Juice Plus
History
NSA was founded in 1970 and before introducing Juice Plus in 1993, was known for other multilevel-marketed products such as water filters, air filters, fire-protection equipment, and educational games for pre-schoolers. Naturopath Humbart "Smokey" Santillo is credited with having developed the Juice Plus oncept and utritional philosophy and for creating what has been described as the riginal formula for the product. According to Santillo, he also worked with NSA to develop other Juice Plus products.
Claims that an early association may have existed between Juice Plus and United Sciences of America, Inc. (USAI), a multilevel marketing company that sold vitamin supplements with illegal claims that they could prevent many diseases, are misleading, since state and federal enforcement actions drove USAI out of business in 1987, well before Juice Plus was introduced in 1993.
The primary products in the Juice Plus line are "Orchard Blend" (a fruit juice powder-based vitamin supplement) and "Garden Blend" (vegetable juice powder-based) capsules, which are sold together in four-month supplies at a cost, in 2009, of approximately $167 USD. Other products in the Juice Plus line include "Vineyard Blend" (grape/berry juice powder-based) capsules, "Juice Plus Complete" (meal replacement powders), and "Chewables". Products no longer mentioned on the company's website include "Gummies", chewable tablets, wafers ("Juice Plus Thins"), and a vitamin formulation for dogs and cats.
Manufacturing
The main ingredients in Juice Plus Orchard Blend and Garden Blend capsules (vegetable and fruit juices, fibers, plant enzymes, and food actives) are reduced to powder through a proprietary process by an unrelated supplier, and are then blended and encapsulated by NAI who produce the finished product. Juice Plus capsules are nriched with pure -carotene, ascorbic acid, vitamin E, and folic acid. According to the manufacturer these are added to restore the levels of micronutrients lost during processing and to ensure uniformity.12] Two NAI-sponsored studies mention that the fruit and vegetable powders in Juice Plus include standardized levels of natural -carotene derived from Dunaliella salina and soy-derived d--tocopherol (vitamin E), which are supplied by the Henkel Corporation (now doing business as Cognis Corporation), and ascorbic acid derived from acerola cherry, which is supplied by Schweizerhall Pharma.
Sales
Juice Plus products are marketed by individual distributors who receive sales commissions ranging from 6% (for enrolling five customers in 30 days) to 14% (for enrolling twenty customers in 30 days). Detailed sales figures for Juice Plus are not publicly available but NSA representatives claimed that Juice Plus achieved monthly sales of $6 million USD in 1993 and that it was the company most successful new product.
Product research
National Safety Associates claim Juice Plus as he next best thing to eating fruits and vegetables, containing the utritional essence of 17 different fruits, vegetables, and grains with key phytonutrients that are absorbed by the body, reduces oxidative stress, promotes cardiovascular wellness, supports a healthy immune system, and helps protect DNA. However, multiple studies have produced conflicting results as to the truth of these claims. Doubts have been raised about the advertised benefits of Juice Plus by Memorial Sloan-Kettering Cancer Center, University of California Berkeley, Center for Science in the Public Interest, and other sources. The product has been criticized on the basis that: its marketing is unsupported by research data, it contains too little fruit and vegetable powder to offer significant clinical benefits, its effects can be attributed to the inclusion of added exogenous vitamins and micronutrients, and it is excessively priced relative to its potential benefits. Memorial Sloan-Kettering Cancer Clinic referred to Juice Plus as a ricey supplement that is istributed through a multi-tiered marketing scheme with exaggerated value and cost."
Of the published peer-reviewed studies on Juice Plus products, seven were funded and/or authored by the manufacturer, Natural Alternatives International (NAI); five were funded by the main distributor, NSA; two were funded by individual Juice Plus distributors; and one was conducted independently.
Nutrients and phytochemicals
Juice Plus+ contains a variety of nutrients native to the original fruits, vegetables and grains used in capsule manufacturing, formulated by a proprietary process. Fruits and vegetables contain many nutrients and phytochemicals, including vitamin C, other essential micronutrients, beta-carotene and less well-known compounds such as polyphenols and other carotenoids.
Concerns have been raised that these nutrients in Juice Plus+ capsules may not be bioavailable, meaning not effectively absorbed by the human body, and that some of the nutrients claimed to be in the products may not be present in significant amounts. Studies on nutrient absorption showed that subjects taking Juice Plus had elevated blood levels of folate and -carotene but the effects on blood levels of vitamin E and vitamin C were inconsistent. Some studies have shown significant increases in vitamin E and C levels, while other studies have shown much weaker effects on vitamin E and C levels, and that the levels of vitamin E and vitamin C are not significantly increased. Juice Plus was found to increase blood lycopene levels in several studies, while other studies have indicated that Juice Plus does not raise the blood levels of lycopene or other phytochemicals from fresh fruits and vegetables such as lutein, zeaxanthin, and -cryptoxanthin.
Concerns have also been raised about the accuracy of product labeling. Three studies which included chemical analyses of Juice Plus have indicated nutrient amounts that differ from the amounts listed on the product labels.
