NUTRITIONAL AND MEDICINAL VALUES OF PAPAYA (CARICA PAPAYA L.)

Amanat Ali1* , Sankar Devarajan2 , Mostafa I. Waly1 , Mohammad M. Essa1 and M.S. Rahman1 1 Department of Food Science and Nutrition, College of Agricultural and Marine Sciences, Sultan Qaboos University, Al-Khoud, P.O. Box 34, PC 123, Muscat, Oman. 2 Department of Cardiovascular Diseases, Fukuoka University Chikushi Hospital, Fukuoka, Japan and WHO Regional Office, Japan. ABSTRACT Papaya (Carica papaya L.) is a deliciously sweet tropical fruit with musky undertones and a distinctive pleasant aroma. It was first cultivated in Mexico several centuries ago but is currently being cultivated in most of the tropical countries. Everything in papaya plant such as roots, leaves, peel, latex, flower, fruit and seeds have their nutritional and medicinal significance. Papaya can be used as a food, a cooking aid, and in medicine. Papaya is considered as a low calorie nutrient dense fruit. The fresh fruit is commonly used as a carminative, stomachic, diuretic and antiseptic in many parts of the world. The nutrients and phytochemicals contained in papaya help in digestion, reduce inflammation, support the functioning of cardiovascular, immune and digestive systems and may also help in prevention of colon, lung and prostate cancers. Overall, the papaya can act as a detoxifier, activator of metabolism, rejuvenating the body and in the maintenance of body’s homeostasis because it is rich in antioxidants, B vitamins, folate and pantothenic acid, and potassium and magnesium as well as fiber. Because of its high vitamin A and carotenoids contents, it can help in preventing the cataract and age-related macular degeneration. Papaya pastes can be used externally as a treatment for skin wounds and burns. This paper discusses the nutritional and medicinal value of papaya (Carica papaya L.) and its relationship to human health. * Corresponding author: Dr. Amanat Ali, email: amanat@squ.edu.om 2 Amanat Ali, Sankar Devarajan, Mostafa I. Waly et al. INTRODUCTION The papaya (Carica papaya L.) is a tropical fruit that is native to the tropics of South America. According to the historical reports, it was first cultivated in Mexico several centuries ago but is currently being cultivated in most of the tropical countries. The current largest commercial producers of papaya include the United States, Mexico and Puerto Rico. Currently many genetically modified hybrid varieties are commercially available for cultivation, which are more resistant to diseases (Jiao et al., 2010). Over the past 40 years the production of papaya has increased drastically. The estimated production in the year 2009 was 10.21 million tons (FAO, 2010). Papaya is normally a single stem plant that can reach up to 10 meters, with spirally arranged leaves confined to the top of the trunk (Rice et al., 1987). It is a highly frost sensitive plant. The plant grows rapidly and starts fruiting within one and half to 3 years. The productive life of the plant is about three and a half year. Although there is a slight seasonal peak in its production in early summer and fall, yet the papaya tree can produce the fruit year round. The flowers appear on the axils of the leaves, maturing into large spherical, pearshaped fruit whose length can vary from 7 to 20 inches and can reach up to 2.5kg in weight. Papaya fruit has normally greenish yellow, yellow or orange color. The fruit is climacteric and exhibits an increase in respiration and ethylene production during ripening (Koslanund, 2003). The fruit ripens rapidly at room temperature. It is ripe when it feels soft and its colour changes to amber or orange hue. The shelf life of the ripened fruit is short only 2 to 3 days (Archbold et al., 2003). The two flesh colours (red and yellow) of papaya fruit are controlled by the same single gene, however the yellow colour is dominant (Yamamoto, 1964). The red colour of papaya fruit is due to the accumulation of lycopene, whereas the yellow colour is the result of conversion of lycopene to β-carotene and β-cryptoxanthin (Hirschberg, 2001). As the fruit ripens, its colour changes, which is caused by the breakdown and disappearance of chlorophyll. The flesh colour of papaya fruit is considered a quality trait that correlates with its nutritional value and is linked to shelf life of the fruit. The full genomic sequences of both yellow and red fleshed papayas have been reported to be identical (Skelton et al., 2006). No significant compositional differences have been reported between the transgenic and nontransgenic papaya (Jiao et al., 2010). GENERAL CHARACTERISTICS AND USES OF PAPAYA Papaya is a deliciously sweet fruit with musky undertones and a distinctive