ARTICHOKE

BACKGROUND

Ingredient Type: Botanical, Extract

Also Known As: Cynara scolymus, Cynara cardunculus var. scolymus, Globe artichoke

Artichoke is a variety of perennial thistle plants that are found in the temperate areas of Europe, Africa, the Americas, and the Canary Islands. It is considered one of the oldest cultivated plants with medicinal uses that date back to the ancient Greek and Roman times. The early Greeks and Romans consumed what was known as the globe artichoke which described the “globe-like” cluster of edible leaves and a fleshy edible heart. Artichoke is known to contain the bioactive agents apigenin and luteolin. According to a study, the artichoke flower head is noted to have one of the highest reported capacities of antioxidants reported for vegetables (1). Artichoke is full of natural antioxidants along with its natural lipid-lowering effect (9).

TRADITIONAL USES

Since ancient times, artichoke has been utilized as a biliary stimulant meant to enhance liver function and digestion. Ancient traditional healers were touted to use the plant to treat conditions such as chronic liver and gallbladder disease, hepatitis and arteriosclerosis (2). In ancient Rome and Greece, artichoke was utilized as a diuretic and choleretic (3).  French and Italian scientists further investigated the medicinal use of artichoke and identified and isolated the compound, cynarin, from the plant’s leaf. From the 1950s to the 1980s cynarin was used to stimulate the liver and gallbladder for associated ailments such as elevated cholesterol (4).

WHAT DOES SCIENCE TELL US?

Artichoke Possibly Supports Liver and Gallbladder Function:

Obesity amongst other metabolic diseases is associated with poor liver and gallbladder function. Digestion is hindered when appropriate levels of bile are not produced or released, often resulting in improper lipid metabolism, digestive issues as well as imbalances of the intestinal microbiota. In one study, the choleretic action of artichoke extract was investigated in a randomized placebo-controlled, double-blind cross-over study. The artichoke extract, Hepar SL forte was studied by measuring intra-duodenal bile secretion in 20 test subjects. The following results were noted, 127.3% increase following 30 minutes after test-substance administration, a 151.5% increase following 60 minutes post-administration. According to the results, in the placebo group, bile secretion fell below the initial levels after 3 hours. The most effective period fell between 120-150 minutes post-administration of the test-substance; resulting in influenced enzymatic digestion and motor function of the intestine. From these results, researchers gathered artichoke extract to be a potential treatment for dyspepsia (7).

Traditionally artichoke leaf extract (ALE) has been utilized due to its strong antidyspeptic actions which are mediated by its choleretic activity. One study was conducted to investigate the effects of artichoke leaf extract on bile flow and the formation of various bile compounds in anesthetized Wistar rats. Administration of ALE occurred twice daily for 7 consecutive days. Measurements of total bile acids, cholesterol and phospholipids were conducted to determine the effectiveness of ALE vs. the reference compound, dehydrocholic acid. Results indicated that the choleretic effects of ALE were similar to that of the reference compound. According to researchers, there was an elevated, total increase of total bile acid concentration over the span of the experiment. “The bile acids-increased effects of ALE were much more pronounced than those of the reference compound” (8).

In another study, the aim was to assess the therapeutic effects of ALE on biochemical and hepatic biomarkers in patients with nonalcoholic steatohepatitis (NASH). This randomized, double-blind trial consisted of 60 patients suffering from NASH. The test group received 6 tablets per day consisting of 2700mg of ALE while the control group received a placebo. In comparison between the test and placebo group, there was a noted improvement in liver enzymes in the test group along with a significant reduction in the levels of triglycerides and cholesterol. From the results of this study, it was recognized how much potential the Cynara scolymus (Artichoke) extract has given its hepatoprotective activity and hypolipidemic effects (11).

Artichoke Possibly Supports Healthy Cholesterol Levels:

With artichoke being known since nearly antiquity to aid in the support of hepatobiliary function, much has been researched on how the plant can support healthier cholesterol levels. One meta-analysis reported a modest reduction on cholesterol levels but needed further investigation to support artichoke’s effectiveness against hypercholesterolemia (5).

A study was recently conducted investigating the effects of artichoke on liver function through the measurement of specific liver markers: phosphatidate phosphohydrolase (PAP), plasma lipid levels, plasma malondialdehyde (MDA) and plasma antioxidant in hyperlipidemic rats. In this study, there were 4 groups of rats fed varying diets from a pellet diet, lipogenic or standard diet plus 10% artichoke to solely a lipogenic diet for comparison. Following the 60-day duration of the study, liver markers were assessed. Liver PAP activity, liver triglycerides, plasma lipids, plasma MDA, and plasma antioxidant levels were measured. The results indicated that diets supplemented with artichoke resulted in significant decreases in all the hepatic biomarkers coupled with a significant elevation in plasma antioxidant power. The results clearly indicated to the team that artichoke does indeed carry beneficial, hepatic effects such as supporting control of hyperlipidemia, balancing abnormal lipid profiles along with the reduction of oxidative stress in hyperlipidemic environments (9).

