RUNNING HEAD: HEALTH BENEFITS OF GINGER
A Review on the Health Benefits of Ginger on Nausea in Pregnant Women
Katie L. Kovage
Russell Sage College
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Abstract
The purpose of this paper is to explore the health benefits that ginger has on women who are
experiencing nausea and vomiting due to pregnancy. The primary focus is ginger and the
chemical components that are responsible for providing relief. Two different studies will be
analyzed to explain how much ginger is needed, if it is safe to consume, and if it believed to be
effective. The two studies include a systematic review and meta-analysis of the effect and safety
of ginger in the treatment of pregnancy associated nausea while the other is a large populationbased cohort study, both of which will lead to a clear evidenced-based decision reporting that
indeed ginger can be beneficial to those who suffer from nausea and vomiting of pregnancy or
what is also known as morning sickness.
HEALTH BENEFITS OF GINGER
A Review on the Health Benefits of Ginger on Nausea in Pregnant Women
Pregnancy is a beautiful thing that is often times turned into a dreadful situation when
one is faced with morning sickness. Morning sickness is also known as nausea and vomiting of
pregnancy or NVP and has the ability to affect between 80-90% of all pregnant women (Viljoen,
Visser, Koen, & Musekiwa, 2014). One of the first signs of pregnancy, (American Pregnancy
Association, 2014) morning sickness typically begins to occur around week 4-9 of gestation. The
most frequent complaints of morning sickness include and are not limited to nausea, vomiting,
feeling dizzy upon standing, and an abnormal heart beat. While most cases of morning sickness
seem to subside by week 16 of pregnancy, roughly 15-30% of women suffer from symptoms past
week 20 of gestation. While the cause of NVP is unknown, severe cases can have negative
consequences on mom and the developing baby. Hyperemesis gravidarum (HG) is a medical
term that is associated with persistent and violent vomiting during pregnancy that can
subsequently cause dehydration, electrolyte imbalance, and liver damage to the mother (Viljoen,
Visser, Koen, & Musekiwa, 2014). While the mother’s health is important, the well-being of the
fetus is why many mothers become worried about NVP. Excessive NVP can lead to the
malnourishment of the baby which can cause an infant to be born preterm and at a low birth
weight (Viljoen, Visser, Koen, & Musekiwa, 2014). In order to treat NVP several women take
part in non-drug interventions and home remedies in hopes to lessen their symptoms. While there
are numerous home remedies, consuming ginger is among one of the most popular. (Bregman,
2014). Ginger has been known to have a positive effect on pregnant women by reducing
“morning sickness” symptoms such as nausea and vomiting.
Ginger is a plant native to countries such as India and China in which the roots are used
for numerous medical and culinary purposes. It is among one of the most commonly used herbs
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in Western countries and is primarily acknowledged as a cure for NVP. Ginger is produced from
a member of the Zingiberaceae plant family known as Zingiber officinale roscoe (Singletary,
2010). Zingiber officinale is geographically found in subtropical and tropic areas where climate
is generally humid and partially shaded (Plants and Fungi: Zingiber officinale (Ginger), 2014).
Ginger is generated and prepared from the underground stem of the plant called the rhizome.
This root can be fresh or dried and manufactured into powder, syrup, and oil. Ginger has
characteristics that allow the spice to be among one of the most diverse ingredients in the market
industry as it is sold as dietary supplements and is present in an array of food and beverages
(Singletary, 2010). The average consumer can obtain ginger year round for relatively low prices
allowing for the relief of nausea and vomiting of pregnancy to be rather unproblematic.
Ginger has been scientifically proven to treat morning sickness due to its chemical
composition and the actions it has on the body once it is ingested. The rhizome contains fat,
carbohydrates, protein, fiber, water, and volatile oil. Although the mechanism of action is not
entirely understood scientists believe that ginger has antiemetic actions on the central nervous
system as well as active components that affect serotonin in the gastrointestinal tract (Heitmann,
Nordeng, & Holst, 2012).
