rhubarb facts; rhubarb nutritional value; rhubarb benefits and side effects
Rhubarb Facts
Rhubarb is a relative of buckwheat and has an earthy, sour flavor. Rhubarb thrives in cold climates and originated in
Western China, Tibet, Mongolia, Siberia and neighboring areas. The traditional role was medicinal-the dried root was a
popular remedy for a wide range of illnesses. Its primary function was to induce vomiting, although rhubarb is also a
mild astringent. This medicinal role caused the price of the dried root to rise. In 1542, rhubarb sold for ten times the
price of cinnamon in France and in 1657 rhubarb sold for over twice the price of opium in England (Schneider, 2001).
Beginning in the eighteenth century, rhubarb began to be consumed in foods, primarily drinks and meat stews.

Botanically speaking, rhubarb is considered a vegetable, but it's most often treated as a fruit — though it's rarely
eaten raw. Just like fresh cranberries, rhubarb is almost unbearably tart on its own and needs the sweetness of sugar,
honey, or fruit juice added to it to balance out the acidity. Rhubarb's nickname is the "pie plant" because that is the
primary use for this vegetable.

Rhubarb was introduced to the United States at the end of the eighteenth century. Today most rhubarb is frozen for
commercial and institutional use; only about a quarter of the crop is sold fresh.

rhubarb nutritional value
One serving size of Rhubarb (half cup of diced, 61g) contains 15 calories, 3 g of total carbohydrate, 1 g of dietary fiber,
1 g of sugar, 1 g of protein and small amounts of calcium, vitamins A and C.

Hothouse, or strawberry, rhubarb appears in markets as early as January and continues to be stocked through April.
Field-grown, or cherry, rhubarb begins to arrive in markets in March and can continue to arrive through the summer
(depending on the area where it is grown). Spring stalks are the juiciest and most-tender.

Fresh stalks are flat, not curled or limp. When stalks that have been pulled-not cut-from the field are available; choose
them. Pulled stalks dry out less rapidly. Size is no indicator of tenderness. Deep red stalks are sweeter and richer.

Potential Health Benefits of Rhubarb

Rhubarb may have benefits of cutting cancer risks.
Rhubarb has been used as a traditional Chinese medicine since ancient times and today it is still applied in various
herbal preparations for health benefits. Reseachers from  National University of Singapore studied the toxicological and
anti-neoplastic potentials of the main anthraquinones from Rhubarb, Rheum palmatum. [1]

It is interesting to note that although the chemical structures of various anthraquinones in this plant are similar, their
bioactivities are rather different. The most abundant anthraquinone of rhubarb, emodin, was capable of inhibiting
cellular proliferation, induction of apoptosis, and prevention of metastasis. These capabilities seem to act through
tyrosine kinases, phosphoinositol 3-kinase (PI3K), protein kinase C (PKC), NF-kappa B (NF-kappaB), and mitogen-
activated protein kinase (MAPK) signaling cascades. Aloe-emodin is another major component in rhubarb to have anti-
tumor properties. Its anti-proliferative property is related to p53 and its downstream p21 pathway. [1]

A recent study suggests that the molecular targets of these two anthraquinones are different, though both potentiate
the anti-proliferation of various chemotherapeutic agents. Rhein another major rhubarb anthraquinone effectively
inhibited the uptake of glucose in tumor cells, caused changes in membrane-associated functions and led to cell death
in the study. [1]

A study has shown that rhubarb help patients with gastric cancer to recover after operations. Patients in the study
group were fed with rhubarb before operation, and at 1 day and 2 days after operation.

Rhubarb positively modulated the acute inflammatory response, promoted the recovery of postoperative
gastrointestinal motility, and benefited enteral nutrition support in patients who have undergone major operations for
gastric cancer. [3]

However, some test-tubes studies showed that some rhubarb ingredients might have mutagenic activities. But the
clinical link between the use of rhubarb and the development of gastric cancer was not clear. [4]

Rhubarb may have benefit on circulation - vasodilation or vasoconstriction?
An aqueous extract of rhubarb (Rheum undulatum L) was found to exhibit a distinct vasorelaxant activity. This aqueous
extract induced a concentration-dependent relaxation of the phenylephrine-precontracted aorta. After a series of
experiments, researchers concluded that the extract dilated vascular smooth muscle and suppressed the vascular
inflammatory process via endothelium-dependent NO/cGMP signaling. [2]

On the other hand, rhubarb and Sanchi Powder were found to promote vasoconstriction, shortening the bleeding time
and blood arresting. The combination could also increase the platelet count and improve the platelet aggregation. [5]

