1.

0 INTRODUCTION

1.1 Citrus Food

The term “functional food,” although arbitrary, is nonetheless useful to convey to

consumers the unique characteristics of the food and its associated health benefits. The

Expert Report defines functional foods as foods and food components that provide a

health benefit beyond basic nutrition (for the intended population). Examples may

include conventional foods; fortified, enriched, or enhanced foods; and dietary

supplements. Functional foods provide essential nutrients beyond quantities necessary for

normal maintenance, growth, and development, and/or provide other biologically active

components that impart health benefits or desirable physiological effects (Whitney and

Rolfes, 1999).

When defining functional foods, a word about dietary supplements is necessary.

Some current legal standards classify dietary supplements separately from whole foods

and apply different requirements for benefit claims and supporting scientific

documentation. The panel considered this legal distinction and decided that, from a

scientific perspective, dietary supplements should be included in the definition of

functional foods. Supplements merely constitute a different delivery vehicle for a

bioactive component, and therefore the scientific demonstration of efficacy and safety

remains the same (Hasler et al., 2004).

1.2. Citrus Fruits

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 Epidemiological data support the association between a high intake of vegetables and

fruits and a low risk of chronic disease (Radhika et al., 2008). A wide range of bioactive

substances for which potential health effects have been postulated have already been

identified in foods and it is likely that many more exist. These include vitamins, trace

minerals, dietary fiber, and a range of phytochemicals. One class of fruits that have

recently received increasing attention in relation to health outcome is the citrus fruits.

Recent studies have documented a number of health benefits associated with their

consumption. In some cases, the data suggest that the incidence, severity and mortality

from several diseases, such as cardiovascular diseases, certain types of cancer, and

obesity, might be ameliorated by the consumption of additional citrus fruit and/or juices.

Overall, the literature indicates that citrus fruits provide a protective effect and play a

specific role in counteracting some of these conditions; the nutritional benefits of citrus

are related, in part, to their anti-oxidative capacity, as well as their nutrient content of

vitamin C, folate and potassium and fiber content. More recently, the role of non-nutrient

components, such as phytochemicals, has emerged (Hasler et al., 2004).

Citrus fruits are one of the largest fruit crops in the world. About 30% of citrus fruits

is processed to obtain various products, mainly juice. Similarly, the citrus industry is also

the second largest fruit-processing industry, surpassed again by the grape industry, which

mainly produces wine. Neither orange juice nor wine can be considered essential foods

but they do have an important role in our lives (Guimarães et al., 2010).

Although citrus fruits have been consumed since ancient times, citrus processing, as

it is known today, was not possible until thermal treatment (to inactivate enzymes and

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microorganisms) and concentration processes were commercially available. Since then,

the citrus industry has developed rapidly, becoming prominent among food industries.

Although consumption of fresh citrus fruits is popular in all producing countries,

processed products must still be considered almost as luxury products. Breakfast with

orange juice is only common in developed countries. Thus, citrus industries process

value-added products whose quality, nutritional characteristics, and purity are

appreciated. Since these three aspects are closely related to composition, the analysis of

citrus constituents is a frequent subject of research work, supported by governments and

industries.

Citrus fruits have long been considered a valuable part of a healthy, tasty, and

nutritious diet and are the main fruits grown and consumed in the world, in part because

their flavors are among the most preferred. Citrus fruits constitute several species of the

genus Citrus of the subfamily Aurantiodeae of the plant family Rutaceae. The

Aurantiodeae has a total of thirty-three mostly subtropical and tropical genera, a few of

which have economic importance. Most genera originated in Southeast Asia, including

the Malaysian and Indonesian Archipelagos, the Indochinese Peninsula, India, and China.

A few genera originated in Australia and in Africa. The genus Citrus is divided into two

subgenera, Citrus and Papeda. The former contains “edible” citrus fruits (including some

less than palatable varieties).

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2.0 Nutrient Components of Citrus Fruit.

Citrus fruits have long been valued as part of a nutritious and tasty diet. The

flavours provided by citrus are among the most preferred in the world, and it is

increasingly evident that citrus not only tastes good, but is also good for people. It is well

established that citrus and citrus products are a rich source of vitamins, minerals and

dietary fibre (non-starch polysaccharides) that are essential for normal growth and

development and overall nutritional well-being. However, it is now beginning to be

appreciated that these and other biologically active, non-nutrient compounds found in

citrus and other plants (phytochemicals) can also help to reduce the risk of many chronic

diseases. Where appropriate, dietary guidelines and recommendations that encourage the

consumption of citrus fruit and their products can lead to widespread nutritional benefits

across the population (Guimarães et al., 2010).

