RAY

Sheesh … who do I listen to now? The consultant nephrologist or the nutritionists? 

New Straits Times, 24 April 2008
Nutritionists defend starfruit 

KUALA LUMPUR: Nutritionists have jumped to the defence of the starfruit.

They were unanimous in challenging a medical expert’s opinion that the fruit was dangerous to renal failure patients because of the presence of a neurotoxin and a high level of oxalic acid.

The experts said the poisoning of an elderly Malaysian visiting China was most likely due to pesticide contamination.

The level of freshness also needs to be checked, they said.

A medical expert with University Malaya Medical Centre told a press conference on Tuesday that the fruit could be harmful to renal patients.

Professor Dr Tan Si Yen was commenting on retiree Tang Gon Seang, 66, from Butterworth, who went into a seizure in China after allegedly eating some starfruit.He was admitted to the Shenzhen general hospital on March 29 where he eventually slipped into a coma.

A specialist there diagnosed his condition as being caused by the starfruit he had eaten.

“You have to be taking a large amount of starfruit and abusing your body with the oxalate (to suffer renal failure),” said pharmacist and holistic medicine expert Datuk Dr M. Rajen.

Oxalate is found in a lot of food and generally healthy people would have no problem with it, he said.

Dr Rajen said such statements that starfruit could be life-threatening may cause a “fear campaign” against the fruit.

He conceded that there could be “the odd case” where people with renal problems eating starfruit suffered severe adverse reactions but one should be clear of the source of the reaction.

He added that other factors should be looked into such as the usage of chemical fertilisers and whether the fruit was fresh or preserved.

Dr Rajen also dismissed the claim that starfruit contained a neurotoxin because if it did, “a lot more people would be affected by eating fresh starfruit”.

Nutrition Society of Malaysia president Dr Tee E Siong agreed that it would take high levels of oxalate, even with kidney patients, to cause such a reaction as in the case of Tang.

“It is very unlikely, although one should analyse the case further,” he said.

Raw leafy green vegetables such as ulam contain a higher level of oxalate than starfruit, he added.

President of the Malaysian Dietary Supplement Association Jagdev Singh said there had been two reports of severe toxicity problems caused by starfruit with kidney patients in Brazil and Taiwan.

However, he said, it did not necessarily mean that they were due to the oxalates as spinach contains more oxalates than starfruit and kidney patients do not seem to have problems with spinach.

“More research is needed and the issue of pesticide presence has to be ruled out.

“Also, the fruit in these cases could be a subspecies of the starfruit found here.”

Jagdev Singh also said that it was highly unlikely that starfruit contained neurotoxins.

A Google search for “starfruit poisoning” refers to the American-based medical website, www.pubmed.gov, stating the fruit contains neurotoxins and oxalate. Oxalate can lead to kidney stones but, once again, local experts agreed it would take large amounts and many years to lead to such a condition.