pleasant aroma. It has a soft texture with butter-like consistency (Bari et al., 2006). Its taste and sweetness increases with the ripening process of fruit. However, the overripe fruit quickly starts deteriorating in quality. This is a greatly loved tropical fruit that was sensibly called “The Fruit of Angels” by Christopher Columbus. Papaya plant is also called a "tree of health" and its fruit is termed as a "fruit of long life". Ripe papaya flesh has a rich orange color with either yellow or pink hues. The inner cavity contains a wealth of black round seeds, encased in a gelatinous-like substance. The leaves, stem, and unripe fruit of papaya release a whitish milky fluid (latex) that consists of proteins, alkaloids (mainly carpaine), starches, sugars, oils, tannins, resins, pectins and gums, which coagulate on exposure to air. Green papaya is a rich Nutritional and Medicinal Values of Papaya (Carica Papaya L.) 3 source of papain and chymopapain. Papain, the proteolytic enzyme, is regarded as vegetable pepsin that helps in the digestion of proteins in acid, alkaline or neutral medium. Papain is used like bromelain, a similar enzyme found in pineapple, to treat sports injuries, other causes of trauma and allergies. Papain is also used in tenderizing meat and other proteins as it has the ability to break down the tough meat fibres and is used since thousands of years. Papain is included as a component in powdered meat tenderizers. Papain is used in chewing gum, in brewing/wine and beer making, textile and tanning industries (Bruneton, 1999, Bhattacharjee, 2001, Oloyede, 2005). Papain and chymopapain have been shown to help lower inflammation and to improve healing from burns in addition to helping in digestion of proteins. The ripe fruit is usually eaten raw, without skin or seeds. The unripe green fruit can be eaten both as raw and cooked but is usually eaten as cooked in curries, salads and stews. Unripe fruit has a relatively high amount of pectin, which can be used to make jellies. In some parts of Asia, the young leaves of papaya are steamed and eaten like spinach. The leaves are also made into tea to be used as a preventive agent for malaria, although there is no real scientific evidence for the effectiveness of this treatment. The black seeds are edible and have a sharp, spicy taste. The ground seeds are sometimes used as a substitute for black pepper. The stem and bark are also used in rope production. Papaya is also frequently used as a hair conditioner. Papaya is used in making soft drinks, jam, ice cream, and flavouring of crystallized fruit and canned in syrup. Papaya pulp nectar prepared using irradiation and mild heat treatment retained its fresh flavour and nutritional qualities closest to untreated controls and was found to be microbiologically safe with acceptable enzyme levels (Parker et al., 2010). Everything in papaya plant such as roots, leaves, peel, latex, flower, fruit and seeds have their nutritional and medicinal significance. Papaya can be used as a food, a cooking aid, and in medicine. In general, the papaya promotes proper functioning of pancreas, alleviates indigestion, protects against infection, aids in diabetics and hepatitis patients. The consumption of ripe papaya is thought to help in the prevention of cancer in organs and glands with epithelial tissue. Papaya has rejuvenating properties that especially assist in controlling the early ageing process. Overall the papaya acts as a detoxifier, activates the metabolism, rejuvenates the body and maintains the body’s homeostasis because it is rich in antioxidants, B vitamins, folate and pantothenic acid, the minerals potassium and magnesium, and fiber. Papaya juice is a popular beverage and can assist in mitigating infections of the colon and breaking down the pus and mucus. It is believed that it can act as a useful tonic for the stomach and intestines, if consumed alone for at least 3 days. In the folklore medicine, sometimes it is suggested to go for “Papaya Therapy” once a year i.e., to eat one or two papayas daily for 2 to 4 week to benefit from its healing properties. CHEMICAL COMPOSITION AND NUTRITIONAL QUALITY OF PAPAYA The nutritional qualities and medicinal value of papaya are closely related. The papaya can be considered as a nutrient dense food, as it provides many more nutrients on per calorie basis as compared to other foods. The chemical composition as well as the mineral and vitamin composition of fresh papaya is given in Tables 1 and 2. It contains only small 4 Amanat Ali, Sankar Devarajan, Mostafa I. Waly et al. amounts of protein and is almost free from cholesterol and fat. The carbohydrate content of ripe papaya mainly consists