Vomiting, which is an adaptive behavior, is controlled in the brainstem and is inducible
by several mechanisms. One way is by irritation in the gastrointestinal tract. When the GI tract
becomes irritated, cells release a chemical called serotonin that stimulates the vomiting center to
eliminate the contents in the stomach as a way to protect the body. It is reported that 90% of all
serotonin is present in the GI tract which is why some researchers support the conclusion that
humans have two brains; “one in the head, and the other in the gut” (Brown, 2005). Similarly,
the second way vomiting is controlled is by the central nervous system which is stimulated often
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by fear, certain smells, or eagerness. (Regulation of Emesis, 2014). Ginger’s cell structure also
has been reported to have antioxidant properties and antimicrobial potential which can be
beneficial as there is an association linked between the infection of H.pylori and the cause of
NVP in women; however this hypothesis requires further testing (Viljoen, Visser, Koen, &
Musekiwa, 2014). The mechanism of action in the body ginger beholds predominantly relies on
the rhizome as its chemical compounds can vary among different plants and its growth location.
The rhizome’s quality of active components is influenced by the cultivation and post-harvest
techniques performed by farmers (Singletary, 2010).
Before introducing the two clinical studies that examined the benefits of consuming
ginger while pregnant, it is of importance to mention the ingredients in the spice that are solely
responsible for improving nausea and vomiting. There are two phenolic or chemical compounds
that contain a hydroxyl group (-OH) called gingerol and shogaol. Shogaol is the dehydrated form
of gingerol and is present in dry and powder ginger (Singletary, 2010). Both gingerol and
shogaol give ginger the distinct taste and smell of the spice and are what contribute the medicinal
attributes (Ozgoli, Goli, & Simbar, 2009).
The first study involved 70 pregnant women during the months of June and July of the
year 2009. The women had to of had experienced mild to moderate nausea either with or without
vomiting and be under week 20 of their gestation period. The participants had to have no medical
or surgical history along with reporting zero drug or tobacco use. Preceding treatment, all
participants were asked to fill out a questionnaire regarding the severity of their nausea with 0
being an absence of nausea and 10 being the most severe. While taking part in this study, women
were asked to refrain from using other medications to alleviate symptoms of NVP. Given this
study there were two groups; the exepermintal and the control. The experimental group was
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provided 4 ginger capsules each containing 250 mg of ginger root powder while the control
group received similar supplements containing lactose. Both groups received their capsules 4
times a day continuously for 4 days and were asked to report nausea levels twice daily. In order
to successfully complete the study, data from 67 women were examined to draw a conclusion.
Three women had to be omitted from the study as they did not follow experiment guidelines. Of
the 67 women, 32 of them belonged to the experimental group and the remaining 35 belonged to
the control group. Based upon the assessments, symptoms of nausea improved and became
milder in 84% of all ginger users verse 56% of non-ginger consumers (Ozgoli, Goli, & Simbar,
2009).
The second study was a systematic review that examined several reports and their
findings to see if there is truly a correlation between consuming ginger and improvements in
nausea and vomiting of pregnancy. When concluding this systematic review, the two authors
pooled together studies of English language from the years 1991-2011 which included 1,278
participants. These participants were women who suffered from NVP at any age or pregnancy
stage. A vast majority of the studies used ginger containing capsules ranging from 1000-1950
mg. In comparison, the control groups were giving placebo capsules that contained lactose,
lemon oil, soybean oil, or flour. In order to measure if ginger was effective symptoms, frequency
of vomiting and side effects were observed. From their findings, the authors established that
symptoms of NVP in pregnant women declined after ginger treatment was completed. In cases
where there were complaints of vomiting present, roughly 50% of all women said incidents of
vomiting declined when using ginger (Viljoen, Visser, Koen, & Musekiwa, 2014).
Although these are only two studies investigating whether or not ginger has a positive
effect on pregnant women, there may have been key factors that could have allowed the data to
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be potentially skewed. Due to the fact both studies had small sample sizes, the findings could be
less significantly reliable and could not be an accurate portrayal of how ginger truly affects
pregnant women. Also, even though both studies stated that there was not selection bias as to
what women participated in the trials, low response rates and self-reporting use could have made
it so there was undeniably some bias (Heitmann, Nordeng, & Holst, 2012). Overall, together
these studies support the notion that ginger does improve or relieve symptoms of nausea and
vomiting of pregnancy and emerge as reliable and valid informants.
