Camu camu

Camu Camu (Myrciaria dubia): A Comprehensive Reference

1. Identity and Botanical Overview

Taxonomy and Nomenclature

Camu camu berries are botanically classified as Myrciaria dubia and belong to the Myrtaceae (myrtle) family. The full accepted scientific name is Myrciaria dubia (Kunth) McVaugh, and the species has historically also been written as Myrciaria dubia (HBK) McVaugh in the scientific literature. The Myrtaceae family contains about 150 genera and 3,300 species of trees and shrubs, widely distributed in the tropics, including well-known fruits and spices such as guava, allspice, cloves, and eucalyptus.

Camu camu is known by several other names throughout South America, including Guayabito in Venezuela, Mitu in Colombia, Camo Camo in Peru, and Araza de Agua or Cacari in Brazil.

Morphology and Natural Habitat

The colorful berries grow on shrubs that can reach 3 to 5 meters in height and are native to floodplains, riverbanks, and swamps of the Amazon rainforest. The plant is extremely adaptable to flooding and can actually survive under waterlogged conditions for up to 5 months. The plant produces round, dark reddish-purple fruits which look similar to large grapes and are between one half to an inch in diameter (1 to 3 centimeters).

The current range of camu camu consists of the Amazonian lowlands of Colombia, Ecuador, Peru, Bolivia, and Brazil. Its distribution extends from the center of Pará state, Brazil, along the mid and upper Amazon River to the eastern part of Peru; in the north, it appears in the Casiquiare canal and the upper and middle Orinoco River.

Common Forms and Preparations

The fruit is extremely acidic and the flavor much like a sour grape with a large pit. The fruit is often used to make a very pink juice with a little sugar, like lemonade. Camu camu is also used in ice creams and sweets, and processed powder from the fruit pulp is beginning to be sold in the west as a health food in loose powder or capsule form.

Today, camu camu is locally harvested among Amazonian communities and used as a highly nutritious food reserve, dried for later use or mixed fresh into recipes, such as jams, jellies, puddings, or drinks. In the international supplement market, the primary commercial forms include freeze-dried or spray-dried fruit powder, standardized capsules or tablets (often standardized to vitamin C content), and liquid extracts derived from the pulp or pericarp.

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2. Traditional and Historical Use

Indigenous Cultures and Documented Uses

Camu camu berries are an ancient fruit used by indigenous populations throughout South America for generations in culinary and medicinal practices. Documentation of traditional camu camu uses is scarce. In traditional Amazonian societies, camu camu is not likely to have ever been nutritionally relevant except for its vitamin C content.

The Yanomami and Kayapo peoples have been living in these Amazonian areas for thousands of years. The fruit of the camu camu plant has been harvested by indigenous peoples of the area prior to European colonization, but there have been mixed reports on the use and timeline of domestication. It is unknown how long the indigenous people have been harvesting camu camu berries, although some accounts say hundreds of years.

Native Amazonian groups living on the banks of the Nanay River in the Loreto region of Peru have been reported as using camu camu as a traditional remedy for the treatment of malaria. Broader lists of traditional medicinal applications found in ethnobotanical accounts include treatment of a wide range of conditions; however, the evidentiary basis for most such uses rests on ethnographic report rather than systematic documentation.

Harvesting and Preparation Methods

The plant is harvested during the wet season, when the trunks are submerged several feet of water. The berries are harvested by guiding canoes through the branches and collecting the berries by hand. Historically, indigenous Amazonian groups have incorporated camu camu into their diets in various ways, often mixing it with water or other ingredients to balance its intensely sour flavor.

In the past few decades, the camu camu tree became part of a reforestation program initiated by the government of Peru, in efforts to conserve the natural habitat as well as provide local income for native populations.

Camu camu berries were officially given their own celebratory day in Ucayali, a department of Peru located in the Amazon rainforest. The native berry is deeply intertwined within the culture of the indigenous peoples of Ucayali. As the Ucayali River seasonally floods, local fishermen harvest camu camu berries from the water's edge in boats and canoes and sell the berries in local villages.

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3. Key Constituents and Active Compounds

Vitamin C (Ascorbic Acid)

Camu camu (Myrciaria dubia) is one of the richest sources of vitamin C (2.4 to 3.0 g/100 g in the pulp) found in Brazil. In Peruvian camu camu, the vitamin C content has been recorded as high as 2,780 mg per 100 g. Significant variation in vitamin C concentration is documented across growing regions and maturity stages; the fruit produced in Paraná State, Brazil, presented a lower content of vitamin C than the one native to the Amazon region, possibly due to different development conditions of the plant, as well as climatic variation, humidity, and characteristics of the soil.

