clinical studiess

For many generations the Mayans, the Egyptians and the Native Americans have benefitted from the medicinal properties of rose hips – the fruit of wild rose species native to Europe, northwest Africa and western Asia. Rosa canina and Rosa gallica are the two types of rose bush most often cultivated for their hips; they are made into teas, syrups and jellies, and used to make oils for the complexion. Rose hips are rich in vitamin C, vitamin A, calcium and iron, and are a good source of bio flavonoids, pectin, vitamin E, selenium, manganese, and B complex vitamins. They also contain moderate amounts of magnesium, phosphorus, potassium, sulphur and silicon.

There are lots of Clinical studies online about the ROSEHIPS which linked to diseases such as: arthritis, rheumatism and osteoarthritis, stiffness and joint inflammation;

The fruit acids and pectin in rose hips have diuretic and laxative properties that helps to relieve symptoms of kidney disorders. Their phytochemical contents protect the body from free radicals and help prevent cancer and other cardiovascular diseases. The vitamin C in rose hips also helps in the production of collagen and red blood cells during menstruation.

The benefits of rose hips do not end with their medicinal value. Rose hips’ high vitamin A (also called ‘skin vitamin’) content helps to prevent ageing by regenerating skin cells, heal wounds and make scars less prominent. It also moisturizes the skin and keeps it elastic, preventing wrinkles and minimizing the ones that have appeared.

These complexion enhancing properties did not go unnoticed by cosmeceutical companies. In the last decades big companies all over the world have already made use of the cosmetic properties of rose hips to strengthen their brands. In the Philippines the first pure rose hips product is KB ROSEHIPS Food Supplement, introduced in 2006.

The company had the word ROSEHIPS as a REGISTERED NAME and KB ROSEHIPS as a TRADEMARK approved by the IPO (Intellectual Property Office) to provide legal protection for its own first pure rose hips food supplement in the Philippines against competitors who keep on imitating the products of the KB brand.

KB ROSEHIPS Food Supplement comes in 500 mg. capsule form, blister-packed and packaged in white box with gold KB logo, with 30 capsules which costs Php295  100capsules Php950. It is GMP, FDA and HALAL certified. (Please be inform that according to RA 3720 of FDA ALL Food Supplement are considered as NO APPROVED THERAPEUTIC CLAIM.) Taking KB Rosehips capsule should be once a day or as directed by your Doctor specialist. Also, Store the box in a cool temperature. If this is not properly store the tendency of rosehips capsule potency will be useless.

KB ROSEHIPS together with KB GLUTANAC Food Supplement is available for only Php439 (20 capsules) and Php1,195 (60 capsules) at all Mercury Drug, Watsons, Generika, Rose Pharmacy and South Star Drug outlets all over the country. However, if you wish to purchase KB ROSEHIPS alone, you can do so only through our dealers/resellers/wholesales in Asianskymall Team as we want to give our fellow Filipinos an opportunity to earn additional income through direct selling of this product.

 

Daily intake of rosehip extract decreases abdominal visceral fat in preobese subjects: a randomized, double-blind, placebo-controlled clinical trial

Source of this Articles from: nih.gov
Suggestion: KB Rosehips & SnL Dietary Supplements (see www.slimnlight.com)
Akifumi Nagatomo,1 Norihisa Nishida,1 Ikuo Fukuhara,2 Akira Noro,3 Yoshimichi Kozai,3 Hisao Sato,3 and Yoichi Matsuura1
Author information ► Copyright and License information ►

Abstract

Background

Obesity has become a great problem all over the world. We repeatedly screened to find an effective food to treat obesity and discovered that rosehip extract shows potent anti-obesity effects. Investigations in mice have demonstrated that rosehip extract inhibits body weight gain and decreases visceral fat. Thus, the present study examined the effect of rosehip extract on human body fat in preobese subjects.

Methods

We conducted a 12-week, single-center, double-blind, randomized, placebo-controlled study of 32 subjects who had a body mass index of ≥25 but <30. The subjects were assigned to two random groups, and they received one tablet of placebo or rosehip that contained 100 mg of rosehip extract once each day for 12 weeks with no dietary intervention. Abdominal fat area and body fat percent were measured as primary outcomes. The other outcomes were body weight and body mass index.

