Health Benefits Of Pomegranate

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Introduction

Punica granatum, or the “seeded apple”, is more commonly known as pomegranate. As the plant is quite resistant to dry climates, it can be found in arid and semi-arid regions like Iran, India, Turkey, Egypt, Spain, and Morocco. India and China are the leading producers of this fruit worldwide. 

Health benefits of pomegranate

The fruit, seeds, and seed oil extract have been studied extensively for their various health benefits. A host of antioxidants, anti-inflammatory and anti-tumour molecules have been identified in pomegranate - making it the ideal superfood.1 The antioxidant content in the fruit is much higher than that found in red wine or green tea.

Anti tumour properties 

Molecules known as flavonoids, ellagitannins, and other phytochemicals found in pomegranate are known for their anti-cancer effects. These molecules help control tumour growth and migration, and can reduce inflammation, thus aiding cancer prevention.2  

In a scientific study, extract of the pomegranate peel was shown to increase the sensitivity of tumour cells to radiation in liver cancer, helping with cancer radiotherapy.3

Anti inflammatory properties 

Inflammation is the body’s response to infections and injuries. Oxidative stress is one of the many aspects of inflammation, where many reactive oxygen molecules attack the primary injury. At times, this response can be prolonged, leading to a negative effect on the body’s tissues. Prolonged oxidative stress has been linked to many chronic conditions like type 2 diabetes, high blood pressure, heart disease, and cancer.4  Studies have shown that consumption of pomegranate juice may reduce levels of oxidative stress.5

Supplementation with pomegranate extract may also reduce levels of factors that contribute to inflammation in blood vessels.6 Additionally, consumption of pomegranate may also significantly reduce the complications of autoimmune diseases like rheumatoid arthritis.7

Since oxidative stress is strongly linked to modern non-communicable diseases, the American Heart Association has recognised Life’s Essential 8 - the eight steps towards a healthier lifestyle - and number one on that list is to ‘eat better’. Pomegranate juice has been correlated with positive outcomes in the management and/or prevention of many of these non-communicable diseases.

Polycystic ovarian syndrome (PCOS)

Polycystic ovarian syndrome (PCOS) is a hormonal disorder affecting young people assigned female at birth (PAFAB), involving menstrual irregularities, acne, excessive hair growth, and/or obesity. Women with this condition are at a higher risk of developing other lifestyle disorders (like diabetes, heart disease, and endometrial cancer). 

Pomegranate juice has been shown to improve not only both cholesterol and blood pressure levels but also inflammatory factors in women with PCOS.8 Furthermore, the presence of linolenic acids like punicic acid in pomegranate seed oil help reduce the bad cholesterol in the body, helping women with PCOS manage their body weight better. 9

Menopause

As women stop having their period as they get older, they experience a variety of symptoms like fatigue, vaginal dryness, hot flashes, emotional disturbances, and joint pains. This is due to the low oestrogen levels during this period. The seeds of pomegranate contain plant oestrogens similar to human oestrogen. Taking pomegranate supplements can control these symptoms in just a 4-week period.10

High cholesterol

We have a combination of good cholesterol (HDL) and bad cholesterol (total cholesterol, LDL, and triglycerides) in our body. Naturally, the levels of HDL are expected to be high, and the levels of the bad cholesterol are expected to be low. Drinking pomegranate juice for at least two weeks has been shown to reduce LDL cholesterol.11  In individuals suffering from non-alcoholic causes of fatty liver disease or metabolic syndrome, it has shown to both reduce bad cholesterol and increase good cholesterol levels.12                                                                   

Metabolic syndrome

The term ‘metabolic syndrome’ comprises a combination of high blood pressure, high blood sugars, high cholesterol, and excess abdominal fat (central obesity). Studies have found that prebiotics (or simply, food for the good bacteria in your gut) are a good addition to the treatment of metabolic syndrome, along with medications. Extract of pomegranate can help with this treatment.13 

