Written by Karen Pilkington and the CAM-Cancer Consortium.
Updated March 15, 2017

Noni (Morinda citrifolia)

What it is?

Description

Noni is a small evergreen tree or shrub that grows in Pacific regions including Polynesia, Southeast Asia, India and Australia.1,2 The fruits, leaves, flowers, stems, bark, and roots have all been used in traditional remedies.2 Currently, most interest is in the yellow-green fruit, which produce a pungent odour while ripening (hence ‘Cheese Fruit’) and are used to produce juice.

Scientific and other names

Morinda citrifolia L. (a member of Rubiaceae, the coffee family).3

Morinda bracteata Roxb., Ba Ji Tian, canary wood, Cheese Fruit, Hai Ba Ji, Hawaiian Noni, hog apple, Indian Mulberry, Noni juice, Tahitian Noni.1,2

Ingredients/components

A wide range of components have been identified in the Noni plant. These include alkaloids, anthraquinones, beta-sitosterol, carotene, flavonol glycosides including rutin, iridoids, linoleic acid, ursolic acid and vitamins A and C.4 Two fatty acids, caproic (hexanoic) and caprylic (octanoic) acid may be responsible for the pungent odour of the fruit. New anthraquinones and saccharide fatty acid esters have also been isolated.5 The unfermented juice also contains glucose, fructose, proteins, lipids, calcium, magnesium, potassium and sodium.6,7 Two novel constituents, xeronine and proxeronine, were apparently identified by a researcher in Hawaii but have not been subsequently characterised or reported.8 Recently five new saccharide fatty acid esters, named nonioside P, nonioside Q, nonioside R, nonioside S, and nonioside T, and one new succinic acid ester were isolated, along with known compounds, from an extract of the fruit. Some of these showed inhibitory activities against melanogenesis in B16 melanoma cells induced with α-melanocyte-stimulating hormone (α-MSH).9

Application and dosage

Noni is administered both orally and topically. The fruit and juice are taken orally for a range of health reasons. The fruit and leaves are used in preparations for topical use in conditions such as arthritis, headaches, burns, sores and wounds. 10 Noni seed oil has also been promoted as a moisturiser for use in skin conditions and joint pain.1 Various dose regimens for the fruit juice are recommended by suppliers but no typical dosage has been established.2 One ounce (approximately 30ml) every 12 hours has been suggested for ‘overall health maintenance’.4 An application to the European Scientific Committee on Food for approval of ‘Tahitian Noni juice’ described the product as a mixture of 89% Noni fruit, 11% common grape and blueberry juice concentrates and natural flavours.11 The suggested consumption was 30 ml/day. Commercially manufactured capsules containing 500mg ripe Noni fruit extract have been used in trials in patients with advanced cancer based on a maximum recommended dose of 4 capsules (2 grams) daily.12

History/providers

Noni has been used by Polynesians for at least 2000 years and is considered one of the more important traditional Polynesian medicinal plants and is still produced locally.8 Preparations of Noni were applied topically, the roots were also to produce a clothes dye while the fruit was eaten as a food.4 The whole plant (roots, stems, bark, leaves, flowers and fruits) has been used in the preparation of medicinal remedies of which around 40 have been recorded.8 These were used to treat a range of common diseases and to maintain overall health.4

Various parts of the plant are still used to make remedies but patterns of use have changed.8 The main focus is on the fruit juice which is now manufactured on a large-scale and can be purchased from health food shops, other stores or via numerous websites.

Claims of efficacy

Manufacturers of Noni juice have claimed a wide range of therapeutic effects.4 Noni juice supposedly ‘helps protect cells from oxidative damage, contributes to the maintenance of normal bones, to a normal energy-yielding metabolism and to the normal formation of connective tissue'.13 There are also claims on various websites of beneficial effects in cancer.8 Traditional use is based on claims of beneficial effects in wound healing and treating inflammation and infection.8

Alleged indications

A wide range of potential indications have been proposed for Noni juice and it has been marketed as a general cure-all for various chronic conditions.14 Among the indications for which Noni is promoted are cancer, depression, diabetes, drug addiction, heart disease and obesity. An application for approval of a Noni juice product in Europe did not specify any indications other than general health benefits similar to those of other fruit juices.11

Mechanisms of action

Studies of the pharmacology of Noni and its constituents have focused on three main areas: cancer, inflammation and metabolic diseases although research is preliminary.6 Two constituents, a fatty acid glycoside and an iridoid, were reported to inhibit neoplastic cell transformation in mouse cells.6 A polysaccharide fraction obtained from the fruit juice, inhibited tumour activity and stimulated cytokine release.15 Prevention of the initiation of carcinogenesis, antimutagenic activity, and inhibition of angiogenesis with capillary vessel degeneration and apoptosis have all been reported.6 Inhibition of the growth of several cancer cell types has also been recorded in vitro using high concentrations of the extract.6 An anthraquinone isolated from Noni appears to be a potent inducer of an enzyme, quinone reductase, known to be protective against cancer due to its involvement in metabolism and elimination of carcinogens.16