Results

Abdominal total fat area, abdominal visceral fat area, body weight, and body mass index decreased significantly in the rosehip group at week 12 compared with their baseline levels (P<0.01) after receiving the rosehip tablet intake, and the decreases in these parameters were significantly higher when compared with those in the placebo group. Additionally, body fat percent tended to decrease compared with the placebo group and their baseline level. Moreover, the abdominal subcutaneous fat area was significantly lower in the rosehip group than in the placebo group at week 12 after the initiation of intake (P<0.05). In addition, there were no abnormalities, subjective symptoms, and findings that may indicate clinical problems during the study period.

Conclusion

These results suggest that rosehip extract may be a good candidate food material for preventing obesity.

Keywords: tiliroside, obesity, dietary supplement, randomized clinical trial, Rosa canina L., weight loss

Introduction

Obesity is one of the most important diseases and has become a global health problem. It is caused when a balance between energy intake and expenditure is lost and is characterized as a state of increased body weight by excessive lipid accumulation in the white adipose tissue.1 Hypertrophied fat cells can increase a risk of type 2 diabetes associated with insulin resistance. Obesity can cause dysbolisms such as hyperlipidemia, hypertension, and arteriosclerosis, and these disorders can induce fatal cardiovascular diseases.2 Therefore, the prevention and improvement of obesity, particularly decrease of visceral fat is important in the control of these metabolic diseases.

Various functional foods or natural components have been recently developed for preventing or improving obesity as the alternative means of lifestyle improvement or medical treatment for obesity. As the result of our screening, we found that tiliroside, a major rosehip seed constituent, has fat metabolism acceleration and glucose clearance improvement effects.3

Rosehip, the whole fruit of Rosa canina L. belonging to the family Rosaceae, is popular all over the world. In Europe and America, rosehip is processed widely into jam and juice, used as a vitamin C supplement, in cosmetics, and as a folklore drug in the form of tisane.4,5 The functional capacities of rosehip includes efficacy on diuresis, as a laxative, and as treatments for gout and rheumatism.6,7 There have also been reports of several effects including antioxidative,8 anticold, and anti-inflammatory actions,9 inhibitory effects on metabolism of arachidonic acid and formation of cyclooxygenase 1, cyclooxygenase 2, and leukotriene B4,10 suppression of inflammation and cancer cell proliferation attributable to anticomplementary effect,11 antibacterial action and suppression of experimental nephrolithiasis,12melanin production inhibition,13 and antidiarrheal action using a methanol extract of rosehip leaves.14Large-scale clinical studies have confirmed the efficacy of rosehip in treating human knee joint arthropathy.15

It is well known that rosehip contains an abundance of vitamin C and polyphenols.16 Especially, tiliroside, a major glycosidic flavonoid isolated from rosehip seed, has a variety of pharmacological activities, eg, an anticomplementary effect,17 a hepatic protection action,18 an anti-inflammatory and antioxidative action,19 an inhibitory effect on the depression of expression of insulin-like growth factor-1 and hypoxia-inducible factor-1 due to oxidative stress,20 and an antibacterial action.21

Recently, the antiobesity effects of rosehip have been clarified by in vitro and in vivo studies. Ninomiya et al showed that an 80% aqueous acetone extract of the whole fruit of R. canina L. significantly suppressed body weight gain and prevented increases in the visceral fat in nonobese mice without any changes in diet intake.3 They also reported that tiliroside upregulated the expression of peroxisome proliferator-activated receptor α messenger RNA in the liver. We showed that an aqueous ethanol extract of rosehip inhibited lipid accumulation in adipocytes using 3T3-L1 cells and diet-induced obese mice.22 Andersson et al reported that rosehip juice decreased the systolic blood pressure and plasma cholesterol levels in obese subjects.23 However, no clinical trials have evaluated the antiobesity effects of rosehip.

Obesity is defined by the World Health Organization classification as a body mass index (BMI) ≥30 kg/m2, where a person with a BMI ≥25 kg/m2 but <30 kg/m2 is classified as preobese.24 In addition, based on the diagnostic criteria for obesity provided by the Japan Society for the Study of Obesity in 2011, an abdominal visceral fat area $100 cm2 is an important factor in obesity-related metabolic disorders.25 In the present study, we targeted preobese subjects and confirmed the antiobesity effects of rosehip extract, where a reduction in the abdominal body fat area and body fat percent were the primary outcome.

