Beneficial effect of pomegranate peel extract treatment on anthropometry and body composition of overweight patients with diabetes mellitus type-2: a randomized, double-blind, placebo-controlled study
Keywords:
Pomegranate peel extract; overweight; Diabetes Mellitus type 2; anthropometry
Abstract
Background: Pomegranate is a rich source of a wide variety of polyphenol compounds with beneficial pharmacological activities for treating diabetes mellitus type 2 (DMT2). Most of DMT2 patients are overweight or obese and obesity by itself is linked to insulin resistance and abnormalities in insulin secretion. The aim of this study was to evaluate the effects of pomegranate peel extract (PoPEx) on anthropometry and body composition of overweight patients with DMT2.
Methods: Sixty patients with DMT2 on continuous metformin therapy were recruited in this double-blind, placebo-controlled, randomized clinical trial. The study group (n=30) received capsules containing PoPEx (250 mg) twice a day for 8 weeks’ period, and the placebo group (n=30) received placebo capsules for the same period. Anthropometric characteristics (weight, waist circumference, fat mass percentage, visceral fat level) were measured at baseline and at the end of the study.
Results: Eight weeks’ treatment with PoPEx resulted in significant changes in BMI (0.18 ± 0.30 kg/m2) and body mass (0.48 ± 0.93 kg). The intake of PoPEx produced a significant decrease in waist circumference z=-4.613, p<0.001 (r=0.60) indicating a large effect size using Cohen-d test, and a non-significant decrease in the level of visceral fat. The results showed a nonsignificant reduction in fat mass percentage in PoPEx group (-0.58 ± 2.21 %, p꓿0.159) compared with the placebo group (0.14 ± 1.24 %, p꓿0.546).
Conclusion: The eight-weeks supplementation with PoPEx had a beneficial effect on anthropometry and body composition of overweight diabetic patients.
References
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28. Hosseini B, Saedisomeolia A, Wood LG, Yaseri M, Tavasoli S. Effects of pomegranate extract supplementation on inflammation in overweight and obese individuals: A randomized controlled clinical trial. Complement Ther Clin Pract 2016;22:44–50.
29. Stockton A, Farhat G, McDougall GJ, Al-Dujaili EAS. Effect of pomegranate extract on blood pressure and anthropometry in adults: a double-blind placebo-controlled randomised clinical trial. J Nutr Sci [Internet]. 2017 Aug [Cited 2019 Oct 8] 9;6(11):e39. Available from: https:/www.cambridge.org/core/product/identifier/S2048679017000362/type/journal_article
30. Sahebkar A, Simental-Mendía LE, Giorgini P, Ferri C, Grassi D. Lipid profile changes after pomegranate consumption: A systematic review and meta-analysis of randomized controlled trials. Phytomedicine 2016;23(11):1103–12.
31. Gheflati A, Mohammadi M, Ramezani-Jolfaie, Heidari Z, Salehi- Abargouei A, et al. Does pomegranate consumption affect weight and body composition? A systematic review and meta-analysis of randomized controlled clinical trials. Phytother Res 2019;1-12 https://doi.org/10.1002/ptr.6322.
32. El-Hadary AE, Ramadan MF. Phenolic profiles, antihyperglycemic, antihyperlipidemic, and antioxidant properties of pomegranate (Punica granatum) peel extract. J Food Biochem 2019;43(4):1–9.
33. Silvester AJ, Aseer KR, Yun JW. Dietary polyphenols and their roles in fat browning. J Nutr Biochem 2019;64:1-12.
2. World Health Organization. Global Report on Diabetes. Geneva, Switzerland: World Health Organization Press; 2016.
3. Low S, Chin MC, Deurenberg-Yap M. Review on epidemic of obesity. Ann Acad Med Singapore 2009;38(1):57–65.
4. Boden G. Role of fatty acids in the pathogenesis of insulin resistance and NIDDM. [published erratum appears in Diabetes 1997;46(3):536]. Diabetes 1997;46(1):3–10.
5. Huang T, Qi Q, Zheng Y, Ley SH, Manson JE, Hu FB, et al. Genetic predisposition to central obesity and risk of type 2 diabetes: two independent cohort studies. Diabetes Care 2015;38(7):1306 -11.
6. Oldridge NB, Stump TE, Nothwehr FK, Clark DO. Prevalence and outcomes of comorbid metabolic and cardiovascular conditions in middle- and older-age adults. J Clin Epidemiol 2001;54:928–34.
7. Banihani S, Swedan S, Alguraan Z. Pomegranate and type 2 diabetes. Nutr Res 2013;33(5):341–8.
8. Shishehbor F, Shahi MM, Zarei M, Saki A, Zakerkish M, Shirani F, et al. Effects of concentrated pomegranate juice on subclinical inflammation and cardiometabolic risk factors for type 2 diabetes: A quasi-experimental study. Int J Endocrinol Metab 2016;14(1):1–7.
9. Sorrenti V, Randazzo CL, Caggia C, Ballistreri G, Romeo FV, Fabroni S, et al. Beneficial effects of pomegranate peel extract and probiotics on pre-adipocyte differentiation. Front Microbiol 2019;10:660. DOI: 10.3389/fmicb.2019.00660.
10. Akhtar S, Ismail T, Fraternale D, Sestili P. Pomegranate peel and peel extracts: Chemistry and food features. Food Chem 2015;174:417–25.
11. Vučić V, Grabež M, Trchounian A, Arsić A. Composition and potential health benefits of pomegranate: A Review. Curr Pharm Des 2019;25(16):1817–27.