The calorie values of 100 g of oranges, mandarins, grapefruit and lemons are 35, 34,

22, and 15 Kcal, respectively. Protein content ranges from 0.69 (grapefruit) to 0.94

(mandarin) gram per 100 g of fruit. Citrus fruits also contain other nitrogen compounds

such as amines, the more important being synephrine, found mainly in sour oranges and

grapefruits, and lemons contain octapamin and tiramin. Citrus fruits are very low in fat,

ranging from 0.1 to 0.31 per 100 g, which is located in the seeds and flavedo. The

carbohydrate content (including sugars) ranges from 8.4 to 10.5 g per 100 g of the edible

portion. The total sugars range from 3.2 to 8.5 g per 100 g. Grapefruits have relatively

less total carbohydrates and sugars than oranges, mandarins or lemons. The

carbohydrates in citrus are such that these foods have a low glycemic index. Dietary fiber

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ranges from 2.5 to 0.6 g per 100 g of the edible portion from lemon to grapefruit (Block

et al., 2002).

2.1 Functional Components of Citrus Fruits.

The membranous segments of citrus fruits have the highest content of bioactive

compounds. As such, it is recommended that the fresh fruit or the juice with high pulp

content be consumed to assure its intake.

2.1.1. Minerals

Citrus fruit contains a range of minerals including Ca, Fe, Mg, P, K, Zn, Cu, Mn,

and Se. These fruits are particularly high in potassium (potassium content ranges from

135 to 181 mg/100 g of the edible portion) but extremely low in sodium (from 0 to 2

mg/100 g). This potassium to sodium ratio promotes the regulation of blood pressure

(Fang et al., 2006). Although citrus fruits are relatively low in iron content (from 0.06 to

0.15 mg/100 g of the edible portion), their high vitamin C content helps release iron from

other foods, so that citrus plays a valuable role in iron homeostasis. Therefore, the

consumption of citrus foods with non-heme iron-containing foods is recommended to

optimize iron absorption.

 Potassium

Potassium is an essential mineral that works to maintain the body's water and acid

balance. As an important electrolyte, it plays a role in transmitting nerve impulses to

muscles, in muscle contraction and in the maintenance of normal blood pressure. The

daily requirement of potassium is approximately 2 000 mg and, while frank deficiency of

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potassium is rare, there is some concern that a high sodium-to-potassium intake ratio may

be a risk factor for chronic disease. Increased consumption of citrus fruits and juices is a

good means of increasing potassium intake. One medium orange and one 225 ml glass of

orange juice provide approximately 235 mg and 500 mg of potassium, respectively

(Whitney and Rolfes, 1999).

2.1.2. Vitamins

Citrus is most commonly thought of as a good source of vitamin C. However, like

most other whole foods, citrus fruits also contain an impressive list of other essential

nutrients, including both glycaemic and non-glycaemic carbohydrate (sugars and fibre),

potassium, folate, calcium, thiamin, niacin, vitamin B6, phosphorus, magnesium, copper,

riboflavin, pantothenic acid and a variety of phytochemicals. In addition, citrus contains

no fat or sodium and, being a plant food, no cholesterol. The average energy value of

fresh citrus is also low (see Table 1), which can be very important for consumers

concerned about putting on excess body weight. For example a medium orange contains

60 to 80 kcal, a grapefruit 90 kcal and a tablespoon (15 ml) of lemon juice only 4 kcal

(Whitney and Rolfes, 1999).

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Table 1: Nutritional Facts about Citrus Fruit.

Orange Grapefruit Tangerine

Weight(g) 131 . 236 84

Energy(kcal) 62 78 37

Fiber content(g) 3.1 2.5 1.7

Ascorbic acid(mg) 70 79 26

Folate(mcg) 40 24 17

Potassium(mg) 237 350 132

 Vitamin C

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 Vitamin C (ascorbic acid), an essential water-soluble vitamin, plays a key role in

the formation of collagen, a primary component of much of the connective tissue in the

body. Adequate collagen synthesis is essential for strong ligaments, tendons, dentin, skin,

blood vessels and bones, and for wound healing and tissue repair. The weakening of these

tissues is a symptom of vitamin C deficiency. Vitamin C is an important aid in the

absorption of inorganic iron; it has also been shown to aid in the treatment of anaemia

and stress. Contrary to popular belief, vitamin C does not seem to prevent the onset of the

common cold, but in some studies it has been reported to reduce the length and severity

of the symptoms (Gershoff, 1993).

Contemporary interest in vitamin C centres on its ability to perform antioxidant

functions. As an antioxidant, it can help prevent the cell damage done by "free radical"

molecules as they oxidize protein, fatty acids and deoxyribonucleic acid (DNA) in the

body. Free radical damage has been implicated in the progression of several diverse and

important disease states including cancer, cardiovascular disease and cataract formation

(Gershoff, 1993; Harats et al., 1998; Jacques et al., 1997). Being a good source of

antioxidants, if regularly consumed, citrus can be an important part of a diet aimed at

reducing the risk of such chronic disease.