In people with high blood sugars, consuming pomegranate seed powder proved to reduce their fasting blood glucose and HbA1c levels.14 In addition, consuming the fruit juice, even for less than 12 weeks, reduced the systolic (upper number) blood pressure by 4mmHg and diastolic (lower number) blood pressure by 2mmHg.15

Brain health

A molecule called polyphenol can greatly aid in cognitive and memory function, while also controlling neuroinflammation.16 In support of this, pomegranate juice or supplements have been proven to improve functional recovery after a stroke attack in adults, and also reduce chances of brain injury in children with pre-existing growth restriction diagnosed during pregnancy.17,18

Anti aging benefits

Fermented pomegranate juice or pomegranate wine is rich in antioxidants. Factors like collagen density, moisture and pigmentation of the skin greatly improves after consumption of the wine.19 Ultraviolet-induced skin damage - which has been linked to ageing and skin cancer, has shown potential reduction to.20

Oral health

Pomegranate extract inhibits plaque-forming bacteria in the mouth.21  Regular use of pomegranate as a rinse has the potential to combat gum inflammation (gingivitis) and its complications (such as gum infections).22

Nutrients we can get from pomegranate

Chemically, each 100g of pomegranate fruit contains 1.67g of protein, 1.1g of fat, and up to 10mg of calcium, magnesium and vitamin C. It is also a rich source of phosphorus and potassium. Raw pomegranates are richer in nutrients than pomegranate juice. Also, processed juice will have a higher caloric content than fresh juice, due to the addition of sweeteners during packaging. 

Essential nutrients of each part

Cold pressed seed oil: This contains a rich fatty acid called punicic acid, which has strong effects against cholesterol metabolism and the formation of cholesterol deposits in the arteries.

Juice and peel: These host various antioxidants such as polyphenols, some organic acids like vitamin C, and fructose.

The roots contain fibre. Each 100g of fruit gives around 4g of fibre.

Is pomegranate a superfood?

A superfood is “a food (such as salmon, broccoli, or blueberries) that is rich in compounds (such as antioxidants, fibre, or fatty acids) considered beneficial to a person’s health. Pomegranate has made its way into the list of superfoods due to its rich antioxidant effect.

How to include pomegranate in our diet

The benefits of this fruit can now be reaped in many forms – like seed oil, powder, supplements, and root and peel extracts. These days, bottled and fermented pomegranate juice is also available. While fermented juice reduces some of its properties, it stabilises the other components and also adds to the sensory experience of consumption.23 It is advised to drink fresh juice rather than bottled and processed juice. Pomegranate molasses can be drizzled on breakfast pancakes, French toast, or crackers.

The seeds are dried (anardana) and used as a souring agent in Indian and Persian households.

The arils, or the red edible pulp, can be eaten with yoghurt, oatmeal, or smoothies – or also alone as a snack. They can also be cooked into delicious candies, sorbets, and jams. Many Middle-Eastern recipes include pomegranate in their rice (pilaf) and hummus (muhammara). Batinjan bi hamud (aubergine with pomegranate) and harak osbao (lentil stew) are also popular pomegranate-containing appetisers in this cuisine.  Desserts like brownies, cakes, tarts, and parfaits can be whipped up using this superfruit. Finally, you can always toss some pomegranate into your salads to give it a sweet kick.

Is it okay to eat pomegranate seeds?

Pomegranate seeds contain fibre, some phenolic acids, and seed oil. Studies have shown that consumption of up to 4.3g of pomegranate seed oil per kg body weight does not produce any toxic effect, which is certainly way above the average daily consumption in humans.24,25 Additionally, the safe level of pomegranate fruit extract is calculated to be 600 mg/kg body weight.26  As a result, it is quite safe to eat this fruit as a part of a balanced diet.

What happens if you eat pomegranate every day?

Unless you are allergic or you are on medication that interacts with pomegranate, it is safe to consume pomegranate every day within the recommended daily allowance as described below.

How much is enough?

Many studies have shown that overconsumption neither produces any adverse effects, nor does it affect liver or kidney metabolism.27  However, the Dietary Guidelines for Americans suggests one cup (8 ounces or 249g) of pomegranate fruit or one glass of unsweetened 100% juice is safe per day.

