Introduction

The Pomegranate (Punica granatum) is a small tree growing up to a height of 5-10 meters specifically in regions with hot dry summers and cool winters. Iran, India, China, Spain, Turkey and California are some of the major producers of pomegranates.

The pomegranate tree is specifically grown for its distinctive fruit, typically round with a tough leathery texture and bright red to reddish brown skin. The seeds of pomegranate called arils are the edible part of the pomegranate. Hundreds of these seeds are packed inside the pomegranate fruit. Pomegranate arils are bright red consisting of a crunchy and fibrous seed surrounded by a juicy red pulp with sweet tart flavour.

The pomegranate arils are rich in anti-inflammatory compounds like polyphenols, punicalagins, and anthocyanins.¹ Pomegranate seeds contain a small amount of punicic acid which is an omega-5 fatty acid with potential anti-inflammatory properties.² All these compounds also act as potent antioxidants reducing the cell damage caused by free radicals. Through this article let's dive deeper into the properties of pomegranate and understand why it is an excellent choice if you intend to reduce the inflammation in your body.  

Nutritional profile of pomegranate fruit

Per 100gm of raw pomegranate contains the below nutrients.³

The above data indicates that Pomegranate is a rich source of vitamins like vitamin C, vitamin K,  vitamin E and a rich source of folate. Pomegranate contains a rich amount of compounds like punicalagins, anthocyanins and ellagic acid. These are potent antioxidants and anti-inflammatory helping to reduce inflammation and prevent cell damage by neutralising free radicals.

How does pomegranate reduce inflammation?

Inhibits mediators in inflammation

Cytokines

• Cytokines are signalling proteins that regulate inflammatory responses in your body 
• Pomegranate reduces levels of pro-inflammatory cytokines e.g. TNF-α, IL-6, and IL-1β⁴
• Pomegranate increases the production of anti-inflammatory cytokines like IL-10 which helps to reduce inflammation⁵

Enzymes 

• Cox1 and cox2 enzymes are needed for the synthesis of pro-inflammatory prostaglandins. Pomegranate inhibits the activity of cox2 enzymes, reducing the production of prostaglandins and thus inflammation⁶
• Pomegranate inhibits the activity of LOX enzymes. Lox enzymes promote the formation of pro-inflammatory Leukotrienes

Modulates pathways involved in inflammation.

NF-kB Pathway

Pomegranate extracts inhibit the activation of the NF-kB pathway and thus it reduces the production of pro-inflammatory cytokines like TNF-α, IL-1β, and IL-6.

MAPK Pathway

Pomegranate decreases the production of inflammatory enzymes and cytokines by inhibiting MAPK signalling pathways.

Impacts on immune cells involved in inflammation

Pomegranate reduces the activation of macrophages and reduces neutrophil infiltration into inflamed tissues,⁷ This leads to a decrease in the release of enzymes that contribute to inflammation.

Impacts on the expression of genes involved in inflammation

• Pomegranate compounds can impact the expression of genes involved in inflammation by modifying histones⁸
• Pomegranate suppresses the expression  of pro-inflammatory genes by influencing DNA methylation patterns

Antioxidant effects

• Pomegranate is rich in potent antioxidants like punicalagins, ellagic acid, and anthocyanins. Antioxidants neutralise free radicals, and thus subsequent inflammation
• pomegranate prevents the activation of inflammatory pathways triggered by reactive oxygen species (ROS)

Affects cellular signaling in inflammation

• Pomegranate promotes programmed cell death (apoptosis) of activated inflammatory cells. This reduces inflammation
• Pomegranate reduces the migration of inflammatory cells to sites of inflammation by decreasing the expression of cell adhesion molecules

Pomegranate can help to reduce inflammation in below health conditions

Rheumatoid arthritis and osteoarthritis

Pomegranates are very rich in anti-inflammatory compounds like punicalagins and ellagic acid. These compounds reduce inflammation in arthritis thus helping to reduce pain and improve physical mobility. Clinical findings have confirmed that regular consumption of pomegranates reduce levels of inflammatory markers like C-reactive protein (CRP) and interleukin-6 (IL-6).⁹ These inflammatory markers are usually elevated in conditions like rheumatoid arthritis and osteoarthritis.

