Does Yerbe Mate matter?

# # # # For a long time we have known that coffee consumption is associated with a reduced risk of developing Parkinson’s (Click here to read a previous SoPD post on this topic) What is under appreciated, however, that that there are other beverages that display similar effects (both in epidemiological studies and preclinical models). One interesting example is Yerba Mate. In today’s post, we will discuss what Yerba Mate is, and explore how it could be beneficial for people with Parkinson’s.  # # # #

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Source: Googlemaps

Question: What is the national drink of Paraguay, Argentina and Uruguay?

Uuuh, I don’t know. But what does this have to do with a blog about Parkinson’s research?

The answer to my question is Yerba Mate.

And we’ll get to the answer to your question in one moment.

Ok, so what is Yerba Mate?

It is a beverage that is a popular in all of the territories of Paraguay and parts of Argentina, Brazil, Uruguay, southern Chile, and eastern Bolivia. Heck, it’s so popular in Argentina, that they declared the 30th November to be recognised as National Mate Day.

Source: Eaust

Yerba Mate is a caffeine-rich drink that is made by soaking dried leaves of the Ilex paraguariensis tree in hot water. Ilex paraguariensis begins life as a shrub, but then grows into a tree, up to 15 metres (49 ft) tall. The leaves are often called yerba (Spanish) or erva (Portuguese), both of which mean “herb”.

Ilex paraguariensis. Source: Herbalgram

While it was originally drunk in the regions that make up Paraguay, consumption became more widespread during European colonization of the late 16th century. So much so, in fact, that it became Paraguay’s main commodity for a while.

When yerba mate (or chimarrão in Brazil) is prepared, it involves a container that is traditionally made from a hollowed-out gourd, which is fleshy fruit with a hard skin.

Source: Urushop

Being made of a complete natural fruit, the gourd must be cured before it can be used as a container for yerba mate, in order to seal the pores, avoid bitterness, and reduce the chance of cracks.

Source: Mashed

The gourd is filled up to three-quarters full with dry leaves of Ilex paraguariensis, and then filled it up with water at a temperature of approximately 70–80 °C (158–176 °F). So it is hot, but not boiling. Sugar can be added if desired. The drink can also be prepared with cold water, but this is generally known as tereré.

Yerba mate is generally sipped through a wooden or metal straw (a bombilla in Spanish or bomba in Portuguese). And like I said, it is a very popular drink in South America. In Argentina, approximately 5 kg (11 lb) of yerba mate is consumed annually per person, while in Uruguay (the largest consumer) annual consumption is 10 kg (22 lb) per person. By comparison, the United Kingdom consumes only 2.8kg (6.1 lb) of coffee and just 1.94 kg (4.28 lb) of tea per person each year.

For those interested, this video provides a lot more background information about yerba mate:

Ok, so what does this have to do with Parkinson’s?

Well, yerba mate has long been associated with various health benefits.

It contains lots of polyphenols (such as flavonoids and phenolic acids) which help with metabolism and weigh. Yerba mate also has antioxidant and monoamine oxidase inhibition properties (Source).

But very recently a stronger link to Parkinson’s has been discovered, with the publications of a series of research reports:

Title:  Yerbamate Tea Consumption: A Protective Factor in Parkinson Disease.
Authors: Sáenz-Farret M, Salinas-Martínez AM, Zúñiga-Ramírez C, Amorín-Costábile I, Maiola R, Mejía-Rojas KK, Galeano MS, Velázquez C, Ruiz G, Micheli F.
Journal: Clin Neuropharmacol. 2022 Jul-Aug 01;45(4):79-83.
PMID: 35849689

In this study, the researchers conducted a multicenter case-control study in 3 countries (Argentina, Paraguay, and Uruguay).

What is a case-control study?

A case–control study is a type of observational study in which two existing groups differing in outcome are identified and compared on the basis of some supposed causal attribute.

Source: Deakin

In a case-control study patients who have developed a particular medical condition are identified and their past history is examined for exposure to potentially influential factors in the development of their condition. These are compared with that of a control group who do not have the disease. This type of analysis permits estimation of odds ratios (which are measures of association, rather than risk or causation).

So in this study mentioned above, the researchers compared 215 individuals with Parkinson’s and 219 unaffected people who acted as matched controls. They gave them all a questionnaire about their yerba mate consumption history. When they analysed the results, the investigators found that the concentration of yerba mate per serving was associated with a reduced risk of developing Parkinson’s (independent of other potential confounders).

