Cancer Decisions - Free Newsletter -May 9, 2004

HERE AT THE MOSS REPORTS

When it comes to taking care of one's health it is often assumed that if a little of something is generally found to be good for you, then more of it must be even better. Unfortunately this is a fallacy - even water can be toxic in excess quantities - but it is surprisingly widespread fallacy nonetheless, and one that has been eagerly exploited in the marketing of nutritional supplements and supposedly healthful foodstuffs.

In this week's newsletter I don my Friendly Skeptic's hat and begin a two-part series examining the wildly popular fruit drink XanGo, the latest in a long line of health food crazes. Many claims have been made for the health-giving effects of this drink. Are such claims founded on good, solid scientific evidence, or are they simply another example of marketing hype?

In thirty years of researching and writing about the treatment of cancer, I have seen many fads come and go, both in the field of conventional and alternative medicine. I have written more than two hundred different Moss Reports on specific cancer diagnoses, bringing the principles of friendly skepticism to bear on the claims made by orthodox and alternative practitioners alike. If someone you love is facing a cancer diagnosis, a Moss Report represents a thorough and impartial guide to help you through the choices ahead.

You can order a report through our website, www.cancerdecisions.com, or by calling Diane at 1-800-980-1234 (814-238-3367 if calling from outside the country).

A FRIENDLY SKEPTIC LOOKS AT MANGOSTEEN

When I wrote Cancer Therapy in the early 1990s, I had the bright idea of putting my mailing address in the book in the hope that some readers would send me information on new treatments. Little did I imagine that such communication would become a torrent of proposals. Today, hardly a day goes by without my being made aware of some new "cure." Would that a fraction of these panned out as well as proponents claimed!

One of the latest in this long line is an exotic fruit drink called mangosteen, or XanGo. Mangosteen should not be confused with mango, an entirely different plant. It is part of a group known as the Guttiferae, a family of mainly tropical trees and shrubs that secrete an acrid yellow resinous juice. Mangosteen's scientific designation is Garcinia mangostana (Campin 2004). It is reputedly named after a French explorer, Jacques Garcin (1673-1751). In Europe and North America, the most recognizable member of this family is the popular herb, St. John's wort.

No one knows exactly where and when the mangosteen was first cultivated. One botanist, Julia F. Morton, believes it originated in the Moluccas and the Sunda Islands. Yet there are also wild mangosteen trees in the forests of Malaya. Some experts say the trees were first domesticated in Thailand or Burma. But in the 19th century, botanists brought seeds to Europe and America. Valiant attempts were made to cultivate the 18-foot high trees in Africa, the Caribbean and central America. But the plant is considered "ultra-tropical" and sensitive: nursery seedlings die at 45º F. In fact, there are few if any mangosteens growing in the continental US. A lone American tree in Florida was said to have yielded a single fruit...and then died. That was the beginning and end of the American mangosteen "industry."

But attempts continued to bring mangosteen to Europe and America as a food. "Despite the oft-repeated Old World enthusiasm for this fruit," says Morton, "it is not always viewed as worth the trouble to produce. In Jamaica, it is regarded as nice but overrated; not comparable to a good field-ripe pineapple or a choice mango."

The mangosteen fruit is the size of a small apple, purple colored, with a hard rind. Inside there are typically five to seven seeds surrounded by a sweet, juicy cover (or aril). The pulp, which is said to resemble a pineapple or peach in taste, is reputed to be a very delicious food - in Asia it is sometimes called the queen of fruits in honor both of its flavor and its economic importance.

Uses in Traditional Medicine

For many years dried mangosteen fruits have been shipped from Singapore to Calcutta and then on to China for medicinal use. As to its many uses in folk medicine, here is what botanist Julia Morton has written:

"The sliced and dried rind is powdered and administered to overcome dysentery. Made into an ointment, it is applied on eczema and other skin disorders. The rind decoction is taken to relieve diarrhea and cystitis, gonorrhea and gleet [a watery discharge, ed.] and is applied externally as an astringent lotion. A portion of the rind is steeped in water overnight and the infusion given as a remedy for chronic diarrhea in adults and children. "

"Filipinos employ a decoction of the leaves and bark as a febrifuge and to treat thrush, diarrhea, dysentery and urinary disorders. In Malaya, an infusion of the leaves, combined with unripe banana and a little benzoin is applied to the wound of circumcision. A root decoction is taken to regulate menstruation. A bark extract called 'amibiasine', has been marketed for the treatment of amoebic dysentery."