of invert sugars, which are easily digestible and absorbed. Ripe fruit can therefore easily boost body’s energy. Table 1. The chemical composition of fresh papaya fruit Parameters Range Energy 39.0 - 41.4 (kcal/100g) Moisture 86.9 – 89.8 % Crude protein 0.5 - 0.6 (g/100g) Total fat 0.1 - 0.14 (g/100g) Ash 0.5 - 0.7 (g/100g) Crude fibre 0.4 - 0.8 (g/100g) Dietary fibre 0.5 - 2.2 (g/100g) Carbohydrates 7.5 - 10.98 (g/100g) Total Sugars 7.2 - 9.8 (g/100g) Sucrose 1.9 - 6.1 (g/100g) Glucose 2.6 -3.4 (g/100g) Fructose 2.1 - 2.6 (g/100g) The values are calculated based on the data reported by Adetuyi et al. (2008), Gouado et al. (2007), Nakamura et al. (2007), Nguyen and Schwartz (1999), Sirichakwal et al. (2005), Wall (2006), Wall et al. (2010), Veda et al. (2007). Table 2. Vitamin and Mineral Composition of fresh papaya fruit Parameters Range Vitamin A (RAE)* 23 – 55 (μg/100g) Vitamin E 3.13 – 5.3 (mg/100g) Vitamin K 2.3 – 2.9 (μg/100g) Vitamin C 57 – 108 (mg/100g) Thiamine (vitamin B1 ) 0.04 – 0.05 (mg/100g) Riboflavin (vitamin B2 ) 0.05 - 0.07 (mg/100g) Niacin 0.34 – 44 (mg/100g) Pyridoxine 0.1 – 0.15 (mg/100g) Folate 39 – 55 (μg/100g) Calcium 17 – 24 (mg/100g) Phosphorous 5 – 9 (mg/100g) Magnesium 10 – 33 (mg/100g) Sodium 3 – 24 (mg/100g) Potassium 90 – 257 (mg/100g) Iron 0.23 - 0.66 (mg/100g) Manganese 0.01 – 0.03 (mg/100g) Nutritional and Medicinal Values of Papaya (Carica Papaya L.) 5 Parameters Range Zinc 0.06 – 0.09 (mg/100g) Copper 0.06 – 0.14 (mg/100g) Boron 0.01 – 0.21 (mg/100g) Selenium 1.2 – 1.5 (μg/100g) The values are calculated based on the data reported by Adetuyi et al. (2008), Gouado et al. (2007), Nakamura et al. (2007), Nguyen and Schwartz (1999), Sirichakwal et al., (2005), Wall (2006), Wall et al. (2010), Veda et al. (2007). The whole papaya fruit is an excellent source of dietary fiber and therefore can also help in preventing the constipation. The fiber content of papaya can help in lowering the high blood cholesterol levels. Papaya is rich in vitamins C and A. One serving of papaya can provide about 100% daily requirement for vitamin C and 30% of vitamin A. It also contributes to small quantities of vitamin E, K, thiamine, riboflavin, niacin, pyridoxine and folate. Folic acid is needed for the conversion of homocysteine to cysteine and methionine. The increased level of homocysteine in blood is considered a significant risk factor for a heart attack or stroke as it can directly damage the wall of blood vessels (Antoniades et al., 2009, Seo et al., 2010). Papaya could be a candid source to reverse the homocysteine mediated cardiovascular diseases since it has profuse amount of folic acid. The nutrients contained in papaya can also help to prevent the oxidation of cholesterol. The oxidized cholesterol sticks to the internal lining of blood vessels, forming dangerous plaques that can eventually cause heart attacks or strokes. Data from various studies indicate that dietary vitamin E and C may exert some effect in preventing the oxidation of cholesterol because of their suggested association with paraoxonase, an enzyme that inhibits the oxidation of LDL and HDL cholesterol (Jarvik et al., 2002, Schürks, et al., 2010, Gaby, 2010). Papaya also contains small amounts of calcium, magnesium, potassium, iron, manganese, zinc, copper, boron and selenium. It has low levels of sodium and high levels of potassium and can therefore be helpful for the hypertensive people to balance their overall daily dietary intake of sodium. PHYTOCHEMICAL COMPOSITION OF PAPAYA In addition to its nutritional contents, papaya also contains many bioactive phytochemicals with diverse structure and functional properties which have not yet been fully exploited for their potential health benefits. The phytochemical composition of fresh papaya is given in Table 3. It contains substantial amounts of carotenoids, flavonoids and polyphenols. It contains relatively high levels of beta-carotene, which the body converts to vitamin A. Papaya contains about 6% of the level of beta carotene found in carrots (USDA, National Nutrient Database for Standard Reference, 2006). Red flesh papaya has been reported to contain significant quantities (4.1 mg/100g flesh) of lycopene (Nguyen and Schwartz, 1999). 6 Amanat Ali, Sankar Devarajan, Mostafa I. Waly et al. Table 3. Phytochemicals Composition of fresh papaya fruit Parameters Range α- carotene 16 – 31 (μg/100g) β- carotene 130 – 730 (μg/100g) Lycopene 113 – 4138 (μg/100g) β-Cryptoxanthin 124 – 3799 (μg/100g) Zeaxanthin 19 – 27 (μg/100g) Total provitamin A 256 – 890 (μg/100g) Lutein 93 – 318 (μg/100g) Total carotenoids 321.2 – 7210 (μg/100g) Total Polyphenols 51 – 59 (mg GAE/100g)1 Total Antioxidant Activity - ORAC 250 – 350 (μmol TE/100g)2 Total Antioxidant Activity - FRAP 350 – 430 (μmol TE/100g)3 Phytate 1.22- 1.45 (g/100g) Oxalate (g/100g) 0.45- 57 (g/100g) Condensed tannins (g/100g) 0.062 -0.087 (g/100g) Hydrolysable tannins (g/100g) 0.021- 033 (g/100g) 1 GAE = Gallic acid equivalent. 