A study of rabbits has demonstrated the beneficial effects on hemorrhagic pancreatitis. Researchers first injected living
measles virus into the main pancreatic duct and the ear vein of the rabbits, leading to increased serum amylase. They
then treated some rabbits with rhubarb. They found that rhubarb treated animals had a lower serum amylase. [29]

There is also a report that it helps stop bleeding from upper digestive tract. [30]

Rhubarb can be used in muscle contraction, in vitro studies suggested.
Rhubarb has exciting actions on isolated gastric smooth muscle strips of guinea pig. The exciting action of rhubarb is
partly mediated via cholinergic M receptor, cholinergic N receptor and L-type calcium channel. [6]

Rhubarb can stimulate the motility of isolated gallbladder muscle strips from guinea pigs. The stimulation of rhubarb
was believed to be related to M receptor, Ca(2+) channel and alpha receptor partly. [7]

Researchers also found that serum containing Rhubarb Mixture amplified the contraction amplitude of an isolated small
intestinal smooth muscle of rabbit. The rate of change of contraction amplitude was elevated significantly after
administration, while the frequency of contraction did not change obviously. [8]

Though there are some in vitro evidence that rhubarb may cause vasconstriction, it showed a protective measure for
high blood pressure during pregnancy. [9, 10]

Researchers found that low doses of rhubarb prevented hypertension developed during pregnancy. Rhubarb (140
cases) or placebo (125 cases) was given to women at risk of hypertension consecutively from the 28th week of
gestation till delivery, and another 68 pregnant women as control. Results showed that 5.7% of rhubarb treated women
developed hypertension, a rate substantially lower than the 20.8% of the placebo group (P < 0.01). [9]

Rhubarb may benefit those with high cholesterol. [11,13]
Both experimental and clinical studies have indicated that a novel source of dietary fibre, produced from rhubarb
(Rheum rhaponticum) stalks, is potentially hypolipidaemic. Researchers found that rhubarb fiber could actually
increase excretion of bile acids and induction of cholesterol 7 alpha-hydroxylase activity in both the normal and the
cholesterol-fed mice. [11]

In a study of 10 patients suffered from high cholesterol, Canadian researchers supplemented the patients with 27 g of
ground rhubarb stalk fiber per day for 4 weeks. They claimed that rhubarb fiber supplementation resulted in significant
lowering of serum total cholesterol (8%) and low-density lipoprotein (LDL) cholesterol (9%). These results signify the
potential uses of underutilized rhubarb crop.

Rhubarb (Rheum rhapontiam) stalk fibre was previously shown to be hypolipidaemic under clinical and experimental
conditions. However, the rhubarb-fibre diet had no effect on the plasma cholesterol or triacylglycerol concentrations of
diabetic rats. [13]

Rhubarb has benefits of anti-oxidant, anti-infammatory and anti-allergy activities. [14-18]
The methanolic extracts from five kinds of rhubarb were found to show scavenging activity for DPPH radical and .O2-.
[14]

Rhubarb supplements showed positive impact on liver inflamation. In a study of 44 patients of hepatitis, researchers
supplied patients with rhubarb, while they supplemented another 20 patients with inosine, vitamin C and glucose as a
control group. They found a satisfactory to marked improvement in 39 patients of the rhubarb-treated group, while only
10% of the control group showed improvements. [16]

Japanese researchers found that the rhizome of Rheum undulatum inhibited the allergic reactions in an animal study
and that these inhibitory effects might be partially attributable to the stilbenes. [17]

Researchers from Kyoto Pharmaceutical University, Japan, demonstrated that stilbenes from the rhizomes of Rheum
undulatum (Korean rhubarb) and the related compounds had anti-allergic activities. Active stilbenes such as
piceatannol, 3,5,4'-trimethylpiceatannol, resveratrol, trimethylresveratrol inhibited ionomycin-induced beta-
hexosaminidase release. And, piceatannol, 3,5,4'-trimethylpiceatannol, resveratrol, and trimethylresveratrol also
significantly inhibited antigen-induced release of TNF-alpha and IL-4 in RBL-2H3 cells. [18]

Rhubarb can exert protective effects on severe acute pancreatitis in rats, probably by inhibiting the inflammation of
pancreas, improving pancreatic microcirculation, and altering exocrine secretion. [35]

Rhubarb demonstrated immune modulation in some test-tube and animal studies. [19, 20]

Some studies showed rhubarb extracts may prevent stone formation. Rhubarb has shown benefits on renal failure or
toxicity in test-tube and animal studies. [21-25]

Researchers found that a rhubarb extract prevented calcium phosphate precipitation in a in vitro study. Thus, they
suggested that supplementation of rhubarb extract may have benefit of preventing calculus formation. [21]