Only 10 mg of vitamin C per day are required to prevent vitamin C deficiency and

the devastating disease scurvy (United States National Academy of Sciences, Food and

Nutrition Board, 1990). However, for good health and sufficient body storage of vitamin

C, 30 to 100 mg/day is generally recommended, although some recent studies have

provided evidence that more than 200 mg/day may be optimal for the prevention of

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chronic disease. Too much vitamin C (above 500 mg), generally seen with very high

levels of supplementation, may be dangerous, especially for those at risk of iron overload

(Fleming et al., 1998). Consuming five servings of fruits and vegetables each day can

result in an intake of about 200 mg of vitamin C. Citrus fruits are a particularly good

source of vitamin C, with one medium orange or grapefruit providing approximately 70

mg and 56 mg, respectively. A 225 ml glass of orange juice contains approximately 125

mg of vitamin C (Whitney and Rolfes, 1999).

 Vitamin A

Although citrus fruit do not contain vitamin A as such, they contain vitamin A

retinol equivalents, ranging from 2µg of edible portion in the lime to 25 µg in the orange,

mainly in the form of the precursor β-carotene (10-130 μg of β-carotene) and, to a lesser

extent, cryptoxanthin, which contribute to vitamin A levels. Vitamin A is essential for

normal growth, vision and cell structure. It confers protection on the linings of the

respiratory, digestive and urinary systems. Vitamin A deficiency is the leading cause of

preventable blindness in children and increases the risk of disease and death from severe

infections (Ayazi et al., 2010). In pregnant women, vitamin A deficiency causes night

blindness and may increase the risk of maternal mortality (Bryce et al., 2008).

 Folate

As a coenzyme, folate participates in converting deoxyuridylic acid to thymidylic

acid, in the production of purines (formation of glycinamide ribonucleotide and 5-amino-

4-imidazole carboxamide ribonucleotide), and the interconversion of many amino acids;

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thus, folate is necessary for DNA production, is involved in homocysteine regulation, and

protein production primarily via methylation transfer reactions. Because DNA production

is high during pregnancy, lack of folate is associated with birth defects such as neural

tube defects. Lack of folate is also implicated in higher homocysteine concentrations,

which increase the risk of atherosclerosis and heart disease. Citrus can be a

complementary source of dietary folate and can provide up to 10% to 20% of the RDA

for adults and children less than 9 years of age, respectively, with just 100 g. A study on

commercial orange juices in Europe found that the folate was 100% bioavailable and

highly stable and, in another study, the consumption of orange juice (750 mL) daily for

four weeks increased plasma folate concentrations in adults by 18%. In the United States,

the recommended daily intake of folate is 180 mcg for females and 200 mcg for males.

Over the past decade, however, it has become clear that higher levels of folic, 400 mcg,

are associated with the prevention of neural tube defects, a severe birth defect (Centers

for Disease Control and Prevention, 2002). A 225 ml glass of orange juice provides 75

mcg of folic acid (Whitney and Rolfes, 1999).

Folate plays an important metabolic role as a coenzyme in amino acid metabolism,

nucleic acid synthesis and in other biochemical reactions requiring the transfer of a

methyl group to a biological acceptor molecule. The principal forms of folate in citrus are

the reduced 5-methyl tetrahydrofolate and polyglutamate derivatives. Citrus fruits are a

good source of folate, with contents ranging from 11 mg/100 g in lemons to 30 mg/100 g

in oranges. The consumption of a medium orange (154 g) a day provides about 12% of

the Recommended Dialy Allowances (RDA, 400 μg/day). Because methylation of DNA

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is an important mechanism for controlling the expression of many genes, including those

involved in cell proliferation, folate has been implicated as a protective factor against a

number of conditions, including (Hubner and Houlston, 2009). Its effect on DNA

methylation may also play a role in the prevention of neural tube defects such as spina

bifida (van der Linden et al., 2006). Folate may be involved in the prevention of

cardiovascular disease, where it acts as a co-factor in the enzymatic methyl group transfer

from homocysteine to the essential dietary amino acidmethionine (Anderson et al., 2010).

2.1.3. Phytochemicals

These naturally occurring compounds found in plants have a wide range of

physiological effects and may help to protect against various chronic diseases, including

cancer and heart disease. The wide variety and number of known phytochemicals

continue to grow, as does understanding of their role and importance in the diet

(Steinmetz and Potter, 2001). Several classes of phytochemicals, including

monoterpenes, limonoids (triterpenes), flavanoids, carotenoids and hydroxycinnamic

acid, have been isolated from citrus. The possible anticarcinogenic mechanisms of

phytochemicals include their antioxidant capabilities, their effects on cell differentiation,

an increased activity of the enzymes that detoxify carcinogens, an altered colonic milieu,

and the blocking of nitrosamines. The regular intake of a varied mix of phytochemicals is

only possible through the consumption of plant-based foods, such as citrus, as part of the

normal diet.

