Across 4 studies, 2 reported beneficial effects on total cholesterol (one moderate, one small) while 2 found no significant effect. The median study duration was 112 days (16 weeks). The most common dose was 320 mg/day, but the only studies using that dose were neutral. Effect sizes are mixed (small to moderate).
Caveats: Evidence is mixed: two large meta-analyses show beneficial effects on total cholesterol, but two clinical trials in specific populations (older adults with mild cognitive impairment, type 2 diabetes) found no significant effect. The beneficial meta-analysis reported high heterogeneity (I²=86.9%), indicating variability across studies. Only two studies reported duration, with a median of 112 days; longer-term effects are unclear. Most studies did not specify the form of anthocyanins, limiting dose-form conclusions.
total cholesterol (SMD: -0.33; 95% CI: -0.62, -0.03; I² = 86.9%)
The biomarkers analyzed included ... cholesterol, LDL, HDL, and triglycerides, which were longitudinally compared between both groups.
the effects of anthocyanins on … TC … in patients with T2DM were not statistically significant
The subgroup analysis test showed that there was a significant effect of ACN on triglyceride concentrations, total cholesterol, LDL-C and HDL-C concentrations in all subgroups of participants (with vs. without dyslipidemia at baseline) and intervention type (supplement/extract vs. food).