The chemical composition of camu camu was analysed at three stages of maturity (immature, midripe, and ripe). As fruit matured, levels of ascorbic and dehydroascorbic acids, reducing sugars (fructose and glucose were the major sugars), amino acids (serine, valine and leucine), and soluble solids increased.

Polyphenols and Anthocyanins

Cyanidin-3-glucoside has been identified as the major pigment in camu camu fruits, representing 89.5% in fruits from one studied region and 88.0% in another, followed by delphinidin-3-glucoside, ranging between 4.2 and 5.1%, respectively. The skin of the camu camu fruit contains polyphenolic compounds including myricetin and derivatives, ellagic acid and derivatives, ellagitannins, proanthocyanidins, cyanidin-3-glucoside, delphinidin-3-glucoside, carotenoids (all-trans lutein, beta-carotene, violaxanthin, luteoxanthin), and acylphloroglucinols (myrciarone A, rhodomyrtone).

The seeds of the camu camu fruit contain betulinic acid (a triterpene), polyphenolic compounds (myricetin and derivatives, ellagic acid and derivatives, ellagitannins, proanthocyanidins), and acylphloroglucinols (isomyrtucommulone B, myrciarone B).

The pulp of the camu camu fruit contains polyphenolic compounds (myricetin and derivatives, ellagic acid and derivatives, ellagitannins, cyanidin-3-glucoside, quercetin and derivatives), ascorbic acid and dehydroascorbic acid, fatty acids (stearic acid, linoleic acid, oleic acid, gamma and alpha-linolenic acid, tricosanoic acid, eicosadienoic acid), citric acid, malic acid and isocitric acid, simple carbohydrates (mainly glucose and fructose), amino acids (serine, leucine, valine, but also glutamate, 4-aminobutanoate, proline, phenylalanine, threonine, alanine), and minerals (potassium, calcium, magnesium, sodium, phosphate, sulphate, aluminium, boron, copper, manganese, zinc).

Carotenoids and Minerals

Citric acid is the major acid in camu camu (from 19.8 up to 29.8 g/kg) and is responsible for the fruit's sour taste. Among the macronutrients, potassium is the most abundant mineral (711 mg/kg) and could be considered, like vitamin C, nutritionally significant.

Mechanisms of Action

Camu camu exhibits pharmacological effects on neuroprotection, antihypertension, antimicrobial, anti-proliferation, and anti-genotoxicity activities. These activities are due to the effects of the vitamin C content, promising polyphenols such as gallic acid, quercetin, and ellagic acid, and proanthocyanins such as cyanidin-3-glycoside.

High glucose-induced overproduction of reactive oxygen species (ROS) was inhibited by camu camu fruit treatment. In response to ROS reduction, camu camu fruit modulated the MAPK/AP-1, NF-κB, and NFAT signaling pathways related to inflammation by downregulating the expression of proinflammatory cytokines and chemokines. Furthermore, camu camu fruit treatment activated the expression of nuclear factor E2-related factor 2 (Nrf2) and subsequently increased NAD(P)H:quinone oxidoreductase 1 (NQO1) expression to protect keratinocytes against high-glucose-induced oxidative stress. These in vitro findings provide mechanistic insight, though their translation to in vivo human outcomes requires further investigation.

Camu camu has been shown in animal models to promote the beiging or browning of adipose tissue, activating markers such as uncoupling protein 1 (UCP1), DIO2, CPT1α, Cidea, PGC1α, SIRT1, and BMP7. These compounds support fat oxidation, cold-induced thermogenesis, and mitochondrial function, thus protecting against diet-induced obesity in animal models.

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4. Scientific Evidence by Area of Health Use

4.1 Antioxidant and Anti-Inflammatory Activity

Human Clinical Evidence

Inoue et al. (2008) reported on the first in vivo study in humans of the antioxidative and anti-inflammatory properties of camu camu. The study population consisted of 20 habitual male smokers considered to have an accelerated oxidative stress state. These volunteers were randomly assigned to take daily 1050 mg of vitamin C tablets or 70 mL of 100% camu camu juice containing 1050 mg of vitamin C as a dietary supplement for 7 days.