Phytochemicals are defined as substances found in edible fruits and vegetables that,

when ingested on a daily basis, exhibit a potential for modulating human metabolism in a

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manner favorable to the prevention of chronic and degenerative diseases. Deficiencies of

phytochemicals in the diet do not lead to the deficiency diseases seen with low intakes of

more traditional nutrients, such as vitamins; rather it is possible that these substances

contribute to optimal health (Hasler et al., 2004). The major phytochemicals in citrus

fruits are terpenes and phenolic compounds.

 Terpenes

Citrus fruits contain monoterpenes, triterpenes (limonoids) and tetraterpenes

(carotenoids). Limonene is a monocyclic monoterpene found in citrus oils, garlic and the

oils of other plants. It can have properties to block and suppress the carcinogenic events

(Sun, 2007). The most abundant terpenes in citrus are the limonoids (Figure 1), which are

present in neutral (monocarboxylated/aglycon) as well as (carboxylated/glucoside)

forms; the former are insoluble and bitter, and the latter are soluble and tasteless (Roy

and Saraf, 2006). Citrus seeds constitute the only natural repository of citrus limonoid

aglycone, with limonin being the most abundant. In animal experiments, terpenes have

shown to have powerful anticancer properties, which are attributed to their structure,

which incorporates a distinctive furan or hydrated furan functionality in addition to

epoxide and lactone functional groups (Manners, 2007).

Limonoids can prevent the incorporation of the growth signaling proteins into

membranes, which become damaged and uncontrollable early in the process of

carcinogenesis. In addition, they may stimulate enzymes that are thought to detoxify

other chemicals, and they have been shown to suppress the growth of tumor cells in vivo

and in vitro (Poulose et al., 2005). These compounds appear relatively stable and may act

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synergistically with other potential anti-cancer agents in model systems. Other effects

described are mainly anti-viral (Battinelli et al., 2003) and hypocholesterolemic

(Manners, 2007). The carotenoids are tetraterpenes that give plants their color. More than

600 carotenoids have been identified, but only a few are of interest in human nutrition: α-

carotene, β-carotene, lycopene, lutein, zeaxanthin and cryptoxanthin. These six

carotenoids are all found in citrus fruits.

− β-carotene is one of the better known carotenes because of its high vitamin A activity

and its distribution in nature. The protective effects of β-carotene may be associated with

anti-oxidant protection, having the highest anti-oxidant potential in the citrus peels

(Guimarães et al., 2010). β-carotene is also related to the enhancement of the immune

response (Imamura et al., 2006).

- Lycopene is an open-chain unsaturated carotenoid that imparts red color to the cara-cara

navel orange and pink grapefruit (Alquezar et al., 2008). As with β-carotene, lycopene is

a proven anti-oxidant.

- Cryptoxanthin is abundant, especially in mandarins. Cryptoxanthin has been attributed

with preventive effects on cancer (Nishino et al., 2009), counteracts induced bone loss in

vivo (Uchiyama et al., 2006), and has a positive effect on serum lipid levels (Sugiura et

al., 2004).

 Phenolic Compounds

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 Phenolic compounds or polyphenolics encompass a wide variety of naturally

occurring compounds that are structurally related to the extent that they all contain one or

more benzene rings, each with one or more hydroxyl group substitutions. Under this

general rubric are the simple phenols, the hydroxycinnamic acid derivatives, the

flavonoids, the coumarins and the furanocoumarins. Polyphenols are thought to play a

number of roles in plants. For example, they help protect the plant from attack by

pathogens and predators due to their anti-microbial properties and astringent taste, and

polyphenols are responsible for many of the skin colors of fruit and vegetables. They

have been shown to have a range of health related effects, due principally to their anti-

oxidant and anti-inflammatory properties.

 Flavonoids

The polyphenol category of flavonoids is a group of low molecular weight

polyphenolic compounds that are widely distributed in plants and are particularly

abundant in citrus plants. Flavonoids are pigments responsible for fruit coloration. The

citrus peel and seeds are very rich in phenolic compounds, such as phenolic acids and

flavonoids. The peels are richer in flavonoids than are the seeds. Citrus juice also

contains flavonoids in an appreciable amount (Sendra et al., 2006). The flavonoid

structure is based on a 2-phenyl-benzo (a) pyrane or flavan nucleus. This nucleus is

defined as having a system of two benzene rings (A and B), which are connected by an

oxygen pyrane ring (C). (Figure 2)

Flavonoids identified in citrus fruits cover over 60 types, of which there are four

classes: flavanones, flavones, flavanols and anthocyanins, with the last present only in

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blood (Tripoli et al., 2007). Flavanones and flavones are the major flavonoid classes

present in citrus fruit. The most abundant flavonoids in all citrus fruits are the 7-O-

glycosylflavanones. Flavanones are present in greater quantities than flavones, but the

highly methoxylated flavones have higher biological activity, even at lower

concentrations. The main polymethoxylated flavones present in citrus are tangeretin,

nobiletin and sinesitin. The concentration of these components depends upon the age of

the plant; most citrus species accumulate substantial quantities of flavonoids during organ

development. The major flavonoids in citrus are shown in Table 2 below.

