Effects of pomegranate juice consumption on blood pressure and lipid profile in patients with type 2 diabetes: A single-blind randomized clinical trial

  • Golbon Sohrab
    Affiliations
    Clinical Nutrition and Dietetics Department, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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  • Hanieh Roshan
    Affiliations
    Clinical Nutrition and Dietetics Department, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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  • Samira Ebrahimof
    Affiliations
    Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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  • Omid Nikpayam
    Affiliations
    Clinical Nutrition and Dietetics Department, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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  • Giti Sotoudeh
    Correspondence
    Corresponding author. Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, NO 44, Hojatdoost Alley, Naderi St, Keshavarz Blvd, Tehran, Iran. Fax: (+98) 2188984861.
    Affiliations
    Nutrition and Biochemistry Department, School of Public Health & Institute of Public Health Researches, Tehran University of Medical Sciences, Tehran, Iran
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  • Fereidoun Siasi
    Affiliations
    Nutrition and Biochemistry Department, School of Public Health & Institute of Public Health Researches, Tehran University of Medical Sciences, Tehran, Iran
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Published:November 29, 2018DOI:https://doi.org/10.1016/j.clnesp.2018.11.013

      Summary

      Pomegranate juice (PJ) has abundant anti-oxidative polyphenolic compounds which are assumed to have cardioprotective effects such as hypotensive properties. This study aimed to investigate the effects of PJ consumption on blood pressure and lipid profile F variables in patients with type 2 diabetes. Sixty subjects (30 in intervention group and 30 in control group) were recruited in this single-blind placebo-controlled randomized clinical trial. The volunteers were randomly assigned to one of two groups. Treatment group consumed 200 ml/day PJ for 6 weeks, while control group received no intervention. Systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) concentrations were measured following 12–14 h of fasting at baseline and at the end of the study. After 6 weeks of intervention, SBP (13.5 ± 1.5 mmHg vs. 12.3 ± 2.5, P < 0.001) and DBP (7.7 ± 1.6 vs. 7.2 ± 1.6 mmHg, P < 0.05) significantly decreased in the intervention group. Similarly, SBP and DBP in the intervention group were significantly lower than the control group after intervention (P < 0.02 and P < 0.03, respectively). At the end of the intervention, TC, TG, LDL-C and HDL-C did not significantly differ between the intervention group and the control group however, TC and LDL-C decreased significantly compared to pre-trial values within the intervention group. It is concluded that PJ consumption could decrease systolic and diastolic blood pressure in patients with diabetes while having no effect on lipid profile. A more definitive result will be obtained if future studies could conducted in hyperlipidemic individuals who might be more prone to respond to the lipid-lowering effects.

