The effects of pomegranate supplementation on biomarkers of inflammation and endothelial dysfunction: A meta-analysis and systematic review.

OBJECTS: Cardiovascular disease (CVD) is one of the leading causes of death worldwide. CVD is associated with increased levels of reactive oxygen species which are pro-inflammatory and can damage the endothelium. The pomegranate fruit is a rich source of phytochemicals with a high antioxidant and anti-inflammatory activity, possessing thus health benefits. This systematic review and meta-analysis aims to evaluate the effect of pomegranate juice on the biomarkers of inflammation and vascular dysfunction. METHODS: Studies were identified using the PubMed/Medline and SCOPUS databases. Screening of relevant articles and references was carried out from inception until May 2019. This systematic review and meta-analysis was performed using the Preferred Items for Reporting of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: Overall, 16 randomized controlled trials (RCTs) involving 572 subjects were included in this study. Combining effect sizes from 16 studies, we recorded that pomegranate supplementation significantly reduced hs-CRP, IL-6 and TNF-α (Weighted Mean Diff ;erences (WMD): -6.57 mg/L, 95 % CI: -10.04 to -3.10, P = 0.000; WMD: -1.68 pg/mL, 95 % CI: -3.52, 0.157, P = 0.000; WMD: -2.37 pg/mL, 95 % CI: -3.67, -1.07, P = 0.00, respectively) levels, when compared to placebo. No significant reduction was found in CRP (WMD: 2.19 mg/dL, 95 % CI: -3.28, 7.67, P = 0.61), E-selectin (WMD: 8.42 ng/mL, 95 % CI: -22.9, 39.8, P = 0.599), ICAM (WMD= -17.38 ng/mL, 95 % CI: -53.43, 18.66, P = 0.107), VCAM (WMD: -69.32 ng/mL, 95 % CI: -229.26, 90.61, P = 0.396) or MDA (WMD: 0.031 µmol/L, 95 % CI: -1.56, 0.218, P = 0.746) comparing pomegranate supplementation to placebo. CONCLUSION: We found a significant effect of pomegranate supplementation on hs-CRP, IL-6 and TNF-α in adults. However, the effects of pomegranate supplementation on CRP, E-selectin, ICAM, VCAM or MDA were not significant in this meta-analysis.

The effect of green coffee extract supplementation on blood pressure: A systematic review and meta-analysis of randomized controlled trials.

Given the proliferation in studies investigating green coffee bean extract (GCBE) supplementation, the purpose of this study was to determine the efficacy and effectiveness of GCBE supplementation on indices of blood pressure. The literature search was performed in four databases, namely, PubMed/Medline, Scopus, the Cochrane Library, and Google Scholar, to identify clinical trials that examined the effects of green coffee supplements on systolic blood pressure (SBP) and diastolic blood pressure (DBP) up to February 2019. Mean change and standard deviation (SD) of the outcome measures were used to estimate the mean difference between the intervention group and the control group at follow-up. Nine studies reported SBP and DBP as an outcome measure. Results revealed significant reduction in SBP (weighted mean difference: -3.093 mmHg, 95% confidence interval [CI]: -3.914, -2.273; I2 = 0.0%) and DBP (-2.170 mmHg, 95% CI: -2.749, -1.590; I2 = 46.5%) after green coffee supplementation with low heterogeneity among the studies. In addition, in subgroup analysis, a significant reduction in SBP and DBP in studies with hypertensive patients, green coffee dosage <400 mg, and administered for 4 weeks was identified. The results of the current meta-analysis study support the use of GCBE supplementation for the improvement of blood pressure indices, with subgroup analysis highlighting improvements in hypertensive patients.