When is the best time to eat pomegranate?

It is a myth that eating fruits on a full stomach leads to bloating due to the fermentation of acids. The stomach only allows a portion of the food to be digested at a time in the intestine, and the acids in the stomach do not allow for fermentation to take place. Pomegranate is mostly consumed during the day as a snack, or on an empty stomach in the morning. However, for individuals who are diabetic, it is better to consume the fruit with a meal to avoid the spike in blood glucose.

Who should not eat pomegranate?

If you have pre-existing allergies or develop itching and swelling after eating a pomegranate, avoid it. Some case studies have been published which report that daily consumption has led to constipation in a few individuals. This happens when people suddenly adopt a crash diet. The seeds get pushed together and are hard to pass (seed bezoar). Avoid eating the fruit daily if you suffer from constipation.

Since pomegranates have so many active ingredients, it is vital to know that certain medications interact with pomegranate metabolism. What this means for you is that if you are on certain medications, it can either increase or slow down the metabolism of that drug. Hence, consult your doctor before consuming pomegranate daily.

Summary

Overall, pomegranates are an antioxidant and nutrient-packed fruit that have a host of benefits against cancer cells, infections, and inflammation in the body. They have wide applications in cosmetic and preventive medicine. Essential calcium, magnesium, phosphorus, potassium, and vitamin C can be attained with minimal calories in a recommended serving of one cup of the fruit. Additionally, it can be consumed as juice, supplements, dehydrated powder, and in a range of desserts and salads. Unless you have specific dietary or medical conditions, it is safe to eat this superfruit every day.

