", but in this case it would actually qualify as "going pistachios" ;-)

Walnuts, almonds and Brazil nuts, these are the stars among the hard-shelled fruits people tend to go nuts about (all puns intended ;-). Pistachios, on the other hand, get very little love. I have in fact written about their surprisingly low effective energy content and their highly bioavailable phenolic content before (learn more), but what the myriad of phenols in these small nutritional powerhouses the ancient Egyptians used as incense, preservative and breath sweetener, while their Iranian neighbors in the North East already knew about their beneficial effects on digestive, hepatic and kidney health (Avicenna. 2008) can do for our health has not been covered here at the SuppVersity.

So what is it pistachios can do for you?

With their traditional use as a remedy for digestive, liver and kidney issues, you already have an idea where this could be heading. The shelled fruits of which we know that they have been part of the human diet for at least 9,000 years and that's cultivated in the Middle East, United States and Mediterraneancan however do more for you:

• Histidine happens to be an excellent chelator and potential weight loss adjuvant, as well (learn more)

  Potent antioxidants: Different parts and constituents from P. lentiscus  have been shown in vitro radical scavenging properties They protect your LDL molecules from being oxidized and will thus have direct beneficial effects on your atherosclerosis and overall heart disease risk (Holvoet. 2004).
• Metal chelators: A 2011 study by Orhan et al reports that pistachios (P. terebinthus fruits) are potent metal chelators (on par with EDTA) and have an impressive radical scavenging activity. Interestingly engough, the Antioxidant activity of the fruits actually seems to increase, when they are roasted (Orhan. 2012).
• DNA protection: More or less a downstream effect from the high content of antioxidant compounds, specifically gallic acid, digallic acid and 1,2,3,4,6-pentagalloylglucose, and polyphenols have direct protective effects on cellular DNA and pro-carcinogenic mutations.
• Antimicrobial activity (incl. anti H. Pylori): Certainly among the most interesting effects are the anti H.Pylori effects of α- pinene, a compound from the essential oils in pastachios (speficifally P.atlantica var. kurdica). Other ingredients, like verbenone, rterpineol, and linalool showed high antibacterial activity against Escherichia coli, Staphylococcus aureus and Bacillus subtilis (Koutsoudak. 2005).
  
  

  You can battle H. pylori with probiotics, as well. If you want to learn more about this, I'd suggest you go back a couple of months and read the full story in the SuppVersity Short News from October 2012 (go for it)

  Sakami et al. report similar beneficial effects against pathologic bacteria (Porphyromonas gingivalis and Prevotella melaninogenica) antiplauqe activity on teeth by inhibiting bacterial growth in saliva (Sakagami. 2009). Özçelik et al. add noticeable anti-viral effects to the list of anti-microbial activities of pistachio species (Özçelik. 2005). The viruses tested in the study were Herpes simplex (DNA) and Parainfluenza viruses (RNA). The effects were significant for both Kernel and seed extracts.
• Anti-inflammatory activity: Extract of the resin of P. lentiscus var. Chia and its isolated phytosterol tirucallol exert direct anti-inflammatory effects on human aortic endothelial cells and inhibit the activity of adhesion molecules that express the inflammatory cytokine TNF-α (Tzakou. 2007). Tzakou et al. ascribe the effects to phytosterol that goes by the name if tirucallol - never heard of it? Me neither, but who knows on which supplement label you may find it in the future ;-)
• Digestive health: I already mentioned this in the introduction. One of the most important traditional uses of gums from Pistacio species is the management of gastrointestinal disorders; and that has been confirmed by several studies (Rahimi. 2009 & 2010; Farzaei. 2013). Resin of P. lentiscus has been shown to significantly reduced the intensity of gastric mucosal damage induced by pyloric ligation, aspirin, phenylbutazone, reserpine and restraint with cold stress  via its  antisecretory and cytoprotective activities (Al-Said. 1986)
  

  Figure 1: Improvements of acid regurgitation and heartburn in forty eight patients fulfilling Rome II criteria for functional dyspepsia were randomly assigned to receive either Pistachio var chia mastic gum 350 mg three times daily or placebo after three weeks (Dabos. 2009)

  A double- blind  placebo controlled trial, P. lentiscus gum lead to significant improvement of the symptoms of patients with functional dyspepsia  (Dabos. 2009). Extracts have been successfully tested in experimental models of acute colitis and IBS (Rahimi. 2013), and there is supporting evidence for beneficial effects of P. lentiscus var. chia resin in patients with established mild to moderate active crohn’s disease (CD) after 4 weeks of supplementation (Kaliora. 2007a,b).