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      References

      1. IDF Diabetes Atlas 2015 [seventh edition]:Available from: http://www.diabetesatlas.org/.

        • Lorber D.
        Importance of cardiovascular disease risk management in patients with type 2 diabetes mellitus.
        Diabetes Metab Syndrome Obes Targets Ther. 2014; 7: 169-183
        • Feingold K.R.
        • Grunfeld C.
        Diabetes and dyslipidemia.
        in: De Groot L.J. Beck-Peccoz P. Chrousos G. Dungan K. Grossman A. Hershman J.M. Endotext. South dartmouth (MA). MDText.com, Inc., 2000
        • Chen G.
        • McAlister F.A.
        • Walker R.L.
        • Hemmelgarn B.R.
        • Campbell N.R.
        Cardiovascular outcomes in framingham participants with diabetes: the importance of blood pressure.
        Hypertension. 2011; 57: 891-897
        • Alavudeen S.S.
        • Dhanapal C.K.
        • Khan N.A.
        • Al Akhali K.M.
        • Paulliah S.D.
        Prevalence and control of cardiovascular risk factors among type 2 diabetes mellitus patients in southern region of Saudi Arabia.
        J Young Pharm. 2013; 5: 144-147
        • Agudelo-Ochoa G.M.
        • Pulgarin-Zapata I.C.
        • Velasquez-Rodriguez C.M.
        • Duque-Ramirez M.
        • Naranjo-Cano M.
        • Quintero-Ortiz M.M.
        • et al.
        Coffee consumption increases the antioxidant capacity of plasma and has No effect on the lipid profile or vascular function in healthy adults in a randomized controlled trial.
        J Nutr. 2016; 146: 524-531
        • Sharifiyan F.
        • Movahedian-Attar A.
        • Nili N.
        • Asgary S.
        Study of pomegranate (Punica granatum L.) peel extract containing anthocyanins on fatty streak formation in the renal arteries in hypercholesterolemic rabbits.
        Adv Biomed Res. 2016; 5: 8
        • Ashor A.W.
        • Siervo M.
        • van der Velde F.
        • Willis N.D.
        • Mathers J.C.
        Systematic review and meta-analysis of randomised controlled trials testing the effects of vitamin C supplementation on blood lipids.
        Clin Nutr (Edinburgh, Scotland). 2016; 35: 626-637
        • Askari G.
        • Hajishafiee M.
        • Ghiasvand R.
        • Hariri M.
        • Darvishi L.
        • Ghassemi S.
        • et al.
        Quercetin and vitamin C supplementation: effects on lipid profile and muscle damage in male athletes.
        Int J Prev Med. 2013; 4: S58-S62
        • Mazloom Z.
        • Hejazi N.
        • Dabbaghmanesh M.H.
        • Tabatabaei H.R.
        • Ahmadi A.
        • Ansar H.
        Effect of vitamin C supplementation on postprandial oxidative stress and lipid profile in type 2 diabetic patients.
        Pakistan J Biol Sci. 2011; 14: 900-904
        • Zhu Y.
        • Bo Y.
        • Wang X.
        • Lu W.
        • Wang X.
        • Han Z.
        • et al.
        The Effect of Anthocyanins on Blood Pressure: a PRISMA-Compliant Meta-Analysis of Randomized Clinical Trials.
        Medicine. 2016; 95 (e3380)
        • Hodgson J.M.
        • Croft K.D.
        • Woodman R.J.
        • Puddey I.B.
        • Bondonno C.P.
        • Wu J.H.
        • et al.
        Effects of vitamin E, vitamin C and polyphenols on the rate of blood pressure variation: results of two randomised controlled trials.
        Br J Nutr. 2014; 112: 1551-1561
        • Rostami A.
        • Khalili M.
        • Haghighat N.
        • Eghtesadi S.
        • Shidfar F.
        • Heidari I.
        • et al.
        High-cocoa polyphenol-rich chocolate improves blood pressure in patients with diabetes and hypertension.
        ARYA Atheroscler. 2015; 11: 21-29
        • Rafraf M.
        • Bazyun B.
        • Sarabchian M.A.
        • Safaeiyan A.
        • Ghaemmaghami Hezaveh S.J.
        Impact of vitamin E supplementation on blood pressure and Hs-CRP in type 2 diabetic patients.
        Health Promot Perspect. 2012; 2: 72-79https://doi.org/10.5681/hpp.2012.009
        • Daud Z.A.
        • Tubie B.
        • Sheyman M.
        • Osia R.
        • Adams J.
        • Tubie S.
        • et al.
        Vitamin E tocotrienol supplementation improves lipid profiles in chronic hemodialysis patients.
        Vasc Health Risk Manag. 2013; 9: 747-761
        • Boruah D.C.
        • Devi R.
        • Tamuli S.
        • Kotoky J.
        • Sharma D.K.
        Hypolipidemic activity of crude polyphenols from the leaves of Clerodendron colebrookianum Walp in cholesterol fed rats.
        J Food Sci Technol. 2014; 51: 3333-3340
        • Aviram M.
        • Rosenblat M.
        Pomegranate Protection against cardiovascular diseases.
        Evid Base Compl Alternative Med. 2012; 2012: 382763
        • Wallace T.C.
        • Slavin M.
        • Frankenfeld C.L.
        Systematic review of anthocyanins and markers of cardiovascular disease.
        Nutrients. 2016; 8
        • Li D.
        • Zhang Y.
        • Liu Y.
        • Sun R.
        • Xia M.
        Purified anthocyanin supplementation reduces dyslipidemia, enhances antioxidant capacity, and prevents insulin resistance in diabetic patients.
        J Nutr. 2015; 145: 742-748
        • Jurgonski A.
        • Juskiewicz J.
