# Healthy Effects of Pomegranate (_Punica granatum_ L.) in Internal Medicine and Dentistry
## 5 Pomegranate in Internal Medicine
### Metabolic Syndrome
The bioactive polyphenic compounds of pomergnate appear to play a crucial role in reducing body weight and improving body composition in overweight or obese subjects [72; 73]. In fact, a study conducted on obese non-diabetic premenopausal female patients, who daily consumed 300 mg of PSO, for 16 weeks, showed a significant reduction in body weight, waist circumference, and liver fat content, as well as in serum triglycerides and C-reactive protein (CRP) levels, of treated women compared to the control group [74]. Regarding blood pressure, pomergnate has also proven useful in counteracting AH, thanks to its anti-oxidative polyphenic compounds. To confirm this, a single-blind placebo-controlled randomized study, conducted on 60 T2 DM patients, who consumed 200 mL/day of PJ, for 6 weeks, highlighted a significant reduction in systolic and diastolic blood pressure, compared to the control group [75]. Recently, a meta-analysis analyzed 14 clinical trials for a total of 573 subjects and demonstrated a reduction in systolic blood pressure and diastolic blood pressure secondary to the PJ assumption. Interestingly, this beneficial effect was dose-dependent and observed when the daily intake was >300 mL, but this antihypertensive effect was lost after two months of PJ assumption [76]. \begin{table}
\begin{tabular}{c c c c c c c} \hline
**Type of the** & **Study** & **Activities Exerted by** & **Natural Bioactive** & **Future Applications** & **Reference** \\
**Study** & **Population** & **Pomegranate** & **Compounds** & **Compounds** & **Future Applications** & **Reference** \\ \hline \multirow{4}{*}{In human study} & \multirow{4}{*}{22 patients} & \(\downarrow\) total cholesterol & \multirow{4}{*}{– Oleanolic acid \(\downarrow\) total/HDL-cholesterol \(\downarrow\) cholesterol \(\downarrow\) cholesterol/HDL-cholesterol \(\downarrow\) cholesterol/HDL-cholesterol \(\downarrow\) arachidonic acid \(\downarrow\) mono-unsaturated fatty \(\downarrow\) LDL-cholesterol \(\downarrow\) lipid peroxidation & – Oleanolic acid \(\downarrow\) Anthocyanin & Lipid-lowering effects & [65] \\ \hline \multirow{4}{*}{In human study} & \multirow{4}{*}{23 women patients} & \(\downarrow\) total/HDL-cholesterol \(\downarrow\) cholesterol/HDL-cholesterol \(\downarrow\) cholesterol/HDL-cholesterol \(\downarrow\) arachidonic acid \(\downarrow\) arachidonic acid \(\downarrow\) multi-inflammatory \(\downarrow\) lipid peroxidation & [66] \\ \hline \multirow{4}{*}{In animal study} & \multirow{4}{*}{Rats} & \(\uparrow\) PPAR- \(\gamma\) & \multicolumn{4}{c}{Pomegranate Flower:} \\  & & & \multicolumn{4}{c}{– Punicalagin \(\downarrow\)} \\  & & & \multicolumn{4}{c}{– Punicalagin \(\downarrow\)} \\  & & & \multicolumn{4}{c}{– Ellagic acid \(\downarrow\)} \\  & & & \multicolumn{4}{c}{– Gallic acid \(\downarrow\)} \\  & & & \multicolumn{4}{c}{– Olianolic acid \(\downarrow\)} \\  & & & \multicolumn{4}{c}{– Ursolic acid \(\downarrow\)} \\  & & & \multicolumn{4}{c}{– Anthocyanin} \\ \hline In animal study & Mice & \(\uparrow\) insulin release by \(\beta\)-cells & – Punicalgin & Antidiabetic effects & [69] \\ \hline \multirow{4}{*}{In human study} & \multirow{4}{*}{60 patients} & \(\downarrow\) fasting blood glucose \(\downarrow\) glycerol hemoglobin & – Punicalagin \(\downarrow\) Elagic acid \(\downarrow\) Dicyclic acid