Materials and methods

Study design

A single-center, double-blind, randomized, placebo-controlled study was designed to evaluate the efficacy of rosehip extract. All experiments conformed to the Helsinki Declaration (adopted in 1964 and amended in 2008) and were conducted under the control of the principal investigator. The study protocol and all related documents were approved by Miyawaki Orthopedics Clinic Institutional Review Board. Appropriate explanations were provided to the subjects for important factors including the study purpose, contents, methods, and predicted adverse reactions. Informed consent was voluntarily obtained from each subject in writing. The study was performed in Fukuhara Clinic in Eniwa, Hokkaido, Japan, from August 2011 to December 2011.

Subjects

In total, 152 subjects agreed to participate in the study, who were paid volunteers enrolled by the New Drug Research Center Inc. (Previously known as: New Drug Development Research Center Inc.), and 32 subjects (16 males and 16 females) who met the following inclusion and exclusion criteria were selected by screening (Figure 1,Table 1). The 32 subjects were assigned to two equal groups to avoid bias related to sex, BMI, and body fat percentage.

Figure 1

Flow diagram through the phases of the study.

Table 1

Inclusion and exclusion criteria for the selection of study participants

Materials

Rosehip extract (Rosehip Polyphenol EX™, Morishita Jintan Co, Ltd, Osaka, Japan) comprised an aqueous ethanol extract of rosehip containing its seeds, dextrin, and cyclodextrin. This extract contains not less than 0.1% of tiliroside. The rosehip tablet contained 100 mg of rosehip extract and excipients, and the placebo tablet was indistinguishable from the rosehip tablet. The compositions and nutritional contents of both the tablets are shown inTable 2.

Table 2

Composition and nutritional content of test foods

Study schedule and measurements

All subjects received one rosehip or placebo tablet once a day for 12 weeks by chewing, and they visited the clinic for assessments and measurements at the start of intake (W0) and on the 4th (W4), 8th (W8), and 12th week (W12). The subjects were allowed to drink only water after 9 pm on the day before the visit for examinations. During the study period, the subjects were not permitted to use medical products or foods with lipid-lowering or body fat-reducing actions, and we instructed the subjects not to change their life patterns greatly compared with that before the initiation of the study. All subjects were assessed to determine their physical parameters (body weight, body fat percentage, BMI, body temperature, blood pressure, and heart rate), hematological parameters (white blood cells, red blood cells, hemoglobin, hematocrit, and platelets), blood biochemical parameters (total protein [TP], albumin, albumin/globulin ratio, aspartate aminotransferase, alanine aminotransferase, γ-glutamyl transpeptidase, fasting blood sugar, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, uric acid, urea nitrogen, creatinine, Na, K, Cl, and Ca), urinalysis (urine protein, urine glucose, urobilinogen, bilirubin, ketone body, occult blood, specific gravity, and pH), and abdominal visceral and subcutaneous fat areas. All biochemical analyses were performed in Daiichi Kishimoto Clinical Laboratory Co, Ltd (Hokkaido, Japan) using the automatic analyzers XE-2100 (Sysmex Corp, Hyogo, Japan) for hematological analysis, JCA-BM8060 (JEOL Ltd, Tokyo, Japan) for blood biochemical analysis, and AX-4280 (Arkray, Inc., Kyoto, Japan) for urinalysis.

Dietary record and physical activity

To determine the energy intake and consumption, we collected meal survey slips where the subjects described their food content and the number of steps counted by a pedometer for 3 days prior to each visit at W0, W8, and W12, and we analyzed the data according to the procedure described by Maki et al.26Based on the meal records, a nutritionist calculated the energy intake and the amount of carbohydrates, fat, and proteins consumed. The energy consumption was calculated as the sum of the basal metabolic rate and kinetic energy. The basal metabolism is usually calculated as the “basal metabolism standard value × body weight”, but in this study, because the basal metabolism becomes excessive in obese subjects, it was calculated using the ideal body weight based on the height. Further, based on the assumption that the kinetic energy was 3.3 metabolic equivalents for males and 3.0 metabolic equivalents for females, the energy consumption (kcal) was calculated by multiplying the walking time from the number of steps by the kinetic energy (metabolic equivalents), body weight, and 1.05 (kcal/kg/h).27

