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Botany, traditional uses, phytochemistry and biological activities of cardamom

[Elettaria cardamomum (L.) Maton] – A critical review

Kaliyaperumal Ashokkumar, Muthusamy Murugan, M.K. Dhanya, Thomas D.

Warkentin
PII: S0378-8741(19)30891-8
DOI: https://doi.org/10.1016/j.jep.2019.112244
Reference: JEP 112244

To appear in: Journal of Ethnopharmacology

Received Date: 4 March 2019

Revised Date: 16 September 2019
Accepted Date: 16 September 2019

Please cite this article as: Ashokkumar, K., Murugan, M., Dhanya, M.K., Warkentin, T.D., Botany,
traditional uses, phytochemistry and biological activities of cardamom [Elettaria cardamomum
(L.) Maton] – A critical review, Journal of Ethnopharmacology (2019), doi: https://doi.org/10.1016/
j.jep.2019.112244.

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Botany, traditional uses, phytochemistry and biological activities of cardamom [Elettaria
cardamomum (L.) Maton] – A critical review

Kaliyaperumal Ashokkumar1*, Muthusamy Murugan1, M.K. Dhanya1, and Thomas D. Warkentin2.

1
Cardamom Research Station, Kerala Agricultural University, Pampadumpara, Idukki - 685553,
Kerala, India
2
Department of Plant Sciences, College of Agriculture and Bioresources, University of
Saskatchewan, Saskatoon, SK, S7N 5A8, Canada
*
Corresponding Author: biotech.ashok@gmail.com

ABSTRACT

Ethanopharmacological relevance: Small cardamom [Elettaria cardamomum (L.) Maton.

(Family: Zingiberaceae)] capsules have been used for traditional medicine applications including

for the control of asthma, teeth and gum infections, cataracts, nausea, diarrhea, as well as

cardiac, digestive and kidney disorders. The versatile use of cardamom capsules has several

other beneficial health effects that are relevant in light of traditional and modern pharmaceutical

perspectives.

Aim of the study: This review aims to provide a critical and comprehensive evaluation of the

traditional and current medical uses of E. cardamomum, and compare these applications with

modern research studies. This critical review also discusses the botanical distribution,

phytochemical constituents and biological activities of cardamom capsule extracts and essential

oil.

Materials and methods: An online survey was conducted of the traditional uses, phytochemical

composition, and pharmacological applications of cardamom essential oil (CEO) and extracts.

Pertinent data were obtained from several electronic scientific databases (Science Direct,

Elsevier, Web of Science, PubMed, Springer, ACS publications, Taylor and Francis, Wiley On-

1
line Library and Google Scholar), and additional information was obtained from textbooks and

local prints and scripts.

Results: Phytochemical analyses have described important chemical constituents of cardamom

including carbohydrates, proteins, minerals, lipids, essential oils, flavonoids, terpenoids and

carotenoids. Cardamom capsules are used widely as a spice and flavoring ingredient in foods,

and are often recognized for their beneficial health properties. The capsules are also used in

fragrances. CEO has several biological roles including antioxidant, antidiabetic, antibacterial,

anticancer, gastro-protective and insecticidal activities.

Conclusion: The widespread availability and recommendation of synthetic compounds for

addressing human health have several side effects besides higher costs. Hence, examining natural

bioactive compounds is imperative. This review investigates and presents the pertinent

information on cardamom and its traditional uses, as well as potential pharmacological properties

of CEO and extracts. Additional research studies are needed to understand the mechanism of

action of bioactive constituents.

Keywords: Cardamom; Botany; Phytochemicals; Essential oil; Traditional and pharmacological

applications

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1. Introduction

2. Botany

3. Traditional uses and ethanopharmacology

4. Chemical composition

4.1. Proximate and mineral composition

4.2. Cardamom essential oil (CEO) and its composition

4.3. Cardamom fixed oil and its composition

5. Biological effects of CEO and Extracts

5.1. Antioxidant activity

5.2. Anticancer activity

5.3. Cytotoxic activity

5.4. Antimicrobial and Antibacterial activity

5.5. Insecticidal activity

5.6. Miscellaneous activity

6. Conclusion

Author contributions

Conflict of interest statement

References

1. Introduction

Elettaria cardamomum (L.) Maton is commonly known as small cardamom, green

cardamom, or true cardamom and is grown in India, Guatemala, Sri Lanka, Nepal, Indonesia,

Costa Rica, Mexico and Tanzania (Garg et al., 2016). In India, cardamom is cultivated in

altitudes ranging from 900-1400 m above msl (mean sea level) covering three southern Indian

3
states (Kerala, Karnataka and Tamil Nadu). In Kerala, it is cultivated mainly in the Indian

Cardamom Hills covering an area of 1050 square kilometers designated as Cardamom Hill

Reserves, (Madhusoodanan et al., 2002). The botanical name of cardamom, Elettaria

cardamomum, originated from the Tamil word “Elettari” which refers to the seeds of cardamom

(Mahindru, 1982).