2 Oxygen radical absorbance capacity (ORAC) expressed as μmol of Trolox Equivalent (TE) per 100 g of fresh weight. 3 Ferric reducing antioxidant power (FRAP), expressed as μmol of Trolox Equivalent (TE) per 100 g of fresh weight. The values are calculated based on the data reported by Adetuyi et al. (2008), Gouado et al (2007), Nakamura et al. (2007), Nguyen and Schwartz (1999), Sirichakwal et al., (2005), Wall (2006), Wall et al. (2010), Veda et al. (2007). Because of its high phytochemical contents, it shows significant antioxidant activities. During the growing process, papaya produces some specific compounds (such as benzylisothiocyanate; BITC and carpaine) to protect itself against the attacks of insects, pests and herbivores. These natural toxins may exert some adverse effects on human health when consumed in large quantities. However, their levels in mature papaya fruit are low and therefore are considered as safe for humans (Roberts et al., 2008). Benzyl isothiocyanate (BITC) isolated from the extracts of papaya whole fruit has shown potent diverse biological activities in inducing the phase 2 detoxifying enzymes and apoptosis (Nakamura et al., 2000 and 2002, Miyoshi et al 2004 and 2007). Nakamura et al. (2007) reported that papaya seeds represent a rich source of biologically active isothiocyanates and the n-hexane extract of papaya seeds homogenate was highly effective in inhibiting the superoxide generation and apoptosis induction in HL-60 cells, the activities of which are comparable to those of authentic benzyl isothiocyanate. In contrast, the papaya pulp contained an undetectable amount of bezyl-glucosinolate. They showed that papaya seeds and not the papaya pulp is a rich source of biologically active isothiocyanate, especially the BITC and its precursor glucosinolate, which are as high as those in Brassica vegetables. BITC is formed from benzyl glucosinolate in papaya seeds (Bennett et al., 1997). Nutritional and Medicinal Values of Papaya (Carica Papaya L.) 7 Papaya is also a good source of carpaine. It is one of the major alkaloid components of papaya leaves that have been studied for its cardiovascular effects in male Wistar rats. Increasing dosages of carpaine from 0.5 mg/kg to 2.0 mg/kg resulted in progressive decrease in systolic, diastolic, and mean arterial blood pressure. It was concluded that carpaine directly affects the myocardium. The effects of carpaine may be related to its macrocyclic dilactone structure, a possible cation chelating structure (Burdick, 1971, Hornick et al., 1978). The extracts of unripe papaya have been reported to contain terpenoids, alkaloids, flavonoids, carbohydrates, glycosides and steroids (Ezike et al., 2009). The papaya lipase is currently considered as a “naturally immobilized” biocatalyst (Dominguez de Maria et al., 2006). The papaya also contains some other anti-nutrient compounds such as phytate, oxalate and tannins. The levels of these anti-nutrients (phytate, oxalate, hydrolysable tannins and condensed tannins) and antioxidants (vitamin C, tocopherols, total phenols, and carotenoids) contents of papaya (Carica papaya) can decrease significantly (P < 0.05) with increased storage period and temperature (Adetuyi et al., 2008). Simirgiotis et al (2009) reported the presence of 10 low molecular weight quercetin glycoside derivatives in the fruit of mountain papaya (Vasconcellea pubescens A DC) grown in Chile. It is also called "cold papaya" as it grows in relatively cooler climates as compared to the popular and widely cultivated Carica papaya L. The fruits of mountain papaya are mostly consumed after processing and are also used in the production of jams, beverages, cold drinks and cocktails (Idstein et al., 1985, Moya-Leon et al., 2004). Oliveira et al (2010) observed that the nutritional quality of papaya (Carica papaya L.) in terms of its vitamin C and carotenoids contents showed excellent stability under the usual handling conditions employed in commercial restaurants. MEDICINAL AND HEALTH EFFECTS OF PAPAYA The overall nutritional and health benefits of papaya are because of the interactions of its nutrients and phytochemicals present in whole fruit, rather than due to a single “active” component. Because of its high antioxidant contents, papaya can prevent cholesterol oxidation and can be used as a preventive treatment against atherosclerosis, strokes, heart attacks and diabetic