• Suggested read: Supplements to Preserve and Restore Insulin Resistance (read more)

  Antidiabetic activity: This is not about the nuts, but about a leaf extract, which has demonstrated significant acute postprandial  antihyperglycemic activity comparable to metformin and glipizide in starch-fed rats, in which it also lead to significant overall improvements in glucose tolerance (Kasabri. 2011). Unfortunately, a study by Kasibri et al. does not support these results - at least not for normoglycemic and streptozocin-induced hyperglycemic rats (Kasibri. 2004) on a regular diet.
  
  This would suggest that there is a direct correlation with carbohydrate intake, and voilá a 2007 human study confirmed that the gum, not the leaf extract can effectively, lower blood serum glucose levels in men... however, there is another "on the other hand attached here": this did not work for the female study participants (Triantafyllou. 2007).

• The Protective Hull of These 61 Super Fruits Can Ward Off Cancer (more)

  Anti-cancer effects: In a relatively recent review of the literature, Giaginis & Theocharis call pistachio mastic gum a "conglomeration of effective anticancer drugs" (Giaginis. 2011) - probably not without reason, after all they cite a plethora of scientific data from peer-reviewed studies to support the anticancer activities of mastic gum and its major constituents and highlighting the various molecular mechanisms through which the triterpenoids work their anti-cancer magic.
  
  Rezaei et al., for example were able to show that the fruit extract of P. atlantica sub. kurdica exerts direct inhibitory effects on human colon carcinoma cells that was comparable to the drug Doxorubicin (Rezaei. 2012). Another example? Well what about the anti-breast cancer, anti liver-, anti cervical and anti skin-cancer effects of oleoresin (Almehdar. 2012)
• Hypolipidemic effects (=lowering high blood lipids): Extracts from P. vera  fruits have shown beneficial effects on HDL and LDL level in rabbit model of atherosclerosis, they exert positive effects on the lipid levels of patients with moderate hypercholesterolemia (Edwards. 1999). And have several animal studies to support their anti-artherogenic effects (e.g. Bakirel. 2003) 

Impressed? Well I'd hope so, after all this turned out to be more work than I initially thought, when I started to "just write a brief overview of the health effects of pistachios" ;-)

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Brazil nuts & selenium: "How much is too much?" A weighty question I addressed in a July 2013 SuppVersity article: "Brazil Nuts & Selenium: Are You Nuts If You Have More Than One Per Day?" (more)

Bottom line: Ok, I have to admit there is no scientific evidence that all the good things mentioned above are going to happen to you, if you have a handful of pistchios every other day, but you know what? It may still be a piece in the puzzle people often refer to as "healthy diet" - so if you are into nuts and can "afford" their relatively high energy content, go for it! After all, the above are only the "confirmed" effects.

Note: Actually everybody can "afford" eating nuts, it's more a question of being able to stop before the whole 500g family pack is annihilated... and trust me, if you love nuts, this can happen pretty fast, even if you have to shell them as it is the case with pistachios.  

Last but not least, in traditional Iranian medicine, certain ingredients in pistachios are known to exhibit various additional pharmacological activities incuding diuretic, lithontripic, anti-tussive, anti-rheumatic, anti-asthmatic, anti-hypertensive, and aphrodisiac effects of which Bozorgi et al. point out that the "are not [yet] supported by any current scientific documents and so, they could be considered  for investigating by researchers." (Bozorgi. 2013)

References:

