The effects of pomegranate consumption on glycemic indices in adults: A systematic review and meta-analysis

Epidemiologic studies have shown that type 2 diabetes (T2D) is more prevalent worldwide; therefore, improving glycemic indices to prevent or control T2D is vital. Randomized controlled trials (RCTs) on the effects of pomegranate consumption on glycemic indices have shown inconsistent results. Therefore, we aim to evaluate the impact of pomegranate consumption on fasting blood glucose (FBG), fasting insulin, hemoglobin A1c (HbA1c), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) in adults. A systematic literature search was performed using electronic databases, including PubMed, Web of Science, and Scopus, up to May 2023 to identify eligible RCTs evaluating the effect of pomegranate consumption on glycemic indices. Heterogeneity tests of the included trials were performed using the I2 statistic. Random effects models were assessed based on the heterogeneity tests, and pooled data were determined as the weighted mean difference with a 95 % confidence interval. Of 1999 records, 32 eligible RCTs were included in the current study. Our meta-analysis of the pooled findings showed that pomegranate consumption significantly reduced FBG (WMD: −2.22 mg/dL; 95 % CI: −3.95 to −0.50; p = 0.012), fasting insulin (WMD: −1.06 μU/ml; 95%CI: −1.79 to −0.33; p = 0.004), HbA1c (WMD: −0.22 %; 95% CI: −0.43 to −0.01; p = 0.037), and HOMA-IR (WMD: −0.30; 95%CI: −0.61 to −0.00; p = 0.046). Overall, the results demonstrated that pomegranate consumption benefits glycemic indices in adults. However, further research with long-term interventions is required. CRD42023422780. •Pomegranate consumption significantly reduced fasting blood glucose (FBG) and fasting insulin.•Pomegranate consumption significantly reduced hemoglobin A1c and Homeostatic Model Assessment for Insulin Resistance.•Based on baseline FBG, patients with prediabetes and diabetes had more improvement following pomegranate intake.