Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. In this randomized controlled trial, in non-alcohol fatty liver disease (NAFLD) patients who were on a weight-loss diet, pomegranate peel extract supplementation lowered mean body weight, waist circumference, body mass index, body fat index, blood pressure, lipid measures, and fasting blood sugar compared to controls.

2. Furthermore, pomegranate peel extract supplementation resulted in improved high-density lipoprotein and fatty liver changes.

Evidence Rating Level: 1 (Excellent)

Non-alcoholic fatty liver disease (NAFLD) is a progressive spectrum of liver disease that can range from mild fatty changes of the liver to fibrosis, cirrhosis, and malignant changes. There are currently no specific targeted therapeutics for NAFLD. Therefore, most efforts are focused on targeting modifiable risk factors such as obesity, insulin resistance, dyslipidemia, hypertension, and cardiovascular disease. Pomegranate fruit has high levels of phytochemicals, demonstrating various clinical benefits in clinical trials on NAFLD and other diseases. However, the pomegranate peel has the highest amount of these beneficial phytochemicals. This study aimed to examine the effect of pomegranate peel extract (PP) supplementation on liver tissue changes and metabolic syndrome risk factors in patients with NAFLD.

This was a randomized control study of 76 adult patients in Iran with NAFLD. Participants were included if they were between the ages of 18 and 60 years and were diagnosed with liver fibrosis and steatosis through elastography or liver fibro scan. Patients who were pregnant, had morbid obesity, or a history of high alcohol consumption, autoimmune or immune disorders, cancer, or liver or kidney failure, were excluded. Participants were initiated on a 500-kcal deficit diet and randomized to receive either a placebo (37 patients) or 1500mg of PP supplement (39 patients) for eight weeks. Primary outcomes measured were lipid and glycemic profiles, blood pressure, body composition, insulin resistance indexes, and liver tissue changes.

The results demonstrated that patients randomized to receive PP extract supplementation had lower mean body weight, waist circumference, body mass index, body fat index, blood pressure, lipid measures, and fasting blood sugar than the controls. Patients who received PP extract supplementation also had improved high-density lipoprotein and fatty liver changes compared to the control group. However, there were no significant differences between the PP and control groups in fasting insulin or homeostatic model assessment for insulin resistance. The study was limited by incomplete adherence to the study diet in some participants, which may have confounded the results. Nonetheless, these results suggested PP supplementation as a potential novel strategy to improve metabolic syndrome risk factors in patients with NAFLD.

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