Treatment of chronic renal failure with rhubarb and adjuvant drugs combined with other appropriate measures
alleviates the suffering of the patients and improves the quality of their survival. [22]

In a clinical trial of 38 patients, Japanese researchers found that rhubarb can retard the introduction-period of
hemodialysis and can also inhibit deterioration of the chronic renal failure. [25]

Rhubarb may have protective effects on lung, too; animal studies suggested.
In a study of rats, rhubarb and dexamethasone could significantly reduce the edema of the lung tissue, decrease the
red blood cell exudation, neutrophil infiltration and plasma protein exudation in the alveoli and all the biological markers
in comparison with the acute lung injury model rats, indicating these two substances have protective action on vascular
endothelium and alveolar epithelium. [26]

A study of rats showed that the application of rhubarb and dexamethasone could decease the expression and
ameliorate the lung damage induced by lipopolysaccharide injection. [27]

Rhubarb was found to have anti-Bacterial, anti-viral effects from animal or test-tube studies. [31, 32, 34]

Researchers from Japan found that rhubarb root (Rheum officinale)and its active ingredient-rhein had significant
activities against bacteroides fragilis which is a major anaerobic microorganism in the intestinal flora of humans. ost
patients can take care of themselves after treatment, and some can engage in half-day work. The treatment prolongs
the life of the patient, and reduces medical expenses. [31, 28]

An animal study showed its effects on herpes simplex virus(HSV) infection. [34]

SIDE EFFECTS AND WARNING
Rhubarb has been used in Chinese traditional medicine for a long time. its side effects should be minimal for usual
doses and dosage design. However, the side effects could be serious if you have cancer or vascular issues. It is
unclear if rhubarb is anti-cancer or carcinogenic. There are reports that it may cause cancer; there are also reports
that its ingredients have anti-cancer activities. Its effect on vascular system is also unclear. A few reports indicated its
vasodilutory effects, while some showed its muscle contraction effects. It may also enhance blod clotting.

The side effects for eating its leave can be fatal. The leaves are poisonous because they contain oxalate. This toxin,
plus another unknown toxin also found in the leaves, has been reported to cause poisoning when large quantities of
raw or cooked leaves are ingested. Some ingredients of rhubarb were also found to be phototoxic.