Morton also writes that "[t]he rind of partially ripe fruits yields a polyhydroxy-xanthone derivative termed mangostin, also beta-mangostin. That of fully ripe fruits contains the xanthones, gartanin, 8-desoxygartanin, and normangostin. A derivative of mangostin, mangostin-e, 6-di-O-glucoside, is a central nervous system depressant and causes a rise in blood pressure." A more complete listing of constituents is given at ethnobotanist Dr. James Duke's informative and useful Phytochemical and Ethnobotanical Databases (Duke 2004).

We can conclude then that mangosteen has many uses in folk medicine, and as such, it can join a fairly long list of plants that can be considered as promising sources of new medicines.

XanGo on the Go

In this age of frenzied commercialism, entrepreneurs are always on the lookout for ways to make it big in the natural medicines market. Under such conditions, however, new medicines of botanical origin cannot be developed or tested in an orderly way.

A common feature of the way in which natural medicines such as mangosteen are promoted is the use of network marketing. This involves the retailing of products through the use of independent distributors. These distributors are then encouraged to build and manage their own sales force by recruiting, motivating, supplying, and training others to sell products. Compensation in such arrangements includes the distributor's own sales as well as a percentage of the sales of his or her entire "downline" (i.e., all those people signed up by an individual, who in turn go on to become salespeople). The term network marketing is virtually synonymous with the older but now somewhat disreputable term 'multi-level marketing' (MLM).

Network marketing turns mere consumers into determined marketers who aggressively sell their product, often to their own friends, relatives and neighbors. The more people they can recruit into the growing network the more money they themselves make. A sophisticated marketing blitz, including books and pamphlets, seemingly objective newsletters, press releases and chattering websites, inflate the importance of a product, creating a buzz that only dies away when the huge supply of potential customers and salespeople is finally exhausted. Or when, as it has on occasion, the government finally steps in. But the essential requirement for a successful MLM operation of this sort is a kernel of promising-sounding scientific evidence, coupled with a credible and compelling story, a compliant doctor willing to underwrite the concept, and finally some patients (who may themselves be distributors) willing to testify that the product led to astounding cures.

Aloe vera, colloidal minerals, gingko biloba and ginseng were all popularized in this way. But perhaps the most memorable example of a network marketing stampede is noni juice, a once totally obscure Polynesian fruit that became the basis of a huge industry. Tahitian Noni International, formerly called Morinda, last year claimed to have passed the two billion dollar sales mark! This is the sort of performance that makes get-rich-quick artists drool.

The techniques of network marketing, honed through decades of trial and error, are now being used by a Utah-based company to position mangosteen as the latest "miracle cure" craze. The price of their XanGo mangosteen juice is currently $37 per bottle (or four for $100). You have to ask yourself: who on earth would pay that much for a bottle of fruit juice, no matter how delicious it might be? The reason the marketers can succeed in selling juice at this price is obvious: when people are suffering from medical conditions for which there does not appear to be much hope, or for which the orthodox medical recommendations are too toxic or expensive, they will actively seek alternatives. And then someone, oftentimes someone they trust, such as a friend or neighbor, convinces them to give some new product a try. Products such as mangosteen exploit humanity's understandable desire to discover simple and painless solutions to intractable problems.

Now that the commercial ball is rolling an increasing number of mangosteen brands are reaching the market. But for the time being the market leader is XanGo (www.myxango.com). A visit to their website triggers an audio webcast from a very pleasant sounding young lady, who assures us that "by integrating the Internet, teamwork, and personal mentoring, MyXanGo.com provides you a vehicle to improve the areas of your life that are most important to you, and we do it for FREE."

I listened in amazement to her polished spiel and the brazen intrusiveness of this message. I was particularly amused when she said, "You should know that this message is not about selling." Right. "It's not about false claims and outlandish statements." Sure. "It's about sharing facts to help you decide if now is the right time in your life to consider XanGo." Really.

The rhetoric gets even more effusive. A March 2004 press release from one seller proclaims: "Mangosteen is now on an unstoppable march to conquer the world" (Goss 2004). Put this way it sounds rather ominous…almost like a cross between Osama bin Laden and the Attack of the Killer Tomatoes.

Xanthones

As stated, one requirement for a successful network promotion is that there be at least a kernel of scientific truth around which exaggerated claims can be assembled. As with noni juice, mangosteen is not entirely without scientific documentation. The problem, as usual, is that the claims for mangosteen are inflated till they far outpace what has been established through careful experimentation.