heart disease. The fresh fruit is commonly used as a carminative, stomachic, diuretic and antiseptic in many parts of the world (Iwu, 1993, Bhattacharjee, 2001). A number of studies have reported the various pharmacological properties of C. papaya (fruit and seeds) such as histaminergic action, inhibition of rabbit jejunal contractions, and tocolytic and antihelminthic activities and anti-ulcer properties (Adebiyi et al., 2003, 2004, Adebiyi and Adeikan, 2005, Okeniyi et al., 2007, Ezike et al., 2009). Papaya can strengthen the immune system therefore can help in preventing the recurrent colds and flu. After treatment with antibiotics eating papaya or drinking its juice can help to replenish the intestinal microflora. Papaya has also been reported to have significantly high hydroxyl radical and hydrogen peroxide scavenging activity (Murcia et al., 2001). The fermented papaya products showed free radical scavenging activity and were effective in providing protection against various pathological disorders including tumors and immunodeficiency (Osanto et al., 1995). The fermented papaya products improved the antioxidant defense in elderly patients without any overt antioxidant deficiency state at the dose of 9g/day orally (Marotta et al., 2006a, b). 8 Amanat Ali, Sankar Devarajan, Mostafa I. Waly et al. Many active components from papaya have been isolated and studied. Papain, the main proteolytic enzyme in papaya, is also being studied for relief of cancer therapy side effects, especially in relieving the side effects such as difficulty in swallowing and mouth sores after radiation and chemotherapy as well as boosting up the immune system and helping body to fight against the cancer cells. The supplements produced by dehydrating and concentrating the whole fruit may be helpful for people who do not get enough of these components in their daily diet. Dried papaya is marketed in tablet form to remedy digestive problems. Papaya pills, juices, and whole food supplements containing papaya are currently being promoted as weight loss aids, digestive aids, and natural pain relievers, as well as for many other health benefits. Whether the papaya pills and supplements can prevent or counteract these ailments is still to be validated through well-designed controlled studies. Papaya leaves are poultice on to nervous pains and elephantoid growths. They are also dried and infused to make a tea, which is used as a vermifuge, an amoebicide, a purgative, to prevent and treat malaria, and as a treatment for gastritis and genitor-urinary ailments. PROMOTES THE FUNCTIONING OF DIGESTIVE SYSTEM The consumption of papaya after a meal can improve digestion, prevent bloating and chronic indigestion as well as may help in preventing nausea, vomiting and morning sickness in pregnant women. Papaya has also been reported to increase the absorption of iron from rice based meals in Indian women (Ballot et al., 1987). Papaya is used in the preparation of antacids, ulcer treatment and to prevent constipation. The unripe papaya extracts have shown cytoprotective and antimotility properties, suggesting the effectiveness of unripe papaya as an anti-ulcer fruit (Ezike et al., 2009). ANTHELMINTIC AND ANTI-AMOEBIC PROPERTIES Human intestinal parasitosis constitutes a significant global health problem with enormous financial implications, in particular in developing countries. In folk medicine, C. papaya seeds have been used to treat the antheminthiasis (Bhattacharjee, 2001, Okeniyi et al., 2007). The papaya fruit, seeds, latex, and leaves contain carpaine, an anthelmintic alkaloid that can remove the parasitic worms from the body. The carpaine can however be dangerous in high doses. In folklore medicine, the papaya seeds when taken with honey are known to be anthelmintic for expelling the worms. The latex of papaya as well as the aqueous extracts of papaya seeds have shown potent anthelmintic and anti-amoebic properties (Satrija et al., 1994 and 1995). Among others, the active chemical agents contained in Carica papaya seeds and fruit are benzyl isothiocyanate and papain that have proven anthelmintic properties (Kumar et al., 1991, Tona et al., 1998, Ghosh et al., 1998). The air dried papaya seeds offer a cheap, harmless and preventive strategy against intestinal parasitosis, especially in tropical communities (Okeniyi et al., 2007). Nutritional and Medicinal Values of Papaya (Carica Papaya L.) 9 ANTI-INFLAMMATORY AND WOUND HEALING PROPERTIES Papaya is thought to contain some natural pain relieving abilities. The unique protein digesting enzymes (papain and chymopapain) have been reported to help in lowering the inflammation and healing of burns. Papaya can lower inflammation