In general, the cardamoms are the capsules of dried fruits in different genera of the

Zingiberaceae family, primarily Elettaria, Amomum and Aframomum. Among them, Elettaria

cardamomum (L.) Maton is most important and is grown predominantly in southern India

(Govindarajan et al., 1982). The false cardamom, large cardamom, or black cardamom from the

allied genus Amomum is native to Nepal, Sikkim, Bengal and southeast Asian countries. African

cardamom, which is botanically known as Aframomum danielli (Hook.f.) K. Schum., is native to

south east Africa especially in Tanzania, Cameroon, Madagascar and Guinea (Govindarajan et

al., 1982; Adegoke et al., 1998). Small cardamom is extensively cultivated in Nepal and Sikkim

and to a limited extent with the large cardamom (Amomum subulatum Roxb.). However,

international trade is now limited to Asian countries as far as small and large cardamom are

concerned because of high prices. Worldwide, cardamom is recognized as the “queen of spices”

for its pleasant aroma and taste, and is the third most expensive spice after saffron and vanilla.

For centuries, cardamom capsules have been used for culinary and traditional medicine

applications including controlling asthma, teeth and gum infections, digestive and kidney

disorders (Hamzaa and Osman, 2012; Saeed et al., 2014), cataracts, nausea, diarrhea and cardiac

disorders (Gilani et al., 2008; Khan et al. 2011). The essential oil and other bioactive metabolites

accumulated in cardamom capsules contribute to their characteristic aroma and utility as a

functional food, pharmaceutical, and nutraceutical (Hamzaa and Osman, 2012). The essential oil

4
(EO) content of cardamom capsules varies from 6-14% depending upon the type and processing

methods (Menon, 2000). EO of cardamom capsules possess predominantly monoterpene

constituents, such as 1,8-cineole, α-pinene, α-terpineol, linalool, linalyl acetate and nerolidol and

the ester constituent α-terpinyl acetate (Kaskoos et al., 2006; Yashin et al., 2017; Ashokkumar et

al., 2019b), all of which have therapeutic benefits including antioxidant, anticancer, antidiabetic,

anti-inflammatory, antifungal, antiviral and gastroprotective activities (Nirmala, 2000; Marongiu

et al., 2004; Hamzaa and Osman, 2012; Winarsi et al., 2014). Recent reports claimed that

flavonoids, terpenoids, anthocyanins, alkaloids and other phenolic constituents from cardamom

were being used for controlling cardiovascular, pulmonary, kidney and lung associated disorders

(Vaidya and Rathod, 2014). The aim of this review is to highlight the main phytochemicals and

beneficial effects of cardamom essential oil (CEO) and extracts on human health.

2. Botany

Small cardamom (Elettaria cardamomum L. Maton), belongs to the Zingiberaceae

family. The basic chromosome number x=12 and 2n=48 indicates its balanced tetraploid nature

(Madhusoodanan et al., 2002). The habitat and field view of the cardamom plant is shown in

Figure 1. Cardamom is an herbaceous perennial plant that grows 2-5 m in height, with

underground rhizomes and is propagated by vegetative division of rhizomes. The aerial stem is

formed by encircling the leaf sheaths. The leaves are 30-35 cm long and 7-10 cm wide,

lanceolate with acuminate tip and dark green in colour. Tillers emerge from the axils of

underground stems. Most of the vegetative buds are produced during monsoon periods (Murugan

et al., 2016). Inflorescences arise from the rhizomes as a panicle possessing a long cane-like

peduncle having nodes and internodes. Normally, 2 - 4 panicles emerge from the swollen base of

5
tillers and certain cultivars have panicles with multiple branches. Flowers of most cardamom

types and varieties are white with the central lip streaked with pink (Telja et al., 2006). The

flowers are bisexual, irregular and cross-pollination is most common. The labellum is oval and

indistinctly 3 lobed. The calyx is tubular, split about ¼ of its length on one side and shortly 3

toothed. The corolla is unequally three lobed with the larger one at the posterior side. The fertile

stamen is united without connective appendages, but prolonged into a short crest. The crest is

positioned above or below the stigma. Anthers are two lobed, adnate to the filament and dehisce

vertically. The size of pollen grains varies from 75-120 microns in diameter. The stigma is

funnel shaped with cilia around a small cavity. The ovary is inferior, trilocular with axial

placentation and ovules are numerous in each carpel. Anthesis typically starts at 3.30 am and

continues until 7.30 am, the maximum pollen bursting occurs between 5.30 am and 6.30 am

(Prameshwar and Venugopal, 1974).

Capsules (fruits) mature completely in about 120 days from flowering. The fruits are

ellipsoidal or almost spherical, non-dehiscent, fleshy and leathery when dry. The fruit colour is

green and turns golden yellow on ripening and is 1-2 cm in length. Depending upon the

genotype, each capsule contains 12 to 32 seeds and the ripe seeds are black and covered with a

white mucilaginous coat (Murugan et al., 2016). Cardamom is highly cross-pollinated and

depends on honeybees for pollination. Cardamom is classified into three types based on the

nature of the panicles namely, Malabar (prostrate panicle), Mysore (erect panicle) and Vazhukka

(semi-erect panicle), shown in Figure 2. The three cardamom types are briefly described below.

a) Malabar: This type is well suited for lower elevation of 600 - 1000 m above msl

(mean sea level) and plants reach 2-3 m height on maturity. Panicles are absolutely

prostrate (Figure 2). This type is relatively less susceptible to thrips and shoot borer

6
 infestation. It can bloom even under low rainfall conditions in Kerala and Tamil

Nadu. Cured capsules are generally round and approximately 18 mm in length.

b) Mysore: This type is adapted to elevation ranging from 900 - 1200 m above msl.