Physical assessment

Body weight was measured using the normal method, and BMI was calculated as body weight/height2. Body fat percentages were determined using body composition analyzer (TBF-310, Tanita Corp, Tokyo, Japan). Computed tomography (CT) scans were performed using a CT-W450 CT scanner system (Hitachi Medical, Tokyo, Japan). Abdominal body fat areas (subcutaneous and visceral fat areas) were calculated based on an abdominal CT scan image using visceral fat measurement software (Fat Scan™ Ver. 3.0, N2 Systems Inc., Osaka, Japan). The total fat area was calculated as the sum of the subcutaneous and visceral fat areas. To consider the risk of radiation exposure in subjects, CT scans were performed only on W0, W8, and W12.

Safety assessment

The subjects entered their subjective symptoms in a subject diary. At W0, W4, W8, and W12, the investigator conducted a medical interview with the subjects based on the subject diary and the health status of the subjects was examined by auscultation and percussion. Body temperature, blood pressure, and pulse were measured at W0, W4, W8, and W12, and hematology tests, blood biochemical examinations, and urinalysis were performed at W0, W8, and W12.

Statistical analysis

Mean values and standard deviations of each datum were calculated for each group. A paired t-test was used to compare the data before and after the intake within a group. The confirmation of homoscedasticity between the placebo and the rosehip groups was conducted using the F-test. If the homoscedasticity was verified, a Student’s t-test was used, whereas Welch’s t-test was used for comparisons if the variances were unequal. In addition, a signed rank sum test was used for intergroup comparisons of the semiquantitative urine values before and after the intake, and Wilcoxon’s rank sum test was used for comparisons between the placebo and test food groups. A P value less than 5% was considered to be significant. Statistical analysis was performed using Microsoft Excel® 2003 (Microsoft Corp, Redmond, WA, USA) and SAS®9.1.3 Foundation (SAS Institute, Cary, NC, USA).

Results

The test food intake rates for the placebo group and the rose-hip group at 12 weeks were 99.5% and 99.6%, respectively. No subject left during the study period, and no outliers were observed for any parameter. Thus, all data were subjected to statistical analysis.

Table 3shows the background data for the subjects. The abdominal total fat and abdominal visceral fat areas were somewhat higher in the control food group compared with the test food group; however, no significant difference was observed between the two groups (P=0.32 for the abdominal total fat area andP=0.21 in the abdominal visceral fat area). In addition, there were no significant differences between the two groups in terms of the other parameters.Table 4represents the energy intake and consumption, which was calculated based on the number of steps counted and the basal metabolism. No significant intragroup and intergroup differences were observed; thus, there were unlikely to have been any major changes in the lifestyles of the subjects during the study period.

Table 3

Characteristics of the subjects at baseline

Table 4

Changes in energy intake and energy consumption after the daily intake of placebo or rosehip

The results of the physical assessment of the placebo group and the rosehip group are shown inTable 5. The measurement values at W12 were compared with those at W0, which showed significant decreases in the body weight and BMI in the rosehip group; the decreases in the body weight and BMI were significantly larger at W12 in the rosehip group than in the placebo group. Moreover, at W12, the body fat percentage was lower in the rosehip group compared with that in W0, but the difference was not significant. At W8 and W12, the abdominal visceral fat area in the rosehip group significantly decreased compared with the area at W0, and the decrease in the area at W12 was significantly larger than that in the placebo group. However, at W12, the abdominal total fat area in the rosehip group was significantly lower than that at W0, where the decrease was significantly larger than that in the placebo group. In contrast, there was no significant intragroup variation in the abdominal subcutaneous fat area, but the decrease in this area in the rosehip group at W12 was significantly larger than that in the placebo group. Further, blood pressure was measured using an automated sphygmomanometer, and pulse rates were measured at the same time as the blood pressure. The results of the measurement are also shown inTable 5.

Table 5

Changes in physical assessment parameters after the daily intake of placebo or rosehip

The blood biochemical parameters, hepatic functional markers, fasting blood sugar, and serum lipids, which are cardiovascular disease risk factors, and other parameters, were measured (Table 6). In the rosehip group, TP (W8), fasting blood sugar (W8), high-density lipoprotein cholesterol (W12), and systolic blood pressure (W4) changed significantly from W0, but the variations were within the normal physiological range.

