title: The effect of cactus pear (Opuntia ficus-indica) on body weight and cardiovascular risk factors: a systematic review and meta-analysis of randomized clinical trials.
abstract: OBJECTIVE
  Hundreds of dietary supplements are currently marketed as weight loss supplements. However, the advertised health claims of effectiveness for most of these have not been proven. The aim of this study was to critically appraise and evaluate the evidence for effectiveness of cactus pear, Opuntia ficus-indica (OFI), using data from published randomized clinical trials.
  
  
  METHODS
  We conducted electronic searches in Medline, Embase, Amed, Cinahl, and the Cochrane Library. No restrictions on age, time, or language were imposed. The risk for bias in the studies included was assessed using the Cochrane Collaboration criteria. Two reviewers independently determined the eligibility of included studies, assessed reporting quality, and extracted data.
  
  
  RESULTS
  We identified seven eligible studies, of which five were included. The studies varied in design and reporting quality. Meta-analysis revealed a nonsignificant difference in body weight between OFI and controls (mean difference = -0.83 kg; 95% confidence interval, -2.49 to 0.83; I(2) = 93%). Significant reductions in body mass index, percentage body fat, systolic and diastolic blood pressures, and total cholesterol were observed. Adverse events included gastric intolerance and flu symptoms.
  
  
  CONCLUSIONS
  The evidence from randomized clinical trials does not indicate that supplementation with OFI generates statistically significant effects on body weight. Consumption of OFI can cause significant reductions in percentage body fat, blood pressure, and total cholesterol. Few clinical trials evaluating the effects of OFI have been published. They vary in design and methodology, and are characterized by inconsistent quality of reporting. Further clinical trials evaluating the effects of OFI on body composition and metabolic parameters are warranted.
authors.affiliation: University of Oxford, Nuffield Department of Primary Care Health Sciences, New Radcliffe House, Radcliffe Observatory Quarter, Oxford, United Kingdom. Electronic address: Igho.onakpoya@phc.ox.ac.uk.
authors.forename: Igho J
authors.initials: IJ
authors.lastname: Onakpoya
authors.affiliation: Department of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.
authors.forename: Jack
authors.initials: J
authors.lastname: O'Sullivan
authors.affiliation: University of Oxford, Nuffield Department of Primary Care Health Sciences, New Radcliffe House, Radcliffe Observatory Quarter, Oxford, United Kingdom.
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Heneghan
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D001823:Body Composition / Q000187:drug effects; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects*; D002318:Cardiovascular Diseases / Q000178:diet therapy* / Q000209:etiology*; D002784:Cholesterol / Q000097:blood; D019587:Dietary Supplements; D006801:Humans; D029747:Opuntia / Q000737:chemistry*; D016032:Randomized Controlled Trials as Topic
chemical_list: D002784:Cholesterol
keywords: Cactus; Clinical trial; Meta-analysis; Opuntia; Systematic review; Weight loss