12. Viuda-Martos M, Fernandez-Lopez J, Perez-Alvarez J. Pomegranate and its many functional components as related to human health: A Review. Compr Rev Food Sci Food Saf 2010;9(6):635–54.
13. Fenercioglu AK, Saler T, Genc E, Sabuncu H, Altuntas Y. The effects of polyphenol-containing antioxidants on oxidative stress and lipid peroxidation in Type 2 diabetes mellitus without complications. J Endocrinol Invest 2010;33(2):118–24.
14. Kim SH, Plutzky J. Brown fat and browning for the treatment of obesity and related metabolic disorders. Diabetes Metab J 2016;40(1):12-21.
15. Grabež M, Škrbić R, Stojiljković PM, Rudić-Grujić V, Paunović M, Arsić A, et al. Beneficial effects of pomegranate peel extract on plasma lipid profile, fatty acids levels and blood pressure in patients with diabetes mellitus type 2: A randomized, double-blind, placebo-controlled study. J Func Foods 2020;64:103692 DOI: 10.1016/j.jff.2019.103692.
16. Meydani M, Hasan ST. Dietary polyphenols and obesity. Nutrients 2010; 2(7):737-51.
17. Wang S, Moustaid-Moussa N, Chen L, Mo H, Shastri A, Su R, Bapat P, Kwun I, Shen CL. Novel insights of dietary polyphenols and obesity. J Nutr Biochem 2014;25(1):1–8.
18. Gurinović M, Milešević J, Kadvan A, Ðekić -Ivanković M, Debeljak-Martačić J, Takić M, et al. Establishment and advances in the online Serbian food and recipe data base harmonized with EuroFIRTM standards. Food Chem 2016;193:30-8.
19. Davis MJ, D’Alessio DA, Fradkin J, Kernan WN, Mathieu C, Mingrone G, et al. Management of hyperglycemia in type 2 diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2018; 41(12):2669–701.
20. Evert AB, Dennison M, Gardner CD, Garvey WT, Lau KHK, MacLeod J, et al. Nutrition therapy for adults with diabetes or prediabetes: A Consensus report. Diabetes Care 2019;42(5):731-45.
21. van Dijk SJ, Feskens EJ, Bos MB, Hoelen DW, Heijligenberg R, Bromhaar MG, et al. A saturated fatty acid-rich diet induces an obesity-linked proinflammatory gene expression profile in adipose tissue of subjects at risk of metabolic syndrome. Am J Clin Nutr 2009;90(6):1656–64.
22. Hooper L, Summerbell CD, Thompson R, Sills D, Roberts FG, Moore HJ, et al. Reduced or modified dietary fat for preventing cardiovascular disease. Sao Paolo Med J 2016;134(2):182-3.
23. Jiao J, Liu G, Shin HJ, Hu FB, Rim EB, Rexrode KM, et al. Dietary fats and mortality among patients with type 2 diabetes: analysis in two population-based cohort studies. BMJ 2019;366:14009, DOI: 10.1136/bmj.14009.
24. Amato MC, Guarnotta V, Giordano C. Body composition assessment for the definition of cardiometabolic risk. J Endocrinol Invest 2013;36(7):537-43.
25. Luo W, Guo Z, Hu X, Wu M, Zhang L, et al. 2 Years change of waist circumference and body mass index and associations with type 2 diabetes mellitus in cohort populations. Obes Res Clin Pract [Internet]. 2013 [Cited 2019 Oct 8]; 7(4):e290-6. Available from: http://dx.doi.org/10.1016/j.orcp.2012.02.005.
26. Lei F, Zhang XN, Wang W, Xing DM, Xie WD, Su H, et al. Evidence of anti-obesity effects of the pomegranate leaf extract in high-fat diet induced obese mice. Int J Obes 2007;31(6):1023-9.
27. González-Ortiz M, Martínez-Abundis E, Espinel-Bermúdez MC, Pérez-Rubio KG. Effect of pomegranate juice on insulin secretion and sensitivity in patients with obesity. Ann Nutr Metab 2011;58(3):220–3.
28. Hosseini B, Saedisomeolia A, Wood LG, Yaseri M, Tavasoli S. Effects of pomegranate extract supplementation on inflammation in overweight and obese individuals: A randomized controlled clinical trial. Complement Ther Clin Pract 2016;22:44–50.
29. Stockton A, Farhat G, McDougall GJ, Al-Dujaili EAS. Effect of pomegranate extract on blood pressure and anthropometry in adults: a double-blind placebo-controlled randomised clinical trial. J Nutr Sci [Internet]. 2017 Aug [Cited 2019 Oct 8] 9;6(11):e39. Available from: https:/www.cambridge.org/core/product/identifier/S2048679017000362/type/journal_article
30. Sahebkar A, Simental-Mendía LE, Giorgini P, Ferri C, Grassi D. Lipid profile changes after pomegranate consumption: A systematic review and meta-analysis of randomized controlled trials. Phytomedicine 2016;23(11):1103–12.
31. Gheflati A, Mohammadi M, Ramezani-Jolfaie, Heidari Z, Salehi- Abargouei A, et al. Does pomegranate consumption affect weight and body composition? A systematic review and meta-analysis of randomized controlled clinical trials. Phytother Res 2019;1-12 https://doi.org/10.1002/ptr.6322.
32. El-Hadary AE, Ramadan MF. Phenolic profiles, antihyperglycemic, antihyperlipidemic, and antioxidant properties of pomegranate (Punica granatum) peel extract. J Food Biochem 2019;43(4):1–9.
33. Silvester AJ, Aseer KR, Yun JW. Dietary polyphenols and their roles in fat browning. J Nutr Biochem 2019;64:1-12.
Published
2020/03/27
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