Table 6

Changes in blood biochemical parameters after the daily intake of placebo or rosehip

In the rosehip group, the following adverse events were recorded: common cold in four cases, headache in four cases, pyrexia and cough in two cases each, and sore throat, congested nose, loss of appetite, and abdominal pain in one case each. Furthermore, the adverse events observed in the placebo group were common cold in five cases, headache in three cases, pyrexia/cough in one case, and abdominal pain in one case. All these events were transient, and there was no observed aggravation due to the continuous intake of the placebo and the rosehip tablet in each group. There were no clinically problematic abnormalities or findings according to the physical assessments, blood biochemical and hematological parameters (Table 7), urinalysis (Table 8), and the medical interview by the investigator, which included auscultation and percussion.

Table 7

Changes in hematological parameters after the daily intake of placebo or rosehip

Table 8

Changes in urinalysis parameters after the daily intake of placebo or rosehip

Discussion

The World Health Organization published diagnostic criteria for a syndrome called “metabolic syndrome” in 1998, and there have been extensive subsequent discussions/reviews on these diagnostic criteria.28Metabolic syndrome is a state that combines the risk factors of high blood sugar, high blood pressure, and hyperlipidemia due to visceral fat type obesity (visceral fat obesity/abdominal obesity). Study groups in various countries have reported that the cardiovascular disease risk is increased in subjects with metabolic syndrome.29–31

Frequent attempts have been made to lower the risk of cardiovascular diseases by decreasing visceral fat in studies of obese subjects. The “VACATION-J study” of Japanese subjects showed that an increase in visceral fat heightened the risk of cardiovascular diseases.32 In addition, a direct correlation was reported between decreased visceral fat and improvement in cardiovascular disease risk factors, including high blood pressure, hypo-high-density lipoprotein cholesterolemia, hyper-low-density lipoprotein cholesterolemia, hypertrig-lyceridemia, and fasting hyperglycemia.33 Czernichow et al reported that abdominal obesity rather than BMI is related to death risk due to cardiovascular diseases.34 Matsushita et al conducted a study of 6,292 Japanese subjects (5,606 males with a mean BMI of 24.1 kg/m2 and 686 females with a mean BMI of 23.0 kg/m2), which confirms that the abdominal visceral fat area is a better index of metabolic syndrome than the abdominal subcutaneous fat area and waist circumference.35

In an analysis of the effects of rosehip on cardiovascular disease risk factors, Andersson et al showed that a rosehip supplement suppressed the progression of diabetes in C57BL/6J mice and that downregulation of the lipogenic program in the liver was one of the mechanisms related to this effect.36 They also examined the effects of rosehip juice on cardiovascular disease risk markers for type 2 diabetes and circulatory diseases using a randomized, double-blind, crossover method with obese human subjects.23

Based on the reports described earlier, we planned and conducted a clinical study to determine the antiobesity effects of rosehip extract. Obtained results suggest that rosehip extract could lead to weight loss, reducing the risk of cardiovascular disease.

The rosehip extract used in this study is commercially available as a functional food ingredient named “Rosehip Polyphenol EX”, which includes ≥0.1% tiliroside as an active component. Prior to starting the study, we confirmed that tiliroside content in the rosehip extract was 0.12%. We showed that an aqueous ethanol extract of rosehip inhibits lipid accumulation in the adipocytes.22 In addition, Ninomiya et al administered 0.1–10 mg/kg of tiliroside to mice for 2 weeks and observed the suppression of body weight gain, decreased amount of visceral fat, and they also found that peroxisome proliferator–activated receptor messenger RNA was upregulated in the liver of tiliroside-administered mice.3 Furthermore, Goto et al demonstrated that tiliroside stimulates fatty acid oxidation in obesity model KK-Ay mice.37 These reports indicate that the antiobesity effects of rosehip extract or tiliroside depend on the inhibition of lipid accumulation in adipose tissue and the stimulation of fatty acid oxidation. The rosehip tablet used in this study contained 0.1 mg of tiliroside in one tablet. Thus, we expect that tiliroside contributed to the reduction of visceral fat by the rosehip extract, and its effective dose seems very low.