in the body, alleviate pain and edema caused by sport injuries. The antioxidant nutrients found in papaya, including vitamin C, vitamin E, and beta-carotene can also help in reducing inflammation. Because of its anti-inflammatory properties papaya can relieve the severity of rheumatoid arthritis, polyarthritis and osteoarthritis. It has been reported that people who consumed the lowest amounts of vitamin C-rich foods were more than three times more likely to develop arthritis than those who consumed the highest amounts (Pattison et al., 2004). This may explain why the people with diseases that are worsened by inflammation, such as asthma, osteoarthritis and rheumatoid arthritis, find a relief in their sufferings when they get more of these nutrients. Collard and Roy (2010) observed that oral supplementation of fermented papaya preparation (FPP) in adult obese diabetic (db/db) mice specifically improved the response of wound-site macrophages and subsequent angiogenic response. They suggested that the beneficial effects of FPP should be tested in clinical trials for its beneficial effects on diabetic wound-related outcomes as it has a long track record of safe human consumption. Papaya is also a rich source of fibrin, an important factor in the blood clotting process and can therefore help in quick healing of wounds. This factor is not common in the plant kingdom and is mainly formed in the body of animals, papaya being an exception. Papaya paste/ointment, made from fermented papaya flesh, is used traditionally for the relief of burns, cuts, rashes and stings. The latex can however, cause irritation and may provoke some allergic reaction in hypersensitive people. Data from the preliminary studies suggest that the treatment with papaya preparations and aqueous extracts may help to facilitate the woundhealing response (Nayak et al., 2007, Pieper and Caliri 2003). Papaya derived enzyme papain has been shown to facilitate the enzymatic wound debridement when applied topically (Telgenhoff et al., 2007). The aqueous extracts have also shown significant wound healing properties in diabetic rats (Dawkins et al., 2005, Nayak et al., 2007). The papaya fruit is used in topical ulcer dressing and for burn dressings to treat the wounds. The possible mechanism of action may be due to proteolytic enzymes chymopapain and papain as well as the antimicrobial activity (Hewitt et al., 2002, Starley et al., 1999). The fruit can also be directly applied to skin sores and seeds could also be effectively used for treating chronic skin ulcers. PROTECTION AGAINST AGE-RELATED MACULAR DEGENERATION (AMD) Papaya is considered as the top ranking fruit in terms of its carotenoids, flavonoids, fibre, vitamin A, ascorbic acid, folate, niacin, thiamin, riboflavin, iron, calcium and fibre contents per serving (USDA, National Nutrient Database for Standard Reference, 2006, LuximonRamma et al., 2003, Lim et al., 2007). The consumption of papaya is therefore recommended to prevent the vitamin A deficiency, a cause of childhood blindness in many tropical and subtropical developing countries (Chandrika et al., 2003, Gouado et al., 2007). Our bodies need vitamin A for the maintenance of epithelial surfaces, for immune competence, for 10 Amanat Ali, Sankar Devarajan, Mostafa I. Waly et al. normal functioning of retina, as well as for growth, development and reproduction. Dark green as well as the coloured fruits and vegetables provide provitamin A carotenoids. Reducing the vitamin A deficiency can save the eyesight and lives of countless children and adults. Higher dietary intake of lutein/zeaxanthin and vitamin E from foods and supplements have been reported to be associated with significantly decreased risk of neovascular agerelated macular degeneration (AMD), geographic atrophy, large or extensive intermediate drusen and cataract (AREDS Research Group, 2007, Christen et al., 2008). Arscott et al. (2010) observed that diets supplemented with papaya, oranges, mangoes and tangerines were able to prevent vitamin A deficiency in Mongolian gerbils. They suggested that these fruits could be an effective part of food-based interventions to support vitamin A nutrition in developing countries and worldwide. Eating 3 or more servings of fruit per day may lower the risk of age-related macular degeneration (AMD), the primary cause of vision loss in older adults, by 36%, compared to persons who consume less than 1.5 servings of fruit daily. Although the intakes of vegetables, antioxidant vitamins and carotenoids were not strongly related to the incidence of either form of AMD, fruit intake was definitely protective against the severe form of this vision-destroying disease. The