Plants are robust and attain 3 - 4 m height on maturity. Panicles are completely erect

(Figure 2). It is best adapted to regions in Kerala and Karnataka with well distributed

rainfall. Cured capsules are three cornered and ribbed and tend to be slightly longer

than Malabar type, being about 21 mm length.

c) Vazhukka: This type is a natural hybrid between Malabar and Mysore types and

exhibits intermediate characteristics of both. It is well adapted to elevations ranging

from 900 – 1200 m above msl. Plants are robust and panicles are semi-erect (Figure

2). Capsules are bold, globose or ovoid shape.

A typical photograph of the various botanical features of these three types including flower

types, androecium, gynoecium, panicles, matured and cured capsules and seeds are presented in

Figure 3.

3. Traditional uses and ethanopharmacology

Small cardamom capsules have been used since the 4th century BC by Indian Ayurveda

doctors and ancient Greek and Roman doctors for treating various health problems such as

bronchitis, asthma and constipation (Al-Zuhair et al., 1996; Bisht et al., 2011), cold, cough,

diuretic, carminative, teeth and gum infections, urinary and kidney disorders, congestion of

lungs, pulmonary tuberculosis, and irritation of eyelids (Jafri et al., 2001; Hamzaa and Osman,

2012; Saeed et al., 2014), and cataracts, nausea, diarrhea and cardiac disorders (Gilani et al.,

2008; Khan et al., 2011). In Chinese traditional medicine, cardamom was used to treat

7
constipation, stomach ache, bladder infections and dysentery in children (Kapoor, 1990; Duke et

al., 2003). Cardamom has also been widely used to treat food poisoning in Ayurveda medicine.

Currently, cardamom oils are used in manufacturing of some plant-based hand creams and soaps

(Ajmera et al., 2018). Powdered cardamom capsules mixed with pulverized cloves, ginger and

caraway have been used for digestive ailments (Govil, 1998). Cardamom powder drink is also an

antidote for snake and scorpion venom. The consumption of cardamom capsules reduces

inflammation and headaches (Govil, 1998).

Cardamom capsule powder is used for bronchial asthma patients with excess saliva and

mucus in the respiratory tract, and as an excellent cough suppressant. Cardamom tablets can be

used for controlling cold and related symptoms (Nair and Unnikrishnan, 1997). In Indian

traditional medicine, cardamom capsules are considered as excellent digestive and balancing

Kapha, mainly in stomach and lungs. Also, it is useful for pacifying Vata dhosa

(https://www.mapi.com/ayurvedic-recipes/spices/cardamom.html). The cardamom seeds are

chewed to avoid bad breath, vomiting and indigestion. Cardamom capsules reduce the caffeine

constituent in coffee and the combination of cardamom and coffee is called ‘gavah’ which is

popular in Arabian culture to relieve headaches and stress. Adding two drops of cardamom oil

along with two drops of lavender oil to the water in the daily bath can be used to maintain

healthy skin (http://ayurvedicoils.com/tag/ayurvedic-health-benefits-of-cardamom-essential-oil).

In Tibetan traditional medicine, cardamom capsules are combined with cinnamon and long

pepper to treat obesity, glycemic imbalance, liver, kidney and heart diseases

(https://www.sowawellness.com/2017/10/07/cardamom/). Some people believe that drinking

macerated seeds in hot water at night has aphrodisiac potential

8
(http://www.agricultureinindia.net/cultivation/cardamom/cardamom-cultivation-varieties-and-

uses-spices-agriculture/15625).

In Kerala and Tamil Nadu, crushed cardamom capsules are boiled with tea and water to

impart a pleasant aroma to tea, which is popularly called “Elakkai tea” and which has been used

to relieve tiredness due to over work and depression. Cardamom capsules contain significant

concentration of β-carotene (0.5 µg g-1), (Ashokkumar et al., 2019a). In traditional medicine,

consumption of cardamom daily with a tablespoon of honey improves the eyesight (Singh and

Singh 1996). However, some people believe that excessive uses of cardamom capsules could

cause impotency in humans (Nair, 2011).

In Ayurveda, cardamom capsules have been used in many important preparations in the

form of powders, oils and decoctions, as well as medicinal fermented beverages like as Arishta

and Aasava (Sahadevan, 1965). The cardamom preparation, ‘Eladigana’ is commonly used to

cure arthritis, congestion and itching. Intake of cardamom increases urine production. A mixture

of medicines known as Ariyau kashayam (six grains including cardamom) is used for curing skin

diseases in children (Nair, 2011). Huang et al. (1999) examined the effect of cardamom extract

on the transdermal-dermal delivery of indometacin and observed that cardamom oil has

enhanced the permeation of indometacin significantly in in vitro (rabbit, rat and human) and in

vivo (rabbit) situations.