Some mangosteen promoters have mined James Duke's famous ethnobotanical database for confirmation of their product's value. And, indeed, Dr. Duke confirms that the plant contains several interesting components. But so do thousands of other plants in his voluminous database. For most of the chemicals contained in this fruit (such as beta-mangostin, catechins, cis-hex-3-enyl-acetate, gamma-mangostin, gartanin, garcinones) the database lists NO particular biochemical activities. Only the compound called "mangostin" seems to have some scientific backing for its antibacterial, antiseptic and fungicidal properties (Recio 1989). Yet scores of mangosteen websites now cite Duke's database as scientific justification for this product. In reality, Dr. Duke has absolutely nothing to do with any mangosteen distributor and is not particularly enthusiastic about the product.

Much is made of the xanthone connection. According to the MyXanGo.com website: "There are over 200 xanthones in nature. Each xanthone can have specific effects on the body. What's remarkable about the mangosteen is that there are over 40 xanthones identified in the pericarp, or rind, making it the single most xanthone-rich source in the world….Only six of the xanthones have been studied in depth. While we don't know fully why the mangosteen works on such a wide variety of physical conditions, we know it has to do with being the world's most potent source of xanthones. Each xanthone has its own effect, and when combined, they take on a synergistic quality that supports the health of the entire body."

But all of this is speculative. It is undoubtedly true that there are many xanthones (a kind of antioxidant) in mangosteen. In fact, according to the Merck Index (11th Ed., p. 5613) the first scientifically defined substance to be derived from mangosteen was the xanthone mangostin. This was isolated by a German scientist named Schmid in 1855. In 1979, mangostin was found to have significant anti-inflammatory and anti-ulcer effects in rats (Shankaranarayan 1979). Yet although mangosteen's xanthones have been known for almost 150 years, there are still only 19 PubMed articles on these xanthones and none of these articles concerns the use of xanthones in the actual clinical treatment of human disease. So I would say the jury is still out on their effectiveness in treating anything.

The main XanGo website also claims that the antioxidant ORAC (oxygen radical absorbance capacity) value of mangosteen is the highest of all edible plants. "It is so potent that literally I know of nothing else in the supplement market that can possibly come even close to it," says J. Frederic Templeman, MD, a Georgia family practitioner who is interviewed at the MyXanGo website. Many other XanGo-promoting websites repeat the claim that while the previous champion, prunes, have an ORAC value of 7,000 per ounce, mangosteen has an ORAC value of 17,000 to 24,000.

Yet XanGo sites claim that "a new champion" has been born in the worldwide contest for ORAC supremacy. But where in the scientific literature is the ORAC value of XanGo published? The source of these numbers is hard to track down. For instance, the Sunsweet prune website states that 100 grams (3.5 ounces) of prunes have an ORAC value of 5,770. While the ORAC values for most fruits and vegetables have been determined by standard laboratories and published in scientific journals, this is not so for mangosteen. I have not seen independent confirmation of these confidently promulgated claims. However, even if we assume for the sake of argument that the figures cited are indeed accurate, it must be pointed out that merely having an astronomically high ORAC value does not in and of itself confer any particular advantage. Not all antioxidants that are confirmed as present in the laboratory can be absorbed by human beings. And there is a limit to how much we can benefit from an increased intake of antioxidants.

According to Dr. Ronald Prior of the US Department of Agriculture Research Service at Tufts University, Boston, Massachusetts, "a significant increase in antioxidants of 15 to 20 percent is possible by increasing consumption of fruits and vegetables, particularly those high in ORAC value." However, in order to have a significant impact on plasma and tissue antioxidant capacity one can only meaningfully increase one's daily intake by 3,000 to 5,000 ORAC units. Any greater amount is probably redundant. That is because the antioxidant capacity of the blood is tightly regulated, says Dr. Prior. Thus there is an upper limit to the benefit that can be derived from antioxidants. Taking in 25,000 ORAC units at one time (as reputedly occurs with mangosteen) would be no more beneficial than taking in a fifth of that amount: the excess is simply excreted by the kidneys.

TO BE CONTINUED, WITH REFERENCES, NEXT WEEK

--Ralph W. Moss, Ph.D.

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IMPORTANT DISCLAIMER

The news and other items in this newsletter are intended for informational purposes only. Nothing in this newsletter is intended to be a substitute for professional medical advice.