bioavailability of carotenoids from fresh papaya fruit and its juice were found to be better as compared to dry slices. It was suggested that fresh papaya fruit and its juice can efficiently contribute to improve vitamin A status of the population. The high carotenoid contents of papaya can provide a better vitamin A value and anti-oxidative capacity to the people living in vitamin A deficient areas. Veda et al. (2007) reported that the bioaccessibility of β-carotene from two different varieties of papaya was similar (31.4 to 34.3%). Addition of milk increased the bioaccessibility by 19 and 38% in these two varieties. They suggested that the addition of milk to mango and papaya pulp is advantageous to derive provitamin A activity. PROTECTION AGAINST LUNG AND PROSTATE CANCERS Data from the in-vivo animal studies suggests that there is a relationship between vitamin A, lung inflammation, and emphysema. Laboratory animals fed on vitamin A-deficient diets developed emphysema (Li et al., 2003). Cigarette smoke contains a common carcinogen (benzo-(a)-pyrene) that can induce vitamin A deficiency. Eating vitamin A rich foods such as papaya can help to counteract the effects of vitamin A deficiency caused by the benzo(a)pyrene in cigarette smoke, and can thus greatly reduce the emphysema. A number of studies have shown the protective effects of dietary intake of supplementary vitamin A as well as provitamin A containing vegetables and fruits in lung cancer. Jin et al. (2007) reported an inverse association between the consumption of vitamin A and pro-vitamin A rich vegetable and lung cancer in Taiwan. In a case control study, Jian et al (2007) observed that regular intake of lycopene-rich fruits (tomatoes, apricots, pink grapefruit, watermelon, papaya, and guava) and drinking green tea may greatly reduce the risk of developing prostate cancer in men. They suggested that the synergistic protective effect of regular consumption of both the green tea and lycopene rich fruits was stronger than the protection provided by either of them individually. Nutritional and Medicinal Values of Papaya (Carica Papaya L.) 11 ANTIFUNGAL AND ANTIBACTERIAL PROPERTIES The ripe and unripe fruits have been reported to have significant antibacterial activity against Staphylococcus aureus, Bacillus cereus, Bacillus subtilus Eschericia coli, Pseudomonas aeruginosa, Proteus vulgaris, Salmonella typhi, and Schigella flexneri as well as antimicrobial activity against Trichomonas vaginalis trophozoites (Emeruwa, 1982, Osato et al., 1993, Dawkins et al., 2005). The latex proteins are considered to have the antifungal action (Giordani et al., 1996). The papaya chitinase has been reported to have antifungal and antibacterial activities (Chen et al., 2007). The bacteriostatic activity of papaya may also be attributed to its free radical scavenging potential. Papaya latex was effective in inhibiting the growth of Candida albicans and showed synergistic action when used mixed with Fluconazole. Papaya seed can be used as an antibacterial agent for Eschericia coli, Staphylococcus aureus or Salmonella typhi. However, further research is needed before advocating large-scale therapy. Being a good bleaching agent, papaya forms a vital ingredient in liquid and bar bath soaps, hand washes, astringents and even detergent bars. ANTIFERTILITY AND CONTRACEPTIVE USE OF PAPAYA In India, Bangladesh, Pakistan, Sri Lanka, and other countries, green papaya is traditionally used as a folk remedy for contraception and abortion, as its phytochemicals can negate the effects of progesterone (Oderinde, 2002). Ripe fruit however did not show any contraceptive properties. Unripe papaya is especially effective in large amounts or high doses. Ripe papaya is not teratogenic and will not cause miscarriage in small amounts. It is speculated that unripe papayas may cause miscarriage due to latex content, which may cause uterine contractions leading to a miscarriage. Papaya seed extracts in large doses have a contraceptive effect on rats and monkeys, but in small doses have no effect on the unborn animals. In animal model studies on rats, langur monkeys and rabbits, the methanol subfraction of the extracts from seeds of Carica papaya L. has been shown to possess 100% contraceptive efficacy by inhibiting the sperm motility without any adverse systemic side effects on libido and toxicity and has been identified as a putative candidate for male contraception (Lohiya et al., 1999, Udoh et al., 2005, Lohiya et al., 2005 and 2008). Goyal et al. (2010) reported that the long term oral daily administration of methanol-sub-fraction (MSF) of the extract of seeds of Carica papaya affected the sperm parameters without