title: Effects of Pomegranate and Orange Juice on Antioxidant Status in Non-Alcoholic Fatty Liver Disease Patients: A Randomized Clinical Trial.
abstract: OBJECTIVE
  The fruit of the pomegranate (Punica granatum) has a high content of polyphenols and is renowned for its antioxidant capabilities. In particular, it is recognized as reducing oxidative stress and, therefore, playing a productive role in obstructing the pathogenesis of fatty liver disease. The aim of the present study was to evaluate the effects of consumingpomegranate juice (high in antioxidant content) and orange juice (low in antioxidant content) when combined with a hypocaloric diet on liver enzymes and the antioxidant status of patients.
  
  
  METHODS
  In a randomized clinical trial, 65 patients who exhibited non-alcoholic fatty liver disease (NAFLD) at a mean age of 39+/-8 years received 250 mL pomegranate juice or orange juice per day as a substitute for two servings of fruit in a hypocaloric diet over a period of 12 weeks. The subjects' levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total antioxidant capacity (TAC), malondialdehyde (MDA) and tumor necrosis factor-α (TNF-α) were measured at the beginning and end of the study.
  
  
  RESULTS
  At the end of the study, the levels of liver enzymes and body mass index (BMI) had significantly decreased in both groups. A significant increase in TAC was also observed in the subjects in the pomegranate group (p <0.01).
  
  
  CONCLUSIONS
  Consumption of fruits that are high in antioxidants could represent a useful means to improve the antioxidant status of NAFLD patients who follow a hypocaloric diet.
authors.affiliation: 1 Department of Nutrition, School of Nutritional Sciences & Dietetics, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Golnaz
authors.initials: G
authors.lastname: Ekhlasi
authors.affiliation: 1 Department of Nutrition, School of Nutritional Sciences & Dietetics, Iran University of Medical Sciences, Tehran, Iran.|2 Colorectal Research Centre, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Farzad
authors.initials: F
authors.lastname: Shidfar
authors.affiliation: 2 Colorectal Research Centre, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Agah
authors.affiliation: 3 Digestive Diseases Research Institute (DDRI), Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Shahin
authors.initials: S
authors.lastname: Merat
authors.affiliation: 4 Department of Math and Statistics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Agha Fatemeh
authors.initials: AF
authors.lastname: Hosseini
keywords: Diet; antioxidants; non-alcoholic fatty liver disease; orange juice; pomegranate juice; punicaceae