Pistacia vera / Pistacia lentiscus / Mastiekboom

De mastiekboom (Pistacia lentiscus L.) is een struik of boom uit de pruikenboomfamilie (Anacardiaceae) die wijdverspreid voorkomt in mediterrane kustgebieden, Portugal en tropisch Afrika. Op het Griekse eiland Chios bestaat een cultivar, Pistacia lentiscus var. chia (Desf. ex Poiret) DC., waaruit de bekende hars mastiek wordt gewonnen. Chios is sinds de middeleeuwen de belangrijkste mastiekproducent en het eiland exporteert Chios Mastiha over de hele wereld. Het is door de EU bestempeld als een Protected Designation of Origin. 

OUDHEID Mastiek was al bekend in de late steentijd. De eerste vermeldingen van de medicinale effecten van Chios-mastiek zijn echter afkomstig van oud-Griekse artsen, zoals Hippocrates, Dioscorides, Galenus en Theophrastos. Zij raadden het gebruik ervan aan voor een verscheidenheid aan indicaties, van indigestie, maagkramp, dyspepsie, maagzweer en chronische hoest tot ‘problemen met bloed’. Ook werd het gebruikt als kalmerend middel. Het zou bijdragen aan een goede werking van het maag-darmstelsel en maagpijn verhelpen. Het werd gebruikt bij (maag)spierzwakte en ontstekingen van de maag, darm en lever, om het lichaam en gezicht te reinigen en als kauwgom om de tanden schoon te maken en de adem te verfrissen. De etherische olie, mastiekolie, heeft samentrekkende eigenschappen en werd onder andere gebruikt bij aandoeningen van de baarmoeder. Mastiek wordt ook regelmatig vermeld in veel Europese farmacopees tussen de 16e en de 18e eeuw.

Tegenwoordig is mastiek een ingrediënt in de Griekse keuken, maar ook in kauwgom en parfum. Daarnaast wordt het gebruikt in de tandheelkunde, in cosmetische en mondverzorgende producten en in verzorgingsproducten in het algemeen. De hars is wetenschappelijk onderzocht, waarbij het meestal P. lentiscus var. Chia betreft. Klinische onderzoeken laten zien dat mastiek de concentratie van Helicobacter pylori kan verminderen en daarmee werkzaam is tegen gastritis en maagzweren die door deze bacterie veroorzaakt kunnen worden. Het verlicht symptomen die daarmee gepaard gaan zoals maagpijn, (maag) zuurbranden en boeren. 

Algemene symptomen waarop mastiek ook een duidelijk effect heeft zijn onder andere: maagpijn in het algemeen, maagpijn door psychische spanningen, doffe pijn in de bovenbuik en zuurbranden. Mastiek verbeterde de klachten van functionele dyspepsie na drie weken behandelen in vergelijking met een placebo. Het gebruik van de hars als kauwgom vermindert ongewenste bacteriële groei in het speeksel, met name Streptococcus mutans en Lactobacillus spp., waardoor het de vorming van tandplak tegengaat en preventief gebruikt kan worden tegen gaatjes. Het helpt bij wondgenezing en vernieuwing van de huid zonder ongewenste bijwerkingen zoals irritatie, jeuk enzovoort. Er zijn sterke aanwijzingen dat mastiek een belangrijke regulator van het immuunsysteem kan zijn bij de ziekte van Crohn. Het lijkt er tevens op dat het cholesterol- en bloedsuikerwaardes verlaagt. Mastiek wordt goed verdragen. Er zijn geen bijwerkingen, vergiftigingen of interacties met medicijnen aangetroffen in klinische onderzoeksliteratuur en case studies.

 “Chios mastiha: A tear that gladdens, scents, comforts, cures!” Uit: Chios Mastiha: Medical and Scientific Reports, een brochure van de Chios Mastiha Growers Association.

http://fyto.nl/wp-content/uploads/2017-3.pdf

REFERENTIES | [1] EMA/HMPC/46756/2015 Committee on Herbal Medicinal Products (HMPC). Assessment report on Pistacia lentiscus L., resin (mastix). 2015. [2] Langenheim JH. Plant Resins. Chemistry, Evolution, Ecology, and Ethnobotany. Timber Press Portland/ Cambridge 2003:385. [3] Manolaraki F, Sotiraki S, Stefanakis A, Skampardonis V, Volanis M, Hoste H. Anthelmintic activity of some Mediterranean browse plants against parasitic nematodes. Parasitology 2010;137(4):685-696. [4] Landau S,  Azaizeh H, Muklada H, Glasser T, Ungar ED, Baram H, Abbas N, Markovics A. Anthelmintic activity of Pistacia lentiscus foliage in two Middle Eastern breeds of goats differing in their propensity to consume tannin-rich browse. Vet Parasitol 2010;173(3-4):280-286. [5] Markovics A, Cohen I, Muklada H, Glasser TA, Dvash L, Ungar ED, Azaizeh H, Landau SY. Consumption of Pistacia lentiscus foliage alleviates coccidiosis in young goats. Vet Parasitol 2012;186(3-4):165- 169. [6] www.plantlist.org geraadpleegd op 14-6-2017.[7] NTvF 2016;4:7. [8] Amit M, Cohen I, Marcovics A, Muklada H, Glasser TA, Ungar ED, Landau SY. Self-medication with tannin-rich browse in goats infected with gastro-intestinal nematodes. Vet Parasitol 2013;198(3-4):305-311.



Pistachio Consumption Decreases Glucose and Insulin Levels in Patients with Prediabetes
Hernández-Alonso P, Salas-Salvadó J, Baldrich-Mora M, Juanola-Falgarona M, Bulló M. Beneficial effect of pistachio consumption on glucose metabolism, insulin resistance, inflammation, and related metabolic risk markers: a randomized clinical trial. Diabetes Care. November 2014;37(11):3098-3105.