FIGURE 1 Limonoid structure

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 Limonoids (limonin).

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FIGURE

2 Flavonoid Structure

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Table 2 Major Citrus Flavonoids.

Flavanones Aglycone: naringenin and hesperitin are the most important.

Glycoside forms: two types are classified,

Neohesperidosides: Naringin, Neohesperidin, Neoeriocitrin.

Rutinosides: Hesperitin, Narirutin, Didymin.

Flavones Glycosilated: Rohifolin, Isorohifolin, Diosmin, Neodiosmin.
Polymethoxylated: Sinesitin, Hexamethoxyflavone, Nobiletin,

Scutellarein, Heptamethoxyflavone, Tangeretin.

The health effects of flavonoids include the following.

1. Anti-oxidant activity: Flavonoids have to be able to act as anti-oxidants by

scavenging free radicals (Benavente-García and Castillo, 2008). According to kinetic

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studies, the anti-oxidant capacity of a flavonoid is linked to its particular chemical

structure. Three structural groups are important: the ortho-dyhydroxy (catechol) structure

in the B-ring, the 2, 3 double-bond, in conjugation with a 4-oxo function, and the

presence of both 3-(a)-and 5- (B)-hydroxyl groups (Di Majo et al., 2005). They have the

ability to act as reducing agents, making them capable of donating hydrogens to free

radicals to neutralize their damaging effects (Ghasemi et al., 2009). Flavonoids can also

act as chelators of transition metals (Renugadevi and Prabu, 2010).

2. Anti-inflammatory activity: Flavonoid action on the immune and inflammatory

responses is associated with their inhibition of key enzymes (i.e., lipoxygenase,

phospholipase, and cyclooxygenase) that control the biosynthesis of proinflammmatory

mediators, mainly the arachidonic acid derivatives, prostaglandins E2 and F2,

thromboxane A2, and other biological mediators responsible for the activation of

endothelial cells. Citrus flavonoids are able to inhibit the kinases and phosphodiesterases

essential for cellular signal transduction and activation (Lee et al., 2009) and inhibit cells

involved in inflammation and the immune (Manthey, 2009).

3. Anti-atherosclerotic activity: Flavonoids are involved in cardiovascular protection,

mainly derived from its anti-oxidant and anti-inflammatory activity. They inhibit the

formation of atheroma at several steps during its pathogenesis. An initial event in

atherosclerosis is the oxidation of LDL promoted by reactive oxygen species. The uptake

of oxidatively modified lipoproteins by macrophages transforms these cells into foam

cells, which are a major component of atherosclerotic plaques. Flavonoids may reduce

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the generation of free radicals in macrophages (Lo et al., 2010) or may protect LDL from

oxidation by regenerating active α-tocopherol (Kadoma et al., 2006).19

4. Anti-carcinogenic activity: Flavonoids are potentially involved in several aspects of

carcinogenesis, not only due to their effect as antioxidants.

- Anti-mutagenic effects. Flavonoids may protect DNA from oxidative damage and

neutralize free radicals that promote mutations (Jagetia et al., 2003).

- Anti-proliferative effects. Various mechanisms have been proposed to explain the anti-

proliferative activities of flavonoids. These mechanisms are likely mediated by the

inhibition of several kinases involved in cell-cycle arrest and apoptosis. The nature of this

inhibition depends upon the particular structure of each flavonoid. The higher activity of

flavones compared to flavonones can be attributed to the presence of a C2-C3 double

bond. As such, the lipophilic polymethoxylated flavones (nobiletin and tangeretin) inhibit

squamous-cell carcinoma cells in a dose- dependent manner (Tripoli et al., 2007). The

planar structure and the last two small substitiuents (hydroxyl or methoxyl) in the A or B

rings of the flavonoid skeleton are essential (Rodriguez et al., 2002). Hesperidin, a

known flavonoid constituent of citrus, reduces the in vitro proliferation of many cancer

cells types such as human colon cancer cells (Park et al., 2008).

- Anti-angiogenic effects. Tumor angiogenesis is of critical importance in the

development and metastatic spread of tumors. Citrus flavonoids are able to inhibit several

key events in the angiogenic process, such as the proliferation and migration of

endothelial cells and vascular smooth muscle cells and the expression of two major

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proangiogenic factors, vascular endothelial growth factor (VEGF) and matrix

metalloproteinase-2 (MMP-2) (Schindler and Mentlein, 2006).