Prevalence of use

Traditionally used in Polynesia and South East Asia, Noni has been marketed in Australia, Canada, Hong Kong, Japan, Mexico, Norway and the USA.11 Substantial increases in sales in the USA have been reported but it is not possible to substantiate these claims.6,14 Use has also increased in Western Europe.11 Women in the USA have reported utilizing noni for the prevention and treatment of breast cancer and as a secondary course of treatment following conventional chemotherapy.17

Legal issues

Food or drink products derived from Noni require authorisation in Europe. Several Noni products have been approved as novel food products in Europe. These include Noni juice in various forms: fresh, puree, concentrated, frozen, dried and mixed with other juices.18-20 The dried and roasted leaves have also been approved as a new novel food ingredient for the preparation of infusions.21

Cost and expenditures

The cost of Noni products varies, an average cost for Noni juice (based on online prices April 2017) is approximately EUR 45-47, US$ 40, or GBP 37, per litre. A week’s supply based on 60ml per day (as recommended by the manufacturers) would cost around EUR 20, US$17, GBP 16.13

Citation

Karen Pilkington, CAM-Cancer Consortium. Noni [online document]. http://cam-cancer.org/The-Summaries/Herbal-products/Noni. March 15, 2017.

Document history

Assessed as up to date in March 2017 by Barbara Wider.
Assessed as up to date in April 2016 by Barbara Wider.
Assessed as up to date in January 2015 by Barbara Wider.
Assessed as up to date in August 2013 by Barbara Wider.
Summary first published in September 2012, authored by Karen Pilkington.

