Pomegranate juice (PG) was recently studied in a randomized placebo-controlled trial conducted by the Nephrology Department of the Western Galilee Hospital, Israel. The study showed an increase in innate immune function and a decrease in the progression of the atherosclerotic processes.
Pomegranate juice contains vitamin C as ascorbic acid and polyphenolic flavanoids with the highest concentration in the juice from its skin. Tests show it has more potent antioxidant effects than red wine. An earlier paper on pomegranate juice reported in patients with high blood pressure that a reduction of 2-5mm systolic pressure reduces risk of CV complications.
This paper from Galilee Hospital reported the effect on kidney dialysis patients who drank just 100 cc PG three times per week for 12 months. People with kidney failure who are on dialysis are prone to heart and cardiovascular system problems. In fact, the major cause of death in dialysis patients is cardiovascular related. The results were quite staggering.
The benefits of the juice were:
1. an improved lipid profile
2. reduced blood pressure and
3. improved heart function.
These three factors had not been studied in hemodialysis patients before with juice.
Key findings in the study include
- A significant reduction in triglyceride levels in pomegranate juice-treated group, but not in the placebo group.
– There was a more significant reduction in triglycerides in patients with a baseline triglycerides level of over 200 mg/dl.
-That is, those with the highest triglyceride levels got the biggest reductions
- A 22% reduction in number of anti-hypertensive medications taken by the pomegranate juice treated group.
- Even in the group who did not warrant anti-hypertensive medication reduction there was still a decrease of 8 mm of systolic pressure
- No Side Effects were noted during the study period.
Pomegranate juice has also been found to inhibit the growth of colon, lung, prostate ,breast and cancer cells
The biologically active components in Pomegranate juice that have been found to be protective against certain types of cancer are called ellagitannins ( a class of polyphenols). Ellagitannins can be further metabolised in gut into Ellagic acid and further into urolithins by the microfloria.
Ellagic acid as an isolate has been shown to be able to inhibit the binding of carcinogens to DNA, of note the caniogens nitrosobenzylmethylamine (NBMA) known to cause esophageal cancer (5) and benzo[a]pyrene a well-known carcinogenic, mutagenic and teratogenic compound (6). Ellagic acid as an isolate also has potent antioxidant properties.
Invitro studies on Urolithins have shown they can deactivate at least 2 cancer growth pathways. The first pathway cited is the MAPK pathway(1,2), the MAPK is chain of proteins that is involved in cellular growth and differentiation, in cancer they can get stuck in the “on“ position signalling uncontrolled growth (tumorigenesis) and resistance to apoptosis (programed cell death)(3). The other pathway of significance which Urolithins can inhibit is the Wnt pathway which is again responsible for cellular proliferation and differentiation, in colon cancer up to 90% of tumours show mutation in this pathway resulting in unregulated cellular growth and proliferation(4). Urolithins because of their abundance in the gut show very encouraging results for colon cancer.
While the metabolites of ellagitannins have experimentally shown anti-cancer properties, ellagitannins as a complete compound have in some studies been found to be more potent than the isolated metabolites. David Geffen from Center for Human Nutrition, School of Medicine, University of California showed that it was ellagitannins that supressed colon cancer cell inflammatory enzymes and that when Ellagic acid was administered on its own it was not effective. In another study it was found that pomegranate fruit extract modulates the expression of Cyclin-dependent kinase inhibitor protein which functions as a tumor suppressor gene, resulting in the inhibition of cell growth and apoptosis (programmed cell death) of the tumor (7). These examples highlight the benefit of a whole food extract over to an isolate.
Other health benefits from Pomegranate Juice
- Anti-inflammatory activity (8)
- Antidiabetic properties (8)
- Antimicrobial properties (8)
- Promotion of Cardiovascular function (8)
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- Larrosa M, González-Sarrías A, García-Conesa MT, Tomás-Barberán FA, Espín JC. Urolithins, ellagic acid-derived metabolites produced by human colonic microflora, exhibit estrogenic and antiestrogenic activities. J Agric Food Chem. 2006;54:1611–20. [PubMed]
- Gonzalez-Sarrias A, Espin JC, Tomas-Barberan FA, Garcia-Conesa MT. Comparative transcriptional analysis reveals key cell cycle and MAPK signaling genes involved in the S-G2/M-phase arrest of Caco-2 cells exposed to ellagic acid and its colonic derivatives, urolithins. Mol Nut Food Res. 2009;53:686–698.
- McCubrey JA, Steelman LS, Chappell WH, et al. Roles of the Raf/MEK/ERK pathway in cell growth, malignant transformation, and drug resistance. Biochim Biophys Acta. 2007;1773:1263-1284. PMID: 17126425
- Meenakshi Sharma,§ Liya Li,§ Jeremy Celver, Caroline Killian, Abraham Kovoor,* and Navindra P. Seeram* Effects of Fruit Ellagitannin Extracts, Ellagic Acid, and Their Colonic Metabolite, Urolithin A, on Wnt Signaling. Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, Rhode Island 02881. PMCID: PMC2850963
- Mandal S, Stoner GD.Inhibition of N-nitrosobenzylmethylamine-induced esophageal tumorigenesis in rats by ellagic acid. Mandal S, Stoner GD.. 1990 Jan;11(1):55-61. PMID: 2295128
- 6.Teel RW, Babcock MS, Dixit R, Stoner GD.Ellagic acid toxicity and interaction with benzo[a]pyrene and benzo[a]pyrene 7,8-dihydrodiol in human bronchial epithelial cells. PMID:3267445. PMCID: PMC1253570
- 7. Arshi Malik, Farrukh Afaq, Sami Sarfaraz, Vaqar M. Adhami, Deeba N. Syed, and Hasan Mukhtar* Pomegranate fruit juice for chemoprevention and chemotherapy of prostate cancer. 2005 September 28
- Arzu Akpinar-Bayizit, Tulay Ozcan and Lutfiye Yilmaz-Ersan . The Therapeutic Potential of Pomegranate and Its Products for Prevention of Cancer Uludag University Turkey.