4. Chemical composition

4.1. Proximate and mineral composition

The proximate composition of cured cardamom capsules includes carbohydrate 68.2%,

protein 10.6 %, fat 2.4 % and ash 5.3 % (Sontakke et al., 2018). One hundred g of cured capsules

contained calcium (93 mg), magnesium (182 mg), potassium (124 mg), phosphorus (183 mg),

9
sulphur (100 mg) and iron (13 mg) (Sontakke et al., 2018; Ereifej et al., 2015; Murugan et al.,

2012). These are essential mineral elements for normal day-to-day physiological activities of

humans. Cardamom capsules and leaves contain significant levels of manganese, zinc and copper

(Table 1). Ashokkumar et al. (2019a) reported nutritionally important metabolites of cardamom

capsules that include flavonoids (catechin, myricetin, quercetin and kaempferol) and carotenoids

(lutein and β-carotene) (Table 1).

4.2. Cardamom essential oil (CEO) and its composition

The yield of the EO from cardamom varied between 0.2% and 8.7%, on a dry basis,

depending on the variety, plant parts and extraction methods used (Table 2). The EO estimation

by various methods is summarized in Table 2. The profiling of EO of cardamom seeds sampled

from southern India predominantly exhibited 1, 8-cineole (28.94%), α-terpinyl acetate (26.7%),

α-terpineol (14.6%), sabinene (13.5%), nerol (5.0%) and α-pinene (2.4%), (Ashokkumar et al.,

2019b). Sharma et al. (2011) indicated that seeds of cardamom collected across the cardamom

growing region of India chiefly contained α-terpinyl acetate, 1, 8-cineole and α-terpineol. The

EO of cardamom seeds from Guatemala, which is the global leader in cardamom production,

possessed α-terpinyl acetate, 1, 8-cineole, sabinene, linalyl acetate and linalool as key

constituents (Singh et al., 2008). The characteristic aroma of cardamom capsules and seeds is

principally developed by a combination of two major constituents namely 1, 8- cineole and α-

terpinyl acetate (Olivero-Verbel et al., 2010). The yield and chemical composition of major

cardamom essential oils across growing regions is presented in Table 3. The molecular structures

of major essential oil constituents isolated from cardamom are shown in Figure 4. The yield of

minor constituents of CEO include limonene (2.9%), 4-terpineol (1.4%), α-pinene (1.1%), β-

pinene (0.8%), myrcene (0.8%), octanal (0.2%), δ-3-carene (0.4%), p-cymene (0.7%), (E)-

10
nerolidol (0.7%) cis-sabinene hydrate (0.6%), geranylacetate (0.3%), cis-sabinene hydrate

acetate (0.2%), β-caryophyllene (0.2%), β-selinene (0.2%), γ-cadinene (0.2%), and trans-

linalooloxide (0.1%), (Mejdi et al., 2015).

4.3. Cardamom fixed oil and its composition

The composition of oil from cold pressed cardamom seeds predominantly consisted of

oleic acid (49.2 g/100 g of oil), palmitic acid (26.4 g/100 g of oil) and linoleic acid (15.2 g/100 g

of oil); these along with other minor fatty acids are shown in Table 4 (modified from Parry et al.,

2006). Among the fatty acids, cardamom oil contains 30.8, 51.3 and 17.9 g/ 100 g of oil of total

saturated fatty acids, total mono unsaturated fatty acid and total unsaturated fatty acid,

respectively. The fatty acids and their breakdown products have a major role in several pathogen

defense strategies in plants (Kachroo and Kachroo, 2009). Cardamom oil also contains several

forms of tocopherols namely, α-tocopherol (10.4 mg/kg of oil), γ-tocopherol (4.3 mg/kg of oil)

and δ-tocopherol (1.6 mg/kg of oil) (Parry et al., 2006). Tocopherols which have vitamin E

activity are also commonly found in oils of sunflower, olive, maize and soybean. Tocopherol is

an effective antioxidant (Robertsii et al., 2007), and diets containing vitamin E are linked with

lower risk of several types of human cancers such as kidney cancer (Shen et al., 2015), lung

cancer (Zhu et al., 2017) and bladder cancer (Wang et al., 2014). Additionally, diets rich in

tocopherol resulted in a 23% reduction in age related cataracts (Zhang et al., 2015). Therefore,

cardamom may play a key role in disease prevention and health promotion.

5. Biological effects of CEO and Extracts

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 The CEO and cardamom extracts have various biological effects including antioxidant,

antibacterial, anticancer, insecticidal and other miscellaneous activities that are summarized in

Table 5.

5.1. Antioxidant activity

Oxidative stress is a chief factor for induction of several chronic and degenerative

diseases such as diabetes, cancer, immune dysfunction and Parkinson’s (Haliwell, 2000;

Metodiewa and Koska, 2000). Antioxidants are natural or synthetic compounds that can be used

for prevention of free radical formation through scavenging and suppression of chronic and

degenerative diseases (Haliwell, 2000). Currently, there is an increasing interest towards natural

antioxidants from herbal sources (Larson, 1988; Velioglu et al., 1998). Cardamom capsules and

seeds are rich sources of antioxidant substances that neutralize free radicals by preventing

oxidation of other components. Nair et al. (1998) reported that cardamom capsules have a

moderate level of natural antioxidant properties owing to the presence of phenol compounds

such as quercetin, kaempferol and luteolins. Natural antioxidants are thought to be safer than

synthetic forms (Saeed et al., 2014). Like phytonutrients and vitamins, EO of cardamom acts as

an antioxidant and helps scavenging free radicals, thus reducing cellular ageing (Nanasombat

and Wimuttigosol, 2011; Saeed et al., 2014). However, some of the studies of antioxidant

activity based on chemical tests including DPHH assays no longer have pharmacological

relevance. Their potential under in vitro and in vivo conditions need to studied for these effects to

be considered clinically relevant (Harnly, 2017).