5. Anti-infectious activity: Flavonoids have shown both anti-microbial and anti-viral

activities. The latter appears to be associated with non-glycosidic compounds, and

hydroxylation at the 3-position is apparently a prerequisite for anti-viral activity. This

anti-viral activity has been shown in vitro against influenza virus (Saha et al., 2009) and

hepatitis C virus, which is actively secreted by infected cells through a Golgi-dependent

mechanism while bound to very low density lipoprotein (Nahmias et al., 2008).20

 Coumarins

Citrus peels contain a number of coumarins that possess mevalonate-derived side

chains with various levels of oxidation. Their effects are related to the suppression of

superoxide generation and lipid peroxidation as well as the induction of phase II drug

metabolizing enzymes. Human studies with citrus fruit and experimental studies with

coumarins suggest that these substances may protect against several human cancers, but

data are still limited (Sekiguchi et al., 2010). Auraptene is the most common coumarin in

citrus and is found in sour oranges (C. aurantium) and grapefruit (C. paradisi). Citrus

fruit products such as grapefruit juice and marmalade retain some auraptene activity.

2.1.4. Other Phytochemicals

Citrus also contain other phytochemicals, including phytoestrogens such as

enterolactone (27 µg/100 g orange) and enterodiol (12 µg/100 g orange); lignins such as

secoisolariciresinol (76.8 µg/100 g orange and 61.3 µg/100g lemon); and

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phenylpropanoids such as caffeic acid (84 ppm orange) and p-coumaric acid (25-60 ppm

grapefruit and 21-182 ppm orange). However, levels of these phytochemicals are

relatively low in citrus compared with other fruits and drinks such as tea.

2.1.5. Fiber

Dietary fiber is the edible carbohydrate and lignin in plants that is not digested and

absorbed in the small intestine; fibers can promote laxation, satiety, reduce the uptake

and/ or reabsorption of glucose, fat, cholesterol, and bile acids thus reducing

cardiovascular disease risk and possibly decreasing food intake and promoting healthy

intestinal fermentation. The main fiber in citrus is pectin, a soluble fiber, which makes up

65%–70% of the total fiber content. Pectin is more completely fermented in the gut by

microflora than foods rich in cellulose like cereals and fermentation produces various

substrates including short-chain fatty acids that can be absorbed and provide energy.

There is conflicting data on whether fiber may interfere with the absorption of other

nutrients; however, most studies on pectin/ nutrition interactions did not show a decrease

in nutrient bioavailability except when large doses of pectin (12 g and 0.15 g/kg body

weight) were concomitantly consumed. Thus, it has been concluded that a diet rich in

dietary fiber will not cause adverse effects in healthy people (Sekiguchi et al., 2010).

The average U.S. adult consumes only ~57% of the RDA for fiber. Because the

RDA for fiber is not being met by many adults and dietary fiber can reduce the risk of

chronic diseases, citrus can make a valuable contribution to meeting daily fiber goals.

Lowering of cholesterol in particular by citrus, however, may depend upon the amount,

degree of esterification, molecular weight, and viscosity of the fiber/pectin consumed

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(Sekiguchi et al., 2010) but may be significant with dietary intake that is achievable (2.2–

9 g pectin for 30 days)

2.2 Possible Health Benefits of Citrus Fruit Consumption

There is considerable evidence that citrus foods may help reduce the risk, or retard

the progression, of several serious diseases and disorders. The health benefits of citrus

consumption by the persons have been related, in part, to their anti-oxidative capacity as

well as their content of nutrients such as fiber, folate and potassium. Ascorbic acid

(vitamin C) accounts for a large proportion of nutritional anti-oxidant activity. However,

other non-nutrient dietary components, such as carotenoids and polyphenols (e.g.,

flavonoids), may also contribute anti-oxidant activity. While ascorbate and carotenoid

concentrations in humans can be elevated by the intake of a variety of fruits and

vegetables (Sun et al., 2002), only few of them, such as citrus, provide specific

flavanones (hesperetin and naringenin, usually as glycosides) and the carotenoid

cryptoxanthin and constitute a major source of these nutrients.

2.2.1. Citrus Fruit Consumption and cardiovascular disease.

It is well accepted that a diet low in saturated fat and cholesterol and rich in fruits

and vegetables reduces the risk of heart disease. Epidemiological studies have also shown

a significant association between vitamin C intake and protection against cardiovascular

mortality, but the precise mechanism of protection is still unclear. One major culprit in

the development of heart disease appears to be a high level of oxidized low-density

lipoprotein (LDL), the so-called bad cholesterol. Significantly, a recent study has shown

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that high intakes of vitamin C (500 mg/day) obtained from the juice of freshly squeezed

oranges, prevented a rise in the levels of oxidized LDL, even in the presence of a high-

saturated fat diet (Harats et al., 1998).