The autonomic nervous system (ANS) participates in the regulation of energy metabolism, and it plays an important role in body weight maintenance.38,39 ANS activity can be quantified based on the power spectral analysis of the heart rate variability.40,41 A preliminary study showed that the rosehip extract stimulates ANS activity and tends to increase the fat utilization at rest and during exercise based on power spectral analysis of the heart rate variability and an analysis of expired gas in 25 healthy male and female adults. In addition, the visceral fat is more reactive than the subcutaneous fat to lipolysis by catecholamine.42,43 In the present study, the abdominal visceral fat area was reduced earlier than the subcutaneous fat area. Hence, it is possible that the fat combustion effect induced by enhanced ANS activity is involved in the body fat-lowering effect of the rosehip extract.

It is well known that the body weight and body fat mass are affected by the daily diet and exercise regimens. Thus, we monitored the energy intake and consumption of the subjects, but there were no major changes in the lifestyles of the subjects during the study period. Therefore, the changes detected in the present study were attributable to the rosehip extract, rather than lifestyle changes.

The safety of rosehip extract has already been demonstrated by a single-dose toxicity test, a 30-day repeated-dose toxicity test, and an Ames test (unpublished data). In this study, the results of the safety outcomes, subjective symptoms, and medical assessments demonstrated that no serious adverse events were caused by the test food during the study period. Furthermore, rosehip extract does not interact with nifedipine, a cytochrome P450 3A substrate, according to a pharmacokinetics study in rats (unpublished data). However, a previous study reported that rosehip fruit juice delayed the peak time required to attain the maximum blood concentration (Tmax) and there was a 16% decrease in the area under the blood concentration–time curve with paracetamol.44 Thus, the rosehip extract is generally recognized as safe, but care should be taken when patients who are receiving medication also use rosehip.

In conclusion, the results of the present study demonstrate that rosehip extract may be useful as a supplement to safely reduce abdominal visceral fat in preobese subjects. Therefore, it is anticipated that rosehip extract will reduce the risk of cardiovascular disease.

Footnotes

Disclosure

A Nagatomo, N Nishida and Y Matsuura are employees of Morishita Jintan Co, Ltd, and were not involved in the data analysis. A Noro, Y Kozai, and H Sato are employees of New Drug Research Center, Inc. I Fukuhara is a principal investigator of this clinical study.

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Rosehip An evidence based herbal medicine for inflammation and arthritis

Rosehip

An evidence based herbal medicine for inflammation and arthritis

Volume 41, No.7, July 2012 Pages 495-498

Marc Cohen

Background

Rosehips – which contain a particular type of galactolipid – have a specific antiinflammatory action. A standardised rosehip powder has been developed to maximise the retention of phytochemicals. This powder has demonstrated antioxidant and anti-inflammatory activity as well as clinical benefits in conditions such as osteoarthritis, rheumatoid arthritis and inflammatory bowel disease.

Objective

To examine the evidence suggesting that standardised rosehip powder may be a viable replacement or supplement for conventional therapies used in inflammatory diseases such as arthritis.

Discussion

A meta-analysis of three randomised controlled trials involving 287 patients with a median treatment period of 3 months reported that treatment with standardised rosehip powder consistently reduced pain scores and that patients allocated to rosehip powder were twice as likely to respond to rosehip compared to placebo. In contrast to nonsteroidal anti-inflammatory drugs and aspirin, rosehip has antiinflammatory actions that do not have ulcerogenic effects and do not inhibit platelets nor influence the coagulation cascade or fibrinolysis.

Rosehips are the berry fruits of the dog rose or wild briar rose (Rosa canina L), a scrambling rose species native to Europe, northwest Africa and western Asia.

Rosehip has been used traditionally to treat a range of conditions including diarrhoea, bladder infections and diabetes. In food, rosehips are used in teas, jams, jellies and soups, and as a natural source of vitamin C. The vitamin C content of fresh rosehips is higher than that found in citrus fruits. Rosehip is also high in folate and contains vitamins A, B3, D and E along with flavonoids, carotenoids, betasitosterol, fructose, malic acid, tannins, magnesium, zinc, copper and numerous other phytochemicals including recently characterised galactolipids.1–4

These nutrients can be depleted or destroyed during processing and the content of phytochemicals has been shown to be sensitive to the maturity of the fruits as well as drying time, drying air temperature and moisture content.5–8

A team from the Department of Clinical Biochemistry at the University of Copenhagen in Denmark has been involved in researching and testing rosehip for over a decade. This research has focused on a specific rosehip powder produced by Hyben Vital, Denmark.

