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Impacts of supplementation with pomegranate on cardiometabolic risk factors: A systematic review and dose-response meta-analysis.

  • 2025-10
  • Nutrition, metabolism, and cardiovascular diseases : NMCD 35(10)
    • Shooka Mohammadi
    • Javad Heshmati
    • Nima Baziar
    • Somayeh Ziaei
    • Farnaz Farsi
    • Sara Ebrahimi
    • Tofigh Mobaderi
    • Tanin Mohammadi
    • Hassan Mir

Study Design

Type
Meta-Analysis
Sample size
n = 2,306
Methods
Systematic review and dose-response meta-analysis of randomized controlled trials

Aims

It has been suggested that supplementation with pomegranate (PO) may improve the risk factors related with cardiometabolic syndrome (CMS). This systematic review and dose-response meta-analysis of randomized controlled trials (RCTs) was conducted to assess the impacts of PO supplementation on cardiovascular risk factors and CMS.

Data synthesis

A comprehensive search of major databases including PubMed, Scopus, and Web of Science was implemented to identify appropriate RCTs that were published until January 2024. A random-effects model was applied for the meta-analysis and I2 was used to report the heterogeneity between included studies. After the screening of the search results a 53 RCTs with 2306 participants included in this meta-analysis. The findings revealed that PO supplementation substantially reduced body weight (standardized mean difference (SMD): -0.14 kg, 95 % CI: -0.25, -0.03; P = 0.01), diastolic blood pressure (DBP) (SMD: -0.39 mmHg, 95 % CI: -0.59, -0.18; P < 0.001), body mass index (BMI) (SMD: -0.17 kg/m2, 95 % CI: -0.30, -0.04; P = 0.01), systolic blood pressure (SBP) (SMD: -0.49 mmHg, 95 % CI: -0.68, -0.31; P < 0.001), serum fasting blood glucose (FBG) (SMD: -0.15 mg/dL, 95 % CI: -0.26, -0.04; P = 0.01), and total cholesterol (TC) (SMD: -0.12 mg/dL, 95 % CI: -0.24, -0.00; P = 0.04) while elevating high-density lipoprotein (HDL) levels (SMD: 0.27 mg/dL, 95 % CI: 0.08, 0.47; P < 0.001) compared to control groups. No substantial changes were observed in waist-to-hip ratio (WHR), homeostatic model assessment of insulin resistance (HOMA-IR), waist circumference (WC), serum values of hemoglobin A1c (HbA1c), alanine transaminase (ALT), triglycerides (TG), low-density lipoprotein (LDL), insulin, and aspartate transferase (AST) levels between PO and placebo groups.

Conclusion

PO consumption may improve specific risk factors associated with CMS. Further RCTs with extended durations and larger sample sizes are suggested to corroborate these findings.

Prospero registration number

CRD42024557368.

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