5.2. Anticancer activity

The essential oil of cardamom capsules in in vitro studies showed anticarcinogenic

effects by inhibiting damage to adult DNA by aflatoxin B1 in a microsomal enzyme

12
intermediated reaction (Hashim et al., 1994). This might be due to bioactive components present

in the essential oil that have potential anticancer roles. Cardamom oil increased the glutathione

transferase and acid-soluble sulfhydryl activities and arbitrates the oxidation and detoxification

of xenobiotics (Banerjee et al., 1994). Bhattacharjee et al. (2007) reported that the constituents of

phytochemicals of CEOs such as 1, 8-cineole and limonene demonstrated a protective role

against cancer development. Further they said aqueous cardamom extract could improve the

activity of the detoxifying enzyme glutathione S-transferase and reduce lipid peroxidation.

Elguindy et al. (2018) stated that oral administration of CEO at doses of 100 and 200 mg/kg/day

for 26 weeks significantly decreased serum creatinine and urea, and LDH activity in

diethylnitrosamine (DENA) induced oxidative stress in rats. Only a few studies have

investigated the anticancer potential of cardamom extracts and CEO, and these were conducted

in animal models, not in humans. Hence, future investigations should be focused on the

bioactivity of CEO in various clinical studies with humans.

5.3. Cytotoxic activity

Cardamom capsule extracts considerably enhanced the cytotoxic effects of natural killer

cells and indicated their anticancer potential (Majdalawieh and Carr, 2010). According to

Raksamiharja et al. (2012), CEO enhanced the amount of lymphocyte, CD4+ and CD8+ in

doxorubicin treated rats in a dose dependent manner. Additionally, Elguindy et al. (2016)

reported that cardamom essential oil or geraniol (200 mg/kg) decreased the level of TNF, IL-1

and NF-κB in diethylnitrosamine induced rats. These researchers also showed that CEO was an

immune stimulant agent for chemotherapy. Even though the safety of cardamom extracts and

CEO was indicated, the use of cell lines based only on in vitro assays limits the pharmacological

relevance of this outcome.

13
5.4. Antimicrobial and Antibacterial activity

The EO of cardamom has robust antibacterial effects against various food-borne

microorganisms (Kubo et al., 1991). Growth of Morgenella morganii was moderately inhibited

by the application of cardamom oil (Shakila et al., 1996). CEO (10 mg/ml) showed antibacterial

activity against S. aureus, E. coli, S. typhi, Streptococcus mutans and C. albicans (Abdullah et

al., 2018), Bacillus pulmilus and Listeria monocytogenes (Bano et al., 2016). Hence, CEO could

play a vital role in developing safe and novel antibiotics in modern medicine. According to

Mejdi et al. (2015), CEO has potential broad-spectrum antibacterial and antifungal activities that

could be used to prevent damage from food-borne pathogens and food spoilage organisms. The

majority of studies focusing on the antibacterial activity of cardamom extracts and CEO have

been conducted using the disc diffusion method (Grădinaru et al. ,2014; Kaushik et al. 2010),

however given its inherent limitations, the method needs to be supplemented by the more

relevant MIC assay (Van Vuuren, 2008).

5.5. Insecticidal activity

The development of bioactive constituents that are less persistent will be beneficial to

both farmers and the environment. Exploitation of natural products such as EOs are being

considered as substitutes to chemical pesticides due to their low toxicity effect on non-target

organisms and their lower persistence in the environment. Therefore, EO of cardamom could be

used as a stored grain protectant by killing or disturbing various life stages of insect pests

(including Sitophilus zeamais and Trilobium castaneum) attacking wheat, through direct

interaction and fumigant action (Huang et al., 2000). Chegini and Abbasipour (2017) evaluated

14
insecticidal activity of CEO against various stages (egg, 2nd larval instars and adults) of tomato

leaf minor (Tuta absoluta) and noticed that CEO has LC50% (lethal concentration, 50%) values

for eggs, larvae and adults as 351.19, 7.88 and 1.55 µl L-1, respectively and observed that CEO

has high potential for controlling T. absoluta, particularly under protected situations. Thus far,

only one study has investigated the insecticidal activity of CEO, so additional research is

required in this promising application.

5.6. Miscellaneous activity

Recently, CEO has been extracted and commercially used in the food industry as a

flavoring agent in bread, cakes, curry powder and pickles. Capsules and volatile oils of

cardamom are being used as flavoring constituents in various types of foods, including alcoholic

and non-alcoholic beverages, frozen desserts, candies, puddings, baked goods, condiments,

gravies and meat products. Cardamom oil is also mixed with massage oil, perfumes and lotions,

because of its soothing properties (Madhusoodanan et al., 2002).

