Immune System Boost: The Power Of Pomegranate

  • Saba Ahmadi BSc Biomedical Sciences - University of Warwick

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Overview 

The immune system is a self-led training camp of immune cells, organs and other blood components biologically programmed to vigorously protect and defend your body from diseases and infections.1 An interaction of your immune cells with harmful microbes or cancerous cells leads to immediate activation of the immune cells, triggering the second line of defence of the immune system by releasing signalling molecules that recruit further immune cells to eliminate the threat.

As complex as it is, the immune system harmoniously regulates the acts of defence in your body. The best way to understand our immune system is to picture the military, loyal to your health and survival in any circumstance. White blood cells act like soldiers by attacking the harmful microbes, whilst other immune cells like macrophages act as medics by repairing tissue damaged  by infection. A healthy immune system ensures that the person can fight infections and diseases with minimal damage. With a deep history in traditional medicine, fruits and vegetables have always been central sources of essential nutrients  and have recently gained popularity as natural boosters of the immune system.

Pomegranates, less frequently known by their scientific name Punica Granatum (PUH-ni-kuh gran-AY-tum), have been a symbol of health, immortality, and life for millennia thanks to their antioxidant and anti-inflammatory packed nutrients. Native to Iran, Persian mythology tells the story of how the heroic warrior Isfandiyar became invincible after consuming one.2 Similarly, the ancient Egyptians, reputable for their advanced medical knowledge, used the berry to treat infections in their patients.3 Ongoing research into the fruit alludes to its potential effects in reducing common diseases and conditions, yet a mystery remains as to precisely how pomegranates support the human immune system.

Immune-boosting components of pomegranates 

Although pomegranates are overflowing with nutrients, most research has identified the following as key contributors to good immune health:

Vitamin C

Often referred to as ascorbic acid in scientific literature, vitamin C is a well-known antioxidant that can stimulate the production, development and possibly the function of white blood cells in recognising and eliminating foreign microbes throughout your body.4

According to the NHS, adults need a dose of 40mg of vitamin C daily; this can be effortlessly achieved by keeping a balanced diet.5 

According to a publication from 2009, it is estimated that pomegranates have up to 72mg/100g and 118.4mg/100g of vitamin C in the arils and peels, respectively.6 

Surprisingly, the vitamin C content in the orange peels is similar to that of pomegranate peels at 110.4mg/100g.7 

So, remember to save your peels the next time you snack on a pomegranate! Clean and dehydrate the pomegranate peels in the oven and then grind them up into a powder. Get creative and add the pomegranate powder to your tea, porridges or curries to fulfil your daily vitamin C requirements!

Ellagitannins

Polyphenols are naturally occurring phytochemicals found in many fruits, plants, and nuts. They have earned high praise in scientific research for their antioxidant, anti-inflammatory, and anti-carcinogenic properties. 

While there are many types of polyphenolic compounds, ellagitannins are distinctly abundant in pomegranates:

  • Like vitamin C, ellagitannins (EH-luh-jee-TAN-ins) are also found in pomegranate peels. However, there is a particularly large amount of the byproduct punicalagin (PYOO-ni-KAL-uh-jin) in pomegranate peel, seeds and arils.8 
  • Research has shown that punicalagin can reduce inflammation by blocking certain processes in the body that cause inflammation.9 Additionally, when punicalagin is broken down in the gut, it  produces ellagic acid. This acid can help grow beneficial probiotic bacteria in your gut microbiota.10 

To optimise the benefits of ellagitannins and their byproducts, consider treating yourself to some pomegranate juice! This natural remedy can help alleviate symptoms of digestive and gastrointestinal issues like, but not limited to, irritable bowel syndrome.11 

Effects of pomegranate consumption on common health issues

One pomegranate fruit is not the same as the other; the exact concentration of each nutrient varies depending on the ripeness and the cultivation of this berry. Scientific research generally supports the addition of pomegranates to further aid the reduction of common diseases and health conditions.

