title: Tomato and lycopene supplementation and cardiovascular risk factors: A systematic review and meta-analysis.
abstract: Epidemiological evidence suggests an association between consumption of tomato products or lycopene and lower risk for cardiovascular diseases (CVD). Our aim was to evaluate the state of the evidence from intervention trials on the effect of consuming tomato products and lycopene on markers of cardiovascular (CV) function. We undertook a systematic review and meta-analysis on the effect of supplementing tomato and lycopene on CV risk factors.
  
  
  
  Three databases including Medline, Web of science, and Scopus were searched from inception to August 2016. Inclusion criteria were: intervention trials reporting effects of tomato products and lycopene supplementation on CV risk factors among adult subjects >18 years of age. The outcomes of interest included blood lipids (total-, HDL-, LDL-cholesterol, triglycerides, oxidised-LDL), endothelial function (flow-mediated dilation (FMD), pulse wave velocity (PWV)) and blood pressure (BP) inflammatory factors (CRP, IL-6) and adhesion molecules (ICAM-1). Random-effects models were used to determine the pooled effect sizes.
  
  
  
  Out of 1189 publications identified, 21 fulfilled inclusion criteria and were meta-analysed. Overall, interventions supplementing tomato were associated with significant reductions in LDL-cholesterol (-0.22 mmol/L; p = 0.006), IL-6 (standardised mean difference -0.25; p = 0.03), and improvements in FMD (2.53%; p = 0.01); while lycopene supplementation reduced systolic-BP (-5.66 mmHg; p = 0.002). No other outcome was significantly affected by these interventions.
  
  
  
  The available evidence on the effects of tomato products and lycopene supplementation on CV risk factors supports the view that increasing the intake of these has positive effects on blood lipids, blood pressure and endothelial function. These results support the development of promising individualised nutritional strategies involving tomatoes to tackle CVD.
authors.affiliation: Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.
authors.forename: Ho Ming
authors.initials: HM
authors.lastname: Cheng
authors.affiliation: Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.
authors.forename: Georgios
authors.initials: G
authors.lastname: Koutsidis
authors.affiliation: Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.
authors.forename: John K
authors.initials: JK
authors.lastname: Lodge
authors.affiliation: Human Nutrition Research Centre, Institute of Cellular Medicine and Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Ammar
authors.initials: A
authors.lastname: Ashor
authors.affiliation: Human Nutrition Research Centre, Institute of Cellular Medicine and Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Mario
authors.initials: M
authors.lastname: Siervo
authors.affiliation: Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK. Electronic address: jose.lara@northumbria.ac.uk.
authors.forename: José
authors.initials: J
authors.lastname: Lara
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D002338:Carotenoids / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D000072001:Diet, Healthy; D019587:Dietary Supplements; D004730:Endothelium, Vascular / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D006304:Health Status; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008055:Lipids / Q000097:blood; D000077276:Lycopene; D018551:Solanum lycopersicum; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D008055:Lipids; D002338:Carotenoids; D000077276:Lycopene
keywords: Blood lipids; Blood pressure; Cardiovascular risk factors; Endothelial function; Inflammatory factors; Intervention; Lycopene; Meta-analysis; Systematic review; Tomato