Car-o-Power by North American Herb & Spice

POSSIBLY EFFECTIVE

• Diarrhea. Oral carob, when taken with oral rehydration solution (ORS) seems to reduce the duration of diarrhea in infants and children with acute diarrhea. Details: Clinical research in children with acute diarrhea shows that drinking 20 mL/kg of juice extracted from raw carob bean immediately prior to taking a World Health Organization ORS over 4-6 hours reduces the duration of diarrhea by 46% and the weight of stools by 44% when compared with ORS alone (40017). Other clinical research in infants with acute diarrhea shows that taking carob pod powder 1.5 gram/kg daily (up to a total of 15 grams) along with ORS for up to 6 days reduces the duration of diarrhea by approximately 47% when compared with ORS alone (39999).
• Hypercholesterolemia. Oral carob seems to reduce cholesterol in adults with moderate hypercholesterolemia. Details: Clinical research in adults with moderate hypercholesterolemia shows that taking a carob fiber containing 80% polyphenols (Exxenterol, Puleva Biotech SA) 4 grams twice daily for 4 weeks reduces total cholesterol and low-density lipoprotein (LDL) cholesterol by 18% and 23%, respectively, when compared with placebo (97846). Other clinical research in patients with moderate hypercholesterolemia shows that taking a specific carob product (Caromax, Nutrinova) 15 grams daily in bread and a fruit bar, along with a regular diet for 6 weeks, reduces total cholesterol and LDL cholesterol when compared with placebo (39986). Lower quality research in patients with moderate hypercholesterolemia shows that consuming carob pulp 15 grams daily in prepared food products also reduces total cholesterol and LDL cholesterol when compared to baseline (39975).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Athletic performance. It is unclear if oral carob is effective for improving athletic performance. Details: A very small clinical study in healthy professional taekwondo athletes shows that taking carob pod powder 40 grams, containing 208 mg of polyphenols, daily for 6 weeks improves total distance covered and maximal aerobic velocity when compared with placebo. Carob also moderately reduced weight and body mass index (BMI), but did not affect fat or muscle mass, heart rate, or rate of perceived exertion (104237). The validity of these findings is limited by the small size and short duration of the study.
• Celiac disease. Although there has been interest in using oral carob for celiac disease, there is insufficient reliable information about the clinical effects of carob for this purpose.
• Diabetes. Although there has been interest in using oral carob for diabetes, there is insufficient reliable information about the clinical effects of carob for this purpose.
• Dyspepsia. Although there has been interest in using oral carob for dyspepsia, there is insufficient reliable information about the clinical effects of carob for this purpose.
• Familial hypercholesterolemia. It is unclear if oral carob is beneficial in patients with familial hypercholesterolemia. Details: A small crossover study in children and adults with familial hypercholesterolemia shows that consuming food prepared with carob gum 8-30 grams daily for 4-8 weeks reduces total cholesterol by 10% to 17% and low-density lipoprotein (LDL) cholesterol by 11% to 19% when compared to baseline. Triglycerides and high-density lipoprotein (HDL) cholesterol levels do not appear to be affected (40008).
• Fibromyalgia. It is unclear if oral carob is beneficial in females with fibromyalgia. Details: A small clinical study in females with fibromyalgia shows that taking carob flour 3 grams dissolved in water twice daily for 6 weeks does not improve blood glucose, cholesterol, blood pressure, body weight, or other measures of body composition when compared to baseline (108309). It is unclear if carob improves symptoms or quality of life in patients with fibromyalgia, as these outcomes were not assessed.
• Impaired glucose tolerance (Prediabetes). It is unclear if oral carob is beneficial in adults with prediabetes. Details: A small clinical study in non-obese adults with prediabetes shows that taking a beverage made with carob pod extract (Fruit Up, Wild-Valencia SAU) 250 mL twice daily for 12 weeks reduces insulin levels and improves insulin resistance by approximately 15% and reduces fasting glucose levels by 10% when compared with a control sweetened beverage (97849).
• Male infertility. Small clinical studies suggest that oral carob might improve sperm motility in males with infertility, but its effect on sperm count and morphology is unclear. Details: A small clinical study in otherwise healthy males with infertility of various etiologies shows that taking a syrup containing 200 mg/mL of ground carob pods as 7.5 mL twice daily for 90 days increases sperm count, morphology, and motility parameters when compared with vitamin E 100 mg twice daily. The rate of pregnancy was higher in the carob group; however, the rates of live births were not different between the two groups (104236). Another small clinical study in males with idiopathic infertility shows that taking carob pod powder 500 mg three times daily for 90 days increases sperm motility but does not improve sperm count, sperm morphology, or sexual function scores when compared with vitamin E 100 mg three times daily (111127).
• Nausea and vomiting. It is unclear if oral formula thickened with carob gum is effective for preventing or treating vomiting in infants. Details: Observational research in formula-fed, full-term infants with moderate to severe regurgitation has found that using a carob gum-thickened formula for 1 month is associated with reduced frequency and volume of regurgitation, with resolution of regurgitation achieved in nearly half of all infants (111128). The validity of these findings is limited by a lack of control, blinding, and randomization.
• Obesity. It is unclear if oral carob is beneficial in adults with obesity. Details: One small clinical study in adults with overweight or obesity shows that taking carob and bean pod extract daily for 3 months modestly improves lipid profiles and the excretion of fat in the feces when compared with placebo (10633). It is unclear if carob improves weight loss.
• Ulcerative colitis. Although there has been interest in using oral carob for ulcerative colitis, there is insufficient reliable information about the clinical effects of carob for this purpose. More evidence is needed to rate carob for these uses.