References 

  1. Gumienna M, Szwengiel A, Górna B. Bioactive components of pomegranate fruit and their transformation by fermentation processes. Eur Food Res Technol [Internet]. 2016 May 1 [cited 2023 Feb 16];242(5):631–40. Available from: https://link.springer.com/article/10.1007/s00217-015-2582-z
  2. Wong TL, Strandberg KR, Croley CR, Fraser SE, Nagulapalli Venkata KC, Fimognari C, et al. Pomegranate bioactive constituents target multiple oncogenic and oncosuppressive signaling for cancer prevention and intervention. Seminars in Cancer Biology [Internet]. 2021 Aug 1 [cited 2023 Aug 31];73:265–93. Available from: https://www.sciencedirect.com/science/article/pii/S1044579X21000122
  3. Elbakry MMM, ElBakary NM, Hagag SA, Hemida EHA. Pomegranate peel extract sensitizes hepatocellular carcinoma cells to ionizing radiation, induces apoptosis and inhibits mapk, jak/stat3, β-catenin/notch, and socs3 signaling. Integr Cancer Ther [Internet]. 2023 Jan 29 [cited 2023 Aug 31];22:15347354221151021. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9893067/
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  5. Lorzadeh E, Heidary Z, Mohammadi M, Nadjarzadeh A, Ramezani-Jolfaie N, Salehi-Abargouei A. Does pomegranate consumption improve oxidative stress? A systematic review and meta-analysis of randomized controlled clinical trials. Clinical Nutrition ESPEN [Internet]. 2022 Feb [cited 2023 Aug 31];47:117–27. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2405457721011219
  6. Wang P, Zhang Q, Hou H, Liu Z, Wang L, Rasekhmagham R, et al. The effects of pomegranate supplementation on biomarkers of inflammation and endothelial dysfunction: A meta-analysis and systematic review. Complementary Therapies in Medicine [Internet]. 2020 Mar 1 [cited 2023 Aug 31];49:102358. Available from: https://www.sciencedirect.com/science/article/pii/S0965229920301308
  7. Malek Mahdavi A, Seyedsadjadi N, Javadivala Z. Potential effects of pomegranate (punica granatum) on rheumatoid arthritis: A systematic review. Int J Clin Pract [Internet]. 2021 Aug [cited 2023 Aug 31];75(8). Available from: https://onlinelibrary.wiley.com/doi/10.1111/ijcp.13999
  8. Esmaeilinezhad Z, Barati-Boldaji R, Brett NR, de Zepetnek JOT, Bellissimo N, Babajafari S, et al. The effect of synbiotics pomegranate juice on cardiovascular risk factors in PCOS patients: a randomized, triple-blinded, controlled trial. J Endocrinol Invest [Internet]. 2020 Apr 1 [cited 2023 Aug 31];43(4):539–48. Available from: https://link.springer.com/article/10.1007/s40618-019-01139-x.
  9. Bahmani M, Shokri S, Akhtar ZN, Abbaszadeh S, Manouchehri A. The effect of pomegranate seed oil on human health, especially epidemiology of polycystic ovary syndrome; a systematic review. JBRA Assisted Reproduction [Internet]. 2021 [cited 2023 Aug 31]; Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9635601/
  10. Adel-Mehraban MS, Tansaz M, Mohammadi M, Yavari M. Effects of pomegranate supplement on menopausal symptoms and quality of life in menopausal women: A double-blind randomized placebo-controlled trial. Complementary Therapies in Clinical Practice [Internet]. 2022 Feb 1 [cited 2023 Aug 31];46:101544. Available from: https://www.sciencedirect.com/science/article/pii/S1744388122000123
  11. Kojadinovic M, Glibetic M, Vucic V, Popovic M, Vidovic N, Debeljak-Martacic J, et al. Short-term consumption of pomegranate juice alleviates some metabolic disturbances in overweight patients with dyslipidemia. Journal of Medicinal Food [Internet]. 2021 Sep [cited 2023 Aug 31];24(9):925–33. Available from: https://www.liebertpub.com/doi/10.1089/jmf.2020.0122
  12. Goodarzi R, Jafarirad S, Mohammadtaghvaei N, Dastoorpoor M, Alavinejad P. The effect of pomegranate extract on anthropometric indices, serum lipids, glycemic indicators, and blood pressure in patients with nonalcoholic fatty liver disease: A randomized double‐blind clinical trial. Phytotherapy Research [Internet]. 2021 Oct [cited 2023 Aug 31];35(10):5871–82. Available from: https://onlinelibrary.wiley.com/doi/10.1002/ptr.7249
  13. Cortés‐Martín A, Iglesias‐Aguirre CE, Meoro A, Selma MV, Espín JC. Pharmacological therapy determines the gut microbiota modulation by a pomegranate extract nutraceutical in metabolic syndrome: a randomized clinical trial. Mol Nutr Food Res [Internet]. 2021 Mar [cited 2023 Aug 31];65(6):2001048. Available from: https://onlinelibrary.wiley.com/doi/10.1002/mnfr.202001048
  14. Seyed Hashemi M, Namiranian N, Tavahen H, Dehghanpour A, Rad MH, Jam-Ashkezari S, et al. Efficacy of pomegranate seed powder on glucose and lipid metabolism in patients with type 2 diabetes: a prospective randomized double-blind placebo-controlled clinical trial. Complementary Medicine Research [Internet]. 2021 Jun 28 [cited 2023 Aug 31];28(3):226–33. Available from: https://karger.com/cmr/article/28/3/226/78359/Efficacy-of-Pomegranate-Seed-Powder-on-Glucose-and