After 7 days, oxidative stress markers such as the levels of urinary 8-hydroxy-deoxyguanosine and total reactive oxygen species, and inflammatory markers were significantly reduced in the camu camu group. This study provided the first in vivo human data demonstrating the anti-oxidative and anti-inflammatory effects of camu camu juice. Moreover, the effects of camu camu were more powerful compared with those of vitamin C tablets, despite the equivalent vitamin C content.

Since both groups consumed the same amounts of vitamin C and significant changes were only seen in the camu camu group, researchers suggest that camu camu may contain substances other than vitamin C that are behind such powerful properties. In addition to high contents of vitamin C, camu camu contains carotenoids and anthocyanins as potential additional antioxidants.

Evidence Strength

Although patients seem increasingly interested in dietary supplements as alternative self-medication in disease states, claims for anti-inflammatory status and the role of the product in specific disease states do not rest on a substantive evidentiary base. The number of studies is limited, but the evidence base for camu camu is more substantive than that for competing products. The pivotal 2008 Inoue et al. trial involved only 20 participants, and the follow-up period was extremely short (7 days); more studies are definitely needed to reinforce the existing evidence base, notably in target small-scale human studies, and to give more confidence to patients and physicians who are looking to alternative medicines.

4.2 Hepatic Steatosis and Fatty Liver Disease (NAFLD/MASLD)

Human Clinical Evidence

Non-alcoholic fatty liver disease (NAFLD) affects 25% of the adult population with no effective drug treatments available. Previous animal studies reported that a polyphenol-rich extract from camu camu prevented hepatic steatosis in a mouse model of diet-induced obesity.

A randomized, double-blind, placebo-controlled crossover trial was conducted on 30 adults with overweight and hypertriglyceridemia, who consumed 1.5 g of camu camu capsules or placebo daily for 12 weeks. Participants underwent magnetic resonance imaging (MRI) to determine fat levels in the liver. Scientists observed a 7.43% reduction in liver lipids when study participants took camu camu extract. With the placebo, they noted an 8.42% increase in liver fat.

Camu camu treatment decreased plasma aspartate and alanine aminotransferase levels and promoted changes in gut microbiota composition. These findings support that a polyphenol-rich prebiotic may reduce liver fat in adults with overweight, reducing the risk of developing NAFLD.

Evidence Strength

This 2024 randomized crossover trial from Université Laval represents the most methodologically rigorous human clinical trial conducted to date on camu camu. It is double-blinded, placebo-controlled, and crossover in design. However, more research is still necessary to fully understand the mechanisms at play and confirm the findings in larger, longer-term trials. The sample size (n=30) is small, and the population was specifically overweight and hypertriglyceridemic, limiting generalizability.

4.3 Cardiovascular Health and Vascular Function

Human/Clinical Evidence

A data article describes the flow-mediated vasodilation (FMD) responses and blood pressure changes in young adults after a single oral dose of camu camu pericarp extract or placebo in a cross-over design. Ten healthy men and 10 healthy women participated in this study. Ultrasonic diagnostic equipment was used to monitor arterial diameter changes indicative of FMD for 110 seconds after administration of the camu camu extract or placebo.

The presence of anthocyanins has been investigated in a number of animal models and randomized clinical trials in their association with blood pressure, endothelial function, and cardioactive protection. The use of camu camu can lead to flow-mediated vasodilation responses and blood pressure modifications.

Evidence Strength

The cardiovascular evidence for camu camu in humans is preliminary and largely based on small, short-duration studies or extrapolated from anthocyanin research more broadly. No large, long-term randomized controlled trials have established cardiovascular benefit specifically from camu camu supplementation.

4.4 Antigenotoxic and Antimutagenic Effects

Preclinical Evidence (Animal Studies)

Researchers tested the genotoxic and antigenotoxic potential of camu camu fruit juice after acute (single dose for one day), subacute (for 28 consecutive days), and chronic (for 56 consecutive days) oral administration. None of the fruit juice concentrations (25%, 50%, and 100%) tested exerted any genotoxic effect on blood cells in male and female mice. In the ex vivo test using the alkaline comet assay, the fruit juice demonstrated an antigenotoxic effect after acute, subacute, and chronic treatments.

