Health Care Professional Information

Common Name

Modified Citrus Pectin, Pectinic acid

Brand Name

Modified Citrus Pectin Power

Clinical Summary

Pectin is a soluble fiber rich in galactoside residues. It is present in most plants but is concentrated in the peel and pulp of citrus fruits, and in apples. Pectin is used as a gelling agent in food. It is also used as a remedy for diarrhea and for lowering cholesterol. Modified Citrus Pectin (MCP) is an altered form of pectin that has shorter carbohydrate chains and is claimed to be better absorbed by the body. In vitro and animal studies show that pectin induces apoptosis in colonic adenocarcinoma cells (1) and has antiproliferative (2), anticancer (3) and antimetastatic effects (13).

Preliminary clinical data suggest that pectin is beneficial in treating diarrhea (4) and in reducing the level of toxic heavy metals (14).
Pectin is also effective against hypercholesterolemia (5), but a recent study showed that the source and type of pectin influence its activity (15).
It has been promoted for reducing the risk of colon cancer and for reducing damage from radiation therapy but there is insufficient scientific evidence to support these uses. In a small non-randomized study, MCP was shown to increase the doubling time of prostate-specific antigen in patients with prostate cancer (6).
Gastrointestinal side effects such as abdominal cramps and diarrhea have been reported with use of pectin (5) (6).

Food Sources

Citrus fruits (lemons, oranges, and grapefruits) and apples.

Purported Uses
  • Cancer prevention
  • Cancer treatment
  • Diarrhea
  • High Cholesterol
Mechanism of Action

Modified Citrus Pectin (MCP) acts as a ligand for galectin-3, which plays a major role in tumor formation and progression (7) (8). Binding of MCP to galectin-3 was shown to inhibit tumor growth, angiogenesis, and metastasis in vivo. MCP is thought to render galectin-3 incapable of binding its receptors that would result in angiogenesis (9). Galectin-3 is also found on prostate cancer cells and in prostate tissue. In another study, MCP was shown to increase the doubling time of prostate-specific antigen (PSA) presumably by binding galectin-3 (6). Pectin was also shown to induce apoptosis in adenocarcinoma cells in vitro via caspase-3 activity resulting in DNA degradation (1). Pectin-supplemented diet was shown to exert antiproliferative effects in mouse distal colon during colonic hyperplasia (2). It also lowered cholesterol in patients with hypercholesterolemia.

Adverse Reactions

Reported (Oral):
MCP caused mild abdominal cramps and diarrhea, which resolved after stopping the MCP.
(6)

Herb-Drug Interactions
  • When taken with lovastatin, pectin caused an increase in low-density lipoprotein in patients with hypercholesterolemia (10).
  • Absorption of supplements consisting of carotenoids and alpha-tocopherol is affected by pectin (12).
Literature Summary and Critique

Guess BW, et al. Modified citrus pectin (MCP) increases the prostate-specific antigen doubling time in men with prostate cancer: a phase II pilot study. Prostate Cancer and Prostatic Diseases 2003; 6: 301-304.
Ten patients with prostate cancer received 18 capsules (14.4g) of Pecta-Sol (Modified citrus pectin) in three doses per day for 12 months. The rate of change in PSA (prostate-specific antigen) levels was used as the primary end point of this study. Researchers found that there was a statistically significant increase in the doubling time of PSA (PSADT). Although there were no serious side effects from Pecta-Sol, mild abdominal cramps and diarrhea were experienced by three patients who withdrew from the study. These effects resolved following discontinuation of Pecta-Sol. Randomized controlled trials with larger sample size are warranted to study the effects of MCP in prostate cancer patients.
 