Three CEO components (α- pinene, β- pinene and α- terpineol) had synergistic effects

with 1, 8-cineole and enhanced the penetration of indometacin. Hence, addition of CEO in

ointments and lotions increased the absorption of medicines through the skin. Al-Zuhair et al.

(1996) observed that CEO has antispasmodic action through receptor blockage, in addition to

diuretic properties. Lahlou et al. (2002) assessed the cardiovascular activity of CEO 1,8-cineole

in animal experimental studies and observed intravenous bolus injections of 0.3-10 mg/kg (1,8-

cineole) stimulated dose dependent decline in aortic pulse pressure. Elkomy et al. (2015)

proposed that the administration of gentamicin along with powdered cardamom at 100 mg/kg

and 20 mg/kg had noteworthy protection of rat kidneys.

15
6. Conclusion

In the present review, we summarize the knowledge on botany, ethnobotanical and

traditional uses, phytochemistry and pharmacological activities of E. cardamomum, which has

been widely used to treat several illnesses in ancient and modern India. According to the

classical Indian medical treatises, E. cardamomum has been traditionally used to treat teeth and

gum infections, asthma, nausea, diarrhea, digestive, kidney disorders and others. Over a very

long history, E. cardamomum has been demonstrated to be reliable, and now it is important to

understand whether modern pharmacological studies on E. cardamomum are available to assess

the traditional uses. We demonstrate that some of the modern in vitro and in vivo

pharmacological studies have confirmed the traditional use of E. cardamomum.

Based on the currently available information, more than 100 secondary metabolites have

been isolated from E. cardamomum, and of these 1, 8-cineole is an most important active

compound, which showed antitumor, anti-inflammatory and cardiovascular activities.

Furthermore, cardamom extracts and CEO has been extensively explored for their beneficial

constituents (Table 5). However, gaps exist in the scientific studies on E. cardamomum, and we

have provided recommendations of several topics that should have priority for detailed

investigations.

Firstly, based on the currently available phytochemistry reports, the investigations on the

structural characterization of metabolites in E. cardamomum capsules are very limited. Thus, in-

depth investigations of structural identification and purification of the bioactive metabolites from

cardamom is essential.

16
 Secondly, the essential oil of cardamom loses it flavor rapidly upon storing under normal

ambience/environment. The change in the aroma or flavor can also cause changes in the

constituents of its phytochemicals. Yet very little research has been conducted on maintaining

the shelf-life quality of CEO.

Thirdly, insufficient pharmacological studies have been conducted on cardamom. Some

biological activity studies were performed using very high dosage concentrations, some were

lacking in comparison with standard positive and negative controls, and others lacked

determination of MIC values, possibly leading to false positive results.

Fourthly, previous pharmacological investigations were mostly focused on the CEO and

organic fractions of crude extracts with little attention on the aqueous extracts; we need to give

attention to its traditional usage. Likewise, comprehensive placebo-controlled and double-blind

clinical trials are required to evaluate efficacy and safety.

Fifthly, although E. cardamomum possesses various potential therapeutic effects on

antioxidant, anti-inflammatory, antidiarrheal, anticancer, cytotoxic and cardio-protective

activities, these studies were performed only in animal and cell models and clinical

investigations in humans have rarely been implemented. Hence, future investigation should be

focused on the bioactivity of CEO in various clinical studies with humans. Such research will

benefit future pharmaceutical applications of CEO.

Overall, E. cardamomum appears to be both a nutraceutical and a functional food, with

regular consumption of cardamom capsules having potential to protect humans from various

chronic diseases. The presence of biologically active molecules such as 1, 8-cineole, α-terpinyl

acetate, α-terpineol and sabinene as major components in cardamom oil can serve as a new

potential natural source, which can be used in the food, aroma, cosmetics and pharmaceutical

17
domains. In the future, studies are needed on the bioavailability and pharmacokinetics of E.

cardamomum to search for the metabolites responsible for its activities. Thus far, the available

pharmacological studies are insufficient to assess the ethnobotanical uses. Further research

should be conducted to expand the medical application of E. cardamomum.

Author contributions

K.A and M.M conceptualized the manuscript. K.A. wrote the manuscript, M.M. and M.K.D.

collected and reviewed the literature on the chemical composition and biological activities. T.W.

contributed to the manuscript editing. All authors approved the final version.

Acknowledgements

We thank Mrs. Surya Raj for reference checking and Dr. Arjun Pandian, PRIST Deemed

University-Thanjavur, for technical assistance to draw the molecular structures of major

constituents of cardamom essential oil. The authors also thank five anonymous reviewers for

their detailed suggestions for improving the manuscript.

Conflict of interest statement

The authors have no conflict of interest.