Prediabetes is a metabolic condition characterized by impaired glucose tolerance and higher fasting glucose levels. The condition is thought to affect more than 900 million people worldwide, and if left untreated, can progress to type 2 diabetes mellitus. Following a healthy lifestyle, including diet, can help reverse prediabetic conditions. Nut consumption has been shown to benefit health outcomes and total mortality in epidemiological studies and controlled clinical trials. To date, say the authors, no studies have evaluated the chronic effect of nut intake on glucose metabolism and insulin resistance in patients with prediabetes. They conducted a randomized, controlled, crossover trial to measure the effect of a diet rich in pistachios (Pistacia vera) on glucose and insulin metabolism and other metabolic-related risk factors in patients with prediabetes.

Eligible patients were men and women aged 25 to 65 years with a body mass index <35 kg/m2 and fasting plasma glucose levels measuring 100-125 mg/dL. They were recruited from primary care centers affiliated with the Universitari Hospital of Sant Joan de Reus in Reus, Spain. At baseline, a medical history, physical examination, and blood sample collection was performed for each patient.

Fifty-four patients (mean age, 55 years) were instructed to follow a normocaloric diet (50% of energy as carbohydrates, 15% as protein, and 35% as total fat) during a 2-week run-in period before the study began. They were then randomly assigned to follow a control diet (CD) or a pistachio-supplemented diet (PD). The PD group received 2 ounces of pistachios (57 g) daily for 4 months. The CD group compensated for the energy from pistachios in the PD group by intake of other fatty foods. At the end of 4 months, another 2-week run-in period was conducted before the patients crossed over to the alternate intervention.
The patients were examined after the 2-week run-in period and then monthly until the end of each 4-month intervention period. At the beginning of each intervention period and every 2 months thereafter, dietary intake and physical activity were evaluated. Fasting blood samples were collected at baseline and at the end of each 4-month intervention period. Of the 54 patients at baseline, 5 dropped out during the pistachio intervention because of personal reasons. No adverse gastrointestinal side effects were observed during the trial.

In the intention-to-treat analysis, glucose and insulin circulating levels decreased significantly during the PD intervention compared with the CD intervention (P<0.001). Also, homeostasis model assessment-estimated insulin resistance (HOMA-IR) decreased significantly during the PD intervention compared with the CD intervention (P<0.001). However, no significant changes were observed in HOMA-β-cell function (a measurement of insulin secretion) or glycated hemoglobin (HbA1c) between the 2 interventions.

Lipid profiles did not change significantly between the 2 interventions; however, low-density lipoprotein cholesterol (LDL-C) levels were nonsignificantly reduced after the pistachio intervention and increased during the CD intervention. "Our results … support the hypothesis that the lipid profile of metabolic syndrome subjects is less likely to undergo changes," write the authors, "because alteration in the cholesterol homeostasis inherent to the obese state makes them resistant to downregulating cholesterol."1

Examination of cellular glucose uptake revealed a significant decrease in cellular glucose transport lymphocytes after the PD intervention compared with the CD intervention (P=0.01).

At baseline, inflammatory and metabolic risk markers were similar among the patients. For those following the PD, the cardiometabolic risk markers fibrinogen and platelet factor 4 (PF-4) significantly decreased during the intervention compared with those following the CD (P<0.05). Glucagon-like peptide-1 (GLP-1) increased during the PD intervention compared with the CD intervention. The authors suggest that the increased GLP-1 levels during the PD intervention explain the effect of pistachios on insulin metabolism. The gastric hormone GLP-1 stimulates insulin secretion and suppresses glucagon secretion in a glucose-dependent manner.2
In the per-protocol approach, oxidized LDL (ox-LDL) decreased significantly during the PD intervention and increased during the CD intervention (P=0.03).
Gene expression data showed that interleukin-6 (IL-6) and resistin decreased significantly by 9% and 6%, respectively, during the PD intervention compared with the CD intervention (P<0.05 for changes between the 2 interventions). Solute carrier family 2 (facilitated glucose transporter), member 4 (SLC2A4) gene expression showed a significant 69% increase during the CD intervention compared with the PD intervention (P=0.03). "These results suggest a potential mechanism by which pistachios could lead to a healthier systemic inflammatory profile," and " … reinforce the potential anti-inflammatory effect of pistachio nuts and their role in chronic inflammatory diseases," write the authors.

Among this trial's strengths are the crossover, randomized design; its medium-term duration; its dietary compliance markers; and its systemic and cellular approaches. Because the trial focuses only on patients with prediabetes, however, the authors suggest that its results may only be extrapolated to healthy subjects or patients with diabetes with caution, until further studies are conducted.
Because pistachios are richer in lutein, β-carotene, and γ-tocopherol than other nuts, they tend to benefit the inflammatory and oxidative states. This study's per-protocol results found a significant reduction in ox-LDL during the PD intervention. Although no change in circulating IL-6 levels was observed, other inflammatory and metabolic risk markers were reduced significantly.

Integrating "pistachios into a balanced diet is proving to be a safe nutritional strategy that can help reverse the risks associated with prediabetes," conclude the authors. The results of this study demonstrate that chronic pistachio consumption "decreases glucose and insulin levels, thus improving insulin resistance and other inflammatory and metabolic risk markers."

—Shari Henson

References
1Sabaté J, Oda K, Ros E. Nut consumption and blood lipid levels: a pooled analysis of 25 intervention trials. Arch Intern Med. May 10, 2010;170(9):821-827.
2Yabe D, Seino Y. Two incretin hormones GLP-1 and GIP: comparison of their actions in insulin secretion and β cell preservation. Prog Biophys Mol Biol. November 2011;107(2):248-256. 
  
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