In December 2007, the Center for Science in the Public Interest (CSPI) filed a complaint with the U.S. Food and Drug Administration (FDA) to alt the marketing of NSA's Juice Plus Orchard Blend and Garden Blend capsules because the products appear to be adulterated and misbranded. CSPI said it was oncerned that the products' claim, he next best thing to fruits and vegetables, may lead consumers to believe the pills are closer to real fruits and vegetables than is likely to be the case." According to CSPI, the labels say the capsules contain high levels of vitamins A and C and folate naturally, but o not disclose that these vitamins and minerals are added to the capsules during processing and are nutrients only characteristic of the original fruit and vegetable sources.
Registered dietician Fudeko T. Maruyama and nutritional education specialist Mary P. Clarke of Kansas State University commented that he promotional literature for Juice Plus, billed as a whole food concentrate, is a carefully worded blend of incorrect information, misleading health claims, and nonscientific jargon and concluded that uice Plus probably won't harm you, but can hurt your pocketbook."
Others have provided similar skeptical assessments of Juice Plus+. However, as of 2008, the Juice Plus homepage still advertises that the products are he next best thing to fruits and vegetables.
In November 2007, the Complaints Resolution Panel for the Therapeutic Goods Administration Advertising Code Council ruled that statements on NSA Juice Plus website were in breach of Australia Therapeutic Goods Advertising Code. According to the panel, the lear message in the ads was that Juice Plus tablets/capsules are quivalent to fruits and vegetables and that onsuming Juice Plus tablets would help Australians to consume the ecommended 5-7 servings of fruits and vegetables. NSA was sanctioned by the Council to withdraw any representations that the products re equivalent to fruits and vegetables or that their consumption can aid in meeting dietary recommendations relating to fruits and vegetables.
Antioxidant activity
In vitro antioxidant activity of polyphenols (as exist in Juice Plus capsules) exaggerates what is the likely negligible antioxidant activity in vivo following oral ingestion and digestion. NSA nevertheless claims that Juice Plus is an effective antioxidant, and quotes a study that showed a 75% reduction in lipid peroxidation (an oxidative stress marker) in subjects that took Juice Plus for 7 to 28 days. Other studies have also reported reductions in lipid peroxidation and DNA oxidation. These three studies were not blinded or placebo-controlled, included few participants (in one case no more than 15), and did not include monitoring or control of the participants' food intake. Other studies conducted under more rigorous conditions, meaning randomized, double-blind, placebo-controlled studies, longer in duration and with more subjects, found no significant reductions in lipid peroxidation, DNA oxidation, or other markers of oxidative stress.
One study, which measured in vitro antioxidant activity, found that 1 g of Juice Plus Orchard Blend/Garden Blend powder (500mg of each combined) had the corresponding antioxidant capacity to approximately 10 g (fresh weight) of fruit or vegetable, amounting to 30 g (roughly one-third of a serving) per four capsules.
Jim Sears, a pediatrician and Juice Plus distributor/spokesperson who co-hosts the syndicated daytime television talk show The Doctors, claimed on a February 27, 2009 episode of the program that Juice Plus elps fight cancer. However, in October 2009, Dr. Barrie R. Cassileth, Chair and Chief of Integrative Medicine at Memorial Sloan-Kettering Cancer Center, cautioned that while Juice Plus is being ggressively promoted to cancer patients based on claims of antioxidant effects, the supplement should not be taken by patients because it can interfere with chemotherapy, nor should it be considered a substitute for fruits and vegetables.
Cardiovascular system
Several studies have examined the effects of Juice Plus capsules on biochemical parameters associated with cardiovascular function, again with conflicting results. In October 2009, Dr. Barrie R. Cassileth, Chair and Chief of Integrative Medicine at Memorial Sloan-Kettering Cancer Center, noted that the results of Juice Plus studies on plasma homocysteine levels were not reproducible, and that studies on cardiovascular effects, such as blood pressure and cholesterol, were inconclusive.
The effects of Juice Plus on blood levels of homocysteine have been reported in the following five studies all conducted in subjects with normal homocysteine levels (15 mol/L). An initial study, which was not double blinded or placebo controlled, reported a 37% decrease in homocysteine levels in subjects taking Juice Plus. More rigorous studies, including three that were randomized, double-blind, placebo-controlled trials, found that homocysteine levels were not reduced or were reduced to a much lesser extent than originally reported.
Two randomized, double-blind placebo controlled studies have examined the effect of Juice Plus on serum cholesterol and LDL levels. One study found that Juice Plus had no significant effects; the other found slight decreases in cholesterol (6%) and LDL (9%) in subjects that took Orchard/Garden Blend, but no reductions among subjects who took Juice Plus Vineyard blend in addition.
A study reported that a combined regimen of Juice Plus Orchard Blend and Garden Blend significantly decreased the impairment of brachial artery vasoactivity caused by a high-fat meal in healthy subjects. The addition of Vineyard Blend to this regimen had no additional effect on brachial artery vasoactivity and led to an increase in total lipoprotein and LDL as compared with Orchard Blend/Garden Blend alone. This study also found that Juice Plus had no effect on blood pressure.