  15. Sahebkar A, Ferri C, Giorgini P, Bo S, Nachtigal P, Grassi D. Effects of pomegranate juice on blood pressure: A systematic review and meta-analysis of randomized controlled trials. Pharmacological Research [Internet]. 2017 Jan 1 [cited 2023 Aug 31];115:149–61. Available from: https://www.sciencedirect.com/science/article/pii/S1043661816307848
  16. Vauzour D. Dietary polyphenols as modulators of brain functions: biological actions and molecular mechanisms underpinning their beneficial effects. Oxid Med Cell Longev [Internet]. 2012 [cited 2023 Feb 16];2012:914273. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3372091/
  17. Bellone JA, Murray JR, Jorge P, Fogel TG, Kim M, Wallace DR, et al. Pomegranate supplementation improves cognitive and functional recovery following ischemic stroke: A randomized trial. Nutritional Neuroscience [Internet]. 2019 Oct 3 [cited 2023 Aug 31];22(10):738–43. Available from: https://www.tandfonline.com/doi/full/10.1080/1028415X.2018.1436413
  18. Ross MM, Cherkerzian S, Mikulis ND, Turner D, Robinson J, Inder TE, et al. A randomized controlled trial investigating the impact of maternal dietary supplementation with pomegranate juice on brain injury in infants with IUGR. Sci Rep [Internet]. 2021 Feb 11 [cited 2023 Aug 31];11:3569. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878922/
  19. Chan L, Tseng Y, Liu C, Liang C. Fermented pomegranate extracts protect against oxidative stress and aging of skin. J of Cosmetic Dermatology [Internet]. 2022 May [cited 2023 Aug 31];21(5):2236–45. Available from: https://onlinelibrary.wiley.com/doi/10.1111/jocd.14379
  20. Henning SM, Yang J, Lee RP, Huang J, Hsu M, Thames G, et al. Pomegranate juice and extract consumption increases the resistance to uvb-induced erythema and changes the skin microbiome in healthy women: a randomized controlled trial. Sci Rep [Internet]. 2019 Oct 10 [cited 2023 Aug 31];9:14528. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6787198/
  21. Menezes SMS, Cordeiro LN, Viana GSB. punica granatum (Pomegranate) extract is active against dental plaque. Journal of Herbal Pharmacotherapy [Internet]. 2006 Jan [cited 2023 Aug 31];6(2):79–92. Available from: http://www.tandfonline.com/doi/full/10.1080/J157v06n02_07
  22. Eltay EG, Gismalla BG, Mukhtar MM, Awadelkarim MOA. Punica granatum peel extract as adjunct irrigation to nonsurgical treatment of chronic gingivitis. Complementary Therapies in Clinical Practice [Internet]. 2021 May 1 [cited 2023 Aug 31];43:101383. Available from: https://www.sciencedirect.com/science/article/pii/S1744388121000827
  23. Gumienna M, Szwengiel A, Górna B. Bioactive components of pomegranate fruit and their transformation by fermentation processes. Eur Food Res Technol [Internet]. 2016 May 1 [cited 2023 Feb 17];242(5):631–40. Available from: https://link.springer.com/article/10.1007/s00217-015-2582-z
  24. Ia M, Cm VR, Ca B, Hg K, J BR, Ze J, et al. Toxicological evaluation of pomegranate seed oil. Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association [Internet]. 2009 Jun [cited 2023 Feb 22];47(6). Available from: https://pubmed.ncbi.nlm.nih.gov/19425183/
  25. C P, P D, L H, Mg S. Safety assessment of pomegranate fruit extract: acute and subchronic toxicity studies. Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association [Internet]. 2008 Aug [cited 2023 Feb 22];46(8). Available from: https://pubmed.ncbi.nlm.nih.gov/18571823/
  26. Vidal A, Fallarero A, Peña BR, Medina ME, Gra B, Rivera F, et al. Studies on the toxicity of Punica granatum L. (Punicaceae) whole fruit extracts. Journal of Ethnopharmacology [Internet]. 2003 Dec 1 [cited 2023 Aug 31];89(2):295–300. Available from: https://www.sciencedirect.com/science/article/pii/S0378874103003076
  27. Paul A, Radhakrishnan M. Pomegranate seed oil in food industry: Extraction, characterization, and applications. Trends in Food Science & Technology [Internet]. 2020 Nov 1 [cited 2023 Aug 31];105:273–83. Available from: https://www.sciencedirect.com/science/article/pii/S092422442030604X

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Tejal Parmar

Dr. Tejal Parmar is a physician with a flair for medical writing working in the oncology emergency department. Having worked in both rural and urban clinical setting, as well as in the non-clinical role as a Medical Science Liaison, she can write while striking a delicate balance in scientific accuracy and plain language. She is currently working for her medical registration to practise in the UK.

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