The production process involves plants grown according to good agricultural practice in standardised fields in Denmark and Sweden. Fruits are harvested when they are fully ripe and optimal fruits are selected using a laser technique.9 This patented process preserves the nutrient content and the resultant powder is standardised to contain at least 5 mg/g of vitamin C. The product consists of seeds as well as shells.

The standardised extract has been available for more than a decade in Scandinavia as a herbal remedy.9 It is now readily available in Australia and New Zealand under the trade name Rose-Hip Vital™.

Therapeutic activities of rosehip

Antioxidant activity

Rosehip is rich in polyphenolic compounds such as proanthocyanidins and flavonoids such as quercetin and catechin.8 The high phenolic and flavonoid content of rosehips has been observed to correlate with antioxidant activity10 and when rosehip extract containing these phenolics is deprived of vitamin C it still shows considerable antioxidant activity.11 This activity includes protective effects against oxidative stress, enhanced activity of antioxidant enzymes such as superoxide dismutase and catalase, and protective effects on gap junction intercellular communication.12

Anti-inflammatory activity

Rosehip has been found to have antiinflammatory and antinociceptive activities in several in vivo experimental models with synergistic interactions between compounds.13 The anti-inflammatory power of rosehip is reported to be similar to that of indomethacin, although its mode of action is different.14 The lipophilic constituents have been found to be particularly active with respect to antiinflammatory properties including actions on arachidonic acid metabolism and inhibition of both cyclooxygenase-1 and 2.10 Much of the anti-inflammatory action of rosehip has been attributed to high quantities of galactolipids, a class of compounds recently shown to possess antitumour promoting and anti-inflammatory activity, both in vitro and in vivo.4 Rosehip and its constituent galactolipids have also been found to inhibit the production of inflammatory mediators and confer chondroprotective effects in vitro.15

A particular galactolipid – GOPO® – has been shown to be the active principle responsible for the observed in vitro inhibition of chemotaxis and chemiluminescence of human peripheral blood leucocytes without any toxicity to the cells.16–19 This suggests GOPO® is important for the clinically observed anti-inflammatory properties of standardised rosehip powder, which include reduced serum c-reactive protein (CRP) and creatinine levels in patients with osteoarthritis and healthy subjects,18,20as well as improved pain and joint movement in osteoarthritis patients.1,21

In contrast to nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin, rosehip has anti-inflammatory actions that do not have ulcerogenic effects and do not inhibit platelets or influence the coagulation cascade or fibrinolysis,22 thereby avoiding potential side effects for patients who may be at increased risk from the gastrointestinal or cardiovascular side effects of NSAIDs.19

Antidiabetic, lipid lowering and anti-obesogenic activity

Rosehip has been used as a traditional treatment for diabetes and has recently been found to possess hypoglycemic effects in diabetic rats.23 Similarly, rosehip extract has been reported to significantly reduce blood glucose levels after glucose loading, as well as substantially inhibiting weight gain and/or accumulation of visceral fat without affecting food intake in mice.24 Rosehip has also been found to produce modest lowering of total cholesterol in humans.1 While these activities are promising, they await further confirmation in large human clinical trials.25

Clinical research on standardised rosehip powder

Since the patenting of standardised rosehip power, there has been a number of clinical trials exploring the efficacy of this preparation in conditions such as osteoarthritis, rheumatoid arthritis and inflammatory bowel disease. It should be noted that all clinical research on rosehip has been performed on the standardised, patented extract with the trials being supported by the manufacturer, Hyben Vital. Clinical research into this extract includes open label and randomised controlled trials with a duration of 6 months or less, along with a number of corresponding systematic reviews and meta-analyses. These studies have consistently found rosehip to be extremely safe, with occasional mild allergic reactions or gastrointestinal complaints but no serious adverse effects.26 In January 2011, the evidence for rosehip was reviewed by Arthritis Australia and for the first time rosehip was included in the Arthritis Australia complementary medicine information sheet.27

Randomised controlled trials

Osteoarthritis, rheumatoid arthritis and back pain

The first randomised controlled trial of rosehip involved 100 patients with painful, radiographically verified osteoarthritis of the hip or knee. These patients, some of who were end stage and awaiting joint replacement, were randomised to receive either 2.5 g standardised rosehip powder or placebo twice daily for 4 months. Results showed that in comparison with placebo, rosehip powder significantly reduced pain (p=0.035) with 64.6% of patients receiving rosehip reporting at least some reduction of pain. Rosehip-treated patients also experienced improved hip flexion (p=0.033) with no significant change observed for internal and external rotation of the hips or knee flexion.21