any adverse systemic side effects and is clinically safe to use as male contraceptive. These results verify the traditional use of papaya as a potential male contraceptive in some parts of Assam, India (Tiwari, 1982). The aqueous seed extracts have shown abortifacient properties in female Sprague Dawley rats, whereas the ether, alcoholic and aqueous extracts inhibited the ovulation in rabbits (Oderinde et al., 2002, Kapoor et al., 1974). The normal consumption of ripe papaya during pregnancy does not pose any significant danger. Only small quantities of ripe papaya fruit should be consumed during pregnancy, as green papaya and papaya seeds can cause miscarriage, particularly in large amounts, due to their contraceptive and abortifacient competence. However, the use of unripe or semi-ripe papaya could be considered as unsafe in pregnancy (Adebiyi et al., 2002). 12 Amanat Ali, Sankar Devarajan, Mostafa I. Waly et al. SUPPORT FOR THE IMMUNE SYSTEM AND ANTI-MUTAGENIC PROPERTIES Vitamin C and vitamin A are both needed for the proper functioning of a healthy immune system. Papaya contains significant quantities of vitamin C and provitamin A (beta-carotene) and therefore may be a healthy fruit choice for preventing such illnesses as recurrent ear infections, colds and flu. The nutrients in papaya have also been shown to be helpful in the prevention of colon cancer. Rahmat et al. (2002) reported that both pure and extracted lycopene as well as papaya juice showed antiproliferative and anticancer properties on liver cell line (Hep G2) and the juice appeared to be more effective than the extracted lycopene in inhibiting the cancer cell growth. Papaya's fiber is able to bind to cancer-causing toxins in the colon and keep them away from the healthy colon cells. The other nutrients provide synergistic protection for colon cells from free radical damage to their DNA. The fermented papaya products (FFP) have shown the ability to modulate the oxidative DNA damage due to H2O2 in rat pheochromocytoma tumor cells and protection of brain against oxidative damage in hypertensive rats (Aruoma et al., 1998). The FFP also exhibit supportive role in reducing the oxidative inflammatory damage in cirrhosis caused by hepatitis C virus (Marotta et al., 2007). The papaya juice when compared with standard antioxidant (vitamin E) showed comparable efficacy and safety in reducing the oxidative stress (Mehdipour et al., 2006). It has therefore been suggested that FPP (because their free radical scavenging potential) can be used as a prophylactic food against age-related and neurological diseases and may improve the lipid profile by inhibiting the lipid peroxidation (Imao et al., 1998, Rahmat et al., 2004). The fruit juice of papaya may contain some anti-hypertensive agents, which may modulate the α-adenoreceptor activity and may help in lowering the blood pressure (Eno et al., 2000). The ethanol extracts of papaya seeds showed some diuretic properties equivalent to that of hydrochlorothiazide (Sripanidkulchai et al., 2001). The nutrients and phytochemicals contents of papaya may be effective in the prevention of diabetes mellitus complications (Savickiene et al 2002). The ethanol and aqueous extracts of papaya have also reported to have hepatoprotective activities against carbon tetrachloride (CCl4) induced hepatotoxicity (Rajkapoor et al., 2002). Papaya seed extract may be nephroprotective in toxicity-induced kidney failure. Papaya seed extracts are currently being marketed as nutritional supplements with the claims to improve immunity and body functioning as they have been reported to have imunomodulatory and anti-inflammatory actions (Mojica-Henshaw et al., 2003). CONCLUSION Papaya can help in the digestion of food proteins, renewal of muscle tissues, revitalization of human body and slowing of ageing process as well as in the maintenance of body's homeostasis. The nutrients and phytochemicals contained in papaya can reduce inflammation, support the functioning of cardiovascular, immune and digestive systems and may also help in prevention of colon, lung and prostate cancers. Papaya pastes can be used externally as a treatment for skin wounds and burns. Because of its high vitamin A and carotenoids contents, it can reduce the cataract and age-related macular degeneration. More Nutritional and Medicinal Values of Papaya (Carica Papaya L.) 13 extensive studies and well-designed randomized clinical trials are however, required to explore the role of papaya in the prevention of different forms of cancers, cardiovascular diseases, age-related macular degeneration and the ailments of gastrointestinal system. 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