The researchers associated the protective effect against DNA damage caused by hydrogen peroxide with the elevated levels of vitamin C, as well as the flavonoids and phenolic compounds present in the fruit juice of camu camu; together, these phytochemicals are very able to eliminate free radicals.

After the treatments, there was no evidence of toxicity or death. The data show that M. dubia juice has antigenotoxic and antioxidant activities, though with no genotoxicity for blood cells. Nevertheless, more in-depth studies should be conducted to assess the safety of this fruit for human consumption.

Evidence Strength

Antigenotoxic evidence is limited to animal (mouse) models and in vitro assays. No human clinical trials have specifically examined camu camu's genoprotective effects, making this an area of preliminary, preclinical evidence only.

4.5 Metabolic Health: Blood Glucose, Lipids, and Obesity

Preclinical and Review Evidence

Overall, six animal studies of camu camu juice have been reported. These have assessed the antioxidant, genotoxic, and antigenotoxic potential of camu camu juice in mice, the effect of camu camu pulp on obesity in rats, the hepatoprotective effect of camu camu juice in rats, the anti-inflammatory effects of camu camu, the mutagenic effect of camu camu juice on mouse bone marrow, and the spermatogenic effect in rats.

Potential antiobesity action has been suggested by the Wistar rat model for camu camu supplementation. A study demonstrated a decrease in fat-storing tissue associated with improvements in fat secretion, insulin levels, a reduction in VLDL (very-low-density lipoprotein), and an increase in high-density lipoprotein.

Animal models have shown antioxidant, anti-inflammatory, antimutagenic, hypoglycemic, and hypolipidemic actions. Camu camu also prevents visceral and liver fat deposition due to brown adipose tissue activation and increased expenditure of energy.

Evidence Strength

The studies found in the literature show that camu camu can be used as a nutraceutical once it exhibits impressive amounts of bioactive compounds that can produce antioxidant and anti-inflammatory actions and, for these reasons, could be considered to prevent several pathological conditions such as diabetes, dyslipidemia, metabolic syndrome, and cardiovascular diseases. However, the majority of metabolic health evidence derives from rodent models and in vitro studies; human clinical trial data in this specific domain remains sparse. The NAFLD crossover trial (Section 4.2) provides the strongest metabolic evidence in humans to date.

4.6 Iron Bioavailability

In Vitro Evidence

It is well known that vitamin C is an important enhancer of nonheme iron bioavailability due to its high reducing capacity. However, an in vitro study using a Caco-2 cell model found a counterintuitive result: the results showed that camu camu reduced rather than enhanced nonheme iron bioavailability. The findings of this study suggest that camu camu, in the traditional way of preparation, may significantly reduce nonheme iron bioavailability because of its high polyphenol content, which overrides the beneficial effect of its high ascorbic acid content.

Evidence Strength

This is in vitro data only (Caco-2 cell model) and cannot be directly extrapolated to human outcomes. The paradoxical effect of camu camu on iron absorption compared to isolated vitamin C highlights the complexity of whole-food polyphenol matrices and warrants investigation in human trials.

4.7 Skin and Dermatological Applications

In Vitro Evidence

High glucose-induced overproduction of reactive oxygen species (ROS) was inhibited by camu camu fruit treatment. In response to ROS reduction, camu camu fruit modulated the MAPK/AP-1, NF-κB, and NFAT signaling pathways related to inflammation by downregulating the expression of proinflammatory cytokines and chemokines. These results indicate that camu camu fruit is a promising material for preventing oxidative stress and skin inflammation induced by high glucose levels.

Evidence Strength

Skin-related evidence for camu camu is entirely confined to in vitro cell-based models. No human clinical trials have specifically evaluated camu camu for dermatological indications.

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5. Body Systems and Health Areas Associated with Camu Camu

• Immune system: As a concentrated natural source of vitamin C, camu camu is associated with immune support through the well-established roles of ascorbic acid in immune cell function.
• Hepatic (liver) system: A clinical study demonstrated that camu camu decreased circulating and urinary markers of inflammation and oxidative stress. These data suggest that camu camu may protect against NAFLD progression by limiting liver injury, possibly through an anti-inflammatory action.
• Cardiovascular system: The presence of anthocyanins has been investigated in a number of animal models and randomized clinical trials in their association with blood pressure, endothelial function, and cardioactive protection.
• Metabolic/endocrine system: Camu camu has antioxidant and anti-inflammatory properties, antigenotoxic effects, and improves the biochemical profile. It can be used as a functional dietary supplement to delay aging and control chronic diseases associated with diabetes, obesity, and cancer.
• Genomic integrity: Preclinical animal data support antigenotoxic activity, protecting blood cells from DNA damage in oxidative challenge models.
• Skin: In vitro evidence indicates potential for modulating oxidative stress and inflammatory signaling pathways in high-glucose-challenged keratinocytes.
• Gut microbiota: Camu camu alters gut microbiota composition, supporting its potential as a polyphenol-rich prebiotic supplement for reducing NAFLD risk.