And other researchers have found similar results. Last year, this report was published:

Title:  A Case-Control Study of the Effects of Chimarrão (Ilex paraguariensis) and Coffee on Parkinson’s Disease.
Authors: Medeiros MS, Schumacher-Schuh AF, Altmann V, Rieder CRM.
Journal: Front Neurol. 2021 Mar 10;12:619535.
PMID: 33776884                    (This report is OPEN ACCESS if you would like to read it)

This report outlined the results of another case–control study that was conducted in southern Brazil, and it too looked at the relationship between chimarrão (another name for yerba mate). The researchers recruited 200 people with Parkinson’s and 200 unaffected control participants, and asked them to fill in a questionnaire about the frequency of chimarrão and coffee intake.

Again, the results indicated that chimarrão consumption was inversely associated with Parkinson’s (meaning that the more chimarrão  being drunk, the less chance of Parkinson’s). And this association existed even after adjusting for coffee intake. The investigators suggested that there could be a possible protective role being produced by chimarrão.

And both of these studies are supported by the results of a larger study that was published in 2015:

Title: Inverse association between yerba mate consumption and idiopathic Parkinson’s disease. A case-control study.
Authors: Gatto EM, Melcon C, Parisi VL, Bartoloni L, Gonzalez CD.
Journal: J Neurol Sci. 2015 Sep 15;356(1-2):163-7.
PMID: 26148934

In this study, the investigators recruited 223 people with Parkinson’s and 406 healthy individuals to act as controls. When the looked at yerba mate consumption, they found an inverse association with Parkinson’s (for the statisticians: Odds ratio of 0.64, 95% CI: 0.54-0.76, p=0.00001). So again, the more yerba mate one drank, the less likely they were to be diagnosed with Parkinson’s (even after taking other variables into account). This led the researchers “to hypothesize that yerba mate may have a potential protective role in the development of Parkinson’s“.

Fascinating. Has anyone ever tried looking at what could be influencing this neuroprotective effect of yerba mate?

Yes, in 2019, this report was published:

Title: Yerba mate (Ilex paraguariensis) favors survival and growth of dopaminergic neurons in culture.
Authors: Bernardi A, Ballestero P, Schenk M, Ferrario M, Gómez G, Rivero R, Avale E, Taravini I, Gershanik O, Guerrero S, Ferrario JE.
Journal: Mov Disord. 2019 Jun;34(6):920-922.
PMID: 30938849 

In this study, the researchers tested the neuroprotective effect of yerba mate on dopamine neurons grown in cell culture. Specifically, they wanted to see if yerba mate treatment would protect the dopamine neurons from spontaneously dying over a two-week period. As a comparison, the researchers also tested the neuroprotective potential of theobromine and chlorogenic acid on the cells as well.

What are theobromine and chlorogenic acid?

They are both chemicals that are found in yerba mate, and the researchers were wondering if they may be responsible for any protective effect stimulated by yerba mate. By including them in the study, they probably hoped to try and isolate the mechanism of action.

We have previously discussed chlorogenic acid in the context of Parkinson’s (Click here to read that previous SoPD post), and yerba mate has been shown to contain very high levels of this interesting molecule (Click here to read more about this). Theobromine, on the other hand, we have never discussed on the SoPD, but it is a vasodilator (a blood vessel widener) and a heart stimulant. It has previously demonstrated some neuroprotective properties (Click here to read more about this).

In the Bernardi study, the investigators found that yerba mate treatment was neuroprotective, and that it was “slightly more” protective than theobromine and chlorogenic acid. They also found that the dopamine neurons treated with yerba mate had more branchings, suggesting that the neurons were healthy and making connections.

The researchers conclude their study by stating that their “work provides the first evidence supporting yerba mate as a promising novel neuroprotective agent for dopaminergic neurons“.

So what does it all mean?

An association between coffee drinking and reduced risk of developing Parkinson’s has been recognised for a long time. Now we are learning that other beverages of a similar nature – such as yerba mate – are also associated with a protective effect against developing Parkinson’s.

It would be interesting to see more research on yerba mate in preclinical models of Parkinson’s to better understand the biology of this protective effect and identify the mechanism of action. Once we have a better understanding of the mechanism of action and are able to measure/assess this, it would be very interesting to see a carefully designed clinical trial to evaluate the disease modifying potential of yerba mate in individuals with Parkinson’s. If this beverage is able to slow the progression of the condition, it would represent a relatively easy lifestyle adjustment.

But before then, we’re looking forward to seeing more preclinical data on this popular drink.

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