Consuming ginger does improve nausea and vomiting in pregnant women, however is it
safe? While ginger is on the United States Food and Drug Administration’s list of safe herbal
supplements (Singletary, 2010), there is no consistent data to draw a permanent conclusion on
whether ginger is safe for pregnant women to consume (Ozgoli, Goli, & Simbar, 2009). Based
upon studies reported, safe dosages range from 1000-1500 mg per day with 2 g being the
minimum toxicity level (Singletary, 2010). Due to a lack of evidence available to state otherwise,
pregnant women who have a history of miscarriages, clotting disorders, or vaginal bleeding are
advised to not partake in consuming ginger as a way to relieve NVP. Possibly side effects that
were reported by women in the two studies were headaches, slight drowsiness, and
gastrointestinal problems such as diarrhea (Singletary, 2010). There were some small reports of
vaginal bleeding after treatment however there was not a significant association linked between
the two (Heitmann, Nordeng, & Holst, 2012). For that reason, pregnant women who are close to
their pregnancy due date are recommended to not consume ginger as it may affect platelet
aggregation (Singletary, 2010). Ginger was not seen as a teratogen, or a disturbance in
development of the fetus as there was no malformations of any kind reported by women in the
studies (Heitmann, Nordeng, & Holst, 2012).
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A majority of all pregnant women experience “morning sickness” which is often referred
to as NVP or nausea and vomiting of pregnancy. NVP has the ability to impact a women’s life
immensely by reducing the everyday quality of life (Heitmann, Nordeng, & Holst, 2012). In
order to make pregnancy for women as pleasurable as possible, health professionals and family
often recommend home remedies in order to help lessen the burden of their loved ones. Ginger is
among one of the most recognized non-drug cure for nausea and vomiting. Studies found that
those who consume ginger are more likely to be educated, non-smokers, and those who
consumed folic acid as part of their prenatal regime (Heitmann, Nordeng, & Holst, 2012). While
there are only a few studies that show clinical evidence of ginger positively effecting pregnant
women against NVP, (Singletary, 2010) it can be concluded that indeed ginger has been shown
to be equally or more effective than other medications against nausea and vomiting (Viljoen,
Visser, Koen, & Musekiwa, 2014). Although there is no information available as to what the best
form of ginger is to consume or directly how much is needed, ginger has the potential to have
positive effects on pregnant women who are experiencing nausea and vomiting.
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References
American Pregnancy Association. (2014, October 20). Retrieved from Pregnancy Wellness: Morning
Sickness: http://americanpregnancy.org/pregnancy-health/morning-sickness-during-pregnancy/
Bregman, L. (2014, October 21). 30 Natural Remedies for Morning Sickness. Retrieved from
MindBodyGreen: http://www.mindbodygreen.com/0-9602/30-natural-remedies-for-morningsickness.html
Brown, H. (2005, August 25). A Brain in the Head, and One in the Gut. Retrieved from New York Times:
http://www.nytimes.com/2005/08/24/health/24iht-snbrain.html?pagewanted=all&_r=0
Heitmann, K., Nordeng, H., & Holst, L. (2012). Safety of Ginger Use in Pregnancy: Results from a Large
Population-based Cohort Study. Pharmacoepidemiology and Prescription, 269-277.
Ozgoli, G., Goli, M., & Simbar, M. (2009). Effects of Ginger Capsules on Pregnancy, Nausea and
Vomiting. The Journal of Alternative and Complementary Medicine, 243-246.
Palatty, P. (2013). Ginger in the Prevention of Nausea and Vomiting: A Review. Critical
Reviews in Food Science and Nutrition, 659-669.
Plants and Fungi: Zingiber officinale (Ginger). (2014, October 21). Retrieved from Kew: Royal Botanic
Gardens: http://www.kew.org/science-conservation/plants-fungi/zingiber-officinale-ginger
Regulation of Emesis. (2014, October 22). Retrieved from
http://courses.washington.edu/conj/bess/emesis/emesis.html
Singletary, K. (2010). Ginger: An Overview of Health Benefits. Nutrition Today, 171-183.
Viljoen, E., Visser, J., Koen, N., & Musekiwa, A. (2014). A Systematic Review and Meta-Anaylsis of the
Effect and Safety of Ginger in the Treatment of Pregnancy-associated Nausea and Vomiting.
Nutrition Journal.