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Table 1. Proximate and mineral composition of dry matter basis of cardamom (Elettaria
cardamomum)
Proximate composition (%) Capsules Leaves Authors
Carbohydrates (%) 68.2 - Sontakke et al. (2018)
Protein (%) 10.6 - Sontakke et al. (2018)
Fat (%) 2.4 - Sontakke et al. (2018)
Ash (%) 5.3 - Sontakke et al. (2018)
Acid insoluble ash (%) 1.76 - Kizhakkayil et al. (2006)
Crude fibre (%) 16.3 - Kizhakkayil et al. (2006)
Phenols (%) 3.26 - Kizhakkayil et al. (2006)
Minerals (mg/100g)
Calcium 92.7 - Sontakke et al. (2018)
Phosphorus 188.5 - Murugan et al. (2012)
Sodium 17.0 - Sontakke et al. (2018)
Potassium 124.2 - Sontakke et al. (2018)
Iron 12.8 28.4 Sontakke et al. (2018); Murugan (2011)
Copper 0.5 1.9 Murugan et al. (2012); Murugan (2011)
Magnesium 181.5 - Ereifej et al. (2015)
Manganese 41.7 26.0 Murugan et al. (2012); Murugan (2011)
Zinc 3.6 0.2 Murugan et al. (2012); Murugan (2011)
Sulphur 100.8 - Murugan et al. (2012)
Metabolites (µg/g)
Flavonoids
Catechin 281.8 - Ashokkumar et al (2019a)
Myricetin 18.6 - Ashokkumar et al (2019a)
Quercetin 4.9 - Ashokkumar et al (2019a)
Kaempferol 8.7 - Ashokkumar et al (2019a)
Total flavonoids 314.0 - Ashokkumar et al (2019a)
Carotenoids
Lutein 2.4 - Ashokkumar et al (2019a)
β-carotene 0.5 - Ashokkumar et al (2019a)

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Table 2. Yield of essential oil from cardamom capsules

Technique or method Oil yield (%) Authors

Steam distillation 0.2 - 5.6 Subaddarage et al. (1985)
Steam distillation 2.6 Sontakke et al. (2018)
Hydro-distillation 1.0 Ebru and Zehra (2013)
Hydro-distillation 6 - 14 Menon (2000)
Hydro-distillation 4–7 Abbasipour et al. (2011)
Hydro-distillation 6 - 8.7 Leela et al. (2008)

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Table 3. Major essential oil composition of cardamom (Elettaria cardamomum)
Origin Parts Constituents Yield (%) Authors
South India Capsules 1,8-cineole 28.94 Ashokkumar et al. (2019b)
α-terpinyl acetate 26.68
α-terpineol 14.58
Sabinene 13.50
Nerol 5.01
α-pinene 2.42
Iran Seeds α-terpinyl acetate 36.61 Chegini and Abbasipour (2017)
1,8-cineole 30.42
Linalyl acetate 5.79
Sabinene 4.85
Guatemala Seeds α-terpinyl acetate 36.80 Singh et al. (2008)
1,8-cineole 29.20
Linalyl acetate 5.20
Sabinene 3.90
Linalool 3.10
Costa Rica Seeds α-terpinyl acetate 39.31 Noleau et al. (1987)
Linalool 5.91
Sabinene 3.78
α-terpineol 2.97
Geraniol 2.66
Sri Lanka Capsules α-terpinyl acetate 74.60 Subaddarage et al. (1985)
Linalool 12.70
1,8 Cineole 4.40
β-terpineol 1.80
Pakistan Leaves 4-terpineol 30.26 Mahmud (2008)
1,8-Cineol 25.74
α-terpene 9.80
Linalool 2.67

30
Table. 4. Fatty acid composition of cardamom oil (modified table of Parry et al., 2006)
Fatty acid Lipid Composition Category of fatty acid
number (g/100g of oil)
Myristic acid 14:0 1.5 Saturated
Palmitic acid 16:0 26.4 Saturated
Palmitoleic acid 16:1 1.6 Mono-unsaturated
Stearic acid 18:0 2.3 Saturated
Oleic acid 18:1 49.2 Mono-unsaturated
Linoleic acid 18:2 15.2 Polyunsaturated
α-Linolenic acid 18:3 2.7 Polyunsaturated
Arachidic acid 20:0 0.4 Saturated
Eicosenoic acid 20:1 0.5 Polyunsaturated

31
 Table 5. The activities of cardamom extracts and essential oil components

Pharmacological Study In Target/ Model Control(s) IC 50/ Results / Remarks Reference

activities extract/ CEO vitro/
Dosage
In vivo

Antibacterial CEO In vitro S. aureus Positive: MIC : 6.25mg/ml Moderate antibacterial Grădinaru
activity Amoxicillin and activity @ 6.25 mg/ml et al. (2014)
MBC: 12.5mg/ml
ciprofloxacin

Antibacterial 1,8-cineole In vitro S. aureus Positive: MIC: 1.25 to Noteworthy antibacterial Grădinaru
activity Amoxicillin and 2.5mg/ml activity @ 2.5mg/ml et al. (2014)
ciprofloxacin
MBC: 2.5mg/ml

Antibacterial Aqueous In vitro E. coli, S. typhi and S. Positive: MIC: 0.5 to Inhibition zone ranged Kaushik et
activity aureus Tetracycline 4.1mg/ml from 12.3 to 20.6 mm al. (2010)
cardamom
with best inhibitory effect
capsule Negative:
against S. aureus
extract
Distilled water