        • Zdunczyk Z.
        • Matusevicius P.
        • Kolodziejczyk K.
        Polyphenol-rich extract from blackcurrant pomace attenuates the intestinal tract and serum lipid changes induced by a high-fat diet in rabbits.
        Eur J Nutr. 2014; 53: 1603-1613
        • Nejad K.H.
        • Dianat M.
        • Sarkaki A.
        • Naseri M.K.
        • Badavi M.
        • Farbood Y.
        Ellagic acid improves electrocardiogram waves and blood pressure against global cerebral ischemia rat experimental models.
        Electron Physician. 2015; 7: 1153-1162
        • Berkban T.
        • Boonprom P.
        • Bunbupha S.
        • JU Welbat
        • Kukongviriyapan U.
        • Kukongviriyapan V.
        • et al.
        Ellagic acid prevents L-NAME-induced hypertension via restoration of eNOS and p47phox expression in rats.
        Nutrients. 2015; 7: 5265-5280
        • Stowe C.B.
        The effects of pomegranate juice consumption on blood pressure and cardiovascular health.
        Compl Ther Clin Pract. 2011; 17: 113-115
        • Asgary S.
        • Keshvari M.
        • Sahebkar A.
        • Hashemi M.
        • Rafieian-Kopaei M.
        Clinical investigation of the acute effects of pomegranate juice on blood pressure and endothelial function in hypertensive individuals.
        ARYA Atheroscler. 2013; 9: 326-331
        • Asgary S.
        • Sahebkar A.
        • Afshani M.R.
        • Keshvari M.
        • Haghjooyjavanmard S.
        • Rafieian-Kopaei M.
        Clinical evaluation of blood pressure lowering, endothelial function improving, hypolipidemic and anti-inflammatory effects of pomegranate juice in hypertensive subjects.
        Phytother Res. 2014; 28: 193-199
        • Tsang C.
        • Smail N.F.
        • Almoosawi S.
        • Davidson I.
        • Al-Dujaili E.A.
        Intake of polyphenol-rich pomegranate pure juice influences urinary glucocorticoids, blood pressure and homeostasis model assessment of insulin resistance in human volunteers.
        J Nutr Science. 2012; 1: e9
        • Esmaillzadeh A.
        • Tahbaz F.
        • Gaieni I.
        • Alavi-Majd H.
        • Azadbakht L.
        Cholesterol-lowering effect of concentrated pomegranate juice consumption in type II diabetic patients with hyperlipidemia.
        Int J Vitam Nutr Res Int Z fur Vitam. 2006; 76: 147-151
        • Rosenblat M.
        • Hayek T.
        • Aviram M.
        Anti-oxidative effects of pomegranate juice (PJ) consumption by diabetic patients on serum and on macrophages.
        Atherosclerosis. 2006; 187: 363-371
        • Banihani S.A.
        • Makahleh S.M.
        • El-Akawi Z.
        • Al-Fashtaki R.A.
        • Khabour O.F.
        • Gharibeh M.Y.
        • et al.
        Fresh pomegranate juice ameliorates insulin resistance, enhances beta-cell function, and decreases fasting serum glucose in type 2 diabetic patients.
        Nutr Res (New York, NY). 2014; 34: 862-867
        • Sohrab G.
        • Ebrahimof S.
        • Sotoudeh G.
        • Neyestani T.R.
        • Angoorani P.
        • Hedayati M.
        • et al.
        Effects of pomegranate juice consumption on oxidative stress in patients with type 2 diabetes: a single-blind, randomized clinical trial.
        Int J Food Sci Nutr. 2017 Mar; 68 (PubMed PMID: 27633135. Epub 2016/09/17. eng): 249-255
        • Bray H.G.
        • Thorpe W.V.
        Analysis of phenolic compounds of interest in metabolism.
        Methods Biochem Anal. 1954; 1: 27-52
        • Hajimahmoodi M.
        • Oveisi M.R.
        • Sadeghi N.
        • Jannat B.
        • Hadjibabaie M.
        • Farahani E.
        • et al.
        Antioxidant properties of peel and pulp hydro extract in ten Persian pomegranate cultivars.
        Pak J Biol Sci. 2008; 11: 1600-1604
        • Gonzalez-Ortiz M.
        • Martinez-Abundis E.
        • Espinel-Bermudez M.C.
        • Perez-Rubio K.G.
        Effect of pomegranate juice on insulin secretion and sensitivity in patients with obesity.
        Ann Nutr Metab. 2011; 58: 220-223
        • Lynn A.
        • Hamadeh H.
        • Leung W.C.
        • Russell J.M.
        • Barker M.E.
        Effects of pomegranate juice supplementation on pulse wave velocity and blood pressure in healthy young and middle-aged men and women.
        Plant Foods Hum Nutr (Dordrecht, Netherlands). 2012; 67: 309-314
        • Aviram M.
        • Rosenblat M.
        • Gaitini D.
        • Nitecki S.
        • Hoffman A.
        • Dornfeld L.
        • et al.
        Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood pressure and LDL oxidation.
        Clin Nutr (Edinburgh, Scotland). 2004; 23: 423-433
        • Sumner M.D.
        • Elliott-Eller M.
        • Weidner G.
        • Daubenmier J.J.
        • Chew M.H.
        • Marlin R.
        • et al.
        Effects of pomegranate juice consumption on myocardial perfusion in patients with coronary heart disease.
        Am J Cardiol. 2005; 96: 810-814
        • Rice B.H.
        • Cifelli C.J.
        • Pikosky M.A.
        • Miller G.D.
        Dairy components and risk factors for cardiometabolic syndrome: recent evidence and opportunities for future research.
        Adv Nutr. 2011 Sep; 2: 396-407