References

  1. National Center for Complementary and Integrative Health (NCCIH). Herbs at a glance: Noni. (updated November 2016). Available at: https://nccih.nih.gov/health/noni. Accessed 15th March 2017.
  2. Natural Medicines Comprehensive Database. Noni monograph. [online]. Available at: http://naturaldatabase.therapeuticresearch.com. Accessed 15th March 2017.
  3. Kew Royal Botanic Gardens. Scientific Research and Data. Rubiaceae. Available at: http://www.kew.org/science-research-data/directory/teams/rubiaceae/index.htm. Accessed April 2012.
  4. Wang MY, West BJ, Jensen CJ, Nowicki D, Su C, Palu AK, Anderson G. Morinda citrifolia (Noni): a literature review and recent advances in Noni research. Acta Pharmacol Sin. 2002 Dec;23(12):1127-41.
  5. Akihisa T, Matsumoto K, Tokuda H, Yasukawa K, Seino K, Nakamoto K et al. Anti-inflammatory and potential cancer chemopreventive constituents of the fruits of Morinda citrifolia (Noni). J Nat Prod 2007; 70(5):754-757.
  6. Potterat O, Hamburger M. Morinda citrifolia (Noni) fruit--phytochemistry, pharmacology, safety. Planta Med. 2007 Mar;73(3):191-9. Epub 2007 Feb 7
  7. Mueller BA, Scott MK, Sowinski KM, Prag KA. Noni juice (Morinda citrifolia): hidden potential for hyperkalemia? Am J Kidney Dis. 2000 Feb;35(2):310-2.
  8. McClatchey W. From Polynesian healers to health food stores: changing perspectives of Morinda citrifolia (Rubiaceae). Integr Cancer Ther. 2002 Jun;1(2):110-20; discussion 120.
  9. Akihisa T, Tochizawa S, Takahashi N, Yamamoto A, Zhang J, Kikuchi T, Fukatsu M, Tokuda H, Suzuki N. Melanogenesis-Inhibitory Saccharide Fatty Acid Esters and Other Constituents of the Fruits of Morinda citrifolia (Noni). Chem Biodivers. 2012 Jun;9(6):1172-87.
  10. MD Anderson Cancer Center. Complementary/Alternative Medicine Education Resources, Therapies: Noni Juice. Available at: http://www.mdanderson.org/education-and-research/resources-for-professionals/clinical-tools-and-resources/cimer/therapies/herbal-plant-biologic-therapies/Noni.html. Accessed April 2012.
  11. European Commission Scientific Committee on Food. Opinion of the Scientific Committee on Food on Tahitian Noni® juice. 2002. Available at: www.noni-pei.ru/ec.pdf. Accessed April 2012.
  12. Issell BF, Gotay CC, Pagano I, Franke AA. Using Quality of Life Measures in a Phase I Clinical Trial of Noni in Patients With Advanced Cancer to Select a Phase II Dose. J Diet Suppl. 2009;6(4):347-59.
  13. Tahitian Noni International. Noni is the difference. Available at: http://research.tni.com/united_kingdom/uk_english/research/difference.html. Accessed April 2012.
  14. Pawlus AD, Kinghorn DA. Review of the ethnobotany, chemistry, biological activity and safety of the botanical dietary supplement Morinda citrifolia (noni). J Pharm Pharmacol. 2007 Dec;59(12):1587-609.
  15. Hirazumi A, Furusawa E. An immunomodulatory polysaccharide-rich substance from the fruit juice of Morinda citrifolia (noni) with antitumour activity.Phytother Res. 1999 Aug;13(5):380-7.
  16. Pawlus AD, Su BN, Keller WJ, Kinghorn AD. An anthraquinone with potent quinone reductase-inducing activity and other constituents of the fruits of Morinda citrifolia (noni). J Nat Prod. 2005 Dec;68(12):1720-2.
  17. Boon HS, Olatunde F, Zick SM, Trends in complementary/alternative medicine use by breast cancer survivors: comparing survey data from 1998 and 2005. BMC Women’s Health 2007, 7, article 4.
  18. National Archives Foods Standards Agency. Noni Product Accepted. 2006. Available at: http://food.gov.uk/news/newsarchive/2006/jan/nonihnllc. Accessed 15th March 2017.
  19. European Food Safety Authority. Opinion on a request from the Commission related to the safety of noni juice (juice of the fruits of Morinda citrifolia). The EFSA Journal 2006; 376: 1-12.
  20. European Food Safety Authority. Opinion on the safety of Tahitian Noni® ‘Morinda citrifolia (noni) fruit puree and concentrate’ as a novel food ingredient. The EFSA Journal 2009; 998: 1-16.
  21. European Food Safety Authority. Safety of ‘leaves from Morinda citrifolia L.’: Scientific Opinion of the Panel on Dietetic Products, Nutrition and Allergies. The EFSA Journal 2008; 769: 1-17.
  22. Wang MY, Peng L, Lutfiyya MN, Henley E, Weidenbacher-Hoper V, Anderson G. Morinda citrifolia (noni) reduces cancer risk in current smokers by decreasing aromatic DNA adducts. Nutr Cancer. 2009;61(5):634-9.
  23. Wang MY, Lutfiyya MN, Weidenbacher-Hoper V, Anderson G, Su CX, West BJ. Antioxidant activity of noni juice in heavy smokers. Chem Cent J. 2009 Oct 6;3:13.
  24. Arpornsuwan T, Punjanon T. Tumor cell-selective antiproliferative effect of the extract from Morinda citrifolia fruits. Phytother Res 2006; 20(6):515-517.
  25. Beh HK, Seow LJ, Asmawi MZ, bdul Majid AM, Murugaiyah V, Ismail N et al. Anti-angiogenic activity of Morinda citrifolia extracts and its chemical constituents. Nat Prod Res 2012.
  26. Brown AC. Anticancer Activity of Morinda citrifolia (Noni) Fruit: A Review. Phytother Res 2012; 26(10):1427-40. .
  27. Clafshenkel P, King TL, Kotlarczyk MB,Cline JM, Foster WG, Davis VL,Witt-Enderby P. Morinda citrifolia (Noni) Juice Augments Mammary Gland Differentiation and Reduces Mammary Tumor Growth in Mice Expressing the Unactivated c-erb B2 Transgene. Evidence-Based Complementary and Alternative Medicine 2012; doi: 10.1155/2012/487423.
  28. West BJ, White LD, Jensen CJ, Palu AK. A double-blind clinical safety study of Noni fruit juice. Pac Health Dialog. 2009 Nov;15(2):21-32.
  29. West BJ, Jensen CJ, Westendorf J. Noni juice is not hepatotoxic. World J Gastroenterol. 2006 Jun 14;12(22):3616-9.
  30. West BJ, Su CX, Jensen CJ. Hepatotoxicity and subchronic toxicity tests of Morinda citrifolia (noni) fruit. J Toxicol Sci. 2009 Oct;34(5):581-5.
  31. West BJ, Tolson CB, Vest RG, Jensen S, Lundell TG. Mineral variability among 177 commercial noni juices. Int J Food Sci Nutr. 2006 Nov-Dec; 57(7-8):556-8.
  32. Wang MY, Hurn J, Peng L, Nowicki D, Anderson G. A multigeneration reproductive and developmental safety evaluation of authentic Morinda citrifolia (noni) juice. J Toxicol Sci. 2011 Jan;36(1):81-5.
  33. Carr ME, Klotz J, Bergeron M. Coumadin resistance and the vitamin supplement "Noni". Am J Hematol. 2004 Sep;77(1):103.
  34. Nima S, Kasiwong S, Ridtitid W, Thaenmanee N, Mahattanadul S. Gastrokinetic activity of Morinda citrifolia aqueous fruit extract and its possible mechanism of action in human and rat models. Journal of Ethnopharmacology 2012; 142: 354–361.