Blood pressure

  • A systemic review, one of the highest levels of evidence-based medicine, involving 3927 individuals across 86 studies has found that most research supports the consumption of pomegranates  for high blood pressure management.12 
  • Eight randomised clinical trials showed a significant reduction in systolic and diastolic blood pressure, with the weighted mean difference being - 4.96mmHg and -2.01mmHg, respectively.13 
  • In particular, animal and clinical studies have demonstrated that pomegranate juice can reduce your blood pressure in both the short and long term.14 

Cholesterol

Cholesterol has an extensive list of risk factors that include:15

  • Smoking 
  • Drinking alcohol
  • Lack of exercise 
  • Pre-existing health conditions (i.e. diabetes, chronic kidney disease)
  • Medications (i.e beta-blockers, steroids)

They can be categorised into two main lipid-bound proteins:

  • Low-density lipoproteins (LDL) 
  • High-density lipoproteins (HDL)

While LDL causes the blockage of your arteries and lead to heart problems, HDL carries cholesterol from your blood vessels to the liver, where it is broken down.16 Studies have shown that pomegranate juice can significantly improve the LDL to HDL ratio.17 Additionally, it can notably reduce LDL levels; a systemic review of 1565 individuals found a weighted mean difference of - 3.07 mg/dl in comparison to the placebo/ control.18

Cancer

  • Indeed, many risk factors overlap between cancer and high cholesterol or blood pressure. However, their approaches to treatment and management widely differ due to the uncontrollable nature of cancer. 
  • Patients may have to endure 4-8 month cycles of chemotherapy, each cycle lasting a month.19 It is important to clarify that pomegranates alone cannot treat cancers, but they can boost the immune system. For instance, immune-boosting chemical components of pomegranates can downregulate the function of vascular endothelial growth factor (VEGF) in breast cancer.20 
  • VEGF is a protein used by tumours to form new blood vessels to further grow and spread to the other regions in the body. 
  • Another example is hormone receptor-positive breast cancer, where cell growth is often driven by the hormone oestrogen. Aromatase is an enzyme that speeds up the process of producing oestrogen in breast tissue, making it a key therapeutic target in oestrogen-positive breast cancer.21 Chemical compounds derived from ellagitannin like urolithins have been shown to significantly inhibit the function of the aromatase.22 

Limitations

Despite all of their immune-boosting properties, they may not be suitable for everyone due to:

Allergies

  • While food allergies are often overdiagnosed in children, there is a 3% higher prevalence of food allergies in children over the last 20 years than in adults.23 
  • Though rare, an allergy to pomegranate can put an individual at risk of anaphylaxis, which can be life-threatening.24 If you suspect that you or your child has an allergy to pomegranates, consult a healthcare professional.
  • Allergic reactions are the most prevalently documented side effects  of pomegranates.25 

Risk of overconsumption

  • Though generally considered to be safe, overconsumption may cause digestive issues like bloating and diarrhoea due to their high fibre content.26 Given this information, it is encouraged to consume pomegranates in moderation. 
  • Moreover, a 2023 clinical review found that an extended administration of pomegranates increased the absorption of drugs used to treat illnesses including hypertension, intestinal infections and HIV by inhibiting the function of intestinal enzymes, specifically CYP3A4 and CYP2C9.27 These findings confirm that it is necessary to thoroughly investigate further possible drug interactions to ensure not only the effectiveness of an individual's treatment but also their safety.

Lack of conclusive research about their health benefits

Ultimately, it is important to reiterate that the scientific research and literature on the immune-boosting properties of pomegranates are limited and by no means conclusive. Further research is still needed to understand the roles and mechanisms by which the active components of  pomegranates influence health. 

Summary 

  • Pomegranates are rich in antioxidative, anti-inflammatory and anti-carcinogenic chemical compounds and vitamins that have been shown to both strengthen and boost the immune system. 
  • Although there is not enough evidence to confirm precisely how and to what extent these berries operate in the human body, high-quality scientific research and reviews have indicated that these components can support the management of conditions and diseases such as high blood pressure, cholesterol and cancer. 
  • Whether you choose to grind their peels into a powder or compress their arils to make a fresh juice, incorporating pomegranates into your meals is a sustainable addition to boost your immune system!

FAQs 

Can regularly consuming pomegranate help cure illnesses or infections?