A low dietary intake of folate contributes to the decrease of plasma folate and the

raising of plasma homocysteine levels (Bloom, 1998; Tucker et al., 1996). Homocysteine

is a toxic agent for the vascular wall and, when plasma levels rise above normal, there is

an increased risk of cardiovascular disease. An inverse dose-response relationship has

been identified for fruit and vegetable intake and plasma homocysteine levels. Frequent

consumption of folate-rich foods, such as oranges and orange juice, tends to increase

plasma folate levels and, thus, lower homocysteine levels.

2.2.2. Citrus Consumption and Ischemic Stroke.

Stroke is defined as the damage to part of the brain caused by an interruption to its

blood supply or leakage of blood outside of vessel walls. Stroke is the third leading cause

of death in developed countries. There are two major types of stroke. The first, called

ischemic stroke, is caused by a blood clot that blocks a blood vessel or artery in the brain.

Approximately 80% of all strokes are ischemic. The second, known as hemorrhagic

stroke, is caused by a broken blood vessel that leaks into the brain tissue. The

consumption of citrus fruits and juices has been reported to be associated with a reduced

risk of ischemic stroke (Mizrahi et al., 2009) as a function of their content of vitamin C

and phytochemicals.

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2.2.3. Citrus Fruit consumption and cancer

After numerous studies of fruit and vegetable intake and cancer development, there

is a consensus that consuming these foods has a protective effect (Block, Patterson and

Subat, 2002). However, it is unlikely that one anticarcinogenic substance in particular is

responsible for the benefit. There is reasonable scientific support for vitamin C's

protective role in cancer. Many of the animal, cell culture and human studies have

suggested it has a positive effect. However, epidemiological studies provide good

evidence that protective effects are more closely associated with the consumption of

fruits and vegetables rather than with the enormous levels of vitamin C often used in cell

culture and animal studies.

Cancer is a major public health burden in the United States and in other developed

countries. In a recent review on citrus fruit intake and cancer risk (Foschi et al., 2010)

conducted on a series of case-control studies (including 955 patients with oral and

pharyngeal cancer, 395 with esophageal cancer, 999 with stomach cancer, 3,634 with

large bowel cancer, 527 with laryngeal cancer, 2,900 with breast cancer, 454 with

endometrial cancer, 1,031 with ovarian cancer, 1,294 with prostate cancer, and 767 with

renal cell cancer), it was shown that citrus fruits provide protection against cancers of the

digestive and upper respiratory tract. This effect was significant even with moderate

citrus fruit consumption (i.e., 1 to <4 portions/week). Several compounds can account for

the observed protection. Among them, vitamin C and flavonoids can protect against

oxidative damage, inhibiting the formation of carcinogens and protecting DNA from

damage. Flavonoids also have anti-proliferative and anti-angiogenic effects. In addition,

24
citrus pectin has also demonstrated anti-cancer activity, explained in part a) by its ability

to block the carbohydrate-binding of galectin-3 necessary for the growth and metastasis

of tumor cells (Bergman et al., 2010) and b) by its immunomodulatory potential (Salman

et al., 2008).

2.2.4. Citrus Fruit consumption and Neural tube defects.

During the first stage of pregnancy, adequate folate intake is critical for reducing the

risk of severe birth defects, namely spina bifida and anencephaly. Public health

recommendations in the United States include the consumption of 400 mcg of folate per

day for women of child-bearing age (Centers for Disease Control and Prevention, 2002).

Regular consumption of citrus foods can help supply adequate folate and thus reduce the

risk of these birth defects.

2.2.5. Citrus Fruits consumption and Anaemia

Vitamin C can increase the absorption of non-haem iron (the inorganic iron form

found in plant foods) two- to fourfold (Fleming et al., 1998). The bioavailability of non-

haem iron is much lower than that of haem iron, which is found in foods of animal origin

(Whitney and Rolfes, 1999). Vegetarians and individuals who consume little meat and

animal products are at an increased risk of iron-deficiency, which can progress to

anaemia over time. Worldwide, anaemia is one of the most serious nutrient-related public

health problems, resulting in poor growth, impaired psychomotor development, reduced

physical performance and decreased cognitive function. Consuming citrus fruits rich in

vitamin C can help prevent anaemia and its devastating consequences.

25
2.2.6. Citrus Fruits Consumption and Cataracts.

Oxidation of the eye's lens plays a central role in the formation of age-related

cataracts. The role of dietary antioxidants, such as vitamin C, in the aetiology of cataracts

has been a recent focus of research (Jacques et al., 1997). Lower cataract risk has been

shown in individuals with high blood concentrations or intakes of vitamin C and

carotenoids. There is now evidence to show that a high level of vitamin C intake over the

long term decreases the risk of cataract development. Although epidemiological studies

that measure past nutrient intake and status suggest a protective effect from citrus, further

studies are needed to examine the long-term benefits of citrus fruit consumption and

cataract protection.