Dosage (Inside MSKCC Only)
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References
  1. Olano-Martin E, Rimbach GH, Gibson GR, Rastall RA. Pectin and pectic-oligosaccharides induce apoptosis in in vitro human colonic adenocarcinoma cells. Anticancer Res 2003; 23(1A):341-346.
  2. Umar S, Morris AP, Kourouma F, Sellin JH. Dietary pectin and calcium inhibit colonic proliferation in vivo by differing mechanisms. Cell Prolif 2003; 36(6):361-375.
  3. Taper HS, Roberfroid M. Influence of inulin and oligofructose on breast cancer and tumor growth. J Nutr 1999; 129(7 Suppl):1488S-1491S.
  4. Rabbani GH, Teka T, Zaman B, Majid N, Khatun M, Fuchs GJ. Clinical studies in persistent diarrhea: dietary management with green banana or pectin in Bangladeshi children. Gastroenterology 2001; 121(3):554-560.
  5. Knopp RH, Superko HR, Davidson M et al. Long-term blood cholesterol-lowering effects of a dietary fiber supplement. Am J Prev Med 1999; 17(1):18-23.
  6. Guess BW, Scholz MC, Strum SB, Lam RY, Johnson HJ, Jennrich RI. Modified citrus pectin (MCP) increases the prostate-specific antigen doubling time in men with prostate cancer: a phase II pilot study. Prostate Cancer Prostatic Dis 2003; 6(4):301-304.
  7. Inufusa H, Nakamura M, Adachi T et al. Role of galectin-3 in adenocarcinoma liver metastasis. Int J Oncol 2001; 19(5):913-919.
  8. Nakamura M, Inufusa H, Adachi T et al. Involvement of galectin-3 expression in colorectal cancer progression and metastasis. Int J Oncol 1999; 15(1):143-148.
  9. Nangia-Makker P, Hogan V, Honjo Y et al. Inhibition of human cancer cell growth and metastasis in nude mice by oral intake of modified citrus pectin. J Natl Cancer Inst 2002; 94(24):1854-1862.
  10. Richter WO, Jacob BG, Schwandt P. Interaction between fibre and lovastatin. Lancet 1991; 338(8768):706.
  11. MICROMEDEX(R) Healthcare Series. 120. 2004. Thomson MICROMEDEX.
  12. Hoffmann J, Linseisen J, Riedl J, Wolfram G. Dietary fiber reduces the antioxidative effect of a carotenoid and alpha-tocopherol mixture on LDL oxidation ex vivo in humans. Eur J Nutr 1999; 38(6):278-285.
  13. Liu HY, Huang ZL, Yang GH, Lu WQ, Yu NR. Inhibitory effect of modified citrus pectin on liver metastases in a mouse colon cancer model. World J Gastroenterol. 2008 Dec 28;14(48):7386-91.
  14. Eliaz I, Weil E, Wilk B. Integrative medicine and the role of modified citrus pectin/alginates in heavy metal chelation and detoxification—five case reports. Forsch Komplementmed. 2007 Dec;14(6):358-64.
  15. Brouns F, Theuwissen E, Adam A, et al. Cholesterol-lowering properties of different pectin types in mildly hyper-cholesterolemic men and women. Eur J Clin Nutr. 2012 May;66(5):591-9.
     

Consumer Information

How It Works

Bottom Line: There is some evidence to support use of pectin for diarrhea and for lowering cholesterol. More studies are needed to determine pectin's benefits for cancer.

Pectin is a soluble fiber present in most plants but is concentrated in the peel and pulp of citrus fruits (lemons, oranges, grapefruits) and apples. Modified Citrus Pectin (MCP) is obtained by changing pectin so it is better absorbed by the body. Data from studies in cells and mice showed that pectin and MCP have anticancer properties. There is also some evidence from human studies that pectin and MCP are effective in treating diarrhea and in lowering cholesterol. Pectin causes side effects such as abdominal cramps and diarrhea.

Purported Uses
  • Diarrhea
    Pectin has been shown to be effective in treating diarrhea in children with persistent diarrhea.
  • Hypercholesterolemia
    Diet supplemented with fiber was shown to benefit patients with high cholesterol in the blood.
  • Cancer prevention and treatment
    Laboratory and animal studies have shown that pectin has anticancer properties. Human studies are needed to verify these results.
Research Evidence

Cancer Treatment
Ten patients with prostate cancer received 18 capsules (14.4g) of Pecta-Sol (Modified citrus pectin) in three doses per day for 12 months. Researchers measured the levels of prostate-specific antigen (PSA) before and after treatment. PSA is a protein found in the prostate tissue of patients with prostate cancer and other prostate-related diseases. Results from the study showed a significant increase in the time it takes for the PSA to double in quantity. However, since this study involved only ten patients, the results cannot be generalized. More studies are needed to verify such effects.
 

Do Not Take If
  • You are taking lovastatin for high cholesterol because pectin may inhibit the action of lovastatin and may increase LDL cholesterol.
  • You are taking carotenoid and alpha-tocopherol supplements because pectin interferes with their absorption.
Side Effects
  • Abdominal cramps
  • Diarrhea
E-mail your questions and comments to aboutherbs@mskcc.org.