The effect of pomegranate on oxidative stress parameters: A systematic review and meta-analysis

Objective: Pomegranate contains remarkable amounts of phenolic ingredients and it has been related to the antioxidant capacity of this fruit. Several primary studies show that pomegranate intake can improve antioxidant status. The objective of this systematic review and meta-analysis consisted in investigating the effect of pomegranate on oxidative stress (OS) parameters. Methods: A comprehensive electronic database search in Scopus, Web of science, Embase, Cochrane library and Medline was performed to identify eligible randomized controlled trials (RCTs). A meta-analysis of included studies was performed on selected variables using a random-effects model. Quality assessment was conducted by means of Cochrane risk of bias assessment tool. Results: Systematic search yielded 575 references. A total of 11 RCTs reporting data from 484 participants included. Meta-analysis of data from 11 included RCTs did not support convincing evidence as to a significant increasing effect of pomegranate intake in TAC (SMD: 0.43; 95 %CI: -0.19, 1.06), Gpx (SMD: 0.18, 95 % CI: -0.25, 0.62, p = 0.4) and paraxonase (SMD: 0.36, 95 % CI: -0.50, 1.22, p = 0.41) as well as not significant decrease in Malondialdehyde (MDA) (SMD: -0.81, 95 % CI: -1.79, 0.09, P = 0.08). Conclusion: Future well-designed clinical trials are needed before definite conclusive claims can be made about the effect of pomegranate on OS parameters.