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[1] Huang Q, et al, Anti-cancer properties of anthraquinones from Rhubarb. Med Res Rev. 2006 Oct 4. [2] Moon MK,et al, Vasodilatory and anti-
inflammatory effects of the aqueous extract of rhubarb via a NO-cGMP pathway.Life Sci. 2006 Feb 28;78(14):1550-7. Epub 2005 Nov 2. [3] Cai J, et al,
Effects of perioperative administration of Rhubarb on acute inflammatory response in patients with gastric cancer. Zhong Xi Yi Jie He Xue Bao. 2005 May;
3(3):195-8. [4] Mantani N, Rhubarb use in patients treated with Kampo medicines--a risk for gastric cancer? Yakugaku Zasshi. 2002 Jun;122(6):403-5. [5]
Fu DC, Yu CY.Observation on therapeutic effect of Rhubarb and sanchi powder in treating patients with hemorrhagic fever in nephrotic syndrome
complicated with digestive tract bleeding Zhongguo Zhong Xi Yi Jie He Za Zhi. 2005 Aug;25(8):744-7. [6] Yu M, et al,Effects of rhubarb on isolated gastric
muscle strips of guinea pigs. World J Gastroenterol. 2005 May 7;11(17):2670-3. [7] Luo YL, et al, Effect of rhubarb on contractile response of gallbladder
smooth muscle strips isolated from guinea pigs.World J Gastroenterol. 2005 Feb 14;11(6):863-6.[8] Zhang HQ, et al, Effect of Compound Rhubarb Mixture
on contraction of isolated small intestinal smooth muscle of rabbit. Zhong Xi Yi Jie He Xue Bao. 2004 May;2(3):210-2. [9] Zhang ZJ, et al, Low-dose of
processed rhubarb in preventing pregnancy induced hypertension Zhonghua Fu Chan Ke Za Zhi. 1994 Aug;29(8):463-4, 509. [10] Wang Z et al, ,Clinical
observation on therapeutical effect of prepared rhubarb in treating pregnancy induced hypertension Zhongguo Zhong Xi Yi Jie He Za Zhi. 1999 Dec;19(12):
725-7. [11] Goel V, et al,  Dietary rhubarb (Rheum rhaponticum) stalk fibre stimulates cholesterol 7 alpha-hydroxylase gene expression and bile acid
excretion in cholesterol-fed C57BL/6J mice.Br J Nutr. 1999 Jan;81(1):65-71. [12] Goel V, et al, Journal of the American College of Nutrition, Vol 16, Issue 6
600-604. [13] Cheema SK, et al, Dietary rhubarb (Rheum rhaponticum) stalk fibre does not lower plasma cholesterol levels in diabetic rats.Br J Nutr. 2003
Feb;89(2):201-6. [14] Matsuda H, et al, Antioxidant constituents from rhubarb: structural requirements of stilbenes for the activity and structures of two
new anthraquinone glucosides.Bioorg Med Chem. 2001 Jan;9(1):41-50. [15] Peng SM, et al, Effect of rhubarb on inflammatory cytokines and complements
in patients with systemic inflammation reaction syndrome and its significance Zhongguo Zhong Xi Yi Jie He Za Zhi. 2002 Apr;22(4):264-6. [16]Huang ZH, et
al, Clinical observation on treatment of infantile cholestatic hepatitis syndrome by rhubarb Zhongguo Zhong Xi Yi Jie He Za Zhi. 1997 Aug;17(8):459-61.
[17] Matsuda H, et al, Study on anti-Oketsu activity of rhubarb II. Anti-allergic effects of stilbene components from Rhei undulati Rhizoma, Biol Pharm Bull.
2001 Mar;24(3):264-7. [18] Matsuda H, et al, Anti-allergic activity of stilbenes from Korean rhubarb (Rheum undulatum L.): structure requirements for
inhibition of antigen-induced degranulation and their effects on the release of TNF-alpha and IL-4 in RBL-2H3 cells.Bioorg Med Chem. 2004 Sep 15;12(18):
4871-6. [19] Ma L.Experimental study on the immunomodulatory effects of rhubarb Zhong Xi Yi Jie He Za Zhi. 1991 Jul;11(7):418-9, 390.
[20] Chen XL, et al, Effect of rhubarb on intestinal immune associated secretion in healthy mice and in burn mice Zhongguo Zhong Xi Yi Jie He Za Zhi.
2001 Oct;21(10):754-6. [21] Hidaka S, et al, Effects of a rhubarb (Rhei rhizoma) solution and its fractions on the formation of calcium phosphate
precipitates.J Periodontal Res. 1996 Aug;31(6):408-13. [22] Yokozawa T, et al, Effects of rhubarb tannins on uremic toxins.Nephron. 1991;58(2):155-60.
[23] Tian J, et al, Effects of Cordyceps sinensis, rhubarb and serum renotropin on tubular epithelial cell growth Zhong Xi Yi Jie He Za Zhi. 1991 Sep;11(9):
547-9, 518. [24] Yokozawa T, et al,Effects of rhubarb tannins on renal function in rats with renal failure. Nippon Jinzo Gakkai Shi. 1993 Jan;35(1):13-8. [25]
Sanada H.Study on the clinical effect of rhubarb on nitrogen-metabolism abnormality due to chronic renal failure and its mechanism Nippon Jinzo Gakkai
Shi. 1996 Aug;38(8):379-87. [26] Li C, et al, Protective effect of rhubarb on endotoxin-induced acute lung injury.J Tradit Chin Med. 2001 Mar;21(1):54-8.
[27] Chunsheng L, et al, Expression of intercellular adhesion molecule in lung tissues of experimental acute lung injury and the affect of Rhubarb on it.
Chin Med Sci J. 2000 Jun;15(2):93-7. [28] Kang Z, et al, Observation of therapeutic effect in 50 cases of chronic renal failure treated with rhubarb and
adjuvant drugs.J Tradit Chin Med. 1993 Dec;13(4):249-52.[29] Role of a virus in hemorrhagic pancreatitis and the therapeutic effect of rhubarb,Zhong Xi Yi
Jie He Za Zhi. 1990 Mar;10(3):162-3, 133. [30] Zhou H, et al, 312 cases of gastric and duodenal ulcer bleeding treated with 3 kinds of alcoholic extract
rhubarb tablets Zhong Xi Yi Jie He Za Zhi. 1990 Mar;10(3):150-1, 131-2.[31] Cyong J, et al, Anti-Bacteroides fragilis substance from rhubarb, J
Ethnopharmacol. 1987 May;19(3):279-83. [32] Hu P, et al, Treatment of bacterial peritonitis with dachengqi decoction and rhubarb in mice Zhongguo Zhong
Xi Yi Jie He Za Zhi. 2000 Jan;20(1):53-4. [33] Wang ZY, et al, Inhibition effects of rhubarb ethanol extract on herpes simplex virus infection in vivo
Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2003 Jun;17(2):169-73. [[35] Zhao YQ, et al, Protective effects of rhubarb on experimental severe
acute pancreatitis.World J Gastroenterol. 2004 Apr 1;10(7):1005-9.
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