• Almehdar H, Abdallah HM, Osman AM, Abdel-Sattar EA. In vitro cytotoxic screening of selected Saudi medicinal plants. J Nat Med. 2012 Apr;66(2):406-12.
• Al-Said MS, Ageel AM, Parmar NS, Tariq M. Evaluation of mastic, a crude drug obtained from Pistacia lentiscus for gastric and duodenal anti-ulcer activity. J Ethnopharmacol. 1986 Mar;15(3):271-8.
• Avicenna.The canon. Translated by: A . Shrafkandi. Soroush Press, Tehran. 2008.
• Bakirel T. The Investigation of the Effects of Pistacia terebinthus L. Upon Experimentally
  Induced Hypercholesterolemia and Atherosclerosis in Rabbits. Turk. J. Vet. Anim. Sci. 2003; 27: 1283- 1292.
• Bozorgi M, et al. Five Pistacia  species (P. vera, P. atlantica, P. terebinthus, P. khinjuk and P. Lentiscus): A review of their traditional uses, phytoche mistry and pharmacology. The Scientific World Journal. 2013.
• Dabos KJ, Sfika E, Vlatta LJ, Frantzi D, Amygdalos GI, Giannikopoulos G. Is Chios mastic gum effective in the treatment of functional dyspepsia? A prospective randomised double-blind placebo controlled trial. J Ethnopharmacol. 2010 Feb 3;127(2):205-9.
• Edwards K, Kwaw I, Matud J, Kurtz I. Effect of pistachio nuts on serum lipid levels in patients with moderate hypercholesterolemia. J Am Coll Nutr. 1999 Jun;18(3):229-32.
• Farzaei R et al. An evidence-based review on medicinal plants used for the treatment of peptic ulcer in traditional Iranian medicine, Int J Pharmacol. 2013 [ahead of print]
• Giaginis C, Theocharis S. Current evidence on the anticancer potential of Chios mastic gum. Nutr Cancer. 2011 Nov;63(8):1174-84.
• Holvoet P. Oxidized LDL and coronary heart disease. Acta Cardiol. 2004 Oct;59(5):479-84. Review.
• Orhan IE et al. Neuroprotective potential of some terebinth coffee brands and the unprocessed fruits of Pistacia terebinthus L. and their fatty and essential oil analyses. Food Chemistry. 15 February 2012; 130(4):882–888.
• Özçelik B, Aslan M, Orhan I, Karaoglu T. Antibacterial, antifungal, and antiviral activities of the lipophylic extracts of Pistacia vera. Microbiol Res. 2005;160(2):159-64. 
• Kaliora AC, Stathopoulou MG, Triantafillidis JK, Dedoussis GV, Andrikopoulos NK. Chios mastic treatment of patients with active Crohn's disease. World J Gastroenterol. 2007a Feb 7;13(5):748-53.
• Kaliora AC, Stathopoulou MG, Triantafillidis JK, Dedoussis GV, Andrikopoulos NK. Alterations in the function of circulating mononuclear cells derived from patients with Crohn's disease treated with mastic. World J Gastroenterol. 2007b Dec 7;13(45):6031-6.
• Kasabri V, Afifi FU, Hamdan I. In vitro and in vivo acute antihyperglycemic effects of five selected indigenous plants from Jordan used in traditional medicine. J Ethnopharmacol. 2011 Jan 27;133(2):888-96.
• Koutsoudaki C, Krsek M, Rodger A. Chemical composition and antibacterial activity of the essential oil and the gum of Pistacia lentiscus Var. chia. J Agric Food Chem. 2005 Oct 5;53(20):7681-5.
• Rahimi R, Mozaffari S, Abdollahi M. On the use of herbal medicines in management of inflammatory bowel diseases: a systematic review of animal and human studies. Dig Dis Sci. 2009 Mar;54(3):471-80.
• Rahimi R, Shams-Ardekani MR, Abdollahi M. A review of the efficacy of traditional Iranian medicine for inflammatory bowel disease. World J Gastroenterol. 2010 Sep 28;16(36):4504-14. Review. 
• Rahimi R, Baghaei A, Baeeri M, Amin G, Shams-Ardekani MR, Khanavi M, Abdollahi M. Promising effect of Magliasa, a traditional Iranian formula, on experimental colitis on the basis of biochemical and cellular findings. World J Gastroenterol. 2013 Mar 28;19(12):1901-11. 
• Rezaei PF, Fouladdel S, Hassani S, Yousefbeyk F, Ghaffari SM, Amin G, Azizi E. Induction of apoptosis and cell cycle arrest by pericarp polyphenol-rich extract of Baneh in human colon carcinoma HT29 cells. Food Chem Toxicol. 2012 Mar;50(3-4):1054-9.
• Sakagami H, Kishino K, Kobayashi M, Hashimoto K, Iida S, Shimetani A, Nakamura Y, Takahashi K, Ikarashi T, Fukamachi H, Satoh K, Nakashima H, Shimizu T, Takeda K, Watanabe S, Nakamura W. Selective antibacterial and apoptosis-modulating activities of mastic. In Vivo. 2009 Mar-Apr;23(2):215-23. 
• Triantafyllou A, Chaviaras N, Sergentanis TN, Protopapa E, Tsaknis J. Chios mastic gum modulates serum biochemical parameters in a human population. J Ethnopharmacol. 2007 Apr 20;111(1):43-9.
• Tzakou, O., Bazos, I. and Yannitsaros, A. (2007), Volatile metabolites of Pistacia atlantica Desf. from Greece. Flavour Fragr. J., 22: 358–362.