While consuming pomegranates can contribute to a healthier immune system due to their rich content of antioxidants, adding pomegranate seeds to salads or desserts will not miraculously cure one of an illness or infection on their own. Instead, consult your trusted GP about your health concerns so that they can guide you in making a personalised treatment plan that is more reliable, effective, and safe for you.

How does pomegranate compare to other fruits and vegetables?

Citrus fruits like lemons and oranges are particularly beneficial for your immune system thanks to their rich vitamin C content.28 Not only are they more accessible than pomegranates, but citrus fruits like tangerines and oranges are often a safer alternative to pomegranates for children. With fewer seeds than a pomegranate, citrus fruits are less likely to be a choking hazard.

Ginger is a vegetable that has traditionally been used in Asian herbal medicine to treat digestion issues including nausea, vomiting, and headaches.29 In modern medicine, ginger formulated into teas, supplements, and juice shots has been used to improve similar digestion issues, cardiovascular issues, and inflammatory disorders.30

Regardless, there has not been any definitive research to indicate that certain fruits are better than others in strengthening the immune system. Rather, studies have highlighted the key components of different fruits that make them a good source of nutrients for your health. Hence, it is best to decide for yourself which fruits you enjoy, or would like to try to incorporate into your daily meals. Remember, enjoying what you eat is just as important as a healthy, balanced diet!

Are there certain populations who may benefit more from consuming pomegranate for immune support?

As long as you do not have an allergy, anyone can benefit from eating pomegranates! However, those who are most vulnerable to illnesses may benefit the most: children, the elderly, and those with a weakened immune system due to a pre-existing health condition. 

