title: Lipid profile changes after pomegranate consumption: A systematic review and meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Transport of oxidized low-density lipoprotein across the endothelium into the artery wall is considered a fundamental priming step for the atherosclerotic process. Recent studies reported potential therapeutic effects of micronutrients found in natural products, indicating positive applications for controlling the pathogenesis of chronic cardiovascular disease driven by cardiovascular risk factors and oxidative stress. A particular attention has been recently addressed to pomegranate; however findings of clinical studies have been contrasting.
  
  
  OBJECTIVE
  To evaluate the effects of pomegranate consumption on plasma lipid concentrations through a systematic review and meta-analysis of randomized controlled trials (RCTs).
  
  
  METHODS
  The study was designed according to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement. Scopus and Medline databases were searched to identify randomized placebo-controlled trials investigating the impact of pomegranate on plasma lipid concentrations. A fixed-effects model and the generic inverse variance method were used for quantitative data synthesis. Sensitivity analysis was conducted using the one-study remove approach. Random-effects meta-regression was performed to assess the impact of potential confounders on the estimated effect sizes.
  
  
  RESULTS
  A total of 545 individuals were recruited from the 12 RCTs. Fixed-effect meta-analysis of data from 12 RCTs (13 treatment arms) did not show any significant effect of pomegranate consumption on plasma lipid concentrations. The results of meta-regression did not suggest any significant association between duration of supplementation and impact of pomegranate on total cholesterol and HDL-C, while an inverse association was found with changes in triglycerides levels (slope: -1.07; 95% CI: -2.03 to -0.11; p = 0.029). There was no association between the amount of pomegranate juice consumed per day and respective changes in plasma total cholesterol, LDL-C, HDL-C and triglycerides.
  
  
  CONCLUSIONS
  The present meta-analysis of RCTs did not suggest any effect of pomegranate consumption on lipid profile in human.
authors: Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Metabolic Research Centre, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
authors: Amirhossein
authors: A
authors: Sahebkar
authors: Biomedical Research Unit, Mexican Social Security Institute, Durango, Mexico.
authors: Luis E
authors: LE
authors: Simental-Mendía
authors: Department of Life, Health & Environmental Sciences, University of L'Aquila, Viale S Salvatore, Delta 6 Medicina, 67100 Coppito, L'Aquila, Italy.
authors: Paolo
authors: P
authors: Giorgini
authors: Department of Life, Health & Environmental Sciences, University of L'Aquila, Viale S Salvatore, Delta 6 Medicina, 67100 Coppito, L'Aquila, Italy.
authors: Claudio
authors: C
authors: Ferri
authors: Department of Life, Health & Environmental Sciences, University of L'Aquila, Viale S Salvatore, Delta 6 Medicina, 67100 Coppito, L'Aquila, Italy. Electronic address: davide.grassi@cc.univaq.it.
authors: Davide
authors: D
authors: Grassi
mesh_terms: D002318:Cardiovascular Diseases / Q000517:prevention & control; D002784:Cholesterol / Q000097:blood; D019587:Dietary Supplements; D006801:Humans; D008055:Lipids / Q000097:blood*; D029561:Lythraceae; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
chemical_list: D008055:Lipids; D002784:Cholesterol
keywords: Antioxidants; Cardiovascular risk; Flavonoids; Lipid profile; Pomegranate