(Read more about CAROB)

LIKELY SAFE ...when used orally in amounts commonly found in foods. Carob has Generally Recognized as Safe (GRAS) status (4912).

POSSIBLY SAFE ...when used orally in medicinal amounts, short-term. Carob fiber containing 80% polyphenols (Exxenterol, Puleva Biotech SA) has been used with apparent safety in doses of up to 8 grams daily for up to 12 weeks (97846). A beverage made with carob pod extract (Fruit Up, Wild-Valencia SAU) has been used with apparent safety at a dose of 500 mL daily for up to 12 weeks (97849). Carob pod powder has been safely used in doses up to 1500 mg daily for up to 90 days (111127).

CHILDREN: POSSIBLY SAFE
when used in full-term infants. Carob-based milk thickeners have been used with apparent safety in full-term infants as an additive in infant formula (39972,39991,104239,111128).

CHILDREN: POSSIBLY UNSAFE
when used in preterm infants. A carob-based milk thickener (Carobel) has been associated with necrotizing enterocolitis leading to death in two low birth-weight infants (39991).

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

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ORAL DRUGS Interaction Rating = Minor Be watchful with this combination. Severity = Mild •  Occurrence = Possible •  Level of Evidence = D Theoretically, carob might also impair the absorption of oral drugs.  Details Laboratory research shows that carob, when consumed as part of the diet or used as a thickening agent in infant formula, reduces the absorption of certain minerals (39972,40007,103719). Take carob 30-60 minutes after oral medications.

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General ...Orally, carob seems to be generally well tolerated when eaten as food or when added to food.
Serious Adverse Effects (Rare):
Orally: Serious allergic reactions in sensitive individuals.

Gastrointestinal ...Orally, the addition of a carob milk thickener (Carobel) to preterm infant feeds has been associated with necrotizing enterocolitis leading to death in two low birth-weight infants (39991). This adverse effect has not been reported in term infants.

Immunologic ...A five month-old child who was allergic to an anti-regurgitation milk formula containing carob gum experienced urticaria, rash, and explosive vomiting within 30 minutes of administration of the formula (39969). In a separate case, an 11-week-old infant with Down syndrome presented with persistent vomiting, watery diarrhea, and lethargy requiring IV hydration. The infant had previously been diagnosed with food protein-induced enterocolitis syndrome (FPIES), likely due to cow's milk. He had consumed formula containing a carob gum thickener; the reaction resolved upon discontinuation of the carob gum additive. An oral challenge test to carob produced a reaction, confirming this as the likely causative agent (104235). In another case, a 52-year-old man experienced chest tightness, throat discomfort, and burning sensations related to an oral allergy to carob pods (97850).
Occupational exposure to carob flour has been reported to cause allergic asthma and rhinitis (39987,40015).

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