In a randomized placebo-controlled, crossover study in overweight insulin-resistant adults, 8-week supplementation with Juice Plus had no significant effect on vascular endothelial function, serum insulin, blood glucose, body weight, total cholesterol, or LDL cholesterol.
Immune system
A non-randomized, non-blinded, non-controlled study in elderly cigarette smokers and non-smokers examined the effects of Juice Plus Orchard Blend and Garden Blend on 9 immunologic parameters, including stimulated T-cell cytokine production (IL-2, IL-6, TNF- and IFN-) and the activity of various immune cells (peripheral blood monocytes, natural killer [NK] cells, T-helper cells, and cytotoxic T cells). Juice Plus significantly increased peripheral blood monocyte proliferation and NK cell cytotoxicity in non-smokers but not in smokers, and increased in vitro IL-2 production by stimulated monocytes in both smokers and non-smokers. Juice Plus had no significant effect on cell counts (NK cells, T-helper cells, or cytotoxic T cells) or on the levels of IL-6, TNF-, or IFN- in either smokers or non-smokers. Memorial Sloan-Kettering Cancer Center noted several faults with this study including that it lacked placebo controls and was not blinded, that the results do not necessarily correlate with an overall increase in immunity, and that it would have been more informative had clinical parameters been measured, such as whether fewer patients became sick.
A double-blind, randomized, placebo-controlled study examined the effect of Juice Plus Orchard Blend and Garden Blend on T cell counts, lymphocyte cytokine production, Epstein-Barr virus (EBV) antibody titers, and the incidence of illness in healthy subjects. The percentage of circulating -CD3+ T cells and -CD3+ T cells did not change significantly in subjects who took Juice Plus; however, at the end of the supplementation period, subjects taking the supplement had a significantly higher percentage of -CD3+ T cells (7.2%) as compared with placebo (5.4%). IFN- produced by stimulated lymphocytes in vitro was reduced in the Juice Plus (68%) and placebo groups (41%), but the reduction was statistically significant only in the Juice Plus group. The levels of other cytokines (IL-4, IL-6, TGF-) were unchanged and Juice Plus had no significant effect on the incidence and symptoms of illness or on EBV antibody titers.
A double-blind, randomized, placebo-controlled 28-week study examined the effect of Juice Plus (two capsules each of Orchard Blend, Garden Blend, and Vineyard blend per day) on cytokine (i.e., IL-6 and TNF-) levels, and on the incidence of illness. Subjects who took Juice Plus had lower TNF- levels than the placebo group at later time points in the study (week 16 and 28) but overall the effect was not statistically significant. Juice Plus was found to have no significant effect on IL-6 levels or on the incidence of illness during the course of the study.
Adverse effects
Adverse effects of Juice Plus have been mentioned in three studies, none of which was randomized, blinded, or placebo-controlled. No monitoring of adverse effects was reported in other published Juice Plus studies. Memorial Sloan-Kettering Cancer Center noted that in one study, some subjects who took Orchard Blend and Garden Blend developed a hive-like rash. Another study in 2000 reported adverse effects (upper-respiratory tract, urinary, and musculoskeletal) in roughly a third of the participants who took the products for 7 days. These events resolved spontaneously and were deemed unlikely to have derived from use of Juice Plus. In a third study from 2007, some subjects withdrew due to gastrointestinal distress possibly caused by the Juice Plus regimen (a combination of Orchard Blend, Garden Blend, and Vineyard Blend).
Juice Plus Children's Research Foundation
The Juice Plus Children's Research Foundation, founded in 1997, is a non-profit medical research organization (NTEE code H99) whose stated goal is to initiate and/or support programs that advance the principle that improved nutrition leads to healthier lifestyle and overall better health in children. The foundation is chaired by executives of National Safety Associates and operates from the company's head office in Collierville, Tennessee. In fiscal year 2007, the majority of funds donated to the foundation were disbursed to Volunteers of America (faith-based social welfare organization) and to the Boys and Girls Clubs of Memphis.
As of 2009, no scientific research had been published by the Foundation. The Foundation's website shows results of an ongoing customer survey (The Juice Plus Children's Health Study) which suggests a link between Juice Plus consumption and a general improvement in diet and lifestyle habits. The University of California Berkeley Wellness Letter and Dr. Stephen Barrett of MLM Watch question the survey's scientific value, and claim that the Foundation is being used mainly as a marketing gimmick to get families to buy Juice Plus products. Quackwatch includes the JPCRF among its list of questionable research organizations (i.e., organizations formed by promoters of questionable health products to exaggerate their effectiveness).
References
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External links
Juice Plus - official website
Juice Plus+ - official website Japan
Categories: Dietary supplements | Multi-level marketingHidden categories: All pages needing cleanup | Accuracy disputes from January 2010 | All articles with dead external links | Articles with dead external links from January 2010 | Pages containing cite templates with deprecated parameters | NPOV disputes from December 2009 | All NPOV disputes