A second double blind, placebo controlled, crossover study involving 112 patients with osteoarthritis of the hip, knee, hand, shoulder or neck, found that compared to those receiving placebo, patients who received 5 g/day of standardised rosehip powder for 3 months experienced significant reductions in pain (p<0.0078) and stiffness (p<0.0025), as well as significant improvements in mood, wellbeing and sleep quality. Sixty-six percent of patients receiving active treatment reported improvement in pain compared to only 36% of placebo patients. Reductions in paracetamol consumption and plasma CRP along with a small but significant reduction in total cholesterol were also observed. After the treatment and placebo groups were crossed over for a further 3 months (without a washout period) no difference was seen between the two groups, suggesting that rosehip has a long duration of action with a strong carryover effect.1

A third placebo controlled, double blind crossover trial involving 94 patients aged over 35 years with osteoarthritis of the hip or knee, randomised patients to either placebo or 5 g/day or rosehip for a period of 3 months. Compared to placebo, treatment with rosehip resulted in a significant reduction in WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) pain (+/–) and consumption of ‘rescue medication’ after 3 weeks and significant reduction in WOMAC disability, stiffness and global assessment of severity of the disease after 3 months of treatment.28

In addition to offering benefits for patients with osteoarthritis, rosehip may offer benefits in other conditions such as back pain and rheumatoid arthritis. A 1 year surveillance of 152 patients found that rosehip provided significant pain relief for patients with acute exacerbations of chronic back pain.29 More recently, a 6 month, double blind placebo controlled trial also found modest benefits for patients with rheumatoid arthritis indicated by significantly improved scores on the Health Assessment Questionnaire Disability Index (HAQ-DI) along with various other patient and physician reported scales. The authors concluded that while the results were promising, the study was not well powered and larger studies were needed.30

A slow onset of action, modest effect size and lack of statistical power may account for the results of a more recent and much smaller open case control study of 20 female patients with rheumatoid arthritis and 10 female controls, which found no significant effects on clinical symptoms, level of CRP or laboratory measures of antioxidant enzyme activity after 4 weeks of treatment with 10.5 g/day of rosehip powder.31

Meta-analyses and systematic reviews

A meta-analysis of the three randomised controlled trials of osteoarthritis patients included 287 patients with a median treatment period of 3 months. This meta-analysis reported that treatment with patented rosehip powder consistently reduced pain scores and that patients were twice as likely to respond to rosehip (as indicated by a reduction in WOMAC pain) compared to placebo (effect size of 0.37, 95% CI: 0.13–0.60). The authors therefore concluded that rosehip powder does reduce pain and that its efficacy and safety need evaluation and independent replication in future large scale, long term trials.32

A more recent meta-analysis provides an indirect comparison of the pain reducing effect of glucosamine hydrochloride and standardised rosehip powder for osteoarthritis. This analysis, which was based on three studies on glucosamine hydrochloride involving a total of 933 patients and the three studies described above involving 287 patients, concluded that rosehip is more efficacious than glucosamine hydrochloride in reducing pain in osteoarthritis patients.33

As well as being the subject of metaanalyses, the clinical trials of rosehip have been systematically reviewed. One systematic review of two relatively small (n=100 and 112) double blind, randomised placebo controlled studies, both of which were considered to be of high quality with a Jadad score of 5 out of 5, concluded that rosehip powder had a moderate effect in patients with osteoarthritis.34 This same conclusion was also made by another systematic review that included four trials (two of which were identified as subgroup analyses).35

Summary

The growing evidence base for rosehip suggests that this traditional herbal remedy has a high safety profile. While further research is required to establish its clinical role, existing research (both in vitro and in vivo) suggests that standardised rosehip powder may offer an effective first line therapy and is a viable replacement or supplement for conventional drug therapies such as NSAIDs in osteoarthritis and possibly other inflammatory diseases.

Conflict of interest: The author has received payment from Brand New Solutions for time spent writing this article and consultancy fees for writing media reports on Rose-Hip Vital™.

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Correspondence afp@racgp.org.au