Diabetes

Chronic inflammation is a key issue in diabetes and it contributes to insulin sensitivity. Regular consumption of pomegranates can help to improve insulin sensitivity by reducing inflammation owing to the presence of anti-inflammatory compounds in it.¹⁰

Inflammatory bowel disease and ulcerative colitis

Inflammation is a major factor in inflammatory bowel disease (IBD) and ulcerative colitis.

Due to the presence of compounds like punicalagins, it acts as a potent anti-inflammatory. Pomegranate also contains ellagic acid which suppresses inflammatory pathways and thus the production of cytokines involved in  Inflammatory bowel disease and ulcerative colitis.¹¹ 

Cardiovascular diseases

Inflammation is a key reason behind various cardiovascular diseases so consuming Pomegranate can help in reducing the inflammation. Pomegranate contains anti-inflammatory compounds like punicalagins and anthocyanins, reducing inflammation.

Psoriasis and eczema

The anti-inflammatory action of pomegranate helps to reduce inflammation, itching and scaling skin conditions like psoriasis and eczema.

Asthma, chronic obstructive pulmonary disease, and bronchitis.

Pomegranates contain potent anti-inflammatory compounds which can help reduce inflammation in the respiratory tract. This helps in conditions like asthma, chronic obstructive pulmonary disease (COPD), and bronchitis.

Alzheimer's disease and multiple sclerosis

Pomegranate reduces inflammation by reducing pro-inflammatory cytokines. It also reduces the activation of microglia which are immune cells of the central nervous system thus reducing inflammation.¹²

Periodontitis and gingivitis

Pomegranate helps to reduce inflammation of gums in periodontitis and gingivitis. Clinical trials have indicated that products containing pomegranate-like mouthwashes and toothpaste can reduce inflammation and reduce the formation of plaque. 

Potential side effects and considerations

• Allergic reactions: some people might be allergic to pomegranate and may experience itching, swelling, runny nose and breathing difficulty in case of severe allergy to pomegranate
• Diarrhoea: if consumed in large amounts, pomegranates may cause digestive disturbance including diarrhoea 
• Blood pressure: pomegranates may lower blood pressure so people taking medications for blood pressure issues should be careful¹³
• Blood sugar: pomegranates may alter blood sugar levels so patients closely monitoring their blood sugar levels should consult health care professionals before adding pomegranate to their diet

Interactions with medications

• Pomegranates may interact with medicines taken for controlling blood sugar, blood pressure and cholesterol so patients with these conditions should make their healthcare professional aware if consuming pomegranates in large amounts
• Pomegranate may affect blood pressure and blood clotting so people planning for surgery should stop pomegranate consumption in large amounts two weeks before surgery

Summary

The pomegranate tree is specifically grown for its distinctive fruit, typically round with a tough leathery textured, bright red to reddish brown skin. The seeds of pomegranate called arils are the edible part of the pomegranate. Hundreds of these seeds are packed inside the pomegranate fruit. The pomegranate arils are rich in anti-inflammatory compounds like polyphenols, punicalagins, and anthocyanins. Pomegranate seeds contain a small amount of punicic acid which is an omega-5 fatty acid with potential anti-inflammatory properties. 

These compounds also act as potent antioxidants reducing the cell damage caused by free radicals. Pomegranate can act as an excellent anti-inflammatory in various inflammatory conditions in the body like rheumatoid arthritis, osteoarthritis, diabetes, inflammatory bowel disease, ulcerative colitis, psoriasis, multiple sclerosis, and Alzheimer's disease. 

However, it needs to be remembered that pomegranates act as a support to reduce inflammation in these conditions and it does not replace the treatment recommended by your physician for these conditions. Pomegranate may affect blood pressure, blood sugar and cholesterol levels so patients where these parameters are closely monitored should refrain from consuming pomegranate in large amounts. Overall, pomegranate is a visually appealing fruit with bright red seeds which can certainly add a pop of colour to any drink, dessert or salad along with its excellent health benefits.