Impacts of Supplementation With Pomegranate on Cardiometabolic Risk Factors: A Systematic Review and Dose-Response Meta-Analysis Publisher



S Mohammadi SHOOKA ; J Heshmati JAVAD ; N Baziar NIMA ; S Ziaei SOMAYEH ; F Farsi FARNAZ ; S Ebrahimi SARA ; T Mobaderi TOFIGH ; T Mohammadi TANIN ; H Mir HASSAN
Source: Nutrition, Metabolism and Cardiovascular Diseases Published:2025

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 aspartate transferase (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. Prospero registration number: CRD42024557368. © 2025 Elsevier B.V., All rights reserved.