2.2.7. Other Health Benefit of Citrus Consumption

- Bone metabolism and osteoporosis: The influence of nutrient intake on bone density

is an area of current research with many unanswered questions. Long-term intake of

various foods may be important to bone health, possibly because of their beneficial effect

on the acid base balance (New et al., 1997). Vitamin C intake has been associated with

bone mineral density, but more work in this area is necessary to understand the

mechanism of interaction.

- Kidney stone disease: A kidney stone is a crystal structure formed by excessive salts in

the urine. The most common type of stone is the calcium stone. A stone will increase in

size until it is not passable and becomes lodged in the ureter. Stone symptoms include

severe back pain, blood in the urine and fever. Stones strike men three to four times more

26
often than women. Some people prone to stones have been found with insufficient levels

of citrate in their urine and it has been suggested that eating citrus fruits and drinking

orange juice may help prevent kidney stones by increasing urinary citrate. More research

is needed in this area, but increasing fruit consumption is a nutritionally sound

recommendation that may prove to be very beneficial for individuals at risk of certain

kinds of kidney stones.

- Cognitive function: Elevated homocysteine levels are associated with cognitive

dysfunction in the elderly. Older subjects with greater intakes of fruits and vegetables,

and the corresponding nutrients vitamin C and folate, have been shown to perform better

on cognitive tests (Ortega et al., 1997). The consumption of a satisfactory diet, containing

nutrient-dense foods, appears to be associated with better cognitive function in the

elderly. More research is needed to determine the effect of long-term citrus consumption

on cognition.

- Asthma: Some studies suggest that a diet low in vitamin C is a risk factor for asthma

(Hatch, 1995). Vitamin C is the major antioxidant substance present in the airway surface

liquid of the lungs, where it could be important in protecting against oxidants. More

research is needed to understand whether vitamin C and citrus consumption is protective

in the causation and progression of asthma.

2.3 Factors Affecting Citrus Consumption.

In many populations, even among people who know that citrus is nutritious; the

consumption of citrus is often very low. The reasons for this are varied, but it indicates

27
that knowledge of a nutritional benefit is just one of the many factors that influence food

choices (Nestle et al., 1998). Among the other factors that greatly influence what foods

people consume are: an individual's food preferences and previous experience with a

given food; cultural values, perceptions, attitudes and societal influences including the

media and advertising; and, most directly, the availability, taste and price of food items.

For these reasons, it is difficult to bring about widespread behavioural change. Clearly,

strategies are more likely to modify behaviour and improve health if they are directed

towards the relevant influences and barriers (Bandura, 2006; Contento, 1995). Some of

the barriers to purchasing and consuming citrus are high cost, fear of harmful pesticides

and quick spoilage (FMI, 1998).

Over the past two decades, rising incomes and the shift in consumer preferences

towards healthier, more convenient products have contributed to a growth in demand for

citrus. Income levels also influence the variety and form of citrus consumed; in

developed countries more processed citrus is consumed than in developing countries

where people consume more fresh citrus (USDA, 1997; Putnam and Allshouse, 1997).

Further increases in citrus consumption are possible, but will require an integrated

approach to improving consumer awareness and bringing about behavioral change.

28
3.0 CONCLUSION AND RECOMMENDATION

3.1 Conclusion

In conclusion, citrus fruits are low in fat, low in energy density, and high in fiber,

water and essential nutrients such as vitamin C and folate and minerals such as

potassium. Citrus fruit also provide phytochemicals, which are active anti-oxidants

(carotenoids and flavonoids) and are proven to counteract chronic diseases. In addition,

citrus fruits and juices have more favorable overall nutrient-to-price ratios than many

vegetables and fruits, which help the consumers to obtain foods which provide optimal

nutrition at an affordable cost. The health benefits associated with citrus consumption are

clear. Citrus fruits are nutrient-dense foods that can be good sources of carbohydrates,

including dietary fibre, and many vitamins and minerals. Citrus fruits are equally

valuable among populations who need to overcome and prevent micronutrient

deficiencies as well as those concerned with problems of overnutrition, obesity and diet-

related chronic diseases. For example, citrus is an ideal component of low-fat, sodium-

restricted diets.

Given that increasing the consumption of citrus benefits both producers and

consumers, building effective partnerships to that end should not be difficult and would

be an invaluable investment in the nutritional well-being and health of the population.

3.2 Recommendation

It is recommended that Citrus fruits have well-documented nutritional and health

benefits. They can actually help prevent and cure some diseases. Citrus fruit intake has

29
been associated with a 10% reduction in odds of developing breast cancer. Citrus fruit

intake is associated with a reduced risk of stomach cancer. Also, citrus fruit juices, such

as orange, lime and lemon, may be useful for lowering the risk of specific types of kidney

stones. Grapefruit is another fruit juice that can be used to lower blood pressure because

it interferes with the metabolism of calcium channel blockers. Lemons have the highest

concentration of citrate of any citrus fruit, and daily consumption of lemonade has been

shown to decrease the rate of kidney stone formation.

30
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