KEY TAKEAWAY: Synthesizes randomized controlled trial data to evaluate the metabolic impact of pomegranate juice and extract supplementation across cardiometabolic risk profiles. Dose-response analysis revealed statistically significant reductions in body weight, body mass index, and diastolic blood pressure, supporting its role as an effective adjunctive nutraceutical.
Abstract
Aims
It has been suggested that supplementation with pomegranate (PO) may improve the risk factors related with cardiometabolic syndrome (CMS). This systematic review and dose-response meta-analysis of randomized controlled trials (RCTs) was conducted to assess the impacts of PO supplementation on cardiovascular risk factors and CMS.
Data synthesis
A comprehensive search of major databases including PubMed, Scopus, and Web of Science was implemented to identify appropriate RCTs that were published until January 2024. A random-effects model was applied for the meta-analysis and I2 was used to report the heterogeneity between included studies. After the screening of the search results a 53 RCTs with 2306 participants included in this meta-analysis. The findings revealed that PO supplementation substantially reduced body weight (standardized mean difference (SMD): −0.14 kg, 95 % CI: −0.25, −0.03; P = 0.01), diastolic blood pressure (DBP) (SMD: −0.39 mmHg, 95 % CI: −0.59, −0.18; P < 0.001), body mass index (BMI) (SMD: −0.17 kg/m2, 95 % CI: −0.30, −0.04; P = 0.01), systolic blood pressure (SBP) (SMD: −0.49 mmHg, 95 % CI: −0.68, −0.31; P < 0.001), serum fasting blood glucose (FBG) (SMD: −0.15 mg/dL, 95 % CI: −0.26, −0.04; P = 0.01), and total cholesterol (TC) (SMD: −0.12 mg/dL, 95 % CI: −0.24, −0.00; P = 0.04) while elevating high-density lipoprotein (HDL) levels (SMD: 0.27 mg/dL, 95 % CI: 0.08, 0.47; P < 0.001) compared to control groups. No substantial changes were observed in waist-to-hip ratio (WHR), homeostatic model assessment of insulin resistance (HOMA-IR), waist circumference (WC), serum values of hemoglobin A1c (HbA1c), alanine transaminase (ALT), triglycerides (TG), low-density lipoprotein (LDL), insulin, and aspartatetransferase (AST) levels between PO and placebo groups.
Conclusion
PO consumption may improve specific risk factors associated with CMS. Further RCTs with extended durations and larger sample sizes are suggested to corroborate these findings.