Hypercholesterolaemia is prevalent in both obese and healthy populations alike. It is directly associated with increased risk for major cardiac disease. Artichoke leaf extract (ALE) is known for its ability to lower cholesterol levels. Another recent study aimed to assess the evidence of ALE vs a placebo or reference medication for treating hypercholesterolemia. Two randomized trials with 167 participants were assessed. The resulting data does convey significance in blood cholesterol compared to the placebo although more studies need to be conducted over a longer period of time and with a larger sample population to assess more consistent, less transient results (10).

Artichoke Possibly Supports a Healthy Weight:

Obesity is one of the main metabolic disorders that result in an increased fat mass. With artichokes hepatoprotective properties, it is used to help support healthy digestion. According to various, compiled studies, the mechanism to which Cynara scolymus (Artichoke) supports appropriate biological weight by inhibiting digestive enzymes, increasing bile secretion while also inhibiting inflammation and ROS, thus improving liver function, gut microbiota, enhancing lipolysis, lipid metabolism and blood glucose regulation (6).

A study in Mexico was conducted recently to assess the potential effects of several plants on weight reduction, which is significant for Mexico because of the growing obese population. The aim of this particular study was to evaluate the effects of artichoke (Cynarascolymus) in homeopathic doses on the body-mass index on the obese and overweight population in Guadalajara Jalisco. 34 adults aged 20-52 with a BMI of > 27kg/m2 were randomly selected. The following biomarkers were assessed and compared prior to and following the Cynarascolymus administration (blood): cholesterol, triglycerides, and glucose. The researchers concluded to assess the weight change, not the BMI to aid in determining the effectiveness of the Cynarascolymus trial treatment. In conclusion, it was found that the Cynarascolymus did have a significant improvement on weight change in the test population (12).

SAFETY

There are currently no known harmful drug interactions that interact with artichoke. With this being said, since there is not enough reliable information about the safety of consuming any form of artichoke, it is also advised to seek your healthcare provider if you are currently with any concern or conditions that may require a professional to follow your care.

Side-Effects:

Currently, there are no known, significant side-effects with the consumption of artichoke aside from allergic reactions for those allergic to artichoke or similar plants such as ragweed, chrysanthemums, marigolds, and daises, etc.

It is however recommended that if you are currently with or suspect to have any biliary obstructions and/or gallstones, it is advised to avoid artichoke until further consultation is had with your healthcare provider.

REFERENCES

1. Ceccarelli, N; Curadi, M; Picciarelli, P; Martelloni, L; Sbrana, C; Giovannetti, M. Globe Artichoke as a Functional Food. Mediterranean Journal of Nutrition and Metabolism. 2010;3(3):197-201.
2. Brown, D. The Herb Society of America Encyclopedia of Herbs & Their Uses. 1st ed., 1995, 270-270
3. Lattanzio, V & K; et al. Globe Artichoke: A Functional Food and Source of Nutraceutical Ingredients. Journal of Functional Foods. 2009. 1(2). https://doi.org/10.1016/j.jff.2009.01.002
4. Behara, YR. Pharmacological Studies on Artichoke Leaf Extract – An Edible Herb of Mediterranean Origin. Journal of Pharmaceutical and Biomedical Sciences. 2011;11(11):1-6.
5. Wider, B; Pittler, MH; Thompson-Coon, J; Ernst, E. Artichoke Leaf Extract for Treating Hypercholesterolemia. Cochrane Database (Systematic Review). 2013;3(3):CD003335
6. Mahboubi, M. Cynara scolymus (artichoke) and its Efficacy in Management of Obesity. Bulletin of Faculty of Pharmacy, Cairo University. 2018;56(2): 115-120.
7. Kirchhoff, R; Beckers, CH; Kirchhoff, GM; et al. Increase in Choleresis by Means of Artichoke Extract. Phytomedicine. 1994;1(2): 107-115.
8. Rodriguez, TS; Gimenez, DG; Vazquez, R de la P. Choleretic Activity and Biliary Elimination of Lipids and Bile Acids Induced by Artichoke Leaf Extracts in Rats. Phytomedicine. 2002;9(8): 687-693.
9. Heidarian, E; Jafari-Dehkordi, E; Seidkhani-Nahal, A. Lipid-Lowering Effect of Artichoke on Liver Phosphatidate Phosphohydrolase and Plasma Lipids in Hyperlipidemic Rats. Journal of Medicinal Plants Research. 2011;5(19):4918-4924.
10. Pittler, MH; Thompson, CJ; Ernst, E. Artichoke Leaf Extract for Treating Hypercholesterolemia. The Cochrane Database System Rev. 2009;7(4).
11. Rangboo, V; Noroozi, M; Mohammadpoorasl, A. The Effect of Artichoke Leaf Extract on Alanine Aminotransferase and Aspartate Aminotransferase in the Patients with Nonalcoholic Steatohepatitis. International Journal of Hepatology. 2016;2016:4030476.
12. Misael, PCE; Torres-Mendoza, BM; Paola, DCSGM; Ledezma, JCR. Effect of Cynara Scolymus (Artichoke) in Homeopathic Doses on Body Mass Index in Obese and Overweight Patients. Biomedical and Pharmacology Journal. 2014;7(2):525-533.