Antifungal activity CEO In vitro Candida spp. and S. Positive: MIC: 0.048 to Inhibition zone ranged Noumi et
cerevisiae Amphotericin B 0.097 mg/ml from 13.3 to 21.7 mm with al. (2018)
best inhibitory effect @
Negative: MFC: 6.25 to
0.048 mg/ml against
12.50 mg/ml
Distilled water Candida parapsilosis

Cardioprotective Aqueous In vivo Wistar male albino Positive: 100mg and Treatment with cardamom Goyal et al.
activity rats induced by Isoproterenol 200mg/kg/oral for extracts (100 & 200 (2015)
cardamom
Isoproterenol (ISO) 30 days mg/kg) resulted in
capsule
significant decline of
extract Negative:
arterial pressure indices,
Normal Saline systolic arterial pressure
(SAP), diastolic arterial
pressure (DAP), mean
arterial pressure (MAP)

32
 and myocardial enzymes
than control

Antidiabetic and Ethanol In vivo Alloxan (120mg/kg) Negative: Not reported Oral administration of Winarsi et
hypocholesterolemic induced Sprague ethanolic leaf extract for al. (2014)
leaf extract Normal Saline
activity Dawley diabetic rats 14 days, decreased blood
glucose level from 201.7
to 102. 8 mg/dl. However,
dose and positive control
was not reported, it
reducing the reliability of
results

Antidiabetic activity Capsule/tablet In vivo Eighty overweight or Positive: 1 g/3 times/day for The results of this trial Aghasi et
obese patients with 10 weeks provides clinical evidence al. (2018)
type 2 diabetes Irisin, and Sirtuin1 on the effectiveness and
(SIRT1) safety of cardamom
Negative: supplementation in
patients with Type 2
Distilled water
diabetes

Antidiabetic activity Capsule/tablet In vivo Obese women Negative: 3 g/d for 8 weeks No significant decrease in Fatemeh et
patients with pre- systolic and diastolic blood al. (2017)
Placebo
diabetic pressure, glycemic indices,
and serum lipids values in
cardamom and placebo
groups.
This study also reported
that 3 g/day of cardamom
would be a large but not
unreasonable amount to
consume as a part of the
diet.

Anti-obesity and Capsule/tablet In vivo Overweight or obese Negative: 1g /3 times/ day In comparison with Daneshi-
nonalcoholic fatty patients with for 12 weeks placebo, cardamom Maskooni

33
liver disease nonalcoholic fatty Placebo significantly reduced et al. (2018)
(NFLD) liver disease (NFLD) tumor necrosis factor-
alpha (TNF-α,), high
sensitive c-reactive protein
(hs-CRP), interleukin-6
(IL-6), alanine
transaminase (ALT) and
degree of fatty liver

Antidiarrheal Hot water In vivo Wistar male albino Positive: Cardamom extract showed Rahman et
activity capsule rats induced by significant antidiarrhoeal al. (2008)
Magnesium 10 ml/kg body
extract magnesium sulphate activity against
sulphate weight
4g/kg for 5 hours magnesium sulphate in the
induced animal model.
However, in this study
dosage was at an
unreasonably high level,
and dosage details were
not clearly reported, thus
reducing the
reproducibility of the
results

Antiulcerogenic CEO In vivo Ethanol induced Negative: 50 mg/kg body Significantly inhibited Jamal et al.
activity gastric ulcer in rats Distilled water weight gastric lesions (2006)

Anticancer activity CEO In vivo Diethylnitrosamine Negative: 100 and 200 Both doses had noteworthy Elguindy et
(DENA) induced Distilled water mg/kg/day for 26 reduction in serum al. (2018)
oxidative stress in rat weeks creatinine and urea and
LDH activity when
compared to
corresponding values in
the control

Insecticidal activity CEO In vivo Female adult of Negative: LC50: 35.7, 49.98, Results showed that Abbasipour
Callosobruchus 57.12, and 64.26 number of eggs laid by C. et al. (2011)
(Oviposition Distilled water
mg/ml for 48 maculatus females in

34
deterrence) maculatus hours treatments 57.12 and 64.26
mg/ml for 48 hours was
significantly lower than in
the control. Other doses
(35.7 and 49.98 mg/ml)
were not significantly
effective.
Note: CEO, Cardamom essential oil, MIC, Minimum inhibition concentration; MBC, Minimum bactericide concentration; MFC,
Minimum fungicidal concentration; LC50, Lethal concentration; IC50, Inhibitory concentration

35
Figure 1. Field view and habitat of Elettaria cardamomum (L.) Maton.

Figure 2. Types of cardamom based on nature of the panicles

36
Figure 3. Botanical features of cardamom

37
 CH3 H3C CH3

H3C CH3 CH3

CH3
CH2 H2C

α-Pinene Sabinene 1,8-Cineole (Eucalyptol)

CH3

CH3

OH

OH
Geraniol (Nerol)

OH
H3C CH3
O CH3
H3C CH3 HO

Linalool α-Terpineol α-Terpinyl acetate 1,6,10-dodecatrien-3-ol (Nerolidol)

Figure 4. Molecular structure of the major essential oil constituents in Elettaria cardamomum (L.)

38