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6. Dosage Forms and Dosages Reported in Studies

To assess the anti-oxidative and anti-inflammatory properties of camu camu in the landmark 2008 human study, participants were randomly assigned to take daily 70 mL of 100% camu camu juice, corresponding to 1050 mg of vitamin C, for 7 days.

In the 2024 NAFLD randomized crossover trial, 30 adults consumed 1.5 g of camu camu capsules or placebo daily for 12 weeks.

A separate investigation examined the flow-mediated vasodilation and blood pressure effects in young adult humans after a single oral dose of camu camu pericarp extract.

Animal antigenotoxicity studies have used acute (single dose), subacute (28 consecutive days), and chronic (56 consecutive days) oral administration at juice concentrations of 25%, 50%, and 100%.

The vitamin C content of camu camu fruit is approximately 1.5%. Taking 6 g provides 95 mg of vitamin C, the recommended daily intake by EFSA for an adult.

The available dosage data from human studies is thus very limited, with the two most prominent clinical trials using either 70 mL/day of juice (delivering 1050 mg vitamin C) or 1.5 g/day of encapsulated powder. No pharmacopeial or regulatory body has established a standardized therapeutic dosage for camu camu as of the time of this reference.

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7. Safety Considerations and Interactions

General Tolerability

Camu camu powder is generally considered safe for consumption as a food or supplement, with no significant adverse effects reported in animal or preliminary human studies at typical doses. Common side effects are not well-documented in the literature. Due to limited human data, uncommon and rare side effects are not well characterized.

As with many high-antioxidant or vitamin C-rich foods, some individuals may experience mild gastrointestinal symptoms such as stomach upset or diarrhea with excessive intake, particularly with concentrated extracts. However, studies in animals and short-term human trials did not report significant adverse effects at typical doses.

Vitamin C Overload Risk

High vitamin C intake is the primary concern. Camu camu's exceptionally high vitamin C content means that supplementation could easily exceed recommended levels. Excessive vitamin C intake may cause gastrointestinal disturbances (diarrhoea, nausea, abdominal cramps), increased risk of kidney stones particularly calcium oxalate stones in susceptible individuals, potential interference with certain blood glucose tests, and pro-oxidant effects at very high doses which could theoretically be counterproductive.

Kidney Stone Risk

Individuals with kidney disorders or those prone to oxalate kidney stones should exercise caution due to the high vitamin C content, which can increase oxalate excretion. People with chronic kidney disease may face increased risk of oxalate accumulation. Those with a history of kidney stones, particularly calcium oxalate stones, should be aware that vitamin C can be metabolized to oxalate.

Iron Interactions

Findings suggest that camu camu, in the traditional way of preparation, may significantly reduce nonheme iron bioavailability because of its high polyphenol content, which overrides the beneficial effect of its high ascorbic acid content. This contrasts with the expected iron-enhancing effect of isolated vitamin C and is an important consideration for individuals managing iron-deficiency conditions.

Potential Drug Interactions

While no specific drug interactions have been formally documented, caution is advised as the high vitamin C content could theoretically affect the absorption or metabolism of certain medications, such as chemotherapy agents. Vitamin C may alter the absorption of certain drugs, including antacids and some antibiotics.

Special Populations

There are no formal contraindications established for camu camu. Safety in special populations, including pregnant or lactating women and children, has not been well-studied, and its use in these groups should be approached with caution.

Overall Evidence Limitations

Research on camu camu is ongoing, with preclinical and small-scale human trials showing promising results. More substantive conclusions are limited by the dearth of long-term cohort studies to evaluate the association between absolute food intakes, dietary patterns, and changes in inflammatory markers. The entire body of human clinical trial data as of this reference consists of a small number of studies with limited sample sizes and short durations. Robust efficacy claims for any specific clinical indication are not yet supported by the extant evidence base.

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References

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