References

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  4. Gorkom GNY van, Klein Wolterink RGJ, Van Elssen CHMJ, Wieten L, Germeraad WTV, Bos GMJ. Influence of Vitamin C on Lymphocytes: An Overview. Antioxidants (Basel) [Internet]. 2018 [cited 2024 Feb 21]; 7(3):41. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874527/
  5. Vitamins and minerals - Vitamin C. nhs.uk [Internet]. 2017 [cited 2024 Feb 21]. Available from: https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-c/
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  7. Sir Elkhatim KA, Elagib RAA, Hassan AB. Content of phenolic compounds and vitamin C and antioxidant activity in wasted parts of Sudanese citrus fruits. Food Sci Nutr [Internet]. 2018 [cited 2024 Feb 21]; 6(5):1214–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060895/
  8. Viladomiu M, Hontecillas R, Lu P, Bassaganya-Riera J. Preventive and Prophylactic Mechanisms of Action of Pomegranate Bioactive Constituents. Evid Based Complement Alternat Med [Internet]. 2013 [cited 2024 Feb 21]; 2013:789764. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3657449/
  9. Xu X, Yin P, Wan C, Chong X, Liu M, Cheng P, et al. Punicalagin Inhibits Inflammation in LPS-Induced RAW264.7 Macrophages via the Suppression of TLR4-Mediated MAPKs and NF-κB Activation. Inflammation [Internet]. 2014 [cited 2024 Feb 21]; 37(3):956–65. Available from: https://doi.org/10.1007/s10753-014-9816-2
  10. Balonska D, Ramnani P, Kasimsetty SG, Muntha KR, Gibson GR, Ferreira D. The influence of pomegranate by-product and punicalagins on selected groups of human intestinal microbiota. International Journal of Food Microbiology [Internet]. 2010 [cited 2024 Feb 21]; 140(2):175–82. Available from: https://www.sciencedirect.com/science/article/pii/S0168160510001819
  11. Banc R, Rusu ME, Filip L, Popa D-S. The Impact of Ellagitannins and Their Metabolites through Gut Microbiome on the Gut Health and Brain Wellness within the Gut–Brain Axis. Foods [Internet]. 2023 [cited 2024 Feb 21]; 12(2):270. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9858309/
  12. Giménez-Bastida JA, Ávila-Gálvez MÁ, Espín JC, González-Sarrías A. Evidence for health properties of pomegranate juices and extracts beyond nutrition: A critical systematic review of human studies. Trends in Food Science & Technology [Internet]. 2021 [cited 2024 Feb 22]; 114:410–23. Available from: https://www.sciencedirect.com/science/article/pii/S0924224421003885
  13. 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 [cited 2024 Feb 20]; 115:149–61. Available from: https://www.sciencedirect.com/science/article/pii/S1043661816307848
  14. Asgary S, Keshvari M, Sahebkar A, Sarrafzadegan N. Pomegranate Consumption and Blood Pressure: A Review. Curr Pharm Des [Internet]. 2017; 23(7):1042–50. Available from: https://pubmed.ncbi.nlm.nih.gov/27748197/
  15. Blood Cholesterol - Causes and Risk Factors | NHLBI, NIH [Internet]. 2022 [cited 2024 Feb 22]. Available from: https://www.nhlbi.nih.gov/health/blood-cholesterol/causes
  16. CDC. LDL and HDL Cholesterol and Triglycerides | cdc.gov. Centers for Disease Control and Prevention [Internet]. 2023 [cited 2024 Feb 22]. Available from: https://www.cdc.gov/cholesterol/ldl_hdl.htm
  17. Sreekumar S, Sithul H, Muraleedharan P, Azeez JM, Sreeharshan S. Pomegranate Fruit as a Rich Source of Biologically Active Compounds. Biomed Res Int [Internet]. 2014 [cited 2024 Feb 22]; 2014:686921. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4000966/
  18. Bahari H, Rezaiian F, Goudarzi K, Nooshan Mirmohammadali S, Asbaghi O, Hosseini kolbadi K sadat, et al. The effects of pomegranate consumption on lipid profile in adults: A systematic review and meta-analysis. Journal of Functional Foods [Internet]. 2023 [cited 2024 Feb 22]; 108:105727. Available from: https://www.sciencedirect.com/science/article/pii/S1756464623003274
  19. Your chemotherapy plan [Internet]. [cited 2024 Feb 22]. Available from: https://www.cancerresearchuk.org/about-cancer/treatment/chemotherapy/planning/your-chemotherapy-plan
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  21. Chumsri S, Howes T, Bao T, Sabnis G, Brodie A. Aromatase, Aromatase Inhibitors, and Breast Cancer. J Steroid Biochem Mol Biol [Internet]. 2011 [cited 2024 Feb 22]; 125(1–2):13–22. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104073/
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  25. Zare H, Amiri Ardekani E, Tavakoli A, Bradley R, Tavakoli F, Pasalar M. Reporting of adverse effects of pomegranate in clinical studies: a systematic review. J Complement Integr Med [Internet]. 2023. Available from: https://pubmed.ncbi.nlm.nih.gov/37116077/
  26. Pomegranate. NCCIH [Internet]. [cited 2024 Feb 21]. Available from: https://www.nccih.nih.gov/health/pomegranate
  27. Mansoor K, Bardees R, Alkhawaja B, Mallah E, AbuQatouseh L, Schmidt M, et al. Impact of Pomegranate Juice on the Pharmacokinetics of CYP3A4- and CYP2C9-Mediated Drugs Metabolism: A Preclinical and Clinical Review. Molecules [Internet]. 2023 [cited 2024 Feb 21]; 28(5):2117. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10003857/
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  30. Mashhadi NS, Ghiasvand R, Askari G, Hariri M, Darvishi L, Mofid MR. Anti-Oxidative and Anti-Inflammatory Effects of Ginger in Health and Physical Activity: Review of Current Evidence. Int J Prev Med [Internet]. 2013 [cited 2024 Feb 20]; 4(Suppl 1):S36–42. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3665023/

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Saba Ahmadi

BSc Biomedical Sciences - University of Warwick

Saba is a volunteer with a deep commitment to charitable causes, as demonstrated through various endeavours since her teenage years. From leading fundraising projects at university to support a blood donation programme in Afghanistan, to actively volunteering at Mary's Living and Giving charity shop for Save the Children, she actively seeks hands-on experiences in an effort to make a positive impact on both her community and the world. Alongside her charity work, Saba has shadowed a global medical communications agency to gain insight into the intricate process of delivering innovative strategies to support pharmaceutical and biotech companies in successfully delivering scientific data to the public and, ultimately, improving patient outcomes. Most recently, Saba has completed a science communication module in which she applied her knowledge of effective communication in a variety of scientific materials for a variety of audiences (i.e. blogs, press releases, and children's educational videos).

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